In some cases of anorexia nervosa, the mother uses projective identification to produce a state of fusion between herself and her child. This makes it impossible for the child to develop a sense of herself as separate. The rejection of food represents a symbolic rejection of these maternal projections. This defence also prevents the healthy introjection of parental objects which is required to establish a sense of identity. The anorexic is left with a profound sense of inner emptiness and an inability to develop adult relationships. The therapeutic relationship can provide a non-invasive environment in which the patient can begin to develop a sense of self. Case material is used to demonstrate how progress was closely linked to the patient's growing awareness of the therapist as a separate individual.