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Absence is characteristic of the psychotherapy of many different types of psychological disorder. However, it is perhaps particularly significant in the psychotherapy of anorexia nervosa. I hope to show that the notion of absence can help to draw together some of the many strands which go to make up this most complex of conditions. Recognition of what is absent can help illuminate the patient's unconscious conflicts and point to the capacities that she has been unable to develop. These absences arise out of early environmental deficiencies, such as a lack of containment, which can result in failures of introjection and an absence of the potential space. They can leave the child ill equipped to experience, understand or deal with her feelings, develop a secure sense of self or think symbolically. Sexual desire, aggression and envy often appear to be absent from the conscious world of the anorexic. In therapy, there is often a striking absence of feeling and of connection between patient and therapist. The work is done largely in relation to what is not talked about, felt or understood and what is apparently not happening. The therapist needs to create a space in which absence and emptiness can be thought about and symbolized, and a sense of self can begin to develop.