Hollow Women, Stuffed Women: Body Image and the Imagined Body in Patients with Eating Disorders

‘Body image’ is a familiar concept in work with patients with eating disorders, but usually refers only to the distorted way in which the patient views her external body. However, patients with eating disorders can also experience distorted ideas about the insides of their bodies, specifically related to their bodies' abilities to metabolize food and fluids; they often conceive of their bodies as stuffed full of undigested and ultimately indigestible food. This aspect of the dysfunctional imagined body (Lemma, 2010) is often not openly discussed but engenders significant anxiety, perpetuates eating disorder symptoms, and can contribute to the eating disorder patient's need for inpatient treatment. Although acknowledging physiologic and cultural contributions to the construction of a dysfunctional imagined digestive system, this paper ultimately utilizes Bion's alimentary metaphor (Bion, 1962a) to discuss the relationship between alpha-functioning and the development of a functioning imagined digestive system.