You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This book represents the culmination of decades of thinking and practice by Jeanne Magagna, who has worked with some of the most difficult patients of all - those who are refusing life, nurture and emotional support through severe anorexia, self-harm and/or pervasive withdrawal.
Reading her work, one is in the humbling presence of someone who has had to dig very deep indeed in herself to find the resources to provide help to patients who are trapped within a prison of their own making, paralysed in their emotional and physical development by overwhelming fear and the need to avoid psychic pain. These patients are turning away from much more than food - many are strenuously rejecting their families and any professional offering help, and furthermore are attempting to switch off their awareness of their own emotional needs, in the grip of an omnipotent self who cannot allow the existence of the inner vulnerable and suffering child.
There are several important and impressive strands to this book. One is the deep understanding of the emotional and psychic state of these young people and of how this deadly internal situation has developed. Magagna draws on her experience of infant observation to clarify the very early and primitive roots of the anorectic young person's distress and their creation of such powerful defensive structures. Feelings of being unloved, unacceptable or unprotected as an infant engender acute pain, rage and cruel impulses which are felt to be catastrophic and impossible to express. The consequent internalized objects are imbued with sadistic and persecutory emotions, making dependency on others intolerable. The individual constructs an omnipotent self who will keep all feelings of vulnerability, need and loss out of awareness, offering addictive and potentially lethal ‘protection’ of the inner child self who is in pain and needs to be cared for. Magagna makes it possible for us to understand the inner logic of what can be otherwise so profoundly baf