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This book, the second one edited by this trio, is a collection of 17 chapters by 10 authors unified by their shared belief in a psychodynamic—in many cases psychoanalytic—basis for understanding and treating patients with eating disorders. To this reviewer, the chapters have an unevenness of clarity, readability, and usefulness. C. Phillip Wilson's opening 56-page 'Ego functions and technique' consists of 35 disparate sections, some of which are further subdivided, like a reference book, presenting a partial literature review but mainly Wilson's ideas about aetiology and treatment, illustrated with his clinical material. There are interesting and potentially valuable ideas, but the tone is often polemical, with an emphasis on authoritative, formulaic interpretations of the symbols of primitive drives and corresponding conflicts. A brief passage, quoted out of context, conveys this tone: 'Stone symbolism develops in connection with the process of teething in the 6th to 12th month. Oral-incorporative conflicts, the wish to devour and to be devoured, are repressed and stone comes to symbolize the primitive object relation with the mother. Basic trust, reliability, and object constancy are symbolized by stone … Stone, which is the most universal and plastic of all symbols, symbolizes impulse control, whether it represents teeth, the baby, the mother, the breast, teeth, bladder, feces, vagina, or phallus' (p. 22).
Charles C. Hogan's 'The adolescent crisis in anorexia nervosa' is clearer and more unified. Hogan enriches his psychoanalytic dynamic perspective by recognising the challenging epidemiologcal and social issues in anorexia and bulimia and then integrates this with a developmental perspective based on Helene Deutsch's seminal contribution to female development (The Psychology of Women, Volume 1. New York: Grune & Stratton, 1944). His sensitivity to the particular humiliation adolescents experience in disclosing their inner lives conveys a sense of real