Chapter III. Appetite and Emotional Disorder1 [1936]

IN THE PSYCHO-ANALYTIC and other psychological literature I find it generally agreed that disturbances of appetite are common in psychiatric illnesses, but perhaps the full importance of eating is not recognized. It is rare, for instance, to meet the word ‘greed’ in psychological writings, and yet greed is a word with a very definite meaning, joining together the psychical and the physical, love and hate, what is acceptable and what is not acceptable to the ego. The only psycho-analytic discussion I know in which the word greed enters inherently into the theme is Love, Hate and Reparation by Melanie Klein and Joan Riviere (lectures 1936, published 1937).

A discussion is overdue on the relationship of appetite to greed. I should like to put forward the suggestion that greed is never met with in the human being, even in an infant, in undisguised form, and that greediness, when it appears as a symptom, is always a secondary phenomenon, implying anxiety. Greed means to me something so primitive that it could not appear in human behaviour except disguised and as part of a symptom complex.

Careful history-taking has had a profound effect on my outlook, for it has made clear to me the clinical continuity of appetite disorders as they present themselves in earliest infancy, in childhood, in adolescence and in adult life. For some years now I have been teaching that history-taking reveals the fact that there is no sharp dividing line between the following conditions: anorexia nervosa of adolescence, the inhibitions of feeding of childhood, the appetite disorders in childhood that are related to certain critical times, and the feeding inhibitions of infancy, even of earliest infancy. Examples of crises would be: birth of new baby, loss of first nurse, removal from first home, first feeding with the two parents, attempts to induce self-feeding, introduction of solids or even simply of thickened feeds, anxious reaction to breast-biting.