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.
ISIPSÈ—OUR INSTITUTE—HAS STARTED A TRADITION OF BRINGING together the old and the new in order to have available more and more theoretical and clinical elements for working with adolescents. The exchange and discussion on anorexia-bulimia can be very useful if we can cope with the many questions that it raises. These patients bring more questions than answers. K's case, too, provides much input for a theoretical-clinical discussion, especially: regarding some aspects that are very dear to us Self-Psychologists, like:
Self-object functions during development and therapy
Therapeutic action
Trauma: What to do next to providing witness
Countertransference-empathy dialogue
Anorexia is a way of responding to negative self-feelings by means of behaviors and actions that make one feel competent, assertive in relation to the body; one believes one has found a way to recover the childhood sense of omnipotence by controlling one's diet and weight.
Bulimia is a way confining and enclosing negative self-feelings by means of the inability to control one's diet and weight. What they have in common is an organized attitude against one's body and appetite, a subconscious need to attack the body and thus express hatred and rejection.
With regard to the “deprivation of self-object functions and experiences,” Kohut (1978) states in chapter 4 of The Search for Self, “In these situations, the deprived Self is at the center of the illness and the content of the transference is formed not by objects but by archaic self-objects that are necessary to keep the self's cohesion.”1
In therapy with these patients, a transference is developed, which is directly linked to the core of the psychopathology, by regressing to the point where the self's development was interrupted or precariously organized.
Just a few remarks on studies in Infant Research (Beebe and Lachmann's recent work) in order to address one o