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I want to thank the discussants for their thoughtful commentaries on my article, The Enigma of Ana: A Psychoanalytic Exploration of Pro-Ana Forums, in this issue. I believe that the points raised in each article are important and deserve thorough consideration. Here I will restrict myself to a few brief comments.
Recently I presented my paper at the yearly scientific meeting of a local chapter of Division 39, the Northern California Society for Psychoanalytic Psychology. Before the paper was presented, both the event organizers and I received numerous e-mails from angry and distressed individuals in the eating disorders treatment community. The concern raised in these e-mails was clear: “Why are you giving a presentation to promote pro-ana forums, which are clearly a disturbing and pathological phenomenon?” At times, I wondered whether I had misrepresented my position. I was reminded, though, that this is a provocative topic that draws out equally intense responses.
Because the literature has consistently focused on the harmful impact of pro-ana forums, my paper highlights the ways that I have been able to generatively leverage patients’ usage of them during treatment. Pro-ana forums provide opportunities for creativity and relatedness in some patients and to some degree. Nonetheless, I have consistently maintained that pro-ana forums are intensely disturbing and problematic. After all, a substantial portion of the paper conceptualizes them as a form of psychic retreat.
Ferguson and Klebanoff ask, “Even if there is benefit in using the [pro-ana forums] in a transitional way, is it worth the risk?” At one level, I completely agree. If at any point in treatment I felt I was able to “provide a new developmental experience of protection and care” by drawing a patient away from pro-ana forums, I would do so without hesitation. I agree that failing to discuss the risks of pro-ana forums and even to encourage alternative behaviors may, in some cases, be a potentially dangerou