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This is not a straightforward book to review for an analytic journal. On the face of it, it presents an excellent account of the phenomenology, management and outcome prospects of anorexia and related conditions, pitched at a level likely to be intelligible to sufferers and to those close to them, without being too simplistic for interested professionals.
None the less, the book left me as an analyst feeling uncomfortable, particularly at what Professor Crisp allows us to glimpse of a rather stilted and old-fashioned view of psycho-dynamics. This does not seem to be an artefactual distortion arising from the constraints of writing for a lay audience, since despite the fact that the book is written at a lay level, it nevertheless faithfully represents the author's views. Technical issues (e.g., of relatively complex physiological processes) are not avoided and there is no other inappropriate simplification of the subject for the sake of popularisation other than the avoidance of jargon.
In many ways it does make sense to see anorexia nervosa, as Professor Crisp sees it, as ‘an illness’ according to the medical model rather than as a collection of symbolically meaningful behaviours, and pragmatically it makes sense to treat it as if it really did arise more or less out of the blue at puberty or in adolescence. In practical terms even committed individual analysts such as Palazzoli have found it more fruitful in many cases, particularly the more malignant, to eschew individual dynamics and to concentrate on the family as a system.
Maybe the intended audience makes such a book an inappropriate forum for such issues to be discussed. However, analytic ideas are raised from time to time, on the whole in relation to the possible aetiology of anorexia but in a way that seems to be curiously naive and simplistic, so that the author's oblique dismissal of them not only fails to convince but also reduces confidence in the aetiological ideas that he does come up with. These seem to