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It is a common observation that anorexic patients often have a body image that can be unrealistic to the point of being delusional. Someone who is emaciated to a life-threatening degree can still think of herself as fat and perceive professionals’ attempts to save her life by getting her to eat as evidence of a hostile determination to make her ugly and unattractive. Anorexics seem to be preoccupied with the space their body occupies even more than with how much they weigh (which may indeed be experienced in terms of fitting into the space below a particular line on the scales). Space to be occupied may not feel like the person's own legitimate space, and it is often unclear into whom any food that is eaten will go.
For example, an anorexic patient described by Rey (1994) felt that she contained both a mother and a baby in a mutually destructive relationship, and that she had to starve ‘herself’ in order to kill the mother and free the baby. Sheila MacLeod (1981), in a book written after her recovery from anorexia, emphasised that pregnancy was the one time when she experienced none of her usual panic on approaching the weight of eight stone. It is as though the fact of physically containing a baby gave her permission to expand. Joyce McDougall's patient Georgette, who had suffered from anorexia as well as from a variety of psychosomatic ailments, was preoccupied with issues concerning skin as a body boundary – both her own and her mother's (McDougall 1989).
Georgette experienced herself as sharing completely in the analyst's life, to the point of talking about ‘our husband’. In the course of treatment, her inability to eat shellfish was resolved when she associated their smell with that of the parental genitalia. Such accounts call to mind the commonly reported confusion seen in anorexics between eating and sexual maturity, between food and babies. However, they also highlight fundamental issues of identity in terms of whose space is occupied by whom.
Children with au