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.
One can approach eating disorders and specific eating disorders from the point of view of what they have in common, and indeed there are certain typical features which may be found in the different eating disorders: the avoidance of dependency on the maternal object and the narcissistic preoccupation with the self, the anal control of the object, the control over instinctual desires, among others. There are similarities between anorexic and bulimic patients in relation to how shameful or humiliating they feel their needs to be, and in their preoccupation with their body image and with being seen.
One can also take an approach which cuts across the specific disorders and considers them more in terms of the level of disturbance of the particular patients presenting these disorders, which ranges from a life-threatening disorder to one which is almost within the normal range of preoccupation with food and body image.
Because the eating disorder is only the symptom and because it is multi-determined, there are many levels and ways of understanding it which also has to take account of the individual patient and his or her history. It is however a symptom which can be so pervasive that it becomes a way of life, or of near death. Often when we speak of anorexia nervosa we are also speaking of a character formation, of a patient whose life and psyche is permeated with that issue, and not of a patient who may as part of his or her problems have an eating disorder which is more or less prevalent at different times.
Unlike some other symptoms, an eating disorder attaches to the most basic and vital function of the body. For this reason it is
tempting to look at it in relation purely to orality, although it clearly interacts which issues of anality, and of genital sexuality, as we know from its typical development at puberty or adolescence. Often there is a confusion of zones, leading to shame. But it also has to be remembered that in normal development eating is linked to the e