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In the course of study and treatment of twelve patients with anorexia nervosa the author concludes that traditional formulations of conflict and defense fail to describe the essential psychopathology. Disturbances of body image, impaired perception of internal bodily states, and an enveloping sense of ineffectiveness are identified as the common salient features. Dr. Bruch's treatment is directed toward
developing awareness of the existence of feelings and drives and their realistic fulfilment.