In a paper which beautifully complements and elaborates on the preceding one by Bruch, anorexia nervosa is presented as a form of narcissistic personality disorder or "borderline psychosis." There has been early failure in establishment of a cohesive sense of self. In the face of the usual developmental tasks initiated at puberty, the anorectic establishes the typical symptomatic picture of extreme, concrete efforts to control body and environment in an attempt to avert a sense of emptiness and fragmentation. The author believes that behavior modification can be destructive in ignoring the patient's potential for individuation; he strongly advocates a slow, careful psychoanalytic approach similar to that espoused by Bruch.