Through the medium of detailed case presentation focusing on one crucial session in the treatment of an anorexic young woman, Bruch further contributes to the already impressive body of her work in this field. She emphasizes the extreme difficulty in engaging the anorexic (self-isolated in her "island" of thinness and non-human self-image) in a good, working therapeutic alliance. She states, "I feel no anorexic is safe from relapse until she has looked at her illness with real emotion, with fear and horror of all the pain and hunger she has suffered, and for having reduced her body to that of an unhuman creature."