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Hilde Bruch's book was completed in 1984, a few weeks before her death. She dictated it, because she was severely handicapped by Parkinson's disease and by cancer. The editors of this inspiring book, Drs. Czyzewski and Suhr, have done an efficient job transforming Dr. Bruch's first draft into a highly readable book.
Conversations begins with a foreword by Theodore Lidz, a friend and colleague of Bruch's. In it he provides a brief biographical sketch (1904-1984) and an overview of her outstanding career. The foreword is followed by a former patient's and her mother's recollections of Bruch as a therapist and a human being. The third section presents the editor's preface, while the rest of Conversations is written by the author herself.
The clinical contents of Bruch's book are transcripts from actual tape-recorded interviews with anorexic women and their families. As very few men are prone to this illness, Bruch chose to concentrate on female patients suffering from it. She is, however, quick to point out that many anorexic women's concerns and psychodynamics overlap with those of their male counterparts. Misperceptions of hunger cues, perfectionistic strivings, identity diffusion, body image distortion, emotional immaturity, and excessive restraint in the expression of affects within the family are examples in point.
In Conversations, Bruch describes how she conducted screening interviews. For instance, she would not see a patient unless the patient expressed a wish to be helped, was willing to undergo a complete physical examination, and if necessary would accept in-patient treatment for nutritional restitution. The author pointed out that diagnostic interviews could sometimes take up to 20 sessions before a sound therapeutic