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This volume is a very valuable addition to the existing literature on eating disorders. Today, when bulimia is often treated behaviorally or chemically, with very little attention paid to unconscious factors, this book is particularly important.
Bulimia was recognized as an official diagnosis by the American Psychiatric Association only in 1980. This “new” syndrome is not new however. What has changed is the current widespread incidence of the disorder.
Necessary for the diagnosis of bulimia are gorging and vomiting along with consumption of high-calorie foods during binges, frequent weight fluctuations greater than 10 pounds resulting from alternating binges and fasts, fear of not being able to stop eating voluntarily, and self-deprecating thoughts following eating binges.
Bulimics are different from starving anorexics, who are emaciated and may require hospitalization at times in order to keep them alive. Symptoms of bulimia are not indicative of a particular underlying character disorder and may be present in patients with neurotic, borderline, and psychotic personalities.
The treatment modalities that are detailed in this volume are all rooted in psychoanalytic thinking. The 16 chapters reflect the range of perspective within current psychoanalytic practice. Most of the authors are experienced clinicians who present rich case material. The editor of the book, Harvey Schwanz, is also the author of the introduction and two chapters. His introduction is an informative and comprehensive guide to the various chapters that follow. His chapter on “Bulimia and the Mouth-Vagina Equation: The Phallic Compromise” emphasizes that in certain bulimic patients, the binge-purge symptom represents the dilemmas of the phallic-oedipal period. These patients cannot tolerate both sexual