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Failure to work through the Oedipus complex may be central to some cases of anorexia nervosa. The negative Oedipus complex seems to be of particular importance in this disorder and inability to work through the negative complex may lead to a premature move to the positive complex. In anorexia, the Oedipus complex may manifest itself as an enmeshed relationship with one parent and the exclusion of the other. This deprives the patient of the opportunity to experience frustration and fantasies of omnipotence are perpetuated. The patient is unable to experience ambivalence and cannot progress from the paranoid-schizoid to the depressive position. Maintenance of therapeutic boundaries provides a challenge to the patient's omnipotence, which allows a shift to the depressive position and the development of a sense of separateness. Case vignettes are used to
1. Throughout this paper, Oedipal dynamics are explored from the perspective of the female child. This reflects the fact that the majority of anorexics are female. Consequently, I have referred to the anorexic patient as female and used the pronoun ‘she’. Oedipal dynamics are, of course, important in male anorexics too but they are significantly different from those in girls and beyond the scope of this paper.
2. In order to protect the privacy of patients, the two cases described are fictional. However, they are based closely on clinical experience and illustrate therapeutic issues that have arisen in work with real patients. Readers will be able to judge for themselves whether these vignettes reflect their own experience of working with anorexic patients.
illustrate these processes in both positive and negative forms of the Oedipus complex.