Emptiness in Bulimia: Clinical Vicissitudes and Theoretical Implications

This work illustrates the analytical therapy of a bulimic and obese patient.

The viewpoint I would like to put forward relates to the specificity of the analytical work with this type of patients. These patients seem to live in a psychic reality where the mental representations of the emotions they have experienced are missing. And they are not able to recognize the full meaning of their emotional experience. Although these aspects are peculiar to all eating disorders and can be present in very different personality structures, the specificity of bulimic disorders would seem to be that they silence emotions (especially rage, sadness and a sense of inadequacy) through food.

The intake of excessive quantities of food creates a condition of numbness which, by dulling the senses, modifies the perception of psychic and emotional reality creating an addiction similar to that of drug taking. Food becomes therefore the tool through which one can withdraw into a narcissistic retreat, devoid of emotions and meanings, and the obese body becomes a prison inaccessible to oneself and the others.

The patient reconstruction of the cumulative microtraumas of these patients during the analytical therapy promotes the transformations of the emotional experience from non-mentalized traumatic vicissitudes to emotions capable of sustaining their mental representation, and restores not so much the knowledge of the experience as the emotional truth of the traumas suffered .