Bulimia, the syndrome of food binging often followed by purging has been reported to be increasing in recent years. This communication reviews the psychoanalytic understanding of eating disorders, focusing on the pathology of early object relation and later intrapsychic conflicts over incestuous impregnation fantasies. Ancillary symptoms of kleptomania, laxative abuse, and vegetarianism are discussed, and associations with masturbatory conflicts and early adolescent phallic activity, i.e., horseback riding, are elaborated.
Get full access to this article
View all access options for this article.
References
1.
Abraham, K. (1924). Development of the libido. In Selected Papers.London: Hogarth Press.
2.
Arlow, J. (1953). Masturbation and symptom formation. J. Amer. Psychoanal. Assn., 1:45–58.
3.
Bergler, E. (1935). Psychoanalysis of a case of agoraphobia. Psychoanal. Rev., 22:392–408.
4.
Bird, B. (1957). A specific peculiarity of acting out. J. Amer. Psychoanal. Assn., 5:630–647.
5.
Blitzer, J., Rollins, N. & Blackwell, A. (1961). Children who starve themselves: anorexia nervosa. Psychosom. Med., 23:369–383.
6.
Blos, P. (1974). The genealogy of the ego ideal. Psychoanal. Study Child, 29:43–88.
7.
Boris, H. (1984). The problem of anorexia nervosa. Int. J. Psychoanal., 65:315–322.
8.
Bradley, N. (1961). The doll: some clinical, biological and linguistic notes on the toy-baby and its mother. Int. J. Psychoanal., 42:550–555.
9.
Brenner, C. (1974). The concept of phenomenology of depression, with special reference to the aged. J. Geriat. Psychiat., 7:6–20.
10.
Brierley, M. (1936). Specific determinants in feminine development. Int. J. Psychoanal., 17:163–181.
11.
Bruch, H. (1978). The Golden Cage.Cambridge, Mass.: Harvard Univ. Press.
12.
Chasseguet-Smirgel, J. (1970). Feminine guilt and the oedipus complex. In Feminine Sexuality, ed. J. Chasseguet-Smirgel.Ann Arbor: Univ. Michigan Press.
13.
Chasseguet-Smirgel, J. (1984). The femininity of the analyst in professional practice. Int. J. Psychoanal., 65:169–178.
14.
Coriat, I. (1921). Sex and hunger. Psychoanal. Rev., 8:375–381.
15.
Deutsch, H. (1930). Hysterical conversion symptoms: paralysis, speech defects, gluttony. In Neuroses and Character Types, New York: Int. Univ. Press, 1965, pp. 43–73.
16.
Edelheit, H. (1974). Crucifixion fantasies and their relation to the primal scene. Int. J. Psychoanal., 55:193–199.
17.
Falstein, E., Feinstein, D. & Judas, I. (1956). Anorexia nervosa in the male child. Amer. J. Orthopsychiat., 26:751–772.
18.
Fenichel, O. (1939). Trophy and triumph. Collected Papers, Second Series. New York: Norton, 1954, pp. 141–162.
19.
Fraiberg, S. (1967). The analysis of an eight-year-old girl with epilepsy. In The Child Analyst at Work, ed. E. Geleerd.New York: Int. Univ. Press, pp. 229–287.
20.
Fraiberg, S. (1972). Some characteristics of genital arousal and discharge in latency girls. Psychoanal. Study Child, 27:439–475.
21.
Frazer, J. G. (1922). The Golden Bough.New York: Macmillan.
22.
Freud, A. (1946). The psychoanalytic study of infantile feeding disturbances. Writings, 4:39–59. New York: Int. Univ. Press, 1968.
23.
Freud, A. (1949). Certain types and stages of social maladjustment. Writings, 4:75–94. New York: Int. Univ. Press, 1968.
24.
Freud, A. (1965). Normality and Pathology in Childhood. Writings, 6. New York: Int. Univ. Press.
25.
Freud, S. (1899). Extracts from the Fliess papers. S. E., 1.
26.
Freud, S. (1900). The interpretation of dreams. S. E., 4 & 5.
27.
Freud, S. (1905). Three essays on the theory of sexuality. S. E., 7.
28.
Freud, S. (1908). On the sexual theories of children. S. E., 9.
29.
Freud, S. (1925). Negation. 5. S. E., 19.
30.
Friedman, L. (1953). Defensive aspects of orality. Int. J. Psychoanal., 34:304–312.
31.
Gero, G. & Rubinfine, D. (1955). On obsessive thoughts. J. Amer. Psychoanal. Assn., 3:222–243.
32.
Glover, L. & Mendell, D. (1982). A suggested developmental sequence for a preoedipal genital phase. In Early Female Development, ed. D. Mendell.New York: SP Medical & Scientific Books.
33.
Goldman, G. (1938). A case of compulsive handwashing. Psychoanal. Q., 7:96–121.
34.
Greenacre, P. (1945). Pathological weeping. In Trauma, Growth and Personality.New York: Int. Univ. Press, 1971, pp. 120–131.
35.
Greenacre, P. (1950). Special problems of early female sexual development. Psychoanal. Study Child, 5:122–138.
36.
Greenacre, P. (1952). Anatomical structure and superego development. In Trauma, Growth and Personality.New York: Int. Univ. Press, 1971, pp. 149–164.
37.
Hamburger, W. (1958). The occurrence and meaning of dreams of food and eating. Psychosom. Med., 20:1–16.
38.
Hartland, E. (1909). Primitive Paternity: The Myth of Supernatural Birth in Relation to the History of the Family.London: David Nutt.
39.
Hendrick, I. (1964). Narcissism and the prepuberty ego ideal. J. Amer. Psychoanal. Assn., 12:522–528.
40.
Hogan, C. (1983). Technical problems in psychoanalytic treatment. Fear of Being Fat, ed. C. Wilson.New York: Aronson, pp. 197–215.
41.
Hudson, J., Pope, H., Jones, J. & Yurgehin-Todd, D. (1983). Phenomenologic relationships of eating disorders to major affective disorder. Psychiat. Res., 9(4):345–354.
42.
Jacobson, E. (1954). The self and the object world. Psychoanal. Study Child, 9:75–127.
43.
Janet, P. (1906). On the pathogenesis of some impulsions. J. Abnorm. Psychol., 1:1–17.
44.
Jessner, L. & Abse, D. (1960). Regressive forces in anorexia nervosa. Brit. J. Med. Psychol., 33:301–312.
45.
Jones, E. (1911). The relationship between dreams and psychoneurotic symptoms. In Papers on Psycho-Analysis. (5th ed.). Baltimore: Williams & Wilkins, 1950, pp. 251–272.
46.
Jones, E. (1927). Early development of female sexuality. In Papers on Psycho-Analysis (5th ed.). Baltimore: Williams & Wilkins, 1950, pp. 438–451.
47.
Karol, C. (1980). The role of primal scene and masochism in asthma. Int. J. Psychoanal. Psychother., 8:577–592.
48.
Kestenberg, J. (1956a). Viscissitudes of female sexuality. J. Amer. Psychoanal. Assn., 4:453–476.
49.
Kestenberg, J. (1956b). On the development of maternal feelings in early childhood. Psychoanal. Study Child, 11:257–291.
50.
Kestenberg, J. (1968). Outside and inside, male and female. J. Amer. Psychoanal. Assn., 16:457–520.
51.
Leonard, C. (1944). An analysis of a case of functional vomiting and bulimia. Psychoanal. Rev., 31:1–18.
52.
Levin, S. (1959-1961). Problems in the evaluation of patients for psychoanalysis. Bull. Phila. Assn. Psychoanal., 9-11:86–95.
53.
Lewin, B. D. (1933). The body as phallus. Psychoanal. Q., 2:24–47.
54.
Lewin, B. D. (1930). Smearing of feces, menstruation, and female superego. In Selected Writings of Bertram D. Lewin, ed. J. A. Arlow.New York: Psychoanalytic Quarterly, 1973, pp. 12–25.
55.
Lorand, S. (1943). Anorexia nervosa. Psychosom. Med., 5:282–292.
56.
Masserman, J. (1941). Psychodynamics in anorexisa nervosa and neurotic vomiting. Psychoanal. Q., 10:211–242.
57.
Meyer, B. & Weinroth, L. (1957). Observations on psychological aspects of anorexia nervosa. Psychosom. Med., 19:389–398.
58.
Mintz, I. (1983). Anorexia nervosa and bulimia in males. In Fear of Being Fat, ed. C. Wilson.New York: Aronson, pp. 25–60.
59.
Minuchin, S., Rosman, B. & Baker, L. (1978). Psychosomatic Families: Anorexia Nervosa in Context.Cambridge: Harvard Univ. Press.
60.
Moulton, R. (1942). A psychosomatic study of anorexia nervosa including the use of vaginal smears. Psychosom. Med., 4:62–74.
61.
Mushatt, C. (1982-1983). Anorexia nervosa: a psychoanalytic commentary. Int. J. Psychoanal. Psychother., 9:257–265.
62.
Oliner, M. (1982). The anal phase. In Early Female Development, ed. D. Mendell.New York: SP Medical & Scientific Press, pp. 25–60.
63.
Parkin, A. (1983). On structure formation and the processes of alteration. Int. J. Psychoanal., 64:333–351.
64.
Pearson, G. H. J. (1965). A young girl and her horse. Bull. Phila. Assn. Psychoanal., 15:189–206.
65.
Risen, S. (1982). The psychoanalytic treatment of an adolescent with anorexia nervosa. Psychoanal. Study Child, 37:421–459.
66.
Roiphe, H. & Galenson, E. (1981). Infantile Origins of Sexual Identity.New York: Int. Univ. Press.
67.
Sachs, H. (1929). One of the motive factors in the formation on the superego in women. Int. J. Psychoanal., 10:39–50.
68.
Sandler, J. & Dare, C. (1970). The psychoanalytic concept of orality. J. Psychosom. Res., 14:211–222.
69.
Sarnoff, C., (1983). Derivatives of latency. In Fear of Being Fat, ed. C. Wilson.New York: Aronson, pp. 327–334.
70.
Schowalter, J. (1983). Some meanings of being a horsewoman. Psychoanal. Study Child, 38:501–517.
71.
Segal H. (1978). On symbolism. Int. J. Psychoanal., 59:315–319.
72.
Sours, J. (1974). The anorexia nervosa syndrome. Int. J. Psychoanal., 55:567–576.
73.
Sours, J. (1980). Starving to Death in a Sea of Objects.New York: Aronson.
74.
Sperling, M. (1949). The role of the mother in psychosomatic disorders in children. Psychosom. Med., 11:377–385.
75.
Sperling, M. (1950). A contribution to the psychodynamics of depression in women. Samiksa, 4:86–101.
76.
Sperling, M. (1968). Trichotillomania, trichophagy and cyclic vomiting. Int. J. Psychoanal., 49:682–690.
77.
Sperling, M. (1973). Conversation hysteria and conversion symptoms: a revision of classification and concepts. J. Amer. Psychoanal. Assn., 21:745–771.
78.
Sperling, M. (1978). Case histories of anorexia nervosa. In Psychosomatic Disorders in Childhood.New York: Aronson, pp. 139–173.
79.
Sperling, M. (1983). A reevaluation of classification, concepts and treatment. In Fear of Being Fat, ed. C. Wilson.New York: Jason Aronson.
80.
Sperling, O. (1943-1945). On appersonation. Int. J. Psychoanal., 24-26:128–132.
81.
Stephens, L. (1895). Case of anorexia nervosa. Lancet, 1:31–32.
82.
Sterba, E. (1941). An important factor in eating disturbances of childhood. Psychoanal. Q., 10:365–372.
83.
Sugarman, A. & Kurash, C. (1981). The body as a transitional object in bulimia. Int. J. Eating Dis., 1(4):57–66.
84.
Sylvester, E. (1945). Analysis of psychogenic anorexia and vomiting in a four-year-old child. Psychoanal. Study Child, 2:3–16.
85.
Székács, J. (1985). Impaired spatial structures. Int. J. Psychoanal., 66:193–199.
86.
Thoma, H. (1967). Anorexia Nervosa, New York: Int. Univ. Press.
87.
van der Heide, C. (1941). A case of pollakiuria nervosa. Psychoanal. Q., 10:267–284.
88.
Waller, J., Kaufman, M. & Deutsch, F. (1940). Anorexia nervosa: a psychosomatic entity. Psychosom. Med., 2:3–16.
89.
Wilson, C. P. (1983). The fear of being fat in female psychology. In Fear of Being Fat.New York: Aronson, pp. 9–27.
90.
Zinner, J. & Shapiro, R. (1972). Projective identification as a mode of perception and behavior in families of adolescents. Int. J. Psychoanal., 53:523–530.
