A psychoanalytic study of eating disorders: I. A developmental profile of 67 index cases.
Much has been written in both the professional literature and lay press regarding the sociocultural basis for the current increase in eating disorders. The typical victims of these afflictions appear to be intelligent adolescent girls from middle and upper class families (Garfinkel and Garner, 1982). Although the general pressure for thinness, mastery, and achievement among women in our culture undoubtedly help shape the course of illness, these social mores do not appear to be its root causes. The data presented here suggest strongly that the truly eating-disordered individual has a history of disturbances in early relationships, leading to a lack of security and pronounced difficulties in trusting others, and in simply being an authentic individual in the presence of others. As such these individuals share many characteristics of others with severe personality disorders such as inner emptiness, problems with identity, fear of abandonment, and peer relationships (Clarkin et al., in press), but differ in the expression of these basic defects or in solutions found to compensate pathologically for these core deficiencies. Therefore, although contemporary cultural ideals and values may supply the shape of the disorder, these individuals would have fared badly in any social climate although their presentation of illness may have differed (Bemporad et al., 1988). It is this profound underlying personality pathology that necessitates prolonged treatment for any hope of amelioration. Later reports will address this indication with a description of the results of therapy.
Bemporad
J R
JR
Department of Psychiatry, Cornell University Medical College.
Beresin
E
E
Ratey
J J
JJ
O'Driscoll
G
G
Lindem
K
K
Herzog
D B
DB
D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy; D001828:Body Image; D002032:Bulimia / Q000523:psychology* / Q000628:therapy; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D010553:Personality Development; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy; D011606:Psychosexual Development; D012931:Social Environment