The crucial role of psychodynamic understanding in the treatment of eating disorders.
Psychodynamic interventions for eating-disordered patients can provide a unique pathway to understanding the illness. Contemporary practice strives to integrate insights derived from drive theory, ego psychology, object relations, self-psychology, relational and attachment theories, and intersubjectivity to claim a more thorough understanding of the antecedents of the eating-disorder symptoms. Placing emphasis on the unique personal history of the individual and finding a safe haven in which to process that history are cornerstones of psychodynamic treatment embraced by each of these schools of thought. This article has emphasized the importance of creating a safe space for these patients to speak, processing the most salient affects that arise in the therapeutic dyad, assessing potential transference and counter-transference paradigms, and assisting these patients in mastering symptomatic behaviors by making healthier identifications with their therapists. Although the selected topics merely sketch how psychodynamic treatment may apply in some cases, it is hoped that they will whet the appetite for a more sustained inquiry for readers. Contemporary psychoanalysis aims to be more "user-friendly" for patients and treaters and eschews a "one interpretation fits all" approach to any person suffering from a particular diagnosis. Attachment theory, infant and developmental studies, and in-depth outcomes research are shaping the way that psychoanalytically informed treatments are carried out. Within the next decade, insights derived from these kinds of psychoanalytic research will be even more concretely and meaningfully used in the treatment of eating disorders and other Axis I conditions.
Zerbe
K J
KJ
Department of Psychiatry, Menninger Clinic, Topeka Institute for Psychoanalysis, Topeka, Kansas, USA. zerbekj@menninger.edu
D000293:Adolescent; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D011574:Psychoanalytic Theory