title: From fetish object to transitional object: the analysis of a chronically self-mutilating bulimic patient.
abstract: This paper challenges the view that food, or the patient's own body, functions as a transitional object for bulimics during the binge-purge cycle or symptomatic equivalents of self-harm. The author proposes that the bulimic patient's actions in and on her body more closely approximate the use of a fetish, which temporarily enhances a deficient and unstable body image and assuages separation anxiety, but does not promote progressive development. To illustrate these distinctions, the author presents an analysis of a self-mutilating bulimic patient who used her body as a fetish until a more integrated "me" evolved within the "shared skin" of her treatment. At that point, a transitional object and an idealizing selfobject fantasy were created, and the patient was able to engage the question of "not me," relinquish her self-mutilation, and resume the process of separation and growth.
authors.affiliation: New York University Postdoctoral Program in Psychotherapy and Psychoanalysis, NY, USA. plsloate@aol.com
authors.forename: Phyllis L
authors.initials: PL
authors.lastname: Sloate
mesh_terms: D000328:Adult; D001010:Anxiety, Separation / Q000523:psychology / Q000628:therapy; D001828:Body Image; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D002908:Chronic Disease; D005201:Fantasy; D005260:Female; D005329:Fetishism, Psychiatric / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D009769:Object Attachment; D011575:Psychoanalytic Therapy / Q000379:methods*; D012652:Self Mutilation / Q000523:psychology / Q000628:therapy*