Reflections on some dynamics of eating disorders: 'no entry' defences and foreign bodies

Int J Psychoanal. 1997 Oct:78 ( Pt 5):927-41.

Abstract

In the context of the treatment of eating disorders, the author describes a specific failure in the container/contained relationship (Bion, 1962) that goes beyond the experience of having projections rejected. She addresses the predicament of those patients who have not only lacked containment, but also perceived themselves as receptacles of unmetabolised phantasies and experiences projected into them by their parents. The author briefly refers to those patients who succeed in protecting themselves from this predicament by developing a 'no entry system of defences' that often includes anorexia. The main focus of the clinical exploration in this paper is the predicament of 'porous' patients, those who remain open to parental projections. The author suggests that in such cases the introjection of an object performing a function opposite to organising 'alpha function' can be hypothesised. She suggests the term 'omega function' to describe a disorganising, disrupting agent in the patient's internal world. The author makes reference to the type of countertransference experienced by the clinician working with the disorganised 'porous' patients, which is different from the type experienced in the treatment of patients prone to envious attacks and, in particular, to attacks on linking.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anorexia / psychology
  • Anxiety / etiology
  • Bulimia / psychology
  • Defense Mechanisms*
  • Feeding and Eating Disorders / psychology*
  • Feeding and Eating Disorders / therapy
  • Female
  • Humans
  • Male
  • Projection
  • Psychoanalytic Theory*
  • Psychoanalytic Therapy / methods
  • Transference, Psychology