Citation

Sloate PL. J. Am. Acad. Psychoanal. Dyn. Psychiatry 2008; 36(1): 69-88.

Copyright

(Copyright © 2008, American Academy of Psychoanalysis and Dynamic Psychiatry, Publisher Guilford Publications)

DOI

10.1521/jaap.2008.36.1.69

PMID

18399747

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.

Language: en

Keywords

Adult; Anxiety, Separation; Body Image; Bulimia Nervosa; Chronic Disease; Fantasy; Female; Fetishism, Psychiatric; Humans; Models, Psychological; Object Attachment; Psychoanalytic Therapy; Self Mutilation