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Reich, G. Cierpka, M. (1998). Identity Conflicts in Bulimia Nervosa: Psychodynamic Patterns and Psychoanalytic Treatment. Psychoanal. Inq., 18(3):383-402.

(1998). Psychoanalytic Inquiry, 18(3):383-402

Identity Conflicts in Bulimia Nervosa: Psychodynamic Patterns and Psychoanalytic Treatment

Günter Reich, Ph.D. and Manfred Cierpka, M.D.

In Germany, as in many other countries, psychoanalytic and psychotherapeutic practice is becoming more and more concerned with the treatment of Bulimia nervosa. The treatment of bulimic patients often calls for certain modifications in psychoanalytical technique. The specific symptoms of the disorder; the conflicts and the ego structures, particularly defense; and the nature of the patients' interpersonal relationships must be taken into consideration. The following observations are based on many years of experience gathered in our special outpatient department for eating disorders. Various types of treatment are used, sometimes in combination with one another (e.g., psychoanalytic and psychodynamic individual therapy, family therapy, cognitive behavioral therapy, group therapy). This has presented grounds for discussion on the various parameters of psychoanalytic therapy.

In Germany, the background for this discussion is as follows:

1.   In the conflict concerning the effectiveness of various therapeutic methods for the treatment of mental disorders, psychoanalysts are under increasing pressure to justify the time and costs their approach involves.

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