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Makman, M. (1989). Adolescent Psychiatry. XIII, 1986: The Psychoanalytic Therapy of Bulimic Anorexia Nervosa. C. Philip Wilson. Pp. 274-314.. Psychoanal Q., 58:170.
Psychoanalytic Electronic Publishing: Adolescent Psychiatry. XIII, 1986: The Psychoanalytic Therapy of Bulimic Anorexia Nervosa. C. Philip Wilson. Pp. 274-314.

(1989). Psychoanalytic Quarterly, 58:170

Adolescent Psychiatry. XIII, 1986: The Psychoanalytic Therapy of Bulimic Anorexia Nervosa. C. Philip Wilson. Pp. 274-314.

Marianne Makman

Unlike many of his colleagues also working with anorexic and bulimic patients, the author continues to believe that psychoanalysis can provide excellent, often curative treatment for some of these people. In a lengthy, complex paper, he differentiates "restrictor" (self-starving) anorexics from "bulimic" (gorging and vomiting) anorexics. He would prefer that the term "anorexia" be replaced with "fat phobia." These patients fear "insatiable hunger as well as impulses of many kinds." He goes on to describe what he considers to be characteristic family dynamics as well as psychodynamics, particularly "unresolved masochistic and oral-phase conflicts" in these patients. He believes it essential in understanding and treating bulimic anorexics to investigate "childhood habits" (e.g., nail-biting, thumbsucking, hairpulling) so often forerunners of the later eating disorder. Using several case studies as illustrations, he discusses psychoanalytic treatment techniques and common resistances and defenses in anorexic-bulimic patients. The author recommends hospitalization only in true emergencies. He also feels that medication (e.g., antidepressants) is contraindicated in those patients who can utilize analysis.

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Article Citation

Makman, M. (1989). Adolescent Psychiatry. XIII, 1986. Psychoanal. Q., 58:170

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