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“Eating disorders are a silent form of destruction: a destruction of vitality and the hope for a meaningful existence. They create the illusion of time stopping. Past, present, and future collapse: the insidious negative self-talk is too loud, and/ or the aftermath of trauma too pervasive and/or the affects too overwhelming. The body itself becomes the theater of war (McDougall, 1989) wherein the feelings, memories, longings, and stories that have led to the symptoms feel so dangerous that they are dissociated from the behaviors themselves.”

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Book:Psychoanalytic Treatment of Eating Disorders
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“A person struggling with an eating disorder keeps their rituals and disordered behaviors secret - it is a double life of sorts - and the behaviors themselves could be thought of as a maladaptive attempt at a solution. The symptoms are used to maintain a state of mind, full of fantasies of the possibilities of a 'moment' or a 'life', without what 'feels' unbearable. The person, in the eating disorder (ED) 'body-state,' truly believes that there is no other way.”

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Book:Psychoanalytic Treatment of Eating Disorders
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“Sadly, fierce in-group/out-group biases live within the eating disorder complex, generating and sustaining an ethical code of the culture as girls and women project their shadow upon one another. Individuals with anorexia secretly scorn those who struggle with bulimia or binge eating, those with bulimia and binge eating feel gross, often “wishing to be anorexic,” yet detesting their slim sisters with vicious jealousy. A callous hierarchy is formed, with anorexia as the ideal; bulimia, as a very distant underworld second; and binge eating, clearly at the bottom of acceptability.”

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Book:Psychoanalytic Treatment of Eating Disorders: When Words Fail and Bodies Speak
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“Controlled mentalization, identification and understanding of emotional reactions, and emotional regulation are significant problems for eating-disordered patients. In general, bulimia nervosa patients show problems in emotional hyperarousal and flooding. The opposite, a dominance of detached and flattened effect, is typically seen in patients with anorexia nervosa.”

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Book:Psychoanalytic Treatment of Eating Disorders
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“…interoceptive confusion and body image distortions are forms of impaired embodied mentalizing and expressions of pre-mentalistic thinking. For example, psychic equivalence demonstrates how patients’ painful self and affect states are expressed though extreme body hatred and the mistaken belief that being “skinny” will bring them self-acceptance, "confidence," and agency. The teleological stance explains the obsessive drive for thinness as a method to obtain self-acceptance and the approval of others. In short, subjugation of the body is a confused attempt to gain mastery and control over feelings of ineffectiveness and lack of self-worth.”

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Book:Psychoanalytic Treatment of Eating Disorders
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“Hypermentalization, frequently seen in patients with bulimia nervosa, is when the patient is so outer-directed that she is prone to obsessively interpreting others' minds but not in an accurate way. Hypermentalized fantasies about another's mind is an effort to meet and satisfy that person's perceived desires and needs (Buhl, 2002; Skarderud, 2007), and based on inaccurate interpretations of self/other mental states because of attachment anxieties. Similarly, pseudo-mentalizing is when the patient appears to be expressing or talking about feelings and thoughts, but the narrative lacks emotional connection. instead, words and expressions are empty of meaning and serve to defend against feelings of worthlessness, insignificance, or desolation (Skarderud & Fonagy, 2012).”

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Book:Psychoanalytic Treatment of Eating Disorders
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