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“While many anorexic and bulimic patients describe themselves as feeling disconnected from their bodies, or even like heads without bodies, they are also trapped in an inability to differentiate affect from bodily state, as evidenced through difficulty articulating feelings verbally, and the use of food and the body as the primary or only means of self-expression.”

Quote by Tom Wooldridge

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Psychoanalytic Treatment of Eating Disorders

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Tom Wooldridge

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“If the eating disorder is concretized by the "not-me" ED, the patient is allowed the safety to look around comers, to follow this "other self' into the kitchen; the bathroom; yes, even the bedroom; to observe. Shame and blame are reduced; curiosity is enhanced. Conceptually this is interesting. Many patients are able to observe once allowed to look. They know well who they are at these moments. Relationally, however, they have never been entitled to look, and, as a result, self-observation and understanding have been thwarted by relational constraints and consequent immediate behavioral enactments. Ongoing, the patient is asked to consider what alternative behaviors can replace eating, purging or restricting. If the patient weren't thinking about food or weight, what else would she be thinking about? What else is needed? As the patient begins to consider concrete alternatives to symptomatic behavior, "contracts" are developed between patient and therapists.”

“If mental health has been associated with the ongoing development of resilient and adaptive coping through early positive attachment experiences, psychopathology later in life has been associated with disturbances in attachment, characterized by deficits in coping with novelty and stress (Schore, 2001). For those who go on to develop eating disorders, there have often been pathological failures in early maternal responsivity, as well as maternal impingements. Bruch (1973), one of the first psychoanalysts to theorize about and treat eating disorders, noted that often. these patients have what she calls an interoceptive problem - difficulty distinguishing between inside and outside and between self and other - as the result of having their mothers' needs imposed upon them throughout development. As a result, the potential, or transitional space, never achieved as a space between two people, becomes an embodied, or "in-myself' space (Boris, 1984).”

“Moreover, the body is the projection screen for deadly objects stemming from primary, traumatic links with caretakers, compulsory binges and food rejection may amount to an angry response aimed at denying and attacking the body. Additionally. dysfunctional eating behaviors are often attempts to regulate extremely painful emotions, especially those that may influence an individual's narcissistic balance. This condition is shared with different forms of psychic distress, whereby an object or a behavior plays the role of regulating the "'outer" emotions in response to a lack of adequate internal resources to contend with traumatic stressors. From this perspective, EDs can be conceptualized as dysfunctional strategies of affect regulation that are connected to an impaired capability to recognize, metabolize, and mentalize affects (Lunn & Poulsen, 2012).”

“Siamo pien3 di frasi fatte sulle emozioni. La paura che attanaglia. L'odio che acceca. La gelosia che arma la mano. La nostalgia che assale a tradimento. Pensare ai moti d'animo come realtà astratte ci fornisce un ottimo alibi per non sentirci responsabili dei nostri stessi sentimenti. Se essi si trovano da qualche parte là fuori, quando ci investono noi non ne abbiamo colpa, sono simili a eventi atmosferici e le loro conseguenze sfuggono al nostro controllo. Ma è falso. La paura non esiste senza qualcosa da temere e qualcuno che la tema. L'odio non aleggia sopra di noi come una nube nera pronta a pioverci addosso: per vederlo, occorre qualcuno che lo provi. La nostalgia non si dà senza qualcosa che ti manca e senza il tuo ricordo a misurarne l'assenza. L'idea che l'amore sia il frutto del capriccio invisibile di un Cupido cieco è un'immagine fatalista e immatura: esclude che amare sia una scelta, perché descrive l'essere umano come una creatura travolta da una forza misteriosa contro cui non può niente.”

“People make mistakes. As often as not, the mistakes aren't deliberate or personal. If you want to, you can let go of any feelings of resentment, of regret, of anger. You could let all these things get you down, fizzle away internally like some emotional acid making you ill and resentful and stuck. Try instead to let them go, embrace them as character forming and in general as positive rather than negative. There is no going back, only forwards. Make it a motto for life - keep moving forwards.”