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“Numerous patients with eating disorders refuse to eat with their families and friends, even insisting on eating only in private. Many of the practices that are seen as essential for creating and sustaining relatedness - the sharing of food, living together, sexual relationships, and even reproduction - are consistently negated by anorexic and other eating disordered practices.”

Quote by Tom Wooldridge

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Eating Disorders: A Contemporary Introduction

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Tom Wooldridge

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“Each internal representation of the mother has its corresponding self-representation - the first as bad, empty, and guilty and the second as passive, compliant, and good. Working together, these internal objects undermine patient’s journeys toward adulthood, which is compatible with the symptoms and behaviors of the disorder.”

“One of our central tasks with patients with eating disorders is facilitating the capacity to postpone action in favor of reflection. We inevitably find especially early on, that this is challenging: the pull to binge, or purge, or restrict is difficult, often impossible, to resist. To understand this fact, in this chapter we begin with a discussion of Freud’s (1914) notion of the compulsion to repeat and then formulate the eating disordered patient's symptoms as repetitions against traumatic themes from childhood, never-ending (because never fully successful) attempts to magically undo the pain of the past.”

“Patients with eating disorders typically report little power to stop their eating disordered behaviors (i.e., reversibility), are often unaware of the thoughts and feelings they have when engaging in them (i.e., self-observation), and, by definition, their behaviors are self-defeating and fail to forward their development in constructive ways (i.e., appropriateness).”

“We all need to feel safe, that the world is predicable, that obstacles can be overcome, and conflicts resolved -in short, to maintain narcissistic equilibrium. When such conditions are met, infants can pleasurably engage with their environments. When faced with overwhelming experience, internal or external, they must find a way to restore their fragile self-esteem. Some infants, especially when faced with overwhelm that cannot be overcome, turn away from reality and toward omnipotent solution. This learned response feels dependable and, over time, takes on an addictive quality, restricting her access to other solutions and pathways to further growth.”

“Mourning is the vehicle of transformation through which traumatic themes can be acknowledged, disillusioned wishes for an ideal object relinquished and painful early relationships transformed into aspects of the subject’s character that are carried forward in constructive ways.”

“In her article, Williams (1997) describes a class of "psychically porous” patients who suffer from eating disorders, most frequently bulimia nervosa, and suggests that they had parents who themselves suffered extensive traumas and as a result were either frightening or frightened or both in relation to the child.”

“Desire cannot be understood apart from the contexts, relational and cultural, that shape it. A patient with bulimia, for example, may not desire food as a substitute for mother but, rather, because that is the only available "vocabulary" through which her desire can be expressed. The analyst's task becomes not only to uncover desires that have been defended against but also to help the patient begin to want freely so that, over time, new containers of desire can emerge, both inside and outside the analytic relationship.”