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Southern Kentucky and Oceans Far Away

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Brian L. Tucker

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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.”

“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.”