A Special K retreat: Dynamics which threatened the psychotherapy of an eating-disordered patient

Author: Rose, Susannah

Source: Psychoanalytic Psychotherapy, Volume 23, Number 1, March 2009 , pp. 78-91(14)

Publisher: Routledge, part of the Taylor & Francis Group

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Abstract:

When considering dynamics which threaten the therapies of patients with eating disorders the first aspect that occurs to me is how much the notion of 'threat' is a feature of the life of a person with an eating disorder. Working as a psychotherapist on an in-patient unit for severely ill eating-disordered patients, I am continually reminded how the patients in our unit live with the constant threat of serious physical damage, if not death (although this last is on the whole not felt to be a threat by the patient). At the same time, they are mostly subjected to ferocious internal threats of what will be done to them if they attempt to give up and therefore betray the eating disorder. Patients with eating disorders can be threatening, intimidating and controlling to the people around them; they will vigorously fight anyone who attempts to threaten the perceived safety of their internal system. In addition, they can feel threatened with punishment by the team on the unit, who they feel can increase their food intake or decrease their freedoms at a whim in a controlling and retaliatory manner.

Keywords: Anorexia; bulimia; threat; retreat; omnipotence; dependency; transference

Document Type: Research article

DOI: http://dx.doi.org/10.1080/02668730802710930

Affiliations: 1: Eating Disorder Unit, Priory Hospital, London, SW15 5JJ

Publication date: 2009-03-01

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