The Fear of Facing Drives and Desires: Is It Still Appropriate to Reduce Anorexia and Bulimia to Eating Disorders?

Abstract

This paper reflects a perspective the author has developed over twenty years of practice as a clinical psychoanalyst and as an academic researcher in the field of eating disorders. Anorexia and bulimia are discussed through the lens of psychoanalytic theory, with the support of empirical evidence in clinical psychology research. The author proposes a new way to consider anorexic and bulimic pathology, assigning primary importance to drive repression and object avoidance and stimulating reflections on the phobic-obsessive displacement onto hunger and food. A brief illustrative vignette is included.

Keywords:

• Anorexia
• bulimia
• eating disorders
• puberty
• drive
• desire
• displacement
• paternal imago
• repression

Notes

1 The risk factors for eating disorders as determined by empirical research studies are, in addition to ineffectiveness, an overweight condition in childhood, particular parental attachments (generally overcontrolling), perfectionism, and bodily shame. Of course, it is well known that the two main risk factors are being female and at the age of puberty.