Anorexia and the Trojan Horse: a reflexive review of written psychoanalytic encounters with anorexic patients

ABSTRACT

A selective and limited sample of clinical case studies of psychoanalytic psychotherapy with anorexic patients, focussing on the author/therapist’s experience of working with such patients, is examined. Patients’ depressive and often angry states of withdrawal, and projections, are frequently noted. A summary of more hopeful interactions, as selected from the literature reviewed, is offered. An understanding of anorexic defences is explored in relation to the ‘Trojan Horse’ mythology, in the sense that that which purports to be emotionally nourishing and sublime can be suspiciously viewed as seeking to enter and conquer, through subterfuge. Some existing challenges to traditional tenets of psychoanalytic clinical practice with anorexic patients are presented.

KEYWORDS:

• Anorexia nervosa
• eating disorders
• container-contained
• ‘no-entry’ defences
• Trojan Horse

Acknowledgments

I thank Gianna Williams for encouragement relating to this paper. I thank anonymous peer reviewers for useful comments. I also thank Maria Papadima and the rest of the editorial team at the Journal for strengthening the paper.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. Considering the potential asexuality of the anorexic patient this ‘aperture closure’ might also include the vagina.

Additional information

Notes on contributors

Joshua Holmes

Joshua Holmes works as a Child and Adolescent Psychotherapist in the NHS. His recent book 'A Practical Psychoanalytic Guide to Reflexive Research: the Reverie Research Method' explores a novel approach to psychoanalytic qualitative methodology. He has been a recipient of the Journal of the American Psychoanalytic Association's 'new author' prize, and the British Psychotherapy Foundation's 'Eileen Curtis' prize.