​Published Work

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​The Inner worlds of Anorexia and Bulimia

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Abstract Information

 

The Inner worlds of anorexia and bulimia : A comparative exploration of internal object relations in eating disordered women.

Journal Title: Psycho-analytic Psychotherapy in South Africa
Volume: Volume 16
Issue:  Issue 2
Publication Date: 2008
Pages: 31  - 68
Authors:  Lihie Gilhar;  Gavin Ivey.

ISSN: 10230548

 

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​Abstract:  This paper is based on an explorative research project investigating possible differences in the meaning of the bulimic's gorging and purposeful expulsion of food, and the anorexic's food deprivation. Differences posited by object relations theorists were systematically investigated using a qualitative empirical research procedure. The method involved administering the Thematic Apperception Test and conducting in-depth, semi-structured individual interviews with five eating disordered women: two bulimic, two restrictive anorexic, and one binge-eating / purging sub-type anorexic. Both the conscious and unconscious themes emerging from their stated relationship with food and their TAT responses were interpreted within an object relations theoretical framework. Both food refusal and the binge-purge cycle, whatever the manifest motives involved, may be understood in terms of pathological internal object relations arising within the historical context of each participant's early development and family dynamics. Underlying both anorexia and bulimia is the struggle with internalising a durable positive link to an internal good object threatened by oral aggression, intrusive projective identification, and intolerable oedipal conflict. While deficient maternal containment is certainly evident, dysfunctional parental and father-daughter relationships play a significant role in the origin of eating disorders. It appears that anorexic behaviour is unconsciously motivated by the desire to repudiate experiences related to dependency, separateness, and object loss, while bulimia involves the repetitive quest to stifle the destructiveness that threatens her internal objects. Intolerable envy, the operation of manic defences, and a 'romance with death' appear to be distinguishing features of anorexia.