Loving them to death: the anorexic and her objects

The author suggests that eating disorders function to reinforce phantasies of control of the internal parents, a feature of Klein's view of the manic defence. Using this hypothesis, she attempts to differentiate between anorexia and bulimia. It is argued that in anorexia objects are felt to be permanently in thrall, suspended or frozen, whereas in bulimia they are attacked in a frenzied and intermittent way. Using case material from three seriously ill patients, the author draws attention to some important differences between them. Two of the patients were treated in psychoanalysis, while the third was seen for an extended consultation and once-weekly treatment thereafter. It is suggested that the nature and degree of the murderous attack on the internal couple may determine the severity of the illness as well as the patient's capacity to benefit from treatment. The conclusions drawn are discussed in relation to some contemporary views on eating disorders as well as writings on the difficulties of working through the Oedipus complex more generally. The author suggests that eating disorders may represent a special case of oedipal illusions.