[Limits of psychotherapeutic effectiveness in anorectic patients]

Catamnestic studies of psychotherapeutically treated anorectic patients show that the pathological attitudes and convictions regarding food, eating habits and body weight persist regardless of whether the treatment was successful or not. Reasons for the persistence of these patterns of attitudes and behavior have not been able to be clarified up to now. The pathological attitudes of anorectic patients towards food, eating and body weight are closely associated with a high narcissistic profit. These patterns of convictions and attitudes fulfil the function of a stable resistance against deeper anxieties and also wishes and needs which are perceived as being threatening; therefore these patterns will survive as long as the level of the resisted wishes and needs remains concealed. During the treatment process they have to be made sizeable as interaction dynamics in order to be accessible for changes. Two characteristic aspects of interaction dynamics are discussed here.