Mind-body splitting and eating disorders: a psychoanalytic perspective

One of the possible consequences of affect dysregulation, resulting from developmental experiences with caregivers who have not been able to attune with the child's emotional needs, is the development of a dysfunctional relationship with food and the subsequent development of eating disorders (ED). ED patients internalize a primary sadistic object with which they can only identify in an adhesive way. The resulting ego ideal is hypertrophic and its inaccessibility generates deep feelings of shame and worthlessness. For these patients, the disordered eating behaviours often represent a way of recovering their subjectiveness and provide opportunities for a relational impact. At the same time, the body becomes a sort of 'safe haven' in which ED patients can imagine protecting themselves from the sadistic object's intrusive attacks. Psychoanalytic work with ED patients requires an analyst who is genuinely available to deeply listen and who knows how to reach these patients and their psychic experience 'beyond words'. The analyst should offer the emotional support necessary to face the self-destructive impulses of a frightened and helpless self.