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Published: 2008
Synopsis
Eating disorders vary in severity from developmental difficulties in adolescence which may be transitory, to serious and chronic mental illnesses. 'The Anorexic Mind' offers a coherent approach to these difficult and demanding problems, always underlining the point that while many of the manifestations are physical, eating disorders have their origins as well as their solutions, in the mind. While anorexia nervosa may be considered the central syndrome in eating disorders, this book also considers how it links and differs from bulimia nervosa, the more common, related disorder. In the process of the research on anorexia and bulimia, valuable insights have been gained into the very common problem of overeating.
Description
The author takes a developmental approach to eating disorders, and is very aware of the continuities between infantile, adolescent and adult experience. Our earliest relationship is a feeding relationship and feeding difficulties early in life are not rare. The view taken in 'The Anorexic Mind' is that feeding difficulties indicate and reflect relationship difficulties whether they occur in infancy, adolescence or adulthood. Most eating disorders apparently begin at adolescence, though if a careful history can be obtained, it is often clear that there have been relationship difficulties at earlier stages of development.
If eating disorders are understood as reflections of relationship difficulties, the author believes that they are best treated within a therapeutic relationship. Examples are given of treatment by formal psychotherapy or psychoanalysis where early difficulties become visible and treatable within the transference relationship to the therapist. The most serious cases of anorexia and bulimia nervosa are treated within institutional settings, and many patients have a number of long admissions.
Part of The Tavistock Clinic Series
'The Anorexic Mind is the culmination of thirty years of clinical practice, teaching, and consultation about the often intractable problems of anorexia and bulimia. One of the many strengths of the book is its dual focus: it moves between psychoanalytic work in the consulting room on the one hand, and work with very ill people in inpatient settings on the other. As a consequence, the respective chapters draw both on long-term intensive psychodynamic psychotherapy and also on approaches to mental health that stem from traditions that lie at the heart of the work of the Tavistock Clinic.'
- Margot Waddell, from the Series Editor's Preface
‘Marilyn Lawrence has produced a book on anorexia nervosa which is both authoritative and imaginative. It covers the subject widely and deeply, with historical, social and psychological perspectives. The authority comes from experience, as well as a wide general knowledge â€" that is her considerable experience of consulting to units struggling with this profoundly disturbing disorder and from her psychoanalytic experience of anorectic and bulimic individuals. Her imaginative approach is exemplified in the clinical work she reports and in her exploration of possible explanations of this widespread and potentially dangerous condition. As she shows, though anorexia is superficially contrary to reason at depth it has its own deadly logic. Professional workers, interested intellectuals and worried parents will all find this book informative and orientating. What makes it an even greater asset in the confusing, conflicted and ideologically infused field of eating disorders, is the balance of its clinically informed opinions.â€TM
- Ronald Britton, FRCPsych., F Inst Psychoanal., DPM
Contents
Introduction
1. Historical Perspectives
2. Assessing risk in eating disorders
3. Eating disorders and object relations
4. Anorexia, femininity and the sexual development of girls
5. Matters of life and death
6. Psychotherapy with eating disorder patients
7. Psychological thinking in hospital settings
Conclusions
The Author
Marilyn Lawrence is a Member of the British Psychoanalytical Society and a Fellow of the Institute of Psychoanalysis. She works in the Adult Department of the Tavistock Clinic and in private practice in London. She has a long-standing interest in eating disorders, as well as in gender and sexual development. Her published works include "The Anorexic Experience" (1984), "Fed Up and Hungry" (1989), and "Fighting Food" (1990). She is currently Programme Director of the Foundation Course in Psychoanalytic Psychotherapy at the Tavistock and Portman NHS Foundation Trust and is Director of Publications at the Institute of Psychoanalysis.
