Abstract
Eating disorders mark deficits in the ability to be nourished and to symbolize embodied experience. Such deficits can be traced to difficulties in early relationships that inhibit the development of self-regulatory functions and the progressive differentiation of self from other. Often, we find mothers who are insufficiently developed, leaving the child either austerely avoiding intrusion or struggling to digest maternal provisions without becoming lost in them. Explorations that link anorexia to deficits in symbolization are in line with psychoanalytic theorizing that marks the concretization of meanings in anorexia. Bulimia, in contrast, has been linked to deficits in self-regulatory capacities that are not necessarily tied to deficits in mentalization. Clinical experience suggests that people with bulimia are often “failed anorexics” who have achieved higher levels of self-development. Case examples explore some of the dynamics underlying such difficulties and how metaphors aid the work with those for whom embodied experience remains largely unsymbolized.
Similar content being viewed by others
References
Bion, W. R. (1959). Attacks on linking. International Journal of Psycho-Analysis, 40, 308–315.
Bion, W. R. (1967a). Notes on memory and desire. Psychoanalytic Forum, 2(3), 271–280.
Bion, W. R. (1967b). Attacks on linking. In N. J. Northvale (Ed.), Second thoughts: Selected papers on psycho-analysis (pp. 93–109). Northvale, NJ: Jason Aronson.
Bion, W. R. (1970). Attention and interpretation. London: Karnac.
Bion, W. R. (1992). Cogitations. London: Karnac.
Birksted-Breen, D. (1989). Working with an anorexic patient. International Journal of Psycho-Analysis, 70(1), 29–40.
Bria, P., & Lombardi, R. (2008). The logic of turmoil: Some epistemological and clinical considerations on emotional experience and the infinite. International Journal of Psycho-Analysis, 89(4), 709–726.
Charles, M. (2000). Convex and concave, Part I: Images of emptiness in women. American Journal of Psychoanalysis, 60(1), 5–28.
Charles, M. (2002). Patterns: Building blocks of experience. Hillsdale, NJ: The Analytic Press.
Charles, M. (2006). Silent scream: The cost of crucifixion—working with a patient with an eating disorder. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 34(2), 261–285.
Charles, M. (2010). When cultures collide: Myth, meaning, and configural space. Modern Psychoanalysis, 34(1), 26–47.
Charles, M. (2012). Working with trauma: Lessons from Bion and Lacan. Lanham, MD: Jason Aronson.
Charles, M. (2020). Creative transformations: The establishment, the mystic and the aesthetic drive. In M. B. Brown & R. S. Brown (Eds.), Emancipatory perspectives on madness: Psychological, social, and spiritual dimensions (pp. 152–167). London: Routledge.
Delvecchio, E., Di Riso, D., Salcuni, S., Lis, A., & George, C. (2014). Anorexia and attachment: Dysregulated defense and pathological mourning. Frontiers in Psychology, 5(Oct), 1218.
Ferrari, A. B. (2004). From the eclipse of the body to the dawn of thought. London: Free Associations.
Fivush, R., Habermas, T., Waters, T. E. A., & Zaman, W. (2011). The making of autobiographical memory: Intersections of culture, narrative and identity. International Journal of Psychology, 46(5), 321–345.
Freedman, N., & Lavender, J. (2002). On desymbolization: The concept and observations on anorexia and bulimia. Psychoanalysis and Contemporary Thought, 25(2), 165–200.
Gallese, V. (2009). Mirror neurons, embodied simulation, and the neural basis of social identification. Psychoanalytic Dialogues, 19(5), 519–536.
Green, A. (1983). The dead mother. In: On private madness (pp. 142–173). London: Routledge, 1997.
Green, A. (1998). The primordial mind and the work of the negative. International Journal of Psycho-Analysis, 79(4), 649–665.
Green, A. (1999). On discriminating and not discriminating between affect and representation. International Journal of Psycho-Analysis, 80(2), 277–316.
Johnson, M. (1987). The body in the mind: The bodily basis of meaning, imagination and reason. Chicago: University of Chicago Press.
Lacan, J. (1962–1963). The seminar of Jacques Lacan: Book X: Anxiety. 1962–1963. In J.A. Miller (Ed.), The seminar of Jacques Lacan: Book X: Anxiety, 1962–1963 (A. R. Price, Trans.). Cambridge, UK: Polity Press. 2014.
Lacan, J. (1974–1975). Seminar XXII:RSI. (C. Gallagher, Trans.). Retrieved from http://www.lacaninireland.com/web/published-works/seminars.
Lacan, J. (1977). The function and field of speech and language in psychoanalysis. In Écrits: A selection (pp. 30–113) (A. Sheridan, Trans.). New York: Norton.
LaCapra, G. (1999). Trauma, absence, loss. Critical Inquiry, 25, 696–727.
Lakoff, G. (1993). How metaphor structures dreams: The theory of conceptual metaphor applied to dream analysis. Dreaming, 3(2), 77–98.
Lakoff, G., & Johnson, M. (1980). Metaphors we live by. Chicago: University of Chicago Press.
Lewin, B. (1951). The psychoanalysis of elation. London: Hogarth.
Liotti, G. (2004). Trauma, dissociation, and disorganized attachment: Three strands of a single braid. Psychotherapy: Theory, Research, Practice, Training, 41(4), 472–486.
Lombardi, R. (2009). Body, affect, thought: Reflections on the work of Matte-Blanco and Ferrari. Psychoanalytic Quarterly, 78(1), 123–160.
Main, M., & Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and/or frightening parental behavior the linking mechanism? In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the preschool years. Theory, research and intervention (pp. 161–182). Chicago: Chicago University Press.
Matte-Blanco, I. (1975). The unconscious as infinite sets: An essay in bi-logic. London: Duckworth.
Matte-Blanco, I. (1988). Thinking, feeling, and being. London: Routledge.
Mayes, L., Fonagy, P., & Target, M. (2007). Developmental science and psychoanalysis: Integration and innovation. London: Karnac.
Meltzer, D. (1990). The Claustrum: An investigation of claustrophobic phenomena. London: Karnac.
Modell, A. H. (2005). Emotional memory, metaphor, and meaning. Psychoanalytic Inquiry, 25(4), 555–568.
Modell, A. H. (2009). Metaphor—The bridge between feelings and knowledge. Psychoanalytic Inquiry, 29(1), 6–11.
Mucci, C. (2019). Traumatization through human agency: “Embodied witnessing” is essential in the treatment of survivors. American Journal of Psychoanalysis, 79, 540–554.
Niemi, T., & Lombardi, R. (2008). Run or die: Bi-logical phenomena at the body-mind border. Scandinavian Psychoanalytic Review, 31(2), 95–104.
Pedersen, S. H., Poulsen, S., & Lunn, S. (2015). Eating disorders and mentalization: High reflective functioning in patients with bulimia nervosa. Journal of the American Psychoanalytic Association, 63(4), 671–694.
Ramis, H. (Director) & Albert, T. (Producer). (1993). Groundhog day. [Motion Picture].
Reiser, L. W. (1990). The oral triad and the bulimic quintet: Understanding the bulimic episode. International Review of Psycho-Analysis, 17, 239–248.
Romano, F. (2013). Anorexia and bulimia: Two aspects of adolescence. British Journal of Psychotherapy, 29(1), 5–4.
Schwartz, H. J. (1986). Bulimia: Psychoanalytic perspectives. Journal of the American Psychoanalytic Association, 34(2), 439–462.
Segal, H. (1957). Notes on symbol formation. In The works of Hannah Segal. (pp. 49–65). New York: Jason Aronson. Also in International Journal of Psycho-Analysis, 38, 391–397. 1957.
Skårderud, F. (2007). Eating one’s words, Part II: The embodied mind and reflective function in anorexia nervosa—Theory. European Eating Disorders Review, 15(4), 243–252.
Strober, M., & Humphrey, L. L. (1987). Familial contributions to the etiology and course of anorexia nervosa and bulimia. Journal of Consulting and Clinical Psychology, 55(5), 654–659.
Strober, M., Lampert, C., Morrell, W., Burroughs, J., & Jacobs, C. (1990). A controlled family study of anorexia nervosa: Evidence of familial aggregation and lack of shared transmission with affective disorders. International Journal of Eating Disorders, 9(3), 239–253.
Vlahaki, I. (2012). “Two in a body”: From the mother’s anorexia to the daughter’s bulimia. International Forum of Psychoanalysis, 21(4), 195–201.
Williams, G. (1997). Reflections on some dynamics of eating disorders: ‘No entry’ defences and foreign bodies. International Journal of Psycho-Analysis, 78, 927–941.
Winnicott, D. W. (1971). Playing and reality. London: Penguin Books.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Marilyn Charles, Ph.D., ABPP, is a psychologist and psychoanalyst at the Austen Riggs Center in Stockbridge, MA, affiliated with Harvard University, the University of Monterrey, and the Chicago Center for Psychoanalysis.
Address correspondence to Marilyn Charles, Ph.D., ABPP, 150 View Drive, Richmond, MA 01254, USA. mcharlesphd@gmail.com
Rights and permissions
About this article
Cite this article
Charles, M. Meaning, metaphor, and metabolization: the case of eating disorders. Am J Psychoanal 81, 444–466 (2021). https://doi.org/10.1057/s11231-021-09324-9
Published:
Issue Date:
DOI: https://doi.org/10.1057/s11231-021-09324-9