Nobody ever really eats alone. We must all negotiate the voice of our culture and its contradictory messages about food and the body. These cultural imperatives especially confuse and burden women as they struggle with the insidious power of the diet culture and current demands about body size and shape. In this insightful analysis of an treatment guide for eating problems, the authors develop a clinically useful theory of how society's injunctions about the "right" body and the "right" diet become inscribed in patients and join with their intrapsychic emotional life. By merging their theory of the internalization of culture (and feminist critique of that culture) with an object relations and interpersonal psychoanalytic theory, the authors deliver for all therapists a powerful therapeutic model, one honed by twenty years of practice at the Women's Therapy Centre Institute.Many treatments for eating problems make controlling the symptom their goal; this book demonstrates that this approach merely reproduces in the patient the loss of agency created by internalized messages from a fat-phobic society.
Only by understanding the symptom as an expression of the confluence of intrapsychic, interpersonal, and cultural experience can the therapist help the patient learn to live in peace in her body. The authors present a psychodynamic understanding of hunger, satiation, food, and body image, and show how everyday body/self and eating experiences contain and reveal the essential dynamics of the person. They also describe how these dynamics, as well as the influences of consumer culture, affect transference and countertransference in treatment.A thoughtful discussion of the convergence of eating problems and sexual abuse extends the existing theory about how consumer culture injures women and aggravates the wounds of abuse. It also details the tremendous value of this feminist psychoanalytic treatment model for helping people with dissociative problems, including multiple personality disorder.Illustrated with rich case vignettes, this practical guide will show clinicians how to use an anti-diet, anti-deprivation model of treatment to help patients learn to feed themselves in tune with their psychic and bodily needs.