17. Psychodynamic Approaches to Eating Disorders

Summary

Psychodynamic therapists have paid relatively little attention to bulimia nervosa (BN) and even less to binge eating disorder (BED). This chapter therefore deals first with anorexia nervosa (AN) and then with BN and BED; this is followed by some comments on working with eating-disordered clients and a brief review of the evidence base for psychodynamic therapy in eating disorders (EDs). There are a number of recurring themes, including control, power, intrusion, containment, identity, sexuality and repressed emotion, in work with anorexic clients, with which it is helpful to be familiar; these are described. These themes do not, of course, occur in all clients and the fact that every client is different is one of the reasons that psychotherapeutic work with this group is at the same time so fascinating and so challenging.