Hungers and Compulsions: The Psychodynamic Treatment of Eating Disorders and Addictions

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JEAN PETRUCELLI & CATHERINE STUART, (EDS.): Hungers and Compulsions: The Psychodynamic Treatment of Eating Disorders and Addictions. Northvale, NJ: Jason Aronson Publishers, 2001, 392 pp. $50.00, ISBN: 0765703181.

This book presents the different psychological perspectives of eating disorders. The editors' goal was to be inclusive about eating disorders and other addictions, and they have succeeded well. Jean Petrucelli, Ph.D., F.P.P.R., is the co-founder and co-director of Eating Disorders and Substance Abuse Service, and is the supervisor of psychotherapy, teaching faculty at the William Alanson White Institute. Catherine Stuart, Ph.D., is the co-founder and co-director of Eating Disorders and Substance Abuse Service, and the supervising analyst, teaching faculty at the William Alanson White Institute. Dr. Stuart is also on the faculty at the Postgraduate Center for Mental Health. This book comes out of the Hungers and Compulsions Conference created by the Eating Disorders and Substance Abuse Service of the William Alanson White Institute.

Hungers and Compulsions presents a thorough exploration of the subtleties of therapeutic work between psychotherapist and patient. The book is a compilation of writing of authors who differ in their psychotherapeutic approach. Each author has a vast experience in either eating disorders or addictive behaviors. The book's seven sections cover: "Addictive Economies;" "Expanding the Analytic Space: Dissociation and the Eating-Disordered Patient;" "On Being Stuck: Enactments, Mutuality, and Self-Regulation with Eating-Disordered Patients;" "To Eat or Not to Eat: The Psychic Meanings of the Decision;" "Creativity and Addiction;" "Desires and Addictions;" and "Winnicott and Masud Khan: A study of Addiction and Self-Destruction."

Joyce McDougall's wonderful opening chapter ("The Psychic Economy of Addiction") defines "addiction" and introduces the concept of a "good enough mother." She provides an excellent synthesis of Winnicott's work, laying the foundation for addictive behaviors. Her thesis is that the addictive solution is an attempt at self-cure in the face of threatening psychic stress.

Judith Brisman, a pioneer in the field of bulimia nervosa, writes a thoughtful chapter ("The Instigation of Dare: Broadening Therapeutic Horizons") on deepening one's understanding of non-verbal communication. She challenges the notion that traditional means in the therapeutic space don't work with eating disordered patients.

Philip M. Bromberg, in ("Out of Body, Out of Mind, Out of Danger: Some Reflections on Shame, Dissociation, And Eating Disorders,") beautifully describes dissociative states, while Lewis Aron ("Narrative, Affect, and Therapeutic Impasse") reviews how therapists get stuck in their clinical work when, because of their own fears in identification with aspects of their patient's story and character, they lose their ability to keep the therapy moving fluidly and get bogged down in analytic statements. He discusses mutual regulation of each other's states of consciousness. …