Book Reviews -- Psychodynamic Technique in the Treatment of the Eating Disorders Edited by C. Philip Wilson, Charles C. Hogan and Ira L. Mintz

Article excerpt

Psychodynamic Technique in the Treatment of the Eating Disorders is a sophisticated text for the experienced clinician who is trained in psychoanalytic theory. Although the volume is a collection of independent pieces by 10 contributors, the bulk of the writing is by the editors themselves, thus allowing for a consistent point of view.

It is an important reference work for those in the field of eating disorders and obesity. The clinician has a chance to gain an in-depth view of the unconscious world of people with these disorders through clinical vignettes that demonstrate the use of psychoanalytic techniques in their treatment.

The symptom complexes of eating disorders and obesity are multidimensional. Although the symptoms of these patients are similar, they differ widely both in their psychodynamics and in the types of character disorders they present, ranging from the hysterical and obsessive-compulsive to the borderline and near psychotic. The editors' hypothesis in this volume is that eating disorders and obesity result from unresolved preoedipal and oedipal conflicts. They present case after case in which the use of psychoanalytic interpretation of the underlying personality disorder was able to resolve and diminish the symptom complex.

The book is divided into six parts. Each is well written and well documented. Some chapters are laborious and the information is repetitive. However, most of the material is invaluable and covers every facet of eating disorders with one major chapter devoted to obesity.

Part I, The Fear of Being Fat contains two excellent chapters by C. Philip Wilson in which he deftly explores and differentiates the personality structure and ego functioning of the anorexic, bulimic, and obese patient. His discussions of body image, countertransference, and counterreactions to these patients are highlighted. Dream symbolism is also reviewed. He emphasizes the dangers of symptom relief without analytic resolution of the underlying personality disorder. …