Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within

By Hilde Bruch | Go to book overview
pregnant, at a time when she no longer expected a child. She had accepted that she would become a mother in the hope of having a child like her sister's plump and cuddly baby. Her newborn baby looked long and stringy, and the pediatrician jokingly remarked, "Put some fat on those bones." The mother took this recommendation literally and a situation developed in which she shoveled food into the infant, who would reject it; she would shovel it back, forcing the child to swallow some more. Initially it looked as if the mother was winning this contest; the little girl grew fat but then was blamed for being clumsy and ugly.This girl was unable to exercise any control over her eating; she was either monstrously fat or maintained her weight at an artificially low level. This she could accomplish only by forcing her parents never to have extra food in the home except what she needed to maintain this low weight. She reproached her parents for having created her as a monster; she now was waiting for them to change so that they could recreate her in a better image. She expressed in exaggerated degree the feeling of having no sense of ownership of her body or any effective self-awareness. She suffered from enormous self-hatred for being fat, though she could not "see" herself either as fat or as thin, and was completely unable to control her food intake or any other aspect of her life. She experienced herself as controlled from the outside, lacking initiative and autonomy, without a personality, the sad product of her parents' mistakes, "a nothing," and the despised body was, she felt, not really hers.
BIBLIOGRAPHY
1. Amis, K., One Fat Englishman, Harcourt, Brace & World, Inc., New York, 1963.
2. Bruch, H., Obesity in childhood and personality development, Amer. J. Orthopsychiat., 11:467-474, 1941.
3. Bruch, H., Food and emotional security, The Nervous Child, 3:165-173, 1944.
4. Connolly, C., The Unquiet Grave, Harper & Bros., New York, 1945.
5. Eustis, H., An American home, pp. 47-64, in The Captains and the Kings Depart, Harper & Bros., New York, 1949.
6. Fisher, S., and Cleveland, S. E., Body Image and Personality, Dover Publications, Inc., New York, 1968.
7. Glucksman, M. L., Hirsch, J., McCully, R. S., Barron, B. A., and Knittle, J. L., The response of obese patients to weight reduction, II. A quantitative evaluation of behavior, Psychosom. Med., 30:359-375, 1968.
8. Gottheil, E., Backup, C. E., and Comelison, F. S., "Denial and self-image confrontation in a case of anorexia nervosa", J. Nerv. Ment. Dis., 148:238-250, 1969.
9. Homburger (Erikson), E., "Traumatische Konfigurationen im Spiel", Imago, 23:447- 462, 1937.
10. Kolb, L. C., Disturbances of the body image, pp. 740-769, in American Handbook of Psychiatry, Vol. 1, S. Arieti, ed., Basic Books, Inc., New York, 1959.
11. Levy, D. M., "Body interest in children and hypochondriasis", Amer. J. Psychiat., 12:295-311, 1932.
12. Nathan, S., and Pisula, D., "Psychological observations of obese adolescents during starvation treatment", J. Amer. Acad. Child Psychiat., 9:722-740, 1970.

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Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within
Table of contents

Table of contents

  • Title Page iii
  • Acknowledgments vii
  • Contents ix
  • Part I - General Aspects 1
  • 1 - Orientation and Point of View 8
  • 2 - Historical and Sociocultural Perspectives 23
  • 3 - Biological Basis of Eating Disorders 42
  • 4 - Hunger Awareness and Individuation 64
  • 5 - Family Frame and Transactions 86
  • 6 - Body Image and Self-Awareness 104
  • Part II - Obesity 107
  • 7 - Diversity of Clinical Pictures 132
  • 8 - Obesity in Childhood 150
  • 9 - Obesity in Adolescence 174
  • 10 - Obesity and Schizophrenia 193
  • 11 - Thin Fat People 208
  • Part III - Anorexia Nervosa 209
  • 12 227
  • 13 250
  • 14 - Primary Anorexia Nervosa 284
  • 15 - Anorexia Nervosa in the Male 304
  • Part IV - Treatment 307
  • 16 - The Practical and Psychological Aspects of Weight Change 333
  • 18 - Outcome and Outlook 387
  • Index 389
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