Bring Me Your Hungers: Omnipotence, Mourning, and the Inexorable Limits of Time and Self in the Psychodynamic Treatment of Eating Disorders

• Published in: The Psychoanalytic review (1963) Vol. 105; no. 4; p. 363
• Main Authors: Zerbe, Kathryn J, Bradley, Kathryn M
• Format: Journal Article
• Language: English
• Published: United States 01-08-2018
• Subjects: Adult; Countertransference (Psychology); Craving; Defense Mechanisms; Feeding and Eating Disorders - therapy; Female; Grief; Humans; Hunger; Narcissism; Psychoanalytic Therapy; Time Factors; Young Adult
• ISSN: 1943-3301
• DOI: 10.1521/PREV.2018.105.4.363

Drawing upon the classic use of physical hunger as both a concrete sign of and metaphor for deep emotional needs, this article elaborates upon the many layers of hunger the eating disorder patient experiences and narcissistic defenses commonly employed to deny them. The authors use two extended case examples that illustrate the arduous but worthwhile task of welcoming patients to "bring their hungers"-an invitation that calls clinicians to make contact with the patient's human desires, to repeatedly chip away at the omnipotence used to mask such cravings, and to provide a space for working through the inexorable limitations imposed by time and mortality. A third example of a clinician who struggled with embodied countertransference reactions further elucidates different manifestations of these defenses. This paper highlights the unique value that psychodynamic clinical work offers patients in tolerating their healthy physical and emotional appetites to ultimately facilitate a more satisfying life.