Presenter: |
Jane R. Lewis, CSW |
Chair: |
Brenda C. Solomon, MD |
Discussant: |
Susan Sands, PhD |
Self Psychology Page | 20th Conference Program
This paper will focus on the therapeutic task in the treatment of eating disorders, of fostering a shift from outer to inner life. Analytic process from the nine year treatment of a young woman with bulimia will be used to illustrate and contrast the point in treatment when this shift begins to occur, with the initial session where pervasive externalization manifests as an all-encompassing inner blindness and requires the need to compensate by developing a different orientation. The Horneyan concept of externalized living will be explored to understand the psychological consequences of this outer directedness which makes it necessary to experience inner conflict in and through the body and one’s relationship to food. Process will also illustrate the use of the analytic relationship to reduce the patient’s need for externalized living. Reference will be made to H. Kohut and D. Brothers’ work to understand the necessity that the patient trust the therapist both to contain the truths about herself and to honestly and undefensively acknowledge failures in empathy and other inevitable mistakes. Process will illustrate Brothers’ "working through" phase of treatment which refers to those responses to failed tests of trustworthiness within the therapeutic relationship that reduce fears of retraumatizing betrayal and promote the maturation of self trust.