Paper Session C

2. Bulimia as Metaphor:
Restoration of the Dying Self

Self Psychology Page | 21th Conference Program

Outline

This paper charts in vivid detail the extreme technical difficulties encountered in conducting self-psychologically informed analytic work with individuals trapped within the metaphor of a dying self. Many patients with severe eating disorders can be understood as suffering from profound self pathology, rendering them unable to receive and retain nourishment from self-selfobject experience. Extensive clinical material from the treatment of a severe case of bulimia is provided to illustrate the technical problems encountered in work with such patients, as well as to demonstrate creative and novel technical innovations. It is proposed that the analyst facilitate the creation of a play space with regressed and fragmented patients in order to initiate the beginning of authentic mutuality. With individuals trapped within the metaphor of a starving, dying self, it is often necessary for the analyst to take the initiative in opening a play space via spontaneous, yet disciplined, enactment. Such enactment can function as a new metaphor of vital, intersubjective connection. An enhanced capacity for nourishing self-selfobject experience can then be evoked in the patient in response to the playful aliveness engendered by the analytic setting.

James E. Gorney, Ph.D.
9322 Millstone Lane
Knoxville, TN 37922

Self Psychology Page | 21th Conference Program