Kyryliuk Inna Mykolaivna (Kyiv, Ukraine), PhD in psychology, Jungian analyst and supervisor of the International Association of Analytical Psychology, member of the Eastern and Central European Community of Jungian Analysts (ECECJA), child and adolescence analytical psychologist, sandplay therapist; Vice-president of Ukrainian Jungian Association (UJA), the teacher in educational programs and original author’s seminars in analytical psychology and Jungian psychotherapy.

Nervous anorexia is a frightening request in practice for any thinking analyst working with children and adolescents. In my opinion it is connected with several reasons.

Anorexia is a deadly disease. There are the largest numbers of fatal outcome not only among eating disorders but among all psychic disorders. Among the people ill with anorexia fatal outcome is even more frequent than among those suffering with depression and schizophrenia; that is why it has been given increased attention for years. The situation becomes particularly acute because anorexia often starts in adolescence and teenage girls become a risk group for this disease.

Anorexia as a disease poses important questions about the nature of self-destruction: «Why am I doing what is destroying me? Who rules the part of me that is harming me?» And the most difficult thing in understanding the patients is that while we are talking about food, the key issue is far from it.

The second difficulty in treatment generally described is different aims of the patient and the therapist. Treatment should be voluntary. If we come to the maternity hospital, we want the birth to occur safely, and we want a baby: the doctor and the patient are aimed towards the same goal. In case of anorexia it is different.

The main symptom of anorexia nervosa is written is the hospital chart as follows: «The fear of the slightest weight gain; the patient undertakes anything to avoid the weight gain». The second symptom is «the low body weight index, lack of weight». Considering the high risks of a fatal outcome caused by the complications connected with the lack of weight, the initial goal of therapy would be the weight gain, and that is the largest fear of the patient. So, the aims of the doctor and the patient absolutely do not match (Lapina, 2018, p. 102).

In we imagine what is the biggest fear of any human being, we could answer in a single word: «to lose». To lose a child, a family, a loved one, a job, and finally a life. In her book «Body, food, sex and anxiety» Julia Lapina writes about it: «And now imagine that you have to come to a specialist in order for the largest terror of your life to come true: «Good afternoon, I am really afraid to have cancer and to become blind, could you please help this happen». Gaining even a 100 grams of weight is the biggest terror for a person suffering from anorexia. Even if they agree for therapy, part of their minds still hopes to remain thin. And ideally – to even lose a little bit more weight, be it counter common sense, against one’s interests, health and the laws of biology» (ibid.).

This paradox, figuratively speaking, knocks you down at once; my colleague told me that his patient would repeat like a mantra for a long time: «We are going to cope, we are going to cope with it, and there is hope that together we are going to cope with it». The therapist was thinking that she wanted to cope with her fear of food and gaining weight, but all that time the patient was repeating, as if it was a spell, that she wanted to cope and lose more weight, cope and stop feeling hungry. My young patient I am going to write further about would say: «I want you to help me, but I don’t want a single extra gram on me. I couldn’t take it. I am perfect now; I have always wanted to look like this. I am beautiful».

When I looked at the sick thinness of this girl, I saw a ghost; she resembled a skeleton, her collarbones too sharp, protruding, were covered with skin too white and too transparent. There is a huge difference between what we see and what they feel. With every new gram they feel fat and experience an unbearable feeling of disgust, hatred, and rage towards their own bodies. The body becomes the transference object for the pain of the soul, and the rage is poured upon it. That is why anorexia is frequently accompanied with body damage (cutting, burning, piercing skin) and other forms of self-destructive behaviour.

Contemporary psychiatry looks at the reasons of anorexia nervosa as a sort of mixture of genetics, environment and personal history. Let’s start with genetics: there exists neither the schizophrenia gene, nor the gene of anorexia. There are interesting pieces of research of this topic, for example: «According to the evolutionary theory of anorexia, during the times of primitive communal system when the tribe was lacking food most of the people got weak, they could only lie down and be ill. But there were some who experienced the boost of energy due to hunger which was sufficient for a loot roll which would feed the whole tribe. So there are people who spend the remnants of energy slowly and quietly which is subjectively experienced as weakness, and there are other people who spend it in one euphoric throw. Why is it so important for us to know it? Because people suffering with anorexia do not possess any extraordinary willpower, they have a genetic predisposition to tolerate hunger easily. It is not their merit, they have just pulled out the DNA lottery ticket of this kind. According to what anorexic patients say, they feel «wonderful lightness and cleanness, all sounds and smells are sharp and even water has taste – there is not a single bit of desire to spoil this bliss with some food» (ibid, p. 104).

VIGNIETTE

I would like to share my experience of working with anorexia as an analyst and supervisor. I have been working with teenagers quite a lot for more than 20 years, but only recently I have encountered someone with the diagnosis of «anorexia», and it influenced me quite a lot. This report is an attempt to deepen my understanding and find the meaning points of this disorder.

A mother of a teenage girl referred to me asking to help her understand where to go and who to see for help with anorexia. I knew this family quite well as I had worked with the child 10 years before. At that time the psychotherapy had lasted 3 years and it gave good results. My client refused to talk to people in her childhood, particularly the unfamiliar people, she was a very reserved, unadapted child, she lived in her childhood world where she loved animals, especially frogs and bugs, and she played with them, which frightened the people around. At that time I was observing pronounced defences of autistic spectrum and the fear of going out of the family system. Gradually, playing at the world of frogs, she identified with them and learned to speak, then to greet and to play mutual games with the other frogs, and then to go to school.

During these 10 years mother has contacted me from time to time with questions, and I knew that my client had difficulties in communicating with her peers and an aggressive attack at her growing body. She experienced her rounding parts painfully and wanted to cut everything off or «choke them». But the information that she weighed 45 kilos at the height of 176 cm sounded frighteningly. Then the traumatic funnel spun around searching urgent help: psychiatrists, clinics, information about the disease. The time was not enough for both understanding the situation and making the decision. Parents were desperate. The weight was falling dramatically, and Juliana was happy about her victories over fat. Juliana wrote in her diary:

«I have chosen a diet: cottage cheese, apples and oatmeal. I want to lose weight. I have found a cool girl on Instagram. I will strive for anorexia.
Throwing out lunches in November and December.
Creating a new account where I am going to post my food.
Cold and weakness.
I cheat parents that I have eaten.
Weight 49 kilos. I have achieved anorexia. Hooray!»

I saw her before she was hospitalized. She was afraid of the clinic and asked me to help her cope with the fear. I was strongly impressed by what I saw. She was totally different, almost transparent, walking slowly and smoothly, with large eyes on a very thin face. It resembled ghosts from movies. From a girl with a very alive and strong body she turned into a transparent fairy. But the dissonance between what I saw and felt in the contact with my client and what she was saying was dramatic. She spoke about the full happiness of the moment, about the freedom from food and from the body. About her heavenly beauty. She tried to convince me that she was eating and that she would have no problem gaining weight. I felt two strong emotions fighting inside me: the fear of death which I sensed even physically, and the enchantment with death when you cannot turn your eyes away. I could not break through the system of her illusions; the false system of self-care had a strong grip on her mind. She demanded proofs that she was beautiful from the people around!

It was hard to get through to the reality. My supervisor told me that my message to her should be truth: «I love your soul, but your body is terrible. You are making it ugly».

He told me about his real conversation with an old soldier who had gone through Vietnam and whose body covered in rumens and scars bore the memory of the war. The old soldier told him how to kill death: «When the other soldier was directing his gun towards me, I saw death in his eyes that I had to kill. The same as he saw death in my eyes instead of me. I was killing death that I saw in his eyes». For me it is an archetypal story.

I have briefly described my experience and now gradually with the help of theoretical ideas I will be moving towards the understanding of this and the other encounters.

Trauma is the defining component in the understanding of the aetiology of anorexia. Being ready to bear the suffering of hunger and the level of pain the people with anorexia put themselves through can definitely be connected with the presence of a concealed trauma. A large amount of research has been collected about the connection of eating disorders with sexual abuse in childhood. The group of researchers have described 158 patients with food disorders, and 30% of them had a negative sexual experience before the age of 16 (Oppenheimer, R., 1985). In scientific circles this correlation was called «the missing link» in the aetiology of food disorders. Other researchers come to a conclusion that most of the people suffering from anorexia don’t have a sexual trauma in anamnesis.

R. Oppenheimer connects these data with the following observation: teenagers with anorexia remind those who have gone through sexual abuse in their behaviour in two aspects: «fear of intrusion» and defences of the «entry forbidden» type (ibid.).

In the aetiology of the disease the anorexic patients have become the objects of intrusion, either/both psychic or/and physical. This formed the intruding object in their psyche which can base on the story of a real of fantasized intrusion.

This should be given separate attention. The term «entry forbidden» was used for the first time by Janna Williams while she described countertransference feelings at work with anorexia (Williams, 1997). The first thing we encounter working with such patients is the «fear of intrusion» in front of the object. The intention to «enter» as setting the emotional contact, seeing the inner world of a person will encounter a strong defence reaction «entry forbidden», which reflects the inner situation of the patient. Help is experienced as intrusion! The analyst is invited at once into the situation already present in the patient’s psyche. The psychotherapist encounters the inner world of the patient which is being acted out outside, he or she has to play the role of the inner object from the past intending to intrude into the patient’s world at once.

«It is the quality of human psyche to project «the inner unseen» to the visible and tangible – the food, the body and the other people – by the movie projector principle: we see the result only when the beams it is sending fall upon the white cloth. Without the screen nothing is seen» (Lapina, 2018, p. 87).

The therapist becomes the screen upon which inner tragedies are frequently acted out.

In practice we shall often encounter bright reactions: open hostility and the projection of intrusiveness, along with the refusal to talk and to become aware of the problem of critical weight.

My young client at the session before the hospitalization was enthusiastically excited and told me that she didn’t see any weight problems and that these were just silly worries of her parents. She had simply been fond of the «right calories», the weight was gone and it was not hard to recover it. She understood the emotions of her relatives, but they were exaggerated. She had been silly, but she was going to put things right quickly. And generally, she was fine. Because she had finally become what she had long been dreaming of, and she couldn’t have even imagined that she could look like that. She had finally become beautiful with her white hair and blue eyes, thin arms and legs, she was like a model from real catwalks, there are very few of such girls, no, there are none around her and everybody is admiring her. She is extremely rare. She is beautiful! She can breathe in the spring air and miss school at last! To my insistent suggestion that there was too little strength for life in her body, and it was not easy to redeem it without help, she made me understand that the support of her family and her own desire was sufficient.

She was telling me poetically and very distinctly at the same time that «the entry was forbidden», I was not allowed to understand her and see her, but at the same time her body was literally making me see something terrible. In her words she was saying that there was nothing special, «everything was beautiful», but her body was catching the eye witnessing that she was lethally ill. She «forbade» intruding into her narcissistic world cut-off from everyone, where she was imagining how she didn’t need food, care and people.

I had no history of starving or lengthy diets, and, accordingly, abrupt weight loss, so I could not empathically tune into the body experience of my young patient. And this induced me to search for the description of emotional experience and body transformations during starving.

Minnesota «hunger» experiment of 1944 conducted by Doctor Ansell Kiss, gives the following description:
«Already in the 16th weak the physical changes have become visible with the naked eye: the facial features have become thinner, the cheekbones protrude, the atrophied facial muscles make the face deprived of any expression, and the face is apathetic – «the hunger mask». The collarbones stick out like blades, wide shoulders shrink, ribs protrude, and shoulder blades stick out like wings, the spine turns into a line made of nods. The knees hang down, and the legs remind of sticks. The fat tissue of buttocks disappears, and the skin begins to slack in folds. The subjects of the experiment were now taking pillows with them everywhere if they were expected to sit down, as sitting caused discomfort. Doctor Kiss discovered that the average heartbeat among the young men had dropped abruptly: before the starving it was 55 beats a minute, and after – only 35. The body was turning to the «energy saving mode» due to the lack of calories. The frequency of defecation made once a week, the blood volume decreased by 10%, the size of the heart had also decreased. Despite all physiological change, the experiment subjects didn’t consider themselves to be to thin. It had started to seem to them that it was the other experiment participants that were fat, and they were normal. Similar thoughts are characteristic of those suffering from anorexia» (Wikipedia).

My client had also been on a «hungry diet» for already six months, and this description helped me feel and understand deeper the level of changes going on in her body and psyche. She couldn’t talk about her condition at that moment and I was searching for the «entry», relying upon my own active imagination.

Another reaction is a pronounced hostility, there are no chances to conduct a dialogue about food and weight. There follows an immediate attack «my body is my business».

What is the psychological nature of this tough defence?

The psychoanalytical theory explains that the «entry forbidden» type of defence forms as a response to the massive parental projections. These projections are perceived in the inner space as hostile foreign bodies. Freud wrote in the «Research of Hysteria» in 1895: «We must suggest… – that the psychic trauma – or to be more exact the memory of the trauma – works as a foreign body that after a long time since its introduction has to be regarded as an agent still at work (Breuer, Freud, 1895, p. 68).

Wilfred Bion speaks about the absent object hypothesis which is perceived as «the present pursuer». It is the gaping void where there is no contact with the object, where the attachment has not been formed, and it can be experienced by the psyche as «the inner pursuer» (Bion, 1962). In Jungian understanding it is when the early mechanism of integration / disintegration after Fordham was disrupted, and as follows the archetypal potential has not been made human in the living contact with the mother, and the negative pole of the archetype comes to action as the evil spirit.

Henry Rosenfeld goes even further and says that projective processes already exist when the foetus is still in the mother’s womb. He speaks about hidden processes that get into the baby in some mysterious way. .. It continues after the birth and doesn’t allow the baby to shape a normal Relationship with the mother: «Children of this type experience phobias about their mother since their birth. They are terrified that any moment they might have to defend themselves from something very frightening being pushed into them. They have to block mother’s influence, it can be seen after the birth of the child, but sometimes it begins immediately after delivery and brings to heavy disorders of feeding and to the tendency of turning away from the contact with mother» (Rosenfeld, 1965, p. 276).

There is a very deep article by Jean Magagnia where she uses the observation of infants method to the «quiet babies» and describes five types of psychic states accompanying eating disorders when children completely refuse to eat and talk, but in this article I couldn’t touch upon this deep interconnection (Magagnia, 2018).

A mother who is not coping with her own psychic states will return projections to the baby. Janna Williams (Williams, 1997) describes it as a «protruding container»: the one that is pouring projections into the baby instead of taking them back from him / her.

According to the containing theory of W. Bion the major function of a mother is accepting and modifying the baby’s projections. Sometimes she is not coping and then the baby introjects one’s own anxieties in an unprocessed manner. In the worst case mother can project her own worries upon the baby.

These theories give an explanation to the inner «unnamed terror» which lives in the inner space of such clients. An attempt to perform the external control over the body gives temporary relief and the protection from pain and fear inside. The refusal from food is regarded as an attempt to protect oneself from taking in unbearable feelings of the parent (mother) and the destructive projections which are experienced as a foreign body that intrudes and destroys. Bion shows a distinct analogy between psychic processes and the intake of food.

In my work I relied upon the analysis of a client case of food disorders which David Rosenfeld had described in detail in his book «The Soul, the Mind and the Psychoanalyst». I would like to give several examples of the transference interpretation from his book:

«I interpreted this story about vomiting in the mornings and at nights as a transference reaction when she vomits me out, plucking out the human or getting rid from the interpretation. As the reader might notice, I am trying to strictly stick to the analysis of psychoanalytical transference – eating, taking in or vomiting out the psychoanalyst or interpretations.

I interpreted it as her having «many kilograms of madness» in her head and her preferring to see them in her body as kilograms of weight (Rosenfeld, 2015, p.69).

FEMININITY AND FEMININE NATURE

M. Lawrence writes about another very important in my opinion reason of anorexia: it lies in femininity itself, biological and psychological peculiarities of belonging to feminine gender (Lawrence, 2000).

Distinct figures show it: the ratio of women to men with anorexia is ten to one. Lawrence introduces the hypothesis that some sides of femininity become the catalyst of anxieties about the intruding object. Sexual development of a girl is physiologically directed towards accepting, the desire to fill the inner world with good objects. And this tendency bears specific anxieties. While the boy is afraid to be deprived of something precious, the girl is afraid that something is going to get inside her and wound her. Here the main anxiety of a woman is based: a fear of intrusion, penetration, the damage of an inner part of a sex organ because of something dangerous getting inside it (Lawrence, 2000).

And here mother plays a huge role.

If mother becomes an unobtrusive but safe container for the daughter’s anxieties, then her fears of intrusion and damage will diminish. In case of anorexic patients the mother’s anxieties are placed into the daughter herself, or the mother lacks the containing ability to process the anxieties of her daughter.

Genetic timer fails: the body of a girl becomes feminine, but the psyche does not change, and thus it is unable to accept the changes happening to the body. She is frightened by the signs of femininity – the hips, the belly, any roundings speaking about her not being a child anymore. The relentlessness of changes happening to the body plunges her into panic, they are disgusting to her. She feels that she is a girl locked into a body of аn «auntie», and hunger doesn’t seem to be too high a price for breaking out of this cage.

Exactly this happened to my young client, when the maturation had frightened her very much, and she started to have ritual fantasies – to cut off extra flesh, to dry it. I wasn’t working with her in that period that is why I can only suggest that at this «threshold age» her psyche was looking for her own «transition ritual». In primitive rituals cutting off always symbolizes a farewell to the old period on the one hand and the new birth on the other. I am not able to give a deeper description of a family situation of this girl, but I liked the description of a ritual and the role of parents in it.

Anthropologist Arnold Van Gennep writes: «Every new step of a child also moves the parents a step ahead towards the end of life. In connection with it I have found it very interesting that a step towards growing up is supposed to take place only at the ritualized agreement of the parents to it. For example, among the Masai in Kenya a boy or a girl can be subjected to circumcision only after his or her father goes through a ritual of «stepping over the fencing», which expresses his accepting a new status of an «old man» who since that moment will be called «father of… (name of a child)»» (Van Gennep 1999).

This ancient ritual shows psychological readiness for a new stage and for new identity which is sustained stage by stage by generations. At our time the fear of the old age, and thus of growing up, leaves parents «behind the fencing» and it is two times more difficult for their children to step over their own «inner fencing» and accept the growing up.

«Food is the very first metaphor of love, the very first relationship which a newly born human being is building. The child cuddling to the chest gets the food, the warmth, protection and love all at once. That is why eating disorders always make us look at other relationships in the life of the person – with the partner, with friends, with children, with parents, but the main thing – with oneself. Putting it very roughly one may say: the root of eating disorders lies in the disorders of a relationship with oneself, in the impossibility to love and accept oneself. For many of us food becomes the psychotherapist, the comforter, the universal solution to problems. Food becomes both punishment and salvation. Gradually the food the same as drugs or alcolol takes over the control over the human behaviour and subjects their existance to itself.

In order to overcome this problem there is no need of violence or the eternal control over oneself: one only has to learn to trust oneself» (Lapina, 2018, p. 86).

Physically, the girls suffering with anorexia are caught into a fantasy of pre-oedipal relationship of merger with the mother and experience a strong uncontained anxiety about their sexuality and feminine body, and the mind is completely occupied with the figure which is trying to intrude and cause damage. They cannot translate their feelings and thoughts into the symbolic level; they cannot think about it, they have no words to describe something. Concrete thinking and difficulties with symbolization are expressed in the facts that some aspects of maternal function are equalled to food and then rejected.

RITUALS

Food, just like sex, has been connected with various rules and taboos throughout human history. Since ancient times food has been used in religious rituals and gave living energy to people. «Food gets into the body and changes it. In fairytales and legends food could kill and resurrect or cause bodily metamorphoses. Food is bestowed with a huge amount of senses and with almost magic powers when it is considered to help take control over various aspects of life» (ibid.).

Initiation rituals have existed from time immemorial in order for the human beings to transform their bodies in order to acquire identity: who they are, a man or a woman, a warrior or a shaman, and to which group they belong. These rituals are also called transition rituals from one life stage to the other.

Anthropologist Arnold Van Gennep has described the three-stage running of a ritual: the separation of an old identity, the transition, and finally – joining the group. Every step is connected with certain actions over the body (Van Gennep, 1999).

The deep task of a ritual is to help a human being to master their belonging to the society. The ritual helps transform individual fears and ambivalence into traditional ritualized actions, into collective involvement. An unshakable and durable connection created by the collective rituals provides people with the identity and the assurance about group belonging.

Primitive people with their body practices passed down from generation to generation, however cruel they might seem to us, express the ambivalence towards growing up. The process of separation is expressed through the body, together with the process of change and a new acceptance, as the result achieving the respectful treatment of and the acceptance of the new society members together with strengthening their self-awareness.

Transition rituals help to symbolize the child’s ambivalence during growing up. The rebelling adolescence is looking for one’s own rituals which will help their self-awareness grow, which could help them be accepted by their peer group. It is the contemporary approach, which is based upon the «identification against» which helps fight against dependence because the teenager defines oneself contrary to the norm. Peter Bloss calls the age of adolescence the second individuation, when the teenager does not use the Ego knowledge of their parents, but creates an individual Ego-structure (Bloss, 2010). It becomes a thin place in the psychological world of a teenager where there is still no structure of one’s own, but the Ego knowledge of the parents is already not used, and then the criticizing archaic Super-Ego may break through with its predominant ideas. The idea of losing weight may as a predominant idea completely overwhelm the psyche of a child.

In psychotherapeutic practice we encounter bodily enactments of various kinds, and anorexia is one of the heaviest pathological enactments.

During anorexia we encounter the pathological bodily enactment which has no development of identity. One can observe a false attempt of creating a transition ritual through diets and the idea of losing weight. A girl suffering with anorexia rebels openly and triumphantly against the demand of accepting feminine identity, but finds nothing for herself and remains in the state of resistance against the identification with the growing feminine body. By rejecting food they find a way of stopping the physical development of the body, it gives them a temporary decrease of anxiety against the fear of growing up. Anorexic girls achieve the power over their bodies and it seems to them that they have acquired control over their lives.

M. Hirsh writes: «This way pathological bodily enactment does not provide any development, it fixes the continuous repetition because the ambivalence and the dependence are not overcome and the identity development stops. The pain connected with the bodily enactment symbolizes not the pain of separation (like in the primitive peoples’ rituals) but the unsolvable tension between striving autonomy and the desire to depend. Here mutilating oneself is not the separation but a desperate attempt to define oneself» (Hirsh, 2014).

To continue with the described ideas about the pathological bodily enactment in adolescence which is in itself a failed attempt to create a transition ritual in order to master a new identity of an adult, I would like to give several examples of ritual behaviour which is necessarily present in the clinical picture of the anorexic patients.

My young client could only eat the food she had cooked herself. The cooking had to take place in loneliness and according to a definite scheme with weighing everything on the scales to grams, a definite temperature of freezing the products, water warmed up to a certain temperature, a succession of combining products, and if a failure occurred in this «alchemical» process she started the cooking process all over again from the very start. Cooking always became an exhausting and nervous procedure. She could only eat in loneliness, nobody was supposed to see her eating. Calories were calculated strictly.

A young man suffering from anorexia in combination with bulimia fits conducted the following ritual before going out of home: he devoured an extraordinary amount of food (a kilo of rice with a pack of ketchup and mayonnaise, different preserves, etc.) after which he caused a gag reflex, emptied his stomach, took a long shower, shaved all hair off his body (facial hair, armpits, chest hair, groin, legs), used lotion, abundant perfume, put on a fresh white shirt and ironed pants.. and only then he could step behind the threshold of home. This exhausting ritual took up to three hours, – this much time he needed to cope with the terrifying anxiety.

And the last very frequent ritual is buying food. Here is one of the descriptions you can find at the open anonymous forums:

«My disease is progressing. I am at work and I understand… that I want to eat. Not just want to eat, I AM TERRIBLY HUNGRY. I WILL EAT UP ALL OF YOU. I stroll to the next shop, and then, the funniest part begins. I take a basket and I choose what I am allowed to eat, I calculate calories and stuff like that. I take neither fruit nor veggies as I don’t want any volume inside my tummy in the middle of the day. Meat-sausage-cheese – no way, ‘cose there are preservants in, I don’t know what they consist of, calories, fat. Sweets – a definite no, it’s just clear. Luckily I am not a sweet-tooth, but just for the sake of experiment I walk by the shelves, what if something would «excite» me. No… Preserved tins – the same as sausages. Bread means volume and calories, I don’t want them. Milk and baby food remain, I take what passes the «face control», I approach the cash desk and … I realize that I don’t want anything. I go back to put the food on the shelves. And it has lasted for one and a half weeks! I sort of want to eat, but as soon as I imagine that all of it is inside me… As a result I take a diet cola, mineral water and a bit of alcohol, if I want to – the liquid will create volume, but after an hour it will all wash into the white friend… Have I gone crazy? I want something nourishing but without calories and without the fear of gaining weight, so that it wouldn’t create volume, and so that it would be pleasant for taste… I walk among the products and I think I DON’T WANT IT!» (Lapina, 2018, p. 98).

My therapeutic practice shows that young people are searching, figuratively speaking, for «archetypal paths» in the transitional periods of their lives. In ancient times the initiation rituals always helped to go through and integrate strong emotions and feelings including pain. Pain is an important meaningful part of the rituals. It plays a separate role during all initiations: pulling out teeth, circumcision, tattooing – they are all very painful. With the help of all these various rites birth is symbolized. At the same time in all similar cases separation pain is present; this way psychic pain is turned into physical pain. To some extent damaging one’s body can be understood as an attempt at «getting to know oneself». The diffuse condition of the soul remains «seen» as the bodily pain, it gives the sense of control and it becomes easier to communicate with fear.

In the three described examples we can see that the psyche remembers the ancient heritage and is trying to create one’s own transition ritual, to embody the psychic pain in order to see the suffering soul. But there is a big difference between the ancient ritual and contemporary false enactment rituals, and it is about the role of the adult and the society. In ancient rituals the whole society was participating and helping, seeing the young souls through the necessary trial. Today the rituals themselves have been lost and the role of the adults and the society is diffuse, inconsequent.

The pathological bodily enactment in our culture represents a lonely attempt to achieve a sort of pseudo-identity in a state threatening disorientation, and thus threatening the psychotic decomposition, particularly in youth. Here we can recall certain hairstyles, tattoos, and piercings – all this provides a sort of transitional identity for the young people. If the borders of the «I» remain under the threat of decomposition, then setting artificial boundaries of the somatic «I» becomes a method of finally stabilizing oneself.

Losing a lot of weight is a replacement war lead with the weight; the real front and the danger for the young people lies in the task of organizing their individual lives separately from their parents, full of independent responsibility.

BIBLIOGRAPHY:

Bloss P. Psychoanalysis of Adolescence / Блос П. Психоанализ подросткового возраста. – М.: Институт Общегуманитарных Исследований, 2010.

Lapina J. Body, food, sex and anxiety / Лапина Ю. Тело, еда, секс и тревога: Что беспокоит современную женщину. Исследования клинического психолога/ Юлия Лапина – М.: Альпина нон-фикшн, 2018.

Magagnia J. Quiet children. Communication without words with the children who insistently avoid life / Маганья Дж. Притихшие дети. Общение без слов с детьми, упорно отстраняющимися от жизни/ Джин Маганья: – М.: 2018.

Rosenfeld D. The Soul, the Mind and the Psychoanalyst: creating a psychoanalytical setting with the patients with psychotic personality aspects / Розенфельд Д. Душа, разум, и психоаналитик: создание психоаналитического сеттинга с пациентами с психотическими аспектами личности. – Харьков, Планета-Принт,2015.

Bion W.R. Learning from Experience. London: Heinemann, 1962.

Van Gennep A. Übergangsriten. Campus, Frankfurt a. M., 1999.

Oppenheimer, R., Howells, K., Palmer, R., &Chaloner, D. Adverse sexual experience in childhood and clinical eating disorders: a preliminary description. J.Psychiat. Research, 1985. N 19

Rosenfeld H. On the psychopathology of narcissism: a clinical approach. London: Hogarth Press, 1965.

Williams G. Internal Landscapes and Foreign Bodies:Eating Disorders and other Pathologies.–Karnac Books, 1997.

Internet sources:
Lawrence M. Body, Mother, Psyche / Лоуренс М. (2000) Тело, мать, психика. Анорексия, женственность и вторгающийся объект http://Freedocs.xyz

Hirsh M. Enactment on the body level – body functions in the society and in psychotherapy / Хирш М. Отыгрывание на телесном уровне – функции тела в обществе и психотерапи// Журнал практической психологии и психоанализа. 2014, №2. http://Psyjournal.ru