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.
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