Pamela Orosan-Weine, Ph.D., Instructor
This 10 week course will explore the development and treatment of eating disorders in adolescents and adults. We will consider various theories of etiology, including the contribution of biological, psychological, familial, developmental, and socio-cultural factors, and attempt to integrate psychodynamic, self-psychological, object relational, cognitive-behavioral and feminist thinking on the treatment of eating and body image difficulties. We will examine the importance of the initial interview, the establishment of a collaborative working relationship with the patient and the family, and the use of the therapeutic relationship to leverage the patient's often fleeting motivation for change. We will look at clinical material and the special transference and counter-transference problems that arise in the treatment of intractable, life-threatening patterns of eating.
Seminar participants are expected to attend all sessions having read the assigned materials, so that we can have an informed discussion of the articles and related issues.
9/9 1. Classic Papers on Eating Disorders
Bruch, H. (1978/2001). The Golden Cage: The enigma of Anorexia Nervosa, Harvard University Press
(First Harvard University Press paperback edition, 2001 with forward by Catherine Steiner- Adair)
-Forward, Catherine Steiner-Adair, pp. vii-xvii.
-Preface, pp. xix-xxiv.
-Chapter 1, The Hunger Disease, pp. 1-21.
-Chapter 3 The Perfect Childhood, pp.38-56.
9/16 2. Classic Papers on Eating Disorders
-Bruch H. (1978/2001). The Golden Cage (continued).
-Chapter 4 How it Starts, pp.57-71.
-Chapter 5 Anorexic Stance, 72- 90.
-Chapter 8 Changing the Mind, 121-150.
9/23 3. Conceptualizing Eating and Body Image Problems
-Boris, H.N. (1984). The Problem of Anorexia Nervosa. Int. J. Psycho-Anal., 65:315-322.
-Boris, H.N. (1984). On the Treatment of Anorexia Nervosa. Int. J. Psycho-Anal., 65:435-442.
9/30 4. A Comprehensive Understanding: Biological, Sociological and Developmental Contributions
Garner, D. (1997). Psychoeducational Principles in Treatment. In Handbook of treatment for eating disorders, 2nd edition, ed. D. Garner, & P. Garfinkel. Guilford Press, pp. 145-177.
Davis, R., Dearing, S., Faulkner, J, Jasper, K., Olmstead, M., Rice, C., & Rockert, W. (1989). The Road to Recovery: A Manual for Participants in the Psychoeducation Group for Bulimia Nervosa. In Group Psychotherapy for Eating Disorders, Edited by H. Harper,-Giuffre & K.P, Makenzie, American Psychiatric Press,1992.
-Overview of the Eating Disorders, pp, 283-292.
-The Multidetermined Nature of the Eating Disorders, pp. 293-301.
-The Regulation of Body Weight and the Consequences of Dieting, pp. 303-310.
-Developing a Healthy Relationship with Food: The Nondieting Approach, pp. 311-318.
-Effective Coping: Attitudes About Weight, Shape, and Dieting as Impediments to Recovery, pp. 319-327.
-Developing a Healthy Relationship with your Body, pp. 329-333.
-The Road to Recovery, pp. 335-338.
10/7 5. Beginning Phase of Treatment
Bruch, H. (1988). Conversations with Anorexics, Basic Books.
-Forward, by Theodore Lidz, vi,-xiv.
-Conversations Remembered, letter from a former patient and her mother, xv-xix.
-Chapter 1, The task of Psychotherapy, pp. 3-12.
-Chapter 2, Evaluation: Finding the Person in the Patient, pp.13-35.
10/14 6. Treatment: Interpersonal and Ego Psychological understandings
-Bromberg, P.M. (2001). Treating Patients with Symptoms—and Symptoms with Patience. Psychoanal. Dial., 11:891-912.
-Chessick,R.D. (1984). Clinical Notes toward the Understanding and Intensive Psychotherapy of Adult Eating Disorders. Annual Psychoanal., 12:301-322.
10/21 7. Treatment: The Place of affect tolerance in the development of disordered eating
-Krystal, H, & Raskin, H. (1994). Affect Tolerance. In The Dynamics and Treatment of Alcoholism, ed. J.Levin & R.Weiss, Jason Aronson, pp. 158-175.
-Krystal, H. (1995) Disorders of Emotional Development in Addictive Behavior. In The Psychology and Treatment of Addictive Behavior, edited by Scott Dowling, pp. 65-100
10/28 8. Treatment: Interpersonal Theories
Davis, W., (1991). Reflections on Boundaries in the Psychotherapeutic Relationship. In Psychodynamic Treatment of Anorexia Nervosa and Bulimia, ed. C. Johnson, Guilford Press, pp. 68-85.
Stern, S. (1991) Managing Opposing Currents: An Interpersonal Psychoanalytic Technique for the treatment of Eating Disorders. In Psychodynamic Treatment of Anorexia Nervosa and Bulimia, ed. C. Johnson, Guildford Press, pp. 86-105.
9. Treatment: Self Psychological contributions and Character Disorders
Sands, S. (2003). The Subjugation of the Body in Eating Disorders: A Particularly Female Solution. Psychoanalytic Psychology,20:103-116.
Johnson, C. (1991). Treatment of Eating Disordered Patients with Borderline and False- Self/Narcissistic Disorders. In Psychodynamic Treatment of Anorexia Nervosa and Bulimia, ed. C. Johnson, Guilford Press, pp. 165-193.
Wooley, S. (1991). Uses of Countertransference in the Treatment of of Eating Disorders: A Gender Perspective. In Psychodynamic Treatment of Anorexia Nervosa and Bulimia, ed. C. Johnson, Guilford Press 245-294
Symington, N. (1983). The Analysts Act of Freedom as Agent of Therapeutic Change. International Review of Psychoanalysis, 10: 283-291.
Related Psychoanalytic Writings
Ghent, E. (1990). Masochism, Submission, Surrender- Masochisim as a Perviersion of Surrender. Contemporary Psychoanalysis, 26:108-136
Akhtar, S. (1996). “Someday…” And “If only…” Fantasies: Pathological Optimism and Inordinate Nostalgia as Related Forms of Idealization. Journal of the American Psychoanalytic Association., 44: 723-753.
Novick, J. & Novick, K.K. (1991). Some comments on Masochism and the Delusion of Omnipotence from a Developmental Perspective. J. Amer. Psychoanal. Assn., 39:307-331.