Psychoanalysis and Psychotherapy

Lost for Words:
The Psychoanalysis of Anorexia and Bulimia

by

Em Farrell

Up to eighty per cent of women suffer from Sub-Clinical Eating Disorder. Twenty per cent will have anorexia or bulimia at some time in their lives. This is the first comprehensive overview of the psychoanalytic and psychodynamic literature on eating disorders Anorexics and bulimic are lost for words. Most are women. They feel they have no way to communicate effectively. They have not found the words to express and name the turmoil of their experience to themselves or others. This leaves them in a world where neither food not words can provide nourishment and sustenance. This book explores the nature of anorexia and bulimia, paying particular attention to the issues of mortality and the complexities of the mother-daughter relationship. It stresses the importance for technique of understanding the violent and agonising nature of these individuals' inner worlds. The author has worked with over 180 women with eating disorders.

The history of theories and treatments of eating disorders is thoroughly canvassed, and the book provides the most comprehensive review of the psychoanalytic literature in print. It draws, in particular, on the Kleinian tradition and the work of Winnicott.

Em Farrell is a UKCP registered psychoanalytic psychotherapist in private practice in London. She lectures and is a tutor at Regent's College School of Psychotherapy and Counselling and has been a member of the Eating Disorders Workshop at the Tavistock Clinic. She is Co-Director of the Free Associations Education Programme.

Some comments on Lost for Words

'This fine book explores in both a sophisticated and accessible way the inner experience of patients with eating disorders. The author is to be congratulated for her nuanced appreciation of the self-alienation that is so common in these patients and the challenges that this presents in the treatment setting. The book details the maturation of the psychoanalytic perspective on these conditions as well as the variety of current points of view. The author's own perspective is Kleinian, an orientation that she represents with thoughtfulness and convincing clinical immediacy.

'Em Farrell's book is a valuable addition to our evolving literature and is one that is deserving of admiration and broad readership. I recommend it highly.'

- Harvey J. Schwartz, M.D., psychoanalyst, editor of Bulimia: Psychoanalytic Treatment and Theory

'What an excellent piece of work it is... It puts forward a persuasive argument about the meaning of eating disorders and a convincing case for how such problems should be understood in the therapy... I feel I would have benefited from reading it some years ago.'

- Paul Gordon, psychotherapist, Open Door - Hornsey Young People's Consultation Service, London

'With creativity and clarity, Em Farrell has "found the words" to convey vividly some of the inherent contradictions in the emotional problems surrounding eating and not eating. This book is a "must" for those people who wish to reach a more sensitive understanding of difficulties surrounding food, body image and therapy with anorexic and bulimic people'

- Jeanne Magagna, Head of Psychotherapy Services, Great Ormond Street Hospital (eating disorders specialist).

You can order this book from Process Press