THE GENEROSITY OF ACCEPTANCE Volume II THE GENEROSITY OF ACCEPTANCE Volume II Understanding Eating Difficulties in Adolescents Edited by Gianna Williams, Paul Williams, Jane Desmarais, & Kent Ravenscroft KARNAC LONDON NEWYORK First published in 2003 by H. Karnac (Books) Ltd. 6 Pembroke Buildings, London NW10 6RE Copyright © 2003 by Gianna Williams, Paul Williams, Jane Desmarais, and Kent Ravenscroft The rights of the editors and contributors to be identified as the authors of this work have been asserted in accordance with §§ 77 and 78 of the Copyright Design and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. British Library Cataloguing in Publication Data A C.I.P. for this book is available from the British Library ISBN: 1-85575-934-9 10 9 8 7 6 5 4 3 2 1 Edited, designed, and produced by Communication Crafts Printed in Great Britain by Biddles Ltd, www.biddles.co.uk www.karnacbooks.com CONTENTS ACKNOWLEDGEMENTS vii EDITORS AND CONTRIBUTORS ix INTRODUCTION xiii CHAPTER ONE “Who’s that girl?” An anorexic girl’s search for identity and fear of contamination by the damaged (internal) parental couple Sue Brough 1 CHAPTER TWO Eating disorders in adolescence: the function of receiving Luisa Carbone Tirelli 29 CHAPTER THREE Paula’s secret: an adolescent with bulimia Kent Ravenscroft 51 v vi CONTENTS CHAPTER FOUR The uncovering of a lack of identity Roberta Mondadori 83 CHAPTER FIVE “I didn’t want to die, but I had to”: the pervasive refusal syndrome Jeanne Magagna 107 CHAPTER SIX Some reflections on the processes of projection and introjection in eating disorders Emanuela Quagliata 139 CHAPTER SEVEN An anorexic girl’s relationship to a very damaged persecutory internal object and its impact on her illness Hélène Dubinsky 175 CHAPTER EIGHT Fantasies concerning body functioning in an anorexic adolescent Diomira Petrelli 195 REFERENCES 229 ACKNOWLEDGEMENTS T he editors would like to give special thanks to Lyndsay Macdonald for her invaluable work on the two volumes, and to Holly Barton, John Shaw, and Jessica Sully for their assistance with preparing the typescripts and proofs. We would also like to mention Andrea Chandler, at the Library of the Institute of Psychoanalysis, for her cheerful assistance with last-minute references. vii EDITORS AND CONTRIBUTORS Sue Brough is a Consultant Child and Adolescent Psychotherapist em- ployed by Solihull PCT. Her interests are working with children and adolescents with eating disorders and their families, and she is presently temporarily seconded into Sure Start where she is able to observe the emerging difficulties in the infant–parent relationship which may later develop into an eating disorder. Jane Desmarais is Lecturer in English and Art History, working in the departments of English & Comparative Literature and History at Goldsmiths College, University of London. She is the author of The Beardsley Industry (Ashgate, 1998) and author and editor of other books, essays, and articles on the nineteenth century. She is currently writing A Cultural History of Decadence for Polity Press (2004), co-writing a book on cancer and psychoanalysis with Law- rence Goldie (Routledge, 2004), and has written (in the journal Soundings, 18, 2001) on anorexia and passive resistance in Hermann Melville’s 1853 tale, Bartleby. Her future projects include a book on skin, based on the work of Didier Anzieu’s Le Moi-Peau. Hélène Dubinsky is a Consultant Child and Adolescent Psycho- ix