THE ANOREXIC MIND Tavistock Clinic Series Margot Waddell (Series Editor) Published by Karnac Books Other titles in the Tavistock Clinic Series Acquainted with the Night: Psychoanalysis and the Poetic Imagination, edited by Hamish Canham & Carole Satyamurti Assessment in Child Psychotherapy, edited by Margaret Rustin & Emanuela Quagliata Borderline Welfare: Feeling and Fear of Feeling in Modern Welfare, by Andrew Cooper & Julian Lousada Creating New Families: Therapeutic Approaches to Fostering, Adoption, and Kinship Care, edited by Jenny Kenrick, Caroline Lindsey, & Lorraine Tollemache Facing It Out: Clinical Perspectives on Adolescent Disturbance, edited by Robin Anderson & Anna Dartington Inside Lives: Psychoanalysis and the Growth of the Personality, by Margot Waddell Internal Landscapes and Foreign Bodies: Eating Disorders and Other Pathologies, by Gianna Williams Looking into Later Life: A Psychoanalytic Approach to Depression and Dementia in Old Age, edited by Rachael Davenhill Mirror to Nature: Drama, Psychoanalysis, and Society, by Margaret Rustin & Michael Rustin Multiple Voices: Narrative in Systemic Family Psychotherapy, edited by Renos K. Papadopoulos & John Byng-Hall Oedipus and the Couple, edited by Francis Grier Organization in the Mind: Psychoanalysis, Group Relations, and Organizational Consultancy, by David Armstrong, edited by Robert French Psychoanalysis and Culture: A Kleinian Perspective, edited by David Bell Psychotic States in Children, edited by Margaret Rustin, Maria Rhode, Alex Dubinsky, & Hélène Dubinsky Reason and Passion: A Celebration of the Work of Hanna Segal, edited by David Bell Reflecting on Reality: Psychotherapists at Work in Primary Care, edited by John Launer, Sue Blake, & Dilys Daws Sent Before My Time: A Child Psychotherapist’s View of Life on a Neonatal Intensive Care Unit, by Margaret Cohen Surviving Space: Papers on Infant Observation, edited by Andrew Briggs The Learning Relationship: Psychoanalytic Thinking in Education, edited by Biddy Youell The Many Faces of Asperger’s Syndrome, edited by Maria Rhode & Trudy Klauber Therapeutic Care for Refugees: No Place Like Home, edited by Renos K. Papadopoulos Understanding Trauma: A Psychoanalytic Approach, edited by Caroline Garland Unexpected Gains: Psychotherapy with People with Learning Disabilities, edited by David Simpson & Lynda Miller Working Below the Surface: The Emotional Life of Contemporary Organizations, edited by Clare Huffington, David Armstrong, William Halton, Linda Hoyle, & Jane Pooley Orders Tel: +44 (0)20 7431 1075; Fax: +44 (0)20 7435 9076 Email: [email protected] www.karnacbooks.com THE ANOREXIC MIND Marilyn Lawrence KARNAC First published in 2008 by Karnac Books 118 Finchley Road London NW3 5HT Copyright © 2008 by Marilyn Lawrence The rights of Marilyn Lawrence to be identified as the author 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: 978–1–85575–383-9 Edited, designed, and produced by Communication Crafts Printed in Great Britain www.karnacbooks.com For Halo CONTENTS SERIES EDITOR’S PREFACE ix ACKNOWLEDGEMENTS xi ABOUT THE AUTHOR xiii 1 Introduction 1 2 Historical perspectives and contemporary debates 7 3 Psychotherapy 25 4 Eating disorders and object relations 41 5 The sexual and emotional development of girls 61 6 Anorexia and femininity 75 vii viii CONTENTS 7 Life and death 97 8 Assessment 115 9 Concluding thoughts and future speculations 131 REFERENCES 133 INDEX 137 SERIES EDITOR’S PREFACE Margot Waddell Since it was founded in 1920, the Tavistock Clinic has devel- oped a wide range of developmental approaches to mental health which have been strongly influenced by the ideas of psychoanalysis. It has also adopted systemic family therapy as a theoretical model and a clinical approach to family problems. The Clinic is now the largest training institution in Britain for mental health, providing postgraduate and qualifying courses in social work, psychology, psychiatry, and child, adolescent, and adult psychotherapy, as well as in nursing and primary care. It trains about 1,700 students each year in over sixty courses. The Clinic’s philosophy aims at promoting therapeutic meth- ods in mental health. Its work is based on the clinical expertise that is also the basis of its consultancy and research activities. The aim of this Series is to make available to the reading public the clinical, theoretical, and research work that is most influential at the Tavistock Clinic. The Series sets out new approaches in the understanding and treatment of psychological disturbances in children, adolescents, and adults, both as individuals and in families. ix