ABSTRACT
Themes of linguistic attunement and concreteness are extended to cases in which patients are focused on their skin. Problems in body narcissism are often linked to shame. The shame is linked to feelings about the entire body or its parts or to the way parents or lovers look. There are countertransference challenges when abject body parts or processes are brought into the treatment. Two cases of women with eating disorders are presented. The first, anxious and paranoid, was obsessed with acne on her face and demanded that the analyst be a “mirror of reassurance.” The treatment proved to be a success when the analyst commented on the appearance of the acne from time to time, combining talking with looking. The second patient was suddenly shamed to the point of panic attacks were she to come upon another woman more fashionably dressed than herself. She defended against exploring this shame through constant movement and not processing the analyst’s interventions. It was concluded that for some patients suffering from shame about their bodies, words are experienced as meaningless and even dangerous.
