ABSTRACT
This chapter shows way of working with eating-disordered patients by addressing the manifestations of the symptom in the transference relationship rather than speaking of the symptom directly. This helps to explore the meaning of the problem and allows communication to take place in a different sphere, hence reducing the pressure to act out somatically and paving the way for more symbolic thinking. While anorexia is, at least partly a defence against sexual oral-genital impulses, bulimia can enact an erotised phantasy. Psychoanalysis offers a stage on which the dramas of the internal world are re-enacted. The provision of the space and the use of words instead of action can in themselves create anxiety. A forward and backward movement is a general feature of mental life, and Freud spoke about this as the fundamental life and death drives. The anorexic patient, on the other hand, tries to prevent bad feelings by refusing food.
