The Emerging Sexual Self of the Patient with an Eating Disorder: Implications for Treatment *
Several commonly encountered sexual themes may arise in the treatment of persons with eating disorders. A variety of sexual dysfunctions may accompany an eating disorder. H. Bruch and M. Palazzoli emphasized sexual inhibitions based on the patient’s fears of growing up and subterfuge of parental conflict, whereas others underscored fears of sexual responsiveness. Knowledge of what constitutes a mature sexual bond can further illuminate the commonly observed difficulties of eating-disordered patients. Sexual excitement may always be heightened by sublimated aggression but should not be tainted with undue hostility. Sexual interludes thrive when based on mutuality, balance, and love. Developing a “good enough” sexuality is predicated on transforming her identity from that of an eating-disordered patient to that of a person willing to explore new, more mature modes of experiencing a vital, lively self. Trauma—particularly in the forms of sexual and physical abuse—has been linked in numerous contemporary reports to eating disorders.