ABSTRACT
Mariah entered treatment in mid-life because of concerns about her bulimia and the impact this was having on her marriage and family. The beatings stopped when Mariah was around ten, for reasons which remain unclear, but angry, punitive interactions continued between her and her parents throughout adolescence. Mariah made a visit to her parents' home in honour of her mother's birthday, bringing an expensive gift for the occasion. Mariah was a chic woman who devoted much attention to her clothing, her hair, and her make-up, all of which were expensive and the height of fashion, yet simultaneously presented herself as sensible, someone who had her values and priorities straight in life. Mariah's sense of reality was insecure. Although never psychotic, her judgment about interpersonal interactions was fraught with so much anxiety, that her assessment of social cues and interpersonal affect was problematic.
