ABSTRACT
This chapter presents a psychodynamic self-psychologically oriented therapy of a patient with bulimia nervosa (BN) and narcissistic personality traits. The therapist's consistent emphasis on the patient's experiences of invalidation, inattentiveness to her needs or lack of empathic mirroring have led to a growing ability to touch dysphoric feelings of emptiness, loneliness and rejection and to discern the connection between these feelings and bingeing. An empathic failure which was experienced by the patient as "optimal frustration" led to psychological growth through processes of transmuting internalization. At the end of therapy, a more cohesive and integrative self was apparent, which was manifested both through increasing artistic creativity and through turning to human beings to provide selfobject needs.
