ABSTRACT

We are now ready to continue to put the conception of BN and AN as two aspects of one eating disorder to the test, by looking at the notes of one of the most focused of the original psychotherapeutic pioneers, himself always looking for the basic processes creating the different psychopathologies. If there is indeed a BN±AN syndrome, caused by dissociation of the Hunger± Satiety drive, Pierre Janet's case report of Nadia must surely help bear that out. Let us recall my hypothesis before we start: dissociated Hunger becomes bulimic; dissociated Satiety becomes anorexic. And I would ask the reader to recall that my suggestion as to the cause of this dissociation was to postulate a pathological turn in the emotional psychization of the Hunger±Satiety drive, speci®cally by archetypal crisis affects (Fear, Sadness, Anger, Shame/Contempt) during a child's stages of development prior to adolescence. I argued, in Chapter 3 of this book, where this formulation can be found, that the disturbance introduced into a child's development by the ¯ooding of his psyche with crisis affects during feedings results in the formation of a pathological eating complex of suf®cient magnitude to cause the dissociation of the Hunger±Satiety drive itself. Using the cases discussed in that chapter, Janey and Luigi, it was possible to demonstrate dissociation of the Hunger±Satiety drive, but I found it dif®cult to identify the crisis emotions in the pathogenic complexes documented in these case reports.