Eating disorders and the mother—Daughter relationship

Eating disorders, notably anorexia nervosa and bulimia, are prime examples of gender-specific psychopathology. The author's thesis, based on current research on female development and on extensive clinical experience, is that women's vulner-ability to these disorders derives at least in part from the nature of early female psychosexual development. The early process of separation-individuation from the all-powerful pre-Oedipal mother is enormously more difficult for girls than for boys, since girls must simultaneously individuate from and identify with a primary caretaker of the same sex. Hostile-dependent conflicts and ambivalent struggles for autonomy from the mother may persist life-long in women and are all too easily acted out via abnormal control of food intake and body shape. The paper indicates some of the ways in which these struggles are reenacted in treatment with the therapist, whose efforts to help the patient modify eating patterns are inevitably experienced as maternal intrusions. It also describes some corresponding countertransference reactions evoked in the therapist.