Affect regulation, object relations and the central symptoms of eating disorders

The ‘over-investment of eating restraint’ is arguably an important common denominator of eating disorders. The present paper explores this characteristic from the perspective of developmental psychology. Recent advances in the integration of psychoanalytic theory and empirical research on infancy, can extend our emerging multifactiorial understanding of eating disorders, and help us to better understand the development and maintenance of this central symptom. It is proposed that the over-investment of eating restraint typical of eating disorders may reflect an underlying need to restrict affective experience in general, and the experience of desire in particular. The clinical implications of these ideas are explored, especially in regard to how the therapist helps the patient to discriminate, integrate and express inner feeling-states. It is concluded that interdisciplinary work can help us to further extend our understanding of eating disorders.