Anorexia nervosa as a defense against anaclitic depression

Abstract

This paper atempts a developmental understanding of the anaclitic depression which frequently underlies anorexia nervosa. Familial lapses in transactional boundaries are viewed as leading to a maternal overinvolvement or unavailability during the practicing subphase of the separation‐in‐dividuation process. The future anorectic is consequently arrested at a sensorimotor level of self and object representations with no ability to evoke a representation of the object in its absence. Such individuals remain vulnerable to separation experiences and the sense of depression, loss, and helplessness which accompany these experiences. Much anorectic symptomology can then be looked at as a defense against such experiences and the potential loss of self‐other boundaries which accompany them.

The Role of Depression and Anxiety in Impulsive and Obsessive-Compulsive Behaviors Among Anorexic and Bulimic Patients

“…Bruce and Steiger (2005) claim that obsessionality, perfectionism and rigidity appear to be clear-cut risk and maintenance factors for anorexia nervosa. These findings contradict Sugarman and Quinlan's (1991) view of anorexia as a defense against depression, as well as other studies suggesting that depression and anxiety are at the root of anorexic symptomatology (McElroy, Kotwal, Keck & Hagop, 2005;Tchanturia et al, 2004) and persist long after recovery (Holtkamp et al, 2005).…”

Spontaneous rupture of the stomach: A complication of bulimia

“…Therefore, treatment of the depression which underlies the bulimia is a crucial aspect of this patient's management. Unfortunately the anaclitic depression, now recognized as a common psychodynamic substrate in the severly eating disordered patient (Sugarman et al, 1981), is difficult to treat because of the relative inaccessability of the conflicts involved. Thus, for G.F., the prognosis must be guarded.…”

Attachment and separation difficulties in eating disorders: A preliminary investigation

“…From the standpoint of theory, the pathological separation distress of eating disordered patients has been primarily understood as resulting from a failure to achieve independence via resolution of the developmental task of separation-individuation from the maternal object (Sugarman, Quinlan, & Devenis, 1981). However, independence is but one side of separation.…”