Nobody ever really eats alone. We must all negotiate the voice of our culture and its contradictory messages about food and the body. These cultural imperatives especially confuse and burden women as they struggle with the insidious power of the diet culture and current demands about body size and shape. In this insightful analysis of an treatment guide for eating problems, the authors develop a clinically useful theory of how society's injunctions about the "right" body and the "right" diet become inscribed in patients and join with their intrapsychic emotional life. By merging their theory of the internalization of culture (and feminist critique of that culture) with an object relations and interpersonal psychoanalytic theory, the authors deliver for all therapists a powerful therapeutic model, one honed by twenty years of practice at the Women's Therapy Centre Institute. Many treatments for eating problems make controlling the symptom their goal; this book demonstrates that this approach merely reproduces in the patient the loss of agency created by internalized messages from a fat-phobic society. Only by understanding the symptom as an expression of the confluence of intrapsychic, interpersonal, and cultural experience can the therapist help the patient learn to live in peace in her body. The authors present a psychodynamic understanding of hunger, satiation, food, and body image, and show how everyday body/self and eating experiences contain and reveal the essential dynamics of the person. They also describe how these dynamics, as well as the influences of consumer culture, affect transference and countertransference in treatment.A thoughtful discussion of the convergence of eating problems and sexual abuse extends the existing theory about how consumer culture injures women and aggravates the wounds of abuse. It also details the tremendous value of this feminist psychoanalytic treatment model for helping people with dissociative problems, including multiple personality disorder.Illustrated with rich case vignettes, this practical guide will show clinicians how to use an anti-diet, anti- deprivation model of treatment to help patients learn to feed themselves in tune with their psychic and bodily needs. Table of Contents Foreword by Susie Orbach Women's Eating Problems: Social Context and the Internalization of Culture by Susan Gutwill The Diet: Personal Experience, Social Condition, and Industrial Empire by Susan Gutwill Tracing Development: The Feeding Experience and the Body by Carol Bloom and Laura Kogel Symbolic Meanings of Food and Body by Carol Bloom and Laura Kogel Beginning the Eating and Body Work: Stance and Tools by Carol Bloom, Laura Kogel, and Lela Zaphiropoulos Learning to Feed Oneself: A Psychodynamic Model by Carol Bloom, Laura Kogel, and Lela Zaphiropoulos Working Toward Body/Self Integration by Carol Bloom, Laura Kogel, and Lela Zaphiropoulos Transference and Countertransference Issues: The Impact of Social Pressures on Body Image and Consciousness by Susan Gutwill Transference and Countertransference Issues: The Diet Mentality versus Attuned Eating by Susan Gutwill Eating Problems and Sexual Abuse: Theoretical Considerations by Susan Gutwill and Andrea Gitter Eating Problems and Sexual Abuse: Treatment Considerations by Susan Gutwill and Andrea Gitter Eating Problems in Patients with Multiple Personality Disorder by Susan Gutwill Epilogue |