TY - JOUR PY - 2007// TI - Death and annihilation anxieties in anorexia nervosa, bulimia, and self-mutilation JO - Psychoanalytic psychology A1 - Farber, S.K. A1 - Jackson, C.C. A1 - Tabin, J.K. A1 - Bachar, E. SP - 289 EP - 305 VL - 24 IS - 2 N2 - Self-starvation, bulimic behavior, and self-mutilation comprise a triad of associated self-harm syndromes that are potentially life threatening, with anorexia nervosa having the highest mortality rate of any psychiatric disorder. They are associated with trauma and are extremely resistant to treatment. These patients present a disturbing lack of anxiety about their own life-threatening behavior, yet are preoccupied with death and anxiety about annihilation. Because dissociation compartmentalizes and separates psychological and somatic aspects of traumatic experience (psychological and somatoform dissociation), it enables these patients to disavow the life-threatening nature of their behavior, which makes the dissociative processes the most destructive factor in this psychopathology. The self-harm symptoms are a presymbolic form of communication that must be decoded and confronted in treatment to make recovery possible. For many patients who starve, purge, or mutilate themselves, the body is speaking of death. They require a treatment that protects their safety, determines their personal construct of death, treats the dissociative pathology and sadomasochism, and builds signal anxiety and other ego functions, especially affect regulation. © 2007 APA, all rights reserved.

Language: en

LA - en SN - 0736-9735 UR - http://dx.doi.org/10.1037/0736-9735.24.2.289 ID - ref1 ER -