Integrating feminist and psychodynamic principles in the treatment of an eating disorder patient: implications for using countertransference responses.

Patients who struggle with a tenacious eating disorder commonly stir strong countertransference feelings in therapists. The author describes a patient who for a number of years had been unresponsive to traditional treatment interventions for anorexia nervosa and bulimic tendencies. By combining principles derived from psychodynamic treatment and contemporary feminist thought, the therapist was gradually able to help the patient engage in the treatment process. Managing a variety of strong countertransference feelings was instrumental to the process. The author underscores the need for patients to take greater personal responsibility, develop self-critical and self-analytical capacities, learn to embrace contradictions in the self, and disavow the tendency to harbor fantasies of utopia, perfection, and "cure."