Bachar E
Department of Psychiatry, Hadassah University Medical Center, Jerusalem, Israel.
Am J Psychother. 1998 Spring;52(2):147-65. doi: 10.1176/appi.psychotherapy.1998.52.2.147.
This article reviews the contribution of self psychology to the treatment and understanding of anorexia and bulimia. It tries to show that the unique conceptualization of self, selfobject relations, and this theory's conceptualization of resistance and defenses constitutes a therapeutic stance which especially fits the therapeutic needs of eating-disordered patients. Clinical vignettes illuminate three main issues exemplifying the opportunities and dilemmas that this new development in psychoanalytic theory brings to the fore in the treatment of eating disorders: (1) empathy with deeds and attitudes of the patient that the therapist finds difficult to empathize with; (2) empathic understanding "from within" from an experience-near stance vs. experience-distant interpretation "from without"; (3) self, selfobject relations with food and as a result of progress in therapy, with human beings.
本文回顾了自体心理学对神经性厌食症和神经性贪食症治疗及理解的贡献。它试图表明，自体、自体客体关系的独特概念化，以及该理论对阻抗和防御的概念化，构成了一种特别适合饮食失调患者治疗需求的治疗立场。临床案例阐述了三个主要问题，例证了精神分析理论的这一新发展在饮食失调治疗中凸显出的机遇与困境：（1）对治疗师难以共情的患者行为和态度的共情；（2）从贴近体验的立场进行“从内”的共情理解与从远离体验的“从外”进行解释；（3）自体、与食物的自体客体关系，以及因治疗进展而与他人的自体客体关系。
