Read for Main and Specific Ideas

Read for Main and Specific Ideas.

The Refused Body in Anorexia and the Foreign Body in Bulimia

My hypothesis is that in treating subjects with anorexia, there seems to be a phenomenon of anesthesia of the libidinal body. In contrast, bulimia seems to be closer to a negative auto-eroticism, due to the constant search for meaning in the bulimic act and the displeasure frequently experienced.

But even if, in bulimia, pleasure frequently comes in the trappings of pain, there is indeed libidinal investment that assures the experience of the body. It is a body in pain, a misshapen body, one that is hated and forever being watched over so as not to succumb to bulimic temptations, but it is nonetheless a body. It is strange and bothersome, and makes noises. With the libidinal anesthesia of anorexic patients, especially those with the restrictive type, we seem to be dealing with a non-body, a body that has been refused in its erotic aspects, its needs, its materiality, its image. It is the negative of a body, one that cannot be constituted as a mental object. It does not come to the point of constituting the patient's own body.

The refusal of the body in anorexia, through the refusal of hunger, accompanied by extreme weight loss, fatigue and pain, indicates the impossibility of constituting a hypochondriac experience. The perception of pain, for example, could contribute to the construction of the structuring function of the body image in subjectivity.⁴ My hypothesis thus sustains the idea that, in patients who show a marked difficulty in perceiving their body, to the point of showing serious distortions in their body images, the experience of the body seems to have remained anchored in the register of need, that is, in a time prior to autoeroticism. It was the constitution of auto-eroticism that was impaired.⁵

A baby's absolute incapacity to assure its own need to survive inevitably joins satisfaction with the image of the caring object. We must therefore try to understand what the basic dependence on the other means for the economy of the subject's libido. Such dependence underlines the importance of the function of feeding in the exercise of the maternal function and, consequently, in the constitution of this erogenous body, whose functioning is the result of the earliest interactions between mother and baby.

In 1920 Freud defined the trauma as the consequence of a disproportion between the intensity of the drives and the ability of the mental apparatus to work through its experiences. Later, in 1926, he wrote that the mother's absence constitutes a traumatic situation. It can therefore be shown that, without a protective function exercised by the mother, the mental apparatus is at the mercy of the drives. Analytic clinical practice often shows that cases of anorexia and bulimia, besides feeding the network of representations that serve as support for the castration anxiety, are also related to the silent character of the death drive. They thus have to do with the more or less durable and harmful effects of the defusing of the drives.

But the idea of defusing the drives implies that there was an earlier time when the drives were fused together. Only what is united can be separated. If we speak of defusing the drives, this implies that we should verify the conditions that had to be in place for the drives to be fused in the first place. And we should investigate everything that might interfere or thwart this process of fusing the drives, which was necessary in order to maintain life. If the mother is to play a central role in managing the drives, this means that we should seek to understand the difficulties that can come to block the operation of the mother's "protective shield" function.

We know that the mother's absence has a traumatic effect on a baby, since the absence represents the disappearance of the baby's protective shield, which protects it from itself. The shield also protects the baby from the feelings that come from inside its own body. Since this absence of protection is traumatic, it can trigger off a compulsion to repeat as a final attempt to fuse the drives together. This failure to connect the drives of Eros and of death creates the conditions for the emergence, among other phenomena, of the effects of masochism in its various dimensions.

The path taken up to this point in the article now enables me to broaden my hypotheses. In the absence of any possibility of feeling what is happening at the level of the patient's own body, as we saw, the onset of anorexia in adolescence brings us face-to-face with a type of discharge that can be understood as an outcome of defusion, or dismantling, of the drives. In the case of bulimia, even if pleasure may come disguised as pain, as we indicated above, it nevertheless indicates the presence of a minimal libidinal investment. It seems that we are not dealing here with a body in the negative, as we sometimes are in the case of anorexia, but with aforeign body. The split between the ego and the body seems to show this impression of strangeness of bulimic patients toward their own body.

In bulimia we are not dealing exactly with a body that has been rejected in its materiality, as occurs in anorexia, but with a foreign hyper-present and exigent body whose demands are frightening because they lack any connection with the subject's ego. The feeling of strangeness that these young women feel can be better understood through the savagery of their bulimic acts. This leads us to note the frightened gluttony of a body that seems not to belong to them. If bulimic acts subordinate the body to such excesses and even to pain, might we not be seeing here a desperate attempt to create a refusioning of the drives, seeking to reactivate the connective functions of the original masochism? Given it´s the masochism that implies an enduring a connection with the object to which such suffering might be addressed, might we therefore consider that in anorexia, the problem predates the original masochism?

As Freud pointed out, auto-eroticism is merely a response to the loss of the object that guaranteed satisfaction. This, of course, implies that, if auto-eroticism does not come about, the baby will be unable to deal with the absence of the object. In other words, the absence will be hard to bear if it cannot be appeased through auto-erotic satisfaction. One can posit that it is under these conditions that the absence of the object takes on its full dimension by preventing or at least hampering what is needed in order to fuse the drives. In metapsychological terms, I suggest that bulimia and, especially, anorexia have made evident how precarious the drive fusion is very early in life. In my view this precariousness may have been installed due to difficulties or discontinuities in the exercise of the mother's "protective shield" function.

Thanks to this protective function, the child acquires an awareness of its body, its feelings, its needs and its affects. By exercising this function the mother organizes the child's contact not only with its love and hate, and its capacity to love, destroy or bind with the other, or to become isolated from it. This contact also serves to foster pleasure and bear suffering. The mother's "protective shield" function, then, has a triple purpose. It is not merely to protect and to mediate. It also has a libidinizing function, and it can thus be affirmed that the libidinizing dimension of the mother's "protective shield" function represents a condition for there to be a fusion of the drives.

The mother's "protective shield" function can be partially replaced only by introjecting it, and it is this introjection that will guarantee the constitution of an internal object, which, in the mother's absence at later moments, will enable the baby to face the excesses and adversities inherent to growth and to the acquisition of autonomy. If, due to some difficulty, the object fails in this function, the mechanism of introjection cannot operate. Strictly speaking, we can say that the introjection of the drives and their vicissitudes supposes a previous introjection, not of the object, but of the mother's "protective shield" function.

Taken and addapted from: http://www.scielo.br/scielo.php?pid=S1415-47142012000500004&script=sci_arttext#nt for accademic purpose.