Dissociative Uses of the Body: Reverberations from the Work of Philip Bromberg

Abstract Individuals with eating disorders (ED) use their bodies to dissociate need and desire, thus maintaining their autonomy from other human beings. Desire is dissociated and concretized in the body, where it is ruthlessly controlled and attacked. In addition, the preoccupation with food and the process of eating (or not eating) substitute for a relationship with a needed, self-regulating other. For these reasons, it is difficult for ED patients to access desire in treatment. A dangerous enactment can arise, in which the patient’s dissociated desire can evoke the analyst’s dissociated neglect, which helps perpetuate the patient’s dissociation of desire, in an endless cycle. Strategies for accessing the patient’s desiring self-states are discussed, particularly the importance of acknowledging the healthy, self-defining functions of the patient’s ED behavior.