The Psychology of Eating: From Healthy to Disordered Behavior

Treating Eating Disorders 257

her relationships outside the therapy room” (Dare and Crowther, 1995a,
p. 298). This is described as transferenceand countertransference.

Transference
The patient’s internal object relations and the function of her symptoms
impact on all of the patient’s relationships, which includes her relationship
with the therapist. The term transferencedescribes the patient’s feelings,
attitudes, and behaviors towards the therapist. Transference for the anorexic
patient can involve fear and suspicion of the therapist’s proffered closeness,
as the patient prefers the sensation of loneliness to neediness because the
latter brings with it a fear of losing self-control and a sense of being taken
over (Dare and Crowther, 1995a).

Countertransference
In response to this transference the therapist will experience his or her own
emotions to the patient, known as countertransference. As Dare and Crowther
(1995a) described, these feelings often involve a desire to protect, indulge,
and nurture the patient rather than “facing her up to harsh reality” (p. 304).
The two processes of transference and countertransference provide the
therapist with information about the patient. The transference provides
the therapist with an insight into the patient’s relationships in the past
and the function of her symptoms. The counter transference provides the
therapist with information concerning how the patient has made others
react to her and how she would prefer them to act. As the therapeutic alliance
and the processes of transference and countertransference take place, the
focal hypothesis concerning the patient’s object relations and the function
of her symptoms is tested, refuted, and embellished. This is considered the
conscious part of the therapist’s work. In addition, the therapeutic alliance
also involves the development of a empathic, involved, and trusting
relationship. The goal of psychoanalytic psychotherapy is, therefore, to
encourage the patient to understand which feelings are being expressed
through her bodily symptoms, to understand how her past relationships
have influenced her desire not to express her feelings in words, and to facil-
itate the expression of her feelings in words rather than through her body.

Effectiveness of psychoanalytic psychotherapy

Psychoanalytic psychotherapy is often the main type of therapy offered to
anorexics and some bulimics both through hospitals and therapy centers