THE FIRST SUPPER: THE ROLE OF THE DIGESTIVE SYSTEM IN MENTAL LIFE AND THE EVOLUTION OF EATING DISORDERS

摘要

The following work explores the significance of the digestive system in mental life and in the evolution of eating disorders. Utilizing Bion's model of the mind, as well as the work of Bick and Meltzer, it is proposed that underlying the overt symptoms of this disorder is a mental structure that lies at the core of eating disorders and which is referred to here as the metabolic mind. The constitution of the metabolic mind, it is argued, is rooted in the transformation of the digestive system into a second skin formation, intended to defend against anxieties of disintegration and to enable a rudimentary level of mental functioning. This type of mental functioning is often characterized by the use of adhesive identification, and is manifested in the presentation of eating disorders in a variety of mental features, which have been less associated with this ailment and merit a close examination. A provisional sketch of some of the potential implications of this mental construct is discussed, with the aim of further expanding the clinical understanding of this disorder.