Eating Disorders - fieldi

Jodie’s Story 99
capacity to make use of the cultural language as a focus for dysphoric
affect is itself an attempted mastery (Krueger 1988).
The spectrum of character development in which we find these
symptoms is broad. Eating disturbances are symptom pictures existing
on a continuum from the food-restricting anorexic at one
extreme to the binge eater at the other, either normal or overweight.
The symptoms vary in cause and function (Ceasar 1988; Gesensway
1988).
Paul Hamburg (1989) says that a symptom is a sign that suggests
a mystery. “We should be intrigued by the multiple clues it suggests
to us, themes of orality, anality, consumption, the body ego, control,
desire, humiliation, and so forth. The richness of these themes is
striking. Depending on our theoretical bias, we might privilege one
theme or another and search for the single, best, all-encompassing
interpretation of the symptom-sign.” Hamburg suggests that we not
obscure the layerings of meanings with our own need for explanation
and certainty.
Often the symptom is all a person has, her only way of communicating.
While forming an alliance with the architect of this complex
construction, one is always mindful of the serious physical consequences
of anorexia and bulimia. Therefore the diagnostic workup
will include consultation with an internist to determine the need for
further tests or hospitalization. Then the therapist can proceed with
a range of possible treatment interventions that grow out of an analytic
understanding of that patient, including whether to focus on
symptoms. Nutritional counseling and group therapy may be appropriate
on consideration of the whole problem.
Whenever I am invited to speak about eating disorders, I always
want to ask “Whose?”—for each is specific to the individual. For the
following account of Jodie’s symptom-signs and their relation to
what they signify, I am indebted to the theoretical work of Paul
Hamburg (1989), whose work derives in part from the theory of
deconstruction as put forth in the 1970s by Jacques Derrida (1978;
described in Hamburg 1989, 133). Interpolating this theory, originally
applied to literary and philosophical criticism, into therapeutic
work, Hamburg illustrates the creative usefulness of searching out
the many-layered meanings of a symptom by metaphorical and associative
ways of thinking. As he does, I “play” with this material and