Psychoanalytical chat: Force-Driven Mechanisms of Defense Reactions on Contact and Position in Bulimic Mental Disorders

Psychoanalytical chat: Force-Driven Mechanisms of Defense Reactions on Contact and Position in Bulimic Mental Disorders

Bulimia has been categorized into bulimia nervosa and binge-eating disorder according to DSM-5. However, these distinctions are merely indicators of whether there are compensatory behaviors or whether negative emotional and mood states replace these behaviors. In any case, one of the unconscious foci of bulimic mental disorders is the feeling of psychological self-boundaries. This involves sensing and solidifying the feeling of self at the level of a person in an autistic-contact position. This process is similar to how one may feel a sense of safety by poking their cheek or touching their chin to feel a sense of boundary, thereby calming the mind. Similarly, eating can also create a sense of safety through skin contact and the feeling of self-fulfillment.

In other words, while the body feels a sense of self-boundary in an autistic-contact position through the sensation of swallowing food, it provides a transitional object to support this sense of self-boundary. This object acts as a substitute for the real support of the environment, similar to the support the mother seems to provide. The person connects themselves with an object that serves as an intermediate area between the imagination of an internal, supportive environment and the reality in which this imagination can be realized. This involves defensively and compensatorily grasping the breast that nourishes through food, and merging the skin contact sensation and the fusion feeling of eating and drinking in an autistic-contact position. This unconscious mechanism aims to merge the sensual fusion of eating and drinking and the skin contact sensation into one, integrating the internal environment with a sense of reality that holds the body firmly with universality and stability. This is not necessarily the cause of bulimic disorders, but in many cases of bulimic mental disorders, there is an excessive use of eating contact to create the required transitional object for the sense of self-image. 

In the case of bulimia nervosa and binge-eating disorder, the unconscious focus of the disorder involves the ebb and flow of psychic energy and the preconscious motivation to feel and solidify the sense of self at the level of a person in an autistic-contact position. The distinction between bulimia nervosa and binge-eating disorder in terms of compensatory behavior or negative emotional and mood states accompanying the urge to overeat lies in whether the ambivalent compensatory resistance to overeating becomes focused and transitions to action. Even if this distinction, might be related to complex predisposition of the nervous system and the differences of different person’s brain nervous systems, but under this different conditions, similar psychodynamic lesions foci of them still can be found.