Abjection, Traumatic Themes, and Alexithymia in Anorexia Nervosa

Patients with anorexia nervosa frequently describe feeling that their bodies, or parts of their bodies, are disgusting, ugly, gross, or "fat." In this article, I develop an understanding of these feelings, using Kristeva's notion of abjection, which highlights an aspect of the subjective experience of anorexic patients. This can be accounted for by two traumatic themes, i.e., aspects of the mother-child narcissistic object relation often observed in this patient population: (1) an experience of having been subjected to intrusive foreign bodies and (2) the formation of a rotten core. These patterns of experience hobble the mind's capacity for representation and symbolization, which has led many theorists to invoke the concept of alexithymia, accounting for the repetitive, concrete quality of the anorexic patient's clinical presentation. Such a conceptualization-illustrated with several brief case excerpts-points to an important mechanism of therapeutic action for this population.