Eating disorders as autisticlike defenses: unmentalizable experiences in primitive mental states.

Autisticlike symptoms have been acknowledged in several fields; thus it cannot be claimed that they encompass a delineated pathological organization. The authors argue that in primitive mental functioning, eating symptoms—both bulimic and anorexic—can be used as autisticlike defenses in which the altered body becomes an objectified protective shell providing shelter from intolerable anxieties that derive from unmentalized and unmentalizable experiences. The role of the psychoanalytic third, rising from the analyst's reverie, as a possible meeting ground between the concrete and the symbolic is discussed. Drawing on case material from the analysis of two patients with eating symptoms used as autisticlike defenses clarifies some of the theoretical aspects of eating disorders.