We are delighted to share with you this exclusive interview with Alitta Kullman, author of Hunger for Connection.
Why did this book need to be written?
When I first began thinking about and researching eating disorders more than 30 years ago, I was struck by the sharp divide in the clinical literature about eating disorders. At one end of the spectrum, psychoanalytic theories focused on the underlying psychodynamics, but often appeared to blame mothers or the patients themselves for their confounding symptoms; at the other end, cognitive-behavioral perspectives seemed to have abandoned the search for meaning in eating disorders and were focused instead on simply treating the symptoms. But the more eating disorder patients I saw, the more the questions gnawed at me: Who develops which eating disorder and why? When do eating disorders begin and what fuels them? How is the thinking in one eating disorder different from another, and what are the implications of all this for treatment? Those questions dominated my thinking and drove me to search for a way of thinking that could help both therapists and patients make sense of eating disorders and find relief from their intransigent symptoms—essentially not an “either/or” perspective, but a “both/and” approach.
What did you find out?
Well, briefly, I found out that eating disorders are like a roadmap, a virtual “blueprint to the psyche.” By observing and exploring the strikingly similar eating and thinking patterns in patients with cyclical eating disorders and integrating these observations with psychoanalytic theory (particularly the work of W.R. Bion), brain and developmental research, and my own four decades of clinical experience, I began to see how the stage can (inadvertently) be set for eating and thinking to remain inextricably linked from infancy, how this goes on to impact all subsequent stages of development, and how food can become the primary source of nurturance and emotional regulation for a lifetime—literally becoming “food for thought!” I eventually concluded that such an early and ongoing unrequited “hunger for connection” can become organized into a unique somatopsychic personality organization with predictable characteristic elements—what I call the “perseverant” personality—that I came to believe not only underlies and fosters the development of cyclical eating disorders, but may also create vulnerability for additional, later-developing psychological conditions and states.
What surprised you about what you learned?
I think probably the realization that eating disorders are disorders of aloneness, and that the last thing people need to do in their efforts at overcoming them is “self-help.” I learned that eating disorders are not the way people try to hurt themselves or others, but rather the way they try to help themselves process thoughts and feelings that overwhelm their minds and prevent them from thinking. I learned that virtually every enactment, and every thought and feeling associated with those enactments, make perfect sense within the psychic space of the individual, and that we can help our patients “un-cover” how they are trying to help themselves (rather than “re-cover” it over and over again), examine whether their efforts are working, and develop more nourishing ways of feeding their hungers for emotional connection.
What do you hope to accomplish with Hunger for Connection?
I very much hope that the idea of the perseverant personality will have meaning for people with eating disorders and those who care for and about them—enough so that it will change the conversation from eating disorders as shame-filled “addictions” or masochistic enactments to understanding them as efforts at clearing the mind and making it possible to think. The perseverant personality is not a pejorative diagnosis; it looks to the ways otherwise intelligent, creative, resourceful, perceptive, and sensitive individuals learn to “contain” (Bion) their own anxieties and substitute their own body-based capacities to manage them. In Hunger for Connection, I illustrate how learning to think together with (an)other can interrupt this perseverant cycle, how food can be de-linked and differentiated from thought, and how the perseveration that fuels an eating disorder can be re-channeled into the perseverance to live a more nurturing life.
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