@misc{Bromberg, author = {Bromberg, Philip M.}, title = {Review Essay: The Fate of Romance Over Time}, series = {Psychoanalytic Dialogues Vol. 11 (2001), pp. 891-912.}, journal = {Psychoanalytic Dialogues Vol. 11 (2001), pp. 891-912.}, abstract = {I offer the view that the symptom picture found in most patients with eating disorders, as well as in the symptomatology of many other so-called difficult patients, is the end result of prolonged necessity in infancy to control traumatic dysregulation of affect. I propose that the central issue for an eating-disordered patient is that she is at the mercy of her own physiologic and affective states because she lacks an experience of human relatedness and its potential for reparation that mediates self-regulation. She is enslaved by her felt inability to contain desire as a regulatable affect and is thus unable to hold desire long enough to make choices without the loss of the thing not chosen leading to a dread of self-annihilation. Trauma compromises trust in the reparability of relationship, and for symptoms to be surrendered, trust in reparability must be simultaneously restored. Because felt desire is the mortal enemy of an eating-disordered patient, this fact becomes a central dynamic in the analytic field, leading analyst and patient into a struggle over who shall hold the desire and whether the issue of control over food is allowed to become a subject for negotiation. I discuss the inevitability of the analyst's own dissociative reactions in response to the patient's internal war over desire and control, and the different types of interpersonal enactments into which an analyst is drawn. In this tension, as illustrated through clinical vignettes, analyst and patient slip in and out of a constantly shifting array of self-states and thereby have an opportunity to coconstruct a transitional reality within which the patient's impaired faith in the reliability of human relatedness can be restored, and eating can become linked to appetite rather than to self-protection.}, language = {en} } @article{Bromberg, author = {Bromberg, Philip M.}, title = {Reply to Spezzano}, series = {Psychoanalytic Dialogues Vol. 11 (2001), pp. 385-404.}, journal = {Psychoanalytic Dialogues Vol. 11 (2001), pp. 385-404.}, abstract = {This is about a small boy and his >imaginary< friend, who happens to be a gorilla - a friend the boy considers very real indeed. It is also about the fact that no part of the self, including every child's relationship to his own >gorilla,< is ever >reasoned< out of existence. It becomes, instead, >not really real,< because it has had to be relegated to >not really me< in order for the child to preserve his attachment bond with significant others. However, it will continue to make its presence known through being relationally enacted, dissociatively, in ways that eventually become repetitious enough and painful enough to bring the child (now an adult) into our office years later. As analysts, our job at that point becomes one of trying to restore the connection between the little boy and his gorilla in the face of intense pressure by the now >grown-up< patient to keep them apart and to discourage the therapist from trying to bring these old friends back from dissociation into the >really real.< The source of therapeutic action that allows this reunion to take place is discussed conceptually and described in clinical vignettes.}, language = {en} }