Autistic patterns: Managing the “black hole” in eating disorders

Over the last three decades, researchers have tried to identify the etiology of eating disorders. In examining the connections between different types of self-and-body dissatisfaction evident in eating disorders, the psychodynamic approach is the most feasible. Implicated are deficits of the self, unresolved problems in separation-individuation and self-definition, and the difficulty in expressing needcalled the “Black Hole.” The current article presents three case studies of anorexia, bulimia, and obesity and compares them through the ability to express neediness. Basic terms from the research of Tustin and others are used to explain the dynamics related to the capacity to express need, as exemplified in the different types of eating disorders.