DISSOCIATIVE STATES IN EATING DISORDERS: AN EMPIRICAL RORSCHACH STUDY

The study explores the DSM-IV-TR classification of eating disorders that is constituted of four subtypes, two of them defined as anorexia (restricting and binge eating/purging) and two as bulimia (purging and non-purging). This classification is based on body weight as the distinguishing criterion. However, psychoanalytic thinking substantially distinguishes between restricting anorexia and the other three subtypes, all of them involving binge eating. Accordingly, binge eating patients are assumed to present different personality characteristics and different dynamics including dissociation proneness as a core component of the disturbance. The dissociative component of binge eating is examined by using the Rorschach Reality-Fantasy Scale (RFS; Tibon, Handelzalts, & Weinberger, 2005) and other Rorschach measures in a sample of 61 female adolescent inpatients diagnosed with eating disorders. This sample was divided into two groups by using the criterion of whether or not the symptoms involve binge eating behavior. The results support the view that dissociation between reality and fantasy is an important facet of binge eating disorders. A case study that demonstrates the utility of the RFS is presented.