The use of the countertransference in the therapy of patients with anorexia nervosa

The self-destructive behaviour manifest in anorexia nervosa is inevitably enacted in the therapeutic relationship in psychoanalytic psychotherapy and leads to difficult clinical management problems. The therapist's ability to tolerate, reflect upon and use the countertransference may be essential in getting an understanding of the patient's conflicts. Four common scenarios are described from the therapy of four patients with anorexia nervosa, and the therapist's countertransference is detailed and analysed to illustrate how such understanding can support and sustain the therapy. © 1997 John Wiley & Sons, Ltd and Eating Disorders Association.