From fetish object to transitional object: the analysis of a chronically self-mutilating bulimic patient.

This paper challenges the view that food, or the patient's own body, functions as a transitional object for bulimics during the binge-purge cycle or symptomatic equivalents of self-harm. The author proposes that the bulimic patient's actions in and on her body more closely approximate the use of a fetish, which temporarily enhances a deficient and unstable body image and assuages separation anxiety, but does not promote progressive development. To illustrate these distinctions, the author presents an analysis of a self-mutilating bulimic patient who used her body as a fetish until a more integrated "me" evolved within the "shared skin" of her treatment. At that point, a transitional object and an idealizing selfobject fantasy were created, and the patient was able to engage the question of "not me," relinquish her self-mutilation, and resume the process of separation and growth.