**5. Conclusion**

Multiple psychoanalytic theories have been proposed in the genesis of eating disorders, ranging from drive-conflict models to ego psychology and object relations theories. This chapter attempts to enrich the psychoanalytic conceptualizations of eating disorders by examining the dissociative structures that may underpin the eating-disordered individual's behavior. Consequently, there has been a description of Janet's pioneering ideas into the splitting of consciousness, where the automatism, or the symptom contained within a particular self-state, actively maintains separation between parts of the self that cannot be formulated, integrated, or held in tension. Through an extended, detailed clinical vignette, it has been demonstrated how the anorectic self-state entrenches the anorexic's conviction that her embodied, corporeal self does not exist. As a result of this defensive disembodiment, she can walk alongside her corporeal self, as opposed to it being her, and teeter comfortably on the edges of death and bodily annihilation. The bulimic self-state, on the other hand, holds the binge-eater's greed, desire, and lust. Wanting and needing, intolerable states which were denied a spot in the assembly room of the binge-eater's mind, are relegated to monster or animal selves that, in titrated states of consciousness, express the insatiability and ravenous passion that remains unsymbolized and unformulated. Treatment considerations have been outlined for clinicians working from a contemporary relational psychoanalytic perspective, highlighting the inevitability of enactments in the intersubjective space in revivifying traumatic reminiscences that are kept at bay by particular self-states, and stretching the limits for mutual regulation of intolerable affect.
