A psychoanalytic understanding of eating disorders in athletes: defensive and facilitative potentials.

While athletes are at increased risk for developing disordered eating, there is little consensus on the most effective treatment. While behavioral and cognitive behavioral approaches are most commonly used, we propose that psychoanalysis has the potential to revolutionize treatment for athletes with eating disorders (EDs). In this paper, we use the theories of Winnicott and Bion to frame our arguments, proposing that psychic overwhelm resulting from impingement as well as failures in containment may drive an individual to concretize their emotional and relational experiences through the body via EDs and sport. While historically sport and athletic involvement have been thought to perpetuate and maintain EDs, we propose that sport participation may also provide a unique path to ED recovery for athletes, a claim that is consistent with recent recommendations. Sport involvement may serve as a bridge to facilitate the process of emotion regulation, psychic symbolization, and self-reflection that is necessary for ED recovery. Through the facilitative function of a containing, therapeutic relationship, one may feel safe enough to practice curiosity and creatively explore the metaphor and meaning behind one's concrete relationship to food and sport, paving the way to recovery from EDs for athletes. [ABSTRACT FROM AUTHOR]