This study explored the interpersonal and intrapsychic experiences of individuals living with longstanding anorexia and considered how such experiences might influence barriers to recovery. Six women, aged between 22 and 44, were interviewed on three occasions using a psychoanalytically informed qualitative research design. Three interrelated themes emerged: “all on our own,” becoming needless and “nobody speaks your language.” Interpersonal experiences were characterized by abusive mistreatment, abandonment, and rejection, which, at times, seemed to be re-enacted with acute health care staff, mental health professionals, and mental health services. Participants developed a conviction of being undeserving and fundamentally flawed, perhaps in a defensive attempt to establish a sense of control and survive these overwhelming experiences potentially operating as a self-protective enclave. Ultimately, participants seemed to be describing, defending against the pain of relatedness by striving to have no needs. Participants seemed stuck in this state of self-protection, hampering their ability to develop trust in the therapeutic relationship. Directions for future research and implications for psychotherapeutic work are also discussed.

中文翻译：

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变得不必要：一项精神分析的定性研究，探索长期神经性厌食症的人际关系和心理体验

本研究探讨了长期厌食症患者的人际关系和心理体验，并考虑了这些体验如何影响康复障碍。六名年龄在 22 至 44 岁之间的女性使用精神分析知情的定性研究设计进行了 3 次采访。出现了三个相互关联的主题：“靠我们自己”、变得不必要和“没有人会说你的语言”。人际经历的特点是虐待、遗弃和拒绝，有时似乎在急性卫生保健人员、精神卫生专业人员和精神卫生服务机构中重现。参与者形成了一种不值得和根本上存在缺陷的信念，也许是为了建立一种控制感并在这些可能作为自我保护飞地运行的压倒性经历中幸存下来的防御尝试。最终，参与者似乎在描述，通过努力没有需求来抵御相关的痛苦。参与者似乎陷入了这种自我保护状态，阻碍了他们对治疗关系建立信任的能力。还讨论了未来研究的方向和对心理治疗工作的影响。