Envy & Emptiness: The Psychodynamics of Eating Disorders & Cosmetic Surgery

A Dedication to Hunger


Louise Gluck

It begins quietly

in certain female children:

the fear of death, taking as its form

dedication to hunger,

because a woman’s body

is a grave; it will accept

anything.  I remember

lying in a bed at night

touching the soft, digressive breasts,

touching, at fifteen,

the interfering flesh

that I would sacrifice

until the limbs were free

of blossom and subterfuge: I felt

what I feel now, aligning these words–

it is the same need to perfect,

of which death is the mere byproduct.


The wish to modify the body comes from the unconscious experiences of envy and emptiness before it is made into a conscious act. Cosmetic surgery and eating disorders are viewed acceptable in society which may interfere with the taxing effort to understand and conceivably resolve the unconscious subjective meanings of envy and emptiness that lead to body modification, starvation, bingeing and purging and binge eating. Unformulated experiences are absent of language and the result is that the experience stays in the body and the body speaks what the mind cannot digest. The process of psychodynamic psychotherapy provides the potential space for talking about anything that comes to mind and the clinician helps the patient find meaning and feeling in their words. Addressing the unconscious experiences of envy and emptiness with reflexive listening allows for thinking psychologically rather than concretely, which will result in new and useful information to broaden a patient’s awareness. Join the Santa Barbara Chapter of Marriage & Family Therapists on April 10, 2019, and myself, when I provide this presentation.