The "Case of Ellen West" is an excellent illustration of why anorexia is not merely a food problem. It reveals a conflict between the ego and the superego, therefore representing a narcissistic neurosis. The severity of the superego is based on the rules for fulfilling ideals. The higher the ideals, the less they can be satisfied. For the ego to be the object of loving investment by the superego, the ego must try to be seen as what it is not, namely, the ideal.
Anorexia; melancholia; narcissistic neurosis