II. The influence of differences in age,sex, and intelligence in determining the attitudes of siblings toward each other 1

This article explores the relational process in a long-term psychodynamic psychotherapy case of a patient with binge eating disorder and the subsequent impacts on treatment when the therapist also struggles with disordered eating. This in-depth case study seeks to examine the reciprocal influence of the subjectivities experienced by the patient and therapist on the formation, maintenance, and quality of the therapeutic relationship and the course of treatment. Drawing on intersubjective theory, a narrowed focus on transference/countertransference dynamics seeks to examine the complexities of a relational approach in the treatment of binge eating disorder. A review of the literature suggests that an exploration of this dimension of treatment breaks new clinical ground and serves to provide more specified and nuanced perspectives for clinicians treating this population. Several clinical vignettes are provided to illustrate the concepts under examination. The use of case composites and thick disguise of patient information has been used to protect confidentiality in this analysis.