In the recent literature on eating disorders, little attention is usually given to the possible role played by heightened death fears and anxieties and failed death transcendence in the dynamics of patients who suffer from anorexia and bulimia nervosa. For reasons that remain unclear, early texts and articles in the literature do address death themes, particularly as they are discernible from patients' dreams and nightmares.
Thoma's 1967 text Anorexia Nervosa may be interpreted as giving further illustration to this thesis. 0 1993 by lohn Wiley & Sons, lnc.
Our research has shown the significance of recognizing themes of death-related anxiety in anorexic patients (Jackson & Davidson, 1986, 1989; Jackson, Beumont, Thornton, & Lennerts, 1992). Evidence for this assertion abounds in previously reported cases in the literature, especially as found in unconscious material such as dreams. Nonetheless, it has not as yet become routine in clinical practice to take death themes into account in theorizing about eating disorders or in trying to assist these patients in treatment. This is why Jackson and Davidson (1989) have described the existing literature bearing on death themes as the "hidden" literature on eating disorders. The central postulated dynamic, that of failed death transcendence, is mostly regarded as an unusual if not unacceptable approach to understanding the etiology and maintenance of an eating disorder (Lifton, 1976; Yalom, 1980).
References to death as a theme in the literature on eating disorders are more likely found in articles in German and French (Bensoussan, 1986; Fouraste, 1979; Nicholle,