Counselors and researchers are increasingly recognizing that persons diagnosed with bulimia nervosa typically manifest high levels of the defense of dissociation. Treatments for bulimia nervosa may be unsuccessful due to insufficient acknowledgment of the role that dissociation can play in mediating the disorder. Failing to acknowledge client dissociation constricts the potential for an efficacious therapeutic relationship because certain aspects of the client's self-experience are prevented from emerging in counseling. The authors explore core concepts in the development of self-formation that illuminate the origins and function of dissociation in bulimia. The exploration suggests developmental explanations, implications for alternate and effective treatment, and possibilities for future research.

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