Letters to anorexia. Narrative tools for working with anorectic patientsin a Dialogical Self context

Tokarska, Urszula; Ryżanowska, Dorota

doi:10.12740/pp/onlinefirst/69394

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…The voice was compassionate and positive . The friendship of AN and self fulfills the desire of participants to reach body goals (Tokarska and Ryżanowska, 2018). AV acted as an aid to voice self-opinions out loud for others and the self .…”

Section: Benevolent Av-a Friend Of An and Selfmentioning

confidence: 96%

“…"This is an opportunity to think about things I tend to avoid thinking or talking about" (Tokarska and Ryżanowska, 2018) "I'm so used to it I didn't notice it" (Hibbs, Pugh and Fox, 2021) "it's so easy to get so consumed in this world that, you know, it is not normal but its just so your norm and it become your reality" (Ling et al, 2022)…”

Section: Identified and Accepted Avmentioning

confidence: 99%

“…This phase denotes the most impulsive and severe AV favoring AN . The transition of AV from being a friend to a 'know-it-all' capable dominator above self-received the majority of submissions (Tokarska and Ryżanowska, 2018). The loss of self-control and helplessness due to dominating AV and AN prominently increased psychological stress and negative eating attitudes in patients (Pugh, Waller, and Esposito, 2018; Tokarska and Ryżanowska, 2018).…”

Section: Malevolent or Omnipotent Av-a Friend Of An And Foe Of Selfmentioning

confidence: 99%

“…The weight restoration aims of all therapeutic interventions around AN arouse fear in patients of weight regain and lost treatment engagement . The intensity of fear entangles AV with self-recovery resistance (Tokarska and Ryżanowska, 2018).…”

Section: Denying Dissociationmentioning

confidence: 99%

“…"I don't want to fight with you because otherwise, I would have to gain weight" (Tokarska and Ryżanowska, 2018).…”

Section: Denying Dissociationmentioning

confidence: 99%

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A Systematic Review of the Influence of Anorexic Voice on the Recovery of Anorexia Nervosa

Dev,

Williams

2024

Preprint

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BACKGROUND: Anorexia nervosa (AN) caused increased mortality, and high readmissions or relapse rates indicates a lack of psychological focus on current AN intervention. Pugh and Waller (2017) thematically analyzed the high frequency of inner-voice prevalent in the AN population, similar to voice hallucinations in other psychological disorders. These remained stigmatized and non-disclosed due to correlations with Schizophrenia. The emotional and psychological AV assisting novel AN intervention is needed. AIM: To review the relationship of AV with self and AN globally, with its influence on recovery using combined research methods. DESIGN: Inductive thematic analysis of qualitative evidence from included studies. The methodological quality and risk of bias assessments of different studies equipped with appropriate tools. SEARCH STRATEGY: Cochrane review, Ovid via MEDLINE, Embase, PubMed, CINAHL, Web of Science, PsychINFO, and ProQuest electronic databases searched for relevant studies selection. REVIEW METHODS: Nine studies (one cross-sectional, one systematic review, four qualitative, and three mixed methods) met the inclusion criterion set. The methodology quality and bias risk assessments employed selective appraisal tool for included combined research methods. All appraisal tools were carefully selected and followed for robust evidence synthesis. RESULTS: The thematic analysis concluded ‘Not one size fits all' and non-generalizable AV for different AN case. The fluctuating AV was studied subjectively since AN onset. The dissociation of AV in AN case significantly assures recovery. CONCLUSION: This review demonstrated improved recovery with better insights in AV’s relationship with patient and AV-inclusive therapies. The need for a novel AV-inclusive psychological therapeutic framework was analysed. The improved motivation, hope, support, and empathy assures treatment success. However, AV standardized framework for unidentified AV in AN patients can possibly trigger and worsen illness.

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Section: Benevolent Av-a Friend Of An and Selfmentioning

confidence: 96%

Section: Identified and Accepted Avmentioning

confidence: 99%

Section: Malevolent or Omnipotent Av-a Friend Of An And Foe Of Selfmentioning

confidence: 99%

Section: Denying Dissociationmentioning

confidence: 99%

“…"I don't want to fight with you because otherwise, I would have to gain weight" (Tokarska and Ryżanowska, 2018).…”

Section: Denying Dissociationmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of the Influence of Anorexic Voice on the Recovery of Anorexia Nervosa

Dev,

Williams

2024

Preprint

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Letter to a grandchild as a narrative tool of older adults’ biographical experience exploration

Tokarska

Dryll

Cierpka

2019

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The paper purports to present a method that allows to obtain and analyze letters written by older adults to their real or imaginary grandchildren. This enables an insight into their individual life experience. The study used a narrative paradigm. Letter texts were obtained from 128 older adults from Poland, both male and female. Data was analyzed with mixed methods combining qualitative content analysis (using inductive analytical categories described in originally created Coder Completion Sheet) with frequency count. The analysis allowed a systematic description of content (themes in wisdom legacy) and the differentiation of two major formal patterns in the letters: (1) the narrative mode (storytelling); (2) the argumentative mode (legacy without narrative examples: advice, warnings, and wishes). The outcomes demonstrate the letter technique may be recommended for future research in psychology, narrative gerontology and for used in applied psychology also.

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A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope

Elwyn

2023

J Eat Disord

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The ethical approach to treatment non-response and treatment refusal in severe-enduring anorexia nervosa (SE-AN) is the source of significant ethical debate, particularly given the risk of death by suicide or medical complications. A recent article proposed criteria to define when anorexia nervosa (AN) can be diagnosed as ‘terminal’ in order to facilitate euthanasia or physician-assisted suicide (EAS), otherwise known as medical assistance in dying, for individuals who wish to be relieved of suffering and accept treatment as ‘futile’. This author utilises their personal lived experience to reflect on the issues raised, including: treatment refusal, iatrogenic harm, suicidality and desire to end suffering, impact of diagnosis/prognosis, schemas, alexithymia, countertransference, ambivalence, and holding on to hope. Within debates as critical as the bioethics of involuntary treatment, end-of-life and EAS in eating disorders, it is crucial that the literature includes multiple cases and perspectives of individuals with SE-AN that represent a wide range of experiences and explores the complexity of enduring AN illness, complex beliefs, communication patterns and relational dynamics that occur in SE-AN.

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Letters to anorexia. Narrative tools for working with anorectic patientsin a Dialogical Self context

Cited by 4 publications

References 5 publications

A Systematic Review of the Influence of Anorexic Voice on the Recovery of Anorexia Nervosa

A Systematic Review of the Influence of Anorexic Voice on the Recovery of Anorexia Nervosa

Letter to a grandchild as a narrative tool of older adults’ biographical experience exploration

A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope

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