Listening in the dark: why we need stories of people living with severe and enduring anorexia nervosa

Conti, Janet; Rhodes, Paul; Adams, Heather

doi:10.1186/s40337-016-0117-z

Cited by 26 publications

(29 citation statements)

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“…It was crucial in the current study to adopt a qualitative research approach given underlying experiences can be missed when using quantitative methods [ 20 , 21 ]. This approach would allow first-hand knowledge to be acquired as to these experiences from the perspective of affected individuals [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

How and why does the disease progress? A qualitative investigation of the transition into long-standing anorexia nervosa

2021

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Objective Despite an increased interest in understanding characteristics of long-standing anorexia nervosa (AN), there is a lack of knowledge into the processes that occur with the development and maintenance of the disease. This has impeded the development of novel treatment approaches that may prove more effective than traditional medical models of therapy. To improve the prognosis of these long-standing presentations, an understanding as to how and why the AN disease progresses is required. It was therefore the aim of the current study to investigate the transition of AN from earlier to later stages. Method The study adopted a narrative inquiry approach and a total of 11 women with long-standing AN participated in an interview. The newly developed photovoice method assisted in data collection with typologies of chronic illness facilitating the emergence of salient themes. Results The qualitative analysis resulted in the identification of five themes: (a) transition, (b) trauma, (c) functionality, (d) identity, and (e) failure of current models of treatment. Conclusions Together with identifying key themes, the study provides insight into some possible reasons why current treatment models are failing to promote recovery. Future research examining the effectiveness of treatment that targets underlying causes and maintaining factors of the illness are suggested. Additional education for health professionals is also recommended in order to reduce the trauma that is currently being experienced by some patients with a long-standing illness.

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Section: Introductionmentioning

confidence: 99%

How and why does the disease progress? A qualitative investigation of the transition into long-standing anorexia nervosa

2021

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“…In seeking to understand what quality of life might mean to people with a diagnosis of SE-AN, clinicians and researchers have recently called for more "sociologically engaged" research (6,15). A number of psychiatric and medical studies have attempted to do this by using traditional qualitative methods of interviews to elevate the voices of people with disordered eating and their carers (13,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Embodiment as a Paradigm for Understanding and Treating SE-AN: Locating the Self in Culture

Musolino

Warin

Gilchrist³

2020

Front. Psychiatry

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There has been a growing call for sociologically engaged research to better understand the complex processes underpinning Severe and Enduring Anorexia Nervosa (SE-AN). Based on a qualitative study with women in Adelaide, South Australia who were reluctant to seek help for their disordered eating practices, this paper draws on anthropological concepts of embodiment to examine how SE-AN is experienced as culturally grounded. We argue that experiences of SE-AN are culturally informed, and in turn, inform bodily perception and practice in the world. Over time, everyday rituals and routines became part of participants' habitus', experienced as taken-for-granted practices that structured lifeworlds. Here, culture and self are not separate, but intimately entangled in and through embodiment. Approaching SE-AN through a paradigm of embodiment has important implications for therapeutic models that attempt to move anorexia nervosa away from the body and separate it from the self in order to achieve recovery. Separating experiencesliterally disembodying anorexia nervosa-was described by participants as more than the loss of an identity; it would dismantle their sense of being-in-the-world. Understanding how SE-AN is itself a structure that structures every aspect of daily life, helps us to understand the fear of living differently, and the safety that embodied routines bring. We conclude by asking what therapeutic treatment might look like if we took embodiment as one orientation to SE-AN, and focused on quality of life and harm minimization.

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“…While these endeavors provide glimmers of hope for this long‐suffering subgroup of eating disorders, they have advanced with relatively little knowledge of the lived experience of longstanding anorexia or what prevents change (Wonderlich et al, 2012). Conti et al (2016, p.3) argue, without consulting the voices of those experiencing longstanding anorexia, we are “listening in the dark” in our efforts to develop helpful and compassionate therapies. To date, only one study has explored barriers to change in this population with five individuals with severe anorexia attending a long‐term community team (Hannon, Eunson, & Munro, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Similar, psychoanalytically informed research methods have been effectively employed in the sensitive exploration of suicidality (Tillman, 2018). Additionally, Conti et al (2016) argue that engaging with the stories of longstanding anorexia requires a relational, intersubjective framework. They advocate for a qualitative, narrative approach focusing not just on what is said but also how stories are constructed to place the voices of these individuals at the centre, recommendations which are in line with the aims of a psychoanalytic informed research method.…”

Section: Introductionmentioning

confidence: 99%

Becoming needless: A psychoanalytically informed qualitative study exploring the interpersonal and intrapsychic experiences of longstanding anorexia nervosa

Blackburn

O’Connor

Parsons

2020

Appl Psychoanal Studies

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This study explored the interpersonal and intrapsychic experiences of individuals living with longstanding anorexia and considered how such experiences might influence barriers to recovery. Six women, aged between 22 and 44, were interviewed on three occasions using a psychoanalytically informed qualitative research design. Three interrelated themes emerged: “all on our own,” becoming needless and “nobody speaks your language.” Interpersonal experiences were characterized by abusive mistreatment, abandonment, and rejection, which, at times, seemed to be re‐enacted with acute health care staff, mental health professionals, and mental health services. Participants developed a conviction of being undeserving and fundamentally flawed, perhaps in a defensive attempt to establish a sense of control and survive these overwhelming experiences potentially operating as a self‐protective enclave. Ultimately, participants seemed to be describing, defending against the pain of relatedness by striving to have no needs. Participants seemed stuck in this state of self‐protection, hampering their ability to develop trust in the therapeutic relationship. Directions for future research and implications for psychotherapeutic work are also discussed.

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Listening in the dark: why we need stories of people living with severe and enduring anorexia nervosa

Cited by 26 publications

References 50 publications

How and why does the disease progress? A qualitative investigation of the transition into long-standing anorexia nervosa

How and why does the disease progress? A qualitative investigation of the transition into long-standing anorexia nervosa

Embodiment as a Paradigm for Understanding and Treating SE-AN: Locating the Self in Culture

Becoming needless: A psychoanalytically informed qualitative study exploring the interpersonal and intrapsychic experiences of longstanding anorexia nervosa

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