Sense of self and anorexia nervosa: A grounded theory

Williams, Karen; King, Jane; Fox, John R. E.

doi:10.1111/papt.12068

Cited by 47 publications

(64 citation statements)

References 63 publications

(70 reference statements)

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“…Given the limitations of current prominent theories of AN, and considering the context of the phenomenological and interpersonal nature of the disorder, we propose a theory of the self in AN in which the self represents the organizing function of the mind that when disturbed, will lead to and maintain the disorder. A fundamental tenet of this approach is that AN symptoms are a way of managing painful internal experiences related to a deficit of the self ( Tasca and Balfour, 2014a ; Williams et al, 2015 ).…”

Section: The Self In Anorexia Nervosamentioning

confidence: 99%

Is Anorexia Nervosa a Disorder of the Self? A Psychological Approach

et al. 2016

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The debate concerning the pathogenesis and the maintaining factors of eating disorders, anorexia nervosa in particular, is ongoing especially since therapeutic interventions do not result in satisfactory and enduring rates of remission. This paper presents a model for the pathogenesis of eating disorders, based on the hypothesis of a deficiency in the development of the self. We present the theory in light of new evidence concerning the role of attachment insecurity in the development and maintenance of eating disorders. In particular, we define the self in eating disorders in a comprehensive way by taking into account recent evidence from experimental psychology and neurobiology. The paper considers the development of the self in terms of its synchronic (i.e., experienced in the moment) and diachronic (i.e., experienced as continuous over time) aspects. Both synchronic and diachronic aspects of the self are relevant to the expression of eating disorder symptoms. Further, the maturation of the self is interwoven with the development of attachment functioning from infancy to adolescence. This interplay between these developmental processes of the self and of attachment could be crucial in understanding the pathogenesis of eating disorders. The final part of the paper suggests a neurobiological link between the theory of the self in the eating disorders and the spatiotemporal functioning of the brain. Disturbances in spatiotemporal functioning may represent the neurobiological pathway by which deficiencies in the self is related to attachment functions in individuals with eating disorders.

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Section: The Self In Anorexia Nervosamentioning

confidence: 99%

Is Anorexia Nervosa a Disorder of the Self? A Psychological Approach

et al. 2016

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“…This results in an inability to distinguish hunger and satiety from other needs and discomforts. It has been long noted that people suffering from AN struggle with identifying their emotional states (e.g., Schmidt, Jichwany & Treasure, ) and often have difficulties with self‐identity (e.g., Williams, King & Fox, In Press). Shoebridge and Gowers () found that mothers of a child that goes on to develop AN often report heightened anxiety during the prenatal and perinatal period.…”

Section: Introductionmentioning

confidence: 99%

The Experience of Caring For or Living with an Individual with an Eating Disorder: A Meta‐Synthesis of Qualitative Studies

Fox

Dean

Whittlesea

2015

Clin Psychology and Psychoth

119

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“…There are frequent references to the construct of the ‘anorexic voice’ in the clinical literature on anorexia nervosa (Higbed & Fox, ; Williams, King, & Fox, ). In a similar way to pseudo‐hallucinations (Hare, ; Jaspers, ), this voice is typically experienced as internally based rather than externally generated, albeit alien to one's sense of self.…”

mentioning

confidence: 99%

“…Such responses can include fighting, escaping or surrendering to the voice (Gilbert et al, ). There is some preliminary evidence that these characteristics might be relevant to the eating disorders (Tierney & Fox, ; Williams et al, ).…”

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confidence: 99%

Understanding the ‘Anorexic Voice’ in Anorexia Nervosa

Pugh¹,

Waller

2016

Clin Psychology and Psychoth

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In common with individuals experiencing a number of disorders, people with anorexia nervosa report experiencing an internal ‘voice’. The anorexic voice comments on the individual's eating, weight and shape and instructs the individual to restrict or compensate. However, the core characteristics of the anorexic voice are not known. This study aimed to develop a parsimonious model of the voice characteristics that are related to key features of eating disorder pathology and to determine whether patients with anorexia nervosa fall into groups with different voice experiences. The participants were 49 women with full diagnoses of anorexia nervosa. Each completed validated measures of the power and nature of their voice experience and of their responses to the voice. Different voice characteristics were associated with current body mass index, duration of disorder and eating cognitions. Two subgroups emerged, with ‘weaker’ and ‘stronger’ voice experiences. Those with stronger voices were characterized by having more negative eating attitudes, more severe compensatory behaviours, a longer duration of illness and a greater likelihood of having the binge–purge subtype of anorexia nervosa. The findings indicate that the anorexic voice is an important element of the psychopathology of anorexia nervosa. Addressing the anorexic voice might be helpful in enhancing outcomes of treatments for anorexia nervosa, but that conclusion might apply only to patients with more severe eating psychopathology. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Experiences of an internal ‘anorexic voice’ are common in anorexia nervosa. Clinicians should consider the role of the voice when formulating eating pathology in anorexia nervosa, including how individuals perceive and relate to that voice. Addressing the voice may be beneficial, particularly in more severe and enduring forms of anorexia nervosa. When working with the voice, clinicians should aim to address both the content of the voice and how individuals relate and respond to it.

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Sense of self and anorexia nervosa: A grounded theory

Cited by 47 publications

References 63 publications

Is Anorexia Nervosa a Disorder of the Self? A Psychological Approach

Is Anorexia Nervosa a Disorder of the Self? A Psychological Approach

The Experience of Caring For or Living with an Individual with an Eating Disorder: A Meta‐Synthesis of Qualitative Studies

Understanding the ‘Anorexic Voice’ in Anorexia Nervosa

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