The anorexia nervosa experience: Shame, Solitude and Salvation

Moller, Naomi; Rance, Nicola; Clarke, Victoria; Moller, Naomi P.

Abstract

© 2016 British Association for Counselling and Psychotherapy Aim: Women with anorexia are often perceived very negatively – for example, as manipulative and deceitful – both by wider society and treatment providers. In this context, it is important for practitioners to understand the experience of living with this illness, but there is very little empirical research focused on the everyday phenomenology of anorexia. This study aimed to expand this limited literature by ‘giving voice’ to the lived experience of women with anorexia. Method: A purposive sample of 12 women – 11 with a formal diagnosis of AN as a result of NHS treatment and one with a long behavioural history of dietary restriction who had received private treatment – who saw themselves as recovered, or in recovery, from anorexia nervosa participated in semi-structured interviews. The women were asked about the history of their eating disorder, their understandings of its cause and experiences of seeking help and treatment. Results: The data were analysed with thematic analysis and three themes identified – Shame, Solitude and Salvation – which, when taken together, describe the dual role of anorexia nervosa as both problem and solution, the cyclical nature of sufferers’ behaviours and feelings and the way in which anorexia nervosa is a form of distress that can make its sufferers feel better as well as worse. Conclusions: Further light is shed on the ambivalence about recovery, and resistance to treatment, that are frequently experienced by sufferers. Implications of these findings for those who work with eating disorders clients are discussed.

• Journal Article Type: Article
• Acceptance Date: Jul 6, 2016
• Online Publication Date: Nov 10, 2016
• Publication Date: Jun 1, 2017
• Deposit Date: Sep 26, 2016
• Publicly Available Date: Nov 10, 2018
• Journal: Counselling and Psychotherapy Research
• Print ISSN: 1473-3145
• Electronic ISSN: 1746-1405
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 17
• Issue: 2
• Pages: 127-136
• DOI: https://doi.org/10.1002/capr.12097
• Keywords: eating disorders, interviews, lived experience, qualitative analysis, stigma
• Public URL: https://uwe-repository.worktribe.com/output/885355
• Publisher URL: http://dx.doi.org/10.1002/capr.12097
• Additional Information: Additional Information : Practitioner Notes Women with anorexia are often perceived very negatively – for example, as manipulative and deceitful – both by the wider society and treatment providers. For example, treatment providers have reported feeling ‘suspicious’, ‘frustrated’, and ‘not valued, not wanted’ when working with this group. Understanding more about how women with anorexia make-sense of their own experience potentially increases empathy and reduces frustration with this client group, however the small body of qualitative research on this population to date has not provided much information about the day-to-day experience of living with anorexia. This study thus aimed to ‘give voice’ to the lived experience of women with anorexia. Data from interviews with 12 women were analysed and three themes identified – Shame, Solitude and Salvation – which, when taken together, describe the dual role of anorexia nervosa as both problem and solution, the cyclical nature of sufferers’ behaviours and feelings, and the way in which anorexia nervosa is a form of distress that can make its sufferers feel better as well as worse. As such the results shed further light on the ambivalence about recovery and resistance to treatment so frequently experienced by those with anorexia and witnessed by those practitioners who work with them. Furthermore, the results enable a greater appreciation of the misery encountered when someone has anorexia – an appreciation that will hopefully enhance both empathy and compassion for sufferers in counsellors who work with this client group. The study findings have a number of implications for therapeutic practice with women with anorexia. For example, the findings provide support for anorexia treatments that are focussed on addressing shame, such as Compassion-Focussed Therapy, as well as loneliness, which is known to fuel eating disorders. Additionally, the study suggests that practitioners and clients might beneficially work together to develop a better understanding of the unique ways in which the sufferer’s anorexia both causes and solves problems for them. Similarly, practitioners might work to develop their clients’ sense of being ‘out’ of the illness to build their non-anorexic identity and help loosen the grip of the illness on them, thus facilitating both a reduction in ambivalence about recovery, and an increase in desire to recover. This is the peer reviewed version of the following article: Rance, N., Clarke, V. and Moller, N. P. (2017) The anorexia nervosa experience: Shame, solitude and salvation. Counselling and Psychotherapy Research, 17 (2). pp. 127-136, which has been published in final form at http://dx.doi.org/10.1002/capr.12097. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Sep 26, 2016