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Regulating ‘untrustworthy patients’: Constructions of ‘trust’ and ‘distrust’ in accounts of inpatient treatment for anorexia

Holmes, Susan; Malson, Helen; Semlyen, Joanna

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Authors

Susan Holmes

Helen Malson Helen.Malson@uwe.ac.uk
Associate Professor in Social Psychology

Joanna Semlyen



Abstract

Abstract
Trust has been seen as a lynchpin of therapeutic relationships. Yet due to perceptions that anorexia is one of the most difficult illnesses to treat and that patients are ‘treatment resistant’, achieving trust between patient and treatment provider may be challenging. This article draws on qualitative data from 14 semi-structured interviews with women who have experience of inpatient treatment for anorexia in order to analyse how trust and distrust figured in treatment contexts. In so doing, the article draws upon feminist approaches which are critical of conceptions of the ‘devious’ ‘anorexic’ and of the clinical discourses within which these constructions are produced. Our analysis suggests a lack of trust shown toward patients in inpatient contexts—particularly a disqualification of ‘voice’ —which has a number of consequences for participants’ subjectivities, including the erosion of self-esteem; demotivation; dropping out/ termination of treatment; and triggering experiences of trauma. As such, our analysis raises serious questions about what participants described as routine treatment practices in inpatient treatment for anorexia, and about the serious consequences of constructing ‘anorexics’ as manipulative and untrustworthy.

Citation

Holmes, S., Malson, H., & Semlyen, J. (2021). Regulating ‘untrustworthy patients’: Constructions of ‘trust’ and ‘distrust’ in accounts of inpatient treatment for anorexia. Feminism and Psychology, 31(1), 41-61

Journal Article Type Article
Acceptance Date Sep 25, 2020
Online Publication Date Feb 15, 2021
Publication Date Feb 1, 2021
Deposit Date Sep 25, 2020
Publicly Available Date Apr 15, 2021
Print ISSN 0959-3535
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 31
Issue 1
Pages 41-61
Keywords Anorexia, Trust, Inpatient treatment, Feminism, Manipulative, Voice
Public URL https://uwe-repository.worktribe.com/output/6707013

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