Eat your heart out : a narrative approach to understanding anorexia nervosa in nine adult women.

Abstract

This study attempted to explore anorexia nervosa (AN) narratively using the writing and reading of self-reflexive stories of 9 adult women participants independently diagnosed with AN. The literature was organised using Zubin and Steinhauer’s (1981) vulnerability model which argues for an integrative approach when explaining psychological disorders. Using a combination of three thematic analysis models the researcher examined emergent themes from participants’ stories and questionnaires. Themes seemed to correspond with Zubin and Steinhauer’s (1981) vulnerability model with the exception of maintaining and moderating factors which corresponded with the Maudsley model (Treasure, Williams & Schmidt, 2009). Themes were categorised under 3 primary headings: Sources of vulnerability, maintaining factors and moderating factors: Sources of vulnerability: Participants’ personalities seemed to be described as characterised by features of emotionality, obsessionality and impulsivity. In addition, these personality features were described as precipitating an increased capacity to magnify negative experiences in childhood and adolescence including family difficulties, social deficits, a tendency to make unfavourable social comparisons and internalisation of thinness ideals. Maintaining factors: Participants’ AN was described as maintained through the proposed AN triad in which repeatedly striving to attain increasing levels of perfection was associated with decreasing goal weights. This pursuit was continually met with failure due to the inherent unattainability of the task, resulting in employment of compensation strategies. Moderating factors: Participants described potential moderating factors as being related to therapeutic approaches which focused on warmth, connectedness and understanding. Completion of narrative tasks in the study was described as beneficial by fostering a sense of normalisation, catharsis and separating the person from the problem. However, participants also described possible harm through a heightened sense of comparison and failure potentially activated by completing the narrative tasks in this study.