Constructing ‘the eating disordered patient’1: A discourse analysis of accounts of treatment experiences

Abstract

In this study 39 participants who had all been hospitalized, either in Britain or Australia, at least once for anorexia nervosa and/or bulimia, were interviewed about their experiences of treatment for an eating disorder. Each interview lasted approximately 1 hour and was semi-structured in nature covering: (i) the beginning of participants' problems and their initial diagnosis; (ii) their history of previous interventions; (iii) their current in-patient treatment episode; (iv) their views on their recovery and future. Interview was audio-tape recorded and transcribed verbatim. The resulting interview transcripts were then analysed qualitatively using a discourse analytic methodology in order to identify the ways in which participants discursively constituted their treatment experiences. More specifically, the article focuses on an analysis of how 'the eating disordered patient' was constituted in participants' accounts both as a self-construction and as a construction attributed to healthcare workers. The implications of these subject im/positions of 'the eating disordered patient' are discussed.

Ambivalent appetites: dissonances in social and medical constructions of anorexia nervosa

“…This paper should not be interpreted as giving a voice to the girls (also see Malson et al, 2004) because it is informed by the ways in which we as researchers have interpreted the interviews. However it does perhaps illustrate some of the reasons why girls struggle in the hospital environment.…”

“…Despite widespread acknowledgment of the lack of success of hospitalization and the need to consider consumer views, there are few studies of patient perspectives in clinical and qualitative research on anorexia (Malson, Finn, Treasure, Clarke, & Anderson, 2004). Furthermore, there is little sociological research that considers how patients negotiate diagnosis and treatment.…”

Un/imaginable future selves: A discourse analysis of in‐patients' talk about recovery from an ‘eating disorder’

“…Discourse analytic research is ideally suited to meet this challenge: to analyse 'recovery' as socio-culturally located and to explicate the potentially diverse meanings that, for example, 'illness', 'self', 'treatment' and 'recovery' may hold (e.g. Gremillion, 2003;Malson, 1998;Malson, Finn, Treasure, Clarke, & Anderson, 2004;Ryan, Malson, Clarke, Anderson, & Kohn, 2006). The aim of this paper is therefore to build on these analyses, presenting a post-structuralist discourse analysis of the ways in which participants talked about their current and imagined future selves and the implications this has for understanding recovery from a more patient-centred perspective.…”

(Un)twisted: talking back to media representations of eating disorders

“…But as this process suggests, it is also important to acknowledge that qualitative research into EDs (or indeed any kind of qualitative research) does not unproblematically give the participants 'voice' in speaking back to dominant discourses (Saukko, 2008, Malson et al, 2004. As Saukko observes in her qualitative ED research, there is a potential tension between the desire to 'listen carefully and faithfully' to the women's experiences of eating and body distress, and the impetus to critically assess the discourses … from which their voices are made… ' (2008: 77).…”

“…But it is to bring into focus how discursive constructions of EDs, including those offered by the media and medical discourse, are also constitutive of people's realities, experiences and self-constructions (Malson et al, 2004), reinforcing a critique of EDs as an 'innate' and individualised pathology. Recognition of this dialogue is entirely absent in previous accounts of how the testimonies of ED 'subjects' 'prove' the causal and 'toxic' power of media culture (Murray et al, 1996, Thomsen et al, 2001) -an omission which abstracts such responses from broader relations of social power.…”