Feminist approaches to Anorexia Nervosa: a qualitative study of a treatment group

Holmes, Su; Drake, Sarah; Odgers, Kelsey; Wilson, Jonathan

doi:10.1186/s40337-017-0166-y

Cited by 22 publications

(24 citation statements)

References 42 publications

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“…Eating disorders have long been theorised in gendered terms as part of feminist discourse [ 27 – 29 ], but the development of feminist principles into treatment practices remains relatively rare [ 30 ]. That is, despite the general acceptance of a ‘biopsychosocial’ model of eating disorders, all three components are not treated equally [ 31 ] – and of course the ‘cultural’ is left only implicit within the ‘social’ category. But findings which suggest that prevalent cultural constructs can have detrimental impacts are a clear invitation to investigate the other side of the coin: whether different cultural inputs could have therapeutic effects.…”

Section: Introductionmentioning

confidence: 99%

Literary reading and eating disorders: survey evidence of therapeutic help and harm

Troscianko

2018

J Eat Disord

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BackgroundThere is growing evidence for the efficacy of self-help bibliotherapy as a treatment for eating disorders, although little understanding of how specific linguistic characteristics may enhance or constrain its effects. Meanwhile, ‘creative bibliotherapy’ (the therapeutic use of fiction, poetry, or sometimes film, rather than self-help books) is widely practised, but even more poorly understood than the self-help variety: although a range of theoretical models exist, claims of the healing power of literature are far more commonly made than tested.MethodsAn online survey including quantitative (forced-choice) and qualitative (free-response) items was designed and administered in collaboration with the charity Beat to investigate the connections between respondents’ reading habits and their mental health, with a focus on eating disorders, and attracted 885 respondents. Responses to two sequences of questions, exploring the differential effects of fiction about eating disorders versus respondents’ preferred genre of other fiction on the dimensions of mood, self-esteem, feelings about one’s body, and diet and exercise habits, were analysed using a 2 × 2 repeat measures factorial ANOVA design for each of the four dependent variables.ResultsSurprisingly, fiction about eating disorders was perceived by respondents as broadly detrimental to mood, self-esteem, feelings about their bodies, and diet and exercise habits, while respondents’ preferred genre of other fiction was experienced as beneficial to mood and broadly neutral on the other three dimensions. The free-response data added detail to these core findings, as well as suggesting numerous other possible effects and mechanisms, drawing attention to the roles of positive and negative feedback structures and of highly selective interpretive filtering, and highlighting the dangers of ‘self-triggering’: using books to deliberately exacerbate an eating disorder.ConclusionsThe findings directly challenge existing theoretical models of creative-bibliotherapeutic mechanisms, which tend to insist on the importance of a close match between the reader’s and the protagonist’s situations. They point the way forward for a new programme of clinical research and practice by suggesting other ways to conceive of how embodied cognitive acts of textually cued interpretation may intervene in the psychopathology of an eating disorder – for good and for ill.

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Section: Introductionmentioning

confidence: 99%

Literary reading and eating disorders: survey evidence of therapeutic help and harm

Troscianko

2018

J Eat Disord

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“…The guidelines acknowledge the complex social issues that are present in ED's, but give no guidance on how to manage the issues. Feminists have been successful in bringing cultural and gendered aspects into scholarly and popular accounts of eating and body management practices (Brown and American Psychological Association 2008); however, the shift towards biomedical paradigm has resulted in a disproportionate presence of biomedical factors within the literature and the narrowing of cultural and social issues into women's "idealization of thinness" (Bordo 2003;Holmes et al 2017). Social and cultural analysis has been parsed along aspects of "body image" disturbance (Katzman and Lee 1997), leaving the meanings expressed by women in their body management practices as a neglected area of research (Malson 2009).…”

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confidence: 99%

Women’s Constructions of Childhood Trauma and Anorexia Nervosa: a Qualitative Meta-Synthesis

2018

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A meta-synthesis was conducted to explore women's constructions of anorexia nervosa and childhood trauma. Following a systematic review of the literature, six studies were isolated and synthesized within a material-discursive-intrapsychic framework to produce five taxonomies: "objectified and controlled bodies," "the abject body," "embodied emotions and self-harm," "medicalizing the body-as-object," and "embodied meanings and new possibilities." The women's experience of anorexia, their bodies, and shifting subjectivities was a response to the materiality of childhood abuse. The women discursively constructed anorexia nervosa as a means of negotiating bodily distress associated with trauma and renegotiating their identities to produce a cohesive, embodied self. This meta-synthesis has implications for further research that elucidates how women make meaning from the transformations of their embodied subjectivities.Keywords Trauma . Anorexia nervosa . Women . Embodiment . FeminismThe association between childhood sexual abuse and anorexia nervosa (anorexia) has long been the preserve of feminist theorists who were amongst the first to raise the issue of abuse in the development of eating disorders (Wooley 1994). Their pioneering work set in motion a body of biomedical and psychological research that established higher rates of childhood trauma in all forms of eating disorders (Eds) that develop at an earlier age, with higher rates of comorbidities, suicidality, and a more severe form of the disorder (see Molendijk et al. 2017 for a Human Arenas (2018) 1:231-248 https://doi

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“… b) Health literacy specific to gender Duffy et al, 2017 [ 40 ], Holmes, 2016 [ 28 ], Robinson et al, 2013 [ 12 ] c) Does gender really matter in treatment? Crenshaw [ 29 ], Drummond, 2002 [ 41 ], Holmes, 2017 [ 44 ], Holmes, 2016 [ 28 ], Robinson et al, 2013 [ 12 ] 3. Creating Pathways into treatment that address stigma and other barriers a) A women’s problem?…”

Section: Resultsmentioning

confidence: 99%

“…In the studies included in the metasynthesis, 5 had only male participants [ 12 , 26 , 41 – 43 ], 3 had only female participants and focused on gender issues in treatment [ 28 , 29 , 44 ] and one study [ 40 ] explored the treatment experiences of transgender that had female, male and non-binary (not categorically either gender) participants.…”

Section: Resultsmentioning

confidence: 99%

Role of gender in the treatment experiences of people with an eating disorder: a metasynthesis

2018

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BackgroundTraditionally perceived as a disorder of women, Eating Disorders (EDs) are known to have impacts on people irrespective of their gender. This study is designed to synthesise the available qualitative research studies to more broadly understand the diverse experiences of ED and their treatment, specifically in relationship to issues of gender.MethodsThe methodology involved a systematic search and quality appraisal of the literature published after 1980 using terms that aimed to represent the primary concepts of “role of gender” and “treatment experiences” and “eating disorders”. Nine qualitative studies met the inclusion criteria. Meta-themes were inductively generated through a synthesis of data across themes from the relevant included papers.ResultsAnalysis of data was constructed around three meta-themes, each with subthemes. The first meta-theme “Out of sight, out of mind” depicted the experience of gender issues that were marginalised in treatment. More specifically for transgender people, when gender issues were ignored by treatment providers, this frequently led to non-disclosure of their gender identity. Furthermore, men were less likely to be assessed for an eating disorder and within this context; diagnosis of an ED and referral to specialist treatment was frequently hindered. The second meta-theme “Lack of literacy among health care providers” focused on issues related to misdiagnosis of EDs, and the question of whether this was related to a lack of health literacy amongst health professionals. The final theme “Pathways into treatment that address stigma and other barriers” highlighted the need for the development of future treatment interventions address the complex social reality of the experiencing person, including questions of gender.ConclusionGender issues impact upon the ED experience and require broader consideration in the development and evaluation of ED treatment interventions, including the further development of gender-informed interventions.Trial registrationProtocol registered on PROSPERO 2017 CRD42017082616.Electronic supplementary materialThe online version of this article (10.1186/s40337-018-0207-1) contains supplementary material, which is available to authorized users.

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Feminist approaches to Anorexia Nervosa: a qualitative study of a treatment group

Cited by 22 publications

References 42 publications

Literary reading and eating disorders: survey evidence of therapeutic help and harm

Literary reading and eating disorders: survey evidence of therapeutic help and harm

Women’s Constructions of Childhood Trauma and Anorexia Nervosa: a Qualitative Meta-Synthesis

Role of gender in the treatment experiences of people with an eating disorder: a metasynthesis

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