Maternalism: a healthy alliance for recovery and transition in eating disorder services

Abstract

Accessible summary• The therapeutic relationship is pivotal to mental health nursing but very little is known about how it is experienced in adult eating disorder services.• This paper reports on research project which sought to discover how the therapeutic relationship is experienced between care workers and women with anorexia nervosa (AN) in an adult eating disorder service.• Both care workers and women spoke of a relationship that had similarities to the mother-daughter relationship, that it felt therapeutic and that it was in keeping with a professional and compassionate nursing approach.• These findings provide new insight. 'Maternalism' is seen as a positive, nurturing and transient relationship that ensures the safety of the person and promotes recovery and transition to eventual independence. AbstractThis paper reports on a U.K. interpretative phenomenological research study which aimed to explore the lived experience of the relationship between women with anorexia and their care workers in the context of a specialist eating disorder unit. Here, the concept of maternalism as a phenomenon occurring within the therapeutic relationship in specialist eating disorder units is discussed. Consideration is given to the parallel roles of the health care worker whose duty it is to protect, preserve life and to promote health and that of a mother/ guardian. Although seemingly simplistic, the comforting, soothing and nurturing techniques that are used by the workers to diffuse distress and help the person feel cared for, have many similarities to 'mothering'. Hence a maternalistic approach which provides a sense of security and nurturing can be a compassionate way to facilitate hope and a route out of their anorexia into recovery, in the same way that good parenting can facilitate maturation and independence.

The lived experience of working with people with eating disorders: A meta‐ethnography

“…HCPs saw limited self‐disclosure as normalizing and facilitating relational safety: “I have talked about things going on in my life…it…puts them on your level” (nurse; Micevski & McCann, , p. 107). For some HCPs, predominantly nurses, maternalism – a protective and nurturing stance underpinned by genuine care for service users (Wright, ) – facilitated unconditional positive regard, and reconciled the need for both empathetic support and boundaries. However, these aspects of maternalism were acknowledged to be “potentially conflictual,” and it was suggested that nurses be supported to navigate this through supervision and training (Ryan et al, , p. 132).…”

The nature of the therapeutic alliance between nurses and consumers with Anorexia Nervosa in the inpatient setting: A mixed‐methods study

“…Consumers and nurses in this study described positively perceived nursing care, some indicating that effective nurses assumed a “motherly” or “sisterly” role. Maternal role assumption in eating disorders nursing has been previously identified and explored (Ryan et al., ; Wright, ). Ryan et al.…”

“…Wright () asserts that nurses deliberately assume a motherly role and mode of interaction, subsequently enhancing care for consumers by harnessing the therapeutic value of maternalistic care and presence. The physical proximity of nurses, their sensitivity, empathy and therapeutic touch, are of a maternalistic quality (Wright, ). From the previous and current research, nurses adopt a maternalistic approach for its therapeutic expediency.…”

Care planning: a neoliberal three card trick

“…Despite the espoused commitment on the part of nursing to therapeutic alliance (Peplau , Chambers , Cleary et al . ,b, Wright ), this has been found lacking within psychiatric wards (Cleary , Lelliott & Quirk , Gilburt et al . , McAndrew et al .…”