Social and Cultural Considerations in Recovery From Anorexia Nervosa

Abstract

New directives in health care research challenge researchers to move analysis beyond that of the individual and focus on social, cultural, and historical processes as interrelated determinants of health and illness. Adhering to a poststructuralist methodology, this article moves the analytic focus beyond individualistic narratives and into social and cultural discourses concerning recovery from anorexia nervosa. This study focused on social and cultural assumptions identified, seemingly as a paradox, through accounts articulated by young women who are in recovery or have recovered from anorexia nervosa. By theorizing outside of an individualized framework, it is possible to foreground the relationships between individualism, health, self-surveillance, women, the body, and the notion of recovery from anorexia.

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

“…To imagine oneself free of weight-related concerns in such a cultural context is perhaps a rather tall order. Indeed, participants in this study and in Hardin's (2003), sometimes pointed to this culturally constituted tension between, on the one hand, treatment goals of reducing weight concerns and, on the other, culturally normative idealisations of slenderness and the near-ubiquity outside of the eating disorder ward of body image concerns and dieting. 'Recovery', one of Hardin's (2003: p. 10) on-line posters wrote, 'is like a mandate to do what everyone else is working not to do'.…”

“…Despite this distinctly troubling picture, recovery rates may well be sometimes over-estimated. As Hardin (2003) has observed, definitions of recovery vary somewhat from one study to another and those with more stringent criteria, covering a range of areas such as social and psychological functioning as well as body weight and eating tend to report lower recovery rates.…”

“…Likewise it has been suggested that patients' comorbidities (Schmidt & Treasure, 2006), 'typical' personality traits such as perfectionism (Holkamp et al 2005) and cognitive abilities or styles (see Tchanturia et al, 2008), for example, cognitive rigidity (McIntosh et al, 2005), may hinder more positive outcomes for those diagnosed. The majority of this research is quantitative in nature but of the few interpretative, qualitative studies of recovery, there is a similar tendency to again focus on within-patient explanations (Hardin, 2003), for example, identifying individual factors influencing recovery (Bruch, 1988;Hsu, Crisp, & Calender, 1990) and individual beliefs that recovery is impossible (Beresin, Gordon, & Herzog, 1989).…”

“…Yet, as Hardin (2003: p. 5) notes, '[n]ew directives in health care research challenge researchers to move analysis beyond that of the individual and focus on social, cultural, and historical processes as interrelated determinants of health and illness'. In one of the very few alreadyexisting, socio-culturally oriented analyses focusing specifically on 'recovery', Hardin (2003) developed a qualitative analysis of a corpus of data combining interviews, autobiographies and postings to an 'anorexia support bulletin board message group'. Her analysis was conducted within a post-structuralist framework.…”

Hashtag Recovery: #Eating Disorder Recovery on Instagram

“…Qualitative studies reveal the complexity of recovery, drawing our attention to the non-linearity of the process (Hardin 2003;Lamoureux and Bottorff 2005), to the challenge of addressing comorbid conditions in later phases of recovery (Pettersen et al 2012), and to how clinical and personal accounts of recovery can differ (Jarman and Walsh 1999). Studies about recovery experiences must be laid over an acknowledgement of how stereotypes around eating disorders can create barriers to treatment.…”