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

Abstract

The paper explores how both the imagining and the seeming inability to imagine their own recovery can be understood in relation to participants' self-constructions and to culturally dominant notions of personhood and eating disorders. The implications of the analysis for therapeutic interventions are discussed.

Developing shared understandings of recovery and care: a qualitative study of women with eating disorders who resist therapeutic care

“…Participants in Malson et al’s study pointed to the ‘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’ ([39] p29). Moreover, setting goals towards weight gain or target weights, while obviously vital to survival and cognitive functioning, are seen as antithetical to current cultural discourses about weight reduction as taking care of one’s health.…”

“…It is critical for the development of a good therapeutic relationship to broaden our understanding of obstacles to recovery within the recipients of treatment, which can portray the client as “‘hostile’, ‘oppositional’, ‘uncooperative’, and ‘impervious to treatment’” ([39] p26), to an understanding of people’s experiences of self-care and health. Boughtwood and Halse argue ‘tension between patients and clinicians over treatment can undermine the therapeutic relationship, which is the social contract between patient and clinician to communicate and collaborate on their shared goals and objectives for treatment’ ([42] p84).…”

Hashtag Recovery: #Eating Disorder Recovery on Instagram

“…These individuals may find themselves "unrecoverable" and without clear instructions for "how to" recover. Additionally, people seeking to recover may consider recovery unimaginable-something that is beyond their reach-while in treatment (Malson et al 2011). We suggest that a part of this unimaginability may relate to the representation of recovery as a place of perfectly balancing the demands of neoliberal health logics and prescriptions for eating disorder recovery.…”

“…Magazines and newspapers often depict recovery as something achieved with relative ease (O'Hara and Smith 2007), in stark contrast to outcome literature reporting lower than 60% rates of "good outcomes" amongst even those whose eating disorders were diagnosed early and who were offered intervention deemed "evidence-based" . Recovery may be unimaginable to those undergoing treatment (Malson et al 2011), may be something about which those with eating disorders are ambivalent (Darcy et al 2010), and may feel overwhelming in the face of cultural narratives urging restraint and slimming . The teachings people receive about "how to be recovered" differ enormously depending on their source; conflicting pedagogies of dominant health dictates and eating disorder recovery may contribute to enduring confusion for those attempting to enact and embody recovery .…”

A critical exploration of lesbian perspectives on eating disorders

“…Seeing other lesbian women "out" and still "happy" led Jess to realise that "it"s not all bad being gay" while Claire relates her recovery to having a girlfriend. As previous qualitative studies (Garrett, 1998; see also Malson, Bailey, Clarke, Treasure, Anderson, & Kohn, 2011) have illustrated, those who have recovered from an eating disorder often view their recovery as a connection or re-connection with self and others. For our participants, witnessing and experiencing the possibilities of social and romantic/sexual inclusion facilitated by coming out to oneself and to family and friends, appears central to (re-)establishing this connectedness and perhaps therefore was also central in facilitating recovery.…”