Fight against anorexia from personalised perspectives:A Phenomenological Analysis
1AcknowledgementI would like to take this opportunity to express my profound gratitude and deep regard to mySupervisor Dr.Jackie Gray for her exemplary guidance, valuable feedback and constantencouragement throughout the duration of the project. Her valuable suggestions were ofimmense help throughout my project work. Her perceptive criticism kept me working to makethis project in a much better way. Working under him/her was an extremely knowledgeableexperience for me. I would also like to give my sincere gratitude to all my peers who withoutwhom this research would be incomplete.
2AbstractEating disorders like anorexia nervosa have been linked with a persistent over concern with bodyshape and physical appearance. Long-term suffering from anorexia nervosa leads to thedevelopment of severe health conditions related to malnutrition. The aim of the present studywas to conduct an exploration of the perceptions and viewpoints of individuals who havereported to have recovered from anorexia nervosa, or are recovering from the same condition. Anarchival qualitative methodology was employed and the data analysis conducted withinterpretative phenomenological analysis. Videos posted by six women were selected fromYouTube in order to study factors influencing development of anorexia nervosa. Analysis leadsto the generation of four possible themes. The main themes include experience of fragile sense ofself, influence of others on self-perception, strategies to employ to manage the sense of self andthe enduring influence of early experience. All these themes will be cited as the reason behindthe development of anorexia nervosa. The findings of the study of this phenomenologicalanalysis will helpful in ascertaining the psychology of the individual suffering from anorexianervosa and their journey towards the subsequent recovery.
3Table of ContentsINTRODUCTION5AIMS AND RESEARCH QUESTION8METHODOLOGY9QUALITATIVEDESIGN9INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS (IPA)9RESEARCH DESIGN10DATA10PARTICIPANT CHARACTERISTICS10ETHICALCONSIDERATIONS11DATAANALYSIS11ANALYSIS AND DISCUSSION13THEME 1- EXPERIENCINGAFRAILSENSEOFSELF14THEME 2- INFLUENCEOFOTHERSONSELF-PERCEPTION17THEME 3: STRATEGIESEMPLOYEDTOMANAGETHESELF- SENSE18THEME 4: THEENDURINGINFLUENCEOFEARLYEXPERIENCES20CONCLUSION22REFLECTION23STUDY REFLECTIONS23METHODOLOGICALCONSIDERATIONANDSTUDYLIMITATIONS23
4REFERENCES25APPENDIX A: VIDEO TRANSCRIPT30VIDEO 130VIDEO 234VIDEO 344VIDEO 450VIDEO 559VIDEO 663
5IntroductionOrganisations throughout the globe are striving at present to reduce the stigma anddisgrace related to eating disorders. Eating disorders have been linked with a persistent overconcern with body shape and size as indicated by extreme behaviours such as strenuous exercise,prolonged fasting and self-induced vomiting to reduce body fat and weight (Costa et al., 2016).Scientists denote eating disorders as mental disorders that have an adverse impact on the mentaland physical health of the person (Costa et al., 2016). The present Diagnostic and Statistical Manual of Mental Disorder classifies eatingdisorders into three distinct categories: Anorexia Nervosa (AN), Bulimia Nervosa (BN), andEating Disorder Not Otherwise Specified (EDNOS). The DSM- IV –TR criteria for AnorexiaNervosa highlights persons who are refusing to maintain a certain body weight above or at anormal level as appropriate for the individual considering the age and height; for people whohave a strong fear of becoming fat or gaining weight; or have certain disturbed body image dueto body shape and weight; Amenorrhea for at least three consecutive menstrual cycles(Mustelinet al., 2016). The Anorexia nervosa category has again been classified into two classes;restricting-type and purging/binge eating type. For those suffering from the first form of anorexianervosa, the tendency is to achieve the weight loss through fasting, dieting and excessiveexercise. For others, there is a regular engagement in binge eating and/or purging wherein theyself-induce vomiting and misuse laxatives and diuretics (Eddy et al., 2017).The health risks associated with anorexia nervosa (AN) had been well pointed out by(Gianiniet al., 2017). Long-term anorexia leads to severe health conditions related tomalnutrition. Potential complications include concerns with bones and muscles, osteoporosis,
6heart conditions, kidney conditions, fertility problems and problems with functioning of the brainand the nervous system. At least1.6 million individuals (approx) in the UK are estimated tosuffer from anorexia and other eating disorders. While an underestimation might be involved, itis known that the needs of the community are frequently unmet (anorexiabulimiacare.org.uk,2018). Anorexia mostly affects women and adolescent girls, and the average age of developingthe disease is 16 to 17 years. Figures for 2015 indicated that about 2.9 million people were livingwith anorexia. Further, about 0.9%- 4.3% of women in western countries suffer from anorexia atsome point in their lifetime. While the condition has become more diagnosed at the presentcentury, the factors contributing to the same are still to be explored (Byrne et al., 2017). A rich pool of literature exists on the involvement of self in eating disorders such asanorexia. The self-concept has been denoted to be multifactorial, containing different empiricalselves; spiritual self, social self and body self. Literature has linked the concept of self inanorexia to two fundamental theories; feminist theories, and cognitive and behaviouralperspectives. Feminist theory in regards to anorexia sits well within the psychoanalyticconceptualisation of self. Theorists have put forward the argument that female psychosocialdevelopment is guided by cultural ideals regarding perfect women (Young et al., 2018). Thesetheorists have repeatedly associated anorexia nervosa and other eating disorders with pressuresfrom the society that conflict with the ability to have a satisfying identity. The reliance on suchcase is mainly the methods of coping with the absence of a distinct self, such as poor eating habit(Holmes et al., 2017). Behavioural and cognitive perspectives relate the concepts of self-image,self-schema and body dissatisfaction in anorexia (Pike & Olmsted, 2016). According to Junneetal., (2016), self-schema is noted to be the cognitive generalisations regarding self due toexperiences. The essence of low self-esteem lies in negative self-image which is derived from
7interactions with the society and related experiences. Abuse, neglect, lack of praise and affectionare the contributory factors. Disturbed body image or body dissatisfaction relates to theindividual’s inclination towards being unhappy due to body weight (Junneet al., 2016). Bodyimage disturbances are probably the most common driving force behind anorexia nervosa andthe related conditions (Junneet al., 2016). O'Connell et al, (2017) have collected quantitativeevidence and have opined that individuals with anorexia nervosa (AN) may nurture beliefs in thedomain of food, body image and appearance that are often delusional nature. While qualitative research regarding the experiences of anorexic patients has attempted toexplore views of the self, there lies a gap in exploring secondary aims. The existing studiesfocused on the application of a discourse analysis (DA), the approach noted to have the focus onthe social construction of reality (Holmes et al., 2017). Such studies gave the suggestion thatadditional understanding would be required in this domain through a different qualitativeresearch methodology. Interpretative Phenomenological Analysis (IPA) is a notable qualitativeapproach aiming at exploring how participants make sense of their personal and social world(Edward, 2017). The two approaches are distinct as the IPA aims at exploring the experience andthinking of participants, contributing more significantly to the understanding of the underlyingprinciples of eating disorder and self.