‘Body of evidence’: the experience of patients with anorexia nervosa regarding imagery related to food, weight and shape

Aims: The primary aim of this study was to augment the body of largely quantitative empirical work informing psychological therapy with people diagnosed with eating disorders, in particular, anorexia nervosa, through a collaborative exploration of the lived experience of sufferers, focusing on imagery related to food, weight and shape. This involved the development of an understanding of the themes inherent in the experience of women with anorexia nervosa, based on their in-depth descriptions. Design: Interpretative Phenomenological Analysis (IPA) offers a framework for exploring the lived experience of people embedded within a context, and the meanings that people attach to their experience. This qualitative approach was considered suitable for this study, given its aim of engaging with rich descriptions of people’s experiences. Method: Participants were ten women aged between 18 and 30, with a current diagnosis of anorexia nervosa, who volunteered for interview. Indepth, semi-structured interviews were conducted with the aim of learning about the participants’ embodied experience and how they made sense of their experience. Findings: Analysis using IPA led to the emergence of three Master themes, each constituting a pair of constructs which represent polarities within a realm of experience, namely (1) fragmentation versus integration, (2) exposure versus protection and (3) isolation versus relatedness. Within each realm of experience, there was stronger support within the data for the first construct (namely, fragmentation, exposure and isolation) than for its polar opposite. Organisation of Master themes according to this interpretation allowed for the possibility that participants might potentially experience to a greater extent the opposite polarities of integration, security and relatedness. Conclusion: Psychological therapy for people diagnosed with anorexia nervosa can be enhanced by an understanding of the use of the body in constricting the self in order to feel safe. Imagery work may be integrated into therapy to support clients in developing the capacity for integrated, self-reflective and embodied engagement in their relating to self, others and the wider context.