Freeing Myself From Self-Blame and Shame: An Autoethnography About Recovering From Anorexia

PURPOSE: Literature commonly discusses anorexia nervosa from a medical model framework. While this approach is necessary in the treatment of individuals with this condition, it does not adequately consider a client’s unique experience and can have an unintended, deleterious effect. I will explore my experience with anorexia and the healthcare I received as a means to address the cultural constructions around anorexia and the potential impact on health behaviors, well being, and the occupational lives of individuals living with and recovering from this condition.

DESIGN: For this study, I used autoethnography to explore the phenomenon of anorexia. Autoethnography “places the author’s lived experience within a social and cultural context” (Reed-Danahay, 2009, p. 30) and uses the author’s personal narrative as data to understand a cultural experience (Holman Jones, Adams, & Ellis, 2013). While this story is mine, it is inevitable that other individuals are implicated when telling my story. Therefore, to assure those mentioned in my story knowingly and willingly agree to be a part of this scholarly work, Institutional Review Board approval was obtained, and informed consent was secured from those individuals.

METHOD: To promote trustworthiness, several data collection methods were employed, including autoethnographic fieldnotes, document review, and analysis of artifacts (Anderson & Glass-Coffin, 2013). Autoethnographic fieldnotes documented my observations of the world and included my interpretations, thoughts, and feelings. These writings promoted reflexivity and acted as a means to better understand myself and my cultural experiences. I also completed document and artifact reviews of items that elicited meaning and memory to promote further examination of my story. In addition, a literature review on autoethnography as method, anorexia, social models of disability, and occupation provided structure for studying this topic. Personal narratives written by individuals who had or have anorexia were also examined to explore similarities and differences in our experiences. Data analysis included multiple readings of data by the author to create preliminary codes that facilitated the development of final codes (Saldaña, 2009). Through ongoing analysis and writing to make sense of the data, as well as regular meetings with my research advisor to discuss findings, final codes were synthesized into meaningful themes.

RESULTS: A key theme revolved around the impact of cultural stigmas that view anorexia as an issue of control. Through analysis, an unpacking of the complex web of emotions and behaviors demonstrated how the over-focus on control resulted in a spiral of self-blame and shame leading to isolating health and occupational behaviors that hindered the recovery process.

CONCLUSION: These findings suggest the importance of treating clients with anorexia using more than a medical model approach and considering the impact of cultural beliefs that may inhibit recovery and induce unhealthy behavior. Furthermore, this study adds evidence to the need for broader education about anorexia to support more effective treatment.

References

Anderson, L., & Glass-Coffin, B. (2013). I learn by going. In S. Holman Jones, T. E. Adams, & C. Ellis (Eds.), The Handbook of Autoethnography (pp. 57-83). Walnut Creek, CA: Left Coast Press.

Holman Jones, S., Adams, T., & Ellis, C. (2013). Coming to know autoethnography as more than a method. In S. Holman Jones, T. E. Adams, & C. Ellis (Eds.), The Handbook of Autoethnography (pp. 17-47). Walnut Creek, CA: Left Coast Press.

Reed-Danahay, D. (2009). Anthropologists, education, and autoethnography. Reviews in Anthropology, 38(1), 28-47. doi:10.1080/00938150802672931

Saldaña, J. (2009). The Coding Manual for Qualitative Researchers. London, UK: SAGE Publications Ltd.