Fighting for survival
: patients' experiences of inpatient treatment for anorexia nervosa

  • Roselle Birkbeck

Student thesis: PsychD


This study investigates patients and ex-patients' experiences of inpatient treatment for Anorexia Nervosa (AN) across a variety of treatment locations and contexts. Adopting a social constructionist approach to grounded theory, data was collected through in-depth interview of 11 participants identified as white, cis-gender and female. This method enabled
examination of the interactive processes and situational properties that influenced patients’ perceptions and the social processes that emerged from them.

The core category ‘Fighting for Survival’ coheres two main categories that constitute the central findings of this study. Category A: ‘The Feeding Clinic –
Embedding Anorexia’ and Category B: ‘Empowering the person – Fighting the ED’ reflect how participants accounts tended to present a split between positive and negative treatment experiences depending on how a service conceived the treatment objective and constructed the patient.
These differences of context were found to generate vastly different interactive contexts and result in radically different treatment outcomes for a patient.

Treatment contexts defined as ‘Feeding clinics’ were found to establish a social order amongst patients and staff defined by distrust and hostility. Perceiving treatment as a coercive regime, profound feelings of disempowerment and desperation lead patients to adopt strategies of resistance that ultimately appeared to entrench patients eating disordered
behaviours and identity. Treatment contexts defined as ‘Person-Orientated’ by contrast were found to help patients (re)gain a sense of their inherent value as a person and to adopt a conceptual framework towards the ‘ED’ that provided both the reason and the means by which patients could begin the process of establishing a recovery position.
Date of Award10 Aug 2018
Original languageEnglish
Awarding Institution
  • University of Roehampton
SupervisorIgi Moon (Supervisor) & Mick Cooper (Supervisor)

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