Not Eating or Tasting Other Ways to Live: A Qualitative Analysis of 'Living Through' and Desiring to Maintain Anorexia
Not Eating or Tasting Other Ways to Live: A Qualitative Analysis of 'Living Through' and Desiring to Maintain Anorexia
复制标题
DOI：
10.1177/1363461518785796
复制
发表时间：
2018-08-01
影响因子：
2.5
通讯作者：
Lavis, Anna
中科院分区：
文献类型：
--
作者：
Lavis, Anna
虽然最近关于神经性厌食症的讨论已经认识到疾病经历的关键方面，如控制和情绪调节，但仍然有一个跨学科的重点是身体形象的关注。在与临床，心理和社会分析的对话中，本文借鉴了民族志和定性访谈，对被诊断为厌食症的个人提供了另一种观点。关注个体对食物和（不）进食的参与表明，饥饿、计算卡路里和思考食物的物质时刻为厌食症对患有这种疾病的个体的影响提供了一个关键的透镜。参与者的叙述表明，厌食症可以使人退回到麻木和保护性的“泡沫”中。因此，这种疾病可能提供了一种既能应对痛苦又能减轻痛苦的生活方式;有些人描述了通过厌食症生活的矛盾的“安全感”。因此，食品做法是一种保持厌食症的价值安全的方式。通过概述这种关系的做法（不）吃和愿望之间的一些人保持疾病，本文有助于讨论治疗阻力。交叉与更广泛的反思创伤，恢复和伤害最小化的心理健康，讨论考虑如何在研究和治疗实践中，这种愿望可能会接近道德。个体的叙述表明，需要将注意力从厌食症本身转移到痛苦和创伤性生活事件上，这些事件可能是疾病和维持疾病的愿望的基础。
Whilst recent discussions of anorexia nervosa have recognised key aspects of the illness experience, such as control and emotion regulation, there remains a cross-disciplinary emphasis on body image concerns as central. In dialogue with clinical, psychological and social analyses, this paper draws on ethnography and qualitative interviews with individuals diagnosed with anorexia to offer an alternative perspective. Focusing on individuals' engagements with food and (not) eating suggests that material moments of starving, calorie counting, and thinking about food provide a critical lens onto what anorexia does for, as well as to, individuals living with the illness. Participants' narratives suggest that anorexia can make it possible to retreat into a numb and protective 'bubble.' The illness may thereby offer a way to be in the world that both responds to and ameliorates distress; some individuals describe the ambivalent 'safety' of living through their anorexia. As such, food practices are a modality of holding onto anorexia's valued safety. By outlining this relationship between practices of (not) eating and a desire amongst some individuals to maintain the illness, this paper contributes to discussions of treatment resistance. Intersecting with wider reflections on trauma, recovery and harm minimisation in mental health, the discussion considers how this desire might be approached ethically in both research and therapeutic practice. Individuals' narratives suggest the need to reposition attention away from anorexia itself to the distress and traumatic life events that may underlie both the illness and the desire to maintain it.