Recovery in anorexia nervosa: the struggle to develop a new identity.

Abstract

This study aims to explore recovery in AN from the perspective of individuals who have experience of it and examine if there are implications for practice. A Grounded Theory methodology was used and semi structured interviews employed to collect the data. The sample consisted of 12 individuals who had experience of AN, either as currently ill or self-defined as recovered from AN. All interviews were recorded and transcribed and the constant comparison method employed to analyse the data. The findings show that recovery for the person involves the successful integration of the four major dimensions of recovery; deciding to recover, sustaining recovering, doing the necessary tasks and building a life without AN. Each of these dimensions represents a series of tasks, which the person must complete, to varying degrees, if they are to recover. The grounded theory that emerged makes explicit that recovery from AN is conditional on the individuals' decision to recover and to take an active part in making it happen. Integrating the four dimensions is a spiralling process where the change in one is dependant on and is influenced by change in the others. They have to improve their physical condition or no recovery is possible because of the effects of starvation. They must tackle the issues that contributed to the AN and take on new roles if they are to move away from the AN identity. They must reconnect with others, asking for and accepting their help because recovery is not achieved alone. If they invest the substantial physical and emotional energy needed to sustain their recovery then they are transformed. They explore and build a life separate from the AN through the integration of the four dimensions. As a result the limited identity of AN is replaced by a more complex identity where individuals are stronger, more connected with others and in control of their lives. This study supports greater attention to the role of self-development tasks and models of treatment that promote autonomy in the person.