This thesis explores the narratives of people with long-term experience of eating disorders and the wider socio-political, psycho-medical discourses that surround these presentations. It comprises a narrative literature review, a research article and a critical appraisal. The literature review provides a social constructivist critique of the limiting nature of language in the case of anorexia nervosa. By reviewing diagnostic criteria, historical accounts and dominant explanations of anorexia, this article explores their epistemological underpinnings, and the consequent impact of these on research, policy and service-user experience in a neo-liberal political context.
The research paper applies a narrative analytic approach to the accounts of eight participants with long-term experience of eating disorders and specialist service provision. The findings are presented in six cinematic style scenes across three acts, which illustrate participants’ first contact with specialist services, a brief overview of what had happened to get them to this point, the context and quality of their current relationship with services, and their needs and hopes for the future. The contributions of these narratives are discussed in relation to the role specialist services play in the construction of participants’ sense of self, and the implications of this for clinical practice and service development going forward.
Finally, the critical appraisal adopts a narrative approach to the exploration of my experience undertaking this research. Using a similar process to the analysis of participants’ narratives in the research article, I reflect on my introduction to eating disorder services and the reason I became interested in this research, what had happened in my life story to influence this decision and approach, before providing an overview of the challenges, strengths and limitations of the process, and reflecting on what I have learned from researching this topic in this way.