Abstract
A meta-synthesis was conducted to explore women’s constructions of anorexia nervosa and childhood trauma. Following a systematic review of the literature, six studies were isolated and synthesized within a material-discursive-intrapsychic framework to produce five taxonomies: “objectified and controlled bodies,” “the abject body,” “embodied emotions and self-harm,” “medicalizing the body-as-object,” and “embodied meanings and new possibilities.” The women’s experience of anorexia, their bodies, and shifting subjectivities was a response to the materiality of childhood abuse. The women discursively constructed anorexia nervosa as a means of negotiating bodily distress associated with trauma and renegotiating their identities to produce a cohesive, embodied self. This meta-synthesis has implications for further research that elucidates how women make meaning from the transformations of their embodied subjectivities.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alcoff, L. (2006). Visible identities: race, gender, and the self. Oxford: Oxford University Press.
Ballou, M., Hill, M., & West, C. (2008). Feminist therapy theory and practice: a contemporary perspective. New York: Springer.
Bhaskar, R. (1989). Reclaiming reality: a critical introduction to contemporary philosophy. London: Verso.
Bordo, S. (2003). Unbearable weight: feminism, Western culture, and the body (Rev. ed.). Berkley: University of California Press.
Brickman, B. J. (2004). ‘Delicate’ cutters: gendered self-mutilation and attractive flesh in medical discourse. Body & Society, 10(4), 87–111. https://doi.org/10.1177/1357034X04047857.
Brown, L. S., & American Psychological Association. (2008). Cultural competence in trauma therapy: beyond the flashback (1st ed.). Washington, DC: American Psychological Association.
Brown, L., Russell, J., Thornton, C., & Dunn, S. (1999). Dissociation, abuse and the eating disorders: evidence from an Australian population. Australian and New Zealand Journal of Psychiatry, 33, 521–528.
Budgeon, S. (2003). Identity as an embodied event. Body & Society, 9(1), 35–55. https://doi.org/10.1177/1357034X03009001045.
Burns, M. (2009). Bodies as (im)material? Bulimia and body image discourse. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating disorders (pp. 124–134). New York: Routledge.
Butler, J. (2011). Gender trouble: feminism and the subversion of identity. Hoboken: Taylor and Francis.
CASP checklist (2014). Better value healthcare web site. Retrieved December 16, 2016, from http://www.casp-uk.net/untitled.
Churruca, K., Ussher, J. M., & Perz, J. (2017). Just desserts? Exploring constructions of food in women’s experiences of bulimia. Qualitative Health Research, 27(10), 1491–1506. https://doi.org/10.1177/1049732316672644.
*Conti, J. (2015). “I don’t think anorexia is the way out”: reconstruction of meaning women’s narrative of anorexia nervosa over 10 years. Journal of Constructivists Psychology, 1–19. doi:https://doi.org/10.1080/10720537.2015.1072485.
Davies, B., & Harré, R. (1990). Positioning: the discursive production of selves. Journal for the Theory of Social Behaviour, 20(1), 43–63. https://doi.org/10.1111/j.1468-5914.1990.tb00174.x.
*Dawson, L., Rhodes, P., & Touyz, S. (2014). “Doing the impossible”: the process of recovery from chronic anorexia nervosa. Qualitative Health Research, 24(4):494–505.
Draucker, C. B., Martsolf, D. S., Ross, R., Cook, C. B., Stidham, A. W., & Mweemba, P. (2009). The essence of healing from sexual violence: a qualitative metasynthesis. Research in Nursing & Health, 32(4), 366–378. https://doi.org/10.1002/nur.20333.
Dyer, A. S., Feldmann, R. E., & Borgmann, E. (2015). Body-related emotions in posttraumatic stress disorder following childhood sexual abuse. Journal of Child Sexual Abuse, 24(6), 627–640. https://doi.org/10.1080/10538712.2015.1057666.
Espíndola, C. R., & Blay, S. L. (2009). Anorexia nervosa treatment from the patient perspective: a metasynthesis of qualitative studies. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 21(1), 38.
Fallon, P., Katzman, M., & Wooley, S. (1994). Feminist perspectives on eating disorders. New York: Guilford Press.
Fredrickson, B., & Roberts, T. (1997). Objectification theory; toward understanding women’s lived experiences and mental health risks. Psychology of Women Quarterly, 21(2), 173–206.
Goldsworthy, K. (2015). What is Childhood Abuse and Neglect? Commonwealth of Australia, https://creativecommons.org/licenses/by-nd/2.0/ CC BY-ND 2.0. Retrieved from https://aifs.gov.au/cfca/publications/what-child-abuse-and-neglect.
Grabe, S., Hyde, J. S., & Lindberg, S. M. (2007). Body objectification and depression in adolescents: the role of gender, shame, and rumination. Psychology of Women Quarterly, 31(2), 164. https://doi.org/10.1111/j.1471-6402.2007.00350.x.
Hay, P., Chinn, D., Forbes, D., Madden, S., Newton, R., Sugenor, L., & Royal Australian and New Zealand College of Psychiatrists. (2014). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. Australian & New Zealand Journal of Psychiatry, 48(11), 977–1008. https://doi.org/10.1177/0004867414555814.
Holmes, S. (2016). ‘Blindness to the obvious’? Treatment experiences and feminist approaches to eating disorders. Feminism & Psychology, 26(4), 464–486. https://doi.org/10.1177/0959353516654503.
Holmes, S., Driake, S., Odgers, K., & Wilson, J. (2017). Feminist approaches to Anorexia Nervosa: a qualitative study of a treatment group. Journal of Eating Disorders, 5, 36. https://doi.org/10.1186/s40337-017-0166-y.
Hund, A. R., & Espelage, D. L. (2006). Childhood emotional abuse and disordered eating among undergraduate females: mediating influence of alexithymia and distress. Child Abuse & Neglect, 30(4), 393–407. https://doi.org/10.1016/j.chiabu.2005.11.003.
Katzman, M. A., & Lee, S. (1997). Beyond body image: the integration of feminist and transcultural theories in the understanding of self starvation. The International Journal of Eating Disorders, 22(4), 385–394. https://doi.org/10.1002/(SICI)1098-108X(199712)22:4<385::AID-EAT3>3.0.CO;2-I.
Keel, P. K., & Forney, K. J. (2015). The prevalence and incidence of eating disorders in western societies. In L. Smolak & M. P. Levine (Eds.), The Wiley handbook of eating disorders (pp. 53–63). Malden: Wiley.
Koenen, K. C., & Widom, C. S. (2009). A prospective study of sex differences in the lifetime risk of posttraumatic stress disorder among abused and neglected children grown up. Journal of Traumatic Stress, 22(6), 566–574. https://doi.org/10.1002/jts.20478.
Kristeva, J. (1982). Powers of horror: an essay on abjection. New York: Columbia University Press.
*Lamoureux, M. M. H., & Bottorff, J. L. (2005). “Becoming the real me”: recovering from anorexia nervosa. Health Care for Women International, 26(2), 170–188. https://doi.org/10.1080/07399330590905602.
Lester, R. J. (1997). The (dis)embodied self in anorexia nervosa. Social Science & Medicine, 44(4), 479–489. https://doi.org/10.1016/S0277-9536(96)00166-9.
Lester, R. J. (2007). Critical therapeutics: Cultural politics and clinical reality in two eating disorder treatment centers. Medical Anthropology Quarterly, 21(4), 369–387. https://doi.org/10.1525/maq.2007.21.4.369.
Lester, R. (2013). Back from the edge of existence: a critical anthropology of trauma. Transcultural Psychiatry, 50(5), 753–762. https://doi.org/10.1177/1363461513504520.
Lupton, D. (1992). Discourse analysis: a new methodology for understanding the ideologies of health and illness. Australian Journal of Public Health, 145–150.
Malson, H. (1998). The thin woman: feminism, post-structuralism and the social psychology of anorexia nervosa. London: Routledge.
Malson, H. (2009). Appearing to disappear. Postmodern femininities and self-starved subjectivities. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating disorders (pp. 135–155). London: Routledge.
Mensinger, J. L., Bonifazi, D. Z., & LaRosa, J. (2007). Perceived gender role prescriptions in schools, the superwoman ideal, and disordered eating among adolescent girls. Sex Roles, 57(7), 557–568. https://doi.org/10.1007/s11199-007-9281-6.
Merleau-Ponty, M. (1962). Phenomenology of perception. London: Routledge & Kegan Paul.
Molendijk, M. L., Hoek, H. W., Brewerton, T. D., & Elzinga, B. M. (2017). Childhood maltreatment and eating disorder pathology: a systematic review and dose-response meta-analysis. Psychological Medicine, 47(8), 1–15. https://doi.org/10.1017/S0033291716003561.
*Moulding, N. (2015). “It wasn’t about being slim”: understanding eating disorders in the context of abuse. Violence Against Women, 21(12), 1456–1480. https://doi.org/10.1177/1077801215596243.
National Institute for Health and Clinical Excellence (2017). Eating disorders recognition and treatment. NICE Guideline NG69. https://www.nice.org.uk/guidance/ng69.
*O'Shaughnessy, R., Dallos, R., & Gough, A. (2013). A narrative study of the lives of women who experience anorexia nervosa. Qualitative Research in Psychology, 10(1), 42–62. https://doi.org/10.1080/14780887.2011.586100.
Piran, N. (2010). A feminist perspective on risk factor research and on the prevention of eating disorders. Eating Disorders, 18(3), 183–198. https://doi.org/10.1080/10640261003719435.
Pugh, M., & Waller, G. (2017). Understanding the ‘anorexic voice’ in anorexia nervosa. Clinical Psychology & Psychotherapy, 24(3), 670–676. https://doi.org/10.1002/cpp.2034.
Sack, M. (2010). Association of nonsexual and sexual traumatizations with body image and psychosomatic symptoms in psychosomatic outpatients. Gen Hosp Psychiatry, 32(3), 315–320. https://doi.org/10.1016/j.genhosppsych.2010.01.002.
Sandelowski, M., & Barroso, J. (2007). Handbook for synthesizing qualitative research. New York: Springer.
Saukko, P. (2009). A critical discussion of normativity in discourses on eating disorders. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating dis/orders (pp. 63–73). New York: Routledge.
Stanghellini, G., & Rosfort, R. (2013). Emotions and personhood: exploring fragility—making sense of vulnerability. Oxford: OUP Oxford.
Steinhausen, H., & Jensen, C. M. (2015). Time trends in lifetime incidence rates of first-time diagnosed anorexia nervosa and bulimia nervosa across 16 years in a Danish nationwide psychiatric registry study. International Journal of Eating Disorders, 48(7), 845–850. https://doi.org/10.1002/eat.22402.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research: techniques and procedures for developing a grounded theory (2nd ed.). Thousand Oaks: Sage.
Tannenbaum, C., Greaves, L., & Graham, I. D. (2016). Why sex and gender matter in implementation research. BMC Medical Research Methodology, 16(1), 1–9. https://doi.org/10.1186/s12874-016-0247-7.
Tiggemann, M., & Williams, E. (2012). The role of self-objectification in disordered eating, depressed mood, and sexual functioning among women: a comprehensive test of objectification theory. Psychology of Women Quarterly, 36(1), 66–75. https://doi.org/10.1177/0361684311420250.
Tolin, D. F., & Foa, E. B. (2008). Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychological Trauma: Theory, Research, Practice, and Policy, S(1), 37–85. https://doi.org/10.1037/1942-9681.S.1.37.
Trottier, K., & MacDonald, D. E. (2017). Update on psychological trauma, other severe adverse experiences and eating disorders: state of the research and future research directions. Current Psychiatry Reports, 19(8), 1–9. https://doi.org/10.1007/s11920-017-0806-6.
Ussher, J. (2000). Women’s madness: a material-discursive-intrapsychic approach. In D. Fee (Ed.), Inquiries in social constructionism: pathology and the postmodern: mental illness as discourse and experience (pp. 207–230). London: SAGE Publications Ltd. https://doi.org/10.4135/978176217252.n10.
Walker, T. (2009). Seeing beyond the battled body’-An insight into selfhood and identity from women’s accounts who self-harm with a diagnosis of borderline personality disorder. Counselling and Psychotherapy Research, 9(2), 122–128. https://doi.org/10.1080/14733140902909174.
Warin, M. (2010). Abject relations: everyday worlds of anorexia. New Brunswick: Rutgers University Press.
*Weaver, K., Wuest, J., & Ciliska, D. (2005). Understanding women’s journey of recovering from anorexia nervosa. Qualitative Health Research, 15(2), 188-206. https://doi.org/10.1177/1049732304270819
Williams, S. J., Bendelow, G., & EBSCO Publishing (Firm). (1998). The lived body: sociological themes, embodied issues. New York: Routledge.
Young, L. (1992). Sexual abuse and the problem of embodiment. Child Abuse & Neglect, 16(1), 89–100. https://doi.org/10.1016/0145-2134(92)90010-O.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Malecki, J., Rhodes, P. & Ussher, J. Women’s Constructions of Childhood Trauma and Anorexia Nervosa: a Qualitative Meta-Synthesis. Hu Arenas 1, 231–248 (2018). https://doi.org/10.1007/s42087-018-0029-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s42087-018-0029-3