Carers’ perceptions of the “anorexic voice”: a thematic analysis
Research type
Research Study
Full title
Exploring carers’ perceptions of the “anorexic voice”: a reflexive thematic analysis
IRAS ID
307132
Contact name
Matthew Pugh
Contact email
Sponsor organisation
Canterbury Christ Church University
Duration of Study in the UK
1 years, 1 months, 2 days
Research summary
Research Summary
People who suffer from Anorexia Nervosa commonly report experiencing a critical inner voice, which comments on their weight and self-worth and has been called the Anorexic Voice. Research into the Anorexic Voice has increased understanding of Anorexia Nervosa, in particular around sufferer's attachment to the voice.
The aim of this research is to explore how people who care for loved ones with Anorexia Nervosa experience and think about the Anorexic Voice. To do this, I hope to interview 10-15 adults with experience of caring for a loved one with Anorexia Nervosa. I will ask participants about how they relate to the Anorexic Voice, the impact of this on their caring role and whether they see a role for the Anorexic Voice in recovery.
Summary of Results
Findings
1. Carers held varying definitions of the anorexic voice - for example, some carers had experienced their loved one hearing a voice very different from their own. In contrast, for other carers, the anorexic voice was more of a metaphor that helped them to separate their loved one from anorexia.2. The anorexic voice attracted both advocates and opponents – for most participants, it fit with how they understood their loved ones' difficulties. For a minority, however, the anorexic voice did not fit with their experiences.
3. Advocates of the anorexic voice saw how it invaded and bullied their loved ones – carers noticed how the anorexic voice 'seduced' their loved ones by initially offering value, such as a sense of friendship, before becoming a powerful bully. Carers also highlighted the contrast between their loved ones and the anorexic voice.
4. The anorexic voice bought up strong feelings for carers – the most common feelings were hate, grief and powerlessness.
5. Carers shared their challenges and successes relating to the anorexic voice – many shared experiences of being drawn into conflict by the anorexic voice. Although challenging, carers had found ways to interact with the anorexic voice that seemed to have positive outcomes, for example, standing up to, ignoring or befriending the anorexic voice.
6. Many carers found the idea of the anorexic voice helped them in their role – for example; it allowed them to separate their loved one from anorexia which helped them to tolerate challenging behaviours and remain compassionate and hopeful. Understanding how distressing the anorexic voice was for their loved one also generated empathy.
7. Carers warned that separating their loved ones from the anorexic voice could cause harm – carers shared heart-breaking experiences whereby they had tried to attribute certain behaviours or remarks shown by their loved one as being influenced by the anorexic voice (called externalising), which had led to arguments, and disconnection. Carers therefore advised to use these ideas gently or keep the idea for themselves.
8. Most carers shared heart-breaking experiences of not being able to access appropriate support – carers explained how struggling to access support in the early stages of their loved ones' presentation meant the anorexic voice could grow in strength.
REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
22/NW/0101
Date of REC Opinion
24 May 2022
REC opinion
Further Information Favourable Opinion