Taiwanese Women’s Experiences in Recovery from Anorexia Nervosa: A Multiple-Case Study

• Main Authors: Yunung Lee, 李御儂
• Other Authors: Chen, Ping-Hwa
• Format: Others
• Language: en_US
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/m3k8v8

碩士 === 國立臺灣師範大學 === 教育心理與輔導學系 === 104 === In Taiwan, understandings surrounding Anorexia are primarily limited to the western psycho-medical perspectives, which are based on a both European individualism and post-positivism paradigm. The current study takes a context-informed and culturally-sensitive perspective in order to comprehend women’s subjective experiences and sense-making during recovery from anorexia in contemporary Taiwan. Bronfenbrenner’s ecological model of human development served as the primary theoretical framework and theories and constructs derived from Chinese indigenous psychology and cross-culture psychology were drawn on as conceptual and analytical references. This study followed a multiple case study design where three women, subject to different subtypes of anorexia for various lengths of time and at different stages of recovery, were selected due to the information richness of their experiences. Multiple forms of data were collected from retrospective in-depth semi-structural interviews, journal entries, eating diaries, pictorial records, which were made during recovery. Each participant’s experiences were treated as a single case followed by cross-case comparisons and contrasts. Data were analyzed using a mixture of inductive and deductive thematic analysis, within each case, to identify salient themes in each ecological system. Afterward, salient themes across all three cases were recorded as well as those distinctive to any of them. Cross-case analysis revealed 12 merged themes: personality traits as a double edged sword and self-help within the individual system, anorexia and recovery associated with family dynamics, relational supports, professional help and therapeutic relationship on the micro-system, anorexia and recovery under western acculturation, Chinese cultural values/constructs interrelated with anorexia and recovery, and bidirectional influences between societal values and anorexia on the macro-system; positive meaning making of recovery, recovery is idiographic in its nature, recovery entailed systemic, multifaceted, and integral transformations, recovery is progressive and stage-like with regard to sense-making of recovery. Overall, findings suggested the interactive nature of anorexia recovery as a reciprocal process between persons and their contexts, within and among various ecological systems. Results also indicated participants’ experiences were related to the specific social, cultural, and historical contexts associated with Taiwan (e.g., western acculturation, emphasis of a relational society on harmony, family, face, stigmatization of the mentally ill, and mental health profession maturity). This research provides an alternative to existing theories and clinical works in anorexia that are mainly based on European individualistic psychology and post-positivistic medical perspectives. Results may be used (a) to encourage mental health professionals in Taiwan to reflect on dominant theories and conventional interventions, (b) to empower women with anorexia to deconstruct dominant social values on femininity and to take on an agent role in recovery, (c) to help researchers and practitioners to develop more culturally-appropriate interventions for Taiwanese individuals and families who live with anorexia in contemporary Taiwanese contexts.