Emotion regulation and the process of recovery from anorexia

Objective: Difficulties in regulating emotions have been implicated in the development and maintenance of anorexia. However, the empirical and theoretical literature lack explanations about how emotion processes change during the process of recovery. This study seeks to theorise about how people with anorexia perceive their experience of emotion regulation and the factors that influence this, including any therapy-related change.

Method: A constructivist version of grounded theory was used to analyse data collected from semi-structured interviews with nine participants. The sample consisted of people attending an eating disorder service who were currently engaged in therapy.
Results: The analysis produced ten categories reflecting different aspects of the emergent grounded theory of change. Participants described moving between positions of creating a sense of safety in a world of uncertainty, seeing through the façade of anorexia, and recovery and growth. A maintenance model of coping ‘badly’ is also suggested by the data.

Discussion: Behaviours associated with anorexia are amongst the maladaptive strategies participants used to subjectively manage emotions and cope more generally. Positive change was experienced through developing awareness around such processes. The findings support an increased focus on emotions in the treatment of anorexia and offer suggestions about what may facilitate change, both in therapy and elsewhere.