Living with the anorexic voice: a thematic analysis.

OBJECTIVES: A factor said to drive the behaviours of people with the eating disorder anorexia nervosa is the inner voice some recount hearing. However, little systematic examination has been made of this entity. The study aimed to investigate experiences of and reflections on living with an anorexic voice. DESIGN: A qualitative approach was used because the study sought to establish the perspectives of those with anorexia who identified with the concept of living with an anorexic voice. METHOD: Individuals from three self-help organizations were invited to write about their life with an anorexic voice in the form of a poem, a reflection, a letter, or a descriptive narrative. Recruitment continued until data saturation was reached. Thematic analysis was employed by two researchers. RESULTS: Written contributions were provided by 21 participants. These data underlined the positive and negative attributes individuals bestowed upon their anorexic voice; the former appeared stronger during the early stages of their eating disorder, the latter coming into force as it developed. In spite of their voice's harsh and forceful character, participants felt an affiliation towards it. DISCUSSION: The bond between individuals and their anorexic voice could explain their ambivalence to change. Therapists must persist in their endeavours to penetrate this tie, whilst acknowledging the hold this entity has over those with anorexia. Interventions that address this component of the eating disorder could prove fruitful in helping people towards recovery.