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Recovery from bulimia nervosa Truant, Laurie Gail

Abstract

Current research on formal treatment approaches to normal-weight bulimia presents inconclusive results on the efficacy of various treatments and limited empirical knowledge of the curative mechanisms involved. In the literature on therapeutic change agent studies which interviews individuals who have recovered from an eating disorder, only isolated aspects of the recovery experience are uncovered so that the meaning and process of recovery are limited. This case study applied Colaizzi's (1978) existential-phenomenological approach to elucidate thematic categories underlying the recovery experience as recounted by a former bulimic in order to provide a more complete and holistic understanding of the process and nature of recovery from bulimia. Initially, four individuals who self-reported feeling genuinely recovered from bulimia were prescreened by an independent rater in order to ensure that they had a previous diagnosis of bulimia nervosa as defined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised (1987) and no previous history of anorexia nervosa, that they were free of bulimic symptoms, and that they exhibited no significant indicators of other active psychological problems since having recovered from bulimia. The four co-researchers described their recovery experience and each interview was transcribed. Categorical themes were formulated from the richest and most comprehensive transcript and information from another co-researcher's transcript served to cross-validate the categories. The remaining two transcripts were not included in the analysis process. The co-researcher validated the thematic categories and their descriptions and also verified that the clustered categories clearly outlined the pattern or meaning of her recovery experience. Results showed that recovery involves a synergetic interaction of curative factors both inside and outside of formal therapy. Once the individual acknowledges her eating problem, her bulimic behaviours begin to decrease as she experiences an increasing sense of efficacy and self-respect in areas of her life other than her body weight and shape. Her bingeing and purging gradually diminish to the point where she no longer engages in them. Aside from an occasional lapse, she now implements other activities to deal with uncomfortable emotional states. She feels stronger in knowing who she is, she cherishes herself as she is, and she is eager to affirm her personal growth by sharing her experience with recovering bulimics. In addition to a more comprehensive theoretical understanding of recovery, this study provided a deepened appreciation of the complexity of the recovery process. It also underscored the need for a multifaceted and individualized treatment approach which is adjusted throughout the recovery process as the adaptive functions or meanings of clients' eating behaviours change.

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