Understanding inner self-states in eating disorders: preliminary findings from a structured elicitation study

Area of Science:

• Psychology
• Clinical Psychology
• Psychotherapy

Background:

• Eating disorders often involve fragmented self-experiences like self-criticism and shame.
• These internal states can be challenging to articulate in standard clinical interviews.

Purpose of the Study:

• To explore the utility of structured elicitation tools for investigating self-experiences in individuals with eating disorders.
• To assess the effectiveness of visual-symbolic prompts in facilitating the articulation of internal self-states.

Main Methods:

• A qualitative descriptive study involving 14 women with eating disorders.
• Participants underwent structured interviews using nine visual-symbolic self-part cards.
• Data analysis employed an inductive thematic approach with cross-case comparison.

Main Results:

• Cards related to self-rejection, internal criticism, and concealment received higher endorsement.
• Four cross-cutting themes emerged: persecutory self-criticism, shame-based body rejection, protective withdrawal, and developmental discontinuity.
• Themes highlight internalised judgment, body image issues, emotional invisibility, and unmet childhood needs.

Conclusions:

• Structured elicitation with visual-symbolic prompts can aid in exploring clinically relevant self-states in eating disorder patients.
• This method shows potential for improving assessment and psychotherapy formulation in eating disorder treatment.
• Preliminary findings suggest a valuable tool for understanding complex internal experiences.