Abstract
A serious problem faced by clinicians treating anorexia nervosa is the egosyntonic nature of the illness, wherein individuals with anorexia nervosa value their disorder, thereby hindering motivation for recovery and engagement with treatment. The objective of this review article is to elucidate the nature of egosyntonicity in anorexia nervosa, reviewing both qualitative and quantitative research pertaining to this topic, and, importantly, to present methods to overcome this impediment to recovery in anorexia nervosa treatment. The authors elucidate functions of anorexia nervosa for patients, both within psychological and social spheres, as well as highlight the detrimental effect of egosyntonicity in terms of illness severity and motivation for recovery. The final part of the paper contains suggestions as to methods of bypassing pitfalls linked with the influence of the egosyntonic nature of anorexia nervosa within a treatment setting, as well as an examination of three current treatments (enhanced cognitive-behavioral therapy for eating disorders, Maudsley Model of Anorexia Nervosa Treatment for Adults, and Specialist Supportive Clinical Management) in terms of the degree to which they target egosyntonicity.
Highlights
Anorexia nervosa (AN) is an illness which is often chronic in nature, wherein sufferers experience a multitude of detrimental effects in various domains of their life as a result of their low weight and restrictive nutritional intake
The analysis revealed different life domains which the patients perceived their disorder as impacting negatively, as well as negative feelings held toward their illness, demonstrating that despite the egosyntonic nature of AN, patients are still able to recognize various ways in which the disorder causes detriment to themselves, their life, and their loved ones
It is apparent that whilst the egosyntonic nature of AN could be argued to be a core facet of the illness and universal to most AN patients, how this egosyntonic nature presents itself is specific and unique depending on the patient considered, and uncovering this idiosyncratic nature within each patient could be crucial to the therapeutic process
Summary
Anorexia nervosa (AN) is an illness which is often chronic in nature, wherein sufferers experience a multitude of detrimental effects in various domains of their life as a result of their low weight and restrictive nutritional intake. Considering these negative effects, apparent in physical, mental, and social aspects, it may be tempting to regard the disorder as entirely negative, and as such, AN sufferers’ reluctance to seek, to continue, or to engage with treatment can often be baffling from an outsider’s perspective. The Egosyntonic Nature of Anorexia number of researchers have identified the egosyntonic nature of AN, that is, the fact that the disorder is often highly valued by those who suffer from it, as a possible culprit in sustaining the illness despite intervention efforts (Serpell et al, 1999)
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