Post-study Reflexivity

Reaching the end of the study felt like completing a long and arduous journey that challenged me both personally and professionally. I was curious to find out more about a topic that had not been investigated much before, but yet seemed so relevant in light of the

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treatment guidelines and current problems with service provision, as documented in the media. Due to my professional and personal experiences I was also highly sceptical of the benefits of CBT and how it was being used to treat eating difficulties.

The unanticipated level of difficulties that I experienced regarding recruitment had a considerable impact on me and my engagement with the study and the emerging material. The difficulties were in stark contrast with the responses from those working in ED services, as those had been largely positive. Although some professionals had expressed a level of concern regarding how long it may take to gain NHS ethical approval. Overall, the process of attaining permission to recruit felt like an endless maze. Dealing with the ever-changing requirements was extremely stressful, as I was eager to move forward with my project and anxious to catch up with my fellow trainees, whom I perceived to be miles ahead. The effort put in certainly did not seem to correspond with the outcome and spending nearly two years consumed by the need to find suitable interviewees impacted on my confidence; many times I thought I had taken on a task that was beyond my abilities. When it came to analysing the transcripts and writing up the analysis, I felt utterly paralysed. This was very similar to how I ended up feeling with the process of attaining ethics and recruiting participants.

Exploring the parallel processes with my supervisor regarding my relationship to my study and what I had observed when looking for participants was a great aid in pushing me forward and finally being able to let go of the study to write up the research process. As mentioned in Chapter 3, the discussions with my peers, supervisor and other professionals helped me to identify that although I sensed a certain kind of protectiveness that services and clinicians had in relation to this client group, I also seemed to be caught up in a similar dynamic, which had an impact on the analytical and the write-up processes. I was concerned that since the individuals that came forward had felt judged and exposed when dealing with professionals, my analysis would be experienced in a similar way. In hindsight, I believe that perhaps I was also concerned about exposing myself through these processes. Since I had been quite struck by Fairburn’s (2008) reservations about those with a history of eating issues providing psychological support to others with similar difficulties, I was hesitant to reveal my own experiences for the fear of being seen as someone, who was perhaps engaging in this research due to their own preoccupation with what Fairburn describes as the core psychopathology of eating disorders. Throughout my struggles, I tried to remain focused on the questions that had initially grabbed my attention regarding what was happening with ED treatments, specifically with CBT.

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Similarly, I found discussing my research process with my fellow trainees and other people unrelated to psychological professions extremely helpful, as they helped me to question my motivations for focusing on different aspects of the research literature and the interview transcripts. As mentioned earlier, I was dubious about the evidence-base supporting the use of CBT and possibly initially approached the topic with this pre-judgement in the forefront of my mind. Attending a number of conferences and reflecting on my research with others working in the field helped me to open up my thinking regarding the research topic, as I came across many, who spoke in favour of CBT, as well as those that favoured a different approach or a combination of approaches.

I also experienced my personal therapy as very helpful in terms of untangling the influence of the participants’ material from my own processes. As I had adopted a number of roles in relation to the topic, such as those of a researcher, clinician and a private person, it was beneficial to examine how these elements interacted with the research process. More recently I joined a professional working group set up to develop guidelines relating to understanding and treating eating difficulties. This allowed me to further engage in the developments in this field.

I feel that engaging in these activities with others and having honest discussions about the research had an enormous impact on the process, as in order to do this, I had to take risks and expose some of my insecurities regarding the project. Through this I was able to shed some of my initial judgements and attend to the material with a more balanced view. I maintain that the previous and current NICE guidelines seem rather misleading in marketing a treatment that has some considerable limitations, but hearing about the potential benefits of CBT and alternative emerging treatments in the field makes me feel hopeful that those with eating difficulties will be able to access treatments that are better tailored to their needs in the future.