Reaching a crisis point

Each participant spoke in detail about the time period leading up to them getting help for eating difficulties. All women had reached a crisis point, where the issues became increasingly chaotic and difficult to hide. Emma and Laura reported being very active in seeking help during this time. However, Sarah and Amber were forced to seek support by their families. The impact of the difference in this initial phase of entering treatment is also

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observable in other parts of the analysis and will be discussed further in relation to relevant themes.

“But at this point I had the process of me starting uni, my eating getting really bad and then me leaving uni and seeking help, all happened within about a three month period. And it’d

been so bad and so intense in that time that six months seemed like a very dangerous possibility. I mean, even with the seeking help, I did it and then take an overdose sort of

thing.” (Emma, 576-582)

Emma had been teetering on the brink of needing and seeking help for some time, but the issues intensified during life transitions in the form of starting university and moving away from home. Here she speaks about the relatively short period of deterioration that culminated in her taking an overdose. There appears to be a sense of chaos in her account with rapid changes feeling increasingly unmanageable and dangerous. During the interview she repeated several times how she had rejected her eating issues for several years prior to deciding to seek help. Being placed on a six-month waiting list when life felt chaotic seems to have felt unbearable. She perhaps felt that she could not trust herself to get through it. Thus, the overdose could be seen as an attempt to reduce this discomfort and tension.

“Whereas when I was bulimic, it was more. Like, I was feeling guilty all the time, that I was making myself sick. And it was like the opposite. I had hundreds of emotions. It was like

emotional like out flow all the time and just like that was the sort of feelings of like desperation and stuff like that would sort of come up more then.” (Laura, 157-160)

Laura also describes the chaos that ensued when she was experiencing bulimic difficulties. Laura’s eating issues started with weight loss and restriction, but later developed into bulimia. Eventually these two “phases”, as she called them, cycled in rapid successions. In the interview she contrasted the phases in a way that was rather split. When restricting, she felt invincible and did not think that there was a problem that needed attention. Yet during the bulimic phases everything felt out of control. Here she describes difficult emotions flooding her, which were reinforced by her purging. There also seems to be a strong sense of being trapped and overwhelmed in her account.

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“I went to A&E… my friend, again in the nurses’ home found me and took me to A&E. And I was, you know, I was really young. This time they phoned my parents and they

came.” (Sarah, 118-120)

Similarly to Laura, Sarah also restricted her diet in the early stages of her eating issues. This lead to her physical health deteriorating and eventually she took an overdose due to feeling totally powerless to change her situation. Here she begins by demonstrating agency in relation to seeking help. However, this quickly fades away and the agency completely shifts to others around her: her flatmate, the hospital staff and her parents. Sarah had not perceived her eating to be an issue and had managed to avoid on-going interventions from others until this point. It is interesting how Sarah’s denial and others’ concerns interact in the quote, as her friend discovering her physical body after the overdose meant that her problems were no longer hidden and that others could already see what she refused to acknowledge. In addition to her feeling powerless regarding her issues, she was also very vulnerable due to her age and the overdose. Others stepping in meant that she was less able to maintain control, as after this hospitalisation Sarah moved back home and her family forced her into treatment.

“And he said, he said “You’ve got to, you’ve got to go.” I told him I was being sick and that was when he said “If you don’t tell someone, I will.”” (Amber, 27-28)

Amber’s account is somewhat different, as she had not felt out of control with her eating issues. However, she had been concerned that her behaviours, such as using diet apps on her phone at such young age were indicative of a problem. Here she describes sharing her concerns with her then-boyfriend. This meant that what had once been a private experience for Amber was suddenly something that she was no longer in complete control of, as the boyfriend threatened to share the concerns independent of Amber’s permission. Later in the interview Amber described how this had escalated into her mother sharing these issues with others. Also, since she was underage, her mother had taken her to their GP. Throughout the interview Amber communicated a consistent lack of agency regarding her seeking and receiving support.