Informed orienteering : a study of navigating systemic positioning dilemmas within the field of anorexia

Jacobs, Nigel (2016) Informed orienteering : a study of navigating systemic positioning dilemmas within the field of anorexia. Doctoral thesis, Birkbeck, University of London.

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Abstract

Systemic Psychotherapists, versed in working from a social constructionist and feminist perspective, can encounter positioning dilemmas when working within the high risk field of anorexia. A common discourse of anorexia is that it has a relationship to issues of control, feelings of subjugation and lack of agency. For professionals, when working within the dominant psycho-medical domain immediate physical risk can be reduced, but so can the client’s sense of agency. On the other hand, if the therapist works within a social constructionist domain agency can be increased, but so might physical risk. Using semi-structured interviews, qualitative data were collected, recorded and analysed from eight systemic family psychotherapists who were currently working with anorexia in a variety of clinical settings. Focus was given within the dialogically constructed interviews to the positions that the participants took within the discourse of anorexia, both theoretically and in action. Positioning dilemmas and issues of power dynamics were given particular focus. The data were analysed using constructivist grounded theory, with three main theoretical codes emerging inductively from the axial codes. The findings that emerged are arranged as a hermeneutic circle of influences upon the positions taken, and encompass history, context, view, position, action and response. The positions of expert, unsettled and not-knowing were identified. Finally the actions of comfort, support and challenge emerged from the data. The participants varied from each other and within their own positioning, with context of client age and chronicity seemingly having a strong influence on how social constructionist positions could be taken in the face of physical risk. The influence of their own and other professional and personal discourses also had bearing. In this study, the findings suggest that an informed orienteering approach (a term that I coined based on dialogic principles, Shotter’s concept of withness and orienteering and Mason’s thinking on working within safe uncertainty) can help systemic therapists position themselves within discourses about anorexia. My informed orienteering approach allows incorporation and attention to both the psycho-medical and social constructionist positions, whilst accounting for issues of power, particularly through feminist critique and the thinking of Foucault and Bourdieu. Implications for the field of family therapy are considered, as are recommendations for future research.

Item Type: Thesis (Doctoral)
Copyright Holders: The copyright of this thesis rests with the author, who asserts his/her right to be known as such according to the Copyright Designs and Patents Act 1988. No dealing with the thesis contrary to the copyright or moral rights of the author is permitted.
School/Department: School of Social Sciences, History & Philosophy > Psychosocial Studies
Depositing User: ORBIT Editor
Date Deposited: 07 Aug 2017 12:04
Last Modified: 07 Aug 2017 12:04
URI: http://bbktheses.da.ulcc.ac.uk/id/eprint/261

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