Regulating “untrustworthy patients”: Constructions of “trust” and “distrust” in accounts of inpatient treatment for anorexia

Holmes, Su ORCID: https://orcid.org/0000-0003-4243-8337, Malson, Helen and Semlyen, Joanna ORCID: https://orcid.org/0000-0001-5372-1344 (2021) Regulating “untrustworthy patients”: Constructions of “trust” and “distrust” in accounts of inpatient treatment for anorexia. Feminism and Psychology, 31 (1). pp. 41-61. ISSN 0959-3535

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Abstract

Trust has been seen as a lynchpin of therapeutic relationships. Yet due to perceptions that anorexia is one of the most difficult illnesses to treat and that patients are ‘treatment resistant’, achieving trust between patient and treatment provider may be challenging. This article draws on qualitative data from 14 semi-structured interviews with women who have experience of inpatient treatment for anorexia in order to analyse how trust and distrust figured in treatment contexts. In so doing, the article draws upon feminist approaches which are critical of conceptions of the ‘devious’ ‘anorexic’ and of the clinical discourses within which these constructions are produced. Our analysis suggests a lack of trust shown toward patients in inpatient contexts—particularly a disqualification of ‘voice’ —which has a number of consequences for participants’ subjectivities, including the erosion of self-esteem; demotivation; dropping out/ termination of treatment; and triggering experiences of trauma. As such, our analysis raises serious questions about what participants described as routine treatment practices in inpatient treatment for anorexia, and about the serious consequences of constructing ‘anorexics’ as manipulative and untrustworthy.

Item Type: Article
Faculty \ School: Faculty of Arts and Humanities > School of Art, Media and American Studies
Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Arts and Humanities > Research Groups > Film, Television and Media
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User: LivePure Connector
Date Deposited: 01 Oct 2020 23:59
Last Modified: 19 Oct 2023 02:47
URI: https://ueaeprints.uea.ac.uk/id/eprint/77072
DOI: 10.1177/0959353520967516

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