Schema modes in eating disorders: an interpretative phenomenological analysis
- Authors: Bowker, Chantal Ann
- Date: 2021-10-29
- Subjects: Eating disorders , Anorexia nervosa , Bulimia , Compulsive eating , Schema-focused cognitive therapy , Interpretative phenomenological analysis (IPA)
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/196072 , vital:45723 , DOI 10.21504/10962/196072
- Description: The DSM-5 prevalence rate of anorexia nervosa is 0.4%, bulimia nervosa is 1% to 1.5%, and binge eating disorder is 1.6% (American Psychiatric Association, 2013). Although treatment approaches for eating disorders have high drop-out rates and low rates of recovery, treatment modalities that address childhood factors contributing to the eating disorder, as well as the eating disorder behaviours, have better outcomes. Schema therapy is an integrative approach that has been used for the treatment of eating disorders for more than a decade. Central features in schema therapy include the identification of early maladaptive schemas arising from unmet needs and schema modes. Schema modes, composed of schemas and coping mechanisms, are active for an individual at a particular time in response to triggers in the environment (Brown et al., 2016). Identifying an individual’s modes is a crucial aspect that reflects the underlying structure of the individual’s creation of reality. A phenomenological understanding of the modes is essential for developing a case conceptualisation and treatment plan. Differences exist in the naming and description of modes in the current schema therapy literature, which suggests the need for a phenomenological investigation of these structures. This research study used a mostly qualitative approach, in the form of clinical interviews, substantiated by questionnaires, to examine schema modes. Case presentations using the schema therapy model are provided for five women with either anorexia nervosa, bulimia nervosa or binge eating disorder. Then, through a process of interpretative phenomenological analysis, specific modes are examined as to how they are experienced by the participants and influence their behaviour. The features of schema modes in these clinical cases are compared to the existing literature to extend the understanding of schema modes in eating disorders. The participants’ experiences revealed that they had schema modes in common, regardless of the eating disorder presentation, but that the features of the individual modes varied. Modes found in the current literature such as the Detached Self-Soother and Perfectionist Overcontroller coping mode, were found in all the participants. Four of the five participants had an Eating Disordered Overcontroller mode. Features consistent with the existing descriptions of the Perfectionist Overcontroller, Eating Disordered Overcontroller and Detached Self-Soother modes were noted, and new features were identified. The Perfectionist Overcontroller and Eating Disordered Overcontroller have been presented here as complex composite modes with sub-modes that work together in a coherent way in the service of the same project (Edwards, 2020b). Twenty-three features are identified in the parent modes. Blended parent modes, with multiple features active in a situation, were described. The blended parent modes expand on the existing literature on parent modes. The findings in this research support and extend the mode structure identified in the schema therapy theory, and highlight the idiosyncratic nature of the modes. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2021
- Full Text:
- Date Issued: 2021-10-29
- Authors: Bowker, Chantal Ann
- Date: 2021-10-29
- Subjects: Eating disorders , Anorexia nervosa , Bulimia , Compulsive eating , Schema-focused cognitive therapy , Interpretative phenomenological analysis (IPA)
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/196072 , vital:45723 , DOI 10.21504/10962/196072
- Description: The DSM-5 prevalence rate of anorexia nervosa is 0.4%, bulimia nervosa is 1% to 1.5%, and binge eating disorder is 1.6% (American Psychiatric Association, 2013). Although treatment approaches for eating disorders have high drop-out rates and low rates of recovery, treatment modalities that address childhood factors contributing to the eating disorder, as well as the eating disorder behaviours, have better outcomes. Schema therapy is an integrative approach that has been used for the treatment of eating disorders for more than a decade. Central features in schema therapy include the identification of early maladaptive schemas arising from unmet needs and schema modes. Schema modes, composed of schemas and coping mechanisms, are active for an individual at a particular time in response to triggers in the environment (Brown et al., 2016). Identifying an individual’s modes is a crucial aspect that reflects the underlying structure of the individual’s creation of reality. A phenomenological understanding of the modes is essential for developing a case conceptualisation and treatment plan. Differences exist in the naming and description of modes in the current schema therapy literature, which suggests the need for a phenomenological investigation of these structures. This research study used a mostly qualitative approach, in the form of clinical interviews, substantiated by questionnaires, to examine schema modes. Case presentations using the schema therapy model are provided for five women with either anorexia nervosa, bulimia nervosa or binge eating disorder. Then, through a process of interpretative phenomenological analysis, specific modes are examined as to how they are experienced by the participants and influence their behaviour. The features of schema modes in these clinical cases are compared to the existing literature to extend the understanding of schema modes in eating disorders. The participants’ experiences revealed that they had schema modes in common, regardless of the eating disorder presentation, but that the features of the individual modes varied. Modes found in the current literature such as the Detached Self-Soother and Perfectionist Overcontroller coping mode, were found in all the participants. Four of the five participants had an Eating Disordered Overcontroller mode. Features consistent with the existing descriptions of the Perfectionist Overcontroller, Eating Disordered Overcontroller and Detached Self-Soother modes were noted, and new features were identified. The Perfectionist Overcontroller and Eating Disordered Overcontroller have been presented here as complex composite modes with sub-modes that work together in a coherent way in the service of the same project (Edwards, 2020b). Twenty-three features are identified in the parent modes. Blended parent modes, with multiple features active in a situation, were described. The blended parent modes expand on the existing literature on parent modes. The findings in this research support and extend the mode structure identified in the schema therapy theory, and highlight the idiosyncratic nature of the modes. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2021
- Full Text:
- Date Issued: 2021-10-29
Embodied difference in manhood: A sociological analysis of the intersection of visible physical impairments and manhood among Xhosa men in the Eastern Cape
- Authors: Sipungu, Thoko Andy
- Date: 2021-10-29
- Subjects: Masculinity South Africa Eastern Cape , Sex role South Africa Eastern Cape , Sex role Psychological aspects , Men with disabilities South Africa Eastern Cape , People with disabilities Social conditions , Xhosa (African people) South Africa Eastern Cape Social life and customs , Male domination (Social structure) South Africa Eastern Cape , Circumcision Social aspects South Africa Eastern Cape
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/191658 , vital:45145 , 10.21504/10962/191658
- Description: In this thesis, I outline possible answers to the question of what it means to be a Xhosa man living with a visible physical impairment. Drawing on 17 one-on-one in-depth interviews and through an interpretive phenomenological thematic analysis, this thesis explores the intersection of physical disabilities and manhood masculinity in Xhosa men in selected rural areas in the Eastern Cape, South Africa. The intention for this study is to better our understanding concerning the creation, negotiation, maintenance, and recreation of manhood identities by traditionally circumcised Xhosa men in the Eastern Cape who by birth, accident, or illness find themselves at the intersections of masculinity and physical disability. Research notes that the bodies of men with disabilities serve as a continual reminder that they are at odds with the expectations of the dominant manhood cultures. The main argument from this area of research is that men with disabilities are outside the hegemony because they undermine the normative role and shape of the body in Western cultures. However, this line of argumentation stands in sharp contrast to arguments that the hegemony in Xhosa manhood masculinity is primarily and conclusively achieved by having a traditionally circumcised penis without any consideration of the full embodiments of men. Therefore, this study, in the first instance, seeks to bring embodiment into the analyses of manhood by focusing on physical disability amongst traditionally circumcised Xhosa men. Through an embodied theoretical approach to their disabilities that accounts for the corporeal experience of impairment, and theories of masculinity that centre the context, this thesis establishes, in the first instance, the significance of embodiment in doing Xhosa manhood. Concerning the research aims and objectives, this study sheds light on what it means to be a Xhosa man living with visible physical impairment. In this regard, the original findings are classified according to each research aims and objective, as outlined below. Concerning the first research aim, I found that the participants struggle to speak about their bodies outside of physical labour/work despite their impairments. I explain their inability to talk about their disabled bodies by looking at traditional Xhosa initiation as a grantor of equality and sameness. Secondly, I argue that there is a higher premium on social bodies rather than physical bodies in this context, thus their inability to speak about their conditions. Lastly, I make connections between the participants’ inabilities to talk about their bodies and the lasting impact of colonial and apartheid histories. Concerning the second research aim, I explore ways and strategies they employ to respond to and negotiate Xhosa manhood masculinity's dominant cultural demands. In this regard, I note that the participants who acquired their impairments after initiation consider their disability as a second initiation because they see it as having set them back to square one regarding their manhood responsibilities. In contrast, the participants who acquired their disabilities post-initiation saw initiation as a gateway to a more respectable personhood status. I also note that there is an emergence of alternative Xhosa manhood masculinities. Lastly, I also found that contrary to western scholarship on disability and manhood, the participants distinguish between threatened manhood identity versus threatened status as a man. I outline how they arrive at this distinction. In terms of researching the last research aim, this thesis explores how the participants negotiate their ‘embodied difference’ in mundane everyday living. I explore their taken-for-granted routines in doing and being disabled Xhosa men every day. In this regard, this study presents original and interesting findings regarding sex and intimacy, social interactions and sociability, and everyday home living. , Thesis (PhD) -- Faculty of Humanities, Sociology, 2021
- Full Text:
- Date Issued: 2021-10-29
- Authors: Sipungu, Thoko Andy
- Date: 2021-10-29
- Subjects: Masculinity South Africa Eastern Cape , Sex role South Africa Eastern Cape , Sex role Psychological aspects , Men with disabilities South Africa Eastern Cape , People with disabilities Social conditions , Xhosa (African people) South Africa Eastern Cape Social life and customs , Male domination (Social structure) South Africa Eastern Cape , Circumcision Social aspects South Africa Eastern Cape
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/191658 , vital:45145 , 10.21504/10962/191658
- Description: In this thesis, I outline possible answers to the question of what it means to be a Xhosa man living with a visible physical impairment. Drawing on 17 one-on-one in-depth interviews and through an interpretive phenomenological thematic analysis, this thesis explores the intersection of physical disabilities and manhood masculinity in Xhosa men in selected rural areas in the Eastern Cape, South Africa. The intention for this study is to better our understanding concerning the creation, negotiation, maintenance, and recreation of manhood identities by traditionally circumcised Xhosa men in the Eastern Cape who by birth, accident, or illness find themselves at the intersections of masculinity and physical disability. Research notes that the bodies of men with disabilities serve as a continual reminder that they are at odds with the expectations of the dominant manhood cultures. The main argument from this area of research is that men with disabilities are outside the hegemony because they undermine the normative role and shape of the body in Western cultures. However, this line of argumentation stands in sharp contrast to arguments that the hegemony in Xhosa manhood masculinity is primarily and conclusively achieved by having a traditionally circumcised penis without any consideration of the full embodiments of men. Therefore, this study, in the first instance, seeks to bring embodiment into the analyses of manhood by focusing on physical disability amongst traditionally circumcised Xhosa men. Through an embodied theoretical approach to their disabilities that accounts for the corporeal experience of impairment, and theories of masculinity that centre the context, this thesis establishes, in the first instance, the significance of embodiment in doing Xhosa manhood. Concerning the research aims and objectives, this study sheds light on what it means to be a Xhosa man living with visible physical impairment. In this regard, the original findings are classified according to each research aims and objective, as outlined below. Concerning the first research aim, I found that the participants struggle to speak about their bodies outside of physical labour/work despite their impairments. I explain their inability to talk about their disabled bodies by looking at traditional Xhosa initiation as a grantor of equality and sameness. Secondly, I argue that there is a higher premium on social bodies rather than physical bodies in this context, thus their inability to speak about their conditions. Lastly, I make connections between the participants’ inabilities to talk about their bodies and the lasting impact of colonial and apartheid histories. Concerning the second research aim, I explore ways and strategies they employ to respond to and negotiate Xhosa manhood masculinity's dominant cultural demands. In this regard, I note that the participants who acquired their impairments after initiation consider their disability as a second initiation because they see it as having set them back to square one regarding their manhood responsibilities. In contrast, the participants who acquired their disabilities post-initiation saw initiation as a gateway to a more respectable personhood status. I also note that there is an emergence of alternative Xhosa manhood masculinities. Lastly, I also found that contrary to western scholarship on disability and manhood, the participants distinguish between threatened manhood identity versus threatened status as a man. I outline how they arrive at this distinction. In terms of researching the last research aim, this thesis explores how the participants negotiate their ‘embodied difference’ in mundane everyday living. I explore their taken-for-granted routines in doing and being disabled Xhosa men every day. In this regard, this study presents original and interesting findings regarding sex and intimacy, social interactions and sociability, and everyday home living. , Thesis (PhD) -- Faculty of Humanities, Sociology, 2021
- Full Text:
- Date Issued: 2021-10-29
Catchment and River Management in Graduate Teacher Education: A Case Study of Student Teacher Learning and Teaching in the Upper uThukela Valley, KwaZulu-Natal
- Authors: Heath, Gavin Edward Craig
- Date: 2021-10-29
- Subjects: Geography Study and teaching (Higher) South Africa KwaZulu-Natal , Watershed management Study and teaching (Higher) South Africa KwaZulu-Natal , Pedagogical content knowledge , Environmental education South Africa KwaZulu-Natal , Teacher effectiveness South Africa KwaZulu-Natal , Curriculum and Assessment Policy Statement (CAPS)
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/190635 , vital:45012 , 10.21504/10962/190635
- Description: This study developed as a progressive focus on a design research process towards the inclusion of new environmental knowledge in teacher education. It is centred on the clarification of pedagogical content knowledge for the teaching of catchment and river management in Geography teacher education. The study was developed as a design research case study with three phases or iterations of experiential engagement and data collection during the teaching of Postgraduate Certificate in Education students at the University of KwaZulu-Natal where I lecture Geography Education. The study’s iterative design was developed around pedagogical content knowledge refinement with curriculum knowledge analysis (phase 1) that was followed by lecture delivery and analysis (phase 2) and analysis of student engagement during fieldwork, and on teaching practice in rural classroom contexts (phase 3). Data and insights were generated across the successive stages of knowledge differentiation and teaching and learning interactions over time, and included reflection with students involved in the lectures, fieldwork and teaching practice programme. The analytical work covered a review of trajectories in new environmental knowledge, social-ecological systems, sustainability competencies, practice architecture and fieldwork pedagogy. This was done using three research lenses, namely social-ecological systems, social learning and practice architectures. All the design research and review processes served to develop, clarify and refine pedagogical content knowledge for sustainability-oriented teacher education. Thus the study conformed to the tenets of design-based research that was centred on clarification and review of pedagogical content knowledge that was carried into phases two and three. Research was focused at the nexus of pedagogical content knowledge and sustainability concerns that is necessary for the teaching of catchment and river basin management within a social-ecological systems perspective for integrated water resources management in South Africa and globally. The findings informed an illustrative model on how the research was carried out. Six design research insights and principles conclude the study and encapsulate the contribution it makes to new knowledge on how teacher education practice can be progressively aligned with new content knowledge teaching and the teaching of sustainability concerns. Specific findings in the form of six research insights indicated that the fieldworkbased teaching practice experience proved a successful learning crucible to develop sustainability competences. The cohort of student teachers passed their fieldwork teaching practice despite inadequate covering of foundational concepts in school and university. The teaching of a catchment management strategy case study was valuable in all three phases of research. A multi-contextual teaching and learning environment was successfully negotiated and navigated by the student teachers. The present Curriculum and Assessment Policy Statement does not speak to the reality on the ground, particularly in deep rural environments. A compulsory virtual Geography teacher training experience is recommended. Lastly, varied and broad responses to the noted multi-contextual challenges are needed in order to prepare and equip student teachers for the demands of the new environmental knowledge in the curriculum. Based on the groundwork provided by this study, there is scope for further research especially regarding the varied and broad responses to this new environmental knowledge in the curriculum. , Thesis (PhD) -- Faculty of Education, Education, 2021
- Full Text:
- Date Issued: 2021-10-29
- Authors: Heath, Gavin Edward Craig
- Date: 2021-10-29
- Subjects: Geography Study and teaching (Higher) South Africa KwaZulu-Natal , Watershed management Study and teaching (Higher) South Africa KwaZulu-Natal , Pedagogical content knowledge , Environmental education South Africa KwaZulu-Natal , Teacher effectiveness South Africa KwaZulu-Natal , Curriculum and Assessment Policy Statement (CAPS)
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/190635 , vital:45012 , 10.21504/10962/190635
- Description: This study developed as a progressive focus on a design research process towards the inclusion of new environmental knowledge in teacher education. It is centred on the clarification of pedagogical content knowledge for the teaching of catchment and river management in Geography teacher education. The study was developed as a design research case study with three phases or iterations of experiential engagement and data collection during the teaching of Postgraduate Certificate in Education students at the University of KwaZulu-Natal where I lecture Geography Education. The study’s iterative design was developed around pedagogical content knowledge refinement with curriculum knowledge analysis (phase 1) that was followed by lecture delivery and analysis (phase 2) and analysis of student engagement during fieldwork, and on teaching practice in rural classroom contexts (phase 3). Data and insights were generated across the successive stages of knowledge differentiation and teaching and learning interactions over time, and included reflection with students involved in the lectures, fieldwork and teaching practice programme. The analytical work covered a review of trajectories in new environmental knowledge, social-ecological systems, sustainability competencies, practice architecture and fieldwork pedagogy. This was done using three research lenses, namely social-ecological systems, social learning and practice architectures. All the design research and review processes served to develop, clarify and refine pedagogical content knowledge for sustainability-oriented teacher education. Thus the study conformed to the tenets of design-based research that was centred on clarification and review of pedagogical content knowledge that was carried into phases two and three. Research was focused at the nexus of pedagogical content knowledge and sustainability concerns that is necessary for the teaching of catchment and river basin management within a social-ecological systems perspective for integrated water resources management in South Africa and globally. The findings informed an illustrative model on how the research was carried out. Six design research insights and principles conclude the study and encapsulate the contribution it makes to new knowledge on how teacher education practice can be progressively aligned with new content knowledge teaching and the teaching of sustainability concerns. Specific findings in the form of six research insights indicated that the fieldworkbased teaching practice experience proved a successful learning crucible to develop sustainability competences. The cohort of student teachers passed their fieldwork teaching practice despite inadequate covering of foundational concepts in school and university. The teaching of a catchment management strategy case study was valuable in all three phases of research. A multi-contextual teaching and learning environment was successfully negotiated and navigated by the student teachers. The present Curriculum and Assessment Policy Statement does not speak to the reality on the ground, particularly in deep rural environments. A compulsory virtual Geography teacher training experience is recommended. Lastly, varied and broad responses to the noted multi-contextual challenges are needed in order to prepare and equip student teachers for the demands of the new environmental knowledge in the curriculum. Based on the groundwork provided by this study, there is scope for further research especially regarding the varied and broad responses to this new environmental knowledge in the curriculum. , Thesis (PhD) -- Faculty of Education, Education, 2021
- Full Text:
- Date Issued: 2021-10-29
Schema therapy for anorexia nervosa: an intensive systematic individual case study
- Authors: Alexander, Graham
- Date: 2021-10-29
- Subjects: Eating disorders , Anorexia nervosa , Anorexia nervosa Treatment , Anorexia nervosa Case studies , Schema-focused cognitive therapy , Anorexic overcontroller , Interpretative phenomenological analysis (IPA)
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/196082 , vital:45724 , DOI https://doi.org/10.21504/10962/196082
- Description: Developed more than three decades ago, schema therapy (ST) was born out of a need for a more effective way of working with difficult and challenging cases where patients were clearly unresponsive to the existing short-term cognitive therapies. While anchored in the primary theoretical orientation of cognitive therapy, ST has carefully integrated techniques and principles from attachment and object-relations therapies, as well as humanistic, gestalt and experiential therapies. The mode model emphasises the concept of “multiplicity” in terms of which the self is functionally divided into parts or schema modes. For a little more than a decade there has been growing interest amongst researcher-clinicians in the application of ST for the treatment of eating disorders (EDs) (Waller, et al., 2007; Simpson, 2012; Edwards, 2015; Munro et al., 2016; Simpson, 2016; Munro et al., 2016). While multivariate studies can provide quantifiable evidence for the efficacy of ST for treating EDs, systematic case-based research offers a means of engaging in an intensive analysis and description of the complex and subtle processes that unfold over time in a real-life therapeutic environment (Edwards et al., 2004; Yin, 1994). This research method also provides an opportunity for the refining of the clinical treatment model as well as its testing. Ten participants were assessed and treated with schema therapy. However, because of the large amount of data gathered, a decision was made to write up only one as an intensive systematic individual case study. Alison, an elderly woman with a longstanding history of AN who had been largely unresponsive to considerable previous therapies, received 100 ST sessions over a two-year period and showed a very positive response. The many challenges that arose and the way these were addressed within the ST framework provide an in-depth account of the application of the ST mode model for the treatment of AN. This is presented in a detailed therapy narrative. After results of the quantitative measures are provided, the next three chapters address three interpretative questions pertaining to the Healthy Adult/Vulnerable Child dyadic relationship, the processes of working with the Angry Child mode, and the conceptualising of an AN-specific coping mode. Several conclusions are drawn about the strengths of the schema therapy model and its particular application to AN. Amongst these is the importance of having a comprehensive case conceptualisation that serves as a collaborative “road map” with which to negotiate the unfolding collaborative therapeutic process. Another is the identifying of the “Anorexic Overcontroller” as a stand-alone coping mode that clarifies the functions of AN to hinder schema-based emotional injury, but paradoxically, still denies the individual’s basic core needs being met. Such a conceptualisation significantly assisted in the suspension of anorexic behaviour. A further significant observation is how emotion-focused work (especially within the context of chair work and imagery) brought therapy to life and was particularly effective in mobilising the conflict between internal voices. Another outstanding feature is how the building of a strong Healthy Adult mode proved vital in the healing process and the development of patient autonomy. Finally, therapy revealed how central the establishment of a sturdy, warm and loving therapeutic relationship is, and how influential the resonance between the therapist and patient is in the outcome of treatment. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2021
- Full Text:
- Date Issued: 2021-10-29
- Authors: Alexander, Graham
- Date: 2021-10-29
- Subjects: Eating disorders , Anorexia nervosa , Anorexia nervosa Treatment , Anorexia nervosa Case studies , Schema-focused cognitive therapy , Anorexic overcontroller , Interpretative phenomenological analysis (IPA)
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/196082 , vital:45724 , DOI https://doi.org/10.21504/10962/196082
- Description: Developed more than three decades ago, schema therapy (ST) was born out of a need for a more effective way of working with difficult and challenging cases where patients were clearly unresponsive to the existing short-term cognitive therapies. While anchored in the primary theoretical orientation of cognitive therapy, ST has carefully integrated techniques and principles from attachment and object-relations therapies, as well as humanistic, gestalt and experiential therapies. The mode model emphasises the concept of “multiplicity” in terms of which the self is functionally divided into parts or schema modes. For a little more than a decade there has been growing interest amongst researcher-clinicians in the application of ST for the treatment of eating disorders (EDs) (Waller, et al., 2007; Simpson, 2012; Edwards, 2015; Munro et al., 2016; Simpson, 2016; Munro et al., 2016). While multivariate studies can provide quantifiable evidence for the efficacy of ST for treating EDs, systematic case-based research offers a means of engaging in an intensive analysis and description of the complex and subtle processes that unfold over time in a real-life therapeutic environment (Edwards et al., 2004; Yin, 1994). This research method also provides an opportunity for the refining of the clinical treatment model as well as its testing. Ten participants were assessed and treated with schema therapy. However, because of the large amount of data gathered, a decision was made to write up only one as an intensive systematic individual case study. Alison, an elderly woman with a longstanding history of AN who had been largely unresponsive to considerable previous therapies, received 100 ST sessions over a two-year period and showed a very positive response. The many challenges that arose and the way these were addressed within the ST framework provide an in-depth account of the application of the ST mode model for the treatment of AN. This is presented in a detailed therapy narrative. After results of the quantitative measures are provided, the next three chapters address three interpretative questions pertaining to the Healthy Adult/Vulnerable Child dyadic relationship, the processes of working with the Angry Child mode, and the conceptualising of an AN-specific coping mode. Several conclusions are drawn about the strengths of the schema therapy model and its particular application to AN. Amongst these is the importance of having a comprehensive case conceptualisation that serves as a collaborative “road map” with which to negotiate the unfolding collaborative therapeutic process. Another is the identifying of the “Anorexic Overcontroller” as a stand-alone coping mode that clarifies the functions of AN to hinder schema-based emotional injury, but paradoxically, still denies the individual’s basic core needs being met. Such a conceptualisation significantly assisted in the suspension of anorexic behaviour. A further significant observation is how emotion-focused work (especially within the context of chair work and imagery) brought therapy to life and was particularly effective in mobilising the conflict between internal voices. Another outstanding feature is how the building of a strong Healthy Adult mode proved vital in the healing process and the development of patient autonomy. Finally, therapy revealed how central the establishment of a sturdy, warm and loving therapeutic relationship is, and how influential the resonance between the therapist and patient is in the outcome of treatment. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2021
- Full Text:
- Date Issued: 2021-10-29
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