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

Su Holmes, Helen Malson, Joanna Semlyen

Research output: Contribution to journalArticle

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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.
Original languageEnglish
Pages (from-to)41-61
Number of pages21
JournalFeminism and Psychology
Volume31
Issue number1
Early online date15 Feb 2021
DOIs
Publication statusPublished - Feb 2021

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