“I’ll have nothing. If I’m not anorexic, I’ll have nothing”: exploring identity in recovery from Anorexia Nervosa–Restrictive (AN-R)

Anorexia Nervosa (AN) is regarded as a challenging psychiatric and emotional disorder due to its apparent resistance to treatment. Neither the condition itself, nor the recovery process, is well understood. Previous research has suggested that confounding the restrictive and binge/purge subtypes is unhelpful. Exploring these change processes for Anorexia Nervosa – Restrictive (AN-R) specifically may provide insight for more effective treatment planning. Drawing on a Constructivist Grounded Theory methodology, the experiences of six women who self-identified as having suffered and recovered from AN-R were explored through semi-structured interviews. Three overarching processes were identified: weakening self-structure, becoming ensnared, and suffering recovery. Weakening the self-structure highlights how life experiences impacted participants’ sense of themselves, leaving them vulnerable to developing AN-R. Becoming ensnared captures how volitional restriction initially provided participants with a new, better, sense of self. Suffering recovery captures the psychological, physical, and emotional pain participants experienced in the gradual and recursive process of recovery, as they relinquished the identity organised around restriction which, when relinquished, enabled a new identity to evolve. Findings suggest that, for these participants, restriction initially functioned as an adaptive means of resolving identity confusion before progressively becoming the valued, identity-organising system around which the self was synthesised. Recovery involved the painful dismantling of this system and gradual identity reconstruction. Effective intervention may require recognising oscillation as intrinsic to recovery, maintaining therapeutic attunement while supporting the reconstruction of a coherent sense of self, rather than symptom reduction alone. Future longitudinal research is needed with larger, more diverse, samples to capture these processes in real time.