The anorexic voice: A dialogical enquiry and thematic analysis.

Although prevalent among those given a diagnosis of anorexia nervosa (AN), the internal anorexic voice (AV) is little understood. This study aimed to explore the AV’s role in the development and maintenance of AN from a new perspective – that of the AV itself. Nine women with a diagnosis of AN participated. Data was collected via dialogical enquiry, which entailed direct, semi-structured interviews with participants’ AVs. Transcripts were analysed using thematic analysis. Three themes build a picture of a symbiotic yet destructive relationship between AV and individual. Firstly, ‘Pragmatism’ describes the AV’s supposedly invaluable, problem-solving persona. Secondly, ‘Relationship’ depicts the valued yet fraught, unbalanced, and often unwanted bond between AV and individual. Thirdly, ‘Self-preservation’ presents the AV’s drive to retain control for its own survival. In clinical practice, curiosity regarding relationships with AVs could highlight barriers to recovery and inform treatment. Future research should focus on diverse samples and consider ways of working with eating disorder voices to promote recovery.