Recovering patients describe their battles with an "anorexia voice"

People with anorexia find comfort in their illness at first, but then it becomes over-powering and they end up battling for control of their own minds. That's according to Sarah Williams and Marie Reid, who conducted an online focus group and email interviews with 14 people recovering from anorexia nervosa, aged 21 to 50 and including two men.

A consistent theme to emerge was that anorexia at first provided a sense of control and identity. The participants recalled enjoying striving for perfection. They saw thinness as an ideal that was within their means to reach. "Anorexia became a friend," said Natalie*. "When I was alone ... I knew that at least I had A." Jon said: "It was a way to control what was happening to me on a day to day basis, and also my weight."

Eventually though, rather than being a solution, anorexia became a problem all of its own. Said Lisa: "I call my anorexia 'the demon' who controls my thoughts, feelings, emotions and actions." Jon: "It's like there are two people in my head: the part that knows what needs to be done and the part of me that is trying to lead me astray. Ana is the part that is leading me astray and dominates me."

"Having developed the anorexic voice, participants came to feel that it was to an extent split from their authentic selves," said Williams and Reid. The research pair explained how their findings, placed in the context of similar results from past studies, provided useful ideas for therapeutic intervention. In particular, they suggested the need for recovering anorexia clients to acknowledge other positions beyond the anorexia voice and their own authentic self. "Wellness cannot simply be the absence of anorexia nervosa symptoms because this can intensify the inner battle with the anorexic voice," they said.

Williams and Reid advised using therapy to help build clients' sense of self. "This study suggests that this means developing the self beyond an ambivalent conflict between the authentic self and the anorexic voice," they said. "This would allow a new more positive dominant position to develop."

One approach that may be particularly suitable, according to Williams and Reid, is emotion-focused therapy (EFT). A technique used in EFT is for clients to address an empty chair, which represents their critical "anorexia voice". With the aid of the therapist, this can lead to a softening of the anorexic critic and the fostering of a new dominant position in the self. However, the researchers cautioned that there are "as yet ... no studies investigating the efficacy of externalisation techniques such as those used in EFT and this warrants further attention."
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Williams, S., and Reid, M. (2011). ‘It's like there are two people in my head’: A phenomenological exploration of anorexia nervosa and its relationship to the self. Psychology and; Health, 1-18 DOI: 10.1080/08870446.2011.595488

*The names used here are the pseudonyms that appear in the paper.

Post written by Christian Jarrett for the BPS Research Digest.

Psychology books of the year 2011

The season has arrived when newspapers, magazines and bookshops publish their "books of the year" lists. The Digest has digested these for you, picking out the psychology books getting a mention:

Moonwalking with Einstein: The Art and Science of Remembering Everything by Joshua Foer. The Sunday Times describes Foer's story of how he became American Memory Champion as "the most entertaining science book of the year". Also selected by Amazon.com editors as among the year's best non-fiction books.

The Indy says Steven Pinker's The Better Angels of Our Nature will generate more discussion than any other science book this year, adding: "His explanations for the apparent paradox of how brutality and even genocide in the modern world coexist with a trend towards diminished violence are entirely convincing." Also listed by the New York Times and Marginal Revolution.

Not strictly psychology, but the Times has chosen Tim Harford's Adapt: Why Success Always Starts with Failure as among the year's best science books. His "engaging" book "looks at how science and statistics can be used to predict commercial successes and industrial disasters and to inform public policy."

For the Guardian, both Jeanette Winterson and Hanif Kureishi chose Darian Leader's What is Madness? as among their favourite books of the year. Kureishi calls the book "magisterial" and describes how Leader "explains that the 'irrational' delusions and hallucinations of the mad are their attempts at sense." Winterson says it's a "thought-provoking book about how we diagnose and differentiate our many kinds of insanities."

Before I Go to Sleep, a novel by S. J. Watson is chosen by Waterstones as among their favourite paperbacks of 2011: "Memories define us. So what if you lost yours every time you went to sleep? Your name, your identity, your past, even the people you love - all forgotten overnight. And the one person you trust may only be telling you half the story. Welcome to Christine's life".

The New York Times highlights Thinking Fast, Thinking Slow By Daniel Kahneman: "a lucid and profound vision of flawed human reason in a book full of intellectual surprises and self-help value."

Mind's book of the year was won by Bobby Baker for Diary Drawings: Mental Illness and Me. "A collection of 158 drawings Baker created between 1997 and 2008, the diary provides us with an astonishing insight into her struggle to overcome mental and physical ill-health."

The Psychopath Test: A Journey Through the Madness Industry by Jon Ronson, is chosen by Amazon.com's editors as among the best non-fiction titles this year. "In this madcap journey, a bestselling journalist investigates psychopaths and the industry of doctors, scientists, and everyone else who studies them."

Through the Language Glass: How Words Colour Your World by Guy Deutscher was shortlisted for this year's Royal Society Winton Prize for Science Books (read the first chapter).

Finally, the British Psychological Society has just announced the shortlist for its 2011 Book of the Year Award.

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Have you read any of these books? What did you think? Are there any psychology books published this year that you enjoyed but which aren't mentioned here? Please let us know via comments!

Suggestions pulled from comments and Twitter so far: Witness to an Extreme Century: A Memoir by Robert Jay Lifton; Altruism in Humans by C. Daniel Batson; An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine by Howard Markel; Redirect: The Surprising New Science of Psychological Change by Timothy Wilson; The Secret Life of Pronouns: What Our Words Say About Us by James Pennebaker; What Should We Do With Our Brain? by Catherine Malabou; Beyond the Brain: How Body and Environment Shape Animal and Human Minds by Louise Barrett ... (click comments to see why readers nominated some of these books).

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Post compiled by Christian Jarrett for the BPS Research Digest.

The taste for competition peaks at age 50

No wonder parents' races at school sports days are such fraught affairs. A new study finds that far from us mellowing as we age, our inclination for competition increases through life, peaking around the age of 50.

Prior to their data collection, Ulrich Mayr and his colleagues had several reasons for expecting that preference to compete would peak in youth and fade thereafter. They cited reductions in testosterone with age; the documented shift with age to a more prosocial orientation (older people give more money to charity); an age-related shift to a mastery (rather than comparison) approach to skills; and age-related falls in confidence, perhaps based on actual cognitive declines with age.

The researchers set up a stall at a shopping mall and invited volunteers to solve mental arithmetic equations (e.g. "true or false: 7 + 2 + 3 - 6 = 5") as quickly as possible in return for points. Points were exchanged for modest cash prizes. The 543 participants (aged 25 to 75), in private booths, completed one round lasting 30-seconds in which they earned more points the more equations they solved. They then completed a second "competitive" round, in which they only earned points for solving more equations than a randomly chosen rival. Participants didn't get feedback on their performance until the experiment was over. Finally - and this was the crucial round - the participants could choose for the final round whether to play solo (known as "piece-rate"), like they had in the first round, or whether to compete once again against another randomly chosen participant. Afterwards participants estimated how well they thought they'd done, as a measure of their confidence.

There were some clear gender effects, consistent with past research. Women were far less likely than men to opt for the competitive version in the final round (correction: 36 per cent vs. 56 per cent). And there were clear age effects across both genders: the taste for competition against others increased with age, levelling off at about the age of 50. For example, nearly 70 per cent of men aged 45 to 54 opted to compete versus just over 50 per cent of men aged 25 to 34.

What lies behind the gender effects? Men and women performed equally well at the task under piece-rate conditions, but the women's performance did drop slightly in the competitive version. Women were also less confident than men. Women's confidence, unlike men's, was also related to their choice of whether to compete or not (men chose to compete without consideration of their likelihood of winning!). However, none of these factors was sizeable enough to explain the size of the gender difference in choice to compete.

What about the effects of age on preference for competition? There was no difference in actual performance with age. Changes in confidence also couldn't explain the age-related change. A potential explanation comes from a recent meta-analysis, which found that the trait of "social dominance" increases with age until the 50s. Said Mayr and his team: "Successfully engaging in competitions is critical for establishing social dominance and therefore it is plausible to assume that with such an increased interest in social dominance comes an increased 'taste for competition."

One important caveat needs to be mentioned. Because this was a cross-sectional study, it's possible that it's not age that's related to competitiveness but rather the era that the participants grew up in - or something else to do with their particular generation. To get around this problem, participants would need to be followed up throughout their lives, to see if their taste for competition changes as they age. However, the researchers can't see any reason why the fifty-somethings' upbringing should have led them to be more competitive than the 30-somethings. Yes, Baby Boomers are known for their competitiveness but 30-year-olds grew up in a prolonged economic downturn that might have increased their competitive tendencies.

What about you - have you found that your taste for competition has altered as you've aged? Or looking at your friends and family, do these results fit with your own experiences of their competitiveness? Please use comments to let us know.
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Mayr, U., Wozniak, D., Davidson, C., Kuhns, D., and Harbaugh, W. (2011). Competitiveness across the life span: The feisty fifties. Psychology and Aging DOI: 10.1037/a0025655

NB. Percentages for men and women's preferences were quoted incorrectly before but have now been corrected.

Post written by Christian Jarrett for the BPS Research Digest.