Title

Figured world of eating disorders: Occupations of illness

Start Time

22-10-2011 9:40 AM

End Time

22-10-2011 10:10 AM

Session Type

Event

Abstract

The biomedical classification of eating disorders, particularly anorexia and bulimia nervosa, follows guidelines created by the American Psychiatric Association’s Diagnostic and Statistical Manual, thus situating it as a mental illness with serious and complex physical health symptomology. There is a paucity of literature written from the occupational perspective of people living with or recovering from eating disorders, and what has been published reflects this predominately medical understanding of the illness. This theoretical paper introduces a socio-cultural framework for understanding eating disorders - figured world – which coexists and competes with the more traditional and established biomedical representation of eating disorders. Figured worlds contextually exist in daily activity and social discourse through mediation of roles, objects, and identity. Such a world invokes an ‘as if’ potential of symbolic and culturally determined significance. Central concepts of figured world will be discussed in relation to the lived world experience of people with eating disorders. Positional identity emerges from the interrelational categorization which occurs in social structures, often being embodied through occupational participation. Self authoring as a component of figured world reflects the dialogical nature of competing personal and social discourse. Semiotic mediation defines the process by which neutral objects or spaces acquire symbolic and personally significant meaning. Each of these three figured world concepts correlates with the occupational reality of a person with an eating disorder. Conceptualizing eating disorders as a figured world requires the appropriation of meaning in illness with the translation to occupational engagement as illness or eating disorder driven. For example, the occupation of shopping is directed by the symbolic meaning of clothing size; items which are not the ‘right’ size will not be purchased and behavior modification will redirect attention to reaching this new ‘goal.’ Addressing occupational engagement through this figured world lens requires the adoption of a broader recognition of where meaning is generated in the occupational experience. Recovery necessitates the re-appropriation of illness-derived occupational meaning toward wellness. Recovery would also signify the exit from this figured world into a perhaps yet unknown world. Figured world is an important framework through which to study occupation because the socio-cultural and symbolic dimensions of occupation within a particular figured world may challenge the assumption that health rather than illness is inherently meaningful.

Discussion Questions:

  1. How might the conception of illness as meaningful co-exist with occupational science’s vision of occupation as health promoting and life sustaining?
  2. Figured worlds invite a different perspective from which to understand occupations and cognitions of specific populations. What might other examples be?
  3. The multiplicity of meaning of a single occupation reflects a complexity from which to understand and investigate it. What methodological tools support this examination?

References

Brooks, A., LeCouteur, A., & Hepworth, J. (1998). Accounts of experiences of bulimia: A discourse analytic study. International Journal of Eating Disorders, 24, 193-205. http://dx.doi.org/10.1002/(SICI)1098-108X(199809)24:2<193::AID-EAT9>3.0.CO;2-9

Christiansen, C. (1999). Defining lives: Occupation as Identity: An essay on competence, coherence, and the creation of meaning. American Journal of Occupational Therapy, 53(6), 547-558. http://dx.doi.org/10.5014/ajot.53.6.547

Holland, D., Lachicotte, W., Skinner, D., & Cain, C. (1998). Identity and agency in cultural worlds. Cambridge, MA: Harvard University Press.

Rich, E. (2006). Anorexic dis (connection): Managing anorexia as an illness and an identity. Sociology of Health and Illness, 28(3), 284-305. http://dx.doi.org/10.1111/j.1467-9566.2006.00493.x

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Theoretical paper

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Oct 22nd, 9:40 AM Oct 22nd, 10:10 AM

Figured world of eating disorders: Occupations of illness

The biomedical classification of eating disorders, particularly anorexia and bulimia nervosa, follows guidelines created by the American Psychiatric Association’s Diagnostic and Statistical Manual, thus situating it as a mental illness with serious and complex physical health symptomology. There is a paucity of literature written from the occupational perspective of people living with or recovering from eating disorders, and what has been published reflects this predominately medical understanding of the illness. This theoretical paper introduces a socio-cultural framework for understanding eating disorders - figured world – which coexists and competes with the more traditional and established biomedical representation of eating disorders. Figured worlds contextually exist in daily activity and social discourse through mediation of roles, objects, and identity. Such a world invokes an ‘as if’ potential of symbolic and culturally determined significance. Central concepts of figured world will be discussed in relation to the lived world experience of people with eating disorders. Positional identity emerges from the interrelational categorization which occurs in social structures, often being embodied through occupational participation. Self authoring as a component of figured world reflects the dialogical nature of competing personal and social discourse. Semiotic mediation defines the process by which neutral objects or spaces acquire symbolic and personally significant meaning. Each of these three figured world concepts correlates with the occupational reality of a person with an eating disorder. Conceptualizing eating disorders as a figured world requires the appropriation of meaning in illness with the translation to occupational engagement as illness or eating disorder driven. For example, the occupation of shopping is directed by the symbolic meaning of clothing size; items which are not the ‘right’ size will not be purchased and behavior modification will redirect attention to reaching this new ‘goal.’ Addressing occupational engagement through this figured world lens requires the adoption of a broader recognition of where meaning is generated in the occupational experience. Recovery necessitates the re-appropriation of illness-derived occupational meaning toward wellness. Recovery would also signify the exit from this figured world into a perhaps yet unknown world. Figured world is an important framework through which to study occupation because the socio-cultural and symbolic dimensions of occupation within a particular figured world may challenge the assumption that health rather than illness is inherently meaningful.

Discussion Questions:

  1. How might the conception of illness as meaningful co-exist with occupational science’s vision of occupation as health promoting and life sustaining?
  2. Figured worlds invite a different perspective from which to understand occupations and cognitions of specific populations. What might other examples be?
  3. The multiplicity of meaning of a single occupation reflects a complexity from which to understand and investigate it. What methodological tools support this examination?