City Research Online

Eating disorders and living with the "Critical Voice"

De Giacomi, E. (2019). Eating disorders and living with the "Critical Voice". (Unpublished Doctoral thesis, City, University of London)


Eating disorders are challenging to treat and have increased in prevalence in recent years. Existing research on the critical inner voice shows that individuals presenting with any eating disorder hear critical inner voices significantly more often than the general population. A qualitative exploration of this phenomenon aims to enhance the understanding of the critical inner voice and provide clinical recommendations.

Semi-structured interviews are conducted with nine women that are diagnosed with an eating disorder and report experiencing a critical inner voice. The transcripts are analysed using interpretative phenomenological analysis (IPA).

During the analysis stage four groups of themes are developed: “A Lifetime with the Voice” outlines how the voice may have come into existence and developed over time; “The Voice in Action” describes the central role the voice plays in eating disorders and all aspects of life; “Living with the Voice” highlights salient characteristics of the voice from cognitive, relational, emotive and social perspectives; “Coping with the Voice” describes personal experiences of managing the critical inner voice and addressing it in a therapeutic context.

The findings of the study emphasise the central role that the critical inner voice plays for individuals suffering from eating disorders. Participants’ experiences highlight the limitations of CBT in addressing the critical inner voice, calling for a stronger focus on its emotive and relational aspects. Results suggest that elements of third wave CBT approaches as well as psychodynamic and humanistic models may be helpful in addressing the critical inner voice and eating disorders.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: Doctoral Theses
School of Health & Psychological Sciences > Psychology
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
[thumbnail of De Giacomi, Elena_Redacted.pdf] Text - Accepted Version
This document is not freely accessible until 12 February 2050 due to copyright restrictions.


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