The central question of this study was to examine the moral orientation and the role of self in subject generated moral dilemmas for information on the developmental and cultural forces contributing to the etiology and maintenance of eating disorders in college women. The research was based on the theories of Carol Gilligan (1982, 1988, 1990). Twelve women identified as bulimic by therapists and twelve women with no eating disorder were administered the BULIT-R and the moral conflict and choice interview. A Guide to Reading Narratives of Moral Conflict and Choice for Self and Moral Voice provided the framework for analyzing the the interviews. Using Chi squares to analyze the data, no significant differences were found between the two groups on presence, predominance, and alignment of the moral voices of care and justice or on relationship framework, although a trend toward the bulimic sample aligning both with the justice and care orientations was noted. The bulimic sample expressed one or more of the vulnerabilities of care and both care and justice significantly more often than the comparison sample. No difference was found for expression of self care, though the quality of self care expressed was different. Subjects from the bulimic sample mentioned self care in conjunction with self-preservation, while subjects in the comparison group mentioned self-care as an ordinary consideration in conflicts. A significant difference was found between the two groups on mention of a problematic relationship with father, with bulimics describing an emotionally distant relationship with father more often. Finally, the quality of the conflicts described by bulimics tended to be more critical to self than those described by the comparison sample. Results were related to what Gilligan (1990) calls the biggest challenge of the adolescent female: how to integrate inclusion of self with inclusion of others. Disturbances in relationships within the family resulted in the women from the bulimic sample having difficulty with this task. Two coping styles were identified: role reversal and hostile avoidant (Salzman, 1990). The relevance of these coping styles to bulimia was discussed. Implications for therapy were reviewed and recommendations were made for future research. / Graduation date: 1992

Clinical observations of families with a member who displays bulimia have suggested that more than one family interaction pattern exist. The purpose of this study was to investigate these clinical observations using three self-report questionnaires: FACES-III, Binge Scale, and a demographic instrument including items regarding three identifiable family types. Data was collected from hospitals who treated persons displaying bulimia and eating disorder treatment centers. A total of 70 women, ages 13 to 39, and both parents of each woman included in the study (Total N = 210).Responses to the FACES-III and certain items on the demographic questionnaire were analyzed using chi-square and one-way ANOVAs with Tukey's follow-up procedure when necessary. Each of the 70 families were identified on the Circumplex Model, but because of methodological concerns only 57 families were used to test most of the hypotheses.Hypothesis One, which stated that more than 50% of the families would be classified as either moderately or extremely dysfunctional, was accepted. Sixty-four percent of the families were labeled moderately or extremely dysfunctional. Hypothesis Two, which claimed that there would be no differences between types of families in terms of the age and birth order of the member displaying bulimia and the number of siblings in the family, was also supported. There were no significant differences found among families with regards to the age and birth order of the daughter or the number of siblings in the family. Hypothesis Three, which asserted that types of families would not differ in terms of the parents' relational status, was accepted as well, but cautiously interpreted. Of the parents, 96.5% were married, while one set was divorced and another separated. Hypothesis Four, which stated that families would differ with respect to their degree of family satisfaction, was also supported. Functional families claimed feeling more satisfied than dysfunctional families. Hypothesis Five, which claimed that types of families would differ in terms of their previous and current level of closeness, was accepted. Dysfunctional, as compared to functional, families reported significantly less family satisfaction previously and currently. Finally, Hypothesis Six, which asserted that types of families would differ with respect to their degree of chaos, perfection, and overprotection, was partially supported. Dysfunctional families claimed to experience greater degrees of chaos and perfection than functional families.Relying on the Circumplex Model of family functioning, results suggest that there are identifiable differences in the family structures of families where one member displays bulimia. Findings from this study may assist therapists when conceptualizing and treating various types of families that are struggling with the interpersonal and emotional effects of bulimia. / Department of Counseling Psychology and Guidance Services

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2009. / Includes bibliographical references (p. 53-55).

Thesis (M.A.)--Marshall University, 2002. / Title from document title page. Document formatted into pages; contains 179 p. Includes bibliographical references (p. 178-179).

A growing body of research recognizes spirituality as a key element in well-being, but the agency of individual spirituality remains unclear. This study explores the role of embodied knowledge in reality construction and its effect on illness by considering how spirituality as embodied existence shapes reality. Spirituality, as a form of embodied knowing, is shown to reach deeply into the fundamental relatedness of existence. The study argues for a mindbody- spirit unity, making no distinction between self and spirit, emotions and subjective experiences situated in the spirit. As the medium between body and self, spirituality gives form to the felt reality of embodied knowledge and meaning, shaping language, cognition, thought and action towards lived reality. New ways of thinking about eating disorders were stimulated by innovative discoveries through investigating the lived reality of the illness within an epistemology that included subjective experiences as part of reality. While acknowledging the influence of social discourse, the study calls for a recognition of vulnerability in the human condition giving rise to the embodiment of a wounded self or disenabling spirituality, manifested in the development of an eating disorder. It uncovers the anti-spiritual properties involved in the lived reality of people struggling with anorexia/bulimia, evident in social withdrawal and/or self-injury. Behavioural patterns of obsession and repetition underscore similarities to addiction and ritual. The study synthesised pastoral therapy and research. A postmodern approach to illness and a qualitative design with interpretive phenomenology were used. Three young women struggling with anorexia/bulimia participated in semi-structured research interviews. Their narrative accounts provided a chronology of developing, living with and healing from anorexia /bulimia. Emphasis shifted from an approach aimed at fixing the body to focusing on individual experiences of the illness; what she brought to the encounter in her own resources and potential to heal. Healing is envisaged as the ongoing development of a renewed sense of self, an inherently spiritual process orchestrated from within. Previous disassociation of body and self is replaced with reconnection between body, self and other, care of the spirit became care of the body, expressed in harmony and wholeness of being. / Practical Theology / D.Div. (Pastoral therapy)

A growing body of research recognizes spirituality as a key element in well-being, but the agency of individual spirituality remains unclear. This study explores the role of embodied knowledge in reality construction and its effect on illness by considering how spirituality as embodied existence shapes reality. Spirituality, as a form of embodied knowing, is shown to reach deeply into the fundamental relatedness of existence. The study argues for a mindbody- spirit unity, making no distinction between self and spirit, emotions and subjective experiences situated in the spirit. As the medium between body and self, spirituality gives form to the felt reality of embodied knowledge and meaning, shaping language, cognition, thought and action towards lived reality. New ways of thinking about eating disorders were stimulated by innovative discoveries through investigating the lived reality of the illness within an epistemology that included subjective experiences as part of reality. While acknowledging the influence of social discourse, the study calls for a recognition of vulnerability in the human condition giving rise to the embodiment of a wounded self or disenabling spirituality, manifested in the development of an eating disorder. It uncovers the anti-spiritual properties involved in the lived reality of people struggling with anorexia/bulimia, evident in social withdrawal and/or self-injury. Behavioural patterns of obsession and repetition underscore similarities to addiction and ritual. The study synthesised pastoral therapy and research. A postmodern approach to illness and a qualitative design with interpretive phenomenology were used. Three young women struggling with anorexia/bulimia participated in semi-structured research interviews. Their narrative accounts provided a chronology of developing, living with and healing from anorexia /bulimia. Emphasis shifted from an approach aimed at fixing the body to focusing on individual experiences of the illness; what she brought to the encounter in her own resources and potential to heal. Healing is envisaged as the ongoing development of a renewed sense of self, an inherently spiritual process orchestrated from within. Previous disassociation of body and self is replaced with reconnection between body, self and other, care of the spirit became care of the body, expressed in harmony and wholeness of being. / Philosophy, Practical and Systematic Theology / Th. D. (Pastoral therapy)