Shame and pride in anorexia nervosa: a qualitative descriptive study

Abstract

During the last decades, there has been a rising interest in the role of shame in psychiatric disorders. Objective To define shame and describe types and subtypes of shame and their relations to symptoms and meaning in anorexia nervosa. The study will also describe the possible role of pride, as a contrasting emotional and cognitive experience. Method Thirteen female patients (age 16–39 years) with anorexia nervosa were interviewed about their general understanding of the concept of shame, what they considered shameful in themselves, past and present, and in others and shame related to eating and body. Results Based on statements from the patients ‘globalised internal shame’, different subtypes of focal shame and different subtypes of pride are categorised. Shame is described both as cause and consequence in relation to symptoms in anorexia nervosa, hence a shame–shame cycle. A shame–pride cycle is also presented. Discussion The use of shame, as well as pride, as concepts in regard to anorexia nervosa may improve our understanding of the nature of this disorder, as well as being a guideline for therapists. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association.