Applying Erikson’s Developmental Theory to the Recovery
of Eating Disorders
Dr. Catherine Gillespie and Ashley Fee
ABSTRACT
MATERIALS AND METHODS
This study investigates women’s experiences of recovery
from a qualitative standpoint. It examines women’s reports
of their recovery from eating disorders in light of VogelScibilia’s (2009) adaptation of Erikson’s stage theory to
recovery from mental illness. Participants in this study are
asked to complete two diagnostic measures. A Brief Mood
Introspection Scale (BMIS) survey is completed,
independently, before the interview process begins as well
as the Eat-26 survey. One-on-one semi-structured
interviews takes place between the experimenter and the
participant after the BMIS and Eat-26 survey is completed.
Each interview lasts approximately 90 minutes. There are
13 questions that are asked by the experimenter that
pertain to the initial diagnosis of their disorder, their past
and/or current treatment, and their views on recovery. This
is a qualitative study that is analyzed using the model for
recovery that mirrors Erikson’s theory of development.
Participants in this study are asked to complete two
diagnostic measures. A Brief Mood Introspection Scale
(BMIS) survey is completed, independently, before the
interview process begins. The survey puts the participant
into one of eight classes: happy, loving, calm, energetic,
fearful/anxious, angry, tired, or sad. Participants are also
asked to complete the EAT-26 survey independently. Oneon-one semi-structured interviews take place between the
experimenter and the participant. Each interview lasts
approximately 90 minutes. There are 13 questions that are
asked by the experimenter that pertain to the initial
diagnosis of their disorder, their past and/or current
treatment, and their views on recovery.
ERICKSON’S STAGES OF PSYCHOSOCIAL DEVELOPMENT
Trust vs. Mistrust
Autonomy vs. Shame/Doubt
Initiative vs. Guilt
Industry vs. Inferiority
Identity vs. Role Confusion
Intimacy vs. Isolation
Generativity vs. Stagnation
Ego Integrity vs. Despair
INTRODUCTION & HYPOTHESIS
There has been a reoccurring problem of not having a
consistent definition of recovery throughout studies,
causing studies and their results to be incomparable
(Noordenbos, 2011; Courturier, 2006; Barton-Cone, 2010;
Stice, 2009). Patients define recovery as more than weight
restoration but also psychological, emotional, and social
well-being (Malson, 2011). Other studies have agreed that a
broader understanding of recovery-definitions including
psychological functioning-have contributed to a more
successful recovery of patients (Bardon-Cone, 2010;
Malson, 2011; Fitzsimmons, 2010). Studies have shown that
women define a full recovery by whether or not they have
regained control of their lives, reconnecting with life, and
achieving self- acceptance (Patching, 2009).
This research study takes a new template paralleling
Erikson’s theory of development to the process of recovery.
This model for recovery has not yet been applied to eating
disorders, so our goal for this study is to try and verify
whether or not the recovery of an eating disorder can
mirror this model. By further understanding the process of
recovery in an eating disorder, therapists and specialists
can be more aware of how to track the recovery of an
eating disorder.
AN ERICKSONIAN STAGE THEORY OF RECOVERY
Trust vs. Doubt
Hope vs. Shame
Empowerment vs. Guilt
Along with the questions, participants are asked to
complete a small activity. They are given slips of paper
containing the descriptive words from the recovery stages
that parallel Erikson’s stages of development (trust, doubt,
hope, shame, empowerment, guilt, action, inaction, new
self, sick self, intimacy, isolation, purpose, passivity,
integrity, and despair). The participant then are asked to
place the most applicable words under the columns they
believe they best belong according to their experience with
an eating disorder. The columns include “where I was”,
“where I am”, “where I hope to be”, and “not applicable”.
One experimenter is asking the questions, while the other
experimenter records the interview via video camera and
types out the responses of the interviewees.
Action vs. Inaction
New Self vs. Sick Self
Intimacy vs. Isolation
Purpose vs. Passivity
Integrity vs. Despair
The interviews are analyzed using the recovery stages
which parallel Erik Erikson’s stages of development.
Depending on the responses from the interview and the
chosen words under each column, participants are sorted
into one of the eight stages of recovery: trust vs. doubt,
hope vs. shame, empowerment vs. guilt, action vs. inaction,
new self-vs. sick self, intimacy vs. isolation, purpose vs.
passivity, or integrity vs. despair. It is important to note that
this process is not a linear process like Erikson’s stages of
development and the transition between stages is not
always clear. This being said there can be participants that
have at one point been in a higher stage of recovery and
have dropped to a lower stage, or there can be participants
that fall somewhere between two stages. By analyzing the
words placed under the specified columns and the
explanations given by the participants, the are able to
analyze which phase of recovery the participant is in.