Recovery from Anorexia Nervosa in Contemporary Taiwan: A Multiple-Case Qualitative Investigation from a Cultural-Contextual Perspective

Grounded in a cultural and contextual perspective, the current study examined the lived experiences and the recovery pathways of three Taiwanese women diagnosed with various subtypes of anorexia nervosa, at varying stages of their recovery. Specifically, using a multiple-case qualitative method, this study explored the complex, dynamic interactions of sociocultural factors and forces (i.e., cultural, familial, and societal influences) that impinge upon the three Taiwanese female participants in relation to living with anorexia nervosa in contemporary Taiwan. Data were collected based on in-depth, semi-structured interviews with the participants and relevant written materials and journal entries provided by these participants. The data were first analyzed within each case and then again across all cases. Accordingly, we present the results of the study by illustrating each participant's story and narrative of struggling with and recovering from anorexia. We then describe three main culturally-related themes that emerged from the cross-case analysis, which pertain specifically to the recovery process of the participants under the East-West 'biculturalism' in Taiwan: 1) anorexia as a function of the conflictual bicultural self; 2) recovery as a pathway towards an integrated bicultural self; and 3) the paradoxical roles of Chinese cultural heritage in anorexia and recovery. Findings of the study highlight the role of local cultural factors/forces, including Chinese familism, Confucianism, filial piety, face-saving, gender role prescriptions, biculturalism, Westernization, and self-relation-coordination, in affecting and shaping Taiwanese women's struggling with anorexia. Implications and recommendations for future research and clinical interventions are discussed.