Russell Delderfield in the following blog post explores and problematises the issue of stigma and eating disorders, within the context of exchanges he had on social media site Twitter.
I have recently had the wind knocked out of my post-PhD prideful sails. I studied male eating disorders using qualitative approaches for my doctorate.
The issue of stigma arises constantly in the research I read and conduct. It feels as if there is no avoiding it. It is pervasive and un-ignorable. I cannot possibly ‘choose’ to set it aside and not engage with it. Yet, when it appears in psychological publications, the treatment of it (within my field, at least) is dissatisfying. The inferences seem to start from a hefty assumption: that ‘stigma’ is a coherent, unified ‘thing’. And more importantly, that it either exists – or doesn’t. In addition, there is a kind of unwritten imperative that I experience. This asserts that mining the data for its evidence about stigma and presenting this to the world is a good thing; it helps to hold it up to the light for further keen observation. And this is where our dilemma begins.
Let me backtrack and fill in some gaps at this point. Whilst I qualitatively explore men’s experiences with eating disorder, I’m not entirely alone. There are other clinicians, psychologists and psychiatrists who investigate male disordered eating. A small number of studies have been published that try to improve our understanding using qualitative methods (I count 6 in my collection, thus far). Although I do not profess to specifically examine stigma in male eating disorders (my interest is broader than this alone), some of my participants share stigma they encounter.
During my PhD, I wanted to address the cursory and superficial coverage of stigma that I perceived in other work. So, I did something that no other person has done (at least to my knowledge) within my field. I did not simply report on the existence of stigma and select some careful quotes from the data to illuminate what men had been through, I took the study of a couple of men’s experiences back to its ‘roots’, with a Bordo-esque exploration of what this stigma meant to these men. I explored stigma through the lens of spoiled identity. I asked, ‘What does it mean to the man to live with stigma?’, ‘What does the experience of stigma mean for a man’s masculine identity?’, and ‘What does the avoidance of stigma mean for a man’s masculine identity?’
This, for me, emulated the ethos of feminist eating disorder work where there is an established history of women and researchers sharing their stories of ‘spoiled’ identity, objectified womanhood and the meanings of what it is to be an anorexic, bulimic or binge-eating woman. I formulated a useful exposition of what spoiled masculinities mean and feel like for men living with an eating disorder. This went beyond simply saying ‘men report they experience stigma and here’s an example of the stigma they had to deal with.’ Finally, I was satisfied. This laudable and novel achievement was a source of pride. Job done (at least for now, I’m not naïve enough to believe that qualitative work is finite).
Well that was then, and this is now. Over the summer a fellow researcher tweeted about a BBC News report that asked why men who have eating disorders keep it a secret. I was straight on the case. I retweeted with my usual ‘awareness-raising-challenge-the-stigma’ gusto. In a painfully cropped 140 words, I said that stigma is one reason that men do not speak out. I tweeted that I knew this due to my qualitative research with the men themselves. I encouraged others to face-down this stigma that can be so debilitating.
And I was challenged in turn. One of the men who has an eating disorder, who follows my research on Twitter, contacted me to raise something that I had not thought of before. In my positively proselytising mission to campaign against the damaging effects of stigma (important as I still believe it is), I had overlooked something. One tweet was all it took:
“I sometimes wonder if (only) talking about how men with EDs feel stigmatised teaches men with EDs that they should feel stigmatised…”
I was floored – both as a man with an eating disorder and a researcher.
I wonder how many men feel similarly? I wonder if it is true that holding a mirror to the nature and effects of stigma simply serves to perpetuate it? In my empowered role as researcher I had overlooked something that, once said, seems so obvious. How could I not have thought about this before? Am I part of the problem, instead of being one among many cogs of the solution?
I didn’t despair for long. My interlocutor and I had a thought-provoking exchange of views. I learnt something extremely valuable. This is the very substance of what critical psychology embraces: it acknowledges the fallibility of research because it is carried out by humans about humans for humans. It challenges the monadic perspective of psychology and the monolithic nature of published research studies. In many ways, the fact that people actually respond to my research on Twitter, rather than just passively consuming it, means that my work finds meaning somewhere. Talking about my research findings with the public leads to dialogue and a shared understanding of my single researcher experience.
However, I’m still left with a dilemma. I accept the proposition in the tweet but I do not have an answer as to how do we erode the deleterious effects of stigma, if we do not highlight the concept and the role it purportedly plays in preventing men from getting help. As a researcher, I must make sense of the potential consequences of my findings. Is uncomplicated campaigning for improvement unequivocally beneficent? I thought so, but I don’t anymore. I set out to redress the lack of complexity in male eating disorders research when it comes to stigma (amongst many other things). In turn, this bred further complexity because it created an unforeseen conversation.
Unforeseen, but not unwelcome: it’s a lesson that I appreciated learning.
Dr Russell Delderfield
University of Bradford