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Externalisation of the problem is a practice that is often taken up within NICE recommended treatments for AN. Dominant understandings of externalisation are that this practice involves making the \u201cproblem\u201d a separate entity, external to the individual. It is an attitude taken by the client and family, stimulated by the therapist to build engagement with treatment and supportive relationships around the individual. However, there is a paucity of research exploring the therapeutic effects of this approach. This research aims to address this gap by exploring the role of externalisation in treatment for AN to elicit an understanding of how this practice is experienced including how it can help and hinder recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirteen adults with a current and\/or past diagnosis of AN participated in semi-structured interviews. This qualitative study used a reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>Participants described their experience of externalisation as a journey which is depicted by four main themes. \u2018Separating the AN from the self\u2019 reflects the tensions inherent in learning to distinguish between one\u2019s perceived sense of \"self\" and \"the AN\". \u2018Making sense of the AN\u2019 describes the experience of language forms used to separate the AN from the individual\u2019s identity. \u2018Feeling seen, or unseen as a person beyond the AN\u2019 illustrates the helpful and harmful effects of externalising practices on relationships. \u2018Navigating a complex relationship with the AN\u2019 depicts the effects of one-, versus two-way externalisation on the individual\u2019s relationship to AN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The notion of separating one\u2019s internal dialogue from one\u2019s concept of self may initially be rejected by the individual experiencing AN. However, as the individual develops trust in the therapist and becomes socialised to common forms of externalising language, they may begin to realise two sides within them, a perceived \u201chealthy self\u201d and \u201cthe anorexia voice\u201d. However, social-cultural discourses around eating contribute to ambiguity during the differentiation between these two voices, thus elucidating the effects of an absence of problem deconstruction alongside externalisation within ED-focussed treatments. Externalising practices were most helpful when led by the individual using their own experience-near language and least helpful when they did not permit the individual to feel seen as a person beyond the AN. Therapists, treatment teams and family members should be cognisant of the emotional effects of language used to externalise AN. Importantly, they should ensure that externalisation is practiced within the spirit of narrative therapy from which it originates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40337-024-01087-9","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T10:02:32Z","timestamp":1728295352000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Experiences of externalisation in recovery from Anorexia Nervosa: a reflexive thematic analysis"],"prefix":"10.1186","volume":"12","author":[{"given":"Sophie","family":"Cripps","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Serpell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,7]]},"reference":[{"issue":"3","key":"1087_CR1","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1177\/0959354314566490","volume":"25","author":"D Botha","year":"2015","unstructured":"Botha D. 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