{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T19:24:16Z","timestamp":1793388256054,"version":"4.5.0"},"reference-count":77,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>There is increasing recognition of phenomenological approaches to understanding anorexia nervosa (AN), interrogating lived experiences and voices of those diagnosed with AN. This article builds on phenomenological accounts of AN, taking a step further for a <jats:italic>spatial<\/jats:italic> phenomenology, to examine how specific central features of AN experience are structured in diametric spatial terms. Building on growing research on the phenomenology of AN, it is remarkable how consistently the phenomenology of AN clusters around structural features of diametric space, as reactive, compensatory coping mechanisms of splitting, closure, and mirror image inversions. Pervasive features of AN experience and motivation, including control, perfectionism, ambivalence, an anorexic \u201cvoice,\u201d the gaze of the other, and self-hate around the body, are all aspects that cluster around the specific spatial system and process of diametric space. Diametric spatial closure from background stimuli offers a spatial concomitant of control. Restriction of food in AN may be part of a wider process of spatial constriction as the operation of a diametric spatial system of experience. This diametric spatial system of experience is in tension with a concentric spatial system, amplifying Ricoeur\u2019s phenomenology of distantiation and L\u00e9vi-Strauss\u2019 anthropological insights regarding the interplay between these cross-cultural structures. This conceptual, desk-based review presents a theoretical framework of AN phenomenology as displacement within experiential space, from concentric to diametric space, proposed as a prior system paving the way for bodily tensions in AN, bringing loss of capacity for concentric structured spatial experiences. This treats AN recovery as capacity for restructuring from diametric spatial oppositions to generate connective, relatively open, concentric spaces in life experiences. Developing a spatial interpretative methodology, phenomenological and qualitative AN research sources for application of this spatial analysis were selected based on their direct relevance to key aspects of DSM-5 diagnostic features for AN regarding drive for thinness, body dissatisfaction, and overexercise, as well as for central psychological understandings of AN in terms of control, identity, and perfectionism.<\/jats:p>","DOI":"10.3389\/fpsyt.2025.1623166","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T05:35:05Z","timestamp":1758000905000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A key system response of diametric space as a paradigm for understanding the phenomenology of anorexia nervosa"],"prefix":"10.3389","volume":"16","author":[{"given":"Paul","family":"Downes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.894178","article-title":"In an otherwise limitless world, I was sure of my limit.\u2019 Experiencing Anorexia Nervosa: A phenomenological metasynthesis","volume":"13","author":"Bryant","year":"2022","journal-title":"Front Psychiatry"},{"key":"B2","volume-title":"Hermeneutics and the human sciences","author":"Ricoeur","year":"1981"},{"key":"B3","volume-title":"Being and Time","author":"Heidegger","year":"1962"},{"key":"B4","volume-title":"Structural anthropology","author":"L\u00e9vi-Strauss","year":"1977"},{"key":"B5","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1163\/156916480X00037","article-title":"The nature of perception","volume":"10","author":"Merleau-Ponty","year":"1980","journal-title":"Res Phenom"},{"key":"B6","article-title":"A phenomenological study of anorexia nervosa","volume":"19","author":"Bowden","year":"2012","journal-title":"Phil Psychiatry Psychol"},{"key":"B7","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/978-94-015-7924-7_12","article-title":"Eating disorders: The feminist challenge to the concept of pathology","volume":"43","author":"Bordo","year":"1992","journal-title":"body Med thought Pract"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00534","article-title":"Embodiment as a paradigm for understanding and treating SE-AN: locating the self in culture","volume":"11","author":"Musolino","year":"2020","journal-title":"Front Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/00017285-197809000-00003","article-title":"The golden cage","author":"Bruch","year":"1978","journal-title":"Enigma Anorexia Nervosa Vintage Books"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-021-01122-7","article-title":"The disappearing body: anorexia as a conflict of embodiment","volume":"27","author":"Fuchs","year":"2022","journal-title":"Eat Weight Dis \u2013 Stud Anor Bul Obes"},{"key":"B11","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1353\/ppp.2021.0008","article-title":"Controlling the noise: A phenomenological account of anorexia nervosa and the threatening body","volume":"28","author":"Osler","year":"2021","journal-title":"Phil Psychiatry Psychol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1080\/08870446.2011.595488","article-title":"\u2018It\u2019s like there are two people in my head\u2019: A phenomenological exploration of anorexia nervosa and its relationship to the self","volume":"27","author":"Williams","year":"2012","journal-title":"Psychol Heal"},{"key":"B13","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1002\/erv.493","article-title":"Decisional balance in anorexia nervosa: capitalizing on ambivalence","volume":"11","author":"Cockell","year":"2003","journal-title":"Eur Eat Dis Rev"},{"key":"B14","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1080\/13642537.2018.1563909","article-title":"The experience of feeling fat for women with anorexia nervosa: an interpretative phenomenological analysis","volume":"21","author":"Major","year":"2019","journal-title":"Eur J Psychother Counsel"},{"key":"B15","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s40337-022-00675-x","article-title":"A preliminary exploration of experiences of integrating the body in the self in two women with anorexia nervosa in view of phenomenological conceptualisations","volume":"10","author":"Naess","year":"2022","journal-title":"J Eat Dis"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1159\/000330258","article-title":"Identity and eating disorders (IDEA): a questionnaire evaluating identity and embodiment in eating disorder patients","volume":"45","author":"Stanghellini","year":"2012","journal-title":"Psychopathology"},{"key":"B17","doi-asserted-by":"crossref","DOI":"10.4159\/harvard.9780674418233","volume-title":"Psychosomatic Families: Anorexia Nervosa in Context","author":"Minuchin","year":"1978"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2845","article-title":"Attachment, motivational systems and anorexia nervosa: A systematic review and proposed framework for eating disorders","volume":"30","author":"Budia","year":"2023","journal-title":"Clin Psychol Psychother"},{"key":"B19","article-title":"The case of Ellen West","volume-title":"Existence","author":"Binswanger","year":"1958"},{"key":"B20","first-page":"81","article-title":"Anorexia Nervosa and the body uncanny: A phenomenological approach","volume":"20","author":"Svenaeus","year":"2013","journal-title":"Phil Psychiatry Psychol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.4324\/9781315101088","article-title":"Reconstructing agency in developmental and educational psychology: Inclusive Systems as Concentric Space","author":"Downes","year":"2020","journal-title":"New York\/London\/New Delhi: Routledge"},{"key":"B22","volume-title":"Descartes: Philosophical writings","author":"Descartes","year":"1954"},{"key":"B23","volume-title":"Concentric Space as a Life Principle Beyond Schopenhauer, Nietzsche and Ricoeur: Inclusion of the Other","author":"Downes","year":"2020"},{"key":"B24","volume-title":"The production of","author":"Lefebvre","year":"1992"},{"key":"B25","article-title":"Thirdspace: Journeys to Los Angeles and other real-and-imagined places","author":"Soja","year":"1996","journal-title":"Blackwell"},{"key":"B26","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/0263775817738782","article-title":"The duality of space: The built world of Du Bois\u2019 double-consciousness","volume":"36","author":"Brand","year":"2018","journal-title":"Environ Plan D: Soc Space"},{"key":"B27","first-page":"95","article-title":"Disability, education and space: Some critical reflections","volume-title":"Spatial theories of education: Policy and geography matters","author":"Armstrong","year":"2007"},{"key":"B28","volume-title":"For Space","author":"Massey","year":"2005"},{"key":"B29","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1080\/17508481003731075","article-title":"Spatializing critical education: Progress and cautions","volume":"51","author":"Ferrare","year":"2010","journal-title":"Crit Stud Ed"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.5195\/errs.2020.495","article-title":"A living spatial movement of relation \u2013 reconceptualising Ricoeur\u2019s oneself as another and Heidegger\u2019s being and time","volume":"11","author":"Downes","year":"2020","journal-title":"Ricoeur Stud"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.17454\/pam-1811","article-title":"Body experience, identity and the other\u2019s gaze in persons with feeding and eating disorders","volume":"1","author":"Stanghellini","year":"2020","journal-title":"Phenom Mind"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2019.02.005","article-title":"The optical-coenaesthetic disproportion in feeding and eating disorders","volume":"58","author":"Stanghellini","year":"2019","journal-title":"Eur Psychiatry"},{"key":"B33","volume-title":"The absent body","author":"Leder","year":"1990"},{"key":"B34","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1353\/ppp.2021.0009","article-title":"Anorexia: That body I am-with","volume":"28","author":"Leder","year":"2021","journal-title":"Phil Psychiatry Psychol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.amp.2015.01.008","article-title":"Anorexie et intersubjectivit\u00e9: \u00c9tude ph\u00e9nom\u00e9nologique et \u00e9thologique","volume":"173","author":"Englebert","year":"2015","journal-title":"Annales M\u00e9dico-psychologiques Rev psychiatrique"},{"key":"B36","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1515\/9783110246599.23","article-title":"The phenomenology of existential feeling","volume-title":"The Feeling of Being Alive","author":"Ratcliffe","year":"2012"},{"key":"B37","doi-asserted-by":"crossref","DOI":"10.7208\/chicago\/9780226844541.001.0001","volume-title":"Oneself as Another","author":"Ricoeur","year":"1994"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5195\/errs.2021.576","article-title":"Introduction \u2013 Ric\u0153ur and the problem of space","volume":"12","author":"Vendra","year":"2021","journal-title":"Perspect Ric\u0153urian \u201cSpatial Turn\u201d Ric\u0153ur Stud"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1353\/ppp.2021.0011","article-title":"(Un) wanted feelings in anorexia nervosa: making the visceral body mine again","volume":"28","author":"Osler","year":"2021","journal-title":"Phil Psychiatry Psychol"},{"key":"B40","volume-title":"The voice of Experience","author":"Laing","year":"1982"},{"key":"B41","volume-title":"The Basic Problems of Phenomenology","author":"Heidegger","year":"1988"},{"key":"B42","volume-title":"The Poetics of Space","author":"Bachelard","year":"1994"},{"key":"B43","volume-title":"The history of sexuality: 2: The use of pleasure","author":"Foucault","year":"2019"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.2307\/464648","article-title":"Of other spaces","volume":"16","author":"Foucault","year":"1986","journal-title":"Diacr"},{"key":"B45","volume-title":"The savage mind","author":"L\u00e9vi-Strauss","year":"1966"},{"key":"B46","article-title":"Claude L\u00e9vi-Strauss: Anthropologist and philosopher","volume-title":"The essential Edmund Leach, Vol. I, Anthropology and society","author":"Leach","year":"2000"},{"key":"B47","volume-title":"Structural Anthropology","author":"L\u00e9vi-Strauss","year":"1963"},{"key":"B48","volume-title":"Minevikult tanapaevani","author":"Mandel","year":"1984"},{"key":"B49","doi-asserted-by":"crossref","DOI":"10.4324\/9781003282921","volume-title":"The Routledge International Handbook of Equity and Inclusion in Education","author":"Downes","year":"2024"},{"key":"B50","volume-title":"A formative, inclusive, whole school approach to the assessment of social and emotional education in the EU","author":"Cefai","year":"2021"},{"key":"B51","volume-title":"Philosophy in the Flesh: The Embodied Mind and Its Challenge to Western Thought","author":"Lakoff","year":"1999"},{"key":"B52","doi-asserted-by":"crossref","DOI":"10.1515\/9783110197532.4.313","article-title":"What\u2019s in a schema? Bodily mimesis and the grounding of language","volume-title":"From perception to meaning: Image schemas in cognitive linguistics","author":"Zlatev","year":"2005"},{"key":"B53","doi-asserted-by":"crossref","first-page":"70","DOI":"10.4324\/9781003282921-6","article-title":"When Inclusion Means Exclusion and The Terms of Belonging are Obfuscated: What\u2019s the Role of Race","volume-title":"The Routledge International Handbook of Equity and Inclusion in Education","author":"Souto Manning","year":"2024"},{"key":"B54","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"B55","volume-title":"A Secular Age","author":"Taylor","year":"2007"},{"key":"B56","volume-title":"Towards a Concentric Spatial Psychology for Social and Emotional Education Beyond the Interlocking Spatial Pillars of Modernism","author":"Downes","year":"2024"},{"key":"B57","volume-title":"The Divided Self","author":"Laing","year":"1959"},{"key":"B58","volume-title":"Toward transformation in social knowledge","author":"Gergen","year":"1994"},{"key":"B59","volume-title":"Deduction. Hove and Hillsdale","author":"Johnson-Laird","year":"1991"},{"key":"B60","volume-title":"The Primordial Dance: Diametric and Concentric Spaces in the Unconscious World","author":"Downes","year":"2012"},{"key":"B61","volume-title":"Psychology and anthropology: A psychological perspective","author":"Jahoda","year":"1982"},{"key":"B62","doi-asserted-by":"crossref","DOI":"10.3726\/978-1-4539-1713-8","volume-title":"The observable: Heisenberg\u2019s philosophy of quantum mechanics","author":"Heelan","year":"2016"},{"key":"B63","volume-title":"Adolescence\u2014the farewell to childhood","author":"Kaplan","year":"1984"},{"key":"B64","volume-title":"Auf Stelzen gehen. Geschichte einer Magersucht","author":"Lena","year":"2006"},{"key":"B65","volume-title":"Wasted","author":"Hornbacher","year":"1999"},{"key":"B66","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1002\/erv.1029","article-title":"What does uncertainty mean to women with anorexia nervosa? An interpretative phenomenological analysis","volume":"19","author":"Sternheim","year":"2011","journal-title":"Eur Eat Dis Rev"},{"key":"B67","volume-title":"On the Basis of Morality","author":"Schopenhauer","year":"1995"},{"key":"B68","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.mhpa.2015.12.002","article-title":"The meaning of compulsive exercise in women with anorexia nervosa: An interpretative phenomenological analysis","volume":"10","author":"Kolnes","year":"2016","journal-title":"Ment Heal Phys Act"},{"key":"B69","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1017\/S1744552312000456","article-title":"Agency, ambivalence and authenticity: the many ways in which anorexia nervosa can affect autonomy1","volume":"9","author":"Hope","year":"2013","journal-title":"Int J Law Context"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2010.04.004","article-title":"Cognitive behavioral therapy for eating disorders","volume":"33","author":"Murphy","year":"2010","journal-title":"Psychiatr Clin Nth Amer"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00158","article-title":"Psychotherapeutic treatment for anorexia nervosa: A systematic review and network meta-analysis","volume":"9","author":"Zeeck","year":"2018","journal-title":"Front Psychiatry"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-021-01118-3","article-title":"The role of embodiment in the treatment of patients with anorexia and bulimia nervosa: a 2-year follow-up study proposing an integration between enhanced cognitive behavioural therapy and a phenomenological model of eating disorders","volume":"26","author":"Rossi","year":"2021","journal-title":"Eat Weight Dis-Stud Anor Bul Obes"},{"key":"B73","volume-title":"The second sex","author":"Beauvoir, de","year":"1989"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1353\/ppp.2021.0010","article-title":"Anorexia nervosa, the visceral body, and the sense of ownership","volume":"28","author":"Maiese","year":"2021","journal-title":"Phil Psychiatry Psychol"},{"key":"B75","doi-asserted-by":"publisher","first-page":"538997","DOI":"10.3389\/fpsyt.2020.538997","article-title":"Severe and enduring anorexia nervosa: enduring wrong assumptions","volume":"11","author":"Guti\u00e9rrez","year":"2021","journal-title":"Front Psychiatry"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2016.00849","article-title":"and tasca GA is anorexia nervosa a disorder of the self? A psychological approach","volume":"7","author":"Amianto","year":"2016","journal-title":"Front Psychol"},{"key":"B77","first-page":"97","article-title":"Eating disorders in the context of attachment theory","volume":"9","author":"Alantar","year":"2021","journal-title":"Alpha Psychiatry"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1623166\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T05:35:13Z","timestamp":1758000913000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1623166\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":77,"alternative-id":["10.3389\/fpsyt.2025.1623166"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1623166","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,16]]},"article-number":"1623166"}}