Date of Award


Document Type


Degree Name


Organizational Unit

Morgridge College of Education, Counseling Psychology

First Advisor

Maria T. Riva, Ph.D.


Assertiveness, Binge eating disorder, Bulimia nervosa, Eating disorders, Interpersonal functioning, Qualitative


Eating disorders are serious mental health problems with high relapse rates (Arcelus, Mitchell, Wales, & Nielsen, 2011; Herzog et al., 1999). Research has demonstrated that eating disorder populations show interpersonal deficits at baseline compared to comparison groups (Arcelus, Haslam, Farrow, & Meyer, 2013; Grissett & Norvell, 1992; Ivanova et al. 2015; Tiller at al., 1997), specifically in assertiveness (Behar, Manzo, & Casanova, 2006; Constantino & Smith-Hansen, 2008; Duchesne et al., 2012; Hartman et al., 2010). The goal of this research was to explore the variables related to relapse and make the social and interpersonal growth that occurs in recovery visible and bring additional understanding to the recovery process. Through a feminist phenomenological approach, 12 women from diverse backgrounds were interviewed via Zoom about their experiences of relapse and recovery from BN or BED. The themes that emerged from the women's stories were divided into two overarching themes: Most Recent Relapse and Recovery. To further describe these themes, subthemes were developed. Within Relapse the themes were organized into: Intrapersonal Factors, Interpersonal Factors, Environmental Stress, Seeking Resources and Support, Motivations, and Navigating Relationships. Within Recovery the themes were organized into: Entry into Recovery, Intrapersonal Factors, Interpersonal Factors, and Environmental Stability and Community. The findings of this study uncovered the intrapersonal and interpersonal challenges women face during relapse from BN or BED, highlighted how participants function in recovery, provided insight into how they reflect on their journey and what challenges they continue to face in maintaining their recovery. The phenomenon of relapse was characterized by self-neglect, low self-compassion, intrapersonal disconnection, isolation, and environmental stressors. Recovery was characterized by increased self-care and self-compassion and openness and assertiveness in relationships. Implications of this study include treatment considerations related to screening and addressing health concerns or trauma that occur at the same time as an eating disorder relapse, developing self-compassion and coping skills, utilizing interventions that develop assertiveness, increasing the duration that women remain connected to therapy in recovery, and support the importance of interventions that address fat phobia.

Publication Statement

Copyright is held by the author. User is responsible for all copyright compliance.

Rights Holder

Britney Tibbits


Received from ProQuest

File Format




File Size

171 p.


Counseling psychology