Uncovering Bulimia’s demanding voice: Challenges from a narrative therapist’s perspective— Kassandra Pedersen

This paper presents responses to a series of challenges faced during work with a 17-year-old girl who sought to reclaim her life from bulimia’s demanding voice. Kiki was at first unwilling to participate in therapeutic conversations, and initial contact occurred through her boyfriend, who became part of an anti-bulimia team. Encouraged by her boyfriend, Kiki, who was determined to ‘stop throwing up at last’, decided to attend sessions. Through externalising conversations, bulimia was personified as ‘The Guy’, who ruled her daily life with judgements. Kiki described The Guy’s effect on her life and developed a stance resisting his influence. The process of working with Kiki raised a number of challenges: assisting a person who initially declined to participate, overcoming pathologising discourses, resisting the tactics of the problem and its allies, supporting a preferred identity in an unsupportive environment, and keeping Kiki’s preferences and beliefs at the centre of our work. This paper explores the use of narrative practices, including externalising conversations, double listening, identifying unique outcomes, and the failure conversations map, to address these issues and support resistance to bulimia.