In the absence of real understanding about anorexia or the
recovery process, participants saw their work in terms of the
behaviour modification programme that they were required
to enforce. The extremely controlling nature of the programme
led to rebellion from patients, who were then perceived as ‘manipulative’, and to struggles from participants
to reassert the control the programme demanded.
Participants followed the programme even when they were
not convinced of its value. As a result, power was in play
between participants and patients, and both groups felt that
they were continually ‘struggling for control’. Instead of the
trust required for a therapeutic relationship, both groups
mistrusted each other.