Abnormal time experiences in persons with feeding and eating disorder: a naturalistic explorative study

  • Giovanni StanghelliniEmail author
  • Milena Mancini


To provide a qualitative analysis of abnormal temporal experiences (ATE) of persons affected by feeding and eating disorders (FED). This is a naturalistic explorative study on a group of 27 patients affected by FED interviewed over a two-year period in a clinical/psychotherapeutic setting. Clinical files were analysed by means of Consensual Qualitative Research (CQR). Twenty-one (77,8%) out of twenty-seven patients affected by FED reported at least one ATE. The main categories identified are 1) Irruption of disturbing bodily experiences (18 patients); 2) Anxiety for the passing of time (17 patients); 3) Ritualization/Digitalization of time (19 patients). ATE are a relevant feature of the life-world inhabited by people with FED and may represent an important link between abnormal bodily experiences and disorders of personal identity in these patients. The sample number is small but our preliminary findings justify testing a larger number of patients.


Abnormal time experience Assessment Dynamic phenomenology Feeding and eating disorders Life-world Psychopathology 



  1. American Psychiatric Association (2013). DSM 5. American Psychiatric Association.Google Scholar
  2. Arnow, B., Kenardy, J., & Agras, W. S. (1995). The emotional eating scale: the development of a measure to assess coping with negative affect by eating. The International Journal of Eating Disorders, 18, 79–90.CrossRefGoogle Scholar
  3. Binswanger, L. (1960). Melancholie und Manie. Phänomenologische studien. Pfullingen: Günther Neske.Google Scholar
  4. Broome, M. R. (2005). Suffering and eternal recurrence of the same: the neuroscience. Psychopathology and philosophy of time. Philosophy, Psychiatry, and Psychology, 12, 187–194.CrossRefGoogle Scholar
  5. Bruch, H. (1981). Developmental considerations of anorexia nervosa and obesity. The Canadian Journal of Psychiatry/La Revue Canadienne de Psychiatrie, 26(4), 212–217.CrossRefGoogle Scholar
  6. Bruch, H. (1982). Anorexia nervosa: therapy and theory. The American Journal of Psychiatry, 139, 1531–1538.CrossRefGoogle Scholar
  7. Castellini, G., Trisolini, F., & Ricca, V. (2014). Psychopathology of eating disorders. Journal of Psychopathology, 20(1), 461–470.Google Scholar
  8. Castellini, G., Stanghellini, G., Godini, L., Lucchese, M., Trisolini, F., & Ricca, V. (2015). Abnormal bodily experiences mediate the relationship between impulsivity and binge eating in overweight subjects seeking bariatric surgery. Psychotherapy and Psychosomatics, 84(2), 124–126.CrossRefGoogle Scholar
  9. Castellini, G., Franzago, M., Bagnoli, S., Lelli, L., Balsamo, M., Mancini, M., Nacmias, B., Ricca, V., Sorbi, S., Antonucci, I., Stuppia, L., & Stanghellini, G. (2017). Fat mass and obesity-associated gene (FTO) is associated to eating disorders susceptibility and moderates the expression of psychopathological traits. PLoS One, 12(3), e0173560.CrossRefGoogle Scholar
  10. Dakanalis, A., Timko, C. A., Zanetti, M. A., Rinaldi, L., Prunas, A., Carrà, G., Riva, G., & Clerici, M. (2014). Attachment insecurities, maladaptive perfectionism, and eating disorder symptoms: a latent mediated and moderated structural equation modeling analysis across diagnostic groups. Psychiatry Research, 215, 176–184.CrossRefGoogle Scholar
  11. Dalle Grave, R. (2011). Eating disorders: progress and challenges. European Journal of Internal Medicine, 22, 153–160.CrossRefGoogle Scholar
  12. Demidenko, N., Tasca, G. A., Kennedy, N., & Bissada, H. (2010). The mediating role of self-concept in the relationship between attachment insecurity and identity differentiation among women with an eating disorder. Journal of Social and Clinical Psychology, 29, 1131–1152.CrossRefGoogle Scholar
  13. Eddy, K. T., Dorer, D. J., Franko, D. L., Tahilani, K., Thompson-Brenner, H., & Herzog, D. B. (2008). Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V. American Journal of Psychiatry, 165(2), 245–250.CrossRefGoogle Scholar
  14. Eggert, M. A., Levendosky, A., & Klump, K. (2007). Relationships among attachment styles, personality characteristics, and disordered eating. International Journal of Eating Disorders, 40, 149–155.CrossRefGoogle Scholar
  15. Eshkevari, E., Rieger, E., Longo, M. R., Haggard, P., & Treasure, J. (2014). Persistent body image disturbance following recovery from eating disorders. International Journal of Eating Disorders, 47(4), 400–409.CrossRefGoogle Scholar
  16. Fairburn, C. G., & Cooper, Z. (2007). Thinking afresh about the classification of eating disorders. International Journal of Eating Disorders, 40(S3), S107–S110.CrossRefGoogle Scholar
  17. Fairburn, C. G., & Harrison, P. J. (2003). Eating Disorders. The Lancet, 361(9355), 407–416.CrossRefGoogle Scholar
  18. Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509–528.CrossRefGoogle Scholar
  19. Foucault, M. (1988). The history of sexuality, Vol. 3: The Care of the Self. New York: Vintage Books.Google Scholar
  20. Fredrickson, B. L., & Roberts, T. (1997). Objectification theory. Psychology of Women Quarterly, 21(2), 173–206.CrossRefGoogle Scholar
  21. Fuchs, T. (2010). Phenomenology and psychopathology. In S. Gallagher & D. Schmicking (Eds.), Handbook of phenomenology and the cognitive sciences (pp. 547–573). Dordrecht: Springer.Google Scholar
  22. Fuchs, T. (2013). Temporality and psychopathology. Phenomenology and the Cognitive Sciences, 1, 75–104.CrossRefGoogle Scholar
  23. Fuchs, T., & Van Duppen, Z. (2017). Time and events: on the phenomenology of temporal experience in schizophrenia (ancillary article to EAWE domain 2). Psychopathology, 50(1), 68–74.CrossRefGoogle Scholar
  24. Gallagher, S. (2006). How the body shapes the mind. Oxford: Oxford UP.Google Scholar
  25. Goldschmidt, A. B., Hilbert, A., Manwaring, J. L., Wilfley, D. E., Pike, K. M., Fairburn, C. G., Dohm, F. A., & Striegel-Moore, R. H. (2010). The significance of overvaluation of shape and weight in binge eating disorder. Behaviour Research and Therapy, 48, 187–193.CrossRefGoogle Scholar
  26. Goodsitt, A. (1997). Eating disorders: a self-psychological perspective. In D. Garner & P. Garfinkel (Eds.), Handbook of Treatment for Eating Disorders, ed 2 (pp. 205–228). New York: Guilford.Google Scholar
  27. Grilo, C. M. (2013). Why no cognitive body image feature such as overvaluation of shape/weight in the binge eating disorder diagnosis? The International Journal of Eating Disorders, 46, 208–211.CrossRefGoogle Scholar
  28. Grilo, C. M., Crosby, R. D., Masheb, R. M., White, M. A., Peterson, C. B., Wonderlich, S. A., Engel, S. G., Crow, S. J., & Mitchell, J. E. (2009). Overvaluation of shape and weight in binge eating disorder, bulimia nervosa, and sub-threshold bulimia nervosa. Behaviour Research and Therapy, 47, 692–696.CrossRefGoogle Scholar
  29. Hill, C. E., Thompson, B. J. E., & Williams, N. (1997). A guide to conducting consensual qualitative research. The Counseling Psychologist, 25, 517–572.CrossRefGoogle Scholar
  30. Hill, C. E., Knox, S., Thompson, B. J., Williams, E. N., Hess, S. A., & Ladany, N. (2005). Consensual qualitative research: an update. Marquette Univ, 52, 196–205.Google Scholar
  31. Illing, V., Tasca, G. A., Balfour, L., & Bissada, H. (2010). Attachment insecurity predicts eating disorder symptoms and treatment outcomes in a clinical sample of women. The Journal of Nervous and Mental Disease, 198(9), 653–659.CrossRefGoogle Scholar
  32. Jaspers, K. (1925). Psychologie des Weltanschauung. Berlin: Springer.CrossRefGoogle Scholar
  33. Jaspers, K. (1963). General Psychopathology. Translated by Hoenig J, Hamilton MW. Chicago: University of Chicago Press.Google Scholar
  34. Kimura, B. (2005). Scritti di Psicopatologia Fenomenologica. Roma: Giovanni Fioriti Editore.Google Scholar
  35. Kuipers, G. S., & Bekker, M. H. J. (2012). Attachment, mentalization and eating disorders: a review of studies using the adult attachment interview. Current Psychiatry Reviews, 8, 326–336.CrossRefGoogle Scholar
  36. Macht, M. (2008). How emotions affect eating: a five-way model. Appetite, 50(1), 1–11.CrossRefGoogle Scholar
  37. Masheb, R. M., & Grilo, C. M. (2006). Emotional overeating and its associations with eating disorder psychopathology among overweight patients with binge eating disorder. The International Journal of Eating Disorders, 39, 141–146.CrossRefGoogle Scholar
  38. Milos, G., Spindler, A., Schnyder, U., & Fairburn, C. G. (2005). Instability of eating disorder diagnoses: prospective study. The British Journal of Psychiatry, 187(6), 573–578.CrossRefGoogle Scholar
  39. Minkowski E. (1933). Le temps vecu. Paris, France: d’Arey.Google Scholar
  40. Minkowski, H. (1952). Space and time. In A. Sommerfeld (Ed.), The principle of relativity. New York: Dover.Google Scholar
  41. Monteleone, A. M., Castellini, G., Volpe, U., Nigro, M., Zamponi, F., Ricca, V., Stanghellini, G., & Monteleone, P. (2017a). The disorder of lived corporeality: a possible link between attachment style and eating disorder psychopathology. European Psychiatry, 41, S557–S558.CrossRefGoogle Scholar
  42. Monteleone, A. M., Castellini, G., Ricca, V., Volpe, U., De Riso, F., Nigro, M., et al. (2017b). Embodiment mediates the relationship between avoidant attachment and eating disorder psychopathology. European Eating Disorders Review, 25, 461–468. Scholar
  43. Nordbø, R. H., Espeset, E., Gulliksen, K. S., Skårderud, F., & Holte, A. (2006). The meaning of self-starvation: qualitative study of patients' perception of anorexia nervosa. International Journal of Eating Disorders, 39(7), 556–564.CrossRefGoogle Scholar
  44. Northoff, G. (2015). Is schizophrenia a spatiotemporal disorder of the brain's resting state? World Psychiatry, 14(1), 34–35.CrossRefGoogle Scholar
  45. Northoff, G., & Stanghellini, G. (2016). How to link brain and experience? Spatiotemporal psychopathology of the lived body. Frontiers in Human Neuroscience, 10, 172. Scholar
  46. Ricca, V., Castellini, G., Lo Sauro, C., Ravaldi, C., Lapi, F., Mannucci, E., Rotella, C. M., & Faravelli, C. (2009). Correlations between binge eating and emotional eating in a sample of overweight subjects. Appetite, 53(3), 418–421.CrossRefGoogle Scholar
  47. Ricca, V., Castellini, G., Fioravanti, G., Sauro, C. L., Rotella, F., Ravaldi, C., et al. (2012). Emotional eating in anorexia nervosa and bulimia nervosa. Comprehensive Psychiatry, 53(3), 245–251.CrossRefGoogle Scholar
  48. Sands, S. (1991). Bulimia, dissociation, and empathy: A self-psychological view. In C. Johnson (Ed.), Psychodynamic treatment of anorexia nervosa and bulimia nervosa (pp. 34–50). New York: Guilford.Google Scholar
  49. Sartre, J. P. (1943/1992). Being and nothingness. New York: Washington Square Press.Google Scholar
  50. Sass, L., Pienkos, E., Skodlar, B., Stanghellini, G., Fuchs, T., Parnas, J., & Jones, N. (2017). EAWE: examination of anomalous world experience. Psychopathology, 50(1), 10–54.CrossRefGoogle Scholar
  51. Schilder, P. (1950). The image and appearance of the human body: Studies in the constructive energies of the psyche. New York: International UP.Google Scholar
  52. Schneider, K. L., Panza, E., Appelhans, B. M., Whited, M. C., Oleski, J. L., & Pagoto, S. L. (2012). The emotional eating scale. Can a self-report measure predict observed emotional eating? Appetite, 58(2), 563–566.CrossRefGoogle Scholar
  53. Schutz, A., &Luckmann, T.. 1973. The Structures of the Life-World Vol. 1. Northwestern University Press.Google Scholar
  54. Schutz, A., & Luckmann, T. 1989. The Structures of the Life-World Vol. 2. Northwestern University Press.Google Scholar
  55. Skårderud, F. (2007a). Eating one's words, part I:‘concretised metaphors’ and reflective function in anorexia nervosa—An interview study. European Eating Disorders Review, 15(3), 163–174.CrossRefGoogle Scholar
  56. Skårderud, F. (2007b). Eating one's words, part II: the embodied mind and reflective function in anorexia nervosa—Theory. European Eating Disorders Review, 15(4), 243–252.CrossRefGoogle Scholar
  57. Stanghellini, G. (2005). For an anthropology of eating disorders. A pornographic vision of the self. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 10(2), 21–27.CrossRefGoogle Scholar
  58. Stanghellini, G. (2009). Embodiment and schizophrenia. World Psychiatry, 8, 56–59.CrossRefGoogle Scholar
  59. Stanghellini, G. (2017). Lost in dialogue. Anthropology, psychopathology, and care. Oxford: Oxford University Press.Google Scholar
  60. Stanghellini, G., & Ballerini, M. (2008). Qualitative analysis. Its use in psychopathological research (editorial). Acta Psychiatrica Scandinavica, 117, 161–163.CrossRefGoogle Scholar
  61. Stanghellini, G., & Mancini, M. (2017). The therapeutic interview. Emotions, values, and the life-world. Cambridge: Cambridge University Press.Google Scholar
  62. Stanghellini, G., & Rosfort, R. (2013). Emotions and personhood: Exploring fragility – Making sense of vulnerability. Oxford: Oxford University Press.CrossRefGoogle Scholar
  63. Stanghellini, G., Castellini, G., Brogna, P., Faravelli, C., & Ricca, V. (2012). Identity and eating disorders (IDEA): a questionnaire evaluating identity and embodiment in eating disorder patients. Psychopathology, 45, 147–158.CrossRefGoogle Scholar
  64. Stanghellini, G., Trisolini, F., Castellini, G., Ambrosini, A., Faravelli, C., & Ricca, V. (2014). Is feeling extraneous from one's own body a core vulnerability feature in eating disorders? Psychopathology, 48(1), 18–24.CrossRefGoogle Scholar
  65. Stanghellini, G., Ballerini, M., Presenza, S., Mancini, M., Raballo, A., Blasi, S., & Cutting, J. (2015). Psychopathology of lived time: abnormal time experience in persons with schizophrenia. Schizophrenia Bulletin, 42(1), 45–55.Google Scholar
  66. Stanghellini, G., Ballerini, M., Presenza, S., Mancini, M., Northoff, G., & Cutting, J. (2017). Abnormal time experiences in major depression: an empirical qualitative study. Psychopathology, 50(2), 125–140.CrossRefGoogle Scholar
  67. Stein, K. F., & Corte, C. (2007). Identity impairment and the eating disorders: content and organization of the self-concept in women with anorexia nervosa and bulimia nervosa. European Eating Disorders Review, 15, 58–69.CrossRefGoogle Scholar
  68. Stice, E., & Shaw, H. E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. Journal of Psychosomatic Research, 53, 985–993.CrossRefGoogle Scholar
  69. Straus, E. W. (1966). Phenomenological psychology. New York: Basic Books.Google Scholar
  70. Tasca, G. A., & Balfour, L. (2014). Attachment and eating disorders: a review of current research. International Journal of Eating Disorders, 47(7), 710–717.CrossRefGoogle Scholar
  71. Tillich, P. (1957). Systematic theology (Vol. 2). Chicago: The University of Chicago Press.Google Scholar
  72. Tozzi, F., Thornton, L. M., Klump, K. L., Fichter, M. M., Halmi, K. A., Kaplan, A. S., et al. (2005). Symptom fluctuation in eating disorders: correlates of diagnostic crossover. American Journal of Psychiatry, 162(4), 732–740.Google Scholar
  73. Vogeley, K., & Kupke, C. (2007). Disturbances of time consciousness from a phenomenological and a neuroscientific perspective. Schizophrenia Bulletin, 33, 157–165.CrossRefGoogle Scholar
  74. Von Gebsattel, V. E. (1958). The world of the compulsive. In R. May, E. Angel, & H. F. Ellenberger (Eds.), Existence, a New Dimension in Psychiatry and Psychology. New York: Basic Books.Google Scholar
  75. Waller, G., & Osman, S. (1998). Emotional eating and eating psychopathology among non–eating-disordered women. The International Journal of Eating Disorders, 23, 419–424.CrossRefGoogle Scholar
  76. Zachrisson, H. D., & Kulbotten, G. R. (2006). Attachment in anorexia nervosa: an exploration of associations with eating disorder psychopathology and psychiatric symptoms. Eating and Weight Disorders, 11, 163–170.CrossRefGoogle Scholar
  77. Zahavi, D. (2005). Subjectivity of selfhood: investigating the first-person perspective. Cambridge, MA: The MIT Press.Google Scholar

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© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Psychological, Humanistic and Territorial SciencesUniversity “G. D’ Annunzio”ChietiItaly
  2. 2.Centro de Estudios de Fenomenología y PsiquiatríaUniversidad “Diego Portales”SantiagoChile

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