Examining Externalization as an Approach for Eating Disorder Recovery: A Qualitative Study of Self-Reported Experiences with Intrapersonal Dialogue

A narrative therapy technique, externalization involves personifying an illness, condition, or part of the self and dialoguing with it as if it were another person. Externalization is used to separate the person in therapy from the problems they are experiencing through the careful use of language and dialogue. This article examines the use of externalization as a tool for eating disorder recovery among a sample of 10 study participants whose recorded responses and interviews were coded as part of a larger discourse analysis related to personal definitions of recovery. Although externalization worked well for some participants, most had either stopped practicing externalization completely or had integrated the externalized eating disorder persona back into their concept of self. This research illuminates the complex and varied experiences people have with intrapersonal communication and emphasizes the care that must be taken when investigating the use of internal dialogue as a tool for dealing with mental illness.