Bulimia nervosa (BN) is a highly researched eating disorder, yet real world recovery rates remain poor and incidence continues to rise. This study provides a focused exploration of the father-daughter relationship where BN emerges, in order to explore this relationship’s significance to the aetiology of BN and to BN’s resistance to CBT-based treatment.

A hermeneutic phenomenological study of six women in recovery from BN was undertaken.

Fathers of daughters with BN were found to be a source of fear, control, abuse, emotional and physical avoidance and gender diminishment. This was a key source of complex traumatic experience in the family setting, with BN emerging in daughters to provide distraction and soothing. Furthermore, BN acts as a survival mechanism from early childhood and is a logical embodied response to the lived experience of complex trauma. The presence of trauma in the aetiology of BN, makes sense of why cognitive-based therapeutic protocols provide for limited treatment success. The research suggests greater potential lies in adopting the individualised, multi-modal complex trauma treatment model for BN, as this more appropriately addresses outcomes of relationship trauma.