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Background  Patients with eating disorders have reported poorer emotional awareness, more emotional suppression, less use of adaptive emotional regulation strategies, and more use of maladaptive emotional regulation strategies compared to people in healthy control groups.    Aim  To explore experiences of emotions by a transdiagnostic sample of patients with eating disorders.    Method  Nine patients with different eating disorder diagnoses at an eating disorder outpatient clinic in Sweden were interviewed for their thoughts on emotions. The interviews were analyzed with Thematic Analysis.    Result  Four themes were constructed: “Not knowing what one feels”, “Switch off, run away, or hide behind a mask”, “Emotions in a lifelong perspective”, and “Using eating behaviours to regulate emotions”. The patients described uncertainty regarding whether they experienced emotions correctly. They described how they tried to avoid difficult emotions through suppressive strategies and eating disorder behaviour. All described strategies were inefficient and all emotions were experienced as problematic, even joy. Since joy was used as a mask, the real experience of happiness was lost and mourned.    Conclusion  All kinds of emotions were considered problematic to experience, but shame, fear, and sadness were considered worst. It is difficult to know if the emotional difficulties preceded an eating disorder, however such difficulties may have increased as a result of the eating disorder.

Just like fireworks in my brain – a Swedish interview study on experiences of emotions in female patients with eating disorders