Art Therapy: Beneficial in Eating Disorder Treatment
By Nicole Pipitone, MAAT, LPC
Eating disorders are one of the most complex and most dangerous disorders due to their medical complications and the challenging thought processes which can increase the rate of suicide. Often treatment interventions to support recovery include; CBT, DBT, nutrition and psycho education, psychopharmacology, and medical monitoring. Additional forms of therapeutic interventions for eating disorder treatment have included expressive therapies, such as; yoga, music therapy, dance and movement therapy, and art therapy. Many times, when individuals walk into treatment, they are unaware of the time investment needed for recovery and the emotional pain that may occur when battling a disorder that can cause death. Art therapy can be a tool for clients to gain insight, develop improved coping mechanisms, practice mindfulness, address and heal from distorted body image and skewed food perceptions, identify their authentic sense of self, and cope with the physical changes that may occur throughout an individual’s treatment.
Art Therapy first began in the mid-20th century and the use of art materials within psychotherapy spread to the United States with the support of the founders of art therapy, Margaret Naumberg and Edith Kramer. As the understanding of how the right side and the left side of the brain work together rather than separately, the use and importance of Art Therapy flourished. Art therapy allows for inner conflicts to be produced in visual forms and provides a path for conflict resolution to occur. Regularly, individuals struggle to truly identify these inner conflicts. By using art materials and creating symbols, clients can awaken the psyche and create a better understanding of the conflict that is occurring. Art therapy creates the bridge between the nonverbal and verbal. Many clients suffer from the inability to speak of feelings related to control, shame, certain life events, and the positives in their lives without the use of maladaptive behaviors. Art therapy offers clients a space to remove themselves from the disorder, even if it is for the length of a session and gain a different perspective on their lives, the magnitude of irrational thinking, the control or lack of control experienced, or the personal change and growth related to body image and recovery.
Individuals struggling with eating disorders frequently discuss their inner conflict between the Eating Disorder ‘voice’ and the individual’s self-voice or ‘my voice’. The use of art therapy can help depict the conversation between the two like the use of “the empty chair” technique. Art therapy can also support the processing of the two voices – which voice is stronger? what triggers the ‘eating disorder voice’? ‘what tools are needed to overcome the ‘eating disorder voice’? These are often questions asked verbally to clients and answered verbally, however by using art materials, the client can become an objective observer. Clients are then able to process through a different lens and may be able to increase understanding their behaviors and strengthen self-identity by making the ‘my voice’ stronger and more powerful than the ‘eating disorder voice’.
In addition to using art therapy to support clients’ increased sense of self, body image, and perfectionism are often topics that can arise within the treatment of eating disorders. Many pieces of art are often disconnected at the neck, representing the disconnection between mind and body. Art therapy supports the reconnection of the mind and the body. Art therapy allows a kinesthetic awareness and aids the understanding of how much space the body feels it fills versus how much space the body actually takes. Clients often have a distorted view of self and their body. The creation of art can help clients describe the discomfort that occurs when seeing their body differently than others see their body. Art allows for clients to begin connecting, validating, and viewing their bodies as vessels that support life.
Perfectionism in body image is a much talked about topic, as is the perfectionism that occurs within career, school, and/or relationships. Perfectionism is often seen in the art work of a client struggling with Anorexia Nervosa. When an art therapist works with an individual in relation to their perfectionism, the art therapist can support the client in trying new materials that are less rigid. Some examples include paint as opposed to colored pencils or using fingers to paint rather than paint brushes. The support from a trained art therapist allows for clients to experience change, lack of structure, and push for further change. In this setting, the client can feel a sense of safety in movement away from ‘being perfect’ and begin to process the faults and imperfections.
Finally, art therapy within treatment for eating disorders promotes the practice of mindfulness and stress reduction. Many studies have been published that support the use of mindfulness in eating disorder treatment with its positive psychological effects and the reduction of behavioral symptoms. Using art materials, such as pre-drawn mandalas in sessions or groups provides mindfulness practice and stress reduction. In addition to coloring, mindfulness can be practiced with a combination of art mediums and music. This can be practiced by identifying and being in the present moment while creating the art, as well as by using the 5 senses when creating art. Many art materials have different textures, smells, and even tastes, if you are using food to make art.
Eating disorders affect at least 30 million people in the United States alone. Art Therapy has become an instrumental part of an individual’s recovery at all levels of care. Access to Art Therapists enhances clients’ understanding of their disorder and assists in their communication about their disorder, their inner conflicts, emotional states, various areas of their lives, and their challenges in recovery. Art Therapists are trained to guide clients in using materials and promote outcomes which develop and improve coping skills, increase mindfulness, reduce stress, understand the self, and claim a sense of empowerment. Eating disorder recovery is possible and Art Therapy during treatment has proven itself as a valuable resource.
About the author:
Nicole Pipitone, MAAT, LPC works as an outpatient therapist at Clarity Counseling Center in Wilmington, North Carolina. Prior to moving to the South, Nicole was the Program Director for Adult and Adolescent PHP and IOP programs at Walden Behavioral Care in Guilford, CT. Nicole received her master’s degree in art therapy and clinical counseling from Albertus Magnus College. In 2012, Nicole found an interest in working with the eating disorder population at Center for Discovery’s residential program for adolescents. Since then, Nicole’s passion for working with individuals and their families struggling with eating disorders hasn’t stopped. As a part of treatment, Nicole has offered her expertise in Art Therapy, promoted psycho-education, conducted Dialectical Behavioral Therapy, and Cognitive Behavioral Therapy within individual and group sessions. Nicole has worked with many families and continues to implement the Family-Based Treatment model within treatment. Nicole has engaged in many community outreach events and led presentations to help address the importance of recovery and the need for further research, as well as the impact that eating disorders have on people and their families. Nicole believes that recovery from an eating disorder is extremely difficult and possible!