Art Therapy in the Treatment of Eating Disorders

By Jennie J. Kramer, MSW, LCSW
Founder and Director of Metro Behavioral Health Associates Eating Disorders Centers Scarsdale and New York City, NY

At Metro Behavioral Health Associates, we are enthusiastic about our use of creative arts therapy to help patients access some of the very complicated feelings at the root of their struggles with anorexia, bulimia and bingeing. Though most people find the idea intriguing, many seem to have misperceptions about the role of art therapy in treating eating disorders.

For instance, though making art can certainly be a nice way to spend time and explore and express one’s feelings, it also happens to be serious therapy. Art therapists are licensed, clinical professionals who have completed extra rigorous training.

Also, many people think art therapy can only be effective for people who are artistic or especially talented – in fact, the opposite is often true.  It is probably a more effective tool for people who don’t regularly express themselves through the arts. It can provide access to feelings and emotions that have long been repressed or suppressed.  Think of it like the difference between drawing something with your dominant hand and then doing it with your non-dominant hand. With the latter, unless you are particularly ambidextrous, you’ll likely produce something seemingly childlike and unpolished. What one creates is then raw, real, unfiltered and also has the potential to bring back thoughts and ideas from childhood.

How Art Therapy Helps Treatment Progress

I asked our creative arts therapist Caren Sacks to share insights about how art therapy helps a patient with an eating disorder progress through treatment and recovery. Here are some of the common ways people benefit from it:

As a communication tool. Art therapy can be helpful in the assessment phase as a way to gather information about a patient. It is also helpful in treatment since making art can be a way to access deeply buried feelings and emotions and (for a few minutes at least) to get past their overwhelming tendency to be self-critical.

To create metaphors that enhance self-awareness.  Art making can be a treatment alternative when a patient finds traditional talk therapy too painful or uncomfortable. It can also help when a patient feels stuck and/or is unable to make changes or develop self-awareness. They can make images that both express their worries and serve as a vehicle for addressing these uncomfortable feelings.

As a starting point for group interaction. In making and sharing art in a group setting, members give and get support from others. Rather than criticizing, group members discuss what feelings are evoked when they look at something someone else has created. The art-makers get to see things from a different perspective and also learn to feel safe expressing themselves.

As a tool for relaxation and meditation. Research supports the idea of art making as an excellent form of mindfulness that taps into the part of the brain that allows you to relax. Making art can be a mindful respite from feelings of anxiety, self-criticism and fear.

The Medium Can Be the Message

With art therapy, the process of making art is as important – often more so – than whatever gets produced in the session. Even the materials used to create art shape the experience in important ways. For instance, colored pencils and markers are typically used in a very controlled way. Paints, especially watercolors, and clay offer far less structure and, Sacks says, may be an inappropriate choice for a person whose strengths needs to be shored up.

As for the assignment, she will sometimes ask people to produce something they want to explore or discuss, while at others times she will offer a specific “prompt.” “It is important to hear what is going on in the moment, to see what feelings people are coming in with,” she explains. “From there I might offer a prompt or directive.” Depending on the mood of the patient or group, she may ask for a depiction of what the eating disorder looks like or, perhaps, ask for a portrayal of the promise (like perfection, for anorexia, or escape, for binge eating disorder) the eating disorder holds out, along with a depiction of the reality it actually delivers.

The real goal, Sacks explains, “is to be able to support someone in doing their own work, so they begin to address their own experiences.” She encourages people to begin trying to look at their emotions in a visual way.  “If you are feeling a particular emotion or have had an experience, we want to see what it looks like.  What colors do you see? What shapes are you choosing? What forms? Are they in conflict with one another or do they flow together? Are they similar or opposites? Is there a sense of turmoil in the image or is it calm?”

A Thoughtful Process

In the hands of an experienced art therapist, what happens in a therapeutic session is not in the least random. “Just as it is in verbal therapy, where the interventions are thoughtful and you’re not just speaking off the cuff, in art therapy we are shaping an experience in a very meaningful way. Everything, from the choice of materials to the words we use to help patients reframe their experiences, is done in a very thoughtful, in-the-moment way.” In the hands of an experienced art therapist, art making is a way to help people communicate their thoughts, feelings and emotions through images. At its core, the basic tenet is to use the process to help people develop better communication skills.

About the author:

Jennie J. Kramer, MSW, LCSW, is the Founder and Executive Director of Metro Behavioral Health Associates, with offices in New York City and Scarsdale, NY.  She is also the co-author of the book, “Overcoming Binge Eating for DUMMIES,” (2014).