Art Intervention with Female Adolescents with Eating Disorders

Diedré M. Blake, MA (Summer 2005)

What is an Eating Disorder?

An eating disorder is a collection of interrelated eating habits, weight management practices and
attitudes about food, weight and body shape that have become disordered. Some common
features of eating disorders include an irrational fear of fat, dissatisfaction with one's body often
coupled with a distorted perception of body shape, unhealthy weight management and extreme
food intake.
There are three primary eating disorders:
Anorexia Nervosa, Bulimia Nervosa & Binge Eating Disorder

Anorexia Nervosa is a potentially life-threatening social and psychological eating disorder

characterized by self-starvation and excessive weight loss. The majority of suffers are female, but
there are also cases of Anorexia Nervosa in men.

Bulimia is an emotional "weight control" disorder characterized by episodes of binge eating

followed by some form of purging or restriction. The majority of suffers are female, but there are
also cases of Bulimia Nervosa in men.

Binge eating is the consumption of unusually large amounts of food in a discrete time period.
Those with binge eating disorder do not practice purging. The majority of suffers are female, but
there are also cases of Binge Eating Disorder in men.

Psychological factors that can contribute to eating disorders include:

 Low self-esteem.
 Feelings of inadequacy or lack of control in life.
 Depression, anxiety, anger or loneliness.
 A quest for perfection.

Interpersonal factors that can contribute to eating disorders include:

 Troubled family and personal relationships.
 Difficulty expressing emotions and feelings.
 A history of being teased or ridiculed based on size, weight or appearance.
 A history of physical or sexual abuse.
 A history of being lauded based on size, weight or appearance.

Social factors that many feel may contribute to eating disorders include:
 Cultural pressures that glorify thinness and place value on obtaining the "perfect body."
 Narrow definitions of beauty that include only women and men of specific body weights
and shapes.
 Cultural norms that value people on the basis of physical appearance, and not inner
qualities and strengths.

Scientists are still researching possible biochemical or biological causes of eating disorders. In
some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite
and digestion have been found to be imbalanced.

Some Comorbid Diagnoses: Obsessive Compulsive Disorder and Depression

Above information gathered and can be found at the following websites:

American Psychological Association (APA)- http://www.apa.org
Anorexia Nervosa and Related Eating Disorders (ANRED)- http://www.anred.com
EDReferral.com- http://www.edreferral.com
National Eating Disorders Association (NEDA)-http://www.nationaleatingdisorders.org
Perfect Illusions- http://www.pbs.org/perfectillusions/eatingdisorders/preventing_causes.html
 Art Intervention Focus: Control

As mentioned above, one of the primary issues facing people with eating disorders is the sense
of control that the disordered eating gives. In the case of adolescents, the need for control over
self is even more pervasive as they experience not only mental and emotional changes, but also
(and more apparent) physical changes. These changes can cause feelings of doubt and anger
for an adolescent, which can be exacerbated by his/her social environment (Manley & Leichner,
2003). This is especially true for female adolescents with eating disorders, who may be unaware
of the tools available (or may not have the social support) to effectively deal with these changes.
With drumming it is possible to begin to explore these issues of both change and control.
Manley and Leichner (2003) state that “adolescent patients [with eating disorders] may well have
difficulty with recognizing and expressing feelings, indicating „I don‟t know‟” (p.34). Utilizing
drumming as a therapeutic means may provide an avenue for expressing emotions, which the
adolescent may not have previously acknowledged or been able to verbally express.
Power and control issues often play a role in the treatment of clients with eating
disorders, especially adolescent clients, as they attempt to remain “in control” of their disorder
and lives. Thus, it becomes the role of the therapist to engage the client “in such a manner as to
avoid, reduce or eliminate the emergence of power struggles” (Sallas, 1985, p. 445). Thus the
below exercise was developed to allow the adolescent relinquish control without feeling forced as
well as avoid the possibility of power struggle between therapist and adolescent.

Intervention Structure
Materials
8.5 x 11 paper/ Pastels/Chalk/Pens/Pencils/ Tape (any kind will do)/ String/Yarn/Pushpins/Thumb
tacks (depending on self-injury status of group members and facility protocol)

Group- Instrument Shift Technique: Losing Control & Community Building

This technique involves the rotation of art from one group member to another. The purpose of
this technique is to facilitate positive control, while opening up the possibility of losing control and
identifying with the group and creating community.

Section One:
The group facilitator gives each group member a sheet of paper, explaining that the group
member will be asked to draw/create an image in a short amount of time. After such time, the
group member will be asked to pass the paper to either the right or left of her. Once she has
received her peer‟s drawing, she will be asked to add her own image to this new paper. The
process is repeated until the original drawings are returned to their owners.

Section Two:
The group members are then given the task of putting the images together to form one whole
image. Once this task is completed, the group members are asked to hang the image on the
wall. After this, each group member is instructed to write her thoughts about the process and the
final image. Some questions: What did it feel like to give your paper to someone else? What did
it feel like to receive someone else‟s paper? What did it feel like to have someone else draw on
your paper? What did it feel like to draw on someone else‟s paper? What was your experience
of putting the final image together?

End: Group processing about the experience.

References
Manley, R. S., & Leichner, P. (2003). Anguish and despair in adolescents with eating disorders.
Crisis, 24(1), 32-36.
Sallas, A. A. (1985). Treatment of eating disorders: Winning the war without having to do battle.
Journal of Psychiatry Res., 19(2/3), 445-448.