Treating eating disorders with drama therapy

Drama therapy has been used to help people facing a variety of challenges, but until recently the benefits to people with eating disorders had been largely unexplored. Above, Lesley students practice a drama therapy exercise.

Drama Therapy Professor Dr. Laura Wood learned the hard way that a box of scarves was not the way to engage her clients with eating disorders. This was several years ago, and she’d brought out a collection of colorful, billowy fabrics — a staple prop used in drama therapy.

“Most people find it creative and freeing and fun and spontaneous,” says Wood. Most, but definitely not all. “My clients with eating disorders annihilated me.”

While movement exercises with scarves or other objects relax many clients, they often do the opposite, at least initially, for those with eating disorders — dredging up insecurity about their bodies or raising fears of looking childish.

“Clients could see it as an opportunity to burn calories or as an opportunity to get a good look at others’ bodies and to engage in comparison, which feed eating-disorder thoughts,” explains Wood.

She realized the need for drama therapy to find new approaches to help these clients, but research on the topic was scarce. As Wood spoke with colleagues, they decided to pool their knowledge and experiences into a qualitative study. Conducted over three years, the study’s preliminary findings are now available in “Drama therapy and the treatment of eating disorders: Advancing towards clinical guidelines” by Wood, Sarah Hartung, Fatmah Al-Qadfan, Stephanie Wichmann, Aileen B. Cho and Dani Bryant. The paper was published in “The Arts in Psychotherapy,” Vol. 80.

“Drama therapy is teaching us to live in paradox, teaching us to increase our access to choice and spontaneity and freedom and all of those are particularly salient for working with clients with eating disorders,” says Wood.

But drama therapists must take an approach that is “counterintuitive” to their training when working with client with eating disorders. Instead of moving from metaphorical concepts to concrete, they needed to flip that model on its head. They also found that it was important to start small.

“A lot of times, clients’ eating disorders formed when they were younger, and oftentimes there’s a message that being playful or free is juvenile or dumb or not respected, and some of those deep beliefs are tied to the eating disorder,” she says.

For example, instead of a full-body exercise that may draw attention to sensitive areas such as a stomach or thighs, “we might need to start with something very small, like a finger or eyes or hair.”

Additionally, clinicians needed to evaluate their own relationship to food, weight and the ingrained culture of fatphobia.

“The drama therapist has to have done significant work on their own to be able to work within their body and to work in relationship to other’s bodies and understand how to adjust exercises to meet the differing needs of different bodies and to also ensure that they are working to identify systemic structures that have created a fatphobic society,” Wood says.

The paper emphasizes the need for drama therapists to understand the range of eating disorders. That includes addressing more than anorexia, which has been glamorized in mainstream society.

Have you ever seen a Lifetime movie about binge eating? Wood asks. Probably not.

“There’s something that we love to idealize about a thin body. There’s something that we, as a society, tend to be disgusted by in a fat body,” Wood says. “That’s really problematic.”

As is the perception that eating disorders are a white girl’s disease, the affliction of dancers, gymnasts and actors. Disordered eating in men, nonbinary and trans people is on the rise, according to Wood.

“Eating disorders are profoundly misunderstood,” Wood says, but she and her colleagues are working to change that.

They will present their findings at the North American Drama Therapy Association Conference in November and plan to expand on their work with a quantitative study that includes more drama therapy clinicians.