Towards Filling the Empty Space: Dance and Drama Therapy for the Treatment of Eating Disorders

Eating Disorders – Anorexia Nervosa, Bulimia Nervosa and Binge Eating – are affecting ever-greater numbers of people in North America and are spreading quickly to other parts of the world. Most sufferers are women though there is an increasing number of men who suffer from these disorders. Many are teen-agers. Some are children as young as seven.

There are many theories about why eating disorders exist and how they should be treated. The causes, complex and different for each individual, are usually a combination of stresses experienced in childhood and our culture’s pressures to be thin. They are also responses to our society’s negative attitudes towards the body.

Individuals who develop eating disorder symptoms, whether the self-starvation of anorexia, the bingeing and purging cycles of bulimia or the compulsive over-eating of binge eating, are trying to cope with unmanageable feelings. Many in this post-industrial culture have been persuaded to believe that if they were beautiful and thin, they would be successful and happy. For someone overwhelmed by their life’s problems, it is easier to focus on controlling their body.

Because the symptomatic arena of struggle speaks through the body, it is important to address this directly in treatment. Dance and Drama Therapy are both creative, experiential approaches. They engage what is healthy in individuals and offer activities which give positive experiences in and through the body.

Negative body image is central to these illnesses. Body image includes how the body is seen in the minds’ eye, one’s emotional relationship to their body, self-talk about the body and the proprioceptive awareness of the body. Someone with anorexia will see themselves as being very fat, in spite of the fact they are extremely thin. Someone with bulimia or binge eating may see themselves more realistically but will hate how they look.

Eating disorders are a way to communicate feelings such as abandonment, rage, fear, grief, and shame. People with eating disorders often speak of an emptiness or void inside. If anything they fear they are filled with a monster. The symptoms can be seen as a kind of fortress that protects from feeling. They are coping tools that are very hard to give up. In denial, the individual will often refuse treatment. But, they are very serious illnesses - damaging to the mind, body and spirit. There are many suicides as well as deaths from physical complications.

The specific behaviors are the tip of the iceberg. In treatment it is crucial to attend to the underlying experience. Creative, body-oriented treatments are used in hospital settings and in private practice. Dance therapy is the intentional use of body awareness and movement to bring growth and healing. It teaches the ability listen to, and trust, the body’s sensate information, revealing emotional, cognitive and physical states underlying the expression of need. Because it is non-verbal, movement therapy bypasses the wall of defenses that talking often re-inforces. Drama therapy helps to understand the roles and patterns used to express feelings by learning to choose ones that are helpful and transform those that are not. Clients are assisted to remain in the present moment, bringing awareness to their experience, thus gaining knowledge about unconscious feelings and beliefs. Thus they can make more effective choices and create a bridge to their embodied selves.

Dance-movement therapy sessions often begin sessions with simple stretches and movement patterns, perhaps combined with drawing or story telling. This allows safe exploration of the body, relieves tension, and teaches healthy self-nurturing. Negative attitudes are transformed. A woman who had abused herself for years began to describe herself as ‘graceful’ and glided with pleasure through the room.

Drama therapeutic role-play can explore the intra-psychic parts and clients may discover that their illness is both best friend and demon. One client had a breakthrough when she chose her sister for support, instead of the anorexia. In another a girl pushed ‘bulimia’ away with a forceful “NO!”

Dance and drama therapy both practice setting limits with others. Feeling safe in the body helps relationships by increasing connection with others, instead of the eating disorder. ‘Safe-space’ dances can bring tears of relief.

The sources of pain blocked by the self-abuse of eating disorders need to be carefully opened and take a long time to heal. There is no magic cure. Dance and drama therapy can thaw these defenses so individuals can find themselves. By joining with their bodies, they are able to accept all aspects of themselves. Thus they gain deep, vital roots to growth. New experiences of self-care create satisfying, fulfilling lives that no longer need an eating disorder. The empty space within flowers into a fully embodied and empowered sense of self.