Recovery in Action: Playing with Eating Disorders

When I am not in my private practice, I work as a lead therapist in a residential and partial hospitalization treatment program for adults suffering from eating disorders and co-occurring disorders in Moss Beach, CA. Check out an article I wrote about the unique portion of my work that I do there as a drama therapist:

“Imagination is absolutely critical to the quality of our lives… Imagination gives us the opportunity to envision new possibilities—it is an essential launchpad for making our hopes come true. It fires our creativity, relieves our boredom, alleviates our pain, enhances our pleasure, and enriches our most intimate relationships.” ― Bessel A. van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

At some point in our lives, we have all experienced the power of imagination. As children, we lived in the world of imagination enraptured by fantasies and storytelling. We constantly played pretend, acting out all sorts of situations, emotions and themes as an attempt to process our daily experiences.

This sense of spontaneity, freedom and playfulness are the opposite of what eating disorders are made of. Eating disorders, PTSD and other mental health issues take over the part of our brain that helps us imagine and play. This can often look like: numbing, withdrawing, being checked-out or shutdown, rigid modes of thinking, high states of fear and anxiety, dis-embodiment, controlling behaviors and limited creative expression.

A common complaint from clients is feeling stuck in their lives, stuck in their eating disorders, stuck in their recovery and being tired of hearing their own broken record repeating the same thing over and over again, but not feeling like anything is transforming. Repetition with no change. This is because eating disorders shut down intuitions or gut feelings, and deprive our clients of the imagination they need to change and create something new to better their health and lives. Without our intuition, we are unable to know what is truly safe and what it is that our bodies, minds and hearts need in order to sustain and thrive.

This is where drama therapy comes in. So, what exactly is “Drama Therapy”?

Drama therapy is the intentional use of drama and/or theatre processes to achieve therapeutic goals. It is a uniquely active and experiential approach that skillfully combines theater and psychotherapy. It aims to uncover and express feelings and appropriately achieve catharsis in order to resolve problematic patterns and facilitate change. Drama therapy provides participants with a safe, yet stimulating context in which the depth and breadth of inner experience can be actively explored. The perspective-inducing and reflective elements of drama therapy help participants integrate the emotional, cognitive, and physical levels of experience. It also provides participants an opportunity to enhance interpersonal relationship skills by moving them out of rigid roles and discover more satisfying ways of relating with themselves and others.

While there are many varieties of drama therapy approaches, here at Cielo House, we have a weekly drama therapy group called, “Recovery in Action”, where we utilize a specific method called Developmental Transformations (DvT for short) created by David Read Johnson. DvT is a practice involving the “continuous transformation of embodied encounters in a playspace.” The improvisational nature is similar to a meditative practice where high value is placed on presence and participants actively experience being in the here-and-now, rather than ruminating about the past or future. Simply put: we play. Yes, with adults! I am an active participant in the play session and the “playspace” is not an actual place or made with real objects, but it is co-created with all the participants’ imagination.

This can often look like playfully rejecting me (the group leader) in the form of food, slaying ED dragons, enacting epic battles scenes consisting of force-feeding me as I take on the role of their imaginary treatment team, and holding award ceremonies for the best tantrum! Similar to when a child comes home from the doctor’s office and immediately wants to role play “doctor” and do things to their dolls and parents what were “done to them”, clients get to have the rare opportunity to express their very real disturbing thoughts and destructive feelings in a safe and harmless manner without the real consequences. This is what it means to have access to our feelings and desires, while also having healthy impulse control.

There are also sweet and tender moments of snuggling together underneath an impenetrable giant blanket that keeps out all the scary monsters that could hurt us, holding support groups for all kinds of real-life and magical creatures, injecting one another with shots of love and admiration, catching each other’s teardrops with our cupped hands and putting bandages on each other’s broken hearts. Clients practice briefly letting go of avoidance, linearity and control by taking in feelings and others—both which cannot be controlled. It is clear to see from our groups that eating disorders are not simply about restricting foods, but also about restricting feelings and relationships.

Together, we often experience fun, relief and dare I say(!) pleasure and satisfaction. Both which are desirable emotions for most folks, but threatening ones for our clients who sense them as feelings of being out of control.

After each client’s first week of drama therapy, I see their faces filled with awe from the rush of dopamine and I typically get replies akin to, “When do we do this again?”

I know that it takes our clients at Cielo House tremendous courage to step into the world of pretend and make-believe each week and play with all the things their eating disorders have stolen from them. I believe that each time they give themselves up into the act of playing, they are actively taking another step on their path towards connection, life, recovery and health.