At last years conference I attended a fantastic workshop called ‘Embodying the dis-embodied: dramatherapy interventions for every stage of eating disorder treatment’ led by Dr Laura Wood.
In that three hour workshop, Laura introduced some of the approaches she used when working with clients at an eating disorder treatment centre. Laura asked important questions like “What happens when the identity of an eating disorder is what sustains the person?” – some of her clients believe they can not function without their food restricting or food purging behaviour. Laura also asked “What is the eating disorder trying to communicate”.
Laura’s approach is to support clients to explore the internal processes which activate the eating disorder responses and to playfully challenge those inbuilt assumptions and patterns of behaviour.
One of the quotes shared was:
Recovery is not just the absence of symptoms…it is the presence of a full life as evidenced by the ability to be human. A truly recovered life will reflect spontaneity, freedom, the ability to breathe, to have wants, needs and desires, knowing that the quest for perfection is an unattainable illusion. Having the ability to embrace the feminine, having close intimate relationships, and it is being aware of the tears in your eyes (whether out of intense or subtle sadness – or out of joy – or from a flicker of utter gratefulness) and then to allow your tears to flow freely. It is a life in which decisions and choices are made more from self and less from a shame and fear based prison. It is a life where you fully experience pleasure, joy, and passion and believe and know it is good to desire and enjoy sex…”Theresa Chesnut
This talk was really inspiring so when I saw that Laura was co-facilitating a longer training this August I was intrigued.
The Three Day Training Weekend
- Laura Wood – President of the North American Drama Therapy Association (NADTA) and trained in Internal Families Systems Therapy (IFS),
- Martin Redfern – a UK based Dramatherapist and IFS therapist, and
- Naomi Nygaard, a UK dance movement therapist and IFS therapist.
Those of you who talk to me often about therapy, or regularly read this blog, may have noticed that many of my personal therapy passions are prominent elements of this training:
- a body based therapy (movement and embodiment) as one of the best way to work with the trauma held in the body
- a creative therapy (dramatherapy, dance therapy) as a way to encourage playfulness and a different way to explore therapy content
- a parts-based therapy (IFS) to look at the internal dialogues and conflicts which can keep clients locked in cycles of self-destructive or restrictive patterns of behaviour.
This is all catnip on paper but the training itself held so many gems which I wanted to share in the next three blogs.
- This one is going to focus on the embodied approaches to IFS and parts of self,
- Next blog will look at meditation, playback theatre, mask work and therapeutic theatre
- The final blog will explore movement, improvisation and a dramatherapy approach called Developmental Transformations.
We are starting with parts because that trickles into many of the activities at this training.
Meeting parts of self
There were many creative and embodied ways that we explored parts of ourselves during the three day training.
Movement and sound
Starting with a simple movement and sound exercise, shared by each person in the circle, and then reflecting on what thoughts or feelings were brought up in that sharing:
- “this is silly”,
- “am I doing this right”,
- “will people judge me”,
- “what is the point of this”,
- “yay let’s play”.
So straight away we were meeting some inner critics, some defensive parts, some curious parts and some inner children.
Another way we met parts was with sociograms – would we rather be in the mountain or on the beach? Which part responds to that question? When did we first meet that part? What is it about that answer that appeals to the part? Was there another part which would have chosen the other answer?
Sculpting and Hot-seating
Parts were invited to do a sculpt of how they were in the body and to share a line. One of the sculpts Laura uses is the invitation to become their eating disorder.
Clients represent their eating disorder as if that was the only part of them. What posture does it take. Which muscles are engaged, which are relaxed or floppy, what is the facial expression.
Laura spoke about window’s of tolerance. Often people with eating disorders are very detached from their bodies; her job as therapist was to offer a window which was small enough not to overwhelm the client and then to gently push that open a bit more at a pace that encourage the client to deepen the work safely. Sometimes a client might only be able to walk up, touch a chair and return to their place in the circle – the way they walked and touched was still revealing. All parts are welcome in whatever way they want to show themselves.
On the other hand, if a client is able to represent their eating disorder in a sculpt, perhaps the next invitation is to add a line of dialogue – what does the part want to say. Maybe they can add movement to the sculpt – start frozen, move and/or speak then return to frozen.
Once a client is familiar with becoming their eating disorder part then there might be an opportunity to deepen the exploration further with hot-seating, where the therapist and/or group can ask questions of the part.
Therapist: What is coming up for you after playing your eating disorder?
Cassandra: Even though I was just yelling I feel sad…
Therapist: What about it makes you sad?
Cassandra: Because I never say any of that. Ever.
Therapist: Right, and it seems like because you can’t, your eating disorder does its best to try to communicate that?
Cassandra: Yah, right… It’s like my eating disorder tries to say what I can’t, because it would be too risky to say all of that”Laura Wood, (2015) Setting the stage for selfattunement: Drama therapy as a guide for neural integration in the treatment of eating disorders. Molloy College. (Page 65)
Patterns and cycles
Often in relations to food, there is a part who tries to control food in some way and one who responds to that control, perhaps a purge part and a binge part, or perhaps a food indulge and a food controller.
For example, when signing up for a new diet we may have a time of following it very strictly (or an intention to) but often there comes a point when we break the diet and have the forbidden food; this is one of the reasons why New Years resolutions are often broken early into January.
For clients with eating disorders or an unhealthy relationship with food, these parts may be particularly extreme, and they are often very polarised:
Food controlling: Restricting and/or purging
“I am the controlling part. I am the one that provides structure in our life. My job is to strive for perfection. Without me there would be no structure – it would be chaotic. Once I took a break from doing my job and it was very messy; we fell into some very bad habits, we took risks with no regard for the consequences. That is why I am needed. I am the one who keeps things on track.
I have very set rituals when it comes to food. I decide what we are allowed to eat, how much we can eat and when we can eat it. I measure and prepare the food very precisely only allowing good foods which are not going to disrupt our target to achieve the body we are striving for.
There is another part over there who always sabotages us. That part is disgusting. They have no self control, no boundaries. They are greedy, impulsive, reckless and destructive. They are never satisfied.
I am constantly having to fight with that part. I work so hard to try to be perfect and then they try to undo all my work in the time it takes to scoff a box full of donuts. They are weak.
Every day I start with a new resolve. I get us through breakfast, through lunch and avoid the temptation of snacks and other evil foods. Then in the evening that part starts to shout louder and louder. I try hard to keep them in line but so often they find a way to undermine me and devour things I put on the “bad food” list
I wish that part would go away forever.”
Food Indulging: Fast breaking and/or Binging
“I am always hungry. Hungry for food because the controlling part is starving us all. Hungry for love because I have not really received that – not from the outside world and not from the other parts that I live here with.
Nobody listens to me. Nobody likes me.
Sometimes I can’t stand the fasting anymore.I worry that it will never stop. I worry that we will starve to death before the restricting part can ever be satisfied. I worry that even if we meet their goals we might still not be acceptable to the outside world.
Every morning the food controller part takes away anything which is tasty restricting us to a life which is bland but “good” as they call it. It doesn’t fill and it doesn’t satisfy. As the day goes on our energy ebbs away, we are un-nourished. At work there are other things to think about that distract us from my pleas for more food.
At night it is different. When we are home the deep loneliness seeps in. We will never be good enough however hard the food controlled works. We are unlovable. I am also hungry. I need something to make these taste buds come alive. I need to eat until the pain goes away.
So I eat. Not just the food which is allowed and rationed and portions. I eat anything I can find. If I did not do that then we might die.
So I don’t care if the whole world hates me and I don’t care if no one ever listens. I do it because I need to. I do it because we have to survive. I do it because I deserve some pleasure in this cruel world. They say I am weak but if I give in to them then they will destroy us all.”
Breaking the cycle
In the above example there is some internal balance between the two parts as they moderate each other, but both are taking very extreme positions within the internal system. In order to move towards healing, both parts need to deescalate their behaviours and change the way they view and relate to the other part. In other words, IFS will offer a kind of conflict resolution for the two parts.
One way might be to examine this behaviour cycle which the parts are perpetuating and notice how the behaviour of one part triggers the behaviour of another and vice versa. Once the parts recognise that their actions are triggering the consequence they want to avoid they may be willing to modify their behaviour slightly.
“Our addictive part becomes willing to see that it hasn’t ultimately been successful in stopping the pain and fear of shame and worthlessness in us. The part trying to control the addictive part becomes willing to see that it hasn’t ultimately been successful in stopping the addictive part from acting out. Both parts become willing to relax their need to be in control, and allow our Self to lead us through the next steps of our recovery.”Naomi Nygaard, Steps 1-3 for ED clinicians after retreat, page 4.
Laura and Naomi both demonstrated a way to map someone’s parts.
Laura Wood’s model of parts mapping
Laura’s method invites the client to sit on a chair and think about a particular issue, this might be a problematic relationship, a part they are struggling with or perhaps two parts which are polarised. Thinking about the chosen subject, the client shares what the first part of themselves or the first feeling is which arises in relation to that.
So if the first response is anger, then we embody that part – how does it stand or move. The client thinks about where in the space the anger is, gives it a physical posture and a line to say. Then we choose a person or a sand tray object to hold the energy of that part. The client sits back in their chair and thinks about the next part – maybe fear or sadness or jealousy or whatever it is which comes up for that person. This repeats until all of the parts are in place and the client is able to get in touch with some Self energy – a place where they can be curious about their parts and connect with them in a creative and calm way. From this place of self, the client could then meet the part and help them to transform slightly, when parts feel acknowledged for the role they play to protect us they can often take a small step back and feel less extreme in our internal systems.
Laura gives an example of this model of parts mapping in her chapter of the book Creative Arts Therapies and Clients with Eating Disorders. In this specific example, the client is asked to map her parts when sat at the dinner table:
“We see that Julie begins to break down the different feelings and parts that are activated for her at the table. Julie is able to identify a number of different protective functions as well as identify a young, exiled part of herself that seems to be directly related to her eating disorder. Julie has the opportunity to continue to cultivate self energy and compassion for her protective functions, rather than blame and self-hate”Laura Wood, Eating Disorder as Protector: The use of Internal Family Systems and Drama therapy to help clients understand the protective functions of their eating disorders. In Annie Heiderscheit (2016) Creative Arts Therapies and Clients with Eating Disorders. London, Jessica Kingsley
Naomi Nygaard’s model of parts mapping
Naomi’s model again starts with the client on the chair next to the therapist, but this time, as parts are “cast” from the group, the person is invited to offer their interpretation of how the part might move or feel, and this is checked back with the client for authenticity.
This works because often people will hold similar parts and because sometimes it can offer the client a little more distance to see someone else’s interpretation of their part. This mapping ended with the client being invited to enter the scene to “be with” an exiled part which held a lot of sadness and to offer comport from a place of Self.
There is so much richness in working with the different parts of a person, in representing those inner conflicts in a way which allows us to reflect on them and engage playfully.
While a lot of the bigger personal insights may come out of the in-depth work such as parts mapping, it is really important to build up to this with a strong foundation of welcoming the parts which are critical or unsure of the process. Starting with the smallest request allows clients, who may be very shut down, to slowly start to let down their defences and be curious about themselves.