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Play It Through

Embodied Approaches to Eating Disorders Part 2 meditation and theatre

Last month I attended a three day training course called Embodied Approaches to Eating Disorders led by Laura Wood, Martin Redfern and Naomi Nygaard – all creative therapiss who are also trained in IFS. I am reflecting on and sharing some of the different strands of that training. Yesterday’s blog looked at an embodied approach to IFS which works with parts of self. Tomorrow’s blog will look at movement, improvisation and Developmental Transformations.

Today’s blog will start with meditation and go on to explore different theatre approaches which Laura and Martin use within dramatherapy treatment.

Reflection and Meditation

Food Freedom Steps

Naomi outlined two structure she uses, called the steps of food freedom, which gently guides clients through their eating disorder treatment following the 12 step programme.

And the Six Pointed Star of FAB (Food and Body Image) where the six points represent:

  1. Create Space for stillness and gentle awareness.
  2. Accountability and support.
  3. Slowing the Food Burden Cycle.
  4. Loving food boundaries.
  5. Finding our flow.
  6. Happiness in our skin.

Meditation is a really important part of allowing clients to wonder about the parts of themselves they believe are fixed and to do some personal reflection. Some of this was in guided meditation, some was through journal writing.

Guided Meditation and Visualisation

Meditation was used on a few occasions during the training to help us get in touch with one or more of our parts.

Naomi invited us to stand in neutral as some instrumental music played. The parts were invited to respond in a way that felt authentic to them. Starting with the breath and a very small movement, perhaps the part wanted to connect to the earth and have a moment of restful comfort, perhaps they wanted a moment of exuberant jumping, perhaps they wanted to keep their eyes closed with the focus inside or perhaps they wanted to look around and connect with other parts in the room in some way.

Naomi shared details of other meditations she uses as part of her Food Freedom Steps.

“Qi-shower’ – stretching hands up over head and stroking down over face and round  and again, while deeply and steadily breathing.  Let your parts be showered in heavenly qi.  Anything that doesn’t serve your parts washed away….

… What does sanity mean to you?  Balance?  Inner-harmony?  Breathe in these concepts/qualities.

Now let firefighter be in your hand and manager rest and wait at your abdomen.  Pass the baton between them – waiting for each other, working together.  If your parts aren’t ready to do this, let this movement just stand for setting an intention for balance, harmony, sanity, integration and wholeness.”

Naomi Nygaard, Food Freedoms Steps 1-3 for Eating Disorder clinicians after retreat, page 3.

(Firefighter is an IFS term which relates to the part which comes in to numb pain – it could be related to binge eating behaviour or possibly also vomiting in a client with an eating disorder. The manager is a part which tries to control – it may be the part which restricts eating or hides the eating disorder or exercises)

Journaling, Creative Writing, Art

The other way we were invited to reflect was through writing and drawing. Both Naomi and Laura spoke about the ways they invite their clients to write journals about how they feel or write a letter as if from one part of themselves; maybe a part which is too afraid to be embodied in the space or a part which feels like it is not allowed to express itself in other ways.

As part of the training we were invited to try one of these ways for ourselves with the offer to do one of:

  • Allow a conversation between 2 parts which are in polarity.
  • Allow part of yourself to write a letter to you
  • Allow self or part to create art
  • Allow part to be out in nature.
Penny Brohen Centre UK

During my time I first drew an abstract representation of my parts but then felt like I wanted to have a more embodied conversation with the part which was feeling unheard; allowing that part to wander through a wild flower meadow, find a den under a weeping willow, climb an oak tree and be in nature in the grounds of the beautiful Penny Brohn Centre, was a way for that part to fully express some of their feelings of joy and sadness.

Theatre

Dramatherapy is not often for public performance as it usually prioritises the process of creativity over the product of the theatre show. If you were the fly on the wall of a dramatherapy room, there might be some sessions where you did not notice the drama, sometimes it works on the basis that if all the world is a stage then life is theatre.

‘Therein resides the essence of Theatre: in the human being observing itself. The human being is not only ‘makes’ theatre: it ‘is’ Theatre. And some human beings, besides being theatre, also make theatre. We all of us are; some of us also do.’

Boal, A. (1995). The rainbow of desire: the Boal method of theatre and therapy. (A. Jackson, Trans.) London: Routledge. Page 13

But at other times, the process if dramatherapy puts theatre approaches front and centre because sometimes adopting a role allows us to show an authentic part of our selves we usually hide.

‘Theatre “Man is least himself when he talks in his own person; give him a mask and he will tell the truth,” Oscar Wilde said (in Ellmann, 1969, p. 389)’

Emunah, R. (1994). Acting for real: drama therapy process, technique, and performance. New York: Routledge Ltd. Page 7

Here are three theatrical models Laura and Martin use in their therapy practice.

Mask Work

Laura shared a case study of mask work she has done at the eating disorder treatment centre.

“Mask work creates another arena in which the client can explore a role as “me-not-me.” Both the construction of the mask and the embodiment of the mask allow the client to continue to make discoveries about a part with which they are working… It is recommended that the use of the photography portion of this project not be utilised until the client has reached a healthy weight, as often when clients are underweight, the focus shifts to their weight rather than the story the body and mask are telling”

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. Page 318

The client first created the mask of their eating disorder. At another session the client wore the mask and embodied that eating disorder through lots of movement, crashing and high energy – allowing the anger, the fear and the other big feelings to be fully expressed.

The client then chose a moment of calm and directed Laura to take a photo of the part.

Laura invited the client to make one small change which would show the next step on the journey to healing. Again the client embodied this and chose how they wanted this photo to be taken.

At the next session the client was shown both photographs and invited to reflect on what they could see in the pictures and what that might represent in their treatment programme.

This work could be done as part of group or individual therapy or a combination of the two but the most important audience member becomes the client once they start to reflect on their two photographs.

What I find really intriguing about this work is that the client was making all of the creative decisions and then discovering their own insights from the image. So the client decides how the mask is made and decorated, where the mask exploration happens, what they wear, what angle the photo is taken from, whether it is black and white or colour. There is a certain rationality that says if the client put that much thought into the creative side how can the finished image have had anything to reveal. But that is the magic of parts work. We are communicating all of the time with our bodies and out choices but sometimes it is only when we stop to look at the photo that we can see those messages clearly.

Playback Theatre

This was a very simple version of Playback theatre, designed so that clients with eating disorders, who had not been trained as Playback performers, could still use the basic approach to present small moments of each others story.

We were invited to think of a moment of empowerment or a part we wanted to connect to and to write a three line story about a time in our lives that related to that theme. The lines would be the beginning of the story, the middle of the story and the end of the story.

In small groups, one storyteller shared their story with the group and then left to join another group. The remaining members took their story and found a way to present that.

So perhaps the group would read one line and show a sculpt, perhaps they would use movement, perhaps they would have some lines, perhaps it would be acted out – however the group wanted to represent the story. The group had some time to plan this and rehearse.

Coming back together as a large group, the story tellers would sit with the facilitator and share the theme of the story “this is a story of empowerment”. The facilitator would cue the performance by saying “let’s watch” and then the group members would show the piece to the story teller.

After the performance, the facilitator would ask the story teller if the performance captured the essence of the story, offer them a chance to change something if it did not or to share any reflections on how it was to watch it back.

For many people this was a very moving experience. Seeing this small but important moment in their life shown back to them allowed them to reconnect to the memory and it’s importance to them and make links to the part which had reached for this memory.

While this is presented in front of an audience, again the most important audience member is the client who offered their story to be dramatised

Therapeutic Theatre

Another way Laura uses acting, which was touched on in the 3 day training and a big focus of the workshop Laura led at last years Dramatherapy conference, is therapeutic theatre. Unlike the other two theatre models above, where the theatre is mostly for the client’s eyes, in therapeutic theatre, the client’s experience is to express something of their truth and share this with an invited audience.

“Co-active therapeutic theater was designed to offer the field of drama therapy a framework and theory for using therapeutic theater with populations who are in important role transitions in their lives. Co-active therapeutic theater is a six-phase model that allows the drama therapist to co-actively partner with participants in the development and execution of a theatrical production with the goal of helping clients move out of the role of “sick one” (Landy, 1994) and into strength-based role of directors and actors of their stories and lives.”

Laura Wood (2016) The Use of Therapeutic Theater in Supporting Clients in Eating Disorder Recovery After Intensive Treatment – A Qualitative Study, The Graduate School at the University of Missouri-Saint Louis. Page 13

Laura developed the “Recovery Through Performance” programme for clients who had recently been discharged from treatment to support them not to relapse during the crucial first 12 months of post treatment. The programme model Laura created follows six stages:

  1. Discovery – group exploration of themes and choosing a topic they want to share with an audience
  2. Generation – explorations, improvisation and script writing
  3. The weekend intensive – clients explore characters and learn acting skills
  4. The rehearsal process – drama therapy to deepen the themes and rehearsal to polish the product
  5. The performance – in front of an invited audience. The clients run a mini workshop after the performance to help their audience to reflect on an aspect of the performance.
  6. Integration – the group reflect on what they have learnt.

As with the mask and the Playback, the creative choices the clients are making are meaningful to their recovery journey only this time they are also designed to convey something of that recovery to the invited friends and/or family members in the audience.

Conclusions

Pretending to be someone else is one of the ways we learn as children – so playing “mummies and daddies”, “builders”, “doctors”, “explorers” or even “superheros” is a way for children to develop their physical skills and to process their place in the world.

For many people at school, drama is a lesson of expression and fun but also a time of self exploration.

Often as adults we stop acting, perhaps we know a few people who do am-dram but mostly we save our performances for trying to impress during work presentations rather than taking on roles to perform. I attended a training last year where the trainer opened with “there is no role play in this training so you can all relax”.

It may be uncomfortable to think about performing – perhaps I will be judged, perhaps I will forget my lines, perhaps I will reveal too much, perhaps I won’t be good enough…

If the client can get past those parts which are resistant of drama and theatre and be supported to enter in, there are many ways that theatre skills can support the healing journey and help the client to understand more about their life by reflecting on it from a fictional character.

But for performance to be therapeutic, it needs to go hand in hand with chances to reflect. To reconnect with the calmness and clarity which is found in breath work, visualisation and meditation and to apply that energy to the internal work being done in preparation for and during the performance.

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