Unmasking truth and healing through art
Illustrations by Sasha Bakinovskaja
by Summer Tao
I first heard about it during my master's research. I was interviewing a substance use treatment clinician, and she was listing her facility's programs. The usual suspects appeared: “general” care, a women's program, high care… and art therapy. One of those wasn't like the others. In true Baader-Meinhof style, it kept appearing in my life's periphery. Whenever I read about mental health programs or personal wellness, art was present. Are we treating body dysmorphic disorder (BDD)? How about bipolar disorder or schizophrenia? There always seems to be space for art.
My interest was piqued, especially when I learned its place in eating disorder treatment. I've lived with an eating disorder since 2015, and I've loved art since I could hold a crayon. I had to know more because art has always been an inscrutably beautiful force in my life. It's freeing and uplifting in precisely the way an eating disorder is not. Even if art didn't present an escape from my eating disorder, it could certainly bring understanding.
Color in the world of medicine
Erika Bent (LMFT, LCPC, CEDS-C) described art therapy as "an integrative therapy approach that draws on various art forms to express emotions, interpret intrapsychic conflicts, and offer catharsis to emotional pain." She identified two broad categories: traditional art therapy and expressive art therapy. Where traditional art therapy "includes painting, drawing, clay molding, sketching, etc.," expressive art therapy adds "drama, movement, dance, and music."
Sasha Bakinovskaja
This wide range of activities speaks to art therapy's greatest strength: flexibility. Erika points out, "Eating disorders are complex and multifactorial psychological illnesses that have different origins." Such complex conditions require flexible tools to tackle them. Art therapy is diverse in its offerings and can be tailored to the treatment space. Immobile clients can benefit from painting at an easel or digital approaches. Guided movement like yoga and dance can encourage awareness of the body in a positive context—one that people managing conditions such as an eating disorder or BDD are often deprived of.
In use, art therapy gives clients an outlet for strong emotions and builds self-esteem through the act of creation. Nilou Esmaeilpour (MSc, RCC, SEP) says that clients who prefer non-verbal approaches benefit from art therapy because it "provides an alternative, non-verbal mode of expression that allows them to convey their inner experiences, thoughts, and emotions through creative expression." This is reflected in my experiences: I'm autistic, and talk therapy has created significant friction for me. A full year of one-on-one therapy once culminated in my therapist telling me that she found it difficult to connect with me. My best mode of recovery works quietly and methodically, and it only requires speaking up when I find it necessary.
Eating disorder clients can find the hands-on work of art therapy beneficial to their body image and self-esteem. Art therapy spaces are still guided and contained, but they're invaluable for allowing people to recognize that containment is different from imprisonment. Whether "creating art that reflects their body image and discussing these creations with a therapist," or exploring the "underlying issues contributing to their eating disorder," Nilou considers art a potent complement to more structured treatment paradigms.
Sasha Bakinovskaja
Hand-in-hand with formality
Just as I found talk therapy to be a poor fit for my communication style, I also found eating disorder support groups stifling and distressing. In my experience, support groups can be filled with highly distressed people. People sometimes air out worrying fantasies without concern for others. Other times, moderators rigorously enforce a toxically positive tone that is at odds with people's needs. The emotional sensitivity inherent to eating disorders and body dysmorphic disorder makes support groups extremely difficult to moderate. Even a platform that is successful at supporting has limitations. Social and emotional support are scaffolding structures that keep us from falling, but the work of elevating ourselves is still ours to do.
Art therapy fills gaps that other modalities can't tackle. Clients who find speaking in a clinical environment stressful can benefit from the quietude of a painting workshop. A grim fixation on exercise can't always be addressed from a couch, but guided yoga can reconnect the desire for movement to a low-intensity outlet. A sculpture class offers those living with body dysmorphic disorder an opportunity to see their bodies as a tool for creation rather than a malfunctioning tool. The result is what Erika calls "several treatment approaches stacked together to have the best outcome for clients because they're not as effective as standalone treatments."
However, relegating art to a support role behind medicine would be a great disservice. For many people, the greatest value of art therapy is that it's the fun part of recovery. Sure, a guided dance class can gently raise a client's bodily awareness, but it's also enjoyable. Sketching can stir reflection and mental focus, but it's also relaxing.
Like other forms of psychiatric care, eating disorder treatment often meets people at their worst. People are routinely checked in at their breaking point or against their will. They're stuffed into an unfamiliar and regimented environment alongside distressed peers. An art therapy slot between meal plans, family meetings, and group therapy can quickly become the day's high point. Well-used art therapy isn't just therapy; it reintroduces eating disorder sufferers to the joys of life–the same joys that our disorders strip from us: color, friendship, and hope.
Sasha Bakinovskaja
Drawing, dancing, sculpting a road to aftercare
A lecturer told us the ideal therapist strives to make themself obsolete. Few things bring more joy to therapists than watching their clients turn therapy into independence. This statement reframed the field for me. It fractured my view of mental health as a “job” and placed emphasized helping us help others. The value of self-work isn't just numbers on a scale or erasing our wounded parts – it's also about making enough bright moments to ease the rest of the journey.
Successful eating disorder treatments have a long tail. Group therapy creates lasting friendships. Family counseling builds support networks to soften future relapses. And art? There's always a good reason to start an art project, whether or not it's destined for completion. After treatment, Nilou says that art is still "a means of self-expression and emotional regulation, providing a healthy outlet for dealing with stress, anxiety, and emotional fluctuations."
Even if art therapy isn't on the schedule, we can still make way for the therapeutic practice of art. We're all capable of appreciating and creating. Sometimes, picking up pencils without fear of how “bad” we are or looking at a colorful scrawl is what our mind needs to find balance. And when I think about it, the time I spend painting a miniature or listening to music is always freed from my fixation on food. It's hopeful.
Five ways art therapy can help
Making art can help heal PTSD: “Art is a safe space to process emotions, and can serve as a holder of the trauma until the person is ready to talk about it.”
Use creativity to heal your inner child: “The goal of inner child work is to reparent yourself into healing…. “Creativity and the inner child are natural companions — engaging in one can awaken the other.”
Psychedelic art can affect identity and emotional well-being: “Besides the immediate benefit as a translator for the psyche, [psychedelic art] also allows people to reconsider and reconceptualize their sense of self.”
Older women and the communities they’re crafting: “A review of 93 studies found visual and creative arts were associated with reduced feelings of loneliness and improved sense of community and social connectedness.”
Graphic art medicine can inform, connect, and heal: “[Comics] can help increase empathy and remove stigma, and… burden of isolation. Making comics about difficult situations can help improve processing of those experiences by externalizing them and organizing sometimes fractured reactions into manageable narratives.”s
Summer Tao has a Masters in Psychology and is currently pursuing a PhD focused on LGBTQ+ healthcare in South Africa. Summer’s writing often covers topics including queer relationships, sexual health, tabletop gaming, and humor.
Sasha Bakinovskaja is a Russian-Estonian illustrator based in Barcelona, Spain. In her work she plays with forms and textures and uses vibrant color contrasts.