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Study: Differences in the Artwork of Eating Disordered Women vs. Non-ED Women

Image courtesy of University of Haifa

Image courtesy of University of Haifa

From Science Daily, a joint study from the University of Haifa, Soroka University Medical Center and Achva Academic College, Israel, published in The Arts in Psychotherapy:

The research team then evaluated the drawings and found various differences between the groups in four aspects:

  • The neck: women suffering from anorexia or bulimia tended to draw a larger neck, a disconnected neck or no neck at all;

  • The mouth: this feature was more emphasized in drawings by women suffering from anorexia or bulimia;

  • The thighs: women with eating disorders drew wider thighs than the other groups in the study;

  • The feet: women with eating disorders tended to draw pictures without feet or with disconnected feet.

    • The study also revealed that self-figure drawings can differentiate between anorexic and bulimic women: those with anorexia tended to omit breasts from their drawings, drew less defined body lines and smaller figures relative to the page size.

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    Eating Disorders

    When I was working with individuals with eating disorders, I was struck by the qualities that seemed to accompany the personalities of anorexics. As I wrote my thesis, my literature review shed some light on my observations and how researchers describe these personality traits. For example, it has been mentioned in numerous studies that anorexics tend to exhibit qualities of perfectionism, obsessionality and the inability to feel happiness except during times of starvation.

    It became clear to me that although the environment definitely has a defining influence on people who eventually develop eating disorders (abuse seems to precede the development of eating disorders in many cases, for example), I couldn’t help but wonder if genes also play a major role. I remember during my thesis defense discussing the possibility that one day we will have a better understanding of the biological mechanisms of anorexia, to the point that new drugs may be developed and be helpful in the same way that Lithium can be helpful for bipolar, or Prozac can be helpful for depression. Having medications that can help alleviate symptoms can increase the chance of therapy being successful…and this is so important in the case of anorexia, which has the highest death rate amongst young women in comparison to any other mental illness.

    The current issue of Scientific American Mind has an article entitled “Addicted to Starvation: The Neurological Roots of Anorexia” that sheds light on the possible underlying genetics of eating disorders. It’s an interesting read and puts a lot of what is observed clinically into context.

    I was surprised at the genetic similarity between drug addiction and anorexia, where people seem to be addicted to not eating. Certainly this had been a thought that crossed my mind before, even to the point where I wondered if something similar to a 12 step program could be helpful to some anorexic individuals, but I don’t recall actually reading anywhere a researched link between addiction and anorexia. Perhaps that is a new finding from recent studies? Or maybe I just missed it in my lit review.

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    Stress Balls

    I first learned how to make a stress ball, using a balloon and flour, when I was working with Jeanette Pailas ATR-BC at the Friends Hospital Eating Disorder Unit in Philadelphia, PA. The purpose of making the stress balls was so that the clients could use the final product itself during times of anxiety, but also the directive may represent a metaphor for eating: filling up a stomach, which is stretchy like a balloon.

    I’m presently working with developmentally disabled individuals. They too have difficulties managing their anxiety. One client in particular tends to squeeze his had so hard in a fist, that he causes lesions to his skin with his nails. This inspired me to introduce stress ball making in my art therapy group. I prestructured the group so that there would be only a small number of steps, insuring the success of the clients (an important goal of artx with developmental disabilities).

    Here is a break down of how I structured the group:

    Materials

    – Balloons
    – Flour
    – The top part of a water bottle (a make-shift funnel)
    – Spoons
    – Small cups
    – Colored pencils

    Prestructuring

    – Stretch a balloon over the top of a water bottle. Prepare as many balloons and funnels as needed according to the size of your group.
    – Prepare several small cups with flour. Each cup should have a plastic spoon in it, making it easy to transfer flour into the funnel. I decided to have a cup of flour per person, but having the clients share with each other can be an option to promote group interaction.

    Execution

    – Introduce the idea of a stress ball- what it is, what it can be used for. I find it important to remind the clients that balloons can pop…discussing squeezing the stress ball in the palm of their hands vs. digging your nails or twisting the balloons.
    – Pass around a pre-made stress ball, so that the clients an see and feel an example of a balloon stress ball.
    – Have a quick demonstration about how to make a stress ball. I began by holding up a pre-prepared balloon/funnel and spooning in some flour. I then demonstrated how to use the back of a colored pencil to pack down the flour. I let the group know that if they needed help holding the funnel or packing down the flour, they could ask (I usually have a recovery specialist in group with me. This can be very helpful if there are several clients needing assistance at once).
    – Hand out materials.
    – As the group began working, I encouraged them to share their techniques- what works to get the flour down and what doesn’t.
    – We discussed what situations they themselves might find the stress ball handy.
    – When a client felt that he/she had filled up the stress ball enough, I helped them tie off the balloon.

    Results

    I found that with encouragement the clients were able to successfully work through the frustration of stuffing the flour into the balloon (it takes some persistence). They also tended to be hesitant about getting dirty. Redwood Place unfortunately does not have a designated art room. We tend to use common areas, or a conference room. I also wonder what would happen if the group had the freedom to “get messy”. So far I haven’t introduced paint or clay in the short time I have been working there. In any case, I realized quickly that flour (as long as its not wet) offers easy clean up. You can sweep it off the floor and brush it off your clothes. I therefore demonstrated this fact to the group by pouring some flour on my pants, and brushing them off, like new.

    After the group was over, several clients seemed proud of their work. I was surprised, however, that the next day the same clients were asking to make more stress balls. Their peers, who had not joined us for the previous art therapy group, had also seen the stress balls, and wanted to make their own.

    Over the next 3 days the art therapy group consisted of making stress balls. Some clients wanted to make a new one because their last one broke. Others wanted two or three- one for their room, one for their pocket. Some wanted to make an extra one for family or friends. All in all, this seemed to be a successful directive that many clients enjoyed and found useful.