Utilizing storytelling and metaphor therapy in the treatment and recovery process.
Learn more about the use of metaphor and storytelling from our Director of Eating Disorder Programming Dr. Anita Johnston.
Narrative therapy for eating disorders can help patients separate themselves from their disorder and claim their power to change the story of their life for the better. Here at ‘Ai Pono Hawaii, we offer effective narrative therapy for eating disorders (or ED) by empowering patients to disentangle their identity from their eating disorder.
Our eating recovery center in Maui, Hawaii has a team of highly experienced therapists who provide effective narrative therapy for eating disorders and other comorbid conditions. We have helped hundreds of patients over the years make use of the power of narrative therapy in healing from their eating disorder.
There are an increasing number of options when it comes to treatment programs and therapies for eating disorder patients. Narrative therapy for eating disorders is a creative and alternative option to explore that can help patients to break outside of the standard treatment regimen.
Many of us are used to hearing statements like “Patient X has anorexia” and “Patient Y is anorexic”. Patients themselves often describe themselves in this manner: “I have anorexia” or “I am anorexic”.
In narrative therapy for an eating disorder, we prefer to use statements like, “Anorexia has taken this person hostage”. By simply using this unconventional way of stating the problem, we challenge their eating disorder; the patient ceases to be the problem, because the problem is just the problem (i.e., the eating disorder) itself.
Narrative therapy is a product of the collaborative work of Michael White, David Epston, and founded in the work of philosopher Michel Foucault. Various case studies have shown that narrative therapy helps lower the risk for eating disorders, depression, perfectionism, over-control, self-criticism, and asceticism.
In the narrative worldview, we believe that people’s realities are socially constructed using language and maintained through their stories. The narrative approach in therapy takes into account each person’s cultural context, social structures, and dominant language and discourse. All of these create and then reinforce each patient’s eating disorder.
Through narrative therapy, we move away from pathologizing patients and challenge this oppression. Instead, we focus on helping patients develop an identity that isn’t intertwined with an eating disorder and a lifestyle that is in line with their personal values.
Narrative therapy is guided by the philosophy that a patient’s eating disorder is based on the stories that he or she has constructed about himself or herself as influenced by multiple factors including upbringing, culture, social influences, and more. Such stories work together to form the foundation of the patient’s understanding of who he or she is.
Narrative therapy is usually considered as a complement to other existing treatments for eating disorders such as dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), cognitive behavioral therapy (CAT), and others.
Narrative therapy for eating disorders may also be considered as a treatment option when traditional approaches like CBT fail to produce lasting effects on a patient. Some narrative therapists point out that traditional treatments typically emphasize the need to control weight and eating (such as through weigh-ins and food diaries), which is ironically similar to the control held by eating disorders themselves.
Here at ‘Ai Pono Hawaii, our narrative therapy for eating disorders involves guiding our patients in creating an alternative and better story, one that reminds them that they have the skills and power to free themselves from their eating disorder. Our narrative therapists are highly skilled in helping ED patients separate their core identity from their problem.
Narrative therapy is empowering, non-pathologizing, and collaborative. We believe that patients already have within themselves the knowledge and skills that they need to change their lives, and our therapists are merely here to guide them through the process of doing it.
We uphold that there is no one version of reality that is truer than another; rather, there are several storylines that exist simultaneously at every given point in a patient’s life. Some of those stories support their dreams and aspirations, while others are problematic. An eating disorder manifests itself when the problematic stories and their outcomes dominate their mind and fool them into thinking that it’s the sole and true reality.
In our treatment center for eating disorders, narrative therapists with many years of experience in this therapeutic modality serve as the audience as well as the collaborator in patients’ efforts to discover and share their alternative stories.
We help patients explore and process the stories or themes that have shaped their life and given birth to their eating disorder in order to help them gain autonomy and agency in their own recovery.
One of the tenets of narrative therapy is that each patient’s life is a collection of storied experiences. Their eating disorder is usually the result of a flawed dominant story — a deficit-based story.
The use of narrative metaphor is vital in understanding this therapy: patients’ multistoried identity influences their behavior, and the stories that patients hear or read about the world and how they should act are based on what’s dominant in society.
Using narrative therapy for eating disorders, we help unload some of the responsibility from patients. We take a close look at their social context, interpersonal relationships, prevailing standards of beauty (e.g., thinness), the media, and the values promoted in popular culture (e.g., self-discipline, self-control). Rather than simply treating the eating disorder as a personal problem, our treatments use complex, holistic, and multidimensional perspectives.
The problem is separate from the patient. The problem is neither the patient nor the eating disorder; rather, there are deeper unmet needs that are driving the eating disorder that are often disguised with food or eating.
‘Externalizing conversations’ is an essential element of the healing process.
The true expert in what it feels like to have a relationship with the eating disorder is the patient.
By detaching themselves from their disorder, we empower patients to liberate themselves from its control over their life. They can then discover or create a new version of their identity that can resist and refute the clearly defined problem: the eating disorder itself.
Using ‘externalizing conversations,’ such as addressing the eating disorder as ‘ED,’ we enable patients to objectify their eating disorder by acknowledging the extent to which the ED affects their life and that of people around them. They map the influence of the disorder ED in their life, as well as their own influence in maintaining their disorder. Using relational externalizing conversations, our therapists ask thought-provoking relational questions that enable the flow of stories and development of counter-stories by patients themselves.
Narrative therapists in our eating disorder treatment center are well versed in asking the right questions at the right times in order to effectively guide patients in developing their alternative stories. We offer specialized narrative and metaphor therapy groups that directly such as:
A group designed to explore the connection between disordered behaviors involving food and eating and our true feelings or unmet needs.
A specialized group that involves reading and telling stories in order to start to learn the language of metaphor and use this powerful tool to begin to reframe and retell our relationship with ourselves, with others, and with our eating disorder.
In addition, we promote patients’ re-telling and re-authoring of their stories in therapy sessions, through writing of letters, and by engaging supportive audiences to help them enrich their alternative story and gradually break free from their previously dominant life story.
Such conversations enable patients to deal with their feelings of isolation, guilt, and other negative emotions. Throughout the course of treatment, patients may be encouraged to create a song, poem, letter, audio or video recording, etc. that addresses their eating disorder.
‘Ai Pono’s Founding Clinical Director Dr. Anita Johnston has dedicated her life’s work to exploring the power of storytelling and metaphor in healing from eating disorders. Dr. Johnston believes that the healing power narrative therapy for eating disorders lies in its ability to arouse strong emotions by allowing the listener to identify with its characters. Stories can serve as a means of externalizing inner conflicts and providing us with metaphors for internal and interpersonal dynamics [1].
Marion Woodman, Jungian analyst and author, believes that storytelling and the use of metaphor have more of an immediate impact than abstract analysis when working with eating disorders.
“So long as it’s theory, it’s removed from the actual feeling…if I put it in a story form or use images, the mind may not hear it, but the body responds. And if it’s reverberating in the body, sooner or later it’s going to get through to consciousness.” [2]
By utilizing narrative therapy for eating disorders, those who struggle with eating disorders can learn the language of metaphor, which can help them intuit the existence of deeper meanings and truths. As they become more and more proficient with metaphor, they can understand how food can be a symbol for emotional nourishment, and how eating can be an attempt to respond to inner hunger for attention, acceptance, affection, or appreciation.
As a result of telling and retelling the stories of their own personal journeys, individuals who struggle with eating disorders can learn to discern the deeper messages behind their eating behavior, and embrace the wisdom of their bodies, feelings and intuitions.
Through ‘Ai Pono Hawaii’s narrative therapy for eating disorders, we regard patients as the expert of their life. They have first-hand or insider knowledge of their problem, which means that they also hold the key to healing themselves. Schedule a call with our friendly staff and find out how our center’s narrative therapy for eating disorders can help you regain control of your life.
[1] https://dranitajohnston.com/the-power-of-storytelling/
[2] https://www.sciencedirect.com/topics/psychology/metaphors
