Psychodynamic group art psychotherapy in anorexia nervosa: A case-based review

Anorexia nervosa is an eating disorder characterized by severe restriction of food intake, distorted body image, and an intense fear of gaining weight. The treatment of eating disorders is often challenging and typically requires a multidisciplinary approach. Difficulties encountered in the treatment of the disorder lead clinicians to adopt therapeutic models that aim to understand patients’ inner experiences more deeply, rather than focusing solely on symptoms or surface-level cognitive variables. The aim of this study is to examine the symptoms and therapeutic experiences of a patient diagnosed with anorexia nervosa through her artworks produced in a psychodynamic group art psychotherapy setting. The sessions lasted for two years, consisting of 58 sessions held twice weekly for two hours. Art psychotherapy interventions were planned in a semi-structured format. Data were evaluated using video recordings and session reports. Throughout the group therapy process, themes related to anorexia nervosa—such as close relationships, affective dysregulation, body image, control, illness course and eating behavior, perfectionism, and the denial of sexuality—were explored. Art materials enabled the patient to externalize emotional content that was difficult to verbalize by providing a symbolic medium; the triangular relationship between therapist, patient, and artwork created a secure and containing therapeutic space. Over the course of therapy, the patient demonstrated notable progress in recognizing her emotions, gaining insight into distorted body perceptions, loosening rigid control mechanisms, and developing more functional interpersonal patterns. Observations indicated increased self-awareness and improved overall functioning. The findings suggest that psychodynamic group art psychotherapy offers valuable contributions to understanding the multilayered nature of anorexia nervosa and supporting clinical improvement, and may inform the development of effective psychological treatments.