Response to "Dangerous Liaisons: Group Work for Adolescent Girls who have Anorexia Nervosa"

By Wrenn Compère, 1st year graduate student at Lesley University in Cambridge. Email: wrenncompere@yahoo.com

Katrina McFerran offers a compelling argument for the use of group work with anorexic teen girls: a population whose competitive edge, it has been argued (Murray, 2002), might cause the intervention to backfire in unintended, destructive ways. In her article "Dangerous Liaisons: Group Work for Adolescent Girls who have Anorexia Nervosa," McFerran provides an overview of recent literature regarding the disorder. Despite the plethora of current research linking the spike in disordered eating with the increasing bombardment of young girls by idealized media images of female beauty (Brown & Lamb, 2006; Martin, 2007), the author chooses to emphasize the lack of a proven causal link between body image and a diagnosis of anorexia nervosa. She seems here to be missing an important opportunity to call attention to a very probable contributor to an increasingly deadly condition. The omission is especially surprising, as her article goes on to shed important light upon the benefits of group work with this population, with her upcoming study aiming to lay the groundwork for future research in this area.

Still, this lack of empirical data, along with the author's observation that adolescents tend to discount the impact of popular culture on their lives (Of course they do! In her video "Killing Us Softly," Jean Kilbourne asserts the universal tendency of all of us to consider ourselves individually exempt from the influence of marketing!), leads McFerran to emphasize a construction of anorexia as a mental illness. Within the framework of this construction, McFerran describes a "Catch 22," in which patients find themselves inappropriately isolated in a hospital setting, yet obliged to be there, since physical stabilization is a pre-requisite for participation in outpatient group therapy. Add to this isolation a fear of "cross contamination" -- the worry that group settings might stimulate unhealthy competition, interaction, and comparison among the girls -- and the likelihood of group work seems greatly compromised.

Yet it is here that McFerran pushes beyond the research proscribing group settings, seeming to follow her intuition in advocating for fellowship and cooperation to be a part of the challenging journey out of anorexia. Such interventions, argues the author, if competently facilitated, can enhance and deepen the recovery of adolescents, who naturally turn to their peer group in order to define their emergent Selves. McFerran's intuition seems to draw deeply from her own clinical experience with this tender population. Although she does not undermine the potential dangers of competition and comparison in such a delicate process, she does suggest that the benefits of group work far outweigh its risks. Bolstering her perceptive instinct by having sought and received encouragement from numerous experts in the field, McFerran's project aspires to gather information about Music Therapy group work with those who have eating disorders. Her hunch and her hope (and mine, as well!) is that it will lead to a demonstration of the benefits of this type of intervention, strengthening the argument in favor of group-oriented Music Therapy with this population.

While McFerran qualifies her project as a "very small step" toward providing the medical world with evidence of the profound benefits of Music Therapy, I feel that she may be underestimating her contribution. Compassionate, skillful facilitation of song writing, as she describes it, leads to an externalization of daunting emotions, even as it creates a window-like opportunity for families, friends, and medical support staff to better perceive the arduous situation of these young women. Far from being insignificant, I would liken McFerran's endeavor to a pebble being thrown into still water, its effects rippling outward, and ever outward.

Songs generated by a group of mindful, well-guided teenagers can thus function as a wellspring, which will swell into a deep pool of creativity. This body of work, in turn, becomes a resource, feeding the rivers with the imperative nature of its voices, creating vital channels for understanding the heartrending plight of so many young people. May it gather the momentum necessary to thwart the powerful currents of unrealistic, media-driven imagery, that our young women may discover more nourishing ways to channel their immense energy and intelligence, and to discover, at long last, their authentic, inner beauty.

References

Brown, L.M., and Lamb, S. (2006). Packaging Girlhood: Rescuing Our Daughters from Marketers' Schemes. New York: St. Martin's Press.

Herrin, Marcia, and Nancy Matsumoto (2002). The Parent's Guide to Childhood Eating Disorders. New York: Henry Holt.

Kilbourne, Jean (2000) Killing Us Softly 3 (DVD). Media Education Foundation.

Martin, C. (2007). Perfect Girls, Starving Daughters: The Frightening New Normalcy of Hating Your Body. New York: Free Press.

McFerran, Katrina (2005). Dangerous Liaisons: Group Work for Adolescent Girls who have Anorexia Nervosa [online] Voices: A World Forum for Music Therapy. Retr. Nov.2, 107, from http://www.voices.no/mainissues/mi40005000173.html.

Murray, B. (2002). Partners in Illness: Patients Trading Thinness Tips. Monitor on Psychology, 33(3), http://www.apa.org/monitor/mar02/partners.html.