Patient, Express Thyself
By Jeanie Lerche Davis
July 9, 2001 -- A bright, accomplished pianist, "Anne" was also a diabetic who had suffered the disease's worst blows. First, she lost her sight -- then a leg to amputation. That's when Anne's spirit lost strength. To help her work through a severe bout of depresssion, an art therapist at her hospital introduced Anne to sculpture. As she worked the clay -- shaping it into delicate flowers, leaves, shells -- Anne found release for her emotions, focus for her thoughts. Her depression gradually lifted.
"Zack" was always in trouble in school. When it came to impulse control, he acted like a toddler, not a 15-year-old. But learning to draw helped slow Zack's actions. Creating art was almost like meditation. His thoughts gained focus; his impulses grew quieter. Slowly, he learned control.
The severe pain of sickle-cell anemia was nearly too much for 8-year-old "Leroy." He spent his days in bed with a heating pad, covered with blankets, trusting no one, speaking little. But when his art therapist made two small clay animals for him, he had a vent for his emotions. "The lion is eating the snake's head," he told his therapist, acting out his anger.
And "Albert" was in the advanced stages of Alzheimer's disease. No longer able to speak, he was often agitated. Yet it was clear from his face that painting simple circles in watercolor gave him focus and happiness. In a matter of a few weeks, the circles evolved into very recognizable forms -- boats, water. It turned out that although Albert had not painted for 30 years, this used to be his hobby. Back then, he favored seascapes.
"We had tapped into a deep piece of his self-esteem," says Laura Greenstone, Albert's art therapist. "The process of creating art had stimulated a cognitive function in his brain. Even though he was never verbal, his attention span improved, he was less agitated, better able to calm himself. He used art to become connected to the world."
A Picture of the Soul
Communicating through the visual arts, achieving a sense of well-being through art -- that is the essence of art therapy. It's a practice, and a process, that's not about talent, but purely about expression.
"Art is a language unto itself, helping us say the things we don't have words for," says Nancy Gerber, MS, director of the graduate school in art therapy education at MCP Hahnemann University in Philadelphia. "Art therapy allows people to express those things for which they have never had words, but which currently affect their lives."
A melding of artist and psychotherapist, art therapists nurture a patient's trust -- the first important step in the healing process, says Gerber. "People can be so fearful of art, fearful of putting it out there," she tells WebMD. "We create an atmosphere of acceptance, that anything they do is fine."
"The beauty of art is that it can be so personal and idiosyncratic," says Randy Vick, MS, chairman of the master's program in art therapy at the School of the Art Institute of Chicago. "The essence of art therapy is to explore the making of the art product as well as the art process -- to find understanding of themselves in their work."
"The physical involvement and activity, the engagement of head and hands together, it is freeing, illuminating," Vick tells WebMD. Therapy, too, "can come from looking at form and color, thinking through the narrative or story of the work."
"When I get into the artwork, I'm in another place, I get so absorbed," says Pat Innes, a 2001 winner in Migraine Masterpieces, an annual art competition sponsored by the National Headache Competition. "Painting is a relief."
A Pain-Free Place
Irene Rosner David has been an art therapist for 28 years, working with patients like Anne, who are in the midst of rehabilitation.
Art can help people regain a sense of control, David says, and lessen their anxiety and sense of victimization.
"Making art takes one from the passive role, from the victimized stance, into an active one," she tells WebMD. "If one can experience that on a small scale, that message is absorbed on an unconscious level."
By applying brush to paper or working with clay, such patients can recapture fine-motor control and gain a substitute for speech. "Art also can help them use metaphor, stimulate the brain in other ways to help them communicate," says Greenstone, a consultant with Philadelphia-based Creative Arts Therapy Resources.
While Albert's story is somewhat special, "a little bit happens with everyone," Greenstone tells WebMD. "Creating art helps trigger memories, brings up something from the past. We learn something from [the patients] every day."
A Bridge to Your Inner Child
Some of art therapy's power comes from the access it provides to childhood experiences.
"How many kids have been embarrassed because some teacher says you can't draw it that way?" says Gerber, who for more than 20 years counseled patients with mental health problems.
In some ways, the hesitancy to create art can be good, Gerber tells WebMD. A struggle with art can tap into feelings of shame and embarrassment, and that's when the walls between therapist and patient may come down, she says. "Trust and communication are essential to this healing process," says Gerber.
Through art therapy sessions, long-held emotions, memories -- hidden inside us, often lost to childhood -- can be coaxed to reveal themselves.
"We've never had words for those things," says Gerber. "They happened when we were little, before we had words. They are stored in the form of images, sensations, smells, touches, even body movements. That's how infants process information. We're so used to them, we're not even aware they exist."
In this process, the simple directive to "draw two people" evolves into talking about how those two people are interacting -- and that provides insights into how the patient perceives his or her world and interacts with others, says Gerber.
Art therapy can be especially comforting for young children, helping them adjust to their illness, to the strange environs of the hospital, says Laura Black-Keenan, also an art therapy consultant.
"Some think they are being punished, that an accident was a form of punishment because of bad behavior," she tells WebMD. "We can help clear up their thinking."
Draw an outline of a child's body, and you've begun a lesson, she says.
"Often, this will stimulate conversation," says Keenan. "One child will share that their heart is sick, that they need a transplant; another child will say it's my blood that has cancer. It's great for them to share information so they won't feel as alone."
For one child recovering from a severe dog attack, creating art helped lower his blood pressure by some 30 points, Keenan tells WebMD.
"It's the art," she says. "It's hypnotic, meditative -- it takes the child from the painful situation, from thinking about the pain. That's what this is all about, learning about the child, supporting the child, helping him develop coping skills, helping him find ways to get through a painful event."
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