The Healing Arts

@im_inebriated to @arttherapynews: Art Therapy is a Fake!

Cathy Malchiodi — Thu, 12 Nov 2009 14:02:56 +0000

I like Twitter; I tweet it up as @arttherapynews a couple of times of day, spreading links to news, updates, and research on art, creativity, and health to followers. But I didn't notice that my Twitter box was filling up with messages from an anonymous tweeter named @im_inebriated* who was eager to make his opinions about art therapy known to me. I don't really know why @im_inebriated decided to make ridiculing art therapy a focus of his Twitter career. At first I dismissed him as a twitwit and even a bit of a twhiner. Once in awhile he was kind of a twouche, tweeting that my professional field was a fraud. How dare he! "Art therapy schmart therapy! How about beer therapy? How about scotch therapy?" No logical rebuttal could persuade him to stop. Sometimes he included a colorful "mua-ha-ha-ha" at the end of his tweet [if he had some characters left to burn], just for dramatic effect. Those tweets actually started to make me laugh out loud--and make me think.

Could @im_inebriated be right? Could his daily micro-messages really have some truth? While @im_inebriated's comments may have hit a nerve, they also begged an answer to this question: Where is the data to prove art therapy's impact on health and well-being? Where is the evidence that art therapy is not a "fake?" @lm_inebriated uncovered something about art therapy that many do not know. Research to support art therapy's clinical application is scarce, despite 50 or more years of theory and practice.

Art therapy, today I am the bearer of some tough love about the field. Evidence to justify the efficacy of art therapy is seriously deficient. It's the 40th anniversary year of the national organization and there is not a lot to show for four decades. Leaders in the field of art therapy talk and talk and talk every year about the need for more large-scale outcome studies on posttraumatic stress disorder, autism, Alzheimer's disease, and the currently popular disorder du jour. Academics continue to churn out more chapters and articles on why art therapy research is needed while very few outcome studies are undertaken, nevermind verified by conventional peer review or published anywhere but in art therapy journals.

Lest you think I am the only naysayer, it's not just me making these observations. Do a Google search of the words "art therapy" and in the top five hits, you'll find Wikipedia's take on the situation. In brief, it says, "Scientific research into the effectiveness of art therapy is lacking." Apparently, an earlier version of the page has been removed [likely by someone who found the criticisms to be a little harsh], but you can still read it here or below. According to this version, art therapy has set itself up for failure by defining its methods as having inherent "healing power," a statement that cannot be proven false if one comes up with the right definition of healing to match outcome. And for most the part, art therapy literature and studies are reviewed by other art therapists, not external reviewers from other fields. On these counts, Wikipedia is correct, albeit as an Internet resource it is uneven in accuracy on other aspects.

Some art therapists will say, "Well, you just can't evaluate art making and creativity by any standard, accepted scientific measures." Not so. Music therapy, art therapy's closest relative in the creative arts therapies, has used accepted instruments to successfully evaluate the effect of music on physiology, behavior, and memory. Others note that arts in healthcare outcome studies indicate art making has positive effect on certain aspects of health, particularly mood, pain perception, and stress. But these studies do not establish the efficacy of art therapy, but instead underscore emerging data on the creative process of making art that may or may not be part of art therapy's scope.

There is some hope on the horizon in the UK [a country where art therapy is a regulated part of the national healthcare system in contrast to the US where it is not]. An initiative spearheaded by colleague Dr. Diane Waller was recently announced at an international confab of creative arts therapies in September 2009; you can learn some of the details here:

The UK art therapy initiative will take some time to yield evidence-based research and outcomes; even the best case scenario will involve years of focused effort, excellence in research design, and patience to tease out why [or if] art therapy makes a difference. But for now, I say to my American colleagues, put aside all the excuses and distractions once and for all and make research the prime directive in the profession so we can understand-- and preserve-- this field. Prove @im_inebriated to be wrong so I can tell him and any of his future Twitter relatives that art therapy is not a fake.

*In case it was not obvious, @im_inebriated is a pseudonym to protect the tweeter's identity.

www.cathymalchiodi.com

Visit the growing community of art therapists from around the world at the International Art Therapy Organization [IATO]. One world, many visions...working together to create an inclusive and sustainable future for art therapy.

Subscribe to my Twitter and get the latest art therapy news at http://twitter.com/arttherapynews .

Original critique from Wikipedia, November 7, 2009:

"Scientific research into the effectiveness of art therapy is lacking. Research into the effectiveness of art therapy is generally published in journals such as the Art Therapy Journal, which is maintained by the American Art Therapy Association, and is therefore evaluated primarily by practitioners and students of art therapy. Assessment of the effectiveness of art therapy by individuals independent from the art therapy community is lacking. Research studies that employ the scientific method by, for instance, randomly assigning participants to either an art-therapy group or a wait-list control group tend to find that art therapy has little or no beneficial effect on the severity of mental disorder. Meta-analysis has indicated that well-established therapies such as cognitive-behavioral therapy can produce successful outcomes in circumstances in which art therapy and other expressive therapies have no identifiable benefit (Wethington, Hahn, et al., 2008). The practice of art therapy therefore should not be considered a form of Evidence-based medicine or evidence-based mental health treatment.

One major difficulty in assessing the validity or effectiveness of art therapy and other expressive therapies is that the tenets and assumptions of art therapy do not meet the criterion of Falsifiability, or refutability. For instance, as indicated in the introductory section of this article, one definition of art therapy "involves a belief in the inherent healing power of the creative process of art making." This statement is nonspecific such that it could not possibly be proven false, and therefore can not be evaluated scientifically. This is because phrases such as "healing power" and "creative process of art making" have so many possible definitions that one could simply pick between them to accommodate any scientific finding to the contrary of the initial belief."

ART PEACE SUSTAINABILITY: A Global Digital Art (Therapy) Event

Cathy Malchiodi — Tue, 03 Nov 2009 14:28:37 +0000

It's time to try your hand at some digital art making; artist or not, you might even find it addictive. Join the International Art Therapy Organization and the Art Therapy Alliance for an interactive global art event reflecting these three words: art, peace, and sustainability. It's an experiment in creating community using digital and social media.

In my previous post on art therapy, digital art and social multimedia, I commented on the somewhat slow uptake of the field of art therapy to utilize and investigate the impact of digital art making and social media in their work. Recently, art therapist Gretchen Miller, community organizer for Art Therapy Alliance, and I decided to try an experiment using an online digital art program and social networking. We wanted to see how (or if) people would respond to making art via their computers and the impact of contributing to and displaying self-created images via an online gallery. To provide some limited structure, we offered three words as a theme-- art, peace, sustainability -- and the option of creating responses "by hand" in addition to digital means. Here's a short film by Miller that will tell you more about the project:

To make digital art making accessible, we chose Polyvore, a free and user-friendly web-based application that allows you to mix and match images from anywhere on the web via your computer. While this application's focus is on stylish fashion-oriented images, don't let that fool you or put you off. There are literally thousands of available illustrations, textures, and text options to use; you can include your own photos and art too. Polyvore lets you create what are referred as "sets" composed of images using a drag and drop editor; essentially it's a digital means of assembling a collage without scissors and glue. But unlike traditional collage, you can easily adjust the size of images and create layers and transparencies not possible with the traditional "handmade" medium. After you have created your set [collage], you can publish and share it with others. To participate in this event--and anyone can-- go to ART PEACE SUSTAINABILITY by clicking here. The event will officially continue through December 31st, 2009.

Now if you do not think you are an artist, this may all sound overwhelming. But believe me, it isn't; in fact, you may actually find that "artist within" you never knew existed. For a quick tutorial, register with the Polyvore site and see http://www.polyvore.com/cgi/help. And take a tour of the current artworks on display; you can "save" images in your items folder from any of the sets for use for your own creations.

What have we learned so far from this evolving exhibit? We're still in the midst of this experiment, so it's too early to draw conclusions. For Gretchen Miller who works as an art therapist with domestic violence survivors, she notes how it stimulated her exploration of the intersection between art making and peace making through the endless variety of images available on the Polyvore site [see Miller's excellent blog Creativity in Motion]. For me, both the gratifying nature of digital image manipulation and the presence of an interactive online community that shares art through a virtual gallery, Facebook, and Twitter is not only inspiring, but also surprisingly fun.

So join the event, explore your creativity, make some art, and let us know about your experience.

Next up: Is art therapy a "sham?" A Twitter tale about how social media views the field of art therapy.

www.cathymalchiodi.com

Visit the growing community of art therapists from around the world at the International Art Therapy Organization [IATO], www.internationalarttherapy.org. One world, many visions...working together to create an inclusive and sustainable future for art therapy.

Subscribe to my Twitter and get the latest art therapy news at http://twitter.com/arttherapynews .

Art Therapy Meets Digital Art and Social Multimedia

Cathy Malchiodi — Mon, 02 Nov 2009 14:25:56 +0000

Traditional materials of 20th century visual arts--drawing, painting, sculpture, and collage or mixed media--have defined the field of art therapy for the past 50 years. In fact, most educational programs that offer art therapy coursework or related degrees require applicants to demonstrate proficiency in drawing, painting, and sculpture as part of prerequisites. But as digital technology has become more accessible and straight-forward, practitioners of art therapy are gradually including digital media as a method and means for client self-expression. Well, maybe...

A decade before the explosion of social multimedia [YouTube, Vimeo, Flickr, Skype, and the like] and availability of digital art making programs via one's home computer or Internet, I wrote a short text on the topic of computers and art therapy, Art Therapy and Computer Technology: A Virtual Studio of Possibilities. First, please don't buy it [my publisher will surely gasp now] unless you want to have a good laugh. It published was 1999 when I had no clue about where digital media was headed, although some of my guesses at where things might go turned out to be accurate. For example, the use of video [now digital] to capture and play back portions of sessions to clients is more common; this medium has proven to be particularly useful in the treatment of trauma related symptoms such as avoidance and dissociation in children and adults. Telemedicine and the possibility of Internet art therapy sessions were mentioned in the book; both areas continue to expand, and in tandem with numerous ethical, legal, and best practice issues still undecided by state licensure boards and professional associations. Art therapists have, of course, capitalized on the visual elements in the digital age. Some receive client artwork via electronic means between sessions, use web cams or Skype with individuals in rural or remote locations, and use digital art making programs to stimulate creative exploration.

In that particular text, I also cited computer art dinosaurs such as MacPaint and its limited counterparts of the time period. Admittedly, I had no psychic vision about the explosion of media possibilities that now emerge on Mashable everyday of the week in this early 21st century. Even today's reigning social media czar Twitter can be used to power virtual art. Tweets are being created and "mashed up" with other content make online art; you can make "portwiture," "twitterfountain," and "twyric" [a mashup of Flickr and Twitter] on your iPhone. There are also accessible film animation programs like Animoto and image manipulation sites like Polyvore [which you can read more about in my next blog] readily available to anyone on the Internet.

How does the move from using one's hands to hold a brush or pencil or to glue, cut, shape, or manipulate materials impact the outcome and benefits of art therapy in practice? As I noted last year in "Drawing on the Effort-Driven Rewards Circuit to Chase the Blues Away," using our hands to create meaningful images or objects may mediate depression as a result of stimulating specific parts of our brains simultaneously. The verdict [research] is not in yet about the impact of digital media on emotions or overall mental health when used in therapy. Creating with the available digital art programs is a somewhat different experience because it generally involves a keyboard or a digital tablet as the points of contact with the medium and a computer screen. So what's the impact of creating digital images as a form of art therapy? There is only anecdotal comment from art therapists themselves, but there are a few studies from outside the field that underscore some of the benefits of computer-based media. Project Sketch-Up/Project Spectrum is one such program that has been researched for use with children with autism; here's a short film on how it is used:

The results of Sketch-Up impress me because they not only underscore that people with autism tend to respond through visual and/or spatial intelligence, but also that using a computer drawing program is actually much more gratifying than a pencil on paper for most participants. In fact, many of the children reported that, "drawing was painful" and clearly not pleasurable. The added bonus of the Sketch-Up program is the skill set it apparently imparts; children learn how to perform and excel at tasks that form a foundation for more advanced computer skills in engineering and tech fields as an adult. In my current work with returning military and the Polyvore program, I am hearing similar comments about accessibility, skill-building, and most importantly, gratification with the imagery created and process of creating it.

Ironically, art therapy as a field is a slow adopter of new ideas; in a recent special art therapy journal issue on technology, there was no reference to the well-known Project Sketch-up and many of the very commonplace digital and social multimedia advancements. Art therapy has been hesitant to even recognize photography as an important medium in treatment and intervention; art therapists tend to remain loyal to traditions, even when those traditions are not proven to be best practices. Meanwhile, younger generations of potential clientele have grown up on digital and social multimedia and are more attuned to them than pencil or paintbrush. In the case of people with autism spectrum disorders, there are some emerging trends that beg the field to reconsider its best practices with this population; drawing or painting may simply not be the best strategy for everyone.

How will the exponential growth of digital art platforms and social media play out in terms of their impact on self-expression and visual creativity as therapy? First, the field of art therapy will have to catch up with fast-moving changes in digital and social media as well as develop research studies to evaluate the benefits of these media with the hands-on activities such as drawing, painting, modeling, constructing, and assembling. In the interim, a lively discussion, Digital Art Therapy, is ongoing via the social networking service LinkedIn and hosted by media expert and colleague Ginger Poole. And stay tuned--the next blog post invites you to give digital art making a try by participating in an interactive global art event.

www.cathymalchiodi.com

Visit the growing community of art therapists from around the world at the International Art Therapy Organization [IATO], www.internationalarttherapy.org . One world, many visions...working together to create an inclusive and sustainable future for art therapy.

Subscribe to my Twitter and get the latest art therapy news at http://twitter.com/arttherapynews .

Playing for Change: Music for a Change of Heart

Cathy Malchiodi — Thu, 23 Jul 2009 13:39:29 +0000

I woke up this morning to the headline that many people who are unemployed have simply given up the search for a job. And last night, while inspired by Barrack Obama's press conference on healthcare reform, I secretly wondered if what is so close will really happen. While my life is generally good, there has been so much bad news for so long. I think it's time for a dose of the healing art that is the best remedy I know to bring about a change of heart - music.

The Playing For Change Foundation (PFCF) is an effort to bring together musicians and vocalists from around the world and to use music as platform to inspire and bring peace to the planet. Their global initiatives have been present through social networking vehicles such as YouTube, Facebook, MySpace, and their blog for quite awhile now. If you haven't heard of their work, please check out this charitable group that is dedicated to connecting the world through music. They provide resources, including educational programs like their first music school, the Ntonga Music School, in Gugulethu, South Africa, and help musicians and their communities around the world.

PFCF started what is now a signature social media project in Santa Monica with a street performance of the classic "Stand By Me" and eventually went on to New Orleans, New Mexico, France, Brazil, Italy, Venezuela, South Africa, Spain, and The Netherlands to get musicians on film. Their latest piece is Bob Marley's classic, "One Love" performed by musicians in Nepal, Israeil, Zimbabwe, and beyond.

A PBS special on Playing for Change premieres on August 1st and can be seen on most public television stations throughout that month. But for now, turn up the volume and sing it with the musicians on this film: “No matter who you are, no matter where you go in your life, you gonna’ need somebody to stand by you.” Now more than ever.

A Facebook Fan Page for Your Private Practice?

Cathy Malchiodi — Thu, 23 Jul 2009 01:07:53 +0000

Are Facebook "fan pages" or MySpace accounts appropriate vehicles to promote a psychology or mental health practice? And is it okay to publicly post films of client or patient sessions, even with informed consent, on FB? It's happening-and it's bringing up a number of questions about how some mental health practitioners are using social networking platforms such as Facebook and what exactly constitutes client welfare in the age of the Internet.

I am Cathy and I am a member of the 250 million humans inhabiting Facebook Nation. I visit FB several times a day, IM my friends, and post daily messages, photos, and media like millions of others. I am a FB believer, having built a large network of contacts via the platform; I used it to establish an organization with over one thousand members literally overnight, promote my writing for PT and other publications, and "Big Tweet" an art therapy story on a regular basis.

While social networking platforms such as FB are generally used to stay in touch with family and friends, many individuals are also now using them to promote causes, events, and business interests. Therapists are using FB too, even setting up "fan pages" for their private practices. A fan page is sort of the ultimate "uber-narcissist" way to shamelessly promote whatever you want to on FB; in the past, these pages were devoted to a famous athlete, actor, or public figure. But now even realtors, marketers, and yes, even therapists apparently have established fan pages for themselves.

Okay--I can live with the idea that many therapists want to use FB to advertize their businesses, whether a coaching practice or traditional psychotherapy practice. But how some therapists are using this platform is where I start to get a little queasy. One FB fan page for an art therapy private practice included both photographs of artwork made by clients during sessions and a series of unedited video posts of actual client sessions with a minor. I fully understand that informed consent may have been obtained to post this material. And possibly the intent of such material is to demonstrate the value of art therapy in treatment-certainly, film and image can promote art therapy more effectively than words alone. In fact, art produced in community, clubhouse, or art therapy open studios is often created in public, because part of the "treatment" is to reframe clients as artists. But art produced as part of psychotherapy or counseling sessions is created in a very different context. Under such circumstances, no matter what consent was obtained or what the intent, inclusion of recordings of client sessions is really pushing the boundaries of ethics and individual welfare. Does any person really understand what it means to have one's therapy session visible in one of the most public cyber-places in the world? How well does any client understand that anything on a social networking site is accessible and downloadable by anyone with a few clicks of a mouse? I am not convinced that any informed consent document or explanation could adequately convey this to any individual, particularly a child.

It is well documented that participation in social networking and online media [including blogging for PT] punctures the very thin veil of privacy in this age of the Internet. Over recent years, the American Psychological Association has posted several articles about the problematic nature of Internet access, including the increasing number of clients who are "Googling" their therapists to find out where they live, their personal interests, and other information. Like many practitioners I am conscious of what my clients can read about me as well as the difficulties that I face in keeping appropriate boundaries with patients in a world of electronic communication.

These issues are complex and I do not pretend to be able to answer-- or even identify-- all of them here. And being over 30 years old, I am part of a generation that did not grow up with an exclusively digital worldview; younger cybertravelers are possibly more comfortable with the public platforms like FB and nonplussed about the increasing lack of privacy of personal lives. So it's hard to say how my FB colleagues will react to what I observe; maybe I will be cyberflogged for bringing this to light. But statement made by Stephen Behnke, PhD, JD, Ethics Director for the APA, sums it up for me: "Putting something on the Internet is no different than leaving it on a table at a coffee shop at the mall." Maybe the Internet has redefined the nature of self-disclosure and privacy, but ethically, it's just too much information.

www.cathymalchiodi.com

Subscribe to my Twitter and get the latest art therapy news at http://twitter.com/arttherapynews.

Helping Children Draw Out Their Traumas

Cathy Malchiodi — Wed, 15 Jul 2009 15:49:26 +0000

It's well known that traumatic events have profound effects on cognitive, emotional, and physical functioning in children. Fortunately, many children recover from traumatic events in a matter of weeks, but others have serious reactions that may last months or years. For those children who do not bounce back, there is hope through structured intervention and one simple activity: drawing.

For almost twenty years, the National Institute for Trauma and Loss In Children [see earlier post, Resilience Matters in Traumatized Children's Lives] has been "ground zero" for the study and promotion of sensory-based interventions [art, play, and somatic therapies] in children's recovery from trauma. Dr. William Steele, founder of the Institute, has been a passionate, dedicated advocate and visionary for development and research on methods to support this approach. I first met Bill in 1994 after a decade of working as an art therapist and a mental health counselor with children exposed to violence, abuse, and neglect. I immediately knew that I had encountered a kindred spirit who understood how trauma is experienced by children -- that it is primarily an implicit experience that involves sensory memories involving sight, sound, touch, smell, and taste.

The idea that trauma is encoded in a sensory fashion by mind and body is now widely accepted by professionals who work with individuals with stress reactions, including posttraumatic stress disorder in children and adults. Well-known traumatologist Bessel van der Kolk observes that when terrifying events such as trauma are experienced, but do not fit into a contextual memory, new memories or dissociations inevitably are established. In other words, when a traumatic memory cannot be articulated with words, it remains at a symbolic level. So to retrieve it, it must be externalized in symbolic forms such as images. This iconic symbolization gives experiences a visual identity because the images created contain all the elements of that experience-in other words, what happened, our emotional reactions to what happened, and the horror and terror of the actual event.

What Bill Steele and I concluded more than a decade ago is that one of the best ways to begin to address the needs of children in trauma is to begin with drawing as a form of intervention. What we began to slowly find out over the next ten years was exactly why having children engage in drawing and similar creative activities made a difference. Here's a brief summary:

1) Drawing taps implicit memory. Trauma and drawing are largely sensory experiences; drawing pictures about aspects of "what happened" prompts sensory memories of traumatic events.
2) Drawing actively engages children in the process of repair and recovery. It provides the possibility to move from a passive to an active role in the treatment process.
3) Drawing provides a symbolic representation of the trauma experience in a concrete, external format.
4) Drawing makes us a witness to children's trauma experiences.
5) Drawing increases children's verbal reports about emotionally laden events. Research supports that drawing encourages children to provide more details and to organize their narratives in a more manageable way than children who are asked only to talk about traumatic experiences.
6) Drawing assists in reduction of reactivity (anxiety) to trauma memories through repeated visual re-exposure in a medium that is perceived and felt by the client to be safe.

This list is a very simplistic overview of why drawing helps children in trauma. Fortunately, we now have a growing body of research to support the reduction of posttraumatic stress in children and adolescents who participate in structured intervention using drawing as a core activity. As a researcher and helping professional, I continue to be intrigued by just how drawing "helps" bring about recovery, whether through decrease of worry or fear or reduction of more complex acute trauma and posttraumatic stress reactions. But of equal importance, giving traumatized children the opportunity to express through images what is often impossible to say with words underscores my responsibility to bear witness to their very human suffering, honoring those voices that might otherwise have remained silenced.

www.cathymalchiodi.com

Visit the growing community of art therapists from around the world at the International Art Therapy Organization [IATO], www.internationalarttherapy.org . One world, many visions...working together to create an inclusive and sustainable future for art therapy.

Subscribe to my Twitter and get the latest art therapy news at http://twitter.com/arttherapynews.

Resilience Matters in Traumatized Children's Lives--and Sensory Activities Make the Difference

Cathy Malchiodi — Tue, 14 Jul 2009 17:58:28 +0000

The capacity to bounce back - more commonly known as resilience - enhances trauma recovery in children. But what about children who do not have the innate capacity to bounce back? Or those whose lives have been compromised by abuse, neglect, fetal alcohol syndrome, or exposure to multiple traumas? There's good news--sensory activities, along with positive relationships and a positive environment, can make all the difference.

I am writing today from the 2009 National Institute for Trauma and Loss Annual Symposium, a gathering of trauma specialists from around the US who share an interest in sensory and somatic interventions for traumatized children and their families. According to John Micsak, symposium keynote and director of a resiliency outreach program for youth, addressing three regions of the brain can help. These regions are defined as 1) the thinking brain [cortex] responsible for abstract reasoning; 2) the emotional brain [limbic] responsible for affect regulation, empathy, affiliation, and tolerance; and 3) the survival brain [brain stem or reptilian] responsible for fight or flight, heartbeat, and other body regulation functions.

From an expressive therapies perspective, it's promising that mental health is beginning to realize that the arts, play, and imagination address the whole brain and support what Bruce Perry calls "neurosequential therapeutics"--a method of working with severely traumatized children using body reactions [survival brain] as a starting place and eventually addressing other brain functions through progressive interventions that focus on refining neural pathways in other regions. The NT process essentially tries to match specific interventions to the developmental stage and specific parts of the brain that mediate presenting neuropsychiatric problems. Application of sensory interventions are key to helping meet the needs of the child and to the development of resilience.

In brief, using this approach distills down to addressing the traumatized brain from an arts therapies perspective as follows:
1) The survival brain needs modulation through rhythmic and patterned sensory input, such as activities like drumming, singing and music at the resting rate of the human heartbeat, basic movement and rocking, breathing techniques, and massage;
2) The emotional brain needs the self-soothing reinforcement through tactile experiences of art making and play as well as the relational aspects of mutual engagement between adult and child using creative arts, imagination, and play as means to establish and reinforce positive attachment;
3) The thinking brain needs the opportunity to engage in storytelling through all the creative arts, relating not only the trauma story, but also as a means to express the self and practice cognitive-behavioral skills used in long-term self-regulation.

As I listen to other professionals share their experiences today, I also quickly realize that the challenges of encouraging resilience in severely traumatized children still seem to be impossible to overcome. After all, the problems most therapists confront in children who have been maltreated, abused, or neglected have had years to take hold. For many children, the intervention needed to redirect behavior may involve a decade of sustained effort; in addition to intervention, the presence of a positive environment and social support are also key. But compared to a few years ago, I can now celebrate that our collective thinking is moving from a traditional medical model to a neurodevelopmental approach that embraces the senses and "how the body remembers" trauma as privotal to reparation and recovery. It is exciting to think about how the simplicity of art, play, and imagination can assist the formation of new neural pathways and re-regulate the survival, emotional, and thinking regions of the brain over time. And most of all, how our growing understanding of sensory interventions is changing young lives.

www.cathymalchiodi.com

Listen to Presences Inside Poems: A Tribute to Poetry Therapist Ken Gorelick

Cathy Malchiodi — Fri, 19 Jun 2009 12:28:29 +0000

Listen to presences inside poems.
Let them take you where they will.
Follow those private hints,
And never leave the premises.

---Rumi

On June 8, 2009, the fields of psychiatry, poetry therapy, and creative arts therapy lost Ken Gorelick, MD, who succumbed to brain cancer after a two-year illness. I became acquainted with Dr. Gorelick because of his contributions to the field of poetry therapy, as a past President of the National Association for Poetry Therapy [NAPT], and as an author and advocate for the power of words to heal. In 2005, Gorelick wrote a seminal chapter on poetry therapy for Expressive Therapies and was widely published on topics ranging from Jung to Kafka.

Poetry therapy is the intentional use of poetry and other forms of literature for healing and personal growth. Clients in poetry therapy often read verse, write it, or both. While there are many historical references to the emergence of poetry in medicine and psychology, Benjamin Franklin was a known advocate as early as 1751. Pennsylvania Hospital, the first hospital in the United States, founded by Franklin, used many adjunct treatments for their patients with mental illness, including reading, writing and publishing writings. Benjamin Rush, often identified as the "father of American psychiatry," also introduced literature and poem writing to patients. Today, the National Association for Poetry Therapy (NAPT) confers credentials to poetry therapists who have met its educational and professional standards. It also maintains a registry of poetry therapy practitioners in educational, medical, geriatric, therapeutic, and community settings.

Poetry has become a therapy of choice with veterans and newly returned military, particularly in combination with art therapy and other creative modalities. Prose and verse are potent modalities for expression of war experiences, homecoming, and challenges of reintegration and redeployment common to the more recent wars in Iraq and Afghanistan [For more information on the impact of poetry on a Vietnam veteran, see previous post on "Words of War, Words of Peace" focusing on the work of veteran Larry Winters].

It should be noted that Dr. Gorelick was not only a poetry therapist and poet; he was well-known for his work as a psychiatrist at St. Elizabeth's Hospital in DC. His expertise as a historian was the basis for a keynote address he gave at the hospital's 150th anniversary. Gorelick was also a Distinguished Life Fellow of the American Psychiatric Association, among other honors. More recently, he was interviewed in the May 2009 Washingtonian Magazine as "doctor as patient" in response to his diagnosis with brain cancer. One of his own poems appears in the interview, written after brain surgery in 2007, and reveals both his humanity and artistry with words:

Looking back I feel my life has been right
No second-guessing that this or that might have been better,
No ache that I might have climbed higher mountains.
I am in a generous leisurely mood with myself
Filled with gratitude and awe for what has been,
The gifts, the luck, the love.

In the Washingtonian interview Gorelick remarked, "I don't want to feel like I've been cheated by life," in reference to his struggles with cancer and treatment. In contrast, those of us in the creative arts therapies always feel a little cheated when we lose someone like Ken Gorelick too soon and within our small field of practitioners. His generosity of nature and mentorship to so many in the creative arts therapies will of course be missed. Fortunately, his work lives on in print, and it taught us on a personal level "that we are all part of the same verse, the universe of words... this is a place where you are not alone, that your story is not the only story" [adapted from Richard Brown, NAPT website].

The Bone Fractured Fairy Tale: A Story of Art as Salvation

Cathy Malchiodi — Tue, 28 Apr 2009 13:40:22 +0000

At the age of 23, Jennifer Brunner was diagnosed with Ewing's sarcoma, a rare form of pediatric cancer that affects one out of over 300,000 children each year. Yet Brunner was a young adult, a university student, and a self-proclaimed health nut. In her words, she had won the "crap lotto" and ended up in a children's hospital for treatment that was both physically depleting and often toxic, to rid her body of cancer.

Fortunately, making images, photography, and writing became part of the treatment. They began as therapy, but in the end became art, allegory, and, ultimately, a compelling story to inspire all who confront mortality when living with the diagnosis of cancer. Brunner's body of art and writing resulted in a one-woman show, "A Bone Fractured Fairy Tale: My Year Lost in Cancer Land," and in true storybook fashion, includes a princess, monsters, demons, and a pink unicorn. But the good news is this: Brunner is now cancer-free, studying to be a nurse, engaged, and planning the travel she envisioned, pre-diagnosis. Of course, art was not the cure, but it certainly was part of her healing.

In a growing number of hospitals across the US, cancer patients are using art to express emotions and reduce stress. It is one application of art therapy that has demonstrated outcome through several evidence-based studies. And it's the subject of a recent public radio interview, "The Role of Art in Healing," featuring Brunner's first person account, and observations by art therapist Emily Johnson and yours truly about the importance of art therapy in cancer recovery and health in general. You can listen to the audio to learn more about Brunner's journey and the field of medical art therapy right here.

During the time of Brunner's exhibition, good news emerged about the role of art therapy in the overall health and well being of women with breast cancer. Swedish researchers reported that women having radiation treatment for breast cancer experienced lasting improvements in mental and physical health and quality of life after participating in as little as five sessions of art therapy. After six months, women who had participated in art therapy showed significant improvements in their overall quality of life, general health, physical health, and psychological health; the control group only showed improvements in psychological health. The women who participated in art therapy also had improvements in their perceptions of body image, outlook, and side effects of radiation treatment.

While this research is wonderful news about the usefulness of the healing arts with physical illness, I feel fortunate to have learned from Jennifer Brunner and other cancer survivors that art is not just merely a way to cope with and adapt to a cancer diagnosis. It is a lifeline, a unique level of vision, and a force of imagination that takes us to a place beyond ourselves. Brunner's story teaches us that art can save us from circumstances that seem to have no solutions. And it allows us to feel whole, even when we are fractured and broken.

And yes, I am back to writing, despite a series of personal fractured fairytales and assorted side trips. It's good to be home.

Check out the International Art Therapy Group ...one world, many visions...working together to create an inclusive and sustainable future for art therapy.

Be Here Now: Mindfulness and the Creative Spirit

Cathy Malchiodi — Thu, 19 Feb 2009 14:28:44 +0000

Mindfulness is the art of paying attention to the details of the present moment. When we are engaged in the process of creating--whether through words, music, art, or movement--without getting caught up in where it might be leading, it is a form of mindfulness.

It's been a rough few weeks and I have to admit that it's been hard to focus on the present; the past and future seem to be taking up most of the neural pathways in my brain these days. A colleague is seriously ill, family and friends have been distressed by tragedies, and my work life hasn't been without occasional irrational and uncontrollable sputters and rumbles. The media is no source of relief either; one week it's the "miracle on the Hudson" and then it's back to watching retirement funds circling down the bathroom drain and witnessing thousands of people facing unemployment or losing their homes. Even Psychology Today has me seriously depressed that I may not have had enough sexual partners to have a happy afterlife after all.

Just before I might have jumped into the Ohio River [the closest body of water available to me other than the bathtub], I happened to stumble upon this film that gave me a needed cosmic nudge. Take a couple of minutes, listen to the music, and watch 400 people persuade hundreds of unsuspecting commuters in London's Liverpool Station to "be here now:"

The film was produced by T-Mobile as a vehicle for an advertisement, but it brought home to me of the value of creativity in a mindful life. To dance -or paint, drum, write, or play-- does not make it all better, but to be mindful in a creative moment does. Some refer to that process as a state of flow and others call it a form of meditation. No matter what this state of being is called, recent studies underscore the potent combination of "being here now" and the creative process to impact illness. There is growing evidence-based research that mindfulness practices combined with creative interventions such as art therapy [also known as mindfulness-based art therapy or MBAT] are transformative experiences in the lives of people with cancer. In brief, there is a significant decrease in symptoms of distress and improvements in health-related quality of life, two key elements in the treatment of psychosocial aspects of cancer recovery, aspects translatable to life and health in general.

Most of all, creativity as a form of mindfulness reminds me that the present moment contains the possibility for all things, including the liberation from the world of suffering. It is not going to make my friend's illness go away, reverse the tragedies of the past few weeks, untangle life's little soap operas, or make my stone-cold dead retirement account reincarnate as the robust portfolio it was last June. But we are here in this drama for other reasons-- to abandon ourselves in this moment and become fully conscious so we can experience the dance of our lives.

[For another uplifting, be-here-now experience, revisit Dance Like Your Life -And World-Depends On It]