Art therapy: Healing for all generations
Art therapy: Healing for all generations
Opportunities for creativity are limitless
In some hospice settings, it might mean children playing with clay or with finger paint. In others, it could mean adults creating quilt squares symbolizing lifetime achievements — or just playing in the dirt. But whatever age group is being served, hospice professionals agree that art therapy presents a powerful opportunity for healing.
It is perhaps its universality that makes art therapy so effective. It represents such a broad range of activities and therapies that hospice professionals have a hard time agreeing on a single definition.
"Art therapy can, for example, include guided visualizations," says Sherry Showalter, MSW, LCSW, an acute-care worker at the Halquist Memorial Hospice Center in Arlington, VA, part of the Hospice of Northern Virginia, headquartered in Arlington. "It’s like reading a story book to a kid — they look at pictures while you read to them. Adults also create while you give them words, which can help them let go of the boundaries of their thoughts."
But Showalter, a bereavement coordinator for five years at the VNA Community Hospice, now a part of the Hospice of Northern Virginia, adds that art therapy can include "anything where you work with your hands — coloring; digging a hole in the earth and screaming your emotion into that hole; planting a tree so that something grows from it; dance or movement. The AIDS quilt is a perfect example of art therapy."
Robin McMahon, LCSW, BCD, the director of grief and loss services at Hospice of Northern Virginia, employs a variety of materials for drawing, such as chalk, pencil, crayon markers, and paint, as well as clay in the hospice’s "Healing Art Program," which targets children ages 5-18. However, she also considers the "healing circles" employed at the hospice’s weekend camps to be art therapy.
For Barbara Trauger Querry, an art therapist at Cleveland’s Hospice of the Western Reserve, it’s not what you do, but why you do it that defines an activity as art therapy. "There’s a difference between art making and art therapy," she asserts. "A lot has to do with the underlying intent, and with the environment in which it occurs. Art therapy requires a safe, nonjudgmental environment that supports the art and the person in a way they might not find if they were just doing crafts. In such an environment, all art activities have a healing potential."
Transcending generations
Art therapy can be as effective with adults as it can be with children, but only if adults are encouraged to think like children, asserts Showalter. While her focus at VNA Community Hospice was clearly on children, Showalter spent a good deal of time in 1999 working with adults.
"Children are much more honest in their feelings," she explains. "Kids grieve a little bit, then play a little bit. As adults, we’ve been taught better,’ but we could learn from children how be honest about what we feel.
"I tend to believe that we often have to look at everything as a whole, so while we are adults we are also children," adds Showalter. "If we can touch that inner part of ourselves that plays in the mud and remembers when we were not so civilized as children, we can touch the real core of our grief and impending death issues.
"Often during times of trauma, stress, and grief, our hearts and heads get conflicting messages. Rationality says one thing, but it doesn’t make sense emotionally," she continues. "But if adults who are newly diagnosed are given crayons and paper or finger painting and allowed the opportunity to be less civilized,’ they will be able to work directly from the heart and not let their heads get too involved," says Showalter.
She experienced this process on a large scale when she had a group of adults create a "remembrance quilt." The quilt was made of 13-inch squares, each of which contained one person’s life memories. "The participants had to be very particular, and they would make some of the most elaborate and simplistic things you’ve ever seen," she says. "The results would send a very cathartic, very healing message; people would send me letters about how it made them feel."
Working through their grief
Again and again, Showalter emphasizes the variety of avenues available. "Men would talk about the power of sanding, of polishing wood to a bright sheen," she observes. "You can work your grief tremendously through this energy."
Even adults as old as 80 or 90 benefited from expressing themselves through painting, says Showalter. "It’s amazing how people can tap that part of themselves they did not know was there; they are vulnerable and in a hurting place, and painting allows that to come out. It helps them to recognize that they are forever changed, and that the threat of loss or grief has made them different. Art allows them to speak to the wholeness of themselves; it’s that powerful."
Trauger Querry works exclusively with adults in a more traditional framework. "I’d have to say that we have stayed fairly consistent with spontaneous art [the program is seven years old]," she says. "By that, I mean we’re not doing a lot in the way of directed therapy, asking people to draw this or that."
In this, says Trauger Querry, "We reflect the teachings of [Elizabeth] Kubler-Ross. I truly believe that the heart does not stray far from that which hurts it the most. People can just be putting colors down, or choosing pictures for a collage; left to their own devices, they will bump up against those things that hurt them most. The art really has to come out of their need."
Healing power of art
In hospice, she asserts, the staff work with people who are healthy. "The person who is dying is still potentially healthy, both psychically and emotionally," she says. "No one comes in and asks for psychological intervention; they come for the healing power of the art. They still have opportunities to express themselves and to heal."
At Hospice of the Western Reserve, any team member can refer a patient to expressive therapy; music and art therapy coexist under a single umbrella. "When the referral comes in, we determine what the needs are," says Trauger Querry. "When the program began, even staff people had the impression you had to be good at art to participate, but very quickly they learned that art therapy works so well we were getting the more difficult cases. We would go in when people were threatening suicide, or had bad family dynamics."
Often, issues will show up in art therapy that hadn’t been apparent before, says Trauger Querry. "There was one fellow who came in only once, and he would only choose the color green [the hospice had 10 to 12 different shades]," she recalls. "He could only squeeze his right thumb and forefinger, so he would indicate an area of the paper and we would drop the paint on it. I asked him what the green reminded him of. He said, Money,’ but I replied, That’s only paper; what does it really mean to you?’ Finally, he said money meant he could buy a car so he could leave the hospice and go where he wanted to go. He was struggling with being confined to a wheelchair. He never came back, but the session alerted the team to a critical issue."
The Hospice of Northern Virginia has always focused on children, says McMahon. "Initially, we offered the program to children of hospice patients or those who were part of hospice families — while the patient was still alive, and up to 13 months after the death." The Hospice of Northern Virginia provides individual art therapy sessions with certified art therapists. "The children use a variety of art materials to express some of the emotions they may not be able to verbalize, or to give them a vehicle for verbalizing," McMahon explains.
The hospice also offers weekend camps and day camps for grieving children after a death. These are open to the entire community; again, the primary vehicle for expressing emotions is art. "Art is used to memorialize the person, to enable the children to express their feelings, and to have somewhat of a catharsis," McMahon observes.
These camp sessions also include healing circles, which give the children the opportunity to talk about their feelings. The camp sessions include up to 20 children, each one having a "big buddy" who spends the weekend with them. In addition, art therapists work with the children on individual art projects. "They are encouraged to share their art with the group, but they don’t have to," says McMahon.
McMahon sees tremendous benefits for the children who participate in the program. "It gives them a vehicle for talking about their feelings, and for being able to describe them a little better through art," she explains. "It lessens anxiety. A lot of what we do is helping them to normalize the grief, to understand that they’re not doing anything wrong, and that their emotions are really appropriate."
All in the family
Hospice of Northern Virginia has some exciting plans for the future. "Our basic structure has remained the same," says McMahon, "but now we’re expanding to more of a family model. In one camp in particular, we have noticed that when parents drop off and pick up their kids, or when we deal with a caregiver facing his own loss, they also have tremendous needs."
McMahon’s goal is to design a variety of programs to meet the needs of the adults, as well. "Not only can we help bereaved parents, but the children will also heal more completely if the person taking care of them can deal with their own grief," she says.
Some changes already are on the calendar. For example, in November, the hospice usually sponsors a "Coping with the Holidays" workshop for children and adolescents. "This year’s workshop will be intergenerational, including art therapy," notes McMahon. In addition, the hospice will be shifting from children’s camps to family camps next summer. "The activities will be somewhat the same, but there will probably be a greater emphasis on verbalizing," she says. "We see that as a really positive modality for adults, as well."
Whether they work with children or adults, hospice professionals agree that art therapy can be extremely efficacious. "That’s because we work with issues of importance to the individual," Trauger Querry explains. "Art can be the complete therapy in itself, or in other cases, it can be the springboard to verbalization of what’s going on. You can really make some progress, reduce anxiety, and help patients find peacefulness they had not had before. I really believe that people get to where they need to be before they die; they get in touch with the divine."
"I’m constantly amazed at the resiliency of the human spirit," says Showalter. "If you can be taught to look at things through different eyes, then you have different options. Art allows people to speak to the wholeness of themselves — to their spiritual side. Suddenly, you’re able to say, I miss this person so much.’ You can also help ease your own journey through drawing, and through other things that are notoriously used with children."
Art therapy can be used successfully with adults, she re-emphasizes. "If given the opportunity, adults can be pretty open to what you give them if they think it will help them heal, and if it will give them a different lens through which to feel their pain."
At its core, what art therapy does is help people live with the differences that now exist in their lives, says Showalter. "Who you are now is not who you’ve been, and you can’t go back there," she says. "But after going through art therapy, people will look at me as if they’ve just discovered gold. They get it, and that’s the way they want think about it. When you are threatened with loss, you see through the eyes of a mouse; when you become more empowered, you look through the eyes of an eagle, and you see there is a way you can heal.
"Once you can begin to heal the spirit, and line up what the eyes see and what the heart feels, you’re on your way. People will walk in beauty again — they just need to do it in their time."
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