Thursday, August 11, 2011

Memorial Art Therapy

Art and its Usefulness as Therapy

Art is a form of communication, traditionally a visual language or assemblage of marks, sounds, ideas or feelings, which may not be communicable as interestingly, or provocatively in written form. Art therapy is a branch of art focused on an individual’s subjective, introspective experience of creating the art. The soothing and cathartic experience for the maker of the art and its lack of expectations make it an accessible and sought after form of therapy for those seeking emotional release from a grief experience.

Art therapy assists the bereaved to gain insight about themselves through the making of art. The art therapist conducts not to critique the art produced, but to evaluate and support survivors’ needs to come to terms with an emotional trauma that is otherwise too painful to investigate through other forms of therapy. The art provides a space of projection, a filter for comfortable self-examination that can be enjoyable and approachable for all participants.

Although we all share a human experience, because of culture, social stratification, the individuality of experience requires the establishment of a baseline from which to evaluate emotional wellness, world constructs, attitudes and outlook. Art media serves as a tool of experiential control for therapy. Additionally, symbols reveal associations and metaphors. Under the guidance of an art therapy counselor, the bereaved can use various media to express feelings related to their grief that would otherwise be too difficult to confront in a safe and or approachable manner. The art allows them to separate the event and or feelings from themselves to gain insight and perspective.

Working with Bereaved Couples

“Change creates loss and grief is how we react.” When one person in the relationship is ready to move on but the other is not, one person can crush the other’s self-esteem or prevent the grieving person from working through their grief at a healthy pace. Unreasonable expectations can lead to animosity and negative or destructive behavior. Working with couples to achieve understanding is of utmost importance because an unhealthy recovery from bereavement can lead to the disintegration of the relationship. Inadequate social or psychic support in events such as SIDS (Sudden Infant Death Syndrome), conflicted feelings after a suicide, or ambiguous unresolved losses like a kidnapping or runaway, often manifest in difficulties in sustaining the relationship. These types of loss are especially traumatic on relationships due to a lack of coping skills. Results from these losses may be low self-esteem, depression, questioning of one’s own faith, sleep disorders, poor impulse control, drug abuse, and other types of chronic emotional pain.

According to Rogers, “Grief is inherent in living – a part of our human experience. It does not need to be ‘fixed,’ ‘treated,’ or ignored. Grief needs to be lived as a normal emotional response to loss. It will be unique to each of us and there is no ‘normal’ timetable to ‘complete’ the process. Emotional trauma can lead to unhealthy coping behaviors that further put strain on relationships. Signs that a loss is not fully being resolved are mummification of the deceased’s room, or intense psychological responses to the deceased’s name coming up in conversation. When a partner’s mourning process is disregarded by the other partner, their family, and or friends, the misunderstanding leads to isolation, and intense psychological pain.

According to Elizabeth Kubler-Ross’ five stages of grief theory, grievers heal at different rates, passing through the stages of grief inconsistently. Each person will process grief differently and this can lead to problems in communication, resulting in negative interactions. For example, one spouse may be in denial of a loss and unwilling to accept the truth, while bargaining with God to bring back a lost loved one. The other spouse who has accepted the loss may have fallen into a depression. Consequentially, neither is able to meet on the same level with the loss and their inner world is threatened, with feelings of helplessness and isolation. This can sometimes lead to self-destructive behavior or betrayal, with the added risk of the relationship ending.

Sometimes a spouse can be a reminder of a traumatic event or loss. He or she may physically look a lot like the lost love one or he or she may have broke a sacred confidence that will never be regained. Bereavement can also be tied to an addiction, incarceration, domestic abuse, gambling, infidelity, etc. One may not bear to see, hear or be reminded of them without flashing back to the distress. In such cases, if the relationship is to survive, couples must find a new normalcy of living and establish a mutual respect and understanding of each other’s grief surrounding the loss event.

Couples can share unresolved anger and guilt through art making. Art allows survivors to objectify pain and healing from their bereavement through discussion and symbolism. Art allows the bereaved to express issues that may never have been addressed. Therefore, the survivor recovers because the making of art gives power to the artist. The introspective nature of the art necessitates nonjudgmental discussions in a safe, and supportive environment. Although the loss event may always be lying silently under the surface, relationships can emerge stronger when grief issues are transcended.

Group Dynamics

Bereavement groups bring trauma survivors of diverse personalities together in a dynamic setting of openness and self-expression. However, to maintain a healthy healing environment for group members, art therapists must manage the various strengths and weaknesses to provide effective therapy sessions. Therapists must be cautious about dysfunctional personalities to prevent them from derailing activities and must also place a priority on keeping the calm, therapeutic atmosphere necessary for effective grief work to be accomplished. Effective therapy groups collaborate well together and support one another to achieve their individual and collective emotional growth and wellbeing.

The bereavement coordinator may not have much flexibility as to who is a part of the group. Group members will often be of varying levels of maturity in their grieving process and personalities may clash due to the dynamic material engaged in the therapy work. Thus “in the various weekly sessions with each new expressive art there may be discussion on reconstruction of meaning.” The individual personalities within the group can add to facilitating or impeding growth. One goal as an art therapy group facilitator is to recognize group members’ emotional states and personal limitations, which reactions are normal or abnormal, and how to guide group activities towards promoting growth, personal wellbeing, and a supportive environment that facilitates grief work being undertaken.
In discussing group dynamics, Rogers (2007) discusses different personality archetypes encountered in the bereavement group setting including:

• The Advice giver – Use of domineering language
• The Self Righteous Faith Moralizer – Use of guilt or supernatural unknown to manipulate behaviors.
• The Talker – A self-absorbed person who monopolizes the group’s time seeking approval.
• The Challenger – A person who looks for fault with everything.
• The Small Talk – A person who uses chitchat to avoid uncomfortable topics.
• Speaker of the group - An overpowering personality speaking out of turn and thereby taking over the group.

The therapist’s understanding of these common personality manifestations is vital to plan each session to avoid dangerous situations. As Rogers points out, “as family, friends, and caregivers, the only gift we have to offer those who are grieving is the quality of our attention.” So an art therapist must manage the personalities of their groups as well as facilitate effective therapy. “Combining the support of the group and the use of physical and creative activities offer the grievers what they need most: acceptance and nonjudgmental listening.”

As Rogers points out, “the final session is Ritual, which is designed to bring the course together and allow healing through creative expression and ritual.” A grief group session may be closed out with the making of art and or a review of the art created. This art may be related to the discussions of the day, and can be an enjoyable conclusion to each session that group members will look forward to. The repetition of the activity also allows members to collect their thoughts and investigate feelings and or ideas in a group setting and nonjudgmental collective manner.


Ref:

Rogers, E. J. (2007). The Art of Grief: The Use of Expressive Arts in a Grief Support
Group. New York, NY: Taylor & Frances Group, LLC.
Kubler-Ross, E. (1969). On Death and Dying. New York, NY: Simon & Schuster


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