Self Experience of Being in a Group of Art Therapy
Tutor: Kate Broom Student: Te-Fang, Chiang (Pam) Student number: S12788976 January, 2013
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Contents Introduction Section 1 – What is group art therapy Chapter 1- A brief definition of group art therapy Chapter 2- The property of art in group therapy Chapter 3- The stages of group art therapy Chapter 4- Why use groupwork and art? Section 2 – Post-traumatic stress disorder Chapter 1 – when we recall our pain Chapter 2 – uncomfortable feeling Chapter 3 – what is post-traumatic stress disorder Chapter 4 – the symptoms of Post-traumatic stress disorder Chapter 5 – the recovery stages for Post-traumatic stress disorder Section 3 – what does all this means Chapter 1 – Emotion and its role in human functioning Chapter 2 – when you pass your pain to others Chapter 3 – the image is still hurtful? Conclusion – how I would use art therapy Reference 2
Introduction >> Whenever we suffer the different kind of pain, people around us always tell us ‘ be brave and keep carrying on’, ‘ don’t worry, it will passed’ or ‘ think at the bright side’. But why should we be brave? And how could we keep carrying on? And there is not only bright side! If you can see the light then there is must dark side. Since I was been taught whenever you suffer pain you cannot cry when I was child. Crying is the way showing your weakness and hopeless. So I have learned whenever I suffer the pain I have to pretend nothing happened. But after years and years, now I am 26 years old. I realized that the pain is still there buried deeply in my mind. When I face the things which connect with the pain, I still suffer by the trauma. And I become sensitive, anxious and depressed. Then why cannot I just face the pain? Before moving on the normal and strong life I think people should give themselves time for being cured maybe by themselves or others. We should keep brave after we can face the pain directly.
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Section 1 – What is group art therapy Chapter1 - A brief definition of group art therapy >> Group art therapy is using art therapy into the members of groups. The interaction is developed by the group members (including member to member and group leader to member) and the interaction promotes the changing and adjustability.
Section 1 – What is group art therapy Chapter 2 - The property of art in group therapy >> The art in group therapy is a way for combining the art therapy and verbal group therapy, and the property of the art in group therapy is during members attend the process of group, members use different material create their own creation by their unique way. According to their own speed and doing their own creation individually; meanwhile, during the individual creating the members are still the part of the group. This property of art therapy group can satisfy the two needs of the members: 1. Dependence: members desire to fit in the group and become the member of the group; 2. Alienation: members except that they 4
can have their own expression and space.
‘The work of some of the pioneers of art therapy certainly involved group work, usually in open studio settings, with an informal structure rather like that found in art school studios of the time (1950s and earlier). When they worked in hospitals,the majority of art therapists were reliant on their own experience of studio groups, or of teaching in adult education classes or school. In the hospital groups, patients would come and go, paint and draw in their own time when the studio was open and the therapist present. The interaction between the tutor/ therapist and the individuals in the room reproduced a familiar art student- tutor dynamic: individuals could discuss their work with the therapist and as this was supposed to be ‘ private’ it often consisted of whispered conversations in a corner of the room to the exclusion of other patients. Patients were often subtly influenced by each other’s productions in the shared space of the art room. The space became like the artwork itself – personal yet at the same time public and shared- and could be entered at the discretion of the artist/ tutor- therapist.’ (Diane Waller, 1993 )
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In addition, the main purpose of art in group therapy is to promote and change the individuals of the members. Not only focus on curing one mental disease. Using the objective perspective works on group and promotes the feeling of group members. Improving the self discovery of members and also promoting the social ability of members. These are different to psychotherapy.
As the tables show, art therapists saw their groups as aiming to enhance and sometimes change the personal and social functioning of the group members, rather than as a specific treatment for a particular disease. Their aims also tie in with Yalom’s curative factors for group therapy:
1. Instillation of hope: ‘ hope’ makes members continue doing treatment. It also makes the other curative factors work. According to the confidence of group art therapy is already maintaining the effect of treatment. 2. Universality Members can see the intercommunity between each other in group. Members find that they are not alone. Then members see the same difficulty and life experience with other members they feel released. 6
3. Imparting of information Including the right knowledge the group leader gives to member, or the advice and comfort from the members. 4. Altruism The members improve their self- respect during giving. Practicing the helping attitude overcomes the solipsism. 5. The corrective recapitulation of the primary family group Most of the members take the unsatisfied experience into group. However the group
makes the experience presenting to a correct way. Although the
members would be kept discovering and challenging, the members are encouraged discovering the new relationship and trying the new behavior. 6. Development of socializing techniques The property of group helps the members developing another social skill by observing the other members. 7. Imitative behavior According to Bandura, imitation is a effective power in treatment. During the group art therapy the members observe the other members and get the benefit from trying new skill. This is a vicarious therapy or spectator therapy. 8. Interpersonal learning 7
The interaction in group provides the members of the reasonable observation and rectified the emotional experience. 9. Group cohesiveness The group cohesiveness gives members the motivation of keeping to stay in group. Group cohesiveness helps the members giving the honesty, promoting the attendance in group and developing the meaningful relationship between members, 10. Catharsis Group art therapy makes the members opportunity to vent their emotion and release the pressed stress. 11. Existential factors ( such as inevitability of death ) Group art therapy presents ‘ apartness’. The members are separated, alone and apart from each other. Meanwhile, the members are the part of group. It makes the members feel comfort.
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Section 1 – What is group art therapy Chapter3 - the stages of group art therapy >> Corey indicated that there are six stages in group art therapy. The leader of the group has to control each stage and observe the factor in advantage and disadvantage. Then can help to improve the members. There are six stages. (Corey, 2000):
1. Pregroup – formation of group Include selecting the members, considering the character of group, the time, the space and doing the preparation for the members. 2. initial stage – orientation and exploration Making the members to learn the function of group, define the goal of members, clarify the expectation of members and know the importance of group. In this stage, the members test the atmosphere in group. If the members are willing to express their feeling then the group cohesiveness can be built up. The members start to define their position in group. 3. transition stage – dealing with resistance The members are afraid of being stared at, misunderstood, lacking the clear 9
goal and rules and the expectable behaviors. At this staged the members strengthen the defenses and anxiety. Therefore the group leader can teach the members of admitting and dealing with the conflict in group publicly. The group leader helps the members dealing with the resistance and provides the example of facing the challenge honestly. 4. working stage – cohesion and productivity At this stage the cohesion and trust are strong. The communication of each other is open, free and direct. The members admit the conflict and handle it directly and effectively. Meanwhile, the members give the feedback free and are willing to achieve the change of behavior out of the group. The members are full of hope in this stage. 5. final stage – consolidation and termination Facing the time is going over, the member might have the sadness and anxiety but the members also decide the action they want to do in next. The group leader has to strengthen the change of the members and assist the members using their new behavior in life. 6. Postgroup – follow- up and evaluation At the end of the group, group leader arrange the follow-up and evaluation for understanding the interaction in members. 10
‘There are five concepts central to the interpersonal approach. These are explicated in existential philosophy and psychology and therein, the authors suggest, lies the difference between this approach and analytically- oriented group psychotherapy. The concepts are as follows: 1. Human actions are not predetermined; freedom is part of the human condition. 2. The corollary of this is the importance of choice in human life. 3. It is essential to take responsibility for one’s actions. 4. Death is inevitable; but the fact that we shall all die can paradoxically give meaning to life. 5. We are each engaged in a creative search for individual patterns that will five meaning to our existence. ( Ratigan and Aveline, 1988: 45 )
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Section 1 – What is group art therapy Chapter 4 - Why use groupwork and art? >> Why use groupwork? ‘For therapists there is a choice between individual work and group work, so it is worth looking at the general reasons for using groupwork. The reasons for using groupwork can be summarized as follows: 1. Much of social learning is done in groups; therefore groupwork provides a relevant context in which to practice. 2. People with similar needs can provide mutual support for each other, and help with mutual problem- solving. 3. Group members can learn from the feedback from other members: ‘ it takes two to see one.’ 4. Group members can try new roles, from seeing how others react ( rolemodeling), and can be supported and reinforced in this. 5. Groups can be catalysts for developing latent resources and abilities. 6. Groups are more suitable for certain individual, e.g. those who find the intimacy of individual work too intense. 7. Groups can be more democratic, sharing the power and responsibility. 12
8. Some therapists/ group workers find groupwork more satisfying than individual work. 9. Groups can be an economical way of using expertise to help several people at the same time.
However, there are also some disadvantages: 1. Confidentiality is more difficult because more people are involved. 2. Groups need resources and can be difficult to organize. 3. Less individual attention is available to members of a group. 4. A group may be ‘ labelled’ or acquire a stigma.
Why use art? So far most of the reasons and purposes given apply to any kind of group. It is worth drawing out the aspects of groupwork which are particularly enhanced by using art as the group activity: 1. Everyone can join in at the same time, at their own level. The process of activity is important, and a scribble can be as much of a contribution as a finished painting. 2. Art can be another important avenue of communication and expression, 13
especially when words fail. The spatial character of pictures can describe many aspects of experience simultaneously. 3. Art facilitates creativity. 4. Art is useful in working with fantasy and unconscious. 5. Art products are tangible and can be examined at a later time. 6. Art can be enjoyably, and in a group this can lead to shared pleasure. ( Marian Liebmann, 1986)
Section 2 – Post-traumatic stress reaction Chapter 1 – when we recall our pain >> While I was studying in the first term of art health and well-being, I can still remember there was one time when we had the subject called ‘ draw your pain’. The rule is you have to draw your pain on paper and then pass your paper to next classmate. The next thing about your classmates have to do for you is to help you covering or curing your pain by their drawing. I remembered that it was really hard for me to do ‘ draw your pain’. Why it is hard for me? Because I have to recall the uncomfortable feeling from my mind. Whenever I recall the pain again I can feel there is the pain comes again. And all the bad 14
feeling about the pain shows up. The image of the pain was so clear. It was even like a video, you can tell the whole story about your pain. ‘This is the process for all ‘ traumatic’ events. The process involves the generation of very powerful emotions that threaten to overwhelm the ego’s ability to function. This is the context of Freud’s often-quoted statement that people with hysteria ‘ suffer from reminiscences’. Memories are charged with strong emotion, or are highly stylized and emotionless. Freud cited clinical examples of ‘ intact’ memories of traumatic events and noted the strong emotions that were expressed by patients. The alarming implication of this finding for Freud was that the traumatising events were being perpetrated in the home by family members. Here was the first instance of the study of trauma pointing to some very disturbing aspects of western family life, structure and character.’ ( Colin Wastell, 2005)
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Section 2 – Post-traumatic stress reaction Chapter 2 – uncomfortable feeling >> There were two funerals in my life before. One was my father who was dead in heart attack and another was my grandmother who wad dead in cancer. Both of the lost have influenced me a lot. I can still remember the last seen of my father who died in hospital and the last three days of my grandmother who chose to die in her own house instead of in hospital. The cold hands, unavailable speaking lips, the blood from the mouth and the purple color on his skin. Those symptoms showed my father was already gone. The skinny body, the orange color on her skin, the unavailable opened eyes and the shaken hands. Those symptoms showed my grandmother was near dead. These were my pain. So I drew dead body who lied down on a bed with cover on his body and face on paper.
‘By definition trauma involves threat to life and very often in traumatic situations someone may die. The death of a loved one in traumatic circumstances can come with such suddenness and ferocity that nothing can mediate the intensity of the loss. There is no preparation for, or 16
anticipation of , death.
However, it is not just loss of another which leads to bereavement following a trauma. Often it can be what is felt to have been lost. The person may have lost a sense of who he or she was; ‘ the protective mother’ or ‘ strong man’, he or she may grieve over lost plans or potential or what could have been done differently at the time of the incident. What is clear is that there is a pattern to human grief which can include shock, disorganization, denial, depression, guilt, anxiety, aggression, resolution and acceptance and reintegration. ( Thom Spiers, 2001)
Section 2 – Post-traumatic stress disorder Chapter 3 – what is post-traumatic stress disorder >>
‘An anxiety disorder in some individuals who have experienced an event that poses a direct threat to the individual's or another person's life. The characteristic features of anxiety disorders are fear, particularly in the absence of a real-life threat to safety, and avoidance behavior. 17
A diagnosis of posttraumatic stress disorder requires that four criteria be met. First, the individual must have been exposed to an extremely stressful and traumatic event beyond the range of normal human experience. Second, the individual must periodically and persistently reexperience the event. This reexperiencing can take different forms, such as recurrent dreams and nightmares, an inability to stop thinking about the event, flashbacks during which the individual relives the trauma, and auditory hallucinations. Third, there is persistent avoidance of events related to the trauma, and psychological numbing that was not present prior to the trauma. Fourth, enduring symptoms of anxiety and arousal are present. These symptoms can be manifested in different forms, including anger, irritability, a very sensitive startle response, an inability to sleep well, and physiological evidence of fear when the individual is reexposed to a traumatic event.
(http://encyclopedia2.thefreedictionary.com/Post-traumatic+stress+reaction)
There are three reason of the post- traumatic stress disorder sometimes is ignored by patients: 1. The symptoms sometimes show up in months or years after the event. This period makes people is hard to connect the symptoms and the event. 18
2. Patiens believing in ‘ I can get rid of this symptom myself’, ‘ this would not absolutely happened to others’ or ‘ other must have the ability to solve this problem. Therefore extend the time for searching help from others. 3. Guilt, blame and pain also extend the time for searching help form others. 4. Avoid to touch anything which is connect with the trauma of events, therefore extending the time for searching help form others.
Section 2 – Post-traumatic stress disorder Chapter 4 – the symptoms of Post-traumatic stress disorder >>
‘PTSD can cause many symptoms. These symptoms can be grouped into three categories:
1. Re-experiencing symptoms:
Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
Bad dreams
Frightening thoughts.
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Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.
2. Avoidance symptoms:
Staying away from places, events, or objects that are reminders of the experience
Feeling emotionally numb
Feeling strong guilt, depression, or worry
Losing interest in activities that were enjoyable in the past
Having trouble remembering the dangerous event.
Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
3. Hyperarousal symptoms:
Being easily startled 20
Feeling tense or “on edge”
Having difficulty sleeping, and/or having angry outbursts.
Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.’
(http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-pt sd/what-are-the-symptoms-of-ptsd.shtml)
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Section 2 – Post-traumatic stress disorder Chapter 5 – the recovery stages for Post-traumatic stress disorder >>
‘Much as in traumatic events we experience, there are also stages of recovery for Post-traumatic stress disorder. Most sufferers would alternate between these stages randomly. Nonetheless, you can observe general patterns of behaviour that’s true for the most part to distinguish which stage the sufferer is already in.
Stage 1: Emergency/ Outcry Stage. The onset of a major anxiety attack that manifests in intense physical reactions (hyperventilation, rapid breathing and
pulse and elevated blood pressure). At this stage, the victim finds himself/ herself in a situation that triggers the “fight or flight” response and makes the victim feel extremely helpless. Fear overtakes them almost completely.. such that when they’ve finally emerged from this situation, they often feel confused about what just happened.
Stage 2: Emotional Numbing and Denial Stage. The classic case of “sweeping under the rug”, pretending they never happened to avoid any emotional responses. There are many who don’t actually move on from this stage. Hence, 22
it’s crucial for caregivers and/or loved ones to pick up on these symptoms to help the sufferer seek help.
Stage 3: “Intrusive-Repetitive” Stage. Flashbacks, major mood swings, irrational behavior are what characterize this stage. At this point in time, the sufferer begins to confront the trauma that started it all. Victims are more prone to being easily startled. Many manifest antisocial behavior, fearing that contact with the outside world would either trigger another repressed memory; or feel that they’re too vulnerable to have normal interaction with the outside world.
Stage 4: “Reflective-Transition” Stage. The survivor by this time has reached a point where they are able to slightly distance themselves from the situation and see it from a bigger perspective. At this point, he/she has begun to move forward with a more positive and constructive frame of mind, with the full intent of moving on. Many refer to this as the healing process where they are finally able to confront the trauma and deal with it.
Stage 5: Integration Stage. At this point, the survivor has finally recovered from the trauma, and has successfully reintegrated into society. He/she has overcome the trauma, and can now deal with it without causing intense
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feelings of fear, anxiety and despair. He/she can finally find peace within himself/ herself and move on to have a happy, full life.’
(http://livingwithptsd.wordpress.com/2010/09/28/recovery-stages-for-ptsd/)
Section 3 – what does all this means Chapter 1 – Emotion and its role in human functioning >> ‘An introduction to the role of emotion in general human functioning, and especially in trauma. The terms ‘ emotion’, ‘ affect’ and ‘ feeling’ will be treated as equivalents. In many cultures, and especially in the West, displays of emotion are not encouraged as they are associated with weakness. A number of researchers have taken a different view, and regard emotion as both adaptive and central to normal human functioning. Its role in trauma is life-preserving, through the activation of responses such as flight and fight. If the physical and psychological mechanisms associated with emotion’s role in trauma remain activated, then problems will arise.’ ( Michael J. Scott & Stephen G. Stradling, 1992)
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Section 3 – what does all this means Chapter 2 – when you pass your pain to others >> During the practice of ‘ draw your pain’ in class, the next step is to pass your pain to the next. But the next have to cure or cover your pain by their drawing. This step gave me the impressive meaning. When I was in pain, I felt sorrow and I could only focus on myself. The moment was like I was in a dark room with only one light which spots me alone. Like I was the only character in the story, I can hardly to find out what kind of pain the other people had. When the group leader said ‘ ok, stop, now pass your pain to other’, suddenly it lights up, the room is not dark anymore. The paper in front you is the pain from another member. You can still tell how hurtful she or he was during seeing their drawing by the color or the score. But now it is your turn to cure or cover their pain. I found that it is easy for me doing this action. But why? Because this not your story? Because you do not put yourself on the main position anymore? In my mind, I always know how to be brave and positive. I can do a lot of things to make people feel happy and joy. But why cannot do this to myself to cure myself? After passing your pain to the others, I finally got my pain back. The 25
interesting thing was, it was hard to recognized what was the original pain I drew before. It is a hopeful and light painting now. And I did feel the ways how people want to support and help me. Although I did not explain my pain to others I can still felt the positive power from the other members.
Section 3 – what does all this means Chapter 3 – the image is still hurtful? >> During sharing the trauma by drawing to others instead of using word to speak the pain out, it could be easier. Sometimes it is hard when you try to explain your pain to others. But the point is not about members have to understand your pain well. The most important thing is you have to know how to share it with others. Whenever you know and try to share the pain with others then you would know the pain now could just be the drawing. The pain could be just a image for you not a whole story. You received the company and support from the members in group. They are not just using words to convince you, they are using their action to help you go through the pain. People used to sharing their pain by word to convince you they had had bad memory before too. But when we suffer the pain, we do not want to compare 26
how worse you were before. Maybe we just want to have the company and comfort. We do not need people tell us how to do it to stand up again. We already know a lot of positive thinking, it is just hard for us to do it. We are looking for a way to speak the pain out like art.
Conclusion – how I would use art therapy >> When people suffer the pain from events, no matter the events are big or small. There are always trauma built up in mind, the trauma might be light or deep inside. But if you do not try to cure the trauma, it could fester in your mind. Whenever you face the familiar events the deeply trauma inside would remain you the pain again. ‘Memory is often conceptuallised as a storage and categorization system for incoming stimuli. The creation of memory schemas results in the integration of information. Human beings look for patterns, not merely isolated bits of information. The role of the central nervous system (CNS) in memory is pivotal for the recall of events. When the CNS is activated in alarm, the memories associated with that alarm mode are recalled in similar states of alarm. This is also the case when memories are accessed from non27
traumatic situations- for example, by smell or image. The memory evokes the traumatically associated emotions, and the survivor re- experiences the trauma as though it were occurring in the present! The extreme emotions generated interfere with coherency of experience and memory storage.’ ( Cloin Wastell, 2005) Looking for a way to express your pain becomes a very important thing. By using art to express your feeling and share with others, I will not hesitate to express my feeling by art. Art is more impressive and clear to express my feeling. I can even use art to communicate to myself when I am alone. Whenever I feel stress, depressed and anxiety, I can always use art to convey my feeling. Different color and material can express my feeling well. The process of art therapy makes me understanding myself well. Understanding the problem of myself and how the problem was created. ‘ knowledge’ itself is important, but not enough for living for a great benefit of life. The most important thing is how to practice the knowledge into the real life and how to move on the life with trauma. By using art therapy I know how to handle those problems in life in a new way or thinking. The process of art therapy might not give the happiness to people, but it is a tool for handling the problem that life gives us. 28
Reference Cloin Wastell., 2005. Understanding Taruma and Emotion. Berkshire: Open university press Diane Waller., 1993. Group Interactive Art Therapy. London: Routledge Living With PTSD [online] Available at: http://livingwithptsd.wordpress.com/2010/09/28/recovery-stages-for-ptsd/ [accessed 05 January 2013] Marian Liebmann., 1989. Art Therapy For Groups. London: Routledge Michael J. Scott & Stephen G. Stradling., 1992. Counseling for post- traumatic
stress disorder. London: SAGE Publications Ltd National Institute of Mental Health [online] Available at: http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-pts d/what-are-the-symptoms-of-ptsd.shtml [accessed 05 January 2013] Thom Spiers., 2001. Trauma: A Practitioner’s Guide To Counselling. East Sussex: Brunner- Routledge The Free Dictionary [online] 29
Available at: http://encyclopedia2.thefreedictionary.com/Post-traumatic+stress+reaction [accessed 05 January 2013]
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