January 2002 - Check Your Head

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Let the Pictures Do the Talking
Well-Heeled

Let the Pictures Do the Talking
by Jodi Helmer

For women like Daniels, art therapy offers a healing alternative to traditional therapy. �Art therapy is more peaceful [than talk therapy],� she says. �In group [talk] therapy, everyone may not get the chance to talk, but in group art therapy, everyone gets a crayon. Art therapy gave me a period of time to work on something finite, and finishing it made me feel successful.� Although people have known for centuries that art offers a means of self-expression and self-healing, it wasn�t until the 1930s that art therapy was recognized as a field of psychology. Since then, studies have shown that art therapy can decrease emotional conflicts, foster self-awareness, improve social skills and decrease post-traumatic stress.

�Art therapy allows you to develop a map of your inner self through non-verbal expression,� says Heather Cohen, a licensed art therapist in Portland, Ore. �Art therapy is very safe because it gives the boundaries of color and space, and unlike talk therapy, art therapy is a practice you can take with you and work with on your own.�

Hospitals have found that working with crayons or clay can help increase the mental and physical, health of cancer and AIDS patients, while physical therapists have found that disabled patients or stroke victims can often express themselves more easily with pictures than words. And art therapy even has benefits for those who don�t pick up a paintbrush - studies have shown that merely looking at art can decrease stress and alleviate depression.

Like traditional therapy, art therapy sessions can range from one-on-one sessions to couples counseling to group work. In art therapy sessions, the materials are carefully chosen for their effectiveness with various mental health issues. �Psychotic clients need small paper and pencils - large pages and lots of color are too much stimulation,� explains Cohen, �and clay is great for anger issues. The squeezing of the clay, kneading it and working with it, provides an emotional release and acts as a safe place to put anger.� For people using art at home, Cohen suggests focusing on materials they�re drawn to rather than ones they think they�ll be good at.

In her practice, Cohen provides a variety of materials, including paper of all sizes, paint, crayons, collage materials and a lot of tactile materials - glitter, feathers, stickers and textured papers - anything that a person might be drawn to. Cohen says that sharing art materials with a patient helps to build trust. �When a client is interacting with your materials, it�s like they�re interacting with you,� she says. This is particularly true for those suffering from autism. �Sitting beside an autistic client and drawing exactly what they�re drawing is a way of relating to them through the art materials without invading their space,� she explains.

While many women seek the guidance of professional art therapists like Cohen, others choose to explore art therapy in a more fluid setting. Annie Danberg co-facilitates painting retreats along with Stuart Cubley of The Painting Experience. The retreats, which range from three days to two weeks, help stimulate personal growth through creative risk-taking. �Painting helps you create a connection to your natural creativity without the pressure of having to get it right,� says Danberg, who started taking workshops with The Painting Experience in 1997 and began co-facilitating in 2000.

Between 75 and 90 percent of participants in The Painting Experience workshops are women. Danberg believes women have a greater inclination to seek the benefits of creative healing and are more willing to engage in expressive and experiential exploration - the foundation for exploring the healing benefits of art. �Healing comes in accepting ourselves in the present moment,� she explains. �We�re always trying to get to some better imagined experience. Art-making puts you in a timeless place and allows you to be deeply present with what is.�

Danberg says many women�s reluctance to explore their creative side lies in the difficulty of letting go of perceived expectations. She believes that part of her role as co-facilitator of The Painting Experience is to help women get past that interior critic and find the joy in creating. �When someone says, �I hate my painting,� I ask them why, and I support them through their self-judgments and help them continue to create,� Danberg explains. For Chelsea McElroy, the timeless place of self-discovery was Esalen, a retreat place of healing and rejuvenation in northern California�s Big Sur. The 30-year-old California native spent a month living at Esalen and participating in painting workshops. �When I first got there�I kept saying, �I can�t paint,� but my instructor told me, �we can all paint.��

For McElroy, learning to tame her inner critic was central to her experience. �Painting has a lot to do with my self-worth and insecurity,� she says. �Most people don�t think about how therapeutic art can be because we�ve been judged and have developed insecurities, and we�re scared of what people are going to think, so we don�t express ourselves. Once I let go of those expectations, I found painting very freeing.�

Painting also forced McElroy to confront issues she�d been ignoring. During one exercise, where participants were asked to trace the outlines of their bodies on butcher paper and fill the silhouettes by painting how they saw themselves, McElroy broke down. �I just couldn�t paint myself,� she explains. After releasing her emotions, she realized she�d begun painting herself as she wanted others to see her, not as she really was. �I had to decide who I wanted to be,� she says. McElroy went back to her outline, plunged her hands into the paint and smeared different colored paint throughout her entire silhouette. �Putting my hands in the paint and smearing the colors was my way of saying, �I am all of these things all mixed together.��

Art therapy doesn�t end when the artwork is completed. The artwork itself can offer important clues and breakthroughs. For McElroy, keeping her artwork was an important part of the healing process. Like a journal, McElroy keeps her artwork very private, but she often looks at it because �it reminds me of who I was at the time and what I�ve been through.� Daniels also found that analyzing her art was insightful. �When I was depressed, my drawings were very symmetrical because that�s what made me feel in control and organized,� she says. But, in the end, she threw away the art she produced and says it was a cathartic move. �I identified what the art meant, and I threw it away,� she explains. �I felt sad because it was a part of me, but it also reminded me of the bad times.�

It�s been months since Daniels has worked with her art therapist, and she believes that art therapy was highly effective in treating her depression. Now, she continues to use the tools she learned in art therapy at home by purchasing paper, paints and crayons and by including artwork in her journals.

Daniels believes art therapy helped her battle depression by reminding her of everyday beauty. �It�s so good to recognize art as a way to look at beauty in the world,� she says, �even if it�s just in the color of an oil pastel.� Art therapy has also provided Daniels with a new avenue from which to see herself. �I feel a lot more creative now,� she says. �I�m starting to do a lot of creative things I let go of when I was depressed. I�m beading, cross-stitching, knitting, making gifts and even considering taking a pottery class. I would do art therapy again in a heartbeat.� NG

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Well-heeled
by Becky Brun

We are accustomed to watching Seeing Eye dogs help their owners cross busy streets, but it�s not as often that we see people with Post-Traumatic Stress Disorder (PTSD) enter a 7-Eleven with a dog. When Michelle* brings her psychiatric service dog, a Rhodesian Ridgeback named Grace, to the office, she does not simply want companionship at work. Once housebound, Michelle was afraid of strangers, would repeatedly miss work, and went hours without eating, using a bathroom, or talking to anyone. She would lock doors, unlock them, and relock them again. Her anxiety led to panic attacks and hallucinations. After being diagnosed with Post-Traumatic Stress Disorder, Psychosis, Obsessive Compulsive Disorder, and Agoraphobia, Michelle tried a combination of talk therapy and medication to treat her mental illness, yet her symptoms persisted.

But then she was introduced to psychiatric service dogs (PSDs) as a third type of treatment, and Grace became the final prescription for Michelle�s physical and emotional health. By placing her paws on Michelle�s lap and licking her face, Grace draws Michelle�s attention away from the anxiety she is feeling. Grace also wakes Michelle up for work, turns on the lights when they enter a darkened room, and alerts her to take daily medication. �I have Grace in my life not only to ensure unconditional love,� Michelle points out, �but to make sure I do what I need in order to hold down a job and take care of myself.�

Traditionally, people think of service dogs as those that assist people with physical disabilities, such as blindness. But what isn�t as well known is that service animals can help people overcome psychiatric disabilities as well. New research shows that dogs, cats and even ferrets offer a drug-less solution to bipolar disorder, schizophrenia and other psychiatric disorders. In 1990, the Americans with Disabilities Act legally defined service dogs as �Any animal/dog individually trained to do work or perform tasks for the benefit of a person with a disability.�

People have known of the strength of the animal/human bond for many years. In the 1970s, the Delta Society was founded to examine the quality of the relationship between pet owners, pets and caregivers. Through their research, Delta showed the positive effects of animals on human health and well being. Thirty years later, its mission to �improve human health through service and therapy animals� has helped people with and without physical and psychiatric disabilities experience the therapeutic effects that animals can provide. Joan Esnayra is the founder of Psychiatric Service Dog Society, a non-profit organization that is dedicated to education, advocacy, research and training facilitation. In 1997, she coined the phrase �psychiatric service dog,� a term used to differentiate these dogs from �emotional support dogs.� Esnayra has helped Michelle and many others by creating an online resource (www.sdid.net) for people with invisible disabilities who own or would like to adopt and train a psychiatric service dog. The Web site serves as a forum for people needing education, support and advice about psychiatric service dogs.

An owner of a psychiatric service dog herself, Esnayra has experienced the benefits of using a service dog in conjunction with medication and talk therapy. �Service dogs help us negotiate the emotional phenomena we experience in our illness,� she says. �The therapeutic benefit that we receive from interacting with our PSDs goes beyond task training: the relationship itself is healing.�

Andrea Wall is co-owner of Pawsitive Resources, an organization that offers workshops on animal-assisted therapy to pet owners in the Portland, Ore., area. Animal-assisted therapy animals and their handlers visit nursing homes, hospitals and other places where people might benefit from an animal�s friendship. �Many people who are certified with their therapy animals say that it is the most rewarding volunteer work they have ever done,� says Wall. �Volunteer coordinators at health care and educational facilities are thrilled to have these high quality volunteers sharing the bond they have with their animal, be it dog, cat, rabbit, horse or llama.�

For animal-assisted therapy teams to become certified through Pawsitive Resources, they must take an eight-hour class or home study course, pass a written test, get a health screening of their animal, and pass a physical test that simulates going to a health care facility and interacting with new people.
Dove Lewis Emergency Animal Hospital in Portland, Ore., has a waiting list of organizations requesting animal-assisted therapy volunteer teams. Therapy teams visit residential treatment facilities, rehabilitation centers, juvenile detention centers, hospitals and a variety of other places. Currently, teams visit the Morrison Center�s Rosemont residential treatment home for teen-age girls once a week. �These girls have problems getting close to people for various reasons,� says Nancy Grant, special programs coordinator for the Morrison Center�s residential programs. �The dogs help reduce the girls� anxiety because the girls are able to whisper to them, show them affection, and care for them.� The girls in this treatment home often come from homes where human and animal well-being are not highly valued. Those values start reversing as these girls watch the animal-assisted therapy teams model responsible pet ownership and respect.

Barb Seipp and her dog, Dewey, went through the Dove Lewis program to become certified to work with people in Hospice programs, which offer holistic care for the dying. When asked what prompted her to enroll in the class, she simply answered, �Dewey.� A gentle greyhound/retriever mix, Dewey has a tendency to put people at ease. �He is such a lover,� Seipp says. Many Hospice patients are widows or widowers who have lost many friends and family, leaving them without a great deal of love and affection in their lives. �Giving love is just as important as getting it,� notes Seipp. During their visits to Hospice, Dewey often props his head up on the patient�s bed in a plea for attention, a behavior that the patients are often not used to. Dewey prompts conversations between Seipp and the patient that usually begin on a superficial level but segue into talks about real feelings and events.

Currently, there are more than 20,000 service animals and nearly 10,000 animal-assisted therapy teams in the United States. Both service and therapy dogs have shown that the human-animal bond can extend beyond simple love and affection.
For Michelle, a psychological service dog provides not only the confidence to travel outside of the safety of her home, but also the strength to spread awareness and educate others about psychiatric disabilities. Like many others with PSDs, Michelle still has to fight store owners, bus companies and hotels to ensure compliance with the American with Disabilities Act. �I make sure that Grace is respectful of others when we are out,� Michelle says, �and I expect the same in return.� Although Michelle still suffers from multiple illnesses, she says Grace has been an effective means of helping her regain control of her life. NG

Becky Brun is a freelance writer in Portland, Ore.


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