Art Therapy

            How many among us have used any form of art to help ourselves get through a difficult time in our lives?  We often listen to music that reflects our moods or hum a tune that reflects our disposition at that time.  Some of us would write a journal, paint or draw, or even dance to express a sentiment or experience that we are having. 

            I have met a few people who profess that art helps them deal with the realities in their lives.  It helps them celebrate the positive, and go through the less pleasant, even painful, situations in their lives.  Art offers an avenue of expression, a way of making sense of an experience. 

            This is the basic principle that guides the practice of art therapy.  In expressing oneself using any art medium (i.e., visual arts, performing arts, music, literature, etc.), one is able to go through an experience and find growth and healing in the experience.  This is when we believe that art is therapeutic, and merely expressing oneself using an art form is enough for psychological healing to take place. 

            Now, it is easy to think at this point that one has to be trained and therefore very good in a particular art form in order to make art therapeutic.  Whereas this is the experience of many trained and talented artists, it is really not necessary to be schooled in a strict discipline of a particular art form for any of us to use art as a medium of expression.  In fact, we don’t have to be very good at it in order to use it as a therapeutic medium.  So, any of us would, in fact, benefit from expressing ourselves using any art form that we find at least suitable for us. 

            For many psychologists, the manner of expression used in a specific art form is also indicative of the experience and the feelings that punctuate it.  This means that our behaviors and the subtle choices that we make in going about doing an art form is also a source of information that can help us gain insight about ourselves and what we might be going through.  This process is often initiated through reflecting observations and asking clarifying questions.  With some reflection on one’s own thoughts and feelings, an individual can gain much insight and understanding of themselves and their process. 

            In effect, art can be therapeutic in itself.  Doing art can promote insight and can also be healing.  At the same time, the art product and the process that one goes through in this production can likewise be used as a means of making meaning and expounding on one’s experiences.  These two ways of understanding art in the context of counseling and psychotherapy, art as therapy and art in therapy, are the two main forces in the practice of art therapy. 

           In many countries, the practice of art therapy is governed by an organization of practitioners or, in some cases, even by law.  In the Philippines, there is neither such organization nor law that guides the practice of art therapy.  However, it is often seen as a specialized area of work for psychologists and artists.  Although I am not an art therapist and would not identify myself as such, I often incorporate art in my work with clients.  I find that clients, both children and adults, are sometimes better able to express themselves through means other than just talking.  

Stigma in the Name

            If you had a headache, would you like to be called an “acher” or simply a person with a headache?  When you are referred to as an “acher,” then this ache defines you.  The ache is who you are.  When you are referred to as the person who has a headache, then you are not defined by it.  It is simply something you have—you might suffer through this seldom or more often, but it clearly does not define you. 

            I must admit that this example I just gave is preposterous, even hilarious.  Who would ever think of calling oneself or another person an “acher,” (Is there even such a word?) just because that person had a physical ache of some sort.  I guess I wanted to show how parallel this example can be to what we frequently do with the diagnoses of many illnesses, not the least of which are mental illnesses.  For example, we often call a person who has Diabetes to be Diabetic.  As far a mental illnesses are concerned, there are more examples, such as, “manic” for those who are in a state of mania, “depressed” and “anxious” for those suffering from clinical depression or anxiety disorders, “phobic” for those with unusual fears, “schizophrenic” for those who have schizophrenia, etc.  The list goes on. 

            Although more cumbersome, the Diagnostic and Statistical Manual for Mental Disorders (DSM, the American diagnostic manual used in diagnosing mental illnesses) recommends that we refer to persons as having this or that mental illness rather than making the diagnosis identify them.  On one hand, it is just a politically correct and accurate way of stating the condition of the person.  On the other, it de-stigmatizes the person and detaches them from their diagnosis.  They simply have this illness, rather than the illness being who they are. 

            This practice of saying that a person has a certain condition or illness can also be liberating.  It helps the person think of themselves as being greater than what it is they have.  It also helps others to see that these people who have this or that condition or illness have other characteristics and traits that make them persons, and not simply a category in one’s minds.  And so, it is a perspective that offers further consideration and a potential for further growth.   

            In many everyday conversations, many of us are guilty of poking fun and trivializing people who may have a condition or mental illness.  Perhaps this is a response to the awkward and ignorant fear of the reality of mental illness in our midst.  It could also be a way of distancing this reality from our own experience, a way of denying that such a condition can befall us too.  We call such people by many names, names that we ourselves would never approve of being used on us.  And yet, many mental illnesses are treatable, just like many illnesses are.  This makes identifying the person to be that illness rather inaccurate and useless. 

            The stigma of mental illness is perpetuated by our own lack of understanding.  If we can only begin by referring to people to have such and such condition or mental illness, rather than identifying that person to be that illness, then maybe we can lessen the stigma of these conditions or mental illnesses. 

Suicide and Suicide Risk

            I was in college when someone I knew, a former classmate, in fact, committed suicide.  It was the first time in my life that I had known anybody kill him/herself.  When friends gathered for the wake, the common questions asked were, “Why?  What would drive a person with a promising future to the point of ending his/her life?”  Of course, these questions were never fully answered.  A young person ended his own life, and also cutting any possibility of justifying his/her actions.      

            In the wake, I heard many of our mutual friends make references to times when this person actually talked about dying and ending his life.  Being the curious person that I was, I asked what they said when they heard such talk from our friend.  One simply dismissed him by saying not to talk about “silly” things.  Another did not know what to say and simply let it pass.  Yet another confronted him and accused him of being a coward for even considering this option.   I must admit that at that point in time, I also did not know what to say or do if someone I knew actually told me that he was thinking of dying or killing himself. 

            So, what can you do as a friend or family member when someone you know tells you that they are thinking of ending their lives?  Here are my suggestions:

-   These threats must always be taken seriously, and the first thing is to understand how serious that person is about ending his/her life.  Is it just a passing thought or have plans been made as to how and when the suicide will take place?  The more concrete and accessible the plan, the more serious it is regarded. 

-   It is best that the person has company.  If you cannot be there, make sure that he/she is accompanied by another person.  Suicide is often a lonely act, and having company actually prevents it. 

-   Listen to the person.  Ask him/her questions and engage him/her in a conversation.  Be with that person and try to feel what he/she is feeling.  Knowing that someone cares can make the person feel supported. 

-   Encourage the person to engage in self-soothing activities.  Taking a warm shower, burning some scented candles, getting a massage or eating comfort food are some things that can help the person feel better.    

-   A professional consult can often help in making a more thorough assessment and implement relevant intervention.  So, report this to an authority figure who will follow through with prompt action.  Psychologists or psychiatrists are the professionals who can help, and seeking their assistance is warranted. 

-   Take care of yourself, delegate responsibility, and avoid being the only caregiver of this person.   

There are also a few things that a friend or family member should not do, and they are as follows: 

-   Do not overlook or trivialize these thoughts and verbalizations of suicide.  They are always to be taken seriously.  If you know you cannot help, report immediately to the person’s relatives or authority figures (e.g., teachers, boss, etc.). 

-   Do not promise to keep this information confidential.  You need to tell such crucial and possibly life threatening information to others, so as to get appropriate assistance. 

-   Do not take it upon yourself to care for the person who is at risk of suicide.  You need to take care of yourself; you owe yourself at least that.  Help, but only to the extent that you are still able to care for yourself. 

-   Avoid drinking alcohol.  Alcohol is a depressant and can make the situation worse for the person. 

            On 21 May 2011 (Saturday), I will be facilitating a seminar-workshop on assessing and responding to suicide risk.  It is meant for various professionals (e.g., mental health workers, teachers, managers, etc.) who would like to have a greater understanding of how suicide can be assessed, and knowing what kind of response is appropriate.  If you or anyone you know are interested to participate, please call PsychConsult, Inc. at (02)4212469, (02)3576427, or (0917)8080193 for details and reservations.  You can also email psychconsult@gmail.com.  Do call now as slots are limited. 

Managing Anger (2)

            Last week, I wrote about managing our emotions through calming our bodies through relaxation techniques.  Relaxing ourselves is a good first step to managing anger, and we cannot stop there.  We need to address the source of our anger by understanding it in a fuller manner, and deal with it constructively. 

            Understanding our needs (see the post entitled Of Basic Needs and Inner Harmony posted on 30 April 2010) might be the next step in knowing what it is we really want from this situation where we find ourselves getting angry.  This often takes some time to think about, and you might need to be calmer and alone.  So, leaving the situation that makes you angry might be necessary at this point.  Is it something you or another person can do something about?  If so, what can you do or how can you ask so that you get some form of what you want that fulfills your needs?  If not, how can you best accept the situation as the most natural thing in the world?   

            Another thing that you might want to do is to reassess how you are thinking about your situation.  Asking yourself questions such as the following can help you think of other ways to make the situation less provocative: 

·         How can I interpret the situation in a way that is less irritating/annoying? 

·         What particular thoughts cross my mind that make me angry?  Are there alternative ways of seeing the situation, albeit remote, that would make this situation better for me? 

·         Is there anything funny about all this?  What about the situation can I take less seriously? 

·         To what extent are your thoughts accurate or exaggerated?  How can you tweak them to reflect reality better?   

You might also want to look at changing some of your thoughts and beliefs about the situation by challenging the thoughts that make you angry.  For a more detailed discussion on this, you might want to refer to the article I posted in this blog on 06 August 2010 entitled ABC-DEF in Managing Our Emotions. 

            Being able to express yourself in a non-threatening and calm manner is the key to being able to communicate to others what you are thinking and feeling.  This can also aid in asking for what you need and negotiating (see my post on this blog entitled Neogtiation as Conflict Resolution dated 22 November 2011) with others.  Assertiveness skills is certainly part of this. 

            If you can’t seem to get a good grasp of managing your emotions consistently, it might be a sign for you to seek professional help.  Now, please don’t think that I am suggesting that you are crazy and that’s why you need help.  As a matter of fact, I think that many of those who seek help are those who are mature enough to admit their areas of improvement and seek venues to make things better for themselves and others. 

            Essentially, what psychologists and counselors will do would be to explore how you experience and manage your emotions, including your triggers and other habits that sustain the anger.  This is helpful information in learning about yourself better, which may be key in helping you manage your feelings more effectively.    

Managing Anger (1)

            When we are angry about something, there are many ways we choose to behave as a way of dealing with this reaction.  Some people are more effective than others in being able to manage these feelings. 

            Suppressing anger is certainly not the answer.  This often just complicates matters, as anger will find expression in other things. 

            Let’s face it, we can’t change other people.  Often times, we are also angry because we cannot change the situation that caused us to feel angry.  If we could, we would not be this angry to begin with.  So, no matter how much we rant about the person or the situation, these will not change. 

            The only thing we can change is our own reactions.  Now, don’t make the mistake that I am implying that we should pretend that we are not angry all of a sudden and behave differently.  That would be suppressing.  In fact, the first thing to do is to acknowledge our anger.  So, ask yourself, “How angry am I?” You might even rate yourself on a scale from 1-10 how angry your are (it can be that 10 is that you are calm and unaffected and 1 is you are very much affected and rather furious; or the other way around—it’s up to you).  Admitting the feeling to yourself is really the first step in managing it. 

            The next step is to understand what you can and cannot do given the level of rage that you are feeling.  Maybe, at a 2 or 3, you are really too angry to be reasonable; or at a 5 or 6, you are not too angry, just somewhat annoyed and you can still have a helpful discussion.  This will now determine what you can and cannot do.  This is probably a step that needs to be visited and re-visited, as feelings can come and go very quickly. 

            When we know that we are angry and to what extent that is so, we need to help ourselves manage both our physical and emotional reactions.  In managing our physical reactions, we need to help ourselves calm down.  One of the most effective ways of doing this is through good deep breathing (see my entry on this blog entitled Breathing Right Towards Psychological Wellbeing posted on 13 March 2010).  Only when we are able to manage our physical reactions can we start to manage the emotional ones. 

            Other relaxation techniques could also include any of the following: 

·         Listening to music you enjoy;

·         Making yourself a cup of coffee or tea and drinking it slowly and leisurely;   

·         Taking a short walk in the park;

·         Imagining happier times; and

·         Doing some strenuous physical exercise. 

            Practicing relaxation techniques is helpful in managing your physiological reactions.  This is certainly a good first step in owning up to your reactions and addressing its effects on your body.  Only when your emotions are not so high can you begin to deal with your feelings more rationally.  Next week, we shall discuss what you can do to manage your angry feelings. 

Anger

            Anger is one of the emotions that is least understood.  For many of us, we were taught from the time we were young that we cannot be angry, that being angry is wrong.  So, instead of learning how to manage this most natural of reactions, over time, we either suppress it until a point that we cannot help ourselves and we erupt like a volcano or hide it and express it in less obvious ways. 

            One favorite of Filipinos in expressing anger covertly is through passive-aggressive means.  Not saying or doing what is expected as a way of getting back at the person who is the object of anger is the usual method done.  We can also appear friendly and nice to a person when they are around, but we can be less friendly and uncaring in the absence of the same person. 

            We also need to understand that anger, just like with other feelings, presents itself in different degrees.  We can be annoyed and irritated at first.  This can then progress to anger, and then to rage and fury.  Although this progression can happen very quickly for some of us, it is important to know that there are milder degrees of the same emotion.  This is one key to helping us manage this emotion better. 

            Anger, just like happiness and sadness, is a feeling.  It is an emotional reaction that we get when we have been hurt or wronged.  When we are mad, it energizes us to do something about our situation.  It is the emotion that helps us avoid or confront potentially life-threatening situations.  So, having some anger can sometimes be helpful for our survival as a species. 

            In modern society, however, there are not very many situations when we need to defend ourselves from a significant threat to our lives.  And so, we tend to think that anger is less useful.  Nevertheless, there are times when anger can be quite helpful when it is expressed appropriately.  Asserting ourselves to others when we have been wronged or when we are unable to get what we need and want is one such way that anger can be channeled constructively.  For us Filipinos, we avoid asserting ourselves for fear of being perceived as arrogant and self-centered.  And yet, only when we are able to express our feelings using words, and effectively express what we want from a situation or person can we really use our anger without hurting others or ourselves. 

            Many people have various myths about their anger that prevent them from identifying it to the relevant people.  Here are some of these myths: 

1)      I do not need to say that I am angry because the other person should know it already without me having to say it. 

2)      My actions speak louder than my words.  If the other person cares, he/she should know that I am angry. 

3)      Saying that I am angry to the person who is the object of my anger only makes me vulnerable to further hurt and disappointment. 

4)      Anger is wrong; so, I cannot admit this to others. 

I say that these are myths because it is these thoughts that promote hostile interactions that bring about more hurt than healing. 

            In learning to understand ourselves, we need to know that feeling angry is a natural part of our emotional reactions.  With this admission, we can better admit to ourselves that there is nothing wrong to being angry, and admitting this to others can oftentimes be helpful.  Such heightened self-awareness and honesty to others can be the seeds of more mature interchanges with others. 

Breaking Down Experiences

I know many people who do not like to analyze much.  They go through their experiences as they come.  They are often able to savor the positive experiences and lament over the negative experiences.  For the most part, this is a good habit, as it enables us to enjoy our experiences as they are.  Living the total experience of our day to day lives certainly enables us to savor every moment and live life to the full. 

There are times, however, when a situation calls for us to understand our experiences more deeply.  We might have caught ourselves behaving in an uncharacteristic manner, such as, displaying our temper more extremely than usual or being rather melancholic.  We might also observe ourselves being more enthusiastic and even impulsive over our decisions.  In both extremes of either negative or positive experiences, we often find ourselves dwelling into some details, causing us to linger on the why’s and how’s of these incidents.  Somehow, this kind of pensive reflection can often help us understand the situation better. 

Although we do this thinking and reflecting rather intuitively, one way of understanding them is by breaking them down into their components.  When we are able to look at parts of a whole, we are better able to scrutinize details that are easier to manage.  In so doing, we are better able to see the components of our experiences that are made up of choices that we have made earlier.  We are also able to decipher which ones are more like reactions to these choices.  This knowledge then enables us to make reasonable evaluations of our experiences, offering us a reflection of ourselves. 

The three basic components of our experiences are our feelings, thoughts, and our actions.  They are the result of the physical events in our bodies.  Although I am dividing them here as if they are separate from each other.  When we experience something, all these three often come together.  They interact with each other in a very dynamic manner.  

Oftentimes, our feelings are reactions to what we sense and the meaning we place on what we witness.  Our thoughts, therefore, often have a huge impact on our feelings.  If we see a child crying, for instance, we can feel pity for the young lad or feel irritated and angry depending on the way we perceive the context of the crying.  So, our evaluation of the situation will dictate our emotional reactions.  Both our thoughts and feelings necessarily affect how we will behave.  So, our actions are then influenced. 

What we often do not realize in this system of feeling, thinking and doing is that they influence each other in all directions.  So, if I am feeling sad about something and behave in a way that makes me feel happier, then I will eventually feel happy.  My actions would influence the way I feel.  Similarly, my thoughts can also influence both my actions and my feelings.  This is why realistic optimism (see my post on 24 September 2010) is so influential in the way we feel about ourselves and the world around us.  In the same way, our actions are influenced by what we think. 

And so, there is really some truth in the power of thinking positively about something in order to keep happy.  Concurrently, doing something different from how we feel can also change our emotional experiences as well.