Professionals for Korea Times issued on July 14, 2010

Art Therapy through BBQ Brainstorming

By Yoona Lim, Art Therapist

Invitations to BBQ parties are one of the joyful signs that tell me the summer is coming. People in America enjoy the festive culture. Potluck is one of the themes in this culture where everyone who is invited to the party brings in a dish he or she enjoys and shares with other guests at the party. It is the reflection of the cultural diversity that is celebrated here in America. Thinking about the diverse cuisines in America, I become curious about the kinds of food that my clients might enjoy. At the same time, I realize that going to the parties may only be an idea for my clients, who are often bound to stay at the hospitals or the nursing homes. The physical and economic conditions of most of those patients bind their feet at home against their wish.

Those readers who have ever experienced feeling depressed may be able to empathize with feeling helpless and hopeless about one’s life circumstances. The negative perceptions towards one’s life often kick in when one is experiencing depression. These negative ideas about one’s life are usually irrational. For example, a client who lives at nursing home feels depressed about not being able to go to a party like he used to when he was young. He is not happy with the rules at the nursing home. Then his feelings lead him feeling miserable about his living situation and ultimately his life. “What is wrong with my life?” is the question that circles around in his mind. One negative thought feeds another and soon, he finds himself in a “black hole” of the depression. Therapists usually encounter their clients at this “black hole.” Art therapists’ job is to help clients to see where their negative thoughts lead them to and stops the cycle of those negative thoughts.

“Here and Now: Why do I feel depressed?”

Are there any solutions?

In group therapy session at the counseling center, I asked clients to plan an imaginary potluck party, based on their past experiences of hosting and/or attending a party. “Let’s pretend that we are invited to a potluck party this weekend. What kind of food is everyone going to bring?” I asked. At first, the clients just smiled at this unexpected question. Then each individual shared their ideas about this imaginary potluck party at their turn. A client who was sitting at the end of the table volunteered to start the group discussion. “I would make the seafood lasagna. I used to make this all the time. Now I feel too old and weak to even cook.” Then another client who struggled to remember the name of an Italian dessert spoke. Soon she appeared as disappointed at herself not being able to recall her memories. “I bet the people at the party loved your Italian dessert! Do you remember what it looked like when you made it?” I prompted her a little to help her describe the dish. “Hmm…it is rolled up like a shell. You put sweet jam inside to make it taste good. It is a very popular party dish,” As she began to describe parts of her dessert dish, the smile came back to her face.

People I see at the counseling center do not only struggle with mental illness, but they also have to deal with the low socioeconomic status. They are often isolated in their communities. Their physical, mental, emotional circumstances and isolation feed into developing a low self-esteem. A twenty-something-year-old therapist like myself could easily forget to see the rich life stories of this population who have been buried in their past. The insights and wisdom of my elderly clients manifest their invaluable life experiences. Despite their physical disabilities and mental illness, my clients have managed to keep a smile on their face. Their inner-strengths are amazing to see. From today's group therapy session, I get to know about different talents of my clients. Our discussion about the imaginary potluck party gives me a chance to learn about all those incredible dishes that my clients used to be able to make when they were healthier. While I am learning about the great talents and qualities of my clients from this activity, I hope that they would also be able to recognize their strengths as well. In reflection of the favorite food and cooking meals for friends and families, the clients capture a moment to think back on their good times in the past. As reminiscing past experiences, their positive energy/perception cast light into the “black hole” of depression, leading towards a better place.

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Professionals for Korea Times issued on June 1, 2010

Schizophrenia and Art

By Yoona Lim, Art Therapist

Cataract, Osteoporosis, Diabetes, Palsy, and/or Pneumonia: These are the most common diagnoses that have accompanied aging process of the clients I see in art therapy. In addition to those, some people struggle with hearing voices and seeing delusional visions, which are the most prevalent symptoms of schizophrenia. For example, Ms. A is afraid of going to bed at night due to the “voice” that she hears from the outside of the windows. This “voice” is not happy with Ms. A using a walking stick. Ms. A who is in recovery from knee surgery and is in need of relying on a walking stick, refuses to use the walking stick accordingly. Recently, Ms. A fell over during her morning walk without a walking stick. She only blames herself for living an “unfortunate” life.

The treatment for the complications of Ms. A’s condition is viewed from various perspectives of the health professionals. A psychiatrist recommends increasing the dose of Ms. A’s medications in order to treat the “voice.” Another expert suggests a psycho-educational approach, which would persuade Ms. A to use her walking stick by providing education and thus prevent further injuries. In my opinion, combining all these interventions and provide them simultaneously would be the most effective way of helping Ms. A. However, the question is: How to persuade Ms. A to choose to listen to the staff over the “voice” from the outside of her windows?

• Presenting issue: Ms. A is not aware of the injuries caused by her mental condition
• Intervention: Help Ms. A become more aware of the injuries. This therapist meets Ms. A in individual counseling. Apply art therapy to encourage Ms. A to make a portrait of the physical pains in her body.
• Art Activity: “To pay attention to the energy inside your body and mark the parts that are painful.”
• Materials: Paper with a pre-drawn image of body, markers, color pencils

Ms. A picks up a color pencil and starts coloring the area around her knees. “My knees feel horribly painful,” Ms. A remarks. Then she elaborates, “I have traveled around a lot when I was young. I had to take a lot of painkillers when I was diagnosed with Osteoporosis 10 years ago. Since then, I relied on Narco (a type of painkiller medicine) for the pain. I grew tired of having to get the prescription from the doctor, so I started getting Narco from the people at the rest home whenever I needed it.” Her story tells me that she has become addicted to Narco a long time ago. “Ms. A, your story tells me that the pain you feel on your knees might be greater than I ever imagined. Your knees must be feeling a lot of pain. I could see that in your drawing. You heavily colored the areas around your knees.” I make a comment after observing Ms. A spending significant energy coloring her knees in the drawing. “Yes. I feel so much pain especially when I walk. I am even afraid of dying if I am to fall over one more time,” Ms A. begins to open up about her pain and the fear. The drawing in front of her is clearly an evidence of her own condition. “Would you pick up another color pencil and show me on the drawing what it would feel like for you to live without the pain on your knees?” I carefully suggest to Ms. A. picks up a handful color pencils and her coloring soon creates a rainbow-looking area on the drawing. “Wow! What a beautiful rainbow! What is happening here?” I ask. “This is fantastic. The rainbow is how I would like to feel,” is Ms. A’s response with a quiet smile on her face. “What would help create the rainbow in you? What can help you feel the rainbow?” I ask. “Narco may do it. But I think I need something else,” Ms. A responds. “Ms A, let me just recall what you told me earlier. You said your knees hurt so badly that you feel like you are going to fall over when your walk. It may feel different from your pain, but I also experienced the pain on my legs. My legs were so tired that they shook and I fell over. You know what I had to do? I had to hold onto the trail on the side of the street for a while until my legs could rest a little. I stood for a while, still holding onto the trail, and my legs felt so much better. So, I think something that you could hold onto might be very helpful for you, Ms. A, especially when you feel like you are going to fall over. Something like a walking stick could be very useful.” I carefully make a suggestion. And this is how far I could go with the intervention. I help Ms. A to become more aware of her pain in the knees and how much it hinders her daily life. Then I give her a suggestion of how to respond to her daily struggle with the issue. After a session with Ms. A, I had an opportunity to present the session to other clinical staff, including a doctor. I used Ms. A’s drawing as a supporting material. During the presentation, the staff brought in their expertise according to their professions. A social worker made a suggestion of making the walking sticks more readily available for Ms. A both at the center and the rest home. A psychiatrist suggests to decrease the dosage of Narco and increase Ms. A’s medication for schizophrenia instead. In this way, the “voice” could be effectively treated.

As an art therapist who works with the elderly population, I often realize that the problems of life become more complicated as one ages. I recall the time when my necklace was hopelessly tangled that throwing it away seemed like the only solution. Untangling the necklace would not only take a long time, but it would also ask me to sit and struggle with it. However, when I remembered how much of the value and meaning that necklace had for me, I knew that I was willing to look for the solution to keep the necklace. A person’s life and the stories it entails are like the precious necklace in my story. Remembering the incident about my necklace becomes a good reminder to me that it is my job as an art therapist to help my patients remember the value of their life stories and guide them through “untangling” the stories that cause them pain.

Professionals for Korea Times issued on May 12, 2010

Flowers Made of Coffee Filter

By Yoona Lim, Art Therapist

The trees begin to lighten the streets with their greenness, as the notorious winter in Chicago found its way to exit. The tulips that are waiting to bloom in people’s small gardens bring a bright smile to people passing by.

The Seasonal Affective Disorder (SAD) is a type of mood disorder, caused by the change of seasons. A long winter with its cold weather and the gloomy sky may affect people’s mood. I remember seeing a lot of them when I worked at a local hospital in 2008. According to the experts, the diagnoses for mood disorders increase during the unusually long winters; that range from a casual mood -swing to a Major Depression and/or a Bipolar Disorder. As the weather starts to warm up with the beautiful sunshine, I find my clients brightened up with a slightly more energy. Those who have to rely on a walking aid make an effort to walk around the hospital building and enjoy the sunshine. All of sudden, I feel convicted about resting my two legs that are always sitting down whenever I get a break. It is my job as an art therapist to stimulate and encourage motivation in my clients, like the sunshine does to them. I use various art activities to engage my clients. Many things could inspire the directives for these art activities. The one I am about to write about was inspired by a coffee filter that was handed to me by my colleague one day.

Coffee Filter-Flower Making

Materials: Coffee Filter, Watercolor paints, markers, Felt-covered wires, Scissors

The clients who come to my art-making workshop seem surprised to find coffee filters that are placed next to other art materials that are more familiar to them. There are always those who come with curiosity and others who are not willing to touch the art materials or who feel uncomfortable with art making. Therefore, the first step in leading an art-making workshop becomes welcoming everyone and creating a safe space for everyone that invites participation. In this space, the participants [clients] take a step-by-step approach towards art making, as they are encouraged by an art therapist and other peers. Soon, the space becomes filled by people, fascinated by the way watercolors dying the paper; and those who explore the different ways each art material respond to each other. As an art therapist, it is refreshing to witness such a transformation taken in the space. One participant who refused to hold a brush in the beginning is now waiting for his 4 coffee filters that he dyed with watercolor paints to dry. Another client who struggle with a lack of motivation and energy due to his depression remarks, “I never thought I could mix such a beautiful color!” as he explores with mixing watercolor paints. Yet, my eyes catch a participant diagnosed with the Obsessive-Compulsive Disorder (OCD). On his usual days, he has to place every object in his hands on a neatly order. However, in this creative space, he is willing to experiment with watercolor paints, which are considered as an art medium that is difficult to control. He appears to be more relaxed as if his tendency to control is thinned out with the watercolor paints in his hands. My heart becomes dyed with amazement as I witness these transformative moments. It is quite beautiful to be part of this creative process in which the one’s physical limits and pains become transformed into something really extraordinary and unique. Paints are dropping onto the paper and making marvelous marks. The hand that is holding a brush seems to be able to forget for a moment that it has been suffering from Alzheimer’s and palsy. I am reminded of the unique strength in each client. The coffee filters that are beautifully dyed and dried are then folded into a flower shape. The fabricated wires become a stem and the leaves are added to it. The group and I reach a decision about what to do with our flowers. We are displaying the flowers on the windows, so that the other people who walk around the hospital could enjoy them too. Public display of artwork that is created by individuals has therapeutic implications as it highlights the integration into a community and making contributions to one’s community. For the clients whose goals in therapy are oriented around developing social skills and integration, art-making and public display of artwork becomes an effective intervention.

Therapeutic Implications of Watercolor

The elderly population experiences a lack of motivation due to the weakening processing of the body that affects both physical and mental strength. In this case, the activities that do not require much energy and physical strength are more effective to engage the elderly clients. Watercolor painting that involves the process of diluting the paint with water and using brushes and water on the paper to express one’s emotions is a gentle and soothing activity. It can be inviting to the participants and encourage them to experiment with the medium. As it is evident in this article, selecting art materials and the activities that are appropriate for the participating client’s physical, mental and emotional circumstances is crucial for art therapists. There could also be numerous occasions in which art therapists’ planned activities or directives may need to change in the moment. Therefore, an open mind and observing eyes of art therapists that could see the client’s responses and find therapeutic implications are essential. Flexibility and creativity of an art therapist can create the interventions that are most helpful and meaningful to the participating clients.