ENGLISH TRANSLATION:

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.