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Irene Renzenbrink, B.A. Dip.Soc.Studs., M.Soc.Admin.,
D.V.A.T.I., C.A.G.S.
PhD Candidate, European Graduate School
Irene Renzenbrink, B.A. Dip.Soc.Studs., M.Soc.Admin.,
D.V.A.T.I., C.A.G.S.
PhD Candidate, European Graduate School
Playing in the Ruins: An Arts Based
Approach to Care of the Dying (and the
Bereaved)
Beyond Words� Give sorrow words, yes, but also paint and
glue and hammers and nails and long walks and quiet and music
and play and all other possible forms of expression, including
silence.
� ( Donna Schuurman 2002)
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A fragmented totalityPutting together fragments of experience ,
building something new out of them
Playing in the ruins to find the gift that lies in wait for us
there
We cannot celebrate unless we mourn.
Levine, S.K. ( 2009)Trauma, Tragedy, Therapy, Jessica Kingsley
Publishers,London
FragmentationIt is essential for human being (sic) to fall
apart, fragment, disintegrate, and to experience the despair that
comes with lack of wholeness and that it is by moving into the
experience of the void that the possibilities for creative living
arise and a new form of existence begins to emerge.
Stephen Levine , Poeisis: The Language of Psychology and Speech
of the Soul
If we can shape the fragments of our broken world into new
forms, we can find a place of meaning and value for our lives.
Stephen K. Levine
We splinter and break into fragments, not to pursue destruction
for its own sake, but to make ourselves anew. Shaun McNiff
Soul pain is the experience of an individual who has become
disconnected and alienated from the deepest and most
fundamental
aspects of himself or herself.
Kearney, M. (1996)Mortally Wounded, Stories of Soul Pain, Death
and Healing,
Scribner, New York)
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The soul finds its form in art
When the soul is in need, art presents itself as a resourceful
healer.
McNiff, S. 2004. Art as Medicine. Boston, MA: ShambhalaPress
A favouriteplace
Pulled in all directionsWe in this work are missing an outer
layer of skin and must take care to renew ourselves.
Dame Cicely Saunders
Total pain: the work of Cicely Saunders and the maturing of a
concept by David Clark
http://endoflifestudies.academicblogs.co.uk/total-pain-the-work-of-cicely-saunders-and-the-maturing-of-a-concept/
She said, Well doctor, the pain began in my back, but now it
seems that all of me is wrong. She gave a description of various
symptoms and ills and then went on to say, My husband and son were
marvellous but they were at work and they would have had to stay
off and lose their money. I could have cried for the pills and
injections although I knew I shouldnt. Everything seemed to be
against me and nobody seemed to understand.
Mrs Hinson, St Josephs Hospice , 1964
all of me is wrong
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ADRIAN HILL (1895-1977)COINED THE TERM ART THERAPY IN 1942ART VS
ILLNESS
Art Therapy
� Provides an alternative to spoken language as a means of
representation and communication( Woods)
� trapped in a web of words( Levine)
� Wood, M.( 1998) Art Therapy in Palliative Care: The Creative
Response, Routledge
Dr.Sandra Bertman
USING THE ARTS AND HUMANITIES WITH THE DYING, BEREAVED AND
OURSELVESin Stillion, J. and Attig ( 2015) T. Death, Dying and
Bereavement: Contemporary Perspectives, Institutions and Practices,
NY Springer
Dr Sandra Bertman� Expressive therapy is predicated on the
assumption that people can heal through use of the imagination
and various forms of creative expression in the artsliterary,
musical, dramatic, and visual. Expressive therapy, also known as
creative arts therapy, differs from traditional art expression in
emphasizing the creative process rather than the final product or
work.
� Bertman, S.(2015) Using the arts and humanities with the
dying, bereavedand ourselves. In Stillion, J.Attig,T.( Eds) Death,
dying and bereavement: perspectives, institutions and practices.NY
Springer, 245-259
Research findings: Art Therapy
In cancer care, calming, peaceful effect, working through
identity changes, distraction ( not avoidance) promoting creativity
and well being
In palliative care, can ease fears and anxieties, sadness and
anger. A non-verbal and tactile approach, leaving something
behind-the idea of legacy for some patients.
Ref. Wood, M. , Wood, M. Art Therapy in Palliative Care: The
Creative Response, Routledge ( 1998)
Wood,M. et al, International Journal of Art Therapy,
2013,Vol.18,No.2, 42-53
How can art therapy help in end of life care?
Life review and reminiscence
Respite from focus on whats wrong
Facilitates expressions of emotion
Ignites a spark of creativity
Restores a sense of capacity
Meaning making
Playfulness
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Arthur Frank: At the Will of the Body, Reflections on
Illness
Boring second hand medical talk
When ill persons talk in medicalese, they deny themselves the
drama of their personal experience.
Disease vs Illness perspective
Treatment is not always care.
Decentering in Expressive Arts TherapyMoving away from the
narrow logic of thinking and acting that marks the helplessness
around a difficult or stuck situation
� Problem saturation: more of the same
� Expanding the range of play-moving into the opening of the
surprising and unpredictable, unexpectedness, the experience within
the logic of the imagination.
� Knill, P, Levine, E. Levine, S. ( 1999) Principles and
Practice of Expressive Arts Therapy, JKP, London.
The restoration of capacity
� The use of the arts in therapy can restore a sense of I am
able and restore a sense of capacity
� Shaping our reality through sensible and imaginative
transformation
� Stephen Levine: Philosophical Foundations of Expressive Arts
Therapy: Toward a Therapeutic Aesthetics Bulletin of Psychology and
the Arts, Vol 2 (2) 2002
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� Good therapists are open to metaphor and symbol; they listen
with a third ear that hears what is not said; they see potential
for development in the person and are animated ( ensouled) by these
invisible possibilities.
� Levine, S. 1997 Poeisis: The Language of Psychology and the
Speech of the Soul, Jessica Kingsley, Publishers.
Use of Metaphor
Metaphor is often used by grieving people as a way of
understanding one kind of thing in terms of another
It generates a richness of conceptual language that captures
multiple layers of meaning
Linda Machin, Working with Loss and Grief, Sage 2009
The symbol touches all chords of the human heart at once,
language is always forced to keep one thought at a time.
Bachofen,1967
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The light is the capacity to reconcile your experience, your
sorrow, with every day that dawns. It is that understanding, which
is beyond significance or meaning that allows you to live a life
and embrace the disasters and sorrows and joys that are our common
lot. But its only with the recognition that there is a crack in
everything. I think all other visions are doomed to irretrievable
gloom.�
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Artful Grief-A Diary of HealingSharon Strouse
I was in pieces. I dripped. I floated about. I was cut in half.
I was disconnected.
Sharon StrouseCollage: Integrating the Torn Pieces
I break into a million pieces
My creative process unlocked doors to unexplored feelings.I was
empowered by the act of creating. I gained control and engaged what
I was reticent to talk about.
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Artful Grief Sharon Strouse
There is some kind of physical release in the experience of
tearing
I had found a way for the unspeakable to speak
Making the collage brought me a measure of serenity
I could manipulate the pieces, the fragments and I felt a
control.
Collage
Creating a collage is a structured activity that engages a
client in making choices and organizing materials, and can be
symbolic of creating order out of fragmented aspects of life or
chaotic feelings.
Catherine Hyland Moon ( 2010) Studio Art Therapy, Jessica
Kingsley Publishers, London
Collage in Arts Based Research
Transforming bits and pieces into new forms can be freeing,
allowing new ideas
to be discovered.
Chilton, G. and Scott,V., Snipping, Gluing,Writing:The
properties of collage as an Arts Based Research Practice in Art
Therapy,
Journal of the American Art Therapy Association, 31:4,
163-171
My mother was on my mind because Id been struggling with
sorting. I think some of the sadness was to do with what outsiders
might perceive as pathetic junkwhat mattered was the feeling of
stillness as we each went about our work. I think I worked my way
through to a meaning at the end.
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Handmade paper, collage with fabric, paper photograph and
pastel
A reflection on attachment and lossand negative space.
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Separationby W.S. Merwin
Your absence has gone through meLike thread through a
needle.Everything I do is stitched with its colour.
Peter Gilbert, Spirituality and End of Life Care ( 2013)
Pavilion Press
Grieving the death of a mother as an adult
� You lose your history, your sense of connection to the past.
You also lose the final buffer between you and death. Even if youre
an adult its weird to be orphaned( Therese Rando)
� I perceived that many people felt that because Mother was old
and I was an adult child, the loss should be less significant. (
Harold Smith)
Harold Ivan Smith� How old was your mother? When I answered
eighty-
three, the frequent response was . Oh, then she lived a good
long life. Oh felt like a slap to my face. Wha t would have been
wrong with with her living eighty-four or eighty-eight years? Was
she a Christian? Yes. Well, then, shes in a better place. Had she
been sick? Yes. Then her suffering is over. Yes, but what about my
suffering?
� Smith, H. I. ( 2003 ) Grieving the Death of a Mother, Augsburg
Books, Minneapolis
SEWINGI cut up all your handkerchiefs
To make a little quiltI had to reinforce them
They were so thin and frail, As thin and frail as you were
When you began to fade.I sorted all the pieces
And then began to sew. Sewed as you had taught me,
Sewed as if to find you,Sewed as if I could repair your
damaged self and mine. Sewed from my heart,
Sewed with love,
Sewed to make you whole.
� I write poems as a form of magic to reshape patterns of being
and look deeper into the mystery. This is an endeavour that lies at
the heart of a spiritual quest.
� Knill, P., H. Nienhaus Barba and M. Fuchs. 2004. Minstrels of
Soul: Intermodal Expressive Therapy. Toronto: EGS Press.
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Robert Neimeyer on preserving the connection
� Life Imprint identifying ways in which the other has left a
recognizable mark on us, e.g. mannerisms, gestures, ways of
speaking and communicating, core values and beliefs
� Letter Exchange- the bereaved writes a letter to the loved one
and then a response as if from the loved one.
Neimeyer, R. Making meaning in the midst of loss, Grief Matters
9(3) Summer 2006
Poems of Address
� One way to bring a person into a poem quickly and intimately
is by using the form of address. By speaking directly to people,
whether or not they are present, absent or deceased, the poet draws
them into the poem and suggests a close relationship.
� Start with the openong line : I could not tell you
Judith Steinbergh
The Delft Gown
Mary Burgess Woven Memories
wovenmemories.com.au
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Healing the pain in my life exercise
1. The pain 2. A healing
symbol3. Combine 1. and
2.
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Lucys painting
Lucy at Edmonton Zoo
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If you suddenly and unexpectedly feel joy, dont hesitate. Give
in to it. There are plenty of lives and whole towns destroyed or
about to be.We are not wise, and not very often kind. And much
can
never be redeemed. Still life has some possibility left.Perhaps
this is its way of fighting back, that sometimes
something happens better than all the riches or power in the
world. It could be anything, but very likely you notice it in the
instant when love begins. Anyway, thats often the case. Anyway,
whatever it is, dont be afraid of its plenty. Joy is not made to be
a crumb.
Mary Oliver-Dont Hesitate
