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self experience of being in group art therapy
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1
Self Experience of Being in a Group of Art Therapy
Tutor: Kate Broom
Student: Te-Fang, Chiang (Pam)
Student number: S12788976
January, 2013
2
Contents
Introduction
Section 1 – What is group art therapy
Chapter 1- A brief definition of group art therapy
Chapter 2- The property of art in group therapy
Chapter 3- The stages of group art therapy
Chapter 4- Why use groupwork and art?
Section 2 – Post-traumatic stress disorder
Chapter 1 – when we recall our pain
Chapter 2 – uncomfortable feeling
Chapter 3 – what is post-traumatic stress disorder
Chapter 4 – the symptoms of Post-traumatic stress disorder
Chapter 5 – the recovery stages for Post-traumatic stress disorder
Section 3 – what does all this means
Chapter 1 – Emotion and its role in human functioning
Chapter 2 – when you pass your pain to others
Chapter 3 – the image is still hurtful?
Conclusion – how I would use art therapy
Reference
3
Introduction
>>
Whenever we suffer the different kind of pain, people around us always tell
us ‘ be brave and keep carrying on’, ‘ don’t worry, it will passed’ or ‘ think at the
bright side’. But why should we be brave? And how could we keep carrying on?
And there is not only bright side! If you can see the light then there is must dark
side. Since I was been taught whenever you suffer pain you cannot cry when I
was child. Crying is the way showing your weakness and hopeless. So I have
learned whenever I suffer the pain I have to pretend nothing happened. But
after years and years, now I am 26 years old. I realized that the pain is still
there buried deeply in my mind. When I face the things which connect with the
pain, I still suffer by the trauma. And I become sensitive, anxious and
depressed. Then why cannot I just face the pain? Before moving on the normal
and strong life I think people should give themselves time for being cured
maybe by themselves or others. We should keep brave after we can face the
pain directly.
4
Section 1 – What is group art therapy
Chapter1 - A brief definition of group art therapy
>>
Group art therapy is using art therapy into the members of groups. The
interaction is developed by the group members (including member to member
and group leader to member) and the interaction promotes the changing and
adjustability.
Section 1 – What is group art therapy
Chapter 2 - The property of art in group therapy
>>
The art in group therapy is a way for combining the art therapy and verbal
group therapy, and the property of the art in group therapy is during members
attend the process of group, members use different material create their own
creation by their unique way. According to their own speed and doing their own
creation individually; meanwhile, during the individual creating the members
are still the part of the group. This property of art therapy group can satisfy the
two needs of the members: 1. Dependence: members desire to fit in the group
and become the member of the group; 2. Alienation: members except that they
5
can have their own expression and space.
‘The work of some of the pioneers of art therapy certainly involved group
work, usually in open studio settings, with an informal structure rather like
that found in art school studios of the time (1950s and earlier). When they
worked in hospitals,the majority of art therapists were reliant on their own
experience of studio groups, or of teaching in adult education classes or
school. In the hospital groups, patients would come and go, paint and draw
in their own time when the studio was open and the therapist present. The
interaction between the tutor/ therapist and the individuals in the room
reproduced a familiar art student- tutor dynamic: individuals could discuss
their work with the therapist and as this was supposed to be ‘ private’ it often
consisted of whispered conversations in a corner of the room to the
exclusion of other patients. Patients were often subtly influenced by each
other’s productions in the shared space of the art room. The space became
like the artwork itself – personal yet at the same time public and shared- and
could be entered at the discretion of the artist/ tutor- therapist.’
(Diane Waller, 1993 )
6
In addition, the main purpose of art in group therapy is to promote and
change the individuals of the members. Not only focus on curing one mental
disease. Using the objective perspective works on group and promotes the
feeling of group members. Improving the self discovery of members and also
promoting the social ability of members. These are different to psychotherapy.
As the tables show, art therapists saw their groups as aiming to enhance
and sometimes change the personal and social functioning of the group
members, rather than as a specific treatment for a particular disease. Their
aims also tie in with Yalom’s curative factors for group therapy:
1. Instillation of hope:
‘ hope’ makes members continue doing treatment. It also makes the other
curative factors work. According to the confidence of group art therapy is
already maintaining the effect of treatment.
2. Universality
Members can see the intercommunity between each other in group. Members
find that they are not alone. Then members see the same difficulty and life
experience with other members they feel released.
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3. Imparting of information
Including the right knowledge the group leader gives to member, or the advice
and comfort from the members.
4. Altruism
The members improve their self- respect during giving. Practicing the helping
attitude overcomes the solipsism.
5. The corrective recapitulation of the primary family group
Most of the members take the unsatisfied experience into group. However the
group makes the experience presenting to a correct way. Although the
members would be kept discovering and challenging, the members are
encouraged discovering the new relationship and trying the new behavior.
6. Development of socializing techniques
The property of group helps the members developing another social skill by
observing the other members.
7. Imitative behavior
According to Bandura, imitation is a effective power in treatment. During the
group art therapy the members observe the other members and get the benefit
from trying new skill. This is a vicarious therapy or spectator therapy.
8. Interpersonal learning
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The interaction in group provides the members of the reasonable observation
and rectified the emotional experience.
9. Group cohesiveness
The group cohesiveness gives members the motivation of keeping to stay in
group. Group cohesiveness helps the members giving the honesty, promoting
the attendance in group and developing the meaningful relationship between
members,
10. Catharsis
Group art therapy makes the members opportunity to vent their emotion and
release the pressed stress.
11. Existential factors ( such as inevitability of death )
Group art therapy presents ‘ apartness’. The members are separated, alone
and apart from each other. Meanwhile, the members are the part of group. It
makes the members feel comfort.
9
Section 1 – What is group art therapy
Chapter3 - the stages of group art therapy
>>
Corey indicated that there are six stages in group art therapy. The leader of
the group has to control each stage and observe the factor in advantage and
disadvantage. Then can help to improve the members. There are six stages.
(Corey, 2000):
1. Pregroup – formation of group
Include selecting the members, considering the character of group, the time,
the space and doing the preparation for the members.
2. initial stage – orientation and exploration
Making the members to learn the function of group, define the goal of
members, clarify the expectation of members and know the importance of
group. In this stage, the members test the atmosphere in group. If the
members are willing to express their feeling then the group cohesiveness can
be built up. The members start to define their position in group.
3. transition stage – dealing with resistance
The members are afraid of being stared at, misunderstood, lacking the clear
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goal and rules and the expectable behaviors. At this staged the members
strengthen the defenses and anxiety. Therefore the group leader can teach the
members of admitting and dealing with the conflict in group publicly. The group
leader helps the members dealing with the resistance and provides the
example of facing the challenge honestly.
4. working stage – cohesion and productivity
At this stage the cohesion and trust are strong. The communication of each
other is open, free and direct. The members admit the conflict and handle it
directly and effectively. Meanwhile, the members give the feedback free and
are willing to achieve the change of behavior out of the group. The members
are full of hope in this stage.
5. final stage – consolidation and termination
Facing the time is going over, the member might have the sadness and anxiety
but the members also decide the action they want to do in next. The group
leader has to strengthen the change of the members and assist the members
using their new behavior in life.
6. Postgroup – follow- up and evaluation
At the end of the group, group leader arrange the follow-up and evaluation for
understanding the interaction in members.
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‘There are five concepts central to the interpersonal approach. These are
explicated in existential philosophy and psychology and therein, the authors
suggest, lies the difference between this approach and analytically- oriented
group psychotherapy. The concepts are as follows:
1. Human actions are not predetermined; freedom is part of the human
condition.
2. The corollary of this is the importance of choice in human life.
3. It is essential to take responsibility for one’s actions.
4. Death is inevitable; but the fact that we shall all die can paradoxically give
meaning to life.
5. We are each engaged in a creative search for individual patterns that will
five meaning to our existence.
( Ratigan and Aveline, 1988: 45 )
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Section 1 – What is group art therapy
Chapter 4 - Why use groupwork and art?
>>
Why use groupwork?
‘For therapists there is a choice between individual work and group work, so
it is worth looking at the general reasons for using groupwork.
The reasons for using groupwork can be summarized as follows:
1. Much of social learning is done in groups; therefore groupwork provides a
relevant context in which to practice.
2. People with similar needs can provide mutual support for each other, and
help with mutual problem- solving.
3. Group members can learn from the feedback from other members: ‘ it takes
two to see one.’
4. Group members can try new roles, from seeing how others react ( role-
modeling), and can be supported and reinforced in this.
5. Groups can be catalysts for developing latent resources and abilities.
6. Groups are more suitable for certain individual, e.g. those who find the
intimacy of individual work too intense.
7. Groups can be more democratic, sharing the power and responsibility.
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8. Some therapists/ group workers find groupwork more satisfying than
individual work.
9. Groups can be an economical way of using expertise to help several
people at the same time.
However, there are also some disadvantages:
1. Confidentiality is more difficult because more people are involved.
2. Groups need resources and can be difficult to organize.
3. Less individual attention is available to members of a group.
4. A group may be ‘ labelled’ or acquire a stigma.
Why use art?
So far most of the reasons and purposes given apply to any kind of group. It
is worth drawing out the aspects of groupwork which are particularly enhanced
by using art as the group activity:
1. Everyone can join in at the same time, at their own level. The process of
activity is important, and a scribble can be as much of a contribution as a
finished painting.
2. Art can be another important avenue of communication and expression,
14
especially when words fail. The spatial character of pictures can describe
many aspects of experience simultaneously.
3. Art facilitates creativity.
4. Art is useful in working with fantasy and unconscious.
5. Art products are tangible and can be examined at a later time.
6. Art can be enjoyably, and in a group this can lead to shared pleasure.
( Marian Liebmann, 1986)
Section 2 – Post-traumatic stress reaction
Chapter 1 – when we recall our pain
>>
While I was studying in the first term of art health and well-being, I can still
remember there was one time when we had the subject called ‘ draw your
pain’. The rule is you have to draw your pain on paper and then pass your
paper to next classmate. The next thing about your classmates have to do for
you is to help you covering or curing your pain by their drawing. I remembered
that it was really hard for me to do ‘ draw your pain’. Why it is hard for me?
Because I have to recall the uncomfortable feeling from my mind. Whenever I
recall the pain again I can feel there is the pain comes again. And all the bad
15
feeling about the pain shows up. The image of the pain was so clear. It was
even like a video, you can tell the whole story about your pain.
‘This is the process for all ‘ traumatic’ events. The process involves the
generation of very powerful emotions that threaten to overwhelm the ego’s
ability to function. This is the context of Freud’s often-quoted statement that
people with hysteria ‘ suffer from reminiscences’. Memories are charged
with strong emotion, or are highly stylized and emotionless. Freud cited
clinical examples of ‘ intact’ memories of traumatic events and noted the
strong emotions that were expressed by patients. The alarming implication
of this finding for Freud was that the traumatising events were being
perpetrated in the home by family members. Here was the first instance of
the study of trauma pointing to some very disturbing aspects of western
family life, structure and character.’
( Colin Wastell, 2005)
16
Section 2 – Post-traumatic stress reaction
Chapter 2 – uncomfortable feeling
>>
There were two funerals in my life before. One was my father who was dead
in heart attack and another was my grandmother who wad dead in cancer.
Both of the lost have influenced me a lot. I can still remember the last seen of
my father who died in hospital and the last three days of my grandmother who
chose to die in her own house instead of in hospital. The cold hands,
unavailable speaking lips, the blood from the mouth and the purple color on his
skin. Those symptoms showed my father was already gone. The skinny body,
the orange color on her skin, the unavailable opened eyes and the shaken
hands. Those symptoms showed my grandmother was near dead. These were
my pain. So I drew dead body who lied down on a bed with cover on his body
and face on paper.
‘By definition trauma involves threat to life and very often in traumatic
situations someone may die. The death of a loved one in traumatic
circumstances can come with such suddenness and ferocity that nothing
can mediate the intensity of the loss. There is no preparation for, or
17
anticipation of , death.
However, it is not just loss of another which leads to bereavement following
a trauma. Often it can be what is felt to have been lost. The person may
have lost a sense of who he or she was; ‘ the protective mother’ or ‘ strong
man’, he or she may grieve over lost plans or potential or what could have
been done differently at the time of the incident. What is clear is that there is
a pattern to human grief which can include shock, disorganization, denial,
depression, guilt, anxiety, aggression, resolution and acceptance and
reintegration.
( Thom Spiers, 2001)
Section 2 – Post-traumatic stress disorder
Chapter 3 – what is post-traumatic stress disorder
>>
‘An anxiety disorder in some individuals who have experienced an event that
poses a direct threat to the individual's or another person's life. The
characteristic features of anxiety disorders are fear, particularly in the
absence of a real-life threat to safety, and avoidance behavior.
18
A diagnosis of posttraumatic stress disorder requires that four criteria be met.
First, the individual must have been exposed to an extremely stressful and
traumatic event beyond the range of normal human experience. Second, the
individual must periodically and persistently reexperience the event. This
reexperiencing can take different forms, such as recurrent dreams and
nightmares, an inability to stop thinking about the event, flashbacks during
which the individual relives the trauma, and auditory hallucinations. Third,
there is persistent avoidance of events related to the trauma, and
psychological numbing that was not present prior to the trauma. Fourth,
enduring symptoms of anxiety and arousal are present. These symptoms
can be manifested in different forms, including anger, irritability, a very
sensitive startle response, an inability to sleep well, and physiological
evidence of fear when the individual is reexposed to a traumatic event.
(http://encyclopedia2.thefreedictionary.com/Post-traumatic+stress+reaction)
There are three reason of the post- traumatic stress disorder sometimes is
ignored by patients:
1. The symptoms sometimes show up in months or years after the event. This
period makes people is hard to connect the symptoms and the event.
19
2. Patiens believing in ‘ I can get rid of this symptom myself’, ‘ this would not
absolutely happened to others’ or ‘ other must have the ability to solve this
problem. Therefore extend the time for searching help from others.
3. Guilt, blame and pain also extend the time for searching help form others.
4. Avoid to touch anything which is connect with the trauma of events,
therefore extending the time for searching help form others.
Section 2 – Post-traumatic stress disorder
Chapter 4 – the symptoms of Post-traumatic stress disorder
>>
‘PTSD can cause many symptoms. These symptoms can be grouped into
three categories:
1. Re-experiencing symptoms:
Flashbacks—reliving the trauma over and over, including physical
symptoms like a racing heart or sweating
Bad dreams
Frightening thoughts.
20
Re-experiencing symptoms may cause problems in a person’s everyday
routine. They can start from the person’s own thoughts and feelings. Words,
objects, or situations that are reminders of the event can also trigger
re-experiencing.
2. Avoidance symptoms:
Staying away from places, events, or objects that are reminders of the
experience
Feeling emotionally numb
Feeling strong guilt, depression, or worry
Losing interest in activities that were enjoyable in the past
Having trouble remembering the dangerous event.
Things that remind a person of the traumatic event can trigger avoidance
symptoms. These symptoms may cause a person to change his or her
personal routine. For example, after a bad car accident, a person who usually
drives may avoid driving or riding in a car.
3. Hyperarousal symptoms:
Being easily startled
21
Feeling tense or “on edge”
Having difficulty sleeping, and/or having angry outbursts.
Hyperarousal symptoms are usually constant, instead of being triggered by
things that remind one of the traumatic event. They can make the person
feel stressed and angry. These symptoms may make it hard to do daily tasks,
such as sleeping, eating, or concentrating.
It’s natural to have some of these symptoms after a dangerous event.
Sometimes people have very serious symptoms that go away after a few
weeks. This is called acute stress disorder, or ASD. When the symptoms
last more than a few weeks and become an ongoing problem, they might be
PTSD. Some people with PTSD don’t show any symptoms for weeks or
months.’
(http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-pt
sd/what-are-the-symptoms-of-ptsd.shtml)
22
Section 2 – Post-traumatic stress disorder
Chapter 5 – the recovery stages for Post-traumatic stress disorder
>>
‘Much as in traumatic events we experience, there are also stages of
recovery for Post-traumatic stress disorder. Most sufferers would alternate
between these stages randomly. Nonetheless, you can observe general
patterns of behaviour that’s true for the most part to distinguish which stage
the sufferer is already in.
Stage 1: Emergency/ Outcry Stage. The onset of a major anxiety attack that
manifests in intense physical reactions (hyperventilation, rapid breathing and
pulse and elevated blood pressure). At this stage, the victim finds himself/
herself in a situation that triggers the “fight or flight” response and makes the
victim feel extremely helpless. Fear overtakes them almost completely.. such
that when they’ve finally emerged from this situation, they often feel confused
about what just happened.
Stage 2: Emotional Numbing and Denial Stage. The classic case of “sweeping
under the rug”, pretending they never happened to avoid any emotional
responses. There are many who don’t actually move on from this stage. Hence,
23
it’s crucial for caregivers and/or loved ones to pick up on these symptoms to
help the sufferer seek help.
Stage 3: “Intrusive-Repetitive” Stage. Flashbacks, major mood swings,
irrational behavior are what characterize this stage. At this point in time, the
sufferer begins to confront the trauma that started it all. Victims are more prone
to being easily startled. Many manifest antisocial behavior, fearing that contact
with the outside world would either trigger another repressed memory; or feel
that they’re too vulnerable to have normal interaction with the outside world.
Stage 4: “Reflective-Transition” Stage. The survivor by this time has reached a
point where they are able to slightly distance themselves from the situation and
see it from a bigger perspective. At this point, he/she has begun to move
forward with a more positive and constructive frame of mind, with the full intent
of moving on. Many refer to this as the healing process where they are finally
able to confront the trauma and deal with it.
Stage 5: Integration Stage. At this point, the survivor has finally recovered from
the trauma, and has successfully reintegrated into society. He/she has
overcome the trauma, and can now deal with it without causing intense
24
feelings of fear, anxiety and despair. He/she can finally find peace within
himself/ herself and move on to have a happy, full life.’
(http://livingwithptsd.wordpress.com/2010/09/28/recovery-stages-for-ptsd/)
Section 3 – what does all this means
Chapter 1 – Emotion and its role in human functioning
>>
‘An introduction to the role of emotion in general human functioning, and
especially in trauma. The terms ‘ emotion’, ‘ affect’ and ‘ feeling’ will be
treated as equivalents. In many cultures, and especially in the West,
displays of emotion are not encouraged as they are associated with
weakness. A number of researchers have taken a different view, and regard
emotion as both adaptive and central to normal human functioning. Its role in
trauma is life-preserving, through the activation of responses such as flight
and fight. If the physical and psychological mechanisms associated with
emotion’s role in trauma remain activated, then problems will arise.’
( Michael J. Scott & Stephen G. Stradling, 1992)
25
Section 3 – what does all this means
Chapter 2 – when you pass your pain to others
>>
During the practice of ‘ draw your pain’ in class, the next step is to pass your
pain to the next. But the next have to cure or cover your pain by their drawing.
This step gave me the impressive meaning. When I was in pain, I felt sorrow
and I could only focus on myself. The moment was like I was in a dark room
with only one light which spots me alone. Like I was the only character in the
story, I can hardly to find out what kind of pain the other people had. When the
group leader said ‘ ok, stop, now pass your pain to other’, suddenly it lights up,
the room is not dark anymore. The paper in front you is the pain from another
member. You can still tell how hurtful she or he was during seeing their
drawing by the color or the score. But now it is your turn to cure or cover their
pain. I found that it is easy for me doing this action. But why? Because this not
your story? Because you do not put yourself on the main position anymore? In
my mind, I always know how to be brave and positive. I can do a lot of things to
make people feel happy and joy. But why cannot do this to myself to cure
myself?
After passing your pain to the others, I finally got my pain back. The
26
interesting thing was, it was hard to recognized what was the original pain I
drew before. It is a hopeful and light painting now. And I did feel the ways how
people want to support and help me. Although I did not explain my pain to
others I can still felt the positive power from the other members.
Section 3 – what does all this means
Chapter 3 – the image is still hurtful?
>>
During sharing the trauma by drawing to others instead of using word to
speak the pain out, it could be easier. Sometimes it is hard when you try to
explain your pain to others. But the point is not about members have to
understand your pain well. The most important thing is you have to know how
to share it with others. Whenever you know and try to share the pain with
others then you would know the pain now could just be the drawing. The pain
could be just a image for you not a whole story. You received the company
and support from the members in group. They are not just using words to
convince you, they are using their action to help you go through the pain.
People used to sharing their pain by word to convince you they had had bad
memory before too. But when we suffer the pain, we do not want to compare
27
how worse you were before. Maybe we just want to have the company and
comfort. We do not need people tell us how to do it to stand up again. We
already know a lot of positive thinking, it is just hard for us to do it. We are
looking for a way to speak the pain out like art.
Conclusion – how I would use art therapy
>>
When people suffer the pain from events, no matter the events are big or
small. There are always trauma built up in mind, the trauma might be light or
deep inside. But if you do not try to cure the trauma, it could fester in your
mind. Whenever you face the familiar events the deeply trauma inside would
remain you the pain again.
‘Memory is often conceptuallised as a storage and categorization system for
incoming stimuli. The creation of memory schemas results in the integration
of information. Human beings look for patterns, not merely isolated bits of
information. The role of the central nervous system (CNS) in memory is
pivotal for the recall of events. When the CNS is activated in alarm, the
memories associated with that alarm mode are recalled in similar states of
alarm. This is also the case when memories are accessed from non-
28
traumatic situations- for example, by smell or image. The memory evokes the
traumatically associated emotions, and the survivor re- experiences the
trauma as though it were occurring in the present! The extreme emotions
generated interfere with coherency of experience and memory storage.’
( Cloin Wastell, 2005)
Looking for a way to express your pain becomes a very important thing. By
using art to express your feeling and share with others, I will not hesitate to
express my feeling by art. Art is more impressive and clear to express my
feeling. I can even use art to communicate to myself when I am alone.
Whenever I feel stress, depressed and anxiety, I can always use art to
convey my feeling. Different color and material can express my feeling well.
The process of art therapy makes me understanding myself well.
Understanding the problem of myself and how the problem was created.
‘ knowledge’ itself is important, but not enough for living for a great benefit of
life. The most important thing is how to practice the knowledge into the real
life and how to move on the life with trauma. By using art therapy I know how
to handle those problems in life in a new way or thinking.
The process of art therapy might not give the happiness to people, but it is a
tool for handling the problem that life gives us.
29
Reference
Cloin Wastell., 2005. Understanding Taruma and Emotion. Berkshire: Open
university press
Diane Waller., 1993. Group Interactive Art Therapy. London: Routledge
Living With PTSD [online]
Available at:
http://livingwithptsd.wordpress.com/2010/09/28/recovery-stages-for-ptsd/
[accessed 05 January 2013]
Marian Liebmann., 1989. Art Therapy For Groups. London: Routledge
Michael J. Scott & Stephen G. Stradling., 1992. Counseling for post- traumatic
stress disorder. London: SAGE Publications Ltd
National Institute of Mental Health [online]
Available at:
http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-pts
d/what-are-the-symptoms-of-ptsd.shtml
[accessed 05 January 2013]
Thom Spiers., 2001. Trauma: A Practitioner’s Guide To Counselling. East
Sussex: Brunner- Routledge
The Free Dictionary [online]
30
Available at:
http://encyclopedia2.thefreedictionary.com/Post-traumatic+stress+reaction
[accessed 05 January 2013]