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A Day in the Life of an Art Therapist
20 April 2017

Ling Choon Lian, 40s

Senior Art Therapist, HCA Hospice Care

My day begins with a routine involving catching up on administrative and logistic tasks, such as scheduling visits with my patients, attending to new referrals, and preparatory work before and after patient sessions.

It starts to transform into a tapestry as I make my way to patients’ home nestled in different parts of Singapore.

As an art therapist, I bring to the patient or the family member another form of care experience that aims to achieve inner wholeness through creative expressions.

“What is art therapy? Can it benefit someone who has never experienced art-making or does not like art?” — such questions are commonly raised by patients and family members, and at times also by members of our multi-disciplinary team.

The answer is an unequivocal “yes”, based on my observations over the last four years while working with patients who may be as young as four years old, or in their twilight years.

I have also noticed that the needs of the patients referred to palliative home-care services have become increasingly varied and complex. Hence, central to the care provided by HCA is an integrated and holistic approach to ensure that our patients and their family members are adequately supported.

Art therapy brings to our multi-disciplinary team unique and distinct plans to enhance a sense of personalised care for our patients and their family members.

Art therapy sessions are customised. A lot of thought goes into the conceptualisation, carefully evaluating the impact of illness on the patient and family, be it physical or psychological.

I usually arrange patient appointments in advance. This may not seem significant to us, but this helps many of our patients, who often experience a sense of helplessness due to lack of physical choices, maintain control and the ability to make decisions.

The length of therapy and session duration are therapeutic parameters instrumental to promoting engagement and change in patients.

It is not uncommon for a session to last up to two hours when the individual grows into the role of an active agent in the search for new expressions and meanings for his/her suffering.

Art therapy offers an experiential learning journey into the unknown where growth potential can be uncovered…

My encounters with patients are usually marked by a degree of unknown. I have on various occasions been intrigued and amazed by the innate ability within the human kind to CREATE, not simply in the artistic aspect, but predominantly in bringing to one’s existence new ways of hearing, looking, feeling and making sense, choices and connection.

One of our patients, whom I’ll call Susie*, has impacted me in many ways. Recalling the experience of working with her and her parents always makes me feel deeply grateful.

Susie was a patient in her early 30s with brain cancer. Affected by her illness, she suffered short-term memory loss; her speech and motor functions were deteriorating too.

According to Susie’s parents, she had become very quiet and passive, and often came across as dull and emotionally flat. They became increasingly worried as it got harder to engage Susie in conversations or activities. Though they were caring for Susie round the clock, they felt painfully distanced from their only daughter.

At the start of our meeting, with very few words, Susie expressed her willingness to try out art therapy. With that, we began a process that saw her making new paths into reconnecting with herself and her parents.

At the start of our meeting, with very few words, Susie expressed her willingness to try out art therapy. With that, we began a process that saw her making new paths into reconnecting with herself and her parents.

The very first piece of artwork Susie created was a collage with many hearts: ‘Love me’ she wrote on one of them. “I need love,” she whispered.

‘LOVE ME’

From that quiet, seemingly unresponsive soul, there was a need to be loved. Her parents were moved to tears the first time they heard Susie verbalising a deep longing within.

Images made in art therapy hold and symbolise aspects of the person who made it. They act as a bridge between body and mind, and between self and others.

Susie was often captivated by the sensorial experience in the process of art making. In another piece of work during the initial sessions, she gave a form to what was unspeakable — the impact of illness on her visual-sensory processing.

‘STUCK’

Susie struggled with each stroke, as it seemed like she was “stuck”, tracing the same line again and again. As the cluster of lines soon loosened to become defined strokes, her face brightened up with a sense of accomplishment.

After witnessing the whole process, Susie’s mum came to see Susie’s impassivity in a new light. She began to comprehend the looming sense of being stuck that she struggled with when she tried to talk to Susie.

What was made even more apparent to me and her parents was Susie’s unyielding determination that defined who she was and how she would be remembered. The nonverbal media of art became a safe expression for Susie and her parents to grieve together as they faced her illness trajectory.

I remember in later sessions, there were extremely poignant yet uplifting moments where amidst pain, both parents and child were held together by their unyielding will to love and hope.

In her response to an image of a stormy sea, Susie muttered, “Worried… my parents.” Tears raced down Mum’s face, and Dad rushed to assure Susie. My heart sinks into abysmal depths even as I recall the moment here.

Another such tender moment was recorded in her artwork. After completing a collage painstakingly, Susie faltered and scribbled her inner feelings: ‘peaceful’ and ‘I feel loved’.

‘I FEEL LOVED’

I have no words to describe my feelings as a witness to Susie’s progress from her initial expression of wanting to be loved, to a profound sense of feeling loved. What’s more for Susie’s parents who have made numerous personal sacrifices for her!

As an art therapist, I totally appreciate the gift of images as a non-verbal tool for holding one’s losses and inexpressible pain. Yet, I am amazed even till this day how Susie and her parents chose to proceed with art therapy even as Susie’s artworks began to show evidence of her disease progression.

We negotiated and worked on new ways of keeping a felt sense of connectedness for Susie.

Both parents took the plunge and made art alongside Susie. They spoke more about their experiences with her. Dad recalled how Susie enjoyed a particular way of being held physically. Mum celebrated with tears and laughter, her daughter’s courage and willpower that shined in the midst of trials and suffering.

This is Susie’s parents’ expression of resilience, invoking a sense of hope amidst the dreadful outlook.

‘RESILIENCE’

I remember the peace that filled Susie’s room on that last visit I made to say goodbye. Her mum and dad maintained a posture of tenderness and calmness, as family members gathered at Susie’s bedside.

I have taken away so much, from the encounter with Susie and her parents. The lessons they gave me will continue to impact me in years to come. I am deeply grateful.

Without their consent and generosity, it is not possible for me to share their personal stories and images made in art therapy.

This work that I am doing makes me feel as if I am walking around death. And death stings and terrifies.

I admit at times, that this great fear within, drives me to engage in mind-numbing surfing on the Internet or even to the ills of comfort food. Still, for me there is a certain lure in this sort of work that I muse over.

‘Is there any meaning in my life that the inevitable death awaiting me does not destroy?’ Leo Tolstoy, A Confession.

There is tension in these realities. I will march on in tension but with lessons from the journeys with patients and their family members regarding self-care. It is ok to take time to grieve and ask for support if needed.

I learn to live with the reality of my mortality and limits and try to look gently and honestly at my fears. Denying pain, fears and real needs only forces them to become greater problems and limitations.

The practice of self-care demands not merely the self-discipline of individual palliative-care practitioners — it also calls for the community of palliative-care services to put in place necessary initiatives, measures and resources to make it a way of life.

*Patient’s name has been changed for privacy reasons