Self-Healing Through Art Intervention for Seniors

An underlying belief of self-healing is that ‘elderlies’, ‘seniors citizens’, or ‘older adults’ have the power and ability to better their own lives.  Art acts as the catalyst and agent which brings out this power.

Background

Seniors in Hong Kong face a challenging life.  The changing pace of urban life over the last few decades has disintegrated the community and social web that was once an everyday reality.  This lack of a support structure has led to poverty, malnourishment and depression often accompanied by loneliness, disorientation and hopelessness.

Families that are unable to care for elders with ailing health at home often house them at day centre or permanent homes.  Even in centres with quality facilities and much needed medical and care assistance, it is very difficult to fulfill the relational and psychological needs.  Without a social life and personal development, seniors experience a very tasteless survival which easily sucks away the joy and will of living.

This lack of hope has also infected family members and carers.  Seeing the deteriorating state of grandparents and elders, the work of caring becomes difficult and visitation becomes odd moments of silences and repetitive conversations.  For those with elders facing dementia, many wonder if the soul still exists within the expressionless face.

A Hopeful Reality

From books, media and personal experiences, we all KNOW seniors who have aged healthily with dignity; and these stories are certainly not isolated cases.

The late Dr. Gene Cohen, director of the Center on Aging, Health & Humanities at George Washington University, through his 30 years of aging research, found that ‘older adults’ brains continue to grow and mature through life.  Combining branches of science from neuroscience to psychology, Dr. Cohen found that the mature brain is more prone to positive than negative emotions, and is better at turning knowledge and experience into wisdom.  From the countless cases he observed, seniors are capable of new creativity and mental challenges that continues to renewal their later life.  What enables such a fruitful aging process?

The Sweet Tonic Singers is an active senior Australian choir, holding steady rehearsals and performances.  In 2008, Dr. Elaine Lally studied the health of its singers between age 51 and 83.  Over the 30 weeks, the participants (except for 1) reported better awareness, walking, less use of medication and less trips to the doctors.  The participants reported being happier and socially more active.  These improvements correlated with improved singing skills, breathing and vocal control.  The physical and psychological improvements resulted in a clear sense of confidence that was felt by the audience at the sold out concert.

What do ‘Older Adults’ need?

Is it simply shelter, nutritious food or physical exercises that keep the aging body going? 

Though these are often considered to be basic human drive, what really drive us are the things that give life hope, joy and meaning.  Renowned psychologist Csikszentmihalyi, in his monumental study of human happiness, found that human civilizations can survive the harshest environments because they have found meaning for existence.  They tell stories, sing songs, made artwork, and found challenges to keep their survival spirit alive.

In a recent aging research of art’s impact on senior health, Art for All artist and chairperson Evelyna Liang, engaged the seniors in telling farming stories by incorporating physical exercises that mimic motions of rain, river and harvesting.  Instead of the mechanical repetition often reflected on the seniors’ reluctant faces during physiotherapy sessions, this narrative exercise brought laughter and more sharing of personal stories over a full body exercise.

This was also observed in Art for All’s Grandpa Grandma Memory Boxes (GGMB).  The food drawing activity brought back seniors’ love of food.  Vegetables of various colours were chosen for looking, touching and smelling before the painting began.  The activity brought out memories, stories and recipes, and exercised eyes, hands and multiple levels of mental processes.

Art and Self-Healing

Whether it is painting, music, dance or drama, Art provides an intricate set of motivations that is self-generating.

Art…..is personal

…It is related to daily lives

…is collaborative and relational

…requires physical and mental exertion

…challenges physical strength and control

…challenges problem solving and creativity

…welcomes emotional expression and contemplation

…is meaningful

…is beautiful

…is fun

A)   Physical and Mental Engagement

Art awakens the body and mind, down to our deepest being.  The simple fun of doing art drives one to continue.  As observed from GGMB or other senior art programmes, art provides the reason and means to stay mentally and physically healthy.  It is only a matter of time before the senior and the carer recognize the physical and mental benefits described above.  Though physical benefits may only slower decline for some, many elderly expresses pride in regaining some physical and mental control.

B)   Social Engagement

The format of community art workshops such as GGMB promotes group work.  Socialization begins with seeing, being and chatting with others in the same activities.  The fun and challenge of doing art provides a common experience to talk about, engaging both the seniors and the carers.

C)   Emotions, Ideas and Memories

The creativeness and expressiveness of art making invites emotions, ideas and memories.  While the misconception is that only young people are creative, Dr. Cohen explained that an older adult’s creativity is grounded in life long experiences.  A children musical organized by Art for All in Henan involved 2 elderly musicians, who grasped the essence of the stories and improvised wonderful musical background with ease.  Not only does the content provoke emotions, ideas and memories, the touch of vegetables and human hands, the sound of a familiar instrument and song, the deep orange of a yam, all provoke personal expression.  These thoughts can be cherished, or revisited within a supportive environment for psychological closure.

D)   Striving for Beauty

The strive for beauty contrasts greatly with the everyday existence in senior homes.  In GGMB, the artists prepared painting canvases for the seniors to draw their own clothing.  The beautiful clothing used in the photography session brought out personal confidence and character.  Dignity is restored through the beautiful artworks and their strive for personal beauty.

Facilitation of Self-Healing

The above descriptions only touch the surface of the power of art to promote self-healing.  They converge during a group art workshop in intricate ways to form the satisfying experience of projects like GGMB; friendship feeding into teamwork, teamwork feeding into artistry, and shared beauty feeding back into shared experience.

The role of Art Facilitator is to create an environment where this can happen freely.  There are guidelines and rules for such a group setting, but the most important is trust.  In addition to trust among the participants, the Art Facilitator, helpers and carers must trust in the participant’s self-healing capacity, using art activities to slowly draw it out until it becomes self-generating.

Hope for Everyone

This hope was given through the seniors.  The artists’ work was to draw out their self-healing capacity.  The artworks and activities gave everyone a talking point with the seniors, reminding us that they are capable individuals.  Carers involved were glad for the seniors, transforming the often work-strained relationship.  Family members rediscover their elders’ dignity, and often hears interesting stories for the first time.  And at a deeper level, the younger generations can witness the dignity and maturity of aging.

Excerpt from Proposal

[April 1, 2013: This is actually an excerpt from my Ph.D. thesis proposal, I think it was edited though.  Now that I am formally accepted, I can clarify this without people asking me: Any news yet?]

...Krensky and Steffen (2009) proposed that ‘Community Art’ is unique where “professional artists work directly with others in grassroots settings to create art in the public interest”.  While this definition instills a romanticized image of community artists empowering villagers in remote mountains, probably many more work with not-so-grassroots groups on projects whose interests are harder to grasp. 

If the community art process is as transformative as all that its advocates claims it to be, an art facilitator should be able to take that high-paying job at the private Catholic school, and open the eyes of that hypothetical spoiled rich kid to see the ‘sufferings of the world’.  In fact, this is sometimes the case reported by community art facilitators who have taken on such jobs.  Therefore, this proposal adopts a modified definition, where “artists work directly with others to create art”.  The reality of this profession has prompted the negation of ‘professional’ from the definition.  Not only is the term ‘Professional artist’ problematic in itself, many capable facilitators used to be social-workers, teacher or longtime participant turned facilitator....

Community is made up of people

Community is made up of people.

I sometimes enjoy making statements.  To play with words and try to make something sound definitive and authoritative.  But usually the process is more rewarding than the final statement.  So this morning I was tinkering with the community art idea, whether or not we are working with people or with communities.  For many frontline community artist who know what they are doing, it seems that they are not really concerned with this question of "community or people?"  But I guess I am the kind of guy that likes to step back and think about these things.

Note: You will notice that I try not to use the word individual to denote a single person.  Because the term individual has a connotation that stands for an isolated existence which I don't believe is true.

This issue of "community or people?" came up recently because I have been reading a lot about therapeutic uses of art, treatment for individuals and so forth.  The readings help me built up some basic concept, but at the same time, I had an internal discussion of whether this was what my/our community art programme was doing.

Since our programmes always dealt with groups of people or a community, we usually don't go deep into a therapeutic process (unless it is during the Sichuan or with other post-traumatic communities).  Instead, we usually emphasize building connection and relationships, of finding one's place within a community.  Therefore, this morning I had the urge to say that "we work with communities".

But then, I thought about our artists, and my time as an artist during some of the projects.  Something was reminding me that we must treat people as people, and not to fall into the danger of treating people as faceless individuals of a community.  This thought began to germinate inside my mind, creating flashbacks of past programmes.

Finally, by the time I arrived at the train station, I had something worth stating.  A community is made up of human beings.  And humans are 'multifaceted', 'multidimensional' and 'multi-whatever', each one of them is at the same time a physical being, a psychological-being, a social/communal being, a spiritual-being, an environmental-being, an artistic-being, an intellectual being......So, by treating a human being as communal being, and providing a platform for group/communal exchange, he or she will naturally be drawn towards communal activities.

Hence, my statement: Community is made up of people.  Without people, there is no community.  Therefore, Community Art begins with people.

This process began with rethinking the term "Art for All" and "community art", but this exercise seems to have  brought up another issue.  Art for All is only the English name, the Chinese name contains a play on word that could mean "everybody move in/for Art" or "a holistic person moving in Art".  Now, this term "holistic" is certainly worth some thought.

From a wider perspective, we could say that our art activities balances all the non-art activities that overwhelms people; so, by joining our activities, a person becomes more balanced.  But this would imply countering 1 extreme (of no art), with the opposite (of all art), which is somewhat reactionary, and complementary.

The above discussion of the nature of human being as being physical, psychological, communal, artistic, intellectual.....seems to have shed new light to this issue.  We have found artistic activities to be embracing of almost all sorts of skills and predisposition; for example, craft material manipulation, blueprint drawing, group leading, stage logistics, pattern creation, story writing, group drumming arrangement...to name but a few, already requires a multitude of skills, physical and mental predisposition.  I have yet to find a single person with NO SKILL to offer in Art.  (This is especially true now that art and art activities are increasingly diverse)

The tricky part is to encourage participation, but that is where "Holistic" meets "Community".  Peter Block explained in "Community: The Structure of Belonging", that community is about exploring each member's potential and sharing it.  It is only within a communal relationship that people can share skills and gifts freely and find their place in relation with others.  I guess that is why Art for All's founders call it "everybody move in/for Art" or "a holistic person moving in Art". 

There are several untied knots here, which is well beyond the scope of this entry:

How does the "Holistic" meets "Community" thingy work in a Community Art setting?
What is a Community? What holds a Community together?

For now, I will recommend the book:
Community : the structure of belonging / Peter Block.
San Francisco : Berrett-Koehler Publishers : Ingram Publisher Services [distributor], c2008.

Henan Rural Programme

Empowerment is the ground work to effective advocacy

We have been working with a NGO in Henan that advocate and work to improve rural equality for women and the people in general.  Our previous projects since 2007 have used art, embroidery and drama for sex education, women issues of marriage, birth right and inheritance which received much participation and positive feedback from a wide range of people.

To involve more artists in this project, and due to scheduling conflict, this recent July 2012 trip consisted of 6 artists new to the project, covering painting, music and drama.  Whereas previous programmes engaged women in similar social circumstances, facing issues that were closely intertwined, this trip required us to work with 3 new groups: a children musical drama, a community mural and an elderly choir.  As this was a new audience with new objectives, the facilitation style and method became a central point of discussion and some tension (this discussion will omit the community mural that involved all ages).  Albeit differences in expectations and opinions, the parties were willing to listen and exchange ideas.

The process has stimulated me to think about issues of advocacy and empowerment.  To provide a frame for discussion, advocacy work is described as usually being issue-based, is more urgent and direct, and is more vocal; such as improving female access to education.  While empowerment work is described here as usually being long-term, tackling fundamental issues, it tries to exercise or actualize rather than simply vocalize the intended change, but that change is often hard to concretize or to observe; such as reshaping a community’s expectation of female.

Children Musical Drama

The expectation of the NGO was to express children rights; especially that disciplinary beating is not okay.  Since this was a 1^st trip, our basic knowledge was that i) all Chinese children are ‘enslaved’ under the education system and ii) that the parents work hard to make a living and are also stressed out about children’s school performance.  Within the time frame, our plan was to a) let everyone have fun and participate well in the drama and b) through the quality participation to improve children-parent relationship. 

This was exercising children’s right to fun and expression, something we value as the most basic children rights, and through that to open the parents’ eye to the children holistic growth, thus lowering physical discipline either due to bad school marks or repressed temper.

After the first day, the NGO’s commented that it was too indirect and wished for clearer portrayal and exploration of physical discipline in the drama.  We agree that should be a long term goal, but too rushed for the 10 allotted workshop hours.  So we inserted a scene of physical discipline, and created a song with each child’s response to being hit.  There was not enough time to explore the parents’ side.  However, one incident suggested to us that the parents were beginning to really listen to the children: During the final day of rehearsal, we scheduled an actors’ meeting that included both children and adult actors.  While the children were giving their comments, not only were the adults listening, they even accepted and put into practice some of the children’s suggestions.

Elderly Choir

With many adults and youths moving to work in the cities, many elderlies stay in the rural homes to farm and take care of grandchildren, while out of disrespect families may show physical neglect or even violence to them.  Also, the changing society and deteriorating communal life has completely taken away many elderlies’ neighbourhood and friends, causing low self-esteem, loneliness and high number of suspected depression cases.  The NGO wanted to start an elderly choir that would bring them together to rebuild communal life, to rebuild their self-esteem and respect from the community.

As we saw it, in order to bring people together, we would want to first build friendship and a trusting environment for them to share stories and emotions of everyday lives.  Since it was the breakdown of family we were fighting against, we began with topics such as taking care of grandchildren and families, using children folk tunes that would evoke such memories.

Again after the first day, the NGO commented that they wanted establish the group by first building respect for the elderlies from the community, by presenting an image of the elderlies being still energetic.  Therefore, singing children folk tunes was too ‘childish’, and might cause further disrespect.  After our artists warmed up the elderlies, they insisted simply preparing 2 songs for performance.  We originally envisioned an intimate performance of traditional and newly composed folk tunes that share about life’s up and down; however, the final performance was yet another conventional performance that mirrored that village’s other larger choir.

Reflections

From the perspective of a participating party, the mural and children choir actually went pretty well.  I think the success was not only an artistic success, but also a successful negotiation of objective and method.  Conversely, the elderly choir’s performance was in part my failure to successfully find a suitable middle ground.  It is frustrating but not uncommon for partnering NGO to suggest or interfere with the programme, but it is always unfortunate that NGO pay artists to do what they can do themselves.

As the visiting artists, it is reasonable for us to respect the local NGO’s assessment of a community’s culture and needs.  It was their belief that elderly wellbeing was an urgent issue that required a clear example for advocacy, and as such an elderly choir was required.  But as mentioned above, the performance of the choir was simply a small version of the village choir that belted out powerful revolutionary songs.  Thinking back to the elderly choir, there is even the danger that, by upholding a facade of strength and capableness, the public would feel that the elderlies are doing fine socially, physically and mentally.  

I agree that advocacy is required to raise awareness and action, however, the message should be a genuine message from the heart of the community and presented in a way that would attract a desirable response.  We might simply say that the elderlies need love and respect.  But what does that really mean and how does it happen in their village and their family?  The artists or the local NGO can try different answers, but why not give the elderlies the artistic tool and expressive platform to explore the answer for themselves?  The setting of a conventional choir provides very limited participation, whereas small group compositions and rehearsal can better share ideas and skills.    The creative process alone already builds mutual respect and connection. And ultimately, through this empowerment process, the envisioned future for advocacy will slowly materialize.

About a Playback Group

“Bringing” theatre to people usually means performing for people.  But we felt that the performance was only half of the theatrical experience, so we started an “Open Practice” to let audience member go through what we do.

Back in the early 00’s, a couple of friends and I were invited to start a Playback Theatre group in a youth organization in Toronto.  What is Playback Theatre ?  It was a great opportunity for us to really dig-in to the art form and build a team of people.

Established for around 40 years, Playback Theatre has expanded rapidly especially in the past decade, where it is widely used as a platform for community building, social awareness and personal growth.  Playback Theatre is such a form that values and balances input.  Each Playback group has their own goal and character, guided and negotiated among its founders and acting members (literally the actors).

As we were amateurs ourselves, we took sometime ourselves to experience what Playback was about.  From within our community, we invited a stable group of youths who would form the majority for over the next 3 to 4 years during my time there.  We usually practiced 3 times a month, and performed 6 to 8 times a year for a small audience.

Only 1 year into our founding, we accepted a difficult task: to prepare a programme for a youth creativity camp that would let participants experience how Playback Theatre could help them grow as individuals.  As part of a youth organization, we valued youth participation and were determined to plan and execute the programme together.  

Having all gone through about a year for Playback training that brought about much self-exploration, we were unanimous in that the programme would focus on the training experience rather than to provide a performance.  But it was not easy to decide which game and exercise to include from the dozens that we have used over the year.

After some unconstructive discussion on activity suggestions, we had no choice but to go back to the very basic and asked ourselves: In what ways have our training affected us?  What did our style of Playback emphasize?  How has our favourite games/exercises shaped and affected us as a person, an actor and a group?  Even though our eyelids were the weight of lead, our ideas finally took shape and slowly turned into a practical flow of activities that would become our programme for the youth creativity camp.

This camp eventually inspired us to insert an education component into seasonal performances called the “Open Practice”, where a small number of audience members can join a day of Playback practise, and then stay for the evening performance.

The process before every theatre performance is long and arduous.  The concept of “Open Practice” idea is similar to a backstage pre-performance tour for the audience to see the its hidden effort.  The nature of Playback Theatre allows for a very in-depth backstage experience where the audience can experience the physical and mental preparation of an actor, and the satisfaction of the process.

2012 Feb India Trip 2

Transformation is a very exciting thought, and is probably a common way to describe what an Artist wants to do in a community.  I wouldn’t say we transformed much in those 3 days, but we definitely started some stories.

This community was relocated from a downtown slum.  The slum was convenient, crowded, lively, full of character, familiar and unhygienic.  This new housing collective is remote, clean, removed and impersonal.

Looking at photographs of bare walls and hallways, I immediately thought of transforming the housing block with mural painting.  But to facilitate a community mural painting project not only requires time and resource, but most importantly sufficient planning and negotiation.  So it was eventually limited to the wall of 1 classroom.

During our 3 days there, there were other visiting groups who photographed and handed out candies, and they attracted much attention from the residents.  Not to debate others’ actions, we took advantage of this outsider status to achieve our goals.

Day 1

Day 1 was our training for kindergarten teachers and Helpers.  Looking at the poorly lit and ventilated kindergarten room, I quickly asked if we could hold the training in the hallway; not a lot of trouble for the organizer, but just out of the ordinary and warnings of probable interruptions from passers-by.  And sure enough, before the morning was over, the number of children surrounding us was so plentiful that we decided to hold an “on-the-job” training for the afternoon.

In the afternoon, unsatisfied with drawing on large pieces of paper, we requested to draw with chalk on the large outdoor walls.  After some string-pulling, it was again granted, and from that point on, the children programme became mostly outdoor, and our songs, games and parades began to focus the usually uncoordinated daily lives of the community.  The potential of this open area as a gathering point also became apparent.

Day 2

The children enjoyed Day 2 much like the first, but an opportunity aroused on Day 2 that involved the their mothers and sisters as well.  During their lunch break between morning and after embroidery activities, most ladies set on stairways and aisles as usual, idling, chatting and watching their children play.  Having seen the children danced and paraded in the open area, Evelyna (team leader) took this chance to get the ladies to dance there as well.  Drumming introduction began, followed by Evelyna’s dance, then her invitation for us and some young local Helpers to join, while she slowly used her dance to pose friendly challenges and taunts to surrounding ladies, who by this time were inching closer to the circle.

Thinking back, I remember amusement in the locals’ eyes, that our dance and music was un-traditional and strange; but there was also a hint of aspiration to be able to let go and have unburden fun.  Finally, senior looking lady responded to Evelyna’s challenge, and as if that was a cue of trust, other married ladies soon joined.  Apparently social codes regarding dancing and photography by unmarried women in the presence of male are still common in many Indian communities; nevertheless, it was great to see the mothers having a good time dancing together.

Reflection and Analysis

The remoteness of this new housing block has posed new challenges and opportunities for this community.  Working men (some women) and children have to walk nearly 30 minutes of dirt road before they can navigate the local transit system to work and school, which is congested throughout the day.  Home-bounded women and children are stranded with no nearby market, relatives or park.  After and before their daily house chore and meals, there is very little to do at home but to see if the next incoming truck might bring food, water or sight-seeing visitors.

Organizing the children’s free time into learning and group activities to nurture friendship, joy and a healthy upbringing was our local partner’s first step.  While embroidery group would be a nature attraction for the ladies, which builds support networks with the possible outcome of long-term income generation.  However, it was equally important to provide dancing activities that exercise the women’s body in energetic gracefulness, in an activity that is not calculated to be productive, but strictly for fun.

Physical presence and use are ways of defining physical ownership.    The kindergarten in operation already uses this open area for daily anthems and school events, and the children also claim the open area as their playground.  The ladies, in charge of household during most of day light hours, should extend this ownership onto the entire housing block as their community, the open space is not just as a driveway or their children’s playground, but also their open area.  

This was a recently relocated community struggling to survive in a new environment.  For those 3 days, we as visiting artists facilitated programmes that welcomed participation, and showed the people that they are the owner this new housing block.  Perhaps such communal ownership would never enter into any written contract, but it has actualized the moment that senior lady took the lead into the dance circle.