Expressive art therapy helps bring out buried feelings - and in Asia it's growing

Very sick or terminally ill people canhide their feelings, but expressive art therapy aims to help unlock difficult emotions - and the technique is growing in Asia, writes Jeanette Wang

PUBLISHED : Monday, 28 September, 2015, 5:01am
UPDATED : Tuesday, 29 September, 2015, 7:52am

They say a picture paints a thousand words. To expressive arts therapists, it can say so much more. By guiding their clients through different creative art forms, the therapists are able to help individuals express themselves and communicate issues in ways that talking cannot.

"We use arts in an integrated way for personal growth and social change," says Fiona Chang, a registered expressive arts therapist with more than 20 years' experience.

The art forms include visual art, music, drama, dance and movement, and creative writing and poetry. Expressive arts therapy can help people awaken creativity, experience new insights, identify their strengths and inner resources, and foster self-empowerment and self-healing, Chang says.

Many people can benefit from the therapy, she says, including cancer patients, people with chronic illness, caregivers for sick people, elders with dementia, children with special needs and their parents, sexual abuse victims and drug addicts.

"Even for healthy, problem-free people, the therapy can be a very good means to understand themselves further, and also have fun and destress," says Chang. It's particularly effective for people who have trouble articulating their emotions, perceptions or beliefs.

Awareness of expressive arts therapy is growing in Asia, Chang says, with many countries offering both the therapy and therapist training programmes. In Cambodia, for example, the therapy is used with orphans with HIV, and in India and Nepal with human trafficking survivors.

Hong Kong will host the 11th International Expressive Arts Therapy Association Conference on October 8-10 at Wu Kwai Sha Youth Village in Ma On Shan. This is the first time the biennial event is being held in Asia. More than 150 presenters will attend from 23 countries, including renowned pioneers and practitioners in expressive arts from both the East and West.

Even for healthy, problem-free people, the therapy can be a very good means to understand themselves further, and also ... destress
Fiona Chang (below)

Expressive arts therapy was introduced in Hong Kong in 1994. "Chinese people tend to suppress their negative feelings or hide their negative experiences, so art provides a very safe medium for them to express themselves in a more subtle way and socially accepted way and help relieve their negative emotions," says Chang, who is working on a PhD thesis on the effects of expressive arts in breast cancer patients and their partners.

Using the arts to heal goes back to ancient times, says Shaun McNiff, a professor at Lesley University in the US state of Massachusetts and an internationally recognised figure in expressive arts therapy.

For example, the Egyptians are said to have encouraged people with mental illness to engage in artistic activity; the Greeks used drama and music for their reparative properties; and the story of King Saul in the Bible describes music's calming attributes.

In more recent times, expressive arts therapy has been incorporated into a variety of mental health, rehabilitative and medical settings as both primary and adjunctive forms of treatment. Music and imagery therapies are now used routinely with patients in hospital to help with pain reduction, relaxation and childbirth.

Private therapists offering one-to-one sessions can charge about HK$800 to HK$1,000 an hour, Chang says, but there are also free sessions offered by a few public hospitals and NGOs.

A typical group session will consist of eight to 12 people, including a mix of youngsters, adults and old people. Therapy programmes usually last for six to eight weekly sessions. In the first two to three sessions, participants get familiar with the different kinds of art available and get to know one another.

After that, they'll begin using the art forms to express their concerns and understand themselves better. At the end of the programme, the artworks will be combined into a gallery, which the participants can reflect upon.

Therapists do not interpret participants' artworks, Chang says, but instead try to facilitate the discovery of personal meaning and understanding.

"Sometimes, if you simplify psychoanalytical knowledge to analyse the art, it's not helpful to the client because you impose your professional judgment upon them," she says. "The more powerful means is to have empathetic understanding, to listen closely and be very sensitive to their body language, and facilitate the client's own interpretation of their artworks."

How art therapy brought colour and perspective to cancer patient's outlook

Shan Shan, who was diagnosed with breast cancer, joined the expressive arts therapy group to enhance her self-understanding and for emotional healing.

She made a sculpture to explore her challenges and resources. As a mother, she takes on different roles and burdens in the family. On the surface of the sculpture, everything looks fine. But when it was turned upside-down, she discovered there were a lot of emotions stuck inside her. The sculpture gave her a new perspective on what is really happening in her.

Shan created another piece of art, a spontaneous painting, by dropping paint on rice paper. She did not like her painting at all. The yellow spot in the centre reminded her of cancer. So, she did another painting with more colours. She looked at the two paintings together and realised the yellow spots were just part of the different colourful circles, and that it's not wise to focus on the cancer. It helped her to be aware of staying open to wider perspectives for positivity and hopeful ideas about the future.

Breast cancer patient faces mortality with creativity

Dolly's breast cancer is at an advanced stage. Her doctor said her prognosis was not that good and she had only a few years to live. She has been through a lot of life struggles and is trying her best to take good care of herself.

She built a "worry-free island" to forget all the misery and doubt. She hopes to enjoy life more fully. However, she is deeply conflicted. She is single with no children. She worries about her future and getting closer to death. Her art betrays her fear of suffering and pain.

She was invited by the therapist to explore her fear through a dramatic enactment of her visual art. She put a black scarf in front of her to represent the darkness and a yellow scarf on herself as protection. She moved around and looked at her art from different angles. She admitted feeling lonely and helpless. It was the first time she had shared her true feelings, which she usually conceals.

She realised she had to express what she felt. She accepted her vulnerability and showed the courage to speak up.

It also prompted her to start a journal about her experiences and made her realise she is not alone in her plight.