Huma's blog: reflections on autism, art therapy, parenting, mental health issues and all about Mo!

Sunday, October 1, 2017

Channelizing aggression in children through art


A 5 year old's expression of her internal trauma
Aggression in children could be a symptom of underlying issues that find external expression in inappropriate verbal and/or physical behaviour. The common course of treatment for anger management in children is behaviour modification and in extreme cases medication. These approaches have their merits and can help in averting disastrous consequences for the child and his/her family. However, focusing on behavioural techniques in isolation may inadvertently conceal the psycho-emotional problems that are at the root of the behaviours and may be a call for help from the child, rather than a deliberate attempt to cause harm.

Children lack the ability for metacognition or the capacity to think about their thoughts. Simply put, they may have no clue as to why they act out, transgress limits, push buttons and indulge in inappropriate behaviors beyond what is considered typical. Amongst the many reasons they may be doing so, attachment issues, familial problems, stress related to school and peers, learning differences and developmental challenges may be implicated. Thus, it seems rather one sided to expect external compliance from a child who may be suffering emotionally, without addressing the internal aspect of the matter.

I find art therapy to be most efficacious when it comes to addressing psycho-emotional problems in children as it has the capacity to tap into the hidden content of a child’s psyche that may not be accessible through words. Art making can by pass defence mechanisms that prevent access to deep-seated conflicts.

Very importantly, art therapists work through metaphors in the child’s artwork thus, if some trauma or difficult emotional content surfaces through art making, it can be processed in a safe and non-confrontational way. Art therapy is a safe therapeutic modality in that it avoids re-traumatization of the individual from exposure to difficult memories.

Art therapists are also trained to direct negative emotions into creative acts through prudent use of art material. Clay may be pounded or kneaded, scratched and poked in order to express anger or frustration just as paint may be splashed or paper torn and crushed to channelize aggressive affect into appropriate expression.

Art making, whether in the form of seemingly random scribbles and doodles or skillful images and sculptures is an expression of the unconscious. Thus, to partake of art therapy absolutely no skill in art making is necessary. In fact I have come across children who do not show any inclination to draw or paint yet can be tempted to engage in acts of creation that lead to inner expression.

A child cannot convey with words what they are not aware of; and some children may not have the ability to speak. You will be amazed to find what can be achieved through the simplest forms of creativity and relational art making with an art therapist.


Time and time again I am asked if art therapy and art class are one and the same? Once again, I will repeat that ONLY a Master’s level art therapist can conduct art therapy. Most art therapists are registered with regional boards of art therapy associations and have gone through hundreds if not thousands of hours of clinical practice.

Tuesday, August 29, 2017

Autism: Another perspective

Traditional definitions of autism focus on deficits in communication, social interaction and imagination. For most of autism’s history, it has been believed that individuals with autism lack interest in and avoid social contact. Observable behaviors across the spectrum such as stimming, repetitive acts, unusual mannerisms and echolalia are targeted for behavioral intervention to be corrected or redirected. In fact, most caregivers of children with autism will vouch that a large portion of the latter’s awake time is spent in behavioral modification and social skills enhancement. However, research over the past two decades has begun to look at autism beyond what is largely a socially constructed interpretation. There has been a shift in science to gain a deeper understanding of why certain behaviors occur. Could we be missing out or misinterpreting the actual reason behind for instance, why a child with autism is seen banging his head incessantly, flicking objects in front of his eyes, or smiling cheek to cheek for seemingly no rhyme or reason at all (these three examples are from my own personal experience with my son).

 Recent research has started to pay attention to sensory and motor/movement deficits that may explain symptoms that are commonly termed as ‘autistic behaviors’. This means that issues in sensory and motor functioning are being implicated for deficits in communication and socialization systems. Hence, researchers are broadening their lens to look at the neurological deficits that underlie autism. This shift in perspective is very significant if we are to get to the source of the so called autistic behaviors and understand why they take place. Our knowledge in this regard has great implications for the way we view these mannerisms and treat them. For instance, would you consider correcting the gait of someone with advanced Parkinson disease or redirecting a tic in someone with Tourette’s Syndrome. Probably not, and the reason for that is because you are looking at them from a neurological lens; you know that it may not be within the means of the individual suffering from those diseases to control the behavior.

To put it plainly, a restrictive view of autism may be misleading us into why someone with autism engages in loud vocalizations, has extreme reactions to small changes, rocks back and forth or repeats nursery rhymes endlessly. Interviews and self-stories of people on the spectrum have revealed that these stereotypical behaviors are more often that not a source of organizing and regulating experience; even perhaps a source of learning. 

Instead of looking at the person with autism as a whole, mind and body, we have relegated autism to a social interpretation of its symptoms. A new way of looking may be necessary so that opportunities to extend learning and develop relationships are not lost. It is essential to understand each and every individual with autism as unique, so that appropriate support can be provided; not to look for deficits but to focus on their strengths and competence.


Our children with autism are often at the receiving end of massive interventions to correct, stop, redirect and modify behaviors. We often forget the little souls that occupy these innocent bodies that are a jungle of misfiring neurons. Let’s get to know our children better and deeper so that we can help them without endangering their self-esteem. (Donellan, Hill & Leary 2013).

For appointments contact Huma at www.colouredcanvas.net

Reference
Donnellan, M. A., Hill, A. D., & Leary, R. M. (2013). Rethinking Autism:Implications of Sensory and Movement Differences for Understanding and support.  Frontiers in Integrative Neuroscience 6, 124. doi: 10.3389/fnint.2012.00124

Friday, June 23, 2017

Art therapy, emotional regulation and so on

Alan comes into the session somewhat anxious. As soon as he sits at the drawing table, he chooses his favourite medium: pencil. Alan begins to draw skyscrapers with multiple storeys, stairs and lifts as is always the case at the beginning of each session. He spins a story around his image as it progresses. The pencil is easy to control, also its marks can be erased, hence it feels less threatening to Alan than paint which has a mind of its own. The deep pressure of the pencil and its willingness to obey Alan’s commands seems to calm him down. 10 minutes into the drawing Alan appears excitable once again, perhaps it’s the turn that his story has taken or something else around him that has triggered this change of mood. I sense Alan’s frenzy and draw his attention to the clay that I have at hand for moments such as these. Clay will help Alan channelise his energy into a medium that has the capacity to ground or contain his anxiety. Alan begins to pound and knead the clay and once again a sense of calm pervades him. Later in the session, I  will ask Alan to use paint as I want to dig deep into his emotions. The session will probably end with Alan back to using the pencil, in control.

This brief anecdote provides a glimpse into how the inherent qualities of art materials are used within an art therapy session. Art therapists are trained to work with a large variety of materials to induce or subdue psychoemotional states according to the specific needs of their clients. Especially in the case of children with self-regulation issues a deep knowledge of the effect of art materials is necessary to modulate sensory/emotional states. For children with sensory integration dysfunction (SID), art materials can be used to sensitise or desensitise hypo or hyper sensitive children. Art therapy is being used effectively with children with autism spectrum disorders (ASD), learning differences and developmental issues. It is an effective mode of intervention for all ages and a wide range of psychoemotional issues such as anxiety, depression, low self-esteem, bullying, trauma, abuse loss, grief and so on.

 When words are not enough; where language has no access to emotions; when verbal expression feels threatening and unsafe, art therapy is the way to go.


*You donot need to have any artmaking skill to do art therapy.

Sunday, April 9, 2017

Therapy for caregivers

In March 2017, I conducted a survey about self-care for caregivers of children with differences. This survey is part of my action research project that aims to bring awareness to caregivers about the importance of looking after their emotional needs. As a caregiver of a child with ASD  for the past nineteen years, I am all too familiar with the highs and lows of raising a child with special needs, the toll it can take not just on the primary caregiver of the child but also the entire family.

The survey revealed three things:

  • Approximately 90% of the caregivers are aware of what self-care means and how it impacts their caregiving.


  • Almost all caregivers agree that their well-being is directly related to the well-being of their child, meaning that if they are mentally and physically well they will be better at caregiving (quality of caregiving has implications for the prognosis of a child).


  • The majority of caregivers take time out some time for exercise or leisure and around 37% indulge in holistic and spiritual practices but only 20% seek any kind of psychological help through counselling or psychotherapy.


Stress impacts everyone varyingly. Likewise, each of us copes with it in a different manner and not everyone needs to see a therapist for counselling or psychotherapy. In fact, some degree of stress is not necessarily a bad thing because it alerts us to situations within our bodies and in our environment that may need to be taken care of. However, when stress reaches a level where it is a constant companion, impairs daily functioning and begins to effect relationships, it can be detrimental to the individual suffering from it as well as their family and friends. Left unaddressed, extreme stress may lead to mental health issues and manifest as anxiety disorders, depression, agitation, frustration, pessimism, guilt and so on.


I myself suffered for many years with chronic anxiety before seeking psychotherapy and counselling and I am so, so glad that I did. I can only say that not only did therapy save me from potentially disastrous consequences, it equipped me to achieve things in the future that I could not have imagined. I am grateful to God for guiding me through this time.

Today I am an art psychotherapist. My son is 19 and interning at a restaurant as a waiter. He wants to work in a café. I tell him one day he will own one. I do art therapy with children and adolescents with ASD, developmental issues and psychoemotional problems. I am in the process of establishing my private practice in Singapore where I hope to run therapy groups for caregivers of children with special needs.

Though I am an ardent advocate of art therapy, be it for children or adults, the point of this writing is not to sell art therapy to you. In fact, I am fully aware that for many of you art therapy may not even be an option since qualified art therapists are not be found everywhere. However, I urge you to seek help in any form that is available to you and not to ignore your mental well-being especially if you feel you are having difficulty coping with the stress of caregiving. Go see a mental health professional, join a support group, reach out to others in similar circumstances. There are many professionals who offer online sessions for those who are unable to leave their homes for mental health services or may not have access to them.

If you want to know more about what art therapy can do for you and would like to connect to art therapists in Asia, write to me at myartherapy@gmail.com


Note: You do not need to have any artmaking skills to do art therapy.

Thursday, February 16, 2017

Anything is possible!

It's been a while since I updated you about Mo but I think this news deserves to be shared for three reasons: firstly, because Mo has taken the first step towards achieving his dream (owning a restaurant); secondly, it has renewed my faith in humanity and finally, it gives me the opportunity to say one that, 'anything is possible'!!!! 

Mo returned to Jakarta in October 2016 after finishing school in England and we had about 8 months before we moved to Singapore in June 2017.  I was panicking about how I would keep him occupied constructively in the interim and Mo too was extremely stressed about his immediate and long term future. In fact there were many 'volcanic eruptions' soon after he bid school in England goodbye  and immediately after his return to Indonesia. Though I was very happy to have him back, I was certainly not happy to be the target of his outbursts.

That is when I had an epiphany and decided to deal with the situation head on. Mo's dream is to work and eventually own a restaurant, so why should he have to wait? Especially, since the past two and a half years in England, this is what we had been preparing him for and the natural progression would be for him to start working towards that.

Consequently, I decided to contact Alex (pseudonym), the owner of a popular resturant in Jakarta, to request an internship for Mo as a waiter. Alex, whom I did not know personally, responded to my email immediately and asked to meet with Mo. At the meeting he agreed to give Mo a chance because he believed that everyone deserves one and, mirroring my thoughts exactly, he added that "anything is possible".

Ready for first day at work

 It has been two months since Mo's been working at the restaurant and loving it. Initially, he was very nervous and totally stressed out that he would fail to perform and be asked to leave, but that is in the past. Now for the first time in his life, Mo wakes up on his own, gets ready for work without reminders (shave and hair gel and all) and is off to the restaurant on the dot. Also, for the first time he has (to my utter delight) started asking for pocket money so that he has something in his wallet in case he wants to buy a snack on the way back from work. He returns from work brimming with confidence and a sense of achievement. What more could I have asked for!

Alex says that Mo is improving everyday and slowly he is beginning to give him more work. Alex is Mo's angel in Jakarta and I hoping there will be others waiting for him in Singapore. 

I have said it twice and I will say it again 'ANYTHING IS POSSIBLE"! 

Wednesday, September 14, 2016

Mo would like an easy job please!

It's been a while since I have blogged. I seem to be running out of topics and also I am not sure what you like to read about since you hardly ever comment. Anyway today I just have to share these gems with you, these jewels that Mo left me with before he went back to school in England. Like I have said a million times before, I am perpetually amazed by the beautiful minds that our children have, so innocent, so unique. So here goes:

Gem # 1

Me: Mo do you want to get married in future?
Mo: Maybe...(after some thought) yes.
Me: But you don't really talk to any of the girls in school so then how will you talk to your wife?
Mo: Well I will need a supervisor to help me communicate and teach me how to talk to my wife.
Me: Ummm okaaay...we'll see what we can do.

Gem # 2

Mo: When I was young, I used to think God was cruel.
Me: Why?
Mo: Because he gave me difficulties.
Me: But Mo he gave you so many strengths as well.
Mo: Yea. But I am over that part of my life.
Me: Which part?
Mo: I have grown out of autism; I am not autistic anymore.
Me: But there is nothing wrong with ... (cut off by Mo abruptly)
Mo: I said I am not, so I am not... OKAY!

Gem # 3

Mo: Mama when I come back to Singapore I want to do a job, an easy job (repeat x10)
Me: Okay Mo we will find you an easy job
Mo: But what if I can't do it? What if i get kicked out? I am stressed!  (repeat x10 agitated x100)
Me: Mo we will figure out something...
Mo: Noooooo you want me to be a couch potato and beg my brothers for money....I want a job BUT I DON'T WANT IT TO BE HARD!

Dear Singapore,

Mo is coming back to you next year. You better have an EASY job ready for him AND a wife with a supervisor in tow!

Sincerely,

Mo's mom.






Monday, June 20, 2016

Identity formation in children with ASD: are you a cat or a horse?

Today’s blog is in answer to a query received by me regarding how to facilitate identity formation in a 13 year old with autism.The teenager in question, lets call her Penny, has severe challenges with theory of mind i.e. relating to/understanding another persons state of mind and responding to it appropriately. Hence Penny frequently misreads tonal variations in others speech, such as when she says to me, “ Ms. Huma why are you screaming” and/ or “don’t make fun of me”, when I am only trying to explain something to her in a deliberate tone. Another example of Penny’s struggle with appropriate social skills is when she made a loud comment about a child’s oversized teeth and called him ‘bugs bunny’ on his face, not realising how he would feel. On being told that her comment had been hurtful she insisted that she was only telling the truth. This is also referred to as ‘mind blindness' and is typical feature of the Autism Spectrum Disorders found in varying degrees in individuals with autism.

Penny goes to a mainstream school where owing to her brash and self-focused attitude, forming friendships with other children is a struggle. She has expressed her loneliness in school and helplessness in relating to others through her artwork in the art therapy sessions that she comes to me for once a week. Judging by my communication with her, it is evident that just as Penny lacks insight into others, she has very limited awareness of herself as well. 

Penny is at the cusp of what Erik Erikson, in his theory of psychosocial development,  calls the stage of ‘identity vs role confusion’. According to Erikson’s lifespan theory of development this stage lasts from 12-18 years of age (adolescence) and is crucial for identity formtaion. During this time, youngsters are trying to gain independence, relationships with peers become very important, and fitting in with others are the main goals of this period.

But in Penny’s case, her diagnoses of autism puts her in a very precarious situation where  her chances of achieving success in the aforementioned psychosocial stage of her life are hugely challenged by her condition. Failure to develop a healthy sense of identity may put Penny in danger of developing a low-self esteem and lack of confidence which can lead to a sense of failure, isolation and perhaps even depression.

So how to help Penny develop: self-awareness (who am I?), acceptance of the self (I have challenges that many others don’t) and goals for her future (I also have many strengths that I can build on).

Below are a few ideas that I would like to share with you. As an *art therapist I would incorporate the following in my sessions but the idea behind each directive can be adapted to other modes of interaction such as  games, social stories and role playing etc.

  •       Draw yourself as an animal/animals. What qualities or weaknesses within the animal/s do you associate with?

  •       Divide a paper in quarters. Draw yourself as a child in one1/4, as you are now in the next,  how you see yourself after 10 years and then 25 and so on.

  •       Draw a self portrait of yourself on one side of the paper and on the other how you think others see you.

  •       Draw yourself as an animal, plant or object in an environment.

  •       Draw all the things you like about yourself in a circle and the ones that you don’t like outside the circle. Now transform one of the things that you don’t like into something that you like.

 The above directives could help Penny gain some insight into herself by tapping into her subconscious through her artwork and then analysing it with her to help her with self-awareness. Frankly, these exercises could work for anyone, you and me including but especially for Penny who may be more visual than auditory as most children on the spectrum are.

All stages of life are interdependent and we hope that all our children pass through each successfully, but as parents of special needs children, we know that the effort that we need to put in is significantly more at each stage. Hence, educate yourself  in order to empower yourself and your child to conquer each and every stage. Penny or your child or mine may never fit in with others or have friends to hang out with,  but  they can face all of these difficulties if they are proud of and believe in who they are . Instead of changing them to become ‘us’ let’s celebrate their differences. Yes, we must equip them with skills that we all humans need to live in society but let’s love them for who they are right now and not what we want them to become.


*Art therapy can only be conducted by a qualified art therapist.