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

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.

Monday, June 6, 2016

"It's a long story..."

Osman and I have decided that Mo will come back home to Singapore next year after he finishes school in England. I apprised him of this plan during his May holidays. Mo on the other hand, wants to go to college in England as according to him his classmates are going to go. However, I told him that we, his parents, felt strongly it was in his best interest to return to Singapore, find a job and settle down. The idea of a job  in Singapore was the carrot that I dangled knowing full well that Mo would acquiesce fairly easily  to the plan. And he did, so much so that he declared with pride, "my friends at school are going to be so jealous because I will have a job". When I reminded him that they too would eventually find jobs he declared "yes I suppose so, but first they will go to college. I can't go to college because I am more special needs than they are". Taken aback by his comment I probed Mo for an explanation to which he replied, "it is a long story", meaning I had reached a dead end and was not going to get my answer. That same day he told me,"I am tired of being surrounded by autistic people, I want to be around normal people". This is not the first time he has said that. In fact a couple of days ago he saw two blind people in the London underground and declared, " I don't like seeing people with disabilities, they give me the creeps"!

Mo's attitude pained me immensely. I began to question myself and my upbringing of my children. I, who claimed to be an advocate of special needs individuals, could I possibly have passed down the 'wrong' ideals to Mo? If not consciously then sub-consciously had I or Osman  encouraged a dichotomy between 'normal' vs' 'abnormal' in his mind? Looking for answers, I rewound my memory over the past 15 years and all I could remember telling my kids was that there is no such thing as 'normal'. Everyone is 'different' and we all have our challenges. Differences must be celebrated and not scorned. So then what had gone wrong and where?!

As I teetered between reflection and hypothesis I came to a possible conclusion. Although Mo gives the impression that he has a significant degree of awareness about his diagnosis of autism, he openly says that he is autistic,  I don't think he sees himself as any different from stereotypical's. He acknowledges that he has difficulties  but as far as his self concept is concerned he believes that he is no different from his brothers. Does it mean that he is in self denial? Or is it that he is not able to perceive himself from another's point of view? Whatever the case should it be viewed as a good thing or not such a good thing? Also could this be a contributory factor to his attitude towards people with disabilities?

Here are my thoughts on the above. Given that Mo is autistic, there is a very high probability that he lacks self awareness and by default is in denial. His teachers are working on his self concept but it is a goal in progress. I believe it is critical for him to accept that he is different, embrace the difference and celebrate it. Once he is able to do that he may become more accepting of others who are different from the norm by virtue of association or empathy.

I believe that Mo's early schooling has a big role to play in his perception of himself and others. Till grade 6 he was in mainstream school where he was pretty much the only special needs child in his class. Inclusion benefitted him in many ways but the lack of exposure to kids similar to him probably created a template of what is normal and not normal in his mind. Henceforth he began to categorise people into normal and abnormal categories based on that template. Had he mixed with both stereotypical and special kids in his primary years this distinction may not have been so black and white. He may have grown up accepting the differences as a norm rather than having to label them.

It boils down to the fact that exposure and integration are key elements to an inclusive society for individual with special needs. If our children grow up amongst individuals who are different physically or mentally, they will embrace the differences and not shun them. Then labels for mental illnesses and disabilities will perhaps only be use to define  symptoms and not a be viewed as a stigma. Just my thoughts on the subject...

Thursday, May 12, 2016

More powerful than the bully!

Tia is 13 and Leo is 8 years old. Both have Aspergers, both come together once a week for art therapy. Their relationship has come a long way in that they are able to work together on the same piece of paper in their own distinctive styles cooperating with  each other which was not the case when they first began. Now at times they even complete each others work, crossing boundaries that were  at first rigid and guarded, commenting and sharing stories.

Slowly the dynamics of this little art therapy group have managed to open up the fiercely protected emotional world of Tia and Leo whose artwork is now beginning to shift from the literal to something a bit deeper. The challenge with individuals with ASD is not that they don't feel emotions, that is a ridiculous misconception, but they do find it difficult to express emotions due to the abstract nature of feelings. Masters of literal representation, when it comes to symbolic expression, they are extremely challenged.

In this particular session, both Tia and Leo were given a directive to draw each other. The idea was to encourage thinking/focusing on the other, beyond the self, and to gain insight into how Leo and Tia perceive each other. After they completed their art work, both were asked to talk about their images aided by prompts from the therapist. For instance, Tia was asked about Leo's expression and why she had drawn him next to a female figure in the picture. Whereas Teo who had drawn a complete story around Tia's life was encouraged to talk about it. Eventually the conversation led to individual likes and dislikes to which Tia said that the one thing she disliked was being bullied in school. Encouraged to elaborate, she shared that she was pushed around by boys in her class and called 'lazy'. Spurred on by Tia's sharing, Leo, who is usually very defensive and emotionally reserved, declared that he too disliked being bullied in school and went on to give examples. In that moment the significance of the mutual revelation was very palpable in the room. One wonders what kind of impact a close bonding moment such as this could have on two children who struggle with friendships and relationships in general. Isn't sharing a burden with another  cathartic? Also to know that one is not alone in ones suffering, that in itself is a liberating experience.

Tia and Leo's artwork


The above disclosure led to a golden opportunity to empower Tia and Leo against the bullies at school. Sometimes circumstances/reality will not change, but what can change is our perception of it; how we internalise it and assimilate it in our memories as experiences. Hence, Tia and Leo were asked to draw the bullies, give them a tangible form, something that could be an external representation of their dislike or fear. They both obliged and once they had drawn their images they were asked to contain the images of the bullies within boundaries. The idea was to literally and symbolically imprison the bullies and take away their power. Both children ended up drawing very solid walls around their respective bullies pointing out to each other where the walls needed reinforcement. The session ended, hopefully with Tia and Leo stronger in their friendship and more powerful in their minds.


Tia and Leo will probably continue to face challenges from society as they grow, as does their exposure to the world. They need to be empowered mentally to deal with these challenges.  Art therapy is an effective modality that can help to give concrete shape to abstract concepts that may not be accessible through language. Also it provides a safe environment to children and adults to process difficult emotions and events that need an outlet.