Sunday 4 December 2011
The Silent Epidemic
Friday 18 November 2011
Speaking the same language
Friday 11 November 2011
A few thoughts...
Friday 28 October 2011
Gibberish or Double Dutch?
Communication is the key to working through personal issues and interacting with society.
Monday 24 October 2011
Happy Families
Saturday 15 October 2011
Drama Therapy and Intellectual Disability
disability (ID).
Here in New Zealand, people with an ID diagnosis often miss out on receiving therapeutic
interventions. Frequently, they are told that their ‘psychological’ issues are disability related, and therefore, no funding is made available for therapeutic assistance.
If depression, Post Traumatic Stress Disorder (e.g. sexual abuse) or anxiety is diagnosed, no suitable therapies are provided by the Mental Health Services that hold the funding. Clients that I work with, have been offered CBT (Cognitive Behaviour Therapy), only to be told after a few sessions that due to their disability, they were unable to follow this therapy. Instead of being offered suitable ‘non-verbal’ therapies, they were sent away.
Drama therapy is a form of therapy that works on the sub-conscious layer of the thought processes. This means that changes are made and established while working in the creative therapeutic module (drama, music, art or dance). By creating a safe environment, the clients are encouraged to experience and experiment with feelings, thoughts, and issues to change their perspective and integrate new coping mechanisms.
I have listed below some of the goals drama therapy is able to achieve for people who have an ID.
- Expression and regulation of emotions
- Expansion of frustration tolerance
- Diminishing impulsive behaviour
- Improvement of reality orientation
- Improvement of social interaction and interpersonal skills
- The ability to set boundaries
- Expansion of behavioural skills
- Improvement of self esteem
- Change and expansion of self view
- Diminishing the fear of failure
- Developing control mechanisms
- Exploring new thoughts and feelings
- Self-actualisation (development of self)
- Development of self reflection
- Dealing with bereavement
- Dealing with grief
- Dealing with change
Friday 30 September 2011
Take two laughs and call me in the morning
Nice to see this therapy from Australian humour therapist Jean-Paul Bell bringing life and living to those, too often, written off by society.
The ripple effect
Friday 23 September 2011
The difference between work and play
Friday 9 September 2011
Practice makes perfect
Saturday 3 September 2011
Live in the moment
Thursday 1 September 2011
Taking a chance
People living with dementia don’t have a lot of time to make slow, ordered progress. They can’t take time to build trust. Their world is immediate and often short lived in terms of memory. yet they are a shining example of willingness to take risks when there is some fun attached. I am continually amazed and impressed by their willingness to try anything imaginative with little knowledge of where it may go or what it might involve. There is some initial caution from some - quite right too -but all of them quickly get involved, share ideas and get stuck in. They embrace play in a way most of us take time to get to.
We can argue that their sense of self is different, they are less embarrassed by others’ potential opinion, but that is not always so.They say yes when they could say no.
This week the news featured an item on those whose memory it total. They forget nothing and have complete and instant recall. The impressive thing about them was that they approached every day thinking “I must make this count because it will always be with me.
At both ends of the memory spectrum there are people willing to take chances because that is where the true quality of their life is for them.
The action methods we use are such fun. The impact on me that working with people with dementia has had is totally positive. They have taught me that saying yes and taking a chance is so much more rewarding than standing in my own way. I haven’t seen the Jim Carey movie about saying yes yet but can I encourage all of us to say yes rather than no if at all possible?
Of course we shouldn’t take foolish risks. Most of us learn to assess risks once we make it through adolescence and realise we aren’t invincible. But then we stop a lot of our play.
using Improv, puppets and drama takes a long time with other groups because they have to get past their inner fogey saying “Don’t make a fool of yourself”.
The most fun I’ve had at work has come from doing just that. And when we do get groups past that barrier they grow and progress so fast.
So, don’t start climbing mountains, bungy jumping or going on the stage- unless you want to, but say yes to as many things as you can and see where it takes you.
Friday 19 August 2011
The King is dead... Long live the King
Inspiration
Photo: Phil Reid/The Dominion Post |
Sunday 14 August 2011
When words can’t do the job
In the modern world we make huge judgements based on language and how those around us use it to communicate. We haven’t moved far from Professor Higgins and Eliza Doolittle in some respects. Fail to express yourself in a smooth, articulate way and this will not enhance your job or promotion prospects.
We do seem able to cope with a wider range of accents than in Edwardian times but style really does matter in the spoken word particularly in the professional world.
Recently I have been working with two people from very different settings. In the past we would have talked about whatever they brought and used a variety of models to try and best address their issues. But these two, both intelligent and sensitive had some barriers to their verbal communication.
The first is highly educated, doing well in a high pressure setting but with a gentle, low key style. Their speaking voice is low, their approach polite. Some perceive this as weak. They have been challenged in an entirely inappropriate way but because they did not respond with volume or rudeness, this was seen as a failure. The initial brief was to change how they spoke but on meeting them it quickly became obvious that there was no major problem. Less explaining, short sentences and no apologising for doing the job dealt with that. This was a mature, courteous professional.
Once we stopped relying only on the verbal side of behaviour we could start to play around with their style non verbally. And play is the important approach. Acting out the fears and then fun preparing, laid the foundations. They discovered that they had many ways to deal with situations within themselves that did not compromise their ethics.The pleasure in their voice when they described stopping a takeover of a meeting without yelling was a treat. They had enjoyed the practice, gained confidence and above all made a change that was fun with no harm to anyone. The rest of the group were stunned by the quiet but effective methods employed. And they all loved seeing a bully shut down - politely.
The second person is an immigrant of high intelligence but a limited grasp of professional English. They are fine with conversation and can make themselves clear. This is someone who speaks three other languages fluently. But his aspirations get crushed when he comes up against a language barrier. He has felt too shy and ashamed to find a way past this barrier. He became so overcome that I was struggling to get to what he wishes to say and then we moved to playing it out. He came alive. His grief at having his great coaching skills overlooked because he “Didn’t sound right” was powerful. I felt his quiet pleasure in outdoing the team he wasn’t allowed to coach was more than justified. Natural justice does rule sometimes.
We could argue that an interpreter would have dealt with this situation but I think it would have reinforced his feelings of inadequacy. As it was he took charge and showed what was happening for him and what he wanted. There is a lot of hard work ahead and no guarantee of a happy ending but he is in charge.
Talking is not always the best way when there are marked differences in language skills or style. I am realising more and more that not only do actions speak louder than words but they can be so much more direct. When you put the two together, it’s formidable.
Sunday 7 August 2011
Directors Cut
The client becomes the director, directing the other person (therapist), projecting their own fears and feelings, as well as being in control of what the end product looks like. The drama therapist can make suggestions and steer the process into ‘difficult’ territory. The client can accept or reject these inputs, or even criticise the ‘actor’ for doing things wrong (a high - low status mechanism). As with many other drama therapy techniques, this technique can help the client to reach the point of catharsis (having a strong emotional response / aha moment or epiphany).
Suffice to say that when practising drama therapy, you need to know what you are doing. During my time working as a drama therapist, I have met people who claim to be providing drama therapy. When I ask about qualifications, and practice methods, sometimes the answers are surprising. Some think that teaching drama is the same as therapy. Sometimes therapists think that working towards catharsis is the main responsibility of a therapist and the end goal. In my opinion, all good therapists and counsellors know (or should know) that this is not the end goal. Often the work only just starts at this point.
If you are looking for a drama therapist or counsellor, please ask for their credentials and experience. Where did they train and for how long? How much supervised therapeutic practice have they undertaken? What therapeutic methods are they trained in and what do they actually use? How long they have been practising? What client groups or issues do they work with/have experience in working with?
As anyone reading this will appreciate - a person not knowing what they are doing can cause more harm than good.
I invite other Drama Therapists to leave a comment setting out their experiences – wherever you are – Linda and I are pleased to see that our blogs are reaching a truly worldwide audience.
Until next time…
Friday 29 July 2011
Dignity – who needs it?
Saturday 16 July 2011
Marching to the same beat
There is much to be considered here. Even moving more and in positions that allow the lungs better movement will always help. More oxygen to our bodies can only be a plus when we make that increase through our own efforts. But this work goes a long way past this. The rhythm, the music and the imagination that goes into dance is stimulating many different parts of the brain.
The results that have been found here bear a close resemblance to those achieved using dramatherapy with the disabled, autism and those with dementia. The increase in confidence, in feeling less anxious and in the ability to interact are rapid and make a huge difference to the lives of those affected by such conditions - not to mention their families and friends.
One of my many happy memories is of a man who started out re-enacting gangster or cowboy movies. He ended by doing the haka for us. For non kiwis that’s the challenge given to important guests as they arrive, a mark of respect but intimidating. To see someone who had only sat in a chair do this, unable to walk except with a stick very slowly, on his feet unaided at full volume was uplifting. And he told us after that this was his gift to us.
We have the opportunity to do that research here, before the arrival of, what the current Minister of Health, Tony Ryall, has described as, the next major threat to our health system. That is the huge increase in those diagnosed with Alzheimers and dementia that will come with our aging population. It is already starting and in a small country like ours we do not have the resources to deal with this.
Let’s invest in some work that does offer positive results. So many people who are affected directly or have family or friends affected by illness that affects memory ,movement or interaction have indicated that they give up in despair because they lost hope. Here is a way that is safe, fun and rapidly beneficial and we haven’t even begun to explore its’ full potential.
Whoever you are, dance, sing, make up stories this week. Do it for yourself, for fun and take a moment to reflect on how much it could help so many.
Friday 8 July 2011
Creating New Behaviours
Monday 4 July 2011
The Past is Another Country
It is understandable that often people walk away or find contact very difficult.
One of the most positive aspects of drama therapy in these circumstances is that it offers a relaxed, fun way to reconnect. Often we base our knowledge of older people on who they are right now, forgetting that they have lived long, full lives. The recent upsurge in interest in genealogy shows that many of us are interested in the past yet how many of us really know our parents and older relations? We may think we do because they may well have repeated many stories but it is often amazing to find out just what they have achieved.
Last year the community based group we worked with had a huge and varied history. Fortunately the people working with the group knew them well and had recorded their individual histories.
It is these earlier memories that are clear and thus accessible. These are the memories that people share when we are developing stories with them. It is so much more powerful if we know what these memories relate to.
It is almost miraculous to watch someone engage who has been totally detached and uncommunicative. When we enter their world, even if it is one from many years ago, we are there with them. It is familiar to them so not a source of worry. It puts them in control at a time when the world may feel very confusing and scary. I loved the quiet man who got asked to do a song in one of the plays and produced not just a pop song but a stunning operatic aria. His family knew of this but felt it might be painful for him to remember as he now no longer sang. The smile on his face as we all applauded said this was an area to talk about with joy. Each person had huge talents and their own fascinating experiences.
An additional bonus is that when families get involved they can continue a relationship that is positive and not a burden. They sometimes learn new things about a person they thought held no surprises. They get to enjoy being with the person again. Being relaxed and happy is something we all benefit from.
Making it easier for them to stay at home for as long as possible can only be an advantage. A more positive relationship is good for the individual but think what it could do for loving but currently exhausted care-giving families.
This is one of the areas we are keen to do more research in. This method is non invasive, does no harm and is fun. And it improves daily life for all using it.
There is nothing to lose for any of us and everything to gain.
We hope to offer a programme for people and their families in the community soon so keep watching – get to know your family and have as much fun as you can.
Sunday 12 June 2011
All work and no play ...
Work is a very serious thing at any time. It's how most of us support the other areas of our life.
With the job market tight and pressure on to make more with less , the workplace is a demanding environment.
We all spend a large chunk of our week at work so how can we make it a happier place to be?
This is just as important for the organisation as it is for the staff. A happy workplace is more productive, loses less time to sickness, is more likely to solve problems quickly.
A lot of unhappiness centres on communication. All of us have times when we can't say what we want. We put barriers in our own way and at times that's a very good thing. That little brake in our head that stops us saying what we are thinking at that second has probably saved lives as well as jobs and relationships.
But at work we sometimes have to say things that may not be well received no matter how diplomatic we are. We don't always distinguish clearly between the fact that lovely though we are, we are at work, paid to do a job. Not everything is personal or about us. Yet because we take ownership of our role for most of us our work is extremely personal. Any comment on what we do is a comment about us.
Organisations spend a lot of time money and effort on promoting good communication. This is a very serious matter indeed. But does the way we do this have to be so serious?
I'm always amazed that teams go away to try and build relationships. They won't be working at a resort in a room at a high level of intensity, or on an assault course.
Why not use the surroundings they will have to work in but make that more fun?
The methods taken from Drama Therapy are just as effective in the corporate and government fields
The puppets in the picture have been an amazing resource for getting people to talk. Someone who is uneasy speaking in a group turns into a lead orator with one of the puppets as his or her mouthpiece. The puppets get away with saying outrageous things and give everyone a laugh.
People who have enjoyed each others' company, not felt threatened will form much more effective working relationships. They will be more comfortable knowing that any impressions their colleagues have of them were at least partially formed in a happy, relaxed place.
No matter how this is approached, having fun is important for us all.
Watching a team that can barely talk to one another except via e mail learn to enjoy and respect each other is a great experience. Watching a new team come together having fun and building positive links is even better.
Whatever you are doing, have a think about having more fun at work. Being a professional, being a high achiever doesn't mean being a misery. So many people feel that some one is pulling their strings.
When in doubt, let a puppet do the talking for you.
Friday 10 June 2011
Expressing Emotion – Clients with an ASD, ID, Alzheimer’s Diagnosis
Expressing emotions in therapy is one of the hardest things to do for many people. We are taught from a young age to keep our emotions in check. This is certainly true in New Zealand. We have the attitude that we can fix it all ourselves (the No.8 wire mentality). Allowing clients to act out their feelings in play using characters, helps them express pent up emotions. Using the hierarchy of needs method – allowing people to express what is on top, allows them to explore what is underneath.
Often conventional therapies (like classic CBT, psycho-analysis, etc) are not suitable for our client group, as you need a certain level of cognitive ability to participate in these therapies. The clients we work with often can’t describe the feelings they have, process the information the therapist/counsellor gives them, or integrate this and form meaningful responses. Using drama therapy, people can show what they feel, experiment and adjust feelings they have, and reflect upon those feelings from a safe distance. (After all it is the police officer that is angry, not me...) It is internationally proven that drama therapeutic methods are successful when working with people having cognitive disabilities (ASD, ID, Dementia, Alzheimer’s, and head injuries).
Autism, Asperger’s & ID
I found that people with an ASD or ID diagnosis are often confused by the emotions they see in others. It is difficult for them to understand what other people feel because they are confused by the emotions they feel themselves. What often happens is that they categorise feelings into good and bad ones. This might look like this:
Good feelings | Bad feelings |
Happy Feeling in love Excitement | Angry Sad Jealous Nervous |
They then respond with a planned response. These planned responses are a safety mechanism which happens automatically. A planned response for bad feelings might be putting your hands over your ears and rocking, swearing, punching someone/something, isolating yourself. A good feeling might be to hug a person.
As feeling annoyed is a negative feeling, it will have the same response as being scared. This is very confusing for the community they live in, as it is for them.
In drama therapy, I use many games to practise different emotions, and different intensities of emotion. For example, anger ranges from slightly annoyed to extremely aggressive. Practising these different levels of anger helps people understand the feeling. It also makes it a valid and useful emotion and is no longer just bad. Practising different emotions also allows the client to practice different outcomes. Having alternative responses will help people be more appropriate in their responses.
Dementia & Alzheimer’s
When Linda and I worked with people suffering dementia, we noticed that expressing emotions was difficult for many of the participants - however, it was very important for those clients to let their emotions out. By validating every emotion/action expressed by the participants in drama and giving an immediate response, people came out of their state of isolation. Once the participants allowed themselves to express emotions, it often had a very strong and profound effect. Some people expressed their fear of dying, others found closure of previous experiences. For example, one person revealed the abuse and fear he suffered. Finding peace with his past allowed him to relax more and be less anxious.
We look forward to hearing your experiences in working on emotions with clients with cognitive disabilities in your practices.
Monday 6 June 2011
Playing has no rules
People with memory loss can rapidly become isolated from those around them. They don't communicate the way they used to.
I keep coming back to how much we all rely on talking to stay connected to each other. And how difficult that is for many of us as we get older. We place so much judgement on how someone speaks. Get a word wrong, mispronounce something or just muck up your grammar and a lot of negative judgements may come in to play. Heaven help you if you stumble a bit. If your memory is not working the way you want it to, so the right words don't come, that can be very frightening. That is even harder on family and friends who struggle with this loss of contact with the person they love and care for.
But playing has no rules. We can make them up as we go along. There is no way we can fail or feel anxious about being second rate, not up to standard. If something doesn't work, we just change it with no baggage, no regrets or worries that it wasn't right. “It's just a story” - how safe does that make whatever we do?
Using play works so well because it just takes away any anxiety. People relax , have some fun and start communicating any way they wish. They use their early memories and the rest of start get a glimpse of amazing lives and achievements. With time this could take many people so much further or at least make daily life a less unhappy and worrying thing.
That's what I have come to love about the action methods of Drama Therapy. It allows us to act out what we want, how we want. No one can query our choice of words. If we don't use words at all just gestures, we are still communicating. If we're communicating, we can be in touch.
It is wonderful for me to see how people respond and reconnect when they get the chance to rediscover memories through Drama Therapy.
Friday 3 June 2011
Using puppets in drama therapy.
puppets are quite big, and very human-like.
Linda having a serious get together with some of the puppets... |
Dementia
When working with a lady who suffered from dementia, and had lost her speech, using the puppets,
allowed her to re-engage with her environment. I put the puppets on the floor, and looked away
from the lady, pretending to be busy doing something else. With her walking stick she brought
the puppet closer to her. Casually I put the puppet in her lap. She started cradling the puppet, and
when she discovered how to operate the mouth, she started singing to the puppet. Everyone was in
awe, as this lady had not spoken for quite some time, only making grunting noises. As the sessions
progressed the lady started to use her voice more and more. The puppets allowed her to re-engage
with her environment.
Autism – Aspergers
I found that people with an ASD diagnosis sometimes have difficulties understanding the world
they live in. They are often frustrated, as they miss social cues, and unwritten rules. They feel often
isolated. Using puppets they can create social situations in which they can let the puppets practice
different social reactions to problems. For example, what can a puppet do if it wants to play with
another puppet? How do you ask? How do you react when they say no, or do not want to play what
you want to? Having experienced different responses and outcomes, people with ASD diagnosis
can recall these memories when they come into similar situations. Having already practised how to
interact will help them connect with their environment.
Cognitive Impairments (e.g. intellectual disabilities, brain injuries, Cerebral Palsy)
Being able to show people what happened to them, without having to rely on oral language allows
people to look at their issues from a safe distance and express their feelings in a safe environment (it
is the puppet who is frightened...not me...). To see people finding closure to traumatic experiences
using puppets is very rewarding.