The Process of Healing: Expression from Within, Insight, and Release through the Arts

The following article was presented as part of the Keynote Panel for the International Creative Arts Therapies Conference in Tokyo, Japan, on October 10, 2006:

Human behavior is extremely complex. It develops based on genetic inheritance, environment before and after birth, and experiences in our families, schools, and communities. Our individual and collective histories, as well as our present, contribute to the emotions we feel, the thoughts we think, and the behaviors we express.

Until recently much of what we have known about psychology and human behavior has been guessed at by theorists and researchers. Some of those guesses were incorrect, while others have been intuitively very close to how we actually function. Psychotherapies that developed from those guesses were either “off the mark” and didn’t work or were “on the mark” and did. But even when therapies did work, no one really knew why they did.

In the last 15 years brain researchers have made many discoveries about how the brain functions. These discoveries point the way to psychotherapies that are effective and should be the treatments of choice for prevention and intervention by mental health systems.

My belief is that the creative arts therapies best fit how the brain actually functions and can provide more effective means for healing than the current talk therapy methods in favor today. Through the work of Damasio, LeDoux, and others, we now know that the neurological systems for emotion and reason interact. Emotion and reason work together within the brain to create feelings, thoughts, and behavior (Cozolino, 2002; Damasio, 1994, 1999; Goleman, 2006; LeDoux, 1998). In the process of decision-making there are several intersections where the rational and emotional systems communicate with each other. In fact, it is impossible to make good decisions using only our rational mind – we must also use our emotions. We know a decision is a good one, if it feels right. Individuals whose brains can’t communicate between the rational and the emotional systems either make extremely poor decisions or find they are unable to make any decisions at all!

Research in immunology has proven that our minds and our bodies are not separate. They work together. The body affects the brain and the brain affects the body. Chronic stress damages the immune system. Laughter and humor enhance it. Art, dance, drama, music, and poetry all engage the body and the mind together, stimulating neurotransmitters that make us feel better, generating hormones that lower the level of cortisol and other stress hormones.

One of the most important discoveries has been mirror neurons. Mirror neurons are activated whenever we see someone take an action – from an activity as large as running to one as subtle as a look of concern. Mirror neurons activate the identical location in our brain that was activated in the brain of the person we saw. For example, when a dancer moves, the same neurons which are activated in the dancer’s motor cortex are activated in the motor cortex of the audience. When a person smiles, the identical motor and emotional neurons are activated in whoever sees the smile (Goleman, 2006; Hagendoorn, 2003).

What is created from this interaction is an empathic connection from one person to another. We are able to understand what another person is feeling or thinking or doing – because our brain is mirroring virtually, what their brain is doing actually.

Sometimes the mirroring creates more than a virtual experience: as our brain copies what the other brain does, we often copy the action as well. Have you ever found yourself automatically smiling back at someone who is smiling at you? Or feeling sad as someone is crying?

Imitative learning is also made possible by our mirror neurons. Have you ever learned how to do something – play a sport or drive a car – by watching someone do it? That is an example of your mirror neurons at work.

In drama, dance, art, music, and poetry therapy our mirror neurons are actively engaged in the therapy. As we interact with each other to create art and to communicate, we are creating brain connections, social connections, and new understandings that just talking about problems with a therapist does not even begin to access.

Trauma researchers have discovered that traumatic experience re-wires the brain (Cozolino, 2002; Van der Kolk, 2002). Trauma enters the body through the non-verbal, emotional systems and gets “caught” there. Without words the trauma cannot be spoken about and understood by the rational systems (remember the emotional and rational systems must work together for us to truly process and understand an experience), so the trauma stays stuck in the emotional system. Therapists who try to release trauma through talk alone, end up with clients who become overwhelmed and dissociate.

However, the arts therapies have nonverbal and verbal elements. Working with line, color, shape, sound, silence, movement, pace, and rhythm allows clients to access the trauma — then the words of lyrics, role-playing , poetry, and story provide a bridge to allow the traumatic experience to be spoken about, healed and released.

One last thought…the creative arts are natural byproducts of the brain. We are “hard-wired” to acquire language (Pinker, 1994). No one needs to go to school to learn how to speak her native tongue. The brain is also “hard-wired” to create arts. Cave paintings, musical instruments, carvings, and depictions of dance and drama exist from as far back as 45,000 years ago – long before the written word brought us from the prehistoric to the historic era (Mithen, 1996; Pfeiffer, 1982). Our ancestors didn’t go to school to learn how to paint, sing, draw, or dance – they just did it! Even today, the arts begin to be naturally expressed at early ages: at 2 and 3 children draw, dance, sing, and participate in dramatic play without any formal instruction. However, to begin to learn how to read and write, we need formal instruction. Those abilities are not hard-wired into our brain.

This tells me that the arts are a natural part of our human heritage – a basic, intrinsic aspect of our biology that we should be willing to employ in our own behalf.

References:

Cozolino, L. (2002). The neuroscience of psychotherapy. NY: W.W. Norton.

Damasio, A. (1994). Descartes’ error: Emotion, reason and the human brain. NY: Avon.

Damasio, A. (1999). The feeling of what happens. NY: Harcourt.

Gallese, V., Keysers, C., & Rizzolatti, G. A unifying view of the basis of social cognition. TRENDS in Cognitive Sciences. 8 (9), Sept. 2004, 396-403, downloaded 1/23/2006 at www.sciencedirect.com.

Goleman, D. (1995). Emotional intelligence: How it can matter more than IQ. NY: Bantam Books.

Goleman, D. (2006). Social intelligence: The new science of human relations. NY: Bantam Books.

Hagendoorn, I. (2003). The dancing brain. Cerebrum. 5(2), 19-34.

Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J. C., & Rizzolatti, G. (March 2005). Grasping the intentions of others with one’s own mirror neuron system. PLoS Biology 3(3), 0529-0534. Downloaded 1/23/2006 from www.plosboiology.org.

LeDoux, J. (1998). The emotional brain: The mysterious underpinnings of emotional life. London: Weidenfeld & Nicolson.

Mithen, S. (1996). The prehistory of the mind: The cognitive origins of art, religion and science. London: Thames and Hudson, Ltd.

Pfeiffer, J.E. (1982). The creative explosion: An inquiry into the origins of art and religion. NY: Harper & Row.

Pinker, S. (1994). The language instinct: How the mind creates language. NY: William Morrow and Company.

Siegel, D. J. (1999). The developing mind: How relationships and the brain interact to shape who we are. NY: Guilford Press.

Van der Kolk, B. A. (2003). In terror’s grip: Healing the ravages of trauma. Cerebrum. 4(1), 34-50.

Clinical Settings

The groundwork for inclusion of the creative art therapies into psychiatric hospitals in the U.S. was laid after World War I. Talk therapy and medical interventions were not very successful in helping veterans recover from what at the time was called “shell shock” (now called Post Traumatic Stress Disorder). However, the arts brought unresponsive patients back to life. In the early 20’s and 30’s inclusion of the arts in hospital programming was expanded. (Phillips, 1994).

Today drama therapists working in a psychiatric hospital or an outpatient mental health clinic might work with patients who have a wide variety of clinical diagnoses, including eating disorders, depression, schizophrenia, bi-polar disorder, addictions, or Alzheimer’s disease. Previous to our current era of short hospital stays, in-hospital drama therapy groups would often work together over long periods of time, several times a week, and could develop original plays or do long-term in-depth work. Today with shorter stays and less coverage for psychotherapeutic services, groups tend to be short-term or a single session. Drama therapists might need to utilize process-oriented interventions in which the drama work is contained within one hour. Developmental transformations can be used in this fashion. Playback Theatre can be used for one-time therapeutic interventions in some hospitals, where a trained troupe of playback actors re-enacts stories told by the patients who comprise the audience.

Anne Curtis, RDT, and Paula Patterson, RDT, two drama therapists in Florida, have worked with acutely and chronically ill patients of all ages in medical hospitals. Puppets, guided fantasies to safe healing places, music, movement, clowning,  and fairy tales help children and adults stimulate their immune systems, get back in touch with their healthy selves, and feel hope. One of Anne’s favorite parts of her visits is the Healing Parade: All the mobile patients dress up in costume and parade throughout the unit past the rooms of those who are too sick to get out of bed, spreading songs, “healing energy,” and good humor. Even staff members ask for drama therapy sessions to help them deal with their stresses, frustrations, and disappointments.

© Copyright Sally D. Bailey, Registered Drama Therapist. All Rights Reserved.