«The changes in the children’s behavior after an art therapy session impress me again and again.»

Prof. Dr. med. Bernhard Frey, University Children’s Hospital Zürich

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Creativity Heals

MUSIC THERAPY IN NEONATOLOGY

A premature baby girl in the 29th week of pregnancy, birth weight of 590g, with a functional short bowel syndrome, serious infections, including sepsis and peritonitis, as well as respiratory distress syndrome and nutrition-related growth disorders. The music therapy began when the music therapist took up her post when the premature baby girl was already a good two and a half months old. The child spent a total of over eight months in the clinic. The music therapy initially aimed to emotionally stabilize both the child and the mother, whose well-being initially depended heavily on her daughter’s condition, and to provide calm and orientation.

The measures included stress reduction, sensory and emotional stimulation of the child, as well as the establishment of sound rituals for orientation, calming and stabilization. The mother was instructed in how to speak, hum and sing to her child, which was a great challenge for her at first. Therapeutic songwriting in Albanian helped to build a bridge. By using situation songs, among other things, the therapy was individualized and adapted to the child and mother over the course of six months and almost 30 sessions.

The music therapy showed clear results. From the very beginning, the child reacted positively to sound offerings, especially to the Koshi sound game and the therapist’s voice, and showed a regulation and stabilization of her condition. The mother developed into a more self-confident personality, learned to make better use of her resources and, over time, used humming and singing specifically in everyday life to calm, stimulate and encourage her daughter. Eventually, the mother sang for her daughter without inhibitions and with growing self-confidence, which significantly strengthened the emotional bond between them.

Overall, the music therapy offered mother and child diverse and individualized interventions to process the premature birth with its medical and psychological challenges, but also support in bonding, comfort, support and orientation during the long hospital stay. 

Art Therapy in psychiatry

The work was sculpted in alabaster. At first, it emerged from the patient without apparent meaning, it was not addressed to anyone. By the end of its shaping, the heart was dedicated to the patient himself, he, who was contemplating ending his life, offered it to himself, giving it a profound meaning of life. The title he gave to the work is: “Live! Live for yourself”. Alberto*, 14 years old.

*name changer

IMG_20231106_155716-EOC-Mulattieri-17.11.23-300x225.jpg

From the everyday life of a music therapist

It was a long and exhausting journey for my patient Leonie*. She was 18 years old. Due to a recurring tumour and other somatic complaints, she was repeatedly hospitalised. During her stay, we listened to music together, danced in bed or sang to forget the illness for a moment. 

There were days when she sent me away. ‘Not today’. She felt too tired or too unwell, which I respected. A patient’s self-determination is always at the forefront of music therapy, which is why I can cater to different needs. This is not possible with medication, for example. 

One morning, I learnt that Leonie had had to be resuscitated the previous night. ‘She just switched off,’ was the doctor’s statement. I visited her in the intensive care unit to discuss with her whether she wanted music therapy. She said yes and wanted her mother and sister to be present. That same day I went by, equipped with song sheets by her favourite artist. The young patient no longer had the strength to sing, so her mother, sister and I took over. Everyone present seemed very touched, and the mother wanted to keep the song sheets. In the end, Leonie chose two songs herself and we sang and danced. The patient was also actively involved and moved to the music.

Together we created a space full of lightness and joy for Leonie. To not be ‘sick’ for a moment. To just be. 

Two days later, she fell asleep peacefully in the presence of her family.

*name changed

Art Therapy in psychiatry

Nadia, 17, is admitted to the hospital with a life-threatening weight loss; she’s been suffering from anorexia for three years now.
The first time, she’s pretty quiet and doesn’t feel like talking. The art therapist suggests painting and invites her to play with colors, without achieving a result at all costs.

Drawing of Nadia trying to break the vicious circle of anorexia.


She relaxes and, as the sessions progress, expresses herself through the paint and images she stages. She begins to talk about her illness and to understand what drove her to self-destruction.

 

She can give form to her fears and anxieties: “When I paint, I feel good”.
She creates a painting depicting the vicious circle of her illness. After a while, she resumes her production, and decides she doesn’t want it anymore.
After five months, Nadia is able to leave the hospital, feeling much happier and livelier. Before leaving, she told the art therapist: “I haven’t won yet, but I have the strength to fight my illness, because I want to get through it.”

 
*name changed
 

Art Therapy in Intensive care

For several months, Geneviève was accompanied by us art therapists in the intensive care unit. 
 
This 13-year-old girl is severely physically handicapped by her illness and can only communicate with her eyes. A yes means she blinks, a no means her big green eyes with their long lashes roll back and forth. It soon became clear that she loves to paint, preferably with her hands, but that she needs our help to do so.

It’s she who decides which colours to spread across the page and which movements her hands and arms make. Waves, dots, lines, circles… She always wants to mix the colours and spread them out, so that the whole sheet becomes grey or brown, rather dark. She calls them “frustration paintings”, as her mother says, and she’s convinced that it’s good for Geneviève to let off a bit of steam. The bigger the mess, the bigger the joy. 

A long process through much pain, frustration and sadness. The images turn into a cloudy sky, a dark night… then come the stars, there can hardly be enough of them, they have to shine golden. She became the architect of her work and asked the art therapist to fill in the stars with glue and gold leaf. She watches with pleasure as the delicate gold is distributed, waits patiently for it to dry, and when the painting is finished, her eyes shine like two luminous stars.
 
Geneviève’s mother is very grateful that her daughter has moments when she can experience something beautiful during her long stay in hospital.

Art Therapy in Oncology

When a child is diagnosed with a malignant tumor, leukemia or another type of cancer, shattering experience for the whole family.

Already in the corridor, on the way to the hospital room, a certain oppression and uncertainty can be felt as a heavy burden. The chemotherapy is still unfamiliar, and the children have to courageously endure a lot of procedures: examinations, blood samples, medications, nausea, fatigue. The whole family has to reorganize itself with the care, and the days in the room are long, marked by many upsets and also unspoken fears.

Art therapy offers a wide range of possibilities and can be used in different situations. For example, it can be used to divert attention from pain, distance from loved ones and boredom.

It can be observed that the mood changes to the positive, some lightness and playfulness is allowed to blossom. New energy can be released and have a very invigorating aspect. The creative, non-verbal activity strengthens the child in its self-determination and its resources. Art therapy cannot cure an illness, but it can help on the road to recovery.

Case example: Art therapy sessions with an eight-year-old boy with an oncologic disease.

The boy would like to be healthy like his brother and the grief of his parents is weighing on him. During our therapy session, he is combative and strong, and it is especially nice to see how motivated he is to paint. He wants me to paint with him. He tells a story about a family who, on a beautiful trip to the forest, is suddenly surprised by a violent storm. Then a long silence. The painting sequence lasts a good 45 minutes and we are both amazed at how quickly the time has passed. The boy is enthusiastic and thinks that it has really done him good. Satisfied and proud of his work, he leans back.

When his mother returned, she was visibly moved and happy, as she noticed that her son’s mood was much better. This session allowed him to express his feelings. The mother emphasizes the importance of this therapeutic offer, which seems to be the ideal outlet for her son. The drawings, of great importance, will be hung on the wall of the house.

Art Therapy in Psychiatry

Therapeutic journey of a young patient who benefited from art therapy sessions.

  This is the story of a young boy, Thomas (not his real name), who did not have an easy start in life. At the age of 7, Thomas has already experienced many breakdowns and knows about emergency shelters, having been placed there several times.

Hospitalized in a child psychiatry department, his medical journey is already quite long. As he communicates very little, art therapy sessions are recommended by the medical team.

But the idea of one more therapy does not enthuse Thomas and during the first sessions, he does not say a word. It is through the exchange of drawings that the art therapist enters into communication with him and gradually establishes a relationship of trust with Thomas.

After several sessions, the art therapist suggested that he work with cardboard boxes. He then chose to build a car, one that would take him to his native country. The first words are shared and he likes the idea of leaving with his car so much that he leaves his study group at the care center several times to find his car.

 As the sessions progressed, Thomas took more and more possession of the boxes and transformed his car into a camper. He set up a bed, a sink, a toilet and a GPS to help him find his way. The sessions turn into a trip around the world.

 “The journey will be long, and it will take patience” he comments.

 Accompanied by the art therapist, equipped with his map and his cardboard passport, Thomas crosses cities and regions to reach his country, that of his family.

 Creativity and imagination allow the therapist to engage with Thomas on painful subjects without the use of words, but through creative play.

 Thomas then creates rabbit cages, with beds and toys. He is concerned about their well-being and safety. After more than six months of weekly sessions, he agrees to work on body feelings. Through the making of bread and mixing of textures, Thomas opens up to the art therapist and talks about the sensations he likes or dislikes.

 Each piece of work created is an opportunity for the art therapist to engage with the child about his emotions, his needs, his experiences. Art therapy has allowed young Thomas to find the path to recovery.

Art Therapy in a Children’s Hospital
In the therapy sessions, I focus entirely on the child’s needs and situation. It is important for me to focus on the healthy issue of the child and to support its autonomy. In this lesson, the child is allowed to say yes and no and choose for him/herself. Here, the focus is not on language but on the child’s own actions, thus enabling the unspoken to find expression. Artistic activity strengthens resources and enables the child to act on his or her own initiative in everyday hospital life. It fills me with great gratitude and joy when I can observe how the child relaxes more and more, so that the current situation recedes into the background, giving way to a creative cheerfulness.
Music Therapy in Psychiatry
Sabine* 16 years old, is hospitalised due to anorexia. For Sabine, music therapy was an important outlet for both non-verbal and verbal expression. In every lesson she managed to discover something for herself and to dare to try something new. These experiences can be like individual mosaic stones. Several mosaic stones together form a picture. In this picture, their self-esteem, which can become stronger, also plays an important role. Sabine’s curious and open attitude supports her in this confrontation.
*Name changed
Music Therapy in Neonatology
“Oh happy day”
A big thank you to the ART-THERAPIE Foundation and the team of authors of the lullaby book. Lisa*, a premature baby, has been in intensive care for several weeks. Lisa’s mother comes to see her youngest daughter every morning at 5 o’clock – there are three siblings at home. My idea was that I would put the “song book” next to the isolette with a note for the mother.
“Oh happy day”, today the whole family visited little Lisa thanks to the school holidays. Tears glistened in Ms D’s eyes when she later came into the waiting room where I was playing music with the three children: “We know “Idas Sommervisa”, I am Swedish”. Mummy sang the summer song with her group of children – the sun was shining in the waiting room of the intensive care unit.
The sensitive and fine gift has found its way into the hearts of the patients, relatives and the art therapist at the Cantonal Hospital of the Grisons in no time at all.
*Name changed

Music Therapy in Psychiatry

“Emma (not her real name), an 8-year-old girl, was admitted to hospital with anorexia nervosa for 5 weeks. Despite her very young age, Emma showed several symptoms of anorexia nervosa: voluntary weight loss with compensatory behaviours (sport), major preoccupation with her weight and a distorted image of her body (she sees herself as fat even though she weighs 23 kg), obsessive thoughts (voice telling her not to eat) and a strong need for control. She was admitted to hospital in June for bradycardia linked to her dietary restrictions.
I was able to see Emma thirteen times during her hospital stay. She was very discreet and not very expressive, both verbally and in terms of sound. She remained in constant control and didn’t allow herself anything that might give her pleasure. Over the course of the sessions, music enabled Emma to come into contact with repressed emotions such as aggression, anger and sadness. What she couldn’t express in words, Emma expressed in music. Her tiny voice grew in confidence, and the percussion instruments enabled her to approach a certain pleasure and let go, to bring movement where her illness had frozen her. The Voice ordering her to do sport to lose weight was represented by notes and colours, making it less terrifying.
A highlight of the follow-up took place at the 11th session. After a particularly emotional meeting with the care team and the parents, the latter came to the session so that Emma could play them a song she had composed. Each verse was about a member of her family. Dad, who was sometimes vindictive and distant with the team, gave up his defensive posture to give way to his tears. It was an intense moment.

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