Original title: Colour a kid’s world – and help him heal through art

The seven-year-old girl drew stalks of flowers, insects and clouds, and coloured them in with cheerful hues of red, yellow, blue and green. She wrote “happy” in large lettering at the bottom.

But on closer look, something else stands out: a speech bubble for the ladybird on top left hand corner with a small scribble that reads, “you are stupid”.

Ms Ho Soo Fung, a principal occupational therapist at the Institute of Mental Health (IMH), asked the girl if she wanted to talk about it. She didn’t want to and it was left at that.

After all, art therapy is meant to be a safe outlet for a child, allowing him to freely express difficult feelings without being forced to discuss them, said Ms Ho.

Art therapy is a mental health profession that is becoming more popular here, particularly with children, who tend to take to art naturally.

In this instance, the girl was fearful and did not do well in school and probably felt she was stupid, said Ms Ho, who was aware of the girl’s background before the session.

Subsequent sessions with the Primary 1 pupil threw up drawings of empty houses as well as Angry Birds cartoons.

At one session, she used plasticine and ice-cream sticks to create two houses, which she attached to a board with excessive amounts of gum. She then painted and used glitter to decorate them.

The girl, who was referred to art therapy to help her deal with her misbehaviour at home and in school, was then learning to relate to a third maternal figure.

Her biological mother had died and she had lost touch with her first stepmother. Her father remarried, but she did not get along with her second stepmother. Her father eventually married again.

The child underwent 12 art therapy sessions over six months, which provided a safe space for her to express her feelings of loss and uncertainty, said Ms Ho.

“It allowed her to work through emotional conflicts she felt at home and to explore building a healthy relationship with her new stepmother,” she explained.

Her new stepmother, who was struggling to build a relationship with the child, was involved in the therapy. With the child’s agreement, she would view the creations at the end of each session and the pair would have brief conversations about them.

“The mother gradually became more confident of herself and of her place in her stepdaughter’s life,” said Ms Ho.

Over time, as the girl developed more trust with Ms Ho, she used more materials and added more details to her drawings.

“In her last session, she painted a bright and colourful house with all her family members in it,” said Ms Ho. “This was seen as a significant positive shift regarding how she now sees her reconstituted family.”

Helping kids during hard times

More art therapists in private practice have emerged in the past two to three years, particularly as more graduate from Lasalle College of the Arts’ Master of Arts in art therapy.

The Art Therapists’ Association of Singapore, which started in 2008, now has 45 members compared with 30 in 2013.

IMH started art therapy for its patients in 2010 while the Singapore General Hospital (SGH) began offering it in 2011 under its eating disorders intensive treatment programme.

The KK Women’s and Children’s Hospital (KKH) also offers it.

Art therapy benefits children who could be experiencing lifechanging or challenging situations, such as long-term hospitalisation, chronic or terminal illnesses, mental health conditions and trauma.

They may also be experiencing significant emotional setbacks and concerns with regard to self-image, self-esteem and confidence.

During the therapy, art is made in the presence of a therapist. The focus is on the process and the relationship between the child and therapist, rather than on the art itself.

Ms Pearlyn Lee, an art therapist at the Child Life, Art and Music Therapy Programmes at KKH, said: “Each person’s work of art is a representation of the things that matter to him at that moment in his life.”

“The art piece is like a container in which these important matters can be contained and viewed with an emotional distance by the child and the art therapist.”

When art therapist Annelaure Vuillermoz worked with a girls’ home here, she conducted weekly sessions for about two months before the girls started to trust her.

“These girls have witnessed domestic violence or have experienced trauma. They would create a huge mess in the art therapy room,” said Ms Vuillermoz, who founded her art therapy practice Colourfully two years ago.

“If they lived in an aggressive environment, making art is a way to release the emotions that are trapped inside and it is very cathartic.”

They did not speak much and just needed someone to be with them and see what they have created.

The final piece of art may not contain warning symbols, such as alarming words. Rather, it could be the way the art is created that gives you a clue of the depth of their emotions, said Ms Vuillermoz.

Art therapist Dian Handayani, who is with SGH’s psychiatry department, said there is a growing body of research that suggests improvements in mood when clients are encouraged to work on art that contains positive emotional expressions, compared with merely creating art for venting and distraction purposes.

Discharging negative emotions such as anger and rage through art can, at times, be a catharsis and constructive.

But given the new evidence, she has begun to encourage her patients to also create art that depicts positive emotions, such as calmness and being in control.

Making art that depicts contrasting emotions often provides patients with richer experiences and insights into their issues, she said.

At her sessions, patients often request to do something that will motivate them to recover from their illness.

And, one of the things Ms Dian has asked them to do is to create pieces on the things in their life worth fighting for. They would draw happy families having a meal together or their future, such as themselves in a graduation gown.

“They can verbalise that they want this or that but when the work of art is created – these dreams are as if they have almost come to life,” said Ms Dian.

“There is a richness to it that words sometimes cannot describe in details, and it can be powerful.”

2 misconceptions about art therapy

1. Art therapists can decode a person’s mind just by looking at a finished piece of art.

The truth is that art therapists do not analyse pieces of art. “In our practice, we cannot interpret or make meaning of an art piece in silo – we see the patient holistically, taking into account input from other professionals working with the patient, personal history and current life situation,” said Ms Pearlyn Lee, an art therapist with the Child Life, Art and Music Therapy Programmes at KK Women’s and Children’s Hospital.

Therapists also observe the patient as he creates an art piece, including the way he interacts with the therapist and his own interpretation of the work or art, she added.

Ms Dian Handayani, an art therapist with the psychiatry department of the Singapore General Hospital said: “While the media like to portray the ‘fortune teller power’ of art therapists to read people’s art pieces and, indeed, it makes exciting TV shows, the real power lies in the patient’s own unique individual self and his expressions.

“For example, a patient may use black to symbolise feeling depressed or scared, but another may use the same colour to express strengths, elegance and beauty.”

2.Art therapy is only for people who can draw or paint.

You don’t need to know how to draw to benefit from art therapy as the focus is not on artistic skills. It is about expressing yourself through art. Art therapists are not there to judge your art piece but to help you process your thoughts and feelings.

“There are no real prerequisites – art therapists see the young and old, with varying levels of abilities and disabilities, and from various walks of life,” said Ms Lee.

Art therapist Annelaure Vuillermoz said she has had clients who felt they could not really do art.

“Clients come and tell me they are not good enough in art. If we explore this belief, we often find out they believe they are not good enough in many areas in their lives,” she said.