Art Psychotherapy in an Oncology Setting

1. Art Psychotherapy in an Oncology Setting Dr Chris Gallagher, Consultant Medical Oncologist Megan Tjasink, Art Psychotherapist

2. Introduction There are two major ideas that I want to convey to you in this presentation: • That art psychotherapy can be a very valuable component in the mix of oncology services • That its value comes especially from its special ability to enable profound personal expression and relationship; to bring humanity back into the equation

3. Background • Medical/Hospital Setting • (Chris has outlined some of this already) • The focus of treatment for oncology patients is very much on the objectified physical body • My Approach to Working Psychotherapeutically • Informed by Existential Phenomenological psychotherapy • Non-directive, non-invasive, non-judgemental, non-diagnostic, non-objectifying • Enabling the patient’s subjectivity to be expressed, explored and witnessed in therapeutic relationship • Enabling honest reflection and personal responsibility

4. Measuring value • In my other place of work we use CORE (Clinical Outcomes in Routine Evaluation), which is becoming a standard measure within mental health care settings, and also the Ryff Scales for Psychological Well-being. The results so far show significant benefits for those engaging in art therapy. • In the Barts setting it is extremely difficult to use outcome measures for evaluating art therapy, mainly due to the uncertainties of patient contact • At Barts, the measurement of art therapy’s value is subjective – it is in the words and work of our patients • We are currently exploring phenomenological research methods which will allow us to gather and present these outcomes in ways suited to academic , medical and scientifically-orientated audiences

5. Vignette 1: Steven • Art therapy in a single session • Steven felt isolated, depressed and unable to communicate with family and friends. • Using drawing, he was able to describe and clarify the emotions he was struggling with. • He used the picture to share feelings with his wife that he’d previously been unable to express. • According to Steven, this brought him out of the isolated and depressed state he’d been in.

7. Vignette 2: Julie • Longer term art therapy (5 months) • Julie sometimes felt out of control and powerless in the face of cancer and her medical treatment. • Along with distressing physical side effects, she struggled with guilt and the choice she’d made to “poison” her own body with chemotherapy. • She used art therapy to explore the impact of chemotherapy treatment on her body and her mind.

10. Vignette 2: Julie • Julie went on to make images that were less cerebral and more about the creative process for its own sake. • This enjoyment of the moment and of process shifted her outlook. She reported feeling changed in a fundamental and profound way. • Julie said art therapy had enabled her to feel more present in her life, regardless of an uncertain future. She spoke of accepting herself, of no longer feeling guilty about what she wasn’t, had done or should be doing. • “Something has broken up in me. I’m more flexible; I feel free.”

12. Closing Remarks • Being poked, prodded and exposed to poisons or to radiation are often essential in oncology and can be deeply unpleasant, objectifying and dehumanising • Art psychotherapy complements these necessary medical processes bringing the humanity and search for and expression of meaning and value back into the equation of life • This is both intrinsically valuable to the patient and also to the quality of their relationships with others