یک مهمان موقت: استفاده از هنر درمانی در بررسی زندگی با یک زن مسن

Whilst on clinical art therapy placement at a community residential care facility for the aged, I had the privilege to listen to touching memories that some of the residents shared with me. Every person had a story to tell that usually related to well-known historical events. Witnessing the storytelling of century-old memories created a rare opportunity for me to travel with these residents back in time, to learn more of their unique perspective on life, and therefore better attune myself to their present needs. I could not help picturing their vivid memories in my mind, and eventually encouraged some of the residents to visualize them on paper. It was then that I decided to further explore whether art therapy could be incorporated into a personal life review process in a way that was beneficial to working with an elderly woman. Robert N. Butler's noted article (1963) was the first to establish life review as a normative mental process that may result in positive outcomes. Butler articulated the various visual aspects of reminiscing in a way that invites analogies with art therapy. Nonetheless, the scope of literature on the use of art therapy in life review is comparatively limited, and so I decided to undertake a project that might offer an additional perspective on the combination of these modalities. The discussion in this paper was similarly narrowed down to one incisive question: Will art therapy enhance the positive outcomes of life review in late life, leading to more self-acceptance and ego integrity? This qualitative single case study is made up of eight art therapy sessions with an 89-year-old woman, who resided in a low-care community home for the aged. Sessions were patterned on a developmental theme-oriented approach ranging from childhood to later adulthood. In order to answer the research question, pre- and post-intervention assessment tasks were embedded in the method.

Differences between pre- and post-assessment images may demonstrate a positive impact of art therapy intervention in this particular case. A comparison between images made in the first and last sessions uncovered a progression from depictions of decline and emptiness to a more balanced view of life. In the course of time, variation in the artwork as well as in the core narrative themes unravelled, highlighting the subtle interaction between the process of art making and recollection in a therapeutic context. The research findings challenge the dichotomy implicit in old-age psychosocial task (integrity versus despair), as well as the common explanation of disengaged social-behaviours of older adults. They argues that, in Israela's case, despair or the awareness of impending death seem to enrich rather than conflict with ego integrity while coping with old-age developmental tasks, and that diminished social activity may sometimes occur due to physical impairment rather than an inherent need to disengage. The findings of this study have, inter alia, advanced the thesis that the geriatric population may be far from uniform. The participant of this research belonged to a group of elderly people who have not attracted much research attention, namely, well-functioning older adults (89+), residing in aged care homes. It is precisely here that more research may be done. Explorations in art therapy modalities with older individuals (89+) could be pursued on a much larger scale, so that some peer group qualities can be more accurately generalized. Similarly, the process of old-age life review could be better understood if more comparative research targeted other subgroups, like the elderly in palliative care, or older individuals living in the community. Finally, the multifaceted linkage between image making and recollection could be explored over longer periods of time. In conclusion, this single case study has generally demonstrated a positive response to art therapy when used as a vehicle for life review. In Israela's case, the art therapy process enabled a progression from depictions of decline and emptiness to a more wholesome view of life. It gave her an opportunity to experience a sense of purpose by sharing her lifetime memories with a supportive witness, and thereby to revalidate them. Perhaps the last words should be left for Israela to say: “… When I walked up here (to the art room), I was wondering if I will ever get here … I felt I had no strength … but I made it … Yes … so, I play and I forget that I’m a temporary guest …” (session 6)