The 'M' word nobody wants to talk about

I had the pleasure of meeting with an old colleague today, after many years. While we were catching up on times past, we happened to chance upon a topic about which we both share very similar views.  The question I am referring to is one that most people are either shy to discuss or wish did not exist. However, the fact is that the reality of the ‘M' word or dare I elaborate…the phenomenon of MASTURBATION within the context of children with different needs, cannot be ignored. The reason why I have capitalized the word is not to cause outrage or evoke disgust but to emphasize that it is an act that most males (at least) indulge in (please note that I said most not all) and that it is NORMAL to do so. I am not aiming for a religious or philosophical debate here, simply stating what is factual. Then why is it that when it comes to our children with differences, developmental or physical, we expect forced abstinence, denial and shame the subject? Why do we stigmatize a natural drive that is considered normal for neurotypicals but unacceptable for the neurodiverse?

I will not deny that when our children with different abilities are going through puberty, masturbation can pose many challenges. For obvious reasons, it is an act that calls for extreme privacy, and without question, no parent wants to witness their child engage in it or exhibit it. Unfortunately, with our special children a lot of times the discretion that we ideally desire, is not possible but that does not mean that the event cannot be handled sensibly. 

Instead of getting rid of the so-called problem (which it is not because it is normal) there are workable solutions to the issue. I found a solution that worked for my son, and I am confident that with the help of empathetic professionals and supportive parenting so can others who are facing the same dilemma.

In my case, I set specific boundaries around the act for my son who was allowed to indulge in it in a specified room beyond which there were consequences. With a few hiccups initially, he began to understand his limits, and we found a resolution to the problem.

Imagine the child whose sexual drive is suppressed continuously and finds no means of satisfaction? It is highly likely that the frustration will manifest in inappropriate sexual behaviours and/or acts of anger and aggression.

There may not be such a thing as a perfect solution, but there is always a way of handling what may seem like an insurmountable problem provided there is acceptance accompanied by perseverance and compassion.

Suggested reading: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/intellectual-disability-and-sexuality

Let your child's art do the talking!

When I tell people that I am an art therapist, more often than not I get a puzzled look followed by the now familiar question “What does that mean? Do you teach art?”. By now I should be miffed by this recurrent inquiry, but I am not because I get another opportunity to talk about my favourite subject. Moreover, every time I talk about it, I realize what an amazing thing it is to be able to achieve mental well-being through art making even if you have no artistic skills. That is why art therapy is for everyone from a child who can make marks on paper to an elderly person who may not be able to do so due to old age or illness.

All individuals with any level of ability, emotional or mental need or desire for mental well-being can do art therapy. It can be done individually, as a family and in groups. The only prerequisite is the will to discover, heal and learn with a trained art therapist who is there to guide you through the process of art-making and healing.

I work with children and adolescents with diverse needs. Some may have developmental differences, some are experiencing emotional ups and downs, others may have familial problems, issues at school or in some cases serious mental health concerns. An art therapist can address the individual needs of each child by tailoring the session specifically to them.

When I work with a child with autism, I am not only concerned with their emotional well- being, but I am also aware of their sensory needs. It is not possible to focus on the mental health of a child who is not well regulated. Therefore, I use art materials to induce sensory modulation alongside the emotional work that is required. Engaging with art materials allows the child an opportunity to achieve sensory regulation as well as provides them with an opening for communication and expression. For a non-verbal child or one who has difficulty communicating this can often be a liberating experience.

Sometimes I get a defiant teenager who is aggressive at home and unhappy at school. The parents are at a loss because their child will not talk to the school counsellor or the talk therapist. They come for art therapy as their last resort. I tell them “the good news is, that your child does not necessarily have to talk in the session”. All they need to do is be present and the rest usually follows. The child who may be reluctant to make art, in the beginning, is usually drawn to art materials and will eventually start engaging with them and the therapist. Sometimes, if there are familial issues, the parents or parent will be asked to join in the sessions. Once again, a conversation may not be necessary as the artwork can do the talking.

It is the process of art making that lies at the core of the art therapy approach. The art product is not judged for aesthetic quality; there is no right or wrong you can do. The art therapist provides the safety and containment needed to confront difficult and sometimes very painful emotions. Art making can tap into the innermost aspects of the psyche that words may not have access to. Children especially, cannot be expected to know why they are feeling depressed or angry or defiant. However, the images they make can tell us pretty much what is going on.

Channelizing aggression in children through art

A 5 year old's expression of her internal trauma

Aggression in children could be a symptom of underlying issues that find external expression in inappropriate verbal and/or physical behaviour. The common course of treatment for anger management in children is behaviour modification and in extreme cases medication. These approaches have their merits and can help in averting disastrous consequences for the child and his/her family. However, focusing on behavioural techniques in isolation may inadvertently conceal the psycho-emotional problems that are at the root of the behaviours and may be a call for help from the child, rather than a deliberate attempt to cause harm.

Children lack the ability for metacognition or the capacity to think about their thoughts. Simply put, they may have no clue as to why they act out, transgress limits, push buttons and indulge in inappropriate behaviors beyond what is considered typical. Amongst the many reasons they may be doing so, attachment issues, familial problems, stress related to school and peers, learning differences and developmental challenges may be implicated. Thus, it seems rather one sided to expect external compliance from a child who may be suffering emotionally, without addressing the internal aspect of the matter.

I find art therapy to be most efficacious when it comes to addressing psycho-emotional problems in children as it has the capacity to tap into the hidden content of a child’s psyche that may not be accessible through words. Art making can by pass defence mechanisms that prevent access to deep-seated conflicts.

Very importantly, art therapists work through metaphors in the child’s artwork thus, if some trauma or difficult emotional content surfaces through art making, it can be processed in a safe and non-confrontational way. Art therapy is a safe therapeutic modality in that it avoids re-traumatization of the individual from exposure to difficult memories.

Art therapists are also trained to direct negative emotions into creative acts through the prudent use of art material. Clay may be pounded or kneaded, scratched, and poked in order to express anger or frustration just as paint may be splashed or paper torn and crushed to channelize aggressive effect into appropriate expression.

Art making, whether in the form of seemingly random scribbles and doodles or skillful images and sculptures is an expression of the unconscious. Thus, to partake of art therapy absolutely no skill in art making is necessary. In fact, I have come across children who do not show any inclination to draw or paint yet can be tempted to engage in acts of creation that lead to inner expression.

A child cannot convey with words what they are not aware of, and some children may not have the ability to speak. You will be amazed to find what can be achieved through the simplest forms of creativity and relational art-making with an art therapist.

Time and time again I am asked if art therapy and art class are one and the same? Once again, I will repeat that ONLY a Master’s level art therapist can conduct art therapy. Most art therapists are registered with regional boards of art therapy associations and have gone through hundreds if not thousands of hours of clinical practice.

Autism: Another perspective

Traditional definitions of autism focus on deficits in communication, social interaction and imagination. For most of autism’s history, it has been believed that individuals with autism lack interest in and avoid social contact. Observable behaviors across the spectrum such as stimming, repetitive acts, unusual mannerisms and echolalia are targeted for behavioral intervention to be corrected or redirected. In fact, most caregivers of children with autism will vouch that a large portion of the latter’s awake time is spent in behavioral modification and social skills enhancement. However, research over the past two decades has begun to look at autism beyond what is largely a socially constructed interpretation. There has been a shift in science to gain a deeper understanding of why certain behaviors occur. Could we be missing out or misinterpreting the actual reason behind for instance, why a child with autism is seen banging his head incessantly, flicking objects in front of his eyes, or smiling cheek to cheek for seemingly no rhyme or reason at all (these three examples are from my own personal experience with my son).

 Recent research has started to pay attention to sensory and motor/movement deficits that may explain symptoms that are commonly termed as ‘autistic behaviors’. This means that issues in sensory and motor functioning are being implicated for deficits in communication and socialization systems. Hence, researchers are broadening their lens to look at the neurological deficits that underlie autism. This shift in perspective is very significant if we are to get to the source of the so called autistic behaviors and understand why they take place. Our knowledge in this regard has great implications for the way we view these mannerisms and treat them. For instance, would you consider correcting the gait of someone with advanced Parkinson disease or redirecting a tic in someone with Tourette’s Syndrome. Probably not, and the reason for that is because you are looking at them from a neurological lens; you know that it may not be within the means of the individual suffering from those diseases to control the behavior.

To put it plainly, a restrictive view of autism may be misleading us into why someone with autism engages in loud vocalizations, has extreme reactions to small changes, rocks back and forth or repeats nursery rhymes endlessly. Interviews and self-stories of people on the spectrum have revealed that these stereotypical behaviors are more often that not a source of organizing and regulating experience; even perhaps a source of learning. 

Instead of looking at the person with autism as a whole, mind and body, we have relegated autism to a social interpretation of its symptoms. A new way of looking may be necessary so that opportunities to extend learning and develop relationships are not lost. It is essential to understand each and every individual with autism as unique, so that appropriate support can be provided; not to look for deficits but to focus on their strengths and competence.

Our children with autism are often at the receiving end of massive interventions to correct, stop, redirect and modify behaviors. We often forget the little souls that occupy these innocent bodies that are a jungle of misfiring neurons. Let’s get to know our children better and deeper so that we can help them without endangering their self-esteem. (Donellan, Hill & Leary 2013).

For appointments contact Huma at www.colouredcanvas.net

Reference

Donnellan, M. A., Hill, A. D., & Leary, R. M. (2013). Rethinking Autism:Implications of Sensory and Movement Differences for Understanding and support.  Frontiers in Integrative Neuroscience 6, 124. doi: 10.3389/fnint.2012.00124

Art therapy and emotional regulation

Alan comes into the session somewhat anxious. As soon as he sat at the drawing table, he chose his favourite medium, pencil. Alan begins to draw skyscrapers with multiple storeys, stairs and lifts, as is always the case at the beginning of each session. He spins a story around his image as it progresses. The pencil is easy to control, and its marks can be erased; hence, it feels less threatening to Alan than paint, which has a mind of its own. The deep pressure of the pencil and its willingness to obey Alan’s commands seems to calm him down. 10 minutes into the drawing Alan appears excitable once again, perhaps it’s the turn that his story has taken or something else around him that has triggered this change of mood. I sense Alan’s frenzy and draw his attention to the clay I have at hand for such moments. Clay will help Alan channel his energy into a medium that can ground or contain his anxiety. Alan begins to pound and knead the clay, and once again, a sense of calm pervades him. Later in the session, I  will ask Alan to use paint as I want to dig deep into his emotions. The session will probably end with Alan back to using the pencil, in control.

This brief anecdote provides a glimpse into how the inherent qualities of art materials are used within an art therapy session. Art therapists are trained to work with a large variety of materials to induce or subdue psychoemotional states according to the specific needs of their clients. Especially for children with self-regulation issues, a deep knowledge of the effect of art materials is necessary to modulate sensory/emotional states. For children with sensory integration dysfunction (SID), art materials can sensitise or desensitise hypo or hypersensitive children. Art therapy is being used effectively with children with autism spectrum disorders (ASD), learning differences and developmental issues. It is an effective mode of intervention for all ages and a wide range of psychoemotional issues such as anxiety, depression, low self-esteem, bullying, trauma, abuse loss, grief and so on.

 When words are not enough, where language has no access to emotions, art therapy is the way to go when verbal expression feels threatening and unsafe.

*You do not need any artmaking skills to do art therapy.