Thursday, November 13, 2014

The power of art therapy with wounded warriors

Another fine interview with my art therapy colleague and supervisee, Jackie Biggs, and the fantastic work that she is doing in her pioneered and established art therapy program at the NICoE via a grant from the National Endowment for the Arts. 

NEA Arts Magazine 

By Don Ball and Rebecca Gross 

 Air Force troop drawing on paper.
Air Force Master Sergeant Earl Covel working on an art piece at Fort Belvoir in Virginia. 

“There’s always somebody who’s got it worse than you,” said Master Sergeant Earl I. Covel, talking about his 12 overseas combat deployments as a member of the Special Operations Tactical Air Control team. “If you just got a little bit of shrapnel, you don’t want to get medevaced out. You suck it up. It was more important to stay with my team. I let a series of incidents compound on each other. I let them accumulate. You can only fix Humpty Dumpty so many times before it can’t be fixed any further.” When he returned to work at the Air Force headquarters at the Pentagon, he found that the toll wasn’t just physical, but psychological. “I was such a shell, getting progressively harder and harder,” said Covel. “I was shut off from my family and my friends. I was becoming more reclusive.”

In addition to meeting with psychiatrists and social workers, he began working with Melissa Walker, the creative arts therapist at the National Intrepid Center of Excellence (NICoE) at Walter Reed Military Medical Center in Bethesda, Maryland. He then transferred to the NICoE satellite location at Fort Belvoir in northern Virginia, where he resumed treatment with art therapist Jackie Biggs. 

Woman at table drawing on paper.
Creative arts therapist Jackie Biggs at the National Intrepid Center of Excellence satellite location at the Fort Belvoir Community Hospital.

The Creative Arts Therapy program at the Fort Belvoir Community Hospital—a state-of-the-art hospital designed to be an instrument of healing, hope, discovery, and learning for service members and their families—was started in September 2013 through a partnership with the National Endowment for the Arts. The Fort Belvoir program uses visual and literary arts to treat military service members dealing with psychological health conditions such as post-traumatic stress disorder (PTSD) and traumatic brain injuries (TBI). The program is administered as an outpatient clinic so that the therapy can continue on a long-term basis, without patients having to leave their units or families for extended periods of time. 

Although art had brought Covel joy in his youth—he frequently drew and participated in his school’s drama program—he initially rejected art therapy, and didn’t participate in the first few sessions. “I was in a totally different place at my life,” he said. “I wasn’t allowing myself to have any enjoyment at that time.” Eventually, with gentle prodding by Walker, Covel began to create, and the walls he had carefully built to block out both people and memories began to tumble down. “I found art was more a vessel that allowed me to open up to the world,” he said.  One of the reasons Biggs believes patients like Covel find success in art therapy is the effect it can have on the stress hormone cortisol. “Engaging in art-making is inherently relaxing,” Biggs said. “It has been shown to decrease cortisol so people become relaxed, their anxiety goes down, and they feel more comfortable.” Feeling comfortable and less anxious is especially important in therapy for military service members, many of whom have been in high-stress situations for much of their careers, and are trained to be hyper-vigilant of their surroundings. “Patients can walk in here really angry, really frustrated with something that happened on their way in, and as they’re engaged in art making you’ll see them calm down. And when they leave, they’ll make comments like, ‘This is like medicine. I feel way better.’” 

The service members Biggs works with exhibit “moral dilemmas and existential topics and shame and guilt, and survivor’s guilt, and, a lot of times, fear of one’s self.” In addition, Biggs’s patients often engage in isolating behaviors, which can make them feel further estranged and out-of-synch with society. Biggs combats this with group art therapy sessions, as well as by hanging patient artwork along the walls of the art room. “The writing’s on the wall in the artwork that they’re not alone, and that other people are dealing with these things internally,” she said. Of course, the goal is to eventually externalize these internal struggles. As service members create and then describe their work, they often find themselves discussing an incident or emotion that they’ve repressed for years, whether intentionally or not. “Sometimes patients call it trick therapy,” Biggs noted. “We’re not really tricking them, but just getting beneath the surface in a different way…. Sometimes patients wind up feeling so overwhelmed that it’s hard to sort through what exactly is overwhelming them and what really is underlying all those emotions. Through creating the artwork and then talking about it later, they’re usually able to identify and pinpoint really what’s underlying what’s going on, and what they can target in therapy moving forward.” 

Biggs noted that for many patients, talking about artwork is often easier than engaging in a face-to-face “stare down” with a psychologist or psychiatrist, which can put people on guard and raise their defenses. Instead, Biggs tries to work around the inner censors that patients may have put in place. “Patients are encouraged to be really spontaneous and follow their gut and really engage in intuitive art-making,” she said. “I think that combination of de-stress, relaxing, and spontaneity often results in artworks that shed light on the subconscious.” For Covel, the art therapy program helped him “to visualize something that’s in my head and to process something into words,” he said. “I’m not somebody who likes to write things down. I’m not a person who likes to outwardly talk. And I guess that’s why I want my art to be perfect is because I want it to be self-expressive where it should answer all the questions.”

 Collage artwork.
MSgt Covel’s artwork How Much Does a Hero Cost? 

One of his artworks, "How Much Does a Hero Cost?," is a collage-piece inside a recycled fruit box. “I have a thing, maybe it’s because I grew up in Portland, Oregon, that I like to recycle things. I try to do that as much as possible with my art.” Inside the box is a collage, with a picture of Covel at the center, and other photos of him hidden among the images. Overlaid on the collage are two foam-cut pistols pasted with either negative or positive words. “There’s kind of a yin-yang sort of thing going on with the pistols in there,” said Covel. “Just making those pistols alone with the words took me a really long time. It was emotionally draining just to do the semi-positive one. I had to force myself to do that one, because that was at the beginning of our therapy. I was in a place that I did not feel real highly of myself. But at the end I was able to breathe a bit of relief and know that in the end, things were done for a reason in that given moment. It doesn’t necessarily make me a bad guy.” 

Covel was working on a self-portrait as he came close to his impending retirement from the service. “Jackie suggested that since I’m retiring that I create something to kind of culminate my career. I always jokingly said I wanted a big, cheesy velvet painting like they have of the generals, like me on a big white steed and everything, with a sword, and hang it above my fireplace. That’ll probably never happen, but Jackie suggested that I come up with something, so I thought I’d give it a shot.” So Covel began working on the piece, drawing and using watercolors. “It’s supposed to be me in my service dress uniform. I’m going to pencil draw it. The decorations are actually in watercolor that I’m going to have bleed down when I have the watercolor. I’m going to have a saying go across the whole thing: ‘The soldier may leave the valley, but the valley never leaves the soldier.’” 

Portrait of a soldier.
Portrait of a soldier. MSgt Covel talks about the self-portrait he is working on. 

Even when the piece is finished, Covel doesn’t plan on putting down his paintbrush. “I look at it as an ongoing process,” he said. “Art has been given back to me. It’s been a gift. I’ll get to take this with me and utilize it to process anything in the future.” 

All photos by Sally Gifford

Friday, November 07, 2014

Some art therapy techniques you can try to de-stress

10 Easy Art Therapy Techniques To Help You De-Stress