November Issue 2014
Medicine for the Soul
The new arrival at Fountain House (the half-way house in Lahore) was nine-year-old Sami. He sat in the waiting-room staring listlessly through the window, as though barely aware of where he was, or who the people around him were. Somewhere at the back of his mind those terrifying sounds were playing on repeat — an earth-shaking blast, the verandah of his little home lying in a broken, undignified heap, bodies strewn around, limbs separated from those they had once belonged to. He shut his eyes, hoping the sounds and images would go away, but they never did…
At the War Against Rape (WAR) office in Karachi, a couple waited anxiously. Their daughter Shazia was barely eight years old, but her ordeal had begun two years earlier. Her cousin had begun to fondle her under the guise of affection, but then he moved on to groping her in a manner that Shazia instinctively knew wasn’t right. A few days later this had led to sexual abuse. The little girl wanted to complain to her mother, but didn’t know how she could describe her molestation and feared she wouldn’t be taken seriously; her cousin had frightened her into remaining quiet. They lived in a joint family system, so there was no getting away from him. His criminal behaviour continued without anyone in the family even being aware of it. The only sign was Shazia’s increasingly withdrawn persona, and her wish to lock herself in her bedroom. In two years she had become so withdrawn, that her increasingly alarmed parents took her to see a doctor. In the calm, quiet atmosphere of the psychiatric unit, Shazia felt safer, but completely empty, still unable to communicate with her loved ones.
Treating cases like these requires intensive training and profound understanding. Such deep emotional disturbance, depression and endless worry are traditionally treated with psychotherapy, medication or electroconvulsive therapy. But now alternative treatments using music and art have been added to the list. However, this sort of therapy is not new, because music and art have soothed troubled minds for centuries.
What is new is the streamlined, professional approach that is being taken to incorporate music and art into psychotherapy. The magical effect of music in restoring inner peace is frequently used to cure depression, dementia, psychosis and neurosis. Background music is regularly used in hospitals for 10 to 12 hours a day, to create a calm atmosphere, a practice that is known to alleviate anxiety and relax patients in critical care. Contemplative music (that is soothing and thought-provoking) is often used to create a meditative atmosphere for patients. This sort of music has helped bring about behavioral changes in clients, evident in the verbalisation of their feelings and a shift from a passive state to a more active one in which the patients select songs themselves, sometimes even volunteering to sing. Where patients have long hospital stays, group singing and playing musical instruments strengthens their feelings of self-confidence and self-worth. Sometimes patients themselves write songs as a form of catharsis, using it to express their grief.
Hypnosis can also be used in conjunction with music therapy, and making suggestions to patients under hypnosis helps to improve their condition. Music therapy can be used to treat emotionally disturbed and also mentally challenged or dyslexic individuals.
The concept of art therapy goes all the way back to 1942, when the phrase is supposed to have been coined by the British artist and therapist, Adrian Hill. In the mental health profession, art therapy is based on the belief that the creative process involved in artistic expression helps therapists understand psychological states and processes. It also helps clients reduce stress, increase self-esteem, and deal with loneliness and loss.
According to the American Art Therapy Association, art therapy has helped autistic children as well as those suffering from Down’s Syndrome to improve their motor skills, ability to think symbolically and recognise and respond to facial expressions. Art therapy has also been used with encouraging results with clients who have attention deficit hyperactivity disorder (ADHD), depression, anxiety, bipolar disorder and depression.
For example, children who have suffered physical and verbal abuse and are therefore withdrawn and feel uncomfortable with verbal exchanges, or those who due to cultural norms are not comfortable communicating with adults and other authority figures, often find they can communicate more freely through art. But it is not the artistic value of the art work that is important; the point is for the therapist to identify non-verbal cues and use them to explore the client’s emotions. Clients can be asked to draw something that best describes how they ‘feel inside,’ and open discussion of the art work is also encouraged in this kind of therapy.
According to a study conducted by the US Department of Education in 2001, roughly eight to 12 per cent of students in the age groups of six to 21 years suffer from emotional disturbances and motor disabilities.
The US, Canada, Sweden, Denmark and India are already providing effective alternative therapy for emotionally and mentally disturbed people. In Pakistan, a significant proportion of the population also suffers mental health problems — and that number is growing. We therefore need to act quickly and also think outside the box and encourage the development of alternative treatments that can assist the mainstream pharmaceutical approach.