Expressions of Grief and BereavementWendy Tucker Garrean, M.A., Expressive Arts TherapistLegacy Hospice Services-McMinnville 5O3 472-9685Legacy Good Samaritan Cancer Healing Center 503 413-8404wgarrean@lhs.org

Expressive Arts Therapy is often referred to as a multi-modal or multi-artstherapeutic modality due to the utilization of many creative means of expressionsuch as visual arts, movement arts, writing, drama, and music. Variousorganizations and individuals are displaying deep interest in utilizing theexpressive arts as a healing modality and informational lens for group andindividual therapeutic support. This widespread interest has been shown byteachers, social workers, occupational therapists, community outreach programleaders, psychologists, and medical personal, to name a few. Such growinginterest is an indication of the effectiveness of creative intervention in providingan avenue with which individuals are able to communicate their inner most self.

Junge (1985), Mclntyre (1990), and Simon (1981), report findings thatshow many bereaved individuals respond favorably and often more quickly withthe creative arts therapies than with traditional verbal interventions. Usingcreative approaches in grief counseling encourages full expression of one'sthoughts and feelings when a loved one dies. Examples of creative approachesare'.

" Aft Making: art expression aids in reflection of feelings andexperiences shared with the deceased and helps bring clarity toone's unique grieving process.

* Use of Symbols and Analogr'es: encourages the mourner to sharephotos, letters, tapes, articles of clothing, and significant objectsbelonging to the deceased and encourages the bereaved to explorepersonal symbols and images of healing.

* Witing: writing letters to the deceased helps the expression ofthoughts and feelings regarding possible unresolved issuesbetween the mourner and the deceased.

* Commemoration: creating a book of stories, pictures,memorabilia, poems, and drawings helps the bereaved reminisceand eventually mourn the death with a more realistic image of thedeceased.

"Healing Rituals: rituals can help ease the pain through engaging inan outward expression of memorializing the loved-one andpromotes healing through creating a sacred act of expressing one'sexperience.

Johnson (1987) explains that the practice of art making as an aid to thehealing process is not a new concept. "Humankind may have developed art toalf eviate or contain feelings of anxiety , lear, crisis, and threat" (Johnson , 1987 , p.7). Dissanayake (1988) supports this opinion, stating that art making marks theimportance of events such as death, through the creation of visual imagery.

Hatcher (1985, p. 7) offers an anthropological view of why creative expression isexplored during these profound points in life:

Whatever the theoretical explanation, it is clear that artsomehow helps human beings cope with the trauma ofdeath. Beauty and art forms have been part of funeralceremonies since Neanderthal times. This universalhuman problem is met everywhere with symbolicsolutions to satisfy the mind and aesthetic solutions torelease the emotions (pp 106-107).

Simon (1981 , p. 7) suggests that artistic expression from the bereavedrepresents efforts of working through conflict and usually occurs in three stages:stage one-expression of the conflict, allowing greater conscious awareness of thefeelings within the stress; stage fwe-the artistic image enables the sufferingexpressed in stage one to find containment while it is converted to mourning;stage three-brings resolution and greater coping skills.

Hill describes the benefits of group art therapy for the bereaved in thefollowing way.

" Hastens the Grief Process and Promotes Coping Skills-ln asupportive environment, resolution through creative expression andcontainment in art frees creative energy necessary to deal withdai ly l iv ing.

" Remember and Commemorate the Deceased-Creativity in arttherapy can also "lead to remembering, to experiencing the rageand the loss, and to regaining the past in all its warmth and itsimperfection....to mourning of losses and to getting to know oneselfand others" (Fleming, 1983, p 7).

* Creation of Healing Rituals-According to Johnson (1987), "Artoriglnally developed as a means of expression of and relief fromtraumatic experiences. Art, song, drama, and dance in primitivetimes were motivated by a need for catharsis and gaining controlover threats to the community" (p. 8)

* Helps to Organize and Regain Sense of Containment-Junge(1985) explains that the ovenryhelming feelings and thoughtsresulting from a loved one's death can be contained withinsymbolism. The container of artistic symbolism presents a sense ofcontrol and organization, which allows greater productivity in dailylife and resolution of the grief process.

* Promotes Exploration of Feelings-Artistic images can promotediscussions that may not have been acknowledged previously( lrwin, 1991; Simon, 1985).

* Facilitates Cathartic Effect and Kinesthetic Release-Catharticexpression through art releases emotions of grief, and theexperience of catharsis allows the healing process to begin (Furth,1988; Rubin, 1987',lrwin, 1991; Junge, 1985; p 8).

* Encourages Self Awareness-"The pro@ss of making art allows forself-awareness and the artworks are safe outlets for individuals toexpress their grief at their own rate, with the emphasis ondiscovering and investigating relevant personal concerns(Schimmel & Kornreich, 1993, p. 9).

* Final Product and Permanence-Persons in grief can look atfinished artwork over time and continue to gain insight from thework. They can engage with the images, increasing selfunderstanding at a pace that is appropriate for them.

lmplementing creative arts therapies can substantially increase thebeneflts of group support. According to Aldridge (1993) and Malchiodi (1991 )creative therapies offer modalities well-suited to the needs of grieving individuals.This is in part due to the difficulty of fully expressing grief through words alone.Art therapy offers a multimodal non-verbal means with which to discover newpossibilit ies in coping with loss (Grant, 1995; Graves, 1994, p 7).

Hospice programs are beginning to implement more art therapy into theirbereavement group sessions. Mclntyre (1990), reports that the goals of groupart therapy serves two purposes; to provide social sanction for the expression ofgrief, and to promote adaptive mourning responses.

Schimmel and Kornreich (1993) suggest, "The sharing of artworkaugments and deepens the connections made during normal verbalcommunications in groups. These important interadions between participants,art therapist, and the art process help the participant move from isolation andloneliness to connection and empowerment; from denial to acceptance; from lossof control and anxiety to relief; and from despair to hope" (p 10)

Schimmel and Kornreich (1993) discuss an art therapy bereavementgroup for those widowed less than one year. The group included weeklysessions lasting for the period of one year and was loosely structured afterKubler-Ross's (1969) five stages of grief and acceptance of death, and Yalomand Vinogradov's (1988) bereavement work. "The goals of the group were toidentify the emotional experiences that the group members could share, howmembers could help one another, and how they might gain relief from sadness,continue with their lives, and grow emotionally'' (p. 10). The participants werepresented with art therapy directives, helping to facilitate the expression of theirexperiences. Results showed that the artistic process brought to the participantsrecognition of thoughts and feelings, and an alleviation of sorrow (p 10)

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