How a Scorpion Lit Up the Room: MedSEA in Action

A group of four Therapeutic Arts Group volunteers knock on a hospital room door in the Neurology and Neurosurgery Unit at the Ronald Reagan UCLA Medical Center.

“We’re here to offer some therapeutic arts—would you be interested?”

“Sure. Come on in,” the patient replies, greeting them with a curious smile.

Second-year medical student, Methma, begins: “We offer art, music, poetry, guided visualization . . .” “Guided visualization?” the patient asks. “That’s interesting; let’s do that.”

The patient’s name is Bryan*, a young man in his early twenties who was previously diagnosed with bipolar disorder. He has been in the hospital for the past two weeks, after a recent accident left him with a loss of mobility in his legs and partially in his upper body.

18-10-19-MedSEA-Justice-10Methma helps him pick out a calming nature soundtrack, and Amanda, a fourth-year undergraduate student, begins to read a guided visualization along with the chosen music. Amidst a room where Bryan is hooked into machines, with an the occasional beep of a heart monitor, the air is calm.

The Therapeutic Arts Group (TAG) is a medical-student-led volunteer group at UCLA which offers social and emotional support to patients through creative arts activities integrated with mental health practices. Such practices include elements such as the use of nonjudgmental language to facilitate reflection and meaningful dialogue for enhancing self-expression and connection, and reducing emotional distress and pain.

18-10-19-MedSEA-Justice-12After Bryan meditates with the TAG team, his interest in their creative offerings grows; however, due to his limited mobility, he asks the volunteers if they can help by drawing for him. He requests that they draw scorpions and crabs, with which he identifies because of his astrological sign: Cancer. For the rest of the hour, the TAG team draws and the conversation flows from astrology and Chinese year symbols to God, technology, the ecosystem, the changing colors of leaves throughout the states, politics, cognitive psychology, and memories of 9/11. At the end of the hour, Bryan asks the team to tape up onto the wall the drawings they had made together so he can look at them daily. Before they leave, he says, “It’s nice to be able to talk to people and just… talk. It’s a very cool program for anyone that wants it.”

“We are part of the recovery,” says Hanh Nguyen, TAG Coordinator and second-year UCLA medical student. “We are that person who listens, participates, and interacts outside of the illness. [TAG] is an opportunity to be with a patient in a non-clinical way…and as an alternative outlet. As I heard a lecturer say recently, ‘it’s good to know the books, but your personality as a doctor is important.’”

At the core of all UCLArts & Healing programs is the mission to transform lives through creative expression, particularly for those living with challenges such as trauma, illness, special needs, and/or social isolation. From colored pencils to sterilized rubber gloves, creative expression can be facilitated in any space and through the most surprising of objects.

TAG volunteers receive training in the UCLArts & Healing Medical Social Emotional Arts (MedSEA) program, a scripted curriculum that integrates mental health practices with the innate social emotional benefits of art, movement, music, and writing. This sustainable program offers flexible activities that can be expanded or contracted according to time, ability, and number of participants. MedSEA can be delivered with little or no supplies, which makes it ideal for settings with shoestring budgets. A condensed training for UCLA medical and undergraduate students is offered twice a year.

The MedSEA Training

18-09-25-MedSEA-GIF-Ketcher-1The introduction is led by Ping Ho, MA, MPH, Founder & Director of UCLArts & Healing. After discussing general guidelines (such as the use of nonjudgmental language to facilitate engagement and dialogue, and how to manage stress responses), Ping teaches us several writing activities for self-expression. One of them involves haiku-like poetry (the brevity of which helps to contain feelings), another involves giving feelings human characteristics (to enable expression of feelings in a way that feels safe), and a third involves writing about one’s name (to deepen self-disclosure and lessen anonymity). After this warm-up, she shows us how to acknowledge one another’s sharing through the use of handmade paper-cup shakers. In one of several humorous moments, a student shares the following haiku (involving a location, an associated sound, and what is seen in nature or not in nature):

In the women’s room,
the sound of water flushing.
A relieved expression.
In the movement session, Gabrielle Kaufman, MA, LPCC, BC-DMT, NCC introduces the tenets of dance/movement therapy. Gabrielle is a board-certified dance/movement therapist and counselor with over 20 years of experience, who has worked extensively with new families and aids in providing solutions to many parenting concerns.

18-09-18-MedSEA-Ketcher-0Gabrielle begins her session by advocating for us to use whatever resources are accessible at the facility to interact with patients. Latex gloves, Q-tips, bandages, and tissue, she explains, are all great props for movement. For example, after fully acknowledging the silliness of the “Tissue Tango” activity, she gets us started interacting with our tissues. First we (pretend to) blow our noses into it, then it becomes a white flag that we wave to surrender, and soon enough we are all swaying and dancing as we experiment with tissue-inspired movement.

Many of the activities in the movement part of the curriculum involve synchrony, or mirroring, because research has shown that this builds compassion and altruistic behavior. As a metaphor for empathy, mirroring enables participants to feel seen and heard, which is essential to developing connection.

18-09-18-MedSEA-Ketcher-7Expanding beyond our senses, Gabrielle demonstrates how visualization and imagination techniques can help take bed-bound patients and/or those in pain to an alternate reality. She guides us through participatory storytelling, where we go on a fantastical cruise ship vacation to a beautiful beach for swimming, sunbathing, and soaking in the sun. At the end of our “vacation” Gabrielle asks us to find a keepsake on the beach and put it in our pocket, transforming our imagined vacation into a tangible experience.

18-09-18-MedSEA-Ketcher-9In the music session, Karen Howard, RMT, CEAP, with 30 years of experience as a music therapist, begins a dialogue about the importance of discovering each person’s unique music preferences. She leads us in a movement experience to demonstrate how different types of music can energize, calm, and motivate. She also shows us how music can be used to facilitate guided visualization.

Karen explains that creating personalized music playlists can evoke memories and spark storytelling. For example, volunteers can ask patients: What songs were popular when you were in high school? What was played at your wedding? What song reminds you of someone important in your life? Finally, Karen engages us in “Mad Libs for Music,” a lively lyric substitution activity, which enables participants to re-write lyrics for greater personal meaning.

18-09-25-MedSEA-Ketcher-8In the art session, Mimi Savage, PhD, RDT/BCT, drives home a central tenet of this work: that there is no wrong way to express yourself. She demonstrates several approaches to self-expression and stress management, such as “3-D Art with Found Objects” and “Structured Doodling.” Dr. Savage teaches practitioners in the use of drama therapy and other expressive arts techniques for working with many populations, such as children and adults in acute psychiatric inpatient units.

Found object sculptures are given titles to reflect their meaning to the creator. In “Structured Doodling,” overlapping shapes are filled in with symbols like sunbursts, cross hatches, zigzags, and squiggly lines. Sometimes images emerge from these doodles.

Mimi also demonstrates the strategy of scaffolding activities as she starts our group with drawing, transitions to sculpting, and then ends with writing poetry. A random doodle transforms into an image that inspires a sculpture made from paper cups, band-aids, cotton balls, and straws. Or it inspires the creation of a puppet that tells you what it wants to say to you. Mimi reviews how to talk about art in a nonjudgmental way that encourages dialogue and makes the artist feel truly seen; for example, being specific about what is noticed in the artwork (instead of saying “It’s beautiful”) or inviting storytelling. She also shares the use of photography-inspired poetry using a sentence-completion “I am” poem template (e.g., I am, I wonder, I want, etc.)

The MedSEA Impact

Surveys of patients taken by TAG volunteers show consistent evidence of the transformative value of these experiences for patients, for example in reduced stress and pain, and improved mood and ability to express feelings. TAG Coordinator Hanh shares an experience when she offered guided visualization with music to an older patient who had clear motor impairments. When she first met him, Hanh remembers, he was shivering and clearly distraught—his heart rate was in the high 100-beats-per-minute range. However, by the time the guided visualization with music was over, his heart rate had gone down to a normal range of 80 beats per minute. “It was clear that there was a physiological impact.”

18-10-19-MedSEA-Justice-16The experience with Bryan demonstrates how quickly guided visualization with music and art exercises can break the ice, and open up an opportunity for connection. The drawings that were made together created a lasting impression on all involved. Hanh reflects, “A common misunderstanding people may have is that art is meant to be aesthetically pleasing or ‘perfect’ when, in actuality, it is a forum for play, connection, and relief. We commonly ask patients how they are, and the skills developed in MedSEA allow volunteers to take interactions one step further in building safe and expressive spaces for sharing memories, telling stories, and creating with one another.” Or as Bryan put it himself during the TAG team’s follow-up visit one week later, with their collaborative drawings still proudly showcased on his wall, “A great memory; it was definitely a highlight.”

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Article by Janelle Ketcher and Hanako Justice.

Interested in learning more about our Medical Social Emotional Arts Program? Check out our upcoming training on March 28 & 29 as part of our 3rd annual Conference on “Creativity & the Arts in Healing.”

For more information on the Therapeutic Arts Group (TAG) at UCLA, contact Hanh Nguyen at HanhNguyen@mednet.ucla.edu.

*The name has been changed to protect the patient’s identity.