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I work in is a ‘sub acute’ Rehabilitation unit for adults with severe brain injury. This is a place where people wake up in hospital to face unimaginable losses- physical abilities, speech, the ability to think plan to recognise people, remember their past, know where they are. For many, in time, this situation improves. But, severe brain injury cannot be totally recovered from. People find themselves in a different place to where they were before, in themselves and in their lives.
In this setting, the usual distinctive between Professional roles often blur. It is s impossible to separate out the brain from the body, or ignore the patient’s previous life and aspirations. Physiotherapists have to take into account their patients’ anxiety; Arts Therapists might need to find out about how someone might be physically positioned so they can hold a brush. Everyone has to be aware of perceptual, cognitive communication and language issues.
I would like to talk briefly about how as a team space needs to be made between treating patients so that we can communicate. I think our neuro specialisms come out of this learning from each other. I will then outline how my practice as an art therapist evolved in this setting (by learning from the patients and colleagues).
The unit has Art, music and a psychology service. Not all brain injury services offer specialist psychological or emotional support. There is however increasing recognition of the need for such help. Many don’t do well psychologically or socially. Even when good physical recovery is made, there are high rates of depression, relationship breakdown, and unemployment.
The creative therapies are particularly appropriate for this client group. People who have had a brain injury are dealing with loss, change, and questions of identity. Most would struggle with verbal psychotherapy due to problems with verbal reasoning, speech and understanding, perceptual and invariably with memory. However taking part in the arts involves a much wider range of brain functions and people with brain injury even when disorientated can make meaningful use of them and work with the issues that are affecting them.
I would like to illustrate some of the ways patients have used art therapy. In the enclosed world of the unit, people often make images of the outside world, real and imagined. These ‘places’ seem to be where often metaphorical meeting point between the self and the world. In creating them, clients begin to find expression of growing awareness of the changes facing them and what George Prigatano, a psychotherapist working with bi people using the arts calls ‘the wounded soul’.
I will illustrate how I have found the Art Therapy room to be a ‘space between’ with potential for clients to begin the slow painful and very complex process of examining the physical and cognitive damage their brain injury has wrought and the implications for themselves and the people around them.
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