Reaching people when nothing else works
Japanese art therapist Miki Goerdt believes that for some people, art therapy is the only kind of therapy that works, especially those who have neurocognitive issues like Alzheimer's.
When individuals with Alzherimer's disease struggle with mental illness, "art is sometimes the only means to bring back their humanity and healing, unless you use medication, but even then, you can't bring the humanity back," said Goerdt, an artist herself and US board-certified art therapist who is now running her own private practice in Falls Church, Virginia.
This week, we continue the talk with Goerdt on how art therapy actually helps, the COVID-19 effect on her private practice and some of the challenges she has faced over the past 15 years working in the art therapy field.
Q: How much do you think people can rely on art as a means to heal or get better?
A: For some people, art therapy is the only way. I have several clients who came to see me because of the continued failure of talk therapy – it didn't work for them. They couldn't figure out why. A particular client came to my office that way ... who is a lawyer, a very successful one. She had five different talk therapists before me. And she felt desperate when she came, having ongoing anxiety and depression. She had no friends and had trouble engaging with people. So at the beginning of art therapy, I asked her to draw a picture of her true self and shadow self. The shadow self is the one who talks when she's feeling down, depressed or anxious. What we found out by drawing was that much of her anxiety and depression is rooted in her childhood.
A lot of the stuff we have gone through during her art therapy sessions involved attending to that younger self – the unattended younger self never felt accepted by anyone. Today, her adult self is communicating to the younger self, recognizing and actually accepting the younger self. That was the healing for the client. And eventually the client became very good at problem solving through making art instead of talking.
Q: How has the pandemic affected your service?
A: Now that I'm not seeing clients in person, as an art therapist, it was an adjustment in terms of how I conduct the sessions. So I do a lot more drawings now because I'm asking them to use what they have at home. The other thing is I'm giving more what's called homework ... Sometimes I ask them to get a new art material, try them out and come back and see me to tell me how it was. Other times, some of my older clients don't have the technology to be on screen. So we've had telephone sessions, just talking on the phone. That's been very challenging. For those clients, one of the homework is to send me pictures. Take a picture related to a theme each week with a smartphone – the thing you thought was beautiful in the world, or something you're grateful for or things you find relaxing.
Q: There are many apps, in terms of mindfulness, art creation and coloring. What kind of roles will they play in the future therapy world?
A: I feel like it's definitely a mixed blessing to have technology, like you're saying. Some of the apps have become more available for things like meditation. There are also some coloring apps my clients use for anxiety management. Because much of my clients' actual art making suffered due to the absence of in-person sessions, the way we met virtually like you and I are doing now, enabled us to connect more. And the more colleagues I can get connected to in the art therapy field, the more ideas and clinical skills I can get to find out. In that way, in the past year and a half, I've gotten to meet more colleagues, and I really think that has been a good means of support on my end, which carries over to my clients.
Especially last year, it was very difficult in the US to witness different racial conflicts and anti-Asian hate. I'm here trying to support my clients going through that. Through the online format, my colleagues have been a tremendous support system.
Q: What's the biggest challenge?
A: Perhaps the profession of art therapy being very Western minded, to be honest. Art therapy comes from a psychoanalytic background, which began in Europe. That means most of the art therapy theories, scholastic work and research out there is very Euro-centric, although it's been changing for the past few years. For me, or for those who are treating clients who aren't white, I have to reach out to other people seeing clients with marginalized backgrounds, or I needed to come up with a way to provide art therapy in a culturally sensitive way. Being an art therapist of color might be the most challenging thing throughout my art therapy career.
Q: How do you make your clients believe in the therapy?
A: That question comes up so much, especially with clients coming from Asia. I see this also with the understanding that in the US, studies say that Asian Americans under-utilize therapy compared to any other population. There's the stigma about mental illnesses and mental health treatment, and culturally, it's not really embraced. Some Asian clients come in because they think they need something, but they're not sure. They might not come in every week like Caucasian clients do. They would say I just want to come in once every month, or once in three weeks, instead of what I think they need. But I go along with what they feel comfortable with. That's one way I accommodate. I also provide cognitive behavioral therapy. I mix that with art therapy. My Asian clients respond very well to that, because it's more structural and lesson-like.
Cognitive behavioral therapy is built on the idea that what we think produces certain feelings, and how we think and feel influences how we act. Thoughts, feelings and actions are all intertwined with each other. Cognitive behavioral therapy uses observations about your thinking habits and target to change how we think about certain things around us.
Q: You're an artist yourself. How did you get involved and find it therapeutic?
A: I started painting when I was in high school, and I've never stopped because painting is a way for me to understand myself, my experience with other people and how I exist in this society and the world. Sometimes I don't really know what's happening or what I'm experiencing. When I paint, I come to understand that my feelings actually meant something to me. As I create my artworks, I understand why I'm painting and what I'm painting. It's much like how my clients unfold themselves in their therapy.
Therapy is like a reflection. Art making for me is an opportunity for self-reflection. Aside from doing oil paintings, every morning when I wake up, usually at least Monday through Friday, the first hour is dedicated to making art. It's like musicians who practice their instrument every day. I do it in my sketch book, one page every morning, and experiment with lots of techniques.
It's called visual journaling.
Q: Any suggestions for people who want to use art as a coping mechanism?
A: Some of the things we mentioned earlier would be good places to start. Like the mandala – it provides the structure. I usually recommend clients start with a smaller book. Big ones are more intimidating. Start with a circular form, and gradually fill in. Or if you're feeling stressed or down, make a card for yourself using collage materials. You know yourself best, and that means you know what you want to hear.
Other times, there are apps where you can look through images and pictures online, and pick out the ones you like. You can pick a theme for each time, like calming and joyful images. You can collect images and compile them like a collage picture. At the end of the week, look at the pictures you found and journal about it. Maybe you'll find something there for you.