When Talk Therapy Fails: Integrating Expressive Therapies into Addiction Treatment
Who says therapy has to be done on a couch in a stuffy office? When people struggling with addiction decide to get help, they often fear recovery means being doomed to a life of monotony, boring people, and dull places. In fact, the sober life can be far more entertaining than a life spent running from your problems.
To reach a broader cross-section of individuals with a range of issues and interests, some of the best addiction treatment centers and drug rehab programs are taking recovery to the stage, the dance floor, the art studio, and the music hall with impressive results.
Art Therapy
For individuals who learn differently, or who have experienced trauma, family struggles, or other issues, communicating with a therapist may be easier said than done. Many people fare better when given the opportunity to communicate in a nonverbal, non-threatening way through drawing, painting, sculpting, photography, or other forms of art.
The American Art Therapy Association (AATA) defines art therapy as "a human service profession that utilizes art media, images, the creative art process, and patient/client responses to the created products as reflections of an individual's development, abilities, personality, interests, concerns, and conflicts." Art has an inherent ability to put people in touch with their emotions, and is another means of getting addicts engaged in the therapeutic process.
Because art therapy doesn't feel like therapy, people are often highly receptive to this form of self-exploration. Rather than sitting down and saying "let's talk about you," art therapists can focus on the individual's artistic creation as a means of starting a dialogue about difficult memories and emotions.
Lynn Anne Madory, M.A., an art therapist at Aspen Achievement Academy, one of the oldest and most reputable wilderness programs for adolescents ages 13 to 17 in Loa, Utah, incorporates various forms of art therapy into her treatment of struggling teens. Whether art is used to describe an addict's relationship with drugs and alcohol or what his pain looks like, Madory says even the most oppositional teenager enjoys expressing himself through art.
Music Therapy
Most people, even those with physical, cognitive, or emotional problems, have an innate responsiveness and deep personal connection to music. Not only is music enjoyable, it can also be therapeutic. Research has shown that the rhythm of a song can stimulate brainwaves, impact breathing and heart rate, reduce stress, lower blood pressure, boost immunity, and improve overall health. Musical training also helps develop the left side of the brain, which is involved with reasoning and processing language, and boosts spatial intelligence (the ability to perceive the world accurately and form mental pictures).
As music therapy has developed into a recognized therapeutic intervention, it has proven popular and effective in many top-notch residential addiction treatment centers. Studies have shown, for example, that drumming circles are an excellent complement to traditional therapy, particularly for repeated relapse and when other counseling methods have failed.
In order to take responsibility for one's addiction and recovery process, addicted individuals must gain self-awareness. By listening to songs that are both pleasant and discordant, joyful and melancholic, patients learn to differentiate between those feelings and to interpret the relevance of those emotions in their own lives. Like art, individuals sometimes feel safer and less judged when they can project their feelings into the song rather than discussing their own intensely personal experiences.
Music can also improve an addicted individual's coping mechanisms and distress tolerance skills. Many recovering addicts, through musical therapy training, will write a song or listen to poignant lyrics rather than turning to drugs or alcohol. Through music-assisted relaxation and guided therapy, patients learn healthy ways to cope. As individuals become responsible for making their own musical choices, they come to realize that only they can control the quality of their lives.
Music is also a great social tool. Individuals who write song lyrics together, practice improvisational skills, or work in concert to create melodies and harmonies develop a common identity, validating each other's experience of the music and building trusting relationships. As a dynamic, open-ended creative outlet, music has a way of breaking down defenses and denial and encouraging addicts to overcome any obstacles to change.
Drama Therapy
Drama therapy has been utilized in many addiction treatment programs to facilitate personal growth and promote health through the use of psychodrama, role-play, theater games, puppetry, and other improvisational techniques. An active, experiential form of therapy, drama helps recovering addicts tell their story, solve problems, set goals, express their feelings appropriately, and improve social skills and interpersonal relationships.
Many addicts feel they have been wearing masks to protect themselves, or "acting" through lying to or manipulating others for a long time. By adopting the role of "other" rather than "self," the dramatic arts allow these individuals to freely express themselves with tears, anger, or withdrawal without fear of personal judgment. As participants act out the full spectrum of emotions and responses to difficult situations, they begin to identify new solutions to old issues. Rather than disconnecting from their emotions or rationalizing negative behaviors, as addicts are prone to do, they can openly acknowledge their feelings, act them out, and release them.
As part of an "acting troupe," recovering addicts join a positive and supportive peer network. At the same time they're having fun and entertaining others, they begin to trust and open up again.
Dance-Movement Therapy
Dance therapy is the use of movement to address emotional, cognitive, social, behavioral, or physical conditions. Unlike artistic dance, dance therapy is less concerned with actual dance steps and the appearance of beautiful, flowing movements than it is with cathartic self-expression. While one patient may express their pain through slow, controlled lyrical poses, another may engage in explosive fits of punching or powerful jolts of energy. Whatever emotions are inspired, the individuals then verbally discuss their experiences with the dance therapist.
Many patients report feeling mobilized or energized by the dance movements, while others explain that dance therapy helped them shed feelings of helplessness, shame, or self-loathing.
Like any form of physical activity, dance releases endorphins that can be invigorating and healing, and can offer a psychological release. But more than a form of exercise, dance combines physical movement with the mental preparation of creating steps and using the body in new and different ways. This unity of body and mind can help addicts with body image issues and the ability to resist urges and experience discomfort without numbing the senses. Achieving a sense of self-mastery boosts the dancer's self-esteem and appreciation for what their bodies can do.
Dance is a direct route to deeply held emotions. When a person is inspired to move in a certain way, it comes from the experience of a feeling. In that sense, every move a patient makes in dance therapy is tearing down barriers, admitting their pain, and sharing their story with others.
Writing and Poetry Therapy
Though frequently misused and abused, language can be immensely healing. Studies have shown that expressive writing can improve mood, decrease symptoms of depression, boost memory, and strengthen immune system functioning.
By expressing one's innermost feelings through the written word, individuals are able to engage in quiet self-reflection, which often leads to the development of new goals and charting a new path in life. In the privacy of their own minds, addicts slow down, become mindful of the present moment, connect with their internal voice, and process their lives.
Writing therapists commonly ask patients to complete assignments such as writing unsent letters to particular individuals or entities as well as imagined replies, documenting a dialogue with the object of abuse (such as a bottle of alcohol), and recording emotions and experiences in a journal.
In addition to helping process thoughts and feelings, a journal serves as a documented history that individuals can refer back to in difficult times or when temptations to use resurface. Because it is an inexpensive intervention that can be accessed at any time, writing is a therapeutic tool that can be called upon for a lifetime.
As one woman described it, "Something happens when I write that doesn't happen when I only think or feel or talk. I come home to myself. I listen to myself with the same care and attention I would give a loved one."
Alternative therapies in the creative arts open another avenue of self-exploration and self-expression for individuals struggling with substance abuse issues and other addictive behaviors like compulsive gambling, sex addiction, and even shopping or food, who often are resistant to traditional talk therapy. Rather than forcing a conversation with someone who is emotionally withdrawn or who communicates best visually or kinesthetically, expressive therapies encourage those in recovery to learn new skills and express themselves through art, writing, drama, music, or other experiential outlets.