From Meditation to Music to Mosaics: Spiritual Practices in the Context of Holistic Care

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From Meditation to Music to Mosaics Spiritual
Practices in the Context of Holistic Care

• Kelley Raab Mayo, M.Div., Ph.D.
• Chaplain, Royal Ottawa Mental Health Centre
  Assistant Professor, Department of Psychiatry,
  University of Ottawa
• September 27, 2010

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Outline of Presentation

• Part I Exploring Creativity
• Part II Exploring Spirituality
• Part III Creativity and the Search for the
  Sacred
• Part IV Spirituality in the Context of Holistic
  Care Cross-disciplinary Teams
• Part V Conclusion

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Part I Exploring Creativity

• Ability to produce something new through
  imaginative skill, whether a new solution to a
  problem, a new method or device, or a new
  artistic object or form. The term generally
  refers to a richness of ideas and originality of
  thinking.
• Ability to transcend context, be open to new
  information, focus on process vs. outcome

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• Need for absent-mindedness
• Plunge into non-differentiation
• Accept chaos as a temporary stage
• Flexible movement between conscious and
  unconscious processes
• It is the privilege of the artist to combine the
  ambiguity of dreaming with the tension of being
  fully awake (Ehrenzweig 196712)

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• Creativity promotes a new awareness, conveying a
  novel truth concerning being (Spinelli, 2001)
• Creative work tends to protect the individual
  against mental breakdown (Storr, 1978, p. 31)
• artists, writers, and other creative
  individuals are far more likely than the general
  public to suffer from mood disorders, especially
  manic depression (Redfield Jamison, 2001, p.
  126)
• While creativity may elevate mood, creative
  thinking follows when mood is elevated.

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Marion Milner

• British psychoanalyst, painter, and mystic
• Author of On Not Being Able to Paint (1950)
• Coined aesthetic moment temporary loss of
  self, loss of discriminating ego
• The arts permit reverie Awake awareness of
  inner and other process, intact connection to
  physical, preverbal, visual, emotional, and
  verbal (metaphoric) information (Paulsen, 2008)
• Art unites thoughts and things, dreams and facts

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Marion Milner (cont.)

• The start of mystical experience is learning to
  attend to ones own body awareness from the
  inside, beginning with ones big toe
• Experience of deep breathing exercise helped
  her paint
• Viewed creativity as a spiritual pursuit
• Art fuses subject and object (I and not-I)
  and then makes a new division of these two
• Both mysticism and art are experiences of body
  awareness

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Part II Exploring Spirituality

• Spirituality is the search for the sacred
  (Pargament, 2007)
• Pargament, p. 33 - from mountains, music, and
  marriage to vegetarianism, virtues, and visions
• The spiritual dimension concerns how individuals
  make sense of the world and how they create
  meaning (van Deurzen and Arnold-Baker, 2005)

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• spiritual practices encompass whatever
  people do to preserve and protect the sacred in
  their lives, including those activities that may
  not be perceived as spiritual in nature
  (Pargament, 2007, p. 83)

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Role of Religion

• Religion involves an organized social
  institution with, among other things, beliefs
  about how one relates to that which is sacred or
  divine. Spirituality does not necessarily
  involve religion. Some people experience their
  spirituality as a highly personal and private
  matter, focusing on intangible elements that
  provide meaning in their lives (Miller and
  Thoresen, 1999, p. 6)

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Creativity, Spirituality, and Well-being

• The heart of spirituality is an experience of
  the mystical union. Those who speak in spiritual
  terms routinely refer to God as the creator but
  seldom see creator as the literal term for
  artist. I am suggesting you take the term
  creator quite literally. You are seeking to
  forge a creative alliance, artist-to-artist with
  the Great Creator (Julia Cameron, The Artists
  Way, p. 2)

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Part III Creativity and the Search for the Sacred

• At the core of the sacred lie concepts of God,
  the divine, and the transcendent the divine or
  transcendent is inherently mysterious, illusive,
  and indescribable (Pargament, 2007)
• Raab Mayo (2009) creativity is both a search
  for the sacred and a search for an authentic self
  

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• The notion of a special access to a power
  beyond what is ordinarily known to an individual
  or to his sic society has extended across many
  different kinds of inspired states the warlike,
  the druidic, the mystical, and the poetic.
  Attributions of inspiration once made to the gods
  or the muses have been transformed, during the
  twentieth century, into the rather more prosaic
  formulations of primary process, pre-logical
  thought, and bisociative thinking (Redfield
  Jamison, Touched with Fire, 1993, p. 103).

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Creative Spirituality The Way of the Artist (R.
Wuthnow, 2001)

• Art can allow one to construct a new identity
• Art can facilitate spiritual exploration of the
  unknown
• Art can express ones relationship with the
  cosmos
• Like religious teachings about possibilities of
  spiritual rebirth of the second coming of Jesus,
  moments of transcendence keep hope alive (p. 264)

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Spirituality and Sacred Dance

• Historically, the body has conveyed the sacred
  symbology of the universe and of the gods
  (Roseman, 2004)
• Through pictorial, gestural, and musical symbols,
  dance provides a means of embodying and
  communicating language of the sacred
• Dance is an expression of the search for the
  sacred/search for the self via the body

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Example Ruth St. Denis

• 19th century American dancer
• Her dance expressed her spirituality (influenced
  by Swedenborgianism, Transcendentalism, Christian
  Science, Buddhism, and other Christian views)
• Established alternative dance schools
  (integration of spiritual and physical)
• Staged numerous concerts in which she became the
  goddess

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Ruth St. Denis (cont.)

• She appeared as Virgin Mary or a female deity in
  many concerts
• Mary was to symbolize the ultimate creating
  principle which embraces compassion as well as
  creation (St. Denis, 1939, p. 241)
• In integrating the spiritual aspects of Mary, St.
  Denis sought to reconcile the split between
  spirit and body (belief that the body can portray
  divine energy)

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Part IV Spirituality in the Context of Holistic
Care

• Meditation, music, mosaics What do they have in
  common? How can they be integrated into
  treatment?
• Clinical work and research suggest that multiple
  ways exist to assist clients in exploring,
  identifying, and meeting spiritual needs

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My Own Story

• Exploration of Milners method of doodling
  as a form of spiritual direction
• 104 doodles made over a 1-yr period
• Drawing facilitated journaling about emotion
• Notion that ones inner voice can be better
  discerned through conscious interaction with
  spontaneous drawings than through talk therapy
  alone
• Led to ordination and current vocation

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Cross-disciplinary Research

• Use of a spiritually-oriented therapy for the
  treatment of generalized anxiety disorder
  research team consists of a psychologist,
  psychiatrist, and spiritual care provider
• Recent publication Koszycki, D., Raab, K.,
  Aldosary, F., and Bradwejn, J. A multifaith
  spiritually based intervention for generalized
  anxiety disorder A pilot randomized trial,
  Journal of Clinical Psychology 66, no. 4 (April
  2010) 430-441.

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Koszycki et al Spiritual Intervention

• Use of the 7 spiritual practices described by R.
  Walsh, Essential Spirituality (1999)
• 1) Concentrate and calm your mind
• 2) Cultivate emotional wisdom
• 3) Awaken your spiritual vision
• 4) Transform your motivation
• 5) Live ethically
• 6) Express spirit in action
• 7) Cultivate spiritual intelligence

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Koszycki et al Commonly-cited goals of
participants

• Less dependent on the well-being of others less
  concerned about the perceptions of others
• Better sleep patterns and pre-bed routines
• Ability to relax and enjoy the moment
• Less fearful
• Less negative self-talk
• Improved concentration

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Koszycki et al Goals addressed through

• Meditation and prayer practices yoga
• Surrendering control of the future cultivating a
  positive vision
• Working with spiritual affirmations
• Doing one thing at a time
• Facing fears
• Focusing on intention vs. results (beginning with
  thoughts) practicing detachment

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Koszycki et al Goals addressed through

• Practicing self-forgiveness
• Practicing loving-kindness meditation
• Practicing the serenity prayer
• Truthful speech and actions
• Cultivating gratitude
• Finding meaningful ways to give to society
• Cultivating a support network for continued
  practice

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Koszycki et al Results

• A multi-faith spiritually focused intervention
  compares well to a first-line psychological
  intervention for GAD (i.e., CBT)
• Treatment response occurred in 63.6 of
  SBI-treated and 72.3 of CBT-treated patients
• With growing public interest in spirituality,
  many mental health clients are requesting
  spiritually integrated care

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Koszycki et al Results

• The results of this study also demonstrate
  that spiritual care professionals working in a
  mental health facility could play an important
  role in the delivery of care of individuals with
  GAD. this could expand the pool of treatment
  providers, improve access to care, and foster
  fruitful collaboration between clergy and mental
  health professionals in the delivery of mental
  health care (Koszycki et al, p. 439)

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Additional Clinical Work

• Use of music in religious services
• Hope and spirituality group for mood inpatients
  empowerment group for geriatric day patients
  spirituality group for substance use rehab
  program stress reduction group for mood
  inpatients
• Work with outpatients using guided meditations
  encouragement of gardening, painting,
  woodworking, music, etc.

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Hope and Healing

• Hope is considered necessary for healing from
  mental illness
• Hope is a central feature of religious traditions
  around the world
• Hope is closely tied to personal meaning, i.e.,
  the spiritual dimension
• Hope is closely tied to imagination, or the
  ability to evoke images in the context of space
  and time

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Hope (cont.)

• Hope is evidenced in treatments which 1) promote
  mastery, 2) provide meaning, 3) reduce
  anticipated isolation or alienation, and 4)
  increase ones sense of dignity and self-worth to
  face the future positively.
• Spiritual practices such as religious services,
  study of sacred texts, and prayer and meditation
  have the potential to accomplish these ends.

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Hope (cont.)

• Religious and spiritual traditions offer hope
  though promoting connection with something
  greater than the individual, promising support by
  divinity and community, permitting grief and the
  expression of complex emotions, enabling a
  ministry of presence, affirming the inherent
  worth of each individual, reframing obstacles as
  challenges that can be overcome, and looking to
  the future rather than the past.

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Conclusion

• Spiritual care takes many forms, from meditation
  to music to mosaics
• Spiritual care providers have unique skills to
  offer to other health care providers through
  specialized training
• Research on spiritual interventions provides
  credibility to the medical establishment through
  testable data
• Integrating music and the arts into spiritual
  care fosters a holistic understanding of
  spirituality

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Albert Einstein

• The most beautiful thing we can experience is
  the mysterious. It is the source of all true art
  and science.
• Imagination is more important than knowledge.

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Albert Einstein

• Science without religion is lame religion
  without science is blind.

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References

• Cameron, J. (2002). The artists way (2nd ed).
  NY Jeremy P. Tarcher/Putnam.
• Ehrenzweig, A. (1967). The hidden order of art.
  London Paladin.
• Jamison, K.R. (1993). Touched with fire. NY
  Simon and Schuster.
• Jamison, K.R. (2004). Exuberance The passion for
  life. NY Alfred A. Knopf.
• Koszycki, D., Raab, K., Aldosary, F., and
  Bradwejn, J. A multifaith spiritually based
  intervention for generalized anxiety disorder A
  pilot randomized trial, Journal of Clinical
  Psychology 66, no. 4 (April 2010) 430-441.
• Milner, M. (1950). On not being able to paint.
  Madison, CT International Universities Press.
• Milner, M. (Ed.) (1987). The suppressed madness
  of sane men Forty-four years of exploring
  psychoanalysis. London Tavistock.
• Miller, W.R., and Thoresen, C.E. (1999).
  Spirituality and health. In W.R. Miller (Ed.),
  Integrating spirituality into treatment
  Resources for practitioners (pp. 3-18).
  Washington, DC American Psychological
  Association.

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References (cont.)

• Pargament, K. (2007). Spiritually integrated
  psychotherapy Understanding and addressing the
  sacred. New York and London The Guilford Press.
• Paulsen, R. (2008). http//kno.google.co/k-randall
  -paulsen/the relationship-between-mindfulness.
• Raab Mayo (2009). Creativity, spirituality, and
  mental Health Exploring connections (Farnham,
  UK Ashgate)
• Roseman, J.L. (2004). Dance was her religion The
  sacred choreography of Isadora Duncan. Prescott,
  AZ Hohm Press.
• Spinelli, E. (2001). The mirror and the hammer.
  London Sage publications.
• St. Denis, R. (1939). Ruth St. Denis an
  unfinished life An autobiography. New York
  Harper and Row.
• Storr, A. (1978). The dynamics of creation.
  London Secker and Warburg.
• van Deurzen, E., and Arnold-Baker, C. (Eds.)
  (2005). Existential perspectives on human issues
  A handbook for therapeutic practice. Houndmills
  and New York Palgrave MacMillan.
• Wuthnow, R. (2001). Creative spirituality The
  way of the artist. Berkeley. University of
  California Press.

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• For further contact
• Kelley Raab Mayo
• Spiritual and Religious Care
• Royal Ottawa Mental Health Centre
• 1145 Carling Ave.
• Ottawa, Ontario K1Z 7K4
• [phone] ext. 6308
• Kelley.RaabMayo_at_rohcg.on.ca