The previous entry was based on some speculative ideas; this one leaps into a speculative/imaginative domain in order to work through some ideas that have been niggling me.
I have various bug-bears…
I find the rhetorical insistence on the centrality of the artist and the near-mystical belief in the special role of the artist in mediating certain experiences by virtue of their vocation and training to be dubious (although understandable from a political perspective). The whole idea looks, to me, like certain groups have taken the priests out of the priesthood and replaced them with artists. Being a good protestant, I tend to resist the necessity of the priesthood in either guise.
I am also uncomfortable with the (not unconnected) use of the idea of creativity, in statements like ‘creativity promotes well-being’. The problem with both the keywords in that phrase is that they invoke huge, nebulous concepts and are used to justify certain practices. Not that I disagree with the practices, I just don’t like their nebulousness.
I want to break them down, tease apart these moments of creative or cultural engagement and find the threads that contribute to individual well-being (however that may be defined). To do that, I want to imagine a hypothetical workshop, take it apart and hold each fragment up and think about what it might be doing. I can’t do it in practice (yet) so this is more an act of imaginative hypothesising.
Any engagement with people comes at a moment in their lives and draws on what they have been and what they are now. Perhaps this is even more so in a reminiscence session than any other sort of activity. The response of people to such interventions and any pathways to impact will have similar autobiographical roots. So… Imagine an elderly couple, they have been married a long time. In their lives together they were not regular museum-goers. The woman was diagnosed with dementia a while ago, she lives with her husband in their home of many years. The strain of caring for his wife is telling on the man’s health and he increasingly feels that the woman that he is caring for is less and less like the wife he has shared his life with. They have been recommended to take part in a series of creative workshops running at an art gallery in the city centre. The man is apprehensive about the difficulties of going out.
The days begins….
Getting ready to go out
Getting ready is in itself a hurdle; getting ready for a particular time adds stress to the routine. The man worries about the social codes of such and unfamiliar space, about his feeling that they do not belong in such places. Overlaid on top of this are worries about how his wife will respond; there is much that cannot be predicted. Nonetheless, having committed to it…
Thankfully a mini-bus is provided as part of the project. The driver is calm and helpful and the couple get into the bus. Once the initial nerves are overcome this begins to feel more like a trip out. Sitting side-by-side on the bus evokes journeys of old, which is comforting. The break from the norm is welcome in itself and the chance to see new things begins to feel more like a blessing. The calmness and happiness correlates with physiological changes which may have positive health impacts (though the research data is inconclusive).
Along with other participants the couple arrive at the gallery. The group was selected to come from broadly similar demographics, this meant that their feelings of being ‘out of place’ were ameliorated. The group share similar ideas about museums (e.g. the British Museum or the Natural History Museum) and the appearance of the gallery plays into their expectations and inducing some nervousness. (Other types of venues may evoke other reactions.)
Once they get out of the bus they receive a warm, friendly welcome from their host who wears a clear name badge. The badge makes life easy for both the man and the woman by removing the need to remember the host’s name. The host explains the next step in the morning, gathering around a table for a cup of tea and a biscuit. The cup of tea and biscuits appeal to the woman’s increasingly sweet tooth (a side-effect of Alzheimer’s for some) and (probably) act as an unconsciously registered social cue for all the participants that this is a social gathering where they are welcome to talk and share stories. The different elements contribute to overcoming the participants’ worries and barriers and they begin to relax a little.
The session begins
The host and colleagues continue the habit of introducing the morning’s activity using clear sign-posting and small steps. This reduces the cognitive load for the woman and encourages her to participate. Throughout the activity the host consistently avoids challenging or closed questions, instead they opt for open questions which means that the woman is less worried about wrong answers. All the staff are careful about how they respond, affirming everyone’s contributions and building on them. Where people decline to join in, the staff accept this and welcome their contributions when they do. The woman retains her social / emotional sensitivity and can perceive the welcome.
The session involves a blend of reminiscence and creativity. The reminiscence element enables people to work from the familiar, where they are more confident. The reminiscence element draws on different types of memory (for example, procedural memory or the sensory components of episodic memory) which are less susceptible to the predations of ageing and dementia. The experience of being listened to and having their life-stories valued and built upon gives all the participants a sense of being valued and raises their self-esteem. The act of storytelling brings the members of the group together. The session is structured such that the participants are encouraged to respond to a variety of cues in the environment and the host has prepared a variety of activities. The diversity increases the chances that the participants will hit on activities that appeal to their interests and play to their cognitive strengths. The reminiscence allows for the re-emergence of the person that the man felt was lost. The sharing of positive experience and emotion helps to strengthen the relationship between the pair and helps to reduce his stress somewhat. The line between reminiscence and creativity is blurry – reminiscence can lead to creative acts, whilst other creative acts can draw on a participant’s past. The creativity allows for new experiences, a rich sensory experience that allows for each person to be fully human, insofar as it draws on all the elements of perception, cognition, action & relationship that make up our humanity. Becoming lost in activity and experiencing success in an activity has positive psycho-social effects for all participants. The encouraging responses of the staff help to overcome the powerful enculturated fear of exposing oneself through creative acts. The focus on the present moment allows the man to forget longer term worries for a moment and reduces his stress somewhat.
Ending for the day
The session is brought to a close and each persons contribution is valued. The theme of the next session is explained to the carers. Whilst this is happening staff are putting together goodie-bags of the thing that each pair has made and some rapidly printed photos of their activity so that the carers can use these as prompts for conversation back at home. Perhaps these will facilitate short term memory or perhaps they will help sustain the conversation and relationship between the man and the woman.
As the weeks go on, the participants become more confident in the gallery setting and find it easier to relax into the creative work. This helps to reduce stress. The participants who were initially quite reticent become more engaged and their contributions become richer with greater emotional rewards for themselves and their carers. This too has psychological and physiological benefits. As sessions go on, the participants with dementia are observed to recognise each other much more and, during reviews, recognise their own voices. Time together and times of sharing between the group members helps to reduce the feeling of social isolation, again reducing the stress and the sense of burden in the care givers. As time goes by, the man becomes more adept at taking ideas from sessions and using them at home. This strengthens the relationship between the man and the woman and helps to maintain their relationship. (The progression of the dementia is inevitable but strengthening their relationship helps to make it more bearable and helps to reduce the toll that caring exacts on the man.)
As with so much of museum / gallery work – this is not about changing the world, it is about creating small moments of beauty, joy or learning that bring a bit of extra light into people’s lives that can have effects beyond the moments themselves.