Spiritual awareness through the arts

The body, mind, and spirit: Each is as important as the other in successfully treating addiction, eating disorders, and other behavioral health problems. But too often, behavioral health professionals neglect spirituality as an important dimension of their clients’ lives. While they address the more familiar medical and behavioral issues, spirituality is rarely discussed in any measured degree.

At the Timberline Knolls residential treatment center in Lemont, Illinois, recovery involves more than immediate physical and mental health treatment. We help women and adolescent girls work to achieve lifelong healing using the principles of 12-Step recovery, strengthening them spiritually, emotionally, and socially. With spirituality an integral part of their treatment, residents gain a larger, more objective perspective on life, as well as a firm foundation for their recovery.
In addition to more traditional therapeutic models, we have built a curriculum focused exclusively on helping residents understand and develop their spirituality. We want our residents to have fun, laugh, talk about spirituality, face their emotions, and examine their personal beliefs. Yet open discussions are only part of how we promote personal and emotional understanding. In fact, we have found that one of the most effective avenues to spiritual development involves expressive therapies such as music, art, and dance. These therapies can help residents unlock and nurture the spiritual aspects of their beings.
This creativity offers opportunities for residents to have truly positive experiences with a power greater than themselves. In the end, we believe our residents must find a loving higher power to draw from and to rely upon no matter what circumstances they might face. Ultimately, this strategy can smooth the road to lifelong healing.
Views on a higher power
A higher power can take many forms and often can be difficult to understand. Most of the residents we treat have come to be blocked off from the spiritual dimension of themselves. When new residents reach our facility and we ask them about God, the typical response is that spirituality is unimportant in their lives. They are likely to scoff at the idea of this kind of higher power. They’re mad at God and think God has failed them—or they simply don’t believe in any kind of higher power.

When residents offer these negative responses, we ask if the lack of a higher power in their lives has constituted an effective strategy. Clearly, it has not, since they continue to struggle with addiction and other behavioral disorders.
Certainly, most people think of a higher power as God, whether they see God through a religious lens or experience God through an aura or feeling of spirituality. But for many, especially those who say they don’t believe in God, a higher power also can be a negative force they cannot control. For those with an addiction, an eating disorder, and other issues, the higher power in their life might be alcohol, cocaine, bingeing, starving, or cutting. It takes control over their actions, time, and priorities, and becomes what they turn to in a time of need.
Describing their addictions as a higher power upon which they rely opens a door in residents’ minds to the higher power concept. This open-mindedness can be expanded upon and nurtured into a willingness to believe in a different type of higher power—one that is life-giving rather than life-destroying.
The next step is asking whether the resident is being helped or harmed by her current higher power. In most cases, it is easy for a resident to understand that she has chosen one that is harmful and has become a controlling force in her life. This opens her mind to consider replacing that authority with a higher power that, rather than hurting, might actually illuminate her and be a key element of recovery.
Including spiritual and religious elements as part of a holistic treatment plan assists residents in gaining a larger, more objective perspective of life. In fact, for true lifelong recovery, patients must address and strengthen all five core aspects of themselves: mental, spiritual, physical, emotional, and social.
This all starts with comprehensive clinical therapy and medical treatment, including medical stabilization followed by a powerful combination of evidence-based clinical treatments that might include medication, cognitive-behavioral therapy, Dialectical Behavior Therapy, integrative cognitive therapy, family systems therapy, and regular doses of 12-Step mutual support. While these standard approaches address four of the core elements (mental, physical, emotional, and social), we believe that spiritual growth calls for special attention and a special curriculum.
A spiritual curriculum
As a way to begin understanding their spiritual side, residents take part in weekly group spirituality sessions. They develop confidence by operating as part of a group, which has more strength than they do as individuals. Plus, the residents learn that they can turn to the group to survive challenges as they arise, thanks to the openness and support of these peers.

During a spirituality session, we encourage personal reflection and provide each resident in the group with a page of thought-provoking questions. For example, we ask if residents have ever had a positive experience with a force greater than themselves. Or residents might be asked to describe negative experiences and how those experiences affect their willingness to believe in a higher power.
During the following spirituality session, group members discuss their answers to the questions. Our director of spiritual development asks them to reveal their thoughts and feelings. While the hour is not always an easy one, these sessions can be powerful for those who open up. Many don’t know whom or what they believe in. Those who do have a religious background may not know why they carry their current beliefs. As a group, the residents come from a wide range of world views, backgrounds, and religious beliefs, and we find they are respectful of one another’s affiliations.
Arts unlock emotional memories
Perhaps the most effective method to begin accessing residents’ spirituality mindset involves the introduction of music and other creative arts. These activities tap into parts of the brain that are involved with emotional memory and emotional regulation—the same portions of the brain damaged by addiction. These areas of the brain are not accessible through talk therapy or purely cognitive therapy, but can be accessed with the power of music, art, and other creative endeavors. Unlock this section of the brain and suddenly residents become able to understand and address emotions they previously did not even know were affecting them, many times at a physical level.
Even more importantly, by addressing these hidden emotions, residents are less likely to relapse. One of the most common reasons for relapse is unhealed trauma. By not exploring unresolved issues associated with trauma, residents are likely to fall back into their old behaviors to cover over deeply rooted and exquisitely painful emotional issues.

For successful treatment, residents must be able to see the goodness in themselves and the world around them. What is most important to us is teaching residents to trust themselves and others, and to uncover their innate strengths and talents. To accomplish these goals, residents must be put in touch with a higher power. For our clinical professionals, the form God takes is secondary to simply establishing a basic belief in some kind of force greater than ourselves. When residents’ spirituality is developed via music and the arts, they can develop a mature spiritual dimension that goes beyond discussion of a higher power. By singing, dancing, or creating art, residents feel their spirituality on a physical level. Incorporating these physical experiences into recovery gives them a positive memory that is stored and reinforced. Residents can take this with them when they are discharged.
Artistic expression and healing
Artistic expression opens the minds of our residents—freeing them to consider new ideas about spirituality. Music can be an effective gateway to spirituality; it soothes, heals, and inspires. Most people have been touched by a song, and the brain is hardwired in such a way that music can tap into otherwise inaccessible parts of the human psyche.

Making it even more powerful, music is universal. It can bring people from different cultures, backgrounds, and religious beliefs together to make them feel united and whole. Music lowers barriers and accesses places in patients’ spiritual minds that were previously locked away.
Music plays a big role in both the enhancement and release of spiritual feelings as well as in restoring residents’ well-being and easing any tensions regarding spirituality. We have seen great success in using music as a form of therapy, particularly when working with residents who initially can’t express themselves through words or who are rejecting treatment entirely. Music helps reduce anxiety and promotes relaxation, which can facilitate an overall sense of well-being.
These unique qualities make music a key element of our spirituality sessions, which help patients reach that part of themselves they have ignored for so long. For example, when our director of spiritual development sang a song he wrote specifically for our residents, many of them almost immediately became more willing to discuss their spiritual selves. Building on this success, our director of spiritual development asks residents to bring original music, a favorite song, a poem, or a painting to share with the group and explain its personal significance. Each resident also is encouraged to take part in individual experiential therapies, such as music, dancing, creative writing, or art. They might be asked to draw or paint a traumatic experience and discuss it with an art therapist. Sometimes, these visual representations are the first time residents have ever shared a key event in their lives with a high degree of detail. It can be freeing and empowering for residents to unlock their spiritual and emotional voice with art. By participating in spirituality sessions, utilizing music and other artistic expressions, almost every resident will establish at least a minimal belief in a power greater than themselves. In addition to helping open the door to spiritual awareness, music and other expressive therapies can directly have an impact on residents’ taking control to become more engaged in treatment, a progressive step toward growth that can lead to lifelong recovery. Reawakening through artistic expression provides the hope and promise that healing is real—and it is this understanding that residents maintain when they leave the healing environment they come to know at Timberline Knolls. What they learn gives them a means to face and express their emotions with courage, and to lift themselves to their newfound power in all circumstances. This spiritual component can be a continual reminder that they are special, beautiful, and able to live a vibrant, healthy life.

Kimberly Dennis, MD, is the Medical Director at Timberline Knolls (www.timberlineknolls.com), a residential treatment center located in Lemont, Illinois that is designed exclusively for women with emotional disorders, including eating disorders, addiction and self-injury behavior. She wrote on ethical standards for clinicians in the March/April 2008 issue.