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ZEEB RD., ANN ARBOR, Ml 48106 8121765 Baer, Beverly AN EXPLORATION OF CREATIVE EXPRESSION AND RELAXATION AS STRESS-RESOLVING EXPERIENCES: SOME SPECIAL IMPLICATIONS FOR CHRONICALLY ILL AND SEVERELY DISABLED POPULATIONS The Ohio State University PH.D. 1981 University Microfilms InternEltionel mX.ZeebRœd.AnnAibor,\n48106 Copyright 1981 by Baer, Beverly All Rights Reserved AN EXPLORATION OF CREATIVE EXPRESSION AND RELAXATION AS STRESS-RESOLVING EXPERIENCES: SOME SPECIAL IMPLICATIONS FOR CHRONICALLY ILL AND SEVERELY DISABLED POPULATIONS DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Beverly Baer, A.B., M.S.S.W. ***** The Ohio State University 1981 Reading Committee: Approved By Kenneth Marantz Martin Keller Roger Blackwell Beverly Toomey Mary MacVicar __ / uj Adviser < Mary Alice Beetham Department of Art Education ACKNOWLEDGMENTS Warmest regards are extended to my advisor. Professor Kenneth Marantz, whose insight, encouragement and appreciation of the unusual nature of my work provided a learning environ­ ment which continually nurtured my creative potential. Also deeply appreciated are my committee members. Throughout my research. Professors Nancy MacGregor, Beverly Toomey, Roger Blackwell, Martin Keller, Beth Wismar, Mary MacVicar and Mary Alice Beetham generously gave me support and suggestions from the perspectives of their areas of expertise. I wish to extend special recognition to Instructors Frank Pierson and Pat Mahoney, faculty and students of the School of Allied Medical Professions Division of Physical Therapy, for their invaluable assistance in providing subjects for my study. Much appreciation goes to my colleagues, Donna Turner, Norma Leclair, Ginny Black, and Pam Giminez, for their time and cooperation in monitoring the research sessions. Many thanks also go to Mike Oskins and Janet Rice, for their com­ puter and statistical consultation. Greatly appreciated are the Ohio State University, for a one-year fellowship, and the Ohio Rehabilitation Services Commission, for financial assistance throughout my doctoral ii program. Without these supportive endeavors, this research contribution would not have been possible. Warmest regards go to my friends and attendants, who gave me the day by day caring and moral support which enabled me to continue my work. Heartfelt thanks are expressed to Tanya Shenk, Ruth Shellhouse, Susie Wolff and Annette Green, for willingly giving of their time for many months, to help me through this project. Finally, special feelings of gratitude go to my family, for always .expecting me to use my capabilities to the fullest. I l l VITA April 4, 1937 ..................... Born— Washington Court House, Ohio 1961 ............................ A.B., Wilmington College, Wilmington, Ohio ,Qgg ............................ M.S.S.W., The University of Missouri, Columbia, Missouri 1974-1977 ................ Rehabilitation Counselor and Researcher, Cancer Rehabilitation Project, O.S.u. Comprehensive Cancer Center FIELDS OF STUDY Major Field: Art Education Studies in Expressive Therapies: Professor Kenneth Marantz Studies in Rehabilitation: Professors Mary MacVicar and Mary Alice Beetham Studies in Research Methodology: Professors Beverly Toomey and Roger Blackwell iV TABLE OF CONTENTS ACKNOWLEDGMENTS........................................ H VITA .................................................. iv LIST OF TABLES........................................ LIST OF FIGURES.......................................... * LIST OF ABBREVIATIONS.................................. PREFACE................................................ Chapter I. INTRODUCTION.................................. 1 Background.................................. 1 Therapeutic Modalities. ........... 4 Limitations of Verbal Therapies ....... 9 Nonverbal Modalities. ............ 10 Visualization: The Common Thread. ...... 12 Creative Experience in Rehabilitation .... 14 Research Objectives and Issues.............. 17 Research Significance ...................... 20 Summary.................................... 24 II. LITERATURE REVIEW........................... 26 Background. ................. 26 Section 1................... 28 Change...................................... 28 Communication . .............. ..... 32 Hemispheric Laterality. ........ ..... 34 Summary ................... 40 Section 2 ........ .............. 41 Background. ........ ................ 41 Trends in Contemporary Stress Research. 43 Research Problems .......................... 46 Definitions of Stress ..... ............ 48 V Mediating Cognitions. ....... ........ 52 Expectations............... 55 Perceptions ........ 55 Interpretation of disparity .......... 56 Rumination................. 56 Perceptual distortion ............ 57 Cortical inhibition ............ 57 Stress and Emotions ........ 57 Coping and Adaptation ..... ............ 61 Coping. ............. 61 Adaptation. ................ 63 Developing Awareness. .... .............. 64 New Options for Stress Resolution ...... 66 Summary 67 Section 3 . 7 0 Background................... 70 Meditation. ................. 72 Progressive Relaxation. .... ............ 74 Systematic Desensitization............. 79 Hypnotherapy................. 80 Autohypnosis........... 83 Autogenic Training.......................... 85 Biofeedback ................. 86 Visualization ........ ........... 90 Combining Relaxation Techniques with Expressive Therapies. ........... 96 Summary..................... 97 Section 4 . ........ ............. 99 Background......... 99 The Meaning of Expression.................... 101 Early conceptualizations......... 101 Personal Identity ........................ 103 Drive toward order. ............ 104 Emotional release ............. 105 Kinesthetic activity........................ 109 Components of Expression. .............. 113 Imagination............................. 113 Intentionality.............................. 115 Intuition ........... 116 Creativity.................................. 118 Practical Applications........................ 119 Professional Organizations. ........ 121 In Pursuit of Identity...................... 122 Present Status............. 124 Economic and political considerations . 126 Art Education and Art Therapy in Contrast . 127 Use of art materials. ........... 128 Product versus process. .......... 129 Communication ............... 130 vi Human relationships in art experience. 132 Research Studies ....... ........ • 133 Projective drawing research. ........ 136 Studies related to chronic and terminal illness. ................. 139 Summary. 141 Section 5 . 1 4 4 An Holistic Approach .................... 144 Rehabilitation Issues.......... 147 Components........... 154 New Directions in Rehabilitation ....... 157 Integration......... 158 Tension-release. ....... ............ 151 Therapeutic Art Experience .............. 163 Cautions ......... ............ .. 167 Other Expressive Modalities.................... 168 An Art Studio in a Hospital Setting............ 170 A Hospital Journal .... .................. 173 Summary of Literature Review .......... 176 Verbal Therapies ..... .................. 176 Non-Verbal Modalities. ............ 177 Art Experience .......... .......... 179 Other Modalities ........ .......... • 179 Personal Viewpoints. ............. 180 Summary. ......... 181 III. RESEARCH METHODOLOGY .......................... 182 Design .............. ........ • 182 Subjects ..................
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