Acting Out: Art Therapy Breaks Down Barriers
By Karin McKie
Meds tackle HIV in the body, but they can’t address deep-seated emotional issues. The stigma surrounding HIV and a fear of rejection leads many to hide their status or internalize their problems. Traditional modes of therapy often aren’t able break through the walls built by people with HIV, not only between themselves and others, but also within themselves.
One of the most effective tools in a therapist’s arsenal is art. "The emotions experienced while dealing with a highly stigmatized illness such as HIV can be difficult to express verbally, so art therapy can provide a route of non-verbal expression," according to Deepa Rao, the co-author of the study "Art Therapy for Relief of Symptoms Associated With HIV/AIDS." "Art therapy can lead to increased awareness of self, as well as improved ability to cope with symptoms, stress and traumatic experiences. The creative process involved in the making of art is healing."
The use of art in therapy with HIV clients has become so widespread that Dr. Robert L. Murphy can’t think of one HIV clinic that doesn’t use it. Creating something enables people with HIV and AIDS to become active participants in their treatment. It also makes it easier to absorb all of the information associated with HIV.
"We don’t want patients to be bombarded with science," said Murphy, director of the Center for Global Health at Northwestern University and a founder of the Northwestern Global Health Foundation in the Chicago suburb of Evanston, Ill. "They can’t digest everything at once, so they need another format to absorb their diagnoses and options."
Murphy often refers his clients to the Center on Halsted, where they can take advantage of the LGBT center’s resident performing arts and dance groups. Just down the street were the offices of HealthWorks Theatre, a touring company that performed HIV-awareness plays at schools, churches and bars and is now part of Chicago’s Imagination Theater.
When Michael Barto co-founded HealthWorks, he and his best friend and co-founder David Turrentine, knew that Barto was dying of AIDS. "As performing artists, theater was the obvious way for us to spend our remaining time together, but also to educate others using creativity," Turrentine said.
In his book, "Acting on HIV: Using Drama to Create Possibilities for Change," Dennis A. Francis recognized "the unique ability of drama to help participants, on the one hand, to externalize their systems of belief; on the other, to step back from it so that they may gain perspective."
Turrentine readily acknowledges that "building our touring company, which was initially called AIDS Educational Theatre, was certainly therapy for those of us who loved Michael and for other community members infected with, and impacted by, AIDS." At its peak, the ensemble annually performed over 250 productions of original works like "The Wizard of A.I.D.S.," a musical that uses the familiar Oz tale to educate young adults about safer sex.
"Shows at places like Test Positive Aware Network were especially moving, because the majority of the audience was HIV-positive," Turrentine said. "Through the comedy in our shows, like when Dorothy kills the Wicked Witch of Unsafe Sex with a giant condom, all audiences were able to laugh -- which some say is the best medicine -- at a disease that was proving so deadly."
When Susan Swartz and Liberty Lee interviewed members of an HIV-positive woman’s group that meets at Food For Thought Food Bank in Forestville, Calif., they would "talk and laugh about everything from sex to shoes."
The interviews became the basis for "People Like Us, a play now in workshop. Swartz said she found the women "eager and amazingly forthcoming in sharing their stories, the stigma, and the shame they experience from a culture that remains uninformed and AIDS-phobic."
A pivotal character movingly describes her struggle to become a proud, independent woman. "I don’t want to be explaining to some guy that I don’t have a killer vagina," she says, an affirmation that neither men nor HIV will no longer define or confine her.
All the characters, Swartz said, "go from feeling isolated to gaining confidence and self-respect as they reveal their status to each other and to the larger world. Knowing we were going to put their lives on stage has been great therapy for them. Their stories aren’t just about a disease. They show how truth telling, humor and real sisterhood can triumph over fear."
The group’s members showed just how empowered they had become when they took to the streets in early November. Wearing shirts saying "Does this T-shirt make me look HIV+?" on the front and "Not Positive? Get Tested" on the back, they posted photos and stories on social media to document their street theater.
Eighty miles to the south, women with HIV are telling their stories themselves in The Medea Project. Dr. Edward Machtinger, director of HIV programs at the University of California, San Francisco, encourages his female patients to use the performance collective to help them express their shame and heal past traumas.
HIV-infected youth present special challenges. Often rejected by their families, homeless and alone, art provides a "safe space" for them to tell their stories. In doing so, they move beyond feelings of shame and denial to managing their condition and improving their lives. For those at risk of HIV infection, art may be the most effective education tool, because, rather than being told what to do and not do, they are showing and telling the message themselves.
New York City-based Real Stories Gallery Foundation uses both visual and verbal outlets to allow youth to tell their stories. Sexually abused and exploited young men and boys from 18 countries create art, poetry and stories in "Show Me Your Life," an ongoing online project.
Participants "explore who they are and who they would like to be," said founder Rachel Chapple. "These kids become absorbed into making art versus hustling. They are creating marks that say, ’We exist.’"
On Dec. 1, World AIDS Day, the foundation will open "Tristan’s Moon. a dedicated safe house/art gallery space near Old Chatham, N.Y. The photographic collages and video pieces empower "kids who have been told they have failed at everything to become masters of the tools that exploited them during sex work," Chapple explained. These young artists are not only documenting their own growth and progress; they’re also becoming valuable mentors to their peers. Many of the participants have the additional burden of dealing with the side effects of medications that can cause extreme nightmares, which, in turn, exacerbate already-existing trauma. Expressing what they’re going through gives them what Chapple called "a temporary reprieve from a disease that tortures them."
Many children are living with HIV-infected parents, which can be both scary and isolating. Kidworks Touring Theatre, founded in 1997, uses improv theater, drumming and dance to build pride and offer inspiration for low-income African-American and Hispanic youth dealing with this situation.
"There was a lot of anger and violence inside these teens," said Artistic Director Andrea Salloum. "They didn’t know how to work together or to build trust, so I created activities to deal with these issues. Drama has a wonderful way of creating a trusting atmosphere. The performance arts allow these troubled kids to feel proud of who they are, and where they can go in life."
HIV is something that people in all walks of life feel they have to keep secret. Dr. Paul Browde is a psychiatrist on Manhattan’s Upper West Side. It was only a chance meeting with Murray Nossel, an old schoolmate he hadn’t seen in 15 years, that he finally was able to come out about his HIV status.
"Telling my story changed my life," Browde said. "I no longer lived with the fear of being found out. I experienced decreased stress, less anxiety, improved friendships and greater capacity for humor."
After that, Browde was able to stand before a conference of his peers as an HIV-positive psychiatrist at conference.
He and Nossel, a psychologist and playwright, founded Narativ, a storytelling project that teaches a "non-judgmental listening" method to allow people to open up about their lives. The two men also teach at the Narrative Medicine master’s program at Columbia University in New York, which uses literature to train healthcare practitioners to empathize with and relate to their patients.
Browde and Nossel have fashioned their own story into an unscripted piece called "Two Men Talking." It can be seen on Dec. 2 at the Spencer Cox Center for Health at St. Luke’s Roosevelt Hospital in New York City; and on Dec. 6 as part of a program presented by TEDxBrooklyn at Brooklyn Bowl.
Art therapy not only complements traditional medicine, it helps practitioners understand their patients and leaves the facilitator, in Swartz’s words, "dazzled and in awe."
Above all, people with HIV shed deeply suppressed feelings. The results are nothing short of liberating. "I heard someone laughing," says Rose in "People Like Us," and I realized it was me."