ma report by Sophia Wenzel

// Dedicated to my Grandfather. I was too young to say goodbye properly.

Goodbye.

ÂŠ Sophia T. Wenzel, 2009

Project Report

Therapeutic Animation Improving communication between parents and their terminally ill child

Sophia T. Wenzel

M00189714 MA Graphic Design 08/09 DES 4301 Project Completion

ABSTRACT

ABSTRACT This paper demonstrates possibilities of enhancing communication between parents and their terminally ill child. The research addresses an among professionals in pediatric end-of-life-care well known lack of communication, while focusing on 2-6 year old children, suffering from a severe malignant, non- congenital disease. It is analysed to what extent and because of which possible consequences it is essential for parents to talk to their child about death, condition and prognosis. Renown authors such as, Elisabeth Kuebler-ross, Judi Bertoia and Myra Bluebond-Langner report of the necessity to talk to a terminally ill child about death, but according to a significant study by the New England Journal of Medicine 1,

only 34 % of concerned parents do so.

This research sets out to contribute to the field of family therapy with a graphic design project, in respect to existing techniques and the experience of experts. The subject will be introduced and examined through a theoretical lens using primary and secondary literature and a significant study from Sweden, accomplished in 2004, as evidences. Additionally professionals have been adduced to support this work with their experience and advice. After the analysis, experiments have been set up and are described, analysed and the results of the testing are externalised. The incorporation of a series of animated movies into family therapy has been the most promising experiment and also successful in the testing. Hence further development, subjects, benefits and issues are discussed in reference to literature and professional expertise.

1 The New England Journal of Mecine, Talking about death with children who have severe malignant disease, Vol.351, No. 12, September 16, 2004

TABLE OF CONTENTS

Abstract Table of Contents

01 02

1.Introduction

1.1 The original research question 1.2 Methodology 1.3 The research problem and consequences

04 04 05

2. Hypothesis

2.1 Existing methods 2.2 The original design brief

06 06

3. Development

3.1 Input, Identification, Interaction 3.1.1 Testing and Results 3.2 Spontaneity, Unconsciousness, Expression 3.2.1 Testing and Results 3.3. Storymaking, Storytelling 3.3.1 Cinema Therapy 3.3.2 The Stories 3.3.3 Testing and Results

09 11 11 13 13 13 15 19

4. Requirements for Animations

5. Final Design

5.1 Chosen Tales 5.1.1 The Woodcutter and Death 5.1.2 Moon and Hare 5.1.3 Coyote in the Land of the Dead 5.1.4 The Parable of the Mustard Seed 5.2 Characters 5.2.1 Kisagotami and her child 5.2.2 Buddha Gautama 5.5.3 People Kisagotami meets 5.3 Design and Style 5.4 Discussion of Keysequences and Issues

20 21 24 25 27 29 29 32 33 34 37

6. Testing and Conclusion 6.1 Future Directions

Appendices References

41 55

INTRODUCTION

1. INTRODUCTION

â&#x20AC;&#x153; Should you shield the canyons from the windstorms, you would never see the beauty of their carvings â&#x20AC;&#x153;2 Elisabeth Kuebler-Ross utilises this expression to describe an among professionals, working in the field of paediatric end-of life care, well-known lack of com-

2 Kuebler-Ross, E., On Children and Death, Scribner, 1997

munication, experienced between parents and their terminally ill child. Having undertaken research on death and dying, Kuebler-Ross explicates the need of talking to children, facing a severe malignant disease, about death, their condition and prognosis, furthermore the necessity of engagement with their feelings and concerns.3

The design project described in this report addresses this lack of communication, while focusing on 2 -6 year old children, suffering from a non-congenital illness. The outcome aims at assisting parents of a terminally ill child to increase an

3 Kuebler-Ross, E., On Children and Death, Scribner, 1997

awareness of their childâ&#x20AC;&#x2122;s internal process and consciousness of his or her current situation, condition and prognosis. Giving children the possibility to express their concerns, parents are likely to gain a better understanding, which equates to an enhanced platform to communicate and therefore an improvement of paediatric end-of-life-care. In 2004 the New England Journal of Medicine4 published a study accomplished

in Sweden in which 561 eligible parents, who lost a child between 1992 and 1997, were asked whether or not they have talked to their child about death of if they, due to different reasons, avoided this topic. The majority, 258 of 429 parents, who answered the survey, stated not to have talked to their child about death, only 147 have. 27% of those parents who have not taken on this conversation did in fact regret not to have done so, whereas none of the parents who had a conversation about death did regret it.

4 The New England Journal of Mecine, Talking about death with children who have severe malignant disease, Vol.351, No. 12, September 16, 2004

INTRODUCTION

Furthermore the study approved that parents, not talking to their terminally ill child about death are more likely to suffer from depression and anxiety for a much longer period of time after the childâ&#x20AC;&#x2122;s death and that communication is 5 The New England Journal of Mecine, Talking about death with children who have severe malignant disease, Vol.351, No. 12, September 16, 2004

more likely if concerned parents are aware of their childâ&#x20AC;&#x2122;s internal process.5

Did not talk about death // 66 % Talked about death // 34 % Not given

1.1 ORIGINAL RESEARCH QUESTION Which medium or device will assist parents of a 2-6 year old child, suffering from a severe malignant disease to communicate with their child and help all three to better cope with the childâ&#x20AC;&#x2122;s imminent death?

1.2 METHODOLOGY During this research it has been of utmost importance to heavily rely on literature, including secondary literature, as well as the experience of professionals working in this field. Due to possible harms, such as emotional distress it has not been possible to either interrogate the concerned audience or to test prototypes with parents or children. In order to gain the necessary knowledge, methods such as literature review, case studies and in-depth interviews have been employed. Quantitative research methods, inter alia open-ended questionnaires have been utilised for the testing at the development stage.

INTRODUCTION / HYPOTHESIS

1.3 THE RESEARCH PROBLEM AND CONSEQUENCES In such an unconceivable situation, faced with grief, parents have several reasons to avoid a conversation about death with their child. The most common and concise reason is the assumption the child would not be able to comprehend consequences of a malignant disease and needs to be protected. According to the Piaget-model6 it is certainly true, that children of the target age

have difficulties to understand details of their illness, as their cognitive thinking is not yet fully developed. But Rando found, that even if it is a” moot issue whether or not these children can comprehend their own death”, it is essential for parents to assist them with their feelings and “whatever understanding they do have”.7

Their potential understanding includes bodily changes and those around them, the medical tests and hospitalisation interrupt normal life.” While children’s understanding depends on many factors such as age and experience, they do know

6 Jean Piaget, Stages of Intellectual development in children and teenagers // www.childdevelopmentinfo.com [accessed:14.11.2008]

7 Quoted in Bertoia, J., Drawings from a dying child, London: Routledge, 1993, p. 4

some of what has happened and will create their own version of circumstances when not told”.8

While the majority of parents does not establish a conversation about death, the majority of terminally ill children does not ask questions about it, because of taking their parent’s feelings into account. Bluebond-Langner reports of chil-

8 Bertoia, J., Drawings from a dying child, London: Routledge, 1993, p. 1

dren explaining: “ We knew certain questions would bring tears to our parents’ eyes, so we learned not to ask these questions.”9

Referring to Mark Coulson, Psychologist at Middlesex University, the sharing of negative emotions can help to reduce anxiety and depression in both, parents and children.10

9 Bluebond-Langner in Bertoia, J., Drawings from a dying child, London: Routledge, 1993, p.2 10 Dr. Mark Coulson, Middlesex University

2. HYPOTHESIS Since the study by the New England Journal of Medicine indicated the empathy of parents for this communication, if they are aware of their child’s consciousness, a potential approach is to reveal the child’s emotional condition by help of a graphical solution.

HYPOTHESIS / DEVELOPMENT

2.1 EXISTING METHODS 11 Prof. Dr. med. Albani, Paediatrician, HSK Kliniken, Wiesbaden, Germany

In our conversation in January 2009 Prof Dr. med. Albani11, a paediatrician from Wiesbaden, Germany, pointed out that in such a seriously lacking com-

munication it is essential to have a third person or a third thing arbitrating between the two parties. Someone or something that provokes questions, answers, a conversation. It is therefore recommended to consult a therapist or counsellor, an expert trained in this field. During this research many approaches have been detected and analysed in order to spot possibilities to contribute to, with a graphical project. The most interesting approach is Play Therapy and Storytelling. Both methods allow a child to express his or her emotions towards a particular situation and is applied in cases such as abuse, domestic violence as well as bereavement and loss. It seems to be a trustworthy indicator, to give children a stimulus to respond to, in order to let them express their emotions.

2.2 THE ORIGINAL DESIGN BRIEF In the original design brief it was proposed to develop a graphical contribution to the field of therapy, an environment, in which offering impulses for the child to narrate can reveal emotions. This environment should be designed for diagnostic purposes, not for a whole therapeutic process and should meet the following requirements: It needs to be adaptable to existing institutions, affordable for institutions supported by the public and of course it must bear benefits and innovation for the field of infant therapy.

DEVELOPMENT

3. DEVELOPMENT Always in reference to literature and professional advice, three experiments have been set up during the development stage. The many different approaches of therapists to solve the described problem provided enough material to experiment with but bore the difficulty of deciding. The first experiment responds to the idea of an input, identification and interaction within an environment, regarded as the wooden cube.[ Fig.1]

Figure 1 Prototype “Wooden cube”, 2009

The wooden cube has been the first concept of a potential spatial design, whose basic construction reminds of children’s playhouses. A child-sized environment, that is not accessible by adults, offers the privacy a child might need in order express his or her feelings in a therapeutic session. The decision was made to leave the cube open on one side, hence the child would not feel locked out, anxious or distracted. Two of the following experiments incorporate the wooden cube as a potential environment for therapy and discuss possible activities within it. For the experiment Prof. Dr. med Albani and Susanne Wenzel, Psychotherapist form Wiesbaden, Germany were adduced to contribute with their experience.

DEVELOPMENT

3.1 INPUT, IDENTIFICATION, INTERACTION Albani pointed out that children learn and express themselves by performance and storymaking, thus suggested the appliance of puppet theatres or joint narration, so as to provide an impulse for the child that can be retold or performed afterwards.12

It is a common practice to adapt children’s stories, Fairy tales or Folk tales for this method, stories that discuss a very similar problem, as it is experienced with the patient. Again Albani is of the opinion that it needs a third thing be-

12 Prof. Dr. med. Albani, Paediatrician, HSK Kliniken, Wiesbaden, Germany

tween the child and the therapist that arbitrates, and provokes a discussion. In conclusion having an impulse such as a metaphor or a story leads the child to identify with the very similar problem or a character in a made up story, since “at 18 months the child becomes aware that other people and other things have feelings. […] Children are role-playing with trucks, dolls and stuffed animals. They may identify with a character in a movie and discuss the feelings of the character. […]. As the child develops, discussions on feelings will expand.”13 After a long research in children’s stories and fairy tales that address themes of bereavement, death and dying, the story of “ the velveteen rabbit” by Margery Williams14 was chosen to be the impulse.

A very meaningful excerpt of the story [Fig.2] explains the conversation of two stuffed animals about “becoming real”. It is said that a stuffed animal may become real if a child loves it unconditionally. The stuffed rabbit seems fright-

13 www.essortment.com/ all/talkingchildren_paj. htm [ accessed 23.04.09]

14 Williams, M., The Velveteen Rabbit, Doubleday, 1958, p.15

ened of this transition, but the old stuffed horse, which is already “ made real” explains calmly that becoming real might hurt sometimes, “ for he was always truthful”, but that “ once you are real you don’t mind being hurt”.15 For me as the reader there has been the explicit transfer of a young client, terminally ill and afraid of the transition and in the ideal situation his or her parents,

15 Williams, M., The Velveteen Rabbit, Doubleday, 1958, p.15

truthfully and calmly responding to upcoming questions. The next consideration for this experiment was the form in which the stimulus can be presented. Referring to Albani an involvement into the story is likely when it is performed.16

Thus the decision was made to incorporate an animation into the environment,

16 Prof. Dr. med. Albani, Paediatrician, HSK Kliniken, Wiesbaden, Germany

DEVELOPMENT

Figure 2 Initial Storyboard, â&#x20AC;&#x153;the velveteen rabbitâ&#x20AC;?, 2009

considering the statement, the child would identify with a character in a movie. Furthermore, so as to guarantee an interaction and expression, the characters of the animation should be part of the setup, as children might role-play with a stuffed animal. The discussion of feelings or interaction with it can be a fruitful indicator for the therapist.

DEVELOPMENT

3.1.1 TESTING AND RESULTS Consulting Susanne Wenzel17 it has been verified that a child would probably

communicate with the stuffed animal, but even though the child would express his own feelings with the toy, Wenzel is of the opinion that there is no necessity for children to have a stimulus in order to reveal true feelings.

3.2 SPONTANEITY, UNCONSCIOUSNESS, EXPRESSION Accordingly it is a moot issue whether or not an impulse is actually needed so as to gain the information that is necessary for a therapeutic diagnosis. Wenzel further explained that those young children have so much access to their unconsciousness, that by a spontaneous action, such as in drawings, a spontaneous response to imagery or a question might reveal much more true statements than by letting the child conceptualise too long what it has to say. In order to meet the requirements of both approaches I made up a second experiment, in which no stimulus is incorporated and which provides the ability for the child to express him or herself spontaneously. In this experiment privacy is still necessary, also no parent should be included into the process as this stage. Like many other therapists Susanne Wenzel makes use of drawings and spontaneous choice of imagery or toys, hence the walls of the “ wooden cube “ may be used as interactive space, adapting imagery that should be randomly chosen by the child. These interactive walls are magnetically responsive, to wit it is possible to stick magnets to the walls.[ Fig.3] The development of imagery has been particularly hard, as metaphors should have been founds for certain feelings to be transferred on to a symbol. It was unavoidable to start off from clichés such as a rain cloud for sadness, trees that would have roots and branches or not, though there is the opportunity to incorporate imagery and metaphors known from children’s drawings. Susanne Wenzel pointed out that any imagery would have been chosen or avoided for a certain reason, as it is the unconsciousness of a child and not the cognitive thinking that would make the choice. The scene on the wall can be inter-

17 Susanne Wenzel, Psychotherapy, Wiesbaden, Germany

DEVELOPMENT

preted by a therapist afterwards. The idea of choosing symbols and to stick them on a wall is similar to the existing technique of “Sand Play Therapy”. For this method a child is asked to choose from hundreds of figures, houses, cars and so forth to then place the chosen items in a sand tray, so as to build up his or her own scene. A therapist is able to interpret the scene from arrangements of figures. [Fig.4,5]

Figure 3 Prototype, “Interactive Wall”, 2009

Figure 4 Sandtray Therapy www.counselingtoys.com [Accessed 5.2.2009]

Figure 5 Sandtray Therapy www.betsymillscounselling.com.au [Accessed 5.2.2009]

DEVELOPMENT

3.2.1 TESTING AND RESULTS The testing of this graphic approach has been very difficult. For this purpose a project expose was set up, which has been sent to therapists in connection with a questionnaire [Appendices, page 43]. Unfortunately only two of 24 responded. Even though this number is so small, the reaction is very concise. Jeff Thomas from Play Therapy UK stated, “ A therapist would make up a story, rather than wait for the child’s story.”18 As it is seemingly an uncommon practice to let a child unconsciously express, and this concept would not be of use for a therapist, the decision had to be made

18 Jeff Thomas, Play Therapy UK Director of Research and Education

to though have a stimulus as a feature. Incorporating the results from the first experiment, the idea of animations was revised and tales, functioning as a stimulus for discussion, further explored.

3.3 STORYMAKING, STORYTELLING As determined in experiment one and two, a therapist would rather make up a story for a child, a story it can identify with, respectively with a character in the story. In this experiment, the idea of a stimulus will be kept, as well as the presentation of it in form of a movie. The concept sets out to provide a similar problem wrapped into a story that the young client can identify with. 3.3.1 CINEMA THERAPY The appliance of movies for therapeutic purposes has increased in recent years and is regarded as “Cinema Therapy”. Gary Salomon, PhD,author of The Motionpicture Prescription, has invented this method, referring it to be “ the process of using movies made for the big screen or television for therapeutic purposes.”19

Movies have a strong ability to touch the viewer, especially if the subject matter resembles the current situation of him or her. In a therapeutic context, movies can be adapted in cases of abuse, domestic violence, bereavement and loss, but also for less upsetting themes.

19 Movie Therapy: Using Movies for Mental Health www.medicinenet. com [accessed: 23.04.09]

DEVELOPMENT

20 International Movie Database www. imdb.com [accessed: 08.08.09]

A very good example is the choice of the movie “ Free Willy” (1994)20, which is recommended for children who were adopted. Since the main character Jesse has

been adopted himself and the movie shows the process Jesse is going through, it might be fruitful for further therapy. If a child with foster parents identifies with Jesse, it is very likely that a platform for discussion of feelings towards the adoption is established. The therapist would now go on to ask questions about the similarity to the character, or even differences. There will be an analysis of how the patient relates to happenings within the story. Young clients would rather be asked to draw a

21 Ann-Marie John, Msc Family Therapy, North Lodon, UK

picture of the story, something that he remembered. 21The spontaneous action of

drawing a picture might reveal more truth than the actual conceptualisation of the seen, as determined in experiment two.

There are few limits for the therapist to go on with the therapeutic process, however the evaluation of those is not subject of this paper. This concept sets out to provide the stimulus for discussion and it is now to be analysed, how this can be achieved. Regarding to the choice of “ Free Willy”, the catch in this case is, that the plot of it is just scratching the surface. It mentions the adoption and shows problems that arise from it, but the actual storyline deals with a whale in captivity and the friendship between the boy and the whale. The fact that is missing in Cinema Therapy is adequate accuracy, providing concise stimuli for discussion, those dealing with the problem, which is to be tackled. In conclusion, there is a need for therapeutic movies, providing a specific impulse. For the purpose of this design project it is the need for movies tackling and dealing with bereavement, loss, death and dying. Hence the decision has been made to produce a series of stories presented as short animated movies, as a graphic contribution to the field of therapy, especially Cinema Therapy. To meet the requirements of a therapeutic animation for diagnostic purposes, Ann-Marie John, a psychotherapist from North London, has been adduced to support this project with her experience. The choice of an appropriate story for a specific case rests with a therapist, however the concept of a series offers the advantage of different stories for different individuals.

DEVELOPMENT

3.3.2 THE STORIES

“ The purpose of a story is to teach and please at once, and what it teaches is how to recognise the snares of the world” Umberto Eco Referring to Prof. Dr. Albani, Fairy Tales and Folk Tales hold the ability to bear and convey messages.22 Thus they need to be considered for this project.

In order to find stories and tales concisely dealing with themes of bereavement, research on old Folk- and Fairy Tales has been undertaken. It has been particularly difficult to find stories that suit the need of this project,

22 Prof. Dr. med. Albani, Paediatrician, HSK Kliniken, Wiesbaden, Germany

as some were just atrocious, vague or simply too confusing and difficult to follow. However, Alida Gersie offers a range of workable stories in her book “ Storymaking in Bereavement”23, which has become the anchor of this concept. Gersie not

only listed the consciously chosen Folk Tales involving death as the main theme,

but also describes why and how those were told and in which situation they are

23 Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991

of use. The tales in this book were told by tribes from almost every continent; they incorporate views about life’s beginnings and death, some metaphorically, some straightforward. In general a Folk Tale, regarded as a story transmitted by the word of mouth, has its origin in a popular culture and has been imagined for entertainment as well as education. They have been told to illustrate the world, but also to frame how to behave in it. Similar to the fables by Aesop, some Folk Tales transfer human beings into animals, to wrap the message or moral into a form less close to the reader. It is indeed a requirement for this project to keep a “ safe distance” to the respondent, yet to involve him at once. A child aged 2-6 should identify with the tale, but should not be scared by any means of it. According to Dr. Ofra Ayalon24 this “ safe distance” can be implied and noticed “by common beginnings such as ‘once upon a time […]’ and the ‘heroes’ being royalty, personified animals or supernatural creatures”. She further explains that “ while these elements allow for safe distancing it is also important to create

24 Ayalon in Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 3-4

DEVELOPMENT

in the audience the necessary involvement with the situation at hand, in order to achieve personal identification with the characters, ideas and emotions in a story.” Another important requirement for a tale in this concept is religious independence and the ability to adapt it interculturally. This project aims at assisting every human being, no matter from which culture or religious denomination. 25 / 26 / 27 Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 56, 71, 104 28 www.pitt.edu/~dash/ mourn.html [accessed 12.3.2009]

Three of the tales by Alida Gersie have been chosen for the final design:

“ The Old Woodcutter And Death”25 from Nepal, “ Moon and Hare”26, told by

the Bushmen and “ Coyote In The Land Of The Dead”27 from the North Ameri-

can Indians. The fourth tale, “ The Parable of the Mustard Seed”28, has its origin in India and is the only one not listed in Gersie’s book.

Due to the variety of views on death and dying and ways to cope with loss this story has been chosen to be storyboarded for the testing in this experiment. [ Fig.6] For an analysis of these tales and their possible transfer please see Chapter 5.1, the original transcripts of them can be found in the appendices, page 46. This parable describes the journey of a young mother searching for a medicine that will bring back her dead child, that she had lost in the winter. On her way she meets different people with different views on her situation and a range of recommendations. The message of this parable deals with a situation of loss and illustrates a process of acceptance, sensitively handled. A full transfer of this tale and the realisation of it for the screen is described in chapter 5.1.4. In order to keep the “safe distance” human beings in the story have been transferred onto personified animals, a promising possibility offered by Dr.

29 Ayalon in Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 3-4

Ofra Ayalon29. The choice of animals living in India, such as Axis deer, seemed

likely, as the tale and its realisation should be a as authentic as possible.

Even though the storyline has been transformed in order to meet the requirements for a movie, the “safe distance”and a fluent narration, it was kept very close to the original tale.

Figure 6 Initial Storyboard, “The Parable of the Mustard Seed”, 2009

DEVELOPMENT / REQUIREMENTS

3.3.3 TESTING AND RESULTS With the prototype, the storyboarded tale, Ann-Marie John30 has been consulted in order do evaluate benefits, issues and further ideas.

The conversation determined the definite adaptability of Folk Tales for therapeutic purposes, even though not every individual, to wit client, might be addressed with it. According to John the concept can be utilised in this case, though it is a matter of evaluation whether or not a client will respond to it. For some clients other therapeutic techniques are more promising, nevertheless the concept of therapeutic animations is working into the right direction and bears much potential.

4. REQUIREMENTS FOR ANIMATIONS Again the experience of professional working in the field of therapy was demanded in order to define requirements for therapeutic animations. As a terminally ill child of the target age should be addressed, each of the animated movies need to meet the following specifications: The message of a story, respectively of a movie needs to be conveyed, making as less use of spoken word as possible. Susanne Wenzel stated that children of this age rather respond to visual metaphors and colours, than language. Thus the communication in a therapeutic movie needs to be indirect, to wit convey messages through imagery. As a child is supposed to identify with one or more characters and possibly projects own feelings onto it, it is essential to give each character in a movie less facial expression. A new interpretation of the seen story is not possible, if feelings of a character, thoughts or meanings are anticipated. This conclusion has been verified by Ann-Marie John, adding that because of this reason it is recommendable to leave some questions open and not to explain every detail in a therapeutic movie. There needs to be enough scope for imagination, phantasy, re-interpretation and moreover storytelling. As explained in an earlier statement, the design of an animated movie is supposed to involve the viewer, yet needs to keep a distance. Another very important requirement is the intercultural comprehensibility.

30 Ann-Marie John, Msc Family Therapy, North Lodon, UK

FINAL DESIGN

5. FINAL DESIGN Even though there is a variety of tales suitable for this purpose, four tales have been chosen for the final design. One of them â&#x20AC;&#x153; The Parable of the Mustard Seedâ&#x20AC;? was animated in order to propose the look and content of a therapeutic animation. The other three chosen tales were storyboarded. Nils Middelstorb,a london based illustrator has been adduced to finalise the storyboards, in respect to initial sketches and determined requirements. Unfortunately, due to restrictions of time, it was unavoidable to reduce the plot to key sequences. However, the final design is supposed to be further elaborated in the future, referring to the prototype described in this chapter. The animation is to be found on www.sophiawenzel.com/mustardseed.html

5.1 CHOSEN TALES The following tales have been chosen for the animation series, considering their qualities, such as variety of views, ability for interpretation, intelligence and hopeful narrative.

FINAL DESIGN

5.1.1 THE WOODCUTTER AND DEATH The first tale I have chosen has its origin in Nepal. ( A full transcript of the tale is to be found in the appendices page 46). Alida Gersie retold the story of an old woodcutter, building a trap for Death, to catch an keep him in captivity, with the aim not to be taken by him, when his time had come. When it becomes obvious how life on earth would change without Death, noticing the overpopulation, hunger and sickness, the woodcutter finally agrees to let Death be free. From this day, death has been invisible, for that no one is able to catch him again, though he can see everybody. Even though death is personified in this tale and the woodcutter knows how long he has left to live, the story is hopeful and does not give any suggestions or religious views. It describes an important decision that had to be made, thus provides a basic for a discussion about it. The tale has been transformed to meet the requirements defined in chapter 4 and to keep the safe distance characters of the story were transferred onto personified animals. The animal for the woodcutter is in this animation a beaver, not least because of the fact that both are cutting wood. Transferring death into an animal is not part of this concept, as it should not be given an image, or suggest any attitudes for it. Hence the character Death will be shown as something indefinite, indescribable, maybe a character consisting of particles, as neutral as possible. This tale offers a great scope for imagination, discussion and further therapy, provoking thoughts about life without death, the appearance of death and acceptance of it.

FINAL DESIGN

Storyboard “The Woodcutter and Death” Illustrated by Nils Middelstorb, 2009

FINAL DESIGN

5.1.2 MOON AND HARE Moon and Hare is a tale about the misdelivery of a message. (Appendices, page 47). The Bushmen told that Hare was sent to the early people, for he was the fastest spirit,to tell them they should not be afraid of death, as like moon they will be renewed when dying. It is Hare who did not listen properly and delivers another message, saying the early people will not be renewed like moon, with the consequence of frightening the early people. As a penalty Hare has received a split nose, additionally from this day onwards, he will be no longer a spirit and has to live on the earth. This tale has been chosen because it meets the requirements, defined for a tale, intelligence, sensitivity and the range of possible interpretations of it. Alida Gersie noticed, that “ Moon cannot intervene” when Hare delivered the wrong message and that “ Moon endures the very human experience of being 31 Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 71

unable to protect the people we love against the terror of death”.31

This is just one of the many interpretations that are possible in this tale, interpretations that connect the client to the tale. The main character is Hare,a spirit, yet already an animal. Thus no transfer is required. Due to the fact that the tale involves ancient people, there is a distance to human beings living nowadays. Regarding to the storyboard, characters and storyline have not been changed, though illustrated.

Storyboard “Moon and Hare” Illustrated by Nils Middelstorb, 2009

FINAL DESIGN

5.1.3 COYOTE IN THE LAND OF THE DEAD This tale, told by the Yakima in North America is very different from the others. Even though it involves the processes of bereavement and grief, it gives an insight of what could possibly happen after death. It describes the trial of Coyote and Eagle Hawk to free the deceased, to bring them back to the land of the living. In this case it is the deceased who give hope and consolation to the living. It is a good example for a variety of themes in a therapeutic tale. Whereas “the old woodcutter and death” describes the trial to escape from death, “ Coyote in the land of the dead” is also “ a moving description of our passage through bereavement”32. Hence it would also be adaptable for therapy with children,

having lost a family member and being faced with grief.

The characters in this tale are likely to be human beings with given names, that are renown for North American Indians, though the Idea of two strong personified animals, coyote and eagle, suits this concept and keeps the story close to the original. For the purpose of a therapeutic application the plot has been shortened, but allowing for the animation to be a as close to the original tale as possible.

32 Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 108

FINAL DESIGN

Storyboard “Coyote in the Land of the Dead” Illustrated by Sophia Wenzel, 2009

FINAL DESIGN

5.1.4 THE PARABLE OF THE MUSTARD SEED As outlined above this story has been chosen for the final design, to be animated and prototyped. The original tale from India ( Appendices, page 51) tells the journey of a mother, who lost her child, to find a medicine that can bring back the deceased. Originally she carries her dead child throughout the story, asking neighbours and friends for this special medicine. She is put off by all respondents and it is recommended to ask Buddha Gautama for help. Buddha Gautama, asks the mother to bring a mustard seed from a house in which no family member has ever died. On her search for this mustard seed the mother experiences different views on her situation and different reactions to it. The fact that she cannot find this special seed leads her to accept the death of her child and helps to find consolation. In order to animate this tale,a storyboard has been prepared, showing the slightly changed tale and the transfer of the characters. The necessary â&#x20AC;&#x153;safe distancingâ&#x20AC;? is achieved by personified animals. Animals living in the concerned area have been chosen and those living in neighboured countries. Buddha Gautama has been transferred to a stag, because of the majestic attitude of the animal. To establish a connectivity between the characters, mother and child have been transferred onto Axis deer. Characters will be further explained in the next chapter.

FINAL DESIGN

Storyboard “The Parable of the Mustard Seed” Illustrated by Nils Middelstorb, 2009

FINAL DESIGN

5.2 CHARACTERS All characters have been designed using Adobe Illustrator with picture reference. Every part of the body was set on a single layer to guarantee the flexibility and ability to move them around in Adobe After effects. Even though the characters are vectorised it was important to keep them close to their natural appearance, since they are part of an animated Folk tale, close to the original and not fantasised. Having over-cartoonised characters might lead the viewer to have a distance, but makes the process of involvement and identification much more difficult. 5.2.1 KISAGOTAMI AND HER CHILD Kisagotami is the mother, losing her child in the winter. She has been transferred onto an axis doe. In the first design [ Fig.11] There are much too less characteristics, especially her motherly appearance and the likable expression has been missing.

Figure 11 Initial Design for Kisagotami, 2009

The second design [Fig.12] shows Kisagotami with more human attitudes, she is friendly, motherly and more easy to identify with. Additionally the eyes, which were designed more expressive, assist in making a character likeable, to enhance the relatedness between viewer and character. Her fawn [ Fig.13] was designed in reference to Kisagotami, alike every following character, in order to keep continuity of the movie. The design of the fawn persuades by authenticity, providing the ability to identify with by incorporation of the scheme of childlike characteristics.

FINAL DESIGN

Figure 12 Final Design of the Character Kisagotami, 2009

Figure 13 Final Design of the Character Fawn, Kisagotamiâ&#x20AC;&#x2122;s Child, 2009

FINAL DESIGN

Figure 14 Final design of the Character Buddha Gautama, transferred to a Stag, 2009

FINAL DESIGN

5.2.2 BUDDHA GAUTAMA In the original story it is told, that Kisagotami needed to find Buddha Gautama so as to find the medicine she needed. Having decided to design the animation series without any influences of religion there was the difficulty of finding an animal that would be as precious and majestic as Buddha, without offending the Buddhistic society. It needed to be an animal, that is standing above other animals, proud and trustworthy. The idea of a stag [ Fig.14] has not been the first but the best decision, as it is an animal that highly suits this position and additionally connects to the other main characters, Kisagotami and her fawn. The painting “ The Monarch of the Glen” by Edwin Landseer [ Fig. 15] accompanies the choice of a stag as a majestic, proud and trustworthy animal. In matters of colouring I used this painting as reference. References for movements are personal recordings of deer in a German deer park, from which I was able animate certain movements such as the turning of a head [Fig.16]

Figure 15

Figure 16

“ The Monarch of the Glen” Edwin Landseer, 1851

Example of a headmovement in a frameby-frame animation, 2009

FINAL DESIGN

5.2.3 PEOPLE KISAGOTAMI MEETS In the original story Kisagotami asks neighbours and friends for medicine. As a means of intercultural adaptability and to support the animation this aspect has been transferred onto forests she visits,some neighboured some in other parts of the world. Respondents of the tale were transferred onto animals as well, inter alia an owl, a squirrel and a panda bear. Each of them with different views and experiences, but all of them from a forest in which several â&#x20AC;&#x153; animals â&#x20AC;&#x153; died. [Fig.17] The characters were designed in reference to the main characters, as natural as possible, friendly and easy to identify with. As a requirement for therapeutic animations their facial expression is reduced to blinking eyes and the lipsynching movements of the face.

Figure 17 Some characters Kisagotami meets in the story, 2009

FINAL DESIGN

5.3 DESIGN AND STYLE The overall animation reminds very much of animated movies by Walt Disney or Studio Ghibli, not least because of the painted backgrounds and the clean vectorised characters. In fact, having a static, painted background and characters in the foreground eases the production of an animation and though achieves a great effect, sometimes even three dimensional, depending on the sequence. In connection with the vectorised images, a painting comes to life and vice versa. Background images were prepared using water colour and ink, in reference to photographs and sketches of Trent Park in North London. Characters and backgrounds have been animated in Adobe After Effects, refer33 Muybridge, E., Animals in Motion, New York: Dover Publications Inc., 1957

ring to the work by Eadweard Muybridge â&#x20AC;&#x153; Animals in Motionâ&#x20AC;?.33 Afterwards the sequences were cut and composed.

The voice for each character sometimes points out from which part of the world the particular animal is from, choosing an actor with a different accent. In a prospective development of this project, this idea needs to be taken further, to wit elaborated. In order to indicate, where the original tale has its origin, traditional music from the respective country was chosen as background music. Two of the three compositions applied in this animation are copyright, though annotated and only of use for educational purposes and the presentation at university. However there is a range of potential compositions adaptable for the future.

Figure 18 Still images taken from the final animation, 2009

FINAL DESIGN

5.4 DISCUSSION OF KEY SEQUENCES AND ISSUES Some of the animated scenes in the movie bore difficulties in their realisation. In some parts the original story had to be altered in order to meet requirements for a therapeutic animation, but even the altered and simplified sequences are matter of discussion. In Figure 19 the sequence is shown, in which Kisagotami’s fawn is too weak to continue with the journey and eventually cannot get up anymore and dies. What seems cruel at the first glance had to be presented as metaphorically as possible without distressing the concerned viewer. Not being trained in this field it has been particularly hard to decide in which way this part of the story needed to be designed. Finally the decision was made not to display details of the fawn’s death, but to let it be obvoius from the context. There are definately more elegant ways to transfer the death, which need to be tested and evaluated by experts, but for this project it seemed sufficient to show the fawn and its weakness. It has been criticised by Ann-Marie John34 that “ it may have been helpful to

comment on what happened to the body, we know that seeing the body can

help with saying goodbye and rituals around burial are very important and may have helped the deer.” In the conversation John expressed the possibility of covering the body with snow as a safe way to engage with the subject matter. Giving very much attention to possible harms in the audiences these sequences have been kept simple, probably too simplified, with a lack of profundity. In respect to an earlier statement these critical points will be acknowledged and taken into account in future developments of this project. Another sequence that is to be discussed is the little duck asking Kisagotami whether or not she has understood what has just happened [Fig.20]. According to Ann-Marie John she might have not understood and the little duck is an appropriate metaphor for the community, sometimes with the wrong choice of words. In the process of bereavement, many statements can fail, exactly like the one shown. It is therefore a metaphor that helps to raise a discussion about people in the community, their behaviour and isolation.

34 Ann-Marie John, Msc Family Therapy, North Lodon, UK, Feedback 09/09/08, Appendices p. 52

FINAL DESIGN

Figure 19 Still images taken from the original animation, “The Parable of The Mustard Seed” 2009

Figure 20 Still images taken from the original animation, “The Parable of The Mustard Seed” 2009

FINAL DESIGN / TESTING

It has been a controversial thought whether or not to incorporate a character into the animation that might seem too humorous on the first glance, in connection with the serious plot of the animation. While looking for a mustard seed the viewer can hear sounds of the owl rummaging in her jerk. Nevertheless it is still a children’s movie, and even if it is therapeutic, it shall still entertain and touch the viewer. This thought was verified by Ann-Marie John.

Figure 20 Still images taken from the original animation, “The Parable of The Mustard Seed” 2009

6. TESTING AND CONCLUSION The testing of the final design needed to be constrained to an evaluation of an expert working in the field of therapy. The consultant for this project, Ann-Marie John, recently obtained a Master degree in Family Therapy, evaluated the design and concept. The full written evaluation is to be found in the appendices, page 52. The first and most important outcome of the testing is, that the design and concept has not yet been tested with the concerned audience, it is therefore evaluation of an expert whether or not it is adaptable. John is of the opinion that “this media has a strong potential to create new possibilities for communication”, which needed to be tested with clinicians.

“The accessibility of the visual form is strength of this media that could be harnessed and this has certainly been demonstrated in the film.”35 John also admits the accuracy of the visual narration, involving metaphors that will be useful in the further therapeutic process.

35 Ann-Marie John, Msc Family Therapy, North Lodon, UK, Feedback 09/09/08, Appendices p. 52

FINAL DESIGN / TESTING

â&#x20AC;&#x153;The

36 Ann-Marie John, Msc Family Therapy, North Lodon, UK, Feedback 09/09/08, Appendices p. 52

strength of the film is that it remained in the metaphor so you could have a whole discussion about the animals using puppets of the characters without talking about anyoneâ&#x20AC;&#x2122;s individual experience. I think this might be useful for a group of families. This is similar to the convention of the arts therapies, that the deer character could be used to express feelings of grief and loss making it safer for the child and family.â&#x20AC;?36

In our conversation in August 2009 it has been determined, that this concept might work with concerned clients,depending on the therapeutic assessment. Even though this project seems to be successful for the original research question, it needs to be tested with the audience and empirical knowledge needs to be gained in a prospective development. There are still points of criticism and discussion, i.e. whether or not a narrator is needed, or which type of background music would be appropriate for children, but these points are subject to evaluate and test in consideration of each original story and the therapeutic process. 6.1 FUTURE DIRECTIONS In order to give a definite answer, whether or not terminally ill children might respond to therapeutic movies, and whether or not it might be helpful to enhance communication between them and their parents, it would be helpful to conduct further research, including individual interviews with children or children in focus groups. These methods would be of use to understand which meanings children derive from therapeutic movies and which consequences they draw from these. Furthermore research that determines the effectiveness of such animations in application for therapy. According to the outcome of the testing and the criticism, the Design would be improved in order to meet all the requirements for a therapeutic animation. Even though in some cultures death is still a taboo subject, I am very pleased about the general approval that my project has gained with professionals while developing. The interest in it increased and it will hopefully be matter of discussion in the future.

APPENDICES

APPENDICES Research Ethics Approval Form

P. 42

Testing Questionnaire // Experiment two

P. 43

Original Tales The Woodcutter and Death

P. 46

Moon and Hare

P. 47

Coyote in the Land of the Dead

P. 48

The Parable of the Mustard Seed

P. 51

Testing // Evaluation by Ann-Marie John

P. 52

APPENDICES

University / School of Arts and Education Middlesex

Research Ethics Approval Form Name Sophia Talina Wenzel Supervisor/Module Leader Carlos Sapochnik Title of project

Award registered for MA Graphic Design Module (if applicable) DES 4102

An Investigation of communication between parents and their terminally ill child

Brief description of and rationale for your study I will be looking for a communication strategy that will assist parents of a 2-6 year old child, suffering from leukaemia, to correspond with their child and help all three to cope with the childâ&#x20AC;&#x2122;s impending death.

Does your study involve the participation of other people? Please describe them briefly (e.g. age, gender, ethnic group, language/educational/religious background, etc.) and the nature of their participation. People involved into the study will be professionals in this field (Medicines, nurses, counsellors, psychotherapists, psychologists) and voluntary parents.

Have you secured their voluntary written consent to participate in the project (in the case of children under 16, that of a parent, guardian or carer)? Not yet

Ethical issues and actions you propose to take to address them Every voluntary participant involved into the study will be adequately informed about the context and aims and about his rights e.g. to withdraw at any time. I will protect personal data and make sure that details are secure. I will take care that the good proportion of benefits and potential risks will be maintained. Every step I do in my study will be well considered to sensitively handle all participants in cooperation with professionals and my supervisor.

What are the potential risks and potential benefits of your study? Benefits include a better understanding of parents and children to establish a better communication and therefore a better atmosphere and an improvement of end-of-life-care. Potential risks may be emotional distress of participants, but I will avoid it with help of professionals such as counsellors.

If relevant, have you consulted relevant bodies (e.g., Royal College of Physicians)? I have consulted hospices, hospitals and the Elisabeth-Kuebler-Ross-Foundation (London)

How will you ensure that anonymity, confidentiality and privacy are maintained? Volunteers should be free to participate, withdraw or publish their details during the study. If they are published, I will keep them secure and not accessible to anyone not involved into the study directly.

Are there any potential risks to the participants? How will these be minimized? A potential risk is emotional distress, which I will avoid with help of professionals, such as counsellors. I wonâ&#x20AC;&#x2122;t work with bereaved voluntary parents until my concept is not fully developed and approved by supervisor and professionals.

Does you research involve animals? No, animals wonâ&#x20AC;&#x2122;t be involved.

Signed by Researcher Sophia Talina Wenzel

Date 06.11.08

Supervisor (if applicable)

Date

Research Ethics Advisor Dean of School Associate Dean: Research (Delete as applicable)

Date

Approved

Approved subject

Referred to University

Rejected

APPENDICES

QUESTIONNAIRE PART A- GENERAL INFORMATION

Name (optional):

Country:

a. For how long have you been working in the field of Therapy? (Please

strike inappropriate)

Less than 1 year

1 to 5 years

5-10 years

More than 10 years

b. Have you worked with terminally ill children? (Please strike inappropriate) Yes

QUESTIONNAIRE PART B – THE PROJECT 1. THE PROPOSAL a. Do you agree with the existence of the lack of communication between parents and their terminally ill child? (Please strike inappropriate) Yes

b. Would you recommend Play Therapy as a tool to solve this problem? If yes, why? Which technique would you prefer? (Please outline briefly) c. Which differences do you see between working with physically healthy and ill children? (Please outline briefly)

2. THE ENVIRONMENT a. The wooden cube - Which thoughts do you have concerning the “environment within an environment”? (Please outline briefly) b. Do you have any concerns about comfort, mental health, health and safety within the cube? (Please outline briefly)

APPENDICES

3. INTERACTION Magnetic Storytelling- Giving a child the possibility to create his or her own scene a. If the child is asked to choose symbols on a gut level, does this reveal his or her emotional condition? (Please strike inappropriate) Yes

b. Why or why not? (Please outline briefly) c. Which kind of information can be obtained? (Please outline briefly) d. If the magnetic symbols were connected with a childâ&#x20AC;&#x2122;s drawings, would this combination enhance the assessment? (Please strike inappropriate) Yes

Not necessarily

e. If yes, which additional information can be obtained? (Please outline briefly) f. Is it necessary to provide an incentive for the child, in order to gather specific information- in this case the emotions towards a terminal illness? (Please strike inappropriate)

Yes

g. If yes, what do you think is appropriate? (Feel free to tick more than one, strike

inappropriate)

A Childrenâ&#x20AC;&#x2122;s Story

Book

Animation/Film

Character/Puppet

Music

Performance

Other (please specify) 4. SYMBOLS a. Do the symbols for pictorial storytelling need to follow a system or specifications? (Please strike inappropriate)

Yes

b. If yes, what are those specifications? (Please outline briefly)

APPENDICES

c. Which of the following will give information? Is it rather… (Please strike inappropriate)

Shape of a symbol

Colour of a symbol

Arrangement of symbols

other……….(please specify)

d. Is there a difference between, e.g. the symbol of a black or a white rabbit? Which difference would it make for the assessment? (Please outline briefly) e. Can you think of shapes, colours or symbols that occurred to you in a therapeutic context? (Please outline briefly) f. Can we find adaptable symbols in children’s drawing? Which are common?(Please outline briefly) 6. COMMENTS Do you have any comments, amendments, thoughts or worries? Please let me know!

Thanks for your cooperation.

APPENDICES

The Woodcutter and Death Retold by A. Gersie Once there lived an old woodcutter. He was very poor and could scarcely make ends meet. One day he went into the forest and gathered a lot more wood than usual. As he bent down to lift the bundle onto his shoulders he found that he was too frail to raise the heavy weight. He sighed deeply and cursing his age, said: “If only I were dead.” Suddenly someone stood next to him. A strange voice asked: “Did you call me?” The woodcutter felt a great fear. “No, no I didn’t”, he lied. Ignoring the old man’s clumsy deception Death made himself known. He explained that he had simply come, because he had been called. The woodcutter became less frightened and looked at Death. He found it very hard to believe that this was really Death himself. Seeing his doubt, Death pointed at an old woman who bathed in a nearby pond. The woman suddenly fell and died. This immediately brought the woodcutter to his senses. He at once remembered why he had wanted to die, and asked Death, now that he was here, if he could please give him a hand and lift the bundle of wood onto his shoulders. Death gladly obliged. The woodcutter was ready to hurry home, when the thought came to him that he might ask how much longer he had to live. As he left, Death answered: “Five years to a day.” That night the woodcutter did not sleep very well. Tumultuous thoughts haunted him. Early the next morning he returned to the forest. He looked for a big, big tree. And when he found it, he cut a single hole in the bottom of the tree. Then he started carving out the inside of the trunk. He carved for five whole years. Then Death returned. Just as he said he would. The old woodcutter promised to come along, but, he said, before he was ready to leave the world, he so much wanted Death to see what he had carved as a gift for the people who would live long after he had died. They went to the woods. Deep into the woods they went. Death climbed into the tree-trunk. Proudly the woodcutter showed him round. When Death was in the top of the tree-trunk house, the woodcutter hastened down, crept outside, jammed a log into the entrance hole and hurried home. Time passed. People and animals gave birth, but Death came to no one. Hunger and illness resided everywhere, yet nobody died. Even the gods became alarmed. They approached the Lord Shiva, the great one, who, donning the garb of a human being, decided to come to earth. He went immediately to the old woodcutter and asked him if he still wanted to go on living.

37 Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 71

The poor woodcutter was by now even older and weaker, and so ill that he could hardly leave his resting- place, let alone return to the forest where Death was locked inside the tree- house. Quietly the old woodcutter acknowledge that, at last, he was ready to die. Then the Lord Shiva helped the old man to get up. Slowly they walked to the forest. They went deep into the woods. Then he opened the tree and released Death. Death was shaken by his ordeal in the tree. He pleaded with the Lord Shiva to make him from now on invisible, so that people could no longer devise ways to stave him off. “So be it”, Lord Shiva said. From that day onwards Death has been invisible to humankind, though he sees all of us. And the woodcutter, he died.37

APPENDICES

Moon and Hare Retold by A. Gersie It happened in the days of the early race. Moon had noticed how frightened the people were of dying. Moon therefore called the animal who could run faster than any other animal. This was Hare. Moon told Hare to run to earth and to tell the terrified people that they need not be afraid of death and dying. Whenever they felt frightened of death they had to look at Moon. They then would know that, like Moon, they too would in dying be renewed again. Before he had grasped what he had to tell the early people, Hare was on his way. When he came to the early people’s dwelling place, he said, ‘ When you look at Moon you see that in dying Moon is made anew. But when you die, you will not be made anew.’ The early people continued to be terrified of dying and it was not long before Moon discovered that Hare had given the wrong message. Moon was very angry and hit hare on the lip. To this day, Hare has a split lip, but that was not the only punishment Hare received. Since that time Hare has not been given a home of his own. He has to sleep in the open, where the wind blows and the sun shines.38

38 Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 56

APPENDICES

Coyote in the land of the dead Retold by A. Gersie When the world was still very young, Coyote visited the Eagle’s lodge. He had known the Eagle-people since the beginning of time, and had not seen them for a while. He was therefore upset when he saw that Eagle’s fire had been left untended, and that the entire lodge was badly neglected. Eagle-man barely returned Coyote’s greeting, and whispered that he had to tell him bad news. Eagle-woman had died. And life without her was too difficult. Coyote had heard such words before from other grieving people. They hurt him sorely. And because Coyote was Coyote he decided, there and then, that the way of things had to be altered. He reminded himself of the new leaves and flowers of springtime and could not see why it should not be like this for people too. Therefore he suggested to Eagleman that they would travel to the land of the dead to bring back the people,so that they too might be renewed. Thus Coyote and Eagle-man set out on their journey. They travelled a long, long time. At last they came to a grey, sombre land, were the sun was rarely seen. When darkness was about to fall they reached the wide river which flows between the land of the living and the land of the dead. On the far-distant shore they saw a village, much like other villages. Coyote and Eagle-man lifted their voices, calling into the darkening night that someone might send a boat to fetch them. Nothing stirred and no one came. Then Coyote thought. His thought travelled deep inside himself, and he lifted to his throat an ancient song, unknown to him, and as he sang this song of power, a canoe set forth from the faraway shore, and made its way towards them. Four men held the oars and four sorrow wisened faces greeted them with a friendly, silent smile. No questions were asked, no words spoken. When they arrives in the village of the dead Coyote and Eagle-man were greeted by a strong tall woman. Her face shone with the same wisened smile they had seen on the face of the oarsmen. Assuring her that they were offered in a small lodge, tightly woven of tule and other rushes. A heap of antelope hides and a warm fire was all they found inside their dwelling. Soon Eagle-man became hungry, wondering whether he should go outside and look for food. But, as they looked around for the doorway, they saw that the lodge had become completely closed off. They searched for an opening, a possible way out, but found none. They tried to scratch a hole in the walls, but each time they made a hole, it closed over. The walls which imprisoned them were strong and smooth and nothing could make them break. Eagle-man was fear-struck. Would they be left to dwell here and starve to death? Coyote thought a moment, a brief eternal moment. Then he knew. He said: ‘ only what belongs to the land of the dead will create an opening in the lodge of the Dead.’ No sooner had he thought these thoughts than the lodge opened and a person came in to bring them food. When he left the lodge again, it closed over as before.

APPENDICES

Coyote and Eagle-man ate the food of yonder world, for they ere very hungry. Coyote took all care to eat both the meat and the bones. But when he was chewing the last bone, he kept a little bit in his mouth. Everything else he swallowed. Eagle-manâ&#x20AC;&#x2122;s longing for his wife hurt greatly and when the person came to take away their empty bowl, he asked when he might see her. A wise smile was all he saw. Again the doorway disappeared, and the walls of the lodge were smoother and more solid than ever. Eagle-man knew that the dead would keep them here until they died. He would never be able to see his wife. His hurt was great indeed. Then Coyote took the bone-splitter out of his mouth and started to scratch the wall. This time it did not smooth over. The hole was made bigger and bigger, until it was so large that they could see through it. In the early moonlight they saw how the dead gathered in a circle to sway and move most gently and beautifully in a mysterious dance. They were dressed in rich ceremonial robes. Some carried musical instruments. The decorations with shells and feathers were splendid as any they had seen in the land of the living. Coyote saw many of the people he knew in that moonlight gathering and also lovely Eagle-woman. When Eagleman saw her, he gasped and wanted to run towards her. But Coyote held him tightly, and helped him silence his cry. Eagle-man watched how Coyote wont over to the antelope hides. He took them one by one, and laid them out for sewing. Then he made the bone-splinter which he had first used to make a hole in the wall of the lodge, into a needle. Using his own hair, Coyote began to stitch the hides together. One after the other. Until he had made a very big hide-bag. Meanwhile the dead danced their ceremonial dance. Coyote looked upon them in awed silence. Then, as if from nowhere, he started to sing a song of his own. It was like the Canoe-song, because it too came from the place of old-knowing deep within him. It seemed as if the whole world shrunk. The dead stood still, held by the embracing song, while all around them darkness dwelled. Now Coyote and Eagle-man moved towards their still circle, dragging the hidebag behind them. And one by one, light as feathers, they took the dead people into the cup of their hands. Each one found a place inside the bag. When all the people of the land of the dead had thus been gathered Coyote and Eagle-man made their way towards the canoe. Suddenly Coyote was in a hurry. His ancient knowing told him the he had to reach the shore of the land of the living before sunrise. Thus Coyote and Eagleman took their place in the canoe, the hide-bag between them, and began the journey across the wide river which flows between the land of the living and the land of the dead. Fear struck as a faint light shimmered on the horizon. Slight groans and shud-

APPENDICES

ders could be heard inside the hide-bag. Eagle-man trembled. Coyote told him once more to paddle as fast as he could. When the light grew stronger, the dead people would awaken, and there wasn’t enough room in the bag for all of them. Their pain would be agony and besides they would be too heavy for the canoe, which would then capsize. They hastened across the river. But soon it happened. The people inside the bag twisted and turned and screamed in blind pain. The canoe capsized, and the hide-bag and Coyote and Eagle-man, they fell into the river. But still Coyote did not give up. Fast as he could, he swam towards the bag. Dragging it with the last of his strength and holding it tightly, he brought his sorrowful load to shore. Then he opened the hide-bag, smiling gladly as the dead people who returned to life, stood before him on the shores of the land of the living which shone n the early morning light. Then Coyote spoke. He told them that he and Eagle-man had brought the people back to the land of the living, so that there would be no more death. All living beings would now come back to life, like the trees and flowers return. Eagle-man and Eagle-woman could go back to their village. They need mourn no more. Coyote looked around. His gaze was greeted with the same sorrow-wisened smile he had seen before. Then the old woman, who had greeted him and Eagle-man on the shore of the village of the dead, stepped forward. She spoke thus: “ It is good to be remembered Coyote and we know that you meant well. But we do not long to return and live amongst you again. Our time here in the land of the Living came and went. Now another time has come and it is good. We find much knowledge and wonder in the land of the dead. We wish to return to it. “ She looked away and turned to the canoe which was lying on the shore, silent witness to the journey. All of her people followed her. The last to go was Eaglewoman. As she was about to step into the canoe, she looked at Eagle-man and spoke: “ Do not grieve for me. We are not like the leaves on the tree, but like its heart. When it dies, the tree dies and it returns to the still heart-beat of the earth. One day you too shall cross this river, and we shall both be there, dancing the endless dance of the dead. Do not grieve for me.” They stood, silent Coyote and silent Eagle-man, as they watched the canoe glide towards the land of the dead. Then they turned and made their way back to the land of the living. 39

39 Gersie, A., Storymaking In Bereavement, London: Jessica Kingsley Publishers, 1991, p. 104

APPENDICES

The Parable of the Mustard Seed Kisagotami is the name of a young girl, whose marriage with the only son of a wealthy man was brought about in true fairy-tale fashion. She had one child, but when the beautiful boy could run alone, it died. The young girl, in her love for it, carried the dead child clasped to her bosom, and went from house to house of her pitying friends asking them to give her medicine for it. But a Buddhist mendicant, thinking “She does not understand,” said to her, “My good girl, I myself have no such medicine as you ask for, but I think I know of one who has.” “O tell me who that is,” said Kisagotami., “The Buddha can give you medicine. Go to him,” was the answer. She went to Gautama, and doing homage to him said, “Lord and master, do you know any medicine that will be good for my child?” “Yes, I know of some,” said the teacher. Now it was the custom for patients or their friends to provide the herbs which the doctors required, so she asked what herbs he would want. “I want some mustard seed,” he said; and when the poor girl eagerly promised to bring some of so common a drug, he added, “You must get it from some house where no son, or husband, or parent, or slave has died.” “Very good,” she said, and went to ask for it, still carrying her dead child with her. The people said, “Here is mustard seed, take it.” But when she asked, “In my friend’s house has any son died, or husband, or a parent or slave?” they answered, “Lady, what is this that you say? The living are few, but the dead are many.” Then she went to other houses, but one said, “I have lost a son”; another, “We have lost our parents”; another, “I have lost my slave.” At last, not being able to find a single house where no one had died, her mind began to clear, and summoning up resolution, she left the dead body of her child in a forest, and returning to the Buddha paid him homage. He said to her, “Have you the mustard seed?” “My lord,” she replied, “I have not. The people tell me that the living are few, but the dead are many.” Then he talked to her on that essential part of his system -- the impermanence of all things, till her doubts were cleared away, and, accepting her lot, she became a disciple and entered the first path. 40

40 www.pitt.edu/~dash/ mourn.html [ accessed 12.3.2009]

APPENDICES

Evaluation by Ann-Marie John, 9.8.2009

â&#x20AC;&#x153;PRESENTATION This is a beautiful animation full of metaphor and images I particularly liked the falling snow and the image of the tree as a shelter for the deer. The background images again were beautifully drawn and I liked the way they helped visually tell the story. A forest can be a metaphor for many things a safe/ dangerous place/ I liked the way there was a community of helpers .The animals were very child friendly. The narrator could have introduced the characters at the beginning this convention can also help the story to be psychologically safe for children. THE FILM AS A STIMULUS FOR DISCUSSION The strength of the film is that it remained in the metaphor so you could have a whole discussion about the animals using puppets of the characters without talking about anyoneâ&#x20AC;&#x2122;s individual experience. I think this might be useful for a group of families. This is similar to the convention of the arts therapies, that the deer character could be used to express feelings of grief and loss making it safer for the child and family. SPECIFIC REFERENCE TO GRIEF AND LOSS PROCESSES I was very moved by the deer asking the doe to get up as I think this expressed some of the searching that often goes on in relation to loss that is part of the grief process. I also liked the idea of asking the elders and the community this for me could help raise discussion about isolation and taboo as community is so important in these times. I also think it may have been helpful to comment on what happened to the body we know that seeing the body can help with saying goodbye and rituals around burial are very important and may have helped the deer. There is no doubt that this is also cultural in that death talk is often taboo and the researcher has shown great tenacity in even attempting to engage with the subject matter.

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SUMMARY AND IMPLICATIONS FOR USE OF THERAPEUTIC PURPOSES I think that the film would be best used in the first instance to work with professionals or in schools to stimulate discussion. I do think this media has a strong potential to create new possibilities for communication. This would best achieved by collaboration between artists and clinicians where families could be involved in making films to help other families. Be With regard to the original research question as to whether the film provides a possible solution for communication among families where a child has a terminal illness I would at this stage be cautious in my response and say that it provides the possibility for different ways of communication. The accessibility of the visual form is strength of this media that could be harnessed and this has certainly been demonstrated in the film. It might be possible to produce a book or games or puppets and create a whole

â&#x20AC;?

package of materials.

Ann-Marie John

09/08/09

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REFERENCES

REFERENCES STAGE 1 BOOKS Armstrong-Dailey, A., Zarbrock, S., Hospice Care For children, Oxford University Press: 2001 Bertoia, J., Drawings of a dying Child, Routledge: 1993 Bluebond-Langner, M., The Private Worlds of Dying Children, Princeton University Press, 1980 Faber, A., Mazlish, E., How To Talk So Kids Will Listen And Listen So Kids Will Talk, Collins Living; 20 edition: 1999 Klanten, R., Ehmann, S., Huebner, M., Tactile, Berlin: Die Gestalten Verlag, 2007 Kuebler-Ross, E., On Children and Death, Scribner: 1997 Kuebler-Ross, E., On Death and Dying, Scribner: 1997 Kuebler-Ross, E., Kessler, D., On Grief and Grieving, Scribner: 2007 Pincus, L., Death and the Family, Faber and Faber Ltd.: London, 1976 Rando, T., Grief, Dying and Death: Clinical Interventions for Caregivers, Champaign, IL: Research Press (1984) Robben, A., Death, Mourning, and Burial, Blackwell Publishing Ltd.: 2004 Rosen, M., The Sad Book, Candlewick: 2008

REFERENCES

ARTICLES Anderson, John E., Psychological aspects of child audiences, Educational Theatre Journal, 2:4, p. 285 Chesley, G.L., Gillett, D.A., Wagner, W.G., Verbal and Nonverbal Metaphor with Children in Counselling, Journal of Counselling & Development, Vol 86, Autumn 2008 Casson, J., The Communicube: further clinical developments of a new therapeutic method, Dramatherapy, Vol 27 No.3, Autumn 2005 Kreicbergs, U., Valdimarsdottir, U., Oneloev, E., Talking about death with Children Who Have Severe Malignant Disease, The New England Journal of Medicine, VOL.351 No. 12, September 16, 2004 INTERNET RESOURCES Middlesex University Learning Resources website, www.lr.mdx.ac.uk Other E-Journal Databases Peter Lance / http://www.peterlance.com.au/selfdefense.html [accessed: 12.10.2008] Childrenâ&#x20AC;&#x2122;s Hospices UK / http://www.childhospice.org.uk [accessed: 07.10.2008] Stages of Intellectual development in children and teenagers / www.childdevelopmentinfo.com/development/piaget.shtml [accessed: 14.11.2008] RESPONDENTS Dr. Mark Coulson, Middlesex University, m.coulson@mdx.ac.uk Prof. Dr. Michael Albani, Wiesbaden, Germany, Paediatrician, HSK- Kliniken Susanne Wenzel, Psychotherapy, su.wenzel@gmx.de

REFERENCES

STAGE 2 BOOKS Bellatoni, P., if it’s purple, someone’s gonna die, Burlington: Focal Press, 2005 Bertoia, J., Drawings of a dying Child, Routledge: 1993 Cattanach, A., Children’s Stories in Play Therapy, London: Jessica Kingsley, 1997 Gersie, A. Storymaking in Bereavement, London: Jessica Kingsley, 1991 Gersie, A., King, N., Storymaking in Education and Therapy, London: Jessica Kingsley, 1990 Jones, M., Interiors For Under 5s, Chichester: John Wiley & Sons Ltd., 2005 Klanten, R., Ehmann, S., Huebner, M., Tactile, Berlin: Die Gestalten Verlag, 2007 Kuebler-Ross, E., On Children and Death, Scribner: 1997 Mahnke, F.H., Color, Environment & Human Response, USA: International Thomson Publishing Inc., 1996

McMahon, L., The Handbook of Play Therapy, New York: Routledge, 1992

REFERENCES

ARTICLES Dermer, S., Hutchings, J., Utilizing Movies in Family Therapy: Applications for Individuals, Couples, and Families, The American Journal of Family Therapy, No. 28, 2000, p. 163-180 Anderson, John E., Psychological aspects of child audiences, Educational Theatre Journal, 2:4, p. 285 INTERNET RESOURCES Movie Therapy: Using Movies for Mental Health www.medicinenet.com, [accessed: 23.04.09] http://www.counselingtoys.com [Accessed 5.2.2009] http://www.betsymillscounselling.com.au [Accessed 5.2.2009] The Parable of the Mustard Seed http://www.pitt.edu/~dash/mourn.html [ Accessed 12.3.2009] Play Therapy UK, www.Ptuk.org [Accessed 5.2.2009] Talking with Children about Feelings http://www.essortment.com/all/talkingchildren_paj.htm [Accessed 23.04.09] RESPONDENTS Susanne Wenzel, Psychotherapist, Wiesbaden, Germany Ann-Marie-John, Msc Family Therapy, North London, UK STAGE 3 BOOKS Gersie, A. Storymaking in Bereavement, London: Jessica Kingsley, 1991 Muybridge, E., Animals in Motion, New York: Dover Publications Inc., 1957