Recreational therapy makes a difference for OSH patients

Statesman Journal, July 19, 2014

Guy Forson (standing) works with Nick Stalheim

Guy Forson (standing) works with Nick Stalheim

“Down, down, sideways.”

Guy Forson repeats the words over and over in a way that is almost soothing. Nick Stalheim uses a scalpel to follow Forson’s directions, cutting squares out of a flat piece of clay that he intends to make into a castle for his eventual fish tank.

Stalheim’s face is scrunched into concentration, his blond mohawk bowed over the clay. Making these simple cuts isn’t easy for him, but he is utterly focused.

This is the goal of the recreational therapy classes Forson teaches at the Oregon State Hospital. Pottery, leather working, yoga: They are not as much about the skills themselves as about teaching patients behavioral skills most of them don’t have.

Forson, 57, has taught at the hospital since 1988. He has worked with patients ranging from children to the most violent criminals, from people just entering the hospital to those about to leave.

He has great faith in recreational therapy.

Every patient has a treatment plan that describes their mental illness diagnosis, what skills they need to work on and how they might go about treating their conditions.

Many take medication and attend traditional therapy. However, recreational therapy allows a place for them to apply their treatment plans in a realistic setting, Forson said.

For example, pottery can help a patient who can’t cope with frustration. Clay can be molded and re-molded again, over and over, flattening over mistakes and smoothing out imperfect edges.

“It’s just dirt,” Forson said. Little failures and frustrations don’t loom so large when one is working with clay.

Some recreational therapy can be very simple, he said. Often when working with new patients who have yet to make real progress in dealing with their mental illnesses, he takes them for walks outdoors.

It can be a triumph for someone with severe anxiety to leave the building, he said. Sometimes recreational therapy is about small steps.

The first time I toured the state hospital, I was skeptical. People who committed terrible crimes were making pots, painting pictures, learning to play the guitar and tossing basketballs around. It seemed, in some way, like a lack of justice. At the very least, it seemed like they should be in therapy.

Sitting in Forson’s class, I came to realize this is therapy.

He offered to let me participate, but at first I declined. I’m not artistic, and I felt shy about showing that off. But when I said, “I can’t,” Stalheim, Matthew Rhorer and Benjamin Purdy all let out an “Ooohhh…”

That’s not something you say in Forson’s class.

I tied an apron over my work clothes, which suddenly felt mildly ridiculous next to Forson’s washable purple plaid shirt and blue jeans, and his mental health aide, Evelyn Thompson, handed me a ball of clay.

I felt about as comfortable as a 19-year-old man holding a newborn baby.

Recreational therapy was never Forson’s plan in life, although in hindsight it seems like it could have been.

He grew up in Las Vegas, one of three children and the only boy. His father was the director of the parks and recreation department for Clark County, and his mother was a homemaker.

He played countless sports, from soccer to skiing to fencing to diving. Forson even became a professional trampolinist and toured around the Pacific Northwest doing shows. He also helped his younger sister, who was developmentally delayed, train for the Special Olympics.

“She’s a great bowler,” he said.

That experience led him eventually to recreational therapy. However, he started out at Brigham Young University with a major in psychology, and he was studying “biofeedback.” It’s an area of study that involves hooking people up to a machine, much like the ones used in a polygraph test, and using the data from the machine to teach people to relax.

They can even learn to slow their own heart rates, Forson said. It can be helpful for people with test anxiety or gastrointestinal problems, for example.

A bachelor’s degree won’t get you very far in the field of psychology, he said, so when he heard about BYU’s master’s program in recreational therapy, it seemed like a great choice.

He had seen how sports had helped his sister flourish, and both sports and creative activities, such as leather working, had helped him cope with his own birth defect: no fingers on his left hand.

“I always feel sorry for people with fingers on their left hand. How do you tie your shoes?” He chuckles at his own joke.

Recreational therapy allowed him to do all the activities he loved, he said, and help people at the same time. The perfect fit.

“All the skills of life can be taught through recreational therapy, and that’s why I love it so much,” he said.

At first I made the sides of my bowl too thin. I pulled the clay up far too quickly and aggressively, stretching it too much, too fast. Thompson watched me and eventually helped me fix it. She also helped me slow down, showing me how to keep my fingers wet and gradually smooth out the bowl.

I had had a bad morning that day. I’d run late and been trapped behind a minivan doing 10 mph under the speed limit, which is a pet peeve of mine. I was tense and stressed out, although I would have said I was fine.

The clay knew I was not. All of my nervous energy came out through my fingers. As I followed Thompson’s instructions and slowed down, so did my heart rate and my thoughts. My mind calmed down, and my bowl looked a lot better.

I chatted with Thompson and with the patients. Stalheim told me how the seated clay man he created was inspired by Kronos, father of Zeus in Greek mythology. Purdy told me how he loves music therapy, having been a musician before, and how pottery has forced him to use an entirely different set of skills. Rhorer told me some about his recent breakup and two friends who helped him through it.

Everyone was calm, focused on what our hands were doing, and conversation flowed easily. I imagined what it would mean to be someone suffering from debilitating anxiety or schizophrenia to achieve that sense of mental peace, and what Forson said about recreational therapy started to make sense.

The class projects Forson’s patients take on run the gamut.

There is Stalheim’s miniature castle for a fish tank, which is essentially one round turret.

There are Rhorer’s intricate, detailed projects, from a Spongebob Squarepants (complete with eyelashes and fingers and toes), to a jewelry box that is really a set of interlocking boxes with tiny chambers for earrings and necklaces. He is the quietest of the three patients in the class, with long hair and a skull ring, easily imagined as the shy high school junior who plays Dungeons and Dragons over the weekend.

Inside that quiet exterior, however, is a creative mind come alive under Forson.

Thompson has worked with Forson for years, ever since he started in the children’s unit. He is patient and helpful, she said, but willing to let people try something new and make mistakes on their own.

Creativity is part of a healthy life, he said, and that is true for everyone. It allows self expression and focus, yes, but it also allows patients an opportunity to connect to the world, he said. People stay in the hospital for years, and they don’t hold jobs, manage families or join community activities while they’re there. That sense of isolation can work against therapy, Forson said, because it creates anxiety about how they fit into society at large.

“The most scary thing in the world is not knowing,” he said.

He teaches patients activities that can help them connect to the world when they leave, from pottery to yoga to hiking. Those activities can help them bond with others and find a healthy way to spend their time, he said.

Recreational therapy also provides patients a metaphor for their mental health treatment, he said. The act of creating something out of nothing but dirt and water takes time, takes small failures and setbacks, takes patience and making connections, Forson said. All of that can be a metaphor for the path toward recovery from a severe mental illness, and it often helps patients understand that path and why they can’t recover immediately.

While his job requires Forson to approach creativity and recreation as therapy, he said those leisure activities are crucial for all humans.

“We know we feel better when we take time for recreation, for recreating ourselves again,” he said.