THE INVOLVMENT OF THERAPY AND GRAPHO-THERAPY ELEMENTS IN CHILDREN’S MEDICAL TREATMENT
ABSTRACT:
Aim: Th e present communication aims to bring into discussion the complexity of the child patients from the point of view of their age peculiarities, and the necessity of implementing psychotherapy elements (in our case, Grapho-Th erapy) accompanied by medical treatment specific to medical diagnosis.
Materials and methods: In this context, the presence and practice of Grapho-Th erapy in the treatment of the young patients, represents not only a sign of a complex therapy, but also the implementation of a new behavioural- professional attitude of the doctor and psychologist/ psychotherapist in solving a therapeutic problem. Grapho-Therapy applied in children helps to eliminate some negative aspects in their development and allows them to take full advantage of their potential, keeping also in sight the precision and accuracy of movements, which have a positive aspect in personality maturation especially during the developmental stages.
Results: Such a structural therapeutic formula is beneficial, Grapho-Th erapy being used in cases of: aff ective problems, communication difficulties, uncertainty and diff erent forms of anxiety, eradicating in time attitudinal- behavioural defi ciencies that occurred at a certain point in a particular child’s development.
Conclusions: Implementing and involving the elements of Grapho-Therapy in child’s medical treatment represents, in this context, the result of team work (consulting physician- psychotherapist) being, at the same time, an effi cient modality for the psycho-medical rehabilitation of the patient, emphasizing thus the complexity of the therapeutic act in all its aspects.
It is known that one can interfere therapeutically not only upon adults but also upon children and, for the success of the therapy, it is important that the physician and the psychologist should work in close contact. In our case, the graphologist is added to the therapeutic team in order to give support in recovering some defi ciencies of certain basic abilities. It is important to act upon the origins of the problems, eliminating causes and re-educating the personality.
Working together with the therapist, the graphologist may, give them advice while discovering the potential of the individual being treated or the opportunity of a treatment. As H. Ploog said, “the graphologist may off er some advice before starting a treatment, may suggest some ways of intervention,and indicate the possibilities of their success.” We have to be aware of the fact that therapy success or failure may depend on early discovery of the defi ciency and handwriting -analysis may determine the existence of sickness or suff ering sensation, indicating some inadequate behavioural schemes, or being able to diagnose a distorted view upon reality. In case of recovery, that is, of therapeutic success, writing becomes larger and warmer; the difficulties in sketching letters and the rigidity of shapes disappear, and the dynamics of pulsations comes back to normal.
From the multitude of definitions, opinions and arguments concerning Grapho-Therapy we chose the one formulated by A.M.Cobbert (1961) who underlines the fact that this kind of therapy hasbetter results in the developmental stage (in children) making also an analysis of parents’ writing. Applied in children, Grapho-Th erapy helps to eliminate some negative aspects in their personality and allows them to make use of their potential. In the same context, Grapho-Th erapy solves child psychological problems, in direct or indirect relation with writing, without being self-healing for other therapeutic situations.
In case of applying Grapho-Th erapy, it is necessary to know its specifi c techniques which are identifi ed by R. Olivaux (1957) as follows:
— the first exercises are aimed at developing self-control and speed control;
— the next exercises use a series of forms that actually help the shaping of writing (at fi rst curved lines, garlands, eight fi gure shaped garlands, little lines and circles, so that, in time, the patient should come to write letters);
— the patient needs to practice writing a few minimum lines on a daily basis.
We have to remember the fact that we have to intervene in order to maintain child’s balance, channelling all positive aspects of his personality and helping him to get over difficulties.
As R. Olivaux (1957) mentioned, the therapeutic action of the graphologist consists in:
a) – deconditioning;
b) – relaxation (going back to simplicity, to the initial gestures of a child learning to write);
c) – discipline (the exercises have to be done on a daily basis, at same hour for 10 minutes, being looked upon as a relaxation moment);
d) – attention and focusing, but without tension;
e) – re-conditioning (bringing in new, well-structured elements, which allow the reconstruction of writing on new basis).
It is interesting to mention M.E.Echevarria’s vision, who recommends children to write a page every morning and another one every afternoon, with the possibility to do so at same hours daily, every time putting the date and their signature on the respective pages. Such actions induce discipline, and, with the progress in writing, the children will be able to write stimulus sentences, too. Grapho-Therapy may be involved in, and it is useful in treating not only children with behaviour problems but also ones with cognitive problems. Also very important is R. Resten’s remark (1949) who gives credit to the grapho – therapist in certain pathological cases, counting the interventions as follows:
Applied attentively and skilfully, Grapho-Therapy helps the children feel they are in the centre of attention while working calmly and relaxed, acting positively on the entire writing task they have been assigned to do.
| Identified characteristics in writing | Necessary corrections |
| Speed = quick, slow or nervous writing | Average speed =150 letters per minute |
| Pressure = strong, weak, irregular | Strong and regular pressure. |
| Dimension = very big, expanded or small, disproportionate, lower area too big or too small, lines too short or too long, unequal |
Letters of medium dimension and well shaped, capital letters surpassing by 2.5 the size of the small ones |
| Continuity = too tight, separated, unstable, too monotonous, jerked, unfi nished |
Grouped, constant rhythm, balance between connections and interruptions |
| Slantness= progressive, regressive, alternating between both | Medium 45° slant to the horizontal |
| Form = artifi cial, complicated, too pointy, too round, garland | Simple and clear |
| Line at „t” = varying, absent, to the left, to the right, above, straight |
Regular, short, visible |
| „o”, „e”, „ă”= too opened, too closed, open at the bottom, ring shaped |
Closed, or only a little opened |
| Left margin = unequal, it gets bigger or smaller progressively | Equal and regular |
| Diacritical marks = uncertain signs, before or after the letter, too up or too low |
Precise, at a reasonable height and quite above the letter |
| Affliction manifestations = tension, interruptions, tremble, missing letters |
Correction; in case of tremble correction is not possible |
From an educational point of view: self-discipline, punctuality and the constant character of the action have benefi cial eff ects upon the child. In addition, the precision and confi dence of moves have a positive eff ect on the process of personality development, especially in its early stages.
In conclusion, we point out that grapho – therapy is widely used, with valuable therapeutic results, in cases of:
— affective problems,
— focusing problems,
— uncertainty,
— different forms of anxiety,
— taking into consideration the privileged relationship with the therapist and the integration into a group, all having useful eff ects.
In this context, a team made up of at least a psychiatrist, psychologist/ psychotherapist, may intervene in aff ections mentioned above in such a way that the client may get the whole specialized support given by those who are certifi ed.
Even if now, grapho – therapy starts its way to the psycho – therapeutic structure, it is important for both the doctor and the psychologist to be opened to new solutions and to accept change for the patient’s benefit. They might look upon the complexity of the applied therapy, starting, why not, just from… the writing ability.
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