The Creation Spiral

Annette Beerens and Marinus Knoope

I would like to share with you the underlying philosophy of my work as a horticultural therapist.

I work with all kinds of people who suffer from ‘knots’ in their lives. Burnout, depression or midlife crisis. All the issues these people encounter have to do with the core question ‘What is my role in this Life?’. 

I work with the Creation Spiral, this method was introduced by my friend, Marinus Knoope. He is physicist who discovered the natural way from wish to reality. I hope this introduction to the Creation Spiral will offer you food for thought and inspiration. 

When a gardener has grown a thousand apple trees, he will probably say, “Don’t make a fuss. Apple trees simply produce apples.” But if you were the apple tree, what would you think? You got through a harsh winter and made it through spring after a couple of frosty nights. Summer was quite dry but at the beginning of autumn, you do have a few magnificent apples on your tree. You would be proud of your achievement.

Annette

Every living organism has its own part and its own meaning in the whole story. Every cell, every plant, every animal and every human being has its own destination. That destination manifests itself as an inner drive. By following this desire, every organism plays its part in the incomprehensible whole of Nature.

From a higher point of view, human beings are just organisms that fulfill their wishes. Of course things do go wrong every once in a while, but that is also the case with apple trees. Not every blossom turns into an apple, after all.

When conditions are favorable, an apple tree produces many apples. There is a natural way for an apple tree to bloom and produce apples, with a number of optimal conditions in each season. For human beings there also are certain ways to fulfill their wishes, with optimal conditions in each stadium.

If you were aware of the different cycles on the natural path from wish to reality, and if you were to know how to use visualization, positive thinking, conscious observation and mindfulness, it would be a lot easier to fulfill your dreams. At the end of the day, that is what we all want.

We all more or less know how the creation process works for an apple tree. In winter the tree is bare. The focus is on the roots. At the beginning of springtime it is ready to take a leap. It starts to bloom. A short while later the blossom falls out and leaves start to grow.  Halfway through spring and summer it has a full coat of leaves. Then the buds that remained start to grow, until the tree is full of fruit. At the beginning of autumn, the fruit falls from the tree. A few weeks later also the leaves start to fall.

The tree thinks to itself “I hope I won’t die”. Anxiously the tree pulls back into its roots. That is exactly what it is supposed to do. If it just stays still and prepares itself, it will bloom again at the beginning of the next springtime.

This is what we call a natural cycle. It is about an ongoing process from winter to spring, from summer to autumn and then to winter again. It goes on and on, until the tree dies and becomes compost…

Nature-based rehabilitation at the Alnarp Rehabilitation Garden

Anna María Pálsdóttir

The Alnarp Rehabilitation Garden, established in 2002, offers nature-based rehabilitation (NBR) for individuals with stress-related mental illnesses such as exhaustion disorder (ED) (ICD-10 F43.8).  ED occurs after many years of prolonged stress and the lack of sufficient recovery. The symptoms are severe tiredness and exhaustion, with low executive function and mental, physical and social impairments. The rehabilitation process has been described as vulnerable, and recovery can take months or even years. It is recognized that individuals with ED are in great need of rest and mental recovery, especially before they actively participate in a rehabilitation program. Therefore, to support rest and mental recovery, a specially designed garden, a select treatment team, and a specially designed activity program were developed at the Alnarp Rehabilitation Garden.

The garden and horticultural occupations were the base for the whole intervention. The two-hectare rehabilitation garden was designed according to theories on nature’s restorative effects and the theory of supportive environments and contains places for work, rest, and contemplation. It is divided into two major areas: the Nature Area (informal and non-cultivated) and the Cultivation and Gardening Area (formal and cultivated). It is further sub-divided into different smaller garden rooms, each with restorative properties that can enhance mental recovery.

The garden contains evergreen and deciduous trees and shrubs, as well as a vast variety of perennials and annuals; there is always something to look at or work with throughout the year. The color scheme is dominated by soft hues; strong hues are limited to certain areas in the garden where the clients can partake of them when they have developed the strength to handle strong colors. The size, height, form, texture, and fragrance of the plants vary in order to stimulate and awaken the senses, with an emphasis on seasonal variation. The connection to the seasons is important as nature has a rhythm of its own that cannot be sped up or forced as it switches between active and dormant phases. Many rehabilitation participants have lived stressful lives without regular rest. By working at the same pace as nature and the plants, the participants note the shift between the phases.

There are also specially designed garden rooms and greenhouses that facilitate meaningful horticultural and gardening occupations. Horticultural occupations capture the participants’ attention and help them be in the moment “right here, right now”, a somewhat diminished capacity for most participants. By working with their hands, they relax their focused attention. Their cognitive function rests and they switch from thinking to feeling – their hands in the earth, feeling and smelling it incorporates feeling in their bodies and their minds can rest, gaining mental recovery. The team works through the garden and the horticultural occupations to reach the rehabilitation goals. Nature is rich in opportunities for this purpose and it seems easy for everyone to find something to engage in as an active or passive (resting) occupation.

For further reading, please see:

Pálsdóttir, A. M., Grahn, P., & Persson, D. 2014. Changes in experienced value of everyday occupations after nature-based vocational rehabilitation. Scandinavian Journal of Occupational Therapy. Early Online, 1-11. DOI: 10.3109/11038128.2013.832794.

Pálsdóttir, A.M., Stigsdotter, U.K. and Grahn. P. 2011. Preferred qualities in a therapy garden that promote stress restoration. Conference proceedings, 27-29 June. Research into inclusive outdoor environments for all. Open Space/People Space, Edinburgh.

Grahn, P., Tenngart Ivarsson, C., Stigsdotter, U., & Bengtsson, I-L. (2010). Using affordances as a health promoting tool in a therapeutic garden. In C. Ward Thompson, P., Aspinall & S. Bell (Eds.), Innovative approaches to researching landscape and health. Open Space: People Space 2. New York: Routledge; pp 116–54.

Adevi, A., & Mårtensson, F. 2013. Stress rehabilitation through garden therapy: the garden as a place for recovery from stress. Urban Forestry and Urban Greening, 12; 230-237.

Horticultural Therapy & Community-dwelling Elderly with Dementia: An illustration of group intervention in Hong Kong

Fung Yuen Yee, Connie

 Horticultural Therapist Registered (AHTA) 

 Registered Social Work

  President

 HK Association of Therapeutic Horticulture   

Population aging is a profound, pervasive and enduring storm sweeping across the world. Hong Kong is no exception. According to the HK statistics 2008, Hong Kong’s population has moved closer to seven-million and one out of eight Hong Kong people will be aged 65 or above. Department of Health and The Chinese University of Hong Kong conducted a study in 2005-2006 (Lam et al., 2008), and found the prevalence of dementia in adults over the age of 60 is 7.2%. It was also found that about 1 in 3 (32%) of the community-dwelling population aged 85 and above had dementia.

Dementia is a degenerative brain syndrome in which there is a gradual, insidious and relentless loss of cognitive functions. These cognitive deficits will further impair individuals’ social or occupational functioning and show a significant decline from previous level of functioning. Dementia can generally be classified into three stages: early, moderate, and severe. The early stage is characterized by the onset of deterioration in short term memory and cognitive abilities while in the severe stage, all intellectual functions breaks down and individuals with dementia will rely on caretakers to look after them in everyday lives. The most common form of dementia is Alzheimer’s disease. Yet, the causes of dementia are not yet known (Hong Kong Association of Alzheimer Disease, 2014).

Treatments for dementia include pharmaceutical and non-pharmaceutical methods. Horticultural therapy (HT) is one of the non-pharmaceutical treatments. HT has numerous advantages in treating dementia especially in fitting the needs of individuals suffering from different stages of dementia (Ebel, 1991).

Smart Golden Age” HT project

“Smart Golden Age” HT project was held from Nov – Dec 2010 at 5 elderly centres in different districts of Hong Kong. Participants were community dwelling elderly who was suffering from mild to moderate dementia. Objectives of the groups were to provide cognitive training and facilitate social interaction among participants. Each group had 10 members and the program consisted of 5 sessions. Members propagated plants by cutting and division. Then they brought the propagated plants home and took care of them. They were required to bring them back to the centre for plant arrangement in the last 2 sessions.

Connie 1  Connie

Connie 3

Schedule of the groups

Date

Theme

Activities

8/11 New Hope I Propagation: Cutting, Division
15/11 New Hope II Propagation: Cutting, Division
22/11 Flower World Flora Arrangement
29/11 New World I Plant Arrangement: Foliage Plant

(propagated in 1st session)

6/12 New World II Plant Arrangement: Succulent

(propagated in 2nd session)

Application of HT with community dwelling elderly with dementia in Hong Kong

Hong Kong has a dense population and the living spaces for most of the people are quite small. As the program required the members to bring the plants home to take care of, it is important for the therapist to consider whether members have enough space at home for the plants. Otherwise, they have to place the plant at the center.

Elderly with mild to moderate dementia can participate in most of horticulture activities. Detailed task analysis is necessary and hence modifications can be made in accordance with members’ needs and abilities. So they can follow the instructions and complete the tasks accordingly.

Plant selection is important in achieving the therapeutic goals. The plants selected have to be safe and toxic free. Since most people live in an apartment and lack outdoor space, indoor plants with small pot sizes are preferable. In addition, the plants have to be grown easily, gripped with ease, and with elements of sensory stimulation and symbolic meanings. Plants that are commonly used are listed in the table below.

Plant

Characteristics

Sensory Stimulation

Propagation

Plant Arrangement

Others

Chamaedorea elegans Mart Easy growing, less pest… Visual, tactile Division

Sowing

shade and humid environment
Fittonia

verschaffeltii

Easy growing, less pest… Visual, tactile Division

Cutting

shade and humid environment
Draceana sanderiana Easy growing

Easy grip

Visual, tactile Cutting Chinese name means “Rich”
Kalanchoe Blossfeldiana Easy growing

Easy grip

Visual, tactile Cutting Chinese name means “longevity”, “happy family
Chlorophytum comosum Easy growing Visual, tactile Division Have baby plant
Succulent

 

Easy plant care Visual, tactile Division

Cutting

 

It is desirable for elderly with dementia to live in the community as long as they agreed. Community based services can provide enough supports for them and relieve the burden of their care givers. HT is a complementary therapy to incorporate into the services to enhance their quality of life.

Reference

American Horticultural Therapy Association, American Horticultural Therapy Association Definitions and Positions, retrieved on 4 Jan 2014 from http://ahta.org/horticultural-therapy

Census & Statistics Department, SAR., retrieved on 4 Jan 2014 from http://www.censtatd.gov.hk/home/index.jsp.

Ebel S. (1991). Designing Stage-specific Horticultural Therapy Interventions for patients with Alzheimer’s Disease. Journal of Therapeutic Horticulture, Vol. XI, 55-58.

Hong Kong Association of Alzheimer Disease retrieved on 4 Jan 2014 from http://www.hkada.org.hk/disease_02.php?lang=chi#.Usgf5nnxvIU

Jarrot, S., Kwack, H., & Relf, D. (2002). An observational assessment of a dementia-specific horticultural therapy program. Hortechnology, 12, 403-410.

Lam LC, Tam CW, Lui VW, Chan WC, et al. Prevalence of very mild and mild dementia in community dwelling Chinese older persons in Hong Kong. International Psychogeriatrics, 2008;20:135-48.

Suzanne E. Wells, 1997. Horticultural therapy and the older adult population. New York: Haworth Press