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Israel concocts a delicious new therapy

Posted By Tania Hershman On March 19, 2006 @ 3:00 pm In | No Comments

“Food has therapeutic value for me, and I think for many people too – not just eating it.” – Aviva Edelman.Chocolate, that most ancient of edible pleasures, has long been claimed as having benefits for body and soul.

Now, for the first time, chocolate is being used as a tool for rehabilitation. Two psychologists from the Traumatic Brain Injury Unit at the Beit Loewenstein rehabilitation hospital in Ra?anana have initiated a course of chocolate sculpture therapy which, they say, their patients find not only highly pleasurable, but also helps to highlight problems they have had trouble talking about and discuss them more openly.

“We have been working together for a long time, and we were sitting and chatting about the needs of our patients,” says rehabilitation psychologist Aviva Edelman, nodding towards her colleague, Dr Miri Tadir, a clinical psychologist. The two are sitting by a small table in Edelman’s office laden with chocolate in various shapes and guises: a marzipan-filled heart; a sculpture of a head with staring eyes and its tongue sticking out; a flawless chocolate face mask. Edelman and Tadir had, until the point that chocolate entered the equation, run mainly traditional individual “talking” therapy with their patients, whose head injuries most often result from a traffic accident or military incident and whose average age is thirty.

Head injuries, are, unfortunately, quite common. Someone sustains a traumatic brain injury every 23 seconds in the US, and approximately 5.3 million Americans currently living with this condition, according to the Brain Injury Association of America: March is Brain Injury Awareness Month in the US.

Patients come to the day clinic at Beit Loewenstein after they have returned home following an often lengthy stay in the hospital. “We have a lot of patients that need treatment that is not only talking therapy,” Tadir told ISRAEL21c. “We wanted a little diversity, a little color.”

“Psychological treatment often has a stigma,” adds Edelman. “[People think] you have to be abnormal to get this treatment. Especially when you already feel that something is wrong with your head. We wanted something a bit more appealing.”

Chocolate, it seems, is the answer. Edelman is a self-confessed “foodie” who paid her way through her psychology studies at Tel Aviv and Bar Ilan Universities by catering for people with special diets. She then began learning how to make chocolates with a local chocolatier who studied the craft in Paris.

“I started making them when I was in the middle of a crisis,” she says. “It was an outlet, it was very fulfilling.” Her colleagues benefited, receiving beautiful handmade chocolates as birthday gifts. In many ways it was a natural step for Edelman to integrate her love of chocolate into her therapeutic regime. “Food has therapeutic value for me, and I think for many people too – and not just eating it.”

Edelman and Tadir took their “chocolate experience” idea to their bosses, expecting to be laughed out of the door. “We were quite surprised when we didn’t get rejected,” smiles Tadir. “They said: “Let’s see what it going to come out of it.’ So they initially gave us the basic budget for two courses.” Last June, the first three-month, weekly workshop began, with a group of eight patients. (It is an optional workshop, with the concept explained in advance to the potential participants, some of whom felt it was “too childish” for them).

The 12 sessions are structured to take the patients through the initial stage, melting chocolate and pouring it onto a slab, to the more complex filled chocolates and chocolate sculptures. Edelman and Tadir use only the best chocolate, dark Belgian, occasionally using milk and white chocolate too, and various filling substances. “They learn how to melt it, you have to have it at the right temperature, we bought a special thermometer to control this,” explains Edelman. Bitter chocolate, she says, is more workable than other kinds.

One of the first things the psychologists noticed is that patients were helping each other when those with motor function impairment were having difficulty working with the substance. Another was the patients’ enthusiasm. “We were taught that you are not supposed to play with your food,” says Edelman. “We are playing with food!”

As opposed to working with clay or other materials, when the patients’ hands get messy, they have other options than simply washing them – they could even lick them clean. “People get really enthusiastic,” says Edelman. “They say ‘I have head injuries but I can make this stuff.’” Says Tadir: “The patients say, ‘Chocolate is the opposite of the hard life that we have.’”

What the patients choose to make when in the later stage of the workshop can be symbolic of their particular condition and concerns. The woman who made the chocolate face mask “was very beautiful but her face was badly damaged,” says Edelman. The creator of the head sculpture with the sticking-out tongue and staring eyes is “a very angry person,” she says. “I think he wanted to show us. It took him some time to show us his feelings. We heard that he didn’t participate in other group therapy sessions; he just sat there not saying anything. He actually started talking about himself and his experience after he came to this workshop.”

Other patients, whom the psychologists describe as “quite self-centered” due to their preoccupation with their injuries, have been taking their chocolates to the hospital’s children’s ward, and one patient with severe head injuries and psychological problems takes his creations home to his children, and was distraught when one chocolate session was cancelled. “He gets a sense of competence from this work,” says Edelman.

The patients work with the chocolate for one hour and then move to another space for a more traditional group “talking therapy” session, and the psychologists have found that “after one hour of chocolate they can talk about all kinds of things that are not directly connected with chocolate,” says Tadir, “but if you are doing what we do, psychological work, you can see the underlying processes which are probably coming from the work with chocolate.”

A second course, with eight new patients, began in February, and Edelman and Tadir are now attempting to analyze the patients’ experiences in order to write a paper for a psychological journal about the new form of therapy. In this way, they hope that psychologists in the US and elsewhere might be inspired to incorporate chocolate into their work – or at least discuss it.

“Food is a special mediator,” says Tadir. “Nobody has talked about it, it is a virgin area.” Quantifying the treatment is not a simple task. “It is not easy to be creative and at the same time try and measure up to the standards of the scientific community,” says Edelman. They are also looking for funding to carry on the workshops, because Edelman and Tadir negotiated with the hospital for budgets for the first two courses, but the hospital may not be able to continue the funding. “We are negotiating this as we go along,” explains Edelman. Fund-raising is a new experience for Edelman and Tadir, and they are as yet unsure where potential sources may lie.

In the meantime, they are continuing with the second workshop, and Tadir, for one, is trying to hold back when it comes to eating some of the products that the participants chose not to take home. “It’s difficult being around chocolate all the time. I love chocolate. I am a chocoholic,” she sighs, reaching for another piece.


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