Iris Grace is a six-year-old girl with autism, who is currently in the media¹ for her extraordinary artistic talent. She creates the most incredible paintings which sell for thousands of pounds. It is not only this that makes her unusual; she also has an amazing relationship with her cat, which has transformed a very difficult family life to one that is, in the most part, ‘normal’.
She was diagnosed at the age of two with severe autism; as a baby she avoided eye contact, was very timid and had an enormous dislike for the feel of water against her skin, making bathing her a very difficult task. Her mother, Arabella, described the way Iris used to ‘spread her books all around her’, saying it was like she was creating a barricade separating her from her parents. Iris did not develop any form of speech as she grew, and communication with her was extremely difficult.

Arabella described how the ‘doctors were quite depressing in what they thought was possible’ when the diagnosis was made. They told her that she may never develop normal relationships. The National Autistic Society describes autism as a ‘lifelong developmental disability’² which affects communication, relationships and causes a disrupted view of the world, seeing it as a ‘mass of people, places and events which they struggle to make sense of’². It is a very difficult condition due to the way it affects all levels of health and illness. Both the sufferer and the family are affected profoundly. The person with autism will find it difficult to understand normal relationships and social constructs, and find the world a very confusing place. There will be a huge strain on the family, with normal day-to-day life being impossible to carry out. The parents will undoubtedly be under huge emotional stress in finding it so hard to bond with a child that will shut them out and not respond to their affection. Resilience is of enormous importance here in trying to cope, and a doctor must recognise the torment the parents are under and help them retain a family system that is as close to normal as possible.

Iris’s parents tried many different methods to help her with her condition. They had heard about animal assisted therapy and how getting a pet can sometimes help with autism, and so they tried Iris with a number of animals. None worked until they found Thula. Thula is a breed of cat called a Maine Coon which is unique in that it loves water and is able to swim. The cat was a miracle for the family and Arabella described her as a ‘super cat’ in the way she came into their lives and helped them more than anything had previously. The bond between Thula and Iris was immediate and they became inseparable; the cat was extraordinary as it stayed by Iris’s side whilst she slept and bathed, and had a huge calming effect on her which completely changed the family’s day to day life. The cat even encouraged Iris to try swimming; something her parents thought she would never want to do.
But most remarkable of all was the gradual development of verbal skills in Iris after the arrival of Thula. It began as two word sentences, which were direct instructions to Thula such as “Sit, Cat”. This then developed it an ability which meant Iris was reading from her books and finally able to communicate her needs to her parents properly. This was unprecedented healing that her doctors did not predict; the simple thing of getting a pet had helped Iris more than any medication could have done.

Animal assisted therapy in autism has been widely reported in the media, with many stories similar to Iris’s being reported and shared. A systematic review³ of studies on animals and autism showed in general, with the presence of a pet, there was increased social interaction, increased use of language and decreased stress and anxiety in the person with autism. I myself have a personal experience in how animals can really make a difference: my cousin Adam has autism, and found it very difficult to communicate with anyone other than his immediate family and my brother for the first ten years of his life. Since getting a dog, however, a miraculous change has occurred, and he is now able to express himself and communicate very well with people. I decided to talk to my aunt to find out more about how he copes with his condition and how much she thinks his improvement is attributed to getting a dog. She told me that very recently he had become a young leader for his Scouting group; a position that requires good communication and organisational skills. She told me how she had never thought it would be possible for him to do something like that, and how his improvement has made him so much happier and that their family life was so much easier. Another interesting thing that she explained was the difficulty of finding somewhere to go on holiday as a family; the change to doing not much at all on a standard beach holiday would be too much for Adam to be able to deal with- he needed routine to be able to cope. However, a few years ago, they were able to start taking him skiing, which he absolutely loved- with skiing there is a routine of getting up and going out for the day, with most hours being filled with activity. It is something he’s developed a passion for and my aunt told me that having an annual skiing holiday has really helped in many ways. When I asked whether she thought any of his recent improvement has been down to getting a dog, she said it had definitely made a difference. The ability to have a relationship with a non-judgemental and loving animal had apparently been crucial in calming him down when he got angry and had also improved his verbal skills.
In the case of Iris Grace, the cat had also made a big difference in helping her mind develop and improving her emotional health, shown by how she began to express herself and her thoughts through the medium of art and painting after getting the cat. She creates the most beautiful pieces which are explosions of colour, allowing her to channel her thoughts onto paper. In many of her works, there is a hint of the feline form included, which shows that Iris’s relationship with her cat is in the forefront of her mind. This form of therapy – art therapy is an effective mindfulness activity, and in the case of autism, it has been shown to do wonders in improving the severity of many people’s conditions. A recent journal⁴ describes art therapy as ‘a pathway toward increased awareness of self’⁴(pg.147). This is important in children with autism as an increased self-awareness may help with their ability to relate to people, thus increasing their social skills. A study⁵ has shown that art therapy ‘enables the child to self-soothe’⁵(pg.30), lessening aggression and which also helps the child to cope with social anxiety. When interviewing my aunt about my cousin, she talked about the importance of music in his life – he is a very talented guitarist, and his success with the instrument has boosted his confidence in many aspects. She described how if he felt frustrated or aggressive, a useful way to help him was getting him to play his guitar; this tends to calm him down and allows him to channel his thoughts into another medium.

I decided to try art therapy for myself, and tried to paint in the style of Iris Grace, using many colours and different brush strokes. It was very enjoyable; due to the style of the painting, I had freedom in what I could do as I was not painting a certain object or landscape. I simply let the brush do what it wanted, and felt extremely calmed by the activity. Art is not something that I am very good at, and often get stressed if I try and draw and the picture I produce is not like the one I imagined. However this form of art was relaxing and liberating, as I was not drawing anything specific, and I felt an elevation in my mood. This experience has opened my mind to art as a form of mindfulness and is something that most certainly could be recommended to patients as a way of calming oneself and escaping from the stresses of illness and everyday life.
The painting I have decided to submit is in this ‘free’ style, and is very much inspired by Iris Grace’s artwork and her story. I feel that the combination and chaos of colours represents the view of the mind of a person with autism; the ‘mass of people and places’ I described earlier. This is my interpretation of what it may feel like, taking inspiration from the real expression of Iris. An image picture of my work accompanies this text.
The importance of mindfulness in a condition such as autism cannot be overstated; an increased sense of the mind and the self will help the person understand and make sense of the world as it appears to them; the blur of confusing speech, sounds and images may start to become more ordered. I feel we can learn from the proven benefits of art therapy and animal assisted therapy in helping with patients in the future; an increased sense of the self and ability to express oneself is very important in the busy and stressful lives of people in the modern world. Many diseases have been shown to have their origins in a high stress lifestyle, and so being able to escape these pressures through art or through the calming influence of an animal companion is very important. Being able to try the art therapy for myself has shown a way I can cope and withstand the strain of being a medical student.

Iris Grace and my cousin Adam are excellent examples of the importance of whole person care. They have shown me very explicitly that being a doctor is not just about looking at the biomedical and cellular side to an illness; that there is much, much more to it than that. A person’s whole life is affected by illness, especially with a condition such as autism, and a doctor must take account of that. As with these cases, sometimes it is the simple changes in lifestyle- such as the addition of a pet to a family- that can cause the biggest improvements in health.

My aunt gave me full consent to write about our interview and my cousin also signed the consent.

References
1. How a cat enabled an autistic six-year-old to communicate. [Online]. Available from: http://www.bbc.co.uk/news/health-35797084 [Accessed 23rd March 2016].
2. Autism. [Online]. Available from: http://www.autism.org.uk/about/what-is/asd.aspx [Accessed 23rd March 2016].
3. O’Haire, M.E., 2013. Animal-assisted intervention for autism spectrum disorder: A systematic literature review. Journal of autism and developmental disorders, 43(7), pp.1606-1622.
4. Emery, M.J. Art Therapy as an Intervention for Autism. Art Therapy: Journal of the American Art Therapy Association. 2004; 21(3): 143-147
5. Epp KM. Outcome-based evaluation of a social skills program using art therapy and group therapy for children on the autism spectrum. Children & Schools. 2008 Jan 1;30(1):27-36.
6. http://irisgracepainting.com/paintings/