Study format

1. General problem: On Consciousness

1.1 Basic problem: Effect of performing art on Consciousness

2. Introduction: Consciousness is a cognitive state in which one is aware of his sensations, perceptions, feelings, emotions, thoughts and memories and the surroundings. Following the model of Integral psychology, it has three layers - outer (Murta), inner (bimurta) and inner core (saraswat). Outer layer is composed of attention, sensations and perceptions. It is everything in man that is visible on the surface for others. It is tangible. It includes all the actions and interactions. For example, Just listening to the words of song is the expression of outer nature. This comes through development of sensory capabilities and control over the different organs. For example, child differentiates objects by developing his capability on shape, size, distance or depth, color discrimination and on the figure ground relations. Inner layer is composed of imaginations, memories, feelings etc. Experience of feeling by listening to songs is the inner layer. Inner core or Saraswat is expression of inner harmony between the living entity and the surroundings. Performing art is the journey across the layers of consciousness. The journey causes changes in each layer and provides different experiences to the individual. This study aims at examining changes across layers due to performing art.

Layer analysis: Though these three layers are overlapped with each other, for the purpose of study, they can be differentiated using different parameters. Any abnormality in outer layer leads to missing and anomalies in expressing the object. Inner layer can be differentiated in terms of vividness, orderliness and complexity. The inner core layer can be differentiated in terms of cleanliness, aesthetic and harmony with environment.

3. Method

3.1 Participants: Six participants (children =2, middle aged=2, senior=2) participated into this study. Average age and interest in their performing art are given below:

Children/middle aged/senior : Mean age= , SD= , Interest: High/Moderate/Low (description)

Following inclusion and exclusion criteria were followed in selection of participants.

Inclusion: Able to follow performing art as administered and able to report the feelings in verbal and in written expression.

Exclusion: Diagnosed as mentally challenged or psychiatric disorders.

3.2 Instruments:

a) Schedule: One introductory schedule was used to know about age, educational level, specific interest and aptitudes in performing art

b) Questionnaire: One questionnaire was used to understand the changes in layers of consciousness due to performing art.

3.3 Procedure to collect data: Initially rapport was established with subject. Rapport included present condition of the subject, the purpose of the study and willingness of the subject to participate in the study. Next, the introductory schedule was administered. Next performing art in terms of song, music, dance or drama was presented. Please see the appendix A (performing art).

Precautions: Following precautions were followed to control intervening variables as noise, distractors of attention etc.

Analysis of data:

Results : Interpreting Table and Figures

Discussion: Summarize results and relate to existing theories

References : Journal, Book and Web

Appendix

A : Performing Art

B: Original data

c: Any picture

Schedule:

1. Name: 2. Age: 3. Sex:

4. Address

5. Latest educational qualifications (Degree and Diploma if available) :

6. Which performing art do you enjoy frequently ? (Rating: Most frequently-5/more frequently-4/ sometimes -3/ less frequently -2/ least frequently -1)

a) Dance

b) Drama

c) Song

d) Music

7. Please write below your favorite songs, music, dance, drama (at least 5 in each)

Questionnaire:

Please recall the song :

Please recall some sentences:

Please perform it:

Analysis of performance:

1. Can he recall correct words? : yes/no ( Score 1 for each correct word)

2. Can he recall the words orderly ? :

3. Can he maintain rhythm ? :

assigned per category is usually consistent:

Category	Possible points	Description
Orientation to time	5	From broadest to most narrow. Orientation to time has been correlated with future decline.[4]
Orientation to place	5	From broadest to most narrow. This is sometimes narrowed down to streets,[5] and sometimes to floor.[6]
Registration	3	Repeating named prompts
Attention and calculation	5	Serial sevens, or spelling "world" backwards[7] It has been suggested that serial sevens may be more appropriate in a population where English is not the first language.[8]
Recall	3	Registration recall
Language	2	Name a pencil and a watch
Repetition	1	Speaking back a phrase
Complex commands	6	Varies. Can involve drawing figure shown.

The abbreviated mental test score (AMTS) was introduced by Hodkinson in 1972^[1] to rapidly assess elderly patients for the possibility ofdementia. Its uses in medicine have become somewhat wider, e.g. to assess for confusion and other cognitive impairment, although it has mainly been validated in the elderly.

The following questions are put to the patient. Each question correctly answered scores one point. A score of 6 or less suggests delirium or dementia, although further and more formal tests are necessary to confirm the diagnosis.

Question [1]	Score
What is your age? (1 point)
What is the time to the nearest hour? (1 point)
Give the patient an address, and ask him or her to repeat it at the end of the test. (1 point) e.g. 42 West Street
What is the year? (1 point)
What is the name of the hospital or number of the residence where the patient is situated? (1 point)
Can the patient recognize two persons (the doctor, nurse, home help, etc.)? (1 point)
What is your date of birth? (day and month sufficient) (1 point)
In what year did World War 1 begin? (1 point) (other dates can be used, with a preference for dates some time in the past.)
eName the present monarch/dictator/prime minister/president. (1 point) (Alternatively, the question "When did you come to [this country]? " has been suggested)
Count backwards from 20 down to 1. (1 point)

Sensation, Attention and Perception

Dr. D. Dutta Roy, Ph.D.(Psy.)
LECTURE NOTES ON SENSATION,ATTENTION AND PERCEPTION :PROBLEMS OF CONSCIOUSNESS
PERFORMING ART THERAPY CENTRE
RABINDRABHARATI UNIVERSITY
KOLKATA
12.1.2011

SENSATION

Sensation refers to awareness of stimulus. Stimulus refers to any thing that elicits response. This may be internal(changes in organ system) or external changes (changes in surroundings). There are five sensory organs excited by different types of stimuli.

1. Visual organ (Eye): Light
2. Auditory organ (Ear): Sound
3. Gustatory organ (Tongue):Chemical
4. Olfactory organ (Nose): Chemical
5. Cutaneous organ (Skin): Temperature,pressure

There is another organ named as kinesthetic organ excited by movement sensation. There are different attributes of sensation as
1. Quality: Generic quality (light and sound), specific quality (red, blue)
2. Quantity: Low and high frequency of sound
3. Localization: sensing pressure across different areas over skin

It will be misnomer to assume that any change in physical stimulus on physical scale causes same amount of change in the response scale. This is illustrated in problems of psychophysics. Psychophysics is a study to understand relation between changes in physical stimulus on physical scale and changes in response pattern on response scale. It discusses three types of thresholds of sensation as absolute, differential and terminal threshold.

Attention
When individual focuses awareness to something, attention takes place. Attention is focus of awareness. It has few functions like:

1. alerting: It is physical and mental preparedness to focus on specific stimulus.
2. selective function: Selectivity refers to a process by which attention is focused on stimulus or stimuli of ongoing interest and other stimuli are ignored.
3. limited capacity channel:limited capacity to carry out the task. We can process one task at a time. This causes serial processing.
4. vigilance: maintaining attention on a task continuously, for some
time, is called vigilance or sustained attention. It has been found that attending to a task for long is taxing, particularly if the task is monotonous and it leads to decrease in performance.

PERCEPTION
Perception occurs when sensation carries certain meaning. This can be explained in this formula:

Perception = sensation+meaning

Sensation = perception - meaning

visual perception must be viewed as an active process by which the visual information is interpreted and grouped according to a large number of rules. These Gestalt laws allow a phenomenological interpretation of the interactions between visual features that lead to the perception of composite objects. These laws are given below:

Laws of Perceptual Organization

(i) Good Form (Law of Pragnanz): This law states that perceptual organization will always be as “good” as the prevailing conditions allow. The simplest organization requiring the least cognitive effort will always emerge. Pragnanz means that we perceive the simplest organization that fits the stimulus pattern.

(ii) Proximity: All the stimuli that occur together in space or time will be organized together.

(iii) Similarity: Other things being equal, elements which are similar in structure or have common characteristics will be grouped together.

(iv) Closure: An incomplete figure will be seen as a complete one. a figure consisting of incomplete lines, that have gap in them. It is perceived as a triangle despite the fact that its sides are incomplete. A closure like phenomenon yields subjective contours.

AS ELEMENTS OF OUTER LAYER OF CONSCIOUSNESS

Success in performing art therapy depends upon its act on outer, inner and innercore layer of consciousness. The three layers of consciousness is given in Figure 1.

Figure 1 Layers of consciousness

Through performing art, one can start journey from outer to innercore layer through inner layer. Figure 2 shows the journey by Rabindrasangeet.

Faulty or poor development of outer layer inhibits this journey.

Figure 2 Rabindrasangeet is a journey across layers of consciousness.

Outer layer of consciousness concerns attention, sensation and perception. Any abnormality in these three causes serious problem in formation of inner and inner core layers of consciousness as these three play critical role in information processing model (Figure 3) specially in relation to filtering stimuli, retaining in memory stores and in developing imagery processes.

Figure 3. The Information Processing Model of Memory (Based on Atkinson and Shiffrin, 1968)
[Ref. Stevens Handbook of Experimental Psychology (2002) 3rd Edition, Volume 2: ‘Memory and Cognitive Processes’. John Wiley & Sons, Inc.; pp 10].

This multi store memory model is later expanded upon by Baddeley and other co-workers and has become the dominant view in the field of working memory (Figure 4).

Figure 4 Baddley's working memory model

The original model of Baddeley & Hitch was composed of three main components; thecentral executive which acts as supervisory system and controls the flow of information from and to its slave systems: the phonological loop and the visuo-spatial sketchpad. The slave systems are short-term storage systems dedicated to a content domain (verbal and visuo-spatial, respectively). In 2000 Baddeley added a third slave system to his model, the episodic buffer. This component is a third slave system, dedicated to linking information across domains to form integrated units of visual, spatial, and verbal information with time sequencing (or chronological ordering), such as the memory of a story or a movie scene. The episodic buffer is also assumed to have links to long-term memory and semantical meaning.

ABNORMALITIES & PERFORMING ART THERAPY

Faulty development of outer layer creates mental illness due to inability to learn. Therefore, attention should be paid to these three processes in order to understand functional efficacy of the outer layer. ADHD or AD, Mentally challenged or mentally retarded children, HIV and Schizophrenic patients suffer from poor organizing functions of outer layer of consciousness.

ADHD or AD: Attention deficit hyperactivity disorder (ADHD or AD/HD or ADD) is a neurobehavioral developmental disorder. It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age. Function and outcome of Autism spectrum disorders (ASD) are affected not only by core deficits but by frequently associated comorbid behaviors- such as irritability, sensory abnormalities, hyperactivity, affective disorders and others. Outcome is further affected by the presence or absence of language and by overall cognitive ability. Robert Sears, M.D., discussed top 7 therapies for autism in his recently published book. To him, “Every child with autism is unique, and so each therapy program should be individualized to meet his or her needs,”. The 7 therapies are (i) Applied Behaviour Analysis (ABA), (ii) Relationship based floor-time therapy, (iii) Functional communication training, (iv) Language therapy, (v) Picture exchange communication system, (vi) Occupational therapy (viii) Treatment and Education of Autistic and Related Communication-Handicapped Children or TEACCH. In another experiment, it is noted that by using Rabindrik dance to one child diagnosed as autistic by NIMHANS., Bangalore, attentive behaviour is controlled. One performing art therapist was asked to train the child Rabindrik dance " Phule phule dhole dhole". The autistic boy initially could not attend to eye movement but he gradually followed each eye and posture movement of the therapist and finally was able to coordinate eye and posture movement keeping in tune of the music. This suggests that one can control outer layer of consciousness by performing art with patience and hierarchical structuring of the dance movement. In this experiment, therapist had used classical conditioning and patting, hugging, verbal reinforcements were the reinforcements.

Mentally challenged or Mentally retarded: In case of mentally challenged or mental retardation, problem is related to impaired cognitive functioning and deficits in adaptive behaviour. Usually their IQ and SQ are below 70 using standard intelligence test and adaptive behaviour test like Vineland Social Maturity scale. Below are the ranges of IQ and corresponding classification of mentally disorder.

Profound mental retardation: Below 20
Severe mental retardation: 20–34
Moderate mental retardation: 35–49
Mild mental retardation: 50–69
Borderline intellectual functioning: 70–84

To provide performing art therapy to mentally retarded children, it is important to follow different principles of behaviour modification technique like shaping, token economy etc.

HIV: Human immunodeficiency virus (HIV) infection is associated with an increased risk for human herpes viruses (HHVs) and their related diseases and they frequently cause disease deterioration and therapeutic failures. Cognitive impairments are one of the major consequences of HIV infection in the human body – as the virus, once in the blood stream, can cause significant damage to the brain. Further, it makes the body vulnerable to a host of opportunistic infections – infections that would not normally affect a person with a healthy immune system (“AIDSmeds”, 2009). Many of these have significant impact on brain functioning.

1. In the early stages the disorder is characterized by minimal cognitive and motor impairments as shown by slowed information processing and slowed extremity movements. The patient can function on his own with minimal assistance such as reminders.

2. As the disease progresses, there is functional cognitive, affective and motor impairment. The patient misplaces things, faces difficulty in performing complex tasks and has problems with verbal memory and new learning. There may be motor dysfunctions like tremors, leg weakness and loss of balance. The patient may become ambulatory, but may be able to perform the basic activities of self-care.

3. With further neurodegeneration, the subcortical dementia begins to resemble global cortical dementia. At this point, there is deterioration of intellectual function, decision making capacity, delirium, hallucinations and loss of behavioural control. The patient cannot walk unassisted, there is considerable slowing of all cognitive faculties (including speech and reaction time), and there may be affective symptoms like apathy, irritability and social withdrawal.

4. The end stage, marking full progress of the syndrome, is characterized by a nearly vegetative state, with rudimentary levels of intellectual and social comprehension and bladder incontinence.

Schizophrenia: Schizophrenia affects approximately 1% of the population worldwide and is a chronic, severe psychiatric disorder. The onset of schizophrenia usually occurs around 18-25 years of age and is often preceded by premorbid behavioral deviations, such as social withdrawal and affective changes (Keshavan et al., 2005). Psychiatrist Emil Kraepelin, was the first to acknowledge psychiatric disorders from a biological perspective, and established the term dementia praecox. In 1911, the Swiss psychiatrist Paul Eugen Bleuler renamed dementia praecox as “the group of schizophrenias” and described it as a cluster of disorders rather than one coherent disease. With reference to prognosis, Crow (1980) classified two categories – type I and type II. Type I schizophrenia patients are those who present, often more acutely, with a predominantly positive symptom profile and who have a good response to neuroleptics or antipsychotics. In contrast, type II schizophrenia patients are those who have a more chronic illness, more frequent evidence of intellectual impairment and enlarged ventricular size and cortical atrophy as seen on CT or MRI scans, a poorer response to neuroleptics and predominantly negative symptoms. Type I category of patients possessed symptoms which are excess or distortion of normal mental functions like hearing voices, so these symptoms are called as positive symptoms. And Type II category patients possess symptoms which are loss or reduction of normal functioning like asocial behavior. These are called negative symptoms. Diagnostic Statistical Manual (DSM-IV-TR) accepts this classification. Of the two types, the negative symptoms are more difficult to evaluate because they may be influenced by a concurrent depression or a dull and un-stimulating environment, but they account for much of the morbidity (unhealthiness) associated with schizophrenia. The positive symptoms associated with better prognosis as compared to negative symptoms.

Positive Symptoms: The positive symptoms of schizophrenia include four "first-rank" or Schneiderian symptoms, named for a German psychiatrist who identified them in 1959 and other positive symptoms.

Ref: http://www.nios.ac.in/srsec328newE/328EL5.pdf

Dutta Roy,D.(2006). Development of picture drawing test to assess consciousness layers of tribal children of Tripura, Journal of the Indian Academy of Applied Psychology,Vol. 32, No. 1, 20-25