Balance, A Short Post!

I interrupt my series of posts about the Pregnant Therapist for a short post on the topic of balance, which I struggle with constantly!

(Future posts include more on the Pregnant Therapist, the Devaluing of Art Therapy in our society and the importance of art making and self-expression for healing…)

Having two businesses that encompass a large part of one’s identity is not easy and sometimes one can be in opposition to the other. I’m talking about being an Artist and an Art Therapist. While I have little trouble making art regularly no matter what form it takes, I tend to be better at marketing, promoting and working on my art therapy business than doing the same for myself as a Professional Artist. I think it is usual for one’s main source of income to take over more than one’s other business if it is not a major source of income! I would love to have more of a balance even with that: ie. making more money regularly from my own art making. I do sell my art, but the sales tend to come in waves and are unpredictable and unreliable as a regular source of income.

As an Art Therapist, I need to keep up my identity as an Artist in order to be effective as a healer, especially an art therapist.

Like many art therapists who have a big body of art work, it is not so easy to get out there and get shows when you are easily diverted by other things in your life.

So I am challenging myself to work on Balance in terms of this double career, identity, passion…

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The Pregnant Therapist: Reflections from the Point of View of the Therapist

Last week I had some surprising reactions of my own to my own post, when I saw my post on “The Communicated Stereotype”, which I was very excited about. Since starting this blog, I have been looking forward to being a guest blogger to other sites and especially to this particular one. Perhaps due to my going back to it and rereading it for edits and slight changes to be a good fit for Anastacia Kurylo’s blog, maybe a few hours after posting the announcement about it, (see most recent post), I was surprised by some interesting reflections that came to me without my thinking about it.
First, I wondered about my tone. Did I come across as seeming angry, more importantly, did I come across as seeming angry at my patients?
Now for some personal information about my own pregnancy and experience as a pregnant therapist, which was what inspired me to want to write in depth about it here and plan a workshop about it. This many part topic has been percolating in me for a long time, in the form of a workshop I would love to do for young therapists who haven’t gone through pregnancy or are pregnant as a topic to learn about that is not taught in any kind of art therapy, psychology or psychoanalytic program as far as I know…
When I was pregnant, from around the end of December 2006 until the beginning of Sept 2007, I did notice heightened feelings of anger that popped up unexpectedly throughout that strange time. Of course I had other feelings, but somehow one of the good sides of being in this strange 9 month state is allowance for being a mad angry pregnant lady!
(I also just remembered that while I have never been in therapy with a pregnant therapist, my last year in grad school, my onsite supervisor was pregnant and left before the end of my internship. The person who replaced her was very different and had many find qualities, but I could see or accept none of them. I was mad at my former supervisor for leaving and considered the new one an imposter. I was very aware I felt quite angry and abandoned in my last experience working at an internship before going through the scary metamorphosis of becoming a graduate and a “real” therapist myself…)
The first full prefnancy is a strange in between time for a woman; you are not a mother yet, but you are in process of turning into one, and it all takes place inside your body, a very private place. Of course your body is ironically the first thing people notice about you when they meet you- what you look like… Pregnancy is a lot of things but it is foremost visual: they know you’re pregnant when they see the baby bump and growing belly. There is a certain strange loneliness about the state of being pregnant; you may be with a partner or not, but sometimes being with a partner brings this solitary feeling to the forefront; your partner is also about to have a baby, but s/he is not pregnant. Only you are in a constant state of flux, change, metamorphosis. Even though you have the constant companion of the growing entity inside you, you can still feel very alone and separate from it, even taken over and pushed around. This stuff in your womb will eventually push all your surrounding organs into weird places. Even at the beginning, it’s existence can cause pain, discomfort, strange weird cravings and a feeling of being invaded by something that is totally not in your control. You are housing an alien who is about to become your mystery lovely but dreadful new roommate. As one woman said, she was not prepared for an unpredictable roommate that wakes you up all night long, has strange ways of eating and screams in such an awful way that they actually record that noise for torturing prisoners!
There are many other things to contend with psychologically as well as physically. There is your own relationship with your mother, dead or alive or mother(s) if you are adopted, whether you know your biological mother or not. For those who do not, this is an intense process, as you are about to meet your first blood relative, and of course, being pregnant brings up all kinds of feelings around your own birth…
Anyway we are focused on the part before you receive your baby. As soon as you become pregnant, your body is not your own. I know some pregnant women who really embraced this state if being, “I now have an excuse for not caring what I eat, and finally society actually wants me to gain weight and have a huge bulge, etc…” It is sort of liberating in our looks conscious constant fad dieting society obsessed with the latest trend in how bodies “are supposed to look” to waddle down the street in a tight shirt that emphasizes the big baby house you’re carrying around…
I have strayed far from the original topic, the angry tone of a therapist looking back at what it was like to be a Pregnant Therapist. So, some of the pregnant therapists in private practice that I talked to while I was pregnant and after reported that they were relieved when their patients figured out or sensed they were pregnant early on in their pregnancy. It seems that there is an unconscious process going on here. Before disclosure of the pregnancy, the therapist is living with a secret in the room, sometimes she is also keeping her pregnancy secret outside of her office. Some even have the strange situation of more of their patients knowing about it than the people in their personal life. The unconscious process that seems to go on in this kind of game of when and how will each person figure it out, is that during the time that you decide you are somehow “ready” for your patients to figure out you are pregnant often coincides with when they feel they have permission to mention it to you. I know of therapists who had patients ask them if they were pregnant within the first 8-12 weeks, and obviously not from looking that different, although perhaps pregnancy immediately affects how you move and feel about your body… These therapists were relieved to get the processing started and felt more relaxed with their patients because of not anticipating and having the time to obsess about each individual’s possible reaction and having a lot of time to prepare for maternity leave.
I had quite the opposite experience. In my personal life I threw caution to the winds and told everyone I knew way before week 12. At work, I dreaded my patients’ finding out and especially was pleased at my ability to sometimes even forget for an hour that I was pregnant. I had a lot of imaginary conversations about it in my head. So I had to contain a lot of anxiety around not wanting my patients to notice any changes and wanting to remain “not pregnant” as long as possible in my studio office. As is often the case with our first explanations of our feelings and defenses with our patients, I framed this prolonging of the ” baby” intruding on the sessions, as being primarily connected to my protective feelings towards my patients, especially those with trauma histories. I imagined I was protecting them from the trauma of dealing with an upcoming separation and kind of “abandonment” over which they have no control. (Of course I was partly projecting my own feelings about my abandonment of my “therapist self” and sudden termination of my work with them. Ironically for me, at some point I realized that work with my patients functioned as a refuge from the quite traumatic experience of pregnancy. Every pregnant woman goes through some kind of identity crisis with the first time they become a mother. Basically your identity is being transformed from one of daughter, girlfriend, wife, friend, etc. to being a Mother. It IS a big deal. For me, I definitely wanted that baby, but I also felt myself undergoing a strange transformation that definitely freaked me out. Was this baby as it grew and took over my body and made me bigger than I’d ever been in my life, going to somehow push out my identity as an Artist and Art Therapist. Of course I knew this seemed ridiculous, but nonetheless it was a very real feeling. Going to work at my private practice provided a refuge from this scare process. I felt more grounded and quite fulfilled and whole working with my patients, while also being overly sensitive to what I perceived their reaction might be. I colluded with my patients(all of course on an unconscious and non verbal level) to keep my pregnancy out of the room as long as possible. I was more aware than ever of how much I enjoy and am fulfilled by being a therapist; suddenly having to leave this role even for about two months seemed very daunting and somewhat scary. At the time I was conscious of being overly concerned about my patient’s possible fragility with regard to abandonment, thus was focused on a few highly traumatized patients but everyone as well. I was also very aware that for me, holding on to my identity as an Artist and Art Therapust was essential to my managing my pregnancy. Being able to have a place where I could hide my pregnancy and ignore it was helpful as I went through the above described identity crisis.
For me, being an artist first and foremost, something that pregnancy and motherhood would never take away, definitely helped me through this crisis and sense of impending doom. Much of my anxiety also involved the thought, “What if all my patients leave me once they find out I’ve had the baby and I come back to an empty practice?” In one of the few books I found about this topic, I had read that some patients actually do that. They have a human need to know that you are ok and have had the baby and all is fine, and then they want to take control and turn the tables and they leave before you return. Some patients are actually afraid their therapist will be too different when she returns. There is a real concern about whether a new mother can really listen and give her attention to her patients. For patients who are not themselves mothers, how could they know that every new mother, no matter how attached to her growing infant, relishes having moments in her day to think about and attend to someone or something else. However, it is very true for some therapists that they return to work feeling very different as a new mother and do have a feeling of distance from their patients. This is a very complicated topic of course, so I will end on the note that in my posts, I try to describe my own experience and those of colleagues who have shared with me. Every therapist will experience this time differently, but for everyone, the fact that a big boundary has been broken is there. This will change the relationship between the pregnant therapist and all her patients. It can be a great opportunity for growth on both sides of the therapeutic process…

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The Communicated Stereotype

I am very excited to announce that my post about the pregnant therapist was just posted as a guest post on a really great blog called The Communicated Stereotype, written and produced by Anastacia Kurylo, PhD. There is an “About Me” section of her website to read more about her and her books.

To access her website, go to:
http://thecommunicatedstereotype.com/

To go directly to my post, go to:
http://thecommunicatedstereotype.com/the-pregnant-therapist-societal-attitudes-and-assumptions-about-pregnancy/

The Pregnant Therapist: Transference and Countertransference: Part 1

This post, Part 1 of a series of posts about the identity of and reactions to the Pregnant Therapist, will focus on the topic: How Societal Attitudes and Assumptions About Pregnancy and Interfere with the Patient’s Transference Towards the Pregnant Therapist, the pregnant therapist’s unique counter transference, and the resulting Invasion of the Therapeutic Alliance and Therapy Session Itself.

Below is a useful definition of the term transference first used by Sigmund Freud. (I quote Wikipedia directly as this part of their entry on the topic is a good description.) Of course you can read more online about the term as well as about the counter transference of the therapist towards the patient

“In a therapy context, transference refers to redirection of a patient’s feelings for a significant person to the therapist. Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, parentification, extreme dependence, or even placing the therapist in a god-like or guru status. When Freud initially encountered transference in his therapy with patients, he felt it was an obstacle to treatment success. But what he learned was that the analysis of the transference was actually the work that needed to be done.[citation needed]”
(“citation needed” came from Wikipedia, not me. I may have to lift this citation but for now it’s a good description to use about the very specific and different transference that comes up with the pregnant therapist.)

1. The therapis’s body is usually what communicates her pregnancy to her patients. In many cases, patients pick up on feeling that their therapist is different in some way and take the risk of bringing it up directly in the session. During the first 3 months of pregnancy, if this happens, it can invade the therapist’s assumption of the secret she has even in her own personal life, if she is limiting the sharing of the news of her pregnancy. If the therapist has a miscarriage at any point in the pregnancy, another set of reactions is obviously triggered in the patient and the therapist. (This loss will be elaborated in in another post on this topic.)

In many cases, however, the patient notices the therapist’s growing “belly” later on in the pregnancy and asks the therapist directly (and sometimes indirectly through dreams or images) if she is pregnant. The only kind of transference this can be compared to is when a therapist is obviously sick or injured and her body tells the story. However, usually the patient is not so surprised if the therapist has suddenly cancelled a session and in the next session the patient can see that the therapist is sick or injured. However, with the pregnant therapist, the transformation of her body is usually not seen as a sickness but as a joyful event. There is an interesting time lag, especially in the case of female patients, in which a patient wonders, “Is she pregnant?” but waits a while to ask for fear of being told, No. The patient in such cases is sensitive to not wanting to insult the therapist if it turns out she has simply gained a lot of weight and is not pregnant. ( I have had patients who know I have a child ask me if I’m pregnant, not because of any visual difference in me but sometimes to express a feeling of abandonment or a sense that something secretive is going on with me, or even as a way to express that I seem to be less attentive.) With patients of all sizes who have experienced such situations themselves and felt wounded, there is a tentative aspect to asking the question. More will be addressed on this topic in another post…

The main point is that the therapist is put in an unusual position in which she cannot control the revealing of private information about something very personal to her patients. (This is of course in contrast to male therapists who are having a baby. Even if the expectant father reveals the news because he is taking a paternity leave, he has much more control over when and how and how much he decides to reveal to the patient.)

2. In terms of societal attitudes that infect or have a part in the patient’s’ transference to the therapist and the therapist’s counter transference, a big one is the idea or notion that any pregnant woman needs extra care taking. With it there is societal permission to invade the personal boundaries of the pregnant woman. (An obvious example is that of strangers asking a pregnant woman to feel her belly. This really does occur!) This can move towards even unconscious assumptions that the therapist is now fragile and even could be needy. There is also often a conscious or unconscious association of unpredictability, lack of consistency, and possibility of the therapist being in medical danger during the pregnancy and delivery. There is also sometimes a perceived possibility of the therapist dying or losing the baby at delivery or having a late miscarriage.

The patients who take on a care taker role thus will become somewhat hyper vigilant about trying to ascertain how the therapist is doing and wanting to some how take care of her. These patients often start the session with a check in which involves questioning the therapist about how she is feeling to alleviate their heightened anxiety before they are able to focus back on themselves. In society, the idea of taking care of the pregnant woman can be positive, negative or neutral. In NYC, the giving up of a subway seat is even an instruction paired with instruction to give a seat to disabled individuals, on a sign in each car. (Even this pairing expresses the attitude that the pregnant woman is weak or fragile. Of course there is some truth to this in terms of heightened exhaustion, difficulty standing in a moving train, feelings of nausea, etc., which are very real possibilities in pregnancy, but many pregnant women feel stronger than before and more aware of their surroundings.)

Other less positive often new experiences for any obviously pregnant woman include strangers’ bossy, intrusive negative reactions to seeing a pregnant person drinking alcohol or even coffee and obviously if she is smoking a cigarette. Thus, normal respect of one’s personal space is often invaded because our society sees it as ok to break the stranger “boundary” when a pregnant woman is involved. In New York City especially, which is known for its inhabitants respecting personal space and expecting the same treatment from others, this sudden infantilization of the pregnant woman is an odd and even traumatic experience for her, especially if this is her first successful pregnancy…

The other unusual aspect of the care taking role taken on by some patients is that some are unconsciously responding to the anticipated abandonment by the therapist when she will interrupt treatment to take a maternity leave. There is a high risk that for this particular “societal attitude” type if Caretaker transference is not recognized and explored, that the patient will wait until s/he finds out the therapist has had the baby and is healthy and able to return to work to themselves terminate with the therapist and take back “control” that they feel was taken away from them. No matter what the therapist does, some patients will feel the need to take control of the therapeutic process by leaving, and as a way to express anger at the therapist for abandoning the patient and prioritizing her baby over the patient’s well being. Even if the pregnant therapist processes these issues and feelings way in advance with her patient and has referrals for the patient to use to continue therapy if needed, sudden “revenge” termination can happen once the patient knows their therapist is healthy, still alive and no longer pregnant…

3. American society has coined a term “baby brain”, referring to a pregnant woman’s loss of some short term memory. Somehow that can translate to her being viewed as unpredictable, disorganized, overly preoccupied with her pregnancy, prone to impulsivity or somehow less sharp and responsive as a therapist, a loss of capacity to empathize or be present with the patient while there is a growing foetus in her body, which is indeed physically invading the session as her belly continues to grow. Patients who adopt this societal attitude are vigilant about observing their therapist closely to make sure she is really listening and giving her full attention to them as well as watching to see if she is able to match their normal expectations of her competence as a therapist, etc.

4. The opposite kind of transference that sometimes arises is linked to another societal view of the pregnant woman as some kind of idealized earth mama. For now, it is highly rare for a male to become pregnant (though not impossible for some transgendered individuals). There are many primitive perceptions and assumptions about the pregnant woman. Though they may involve idealizing and elevating her for being “special” in that she is actually growing a potential new human being in her body, these attitudes can take on a quite sexist or at essentialist quality. Being made special or seen as having some kind of magic power, even the positive wonder of how a new person is created in the female body, can result in the pregnant woman feeling weirdly objectified and idealized.

Go into any museum with “older” paintings in it, and the ones of mothers with babies, whether actual religious depictions or not, idealize the female pregnant form and the female with infant

I will end this post with the thought that being idealized and seen as a Major Archetypal Symbol coupled with all the expectations and attitudes about Motherhood in our culture can be quite a challenge and difficult experience for any pregnant woman or mother. This idea can become magnified in the therapy session…

To be continued…

My 9/11/12 post a day late…

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These photos did not show up in the order I intended, however they are a good representation of the way the day of 9/11 is punctuated by memories, memories of artwork I did that was very much a personal response, and the present day 11 years later with the ghost of the towers shining in the clear night sky. I also took some pictures of sunflowers at a deli on Chambers st. That I should have included…

So there was this desire to take many photos of the ghost lights making a large eleven and two white towers in the night sky; I took many photos of them on my walk home in the neighborhood. I also took sone self-portraits with them in back of my face. As well, there was a desire to take photos of the street signs and flowers in the deli, even the sidewalk, perhaps an expression of the weird feeling of, it’s as though it never happened when you look at the essential life of any NYC neighborhood: there are the street signs, different signs in a different color but the same street names, there is the concrete sidewalk and the corner brightly lit up deli open late…

The twin lines of light always inspire and move me; they function as a better expression of a “memorial” than any building or fountain or plaques could be, and there is something evocative about their annual reappearance and disappearance. Also, their simplicity and visual effect if having no words, accounts, stories, explanations, even objects from the day, etc., as no words capture the essence of such monumental events such as 9/11 and other more personal private losses people suffer with: because there are no words for the big gaping hole of a traumatic loss, any death of a loved one really… These twin white lights stretch high into the sky until they link together, no longer seen as separate, one white far away blurry line swallowed up by the night sky…

In my art work there is a continuity since 9/11/01 versus before it. I posted some images done soon after the event, the one with ink and green background and the double one with a filmstrip like composition of a face and traces of a building in pinkish colors.

Another photo posted here of two framed drawings is a diptych, entitled “Falling Towers” fine with pen and mostly bright pink ink, from around 2009.

Finally, tying it all together are 2 tiny pieces made yesterday evening in my studio. They were response art but seemed to be connected with the day, a long one which swung from everyday “normal” activities with my oblivious 5 year old keeping me in the present moment, and pockets of moments of replaying parts of the day 11 years ago, tiny emotional moments punctuating a beautiful September day with a clear sky…