Appearances and Blog Exhaustion!

I think I have tried about 15 different themes in the last week on my blog, trying to find the right one that looks good. Taking the two Blogging classes I took got me thinking about my blog in so many cool ways I had never thought of before. I can’t believe I’ve been blogging a few years and only recently understood what widgets are and what themes even are. I think I just randomly threw up my blog, which was a great way to start, as I am the opposite of perfectionist. I like to just go for it, with art and blogging. Thinking too much and criticizing just isn’t good for creativity, but it is of course a balance, and looking into things more and editing are useful things I am often quite lazy about. I know that I am good at helping people just get going and jump beyond their blocks and critical mind, and those same people help me realize it’s good to reread an email before hitting send and that blogs can be deeper than I thought, and that I have to keep my websites updated, and looking good.

Appearance! Here I am an artist and it took me so long to think, what do I want this blog to look like? I just now learned you can find a great theme and love how it looks, like the “Plane” theme I threw up yesterday, only to be frustrated by being unable to use a featured image. Now I’ve changed themes again and picked one that has featured image as part of it, only to find that the featured image is put inside your “header”. I am very into the header as I have cool images to use and you can change the header a lot. The header is at the top of your blog when people click on it, they see it and the title of your blog is in the header, so then the color of the font etc. becomes important.

Anyway I’m still tinkering with the appearance of this blog, as I am just not into the themes I have tried and I’m in the middle of trying to fix both my art therapy website and my art website, so I’m going to leave this theme up for now even though it’s not ideal.

I get excited by all the possibilities of the internet, but it sure eats up time, the upkeep of everything. It’s like cleaning your studio or apartment; there are other great things to do, so things pile up. It’s very hard to set priorities and get things done and remember to do important things. It’s crazy, this life on and off the internet. We introverts can get really sucked in to the internet and expressing ourselves and checking out what others are doing because it’s what you do late at night after 10:30 when you should be off the computer and getting ready for bed! It doesn’t help that I just picked a featured image and it wouldn’t crop it how I wanted so I had to remove it. Totally frustrating…

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Instructional Post for Writing 201: How to on Radical Self-Acceptance!

“It takes a really long time to realize this, but if you’re lucky you eventually see that you’ve got this life on this planet and you’re responsible for really loving yourself. And I mean really, really, really loving yourself. Love is never a corruption. I’m talking about loving yourself with a true love, a love that’s incorruptible and everlasting.”
― C. JoyBell C.

“To be beautiful means to be yourself. You don’t need to be accepted by others. You need to accept yourself.” ~Thich Nhat Hanh

What is radical self-acceptance? Really it is pretty simply exactly what those words mean. For something that easy, it is pretty hard for many adults to practice Radical Self-Acceptance.

Try saying out loud: “I accept myself completely as I am right now.” It sounds simple, but remember, it means you accept everything about yourself in this exact moment: your physical body, your emotional body, your mental, creative and spiritual bodies, not the way you might have looked or felt or been several years ago or as you think you “should be” right now or how you want to be in some future time. This means you accept your whole body, for example, you can’t just accept your head and pick apart which parts of your body are acceptable and what isn’t. It’s all or nothing. As one of my patients once told me, “You cannot receive something in parts or somewhat, you have to receive it completely or not at all.”

So the challenge is, can you receive yourself and accept yourself in this present moment, no matter what you are feeling, how you are looking, what is going on with you and your life. I posted a while back about this kind of self-acceptance. I took a piece I read about yoga “not caring”, which had a lot in it about yoga not caring what you know, how flexible you are, how you eat, etc., and turned it into a challenge to not “care” what state of affairs your life, body, career or lack thereof, apt or lack of home, family or no family, etc. is and to just care that you have showed up to your life in this moment. The link to the post is:
https://natashashapiroarttherapy.wordpress.com/2014/12/01/just-show-up-and-be-here-now-getting-through-difficult-times-like-the-holidays/

Here are a few of the sentences:
“I don’t care what color my skin is or what gender I choose to love or what gender or non gender I am. I don’t care about others’ appearance, sexual orientation, gender, etc. either. We all share similar struggles and pain.

I don’t care how much money I have, what house or space I live in, what car I drive, or if I have to live on the streets right now.

I don’t care what my apartment, house, living space etc. looks like right now. It doesn’t matter; what matters is that I am still here anyway.

I don’t care if I smoke cigarettes, drink, use substances that are illegal, eat too much, binge and purge, starve myself, or am addicted to sex or other things or whether I hoard things in my abode. I’m still here and I showed up to this new day and that is enough.

I don’t care if I am single, with someone, with several people, in a messy relationship, stuck in a difficult relationship or anything else.”

To take these ideas into radical self-acceptance, we would not use the words “I don’t care”, but instead, “I accept that…”. For example, I accept myself as I am right now, including what I am doing right now, even if I am drinking, smoking, binging. I accept myself as I am right now, that I live alone in a tiny apartment and am in terrible debt and unemployed. I still can accept myself as I am in this moment, even though I need to lose 20 pounds and my house is a mess…

I first read about the concept of “Radical Self-Acceptance” in a DBT workbook. DBT is Dialectical Behavioral Therapy, first discovered and invented by Marsha Linehan.
Here is a link to a description of the concept: http://www.dbtselfhelp.com/html/radical_acceptance_part_1.html

Here is something from that article: “So what’s Radical Acceptance? What do I mean by the word ‘radical’? Radical means complete and total. It’s when you accept something from the depths of your soul. When you accept it in your mind, in your heart, and even with your body. It’s total and complete.

When you’ve radically accepted something, you’re not fighting it. It’s when you stop fighting reality. That’s what radical acceptance is.”

So there is the importance of sort of surrendering to the reality of yourself and your life as it is, not as you would like it to be. The word “Radical” may sound extreme but it is just the right word to really pin down this concept, the idea of complete and total acceptance.

There is this too: “Often when you’ve accepted you have this sense of letting go of the struggle. It’s just like you’ve been struggling and now you’re not. Sometimes, if you have accepted, you just have this sense of being centered, like you feel centered inside yourself somehow. ”

So as this article says, this is an interior process but I disagree that it is hard to describe, as it is really very simple. The sense of struggle versus letting go gets at it. It reminds me of the feeling you have when you tense up part or as much of your body as you can and then release. That moment of release is what this is about. Radical Self-Acceptance is a bodily sensation as well as a verbal affirmation. It is what goes on when you focus on your breathing in and out. When you let the breath out, you let go; that is what goes on with this process. Hold your breath for a few seconds, then release it. There is a kind of metaphorical holding of the breath that people engage in during times of stress. Studying for law school exams and saying, I will attend to my body and get a massage and relax after the exams. That is holding your breath till you’re done. Taking care of yourself while going through some kind of big stress like this is a kind of radical acceptance. Accepting that you have no control over what might happen tomorrow, much less a week from now in the exam room is part of this process, for example.

When you are not calm, not grounded, not relaxed, not liking yourself, not using “healthy coping skills”, that is a time to practice this kind of self-acceptance. I accept that I am a mess, that I messed up, that I was doing great at “fill in the blank”, not picking my skin, not binging and purging, not getting drunk, whatever, and now I’m back in the muck, out of control, disgusting, ashamed, whatever. BUT, I can just stop, breathe and accept myself even in this moment of complete “failure”.

I have sat with very smart, very put together, very successful adults and asked them to say the words, “I accept myself as I am in this moment, right now, completely.”, and had them respond that they cannot do it. I press them to just say it out loud even if they do not believe it. Just getting someone to say that out loud is a huge struggle; for some, it is way more challenging than doing stuff that seems impossible, they can run a marathon, write and publish a book, etc. etc., but to say those words can feel impossible. Say them anyway, say them as if your life depended on it, because in a way, it does.

What I love about the theory of the “Dialectic” in Dialectical Behavioral Therapy, is the idea of two opposing things being true at the same time inside a person. That includes radical self-acceptance alongside the desire to change behaviors. It turns out you can’t change much until you completely accept yourself as you are now, in the bad, unchanged messy state. You can feel sad and self hateful and want to die and still accept yourself right now, and it is the only route to ever living at all.

Radical Self-Acceptance happens right now, but it is also a work in progress. I can say that I radically accept myself as I am now, and most of me not believe it and say it isn’t true, but when I say it, it is true.

It is 11:11. I should have done my yoga practice and be getting ready to go to sleep. I should have written this article last week as it is not this week’s assignment. I haven’t done the first assignment, the interview yet. My mouth tastes lousy and I should brush my teeth. I think I missed going to the dentist and probably haven’t flossed enough. Now that I focus on it, my teeth are too yellow. My body feels uncomfortable from eating too much heavy food a few hours ago. I am behind on some bills and not budgeting. That could lead me to my issues with money. There’s the graphic novel I started in 2000, 14 years ago, and ten pages of it that I misplaced in my own house/apt. I won’t go to the apartment and what kind of state it is in right now, versus how it should look. There’s my studio too, in disarray. I could go on and on about all the ways I am disorganized, not good enough, my little private addictions, like shopping for stuffed bunnies and old Betsey Johnson jewelry on Ebay, during a month when I am buying holiday gifts and have no business buying crap for myself. I will say, I accept myself anyway, as messed up as I could portray myself. I am vain about my hair, but I accept that it doesn’t look like it did ten years ago, and I accept my gray hair and my age.

None of this stuff matters. What matters is that I am trying to accept myself anyway, just like the rest of humanity. I still mostly can believe in my own inner goodness, good intentions, caring, alongside my grandiosity and selfishness, petty jealousies, etc.

I accept myself completely as I am right now. Can you say this too? Of course you can! Just do it, just say it. Look in the mirror and say it every day.

Just Show Up and Be Here Now! Getting through difficult times like the holidays…

For some, the holidays are your favorite time of year and you love almost everything about them. As therapists, we are well aware that the holidays may be more than unpleasant for other people. In fact, for some, it is a matter of surviving the holidays and breathing a sigh of relief on Jan. 2.

For anybody, whether you like the holidays or not, if you need to ease up on yourself and your own self judgments, this piece from Elephant Journal about Yoga is great. I will copy the link but also take the article and substitute “I” and other appropriate words for the word Yoga and change it around slightly to be a reflection on our abilities to be nice to ourselves.

Here is the original article. You may not be able to read it after today as the Elephant Journal locks the articles on their site to encourage joining…
http://www.elephantjournal.com/2014/11/yoga-doesnt-care-a-disclaimer-that-should-be-posted-in-every-studio/

You and your life are not defined by your lifestyle, beliefs, weight, diet, flexibility, how spiritual or enlightened you are, or if you even are “spiritual” at all. You are just about being yourself and just choosing to show up each new day—You are not alone in the daily struggle. For many, each day is a new struggle just to show up to his/her life and stay. This post honors those with the most despair and pain who are brave and show up despite all the emotional scars and pain.

Try saying this to yourself when you are down on yourself or not “doing enough” or “changing” enough.

I don’t care what my hair looks like.

I don’t care how I am dressed today or if I even was able to get out of bed and shower and dress.

I don’t care if I am following some kind of fancy or healthy eating plan or eating the “bad” foods today. It’s good enough that I show up and eat something to keep myself going…

I don’t care when the last time I did this particular activity (fill in the blanks)

I don’t care if I show up cranky or exhausted to my life today.

I don’t care what I believe in or if I believe “in” anything. I’m here and that is enough.

I don’t care what color my skin is or what gender I choose to love or what gender or non gender I am. I don’t care about others’ appearance, sexual orientation, gender, etc. either. We all share similar struggles and pain.

I don’t care how much money I have, what house or space I live in, what car I drive, or if I have to live on the streets right now.

I don’t care what my apartment, house, living space etc. looks like right now. It doesn’t matter; what matters is that I am still here anyway.

I don’t care if I smoke cigarettes, drink, use substances that are illegal, eat too much, binge and purge, starve myself, or am addicted to sex or other things or whether I hoard things in my abode. I’m still here and I showed up to this new day and that is enough.

I don’t care if I am single, with someone, with several people, in a messy relationship, stuck in a difficult relationship or anything else.

I don’t care when I woke up or if I have not gotten out of bed, I’m still here even if I have to stay in bed all day.

I don’t care what my job is, whether I have one, whether I graduated high school, college, grad school, whether I finished any project or life goal or whether I even have anything I want to “do with my life”.

I don’t care if I have a family or none at all, and I don’t care what my family or anyone else thinks about me.

I care that I showed up for today. I care enough to stay.

Valentine’s Day Post: Be Your Own Valentine!

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I used to have a very jaded view of Valentine’s day as a marketing ploy for chocolate, flowers, stuffed animals with hearts and other stuff, as well as this idea of high expectations and not a great day for single people, of which there are many in NYC.

Even when not single, I thought this holiday was tacky and so mainstream boring; every day challenge is to be loving and celebrate love and give gifts that are not expected. However, since having a child age 3 and up, my point of view has totally changed. I see how the day can be fun and a celebration of love not between romantic partners, but for family, friends and the idea of inclusion in terms of school age kids’ making valentines for everyone in their class, especially age 4 to at least 8 or 9, when gender is not so important and children are excited to make valentines for their friends and family. Of course being an artist and art therapist, I have used the day as an occasion for making art with my child and patients. 

The idea of making your own valentine came from my child when she was 4 or 5. We were cutting out little hearts to decorate for each person in her class. The first one she made she liked so much she asked if it could be for herself. “I like this too much; I want it to be mine!” she said, excitedly. How cool was that. From the same person who said, “of course you have to love yourself,” when we were talking about who we loved the most. What a great idea, while making valentines for others and focusing on who you love, to make one also for yourself. I think she ended up keeping two of her own. We always make one for the teacher and she makes me one and I make her something extra special each year. All home made with art supplies.

This year was no different. Valentine’s Day happened to fall on a Friday, one of my busiest days in my practice. I went to work thinking, I want to make valentines’ cards with my patients and invite and challenge them to make themselves a card. I had a few phone sessions which worked out well for this directive too.

The main idea is to make yourself a Valentine’s Day card and in so doing , remind yourself to love yourself. WIth each patient who did this, I asked them if they would be comfortable for me to make them a card. Nobody refused! For adults this was definitely more oriented toward female clients, or it might have been that everyone I did this directive with was comfortable already with making art in the session, so they happened to all be women.

Anyway, for the people who came in person, I had lots of materials out all day, including: colored cardstock paper for the card, sharpies colored and metallic, decorative paper, foam heart shapes and other shapes, jewels, rhinestones and lots of fun stickers… I had fun in the session making each patient their card, and discovered a new kind of card — the triple decker card. I had cut a small peice of colored paper for a card and realized it needed to be bigger, so I added another card and glued it on top. Sort of like a stacked cake. 

This directive is a simple example of how great art therapy can be for helping people appreciate and accept themselves as they are right now, not who they have been or want to be. Also, accepting a card from me seems to be a sort of connection to their own therapy process and their appreciation of their work on liking themselves in art therapy. The card from the art therapist functions on many levels; as a “transitional object”, as a concrete object to represent the therapeutic relationship, as an indication of the trust that has built in the relationship with the therapist, and as a positive kind of statement about being in therapy and feeling good about it.

Making Valentine’s cards all day long from 8am until 8pm was definitely a fun and different way to spend Valentine’s day. I think throughout the day about 6 of the 8 sessions I had involved making Valentine’s. With the phone sessions, there was a fun part of the process involving knowing what we were making and having a surprise email afterwards, emailing back and forth photos of our cards and knowing that the patient would be getting their card next week.

I also made a Valentine for my colleague during our peer supervision and she made herself a birthday card. At the end of the day, I realized I had not had time to make a card for myself! As an art therapist I am a firm believer in doing the art you ask your patients to do always, so I knew I would be making one for myself. Yesterday while drawing with my daughter, we ended up making Valentine’s for each other; I had already given her two on Valentine’s, but as I started my own one, she asked for it, so I had to make a whole new one for myself. I had fun doing it, especially enjoying writing the phrase: “Happy Valentine’s Day to Me”, with the idea that anyone can look at my image of my valentine and say it to him/herself!

I am happy to be less jaded as I age, and a convert to all things childlike: hearts, rainbows, glitter, beads, Valentine’s Day, stencils, coloring pages, mosaics, all of which I had much disdain for when in art therapy school. Thankfully, I now know better and have a much more broad view of art making and art therapy.

Happy Valentine’s to me and to you and your Self! Make yourself a Love card as a reminder to love yourself every day…

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Photos: Top, my own card to myself, Sharpie on collaged paper cut out heart
First on bottom: Triple decker pieced together card for a patient, mixed media on cardstock
Second on bottom: detail of above
Third and fourth: other valentine’s cards made by me for patients
Fifth and Sixth: front and back of a card I made for my daughter
Last photo: Part of a Valentine made for a patient

The Relationship Map: A Great Art Therapy Intervention!

The Relationship Map is very simple in structure: it is a mandala (sacred circle) drawn on a colored square piece of paper with a smaller circle inside it.

I have found it very useful to do this “intervention” with many adults patients, especially people working on their relationships with other people and learning to set better boundaries. The goal is to build/establish a balance between rigid and loose boundaries, thus “flexible” boundaries. If you imagine a barrier that feels like a brick wall, that is a rigid boundary. An overflowing puddle is an image of a loose kind of boundary, whereas a flexible boundary would be some thing that can move and tighten and loosen based on the circumstances of the here and now, so it is a balancing act, and we all have challenges working on our boundaries. The people who seem to find this exercise the most helpful and useful are those whose boundaries are too loose. They merge easily with others and have a hard time setting limits and saying no. Things like giving people money with no consideration of their own finances, overly caretaking, doing things that later make them feel resentful and upset, but caught in a bind where they feel they have to be “nice” and saying No I won’t do that, or I don’t like when you do that, or I disagree with you, feels like they are being “mean”.

We all have had challenges at crossroads in our lives where we look around and question our relationships and sometimes “weed the garden” and get rid of anything toxic, which could be very deeply rooted.

The first step is to pick a colored square piece of paper and put a paper plate about the size of a face on it and trace a circle. Right away you have a symbol of the self, a mandala. Then I invite you to write your name in the middle with the colored sharpie of your choice and put a heart or other shape around it. Then you write down qualities about yourself such as kind, creative, optimistic, good friend, compassionate original,adventurous, kind or whatever you come up with. It’s a time I will observe to my patient, “You forgot such and such” and give then additional qualities I know to be true about then that they overlooked.

Next, you draw a smaller circle with isn’t the big circle. The big circle can be conceived of as a barbed wire fence with xs in it and then the area outside it you write toxic zone. That is the area to put the people you can’t interact with at all anymore who have become poisonous. It is very therapeutic to have your therapist witness you place bad abusive people in your life in the toxic zone. I am not a proponent of the theory that forgiveness frees you. I actually believe there are people who are so damaging to you that you cannot forgive their actions unless that person realized how terrible s/he has been to you and take responsibility and apologize which, is not a frequent thing. So putting even your own parents in the toxic zone and bring supported about setting a form bound site of no longerletting them into your life is a very powerful aspect of healing.

Another dimension of this relationship map involves, what you start with, whom you put where, and whether you include your therapist herself in it. I also give people an opportunity to suggest people include dead people or animals as well with a different color or shape around them. Some of the nuance of the use of the circles is where you put the person. a person could be right on the line, meaning they are going in one direction or another soon but you’re not quite sure, or someone you just met would be appropriate to put in the outer circle. When someone puts new people in the inner circle, it provides a great opportunity to discuss their patterns of trusting right away and letting people in too quickly perhaps.

The other great thing about this relationship map is that you put the date on it, and make a new one a few months later. I usually have the patient do the whole thing and then bring out the older one and we can see what has happened, who has moved where, who has disappeared altogether, who has appeared, etc.

Below are images of an example of how to make a map like this.
Having a visual diagram is actually a very powerful way to take a good look at the relationships in your life and re evaluate what you want from others and, most importantly, who deserves to share your good qualities that you wrote in the beginning…

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Multiple Blog Topic Disorder!

I have so many ideas and so many different topics I am thinking about and wanting to blog about my head is spinning! This happens to me in other areas of life, like my art making: Suddenly presented with even 20 minutes (which is a ton of time to have to myself these days) in my studio I have to make a quick decision as to whether to start something new, work on my graphic novel, get back to my big huge project, do another weird mixed media thing that is newish, or pick up a piece and keep working on it, or just chill out and do a collage in my journal. In a case like this, luckily being alone and in my studio, I just go for it and usually just do what feels easiest. If I am at my home and have a very rare opportunity of being alone with a million choices and a few hours time, I am extra challenged. Either I try to do a little of everything, or force myself to just clean some area or do what I did yesterday: I had a book I wanted to read and just sat on the couch reading that book for several hours. That was relaxing for me. No noise whatsoever, no need to look around at the chaotic apartment or be distracted by other things, just focusing on a fascinating riveting book I was learning something every page.

So I could blog about that book or topics related to it. But I have so many topics buzzing in my brain. In no particular order:
1. choose the easy way out and find a cool cultural ritual to discuss and celebrate.
2. pick something to add to the series I’m doing on society’s view of mental illness and separating fact from fiction
3. Mindfulness and how it is used in therapy and everyday life, prescription for any human suffering from anything or avoiding suffering
4. Basic fundamental of the idea of DBT, the dialectic between acceptance and change…
5. Self worth, liking yourself, self esteem, self love, whatever you want to call it and why it is so difficult to deal with in oneself and others and as a therapist as all patients seem to share this issue…
6. Importance of validation for parents
7. Trauma, a million topics emerge from just that word!
8. A holistic view of what “Recovery” means and how it can be empowered and person centered…
9. Borderline Personality Disorder, the hush that still surrounds it, despelling myths
10. many things you might share wtih someone with Borderline Personality Disorder even though you don’t have it, so why does everyone get so angry at even the name of it and why did people argue about it not existing and not being correct to put it in the DSM5 or changing the wording…
11. 9/11 is creeping up on us downtown New Yorkers, what ghosts still lurk down here and in our psyche and collective psyche as humans?
12. All healing boils down to finding balance, following the “Middle Path”. Why is this so incredibly hard to do???
13. Body image again: how can someone say that their low self worth has nothing to do with their body. Liking yourself starts with liking the form that you are in as a person, your shape and size, the inside of your body, things your body does, things you don’t know it does, what you do to it, put in it, stimulate it with, relax it with, soothe it with etc. what is the definition of negative and positive body image? If our own culture is any sign of our relationship with our body, we Americans have a very distorted image about what a body is and a lot of preoccupation with what shape and size it is and what kind of outside appearance we have, and obsession with food, nutrition, good eating, bad eating, dieting, fasting, extremes and middle grounds, feeding our babies and kids, etc. When you think about that, you have to really look at yourself and see how much you unconsciously on a daily basis participate in these fixations…
14. making assumptions about people too quickly. Learning to go back to the child’s curiosity and scientific investigation of everything you encounter through every one of your senses…
15. I can’t end at 14 as I have a crazy preoccupation with odd numbers. For alarms to wake up I have to set the time at an odd number, 8:01, not 8 for example, so I can’t end this post with only 14 topics. I guess the 15th is also about indeciciveness and making choices.
16. Uh oh I just remembered another. Noticing in your relationships with others, do you have some conflicts that could just be reduced to having totally opposing types of coping skills? This is so common in couples as opposites do attract.
17. “Look before you leap” versus “He who hesitates is lost.” The dilemma of the extremes around decision making and reactivity, ie. the person who spends too much time with a pros and cons list versus the person who can’t tolerate being in the “I can’t decide, I don’t know” zone and goes in the direction of acting on impulses and quickly…
18. The use of dollmaking in art therapy.
19. Systems theory explained simply: we all have many parts inside ourselves and we can get to know them better to help them work together. Often extreme crisis, even psychosis happens when all your parts of your psyche are at war or shouting at you at once. Hearing voices could be related to hearing from your parts… (look at “The Beautiful Mind” as example.)

Ok. I am sure I have a hundred more topics but at least I got some of them out there as things I want to investigate. Usually I veer towards making decisions too quickly, but I guess blog writing is helping me slow down, notice my mind’s chaos and speed and curiosity, wanting to connect many ideas and actually having a hard time making a decision!

The Altered Book: A Great Project for In Session Art Therapy

When I was in graduate school for art therapy, I had never heard of an altered book or seen one, and certainly it did not come up in my “Materials” class. We did not get assigned any kind of Altered Book in any class, whereas now I am hearing from grad students that in some class or other, one of their assignments involves an altered book, which is usually assigned to do outside of class.

I think my first experience of an altered book may have been at the Outsider Art Fair. I distinctly remember going to this Fair years ago when it was always in the lovely Puck Building, which is still there, located on Lafayette near Houston St. in Soho, downtown NYC. In fact years before that, I had some of my graduate art therapy classes in the Puck Building and we organized the student art show on one of the floors of this building. It is certainly a beautiful building. The last time I was there for an art event was the comic book graphic novel fair a few years ago when I met one of my favorite graphic novel authors/artists, Lynda Barry. It must have been back in 2008 when she had just published this beautiful book about her art making process, called “What It Is”. Anyway I think I saw an altered book years before that encounter in the same building. It was made by a female outsider artist and I remember the book being very thick and beautiful and having a lot of glue on all the pages. It was very inspiring and I wish I could remember the artist and find a photo of it.

I made my first “altered book” years before that without knowing it was an “altered book”. It was not quite what we tend to think of these days when thinking of Altered Books. I took all the pages out of this strange pretty bad dramatic novel I did not read and altered the cover completely to the point where it was not recognizable as having been a book. I put a lot of plaster of paris on it and then mod podged tissue paper collage. Then I somehow found part of a cardboard box and attached the book to it so the top opened up as the cover. I think I used the pages to rip up and glue inside the box. I will take a photo of it. Strangely it was a gift for a close friend, but she was a close enough friend that she told me she found the box to be too disturbing to use or look at, so I took it to my studio, where it has been more appreciated! It inspired one person to make something like it with me, and she ended up taking a dislike to the project and left it with me when she left town after we went through her art that she had done in art therapy with me. I still have that rejeccted box in my studio as well. (It inspires me to write a whole post about “ugly” and “rejected” art work and how it is therapeutic in art therapy!)

More recently, a few years ago I stumbled on an online class about altered books, and in fact I have now taken 3 online classes about it, each class covering different aspects of the art making process involved in altering books. I have been making them with patients for a while now, and by making, I really mean inviting patients to try it out and see if they like it. The first part of the process involves the explanation of what it involves, which is, basically, you choose a book and then you can start anywhere in the book or with the cover or back cover and start picking art materials to use on the book. The first steps also often involve ripping out pages from the book, either to use in the book or to throw out. It is usually good to do this at the beginning as a way to give yourself permission to “alter” the book. We all have pretty fixed notions about the sacredness of books, which I think still exists despite the internet, reading on tablets and other devices, or perhaps, the tablets have made books seem even more precious. Jumping in to starting an altered book project requires a certain amount of adventurousness, ability to tolerate anxiety about the unkonwn and anxiety about trespassing a boundary and destroying something in some way in order to create something completely new. It also involves changing ones mind in framing the idea of that book, from something to be read and kept intact, to an object just like any other “found object” to transform and make your own through your own creative expression.

There are many different aspects to altered books as part of the art therapy session that are quite fascinating, so this post will only touch on the first part, the beginning. Once invited the interested patient will next be introduced to the random assortment of books I have to choose from and pick something that speaks to them to alter. Usually Hardback books are more inviting as it is easier to treat the cover like a canvas, but lately I have seen a few people pick soft cover books, becasue I have a few that are an interesting size, kind of square and with a lot of photos, and a cover that is more sturdy than the usual paperback. So far, nobody has decided to go home and pick out one of their own books. Part of this I think is the therapeutic value of taking a book that’s in my studio already taking up space as a book waiting to be chosen, so the process of accepting this odd art project is made easier as you are not “ruining” one of your own books. And I really have a strange random assortment of everything from dictionaries/thesauruses to cookbooks to spiritual meditation type books. Included is a thick hard back Italian novel and some other random novels as well as several books with pictures about fashion or the styles of certain decades. I have a travel guide. I had a guide for artists about materials and how to use them.

This aspect of rejection of the project that began when I made my own rejected “too intense” book box and then an “ugly” book box with a patient is a part of the altered book project. I have had a few people pick out a book and start altering it and then by the next session ask to shelve the project until “I’m in the mood for it. It’s too daunting right now.” The Altered Book will either be seen as a great container that is continually inviting or sometimes it represents being overwhelmed and unable to make any decisions about what to do, resulting in the project getting “shelved”. One of my patients started a first session very excited about all the varied materials I had, wanting to jump right into art therapy and got going very creatively with some book that she even worked on for the first few sessions. At some point I think she started cutting pieces out of the book to create a kind of box within the book, maybe even using an exacto knife. Then in the next session she declared she no longer wanted to work on it, was not in that “headspace” anymore and went to other forms of art making. She made great use of art therapy but never went back to the book until we were terminating and she fondly remembered it as her introduction to me and our work and I think decided to take it with her. The book project just functioned as a jumping in point.

Why do some people get excited to do an altered book in the first one or two sessions of trying it out and then run away from it, shelve it, reject it? Maybe when this happens it is because I, the art therapist, am actually more excited about it than the patient and have high expectations for it being a great kind of project for long term therapy. Perhaps for some people, there is too much commitment too early and they are not really ready for it.

The other interesting thing about doing Altered Books is when people do get invested in them and go back to them every session. Lately that has been happening, probably because a few people in my supervision group randomly chose to work on altered books without my prompting them. Two people have left the group with unfinished books they have taken with them. One person brought her own book to the group to alter with materials from the studio. So that energy of the altered book I really believe was “percolating” for a while in the studio. I had another rejected altered book started about a year ago in one session and then put aside. For a while I was not really focusing on altered books in the studio, just taking these classes and thinking once in a while about it, and learning more ways to approach the Altered Book.

At this moment, my studio feels filled with Altered Books! Like anything that grows in a garden on its own, it feels like this altered book contagion has just sprung up naturally. Just this week I introduced the altered book as an option to 2 patients who got excited about it, chose their books and jumped right in using different media. Last week I had started my own altered book project in the supervision group I facilitate, thinking that now that I have so many patients working on them, I want to do one at the same time. So I chose a book that is a guide to artist’s materials for artists. It was very exciting to imagine taking this book that divides up all the materials and methods and painstakingly describes how to achieve certain effects, and how to “properly” use the different materials and media and rip up the pages and paint on it and collage ripped pieces on to the pages to start the process of making it into a book I hope will be hard to guess exactly what it was even called or to have a vague sense when looking through my book that there are a lot of pictures of how to make art and art materials terms but nothing much else kept from the original book. Synchronicity abounds in doing altered books. For me it came when I opened the book and realized it had belonged to the friend who rejected my first book box project and returned the gift to me. Of course I ripped her name out of the book first.

Anyway, at this moment there are at least 8 altered book projects that have been just begun or are in the mid stages of alteration. If I actually count how many patients have started altered books recently, excluding the person from last year who has not expressed interest in going back to the project, it would be 7, so my guess was not far from wrong, as I am the 8th and then there are one or two people in supervision doing them.

The next post would raise the question: What helps a person stay with an altered book project and continue working on it regularly? and What is it about Altered Books that some people become “blocked” or lose interest after jumping in excitedly.

The one thing true of everyone is that the beginning, that first session of being invited to make one, choosing the book and jumping into it or onto the cover and starting right away to alter it is universally exciting and stimulating. I have only seen people be intrigued and excited when they begin this process. Some express having a weird feeling about “destroying” a book but when encouraged get past that feeling. The fascinating part of the Altered Book is after the initial excitement and embarking on this without a doubt long-term project, there is a moment of remaining with it and committing to it further through getting inside the book and getting going with paint, collage, mixed media, ripping out pages and getting one’s hands dirty. It seems to require about 3-4 sessions at least to determine if one is going to get “turned off” of the project and too overwhelmed, or further jumping in and committing more and more to it. Those who find it to be a kind of safe container stay with it. Leaving it with me in the studio is a big part of that process. I will hold on to their book until they come back to it, so they don’t have to see it for a week. It is very different to work on a long term art project whether it is because the work is very large and will take a long time to finish no matter what or the project by its very nature requires time invested. It is hard to work on a lot of pages at once, especially if you are using any kind of paint or ink. Anyway, leaving the book with me allows the creator to take a break from it and not have to look at it in between sessions. This seems to help the project to become a safe container and holding environment. Even with my own altered book, I decided to try out at first just working on it during the supervision group and leaving it alone, so I also take a week off from it, in order to further get into the experience of my patients and supervisees doing this kind of project…

To be continued…

Here are some photos from my own altered book which I have worked on in different situations, first started it in the supervision group I facilitate, then worked on it alongside several patients who are doing altered books as well as in my studio the other day when I added a kind if nest into the book…

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The Pregnant Therapist, Continued: The “Recognition” Session

Finding Out About The Pregnancy: “Intrusion” in the Therapeutic Space
This post got so longwinded, I’m not sure what to do with it, so I will edit a few paragraphs, and save the rest for another post continuing this longwinded “pregnant” topic! At least it won’t take 9 months to write about it…
You are pregnant and in your office with your patient. There are now 3 heartbeats in the room.  Now, jump ahead to your fifth month. If your patients haven’t “guessed” yet about your pregnancy, this is the time in which you will have a lot of “pregnancy recognition” sessions and a few sessions where you might actually inform your patient about the pregnancy and help him/her prepare for the upcoming changes, such as your maternity leave.
In one of the books I mentioned in my last post, the authors remarked that there are many ways your patient may let you know that they have become aware of your pregnancy besides direct verbal comments asking if you are pregnant, including dreams and images, even discussion of the patient wanting or not wanting to have his or her own baby.
Sometimes a patient, usually a woman, will wait a few sessions to see if your belly is getting bigger, as many women are sensitive to body image and don’t want to make a big “mistake” and find out you have gained weight for some reason and are not pregnant. I’m sure this happens sometimes, as I’ve had a few patients tell me they get asked if they are pregnant, sometimes by strangers, and are not. (Not always people who are overweight, but nonetheless, an odd unpleasant experience no matter what you look like…) Of course this can be very wounding to a person and most of our patients are very careful not to hurt our feelings, especially if they already know what it feels like…
(Confidentiality note: these “stories” are made to be not identifiable, as I do not supply any identifying information beyond gender of the patient. In some cases where the gender is not important, I have changed that, but given the nature of pregnancy, often the reactions are different in women versus men, as well as children, teenagers, adults, older adults, etc…)
So by around five months into my pregnancy, I had to have the inevitable “Recognition” session with each patient. Each person reacted completely differently.
One person had discussed noticing it with another patient, a friend of his whom he saw once in a while, and the two discussed it and decided the one who noticed would say something so he did. I don’t remember much of that session as he was fairly honest about his feelings and reactions. Then the friend came for her own session and got distracted by focusing on feeling bad that she didn’t notice, and her friend did. This may have been a convenient way to avoid the real topic, but I pointed out that I actually saw her “not noticing” as a good sign. Given certain issues around boundaries she was grappling with, I observed that it was great she was able to be so focused on herself.
One patient had a very interesting reaction. As a woman with mother issues (just like the rest of us, who doesn’t have mother issues!) that were unresolved. ambivalent and complicated, she was overly sensitive to my being pregnant and told me she was very concerned that her own negative energy would “hurt” both me and the “baby”,even though I reassured her that this was not the case. She simply did not believe it and was convinced she was right. While I was on my leave, she communicated to me that she could not come back to therapy knowing I was a new mother and explained as thoroughly as possible the issues this knowledge was triggering and not wanting to process them with me despite encouragement…This is an example of a patient who cannot be comfortable during but also after the pregnancy, as opposed to the majority of patients who do return to therapy with their now mother therapist. Quite a few young female patients openly admitted to feeling a discomfort in the sessions and being very aware of my body changing from week to week. One person expressed this through chronic lateness to the sessions and had no interest in exploring the connection to my pregnancy… Of course I supported all reactions, and once I knew the discomfort caused by my actual body changing, I was more sensitive than usual about checking in with people a few times in the session to see how they were feeling about it.
This reaction is related to the conscious and unconscious feeling many patients have that the now pregnant therapist is and will become more and more sel preoccupied and unable to be present and focused in the patient. Most children feel this way and show it non verbally. Having a younger sibling does not always mean a child is more comfortable with the therapist having a baby. The therapeutic space belongs to him or her and many children feel the therapist is going to be inattentive and absent. This reaction at any age can be very real in many ways. The pregnancy is a very real intrusion as well as a big or little distraction for both therapist and patient.
For me, as I contined to view my work with patients, despite the changes of pregnancy, I continued to see my work as a good distraction for me from focusing on the pregnancy and the inevitable birth of the child and shock of now having a real human to take care of… I could not avoid talking about it at relevant moments and accepting that it was very disturbing for some. Even the people who ignored it completely, were nonetheless deeply affected by the change in the therapeutic space, however, they ndicating that it was easier for them to “forget” about this intrusion and sort of get rid of the belly in order to avoid some kind of discomfort. Other therapists that I’ve talked to during their pregnancy have expressed that it was increasingly difficult to focus on and care about their patients, especially therapists at very difficult often traumatizing jobs, so this concern is very natural and needs to be addressed even if the therapist or especially if the therapist is colluding with those patients to try to ignore the inevitable change, that the therapist will be taking a leave, some short, some longer, and the patient has no control over the timing of it in their own life’s journey and their own progress/process in therapy. The return of the therapist is also not in the patients’ control. In private practice, there is usually trust that if the therapist says she will return in two months or three, she actually will; however, I have known a lot of therapists in all kinds of jobs who have been unsure of whether having the baby will cause them to decide not to return to their job, or to return briefly and terminate. In short term settings, the pregnant therapist usually has more emotionally laden issues with the rest of the staff, rather than the patients who may be at the site, such as a hospital, very briefly. These patients tend to be the least affected by the therapist’s pregnancy, although in many cases, people still have strong reactions and transference towards the pregnant therapist, more related to their own particular feelings about mothers and mothering… Thus, short term sites can actually allow for some interesting issues to emerge in therapy and art therapy groups when the pregnancy is addressed in a less personalized way. Discussions that would not normally occur may happen due to the pregnancy bringing up a lot of issues and feelings…
There is much more to say about the topic of “Recognition” and lack of it (thus the therapist’s inevitable “Announcement”. When in the session to tell the patient and how are another interesting focus to be further explored, as there are going to be people who simply do not say anything and even admit to waiting for you to tell them, as well as those mentioned above who probably are avoiding it altogether…
To be continued…

The Pregnant Therapist, Continued! Part 3: What Little Info Is Out There Still!

This is my third post on this topic. I am planning to put together some kind of workshop for therapists that will be about the very particular experiences in therapy for both therapist and patients regarding the pregnancy of the therapist. In my experience, there is very little preparation, actually maybe none, for the female therapist regarding how to manage the very unique experience of pregnancy, especially those experiencing it for the first time. In my personal experience, it was never discussed in my grad school program, although, actually, while I was in grad school, one of my classmates got pregnant and went to her internship during the beginning and middle of her pregnancy. She had her baby after we graduated, but I have some vague memories of her sharing some of her experience with us. At the time, pregnancy and babies were not in my radar or future plans, so I did not retain many memories of what her experience was like, besides that there was nothing in the curriculum about it, and besides one woman with teenage children, she was probably the only person in the class about to be a mom.

Anyway, I did find two helpful books that I read while pregnant. Both were not recently published. I don’t know where they are in my bookshelves, but I think they were the following two that I found on Amazon after a big search:

First one was published in 1994: The Therapist’s Pregnancy: Intrusion in the Analytic Space, by Sheri Fenster, Suzanne B. Phillips and Estelle R. G. Rapoport

The other one was: Awaiting the Therapist’s Baby: A Guide for Expectant Parent-Practitioners, by April E. Fallon and Virginia Brabender, published in 2002

A quick google search just now (2012!) did not produce much besides the first book mentioned and a short blog post on Psych Central: http://blogs.psychcentral.com/unplugged/2010/07/the-pregnant-therapist/

So this short post simply reveals that this is a very important topic for women therapists who are curious about the topic even if they are not sure they want a child, or thinking about becoming mothers, of actively trying to get pregnant, or pregnant right now and experiencing the “intrusion” in the “analytic space” or therapeutic space as I prefer to call it.

On the one hand, I am happy to have stumbled on a topic that is very relevant for therapists and patients of pregnant therapists, yet not a very popular topic that has been written about exhaustively. Seems like there is plenty to say about it, and not much that has been written since 2002, ten years ago! The first book which is probably more well known, is way out of date, as it was published almost twenty years ago!

In posting about this topic, I am curious to hear people’s experiences both as therapists and patients. In addition, since my pregnancy, I have worked with pregnant patients as well as patients who are thinking about having kids and for one reason or another know that I have been through it, and found that to be an interesting experience. I had one therapist patient who went through my pregnancy with me, came back after my maternity leave and then got pregnant and went through her pregnancy with me, leaving therapy to have her baby. I also have worked with patients who came to therapy due to the loss of miscarriage and seen some of them get pregnant and work with me through their pregnancy. I have also had patients who have gone through the experience of abortion and processed this experience with me, a whole different but very important topic as well, as it can be a lonely difficult experience in which the person needs a lot of support for various reasons, especially the often secrecy of this process, in which a woman often does not want her family to know and only tells a few people…

I have also since having my own child been a close witness to colleagues who have gotten pregnant and experienced the “before” and “after” of private practice, in which your caseload goes through a lot of upheaval in terms of patients who stay through your pregnancy and return after the birth, patients who leave in the midst of your pregnancy, and patients who stay up to your leave and then do not return. Of course, how a patient leaves therapy in the course of a pregnancy and birth can be very important, just as it is in general. Having someone process why they are leaving and terminate in a more healthy manner is very different from some abrupt terminations, and some that come with no communication whatsoever. By chance I had a few patients who were moving out of NY during the time when I was pregnant and left before I had the baby. The termination was the more natural kind with a lot of time to process the person’s leaving therapy due to moving and their feelings about leaving as well as feelings about “missing” the opportunity to work with me after the birth, which they were all curious and slightly sad about in addition to the other feelings around termination… One of my patients had been processing a lot about whether she wanted to be a mother or not and had a lot of ambivalence about it. She found it helpful to see me go through the pregnancy and share some of the experience with her before her move. She subsequently sent me a very nice package with a hand made gift for me and several baby gifts. In addition, she emailed me a couple of years later to share her announcement of her own pregnancy and the birth of her first baby. Of course this was especially meaningful and I was thankful to find out about her decision and happiness about becoming a mother…

So there are many aspects to this experience for both therapists and patients. I found it an odd synchronicity that for some odd reason, before my pregnancy in my private practice, I do not remember working with a mother although I may have had a few patients with kids that I forgot about; I do remember working with a father of teenage girls, with whom I did discuss parenting, especially the particular experience of being a father of teenage girls. I actually used my own experience as a teenager to reflect with him upon the particular challenges he was dealing with. Once I became a mother, I started working with more patients who were pregnant, trying to get pregnant as well as people who were already mothers.