Day Before Workshop!

All blog posts related to this workshop will have the category that you can search, “Altered Books Gender Identity Workshop”.

I am excited for tomorrow’s Altered Books and Gender Identity/Gender Diversity Workshop that I am fascilitating at the Expressive Arts Therapies Summit Conference from 2-5pm.

I will be posting materials for the workshop, used in the workshop, and for workshop participants and others to have that have not been fully covered or to continue any topics about altered books as art therapy and gender identity and diversity.

I am going to be “showing” more than telling, in terms of directives that are useful with clients using altered books and directives about gender identity and both.

 

 

The main focus of the workshop can be summed up as:

Let’s play with gender, and let’s acknowledge and celebrate the gender spectrum. Your altered book in progress is your personal gender story unfolding.

I will try to post photos and images to these posts when I have time and hope to post photos from the workshop itself, which I will be writing up to submit to the new Trans Bodies Trans Selves book…

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Being Authentic to Myself and Others, Both as an Artist and a Therapist

It is not easy to be honest with oneself, to confront strengths and weaknesses, to take off the masks and see ones’ true Self and be authentic to oneself as well as others.

What does this really mean? I read something recently about “right speech”, as in mindful speech. One key is to ask yourself if what you are saying to yourself or anyone else is “true”, “kind”, and/or “necessary”. We may not always be able to do all three, but I think it is a safe bet that if you are aware of at least two of these, what you are saying is more likely to be authentic and “real”.

What are we all doing on this planet? What is life truly about? What is meaningful and how do we spend our brief time on earth in as meaningful and authentic a way as possible. What does it mean to contemplate your life’s “purpose”? I think these questions are important ones at every age and stage of life.

I am at a turning point in my life, which I have realized more through the process of really contemplating the passage of time and the new year. In my process with my patients of joining some of them in writing down what we are ready to let go of from last year and what we are wanting to focus on and embrace in this new year, I have learned that I want to be more true to who I am, and more authentic to myself and others. I read a great blog post about how therapists often put a lot of “baloney” and fakeness in their public profiles and even the photo can be hiding more than revealing. I think the patients over the years who have confronted me about what I am about and what I have to offer. Sometimes being a bad fit with a patient can teach you a lot about what and who you are as a therapist and person and what your limitations are.

It is always strange to come to an awareness about myself, I have found, as usually it hits me over the head and then I say, “wow, this is so obvious, how come it has taken me so long to figure this out. what kind of fool have I been, etc.”

Maybe the truth about getting older is that you come to see more what you are about and what you have to offer as a human, a parent, a family member, a partner, an artist, a therapist, etc. How can you have self-acceptance without being real about who you are.

This blog post I mentioned above: https://girlintherapy.wordpress.com/2015/01/03/dear-potential-therapist/, as well as the reflections on the passing of the old year and the coming of the new year actually led me to look long and hard at my therapist profile on Psychologytoday.com, the sort of Yellow Pages of therapists website. I had an ok photo, but I updated it to reflect that I am older and do look older, as much as I may be vain about my hair and like it better in the older photo. Then I rewrote my personal statement, trying to follow some of the advice of Girl In Therapy, to avoid a lot of intellectual garbage and boring explanations, and take a risk and show something of the Real Me, that my patients all see anyway. And to make it more personal. I may not have shared my interest in Chakra and Tarot and other things, but I talked about my tea, as the first thing you will be asked when you come to my studio office after the preliminary greetings, is, “Would you like a cup of tea?”

I thank my colleague Nadia Jenefsky at ArtSpa (https://nycreativetherapists.com) for many years ago introducing me to the idea of sharing tea with whoever comes to the studio, when I went to her first office for the first time, probably about 8 years ago, and she offered me tea. (FYI, for those interested, they are having their 8th annual Open House at ArtSpa on January 16, 6:30-8:30pm so if you’re in Williamsburg, I recommend visiting, quoting their invite: “Try your hand at art therapy. Dabble in drama therapy, Eat good cheese. Drink a little wine. Network the old fashioned way—in person!
Every year for the past eight years, we have welcomed friends, colleagues, and other Willliamsburg business owners to make themselves at home in our creative arts therapy studio. We hope that you will join us in anticipation of a healthy, happy New Year.” Knowing my colleagues there, I am happy to say that they have a great thing going on there, really unique in the field of creative arts therapy, so I am always glad to send people their way!)

I lived in Japan for two years when I was 11 for fourth and fifth grade, and that was when I learned/discovered the ritual of tea and that drinking tea with others is a lot more than just sharing a hot drink on a cold day. Tea has always been associated with ritual, connection and camaraderie, with the sharing of current news of your life with another person. It’s cosy, full of variety, warming on a cold winter day and cooling on a hot day. From collecting teas and being given great new teas, I have developed an array of flavors of herbal non caffeinated teas as well as a supply of a variety of green and black teas. For a long time, I saved tea bags, and collected and displayed them all around my studio with dolls I had made. I was inspired by seeing art made on tea bags, and I have used tea bags in my art, from gluing them onto canvas, including them in altered books, painting them, adding them to dolls, even gluing tea bags together to form a doll’s body.

Anyway, that blog post got me thinking that when people see your profile on psychology today, they want to see what you really look like and what you are about. This makes sense as all the studies on the effectiveness or lack thereof of therapy point to the fact that people feel they are comfortable with their therapist and making progress in their therapy when they feel good about their therapist and actually “like” their therapist. Everything seems to point to it being NOT as some would think about what you studied, what your “approach” is, whether you are psychodynamic, cognitive behavioral or “eclectic”, but just how the patient feels coming to your office and sitting sharing with you for the session time. Of course one’s training and education and professionalism are all important, but the human element is too.

So here is what I put in my new revised profile. Let me know what you think. 2015 for me is all about taking risks and trying to be braver, so even if I fell on my face or went too “out there”, I am happy to be trying hard to be as authentic and true to myself as possible.

As an artist, it is easy to be myself, because I just make my art and let it come from my creative place and I follow where it wants to go. I love making stuff because it is such a free and playful process. I hope I can be more free and playful in other areas of my life as well!

Here is the link to my profile: http://therapists.psychologytoday.com/rms/name/Natasha_Shapiro_ATR-BC,LCAT_New+York_New+York_65057

This is what I said:
We all have a creative spirit within us; I strongly believe that depression anxiety and other imbalances are fundamentally a wound in the creative spirit. Art therapy with me involves our embarking together on a journey to find and nurture your creative spirit; we may make art together; we may talk about what’s missing in your life and reconnect to your life force energy and find images within you. The journey is yours. I can help you find your true self and open up to awareness, self discovery and self acceptance.
Art therapy includes a variety of approaches It is useful for exploring emotional issues as well as other goals and relationship challenges. Mindfulness, sitting with yourself and being in the here and now, is one important key to growth and increased self awareness.
When you come to my studio office, I will offer you a cup of hot tea in winter and mixed flavor herbal ice tea in summer. I have collected all kinds of teas and believe in the sharing of tea! Also, I love to work with culturally, ethnically diverse clientele.

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Is This Art My “Art Therapy” Art or my “Artist ‘Real'” Art?

This post is probably mostly of interest to other art therapists and those who are curious about art therapy and its connection to “Real Art” or “Fine Art”. There is also a big topic of “High” Art vs. “Low” Art and so called Outsider Art vs. “Fine” Art… Labels labels labels. We like labels when they help us define and differentiate, and we don’t like them so much when they limit us…

So, to begin with, for people who don’t know much about “art therapy” or “art psychotherapy”, there are usually two roads to becoming an art therapist, or two “Main” roads. One is the person who majored or minored in Psychology or took a bunch of psychology classes in colleges and got interested in becoming some kind of therapist. This person finds out about art therapy and realizes s/he also has a creative side and is interested in art making and how it impacts psychotherapy, so this person continues on the road to learning more about what art therapy is, and becoming an art therapist. Along the way, this person may have had his/her own personal therapy or even sought out an art therapist to try out art therapy as a patient. Some of these people skip going to therapy as a patient and end up in some art therapy graduate program after s/he has taken the extra art classes that are prerequesites to starting grad school in art therapy. Those who skip being a patient themselves are usually encouraged to go to therapy and at some point in their time as a grad student start therapy with a therapist, art therapist, psychoanalyst or some combination of these… This person may enjoy art making and even have a media s/he prefers working in but has not really identified as an artist before becoming an art therapist… There are many variations of this type of road towards becoming an art therapist, not in the scope of this post, so I don’t mean to have this description seem limited.

Then there is the other road, that of the “Artist” who then becomes an art therapist. Some of these people are what is called a “wounded healer”. S/he may have gone through therapy of some sort at some time in his/her life and had much more experience being a “patient” than some other art therapy students and art therapists. In any case this person usually finds out about art therapy at some point in his/her career as an artist and decides to obtain training to be an art therapist because of his/her experience as an Artist and Patient or as an Artist who is interested in the healing professions for some reason. Perhaps s/he has found art making to be transformative and healing, whether or not s/he has experienced the therapy process. So this person if need be, takes the psychology courses they may not have taken in college as prerequisites for going to grad school for art therapy…

OK. So now you’re in some art therapy graduate program. You might have gone through some training by attending some sort of Art Therapy Certificate Program to see if art therapy is for you or you just dove right into grad school. While in school, no matter what the philosophy of the school is, and there are many different kinds of art therapy programs with many different philosophies, slants, approaches. Where ever you are studying, at some point in some classes, you will be asked to make art. Some might be art directives from the teachers to get across some points on the subject they are teaching. You will probably make art in supervision class, either what’s called “Response Art” responding to your work with your patients at your internship or art work in response to a classmate’s case presentation. In some programs, there is a lot of art making that takes place in your training in the classes themselves. At the program I went to, my favorite class was my first year “Materials” class, in which we learned about all kinds of art materials and their uses with different client populations. The class was a place to do a lot of “experientials” which basically means you learn through experience of using the materials in your own art work in class and at home for class assignments. As a self identified “artist”, I loved the class as it was the class with the most art making in it, and I learned some new techniques and ways of using art materials that I considered useful both in my own personal art work and in the art I made with patients or witnessed patient making.

During graduate school at some point, the phrase “art therapy” artwork or something like it comes up and is understood to opposed to the concept of personal art work or art work that you are in process of making as an artist. I went to grad school many years ago, and a lot has changed since then. At the time, I continued to have my own art studio outside of my home, and I continued to have my open studios and continued to exhibit my work in various settings and to pursue exhibitions to further my career as an artist. I made this same distinction in the sense that most of the time, as far as I remember, I was working on some series of paintings or drawings that were very different from what I made in classes and at my internship. However, I also remember making some things that I thought of as my “regular” art work even though it was made as a class assignment. I also remember being surprised that so many of my classmates did not like making art in our classes. Even in the classes that involved more lectures than actual experientials, I would be drawing in my journal anyway, as I find drawing helps me focus on what the teacher is saying. Even these days, when I attend some sort of Professional event, such as a talk or conference, I usually draw pictures as I’m writing notes in order not to lose focus on what the speaker is saying!

Anyway, at some point in studying art therapy and then beginning to work as an art therapist, I saw there is a kind of division that exists between what people term their art therapy art work and their “actual” art work that they make at home or in a studio in solitude. I did not go to art school, but my first exposure to making drawings and paintings on paper was a very unique class that I have described more in another post, so my first experience of making art was in a room with a lot of people in it, including grad student assistants to the drawing professor as well as the professor. After I graduated college, I had the great fortune of having my first art studio, a very tiny studio but my own. I immediately began paintings that involved having friends sit for me while I painted. These were more than simple portraits, but I think, looking back at my very young beginning artist self, I see that I liked having people in the room while I made my art. Along the way, I eventually developed a taste for solitude and spending time making art alone. However, I see now that I began the process without a need for solitude and that making art among others or with others was very comfortable for me, so making art in classes at graduate school did not seem so different from making art in my studio or at home. I also along the way, probably during grad school, developed a liking for making art while watching TV, even though I always had an art table at home and an art studio seperate from home in which to make art.

As I developped my private practice, I noticed this split between art therapy art and so called more “personal” art, though maybe the art therapy art is more personal as the person is more loose and open while making it. However, I have always had art therapy grad students as patients over the years, as they sometimes want to try out art therapy as a patient, and I very much enjoy working with all kinds of students. With these art therapy grad students, they either had great discomfort making any art in my presence despite what they were doing in classes and would prefer to talk in session and make no art, or they would be quite comfortable making art in session with me, but tended to see the art they made in our sessions as their “art therapy” art, which basically means they would not think of putting any of their “art therapy” art in an art exhibition, while they might have work they were making on their own at home or in a studio that they would consider as art to put in their portfolio or an exhibit. They looked upon the art they made in school and in supervision much the same way.

Probably not everyone makes such a strong distinction in their work. However it is made enough that the topic has caught my interest and brought up questions for me as an artist and art therapist. Is there a difference between the two kinds of art? For me the blurring of the distinction began in my own therapy a number of years ago when I began bringing scribble drawings and other more “unconscious” drawings to my therapist. I noticed that a theme started emerging which I then developed in my “regular” art work. However, I still kept this sketchbook of therapy art work separate from my “regular” art work. At the time I was working with a great therapist who was not an art therapist but who enjoyed free associating with me about the drawings that I would bring in. Many of them I did on the subway on the way to therapy. A while ago with a different therapist I decided to try the same thing, with scribble drawings and bringing them in to therapy. However, this time what happened was quite interesting for me in terms of the complete blurring of the boundaries between these two types of art works that we art therapists tend to make. The sketchbook was started with making traditional scribble drawings, some of which I have exhibited in this blog. I would make a scribble with whatever I had on hand, pencil, pen, sharpie, etc. and then try to find people, heads, animals, fish, or something “representational” inside the scribble. Then I jumped to continuing that process and adding collage from magazines. My first scribble drawing with collage was a kind of bridge between the traditional form of scribble drawing and something new that began to emerge. I think the photos I’ve posted here show some of this transformation process.

Then something new happened. I continued to add collage from magazines, but I started going over the initial scribbles and making them darker and filling them in next to the collages. I think of these as a kind of “meta” scribble drawing, as suddenly the marks of the initial scribble, instead of being deemphasized in service of creating some kind of image with some of the lines, became emphasized on their own as ovals and curved lines which I then began to fill with collage elements. It progressed further to the point where I began seeking two kinds of images in random magazines. The first was patterns that resembled scribbles or marks or other kinds of black and white dotted circular patterned collage pieces that went with the repetitive drawing and filling of the scribble lines with tiny circles. This is what I see as the “abstract” “meta scribble” portion of these new works on paper. The other kinds of images started to develop repetitions, and I noticed I was looking for specific images of actual things, to be very specific: arms and hands disembodied, other body parts, animals, especially elephants, owls and birds, fish, peacock patterns, and also such things as light bulbs, dolls, strangely drawn faces, and I’m not sure what else will join this list. I also brought back a drawing of a face that was used in work I made a few years ago, so that some of these scribble collage works had drawings of this “face” that is probably thought of as a kind of self-portrait. Often I also find figures of females that are put in with everything else and often they seem to be watching the entire image or dreaming it. Words cut out from magazines have also emerged in some of these works.

It is beyond the scope of this post to discuss the ideas of Outsider Art versus Fine Art and other such topics, but I think these works represent the closest I have ever come to merging my “therapy” drawings with drawings I put up in my studio as part of a series of works I am engaged in. In fact earlier today, for the first time, I took a bunch of these Scribble Collages and put them up on my studio wall. In taking them out of the sketchbook and putting them on the wall, I make the leap from the personal to the Personal Art I Want The World To See… The other sign of this transformation was that I went from the small sketchbook to a larger one and challenged myself to do these pieces on much larger paper. This happened in the same time frame that I began to actually work on these drawings in my therapy sessions on the suggestion of my therapist even though my personal therapist is not an art therapist. So this is uncharted territory for me… To be continued…

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More Musings on the Possibilities in a Scribble Drawing…

I have been exploring and obsessing about the scribble drawing lately, both in my practice but especially in my personal art work. It is an interesting journey I’ve never been on before. Last times I assigned myself a kind of “frequent diary entry drawing” in my journal, they have mostly been mandalas or whatever I felt like doing at the time. Now I’m back to the scribble. I think of it as the origin of drawing. So here I am at its source!

Wikipedia definitition of the verb scribble:

[1] To write hastily or carelessly without regard to legibility or form. To cover with careless or worthless writings or drawings

[1] Etymology: Middle English scriblen, from Medieval Latin scribillare, from Latin scribere to write

How interesteing that it is defined as being a “worthless” product or activity, yet the origin of the word is from the word to write! Writing conveys something of some communication or other.

Generally the scribble drawing is associated with automatic drawing; as I mentioned recently in another post, the person doing the drawing is instructed to relax and draw lines and scribbles on the paper while looking or averting/closing their eyes. Sometimes it’s interesting to keep the pen on the paper and not take it off until one finishes the scribbling.

I started out doing this kind of drawing the usual way, scribbling and then trying to find something recognizable in the drawing arising from my unconscious. I posted some of these ones recently. Then over this week I’ve become obsessed for lack of a better work, with this new genre of scribble drawing with collage. The result looks really controlled; at the same time I’ve followed a lot of the original random scribbls and just darkened them. A lot of oval shapes are emerging and I’ve been into filling the spaces with small black circles. Unlike most scribble drawings with are meant to be fast and to bypass the “thinking” part of the brain, these drawings are taking longer and longer to complete. I was making them on very small paper and recently moved to a bigger size paper. I will post the one I’m in progress with.

The other interesting food for thought that has arisen in this process is that the weekly scribble drawing I’ve been doing emerged and began as a kind of art therapy exercise for myself, a kind of weekly check in. As I continued with the collages, I noticed that I’m thinking of them not as my “art therapy” personal drawings but as works in progress, part of a new series of works on paper that I will likely post on my artist website. The scribble bridged the way between self therapy and “artist” art work. Often those lines can become blurred anyway. This will likely be my topic of the next post… The photo is of a work in progress begun today…

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Silence and it’s Many Meanings

Unfortunately I already wrote a beginning to this blog 2 times, and it got erased both times, so I’ll try again.

Silence. Quiet. Breath. Pregnant pause. Calm. Peaceful. Meditative. The silent moments in a therapy sessions, filling the room. Hearing the noise in your head when you try to quiet the mind. Death. Sleep. Dreaming. Awakening. Feeling words in your head but they can’t come out. Non verbal communication. Silent witness. Silent treatment. Quiet art making, uncomfortable silence, an angel just flew through the room. Silent meditation retreat….

These are just some associations to the idea of silence. It can be deeply relaxing to be silent with someone or incredibly uncomfortable. Both children and adults at times choose on purpose to stop talking. In some cases, as a result of some kind of trauma, including deaths, accidents and all kinds of abuse, a child or adult can become “selectively mute.” S/he has not stopped being able to talk, but has “chosen” to stop saying anything out loud. The younger the person, the less control they tend to have over it. Adults in group settings report noticing that they have decided not to say anything for whatever reason, often to see what happens if they do not talk, and whether anyone notices. In a group therapy setting, a good group therapist will notice this pretty quickly and note it to the group and the person without putting pressure on him or her to say anything. In 12 Step groups, members will just wait until the new person feels comfortable enough to talk. The positive effect of this, is that the person will feel accepted and ok to just sit there and be welcomed and supported without having to say anything, which is often too scary for them. Usually the effect is positive, and the person will continue attending meetings because they feel no pressure to do anything but just show up, and often eventually after many meetings, this person will suddenly be moved to share with others. The same may be true for group therapy. Usually the group therapist asks the members to “just show up consistently” and the rest will take care of itself. In fact, when I was in one of my early jobs in my career doing a weekly group with my caseload, I forgot what this group was called, but every case manager did the group once a week, anyway, I got very concerned with coming up with ways to “fill” the group, with talk about some topic, or special music or other types of ways to hold the group. I still remember my supervisor saying, “You’re trying too hard, which is why you are finding this group stressful for you. Just show up and the group will be fine with that. Try to work less.” It was some of the best advice I ever got about leading/facilitating group therapy; I did what she said, and felt more relaxed with the group, and they probably felt more relaxed with me. Group art therapy is especially holding and comfortable for people who don’t like to talk in front of others that they don’t know well, especially when very intimate and personal issues are being shared. The good thing is that the silent member of the group can still communicate a lot nonverbally about himself or herself in the art work.

The Silent Treatment. Who has not used that with a romantic partner or parent? It’s so nasty and effective. If you’ve been on the receiving end of the silent treatment, you probably felt very hurt and upset. It’s very hard to deal with a loved one refusing to talk, especially when there is probably a lot to talk about and both people involved feel hurt and angry… Often the “Silent Treatment” can really be toxic and put a stop to any kind of positive form of processing and communicating, as both people move further away from each other, unless the silence gets broken.

Silent Retreat: quite the opposite of the above paragraph, as going on a Silent Retreat with a meditation group can be very eye opening for the individual. Choosing to be in a structured situation of complete silence for a week or even a weekend can be very powerful. People notice their inner voices that won’t shut up because as they are quiet, they become highly aware of their mind, which is usually very noisy, as all our minds are full of noisy voices, often critical exacting voices constantly commenting on what we’re doing and what’s wrong with it. When you choose to be silent for so many days, you become extremely painfully aware of your different “Selves”. It becomes like peeling an onion, and the more time you spend, the better you can be at quieting your mind so you can become more aware, more awake, more present to the here and now, and get out of your “Noisy Mind”. Some people choose one day of the week to be quiet all day, as a kind of day of rest and way to get in touch with where you’re at and Be Here Now…

There is another kind of noise in our world that we can choose to shut out and it is not necessarily sound though sometimes it does involve actual sound. Try a day with no TV, no internet, no texting, phoning or emails, no radio or outside info from the outer world. You don’t have to stop talking all together to become more present to your inner state and to what is going on around you. This is what vacations are truly for, to take a break from your life and all the “noise” in it and get relaxed and calm to be in a state of mind where you can accept yourself and even get to know yourself better.

Medication and Therapy

In my last post, I touched on the topic of medications and mental illness. This post will attempt to address some of the issues connected with this vast topic…

Psychotropic medications have always been a controversial topic in many different societies. I have had much experience working with people on all kinds of medications, as well as working with people in the midst of going off their medications, starting to take medications for the first time, and many who tried out medications and then stopped them without finding a medication that was helpful. In addition, I have encountered people suffering from various emotional and mental difficulties and disorders who were vehemently opposed to taking any form of medications but were willing to try alternative forms of healing instead of medications.

I try as a therapist and person to be open to all points of view about this topic. What one chooses to put in one’s body is a very often private and vulnerable personal topic. While psychiatrists that I have talked to about this admit that we know very little about what makes a medication work and why and how, we also know a lot more now than ever before, and there are a lot more choices of meds than ever before…

As I mentioned in my last post, I have found that people struggling with and suffering from such issues/disorders as schizophrenia, schizoaffective disorder and bipolar disorder (both 1 and 2 as they appear in the DSM), really benefit from regular medication for an extended length of time. Often the reason for a re hospitalization or “relapse” with one of these serious disorders is caused directly by the person stopping taking their medications, usually because the person feels a lot better and thus thinks, “Oh, now I can stop taking these medications,” which makes some sense, as very often when our suffering is relieved by medication, it makes sense to stop taking it. But these disorders are more like diabetes. You don’t stop taking your insulin because you feel better. When I worked at a Continuing Day Treatment Center for adults and also at a residence for emotionally disturbed children, I saw how the medications really helped people with these serious types of disorders. Almost all the adults at the CDT were taking some kind of psychotropic medication, and a lot of but not all of the children I worked with at the residence were also on medication. The topic of medication and diagnosis and children is a complicated topic better addressed in a separate post. Suffice it to say that I saw children also helped by medications, especially those with ADHD and other behavioral disorders.

While Bipolar Disorder is a serious and sometimes even deadly illness, it is amazing how much medication taken regularly can really transform someone and their ability to function, such that people who continue to take their medications on a regular basis can function and thrive. Sometimes one or sometimes a combination of medications, and there are now many different mood stabilizers whereas a while ago it was mostly lithium, anyway these meds can really help balance the fluctuation of moods from manic to depressive. Most people have to learn the hard way that they need to accept their biology and that they suffer from Bipolar Disorder, by going off their medications, having a relapse or even two or three, and then accepting it and staying on the medications that work for them. Luckily there are now a variety of mood stabilizers, and these medications don’t all take away a person’s creativity and liveliness; they just help an individual to manage their mood disorder.

Schizophrenia and schizoaffective disorder are much more debilitating than bipolar disorder. However, I witnessed many of my patients healing with a combination of therapy, day treatment which provides structure and socialization, and medication. This combination of approaches really help people with severe symptoms, such that the voices they are plagued by can disappear, or at least subside to the extent that the individual can function on some level and receive some relief. It is very unusual for an individual suffering from these illnesses to be able to not take any medications. There are many good medications out there that work; unfortunately many of these  st cause weight gain, and I saw my patients suffer with the side effects of weight gain as well as worse side effects. Some people manage to be careful with their diet and are able to take these very potent medications without experiencing weight gain. However, I saw many of my patients at the program who were on Medicaid and had poor dietary habits; still for many to be able to socialize with others, even to be able to leave their house or residence and attend the program was a big step towards healing. The medications were only one part of this; therapy, groups, meeting others with similar issues, having a structure to their day — all of this was necessary for some or partial recovery.

Depression, including both major depressive disorders and other less serious depressions, is much trickier in terms of medication management. I have certainly seen people with bipolar disorder take medication for depression along with a mood stabilizer and be helped by the extra medication. I have also seen people get out of a terrible depressive period with the help of anti-depressants. Some of these people were helped by taking some  kind of anti-depressant for several months to a year and then were able to stop their medications and use other means for their daily self care to avoid slipping back into a depression. I have also seen people with depression who continue to take their medication even when they are not depressed, and these people find it helps them to combat the return of depression. Any person taking anti-depressants temporarily or permanently is greatly helped by having  some form of therapy, as well as a support group or yoga or regular exercise or any other number of  “non medications” that help with healing. In fact, sometimes the medication helps the person to be able to be motivated to do these other things that they were too depressed to do for themselves before taking medications.

On the other hand, I have seen some people struggle with taking anti-depressants, even to the point that they are willing to try a few different ones, looking for one that works, only to be defeated. These people sometimes can find no medication that works for them ,and they often make a valiant effort to find one. However, the good news is that there are other ways to shift depressive brain chemistry. Art therapy is especially effective in that the act of making art and being creative in the moment does have a positive effect on the brain. With the support of the art therapist or the group therapy, a person with depression can begin to shift his/her mood towards feeling better. Regular exercise has been proven to help with depression as does yoga. With good support from friends, family, a therapist, a support group or therapy group, some people are able to combat their depression without the help of any psychotropic medication.

Of the people who refuse to try any of this kind of medication for their depression, many do self medicate and even are aware they are doing so. Some use drugs or alcohol, which of course actually physiologically contribute to depression, but the slight lift or high at the beginning of injesting substances can outweigh the crash for many people caught in a cycle of addiction or dependence. Even limiting food intake to an extreme is known to produce a high, so restricting food intake can be another form of self medicating. The challenge for this group of people is to become aware that they are self medicating in an unhealthy way and after that to change these behaviors.

There are people who do not self medicate with unhealthy behaviors who believe alternative medecine is the way to go. These people really work hard to combat their depression with positive self caring behaviors such as regular yoga, massage, reiki, some kind of creative endeavor or creative arts therapy, as well as writing and using some of the cognitive behavioral therapy techniches as well as creative visualization, acupuncture, and even being careful with their diet, as it is true that certain foods contribute to depression.  Often it can become a vicious cycle where depression leads to eating unhealthy foods or bingeing on unhealthy foods, then becoming more depressed and continuing to take bad care of oneself. So changing one’s diet can really help with depression.

Art Therapy as Food

The holiday season is here and that means trouble for people with any kind of eating or food issues. Holiday dinners and tons of holiday parties which seems so cheerful and fun for some, for others can be big triggers. If you’re in some recovery process of relearning healthy eating and trying to follow a good schedule of meal times and eat nutritionally well, this is a time of many challenges. It’s a good idea to try to be flexible with yourself and allow yourself to eat more and eat things you don’t normally consider healthy rather than fall into the trap of self-punishment or get caught up in obsessing about food and body. It’s also a great time to focus on the non-eating activities of the holidays. Make your own wrapping paper or make your own cards. Make a holiday card to send out to family and friends. Make a fun photo or art calendar for 2012. If you like singing focus on the songs and sing a longs at the parties you go to. Enjoy dressing up if you like doing that…If you go to O.A. meetings talk about this season and your struggles with it tripping you up and any worries you have about getting into old bad habits/and/or destructive behaviors… Just a few suggestions for this time of year that itself is a big trigger for many.

I mentioned some art activities in the above paragraph but this post is meant to try to focus on art therapy and the question, Why is art therapy so effective at helping people with eating disorders as well as body image issues, food and exercise addictions, obsessive thinking about food, weight, body, etc.? Unlike other types of “obsessions” and “addictions”, such as alcoholism and drug addiction, when a person has issues around food and eating, s/he cannot simply avoid food, grocery stores and restaurants for obvious reasons. Triggers are everywhere and food and meal planning are necessities for becoming healthy. One has to change one’s relationship to food altogether and then rigorously watch out for and identify triggers and then have a plan for how to deal with them. For re-learning how to eat, how much to eat, what it feels like to be full, etc., cognitive behavioral therapy techniques can work very effectively to help a person manage their day to day life and find the difficult balance between being observant and watchful of one’s behaviors and familiar feelings or lack of feelings that trigger self-destructive behaviors around food and exercise. Just being able to call your therapist or some other helpful person when you feel challenged and scared you’re going to “relapse” is of course very useful. I have had many patients who reported that calling me when something difficult came up was very helpful or even knowing that s/he could call was also helpful. Speaking up when you’re feeling vulnerable is always helpful and can really get you through some bad moments if you know whom to talk to and can get in touch with him/her.

So where does art therapy fit in? To battle an eating disorder like bulimia or binge eating or anorexia and other related issues, one needs to learn more than ways to avoid unhealthy behavior. Besides becoming armed with ways to identify triggers for unhealthy behaviors and learning to identify one’s feelings rather than using food to literally stuff one’s feelings or cut off from them, you have to learn ways to notice when you feel a self-destructive impulse coming in, what was going on in you and what can you substitute the unhealthy behavior with, ie. learning about self-soothing. Any disorder or issue involving dissociating, getting out of one’s body, etc. can be very much helped by activities that bring you back into your body. A major part of the art therapy process in working with trauma of any kind involves using art making to learn or relearn self soothing.

Art making in the presence of a therapist or in a group with an art therapist can be healing in many different ways. There are many different forms of art making that are soothing to most people. Being given a blank piece of paper or a canvas has been shown to actually increase anxiety and trigger self-criticism in many people. So one must pick particular art making activities that are able to decrease anxiety levels and can even help a person get back in his/her body. Making a mandala with oil pastels or watercolors, which involves tracing a circle or filling in a circle that the therapist has already pre-made for the session is a very popular and tremendously healing activity. Not only are mandalas soothing, as a symbol for the self, the mandala can give one information about one’s feelings about oneself. How you treat the boundary of the circle is of course important. I have found that having people do the mandala with their non-dominant hand can release a lot of worry about how it will look and decrease perfectionistic tendencies. For some, the lack of control of the non-dominant hand becomes too frustrating to be therapeutic, but this seems to be in a minority of cases. Making the mandala on black or colored paper is also a useful way to reduce anxiety and increase excitement about the task, just by being stimulated by the color of the paper or soothed by its darkness. Mandalas are very useful for identifying one’s body energy in the here and now. For example, I have done workshops involving doing a quick mandala at the beginning of the session, followed by some form of meditation exercise, and then a much longer time to make and complete a second mandala. People are always pleasantly surprised to see that their energy at the beginning (often more chaotic or too controlled or else a minimal effort to complete the picture without much satisfaction), has completely changed from the meditation and the art making at the end of the session. The two mandalas can be compared and give a person an actual blueprint or “emotional x ray” of what was going on in their bodies at the beginning of the session, and how changed their energy feels by the end of the session, usually descriptions include “more grounded”, or that the picture feels “more whole”. At some points in treatment or recovery or self-care, it can be useful to do daily or weekly mandalas and then write a few words about one’s feelings and thoughts. put it away and look at your mandalas later as a group to see what changes may have occurred.

Other soothing art making activities involve collage, beading, and decorating boxes as well as making dolls or decorating and covering/painting pre-made dolls. For some people painting is incredibly soothing. The metaphors of art therapy in direct relationship to food are interesting in themselves. The materials and the media are a different form of food which can literally be used for symbolic filling up. If the art therapy session is highly structured with some form of directive and structured around time to make art and time to process, this structure can help a person feel more regulated and grounded. Most impulsive unhealthy behaviors are performed when one is not grounded in one’s body and in some kind of anxious or compulsive state or fughe state. Meals in themselves are what structures the day for many people, and when there is no structure to when one eats, one can get easily caught up in feeling out of control. There are many art directives that are helpful for all sorts of aspects of recovery and regaining a healthy lifestyle as well as a healthy relationship with one’s body. Identifying and making pictures of different forms of hunger: emotional hunger, mental hunger, physical hunger and even spiritual hunger. Just describing and identifying these states is helpful. However as in most cases with art therapy, having an image to play with, observe and help organize oneself is highly useful. It is a great tool for measuring progress in therapy; to have something tangible like a body of work over time — what better way to actually see self transformation/

Of course there are all kinds of directives and activities (the art therapy “menu”) specifically geared around confronting and dealing with eating issues. I have named only a few above. Positive self image collages are another great art activity that is fun, non-threatening and promotes thinking good thoughts about oneself. Making affirmation boxes, a great transitional object for you to bring home and add to on your own. For some people that I have worked with, doing a body tracing by lying on the paper and having the therapist trace around your body and then filling it in in any way with whatever materials there are at hand is very useful in working on these difficult body image issues. Again, this is even better if you are in long term therapy and do one every couple of months or so to be able to compare the different images and notice what has changed for you. This is one of those activities that is best done when you have come to trust your art therapist and are ready to grapple with difficult feelings, even trauma memories, that can surface while filling in the body tracing. This is a prime example of why our training in working with trauma is so important. It is also a great activity to do with pregnant women in a group or individual session.

Besides the structure and the helpfulness of particular directives, non-directive forms of art therapy also work well. I have had patients with eating disorders who enjoyed having choices of what to do and figuring out on their own what they liked, being able to explore my art studio and feed themselves. What can replace walking into a deli or grocery store hell bent on buying certain foods to fill an empty hole inside that one is barely aware of?  Walking into the art studio/office and taking in the visual stimulation. The atmosphere may be overwhelming at first, but the excitement of just picking out a material and playing with it is hard to describe in words and hard to pinpoint in terms of feelings. I get the same feeling in art supply stores, but there is a big difference between an art supply store and an inviting healing creative space. (I knew I was on the right track with my studio when  a father who had no interest in art making suddenly picked up a piece of cardboard and started painting! freely with all sorts of colors; his kids who had been focused on their own projects of course rushed over and asked for cardboard so they could imitate him!) As an art therapist, I can say that there is nothing like the satisfaction of having a patient who has been talking to you for months suddenly out of the blue pick out some art materials with no encouragement, suggestions, or pushing from me. It is delightful to witness!

Certainly the art materials and art making can just function as a good distraction from obsessive thinking about food and body. Havi ng an hour of respite from one’s own intrusive thinking is not only worth while but provides hope that this experience can be repeated, both in the studio and at home. So there is a lot to be said for allowing for discovery and choice of media, especially with people who are very aware of how “in control” they feel from moment to moment. In some cases, consuming the therapist’s materials can replace bingeing. There is a delicate balance between feeding oneself emotionally and spiritually in a session and working on mindfulness, versus mindless consuming and using of art materials that can be perseverative and imitate unhealthy behaviors outside of the studio. I try to stay mindful that any substance or activity has healing properties when used in a mindful prescribed manner versus when the material, activity or person is abused or addictively consumed to fill an empty hole. As therapists, we can sense sometimes during, sometimes after a session, whether the session has been a healing one or a “filler”; it is not so bad to have some sessions be fillers once in a while anyway.

This is only a mere blog post, not meant to be an exhaustive discussion of the merits of art therapy for  people with eating disorders and related challenges. Please feel free to share your experiences as a therapist or patient…

As a side comment, I was thinking tonight about the challenges of being a therapist and eating healthy meals. A lot of us work through the dinner hour and come home exhausted and starved with no energy to cook a proper meal. It can become a major family issue; how to have meals with partner and/or child/children all together and at regular meal times. I try to have extremely moderate goals, such as, let’s try to have a family meal at least once a week, not too great I admit, but I get home late several evenings a week and then there are other schedules besides my own to accommodate. This is going into a new related topic, probably good for next week’s post…

Welcome to my Art Therapy Blog at WordPress

Hi. To people who started reading my blog at google blogger, I have moved over to WordPress due to technical difficulties that were too frustrating to deal with. So I will repost all the posts from the other site and then post a new weekly post for this week.

Thank you for reading and spread the news. Also tell me about your blog; it doesn’t have to relate directly to art therapy and psychology. I have a wide variety of interests!