Inspiration Wall!

In my last post I mentioned having an “Inspiration Wall” in my last studio and present one. It is common for artists to have an area where they pin up little images that they love or which inspire them… In discussing Pinterest and art therapy, I was reminded of my inspiration wall which I could actually “pin” to one of my Pinterest boards!

I have used two sides of a wall in one corner. Here are some photos if the images I used thus far. The Inspiration Wall can be changed and added to as you discover different images…

Do you have an inspiration wall? You don’t need to be an artist to make one…

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Pinterest is Really A Form of Art Therapy!

I only started using the social media Imagery site called “Pinterest” about six months ago. I have not fully immersed myself in it and really participated regularly, but yesterday I was looking on a site and saw a bag I liked and “pinned” it to one of my boards. Then some time later I was still thinking about Pinterest and thought, “Wow, It really is similar to a certain kind of art therapy, how fascinating! I’ve got to blog about this discovery!”

To begin with, here is Wikipedia’s description of the definition and origins of Pinterest. I usually attempt to find other sites to cite on my blog but once in a while I find Wikipedia is best at doing the descrtiption and especially history and origin of some kind of phenomenon… I was surprised to find that in its beginnings the originator was interested in keeping it very “closed” and private and even wanted to talk and meet with its users. That strikes me as really a nice way to start a social media site, and I was quite surprised as right now, June 2013, is about 3.5 years since the development began.

“Pinterest is similar to earlier social image bookmarking systems based on the same principle, such as David Galbraith’s 2005 project Wists.[3] It allows users to save images and categorize them on different boards. They can follow other users’ boards if they have similar tastes. Popular categories are travel, cars, food, film, humor, home design, sports, fashion, and art.
Development of Pinterest began in December 2009, and the site launched as a closed beta in March 2010. The site proceeded to operate in invitation-only open beta.
Silbermann said he personally wrote to the site’s first 5,000 users offering his personal phone number and even meeting with some of its users.[4]
Nine months after launch the website had 10,000 users. Silbermann and a few programmers operated the site out of a small apartment until the summer of 2011.[4]
Early in 2010, the company’s investors and co-founder Ben Silbermann tried to interest a New York-based magazine publishing company in buying Pinterest. The publisher declined to meet with the founders.[5]
The launch of an iPhone app in early March 2011 brought in a more than expected number of downloads.[5]”

For those of you interested in the future of Pinterest and where it may be going with marketing and trying to get more traffic and interest businesses in it, I found a good link:

The State of Pinterest: What Content Marketers Need to Know Now

I was actually just trying to find out how many users there are currently. As of mid may there were 11.7 million Pinterest users, which was behind of course Facebook, Twitter and LinkedIn, the other big social media sites. The surprise data reported was that people were giving Pinterest and Facebook the same amount of their time when on the sites! Here is that interesting report on this data:
http://www.mediabistro.com/alltwitter/social-media-users_b22556

Ok. Moving on now that I’ve explained a lot about it the most common types of investigation of Pinterest, that is, looking it as a social media site and phenomenon and also slightly related to a lot of shopping/fashion social media type sites where people post items of things that consumers can actually buy, as Pinterest is a cross between a kind of personality identity statement and a kind of gathering of consumer generated images, which is probably where they are going in terms of the Pinterest people looking to the future in marketing and development.

My discovery when I was musing about it had to do with the concept of simply “picking out images of anything that you like” which also translates to, in my words: “express yourself in images more than words, by looking at all there is in the known universe and finding what you love to do, look at, want to do in the future, have already done, or images that express an important aspect of who you are, including mostly images of things that are generated by others, either some photographer who put this image on the internet, or some piece of art work by someone else that you like, or your own image of something personal to your life, including, of course, your own art work…” On my own Pinterest, I have not really paid so much attention to what I do and how much I pin as I do not do it often enough, though, just as with Facebook and LinkedIn, and perhaps Twitter. I expect to follow the same pattern of checking out the site and going on the site not too often, going through periods of more interest, and forgetting about it, until the magic moment when I suddenly really “get into” it and start “using” it not just more often but to its fuller capacity and participating in it more than the average user. With Facebook, it meant starting my own Public Artist Page about my Artist career, a few years ago, and just last year, with my launching of my Tribeca Healing Arts Website, I launched my Public Art Therapy page. Along with this, I was visiting Facebook a lot more frequently and joined some art therapy related groups, most recently the “Visual Art Circle” which I will discuss in another post. With LinkedIn it involved posting more, connecting more, and joining about 50 groups, both Artist and Art Therapy related.

So probably like a lot of other people who blog, have a website and Public Facebook pages and participate in LInkedIn and are into social media, Pinterest is sort of an after thought, and given that all this Social Media stuff, whether personal or mostly professional, including blogging, takes up a lot of time, Pinterest was lowest on my time factor and still is.

As I defined Pinterest above, it is based on a very simple principle that is connected to art therapy, which is that people enjoy images and their non verbal power of communicating about themselves and the world, and that images have a lot of power, and that images are enjoyable; nvesting in expressing oneself through imagery is very healing and, here is a very important part of it — it is a great way to connect with other people and sometimes preferable to communicating just non-verbally!

Most non art therapist do not know that, among the principles of the healing power of art therapy is the idea that just looking at and sorting images as well as picking out images you like is therapeutic and a part of the art therapy process or even can be The Art therapy process which you choose to use to make contact with and engage with patients. With some client populations, certain individuals and also at certain points in the art therapy process, the therapist will use this style of intervention, which may involve showing an individual or groups a few boxes or container or files of “images”, often divided into categories, such as, art by interesting artists, images from nature and landscapes, images of people in various settings and from different ethnicities and cultures, and other such groups of images. The form can be through images the art therapist “pre cut” before the session or group. With the internet now available, the images can be from various magazines or from different websites on the internet, in which case, the art therapist prints out different images to fill these types of categories. In this case where the art therapist did this, what we call “prep work”, the art therapy intervention that is similar to the Pinterest process would be, “Look through these images, maybe pick categories that are appealing to you, look through and pick out images you like, or just images that intrigue you, and this can include images you don’t like or images that disturb you.” (By the way, this last part just made me think of adding a category to my personal Pinterest called “Ugly Images” which would be images I find disgusting, ugly, repelling, gross, unappealing…) Only that last idea does not seem to be what Pinterest aims at.

Usually most users approach Pinterest as a way to express their individual identity through images they love, like, are interested in, and positive about. I don’t imagine most users think to post images of things they find negative and disgusting, but in art therapy, actually, the “Ugly” image or art work can often yield a lot more discovery and information about the Self than what we are pulled towards. Whenever someone makes something they really don’t like, I take extra time to investigate with them its power and what it means to the person and why they hate it so much. In fact the “Ugly Art: Make something with colors you hate and try to make it as ugly and unappealing to you as possible” is a directive I am interested in trying out with people. (yet another post topic).

Anyway, Pinterest involves having “Boards” which are like bulletin boards that you “virtually” take a push pin and stick images on, but you have an unlimited number of these boards and can use suggested categories or invent your own categories. Until I wrote this post, my boards were in this order called:
“My Style, Favorite Spaces and Places, Stuff, Books Worth Reading, People I Admire, Cool Stuff, Bunnies, Art and Artists I Love”. You can have as many boards and thus categories as you want, I think! I have about 118 pins. I have now gone back on Pinterest and added the boards “My Art Work” and “My Past Artwork” and rearranged the order of the boards…

The reason I cited that info about my participation in Pinterest is that I did not think much about what boards I made up and wasn’t really invested in thinking of my own Pinterest as being an expression of where I find the most meaning in life. If I had approached it that way instead of casually, it would be the way it is now…This is to show that I approached this like other social media, attitude being “Looks interesting, why is everyone so into this, I will try it out but I don’t really have time to do it really, its not super important or meaningful, so I will just jump in without giving it a lot of time and energy”, then building up to, “Wow, I didn’t realize all the potential in this social media site, I’m going to give it more time and energy and shape it more to be useful to me and/or an expression of who I am.”

And so, I am going to try to invest a little more time and interest in my Pinterest, as I have not fully explored the potential of this particular social media. What makes Pinterest social, and thus a bit like a very large art therapy group, is that like with other social media, you can “follow” people whose images you like. Also, you can find “pins” (images to pin) which you like and decide to “repin” them from some other person you randomly found on Pinterest by looking up a particular subject. Also of interest about Pinterest, is that you can find images on other sites and often now have the option of clicking on the Pinterest logo to “pin” anything on the internet to your personal boards. You can find a lot of cool images on Pinterest itself by searching for a subject you like. Also, I receive weekly emails from Pinterest with suggestions of boards and pins to investigate. So the social part is “sharing” images with people and also “liking” them, similar to liking on Facebook.

I find the name “Pinterest” is itself interesting and inviting. The idea of a “virtual” online kind of bulletin board or group of boards that are unlimited in size for “pinning” images on is cool in the way that people sometimes find ways the virtual world can imitate the real world. If I had the time and space I would love to get pushpins and pin cool images on a bunch of boards, but it would of course not allow for unlimited images or the amount of sharing that takes place on Pinterest.

In fact, I actually do have a kind of “Board”, my Inspiration Wall in my new studio. I had one in my old studio too. I put up postcards of art by artists that I admire as well as some of my own images, and my new studio’s Inspiration Wall is actually on two little walls and for the first time includes an image I made with an artist friend,another form of art therapy, combining the studio visit with another artist with making art together…

I have not fully explored all the possibilities and scope of Pinterest yet, but I really do enjoy the connection with art therapy and the healing power of looking at images you like and feeling inspired or comforted or excited by them!

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…

Money and Therapy; A Very Confusing Topic

I just wrote a long draft for this post, and it disappeared, so I am very frustrated. I will try a shortened version of what I had in mind.

I started by describing a lot of potential scenarios (in private practice as opposed to clinics or training institutes or agencies) for therapists and patients to raise questions such as the following:
1. What is it about the exchange of money for therapy that directly affects the therapy?
2. With insurance companies often paying the bulk of your therapists fee, does your copay to your therapist hold any meaning for you or your therapist?
3. Is there such a thing as too low or too high a fee?
4. What does it mean for the therapy for a patient to be paying a very low fee over a long period if time due to real financial hardship?
5. Is the therapy compromised or changed when an outside party such as a parent or friend pays for all the therapy?
6. What is it like as a therapist to be mistakenly seen as very wealthy by your patients due to some misconceptions about therapists in private practice and their incomes?
7. What is it like for a therapist to have a patient who makes over twice the therapist’s income?
8. Is it wrong for a therapist to let a patient who has money problems and is paying a low fee get very far back in payments to the therapist and owe months of therapy? Who should bring up the topic?
9. Is there something strange about this scenario: therapist goes to a supervision group and pays a monthly fee 30$ more than the fee s/he charges her own supervises in the supervision group she runs.
10. What makes most therapists say no to bi-weekly (2 times per month) instead of weekly sessions and what makes a few therapists accept this scenario as well as a low fee due to the patients’ financial hardship?

In the world of many therapists the whole topic of the fee and sliding scale and how to handle the negotiations of it is hotly debated. Some say if you don’t pay attention to the fee and how it is paid you are avoiding a lot of important issues. Others have a philosophy of really using the sliding scale fee and accommodating people other therapists would never work with. I confess I fall in the category of those, the ones who lower their fee to accommodate patients with little money and at times I accept a patient coming only twice a month. In most cases it is a patient who has been coming weekly for a long time but not always. There are other reasons I have accepted this type of patient besides money issues though I agree with most therapists’ opinion that much more can be accomplished with the regularity and structure of weekly sessions. I also would never run a supervision group that did not meet weekly as I think the group process works with weekly meetings and consistency and keeps the group functioning for support as well as clinical issues.

Many years ago I read in the New York Times magazine a profile of a British therapist. I don’t remember his name or why the article was on him but I do remember him saying, ” I strongly believe that therapy should not cost more than (don’t remember the amount but it was equivalent to about $80 which these days might be around $120 as this was written around ten years ago)…” anyway I was really struck by his point. He actually thought there was a limit to a decent fair fee for his services despite his education, training and experience. Sort of like saying an ice cream cone from a truck shouldn’t cost more than 3$. This was and is very unusual in our profession to actually say that it’s indecent to charge more than a typical amount such as $100-$120 per session as your highest rate. Putting a limit on the value of therapy. Most therapist’s focus much more on the difficult issue of, can this particular patient afford to pay my highest fee and if not what can they afford. On the patient’s side, I have seen people say I don’t want to pay you less than such and such as I don’t want you to feel disrespected so this is what I could afford to pay you.

I admit I had a conversation with someone about couples therapy and how insurance companies often pay too little for it. Yes, some therapists charge more for couples than individuals. The reasoning is that couples therapy is much more difficult to do, which I think is definitely true. In addition, most couples don’t stay in therapy that long with some exceptions. While it is not unusual to have a patient in therapy for five years or more, the average couple dies not remain in therapy that long. I could diverge into a discussion of couples therapy but that is for another post. I will add that it’s not unusual for a couple to go to a couples therapist and end up with one partner continuing with the therapist individually and thus stopping their couples sessions. It is one way people kind of accidentally find a therapist they like for individual…

Back to money. The idea of going to someone’s office to share intimate details of your life and expose your self in various verbal and nonverbal ways is hard for some people to wrap their head around. Usually the boundaries of not knowing much about your therapist helps with this scenario and makes the whole money transaction make more sense to most patients. I am going to a doctor of the mental, emotional and spiritual body so of course I am paying as I would for a doctor of the “physical” body. This is how I would explain the process to a curious and puzzled Martian.

People may notice they are sometimes treating their therapist like their mother (transference) but it helps to have the distance and strangeness of the personal information mostly flowing one way, from the patient to the therapist.

I admit or confess to sometimes wracking up a large bill with a patient who is on a low fee and having a very hard time confronting the patient about it. It certainly would be easier if the patient brought up the topic. Confronting someone who has a job they work hard at and are paid little for who has loyally stayed my patient when s/he could have found someone in network on their limited health plan and now owes me for quite a few months if therapy is not easy. I also have a patient who left therapy suddenly owing me about $300. She has paid off most of it but still owes enough that I need to chase after her every once in a while.

The majority of my patients not using their insurance pay me some fee lower than my regular fee and pay it on time.

The one insurance company I am in network with pays me a little more than half my regular fee. What does this mean? Probably that the insurance company undervalues my work in a much more insulting way than any patient is capable of doing. It says with your license, level of training and experience we agree to pay you almost half your fee. If course experience usually doesn’t mean much to the insurance companies nor do they raise your fee according to inflation and cost if living.

Raising your fee is another big topic which a lot of therapist’s struggle with.

Money and therapy: big topic to be continued in the next post!

New Topic: Our Very Emotional Relationships with Our “Companion Animals”

This post will swing back to the more psychological, relationship exploration type of topics, away from the identity and artwork topics I’ve been posting about lately.

Of course this is a very personal topic for me, and I will include my own experiences in here. I have been thinking about posting about this for a few weeks now. I forgot what inspired me to think about this, although I think of my own dear departed doggie daily.

In fact, I have to start with my personal experiences in order to reflect upon this topic…

This morning, by chance, I had a DVD from the library, “Lassie” the movie. I think there may be several versions of this movie. I don’t remember seeing the TV show but I knew about the character Lassie of course. As we hadn’t yet watched it, I put it on and watched it with my daughter. I am very emotional about animals of all kinds, but especially dogs are near and dear to my heart. I was tearing up off and on throughout the movie. The main kid character is a young unhappy boy who misses his dead mother. Of course Lassie attaches to him and even leads him to his mother’s diary in one of the closets. Anyway, the story begins with loss, Lassie’s loss of his former owner, the sheep farmer, and then the boy’s family takes him, and the loss theme shifts to the loss of the mother. At some point towards the end, after a couragesous act of saving the boy, Lassie drifts into dangerous waters and is assumed dead. I knew somehow she wasn’t dead, but I cried anyway. At the end the boy finds her and hugs her and says, “I love you.” Maybe this movie was trite but it certainly touched me.

I have always been aware of the different kind of relationship we have with animals than with other people. Growing up I did not have a “real” pet. I had turtles, fish and at one point, a hamster. For one day I had a cat, that my older brother got me, thinking somehow we could hide it from our mother. The cat found a good home, but for a day I was exstatic to have a real pet and immediately got attached to the little kitty.

Anyway, in my adult life I had a small dog that I got when I was about 24 or so; at the time I was nowhere near “ready” for the responsibilities and everything that go with having an animal, especially a small dog. But it did not matter. Love was in the house and stayed there no matter where I went for almost 17 years. This little dog, during healthy times between 11 and 12 pounds, taught me more about a certain kind of love than anyone in my life could have. It is indescribable, this love between a dog or cat and their “owner”. I will talk mostly about dogs, only because I know more about them. At the moment I am at a loss for words. That moment when the boy sees Lassie through his classroom window and realizes she is alive and has come back to him and runs out to hug her, is a picture worth a thousand words. The way a dog sits when s/he knows you will sense his/her presence, that look on the dog’s face as s/he waits for you to notice him/her; this is very special. A dog will wait full of love and anticipation and solid concentration in a way that is hard to describe. It is not the same thing as your child waiting for you to come home. It just isn’t. Whenever there is a big family that has one dog, there is usually one person that dog especially picks, even if she plays with all the kids and gets walked and fed by everybody, there is one person whom she will be focused on the most, just as in the movie, Lassie senses that the boy needs him the most, even though his younger sister was the one who found her and pleaded with dad to keep her. And that love bond just will not break. It is the strongest thing in that dog’s life, and when he is separated from that person for too long, he suffers in a way that is difficult to describe. This is an inter species relationship that is based on mostly non verbal exchanges. I confess that when my little doggie was alive, I had a million special names, terms of endearment for him. And I do catch myself saying these nonsense love words I made up then to my daughter. Not because she has replaced him or that I link them together in some way; in fact I don’t know why. I guess saying these silly words while holding or hugging her is a way of remembering my doggie while at the same time making her laugh or enjoy them herself. I readily admit that my relationship with my dog was very far from what the famed “Dog Whisperer” says is the proper way to treat dogs. He was my “baby”…

A dog’s life span ranges from about 10 to 18 or so years. For some people who grow up with a dog or dogs, the dog is a part of their childhood. Although my dog died when my child was around 2 or so, she still remembers feeding him chicken, what he looked like and she somehow understands how sad it was for me to lose him. Losing him was her first very early experience of death. It was a bittersweet parting as he had been sick for too long and was at the stage where he really had lost his mind to brain cancer. But I knew he still knew who I was. Sitting with him and saying goodbye to him and watching him be put to sleep was one of the most painful experiences I have ever had. However there also was relief that his suffering was at an end, and a feeling of guilt that maybe I had let him suffer too long. This dog also symbolized for me a certain long span of my life where I developed into a “person”, found myself as an adult, went through many different experiences, but always with him at my side. With time I became better at taking care of this very dependent being. He taught me how to think of someone outside of myself, to care for another completely dependent being…

There is something to be said for the structure of a dog’s life and how it helps humans. If you live alone, you cannot stay inside all day, no matter how you are feeling. I have heard many depressed patients comment about how they were lost to human contact, could not function in any way, but managed to get out of bed several times a day to take their dog out for his walks. And no matter how isolated and alone they might be, they were not ever alone at home, as they had their dog sticking to their side, loving them throughout this difficult period. I remember reading that elderly people with a dog or cat tend to be healthier both physically and emotionally than other elderly people living alone. A dog forces you to go outside, breathe fresh air, walk, exercise, and at home, he will stay at your side whether you have forgotten to take a shower or eat but still remember to feed him. I am sure there are many animals out there who have stopped someone dead set upon suicide in his or her tracks. The animal says to you, “I love you. You can’t leave me. You are my LIFE.” When no body else could stop someone from ending their life, the animal companion is there to save the person from himself. Not always successfully, but very often a dog saves his owner from himself and from all kinds of self-destructive behaviors.

Which brings me to more on the topic of animals and therapy. While an animal can be a stronger “anti-depressant”than any medication, s/he can become the focus of the therapy session. Many people acquire their animals in a breakup. Sometimes the person will enter the relationship and the animal will go to him/her, even though the animal was the girlfriend’s or boyfriend’s. And so the breakup happens, and the dog or cat is suddenly yours, as for some obvious reason, you are the one best equipped to take care of it. And it can be hard to have an animal that is associated with a difficult loss in your life. At the same time, this animal is with you in very lonely times and you are not alone, and love has not left the house; instead a different, more steadfast love, is there…

I am not suggesting that an animal can “replace” a romantic relationship, but it is very different to suddenly find yourself single and alone and to find yourself single and with a companion that was there during the relationship’s ups and downs and is still there.

Animals in the therapy session: Many people come to therapy and at some point talk about their relationship with their animal. In some cases, it is because of the above mentioned situation, that the person is aware of “inheriting” the dog or cat a, part of the breakup, and so the animal comes into the session in that perspective. Often the focus on caring for the animal outweighs his symbolizing that failed relationship. Living with this animal you are already involved in a relationship that cannot fail, and you are in complete control, which can be somehow therapeutic.

Another way an animal enters the therapy space is when that animal himself is sick, physically or psychologically. There is nothing more difficult than caring for a being who is suffering yet cannot communicate in words. Babies and small children at least let you know when they are hurt. Many animals are stoic to a fault so by the time they make any noises you know it is really bad. I’ve had patients with their own trauma recognize that their pet came to them also traumatized. I have seen people endure bites and all sorts of weird and scary difficult behaviors from their animals because they know the animal is sick. After all, many loving people aquire their animals as a rescue. I always place as much importance on my patient’s discussing their relationship with their animals as with another person. People sometimes feel silly talking about their dog or cat in therapy, but I always emphasize how central this relationship is to their life.

The worst way an animal enters the therapy session is when s/he dies. I’ve seen people who cannot cry in front of me finally let go and weep when their animal dies. For some people, this is their first experience of the death of a close family member. Even if this is not the case, there is always a mourning process that is usually very painful. Dogs and cats are not built to last as long as people, so when you acquire one, there is this knowledge in the back of your mind of loss. I was very often aware of the precarious part of that relationship with my dog, and that he would not be able to accompany me throughout my life no matter how strong the bond. At times when my dog was older I felt the weight of this feeling that I held his life in my hands and it was my job to prolong it, a job doomed to failure. I also had many tears shed talking to friends about feeling “not good enough” in terms of giving him the best life possible. I guess at times I took this relationship too seriously. And there are times when your animal can feel like a burden; it is only natural to feel this way about a being completely dependent upon you.

People treat the loss of their animal in all sorts of ways. Some get a new but different breed of dog or cat pretty quickly following the death of their animal. People sometimes wrongfully assume you are “replacing” the dead animal, but this is never true. There may be a longing for the presence of a dog or cat in the house to fill that empty space, to comfort you in your grief even to distract you from it. Others may wait a very long time to get another animal they know they will eventually lose as well. The shadow of this next loss mat overshadow how much you miss that special kind of connection you can have with an animal. Of course there is no right answer. No matter what, the loss of an animal requires that you look at your life and where you are on your personal journey when you lose that loved one.

I remember someone thinking after I lost my dog that I had my little girl to “replace” him. If course thus was not true. I did have to continue taking care of her as much as before, but that is different. For me losing him involved losing a certain part of myself. How much that tiny presence in my life taught me about love and how to love. I will carry that with me for the rest of my life. And I do hope one day long from now at a very different time, I will again have a dog. The relationship will not be the same as with my first dog. It’s like a first love, he defined me as much as I defined him. I know that won’t happen again, and that I will not need it again. I will continue to miss him no matter what. It is a heart ache, but I wouldn’t trade that heart ache in for anything…

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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Weekly Scribble Drawings

Every Monday I try to do a scribble drawing in one of my sketchbooks. This is a great way to keep drawing but also not like working on my other art projects which usually have a theme and concept behind them. The scribble drawing is a tiny visit to the unconscious. You close your eyes or avoid looking at the paper while you scribble. I try to make a loose scribble. Some are more “scribbly” than others. I started doing this at the beginning of December and have kept it up on a weekly basis. Some weeks I’m not satisfied with the first one and if I have time I’ll do a second. The interesting thing that happened is on 2/27 I started incorporating collage elements, just from magazines. It is more fun and right now in all my art work I’ve been obsessed with collage for quite a long time but on my regular work I use all sorts of media and in my scribble drawings I keep it flat as it’s in a sketchbook…
Images uploaded are from the following dates:
1. 1/9/12
2. 1/23/12
3. 2/27/12
4. 3/5-3/6/12

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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.

Mindfulness and Art Therapy

I started writing this post a while ago and somehow two paragraphs got erased so I’m starting over again. Maybe it makes sense due to the topic. Computers can really test how mindful you are. Especially to be mindful about saving and backing up stuff but even more so to be able to let go of your attachment to your stuff when you lose data…

Anyway I randomly picked up a book about meditation by a Yoga/Buddhist meditation teacher and therapist. Michael Stone’s “Awake in the World: Teachings from Yoga and Buddhism for Living an Engaged Life.” He talks about replacing the word enlightenment with intimacy and realization with relationship. “Little by little, we step into our real life, the one that’s always been here, because the present always finds us in our bodies, even when we are lost.” (page 24) I pick this sentence because I can easily connect this idea to the art therapy process itself as a way to get back into our real lives and be in the here and now in our bodies. I think that is one of the connections between mindfulness and art therapy. The here and now of the therapy session is all about intimacy and relationship as well as connecting to our bodies.

Of course there are many moments in any kind of therapy where we disengage from our true self in the moment and fly off somewhere into stories about the past or predictions about the future. However, the process of art making in art therapy keeps us back in the here and now through the use of the art materials no matter what one chooses to make. There are those special moments in the session when a quietness settles into the room as I sit with a patient who is intently working on their art project. I have had a few rare patients who are mostly quiet throughout the session, for many different reasons. For some, this is their first experience of being at peace with themselves, of allowing for a calm being in the here and now, and slowing down to just be with the materials, me and the art making process. True healing can take place in these quiet moments of therapy. For people who have survived a lot of early childhood trauma of one kind or another, feeling safe enough to be in the room in the here and now and to be able to focus on something tangible and concrete like the art materials helps a lot with the process of letting go as well as being able to be in one’s body and not dissociate. The dissociation is a learned behavior that has worked for the person in the past as a way to get through times when they feel themselves shutting down due to overstimulation of some kind and overwhelming feelings as well. Slowly the act of making art in a safe space with a therapist as witness and collaborator of “the moment” can take the place of dissociation. Finding new methods to soothe oneself is a key part of the healing process for all of us.

However, the majority of the people I work with tend to talk during the art making process, and some choose just to talk with me and find the art making to be too scary or associate it with their insecurities and perfectionism and shame. So no matter how the session proceeds, there will still be these moments of real intimacy in the here and now, which is the stuff of mindfulness. With a few people I have been able to meditate with them for part of the session and then discuss what came up while they were attending to the breath and the body. Some take up my invitation to engage in making a mandala after meditation with me and then see what their energy looks like and what was going on for them during the meditation.

This author, Michael Stone, and others for that matter, like to refer to “failing” at meditation, the idea that you will of course fail at it and go off into your head and then witness that you “failed” and bring yourself back to the breath, the body, the moment. Especially people unfamiliar with the meditating process can be easily put off by the fact that they “can’t” do it because as soon as they start to focus on the breath they go off into their head and it’s too frustrating to constantly notice and bring oneself back to the breath. Many people mistakenly think that the object of meditation is to achieve some kind of special state of mind that they could never get to. A lot of meditation involves feeling uncomfortable and fidgety or spaced out and then having to bring oneself back into the room. I have done some walking meditation groups and have found the walking meditation to be very helpful with this. Just being able to stand up and focus on each step and be moving the body very slowly helps with awareness and being in the moment.

We are always waking up to ourselves and our bodies. Even powerful emotions can bring one into the here and now which explains why some people report that they cry at the end of a yoga class or some other meditative practice. Being in touch with the real feeling of love for those you are most intimate with only happens from time to time for most of us as we are mostly preoccupied with what we are doing, what we are going to do next or what already happened.

The art therapy process can involve many fluctuations between moments of awakening and then sort of going back to sleep and just talking around oneself. This can be more noticeable for people during the art making process that they “went off somewhere” and then became aware of coming back into the room. As therapists we are also mindful of when we tend to disappear or get into our heads or leave the room when with different people. And the moments when we awaken together with our patient are the most treasured moments that are usually what keeps us going in this very challenging kind of intimate relationship work…

Separation Anxiety

Separation anxiety is normal in extremely young children up to around 14 months old. As the child gets older s/he can tolerate periods of separation from caregivers. Obvious signals that your child is too anxious about separation includes crying and inability to be soothed after separation, nightmares about separation, excessive obsessive “checking” that parent is there and clinging, constant temper tantrums at separation and reuniting, even bed wetting.

Often a child will pick up on an adult’s anxiety, and sometimes changes in the caregiver’s behaviors can go a long way towards easing the anxiety of the child.

What happens when these issues don’t get addressed? What behaviors linger on into adulthood?

“I notice that I get very anxious when I know the time I’m spending with a friend or on a date is running out and we are about to say goodbye. I know it’s an overreaction but I still feel this anticipatory anxiety and after we part ways I feel immediately a lot of sadness, loneliness and fears of being alone.” At other times this person is fine with being alone.

Another interesting scenario: “I seem to keep getting into long distance romantic relationships. Reuniting is always so dramatic and intense but then when one of us has to leave, it feels almost as bad as if we’re breaking up, and the depression lingers for a few days. During that time I’m excessively calling, texting, chatting online with him/her. Then for a while I feel fine and then it’s time for another visit and the whole pattern starts all over again”

“I hate the beginning of the therapy session. I always feel really uncomfortable. And at the end of the session it’s hard to leave. The worst is when you announce a vacation…”

Some people express their anxiety through needing to control the session, wanting to be the one who alerts their therapist that the session is over every time.

Of course as therapists we constantly see different styles of attachment. Aloof and avoidant: this may be the patient who can only tolerate bi-weekly sessions and/or “misses” sessions often through forgetfulness. It can be very challenging to work with a patient with this attachment style as they have a hard time staying in therapy. They may need to control things so much that they become the patient who suddenly leaves therapy when the therapist is noticing that s/he is finally starting to open up and trust. Next minute the patient leaves with no warning or notice. S/he may be able to send an abrupt text or email saying s/he needs a break from therapy, but in some cases this is the elusive patient who just stops coming to sessions and avoids any contact with the therapist. In these cases I have found it is still a good idea to contact the patient and leave a message voicing concern about this behavior, demonstrating to your patient that you have noticed their disappearance and are concerned about it. Often the “parentified adult”, used to the role of caretaker of absent, unstable or anxious even alcoholic parent is very accustomed to their role and has a hard time being in therapy and admitting they need care and attention.

The “ambivalent” attachment style can be expressed quite differently. This may be the patient who opens up very quickly in therapy, demonstrates many shifts in and dramatic affect states, even starts a fight with the therapist. This person needs a lot of contact but feels conflicted about needing it and how to express that need. The consistency and firm boundaries of the therapist with this type of person can be very effective.

The very neglected child can be very consistent as a patient and respond well to individual psychotherapy. S/he is often punctual and gets a lot out of the consistency and holding support of the therapeutic relationship. While this person may take a long time to trust the therapist, I have found patients like these to be very self aware even if their awareness includes a lack of connection to their feeling states and a lot of intellectualization. The goals of therapy are as clear as the patient is eager to work on his/her self…

Many people oscillate between different attachment styles and feeling states about separation depending on the stressors in their lives.

Personally I have oscillated a lot in my life between feeling overly needy and clingy to feeling overly detached, uninterested in connection with others and when under too much emotional stress, reacting very differently as a teenager versus young adult versus older adult. Most of us have a variety of experiences with separation.

I also find it interesting that having a pet dog or cat can help a person heal from whatever childhood separation anxiety they may have experienced. The unconditional consistency of a dog cannot be matched by a human. While this leads probably to a big topic for another post, I find it fascinating how our relationships with our pets can help repair early anxiety and trauma. Of course there is the other side to this, when people get overly attached to their pets and it affects their relationships with people…