Guidelines about Boundaries in THERAPY

This is my post for my Tuesday “words” post.

Finding a therapist that is a good fit is hugely helped by the internet. In addition, if you’re confused at any point about the therapy and your therapist’s boundaries, You can find a lot of top ten lists online about therapist’s boundary violations.

In fact, here is a great list of 30 things to watch out for in your relationship with your therapist. All are very good things to notice; a few things on the list are sometimes ok if you feel your therapist has your best interests in mind (ie. when therapy is free of charge, what are the terms of the contract?)

http://www.therapyabuse.org/p2-wrong-questionable-treatment.htm

Here is another good, slightly humorous view of top ten things you might not know about therapists:

http://www.bustle.com/articles/61462-10-things-therapists-wish-youd-understand-about-what-they-do

I thought I might have something to add to these very good tips and important boundaries to the only thing I think might be missing from these types of lists:

THE INTERNET and SMART PHONE DOS AND DONTS in THERAPY

The internet and other technology make every field completely confusing again and cause us to scratch our heads and reconsider the way we do what we do. From the law to the music business to anything, we need new GUIDELINES:

The Internet (social media, websites, etc.)

DO NOT GOOGLE or LOOK UP former patients:

One interesting mention of the internet in the second link was about how therapists do think about former patients more than you’d imagine but we still don’t/shouldn’t google them to see what is going on with them.

I know that is a good one, as I have been tempted, when thinking about a former patient, to look them up and see how they’re doing/what they’re doing. I have NOT done so with anyone, as I saw a big STOP sign in my head and it was a fleeting “fantasy”.

Social Media makes things extra fun and confusing:

USE SOCIAL MEDIA THERAPEUTICALLY ONLY:

It is great for people to find support and other people going through their experience, whatever media they are using, Youtube, Facebook Groups, Facebook, Pinterest, etc. I often recommend to patients who are interested and use social media, that they look for support groups and other things online, AS WELL AS out in the physical world.

I have watched a few Youtube videos made by patients and listened to Podcasts. The reason is important: The patient wanted me to and asked me to and it was always an important aspect of their therapy work, especially self-esteem and recovery topics. I have even used Youtube videos in session when appropriate.

In addition art therapy gives a patient alternate ways to express him/herself, including through social media. Think of it as similar to brining in some art you made between sessions that is relevant for therapy.

SOME DON’TS OF SOCIAL MEDIA. Some seem obvious:

DOn’t be Facebook “friends” with any patient and with former patients, with some exceptions about former patients. You cannot control patients accidentally seeing posts of yours and finding out you know someone in common. There are proper ways to handle this which would be a post in itself. Start with asking your patient about it  or if you found something, telling them as soon as possible and exploring this.

DON’T connect on  LINKED IN with patients and most former patients. If you’re in the same field, art therapy, you may not be able to avoid some LINKED IN stuff and can have a little more flexible boundaries about it. I never accept Invitations to Connect from current patients; I don’t usually bring it up unless my patient is on LINKED IN a lot or brings it up themselves.

TWITTER: Can I “follow” some patients on Twitter? My answer would be what’s the reason? I have avoided it except in cases where someone had something important related to treatment on Twitter. As a rule, I abstain.

FACEBOOK PAGES: I have public Facebook pages that I cannot avoid patients finding and considering “liking” my page. As they are related to therapy and art, I consider it ok for patients to do that only if they decide on their own for some reason. Also, I do not look a lot at who is “liking” my pages and don’t care much about how many followers or who. IF you’re very into that, be aware of any feelings about patients liking your posts or not…

In some cases you may have liked someone’s Facebook page and then found a patient involved with it. There are cases when you can’t avoid this, especially having patients who are/were art therapists and got a diploma from the same place. Your worlds will be very close and it’s a good boundary test to be aware of this. (IF I am attending an event or workshop etc. and a patient is likely to be there, I process this with the patient before hand.

BLOGS:

This is a huge question mark for me. Do any of my patient s or former patients follow or ever read my blog? I actually don’t know. When I post here, I am aware that a patient may come across my blog, so I do have that in mind. As a rule, if it does not come up, I of course do not bring it up, and if it does in the future, I would of course explore the topic with my patient. I have read a patient’s blog only if they give me the link and it is connected to their recovery and they want me to see it.

Therapist bloggers out there: Please share any further guidelines and experiences! You can put it in my comments section.

Blogging Classes: Most therapists out there don’t take these classes, but I do, and I even recommend some of them to patients. If I recommend a particular class, I do not enroll in it, even if I thought I wanted to before. If I found a patient in a class, I would address that and most likely leave the class or at least stay passive (no posts or comments on Blogging U site).

DOs and Donts of SKYPE/Video session: A big topic to address in future…

This is by no means an exhaustive list. Next post could be about the SMARTPHONE and boundaries. It’s a fascinating aspect of therapy and books or at least long chapters could be written about the uses and abuses of the SMARTPHONE technology…

 

Tuesday Post: Words: One Sentence or More

As a therapist, I sometimes say some useless, some unnecessary things, some not-well-thought out things, and every once in a while I say something quite useful, as I did yesterday with a patient who wrote it down and asked me to print it. Here it is and, not to be showing off too much, I have to follow this “advice” myself often! It’s pretty simple and not anything people haven’t said before…

If you are too busy trying to hold it all together you can’t let it all hang out.

BLogging 101 Day 9: Inspire Yourself!

This assignment comes from the assignment of the day before, to create an “About Me” page. I just got rid of my boring “Profile”  and substituted a more passionate “About Me” page: https://natashashapiroarttherapy.wordpress.com/about/

I’m pretty satisfied with it, but the featured image does not seem to show up. Anyway I will post some images to this post that reflect the idea of writing a post inspired by my “About me” post.

While writing it, I remembered this great quote from one of my favorite artists, Louise Bourgeois; its from her book, “Drawings and Observations”, which is a great book that I own and used to look at frequently but of course, like lots of things at my house, I can’t find the book!

So from another book of her work, here are some interesting quotes:

My early work is the fear of falling.

Later on it became the art of falling. How to fall without hurting yourself.

Later on it is the art of hanging in there…Hanging in there-the art of living, the art of a lifetime. -Louise Bourgeois

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I choose these three because they also apply to art therapy and the therapeutic process for both therapist and patient. “Hanging in there” sums it up in terms of once you get yourself going; now that I am in my 40’s I have passed the other stages, the fear of falling and the art of falling.

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There is much to say about hanging in there, but for me it involves returning to my basic survival kit, my art supplies and my “portable studio”, doing art anywhere and everywhere including in my current studio.

As the making marks on paper or any surface is mainly a non verbal process, I won’t say too much about it, as I still believe what I discovered over a quarter century ago, that art making was a balm for all the words expected of us all the time, a sanctuary from explanation, a sacred space to make your own without need for verbalizing. Hanging in there is about just showing up every day to your life.

Here is the image I tried to use for the About Me page:

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It’s a page from my journal, from 9/25/2010.

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Here are a few pages from the journal I started this month:

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Death and Facebook: A New Type of Supportive Therapeutic Community

I wrote an original post on this topic a few months ago and then decided it was problematic and needed to be reworked.

The purpose of that post and this new post is to show how Facebook can have an unusual, unique, therapeutic and healing aspect to it…

Besides all the “mundane” aspects of “status” posts on Facebook that many people complain about, (which, by the way, I actually don’t mind at all as I enjoy seeing photos of someone’s dinner or their kid doing something amusing), and other non serious or silly parts of the Facebook process, and also the professional aspect of Facebook, there is something quite new and interesting about Facebook in terms of its relationship to death. To begin with, I am a person who really enjoys Facebook and social media both personally and professionally, as those who follow this blog would know from my posts… So, I find lots of aspects of Facebook to be therapeutic, especially Facebook groups involving something creative or support groups…

I’m sure as long as Facebook has existed, there has been space on it for posts about death, whether the death of a celebrity or of an actual Facebook “friend”. I am curious to know how long Facebook has been a place for death announcements and mourning groups, and if activity of this sort has increased in the last few years or with growth of users…

So I just found an interesting article about this whole topic. I am not sure if I am adding anything new by writing this post, but perhaps writing from the perspective of a therapist, I can make this post different.
Here is the link to it, from Mashable.com, which I will quote from on here.
http://mashable.com/2013/02/13/facebook-after-death/
It’s entitled “How 1 billion People Are With Death and Facebook”, a title I might have changed to “With Death Through Facebook.”

The first aspect of this topic is the less personal: the concept of communal mourning of the largest scope, i.e. what happens on Facebook when a well-known person has died? One result involves regular people posting statuses and commenting on their feelings about this person dying, what this person has meant to them personally or what kind of a loss to the country or planet this death signifies. This seems to have been a common phenomenon since the advent of Facebook, as people often post links to interesting articles or info about celebrities, not just their death. I have observed it since joining Facebook around 2008. You hear about the death of a well known person in any aspect of life: the arts, politics, a religious figure, famous scientist, journalists, TV personalities, celebrities of all kinds, and notice your Facebook friends posting musings about this person, how s/he affected him or her personally, quotes from the person, references to articles or videos, etc. So with a very public death, Facebook serves as a place for people to comment on the famous person and his/her effect on their life, and also a place for easy access to a large variety of information about this person’s life and death. This is a significant aspect of Facebook and deaths of celebrities, that you can find all kinds of links to other websites/publications to access more information very quickly. I think people have not fully appreciated this aspect of Facebook. It also occurs on the anniversary of a celebrity’s death.

Since I first wrote this post, the big one has been the terrible tragedy of Philip Seymour Hoffman’s recent death. Another person whose relatively recent death resulted in a flurry of posts was Lou Reed. These are two good examples, as the kind of posts about their deaths is very different. Most of the ones about the recent death of Hoffman have been about how tragic it was and about heroin addiction and overdose, and what it means for a high profile very much loved and admired actor to die in such a terrible manner. There was shock at first about how he relapsed after so many years of recovery and then shock at the depth of his addiction and what was found in the apt. He died in, etc. Lou Reed’s death was fascinating for other reasons, as the loss of this public figure was elevated to the loss of an icon, which means he represented more than the sum of his creative acts and life on earth, but is a point of reference for a whole decade and generation and symbolized something more important than just his music and art — i.e. the era of Andy Warhol; with him, people are mourning not just a person and celebrating not just his music and talent, but something even bigger, how he fits into our culture as an icon, what he represents and represented in a much larger way than just his life and work… Facebook serves as a unique way for the intersection of the very personal emotional aspects of death and the phenomenon of the philosophical and cultural “legacy” left by someone that important to our “zeitgeist”… It also is a space then for nostalgia about the other loss, the loss of that time period and its particulars, such as the social, political and artistic realm of that particular “era”.

The other aspect of Facebook and death is the personal one, and there are different kinds of uses of Facebook in this category of loss. This can involve a dead persona who was active on Facebook or it could involve a Facebook friend’s using Facebook to mourn someone who was not on Facebook at all. One personal aspect of Facebook and death involving the mourner and not the dead person is the phenomenon of the anniversary of a death. Recently a Facebook friend posted a lot of photos of her father and family on the anniversary of her father’s death. It seemed likely her father was not a member of Facebook, but the important thing is that she was able to share with her friends some great photos and memories and also be able to share the loss on the anniversary in a way that people were not able to do before the existence of Facebook. It is also true for dead animal companions, the posting of photos on the anniversary of their death. I have seen a great eulogy written for a dead animal companion on Facebook, as well as people starting a Facebook “Page” or “group” about their animal.

One very odd aspect of death and Facebook is the actual discovery of someone’s death through Facebook, as we are used to finding this news out on the “news” itself, not second hand from a Facebook friend or Page. I think I have found out about celebrity’s deaths on Facebook itself, waking up to this news while looking on Facebook, before even reading or looking up news sites, where I would be likely to first see the news of someone’s death. On a personal level, the news of a peer’s or other connection’s death is sometimes first encountered on Facebook. Although it may seem too shocking to learn of your friend or family member’s death on Facebook, it serves as an immediate way to find out more information, both about the death itself and about arrangements for funeral and/or memorial service, and to be able to immediately communicate with others who share in this loss. I emphasize this aspect as it reveals an immediate therapeutic aspect of Facebook and death of a loved one. Through other’s posts on that deceased person’s own private page or through statuses of other mourners, there is instantly opportunity for dialogue and not being and feeling ALONE with the loss. One of the most healing aspects of the mourning process involves the ability to dialogue and communicate with others who share in this loss. There is much to be said for being able to share memories and nonverbal aspects of the person, such as photos, videos and songs, which Facbook allows immediate access for in a way that no other “social media” or other process can provide.

The Facebook personal page of the deceased and the Facebook Memorial Group or Page of the deceased: both are important as vehicles for communal mourning but in different ways. The article above describes the option people have of removing a dead person’s “Facebook profile” and presence or having the option of keeping it on Facebook for some very interesting reasons. Here are the options described verbatim from the Mashable article:

“• The profile remains untouched, unaccessed, unreported and therefore open to everyday wall posts, photo tags, status mentions and Facebook ads. In other words, business as usual.
• A family member or close friend may choose to report a death to Facebook. Upon receipt of proof of death, such as a death certificate or local obituary, Facebook will switch the dead user’s timeline to a “memorial page.”
• A close family member may petition Facebook to deactivate a dead user’s account.
• Users may gain access to a dead user’s profile in one of two ways: either through knowledge of the dead user’s password, a practice against Facebook’s terms of service, or through a court subpoena. However, per Facebook’s privacy policy and strict state law, courts rarely grant outside access to said social data. More on that later.
Facebook’s official policy for handling user deaths is the memorial page. In 2009, the social network began switching dead users’ profiles to memorial statuses, should the deceased user’s friends or family request the change.”

Interestingly, a lot of people do not choose to request a change in the dead Facebook User’s Profile from active to a Memorial Page. Not as a way to deny that the person is dead, but as a place to find actual real memories of posts that the dead person had written or posted. This can be especially meaningful to mourners if their dead loved one was very active on Facebook and also those who were not just active, but really used it as a direct form of self-expression. In addition, not mentioned in Mashable’s article, there are the Facebook Groups the dead person may have started and managed as well as any Public Facebook Pages this person may have maintained. A Facebook group has a number of privacy levels and kinds of access, but the point is that people who were actively involved in a Facebook Group with the diseased can continue posting particular posts relegated to that topic and to dialogue with the select people chosen by that dead person to be in that group. It’s like having 3 or more portals to mourning communally on Facebook. You can go directly to the dead person’s private Facebook page and look at old posts or new posts from other mourners. The interesting aspect of it being Facebook is that I have seen people address their post or comments to the lost love d one directly, which is a healing way to be able to “talk” to that person and get out what’s inside that you wished to have said or want to say. The other portal is the Facebook Group or Public Page of the dead person if they had a group they managed. Last of all is the possibility to create a special Memorial Page or Group for the loved one, whether or not s/he was a member of Facebook.

The Facebook Memorial Group is a very therapeutic and interesting phenomenon. It allows for a kind of constant memorial to occur and for people who cannot attend events like funerals/memorials who live far away to participate actively in the sharing of memories, feelings, and thoughts… Another great aspect of having a special Memorial Group for the dead person is that it can be created immediately to serve as a place to express shock and just feelings or other immediate things right away even before the formal ritual of a funeral/wake/service/memorial. It is also informational, a way to easily share info about such events so people can know quickly and make their plans in order to attend the particular event planned. In order to create a memorial group as opposed to a “Page” (which is more public), someone has to take the e initiative to be the one to create it, which just involves giving the group a name and picking the level of privacy of which there are three: Open, Closed, and Secret. If it’s open anyone who logs into Facebook can see everything about the group and who the members are. If it’s closed, it’s accessible in some ways, but only members of the group can view the “posts.” If it is Secret, there are further limits to access that make it much more private. For a fuller description, see this chart Facebook provides regarding groups of any kind:
https://www.facebook.com/help/220336891328465

Another important aspect of the Facebook Memorial Group is that it continues for no limit of time and people can be invited or ask to join at any point in time after the group was created. At various points in the years following the death, there are certain times when more people actively go to the group for solace and support, such as anniversary of the death or birthday of the lost loved one and other significant dates that people share as markers, such as a particular holiday the loved one especially loved etc.

In addition, this is also a way to be able to see the diseased and even hear his or her voice as people can post photos, videos and recordings. I think this aspect of it is really important as it can be very healing as part of the mourning process.

The other aspect of the phenomenon of the Memorial Group as well as the deceased continued presence through their profile and old posts and /or groups they participated in or managed, is that there is automatic allowance for the idea of mooning as having no expiration date. I think in a society where we are expected to “get over it” too quickly, this aspect of Facebook is very empowering for mourners who may not be able to “get over it” perhaps ever really, and are not required to completely…
This idea of loss is very beautifully expressed in the following quotation I found and actually posted on some memorial pages I am a member of:

Time does not heal, it makes a half-stitched scar
That can be broken and again you feel Grief as total as in its first hour.
-Elizabeth Jennings

Philip Seymour Hoffman’s Death and Legos

On Feb.2, 2014, (James Joyce’s Birthday), Philip Seymour Hoffman died of an overdose. On that same day in the United States, about 99 other people also died of drug overdose.

This week in my practice, I had quite a few intense sessions with people, the kind of sessions that feel like they are of an existential matter, or an existential crisis. Talking people from the ledge, not necessarily people about to end their life immediately or go overdose, but people questioning their own life and its possible meaninglessness, feeling a lot of self loathing and worthlessness, or destroying their creative spirit with judgments, comparisons and criticisms. In about 9 sessions yesterday, I think Philip Hoffman’s death came up somehow in about 8 out of them and the morning before also in another session. What does his death represent besides a reminder of the deadliness of drug addiction and polysubstance and heroin abuse? It’s about recovery and finding yourself at a crossroads in your life, your shadow is beckoning you to eternal emotional pain and despair and a small shred of hope, a light in the distance, is still also there calling you away from the darkness. It’s about the work in most therapy, the goal being for the person to come to like him or herself more and hate him or herself less…

Some of these sessions went to a very blunt place where I pointed out, we all have what I see as 3 choices when faced with existential angst and self destructive thoughts about life being meaningless or ourselves being failures, worthless, whatever we make is not good, and being told positive things about ourselves makes us feel worse instead of better. So your choice is to end it now and be done with the endless suffering — what the BUddhists refer to as suffering due to addiction, attachment and delusion. The other is to kill yourself off symbolically and destroy your creative spirit and continue living the life of a deadened person; this choice involves giving up on yourself but continuing to appear to be alive but to be dead inside. Many have made this choice, a kind of circle of hell on earth, an acceptance of depression as part of everyday life. The other choice is the hardest for people who have been to the darkest part of their psyche and lived through it: the choice to awaken and emerge from the traps of addiction, delusion and attachment. All humans are at times addicted, deluded or attached. People wake up everyday and live through the day in such a state of mind. Addiction is not just to substances or gambling, sex, love, shopping, food or work, money, success, approval, anger, etc.

Delusion is not limited to humans wandering around in psychotic states. We are in delusion quite often in everyday life, when we do not observe what is really going on and enter a kind of state of ignorance.
“In the Mahayana tradition, two levels of ignorance (avidya) are identified. Dzigar Kongtrul explains:
There are two levels of ignorance: ignorance of the absolute, or the essential nature of phenomena, and the ignorance that prevents us from taking an accurate reading of the relative world. These two kinds of ignorance are like two kinds of thread: When they are tightly woven together, they are not easy to identify, yet they make up the fabric of delusion.
As a result of the first type of ignorance, we lack wisdom. Lacking an understanding of our true nature, we perceive that which is illusory and spacious to be solid and real. The second type of ignorance is the inability to clearly understand the laws of karma and interdependence, which then results in an inaccurate relationship to the world.” From Wikipedia

Carl Jung referred to this type of ignorance in terms of “attitudes”. When a person does not see clearly what is real, they take on an attitude or attach a kind of power to something that then renders it not real and the person continues to see it that way. We see this all the time with various kinds of simple realities. Your “boss” at work becomes more than a “boss”. A boss is someone who has the role of directing people who work for him or her and defining the tasks and roles of the people who work for him or her, but for many they attach more power to their boss and their boss becomes too powerful or their parent instead of simply their boss. We do this with all kinds of things. As an artist I have done this with a gallery or exhibition. My work gets rejected and for a while I live in a delusional state of mind in which this particular gallery and the “juror” who picked the work to go in the show and the work that was not admitted to the show become more than what they really are. I give them some kind of power to decide that I am a “bad artist”, “not good enough”, a “failure”. The gallery is one of probably millions and it is simply a place that payed someone to look through images of work submitted by artists and decide which to put in a particular show that would take place for about 30 days. When I let go of my delusions and attachments to this delusional idea of the gallery and juror of the show, I see the reality, and go back to doing what an artist does whether s/he gets in a show or not, creates art on a daily basis.

In reality, the gallery’s juror did not want any of ten images I emailed them to be in some show of theirs. I know these are ten of countless pieces I will continue to make. When I am not attached to my work being seen or to this gallery’s show, or even to a particular art work being good or bad or craving attention for my work or addicted to approval from the outside, I can be a relatively happy being who engages in the creative process for the sake of the process and my happiness is derived from the engagement with the materials and the process not with any product or result of a product. Because I have survived many of these rejections, each time I am quicker to be able to return to reality. Reality is always much simpler than the delusional or attached or addicted version of reality. In reality a glass of wine or a new dress is a material thing to enjoy but it does not have more power than that. Having a book published or a painting in a show or an award for a movie is a part of reality but cannot define a person. Exhibit A: Philip Seymour Hoffman, human who, given 46 years on earth, achieved a level of success, reknown, acclaim and material riches, as well as a family, and promise of more opportunities to hone his craft, gain more reknown and more enjoyment from his creativity as well as further fame and money, perhaps the joy of watching his children grow, that few ever come close to, he, who with all of thi,s was not able to escape the suffering that addiction brings to all who succomb.

Bringing us back to the choices and the therapeutic session sometimes taking on the conversation of existential dilemmas nobody escapes. Challenge is: can you wake up tomorrow and show up for life whatever it brings and be awake, not living in the past or some fantasy of the future moment? If you can do that, you will escape your own attachments to some definition of who you are, who you are supposed to be, who you expect yourself to be, your addictions to anything that seems like it will fill an empty hole, your delusions about your own reality and the people and other beings you encounter throughout your day. It’s an invitation to let go of your beliefs, your assumptions, your cravings, your attachments to outcomes and goals. As Marsha Linehan wrote: “The fundamental nature of reality is change and process rather than content or structure.” I found this quote, wrote it in my journal and shared it with about 4 patients in the course of my day, as I need to constantly remind myself of this truth; armed with this one small bit of wisdom about reality, you may save yourself from the terrible fate of Philip Seymour Hoffman and the 99 other unknowns who died on Feb.2, 2014 in the USA of the same cause… as well as the countless people walking the earth, who have no awareness of their own suffering in the form of addiction, delusion or attachment…

The philosophy of playing legos, contributed by a five year old, to be explored in another post.

Basic Guide to the 3 Stages of the Altered Book Process in Art Therapy

I divide the process it into, The Beginning, Getting Into it! (like the middle), and The End. There are 3 subphases to the First Phase:

Stages, Activities, Directives and Methods of Altering Books:

 First Stage of The Beginning: The “Invitation”!

  1. Inviting your patient to do the altered book, introducing the process and choices of media as well as books to alter…
  2. It is best to have a variety of choices of books that you supply so the person does not feel like they have to “ruin” a book of their own and feel that the therapist will hold the “bad” part by giving permission to destroy a public already created object…
  3. Having, displaying one or more of your own altered book projects, finished or not, is a good way to show/explain the project, and make it fun, acceptable and inspiring!
  4. The Big Choice: Witness the patient choose what kind of book to alter or actively help with suggestions if appropriate. See list of materials for further classifications and descriptions.

 

Second Stage of the Beginning: Destruction/Preparation of Book as “Ground” “Surface” for Altering: The Separation Process of Removing Former “Author”/Identity of the Book to Prepare for Creation of Your Original Artwork:

Destroy, Take apart, Eliminate, Discard, Remove, Rip, Tear, Cut, Alter surfaces, Change, Separate, Dissolve, Kill, Remove, Expell, Extract, Remove

1.Take out pages, rip off half of pages, glue together pages, rip surface off board book pages, gouge out board book pages, make holes and tears on paper pages. Cut pages, cut edges of pages, staple or attach other pages or paper materials to be inside the book or extend beyond the page, Cut deep into the book through layers of pages, poke holes, use Sandpaper to rough up surface for holding paint or to alter photos and images in the book, keep book jacket as is, cut out parts, or discard. A whole session spent altering the surface and ripping and throwing out pages can be a good way to jump right in, have fun, and avoid getting overwhelmed with ideas about content.

 

Third Stage of the Beginning: Start Creating, Doing, Making, Using Materials:

Look, Find, Discover, Create Space, Begin Anywhere, Open, Enter, Conceive, Start Rebirthing Process (Book as House, Body to Redecorate, Design, Embellish)

            1. Choose some art materials, supplies, mixed media. See list provided.

2. Choose to jump in and explore and let the process lead you somewhere without an intention or with an intention, theme. What will this be? A Book, An Object made with the book? Note: Calling it a Self-Portrait can give permission to let the book unfold session by session. What makes this project so open, playful, fun and non threatening is often the idea of surrendering, seeing what happens, knowing you can redo pages and even rip them out, so it tends to go well with a “go with the flow” attitude which is mirrored in the improvisational aspect of the therapy session, thus, unless my patient states an intention or purpose for the book, I encourage him/her to wander, let go, play…

* Closed Flat Book versus Open “Accordion Book”: To keep the book flat if using thick or 3D media, remove pages all over the book so it can close. Otherwise, dive in and expect the book to start expanding like an accordion. (See Case Examples Presented.)

  1. Locus: Decide whether to start with cover or back cover, keep book jacket to use, or start at beginning, or dive into the book and work on pages at different sections.

4. Start altering/creating, with therapist as witness, companion, container, mirror, security guard…

 

Second Stage after 3 Beginning Stages: Getting Into It! Down the Rabbit Hole…

Play, Connect, Attach, Add, Embellish, Dig Up, Hide, Conceal, Reveal, Layer, Build

Directives/suggestions for this stage, which is the longest part of the process:

Note: There are so many things to do with altered books, these are just a few ideas to get you started… If a patient is “stuck” with how to begin in a later session with their ongoing project, I usually suggest some new materials. Otherwise, you can ask if s/he wants a directive or choice of ideas to experiment with…

  1. In individual art therapy, with the altered book project, each session begins with an invitation and choice to bring out the book and work on it or not. Some patients work on it every session, and some put it aside and get reignited at a later time. Putting the book “on the shelf” can be therapeutic in terms of the idea of letting something be unfinished, unknown, waiting for a new moment, accepting that you don’t feel like working on it. Or take out some other art work from previous sessions and consider recycling it, cutting it up, incorporating it into the book somehow.
  2. Tape up or paint on page or page spread and just reveal a few words that you choose.
  3. Paint/mark up one side and stick it to the other and then separate for mirror image effect/print.
  4. Openings and pockets: make different kinds of windows, doors openings: holes of different sizes and shapes, windows that open and close, fold page in some way to create a pocket.
  5. Experiment with unfamiliar materials from the list provided or take a familiar material and do something new (stick feathers or other objects into model magic and glue to the page…)
  6.  Pick a paper doll cutout and glue it on a page to create a full body self-portrait.
  7. Glue an envelope to a page and hide or store things in it. Pick words from magazines, other pages of the book or a word box.
  8. Yarn and fabric, sewing supplies, experiment with sewing paper and fabrics on the paper of the book or create a new page to put into the book somehow.
  9. Go through the book and start creating layers by working on several pages at a time. If you wet the page you can put objects between pages to keep them from sticking together or use binder clips. Big binder clips can allow you to use wet media in different areas of the book in one session.
  10. Consider the layout, you open the book and there are two sides. Are the two sides delineated and separate or do you take both sides and turn them into one continuous surface? Can each side represent opposing aspects of the Self?
  11. Consciously consider the book to represent different aspects of who you are, your identity, parts of yourself that you hide or reveal, parts you want to transform.
  12. Write a letter to yourself or to your future self or someone else and put it in the book.
  13. If you want to consider a topic or theme, think about what part of your story to tell: Is this book about childhood, you now, the therapy process and what you are doing in therapy, or dedicated to someone else, living or dead. Is it about a loss of some kind? Or your future child/baby? Does the theme reflect an interest or passion of yours or something new to discover?
  14. You can surrender to the book and let it lead you where to go and enjoy the process without having any idea what it is about or how it will turn out. Or, ask the therapist to lead the way with his/her book and copy the what s/he is doing.
  15. Take a page or page spread and deliberately make it ugly, use colors you don’t like, put words you don’t like on it, make an image that you find unpleasant. Put it aside and look at it during another session to see if your attitude towards it has changed and what you learn from this Ugly Self. Keep it or rip it out and cut it up and put it throughout the book.
  16. Try weaving with paper, ribbon, yarn, rubber bands…
  17. Use double sided decorative paper or fabrics or foldouts to add new pages into the book.
  18. Glue two books together and start from there.
  19. Find words in the book to create a title…
  20. Create fold out pages and add things in the hidden page.
  21. Deliberately use materials that extend beyond the page, horizontally or vertically, like suspending cut fabric or thread or wire with bead on it, a painted tea bag, or a glued on book mark.
  22. Use an unconventional type material: glue a teabag somewhere, make a chain of safety pins, play with aluminum foil, napkins, paper clips, coffee beans, sand, etc.
  23. Add in personal objects, old photos, tickets, menus, receipts…
  24. If your patient wants to, you could create two books at once, either by both working on similar or different books at the same time or even passing books back and forth.
  25. Use a page spread or page in the book to process a dream.
  26. Make a small doll, figure or animal to attach somewhere to the book, either to be able to move it to different parts of the book or to stay in one place with the book as environment.

 

Third and Last Stage: Finishing the Book!

The End, Time for Reflection on the whole process… Book as Therapeutic Object

  1. How do you know it’s finished? Does the book supply the stopping point? Do you intentionally “end” it? Do you choose to finish it by stopping but considering it unfinished and that it will remain unfinished? (Accepting the unresolved parts of the Self, seeing the Book as a Book of life that you put aside or decide to end with extra pages left in unaltered.)
  2. What feelings come up around finishing your book and your therapist witnessing the ending of this big Project?
  3. Does the book mirror something in the therapy process? Are you feeling like you have reached a turning point in therapy and ending the book satisfies that feeling? Does the book signal that you want a break in therapy or to end therapy?
  4. What else comes up around ending/finishing/completing or leaving incomplete?
  5. What do you want to do with your Altered Book? Does it now have a Title? How does it feel to hold it in your hand and look through it? How does it feel to watch your therapist hold and look through it? Are there moments you remember that were important for you on certain pages? Do you have a narrative that tells a story and how did the story arise? What does it feel like to have a chaotic book with no title that was made in no particular order with many different media versus making a book where you started at the beginning and knew you were finished when you reached the last page?
  6. If you and your therapist made “mirror” books together, what do you want to do with the finished books? How do they reflect your therapeutic relationship?
  7. For those who started the book at the beginning of therapy with their art therapist or a few sessions after beginning and worked on the book continuously in every session, what does it reflect to you about the therapeutic relationship, the therapeutic process, trust, intimacy, vulnerability? What does it feel like to have a concrete physical record contained in a book as reflected or symbolic of the therapy?
  8. Does ending this book inspire you to start another one or take a breather? Are you working on more than one book? If so what is it like to end one while continuing with one or more others?
  9. Post-partem feelings: process any emptiness, sadness, feelings of loss about finishing, ending the book…

 

Probably Last Post Before Vacation! Should Be About Vacation!

What to say about vacation this year that I did not already cover about a year ago?

I am following my new rule about taking at least 14 days off. I will be away from the afternoon of Friday, July 12 through the afternoon of Monday, July 29, which turns out to be actually 17 days if you count the two half days at beginning and end as one day, so I am pleasantly surprised as I thought this year I could only miss two weeks of work. Essentially I will miss the two weeks and maybe a few more hours total.

Why care about missing days? For one, Money! Money, as I have blogged about it before, is quite important, especially when planning a vacation. First of all, I don’t get paid vacation days or sick days, so every day off is a day I am not making any money. In addition, vacations always cost money. This year, like last year, there are no expensive plane flights, just car rental and gas costs. Staying in a friend’s cabin upstate means no extra hotel costs, so it is a pretty low budget great vacation. Those of you that enjoy camping and being outdoors in the middle of nowhere would appreciate my choice of going again to the Froggy Pond Cabin in upstate NY near Cuba, NY which is close to the bigger town of Olean, NY. Another reason to care about days I will be on vacation is really just that I discovered the hard way that one week is not enough for me. It takes me a while to get used to being away from the noisy energetic city and adjust to the relative peaceful, calm and silent aspects of the woods. Then coming back involves transitioning back to civilization, so usually there is a visit at the end to old friends in Ithaca, which is a small town but not in the woods in the middle of nowhere!

Some of the great things about taking this same vacation for the third (I think it’s three, might be more) year in a row is that I get the same benefits at a low cost: being in nature, away from the city, for the most part away from the internet though I check emails from time to time, but it’s really a vacation from the annoying distractions of TV and internet, then the frogs again. Going there in end of July is a perfect time to hear the frogs wonderful chorus, especially at night! Plenty of time for art making out doors and making art on vacation is different from making art in NYC. This year wanting to pack light, I will not bring a ton of materials but will have the fun of shopping at JoAnne’s, which is really fun, as usually I get things from there online. There is a Joannes in Staten Island but I have no idea how to get there. Plus shopping on vacation is more fun anyway. There are cool dollar stores with odd kinds of things and surprises, plus JoAnnes which has a lot of crafts materials, and once in a while some random shopping mall has cool outlets to check out. There is also some planting to do, so going and buying soil and flowers and stuff like that is fun and different.

Each year we try to think of new things to do. Last year we went to a drive in movie, which I think was the first one I’ve ever been to! So we will do that again. Maybe some berry picking and hiking. For me always there is reading as I love reading but seldom have time to really read a whole book. This year I am being strict with myself, no books related to my work, so I will bring some kind of book of poetry, one or two graphic novels and maybe a memoir…

Ok. I’m off to a movie, so I will actually post again before vacation! as I haven’t finished with my thoughts on vacation…

Altered Book Workshop Proposal Accepted!

The good news is that my altered book workshop proposal for the 2013 Creative Arts Therapy Summit this fall was accepted! The whole event will be taking place in NYC in various locations, from November 7-13, 2013. Link to the site is:

http://www.cvent.com/events/expressive-therapies-summit-2012-registration-site/event-summary-a631d616cdd6499c92f749761a4d1d3a.aspx

The other part of my news is that instead of a 3 hour experiential workshop, I will be doing the workshop in 80 minutes, basically and hour and 20 minutes, which basically cuts out a little over half the time, so I tried to re focus the workshop.

Here is my description of it: (Let me know what you think; it’s a lot to pack into 80 minutes!!!)

Title: Altered Books with Adults in Art Therapy; Conquering Creative Blocks and Depression

Description:

In this workshop, we will discuss how the medium of altering books in art therapy uniquely treats adults with any kind of creative block and/or depression, connected with past or present trauma and feelings of creative deadness or loss of the creative “spirit.” Through the experiential, participants will choose a book and begin to alter it, thereby experiencing the uniqueness of this format that allows for the creative spirit to reawaken. The transformative experience of “destroying” a book to create something new can jump start the creative process through the variety of options, length of the project and the holding environment of therapy. I will also provide actual examples of Altered Books in process by some of the adults I am working with to demonstrate the scope of options in this particular medium and the essential role of the art therapist and therapeutic relationship in this long- term process.

3 Measurable Objectives:

  1. Participants will learn about ways that creative blocks and/or loss of creative spirit in adults is best treated through the creative process itself combined with the relationship with the art therapist.
  2. Through art making and viewing real examples of patient and therapist artwork, participants will learn about the different options provided by altering a children’s board book versus an “adult” hardcover book, and the messages the choice of book can convey to the patient and therapist.
  3. Through the experiential, participants will start the process of altering books and use at least 3 different media and techniques involved in the process of making an altered book.

 

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:
http://www.copyblogger.com/pinterest-2013/

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!