It got me again.

I’m freshly out of the hospital from a brief surgery stint, due to an abscess/fistula combo that came about from Crohn’s disease. I’m doing well, thank you for asking and I should be back to work in no time.

Its been almost 8 years since I needed to be hospitalized, and I was surprised by how the memories of past hospitalizations (which were traumatic for various reasons) came back to me…with a vengeance. It made me realize- I mean, really realize…not in the way you would take in information from reading and think about it, but from actual experience- how traumatic memories can be triggered, and how they can become bothersome once again if a similar situation arises later in one’s life. This is probably something that happens to many people with chronic illnesses, but I don’t know for sure since I tend to avoid any research on the subject…it just hits too close to home.

Although I was not feeling up to creating artwork during this incident, I did notice there were some symbols that popped into my head, that I’ll probably make artwork about in the future. A recurring fantasy is that somehow my muscles will give way, causing everything to spill out, and I’d be left a lump on the floor. Also, being cut and sewn up from surgery causes me to feel sort of Frankenstein-ish, and some of my past artwork reflects that.

When the new pieces come, I will be sure to put them up on the artwork page.

Web Therapy

In relation to a previous post I made about tele-therapy, I happened to hear about Lisa Kudrow’s internet tv series, web therapy, that spoofs therapy over the internet. So…I searched on google to check it out (it is pretty funny, btw), but the first link that google pulled up was webtherapy.com. Curious, I searched around the site, where it discussed the benefits of using the webtherapy service. Here’s an example from the site:

Webtherapy is a unique, affordable, confidential online counseling service which provides an ongoing relationship with your own personal licensed psychotherapist.

Webtherapy allows you to communicate to your therapist as often as you like (daily, or more than once a day, if you wish), by leaving private messages on a secure, personal site. Up to five days a week, once each day, your therapist will provide helpful responses and therapeutic interventions.

Webtherapy provides you maximum security in an encrypted environment to ensure the absolute confidentiality of your interactions with your therapist. You can capture your thoughts and feelings on the spot, rather than waiting up to a week for your next therapy session in an office. And you can feel confident that no one–not even your family–needs to know about your webtherapy.

As I understand it, when you sign up you get to contact your therapist as much as you want when you want through leaving messages on a secure part of the web therapy website that is only used by you and your therapist. This is interesting to me, and perhaps the way this is used is similar to asking a client to write down their thoughts between therapeutic sessions, encouraging the tech savy client to use a secure website rather than a pen and paper. However, the information above states that as a client you have your own personal therapist at your disposal once a day and your therapist can respond back to you up to 5 times a week. Would that make the contact between client and therapist closer to traditional psychoanalysis (3-5x per week), or does it blur the temporal boundaries of the therapeutic relationship since the client does not seem to make and keep an appointment but rather logs in when he/she feels like it?

The website also states that they have a large staff membership of highly qualified professionals who specialize in many different populations. They do not disclose the pricing or how payments work, nor do they give out the names and credentials of their therapists. The site does, however, offer many reassurances of confidentiality, ethical standards and states that all the therapists are indeed “licensed professional psychologists, licensed clinical social workers or licensed mental health counselors”. I thought that maybe if I clicked on the “sign up” link on the website, I may get a better idea of cost and more information on the different types of web therapists, however, the message that I got when trying to sign up stated that they were no longer accepting new registrations. This was surprising to me, as it seems to imply that they had so many clients that the practices of the numerous web therapists were full at this time.

I am left with many questions about webtherapy and tele-therapy, so much so that I am still trying to tease out what my questions and concerns really are…just another reason why its so important to be thinking about this new frontier of therapy.

Tele-Therapy (Cyber Counseling)

The latest Creative Therapy Session podcast featured a topic that I have always been interested in, but always felt hesitant to bring up during my schooling. I felt that the idea of conducting art therapy sessions online would have been a taboo topic in a program that emphasized the presence of the therapist with the client in order to foster a therapeutic relationship, not to mention the fact that I had no idea how one could go about making artwork online.

In this fourth episode of the podcast, Melissa Solorzano, ATR, interviews Kate Collie, PhD, ATR, RPsych, about the work she does in the emerging field of cyber counseling and the way she combines tele-therapy with art therapy. During the interview, Melissa and Kate discuss many of the questions described above and more.

Thank you Melissa for getting this interview! I believe that cyber therapy is a field that is not only emerging, but is here to stay and will only grow bigger, and for this reason its something that needs to be addressed and talked about extensively amongst the psychological community. Like it or not, there therapists like Kate who offer online group therapy services for people who live in remote areas, and there are also therapists who have set up shop in virtual communities like Second Life. Not only must we begin exploring the effect working virtually has on the therapeutic alliance, transference, picking up nuances during sessions, curative factors in therapy, socialization etc…, but we must also remember issues such as confidentiality and technological limitations (i.e., whether someone has a computer, speed of internet, malfunctioning software). Other questions to consider; is there a difference between being present in a therapy session as an avitar versus through a webcam where the therapist and client can see each other’s faces? What are the differences between text forms of communication (email, instant messaging) versus hearing someone’s voice through a microphone during an online therapeutic session? Are there populations that online sessions are more suited for than others? Is online therapy more effective than no therapy at all?

Its certain that a new frontier in therapy is already here and cannot be ignored. To quote Heidi Klum from Project Runway, “either you’re in or you’re out!”. I certainly don’t want to be left behind by technology, if in fact there are ways to work around all the issues discussed above and more.

Scientific American Mind

This month’s Scientific American Mind is really great. There are tons of articles on topics I am very interested in such as, creativity, anorexia, clues to the origin of consciousness through split brain patients, as well as epigenetic theory that gives new clues to how the environment influences gene expression, but does not actually alter our genetic codes.

In today’s post I’ll briefly address the article on creativity entitled “How to Unleash Your Creativity”. Three experts in creativity; one psychologist (John Houtz), one academic scholar (Robert Epstein) and one writer/filmmaker (Julia Cameron) discuss the nature of creativity and what one can do to help oneself become more creative.

Here is an excerpt from the beginning of the article,

John Houtz: There’s so much power in a new idea taking shape and changing the way people live and act. Often the rest of us are in awe, or we are even afraid of a new idea, and sometimes our fears spur us to learn more about it. In addition to what some academics call Big Creativity or “Big C” profound ideas that sometimes change the world—there is what we call the “little c” type of creativity: the everyday problem solving that we all do. The bottom line is that we’d all like to be more creative. We’d all like to be able to solve our problems in a better way. We don’t like being frustrated. We don’t like having obstacles in our path.

The three experts then begin discussing their conceptualization of the creative process and how one needs to practice being creative. Here are some observations by Cameron as to the changes that occur internally when people discover the creative process and try to incorporate these practices into their everyday lives,

I…have found the creative process to be teachable and trackable. I teach people three simple tools, and anyone using those tools has what might be called an awakening. They become much more alert; they become much more friendly in interacting with people and much less threatened by change

Epstein describes four skill sets needed for creative expression to take place, according to his research,

The first and most important competency is capturing preserving new ideas as they occur to you and doing so without judging them…The second competency is called challenging, giving ourselves tough problems to solve. In tough situations, multiple behaviors compete with one another, and their interconnections create new behaviors and ideas. The third area is broadening. The more diverse your knowledge, the more interesting the interconnections, so you can boost your creativity simply by learning interesting new things. And the last competency is surrounding, which has to do with how you manage your physical and social environments. The more interesting and diverse the things and the people around you, the more interesting your own ideas become…

There’s lots more great stuff in this article, but I was happy to find that Epstein acknowledged the effect our society has on discouraging creative thinking from a very young age,

When children are very young, they all express creativity, but by the end of the first grade, very few do so. This is because of socialization. They learn in school to stay on task and to stop daydreaming and asking silly questions. As a result, the expression of new ideas is largely shut down. We end up leaving creative expression to the misfits, the people who can’t be socialized. It’s a tragedy.

Its sad for me to think how many children are being steered away from creative problem solving, thinking or expression for the purpose of following the rules or conforming, for example. And then for some of these children as adults, striving to relearn what used to come instinctually…I guess thats just one of the ironies of living in our society…or perhaps in any society? What I mean by this is that perhaps the pressure to conform to certain styles of thinking may be an important part of learning how to live in any society, not just ours.

Movement and transformative experiences

The following was an emailed question, which I am posting with the permission of the author.

Hello Ms. Beck,

I found your website looking up a life coaching program, and found your site. I thought it was a great site and a neat coincidence because I’m also doing some web work, and recently did process art few weeks ago with Pamela Hoschstetter as part of my Masters Program for Conscious Evolution. It was my first experience with process art, and really, I had never painted before. Looking at your thesis helped me think about my own, which is looking at the Self-Aware Movement Practice and Transformation/Conscious Evolution. I’m still working out the actual questions to explore, as it seems to become bigger and broader by the moment. Would you have any thoughts on the matter – what part does physical movement practice, and specifically, movement where we bring our conscious attention to task, play in the transformation of consciousness. What are your experiences?

Thank you! I hope you are having a wonderful weekend,

Alex Iglecia
www.iglecia.com
www.ownyourlifeexperience.com

Hi Alex,

Thank you for taking an interest in my blog.

When I read your question I couldn’t help but think- what would a Dance/Movement therapist would have to say? I am no expert in movement, however, in my opinion bringing conscious attention to a task through movement can lead to the transformation of consciousness especially if the movements and conscious attention are practiced/ repeated over time. I feel that repetition and practice is often the key to transformative experiences that involve using the body and its connection to the mind. Many people find the movements involved with Tai Chi and Yoga to be relaxing and eventually transformative. I also found art making and drawing from life to be transformative too, albeit after I had achieved a certain skill level. In these cases, in order to achieve the transformational experience, one often needs to repeatedly pursue the activity on a daily or weekly basis, where one no longer has to concentrate or think what one is doing, but rather, the movements have become somewhat intuitive.

When people discuss creativity, often times the word flow is used to describe the relaxing, pleasurable feeling people get from creative tasks (which often involve movement of some kind), where somehow one doesn’t seem to experience time in the same way and can be, for example, dancing or painting for hours without noticing. It seems to me that when we are in the state of flow we are able to be in the world and in our bodies without judging or thinking…we are able to just do. Perhaps when we are able to act without having our inner speech cluttering our perception, that allows for a transformational experience to occur? Maybe the intensity of the experience or how quickly a transformation in consciousness is achieved would be changed depending on how often you practice? I’m not sure, and I would need to do more research before being able to answer this question as fully as I would like.

Also, I think its worth discussing the fact that a “transformation of consciousness” is a difficult thing to explain. I seem to use it in a way that is analogous to learning something new about the world that somehow I never noticed before. For me, this can be any number of things. For example, a new way for perceiving a situation, a new way of looking at objects and understanding spacial relationships, the realization that I can tense each muscle in my body separately if I concentrate, or being able to perceive colors and shadows with more acuity. Some of these experiences may be strictly developmental in nature (where as you grow up and your brain develops, you would expect that these new perceptions would develop too), where as others may be achievable with training over time.

I think its important to remember that no matter what you may be doing, you may experience a transformation in consciousness, and you would have never been able to guess in advance what you would have learned. I suppose thats one of the beautiful and mysterious parts of being a human being.

I hope this helps get you on your way to formulating new questions to ask and to be answered. It may be helpful to research topics in perceptual and cognitive psychology, where you may find less subjective ways of approaching this subject.

Mindfulness and Artx

After doing a substantial amount of podcast listening on mindfulness and its integration into therapeutic practice, I couldn’t help but wonder, doesn’t art making bring us into the present moment and help us pay attention to the details of the world that surroundings as well as out inner world?

In regards to paying attention to the world and its surroundings, I remember taking a course where I was taught how to draw from life — models and such. It was a painful process for me, training myself to see all the details of shadow and light on a body or a piece of fabric. After months of everyday practice, drawing for at least 15 min to 1 hour per day (similar to a daily formal meditation schedule) my perspective of the world changed. I noticed that I saw color, pattern, form, light, and movement differently. I saw these details and took notice, rather than merely looking at them as I had done before. Upon reflecting on what exactly was different, I believe it was that I was finally able to take notice of my surroundings in a way that was present and in the moment.

I have struggled to come up with ideas for art therapy group directives that would be relevant to the clients I work with. Directives that they can participate in and take something from, which can potentially be generalized in their everyday lives. Perhaps still life drawing is the directive I have been looking to experiment with.

This Too Shall Pass

Working with the clientele I have been exposed to at Redwood Place, I have noticed that many of the clients struggle when it comes to sitting with negative emotions/situations. I doubt that this is something only reserved for the dually diagnosed DD and mental illness population, but rather this is something we all struggle with. Indeed certain aspects of western culture seem largely based on instant gratification.

In any case, the other day I was on the cusp of falling asleep, a time when the creative juices begin flowing, when I thought of the saying, “this too shall pass”. I didn’t pay much attention to it, but it stayed in my dreams…The next morning, as I traveled to work, I realized that this saying resonated with me in a way that applied to not only to my life, but also to my practice as an art therapist.

Working at a residential facility there are often interpersonal conflicts that come up, sometimes over and over again. During these times, I can easily spend half my day conducting conflict resolution, which may be repeated later again that day, week, month, etc. It occurred to me that this may partially be due to difficulties with sitting with the unpleasantness of a certain emotion or situation. Lack of tolerance to the negative aspects of life can cause social relationships to suffer. For example, one might become highly irritable, curt, or avoidant of others. This sometimes makes other clients feel targeted or left out of their friend’s life, which can perpetuate a cycle where client #2 has difficulty sitting with their negative emotions, and both clients become increasingly agitated, requiring some kind of crisis intervention and/or conflict resolution.

Another common scenario I have been exposed to are clients who are frustrated with waiting for their next placement, as they find that they have gotten everything they can out of the program. Sometimes clients wait years for a new placement, depending on their situation. These clients describe feeling like they are in jail, against their will. Indeed, wouldn’t every one of us feel somewhat trapped if we were waiting to move on with our lives for years? In any case, these feelings of frustration are sometimes acted upon in aggressive and violent ways, often against others.

Part of my job as a therapist, as I see it, is to help these clients express their emotions through artwork and through their words, so hopefully these clients will be able to tolerate their emotional states and situations without becoming aggressive. Another aspect of my job is to encourage an increase in frustration tolerance and hope by reminding each client they have choices regarding their behaviors (changing an external locus of control to an internal locus of control). Somehow, though, something seemed to be missing in my job description, in my philosophy of conducting therapy with this population and that something came to me right before I feel asleep, “this too shall pass”.

The idea that everything in life; our emotions, our situations, our very existence is transient. Everything changes, although while we’re in the moment waiting for change to occur time can feel like its moving at a snail’s pace. For me, when I am unhappy with my current situation and there is nothing I can do to change it, in the near future or the distant future, the idea that everything comes to an end brings me both comfort and hope. I think that’s why I have decided to introduce this concept to the clients I work with.

I understand that this is an abstract concept, that it will take time for this idea to be experienced and understood, and that some may never identify with the notion. However, I believe that with some encouragement, especially after a crisis occurs, this notion can be a valuable tool in building one’s tolerance. For example, during a debriefing after a crisis, the client and therapist could discuss or make artwork regarding the emotions and situations involved, how they may have resolved themselves without becoming aggressive, and what coping skills could have been used to help make it through this tough time (i.e., listen to music, deep breathing, take a walk). If a client avoids aggressive or self-injurious behavior during a crisis, discussing how they were able to sit with negative emotions long enough for it to pass by in the moment. It could also be suggested that clients repeat to themselves “This won’t last forever” or “I’ll get through this alright” when they are upset, anxious or disappointed. In art therapy, posters can be made with self affirmations focusing on tolerating emotions.

I have been using many of the interventions described above since I began working with this population, without having analyzed my philosophical stance. I was following the lead of my colleagues, because they have many more years of experience than me.

I somehow feel grounded in the notion “this too shall pass”, and have found a confident direction to focus upon before, during and after a crisis situation. I suppose this means that I becoming more comfortable working with this population and sitting with my own difficult emotions that I experience when clients become anxious, upset, aggressive and/or self-injurious.

Motivation for Art Making

Christo and Jeanne-Claude are known as environmental artists, who use rural and urban environments for mass scale projects. For example, in 1983 they wrapped 11 islands in Biscayne Bay, Florida, in flamingo pink fabric. More recently (2005) they created “The Gates”, where 7503 saffron colored fabric panels hung in Central Park, NYC, for 16 days.

In a National Geographic article written for the November 2006 issue, Christo answers the following question (p. 41):


Why…Why surround 11 islands with 722 200 square yards of pink polypropylene? Why hang 7503 saffron yellow panels in Central Park? Why?

Christo responds:


All our projects are absolutely irrational with no justification to exist. Nobody needs…surrounded islands. They are created because Jeanne-Claude and I have this unstoppable urge to create. They are made for us first. Not the public. Artists have a huge white canvas and an indestructible urge to fill it with color. There is no reason. Of course, if Mr. Smith likes the canvas, it’s good, but the true artist doesn’t make it for Mr. Smith…

While reading this quote I wondered to myself, isn’t this exactly what we mean when an art therapist tells his/her clients that art is not about making a “pretty picture”? It’s not about pleasing others with what comes out. It’s about self expression and sometimes it can take self-reflection and processing to become even remotely aware of the significance of the symbols used in one’s artwork. I suppose Christo would agree that those who participate in art therapy are truly artists no matter what the final art product.

Knitting

I first learned how to knit during my internship at the Friends Hospital Eating Disorder Unit. Knitting was taught to the patients as a way to build frustration tolerance, and later, once knitting became easier, it became a way of managing anxiety.

Although knitting can be used as a way of managing anxiety, I did not experience it in this way when I first began. Learning to knit was a long process for me. It took several attempts and lots of patience before I was able to be successful at this activity. I also needed someone to sit down and teach me how to knit. For some reason I am never able to learn through pictorial instructions from a book. However, when I wanted to learn how to pearl, I was able to learn quite easily from a youtube video.

Now that I have learned to knit, I’ve noticed that (especially when I am anxious) it helps to clear my mind of thoughts. It helps keep me in the here and now because I am concentrating on completing each stitch properly. When I stop, I tend to be less anxious than when I started and I am proud of what I have completed during that session. Perhaps my experience will change as I become more adept at this task. However, at this point I find that just switching needle sizes or the type of yarn is challenging, therefore requiring my attention in the present.

I have also noticed that when I knit, the activity evokes memories of my grandmother. She was an avid knitter and cannot knit anymore due to Alzheimer’s disease, which has effected her ability to sequence. This reminds me that as an art therapist, you never know what the transference experience will be in relation to a specific directive. Furthermore, the ability for the art therapist to assess the ego strength and the cognitive abilities of the person they are working with is crucial.

Documentary Film Making

I was back in Montreal for a few days the other week. I stopped into a documentary screening at the POP Montreal Festival where I saw an amazing film by Marc Israel called A Balancing Act. During the Q&A period, Marc happened to mention that he had also created another film by the name of Nearer My God To Thee, which explores his struggle with mental illness, physical illness and loss. This piqued my interest and I asked Marc how I could get my hands on a copy.

Approximately one week later I opened my mailbox and to my surprise there was the film! Excitedly I opened the package and settled myself in for what promised to be an honest and open look inside the psyche and life experiences of the filmmaker. As I watched, I realized the amount of ego strength Marc must possess to open himself to his audience in such a direct and sincere way. Nearer My God To Thee was like witnessing the healing process of one man as he coped with the loss of a breakup, the loss of mental/inner stability and the loss of mobility and dexterity in his hands.

I marveled at how candid Marc was able to be, and how using a video camera to record one’s thoughts and life events in the moment, partially allowed for this candidness. It seemed that for Marc, the process of filming one’s life in the moment, editing the hours of video footage and creating a narrative, requiring both introspection and self-confrontation, allowed for the development of healing and change.

Indeed, some of the advantages of creating art are that it can be reviewed at a later date, and that artwork is flexible — it is changeable and new solutions can always to found. I am used to this process with fine art and craft materials, such as paint, clay and collage materials, where a piece of artwork or a series of pieces can be worked on and worked through so that what you started with is not what you end with. It seemed that Marc used the film making process in a similar fashion. He took snippets of his life experience, in the moment, and edited them together with a narration that seemed to mimic his inner dialogue. This transformed what could have been a personal video diary into a documentary; a way to communicate with the world he at times felt so shut out from.