Structuring yourself

So I’ve been waiting about a month to start a new job and I have been out of school for about three. I have always either been in school or working. There has never been such a long peroid of time (except when I have been sick in the hospital) where I was completely in charge of what to do with myself. Not that school and working weren’t my choice, but you know what I mean…

Structuring your time is probably one of the hardest things a person can do. I find myself on the verge of complete lethargy, which could easily turn into a depressive state if I had nothing to look forward to in the near future.

This brings me to the point of this post. When working with clients who for one reason or another have little to do with their days, it is important to discuss options for structuring one’s time. For example, are there organizations that could use a volunteer a few days a week? Are there inexpensive classes available through various community organizations? How about just getting out of the house for a few hours and reading in a coffee shop? Of course, lets not forget the idea of beginning an art project. Time flies when you are in a state of creation.

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.

Mindfulness and Psychoanalysis

This post refers to a passage taken from a book by Elio Frattaroli, M.D. entitled Healing the Soul in the Age of the Brain: Why Medication Isn’t Enough, pages 190-193. Frattaroli argues against modern therapeutic practice, where all too often psychiatrists (in the U.S.) are pressured by managed health care to medicate with short length-of-stays in hospitals and in therapy. He advocates for a more balanced system, where the scientific method is not the “be-all and end-all” when it comes to understanding the human experience.

In his book, Dr. Frattaroli had a conversation with a patient, who was considering suddenly ending treatment because she felt she no longer needed therapy. Dr. Frattaroli felt that this urgency to end treatment came from resistance to repressed emotion(s).

Although he does not explicitly mention it, it seems to me that Frattaroli (who is a strong advocate for psychoanalysis) implies a Buddhist philosophy in his understanding of human nature and the origin of symptoms. He discusses allowing feelings to emerge without trying to control them, and remaining open to the human experience while noting what feelings come up spontaneously. These are some of the concepts discussed within Zen Buddhism and mindfulness. In recent years mindfulness and meditation have been successfully incorporated into several theories and practices in the United States. For example, dialectical behavioral therapy has been successful in the treatment of individuals with Borderline Personality Disorder.

These passages inspire me to rethink the application of mindfulness to art therapy practice, which is traditionally rooted in psychoanalytic philosophy. Teaching the lessons of mindfulness may aid the client to be more open to their inner experiences without judgment, while creating and processing artwork is in many instances less anxiety-provoking than talking. Intuitively, it seems that using both together may allow the client to cope more effectively while examining him/herself as the unconscious is made conscious. This may mean less resistance to treatment and more effective ways of coping with negative emotional states.

However, the therapist must always ask him/herself whether the client has the ego strength for treatment using a psychodynamic combined with a mindfulness approach. For example, if a client has difficulty describing/understanding/managing emotions and their emotional states due to cognitive deficits, perhaps this approach would be both frustrating and ineffective. Above all, the therapist must meet the client where they’re at.

Printmaking: Monoprinting with eating disorder patients

Being an art therapist often means adapting already known art techniques to the current population one is working with. The specific needs of a group or a population may only become apparent while working directly with the individuals. Therefore, the art therapist must be versatile and creative in her practice, while always ensuring that her techniques are theoretically grounded.

I first learned how to monoprint while volunteering at La Rue Des Femmes with Saundra Baly in Montreal, Quebec. I adapted this technique to include both sides of the art therapy philosophical spectrum: art as therapy (product oriented) and art psychotherapy (process oriented). This technique was specifically adapted for an inpatient eating disorder population.

Part 1: Printing

Materials

  • Acrylic paint
  • Cafeteria trays
  • Paint brushes, rollers, things to make marks into the paint, such as popsicle sticks or pieces of cardboard
  • Water
  • Cloths (to clean trays between prints)
  • Paper (4″x5″s or small pieces of paper to add structure to the directive)

Procedure
Mark off boundary of paper on the back of trays. Do a demonstration for the group as to how to make a print:

  • Put paint down onto the tray (within the boundary for the paper)
  • Press the paper down onto the painted area and then pull up.

Voilà! You have a print. You can wipe excess paint off with a wet cloth and begin the printmaking process again. Discuss different ways of doing prints, for exapmle, lots of paint vs. watery paint. If someone puts a lot of paint down on the tray, more than one print may be possible.

Instruct the group where they can leave their prints to dry. Discuss how this will be a two-part group, and allow the group to begin experimenting with the procedure. Mention that they probably will find that things are not coming out the way they intended, and that’s ok, it’s all a part of the process. Leave some time at the end of group to process what this directive was like: experiences, thoughts, emotions.

Part 2: Framing

Have some pre-made frames handy. Invite the group to make their own frames too, out of paper or popsicle sticks. Find the test print you made, and demonstrate to the group how to use the frame as a viewfinder to look for parts of the prints they enjoy, or find nice. Encourage the group not just to find nice parts in the prints they already like, but also in prints they didn’t think turned out well.

Leave time for a discussion at the end of group to process parts 1 and 2, and what the group thought this was about. Any new thoughts/anything change in the experience between parts 1 and 2?

Goals:

  • Raise autonomy
  • Raise frustration tolerance
  • If color is equivalent to affect, this directive provides boundaries for affect/holding environment through the borders of the lunch tray and paper.
  • Getting in touch with potential space, which is essential for any creative act to take place, as well as play; allowing oneself to play and let experience flow, the ability to be in the moment without thoughts or judgment.
  • Success-oriented
  • One cannot rely on perfectionism because there is no way to control the outcome of a print.
  • Promoting individuality, positive self discovery
  • Not having control can be ok
  • It’s possible to make something out of mess.

Affective media

  • Helps promote spontaneous verbalization
  • Tactile — involving the body, which is often denied in eating disorder patients
  • Lowers the amount of control patients can have over the media

Framing

  • Finding the good/beauty in mess/chaos, even when its hard to see
  • Making something out of mess/chaos
  • Putting boundaries to the mess/chaos
  • Can take the framed prints home- both a reminder of success and a transitional object
  • This part of the directive seems to open the group up more for reflection and processing