Art Speaks Out Loud

UPDATED OFFICE POLICIES – July 2018 for E. Hitchcock Scott, PhD, LPCC917 – from HIPAA Policies Recommendations Dated August 27, 2013

© 2018 E. Hitchcock Scott, PhD, LPCC917, NCC, ATR-BC
Licensed Professional Clinical Counselor
Internationally Certified Advanced Addiction Counselor
Board Certified Registered Art Therapist
Registered Expressive Arts Therapist

PO Box 6806
Malibu, CA 90264
C 310-880-9761

JULY 2018 OFFICE POLICIES

• OFFICE HOURS: Tuesdays, Wednesdays and Fridays from 11:00 AM till 9:00 PM.
• PAYMENT OF SERVICE: You are expected to pay for services at the time they are rendered unless other arrangements have been made. Please notify me if any problem arises in your ability to make timely payments. 

$350.00 for 53 minute session, due upon date of service.

$525.00 for 80 minute session, due upon date of service.

Please have a check made out before session and arrive on time so we are able to spend the whole 53 or 80 minutes for our work. If you have been granted a scholarship due to need or a courtesy for professionals, I request that you do not share your discount with others. Doing so may result in the loss of the scholarship. Billed accounts due upon receipt, if payment is received more than 2 weeks after billing date, a ten percent penalty fee may be applied.

• INSURANCE REIMBURSEMENT: I do not bill insurance companies, nor do I accept payment from them. However, if requested I will provide a super bill for each billing period for you to submit to your insurance company, or a billing statement for you to use as a tax write off. Insurance agencies will not reimburse for missed appointments. By signing this document you agree to billing via email. Periodically, there are times I grant financial grace or scholarship, it is the author’s prerogative to give grace to a client or not depending upon your progress in counseling, therapeutic need or circumstances. Please note, if you request a full scholarship or weekly discounted rate, then you must provide the most recently filed tax return, the year prior, for consideration. 
• SESSIONS GREATER THAN SCHEDULED: 53-60 minutes for an hour session or 80-90 minutes for an hour and thirty minute session will be prorated to the nearest quarter hour for $87.50, unless prior arrangements have been made.
• CANCELLATIONS: Missed appointments without 48 hours notice will be charged the full fee; messages can be left at ehitchcockscott@me.com, or 310-880-9761 – 24 hours a day.  An email is best for documentation of the time of cancelation. Please avoid texts, as they are less secure. Again, insurance companies will not reimburse for missed appointments even if you are responsible for the full fee. 
• TELEPHONE TIME: Standard fee listed above for telephone calls, consults, written reports, and travel. Telephone messages left for Dr. Scott at 310-880-976, after working hours (Tuesdays, Wednesdays and Fridays noon till 9 PM or after five Tuesdays, Thursdays and Fridays), will be returned the next day. Weekend calls will be returned on Monday.
• Unpaid bills over 60 days due, will be forwarded to a collection agency. 
• I am not a child custody or divorce expert; therefore, I do not offer expert witness services. In addition, I do not voluntarily speak to lawyers or provide expert witness testimony of any kind. I charge my full fee for all duties related to conversing with lawyers or courts, plus travel, food and lodging.
• EMERGENCY PROCEDURES: An emergency is an unexpected event that requires immediate attention and can be a threat to your health. If there is an emergency of any kind, personal or otherwise, please call 911. If you leave an emergency telephone message for Dr. Scott please say so in the message that you are calling about an emergency and I will return your call as soon as possible. 
• If I have not called you back within sixty minutes or sufficient time to intervene upon the crisis (which ever comes first), and the emergency persists, and the emergency requires it, please call 911, or your physician, or admit yourself to the nearest hospital for observation. If you have an emergency, even if you have admitted yourself to a hospital, please let me know where you are, the nature of your emergency, and how to reach you.

INTRODUCTION:

Everyone knows about transference, even if they do not know the meaning of the word. 

Everyone has experienced it, especially those of us who have experienced childhood trauma, familial chaos, distress or mental health and addiction problems.

We might be conscious of transference, or not, or honest about it, or not. 

We might recognize it via a person we disliked instantly and intensely who upon reflection, reminds us of a bully in high school. 

Dory Previn, the ex-wife of Andre Previn, wrote song lyrics that illustrate the inherited legacy of trans-generational transference. Although her description is extreme, it embodies many elements of truth.

THE EMPRESS OF CHINA

I tell you how I hate you in the voice my father used

You answer with your mother’s worn clichés

And in another life, your father hears his wife

And I see his fury blazing in your gaze

An echo hears an echo and my mother’s fist is raised

The hand I clench at you shows her distrust

The way one behaves is determined in the graves

Of all the great grandparents gone to dust

Our fathers fight through us

As they fought their father’s war

And the same old scene’s repeated

As before and before and before

And before and before

And when I tell you how I hate you

Before the birth of Jesus

Before the death of Caesar

Before Siddhartha

Before Ulysses

Before the Trojan war

I tell you how I hate you

And a long decaying anger

Comes alive inside a castle

And behind an ancient door

The empress of China

Tells her lover how she hates him

She tells him once more

And once more, and once more

And once more

Songwriter: Dory Langdon Previn 1974

The Empress of China lyrics © Sony/ATV Music Publishing LLC

Basically, transference means that we transfer unacknowledged, unexpressed or incomplete experiences from the past to those close to us in our lives today.

We might surprise ourselves by suddenly calling a spouse Mom – or Dad –  especially when we are particularly irritated or in the heat of an argument.  

Usually we dwell on the negative transferences because they can feel so unfair to the recipient. For example, imagine forgetting to take out the garbage to find your spouse responding with intense anger as if you had had a sexual liaison with a neighbor. Transference can feel justified and real to the one dishing it out and confusing and unfair to the recipient.

Yet, the action of transference can also include positive emotions. For example, there may have been a time we assumed someone’s moral code was much better than what it was in reality, because that woman or man reminded us of our decent and kind mother or father. 

Transference means we project our negative and positive experiences, as well as our emotions and desires from childhood, onto another person in adulthood such as a supervisor, colleague, romantic partner and sometimes even our own children. The more intense the childhood experiences, positive or negative, the more intense the emotional transferences. 

Transferences positive and negative can be triggered by a similar physical appearance to a caretaker in childhood, a tone of a voice, a certain critical expression, the scent of a perfume or cologne, as well as an age, power or gender differential. The triggers can be small, and seemingly insignificant, but powerful. 

It is important for the general public to understand the phenomenon of transference and how it can undermine relationships. It is also important to understand how it can be resolved with accountability. For example, around age 27, I attended Terry Kellogg’s Life Works Intensive with my family. A therapist there reminded me of my alcoholic mother. In advance, I told her of my potential transference. She responded with such loving care that the transference dissolved and she became a powerful support ally for me during the week long intensive.

If you need to understand more about transference, consider reading about Transactional Analysis by Eric Berne, or Self-Gestalt Therapy by Muriel Shiffman.

If reading is not enough, and you feel your relationships are being negatively impacted, please consider finding a qualified therapist to help you. 

INTERNATIONAL EXPRESSIVE ARTS THERAPY ASSOCIATION’S: Newsletter Edition 1 (NOTES FROM THE FIELD Reproduced with Permission).

“PSYCHE AS A RESEARCHER”

2016 Newsletter edition 1-2

Please click on this link directly above this line to the FULL article,

and then click again on the red link that pops up after the first click.

ANNOUNCEMENT!

Please see my April first publication in the 2016 EDITION 1 Newsletter, by the INTERNATIONAL EXPRESSIVE ARTS THERAPY ASSOCIATION:

Please check out 2 articles on the topic of self-mutilation in the same issue.

1) The first article is in the section entitled, Professional Exchange. This article is a portion of a previously published article, The Body as Testament on the topic of self-mutilation (Scott, 1999, pp. 149-164). This article describes the phenomenon of self-mutilation from a research study by the author. This study describes the experience of self-harm in the words of those who struggle.

2) The second article published is also on the topic of self-mutilation, and this article is located in the section entitled, Notes to the Field. This article is a commentary piece about counter-transference and resolution via art. The article discusses the differential between providing psychotherapy and research. This piece includes a self-portrait of myself, as if I was a person in my own research study.

The editor, Roselle O’Brien was very generous to this author. She allotted 12 pages of my writing in a 95 page newsletter. I also wish to thank The Journal of Arts in Psychotherapy for granting the editor permission to republish.

If you are interested in more information, please contact Dr. Ericha Scott via the contact page listed in the menu above.

© E. Hitchcock Scott, PhD, 2015

Since the 1800s people have been interested in lucid dreaming, the practice of  consciously directing your dreams while sleeping. While reading a book entitled Fractal Time, the content has influenced my art and dreams. I am dreaming more often and more deeply….. Recently, I dreamed that my house was sinking into deep waters and I escaped unharmed and even completely dry. After the crisis my house was in better shape – sparkling clean – than before.

Lucid while sleeping, I thought my way out of the disaster.

CHILD SEX TRADE @ ORGAN HARVESTING

August 2015 © E. Hitchcock Scott, PhD

This week I found the skin of a baseball with no insides, as if the innards had been ripped out by a malevolent hand. The crisscrossed red seams stand out boldly against the yellow cover, mimicking the appearance of surgical stitches.

I feel as if my heart has been torn open and sewn back together without anesthesia. I ponder the reason for such a visceral response.

I pick up and hold the piece of seemingly innocuous trash.

According to private conversations with various agency personnel, over a thousand children have gone missing from the LA foster care system within a year’s time. They have most likely been kidnapped, traded or sold, into child sex trade or organ harvesting, or child sex trade then organ harvesting. It has been reported that gang members and traffickers are able to earn $250,000.00 per sell of a child.

Robert Jay Lifton, in his book Nazi Doctors speaks of how concentration camp scientists researching bone marrow transplants would hear shots in the court yard, to have new tissue samples arrive in short order.

How have we allowed ourselves to decline to such levels of depravity in the United States of America?

Human slavery, which includes child sex trade and trafficking, is the second fastest growing illegal business industry in the U.S., second only to drug dealing.

Timothy DeFoggi a former director of cybersecurity at The U.S. Department of Health and Human Services (HHS), which includes CPS oversight, is now serving a 25 year prison sentence for using the dark web for profound child pornography, and soliciting a meeting with a man so that they could realize their mutual fantasies to rape and murder infants and toddlers. Unfortunately, even after he was indicted for child pornography, his top secret security clearance was not immediately revoked. Timothy was in a perfect position of skill and power to identify and set up children within the system of CPS for kidnapping.

There is also an investigation regarding the illegal selling and improper adoption of infants via CPS staff members for a fee of approximately $25,000.00 per sale.

I am a psychotherapist who has listened to child sexual abuse and torture for thirty years, and even I cannot bear this information, certainly not alone.

Please do not think that because your child is a member of a higher socioeconomic group that he or she is safe. A false belief would follow from that cognitive error, that this community issue although tragic, is not yours. The traffickers have learned that children with beautiful hair, skin, straight teeth and good health sell for higher rates, especially in foreign countries. They have also learned that children who come from privilege, are easier to coerce, bully and intimidate. Privileged children do not often have the same level of toughness of children who have been neglected and hungry and therefore have had to forge for themselves in a hostile world.

Please consider donating your time and energy to reputable organizations who do their best to intervene upon this tragic and quickly growing phenomenon.

The eviscerated baseball, reminds me that the organ harvesters take the heart last.

SAND PLAY AND SYNCHRONICITY

“Dora Kalff, one of the first theorists and practitioners to use miniature figurines, referred to her unique approach as, “western meditation.” She was most influenced by Carl Jung, Margaret Lowenfeld, and a Tibetan monk refugee who lived in her home for seven years. Dora brought to the practice of sandplay therapy a combination of Neumann’s theory of personality development, Carl Jung’s concept of active imagination, and spirituality. Dora’s therapeutic directives for the process were very simple. She told patients to make a picture with the sand and figurines and then tell the story portrayed in the sandbox” (Scott in Sierra Tucson’s 2006 Progress Newsletter, Kalff, 1980).

I use sand tray experientials with my clients, as one of many art therapy and imagistic techniques in my repertoire. I have been collecting figurines for over twenty years. I have figurines collected from around the world, as well as small, antique figurines that belonged to my grandparents. I also have sacred semi-precious stones and gems. In my collection are families of figurines from five different races, and three generations for each family. I also have a large collection of animals and birds, fantasy and archetypes.

Jung first wrote about synchronicity. His concept, deeply embedded in spirituality, spoke to meaningful coincidences that cannot be explained by causal events.

I think of synchronicity as petite answers to my prayers. Most days I take a walking meditation and it is wondrous how often I find small items that comfort me on my spiritual journey. For example, recently, I found a heart shape (not exact) in the patterns of a found feather. I find heart shapes often.

How exciting then when this type of synchronicity happens for clients in our sessions. Recently, a client was processing (in a sand tray) a complicated and painful adult relationship. We discussed how the current relationship was possibly a replication of a childhood familial dynamic. The photo above at the top of the page, might not show it as clearly as it appeared in the session, but as we removed the figurines from the sand tray (about the current relationship), it looked as if there was a small child’s hand print in the sand. I looked at the bottom of each figurine, most of them round, and I cannot figure out how those patterns created what appeared to be a child’s hand print. The image of what appeared to be a child’s hand print felt as it is was a confirmation of the direction we were taking in therapy. In that same tray, the person portrayed an ideal relationship. In her mind, this relationship included warmth, caring, listening, shared interests and creativity.

Underneath that section of the tray (notice that the symbols were specific to the location of the topic in the tray), the image looked a bit like two hearts, one inside of the other with a pyramid type shape in the middle.

I cannot tell you that I have proof of the meaning of these symbols. Instead, I ask you to check it out for yourself and tell me what you think. Please let me know if these symbols are comforting to you, and whether or not you can entertain the possibility that maybe there are other realities beyond concrete reality and the jungle of urban life.

MASK MAKING

© E. Hitchcock Scott, PhD, 1995-2003.

Since ancient times, before language, man made image. Marks were made on stones and the walls of caves by the earliest humans, we hypothesize, to establish absentia communication and personal or community identity. The commonly recognized prehistoric cave hand print suggests, “I am,” or “I exist”.

Cave drawings of animals were used to prepare for the hunt, to bolster courage, and to call on the aid of spirits for success and protection. In the age of prelanguage, masks were used in much the same fashion as cave drawings. What stands out about masks, that is a bit different from the phenomenon of cave drawings, is the representation of the faces of god(s), with the specific agenda to embody divine spirit in flesh. The tribal leader would wear the mask of a deity’s face, and while in a trance state, imagine becoming the diety in order to better perform sacred healing rituals.

In the contemporary therapeutic setting, mask making is an interdisciplinary activity that may incorporate existential, ego-state, phenomenological and/or Jungian psychology, social commentary/activism, multiculturalism, biology, health and sickness, and spirituality.

Masks have been created and used by human beings for at least 30,000 years. “The origins of the word mask are unclear, but it probably comes from the Arabic maskhara (mashara), which meant “to falsify” or “transform” into animal, monster, or freak.” (Numley and McCarty, 1999, p. 15)

In a video by Gillian Wearing entitled, “Trauma,” she has her subject wear the mask of a child’s face and a, ”blatantly synthetic wig,” while talking about her childhood sexual abuse.

The author Roberta Smith responds to the video in these words, “The mask alters the revelation in a fascinating way, both buffering and intensifying its dreadfulness, creating the conflicting desire to hang on every word while also pulling back to decipher the visual power and artifice of the scene. the mask is delicately tactful, yet deadening. it respects the speaker’s need for privacy, yet it executes a weird, surreal transformation, turning the speaker into a kind of freak. making the past present, it stands for the child within, symbolizing the trauma’s stunting legacy, the innocence lost, and the rage concealed, yet its static expression and smooth surface make the pain-slicked eyes that glisten through its eye holes almost comical.” (New York Times, December 3, 2002, B3)

In the quote above, the purpose of the mask is multifold, it protects the identity of the adult, reminds us of the child she was, heightens our focus and attention so that the message is even more potent.

The goal of mask making in therapy is largely personal, may vary throughout the trajectory of progress in therapy. The themes that emerge are quite diverse. The chosen theme of the mask is to be determined within the context of the participant’s life and the issues at hand. Over time I have found that large drawings carry more transformative power than small, and three dimensional creations carry more power than two.

After decades of mask making, the results from the process continues to amase me. I find it to be a rich, powerful, transformative, provocative technique and a life changing process.

Masks are the most ancient means of changing identity and assuming a new persona. “From the beginning,putting on a mask has never been a singular activity. in order for masking to have meaning and relevance, it needs an audience, a minimum of one observer. The urge, perhaps even universal human need, to transform ourselves has coexisted with the development of human society. . . . masks have appeared in virtually every region of the world. They have been created to satisfy the desires and challenges to which societies must respond in order to survive and prosper, to maintain or reinvent identity. Masks symbolize our ability to change, transform, to go to other worlds, to appease the spirits. (Numley and Mccarty, 1999, p. 15)

The masks, and the rituals associated with them, were made to ensure a successful hunt or harvest, for rites of passage for various stages of life, to observe and celebrate the change of seasons, and to draw down healing spirits for physical, mental and spiritual health. As said before, in ancient tribal rites the intention of the person wearing the mask is to be transformed into the deity or spirit the mask represents. Masks are used in contemporary secular society for holidays, festivals, dramatic performances, to disguise identity for criminal activity, and also for social commentary and protest.

In therapy, masks have been used to help clients explore identity, to identify and integrate disowned aspects of self, to process trauma, to explore spirituality through sacred art, to forge a deeper connection with a higher power, to assume a different or more empowered self, to honor the wounded self, to celebrate the survivor self and to grieve the dead.

If mask making interests you, please call Dr. Ericha Scott at 310-880-9761.

Title of Painting: “JOY!”

© E. Hitchcock Scott, PhD, 2015

Clients and patients arrive for addiction treatment seeking help, relief, and rescue. This is understandable, the pain and consequences of addiction are great. Even if a person has been admitted to treatment at a young age, or at a very early stage of addiction, the emotional pain underneath the chemical abuse can be overwhelming and crippling.

Upon admission to treatment I ask a new person, “What do you want to create with your life?” I ask this question to help anchor and couple sobriety with future dreams and visions. I ask this question because clients can become easily confused about the goals of recovery. The problem with a goal that is unattainable or mythological is that failure to meet that goal, even a false goal, can be a set up for relapse.

Early in sobriety I often hear this response to my question, “I just want to be happy,…. can’t I just be happy?” I have heard this statement spoken as a lament and a complaint, as if to suggest that life is inadequate. More than once I have said to various clients, “If you are sitting in a room with a view of the ocean, and you are not happy, what will it take for you to become happy? Items I have heard listed as a requirement for happiness may include the wish for more – alcohol, drugs, possessions, freedom, or sex.

Happiness, as a form of self-serving satisfaction is fleeting, as fleeting as: a shot of Tequila tipped back and gulped, a prick of the needle on skin, the ding of a cash register after a new purchase, a roll of dice, the afterglow of sex with an exotic stranger, a quart of ice cream…. and therefore happiness is addictive. This form of happiness, versus joy, sells products, but it does not bring peace.

Joy is not dependent upon an external circumstance, substance or object. Joy cannot be manipulated. Joy emerges from deep inside of our core selves. Joy surfaces when we feel connected to another human being (without expectation), a higher power, nature, beauty, and/or our souls’s destiny. Joy is ethical, happiness,…. maybe not so much.

I do not believe I have ever heard anyone express guilt or shame after feeling joy, instead I hear descriptions of awe, a sense of wonder, or gratitude.

Yet feelings of shame, disgust, fear, terror, angst, guilt, remorse, and even horror can follow seconds, even milliseconds, after attaining moments of happiness. The half life of happiness is short which exacerbates the addictive potential.

There are many pathways to happiness and joy. One surprising pathway to joy is – truth telling – in the counseling setting. No matter how difficult it is to tell the truth, and even painful at first, telling the truth opens the door to joy.

Joy may be foreshadowed or revealed in an art piece or poem, before it has fully emerged into consciousness. A client’s awareness of joy may be simple at first, “Oh, I am using so much more color now,” or “My painting looks more playful than in the past”.

After processing and releasing trauma, grief and loss, there is now room in the psyche for joy, peace and self-love.

As people begin to feel and express joy, they tend to parallel process self-love, “I never knew I mattered until this minute”, or “I never felt love for myself until today”.

Joy arrives with the birth of self.

– TOM –

In the early 1900s, shadow boxes or object-boxes were used by artists affiliated with the Dadaism and Surrealist movements. Joseph Cornell (1904-1983) is the American artist most noted for this mode of expression, often using found items juxtaposed in an irrational and dream-like fashion. Arthur Bispo do Rosário (May 14, 1909 – July 5, 1909), a Brazilian outsider artist who used shadow box like creations, was hospitalized with schizophrenia for 50 years. He refused all traditional medical treatment but created art with objects appropriated from the hospital environment. Like Cornell, but with more whimsy, Arthur’s juxtapositions of objects had a dream-like and spiritual quality.

Conroy Maddox speaks of artwork by Joseph Cornell, “Those objects reflect a universe brought back to life. Obeying only the laws of chance or psychic necessity, they establish a kind of canon of the unexpected, lending coherence to a dream world which identifies itself with a new and exiting experience.”

In 1981, while working for The Discovery Center Museum in Florida I implemented a version of a shadow box construction for the child visitors. For a special event, I found approximately ten over-sized furniture and appliance boxes and painted them white inside and out. With most of the boxes, if the box was sufficiently structurally sound, I cut out one whole side of the box. For a few boxes, I cut out only a door. Then the boxes were arranged together, not unlike a Louise Nevelson sculpture, on the front lawn. The children were given tempera paints and allowed to paint anywhere they wanted. The boxes were tall enough that for many of the small children, it was like painting on a living room wall. I can remember children running in and out of the boxes, with brushes loaded with colorful paint, shrieking with glee.

The first shadow box workshop I held for adult clients was in 1992. I had shadow box frames of Poplar built by a local carpenter. I chose Poplar for the frame because it is a soft wood that can be easily painted, carved or burned. At the time, I worked with men and women with a profound trauma history and therefore they were likely to engage in some form of self-harm. With this caution in mind, I designed a shadow box frame, with a slit in the side for the plexiglass cover, as opposed to an attached hinged glass top. This meant that I could hold onto the plexiglass cover until the end of the workshop in order to ensure group safety. I also liked having the availability, for those who self-mutilate via cutting and burning, for workshop participants to be able to do exactly those same activities of cutting and burning to the wooden frames, versus their own bodies.

In the photo above, I have included a shadow box construction I made to commemorate my brother’s life. Tom, my younger brother, died of alcoholism, drug addiction and AIDS at age 33.

Although it may seem obvious, it can be said that art therapy, when it is authentic, is very political. My brother, suffered from the rejection he experienced regarding his sexual orientation.

What emerged from the shadow box construction workshop in 1992 was emotionally moving to me, not only because of what was revealed but also because of the quality of art produced. People allowed themselves to be vulnerable as they grieved losses and memorialized triumphs. Each box incorporated a full life continuum of losses and successes.

As I watched participants paint with awe, I can remember thinking that neither myself, nor my graduate school peers, were as genuine, honest, or creative as the people attending my workshop.

I have said for decades that while trauma blocks creativity, using creativity to process trauma, grief and loss opens the locked door. The carefully placed objects, arranged in the sacred space of a shadow box, “reflect a universe (or person) brought back to life,…. lending coherence to a dream world which identifies itself with a new and exiting experience.”

HAIKU POETRY FOR EXPRESSION
© 2002 E. Hitchcock Scott, PhD, LPCC917, ATR-BC

Blending the Japanese tradition of poetry writing with western psychotherapy, this experiential is designed to honor the cycles, stages and experiences of life. Haiku poetry is a very simple and non-threatening form of contemplation. In Haiku poetry there is usually a reference to the seasons of nature in relationship to human experience.

Freud (in Morrison, 1987) credited poets with discovering the unconscious before he did. Freud described poets as, “…those few to whom it’s given. . . to salvage from the whirlpool of their emotions the deepest truths to which we others have to force our way, ceaselessly groping among torturing uncertainties” (p. 24).

Carl Jung referred to creative experiential therapies “imaginative action,” (writing, movement, and visual art) as having a powerful healing impact upon clients. This author refers to the process as, “active meditation”.

One of the most useful aspects of poetry therapy is “cathartic release”. When a workshop participant or client finds the right symbol or word(s) to describe his or her inner world they experience relief.

Please remember this exercise about process and NOT good poetry. In fact, I ask people to be sure to write ugly poetry so that I know they have been authentic. While this directive, to write ugly poetry, may sound trivial – it helps unblock and free creativity.

For those with addiction or family members of those with addiction, writing poetry is a safe form of meditation and expression. Writing poetry is able to help organize, prioritize and even lay to rest our list of worries. Often the writing process helps reveal subconscious thoughts and feelings. It is important for subconscious thoughts and feelings to be revealed in order for them to be identified, addressed and healed.

Before writing poetry,  I asked clients or workshop participants to start with an event and write about it in a stream of consciousness fashion.

Here is a brief excerpt from one adult man’s writing flow about his now sober alcoholic father…. from a time during childhood,  “I realized he had been drinking pretty heavy because he took a handful of breath mints and started to chew them up. I figured he would be fine to drive because of all of the other times I had seen him drive before. When we pulled out of the driveway, it was a sketchy pull out, then when we got going we ended up hitting the car in front of us”.  After the minor wreck and even after realizing that everyone was unharmed he still felt, “….my blood starting to run faster and it was so embarrassing and kind of scary at the same time”. The author, young at the time, worried along with his father that the other people would call the police.

HAIKU

Loud waves while driving

CRASH, conversation now worries

Short breaths, I take

Crisp feel to the breeze

Fear passes embarrassment

Prayer follows all

It is easy to dismiss a forgotten memory from the long ago past as unimportant. Yet, unprocessed memories live in us and shape our relationships with each other and the world.  Often our adult lives become the report card that grades the quality of our youth.

Replicating our childhood in our adult life script is referred to as re-enactment. Isn’t it better to write out these experiences in poetry and paint them out in art than to see these destructive dynamics played out over and over?

The processes of professionally directed poetry and art are able to give you insight and points of choice for healing and transformation.

References:

Morrison, R. (1987). Poetry as therapy. New York: Human Sciences Press,
p. 24.
Scott, E. H. & Ross, C. (2006). Integrating the creative arts into trauma and      addiction treatment: Eight essential processes. In Psychological Trauma and Addiction Recovery. New York: Haworth Press.

In October 2000, three days after our marriage, my husband received a bone marrow transplant. In many ways we were blessed, the strength that emerged from our union helped carry us through the gauntlet of chemotherapy and treatment. Randy, age 50 at our wedding, had never been married. His excitement, about marriage and his role as husband, was contagious.

For over a year Randy did very well. In fact, just before his last hospitalization the doctors had taken him off of all of his immunosuppressant drugs. We were hopeful that he would be able to have a normal life. Sadly, a few months later, Randy was hospitalized for the last time, succumbing to immunological problems common to those with transplants.

A few weeks before Randy died, we both lived on the hospital unit amid the chaos of staff hysteria, coupled with long periods of tedious boredom. During a few moments of boredom, Dr. Randy Tufts, a Lunar and Planetary Scientist for NASA, turned to me and said, “You know I have always wanted to draw a body map.”

On March 3, 2002, three weeks before his death, I brought in my art supplies and Randy painted a life-sized silhouette mandala (body map) of all of his transplant symptoms. Later, He painted another body map of his hopes and dreams.

Although a quantitative scientist, Randy was also a certified Robert Fritz trainer. Randy embraced Robert’s model of creativity and the importance of grounding yourself in current reality before or in relationship with your vision for the future. Randy titled this body map, “Current Reality”.

As Randy drew his painful symptoms in detail, I felt panic. First, I had not known how much Randy was suffering. Immediately, my mind went blank. This art was not by a client, but my beloved husband, and I could not think of one word or a cluster of words to say that would be adequate to sooth his pain.

As he continued to draw, I watched silently. I kept a straight face, but inside my heart was shattering. I began to pray, but by the time he was nearly finished with his mandala, I was distressed. I even spent silent time chastising myself for allowing him to do art in his precarious state. I consciously sat on my hands and held my tongue.

When suddenly, with an amazing level of gusto, he turned around to face me and said, “OH HONEY, I feel SO much better!!!” There was a spiritual glow on his face, and for the first time in a long time, his eyes twinkled.

If it wasn’t for my professional experience and training, the logic of his joyous expression would have escaped me. How could he list all of these horrible and painful symptoms and not feel worse?

Yet when people find and express a symbol (visual or otherwise) that closely represents their inner world, they often feel relief. This process is referred to as catharsis.

Here is a list of color coded symptoms created by Randy for his life sized silhouette mandala.

PINK = Bone and Bone Marrow
PINK on arms = Pain
RED and RED DOTS = Graft vs Host and Rash
RED at ANKLES = Swelling and Pain
RED LINES LEFT SIDE NEAR LUNGS = Back Pain
DARK GREEN UNDER EYES = Eyes Watering
YELLOW UNDER EYES = Jaundice
BLUE INTESTINES = Feels Like a Short Straight Pipe
ORANGE = Diarrhea
BLUE SPIRAL = Dizziness
PURPLE = Dry Mouth
PURPLE LINES WITH ARROWS = Weight Loss
PURPLE on HEAD and EARS = Greasy Sun Tan Oil
BROWN SQUIGGLES COMING OUT OF HEAD = Fatigue
BROWN SQUIGGLES at HIPS AND ARMS = Weakness
GREEN DASHES at HANDS = Shaky Limbs
BLUE NOTES at HEAD = Good Mood In Spite of the Bullshit
RED LINES at the EYES = Forward Looking
YELLOW and PINK OUTLINE OF BODY = Surrounded in Light, Hoping for a Cure
GREEN CIRCLE = A Honeymoon Trip Planned to Europe

Even today, I do not have adequate words for this body map. It has taken me twelve years to take it out of storage, photograph it, and to write about it. I think of the body tracing as if it is/was an effigy of a shamanic medicine man absorbing the pain for the patient. I too absorbed the pain, as witness.

Of course our dream was for a medical treatment that would extend his life. That did not happen. Does this mean that the art exercise was a failure? Does this mean that the art gave Randy false hope? Was this time wasted? Did this exercise make our situation worse? Truthfully, putting Robert Fritz’s model aside, neither of us had illusions that an art piece would save him.

What I do know is this, from my experience, bone marrow units are possibly the most horrible environment, second only to a torture chamber.
For a period of time, Randy was able to express the pain that he would not talk about, and for him that process was satisfying. Not only was that process satisfying, he felt better in spite of all of the painful symptoms and intrusive medical treatments.

The experience of painting his body map was a very tiny oasis in a large desert of suffering, but that painting allowed him to catch his breath, sit in the shade a while, and take a small drink of cool water.

If you need help with or support for the role of caretaker, grief and loss please consider counseling. For more information please visit www.drerichascott.com, or call 310-880-9761 for an appointment.

With great respect for the Indigenous Peoples, I have adapted a few of their spiritual practices for art therapy. I do not mean to make light of or to dishonor any sacred rights or beliefs.

Prayer sticks are used in various religions, not only Native American, but also Buddhism and Wiccan.

As a person who is a certified Interfaith Spiritual Director, I have studied world-wide religions. I have done so as part of my own personal quest for a deeper connection to spirit. I have also studied interfaith religions to be fully present for the spiritual or religious practices of those who enter my office.

For some, counseling helps heal childhood religious or spiritual abuse, so that the person is able to return to the religion of their birth with a renewed sense of awe and commitment.

There are cases where the religious or spiritual breach is too profound for a return to the religion of youth. One of the greatest tragedies of sexual abuse by religious leaders is the profound negative spiritual block it creates inside of a child.

This is especially true for those who have been abused by deviant social movements and/or religious cults. The pain and betrayal caused by the perpetrators are often associated with or attached to the spiritual, God, or Higher Power concept.

In these cases, rebuilding broken trust in spirit can be a delicate process.

Most often, nature is a safe pathway to rekindle the light in a broken soul. Then it follows that ancient religions grounded in a love of and respect for nature have something to teach us.

Decades ago I began to ask clients to make a personal version of a prayer stick. Prayer sticks may be used to assist in prayer and meditation. This is especially helpful for newly sober addicts in 12-step recovery.

Wikipedia states that prayer sticks are used as offerings. In my own practice, I liken prayer sticks to a positively charged lightening rod. It seems as if prayer sticks help forge an easier and deeper felt sense of connection to spirit. Prayer sticks help burn away the dross and the distractions from the practice of prayer and meditation.

Most people who are facing addiction or trauma have trouble with focus and concentration. Hand held objects help anchor the attention.

My directives are very simple.

First I ask a client to collect objects of nature while hiking. I ask them to collect objects that attract them, objects that open their hearts.

Then I ask clients (or workshop participants) to experiment with the arrangement or juxtaposition of these objects so that it feels right. I explain that the felt sense of what is right does not have to make logical sense. What is most important that the prayer sticks are made with a reverent intention. In fact, praying while constructing a prayer stick is very important.

The process of making a prayer stick is a form of what I call, “active meditation”.

Once made, the prayer sticks may be held during prayer and meditation. If that is too distracting, then the prayer sticks may be placed near a meditation pillow or on an altar.

These personally made and often beautiful prayer sticks are able to help ground and connect the distracted mind or hurt soul.

In a small way, isn’t this what healing and transformation is all about?

A common “cognitive error” (Friedrich Wilhelm Nietzsche) is to see people, places, things, beliefs, and even the world in extremist terms.

The worst despots, tyrants, and terrorists think in a polarized fashion. In overly simplified language, the despots think they themselves are “good”, or “right”, or “better”, and that “the other” or “not me” is “evil”, “wrong”, or “less”. The split of good and bad/evil resides inside of the self. Depending upon the history and profile of the individual, the split is externalized, internalized, or both. For those who internalize the split, this split manifests in forms of self-harm, attempts at self-annihilation or suicide.

Carl Jung, Marsha Lineman, and Stephen Wolinsky, are counseling theorists who were all influenced by Buddhism. Each in their own way address the problem of thought polarities and/or the juxtaposition of opposites. Opening the door to non-linear forms of thought, integrating the opposites, is able to bring peace to the disturbed mind. All three professionals found ways to treat the commonly noted black and white thinking of clients new to health and healing. All three found ways to integrate thought, and also the disparate aspects of self, split apart by trauma, grief and loss, addiction, neglect, and self-harm.

In my practice, I find that painting mandalas, whether a circle or a body tracing, is able to help a client focus better. Focusing better enables the client to identify, discriminate, and address patterns of thought that are self-destructive.

A mandala, is a painting inside of a circle. The term mandala is a Sanskrit word meaning center, circumference, or magic circle. (S. Fincher, 1991).

“Unlike a diary, a linear account, the mandala acts in the manner of gestalt for retrospective reflection” (Kellogg, 1997, p. 3). Dairies are a very potent aspect of healing, what Kellogg is saying here is that adding a sensory motor activity, such as painting, deepens and expands the experience as well as the learning.

First of all, painting a mandala is a form of meditation. No matter what your cultural or religious background, meditation can be helpful. Yet how many clients, after sitting in front of a candle flame, while trying to focus attention and calm the mind,… find the task an illusive quest?

Painting a mandala is a task I refer to as, “ACTIVE MEDITATION”. Jung spoke of “active imagination”, which is a very powerful concept. Today in our busy world, “active meditation,” can work wonders with our short attention spans and need for novelty.
I have an office motto, “Keep the hands busy and the mind will quiet and awaken”.

Not only is art therapy able to help us center ourselves in a very short period of time, painting a mandala is able to help us become more awake. “Active meditation,” (a term coined by this author), works in a similar manner to a traditional meditation practice, but it reaches a larger audience. A mandala, “Shows the natural urge to live out our potential, to fulfill the pattern of our whole personality.” (Fincher, 1991, p. 2)

The two mandalas above were painted back to back, one week one mandala, the next week the other. I refer to these mandalas as, “Inside Out/Outside In”. The actual topic or focus of these mandalas is not as important as how much they helped the client move forward in his ability to think in dream possibilities for the future. Somehow these paintings, along with other activities, brought him moments of hope. Once he had a bit of hope, motivation to develop more personal autonomy and accountability in his life became easier.

In the early 1990’s, I volunteered to photograph people who live on the streets for an amateur documentary. For this project, I used black and white photography, and hand colored the images.

Within a few minutes after my arrival downtown, I was threatened, at first with a six foot metal pipe, then someone offered to slash my tires, another called me names.

I was frightened.

I was told I could photograph my slashed tires. Realizing I had no power, nor did he, I said, “You can slash my tires, but I will not photograph it, I am not here for that.”

Although shaking, I refused to give up. I kept listening to the fear of those who do not have a door to lock. I heard about the coercion they felt that often accompanied the handouts, most likely a long stereotypical sermon.

At the end, after time, I was trusted. Several people actually set up their own photo scenes to demonstrate their addiction, or poverty, or loneliness.

Two men, the one with the metal pipe, and the one who threatened to slash my tires, apologized. The largest man grabbed both my hands in his and said, “God Bless You!!!

I see these signs, like the photograph I took this week, and I think of them, their humility and their kindnesses to me in spite of their fear and despair.

This is why I ask clients to bring in their photographs to the counseling session. There are times that words are not enough. There are times that memory is encoded in image rather than language. There are times that the experience has only a few words attached to it and therefore cannot be adequately described without an image.

How much more does my story above of the homeless people mean to you, with the photograph? How much less would my story mean to you, without my photograph?

As clients grow and mature in counseling, they become less focused on petty concerns and more aware and attentive to global suffering. This has been observed in people from all walks of life including a study of men in prison, after a period of intensive neurotherapy. (Elmer Green, PhD).

The basic tenet of existential phenomenology, whether counseling or research, is to find meaning and purpose. Victor Frankl, describes his theoretical attention to the importance of meaning as a different developmental stage than the work of Freud or Adler. He stated that Freud’s concept of the “will to pleasure,” is the focus of the developmental stage of childhood, and that Adler’s concept and focus of “will to power,” is the developmental stage of adolescence. Frankl’s attention on the “will to meaning,” is an adult stage of development.

Frankl states, “In some way, suffering ceases to be suffering at the moment it finds a meaning”.

Bruce Douglas and Clark Moustakas (1985), wrote about existential processes, “Through disciplined focus on the structure of experience (e.g., time, space, materiality, causality, interpersonal factors), the phenomenological investigation attempts to reveal the actual nature and meaning of an event, perception, or occurrence, just as it appears” (p. 43).

There are times that a photograph is essential to the process of focus, attention, exploration, revelation, and meaning.

No one really disputes the lethality of anorexia. Anorexia is the most deadly of addictions and long before death,…. the compromised brain, body, and low levels of functionality are devastating.

Eating disorders can be as crippling and fatal as just about any toxic chemical.

In 2003, I read read a significant amount of ED literature. My goal was to integrate, in a more overt fashion, the art therapies into eating disorder treatment. While browsing, I found a reference to the work of Wooley SC and Wooley OW (1985). Their long-term success rates, caused me to sit straight up in my chair. I nearly dropped my book.

Although stunned by their results, at first I could not determine a differential between their work and mine. Their treatment approach was an integrated program of psychodynamic, experiential, educational, and behavioral interventions. This was not an unusual approach in the decades that followed them. In addition, their focus on body image was very similar to mine,…. except in one important way.

The difference, from what I could tell, was how much and how often they focused on body image experientially.

This made good sense to me. First of all, the greater the body image distortion, the greater the psychopathology.

The slide posted above reveals four drawings, during a period of six weeks, by one client. There are two life-sized silhouette mandalas (body maps), and two blind contour self-portraits.

The client’s statements and art work titles, in order of the dates of the drawings were, “Anxious Peace, I am too thin,” “I look more grown up when I am angry” (The client was angry with this author for insisting that she participate in the exercise even if she was uncomfortable), “I am not for sale, I am not even a real blonde,” and, “What have I done to myself, is this me?”.

A select few of statements made by other clients include: “I never knew my body was in proportion, I will never let anyone shame me again for my weight” (for being Rubenesque), “I didn’t know that I look like a little girl,” “I look like I want to die,” and,  “I am so afraid of life, I hide by wasting away”.

The clients above came to their conclusions on their own, during the drawing exercises, without prompting by me.

We all know that insight alone is not curative, many people have died of a self-acknowledged addiction.

Yet, neither therapy or the 12-steps can begin to have a true healing impact until the denial is broken. It is at this point, the point when the denial is broken, that a person is better able to ask for and receive help.

How much better to let paint and image be confrontational (the interventionist), so that the therapist is able to remain aligned with and supportive of the client throughout their awakening.

In 1985, I was hired by CareUnit Hospital in Ft. Worth as a drug and alcohol counselor. I had no experience and my one page resume had more space than text.

My supervisor, Mr. Ron Elkins, suggested that I add art processes to my work as a drug and alcohol counselor, since he knew I had experience as an artist and a college educator. He gave me a few suggestions and with trepidation I began to ask clients to draw and paint along with their journal writing.

At the end of my first year, with no experience and little training, my clients had the lowest recidivism rate of any other therapist in a 200 bed hospital. Upon reflection, I believe that there were two important contributing factors to my success, 1) I addressed trauma, abuse, and shame along with the problems of addiction and, 2) I added art processes when ever possible.

During that first year as a counselor, in the year 1986, my younger brother was suddenly hospitalized for a brain mass that was causing him to have severe problems with balance and he had also developed problems with his ability to speak.

When I went to visit him in the hospital he had to hold onto the furniture to walk to the bathroom. I was concerned, even alarmed.

Fortunately, since Tom and I used to paint together as children, I had brought my art supplies.

I really did not have a clear agenda. I had been reading Elisabeth Kubler-Ross and I had also read Bernie Siegal’s new book, LOVE, MEDICINE & MIRACLES (1986).

My brother asked me, “What do you want me to draw?” I thought about an exercise in Bernie’s book on Integrative Medicine and said, “Why don’t you draw the brain mass as a monster, and then make it smaller on each subsequent page….”  Tom began to draw and each time I turned the page he drew the image a little bit smaller than the one before.

I do not know whether or not Tom thought much of the exercise.  I did notice that he appeared to be more relaxed. So, after a short period of time, I left to drive home.

I returned the next day to hear the doctor’s report. By the time I arrived the doctors, Tom, and my father were standing in the hallway. Tom was packed up and ready to go home.

I asked what was going on. Dad said, “His brain mass disappeared, he is going home”.

I was completely excited, first I was SO SO happy that Tom was OK and going home! Next, I thought to myself, “Did our drawing exercise help?” I asked the doctors if they were surprised Tom was going home. They were. I was too shy to ask, “Could our drawing exercise last night have anything to do with Tom’s remarkable recovery?” It was 1985, I knew their answer would be negative.

NOW, 30 years later, I can say exactly what I thought then,….. Yes, possibly, our drawing exercise made a contribution to the sudden positive change in Tom’s health.

Today there is significant research on the topic of Art Therapy and physical health from journal articles to books, here in the US and other countries. For a good starting place please read two books by Cathy Malchiodi, Medical Art Therapy with Adults and, Medical Art Therapy with Children.

Here is a brief list I have compiled for my lecture series.

Clinical observation, empirical research, and outcome studies 

suggest that MEDICAL ART THERAPY 

is able to help patients in treatment for physical illness:

1) Significantly reduces symptoms of cancer treatment (Nainis, 2006), in eight out of nine symptoms tested, Tiredness (patients reported feeling energized after  sessions), Pain,  Anxiety, Depression, Lack of appetite, Drowsiness,  Shortness of breath, and Increased sense of well being (reduced sense of poor health).

2) To handle physical pain with less medication (Camic, 1989, 1999)

3) Significantly reduces the physiological symptoms of stress of children in treatment for cancer, i.e. heart rate within 15 minutes (DeLue in Malchiodi, 1999)

4) Indications of diagnosis, prognosis, and life span of the severely ill (Bach, 1990)

5) Anecdotal and documented reports of improved health and spontaneous remissions (Chopra, Dossey, Remen, Segal, Scott, and Simonton, etc.)

6) Experience life affirming and life enhancing activities

7) Improve quality of life

References:

Bach, S. (1990). Life Paints its Own Span. Zurich: Daimon.

Nainis, N., et al. (1996). Relieving symptoms in cancer: Innovative use of art therapy. Journal                of Pain and Symptom Management, 31 (2), 162-169.

Malchiodi, C. A. (Ed.), (1999). Medical art therapy with children. London: Jessica Kingsley.

The art therapies evoke responses precisely at the level at which psychotherapists seek to engage their patients and do so more directly and immediately than do the more traditional psychotherapies.

Betram Brown, M.D., Director of NIMH, 1979.

NOTE: The monster represented in the drawing above is my best approximation of Tom’s drawing of a monster from 1985.

To a person looking from outside in, self-portraiture in therapy could appear to reinforce egotism and narcissism. This is especially true in an age when appearance is deemed to be so important.

But Aristotle said, “The aim of art is to represent not the outward appearance of things, but their inward significance.”

Now, with over three decades of facilitating art, at various times for graduate students, psychotherapists, medical doctors, and clients,…. I have found that self-portraiture is one of the greatest tools in my repertoire of psychotherapeutic techniques.

Self-portraiture, no matter the technique used, can facilitate the: identification of self and affect (functional or not), establishment and strengthening of a recovery identity, foreshadowing of a deeper level of recovery and/or potential for relapse or violence (toward self or others), grieving, processing of addiction, trauma, physical illness, and chronic pain, processes for self-soothing, affirmations, and self-love, and a place to anchor positive visualizations for the future.

While there are many ways to draw the self, for therapeutic purposes, my favorite is one that was used by Elizabeth Layton, blind contour self-portraits.

Elizabeth Layton first began drawing at age 68, while depressed over the death of her alcoholic son. Just before the moment of her son’s death, the nurse “pushed” her out into the hallway, where Elizabeth waited, standing alone as her son died.

Through large portions of her life, Elizabeth had been in and out of psychiatric treatment for bipolar disorder with poor results. While grieving the loss of her beloved son, and the circumstances of his death, she took a drawing class.  Elizabeth studied and practiced a blind contour drawing technique, commonly used in most college level art programs, and unknowingly, spontaneously, she incorporated a form of free association. Her first drawing was of herself standing alone in the hospital corridor. This first drawing by Elizabeth is reminiscent of the painting, The Scream by Edvard Munch.

Free association is a technique that was practiced and made known by Sigmund Freud. Ludwig describes free association and/or stream of consciousness writing in the following manner, “write down, without any falsification or hypocrisy, everything that comes into your head” (Wikipedia, Feb 12, 2015).  As a certified expressive arts therapist, I would add that for this process, a student or client is to write, draw, paint, act, sing, or say everything that crosses your mind without editing, no matter how seemingly insignificant.

By focusing on sorrow and loss in her drawings, Elizabeth created paintings that were authentic, painful, and powerful. After six months of painting daily, she was relieved of her lifelong experience of depression. Her depression never returned and she exhibited her artwork at the Smithsonian Museum.

Her drawings chronicle her growth and awakening. At first her art is despairing and very personal. Then her art began to take on global topics such as the Jonestown mass murder, coupled a deep awareness and concern for mankind. Later, she approaches allegedly taboo subjects with a great amount of humor. One painting that comes to mind is an image of her, a senior woman, in a pink see-through negligee. Through the negligee you can see sagging breasts, sun spots, wrinkles, and you can also see a twinkle in her eye as she gleefully dances away from her husband’s outstretched hand. In these paintings she welcomes aging with acceptance, compassion, and joy.

In the mid-1990’s, I spoke with several cognitive and neuropsychologists. My question had to do with the effects of the hand-eye coordination and motor skills used to paint a self-portrait, while not looking at the paper (blind contour process). I asked if there was any chance that this drawing process mimicked EMDR, a well known trauma treatment modality. I asked this question because of the positive results I was seeing in my clients. All of the neuropsychologists agreed with me, that yes, this is likely a non-traditional “internal” form of EMDR. This said, quantitative medical researchers need to follow up with this hypothesis to be sure it has merit.

It is important to note that Elizabeth’s success was fostered by art, but also by her high level of motivation and determination. By her report, she painted one painting a day for the rest of her life, as if a prescription. In the past, Elizabeth had experienced electroshock as a form of mental health treatment. Maybe that experience, the experience of electroshock, was what fueled the fire underneath her motivation.

Art can heal, yet to heal from art, you must paint autobiographically and authentically, and you must paint autobiographically and authentically – weekly or daily – with the guide of a licensed and certified art therapist.

Psychological diagnosis is not as reliable as our profession would hope. More than a few times, clients have shown up for counseling with a long list of prior, and periodically contradictory, diagnoses.

I have found that there are problems with a tendency to over-diagnose or under-diagnose due to inaccurate information, insufficient information, and assessor bias. For example, women tend to be diagnosed borderline personality disorder more often than what is warranted, while men who present for treatment are not diagnosed borderline personality disorder as often as it is warranted.

It is possible for art therapy to illicit information that can help correct or adjust problems with diagnosis and therefore enable the establishment a more effective treatment plan.

When a client arrives with a prior diagnosis of schizophrenia, with an attending presentation list of paranoia, hallucinations, delusions, inactivity, flat affect or little emotion, tangential thought, poverty of speech, difficulty connecting and relating to others, plus problems with memory, and at times odd in their presentation – these symptoms would appear to be a slam dunk as a diagnostic confirmation.

Chemical abuse or dependency complicates the above problem because the use of non-prescribed psychoactive drugs can trigger short-term and/or sadly long-term mental illness, sustain mental illness, and mask mental illness.

It is also risky, in fact dangerous, for an uneducated, undereducated, unlicensed and/or uncertified art therapist to challenge any diagnosis at any time due to an image produced in a session. In addition, no one, anywhere, except a licensed medical doctor, can tell a client to reduce or quit their psychotropic medication(s).

All of this said, it can be very powerful to ask a client, who is stable (and with team approval), to paint what the voices are saying, (or have said in the past). This serves to check on the current level of mental health, and/or open the door to new and possibly useful clinical information, and it may also help bypass family rules for keeping secrets.

Once when helping a client paint a life-sized silhouette mandala, I asked about the voices in his head. He was reluctant to say, I imagine, for a myriad of reasons. I asked, “Can you paint them?” He said slowly, “Yes.” I sat silently as he painted, “Shhh, just relax,” and “No one will believe you,” and “This is our secret”.

This question, “Can you paint the voices?” has been, in more than a few cases, a very important power point of nexus,… the beginning of positive change and transformation.

Childhood trauma, is always tragic information to hear. Even so, in this case, I felt a sigh of relief because trauma is treatable to a point of resolution.

Interesting isn’t it how signs and symptoms for one or more diagnoses might be explained by normative or at least understandable responses to profound childhood trauma. How many adult survivors of childhood trauma have experienced, 1) periods of feeling frozen and flat, 2) periods of difficulty speaking in a way that might look like mutism, 3) problems of attachment, especially an avoidance of or difficulty with connecting to other people, 4) intrusive traumatic memory seeming and feeling like a hallucination, 5) moments of severe anxiety, terror, or paranoia, 6) problems with attention and memory and, 7) having an odd presentation or dress such as wearing too many clothes in summer in an effort to hide.

Many people with schizophrenia do not have childhood trauma, but for those who do, identification of trauma is a possible gateway for improvement.

Schizophrenia has a poor trajectory,… those with the diagnosis tend to have a much shorter lifespan than that of the general public. In addition, those with schizophrenia have lives that are chaotic and difficult.

Therefore, if there is a chance for a small window of hope and change, however small, let’s do our best as a profession to find it.

NOTE: All art submissions are posted with a signed authorization to release confidential information. The cases are disguised. This means that they are a conglomerate of several cases, from three decades of work, and from a variety of locations across the United States and abroad.

The art piece above is by a person, well on his way to a better recovery, who was previously misdiagnosed as schizophrenic.

Chemical addiction may begin slowly over time or within the first puff. However the process begins, mayhem follows. For some the mayhem or destruction is cushioned by social systems designed, or not, to protect. For example, there are times that a jail sentence has saved a life.

Even sober drug addicts and alcoholics wonder, “How did I not see what was happening around me?” Of course the obvious answer,… alcohol and drugs numb reality. But there are more complicated answers, such as the cognitive defense mechanisms which can be profound without any chemical assistance. There is also the impact of learning on a naive mind. Almost thirty years ago, I felt great empathy for a man who was very frustrated with his diagnosis of alcoholism. He was drinking a six pack of beer every night, “WHAT do you mean I am alcoholic? My Dad drank a case a night!” I assured him that he deserved credit for not drinking a case like his father, but that a six pack a night was still considered a dependency. There was another the time I worked with a mother of an incest survivor as she processed her denial, “How did I NOT know what was going on, I washed the sheets, I saw the stains,” she lamented.

This is why we need each other. There are times we cannot see ourselves or others in a bright, clear, light. The inability to see is not limited to addiction, or mental illness, but can manifest in normative, and sometimes but rarely functional, blindnesses in business, religious organizations, schools, and even rush hour traffic.

As a past clinical supervisor, there are times I have wished that all therapists would take a drawing class. I say this because a drawing class teaches you how to see reality as it is, instead of stereotypical assumptions of reality.

In college I remember a friend who drank too much. She was not alcoholic and she was not truly drinking more than her sorority peers. She described an evening at a party off campus, as if she had been the belle of the ball. A week later we visited the party host and I watched as the host (an older woman) quietly showed us photos from the week before. She made no comments. I remember my friend’s face as she saw pictures of herself looking – well – a bit droopy. Instead of dancing, she was hanging limply on her dance partner. Now 30 years later, my friend has never developed alcoholism. The gift of being able to see yourself, as others see you, without judgment, is profound and possibly one of the most powerful interventions of future problems.

Using the force of image in art therapy provides us the ability to see from outside in and inside out.

All of us are bombarded by media images on a daily and possibly hourly basis, so much so that it seems to have undermined our ability to form an internal screen of original and personal imagery. Even more than ever, people need to SEE the consequences of their addiction, or mental illness, or dysfunctional behaviors. It is powerful and effective to make a painting, a sculpture, or a sand tray of the consequences of the problem all in one place. Making one painting of all of the consequences intervenes upon compartmentalization, the inability to connect linking causal events. In some circles this function, linking causality and seeing parts as a whole, is referred to as a Gestalt. One woman in my research study who had lost everything due to her self-mutilation said (this is a paraphrased quote), “If only I had seen this body map years ago. Till now, I thought of each event as separate. I had no idea how much damage I was doing cumulatively over time.”

This is why it is important to add visual image to the counseling arena.

I call many of the interventions I use, “A Visual First Step”, because these therapeutic art assignments help us all (client and therapist) see – literally see – the powerlessness and unmanageability of past actions. This first step of integrity, is essential to change the negative trajectory to a positive future.

No matter what the diagnosis may be for a client who enters treatment for the first time, they arrive with a broken heart. The etiology of their broken heart varies, but the hurt has universal commonalities. As a counselor for thirty years, I hold close to my own heart this sad truth, and it is with this truth that I am able to forge a connection.

Too often I hear the alleged axiom, “God does not give you more than you can handle”.

This is not true. This is a statement that helps the witness keep a numb distance from the victim’s pain, as if tragedy, grief, and loss might be contagious.

When I hear a clients’ story behind the pain, often I have said, “I am so impressed with your strength, how are you still standing up right?” Then I say, “Let’s get to work, so that your life can become more manageable.”

It might be said that all addiction and mental health treatment has a grief and loss element.

Some of you may remember the horror film The Shining,” and the role of Roxanne (played by Shelly Duvall). I think of her role and how well she played it,… shaking, weeping, while terrified of her insane and bizarrely homicidal husband. Yet, she surprised us all with her perseverance, determination, and survival skills. Contrary to what was expected, she got away. With great respect for those who do not get away, I also honor how many people survive great disappointments and tragedies, against all odds, to arrive at my door step.

When you do arrive, I will be there, waiting, with a large kit of life experience and therapy tools to help.

Using the visual arts in the therapy session, opens the door to more creative thought in all aspects of life, within and outside of the therapy session.

The book, Healing the Child Within by Charles Whitfield, has helped people learn how to self-soothe and nurture themselves in a safe fashion. While it can be difficult to teach a new client self-love, it is a concept that is much more accessible once the person imagines themselves as a vulnerable child. Most people can love the symbol, image, or ego-state of a child.

I explain to clients that while our relationship and connection is very important, it is most important that a discipline is fostered that deepens their connection between adult and child parts of self. The reason for this is that I am not available 24/7, but you are. While it may seem unfair (at first) that you the adult must reparent yourself,…. this is a model that works best. As you become more connected to the parts of you that have been lost or separated due to trauma, abuse, neglect, grief and loss, or addiction, the more you become integrated and whole. The more integrated you become, the more you are able to consistently and reliably access your skills, talents, abilities, creativity, connection, and love on a consistent basis. For those with addiction, this is a good way to help reduce cravings,….. self-love for all parts of self. Even the most difficult parts of self, the parts that continue to act out in destructive ways, were created for a good purpose. They just need your adult attention, grounding, love, help, forgiveness, and a new job description.

This art piece was created by a scientist with no art background. This was not an official assignment, but instead it was an art piece that emerged organically from personal insight and inspiration. This art piece accurately describes the trajectory from broken inner child, to the adult’s self-parenting, and the resulting wholeness that emerged from these processes. The irony, is that by loving the little boy inner child state, the man became more of a man. This level of transformation was very evident, even in his posture and ways of relating to others.

Most addiction programs teach a model of birth order and dysfunctional family roles. Identifying these roles are important for several reasons, they are able to reduce shame and help people ponder, reassess, and intervene upon assumed ways of relating to others.

Quite often a person in treatment identifies which role best suits their position in the family system. Examples of roles are: hero, scapegoat, lost child, and mascot. Karpman’s Triangle provides another taxonomy of roles: perpetrator, rescuer, and victim. I like Dr. Renee Fredrickson’s addition to this list, the role of denier. One of the important lessons regarding the Karpman Triangle is that we may assume various roles at different times, as if a game of musical chairs,…..  except no one wins.

When I ask a client to paint a life-sized silhouette mandala (body map), I ask them to include all aspects of their bio and psychological history. They are asked to list and paint on the body map where they have knowledge of or a somatic experience of: consequences of addiction(s) and untreated mental health problem(s), trauma, abuse, accident(s), surgery or surgeries, positive and negative spiritual experiences, self-harm and/or self-mutilation…. etc. For those who have a history of childhood sexual abuse and also, seemingly by chance, a history of gynecological problems, important links of understanding are made regarding how the body becomes a testament to the untold story.

In the body map below, the client identified with the role of victim. As she began to portray her experience of the role, she placed footprints across her body, as if she had been walked on. I had turned away for just a second to hear a stomping sound. I turned to see that not only was she marking a symbol of her role, but she seemed to be stomping on the symbol of herself with a remarkable level of intensity. I asked, “Are you painting or are you stomping on yourself?” The answer was a shy, “Yes.”

This question brought to the surface several important discussions, but for the purpose of this post, we will address one. There are times victims hurt themselves in an effort to show the perpetrator the damage done, and/or to punish the perpetrator who may not appear to feel remorse. The problem is that actions of this form of self-harm, conscious or unconscious and even understandable, backfire.

Through visual imagery, a safe way of processing, self-harm dynamics are able to be illuminated, which enhance the potential for open dialogue, understanding, and healing.

Green Feet

In today’s world, an inordinate number of people hold and carry tremendous stress, not only in the mind, but also the body. This stress can exacerbate other problems such as temper, chronic pain, or a sharp, critical tongue. For an addict, untreated excessive stress can be the harbinger of relapse.

I use a life-sized silhouette mandala (body map) to help people process where and how stress presents somatically.

For new clients, I might ask them to rank stress according to the colors of a flame. For the purpose of this exercise, red equals the lowest level of heat, and blue the hottest.

I ask questions about where stress presents first, second, and so on. I ask about the quality and texture of stress or body pain. I ask clients to add other categories of stress beyond the prescribed colors I have suggested. In other words, I want the process to be as personal and as descriptive as possible.

Because of the unique and idiosyncratic nature of symbols, each person creates a personal legend of symbols and meaning as a guide.

Generally, people gain insight such as, “I never knew this,” about myself. Others determine at what point they need to stop, take notice, and intervene before a larger problem emerges.

There are people who can wait until the subjective ranking of stress has become the level yellow before a personal intervention, just before the hottest color blue. Others must intervene much more quickly in the process, maybe even at the first glimpse or hint of embodied stress – level red.

At the point of intervention, where ever that falls, self-soothing techniques are applied.

I have been a witness to how this technique has helped people gain control of an alleged, “hair trigger,” temper, or helped prevent relapse, and/or reduce pain.

The creative arts therapies help people bypass cognitive defenses and touch the center of an issue; it is a process that is elegant, sophisticated, and fun.

Art may be used celebrate a joyous occasion or memorialize a loss. A long ago client once said, “What I have learned from you is that I can have and hold two conflicting emotions at the same time and that this is healthy”.  Art is able to help us see, acknowledge, define, and celebrate our simple joys and pleasures, as well as the very complex and layered. Today is the birthday for a new friend. Is there a better way to celebrate than to give her a painting of the ocean while wishing her oceans of joy, peace, and love? The meaning of the handmade gift may be more important than the painting.

NOTE: All art submissions are posted with a signed authorization to release confidential information. The cases are disguised. This means that they are a conglomerate of several cases, from three decades of work, and from a variety of locations across the United States and abroad.

Ocean of Joy! by Dr. Scott