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Play, Winnicott and Creativity

(LO 2) Today was an opportunity for me to play within my group. It has been a while since I last experienced mess and I had a lot of fun along the way. Sometimes I feel it is easy to get caught up with the way you look, act and present yourself in front of people. Play is such an important aspect to my own therapy.  Just as Winnicott has taught us, the very nature of play is itself  therapy (Winnicott, 2005) Our jobs as therapists is to help our clients play. Play often uses the whole personality and through play we find our creativity which in turn leads to self-discovery. If the therapists cannot play then is may not be the best profession for them, but if the client/patient cannot play then it is up to the therapist to find a way for this to happen. (Winnicott, 2005)

I often encourage play with my clients both in my workplace and in my placement. Through play and using assessment tools such as Story Stems, MIM and social atoms at work, I have observed and reflected at times how the child may use a toy for example as a transitional object  and what happens in the presence of a mother or the absence of mother. What is interesting in all of this is the level of creativity and how the child engages with their imagination. In Play is fundamental in how the child communicates and expressed him/herself.  

Winnicott, D. (2005). Playing and reality. London: Routledge.

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Relationships and complex trauma

(LO 1,3,6) I have been continually reflecting on my personal relationships within a psychosocial context. I often think about my interpersonal relationships with family and my social network and social situations e.g. work, university, friends. etc and I feel that for the most part my relationships have been quite healthy. Lately, I have been experiencing a bodily response like a knot within myself. I wanted to use the string to help me untangle this and to help me release some of this tension. I thought in the process of compartmentalizing my relationships into groups, I would lessen this friction and stress. However, in doing so I realised something quite profound and it occurred to me how rather fortunate I am that I can even have and maintain healthy relationships. I thought about the young adopted people who I work with and who have experienced profound trauma and exposed to violence, addiction, abuse, neglect etc. Their ACE’s (Adverse childhood experiences) have greatly impacted their social, emotional and cognitive development which means they are at risk of long-term problems with health and well- being if they do not receive therapeutic treatment. 

I facilitate a small group called The Young People’s Forum at work. This was initially set up to provide a safe space/platform for young adopted people to come together and share and explore feelings/ issues and to provide opportunities to build on their relationship, develop new skills and use the arts for expression. Through this group, I realised the daily challenges they encounter and the maladaptive coping mechanisms at work for those who are repeatedly coping with shame and unclear identity. I found a video on Ericson’s psychosocial stages on YouTube which I have attached and thought about stage 1. Trust vs Mistrust – This stage occurs around birth to two years where the child begins to develop a sense of trust in caregivers and the world.  I have realised how difficult it has been for these young people to trust and often questioned myself if I have done enough to support them with the group, to help them communicate this. 

https://www.youtube.com/watch?v=aYCBdZLCDBQ

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Art Therapy, Race and Culture

(LO, 3,1) I stumbled on an interesting book today in the library called Art Therapy, Race and Culture.  The book is a collection of writings about contemporary art therapy practice in multi-cultural Britain in relation to race and culture. One of the questions that sparked an interest in me which is outlined in this book is: How does race and culture of both therapist and client impact on the process, product and relationships in art therapy?

(Campbell, 2004) suggest that there is not such thing as therapist neutrality and that we all come with our own constructs. Assumptions are sometimes made and misunderstandings arise and in the worst case leading to scapegoating.This is sometimes on a conscious or unconscious level but nevertheless an important question and one that I believe should promote ongoing dialogue as practitioners, because it may not be something that we think about regularly during therapy with our clients. I know that my that values, experiences, race and culture will impact the way I feel, think and behave and also what our clients bring and how they mentalise this. I think another important wider question should be how sexuality, gender, class and age impact the therapeutic relationship also?

From a trainee perspective, I acknowledge that more women are attracted to this profession and that could be due to a myriad of reasons but I often wonder why there are so few men? I am one of two males on my course and one of four males at my work out of twenty-five female therapists, psychologists and social workers. What does this say about me? Or what does this say about the profession? Of course, I strongly believe that there should be more male role models working with complex young people and children and I am an advocate of this. I searched this extensively online and could not find any decent literature on this question. Perhaps this is something I will focus more on as the course progresses.

Campbell, J. (2004). Art therapy, race and culture. London: Jessica Kingsley Publishers.

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Alchemy of groups

(LO 7, 8) Today was the penultimate training group session before we complete our 8 weeks together. There was a lot of discussion around it being a therapy group or a training group and what the difference is. We also reflected on what emotions we experienced, if any, during the whole process and wondered whether the art making stood as a catalyst or a distraction.  I sat there today feeling quite indifferent and ambivalent about the whole group experience and I made some art in response to this. I created a chair and in the process I thought about how far back we as humans have experienced groups - even as far back in evolution as hunter gatherers.  We all play a part in groups, in society, in our familes, we have been in groups all our lives. 

The chair for me symbolised my place in this group. Where do I belong?  What do I bring? What does me feeling so avoidant at times mean? Does this say something about me or other people in the group? Why did I have such a visceral response at times? What I came to realise is these were all important questions and that maybe I will not be able to answer them now and it’s ok to that it feels unresolved. Groups are complicated and just like clay that are malleable, organic and dymanic - constantly changing and shifting shape. Just like clay they may require water at times for growth or they may start off with a small surface or layer and build up from a secure base. I have also come to understand that groups are relational and what is happening in the group is sometimes more important than the subject matter.  

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(LO, 4, 6, 8) I presented for the second time today in my reflective group. This felt like a good learning curve for me today and much was dicussed in relation to counter- transference and my feelings towards my client. My client J who I shall name for confidentially reasons was referrerd to me beacuse he was having some behavioural and emotional difficulties due to a recent parental seperation.  He was experiencing his father as absent, distant and unavailable, while during this period of therapy, I too realised that I was experiencing my childhood as unavailable and absent, as if this part of life seized to exist. I realised that I had very limited recollections of the latency stage in my life and it was only in my teenage years where I felt that I came alive. I was able to share with my group rather openly my experinces as a teenager and my troubled youth in the sense that I lacked direction and was mixed up and involved in drugs, gangs and violence. I remember that this felt very dangerous for me at the time yet very exciting not only on an emotional/physical level but also on a chemical level like a surge of adrenaline and I was not experiencing this level of ‘risk’ with  my client and so my amygdala felt charged.  

I read Joseph betty’s article, Addiction to-near death (1982) as recommended by Hayley. This was an interesting read  whereby Joseph looked at a patient addicted to near death as being caught up in a desire to gain pleasure by wrecking both himself and the therapeutic relationship. Joseph also talks about the diffciulty for pateints sometimes to aknowledge mascochistic pain and that sometimes there is an emptiness which derives from the relinquishment of the excitement associated with the masochistic situation. This was very much my experience in the counter- transference but I was unable to process and reflect on this beacuse this felt risky to share with my supervisor at the time and the ambivalence which had manifested itself made it difficult for me to admit to the fact that I should have consulted the supervisor earlier. It is now evident that prior to this incident, I was perhaps less open and hesitant to share my own childhood experiences and current feelings. Upon reflection, offten, our dilemma as therapists is being able to manage and tolerate our own personal pasts and to also experience those difficult emotions that our clients bring to the therapy space (Greatrex, 2002). This experience has changed and developed my thinking in learning about the importance of reflection and supervision and being honest with myself and open with the supervisor. Furthermore, it has reminded me that I must behave professionally and be mindful in adhering to the HCPC standards, especially in this case for supervision. As instructed by the HCPC standards (11.3) I must “Understandthe role and value of ongoing clinical supervision in an arts therapy context”

HCPC Health & Care Professions Council (2018) Art Therapists:The standards of proficiency for arts therapists. Available at https://www.hcpcuk.org/standards/standards-of-proficiency/arts-therapists/[Accessed:22 March, 2019]

Greatrex, Toni. M. D. (2002) Projective identification: How does it work? Neuro-Psychoanalysis, 4(2): pp. 187-197.

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Personal therapy and the Wounded Healer & Ghost of a Flea.

(LO, 3) Willaim Blake’ s A Wounded Healer is an interesting story that came up in my therapy last week. Inspired by Greek mythology, Blake created a montrous being which revealed that all fleas were inhabited by the souls of men and that men were bloodthirsy by nature. Other interpretations suggest that this image represented fears about our unettling world and all the sufferring and wars that we have experienced. I identified with this ‘beast’ early on in my therapy and I found myself making art depticting wild, untamed but misunderstood creatures. The ‘beast’ was something that I felt was deep within me that was left dormant and untouched for years. The ‘beast’ represented anger, hurt and shame all of which I experienced all my life but particulary in the last year.  

I also saw the ‘beast’ as my unprocessed sadness and grief with losing my sister last year and all the things that I wanted to say or do but feared hurting people’s feelings or being judged for it. This unpleasant and often grotesque creature needed to come out but I couldnt find myself releasing it which I knew on some level would be cathartic. I would often destroy images I made in therapy because I could not stand to see them . I am still working on this with my therapist and wondering and curious as to why this feels so hard. Maybe time will tell.  

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Sitting in Silence

(LO, 2, 1 5) Today was an interesting day in our training groups where we sat in silence for a short time. I could feel how this was uncomfortbale for some and there was a disconcerting energy in the room. I recognised this energy but I also wanted to embrace the silence and I wanted to sit with it. In the past this would have felt very awkward and still is to some degree it did. Thoughts of ‘what are people thinking about’? ‘Am I being watched?’ ‘I can't wait for this to be over?’ all came to mind but I tried hard to let this wash over.  The group felt stuck at times but also I reminded myself that if we do not to be make or talk then we can just sit and that’s ok too.

I made some art in response to this and I tried to think about the white space as white noise where nothing happens but we are aware of it. I wanted to use an organic material and chose charcoal to represent ‘conversations’ and then how they fade out at the end until a new one is created. 

The journal ‘Silence in Art therapy- The client’s perspective’ looks at how silence is used as part of the therapeutic  process and how this affects or improves that process. What stood out for me was ‘Silence, like meditation, may contribute toward the development of inner peace and harmony that offers a sense of control that may lead to a better and deeper process of introspection’ This in itself mirrors what I was trying to achieve today, a zen like inner peace but still trying to hold onto the group at the same time. 

Regev, D., Kurt, H. and Snir, S. (2016). Silence during art therapy: The art therapist’s perspective. International Journal of Art Therapy, 21(3), pp.86-94.

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Digital Culture in art therapy & Piaget

(LO, 2, 5, 3) I visited the ‘We live in the ocean air’ exhibition at the Saatchi gallery on the weekend. A multi sensory immersive experience of being inside the world’s oldest tree, the Sarcoma tree. I really enjoyed this 20min experience and I was excited to being totally immersed in sound, touch and smell. I experienced this as peaceful at times but also quite over stimulating at other times- it made me think about VR and the future of synthetic/digital art and its place within the framework of Art Therapy. Technology, digital media and the internet has expanded into daily life and Art therapists are using technology more and more on a daily basis whether that be sending emails, networking or reserching. However, in this digital age, therapists are having to think of creative ways to engage children and youths with the use of animation, photography, tablets and video as clincal tools. From my experience, I too have reconnected with my photography and I am searching for creativity. I have recently purchased a film camera with B&W film which I hope to use soon and excited to see what I have shot when this has been developed.  

This experience also reminded me of Piaget’s sensorimotor theory (2011) and how infants start to make connections between sensory and motor interactions. According to the literature, the final stage of this development is the 6th stage which is called symbolic thought. This is when we learn to visualise what is not physically there. The VR experience distorts this notion of thinking.... I knew the ‘Scarcoma tree’ was physically not present in the experience but it felt present and felt real. My sense is that the creative industry is trying to connect to the two, and trying to push the boundaries of reality.  

Spencer K.S. (2011) Piaget’s Sensorimotor Period. In: Goldstein S., Naglieri J.A. (eds) Encyclopedia of Child Behavior and Development. Springer, Boston, MA

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Hungry for knowledge

(LO, 3, 5) I made some art today with Gary Nash as he came in to discuss group facilitation with us. This was an interesting experiential lecture whereby we were asked to think about: What does art do to me when I create? How does it change me or fulfill me? How does art making in groups affect creativity? How do we as art therapists facilitate creativity in groups? I found the whole experience quite powerful and exposing also working in such a large group but it was a good opportunity to make with these questions in mind and to then have a short dicussion about the whole experience. I created a mouth and thought about how much information I am able to ingest currently. I think I have been feeling quite overwhelmed lately with personal issues, my work, and my studies and I feel my rate of progression is slow. On reflection, I understand that I am putting a lot of pressure on myself and that I have to be patient. I always have Hayley's voice in the back of my head saying ‘to let is wash over’. My work is very intense and I am in a privileged position to be working at Family Futures and with such complex young people but sometimes I feel this overshadows my learning at times. Is it the work? or does this say more about me and my ability to organise my time!

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(LO, 5) An image I took of something I made in the group today. I was feeling quite sheltered and didn't want to share my creation but I know that people were watching me and I was (playing in the presence of others). The group tried to do something different today and work around a table instead of a circle. It felt nice to do something different and to experiment but it also felt artificial like everyone was just wanting to agree for the greater good of the group and so people worked, but sat in silence. I found myself glancing up from time to time and saw how some groups members were completely into their work. Was this what we the group intended today? or does that even matter? maybe in this process we realized what we don't like or what we do. Maybe the image I created was  something to show how exposed I felt within the group- like a bright yellow flower sticking out. Today was a confusing day for me and I did not enjoy the process, in fact I am surprised I kept this image. 

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(LO ,7, 5)  I visited the Tate a few weeks ago and this special piece caught my eye. I sat there starring at it whilst my fiance went to the toilet. The more I read about Robert Indiana, the more I was fascinated by him. He created such an iconic symbol and it felt so significant. I sat reflecting on how love is thought about in the context of specialist and non specialist audiences. For example, the difference between those working within the frameworks of art therapy such as tutors, clinicians, practitioners , service uses etc and those who do not e.g some of my family and friends who’s understanding of love is that of which they see in the media and movies etc. I thought about all the clients at work and on placement that have never experienced love, or have never had a primary atthachment figure in their lives to tell them they love them and those that will strggule to form romantic relationships later on in their lives. I asked myself 

What it Love? 

What role does oxytocin play? 

Love for me strange - it’s not something I can’t touch or see yet it’s something I feel and is visceral. It has many functions for me, it priovides a sense of safety and reduces my anxiety at times.  I read up on oxytocin and found that oxytocin is a hormone naturally produced by the brain and is often called the “love hormone”. It is the glue that bonds a mother and child and romantic relationships together. It is also known to increase sociability and to help maintain emotional regulation. However,  the success of this love hormone is dependant on environmental factors. Changes occuring during infancy and adolescence can have an effect on the oxytocin system.  For example, exposure to nurturing and loving carers can contribute to the normal developmment and promote resilience. However, prolonged stress and signifcant harm can have a profound detriment to this system also. 

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(LO, 5) I made this in our training group and another member offered to paint the shape on the right for me, which I welcomed. I am not sure whether it added or took anything away from my art but it was a nice offering and felt genuine from a co member. The image on the left reminded me of the ‘beast’ which I have documented in other blog posts but also the image as a whole reminded me of something colonial or something shipwrecked from Pirates of the Carribean. I thought about my exhibiion essay and how my art pieces so far were small and delicate and I found myself hiding them in the group - like some ‘treasure’ washed up- buried in the sand like a message in a bottle. The ocean representing the unconscious but also the all mighty giver and taker of life. 

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Client Art and Supervision

(LO 6,8,4) I discussed this piece today with my supervisor on my placement. J, who I will name for confidentially reasons is 9 and referred to me as he is experiencing some behavioural and emotional difficulties as mentioned in my previous posts. I shared this image and my supervisor was initially impressed that J was able to make this as he has struggled in the past with his previous therapist. We discussed gender and if this may have contributed to this and why J found it difficult to maintain relationships with women. This made sense in terms of how he currently experiences his mother. He has been very blaming towards her in the past and now oppositional and defiant (which made me think of the good and bad breast) J and I were able to discuss some of his current anxiety and worry he has and how the school and I can best support him. J found it difficult to answer this but we discussed in supervision the disparity between his reality and his phantasy. His desire for this image of an idyllic family – mum, dad and brother and the reality of the rupture within this with dad leaving them behind/moving on and to best balance and support him with it. 

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A lecture with Graham Music - Nurturing Natures

(LO, 7,2,1) Graham introduced trauma, the body and the nervous system today and shared some of his theory and concepts from his book Nurturing Natures. I had already heard of Graham prior to this lecture as there are some ties with Tavistock and Family Futures.  Graham began by explaining intersubjectivity which I found very useful because I have always struggled to understand this concept. Graham described it by saying that if two people look at a picture and one person looks at the other person and they know what the other person is thinking then this becomes a shared thought. I found this analogy very useful, I hope it is right. 

The most interesting aspect to this lecture for me was the discussion around epigenetics and studies with Mice and also studies with holocaust survivors. I found it astonishing that there is now evidence supporting the notion that offspring are impacted by parental trauma exposures happening before their birth, and possibly even prior to their conception. Mother’s of traumatised children with their own early neglect and trauma can be ‘transferred’ to their children’s nervous system. As Rachel Yehuda comments in her article‘Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms’ (2018) 

On the simplest level, the concept of intergenerational trauma acknowledges that exposure to extremely adverse events impacts individuals to such a great extent that their offspring find themselves grappling with their parents’ post‐traumatic state.  

However, I could not find any literature to support this with the holocaust survivors but still a very intersting concept nonetheless. 

Yahuda, R. and Lehrner, A. (2018). Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127768/