Using Expressive Arts in Therapy

eafwebimages-v91When I reflected on this question about the use of expressive arts in my work, I was surprised to find that it has taken more of a prominent role than I had realized. The foundation of my training is in psychodynamic and family systems, with training in many other therapies layered on. I don’t identify myself as an art therapist, yet meeting my clients where they are – that tried and true social work value – has required the use of expressive arts at different times, with different populations. When I finished my MSW, my first job was at a child guidance center, where I learned about working with kids through play therapy that often included art. Then I did a post graduate year-long training in Virginia Satir’s model of family therapy, which included family “sculpting” and other tools that moved far beyond talk therapy, which I also value greatly, as the repair in disrupted attachment that can occur through the therapeutic alliance is often profound.

At the same child guidance center, I trained in sand-tray therapy, an infinitely creative process of listening to and witnessing the unconscious wisdom that seems to direct the process quite effortlessly for many clients. I’m aware that there are widely divergent schools of thought within all of the modalities that I bring up, but the through-line for me is that all of the creative expression that I have incorporated in my work has opened up surprising connections for my clients and me; I have found great resonant meaning in their expressive explorations that connect with our collective humanity, all without the use of interpretation or self-disclosure, but instead a kind of shared awe as we witness together the clarity and integration that can emerge through creative inquiry.

Shortly after moving to Seattle in 2004, I took a six year break from private practice in which I did adult and pediatric hospice and palliative care social work; once again, I found myself using art to connect with kids’ experiences. Now back in private practice, I am co-leading a group with my colleague, Jane Fleming, called “Reclaiming Our Lives” for women in mid-life. The group combines contemplative mindfulness practices, ritual, and creative expression to bring more clearly into awareness what is most important and how to align our lives accordingly. We envisioned it also as a bit of an antidote for women feeling overextended, overbooked, overstimulated, and exhausted. It’s also a natural calling, as I find that as we are both well into mid-life, we and many women during this phase of life are in this sorting process already, trying to shed what is no longer useful and opening to what is most nourishing and enriching. So, the creative process for Jane and me is that we design each group in response to what has come up before for the group participants. We always include a simple ritual, even as simple as lighting a candle; a silent time wherein we introduce a meditation or contemplative practice; and an activity of creative expression, done in silence. We also allow time for check-in and reflection on the process.

So far, we have used drawing, writing, weaving, sculpting, collage, and story-telling. As we continue to respond to what each group brings and how they evolve as a group – we will be starting our third eight week cohort in February- we will continue to add on what seems to fit, expanding the list above. Some of the women in our group have recently sparked a curiosity about adding more movement and sound into our process. So far, the only movement has been walking meditation and gentle stretching. Who knows what might happen next? We don’t and that’s what makes the process so rich.

This article was first published in the Winter 2014 Newsletter of the Washington State Society for Clinical Social Workers. My thanks to them for asking the question that led to this article.

Meeting Shame with Compassion

helping-hand-1Easier said than done? Absolutely, but still worth it. Shame is one of the most difficult inner states to be with. We all experience shame but sometimes move away from it so quickly we don’t even notice. Avoidance strategies tend to deepen shame, whereas compassion in response to our felt experience of shame helps connect us to our shared humanity through the suffering we all feel sometimes. Often, we would rather distract ourselves, deny shame or numb-out somehow through compulsive or addictive habits, but these strategies only serve to catch us in a loop – increasing shame after the numbing wears off, and starting up the cycle again. Another way of avoiding shame is to deflect responsibility by blaming someone else (you’re making me feel/act this way), thereby side-stepping the responsibility for our own actions, the only ones we actually can control. When we avoid shame, we may end up causing more harm to ourselves and others in the process.

We may also believe that to turn toward our own feelings is to wallow in them, but do we instead overcompensate by ignoring our difficult feelings altogether? Does this really help us build up the skills we need to effectively manage painful emotions? Can we touch into the shame we experience with compassion and see that it is just a passing experience that doesn’t define us?

But how do we actually practice meeting shame with compassion? Together, the root words com-passion, literally translated, mean to suffer with. So, can we stand gently alongside of our suffering, simply acknowledging the truth of it? (“This really hurts.”) And then gently suspending another layer of judgement or shame, we can employ investigation instead: “So this is what shame feels like in my body/mind/heart.” If we can practice this kind of resilient reflection, even for a few seconds at a time, we begin to understand ourselves beyond this one present experience, letting it move through us, as it will. This is a courageous act that can bring surprising results over time. See my earlier post: “We Strengthen What We Practice.”


We Strengthen What We Practice


What are you strengthening right now? Maybe curiosity, maybe learning new skills, maybe taking a risk because you’re thinking about asking for help with a difficult problem. Maybe you’re practicing avoidance because there is something else you told yourself you’d do right now. (This is a short post so read on!) The point is we are always strengthening something, whether we’re aware of it or not. You’ve likely heard a lot of talk about the power of intention, but following intention with mindful attention of even the most mundane moments in life is like adding jet fuel to your intentions.

If you’ve ever been engaged in an exercise program, you know that you get a lot of benefit from exercising regularly, even if its not a big work-out, like climbing the stairs at work instead of using the elevator. So mindful attention works the same way – its like adding reps of self awareness throughout your day.

Here’s an example that happened this weekend: I made an intention a few months ago to practice taking risks to speak up, verbally and through writing, especially at times when it might be more comfortable to stay silent. I also had made an earlier intention to practice kindness.

When I set out for the beach the other day, I had no idea that I would have the perfect opportunity to practice both at once. When we got there, there was a parked car with the headlights on. As I walked past the car, I thought about the disappointment and hassle of having your battery run down. I wondered if I could just show up at the small beach, make an announcement about it and then set up my chair and towel to read. As I thought about it, my stomach tightened a bit anticipating embarrassment. As we continued down the path, I weighed the few seconds of embarrassment against the hassle of a dead battery. It was tiny.

“Someone with a maroon car has left their headlights on,” I said as loudly as I could. Everyone turned to stare. My husband joked,”We’re hee-yer!” At first nothing happened, then a few chapters into my book, long past the stomach tightness, two women came up to thank me and offer me some cold water they had brought. “You saved our day,” they said.

So give it a try – throughout your day ask yourself, “What am I practicing right now?” And try to leave the judgement out of it, which is likely to shut down awareness, even if what you find yourself practicing is judgement of yourself or others. There’s no need to add anything; take notice, but that’s all and then let it end on its own. Let me know how it goes!

Ingredients Of An Interaction

walk-beachI attended a year long training program in 1995-1996 to learn Virginia Satir’s Growth Model of family therapy in more depth. I had started learning about it in graduate school and I was both excited and comforted by its simplicity and strength-based approach. I learned a tool, among many others, called “Ingredients of An Interaction” that I have taught to countless individuals, couples and families.

In this tool, the therapist guides a person through specific steps, often as one or more people watch before their turn. It is a slow-motion, magnified look at what happens when we react to something someone else has done or said. We may be angry in a split second, for instance, but don’t know much about how we got there, focusing only on another person’s actions as the impetus. Then we may repeat the interaction through obsessive review or speech, (see previous blog post: “We Strengthen What We Practice,”) thereby strengthening our defensive reactivity, which is just a layering of feelings, rules and habit patterns piled on top of the primary feeling.

One of the steps in this tool is called “Feelings About Feelings.”  We start out getting sensory input, make meaning(s) of that input, have feelings about those meanings, then have feelings about the feelings, then family rules come in, etc. before we respond. It is worth mentioning that the response after close examination is quite often organically altered by this focus of attention without judgment.

Try it on next time you have a strong reaction. Or maybe just ask yourself: What feelings do I have about feelings I experience? Suppose the feeling is fear – is it okay to feel fear, to admit feeling something that is universally experienced in all of life? How about anger? Sadness?  Sometimes people have rules that equate kindness or gratitude, for example, with weakness or vulnerability, even stupidity. What are the layers of conditioning: familial, cultural, educational, spiritual….. that can and do weigh in outside of our everyday awareness?

What do we add on to the bare experience of feelings, especially those we would like to banish to another planet? Shame, for example- UGH!  How do we relate to feelings that seem to be the most well practiced, intentionally or not?  Ever worry about worry? Been angry about anger – yours or others – or afraid of it? Been in love with love? What are the rules you may have been following that categorize feelings into good or bad, simply based on how pleasant or unpleasant they are to experience?

How would it be if we could learn to experience feelings in their fullness without adding on judgment, allowing them to naturally come and go?  Is it the feelings that are problematic or what we do with them?  If we slow down reactivity with awareness, can we open to our choices about how to respond with skillful action?

Let me know how it goes!