Focusing-Oriented Art Therapy

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Focusing-Oriented Art Therapy

of related interest Inner Journeying Through Art-Journaling Learning to See and Record your Life as a Work of Art

Marianne Hieb ISBN 978 1 84310 794 1

Art Therapy and Anger Edited by Marian Liebmann ISBN 978 1 84310 425 4

The Expressive Arts Activity Book A Resource for Professionals

Suzanne Darley and Wende Heath Illustrated by Mark Darley Foreword by Gene D. Cohen MD PhD ISBN 978 1 84310 861 0

The Healing Flow: Artistic Expression in Therapy Creative Arts and the Process of Healing: An Image/Word Approach Inquiry

Martina Schnetz Forewords by V. Darroch-Lozowski and David C. Wright ISBN 978 1 84310 205 2

Art-Based Research Shaun McNiff ISBN 978 1 85302 621 8 paperback ISBN 978 1 85302 620 1 hardback

Little Windows into Art Therapy Small Openings for Beginning Therapists

Deborah Schroder ISBN 978 1 84310 778 1

Focusing-Oriented Art Therapy Accessing the Body’s Wisdom and Creative Intelligence Laury Rappaport Foreword by Judith A. Rubin, PhD

Jessica Kingsley Publishers London and Philadelphia

First published in 2009 by Jessica Kingsley Publishers 116 Pentonville Road London N1 9JB, UK and 400 Market Street, Suite 400 Philadelphia, PA 19106, USA www.jkp.com Copyright © Laury Rappaport 2009 Foreword copyright © Judith A. Rubin 2009

All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, Saffron House, 6–10 Kirby Street, London EC1N 8TS. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher. Warning: The doing of an unauthorised act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution. Library of Congress Cataloging in Publication Data A CIP catalog record for this book is available from the Library of Congress British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library

ISBN 978 1 84310 760 6 ISBN pdf eBook 978 1 84642 852 4

Printed and bound in the United States by Thomson-Shore, 7300 Joy Road, Dexter, MI 48130

Contents ACKNOWLEDGMENTS

11

FOREWORD

13

Introduction

16

Part I: Focusing and Art Therapy Chapter 1: Focusing: History and Concepts

23

Chapter 2: Gendlin’s Focusing Method

36

Chapter 3: Focusing-Oriented Psychotherapy

49

Chapter 4: Art Therapy: History, Concepts, and Practice

64

Part II: Focusing-Oriented Art Therapy Chapter 5: Bridging Focusing and Art Therapy

87

Chapter 6: Focusing-Oriented Art Therapy: Basics

91

Part III: Clinical Approaches Chapter 7: Clearing a Space with Art

111

Chapter 8: Focusing-Oriented Art Psychotherapy

123

Groups: Theme-Directed Chapter 9: Stress Reduction in Adult Psychiatric Day Treatment

139

Chapter 10: Emotional Healing and Self-Care in a State Prison

147

Chapter 11: Transforming the Inner Critic

153

Chapter 12: Bridging Cultures with Focusing-Oriented Art Therapy

163

Specialty Applications Chapter 13: Health and Wellness

171

Chapter 14: Working with Trauma

188

Chapter 15: Spirituality and Psychotherapy

199

Chapter 16: Expanding to the Other Expressive Arts

212

Part IV: Focusing-Oriented Art Therapy Exercises Chapter 17: Guided Exercises

219

APPENDIX A: SUPERVISION AND SELF-CARE

236

APPENDIX B: RESOURCES

237

REFERENCES

240

SUBJECT INDEX

245

AUTHOR INDEX

250

Figures 4.1 4.2 4.3 4.4 4.5 6.1 6.2 6.3 6.4 6.5 7.1 7.2 7.3 7.4 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 9.1 9.2 9.3 9.4 9.5 9.6 10.1 10.2 11.1 11.2 11.3 12.1 12.2 12.3 12.4 12.5 12.6 13.1 13.2 13.3 13.4 13.5

Oil pastels Watercolor Feeling expression Conversation Drawing Active imagination Expressing the handle/symbol in art Acceptance and compassion Felt sense, bruised heart Felt shift, strong hands holding it together Getting a felt sense of the art Clearing a Space with Art, Nicole Clearing a Space with Art, Mary Clearing the background feeling, Steve “All Fine Place,” Rebecca Sarah, felt sense, tears held in Sarah, felt shift, tears released Donna, felt sense, heavy sad blob Donna, unheard, abandoned, alone Donna, felt sense, anger Donna, felt sense, want Donna, felt sense boundary Donna, felt shift, clear solid Lucas, felt sense, stress Lucas, felt shift, peaceful place Adam, felt sense, tension Adam, felt shift, release Lisa, felt sense, anger Lisa, felt shift, peace Name Drawing Source of spiritual nourishment Felt sense, Critic attack Felt shift, new relationship Janet, Critic show Art warm-up #1, felt sense Art warm-up #2, felt sense Ana and Takura’s Conversation Drawing Takura’s felt sense Takura’s felt shift Bridging cultures Cindy, Clearing a Space Cindy, source of strength Cindy, What I want to carry with me Mindful awareness of pain Felt sense in core of the body

73 73 74 75 77 94 96 98 100 101 111 113 114 115 125 126 129 129 131 132 133 134 142 142 143 143 145 145 150 151 158 158 160 164 164 165 167 167 168 177 178 181 184 185

13.6 14.1 14.2 14.3 14.4 14.5 15.1 15.2 15.3 15.4 15.5 15.6

Felt shift, envisioning pain all healed Alissa, Protector Alissa, felt sense, sad Alissa, felt sense, rage Alissa, felt sense, transforming anger Alissa, felt sense, life Patricia, felt sense of how I am now Patricia, imagining felt sense of self safe Patricia, felt sense after meditating Patricia, felt sense, spirit Felt sense, word, mail Melinda, felt sense after meditating

186 193 193 195 196 197 202 203 204 205 209 210

Tables 5.1 6.1 9.1

Interconnections: Focusing and art therapy Gendlin’s Focusing Steps and Focusing-Oriented Art Therapy Group themes and skills: 12 weeks

88 104 140

Boxes 1.1 1.2 6.1 7.1 11.1

Benefits of Focusing Properties of a felt sense Benefits of Focusing-Oriented Art Therapy Art materials for Clearing a Space with Art Strategies for taming the Critic

26 33 102 116 154

Exercises 1.1 1.2 2.1 4.1 4.2 4.3 4.4 6.1 6.2 6.3 6.4 7.1 7.2

Guided directions for accessing a felt sense Guided Focusing for symbolizing a felt sense Basic Focusing instructions (without art) Exploring lines, shapes, and colors; the language of artmaking Art and feeling Conversation Drawing Exploring clay Acceptance and compassion Focusing Check-In: “How am I right now?” Getting a felt sense of the art Basic Focusing-Oriented Art Therapy guided instructions Clearing a Space with Art I: Nondirective Imagery Clearing a Space with Art II: Directive Imagery (eyes open or closed)

31 32 40 81 82 82 83 95 97 101 105 118 120

7.3 9.1 9.2 9.3 10.1 10.2 11.1 13.1 13.2 14.1 15.1 15.2 15.3 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19

Clearing a Space with Art III: Concrete Imagery (eyes open) Focusing Stress Check-In Peaceful Place and “being friendly” Tension-release exercise Name Drawings Guided Focusing: Higher power or source of spiritual nourishment Relationship between the Critic and the Criticized Part Source of strength What I want to carry with me Protector Focus on spiritual inspiration Mindfulness sitting meditation Pebble meditation “Who am I?” collage Collage of ten things I feel drawn to Inside/outside me How I see myself now/how I would like to see myself How I see myself/how others see me Social atoms How I feel in this group now/how I’d like it to be Resources toolbox How my health is now/how I would like it to be How I spend my time now/how I would like to spend my time Safe space Personal boundaries Identifying issues and felt sense Mandala: how I feel about the trauma Spiritual lifeline Where I am now/where I’d like to be spiritually Walking meditation Relationship now/how I’d like it to be What I need from you/what I can offer you

121 141 141 142 149 151 157 174 175 192 206 207 208 219 219 220 221 222 222 223 225 225 226 227 228 228 229 230 231 232 234 235

Acknowledgments Although words are linear, my gratitude goes to everyone in the same moment. To Eugene Gendlin for naming the felt sense and spending much of your life writing, teaching and encouraging others to explore how Focusing fits with other things. I carry Gene’s smile and affirmation—which always says “yes” to my explorations. I thank Mary Hendricks-Gendlin and The Focusing Institute for supporting my interest in combining Focusing with the arts. Joan Klagsbrun, long-time Focusing teacher, coordinator, and dear friend of 30 years, opened many doors for me to bring Focusing and the expressive therapies into the world, and affirmed this book every step of the way. I would not be who I am as an art therapist and expressive arts therapist without the inspirational mentoring and friendships of Shaun McNiff, Paolo Knill, Norma Canner, and Peter Rowan. And Shaun—a special thank-you for all the ways you supported me and always answered my questions in the book writing process. I am also grateful to my other Lesley colleagues: Julia Byers, for her compassion and belief; Vivien Marcow-Speiser for creating new programs and inviting me to offer Focusing; Susan Spaniol, for sharing and reviewing my original proposal to write this book; and Philip Speiser, Karen Estrella, Michele Forinash, Mitchell Kossak, Elizabeth McKim, and Stan Strickland for the rich interchange. I thank all of the clients, students, and professionals who explored the use of Focusing and the expressive arts—you have helped this book come into existence. Terri-Halperin-Eaton, Sophie Glikson, and Shelley Cushner Gardner gave ongoing coaching and support, read drafts of chapters, and gave invaluable feedback. Jacob Morris provided ongoing dialogue and thinking about the book, reassurance, editing suggestions, and a compassionate heart. Thank-you to all of my colleagues who offered advice, feedback, endorsements, and support to help launch this innovative approach into the fields of art therapy, counseling and psychology, Focusing, and other areas—Judy Rubin, Shaun, Michael Franklin, Akira Ikemi, Paolo, Cathy Malchiodi, Barbara Okun, Mako Hikasa, Maki Miyaki, along with my new community of colleagues at Notre Dame de Namur University—Doris 11

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Arrington, Richard Carolan, Arnell Etherington, Carolee Stabno, Gwen Sanders and other faculty, students, and administrators who are so welcoming of this new work. Much appreciation goes to Neil Friedman whose support and questions on the Focusing part of the book inspired a new form. I have immense gratitude to Jessica Kingsley for giving me this opportunity to put together over 30 years of work into this groundbreaking book on the integration of Focusing and art therapy. In addition to being an astute publisher, Jessica responds to every email and interaction with great heart and wisdom! Thank-you! This book could only be written with the daily unconditional love, acceptance, and belief from my husband Wayne and daughter Zoe. Not only did Wayne read every word in the many drafts, his keen mind, technological wizardry, and soul informed and helped deliver the final product. Together, with Zoe’s aesthetic contributions, they created a “Dream Team” along with my dear friend and writer Pamela Gray, who added just the right touch to honor my voice. An enormous appreciation goes to the detail holders—Megan Rajbanshi, my research assistant, Marilynn Carter who assisted in formatting and timely feedback, and to Lisa, Helen and the responsive editorial staff at Jessica Kingsley’s. I also would like to thank my parents, Renee and Sol, who believe in me and taught me about bringing goodness into the world; my brother Steve who assisted me with book writing mentoring; and my sister Jodi who always kept the faith. Thank-you to other dear friends who are part of the fabric of this book—Michael Siegell and Lakshmi Mudinuri, Trudy and Les Fagen, Robert and Judith Gass—and to Natalie Rogers for our synchronistic connection and the good writing vibes on the mountain. This book is written in service to the great teachers of compassion that I have been fortunate to learn directly from—Gurumayi and Thich Nhat Hanh.

Foreword In the mid-eighties when art therapy was growing rapidly in the U.S., many theories and terms were being used, often without full understanding. So I invited some colleagues to contribute chapters on the particular approach to art therapy that each of them had developed to Approaches to Art Therapy: Theory and Technique (Rubin 1987). In 2001, I invited 12 more colleagues to contribute chapters and commentaries to the second edition (Rubin 2001). In that book, art therapists who have studied particular orientations describe how they have applied the thinking therein to their work. I regret that I did not know about Dr. Rappaport’s work until recently, but I am delighted to be able to refer to it in a revision of an overview (Rubin 1998) of the field, Introduction to Art Therapy: Sources & Resources (Rubin 2009). In addition to noting Focusing-Oriented Art Therapy in the chapter on Approaches, Dr. Rappaport has graciously allowed me to use an excerpt from a videotape of her work on the accompanying DVD. It might be helpful to put this book in a historical context before saying how much I think that it will be helpful to art therapists and to other clinicians, especially those already using Focusing as an approach to their work. Because I am a licensed Psychologist and Psychoanalyst (child and adult) as well as an art therapist, I can see many ways in which Dr. Rappaport’s synthesis of art therapy and Focusing would enhance the clinical skills of different kinds of practitioners. Because art therapy was born in the forties when analytic thinking dominated mental health, the earliest theories were Psychodynamic, whether the emphasis was on making the unconscious conscious, strengthening the ego, object relations, or the development and individuation of the Self. The ability of art to express censored unconscious material in a safe way is at the core of all of these approaches, whether from a Freudian or Jungian point of view. Dr. Rappaport’s method, while applicable to all theoretical orientations, falls best within the Humanistic approaches, including phenomenological, Gestalt, person-centered, holistic, and spiritual (transpersonal) viewpoints. These approaches focus on people’s capacity to take charge of their lives, and art has a unique ability to help human beings 13

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realize the goals of both self-actualization and self-transcendence. Rather than being the object of transference or the source of interpretations, the art therapist in these approaches is viewed mainly as a companion, a guide, or a witness. Psycho-educational approaches to art therapy include behavioral, cognitive, cognitive-behavioral, and developmental orientations as well. Systemic approaches integrate an understanding of family or group dynamics with art therapy. There are also some “Integrative” chapters in Approaches to Art Therapy (Rubin 1987, 2001), two dealing with the issue of choice for the therapist, and two using different art forms in “expressive therapy” and a “therapeutic curriculum.” A later book (Malchiodi 2003) includes discussions of solution-focused and narrative art therapy, both of increasing interest. Like those pioneers who synthesized a deep comprehension of a theoretical orientation with their own understanding of art therapy, Dr. Rappaport has added a very important chapter. Only when someone has really digested a theory and its associated methodology, can they truly integrate it with art therapy in an authentic fashion. Dr. Rappaport, a seasoned and sophisticated Focusing practitioner, has done just that. She has created something new out of her two passions, articulating it in a clear and useful way that I believe will resonate with all mental health workers. I agree with Dr. Rappaport that the method of quiet inner listening which is at the core of Focusing has a natural affinity with art therapy, since both involve inviting the client to stop, listen, feel, look at, and then express ideas, feelings, and images from within. Her “bridging” chapter about combining the two is extremely thoughtful. Because Focusing also invites attention to the body, it seems equally compatible with dance/movement and drama therapy, as well as the many psychotherapeutic approaches which focus on bodily awareness. These include early methods, such as those developed by Wilhelm Reich (1961,1980), Alexander Lowen (1994), Ilana Rubenfeld (2001) and Ida Rolf (1977); as well as more recent ones, like those developed by Ron Kurtz (2007) and Pat Ogden’s Sensorimotor Psychotherapy (Ogden, Minton and Pain 2006). (See also the U.S. Association for Body Psychotherapy: www.usabp.org.) Therapists looking for another way to think about what they do with clients will find inspiration. In addition to a clear explanation of the theory and practice of Focusing, Dr. Rappaport has done what the subtitle of

FOREWORD

15

Approaches to Art Therapy (Rubin 2001) requires: translating Theory into Technique. Examples of work with different individuals and groups promote a deeper and richer understanding of what the author is proposing. In a world where everything seems to be in “fast forward,” this book offers a welcome respite. I hope that art therapists and other mental health practitioners will embrace this sensitive and useful invitation to add the thinking and the methods of Focusing-Oriented Art Therapy to their work. Judith A. Rubin, PhD

Introduction

I am excited to introduce this new theoretical and methodological approach to art therapy, namely Focusing-Oriented Art Therapy. Focusing-Oriented Art Therapy integrates Eugene Gendlin’s method of Focusing with the practice of art therapy. Both Gendlin’s original teaching method of Focusing (1981a) and the principles of Focusing-Oriented Therapy (1996) are intertwined with art therapy theory and practice. Focusing offers a gentle yet powerful way for accessing the body’s wisdom, while art therapy harnesses and activates one’s creative intelligence. While Focusing and art therapy are each complete practices for self-awareness, growth, and therapeutic change, a rich transformational alchemy occurs when wedding the two disciplines. Focusing-Oriented Art Therapy benefits art therapists, expressive arts therapists, Focusing-Oriented Therapists, Focusers, and others interested in applying Focusing and art therapy to their discipline. Focusing incorporates inner listening, an empathic way of being towards oneself, and provides access to the body’s innate wisdom (Gendlin 1981a, 1996). Gendlin’s first book, Focusing (1981a), grew out of research that he did at the University of Chicago with Carl Rogers on what led to effective psychotherapy. After analyzing hundreds of therapy transcripts, Gendlin discovered that those clients who naturally accessed their inner experience beyond the cognitive mind were the ones to demonstrate successful change. Gendlin developed a six-step method, Focusing, to teach how to access this inner experience, which he termed felt sense. Focusing-Oriented Psychotherapy (1996) is Gendlin’s adaptation of the broader based application of Focusing into a psychotherapeutic framework. Both Gendlin’s six-step method and the Focusing-Oriented Psychotherapy framework inform the underlying theoretical base and methodology in the creation of Focusing-Oriented Art Therapy. Although 16

INTRODUCTION

17

Focusing-Oriented Art Therapy is viewed within the Person-Centered Approach, it is applicable to all orientations, including psychodynamic, cognitive, behavioral, etc. (Gendlin 1996; Purton 2004).

Why combine Focusing with art therapy? Gendlin has consistently maintained the view that Focusing needs to be combined with other things, stating: “Focusing is an entry into a crucial mode of sensing. Every other method works more effectively, when Focusing is added” (1991, p.65). Focusing and art therapy have primarily been researched and explored as individual disciplines, with little cross-fertilization of the two. While there are some Focusing therapists integrating art into their work (Ikemi et al. 2007; Leijssen 1992; Marder 1997; Murayama and Yuba 1988; Neagu 1988; Tsuchie 2003), as well as a few art therapists applying Focusing into their work and research (Knill 2004; Knill, Levine and Levine 2005; Merkur 1997; Rappaport 1988, 1993, 1998, 2006) the depth of combining these two disciplines is relatively unexplored. As a practitioner who has been combining Focusing and art therapy for the past 30 years, I can attest to the profound levels of therapeutic change and personal growth that occur through their synergistic integration. I have coined the phrase Focusing-Oriented Art Therapy to describe the particular approach of integrating Focusing and art therapy that I have developed over these years. While art therapy offers Focusing a profound process of working with imagery, visualization, and the creative process, Focusing offers an added dimension of connecting the imaginal realm with mindfulness and the bodily felt experience. Art therapy brings Focusing an array of methods, tools, and materials, as well as depth of understanding of the healing power of imagery to give visual expression to what Gendlin named the felt sense. Art therapy offers a nonverbal modality to capture aspects of the felt sense that are beyond words or before words. Focusing also provides art therapy with more than a method—but a therapeutic approach that addresses the therapeutic relationship, “the person in there” (Gendlin 1996, p.287), the significance of listening, the experiential dimension, and how change occurs.

How this book is organized This book has a unique challenge in that it is written for several audiences: art therapists and expressive arts therapists who would like to learn this new approach of incorporating Focusing into their work; Focusers and

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Focusing-Oriented Therapists who would like to learn how to incorporate art therapy into their work; and psychologists, psychiatrists, counselors, mental health and healing arts professionals who have an interest in both art therapy and Focusing. In order to fully understand the practice of Focusing-Oriented Art Therapy, it is necessary first to understand the main theory and methodology of each discipline. To accomplish this aim and to address the needs of the different readerships, Part I provides an overview of the main theoretical and practice components of the separate disciplines—Focusing and art therapy. Chapter 1 includes an overview of the history and method of Focusing, along with its main concepts—the Focusing Attitude, felt sense, handle/symbol, felt shift, and life-forward direction. Chapter 2 describes Gendlin’s six-step Focusing method, followed by the principles of Focusing-Oriented Psychotherapy in Chapter 3. Chapter 4 moves to an overview of the theory and practice of art therapy. Only one overview chapter of art therapy is included, compared to three on Focusing, because in the field of art therapy, there are many books that provide an overview of the subject while this is the first book that describes the use of Focusing in art therapy (therefore it needs more description). My intention for the art therapy chapter is to provide a brief overview of the history, training, theory, and practice of the field for newcomers—and a succinct reference point of theory and practice for experienced art therapists to touch back into. Exercises and vignettes are included in Part I to demonstrate and illustrate both Focusing and art therapy. Depending on which readership you come from, feel free to skim over the parts you are most familiar with in order to fill in the missing pieces—and to get to how Focusing and art therapy are integrated in Parts II and III. My hope though is that there is new information or exercises even if you are an experienced Focuser or art therapist. (For those seeking more of an overview of either art therapy or Focusing, please consult the resources for each in the Appendices and References.) Part II describes the basic theor y and methodology of Focusing-Oriented Art Therapy, including preliminary steps for creating safety, the significance of reflection, basic steps for symbolizing a felt sense in art, seeing the felt shift, and an overview of how Gendlin’s Focusing method is adapted to create three basic approaches to Focusing-Oriented Art Therapy. Part III is the clinical application of Focusing-Oriented Art Therapy and is divided into the three basic approaches: Clearing a Space with Art, which helps clients to identify and set issues aside and experience a place within that is inherently whole; Focusing-Oriented Art Psychotherapy,

INTRODUCTION

19

a more in-depth approach applied primarily to individual and couples therapy; and Theme-Directed, which is most often used in groups. Part III also includes an application to specialty issues of health and wellness, trauma, and spirituality. The clinical examples are based on actual case material with names and other identifying information altered in order to protect confidentiality. In some vignettes, case examples are a fusion of clients with similar issues so that one particular client’s story of suffering does not have to continue in its original unhealed form. A brief chapter on “Expanding to the Other Expressive Arts” introduces a beginning theoretical and practice framework for integrating Focusing with the other expressive arts therapies. Guided exercises are included throughout each section and expanded on in Part IV. (To best address gender-neutral language, I have elected to use the singular plural “they” throughout the book).

Personal roots of Focusing-Oriented Art Therapy I first discovered the combination of Focusing and art therapy, informally, as a teenager. During that time of angst and confusion, and of searching for life’s meaning, I would come home from school, go into my room, close the door, and take out a sketch pad and charcoal drawing sticks. I sat on the bed or the floor, closed my eyes, waited…and then saw an image that came from somewhere inside myself. It was more than a visual image. The image resonated a sense of truth in my body. I proceeded to draw the image. I kept drawing until the image felt complete on the paper. There was a sense of rightness. There was also a shift in my breath. There was usually a sense of ease. The images that emerged were of hungry, starving people; many were from underdeveloped countries. Somehow, as the images came out onto the paper, I found myself feeling better. They expressed a deep sense of my own hunger, starvation, isolation, and loneliness. A profound paradox seemed to emerge. As the images of the pained people took form and expression on the paper, I felt as if I were throwing a lifeline deep down within, finding my true self. As I found this authentic being, I began to actualize my true self in the world. Guided by this process of inner listening, I followed a calling and passion to bridge working with people and art. During the early 1970s, there were very few programs on art therapy. One could either study fine arts or psychology but traditional education at that time did not promote interdisciplinary studies. After transferring to my third undergraduate

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college—where I was about to pursue occupational therapy because it seemed like the closest thing to art therapy—I overheard a voice outside of the advisor’s office. I inquired, “Did you say, art therapy?” The person replied, “Yes.” “Do they have that here?” I asked. “No…I mean yes…sort of… You can create your own major.” Finally, I reached my destination to study art therapy. As most therapists become clients in their journey to become professionals, I serendipitously discovered that the quiet inner listening that I was doing when I was a teenager actually had a name—Focusing. During my graduate training, I was seeing a therapist who integrated Focusing into her practice. Every so often, after my sharing, she would say something like, “…and can you check inside and see how that feels?” What she meant was: “Can you slow down, close your eyes (if that’s comfortable), and sense from the inside of your body what that whole thing feels like.” I did just that. I closed my eyes. There were a few moments of silence. The silence was filled with a presence—not an emptiness. The presence felt supportive, patient, and compassionate. I felt the therapist’s silent presence accompanying me internally as I sensed inside for what the whole thing felt like from within. After some time, an image or a word or phrase came. Sometimes a kinesthetic sense came. This process felt familiar to me. This is what I did in my room as a teenager. I listened to the whole felt sense within. The difference between what the therapist did and what I did was that I added drawing. Drawing and art became the vehicle for the expression of my inner felt sense—and a means of profound inner and outer transformation. While the therapist could accompany and witness me on my inner journey, art allowed me to do it for myself. Throughout my profession as an expressive arts therapist, I integrated Focusing into every aspect of my clinical work. After 30 years of its development, I am proud to launch the integration of Focusing and Expressive Arts as a new unified theoretical approach—Focusing-Oriented Expressive Arts Therapy. I think of this book, Focusing-Oriented Art Therapy, as a first in a series on the subject. My hope and vision for this book is that you will find it informative and practical. While the guided exercises are designed to be applicable to clinical work, they work well for experiential learning as you sift your way through the theory and methodology. I look forward to the developments, research, articles, books, and sharing that will come from planting this new seed into the world.

Part I

Focusing and Art Therapy

Chapter 1

Focusing: History and Concepts

Focusing is the process of listening to your body in a gentle, accepting way and hearing the messages that your inner self is sending you. It’s a process of honoring the wisdom that you have inside of you, becoming aware of the subtle level of knowing that speaks to you through your body. (Cornell 1996, p.3)

What is Focusing? Focusing is a mind/body practice of bringing a welcoming, friendly attitude towards one’s felt sense of an issue, situation, or experience. Listening to the felt sense opens the doorway to the body’s wisdom—bringing next steps towards growth and healing. Instead of jumping to conclusions, or falling into habitual ways of thinking about something, Focusing offers a fresh look into how your whole being is experiencing something—mind, body, and spirit—in the present moment. While the intellect or mind tends to think it knows all of the answers, Focusing accesses an integrated, embodied knowing through what Gendlin (1981a, 1996) describes as the “felt sense”. Taking time to listen to the felt sense brings something new or not yet known, unfolding steps in a life-forward direction towards resolution—resulting in a felt shift, or actual change.

History Focusing was developed by Eugene Gendlin (1981a, 1996) at the University of Chicago in the 1960s, emerging out of research he did with Carl Rogers on what led to success in psychotherapy. Gendlin was a graduate student in philosophy with a particular interest in exploring the difference between our lived experience and the words or symbols used to describe it. During that same time period, Carl Rogers was at the University of Chicago pioneering 23

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Client-Centered Therapy which included a way of reflecting back verbal and nonverbal communication that matched the client’s inner experience. Rogers named this type of communication “active” or “reflective” listening (Rogers 1951, 1961). Gendlin saw a connection between Rogers’ nondirective clinical method, which aimed to reflect the client’s inner experience, with his own interest in symbolizing “experience.” Gendlin trained in Rogers’ nondirective approach to psychotherapy and later collaborated on research designed to explore the following questions: Why doesn’t psychotherapy succeed more often? Why does it often fail to make a difference in peoples’ lives? In the rarer cases when it does succeed, what is it that those patients and therapists do? What is it that the majority of patients fail to do? (Gendlin 1981a, p.3)

The research consisted of analyzing hundreds of transcripts from the psychotherapy sessions; Gendlin and Rogers were the first researchers to record and transcribe actual therapy sessions. The results of the research showed that the success of the therapy did not correlate with the therapist’s theoretical orientation, the content of what the client spoke about, or the therapist’s technique. Instead, they found that the crucial factor was how the person spoke. Those clients who were able to hear how they were “inside,” to a place beyond the cognitive mind, were the ones who demonstrated progress in therapy. A typical transcript of this type of “checking inside” went something like this: “I was feeling kind of weird today… Well, it’s not that I was feeling weird, hmmm…no…isolated…lonely… Yeah that’s it…isolated and lonely.” Successful clients in therapy knew how to listen to their whole body/mind sense of their experience. They knew how to hear when the word or words matched, or didn’t match, their inner experience. Gendlin believed that if some people naturally do what it takes to be successful in therapy, then why not teach others to do the same. Gendlin (1981a) developed Focusing as a six-step method (described in Chapter 2) to teach people how to hear their inner experience, find a “handle” or symbol (a word, phrase, image, gesture, or sound) to describe it, and then to resonate the symbol with the felt experience for a sense of rightness. Focusing helps people to learn how to listen to themselves and others with greater self-acceptance, to “sit with” their experiences, to listen deeply to what the felt experience is about, and to receive what the felt meaning has to offer. As part of the research on Focusing, Gendlin and Zimring (1955) developed a seven-stage process scale, later refined as the Experiencing scale

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(Klein et al. 1969) to measure the extent to which clients referred to their inner experience. Quantitative measures using the Experiencing scale led researchers to be able to predict, by the second session, which clients would succeed in therapy. Those who were higher Experiencers, who referenced their inner felt experience, correlated with greater success in therapy. Research studies have also shown that clients with low Experiencing levels who learn Focusing can reach higher Experiencing levels, thus increasing their ability for success in psychotherapy and change (Hendricks 2001). Gendlin also taught Focusing as a method that could be used outside of a clinical context, for self-help and self-care. In the early 1970s Gendlin developed “Changes” as a drop-in group for people to exchange Focusing and listening turns with one another, and to introduce newcomers to Focusing. This six-step Focusing method (Gendlin 1981a) has evolved into what is known as Focusing-Oriented Psychotherapy (Gendlin 1996), described in Chapter 3. Focusing-Oriented Psychotherapy includes Gendlin’s Focusing method as a complete process unto itself, as well as interspersing specific Focusing steps (described in Chapter 2) into the psychotherapeutic process. Additionally, Focusing-Oriented Psychotherapy incorporates aspects of the psychotherapeutic process that go beyond the Focusing method, such as the therapeutic relationship, awareness of “the person in there” (discussed in Chapter 3), and the client-centered values of unconditional positive regard, empathy, and congruence. While the Focusing method and Focusing-Oriented Psychotherapy come out of a client-centered framework, they are compatible with other schools of psychotherapy, including psychodynamic, cognitive, behavioral, systemic, brief therapy, and more.

Focusing today Focusing is taught and practiced on nearly every continent with Certified Trainers, Certified Focusing Therapists, and Certifying Coordinators. In addition to psychotherapy and self-help, Focusing is integrated into other fields, such as medicine, education, bodywork, creativity, writing, business, coaching, philosophy, and spirituality. Focusing is also taught as a tool for peace and conflict resolution in various countries throughout the world, such as in Kosovo, Afghanistan, El Salvador, Israel, and Palestine. To support Focusing in daily life, many people participate in Focusing partnerships and Changes groups around the world where Focusing and listening turns are exchanged.

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Focusing has been found to have numerous benefits, summarized in Box 1.1.

Box 1.1 Benefits of Focusing • Facilitates connection among mind, body, and spirit. • Opens the doorway to the body’s innate wisdom. • Cultivates acceptance, loving kindness, and compassion

toward self and others. • Accesses creativity. • Aligns one with their authentic self. • Reduces stress. • Improves decision-making. • Serves as an entry into spiritual dimensions of living.

Focusing: the main concepts ·

Focusing Attitude

·

felt sense

·

handle (symbol)

·

felt shift

·

life-forward Direction.

Focusing Attitude Loving the felt sense is more important than understanding it. Understanding will come in its own time. (Cornell 1996, p.32)

The Focusing Attitude is a stance of conveying to the inner self that all feelings, thoughts, emotions, and felt senses that are present within the body/mind are welcome. There might be a river of sadness, a mountain of tears, a storm of rage, a still lake of peace, or a fountain of joy. The Focusing

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Attitude creates a safe inner holding atmosphere for the Focusing process to unfold. As Gendlin states: Just as the therapist does from the outside, it is important for clients to take a friendly attitude toward the felt sense… We might not like what we hear from the felt sense, but we want to be friendly to the messenger. So instead of criticizing or attacking “it,” the client learns to be friendly toward it and glad about its arrival. (Gendlin 1996, p.55)

Key components of the Focusing Attitude: ·

welcoming

·

being friendly to

·

keeping company with

·

friendly curiosity.

Welcoming is a way of letting the feelings, thoughts, and felt senses know that they are okay as they are, and of inviting them to come into presence. Whether the inner experience is powerful, explosive, intense, gentle, quiet, dull, or barely audible, it is welcome. “Welcoming” can be introduced through brief guided instructions, such as: “Take a few deep breaths into your body. As you breathe, bring a welcoming attitude to whatever is happening inside your body right now.” Clients can keep their eyes open or closed, depending on their clinical needs. Ann Weiser Cornell (1996) includes a process of “saying hello” to whatever the felt experience is inside. As in social and business contexts, we often say hello as part of welcoming and making contact. Cornell’s “saying hello” is a beginning step of welcoming the felt sense inside and making initial contact with it. Being friendly to: Gendlin came up with the phrase, “being friendly to.” While sometimes it is difficult to completely welcome more difficult feelings, thoughts, and felt senses, it can be easier to “be friendly to” them. If a felt sense is overwhelming or scary, the therapist might gently ask, “Can you be friendly to that?” Being friendly helps clients make a safe inner space to hear the inner felt experience that is affecting them. Keeping company helps clients to have a relationship with their inner felt experience in which there is a whole, integrated self that can both witness and be in connection with the inner felt sense. For example, a client, Chrissy, has a sense of gripping rage in her abdomen. The therapist asks, “Can you

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bring your attention inside to your body where you experience the gripping rage?” Chrissy nods yes. The therapist continues, “Imagine sitting down next to it and keeping it company, much the way you would with a young, shy child.” While Chrissy is “keeping company with” her felt experience, she can be in touch with the felt sense of gripping rage while simultaneously having the experience of an integrated self that is sitting next to it. Chrissy is accessing a part of self that can witness and listen to the gripping rage. She can also have a felt experience of the gripping rage without believing she is the gripping rage. In this way “keeping company” enables clients to be in touch with their authentic felt sense without being identified with or lost in it. Friendly curiosity: Approaching the inner felt experience with friendly curiosity helps to create an atmosphere of acceptance when approaching the inner felt experience, even when it is painful or difficult. The therapist can invite an attitude of friendly curiosity using varied approaches, such as: “Gripping rage… Can you say to yourself, ‘Oh that’s interesting’?” The Focusing Attitude helps the Focuser find a safe way to make contact with an inner felt sense. As the Focusing Attitude is practiced and experienced, the Focuser learns that there is a self inside that can be “friendly to,” or accepting of, the inner experience. The Focusing Attitude begins to help the Focuser know that there is an aspect of self that is separate from the felt experience and larger than it.

Felt sense The felt sense is a wonderful phenomenon. It contains all of your inner knowing about a given situation and that which you do not yet know about yourself. Your felt sense can lead you to the next growth step. It can even sense an answer that has not yet been experienced. The felt sense is something before mind, body, and spirit are split apart. (Hinterkopf 1998, p.19)

The felt sense is a direct bodily awareness and experience of our inner state. It is more than simply knowing there is sadness, anger, or happiness inside. It is as if you can extract a feeling and all that surrounds it—where the feeling came from, what’s inside of it, the strands of its intricacies and subtleties, and its historical roots. Gendlin states: A felt sense is not a mental experience but a physical one… Physical. A bodily awareness of a situation or person or event. An internal aura that encompasses everything you feel and know about the given subject at a

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given time—encompasses it and communicates it to you all at once rather than detail by detail. Think of it as a taste, if you like, or a great musical chord that makes you feel a powerful impact, a big round unclear feeling… A felt sense doesn’t come to you in the form of thoughts or words or other separate units, but as a single (though often puzzling and very complex) bodily feeling. (Gendlin 1981a, p.32)

A felt sense can be about anything—difficult feelings and experiences or uplifting, positive experiences. For example, you can have a felt sense in relation to an experience such as the loss of a loved one, getting a new job, having a child, viewing a painting, or listening to a song. As a living and breathing organism we have a river of experience within that is occurring all the time. Focusing enables one to pause, to focus in on the river of experience, and to capture the felt sense of a particular experience. EXAMPLES OF FELT SENSE

Something challenging

A client, Sam, is talking about the pressures of his job, being a parent, and dealing with his aging parents. I ask, “Would you like to sense how all of that feels inside the body?” Sam pauses, becomes quiet, and listens within. He says, “I feel a sense of my torso being squeezed…there’s a pressure from the outside…squeezing.” The felt sense is the bodily experience of Sam’s torso being squeezed with a pressure from the outside. Something uplifting

After a painful divorce ten years earlier, Talia, a client in her early forties, is excited to be moving in with a man with whom she has been developing a relationship over the past year. I gently ask, “Can you take a moment and notice how all of that feels inside your body?” Talia shares, “I feel a sense of leaping in my heart—like a dancing that sends a warm feeling up into my eyes.” The felt sense is the bodily sense of the leaping in Talia’s heart that sends a warm feeling up to her eyes. HOW TO ACCESS A FELT SENSE

Directed attention inside the body

Because the felt sense lives in the body, attention needs to be directed to that inside space. This can occur with the therapist guiding the client to bring awareness to the inside body sense. Some clients have a difficult time

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accessing an inner sense of their body, in which case it is helpful to begin with body-awareness exercises (see Tips and troubleshooting at the end of Chapter 2). Awareness

Once the attention is inside the body, mindful awareness is directed to notice the sensations, content, and intricacies of the felt sense. Creating a welcoming space

For a felt sense to form and become known, it needs to know it is welcome. Begin with the Focusing Attitude (accepting, welcoming, nonjudgmental), inviting the felt sense to form, and letting it know that whatever it is will be welcome. Time

The felt sense needs time to form. Sometimes it can be as brief as a pause—just enough time to follow your awareness down into your body. The amount of time varies with how much experience you have with Focusing, the issue you are checking in with, as well as the physical, emotional, and spiritual factors influencing your present state. There is no contest to find a felt sense quickly. What matters is giving yourself and the client time to allow the felt sense to form. Being friendly to

As one becomes aware of the felt sense, being friendly to it deepens the safety for the felt sense to reveal itself and become known. Keeping it company

Sitting down next to the felt sense and keeping it company facilitates an inner conversation with the felt sense and enough space or distance to hear what it has to say.

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Exercise 1.1 Guided directions for accessing a felt sense Take a few deep breaths down inside to your body. Let yourself feel the support of the chair that you’re sitting on, the floor and earth beneath your feet, and sitting here in this room. Follow your breath down inside to your body and imagine that there is a searchlight that illuminates everything on the inside [Directed attention inside the body]. Let yourself notice how it is in the inside—is it tense, or jumpy, tight, relaxed…or something else? [Awareness]. See if you can be friendly or welcoming to whatever you find there [Creating a welcoming space]. Take your time…to just notice…and see what’s there [Time]. Imagine sitting down next to whatever you find…being friendly to it and keeping it company.

The handle: symbolizing the felt sense As a client sits with a felt sense, bringing the Focusing Attitude toward it, the therapist invites the client to see if there is a word, phrase, image, gesture, or sound that matches, symbolizes, or describes the felt sense. Gendlin calls this symbolization of the felt sense a “handle” and describes it as follows: “As with the handle of a suitcase, which brings with it the whole weight of the suitcase, the whole weight of the felt sense is brought forward by that one word or phrase” (Gendlin 1996, p.48). It is important for the symbol to arise from the bodily felt sense rather than imposing a mental label onto the felt sense. WHEN THE “HANDLE” COMES AS A WORD OR PHRASE

Client: My mother’s Alzheimer’s is progressing more quickly, and I feel I’m losing her more and more each day. Therapist: Can you take a moment and sense what that feels like in your body? Client: (Eyes closed, quietly sensing) I feel a heaviness in my chest… the words that come are “profound sadness.” “Profound sadness” is the “handle” for the client’s bodily felt sense of the heaviness in her chest.

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WHEN THE “HANDLE” COMES AS AN IMAGE

A student, Rita, describes how the “handle” for her felt sense emerged: “During Focusing I noticed a tightness in my chest with a sense of feeling completely drained and exhausted. As I sat with the felt sense, I got a very distinct image of being in a forest—not the usual peaceful trees…they were frozen and not able to move.” The handle is the image of trees in a forest that are frozen and unable to move. A “handle” that comes as an image is easily transferred into art, which will be discussed in Parts II and III. WHEN THE “HANDLE” COMES AS A GESTURE OR SOUND

A client speaks about her harsh inner critic: Client: I have a memory of my mother locking me in my room, insisting that I was going to put away all of my toys and clothes in their exactly right places and that I was going to stay there until it was done the way that she liked. Inside of me were her words: “Do it right!” “You never get it right.” “What’s wrong with you?” Therapist: You have an inner sense of your mother forcing you to put everything away exactly right—and there’s the strong critical voices exclaiming that you never get it right and asking, “What’s wrong with you?” Can you sense the whole feel of that inside your body? Client: I see myself reaching inside my heart, pulling out her words, and throwing them far away…way outside of me. The handle is the gesture/movement of reaching inside the heart, pulling out the words, and throwing them far away. (An intervention might follow with the client showing the gesture or movement of reaching inside the heart and throwing the words away.)

Exercise 1.2 Guided Focusing for symbolizing a felt sense (continued from instructions on “Accessing a felt sense”) Keeping your attention on the felt sense, see if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense. The properties of a felt sense are described in Box 1.2.

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Box 1.2 Properties of a felt sense • It is bodily—a felt sense resides in the body. • It is an integrated whole of mind, body, and spirit. • It occurs at the border between the conscious and unconscious. • It is more than a feeling or emotion: it carries with it the whole

of experience—what the feeling is connected to, its history, connections, and so forth. • Initially, a felt sense seems vague, unclear, and almost blurry

prior to it coming into “focus.” • It takes time to sense and/or to form. • It opens and offers more, in steps—what it is about, its essence,

and what it needs. • It can offer a felt vision of what it would be like to be all healed. • It can identify its own steps toward healing and change. • It connects one to their innate wisdom. • It is a doorway to creativity.

The felt shift: change The most exciting characteristic of all is that a felt sense, when you focus on it well, has the power to change. (Gendlin 1981a, p.37)

When you bring a friendly, welcoming, attitude to a felt sense and keep it company, a natural inner movement or change occurs, which Gendlin calls a “felt shift.” The bodily felt shift may be subtle or profound. It can be as subtle as a slight change in breath, or a change in the color of the skin such as a paleness becoming rosy. Or, in a more dramatic shift, a tightness, burning, and clenching of the stomach might change to a softening of the belly, with renewed energy spreading throughout the trunk and into the extremities. When a felt shift occurs, it is an actual manifestation of change occurring within the body/mind. Gendlin describes this change process: “…a felt sense will shift if you approach it the right way. It will change even as you are

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making contact with it. When your felt sense of a situation changes, you can change—and therefore so does your life” (Gendlin 1981a, p.32). The felt shift itself is experienced within the client, while external changes may be observed by the client, therapist, or witness. A felt shift typically feels good even when one is Focusing on something painful or difficult. That may sound ironic, but it tends to be true. Why? Because the client is in touch with the felt sense of the pain while also experiencing an inner caring presence—the Focusing Attitude of friendliness and acceptance—as well as the compassionate, unconditional regard of the therapist. As the client keeps company with the felt sense, it opens, revealing more about itself, and changes, moves, or shifts into a new felt sense. This inner movement releases energy and is forward moving to a new step toward resolution or growth. As Gendlin states, “Such a step feels good; it releases energy. What one finds may feel good or bad, but its emergence—the step of finding—always brings relief, like fresh air” (1996, p.26). EXAMPLE: JEFF

Jeff is a 48-year-old client who came to see me for individual psychotherapy. He was between jobs and trying to figure out a work path that balanced career, family, and leisure in his life. During one session, Jeff began to talk about the possibility that a recent job interview he had may not have gone very well. I invited him to access a felt sense: Therapist: Take a moment, breathe, and notice what the whole feel is inside around the possibility of not getting this job. Jeff: There’s a heaviness inside and a turning inward. [Felt sense] …a feeling of shame. That’s it…shame. [Handle/symbol] Therapist: Can you be friendly to the heaviness, turning inward, and shame… [Focusing Attitude]? (A couple of minutes of silence in which there is a sense of Jeff being in contact with his felt experience.) Jeff: Hmmm. I sense this sadness with it. Therapist: Can you be friendly to the sadness and keep it company? Jeff: (Focusing inwardly for a moment) It likes me sitting with it. Therapist: It likes you keeping it company. Can you sense how it is now? Jeff: There’s a gentle smile. It’s near my eyes. My eyes can see it—that it knows I count.

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The felt shift is a change from one felt sense into another. Jeff ’s felt sense began as a heaviness and a turning inward. Being friendly to it and keeping it company helped the felt sense shift into sadness, and then shift again into a gentle smile, with something near the eyes—with a feeling of knowing he counts. A felt shift is evidence of actual change.

Life-forward direction Your body knows the direction of healing and life… If you take time to listen to it through Focusing, it will give you the steps in the right direction. (Gendlin 1981a, p.78)

One of the things that touches me deeply about Focusing is what Gendlin describes as its “life-forward direction.” During the Focusing process one can sense the forward movement of the felt sense as it opens and unfolds the body’s knowing. The Focusing Attitude, keeping the felt sense company, and listening nonjudgmentally to felt experiencing create the conditions in which the body’s innate wisdom reveals itself. These main concepts are expanded on in Gendlin’s six-step Focusing method as described in Chapter 2.

Chapter 2

Gendlin’s Focusing Method

Creative people have probably always used this method. What is really new in it is the specificity with which we can describe the steps and teach them. (Gendlin 1981b, p.16)

After trial and error with various ways of teaching Focusing, Gendlin developed a six-step method to teach the Focusing process. While the steps are useful for learning the basic method and main concepts of Focusing, the actual Focusing process does not always occur in a straightforward, linear manner. Each person is unique, the body is complex, and everyone has their own organic unfolding. As my colleague Joan Klagsbrun says, “The steps are the map, not the terrain.” There are times when the steps will not feel right. At those times, it is important to do what Gendlin (1981a) advises—honor your own inner felt sense above any instructions. If the instructions don’t fit, let them go. Over time, other Focusing trainers developed their own methods of teaching Focusing. While many teachers adhere to Gendlin’s original six-step method, others have added steps, deleted steps, and revised the original Focusing instructions (Campbell and McMahon 1985/1997; Cornell 1996, Cornell and McGavin 2002; Friedman 2003; Hinterkopf 1998). Throughout the years, I have found it is most effective when clinicians and students learn Gendlin’s six-step method as a solid foundation and then become creative with its application (as you will see in Parts II and III of this book).

The Focusing Steps The Focusing Steps can be used as an exercise in a clinical context with individuals, couples, and groups, and as a tool for self-help, self-care, and supervision. The six steps are: 36

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1.

Clearing a Space.

2.

Choosing an issue and felt sense.

3.

Handle/symbol: a word, phrase, image, gesture, or sound.

4.

Resonating.

5.

Asking.

6.

Receiving.

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1. Clearing a Space Clearing a Space is a way to take an inventory of the things that are in the way of feeling “All Fine,” or at ease or peace. The inventory does not consist of everything from the client’s entire life history but rather of the three to six things that are affecting the client in the present moment. The client takes some time to sense how each “issue” is carried in the body, and then imagines placing it outside the body, at a distance that feels right. The client continues placing or stacking the issues at a distance until reaching a stopping place. BACKGROUND FEELING

Gendlin identifies what he calls a “background feeling.” This is an “always feeling”—something that you chronically carry that is difficult to see, much like the way wallpaper blends into a room. A background feeling is something like always kind of tired or always kind of anxious. To clear the background feeling, one checks inside and asks, “Is there a background feeling that’s in the way of feeling all fine?” If there is a background feeling, the client sets it aside with the other issues placed at a distance. THE “ALL FINE PLACE”

After Clearing a Space, the client is guided to take time to experience the “All Fine Place,” or cleared space. The “All Fine Place” is an aspect of self that resides within every person and has an inherent sense of well-being. Issues, feelings, concerns, and pain are set aside, clearing the way for a sense of inner peace, “okayness,” and wholeness. It is helpful to encourage clients to take some time to rest in the experience of well-being. This step allows clients to access their life-affirming energy, which assists in later working on an issue that’s been set aside. (The client can choose to stop after Clearing a Space—which is useful for centering and stress reduction— or move on to the following steps.)

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2. Choosing an issue and felt sense After Clearing a Space, the client chooses something to work on that has been set aside in the previous step. Choosing an issue to work on occurs in two ways. The client can ask the bodily felt sense which “thing” that was set down during the first step would like to be worked on now. In other words, the client listens to what the body says—which may be different from the mind’s answer. Or, the client may have a clear idea of what they would like to work on from the issues set to the side during Clearing a Space. The therapist then invites the client to sense the whole feel of the issue, noticing how it feels in the body, to get a felt sense.

3. Handle/symbol: a word, phrase, image, gesture, or sound Once in touch with the felt sense, the therapist invites the client to see if there is a handle or symbol—a word, phrase, image, gesture, or sound—that describes it. The effect of finding a handle/symbol that matches the felt sense is that it helps to hold onto the felt sense, and assists the felt sense to open or move.

4. Resonating The therapist asks the client to check the handle/symbol (word, phrase, image, gesture, or sound) for an internal sense of rightness by going back and forth between the handle and the bodily felt sense. If the handle/symbol does not feel right, the client is encouraged to let it go and to invite a new word, phrase, image, gesture, or sound to come.

5. Asking This step involves imagining sitting down next to the felt sense, asking it questions and hearing its answers through an inner dialogue. There is a dual awareness—of the felt sense and an aspect of self that can sit next to the felt sense. The part of self that can sit down next to the felt sense is in relationship with the felt sense, and able to engage in an inner dialogue. Questions are posed to the felt sense to help it open, unlock, or move. Variations of questions to ask the felt sense are: ·

What makes it so _______? For example, if the handle is the word “releasing,” imagine sitting down next to the felt sense and asking, “What makes it so ‘releasing’?” You simply fill the blank in (What makes it so _______?) with the handle/symbol.

GENDLIN’S FOCUSING METHOD ·

What’s the crux of it? Or, what’s the main thing about it?

·

What’s the worst of it?

·

What does it need?

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During the “Asking the felt sense” step, it can also be useful to engage the body’s wisdom and imagination to get a glimpse of the issue healed or resolved: ·

Imagine that this issue were all resolved. Sense inside your body what it would look and feel like if this were all resolved. See if there’s an image or words that match or act like a handle for the inner felt sense of this issue all resolved.

This solution-focused orientation to the felt sense helps to mobilize the innate healing abilities of the individual—as Gendlin would say, the “life-forward direction.” The creative imagination is activated to see one’s way around a stuck issue, feeling, or dilemma. After the client imagines the resolution, the following questions are useful in working with the felt sense: ·

What’s in the way (between the issue and resolution)?

·

What’s needed (to achieve this resolution)?

·

What’s one small step in the right direction?

The questions to the felt sense are designed to deepen contact with the felt sense, help it to open up through an inner relationship (the Focusing Attitude), and allow it to naturally unfold in a life-forward direction. The last question, “What’s a small step in the right direction?” helps a client to discover, from the body’s wisdom, an attainable step toward change. Often to get from where one is to where one wants to be can seem like getting from the bottom of a mountain to its top. Change is easier to successfully accomplish in steps. Identifying one concrete do-able step helps the client to move forward, step by step.

6. Receiving Receiving is listening with openness to what the felt sense says in response to the questions. Your mind may come in and try to dismiss the response. It is important to welcome what comes. As Gendlin (1996) states: To “receive” in our sense means to let the step be, give it a space to be in, not to reject it, however odd or wrong it may seem in itself. It comes

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with a little bit of bodily felt release, a breath, a bodily sense that something is right about it, and that is what you want (p.75).

The following guided instructions are based on Gendlin’s six-step Focusing process and are intended as an introduction to the basic Focusing method. Throughout the book you will find variations of these instructions that integrate art therapy and are adapted for various themes and populations.

Exercise 2.1 Basic Focusing instructions (without art) 1. Clearing a Space (without art) Find a comfortable way of sitting. Take a few deep breaths into your body, noticing the breath as it comes in and moves out of your body. Feel the support of the chair that you’re sitting on, the earth beneath your feet, and being here. Feel free to close your eyes or keep them open…whichever is more comfortable for you. As you breathe, follow your breath down inside and notice how you are on the inside. Notice if it’s tight, or warm, or jumpy or calm…or anything else. When you’re ready, ask “How am I from the inside right now?” Just listen… Give an answer time to form in your body… Be accepting to whatever you find there, without judgment. (Pause.) Now, imagine yourself in some peaceful place…it may be a place you already know, or it may be one you create in your imagination. When you’re ready, ask, “What’s between me and feeling ‘All Fine’ right now?” Let whatever comes up, come up… Don’t go inside any particular thing right now… As each thing comes up, imagine placing it at a distance from you. Some people like to imagine sitting on a park bench and placing each thing that comes up on another bench at some distance from it. Others like to imagine placing it on a boat on a lake and letting the boat go out a certain distance…or wrapping each thing in a package and setting it down at a distance from them that feels right. (Pause.) If the list stops, ask, “Except for all that, I’m ‘All Fine,’ right?” If more comes up, add that to the stack. Keep a comfortable distance from your stack.

GENDLIN’S FOCUSING METHOD

Background feeling Sometimes there’s a background feeling—which is like always feeling…like always a little anxious or always a bit depressed… Check inside to see if there is a background feeling that’s in the way of feeling “All Fine”…scoop it up and add it to the stack. Check again. How is it now? (Pause.)

The “All Fine Place” Now, I’d like to invite you to sense the “All Fine Place.” Turn your attention inside, and let it rest on the “All Fine Place”… See if there is a word, phrase, image, gesture, or sound that matches or acts like a handle for the “All Fine Place”… Check it against your body to make sure it’s right. If it isn’t, invite a new word, phrase, image, gesture, or sound that matches, or acts like a handle for the “All Fine Place” to come. 2.

Choosing an issue to work on and felt sense

As you look over at the things you set down, see if there’s something needing your attention right now. You can see if something lets you know it wants to be worked on or you can choose something to work on. Check with your body to see if you have its permission to Focus on it… Be accepting to whatever’s there. (Pause.) Felt Sense: Take a moment to sense the whole issue freshly… Ask, “What’s the whole feel of it?” Be accepting to whatever’s there. (Pause.) 3.

Handle/symbol

See if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense. 4.

Resonating

Check the handle/symbol against your body for a sense of rightness. If it doesn’t fit, let it go and invite a new word, phrase, image, gesture, or sound to come. 5.

Asking

We’re going to ask the felt sense some questions. Some it will answer and some won’t have any relevance—so you can let them go (and let me know if you’d like).

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Imagine sitting down next to the felt sense, keeping it company. • Ask, “What makes it so_______?” Or: “What’s the crux of it?”; “What’s the main thing about it?”; or “What’s the worst of it?” • Imagine that this issue were all resolved. This is like looking the answer up in the back of the book. Sense inside your body what it would look and feel like if this were all resolved. See if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense of this issue all resolved.

Invite the client to ask the felt sense: • What’s in the way (between the issue and resolution)? • What’s needed (to achieve this resolution)? • What’s one small step in the right direction?

6.

Receiving

Receive what comes. Take a few moments to reach a stopping place inside. You may want to take note of where you started from at the beginning of the Focusing and where you got to. See if there’s anything you’d like to carry with you.

The six steps in action: a Focusing session with Kiersten The following vignette demonstrates the application of Gendlin’s six-step Focusing with Kiersten, a 45-year-old woman who was experiencing various conflicts in both her family and work life.

1. Clearing a Space The therapist guides Kiersten to turn her attention inward and begin to identify the issues in the way of feeling “All Fine.” (For suggested phrasing, see “Basic Focusing instructions” above.) Client: (sensing into her body) There’s the issue with my son…there’s my work…anxiety about my mother.

GENDLIN’S FOCUSING METHOD

Therapist: There are the issues with your son, your work, and anxiety about your mother [reflection]. Can you check again inside your body and ask, “Except for that I’m ‘All Fine’?” Client: (sensing inside) Yes. BACKGROUND FEELING

Therapist: Sometimes there’s a background feeling—an always kind of feeling, like always kind of anxious or always kind of hurried. See if there’s a background feeling that’s in the way of feeling “All Fine.” Client: (after a minute) There’s a sense of always worrying about the details to take care of…never resting. Therapist: See if you can take that whole background feeling and scoop it up…and set it over with the other things that you set aside, outside of your body. (After several moments Kiersten’s face softens and there is more color in skin tone.) Except for all of those things, are you “All Fine”? Client: (nods) Yes. THE “ALL FINE PLACE”

Therapist: Keeping your attention on the “All Fine Place,” see if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense. Client: My heart feels full. It’s like there’s a sculptured 3-D cradle at the bottom of my heart. Both of my hands are around it. There’s a rhythmic movement. (Client’s voice sounds soft and comforted. Therapist reflects back the essence of the full heart, cradle, and rhythmic movement.)

2. Choosing an issue and felt sense Therapist: Glancing over at the issues you set aside earlier—issues with your son, your work, anxiety about your mother, and the background feeling about worrying about the details—sense if one of those is needing your attention most right now…or if there’s one you would like to Focus on. Client: My son.

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Therapist: Take the issue you’re carrying about your son…sense the whole feel of it in your body. Client: (The client senses inwardly and then brings her hand up to her throat.) There’s a scratchiness in my throat [felt sense].

3. Handle/symbol Therapist: See if there’s a word, phrase, image, gesture, or sound that acts like a handle for the inner felt sense. Client: (quietly sensing) “Scratchy.”

4. Resonating Therapist: “Scratchy” matches a scratchiness in your throat. Go back and forth between the word “scratchy” and the sensation in your body. Is it right? [Resonate] (Client nods “yes”.)

5. Asking (the felt sense) Therapist: See if you can be friendly to the scratchiness in your throat. [Focusing Attitude] Imagine sitting down next to it…and ask it “What makes it so scratchy?” Or, “What’s the crux of it?” [Asking]

6. Receiving Client: There’s a fear there. (The following shows an inner dialogue, alternating between the Asking and Receiving steps.) Therapist: Can you ask it what makes it so afraid? Client: (inwardly attending for a few moments) My son is becoming an adolescent. There’s a fear that life will strip him of his heart as he goes from a baby to a young boy to a man. Therapist: There’s a fear that life will strip your son of his heart as he grows into adolescence and adulthood. (Client agrees.) Imagine what it would look and feel like if this issue were all resolved.

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Client: (sensing into her body) [During the Focusing] I felt an elongation…being taller than my physical body. Therapist: Can you ask, “What’s in the way of the elongation…being taller than your physical body?” Client: The fear of losing my baby. Therapist: Fear of losing your baby. Can you ask the fear what it needs? Client: (after a few moments) I saw the image from earlier of my own heart—it being cradled and my hands resting on it. Therapist: Can you go back inside and ask, “What’s a good small step in the right direction?” Client: (inwardly listening) It helps to acknowledge my own fear and the loss. The hands on my heart are a reminder to take care of my own heart. It helps me to feel more spacious—which my son needs in order to grow. Kiersten shared afterward that it felt calming to set each issue aside and that the whole process felt like a gentle unraveling of something held tight and constricted into greater understanding and spaciousness.

Benefits of the Focusing Steps ·

Clearing a Space: Helps clients to dis-identify with the issues or problems they are carrying. By setting the issues at an imaginary distance, an experience of self is experienced that is “whole.” Clearing a Space puts the client in touch with a natural life-affirming energy that is always available yet is often buried or blocked by issues or problems. Clearing a Space helps clients to know they are not their problems and that there is a deeper self separate from their psychological difficulties. As troubles are set aside, the weight is lifted and a new freeing energy comes into the body. From this cleared space and vital energy, the client is able to turn towards the stacked concerns and choose something to work on.

·

The background feeling: Identifying the background feeling helps to bring awareness and a healthy distance to chronic, unconscious conditions that interfere with well-being (e.g. tiredness, anxiety, worry, fear, etc.).

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The “All Fine Place”: Taking time to keep the space cleared and to know this “All Fine Place” helps to strengthen the client’s experience of wholeness. This self can be explored further through transpersonal approaches to psychotherapy and spiritual practices.

·

Choosing an issue: Helps to make progress and create change by clarifying an issue to work on rather than feeling lost in a sea of confused, enmeshed, or distant feeling.

·

Felt sense: Provides a body sense of an issue and opens the door for more to be known about it. The felt sense of an issue carries with it life-forward movement and its own healing solution.

·

Handle/symbol: Helps to remember and carry forward a felt experience.

·

Resonating: Facilitates a body sense of inner knowing of what is authentic and true.

·

Asking: Deepens an inner connection with oneself, affirming that the questions and answers are within each person’s embodied knowing.

·

Receiving: Unlocks the door for inner wisdom and solutions to be heard.

Tips and troubleshooting 1.

If you have difficulty accessing a felt sense: ·

Begin with body-awareness exercises such as the following: notice the breath coming in and out of the body; stretch arms, legs, do head circles, lift shoulders, etc.

·

Be sure you are “being friendly” to whatever you experience inside.

·

Don’t worry about doing it right or whether you are “getting” it; trust what is happening.

·

See if there is a critical part of you judging or attacking you as you attempt to sense inside the body. Say hello to it…and see if you can set it at a distance from you.

GENDLIN’S FOCUSING METHOD ·

2.

3.

4.

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See if there is a perfectionist part of you expecting you to get it all in a “perfect” way. Say hello to it and see if you can set it at a distance from you.

If you have trouble imagining setting things at a distance or they won’t go where you’re trying to set them: ·

Try different imagery. You can imagine setting issues outside the door, having someone hold them for you, putting them on a boat and sending it out across a lake to the right distance from you.

·

When using imagery to set things at a distance doesn’t work, imagine taking a step back from the issue just to get a little bit of space from it.

Sometimes physical pain is exceptionally difficult to get any distance from. At such times: ·

Imagine putting the pain inside a helium balloon and having it float away.

·

Imagine a special cocoon that envelopes you with protection and takes you on a trip away from the pain.

·

See if you can be friendly to the pain.

·

Get a felt sense of the pain in the core of your body. Listen to what it has to say and to what it needs.

During the “Asking” step, the mind sometimes rushes in with an answer to solve the problem and offers a step. This can be approached in two ways: ·

Notice that the mind jumped in with an answer. Thank it and let it know that you’d like to check in and then see if the body has a step. Then bring your attention inside the body, and ask the question to the felt sense.

·

You can check the mind’s answer for a sense of rightness by resonating it with the bodily felt sense. Take the answer down into the body and ask, “How does this answer feel in the body? Does it feel right?” If not, just notice that and ask if there’s a step from the bodily felt sense that feels more right.

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5.

Wishing the issue were all resolved: Just as bulbs planted in the fall cannot be seen during the cold winter months, green shoots begin to emerge in the spring when they are ready—growing step by step into the bloom of rich, colorful flowers. Some issues resolve in one Focusing session, while others need the practice of change happening step by step over time. Practice accepting the steps that come while Receiving.

6.

When the Focusing process seems to slip away or feel elusive: Combine inwardly directed Focusing with artmaking (Parts II, III and IV), journal writing, or dance/movement to concretize the felt sense and inward journey.

Chapter 3

Focusing-Oriented Psychotherapy

Focusing-Oriented Therapy, rooted in existential philosophy and the theoretical framework of Person-Centered Therapy, integrates specific concepts and practices from Gendlin’s development of the Focusing method into psychotherapy. Focusing-Oriented Therapy can include teaching and practicing Gendlin’s original six-step Focusing method (or other variations of teaching Focusing) within a psychotherapy session, as well as interspersing individual Focusing steps—Clearing a Space, Choosing an Issue, Handle/ Symbol, Resonating, Asking, and Receiving—in bits and pieces at various moments within an overall psychotherapy framework. Focusing-Oriented Therapy considers the client’s sense of safety above all intervention, as well as the quality of the therapeutic relationship. Experiential listening is a key component of Focusing-Oriented Psychotherapy. In addition to viewing Focusing-Oriented Psychotherapy within a PersonCentered framework, it can be integrated into other psychotherapeutic approaches, such as psychodynamic (Preston 2005), Brief Therapy (Jaison 2003), EMDR (Armstrong 1998), and expressive arts therapy (Rappaport 1993, 1998, 2006), and others.

Main ideas of Focusing-Oriented Psychotherapy Person-Centered Focusing-Oriented Therapy is Person-Centered in that it incorporates the underlying philosophy of Carl Rogers (1951, 1961), based on the inherent belief that each individual has intrinsic worth, dignity, and the capacity towards self-actualization. Person-Centered Therapy fosters conditions for personal growth through the therapeutic relationship based on unconditional positive regard, empathy, and congruence. Rogers’ “reflection of feelings,” or “active listening,” was developed as a way of saying back the 49

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essence of what a client spoke about in order to demonstrate to the client that they were empathically understood. At times Rogers’ method of active listening is misunderstood when therapists reflect exact words but miss the felt meaning of the communication. Instead of feeling empathically understood, clients are met with an empty parroting of their words. When active listening is done well, clients feel profoundly received and understood, while their experience unfolds with increased authenticity, meaning and depth in the direction of growth. Gendlin complements and expands on Rogers’ approach, addressing similar and different aspects of Client-Centered Therapy, including “the person in there,” the interpersonal relationship, the Focusing Attitude, the bodily felt sense, experiential listening, and the life-forward direction.

“The person in there” Gendlin writes: In my student days, one of the most useful things anyone told me was: ‘There is always a person in there.’ In infants and in senile people, seemingly worthless people and seemingly stupid children there is someone in there. Usually it is an embattled person struggling to live somehow with (or in spite of ) all the inner and the outer content. (Gendlin 1996, p.287)

When I first read that phrase, “the person in there” in Focusing-Oriented Psychotherapy (Gendlin 1996), I had a deep sense of reverberation in my heart, since that is what I see too when I meet or work with anyone. Although “the person in there” is discussed in the second to last chapter of Gendlin’s book, I assign it as one of the first readings. The “person in there” comes first.

The therapeutic relationship In Focusing-Oriented Psychotherapy, the quality of the therapeutic relationship is paramount. Cultivating a feeling of safety and trust in the client comes before any method, technique, or intervention. If the safety is not present, techniques are devoid of meaning and often engender client resistance. In my own experience as a therapist, when I encounter resistance in a client, I attend to how safe the client is feeling. Safety within the therapeutic relationship is founded on a deep respect for the client and their experiencing, an appreciation for “the person in there,” the therapist’s own self-awareness (to monitor countertransference reactions), and the therapist’s integrity and

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genuineness. The Focusing Attitude and Experiential Listening help to enhance the client’s sense of safety.

The Focusing Attitude in psychotherapy Gendlin’s emphasis on “The Focusing Attitude” redirects Rogers’ attention for growth (unconditional positive regard, empathy, and congruence) in the therapeutic relationship toward the inner felt sense. As Gendlin states, “The client’s attitudes and responses toward the felt sense need to be those of a client-centered therapist!” (Gendlin 1984). The Focusing Attitude is a beginning step of Focusing for both the client and therapist. The Focusing Attitude helps both the therapist and client to bring a welcoming, friendly attitude to whatever the client is experiencing, helping the client to learn early on how to create a sense of safety within towards their own felt experiencing. Through the Focusing Attitude, the client also learns how to “keep company with” their felt experience—learning to both be in touch with the felt sense and to have a part of self able to witness it. Over time, the client cultivates an inner attitude of self-acceptance and compassion. The Focusing Attitude is nourished within the client toward their felt sense as well as from the therapist toward the client and their experiencing. THE FOCUSING ATTITUDE WITHIN THE CLIENT

To assist a client in developing the Focusing Attitude toward their inner self, the therapist transmits compassionate acceptance through their presence and guides the client by asking questions that invite a Focusing Attitude. For example, Marion, a client in her thirties, begins to talk about the difficulties she’s having with her boss at work: “I prepare and prepare and prepare for this presentation I have to do and then after it’s all over my boss walks right by and doesn’t say anything. He always does that. It’s like I’m invisible! I’m so angry!” Helpful questions to elicit the Focusing Attitude within Marion would be: ·

Can you be friendly to that (feeling invisible and angry)?

·

Can you say hello to the place inside that feels invisible and angry?

·

Imagine sitting down next to it. Can you keep it (the invisible and angry place) company much the way you would keep a vulnerable child company?

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Hmm…angry and invisible? Can you say to yourself, “Oh…that’s interesting.”

·

Can you imagine both of us sitting down next to that place that feels invisible and angry…and keeping it company?

The therapist’s questions are offered to the client to take inside toward the felt sense, eliciting a Focusing Attitude. The therapist helps to teach the client to be in touch with a part of self that can hold a friendly, welcoming space while at the same time experiencing the inner felt sense. Helpful questions to elicit the Focusing Attitude include: ·

Can you be friendly to that (felt sense)?

·

Can you say hello to that (felt sense) inside?

·

Imagine sitting down next to it (felt sense). Can you keep it company much the way you would keep a vulnerable child company?

·

Can you imagine both of us sitting down next to that part (felt sense), keeping it company?

THE FOCUSING ATTITUDE TRANSMITTED FROM THERAPIST TO CLIENT

While inviting the client to bring the Focusing Attitude toward their inner felt experience, the therapist is also sitting with the client transmitting those same attitudes toward the client’s inner experience. The therapist accesses that part of self that experiences a “friendliness toward” and welcoming of the client’s experience. The therapist senses the place inside that is keeping company with the client’s unfolding inner experience while the client is keeping company with their own felt experience. “Keeping company” is a way of staying present and holding attention on the felt experience. The client stays present to their experience; the therapist stays present to the client and to their own experience. Often clients report that they can feel being with themselves in a profound way, as well as feeling the presence of the therapist. The therapist also feels a groundedness within while feeling a connection to the client’s unfolding experience. THE FOCUSING ATTITUDE WITHIN THE THERAPIST

Training to become a Focusing-Oriented Therapist requires that the therapist learn and practice Focusing. To effectively help a client to experience the Focusing Attitude (compassion and loving-kindness toward the

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self ), the therapist needs to be practiced in living the Focusing Attitude. Most Focusing-Oriented therapists integrate Focusing as a way of life. Some have an ongoing Focusing partner to deepen their practice; others Focus on their own. Life offers moment-to-moment opportunities to practice being friendly, accepting, kind, and compassionate toward one’s inner experience. The more developed the Focusing Attitude is within the therapist, the more a client will feel an unconditional presence of acceptance toward their felt sense.

The experiential dimension: the felt sense Focusing-Oriented Therapy engages a bodily dimension that Gendlin (1996) describes as occurring at the border zone between the conscious and unconscious. Gendlin states: A direct sense of the border zone occurs bodily, as a physical, somatic sensation. It is a special kind of bodily sensation…sensed inwardly… (1996, p.18). What I am referring to is the layer of the unconscious that is likely to come up next. This is at first sensed somatically, not yet known or opened, not yet in the “preconscious.” Freud had no term for this layer, nor has there been a term for it in the common language. We now call it a “felt sense.” (1996, p.19)

Focusing-Oriented Therapy helps the client to become aware of a felt sense (described in Chapter 2), to sit with it, and allow it to unfold its wisdom. It does this through the client–therapist relationship, the Focusing Attitude, experiential listening, the Focusing steps, and interspersing Focusing into therapy.

Experiential listening Listening is an integral part of Focusing-Oriented Psychotherapy. As Gendlin (1996) states: I feature reflective listening much more centrally than Rogers did. Without reflecting, bit by bit, neither therapist nor client can easily discover what really is meant and felt, let alone what might come further at the inner edge that opens once a message has been fully received. (p.297)

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Gendlin’s refinement of Rogers’ active listening is called “experiential listening” in order to clarify that listening responses are meant to capture the client’s experiencing process—their felt sense. During a psychotherapy session, the therapist takes in the whole of the experience of what the client is communicating—through words, energy, and other nonverbal communication signals such as tone of voice, facial expression, gestures, and posture. The therapist senses within, how the client’s communication feels, what the client is really saying, and what the meaning is. The therapist is in touch with their own felt sense as they receive the client’s communication. The therapist then makes an “offering” to the client—a sentence or two that shows an understanding of the whole meaning of the client’s communication. The therapist offers the reflection to the “person in there” who receives the reflection and checks inside to see if it feels right. If it doesn’t fit or match what feels true inside to “the person in there,” the client says that it is not right and, it is hoped, clarifies the communication. The therapist freshly receives the new communication and tries again. In experiential listening, not getting it right some of the time is part of the process; it helps clients access their felt sense, hear how it is, and clarify it anew. When the listening response is right, the client’s process unfolds with increasing clarity, depth, and meaning. GUIDELINES FOR LISTENING (ADAPTED FROM GENDLIN 1981A; MCGUIRE 2007)

1.

To listen well, begin by centering yourself either by doing the first step of Focusing, Clearing a Space, or any other method (e.g. journaling, art, movement, meditation, and so forth) that helps to set aside issues or feelings that might impede being fully present with the present.

2.

Give the client your complete attention, putting aside your own judgments and accepting them for who they are and what they have to say.

3.

Take in the whole of the person—words, feelings, tone of voice, posture, facial expressions, gestures, and so forth.

4.

Show that you understand. ·

Respond with a sentence or two (in your own words or theirs) that conveys the personal meaning the client is trying to get across.

FOCUSING-ORIENTED PSYCHOTHERAPY ·

5.

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Do not try to fix or change or improve what the client said. Just listen openly, respond authentically, and keep the person company.

Vary the way you reflect. For example: Gina, a college student, states, “I am so sick of living in this crowded dormitory. I feel claustrophobic and can’t wait until Thanksgiving!” ·

Say the same words—especially where there is affect. You’re feeling claustrophobic; you’re sick of living in the dormitory and can’t wait until Thanksgiving!

·

Paraphrase You’re feeling claustrophobic in the dormitory and can’t wait for Thanksgiving to get out of there!

·

Affirm You are really feeling sick of living in that dorm and can’t wait to get away!

·

Compare with an image It’s like you’re a caged animal and can’t wait to get free!

The following two variations are useful when a client is talking about something that is less clear than the example of Gina. For example: Ryan, a 28-year-old client is thinking about getting married: “I want to marry Alison but I’m concerned about the differences in our backgrounds.” ·

Ask tentatively It sounds like you’re saying one part of you wants to marry Alison and another part is unsure. Is that it?

·

Make the refection a question You’re really not completely sure that you’re ready to marry Alison?

6.

When what the client says is complicated. ·

Make a sentence or two about the crux of what was said.

·

Check it out with the client. Let the client correct it, add to it, and so forth. Take in and say back the parts you do

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get—for example, “I didn’t fully understand all of what you said… What I do get is…” 7.

8.

It’s okay to be wrong. ·

The client feels your intention to understand.

·

Knowing what their communication isn’t can lead a client to discover what it truly is.

How to know your reflection is wrong and what to do. ·

The client repeats the same thing over and over. See how their words differ… Say it again… Ask the client if your understanding is right; if not, listen carefully and try again.

·

The person’s face gets tight, tense, confused, trying to understand what you are saying… Stop… Tell the client you’re not quite clear about what they are saying… Ask the person to say it again… Say back what you hear.

Integrating Focusing into therapy Both Gendlin’s six-step Focusing method and each aspect of it can be integrated into psychotherapy.

Gendlin’s Focusing method It can be useful to teach clients the entire six-step Focusing method (described in Chapter 2), sometimes referred to as a Focusing round. This can be useful for individuals, couples, and groups. After learning the method, couples and groups take turns practicing with each other, which is helpful for carrying the Focusing process beyond the psychotherapy context. Individuals in psychotherapy can continue their Focusing practice and support through Focusing resources outside of a therapy context (see Appendix B).

Interspersing Focusing Steps into psychotherapy Another way of applying Focusing in psychotherapy is by interspersing individual Focusing steps (i.e. Clearing a space, Choosing an issue and felt sense, Handle/symbol, Resonating, Asking, Receiving) with the client’s experiential process, as illustrated in the following brief descriptions followed by the clinical example of Michelle.

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CLEARING A SPACE

A client who comes in overwhelmed, unclear, confused, or stressed out can benefit by beginning the session with Clearing a Space. Focusing-Oriented suggestion: “Since you feel overwhelmed (or unclear, confused, or stressed out), it is often helpful to begin with the first step in Focusing, in which you notice what’s in the way of feeling “All Fine” right now and place each thing that arises at an imaginary distance from you. Would you like to try that?” CHOOSING AN ISSUE

Clients often come into a session and start speaking about what happened on their way over, what they read in the waiting room, something they noticed about the therapist or the therapist’s office, or a story that’s been in the news. Sometimes they are silent. Sometimes they say that they have no idea what to talk about. Having the client check inside for an issue to discuss helps the client learn to listen within to hear and attend to what is important to them. Focusing-Oriented suggestion: “Would you like to take a moment to listen inside and see what is needing your attention today?” CHOOSING AN ISSUE AND FELT SENSE

When a client is talking or telling a story about an experience, the therapist can listen for moments when the client seems to be in touch with something significant. This often appears as an emotional tone in the voice or a nonverbal cue such as tears welling up, changes in muscular tension, and changes in skin color. The therapist helps to create a space for accessing the felt sense by becoming quiet or taking a few deep breaths. Depending on the client, the therapist may invite the client to “take a few deep breaths, close your eyes if you’re comfortable doing so, and follow your awareness down inside to the body to see how it is in there.” For clients who do not feel safe closing their eyes, the therapist simply slows down, breathes mindfully, and asks the client to notice—with eyes open—how it is inside while talking about the situation or issue. The therapist’s slowing down and directing questions to the inside space of the body encourages the client to become more aware of their felt sense. Focusing-Oriented suggestion: Questions are posed to help clients notice what they are experiencing, such as:

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Can you take a moment and notice how it is inside (your body) while you are talking about that?

·

What’s happening in your body now?

·

What’s happening inside right now?

For example, Shirley, a 50-year-old client, was speaking about the changes in her life: Shirley: I’m just at this place in my life where I don’t know what’s meaningful anymore. I feel kind of empty inside. Therapist: There’s an emptiness inside. [Experiential reflection] Can you sense the whole feel of it? [Guiding into felt sense] Shirley: It’s in my heart. [Felt sense] Shirley’s work continues below in finding a Handle/symbol and Resonating. HANDLE/SYMBOL

After the client contacts their inner sense of an experience, or felt sense, the therapist may suggest that they see if there is a “handle,” or symbol, that matches the inner felt sense. Focusing-Oriented suggestion: Therapist (to Shirley): Keeping your attention on that inner sense (in your heart), see if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense. [Guiding to Handle/symbol] Shirley: There’s an image of my heart with my arms reaching out longing for connection. [Handle/symbol] RESONATING

As the client is speaking, the therapist listens for descriptions that have a resonance of feeling or meaning. The therapist invites the client to check it for a sense of rightness, or congruence. Focusing-Oriented suggestion: Therapist (to Shirley): Can you check that image (of your heart with your arms reaching out longing for connection) against your body and see if it feels right?

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ASKING (THE FELT SENSE)

As the client is speaking about something, clients might look to the therapist for an answer. Noticing this, the therapist can redirect the client back inside to their felt sense. Focusing-Oriented suggestion: “Let’s take a moment…bring your attention inside to the place where all of that is…imagine sitting down next to it…and ask it, ‘What makes it so _______?’ [or another felt-sense question such as, ‘What’s the crux of it?’; ‘What does it need?’; ‘What’s the worst of it?’; and so forth].” RECEIVING

The therapist encourages the client to hear what the felt sense has to say. Focusing-Oriented suggestion: “Take a moment and listen to what it [felt sense] has to say [after posing a question to the felt sense].” When the client expresses some type of relief, or something positive that has come from inside, the therapist can encourage the client to receive it more fully: Focusing-Oriented suggestion: “Can you take a minute or two and simply stay with that experience, receiving what it has to offer?” Receiving allows clients to take in the wisdom from their own body. It helps to deepen the client’s knowing that, under the right conditions, answers and steps for healing arise naturally from within. EXAMPLE: MICHELLE

Michelle is a 54-year-old woman who lost her job in a high-tech field. She became discouraged, depressed, and hopeless after engaging in an unsuccessful job search for six months. As she was speaking, I noticed that her body was slightly slouched over and her voice was becoming shaky. I led Michelle into accessing a felt sense, first through verbal reflection and then by guiding her to attend to the felt sense in her body. The verbal reflection helps to build an empathic connection between therapist and client and to ascertain for both client and therapist that the experiential reflection matches the inner experience. Client: (voice shaky, slightly slouched over) I feel hopeless and despairing about this job search. I’m never going to get a job. Therapist: Something inside you feels hopeless and despairing about ever getting a job. [Experiential reflection]

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Client: Yes…it’s humiliating. Therapist: And there’s a place that feels humiliated. Client: (nods) Yes. Therapist: Can you sense inside your body the place that feels hopeless and humiliated? [Guiding into felt sense] Client: (after a few moments) I have an inner sense of my body curling up [Felt Sense] and I have an image myself feeling so ashamed. [Handle/symbol] Therapist: You sense your body curling up and an image of yourself of feeling ashamed. Can you be friendly to the curling up and the place inside that feels ashamed? [Focusing Attitude—“being friendly to”] Can you imagine sitting down next to that part and keeping it company? [Focusing Attitude—“keeping it company”] (The room is quiet, Michelle’s eyes are closed, and there is an energetic quality of Michelle being present with herself.) Therapist: See if there’s a word, phrase, image, gesture, or sound that matches the inner felt sense of your body curling up and the place that feels ashamed. [Guiding to a Handle/symbol] Client: Defeated. [Handle/symbol] Therapist: Can you ask it, “What makes it so defeated?” Or, “What’s the crux of it?” [Asking the felt sense] Client: I have an image of myself trying to climb a mountain but I keep slipping backward no matter how I try. [Receiving] My own inner felt sense is that Michelle is trapped inside the felt sense of defeated. To help her get some distance from being lost within the “defeated,” I invite Michelle to remember a time in her work when she felt confident. (I intersperse one of the questions from the “Asking” step.) Therapist: Take a moment to close your eyes if that’s comfortable, or keep them open if you prefer. See if you can recall a time when you felt confident in yourself at a job. Let yourself become aware of your skills, your strengths, the things you did well. Let me know when you have that memory. (Michelle nods, indicating she has something.) Notice how it feels in your body as you imagine that time of strength and confidence. [Guiding into a felt sense]

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Client: I feel a strong energy come up from the ground that is like a rod straightening my body. I am no longer hunched over, feeling small. I feel the sun at the mountain… I feel solid like the mountain. [Felt sense] Michelle is able to access a felt sense of a strong energy and solidity from a previous positive experience that helps her to move around the place that felt stuck in the defeated and ashamed felt sense. She then identifies concrete steps to move forward in regard to her job challenge. (As you will see in Parts II and III on the application of Focusing-Oriented Art Therapy, Michelle’s felt sense can naturally lead to an artistic creation of the sun on the mountain, enhancing and deepening the life-forward direction of the new felt sense.) In this example, there is an ongoing flow between Michelle’s talking about her experience and the therapist offering suggestions to elicit a Focusing Attitude, to access a felt sense, and to engage in an inner dialogue with the felt sense. There is a back and forth between eyes open, talking, checking inside, talking, and so forth. Interspersing Focusing suggestions into the psychotherapeutic encounter has a different flow than guiding a client through a whole Focusing round as described in the previous chapter.

Focusing fits with other psychotherapy schools While the clinical example above shows Focusing-Oriented suggestions used within a Person-Centered style of psychotherapy, Focusing can be integrated into other schools of psychotherapy, including psychodynamic, humanistic, cognitive, behavioral, and transpersonal. Each theoretical approach can include a reference back to the felt sense. The following two examples offer a glimpse into how Focusing can experientialize psychotherapy. In a psychodynamic therapy session, the client can be invited to explore her transference reaction: Client: When I canceled my appointment last week, I thought you would be really upset with me…like somehow I was taking care of you. Therapist: You thought I would be upset with you for canceling…and that you weren’t taking care of me. Can you sense inside what the whole feel of that is? [Guiding into felt sense]

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A further exploration might be: “Can you sense if the way you imagined me is connected to anything in your past?” In this simplistic example, the underpinnings of a psychoanalytic orientation can be integrated with a Focusing orientation of checking in with the bodily felt sense. A cognitive approach can also be integrated with a Focusing orientation. For example, a client has repeated negative self-talk, such as “You are so stupid! You always do the wrong thing! You never get it right!” The therapist may suggest, “See if you can be friendly to that place inside that talks so negatively…and notice how it feels inside in response to those words.” Client: “I feel myself shrinking in a crevice deep inside my body.” Therapist: Can you ask it, “What would that part really like to hear inside?”…and see what comes. Client: (after a pause) I heard the sentence, “It’s okay to make mistakes. It’s okay to be human.” The therapist continues guiding the client to substitute the new-found phrase, “It’s okay to make mistakes…” when noticing an automatic thought such as “You are so stupid…” Focusing provides a way to access a healthy internal message that comes from the bodily felt sense—which can be worked with on a cognitive level. Since the scope of this book is on integrating Focusing and art therapy, I am limiting the examples of how Focusing can be integrated with numerous other schools of psychotherapy. The concept of this integration is important as it forms an underlying foundation for Focusing-Oriented Therapy, described in Chapter 6, after an introduction to art therapy in Chapter 4.

Reminder: questions to engage the felt sense Bits and pieces of the Focusing steps are interwoven into an organic unfolding of the client’s experiential process. They do not need to be used in any particular order.

Getting started ·

Would you like to take a moment to listen inside your body and see what is needing attention most today?

·

Would you like to set aside [Clear a Space] of whatever is in the way of feeling “All Fine”?

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Felt sense ·

Can you notice how it is inside your body while you are talking about that?

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What’s happening in your body now?

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How is that on the inside?

Handle/symbol ·

Is there a word, phrase, image, gesture, or sound that matches or acts like a “handle” for the inner felt sense?

Resonating ·

Can you check and see if that’s right [the word, phrase, image, gesture, or sound]?

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Does that [handle/symbol] match your inner experience?

Asking ·

What makes it so _______? [insert felt-sense word]

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What’s the crux of it?

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What’s the worst of it?

The following four questions work as a unit and are asked sequentially. ·

Imagine what it would look and feel like all resolved.

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What’s in the way (between the issue and resolution)?

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What’s needed (for that resolution)?

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What’s a good small step in the right direction?

Receiving ·

Can you take a moment and listen to what it has to say?

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Can you take a moment to take in what you just received?

Chapter 4

Art Therapy: History, Concepts, and Practice

What is art therapy? Art therapy incorporates visual art, creative process, and psychotherapy to enhance well-being—emotionally, cognitively, physically, and spiritually. Art therapists are trained in visual art and clinical mental health practices to work with children, adolescents, and adults in a variety of settings, including community mental health centers, inpatient hospitals, day treatment programs, schools, nursing homes, prisons, medical facilities, and studio settings. Most art therapy training programs today include courses and practicum experience to later become eligible, after additional clinical hours, supervision, and passing an exam, to meet the requirements to become licensed mental health professionals, such as mental health counselors or marriage and family therapists. In addition, art therapists continue their training and expertise after obtaining a Master’s degree to become Registered Art Therapists or Board Certified Art Therapists (the credential depending on the country’s art therapy association’s criteria). Art therapists integrate creative expression within a psychotherapeutic framework, such as psychodynamic, Jungian, cognitive-behavioral, narrative, family systems, Person-Centered, transpersonal, and so forth. Art therapy is used both for assessment and ongoing intervention to address issues such as self-esteem, anxiety, depression, trauma, post-traumatic stress, developmental delays, psychosis, cognitive impairment, neurological problems, addiction, eating disorders, anger management, conflict resolution, and other mental health concerns. Art therapists also specialize in medical art therapy (Malchiodi 1999)— a health and wellness application—as well as in spiritual and contemplative approaches (Allen 2005; 64

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Farrelly-Hanson 2001; Franklin et al. 2000; Franklin 2001). In addition to a clinical application, art therapy is also being used as an aid in disaster relief, in social action, and peacemaking efforts.

Roots of art therapy Although art therapy emerged in the United States as a profession in the 1940s, its roots can be traced to the arts in indigenous cultures, the Industrial Revolution, the early influence of Freud’s psychoanalysis and Jung’s analytic psychology, discoveries by art educators, and the impact of modern art. Reflecting on indigenous cultures from the past and present, we can clearly see how the arts are integrated into daily life—in rites of passage rituals, healing ceremonies, cookware and eating utensils, and communication. This ancient and universal use of art is seen in cave paintings, religious mandalas, iconography, Navajo sand paintings, and the tribal masks, jewelry, and costumes of Africa. For ages, beads, feathers, stones, and wood have been used to create talismans, totems, and other symbolic representations invested with healing and protective power. Art in indigenous culture was and is still used today as a conduit for healing and communication. While early writings in art therapy referred to the ancient connection of ritual, art, and healing, McNiff (1979, 1981, 1992) articulated the profound healing power of the indigenous roots of art therapy with his seminal paper, “From Shamanism to Art Therapy,” and respective chapters “The Enduring Shaman” in the Arts and Psychotherapy, and “Shamanic Continuities” in Art as Medicine. As society became industrialized, the arts lost their function in people’s daily lives. Art became a commodity for the wealthy to commission portraits and other paintings of their choosing. The use of art as a healing agent was viewed as something from a “primitive” culture—not for the civilized world. Ceremonial roles like that of the shaman, who could perhaps retrieve and return the spirit of someone lost in a hallucination, were replaced by treatments in the “mental asylum.” Prior to the development of psychotropic medications in the 1950s, it was nearly impossible to reduce or control hallucinations, psychotic thoughts, major depression, anxiety, or mania. Methods for reaching those who were deaf, blind, or “mentally retarded” were undeveloped and consisted primarily of institutional management. Creative staff and artists introduced art in mental institutions to soothe patients’ agitated states of mind, offer an outlet to disturbed thinking and

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moods, and provide a means for communication beyond words. Art was able to reach those in institutions in ways that words and language could not. Beveridge (2001) provides an interesting account of art created by those with mental illness beginning in 1801 with Pinel’s Medical Treatise on Mental Disorder or Mania, in which he refers to two patients who drew and painted. Beveridge cites additional accounts of art created by those with mental illness including John Haslam’s Illustrations of Madness (1810); W. A. F. Browne’s article “Mad Artists” (1880); Lombroso’s The Man of Genius (1891), which included the art of 108 patients; Paul Meunier’s Art by the Mad (1907), published under the pseudonym Marcel Reja, which viewed art from an aesthetic rather than a diagnostic or clinical perspective; and A Mental Patient as Artist (1992), in which Swiss psychiatrist Morgenthaler documented the work of Adolf Wolfi, a patient who became known as a prominent Outsider artist. The largest and best-known collection of art by those with mental illness is the collection of Hans Prinzhorn (1922), a German art historian, philosopher, and psychiatrist, who published the work in Artistry of the Mentally Ill. The Prinzhorn Collection has also been exhibited throughout the world, providing insight into the art and psyche of those with mental illness, connecting those shut away with society, and carrying the unique aesthetics of their work into the modern art world. Art therapy is also an outgrowth of modern psychiatry, rooted in the influences of Sigmund Freud and Carl Jung. Freud’s contribution of the unconscious, methods of free association, and dream analysis informed the beginning approaches of art therapy, as is seen in the work of pioneer art therapist Margaret Naumburg (1966/1987, 1950/1973). Jung’s emphasis on the collective unconscious, archetypes, and symbolism paved a way for depth-oriented exploration, using art as an introspective medium with both his patients and in his own healing journey. Jung’s method of “active imagination” laid the groundwork for listening to the messages, meaning, and story of artwork (Chodorow 1997; Jung 1968; Jung and Campbell 1976; McNiff 1992). During the same era, art educators Rhoda Kellogg (1967) and Viktor Lowenfeld (1987) observed emerging patterns in children’s art that they paralleled human development. Rhoda Kellogg was a psychologist and nursery school educator who collected nearly one million drawings of children between the ages of two and eight years old from different countries. She found repetitive patterns beginning with scribbling,

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placement patterns, emergent shapes (rectangle/square, oval/circle, triangle, Greek cross, diagonal cross), combines (two or more diagrams put together), aggregates of three or more diagrams, mandalas, and sundials, which predated the depiction of humans and pictoralism. Lowenfeld noted that children’s drawings progress though phases (i.e., random marks, uncontrolled scribbling, controlled scribbling and realism) which corresponded to their developmental stages and emotional, social, and cognitive abilities. Florence Cane (1951/1983), art educator and the sister of Margaret Naumburg, taught innovative methods of creating art, such as incorporating movement exercises to enhance drawing skill, accessing imagery by projecting onto a scribble drawing, and teaching color through sound and chant. Lastly, art therapy must be viewed in the context of the larger art world. At the same time as Freud’s discovery of the unconscious, Jung’s interest in archetypal and depth psychology, and intrigue in art created by those with mental illness, there was a move away from Realism in the art world towards art as an expression of an inner reality. Artists were disenchanted with societal norms and began to search for new sources of inspiration, such as primitive cultures (e.g. Gauguin, Rousseau), the art of children (e.g. Paul Klee, Joan Miro), and the art of “madness” (e.g. Dubuffet). Prinzhorn’s book inspired art circles during the rise of Cubism, Dada, Expressionism, and Surrealism. Dubuffet, who had his own collection of art created by people with mental illness, coined the term Art Brut (Outsider Art)—which recognized the artistry of those with mental illness as well as others untrained in art and living outside the influence of the larger society (Thevoz 1976/1995). The innate need for human beings to create and communicate, combined with the evolution of psychology, science, art education, and the modern world in the first half of the twentieth century, sparked the optimal conditions for the birth of art therapy as a profession.

Art therapy: the profession Margaret Naumburg and Edith Kramer are credited as the grandmothers of art therapy, launching the profession in the United States during the 1940s. Margaret Naumburg brought her experience as an educator and artist to her work with psychiatric patients. As the psychiatric climate was primarily psychoanalytic at that time, Naumburg applied the use of art in a similar manner, asking clients to draw spontaneously and free associate to their pictures. Working with the art creation towards insight became known in the field of art therapy as an approach which focused on “the product,” and is referred to

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as “art in therapy,” or art psychotherapy—in contrast to “the process,” or “art as therapy,” which emphasized the creative process itself as healing. Naumburg’s approach is also known as “dynamically oriented art therapy” (1966). In the 1950s, Edith Kramer (1958, 1971, 1979, 2000), who worked primarily with children and adolescents, emphasized the “process” of making art. Kramer is known for the concept of “sublimation” in art therapy, in which inner conflicts and socially unacceptable impulses, feelings, and thoughts are expressed appropriately through the art process. According to Kramer, sublimation in the process of artmaking is the curative factor in art therapy. Kramer emphasizes formed expression, quality, and content, thereby focusing on the aesthetics of the product. Other pioneers charting new territories using art in mental health included Mary Huntoon at The Menninger Clinic in Kansas (Malchiodi 2003), followed by Don Jones and Robert Ault (Rubin 1998); Janie Rhyne (1973) in California developing Gestalt Art Therapy; Hanna Yaxa Kwiatkowska (1978) in Washington DC trailblazing Family Art Therapy; Elinor Ulman (Ulman and Dachinger 1996; Ulman and Levy 1987) who started the first journal of art therapy; Arthur Robbins (1986, 1989, 1994, 2000) in New York integrating psychodynamic and object approaches to art therapy; Myra Levick (1983, 2003) who created the first art therapy program at Hahnemann Medical College in Pennsylvania; and Shaun McNiff (1981, 1986, 1988, 1989, 1992, 1998, 2004) in Massachusetts exploring the interrelatedness of all the arts (expressive arts therapy), Judith Rubin (1978/1984/2005, 1984, 1987/2001, 1998, 2005) and others. In Britain, art therapy emerged through the work of Adriann Hill in the 1940s and 1950s, E.M. Lydiatt (1971) and others. Both the American Art Therapy Association and British Art Therapy Association were formed in the 1960s. Today, art therapy associations exist throughout the world (see Appendix B: Resources).

Key concepts of art therapy Art as a safe container The metaphor of “art as a container” is used extensively in art therapy. Art is strong and flexible enough to hold and contain the entire range of human experience—pain, fear, anger, hatred, and shame, as well as love, joy, compassion, and peace. In art therapy, materials are chosen that offer the right container for a given experience or feeling—for example, a box to hold

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feelings, a mandala to express the wholeness within, clay to pound anger, paint for the fluid expression of love, or magazine photos to create a self-image collage.

Experience beyond words Art offers the ability to express aspects of experience that words alone are unable to access. Using colors, lines, shapes, textures, and imagery, clients can convey feelings and emotional tones accompanying an experience. A sense of heaviness, lightness, openness, closedness, airiness, or a feeling of being trapped, boxed in, overpowered, or empowered can be expressed through visual form, structure, and symbolism. For clients with unresolved emotional experiences that occurred at a preverbal level, or with limited verbal capacity, art therapy provides a nonverbal means for conveying experience. Verbally sophisticated clients also find art therapy a powerful medium through which to communicate feelings that are more complex or more subtle than words can describe.

Unconscious to conscious Art is a vehicle for expression that engages the unconscious and conscious mind through imagery and the creative process. Since we are less sophisticated and practiced with expressing feelings through artmaking than through language, unconscious processes are typically projected into the creation. As art therapist Michael Franklin states, “The visual symbol is the transportation between the unconscious and conscious awareness” (M. Franklin, personal communication, 2007). These unconscious contents are brought into greater conscious awareness through reflection on the art process and product.

Catharsis A natural process of release occurs as feelings and experiences are discharged into the art process. In addition to more subtle levels of catharsis, art therapy provides a safe place to symbolically release stronger, unresolved emotions into an artistic creation. For example, anger can explode into a rageful painting of intense, dynamic color; paint can be applied with boldness, releasing a need to be strong; tears can be painted, releasing a held-in crying place. Drawing wavy lines can transfer fear from one’s body to the paper.

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Artwork can be ripped, torn, crumpled, and thrown away, symbolically enacting the letting go of the experience in the body. It is essential that art therapists and students-in-training be mindful of whether it will be productive for a client to release emotion through a cathartic visual art expression or if doing so is more likely to lead to regression and destabilization. At times catharsis is contraindicated, and containment is the appropriate art therapy intervention—such as creating a collage of peaceful images, or painting a small box to fill with affirming words. Catharsis always needs to be handled with skill, knowledge, and clinical judgment.

Witness Art therapy activates the inner witness, the part of self that can stand outside of a feeling, experience, or perception, and observe it from a distance. As the client engages in artmaking, the inner experience is brought outward and the client begins to see what they are creating. After completing an art process, the art product can be placed at a distance or hung up so the client and art therapist can stand back to observe it. The client and therapist witness the issue outside of the client, in the art. Transformation occurs as the client looks at their creation. The client can have a sense that there is an aspect of self that can stand outside the experience (e.g. rage, grief, fear, despair, anger, trauma) and have an embodied knowing of being more than those feelings.

The whole of an experience Art therapy enables the client to get the whole feel of an experience and to express it all at once. Wadeson (1980) refers to this as “spatial matrix.” The complexity of an experience can exist at once, such as the simultaneous occurrence of conflicting feelings in one art piece (e.g. a part of self that wants intimacy while another part wants independence). Art captures the totality of the experience in one moment—whereas describing the picture is linear and unfolds, word by word, over time.

Body/mind integration Artistic expression involves a synthesis of body, mind, and spirit. The client begins with an image or a spontaneous action of creating. The senses are activated in creating art—seeing, touching, smelling, moving, and

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hearing—promoting sensory integration through artmaking. Reflections on the artwork can lead to an integration of meaning.

Creative spirit Art therapy connects one with the “inner creator” which is inherently whole and healing. Accessing the creative spirit through artmaking is uplifting even when working on painful, difficult issues. Engaging in art helps one connect with life-affirming energies that are the fabric of creative expression.

Art therapy in practice The historical debate about “process” versus “product” in art therapy, also referred to as “art as therapy” or “art in therapy,” seems to be part of a developmental evolution of the field. Today, the contribution of each approach is more deeply understood. I view “process” and “product” on a continuum which includes both Art as Therapy, where the process of creating is emphasized, and Art in Therapy, where the art product is used for assessment, insight, and meaning. Aesthetics can be considered both as a process of artistic discovery, as well as a product, in which the finished piece is emphasized.

Process Art as Therapy act of creating aesthetics: exploration

Product Art in Therapy assessment, insight, meaning aesthetics: self-esteem, beauty

I employ a flexible approach, moving back and forth along the continuum based on the needs, goals, and preferences of the client. It is important to note that, while the creative process of artmaking is encouraged today in many arenas, including the use of art in therapy by professionals other than art therapists, as well as nontherapeutic applications in daily life, the presence of a skilled art therapist makes a substantial difference. A professional art therapist knows how to attend to both the making of art, the creative process, the attributes and benefits of different media, the power of imagery, aesthetics, and the major and subtle psychological

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processes that accompany artistic expression. Additionally, professional art therapists know how to choose which dimensions of the “art in therapy” and “art as therapy” continuum will best serve the client’s needs. While this book encourages the use of art with Focusing by other therapists and provides many exercises, it is not saying that anyone can do art therapy. Rather, I encourage the use of art as a creative expression that is basic to our humanness—while seeing that art therapy as a profession encompasses much more than creative expression. The descriptions below of “art as process” and “art as product” are meant to describe both the use of art for creative expression, and the many more complex ways of working with the art, imagery, and creative process. Several art therapy exercises are included at the end of the chapter to provide an introduction to the use of “art as process”—for creative expression and becoming more comfortable with art materials.

Art as process Examples of “art as process” include exploring an artistic media or expressing feelings in art without being concerned about the final product and participating in an interactional joint drawing (e.g. draw a picture together) in which the interpersonal and intrapersonal processes are more important than the final piece. MEDIA EXPLORATION

Depending on a client’s therapeutic needs and goals, the art therapist may encourage the exploration of a particular artistic medium—e.g. oil pastels, chalk pastels, watercolor, tempera paint, clay, or collage. The emphasis is on discovering the medium’s properties—how it feels, what you can do with it, and the images that arise in the process. Example: Larry, a 28-year-old client, wanted to overcome some of his need for control and to allow a more spontaneous, passionate part of himself to come forth in his life. Typically, Larry would use oil pastels and create a structured drawing of his feelings, as in Figure 4.1. I suggested that he might want to try using watercolors, which have a more fluid and spontaneous quality. Larry painted using a wet-on-wet method in which the watercolors are brushed onto paper that has been dampened. Larry enjoyed the brilliancy of the colors and the exploration of how the colors change shape on their own, moving and blending into one another (Figure 4.2). The emphasis is on the process—not the product.

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Figure 4.1 Oil pastels

Figure 4.2 Watercolor

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FEELING EXPRESSION

This approach is common in art therapy as its goal is to help the client express feelings through artmaking. The client is encouraged to choose colors, lines, shapes, and/or images that match the feeling inside, whether it is fear, love, anger, hate, anxiety, trust, or anything else that is present. The focus is simply to express the feeling through artistic means, without emphasis on the product. Sandra, a client in a psychiatric day-treatment program, explored her feelings of “Hate” as she drew a page filled with alcohol bottles. As a recovering alcoholic, she shared how much she hated the alcohol for having created so much suffering in her own life and for people close to her.

Figure 4.3 Feeling expression INTERACTION

Art therapy may incorporate interactional art interventions such as a “Conversation Drawing,” in which two people have a conversation without talking, using only the art materials. Figure 4.4 is “Conversation Drawing” by Linda and Ruth, two clients in psychiatric day treatment.

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Figure 4.4 Conversation Drawing

Linda immediately drew a purple line down the middle of the page, clearly declaring her space. Linda drew the sun, mountains and lake on the right while Ruth responded with the sky and airplane on the left. After sharing about their art and the process, Linda and Ruth were able to see how their conversation in art reflected their interpersonal styles in life. Other examples of interactional art therapy processes include “Building a World Together,” in which a group uses clay or other art materials to build a world together (Rhyne 1973); Family Scribble Drawing, where a family chooses one member’s scribble, decides together what they see in it (like seeing images in a cloud) and develops the drawing together; or Group Mural, in which the group is asked to create a mural together on a particular theme. Although the finished product can also be explored, the emphasis in these exercises is the interpersonal interactions and the process of the experience, such as: Who took on the role of leader? Who was accommodating or submissive? Who started the process, and who had the last word? Parallels are drawn between interactions in the art exercise and those occurring in everyday life.

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INTERMODAL TRANSFER AND EXPRESSIVE ARTS

A visual art piece can also be transferred to another expressive arts modality, such as creative movement, music or sound, writing, psychodrama, or drama therapy. See Chapter 15 for an example and Chapter 16 for a discussion.

Art as product The art product can be used to access meaning, as a tool for assessment, and simply to achieve aesthetic satisfaction. ART FOR MEANING

The art product can be used to gain additional insight and enhance personal meaning. Common art therapy methods include sharing the artwork verbally and visually, objectively describing the art, incorporating Jung’s active imagination, and Gestalt art therapy. Sharing

Clients are encouraged to verbally share about their art while the therapist and/or group listen nonjudgmentally and with openness. The therapist or group members may offer their perception of the art; the client is encouraged to notice whether the feedback feels right to them. Clients often experience increased meaning from the sharing process. Objective description

Clients are encouraged to describe the artwork in terms of its elements—color, lines, shapes, images, and so forth. This objective description helps clients to organize their visual thinking and increase their mental clarity and focus. It can also help clients to feel more grounded. Active imagination

Jung developed “active imagination” as a method in which the client accesses a quiet, contemplative state, allowing the imagination to unfold in response to the art. Various art therapy methods, such as storytelling, dialogue (McNiff 1992), and Gestalt incorporate active imagination, as illustrated in the painting of the girl, dog, and sky (Figure 4.5). ·

Storytelling: The client is invited to tell a story about the art. The story typically conveys symbolic meaning as the client

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Figure 4.5 Active imagination

projects unconscious and conscious elements into the storytelling. The art and story may be projections of the client’s inner experience. For example, a client listens to elements of her painting of a girl, her dog, and a dark sky. Using active imagination, the client incorporates storytelling: The little girl took her dog for a walk one day when the sky became very dark. She started to become very frightened but then she remembered that she had placed the sticker that her big brother had given her onto the back of the dog’s tag. She looked to see if the sticker was still there. It was. After looking at it, the little girl pretended her big brother was walking with her. She felt much safer as she continued to walk all the way home. ·

Dialogue: Using dialogue, the client spends time contemplating the art, and then asks a question to the whole art piece and/or parts of the art piece. The dialogue can occur verbally aloud or through writing. Typically a question is asked to something in the painting; e.g. (to the girl in the painting): “Tell me who you are.” The client listens and speaks or writes what she hears. The dialogue continues…questions can continue to the girl, such as “What would you like for me to know?” Questions move to other parts of the painting, e.g. to the dog, the sky, the whole of the painting, the colors, etc.

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Dialogue using writing can also incorporate the use of the nondominant hand where the question is written with the dominant hand and the answer is written with the nondominant hand. Using the nondominant hand tends to encourage a connection with early, unconscious experience and therefore should only be used when the therapist has a sense that the client has enough ego strength and internal safety to access such material. I caution the use of the nondominant hand with clients who have major mental illness and those in the early stages of trauma recovery. Using the nondominant hand with dialogue is most appropriate for higher functioning clients who have already gained a significant degree of insight into themselves. An example of dialogue with art is presented in Chapter 11, Transforming the Inner Critic. ·

Gestalt: Gestalt can also be incorporated to process the art product through projective methods of seeing the art as an expression of the self. In Gestalt, art therapy clients use the word “I” to describe parts and/or the whole of the artwork. For example, in the painting with the dog, child, and dark sky the client may begin, “I’m the little yellow dog. I’m watching the little girl run towards me and I’m hoping she’ll carry me home so I don’t get caught in that storm.” Parts may speak to each other, such as: Dog to Sky: I’m scared of you. Sky to Dog: Why are you so scared of me? I’m stormy but that is my nature. Girl to Dog and Sky: Yeah, I’m scared of you too. But I know sometimes I have a storm inside of me.

Dialogue methods expand the client’s creativity while providing access to greater meaning and insight. ART FOR ASSESSMENT

Prior to the birth of art therapy, drawing was used by psychologists in clinical assessment tools such as the house-tree-person (Buck 1948) and Draw-a-Man (Goodenough 1975) tests. Throughout the art-therapy literature one finds arguments for and against the usefulness and validity of assessment. On one side are those who are comfortable formulating a diagnostic

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assessment from art without seeing the client in person, and those on the other side feel that any interpretation of artwork by the therapist constitutes a violation of artistic integrity. In my opinion, art is a language providing clues that may offer helpful information. Informal and formal assessments can be done in a way that preserves the client’s personal and artistic integrity and avoids reducing them to a diagnostic label. Of primary importance is the recognition that there is always “a person in there.” Informal assessments are done with the art therapist noticing imagery, use of line, shape, and color, along with an intuitive sense of the artwork. It is always wise to first ask the client about the personal meaning of the art and process of its creation. Art therapists use their clinical judgment as to whether sharing their own perception of the art at a particular time will be helpful. There are times when it is appropriate to say something like, “When I look at your art, I notice ______. Is that right for you?” Other times it is advisable for the therapist to reserve the information for a later session. For example, if the therapist gets a sense from the art that there may be a trauma unknown to the client, they may wait until the client seems to have a sufficient sense of safety with the therapist and enough ego strength to explore the issue. A detailed discussion of the various art therapy assessments and rating instruments available today is beyond the scope of this book. Please consult Appendix B: Resources at the end of the book for further information.

Materials in art therapy The choice of materials in art therapy is guided by knowledge of their use, appropriateness to the clinical population, personal preference of the client, health considerations, and budgetary limitations. In art therapy, it is important to understand that materials affect clients in different ways. For example, drawing with a pencil offers the client a degree of control and precision. It doesn’t offer the client an easy ability to express color or make broad strokes. Watercolor, on the other hand, is extremely fluid and difficult to control. After dipping the brush into the watercolor paint and water, it easily runs and spreads on the paper—it is not a boundaried medium. A client needing a sense of control may feel comfortable creating art using a pencil, but be overwhelmed by the uncontainable diffusion of watercolor. On the other hand, a client who would like to express the fluidity of her new loving relationship may want a flow and merging of colors in which yellow

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dissolves into red, leaving traces of both and also giving birth to orange; this client would feel restricted and perhaps even frustrated by the limitations of pencil. It is also essential to assess safety considerations—such as not using sharp objects with acting out, self-harming, or suicidal clients. It is also advisable to use non-toxic materials for health reasons.

Basic supply of art materials ·

Drawing materials: Lead pencils, colored pencils, charcoal pencils, charcoals sticks; assorted colored markers, thin and thick; chalk pastels; oil pastels.

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Paints: Poster paints, acrylic paints, watercolors.

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Brushes: Assorted sizes.

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Tape: Masking tape, Scotch tape.

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Glue: Glue sticks, white glue (Elmer’s type).

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Clay: Modeling clay, ceramic clay, Sculpey.

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Paper: Assorted sizes of white paper, colored paper, colored tissue paper.

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String: Twine, various colors of yarn.

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Assorted materials for collage and assemblage: Feathers, buttons, found objects, dried flowers.

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Nature materials: Twigs, branches, sticks, rocks, stones, shells.

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Boxes: Shoeboxes, assorted boxes of different shapes and sizes.

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Optional: Camera, digital media, video.

Getting comfortable with artmaking To use art with others, it is important to become comfortable with art materials and to understand their properties. In groups and with individuals who are new to art therapy, I introduce art exercises as a “warm up” to the use of art as a language for expression. I tell them that if they watch children, it is easy to see how natural it is to create art. Children simply pick up a crayon and marker and start drawing. They rarely think about it ahead of time and barely show resistance. In fact, most children draw before they even speak. If

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you are new to art therapy, I’d like to encourage you to try out experimenting and playing with different materials. The following exercises are designed as an introduction to various art materials and to explore how art can be used as a language for self-expression and interaction. The application of how to combine Focusing with art therapy will be described in Parts II, III, and IV (Guided Exercises).

Exercise 4.1 Exploring lines, shapes, and colors; the language of artmaking Materials needed: Paper, oil pastels, chalk pastels, and markers. Time: 20 minutes. Set a sheet of paper in front of you. We’re going to begin with exploring all the different possibilities of making lines and how they feel. Don’t judge what the line looks like—just explore the making of lines. To begin, we’re going to explore what it is like to make a wavy line. Let yourself be drawn to a medium that you’d like to use first—the oil pastel, chalk pastel, or marker. When you’re ready, begin making a wavy line on your paper. Continue exploring different wavy lines, perhaps making them at a medium pace, a slow pace, and fast pace. Switch hands and make a wavy line with your nondominant hand. Make a few wavy lines with that hand. Notice how it feels to make wavy lines. Notice how it feels making it with the different hands. Now make a jagged line—one that goes up and down and up and down. Keep exploring the jagged line. Feel free to change colors at any point. After a few moments, notice how it feels to make a jagged line. Now make a dotted line. Explore dots. Hear the sound. Keep exploring the dots. Feel free to change colors. Vary the intensity—gentle dots…hard dots…then dashes. Notice how it feels to make dots…and dashes. Now make a light line. Continue making light lines. Notice the difference between light and heavy. Take a moment to reflect on the experience. Which lines, shapes, and colors do you resonate most with? Which do you not? Create an art piece using the lines, shapes, and colors that resonate with you now.

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Exercise 4.2 Art and feeling Materials needed: Paper, oil pastels, chalk pastels, markers, and paint. Time: 30–45 minutes. We’re going to explore the connection between feelings and artmaking. You will have one sheet of paper for each feeling. After you read (or hear) the feeling to be explored, you will have a few minutes to express that feeling using color, shape, line, texture, and/or image. Trust what comes to you after reading or hearing the word describing the feeling: Sad , Happy, Fear, Love, Hate, Trust. See if you can be accepting to your artistic expression and feelings. Feel free to substitute other feeling words that you would like to explore.

Exercise 4.3 Conversation Drawing This drawing exercise takes place with a partner. Materials needed: One large sheet of paper to be shared. Drawing materials such as oil pastels, pastels, or markers. Time: 8–10 minutes. You are going to have a conversation on paper using the art materials, without talking. One person will begin, much the way a conversation begins; the only difference is that you will use the art materials to communicate. You can communicate through lines, shapes, colors, and/or images. Don’t feel pressured to understand what your partner is trying to communicate. You may or may not understand their intention. Just enjoy the process and let the conversation unfold through the art materials. Have fun! Although there is no talking, it’s okay if laughter comes up. After the drawing process is completed, take a few moments to share how that was for each of you. It’s interesting to hear what each person intended in their part of the conversation and what each imagined the other was trying to say.

ART THERAPY: HISTORY, CONCEPTS, AND PRACTICE

Exercise 4.4 Exploring clay Materials needed: Clay or other modeling material; surface to work on with clay; water. Music: Something quiet and contemplative, yet uplifting. Time: 35 minutes. Warm-up: 15 minutes: Place the clay in front of you. Take a few moments to look at it. Take a piece. Begin to feel it…its texture, temperature, smoothness, or roughness, softness or hardness. Press it, squeeze it, roll it. See what you can do with it as you respect its properties. Take some more clay if you’d like. What is it like to add more clay to the piece you have? Is this the amount you’d like to work with? If you’d like more, take more. Explore making different shapes with the clay: a ball, something flat; a ball with spikes sticking out; a ball with holes in it; a thin long shape; a donut shape; a flat circle; a square, a rectangle; an amoeba shape. Clay experience: 20 minutes: Now, putting the clay pieces together, press the parts to form one piece of clay. Create the size or amount you’d like to work with. When you have that, put the clay in front of you…take a look at it. Put the music on. You can do this with your eyes closed or open…whichever is comfortable to you. As you listen to the music, connect with the clay. Feel it…listen to it…and let it be formed through your connection to it. Allow the clay to unfold…there is nothing it is supposed to be. Trust in the unfolding. At the end of the 20 minutes, gently open your eyes if they’ve been closed. Take a few moments to see the clay now. How has it changed from when you began?

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Part II

Focusing-Oriented Art Therapy

Chapter 5

Bridging Focusing and Art Therapy

Focusing and art therapy are each powerful methods for facilitating change. Although Focusing and art therapy have very different theoretical frameworks and methods of practice, their complementary relationship becomes evident when looking at their numerous interconnections. One fundamental aspect that both Focusing and art therapy share is the engagement of the bodily felt sense—the crucial experiential dimension that Gendlin named from his research with Carl Rogers on what contributed to successful psychotherapy. In Focusing, the felt sense becomes explicit, whereas in art therapy, the felt sense is often implicit within the experience. During Focusing, the client accesses a bodily felt sense through mindful attention and a friendly, welcoming attitude to what is there. Initially the felt sense is often vague but comes into greater clarity as the client inwardly keeps it company. The client then sees if there is a handle or symbol that matches the felt sense. Eventually the felt sense comes into “focus” where the client listens and dialogues with it, as it unfolds its meaning and steps towards growth. In art therapy, the felt sense is engaged through the experiential nature and role of the body in artmaking. The hand, arm, shoulder, and torso move while drawing, painting, and sculpting. The breath changes in response to different amounts of physical pressure on the art instrument. Often, the client will be engrossed in the artistic process, not conscious of the felt sense. The felt sense, however, is implicit in creative activity—informing choice of colors, selecting materials, developing an image, engaging in dialogue, accessing meaning, and knowing when an artwork is complete.

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Gendlin describes the significance of pairing the inner directed process of Focusing with an outward expression: If therapy deals only with inner data, whether emotion or felt sense, it misses a crucial dimension of the process of change. Therapy must involve more than Focusing on inner data in reflective inner space. There also needs to be a movement outward, into interaction. Focusing as such does not sufficiently provide the moving out. (1991, p.267)

Focusing provides the inner direction while art therapy offers the outer expression. They fit together like a pair of matching gloves. Focusing provides mindful access to the inner resources of the bodily felt sense while art therapy carries its rich source of imagery and wisdom into an outward visual artistic expression. There are numerous interconnections between Focusing and art therapy, summarized in Table 5.1, that will become alive with greater meaning as you read the methodology and clinical examples in Parts II and III. Table 5.1 Interconnections: Focusing and art therapy Focusing

Art therapy Engage the body

Awareness is brought to the felt sense, which is in the body.

While creating art, the body—arm, hand, head, breath, torso, etc.—is engaged while drawing, painting, or creating collage or sculpture.

Border zone between conscious and unconscious Takes place in the border zone between the conscious and conscious.

Engages the unconscious and brings it to conscious awareness.

Whole constellation of an experience Accesses a felt sense, which is the somatic reflection of the whole of an experience—its intricacy and complexity.

Spatial, rather than linear. Captures an experience and conveys it in one glimpse.

Clarifies vague and undefined felt experience A felt sense begins as an unformed, undefined, unclear bodily sense.

Art evolves from an image or felt sense that becomes clearer through the process of artistic creation.

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Natural unfolding of experience Bringing the Focusing Attitude of friendliness and acceptance helps the felt sense to unfold or open, revealing more about itself.

During the artistic process, felt experience naturally flows into media, colors, shapes, imagery.

Cultivate two aspects of self—witness and experiencer There is a part of self that listens to the felt experience, asks questions, and receives answers—while simultaneously experiencing the felt sense.

There is the self engaged in the internal experience and process of artmaking—and the aspect of self that can look at and observe the artwork.

Inner dialogue An inner dialogue occurs through the Asking and Receiving steps of Focusing.

Dialogue can occur through looking at the artwork, asking it questions, and receiving what it has to say.

Inner relationship An inner relationship develops through the Focusing Attitude (being friendly to, accepting of, etc.) and the Focusing steps (Choosing an issue and felt sense, Asking and Receiving).

The art expresses the experience from within, which can be witnessed and interacted with.

Inner rightness The step “Resonating” is a way of checking with the bodily sense for a feeling of rightness.

Looking at an art piece in relation to the creator’s sense of aesthetics provides a sense of rightness (color, balance, completion, etc.).

Externalize issue, problem, or difficult feeling Clearing a Space helps to identify issues and set them at a distance where they can be named and identified.

Inner experience is externalized through artistic representation.

Finding the right distance When working on an issue or having a felt sense, one can imagine placing at the right distance for working on it or being with it.

An art creation can literally be placed at a distance that feels right when looking at it, talking about it, or dialoguing with it. Various materials can keep something at more of a distance—e.g. putting something in a box, wrapping it up, layering things over it.

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Table 5.1 cont.

Focusing

Art therapy

Means other than words to symbolize experience A felt sense can be symbolized as an image, gesture, or sound (as well as a word or phrase).

Art materials offer a means of expression beyond words—through color, shape, form, texture, image.

Marker for further work The end of a Focusing round or process can be identified as a place to return to for further exploration—a starting point from which to begin a new round or Focusing process.

The art product provides a tangible object that can be looked at again at any time for review, continuation, or reflection.

Process that feels good or healing The Focusing process is said to feel good even when working on difficult issues or experience.

The creative process is uplifting even when expressing painful or difficult experience.

Chapter 6

Focusing-Oriented Art Therapy: Basics

Overview Focusing-Oriented Art Therapy is a theoretical and methodological approach that synthesizes Gendlin’s original teaching method of Focusing and the principles of Focusing-Oriented Psychotherapy with art therapy theory and practice. Focusing-Oriented Art Therapy begins with establishing a sense of safety for the client, attending to the therapeutic relationship, and integrating empathic reflection through a variety of methods such as experiential listening, artistic reflection, and mirroring. Through the Focusing Attitude, the therapist helps the client to bring a welcoming, friendly, and accepting attitude towards their inner felt sense of an issue, problem, or experience. The client listens to the body to access a felt sense, waits until a handle/symbol (image) comes from inside, checks it for a feeling of rightness, and then expresses the image artistically. Typically there is a “felt shift,” or experiential change in the body. The “Asking” and “Receiving” steps of Focusing can be incorporated to further explore the art and client’s experiential process. Alternatively, clients may also begin with art, and then integrate Focusing by accessing a felt sense of the art piece and image, or interweaving Focusing steps into art therapy. Focusing-Oriented Art Therapy includes three basic approaches: Clearing a Space with Art, Focusing-Oriented Art Psychotherapy, and Theme-Directed. Clearing a Space with Art is beneficial for centering, stress reduction, clarifying and dis-identifying with issues, and helping clients to have an experiential knowing of their intrinsic wholeness. Focusing-Oriented Art Psychotherapy is primarily applied to individuals and couples where the orientation is toward authenticity, congruence, 91

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empathy, depth-oriented insight, communication skills, and change. A Theme-Directed approach is most often used in groups, incorporating Focusing with art therapy to address topics related to the group’s needs. Although Focusing-Oriented Art Therapy is primarily a Person-Centered Approach, it is applicable to all orientations, including, psychodynamic, cognitive, behavioral, etc.

Establishing safety The first step in Focusing-Oriented Art Therapy is to create a sense of safety by creating a connection, finding a bridge, and conveying to the client that “the person in there” comes first. Safety is established through the presence of the therapist, the Focusing Attitude, grounding, awareness of physical and energetic boundaries, and clinical sensitivity.

Therapeutic presence This first step begins with the therapist’s awareness of their own state: are you willing to be here, to be present, to meet, and welcome the “person in there”? Can you be mindful of your own issues and states of mind, monitoring your own countertransference reactions, so that you can see the client as clearly as possible? Can you “be friendly to” your own self ? Can you address your own self-care to be present?

The Focusing Attitude “Being friendly,” accepting, and welcoming are directed both towards the client’s inner felt sense of experience and to the creative process. (See Chapter 3 for detailed discussion in eliciting the Focusing Attitude within the client, transmitting the Focusing Attitude from the therapist to the client, and cultivating the Focusing Attitude within the therapist.) The Focusing Attitude of welcoming and acceptance is also directed toward artmaking and the art product.

Clinical sensitivity It is important to be mindful of the needs of the clinical population you are working with and to adapt Focusing-Oriented Art Therapy accordingly. For example, in Focusing, closing the eyes can help clients to access their inner experience. However, some clients—especially those with a history of trauma, dissociation, psychosis, or severe mental illness—may need to keep

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their eyes open in order to maintain a sense of safety. Exercises are adapted to match the needs of various populations and are discussed in greater detail in Part III, Clinical Approaches.

Grounding Breath awareness and body awareness exercises prior to Focusing instructions can help clients feel more grounded and in touch with their body sense. Exercises may include: being aware of the breath going in and out of the body; feeling the feet on the floor connected to the earth; body awareness of legs, abdomen, back, chest, neck, shoulders, arms, hands, face, and head. Simple stretching exercises can follow, bringing greater awareness and energy to the body.

Reflection: empathic understanding Experiential listening In Focusing-Oriented Art Therapy, the therapist demonstrates empathic understanding in response to the client’s verbal, nonverbal, and artistic communication. The therapist takes in the whole of the client (verbal, nonverbal, and artistic communication), listens for what is most important, and succinctly reflects back the heart of what the client is saying. (See Chapter 3 for detailed instructions for experiential listening during a verbal session.) Experiential listening is also directed toward the client’s artwork. The therapist offers reflections with an inquisitive tone: It seems like the figure is angry…does it seem that way to you? I get the sense of power in this painting… What is it like for you? The therapist offers a listening response and waits for the client to check it against their own felt sense to see what is true.

Artistic reflection In art therapy, with certain clients, the therapist may also convey a listening response through an artistic reflection. For example, the client begins with a line, shape, or image. The therapist responds artistically mirroring the lines, shapes, colors, emotional tones, and energies of the client. Reflecting the client’s artistic responses demonstrates empathic understanding on an artistic, symbolic, and energetic level.

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Mirroring Mirroring through body movement, sound, or gesture can facilitate a sense of connection, safety, and understanding for certain clients and clinical populations. It is especially helpful with clients who are nonverbal (and applicable to those who are verbal as well).

Integrating art therapy into Focusing Expressing the felt sense in art A basic step to integrate art therapy into Focusing is to express the felt sense in visual art. This requires bringing the Focusing Attitude (being friendly and welcoming) toward a felt sense, finding a handle/symbol as an image (or word, phrase, gesture, or sound), and expressing it in art (as depicted in Figure 6.1). If the symbol comes as a word, phrase, or gesture, the client is encouraged to express it in visual art. This process of listening to the felt sense—and seeing if there is an image that matches it—is the source and inspiration for artmaking.

Felt sense

Handle/symbol as image (word, phrase, gesture, or sound)

ART

Figure 6.1 Expressing the handle/symbol in art

The Focusing Attitude in Art I often begin trainings for therapists with the following exercise on acceptance and compassion as a safe way to introduce how to access a felt sense, find a handle/symbol and resonate it for a sense of rightness, and express the handle/symbol in art. Accessing a felt sense of acceptance and compassion also provides an entry into qualities of the Focusing Attitude.

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Exercise 6.1 Acceptance and compassion Art materials: Drawing paper, oil pastels, chalk pastels, markers. (Optional: watercolors, feathers, beads.) Let yourself sit in a comfortable position. Take a few deep breaths, noticing the breath moving in and out of the body. Feel free to close your eyes or keep them open…whichever is most comfortable to you. Feel the support of the chair, the floor where your feet touch, the ground, and being here. I’d like to invite you to become aware of someone or something that transmits the qualities of acceptance…gentleness… kindness…compassion. It could be someone you know, or a place, something from nature, a spiritual presence…anything. Begin to sense these qualities…bringing them right here into the room. (Pause.) Now imagine that these qualities—of acceptance, kindness, and compassion—are here for you. …Sense in your body what it would feel like to have these qualities for you. (Pause.) Be friendly to what you receive. See if there’s an image that matches the inner felt sense… Check it against your body to see if it is right. If it’s not, let it go and invite another image to come. (If an image doesn’t come, that’s okay…it may come as a word, phrase, gesture, or sound.) When you have the image (handle/symbol) for the felt sense, express it using the art materials. EXAMPLE: ADRIENNE

A graduate student, Adrienne, shares her experience: I imagined my grandmother who always loved me no matter what I did or what I felt. As I focused on her, I felt this yellow and orange warmth circling around the inside of my body. I saw an image of myself curled inside the warmth, as it protected me and encircled me. When I looked at the art materials, I picked up the yellow and orange oil pastels. I created an image conveying the warm light I felt inside (Figure 6.2). The blue feather is my vulnerability.

This beginning exercise helps to access felt sense qualities of the Focusing Attitude—and to symbolize them in art. Adrienne’s felt sense of her grandmother’s unconditional love is the yellow and orange warmth circling around the inside of her body. The handle/symbol came as an image of

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herself curled up inside the warmth. Adrienne symbolized the image of herself curled up inside the warmth using the art materials that matched the felt sense (orange and yellow oil pastels and blue feather).

Figure 6.2 Acceptance and compassion FOCUSING REMINDERS TO ELICIT FOCUSING ATTITUDE ·

Can you be friendly to that (felt sense)?

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Imagine sitting down right next to that (felt sense), keeping it company much like you would a young, shy, child.

Checking in with the body’s felt sense In Focusing-Oriented Art Therapy, it is essential to check in with the bodily felt sense. The therapist guides the client to bring a friendly attitude to how

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they are right now, and to see if there is an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense. Checking in with the felt sense can occur in brief moments throughout a session—as a lead-in to help the client to see how they are, in-between artmaking to ground the experience and integrate meaning, and at the end of a session. The second exercise, “How am I right now?”—a core method of Focusing-Oriented Art Therapy—invites the client to check inside and get a felt sense of how they are. It also continues the basic method for learning how to connect with the inside of the body and to symbolize a felt sense in art. (Please note that this exercise can be adapted for clients where it is not safe to close their eyes, or follow a guided inner process. Instead of leading clients in a guided process, simply ask them to notice how they are inside now…and to see if there’s an image that matches their inner felt sense. See Part III for adaptations.)

Exercise 6.2 Focusing Check-In: “How am I right now?” Let yourself sit in a comfortable position. Take a few deep breaths, noticing the breath moving in and out of the body. Feel free to close your eyes or keep them open…whichever is most comfortable to you. Feel the support of the chair, the floor where your feet touch, the ground, and being here. Gently follow your breath inside your body and just notice how it is right now. Ask, “How am I on the inside right now?” See if you can be friendly to whatever you find. Notice if it’s tight, or jumpy, or warm, or some other quality. (Pause.) See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense…check it against your body for a sense of rightness. If it’s not right, let it go and invite a new image (or word, phrase, gesture, or sound) to come. When you’re ready, gently stretch your body and open your eyes. Notice which art materials you feel drawn to, and use them to create an artistic expression that matches your felt sense. Option: Instead of asking “How am I right now?” the therapist can ask, “How is it on the inside right now?”

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EXAMPLE: BRIANNA

Brianna is a 55-year-old woman in the midst of a divorce. We had worked together for a year using Focusing-Oriented Art Therapy. As Brianna begins to speak about her feelings, I invite her to Focus to access a felt sense, guiding her in Exercise 6.2, “Focusing Check-In: How am I right now?” After a few moments, Brianna opens her eyes, reaches for a purple pastel, and begins making the shape of a heart that is being torn open (Figure 6.3).

Figure 6.3 Felt sense, bruised heart

She adds pink to the surface of the heart and grey inside the crevice where the heart is torn. Brianna writes the words “bruised heart” on one side of the paper and the question “Will it fall apart?” on the other. Brianna says that when she Focused inside, she had a burning sensation in her heart and chest and then the image of the torn heart came. The felt sense is the burning sensation in Brianna’s heart and chest. The purple and pink, torn-open and bruised heart is the “handle” (image) that symbolizes her felt sense.

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Reading this, an art therapist might think, “This is what we all do in art therapy.” But what makes Focusing-Oriented Art Therapy different is its recognition and accessing of the felt sense. The art in Focusing-Oriented Art Therapy emerges not simply from the mental imagination but from the body’s felt sense and mind as a whole. FOCUSING-ORIENTED REMINDERS FOR ACCESSING A FELT SENSE ·

Can you take a moment, and notice how that is in your body?

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Can you check inside and ask, “How am I right now?”

FOCUSING REMINDER TO SYMBOLIZE A FELT SENSE ·

See if there is an image (or word, phrase, gesture, or sound) that matches or acts like a “handle” for the inner felt sense.

The felt shift: art and body In Focusing-Oriented Art Therapy, visual art both documents the client’s felt sense and carries it forward, resulting in a “felt shift,” or change. The change, or felt shift, is experienced in the body and seen in the art. Sometimes a felt shift can be observed in one piece of art, as the creative process unfolds. Other times, the client expresses a felt shift in additional art pieces. Gendlin states: …we will consider imagery now, in relation to the bodily way to forms, and also, we will ask about the changed body as a result of its formation. This leads to a different practice with imagery, a constant return to the body between each image and the next. (1980, p.67)

In the example of Brianna, we can see a felt shift as the session continues. After Brianna and I reach a stopping place in her sharing about the bruised heart (Figure 6.3), I invite her to Focus again—to go back to the felt sense, imagine sitting down next to it, and ask, “What does it need?” Brianna closes her eyes again, listening within. After a few moments she opens her eyes, picks up a purple pastel and draws the outline of two large hands holding the heart—coloring them in with orange and filling the space around the heart with yellow light (Figure 6.4). On the paper, she writes the words “Strong hands holding it together.”

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Figure 6.4 Felt shift, strong hands holding it together

Brianna shares that when she asked the felt sense what it needed, a sense of faith emerged within and there was a warmth in her chest area [felt sense] that soothed the bruised feeling in her heart. The felt shift is the change from the first felt sense of a tight burning in Brianna’s chest to the second felt sense of a warm soothing of that area. The felt shift is observed in the change in Brianna’s art—from the torn, bruised heart to it being cradled and supported by warm, orange hands and light. The felt shift is also echoed in the words—from “Bruised heart/Will it fall apart?” to “Strong hands holding it together.” While the felt shift can be seen in the art, it is important to have the client notice the changes in the body. The therapist can inquire after artmaking and sharing, “How is it on the inside now?” Or “How does that feel in your body now?” The power of viewing the felt sense visually in art is that the client sees how their inner experience has changed. The client sees a change in the image, such as colors, shapes, imagery, or media. The art serves as a visual reminder, affirming movement in the direction of growth and healing.

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Integrating Focusing into art therapy Getting a felt sense of the art In Focusing-Oriented Art Therapy, one can also begin with art, rather than incorporating Focusing as a preliminary step. After creating the art, the therapist guides the client to bring a friendly attitude toward the art and inner experience, access a felt sense of the art, and then to see if there’s a word, phrase, image, or sound that matches it (handle/symbol), as depicted in Figure 6.5. This is a helpful approach for clients who are inclined towards a more spontaneous artistic expression first. Focusing helps to ground the artistic experience in the body and bring a sense of mindful awareness to the artistic process. In addition, getting a felt sense of the art helps to access meaning, integrate the experience, and enhance the mind–body connection.

The Focusing Attitude

ART

Felt sense

Handle/symbol as image (word, phrase, gesture or sound)

Figure 6.5 Getting a felt sense of the art

Exercise 6.3 Getting a felt sense of the art Looking at the art, gently ask, “What’s the whole feel of this?” See if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense in the art. Check against your body for a feeling of rightness. If it’s not right, let it go and invite a new word, phrase, image, gesture, or sound to come.

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After artmaking, the client can also do a Focusing Check-In (see Exercise 5.2) to get a felt sense of how they are. This can lead to integration or further artmaking. The benefits of how art therapy and Focusing enhance one another are summarized in Box 6.1

Box 6.1 Benefits of Focusing-Oriented Art Therapy

Art therapy offers Focusing • Art externalizes, concretizes, and symbolizes a felt sense. • The physical act of drawing helps the felt sense to open and

move, thus bringing about a felt shift—enhancing the life-forward direction. • The art product enables both the client (Focuser) and therapist

to see the exact same image that symbolizes the felt sense. • The visual art is a mirror of where the felt sense began, where

the felt shifts occurred, and where it ended in the session. • The art product can serve as a tangible reference point to

review—to see growth and change (felt shifts). • Clients can take the art product with them as a reminder to

integrate the experience into life.

Focusing offers art therapy • The felt sense grounds imagery with the body. • The felt sense can guide the artistic process—informing choice

of materials, colors, shapes, textures, and imagery. • The felt sense can be symbolized as an image and expressed in

visual art.

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• The felt sense indicates when something feels right, or doesn’t

feel right. • The felt sense unfolds the body’s next steps (towards healing,

change, wellness, etc.). • The felt sense opens the door to the body’s wisdom and cre-

ativity.

Approaches Gendlin’s six-step Focusing method is adapted to create three basic approaches in Focusing-Oriented Art Therapy: Clearing a Space with Art, Focusing-Oriented Art Psychotherapy, and Theme-Directed. Clearing a Space with Art, the subject of Chapter 7, is a simple yet profound exercise that helps clients to have an experiential knowing that there is a self separate from their issues and that there is also a place of intrinsic wholeness within. It is useful for stress reduction and centering, and can serve as an entry point to the two other approaches. Focusing-Oriented Art Psychotherapy, described in Chapter 8, is primarily applied to individual and couples psychotherapy where the issue arises out of the client’s experiencing and the orientation is towards insight. Chapters 9–13 and 15 provide examples of a Theme-Directed approach which is most often applied to groups in which topics such as strengths, fears, families, hopes, change, career, life balance, addiction, and so forth are explored. Focusing-Oriented Art Therapy steps are summarized in Table 6.2 which depicts the places where art is added into Gendlin’s six-step Focusing method. Basic Guided Focusing-Oriented Art Therapy instructions (Exercise 6.4) follow which are adapted to the three approaches. The instructions will come alive in Part III.

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Table 6.1 Gendlin’s Focusing Steps and Focusing-Oriented Art Therapy Gendlin’s six-step Focusing method

Focusing

Focusing-Oriented Art Therapy

1. Clearing a Space

Inwardly sense what’s in the way of feeling “All Fine”

Clearing a Space with Art

Choose something from issues set aside during Clearing a Space

Focusing-Oriented Art Psychotherapy

2. Choosing an issue and felt sense

Use art materials to set things at a distance; artistic representation of “All Fine Place”

Choose something from issues set aside during Clearing a Space; or begin with this step: “What’s needing my attention right now?” Theme-Directed: Focus on theme; Get a felt sense

3. Handle/symbol

Handle: word, phrase, image, gesture, sound

Handle: image

4. Resonating

Check handle against felt sense to see if it is right

Check handle against felt sense to see if it is right; Sense the right art materials to match the felt sense; Express handle/symbol in art

5. Asking

Ask the felt sense questions:

Ask the felt sense questions:

What makes it so______?

What’s the crux of it?

What’s the crux of it?

What would it be like all resolved?

What would it be like all resolved?

What’s in the way?

What’s in the way? What’s needed? What’s a small step in the right direction?

(or word, phrase, gesture, sound)

What makes it so______?

What’s needed? What’s a small step in the right direction? Dialogue with art: What do you have to say to me? What do you need? Dialogue with different parts Gestalt the art Active imagination Felt sense of art (word, phrase, gesture, or sound) into intermodal transfer

6. Receiving

Receive and welcome what comes (from the felt sense)

Receive and welcome what comes from the felt sense and from the art

FOCUSING-ORIENTED ART THERAPY: BASICS

Exercise 6.4 Basic Focusing-Oriented Art Therapy guided instructions 1.

Clearing a Space

(See various instructions adapted for different populations in Chapter 7.) Take a few deep breaths down inside to your body. Feel the support of the chair that you’re sitting on, the earth beneath your feet, and being here. Follow your breath inside of your body and notice how it is inside right now… Is it jumpy, or calm, tight, warm…or something else? See if you can be friendly to whatever you find. Imagine you’re sitting somewhere peaceful. It may a place you already know or one that you make up in your imagination. Once you have it, ask, “What’s between me and feeling ‘All Fine’ right now?” As each thing comes up, imagine wrapping it up into a package, or using other imagery to set it at a distance from you. Some people imagine placing it on a boat and then letting the boat go a certain distance out on a lake. Others imagine placing it in a balloon and letting it go up in the sky… (Pause.) When the list stops, check again, “Except for all of that, I’m ‘All Fine,’ right?” If something else comes up, set that a distance outside of your body… (Pause.) Background feeling: See if there’s a background feeling, an always feeling, like always kind of tense, or always kind of anxious. (Pause)…and set that at a comfortable distance too… Check again: “Except for all of that, I’m ‘All Fine,’ right?” All Fine Place: Take a moment and sense the “All Fine Place.” See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense. (Option: Stop here and create art from Step 1.) 2.

Choosing and issue and felt sense

As you look over at the things you set down, see if there’s something needing your attention right now. You can ask your body sense if something is wanting your attention —or you can choose something that you’d like to work on. Check with your body to see if you have its permission to Focus on it.

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Felt sense: Take a moment to sense the whole issue freshly…notice how it feels in your body. (Pause.) Gently ask, “What’s the whole feel of this?” 3.

Finding a handle/symbol

See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense. 4.

Resonating with artistic expression

Check it against your body for a sense of rightness. If it doesn’t fit, let it go and invite a new word, phrase, image, gesture, or sound to come. When you’re ready, gently open your eyes, and create an artistic expression of your felt sense image. (Option: To continue to the end of the guided Focusing and create art at the end.) 5.

Asking the felt sense

(After the client creates art.) We’re going to ask the felt sense some questions. Some it will answer and some won’t have relevance, so simply let those go. Feel free to close your eyes or to leave them open. Imagine sitting down next to the felt sense, keeping it company. In a gentle way, ask it: • What makes it so__________? (insert handle/symbol) • What’s the crux of it? Or, what’s the main thing about it? • What’s the worst of it?

Imagine for a moment that this issue were all resolved. This is like looking the answer up in the back of the book. Sense inside your body what it would look and feel like if this were all resolved. See if there’s an image that matches or acts like a handle for the inner felt sense of this issue all resolved. When you’re ready, ask: • What’s in the way (between the issue and resolution)? • What’s needed (to achieve this resolution)? • What’s one small step in the right direction?

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6.

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Receiving

Welcome what comes. Create an artistic expression that matches the colors, shapes, or images that you received during the Focusing. Include what was meaningful to you during the Focusing.

Interweaving Focusing into art therapy moments Focusing can also be integrated into art therapy in brief moments, at the beginning, middle, and end of a session. CENTERING

At the beginning of a session, Focusing can be used as a centering and quieting tool, helping the client to relax and settle into a mind/body connection. ·

Focusing Check-In (see Exercise 6.2)

·

Clearing a Space (see Chapters 3 and 8)

·

Focusing on something peaceful, centered, safe (see Exercise 9.2).

CHOOSING ART MATERIALS

During the beginning and throughout a session, the client is encouraged to see which art materials match their felt sense. As the artmaking and felt sense unfold, the client is asked to keep in connection with the felt sense for a right fit of the materials, colors, medium, image, etc. GROUNDING THE ARTISTIC EXPRESSION AND SESSION

In the midst of an art process, or at the conclusion of the artmaking, the client can check inside to see where they are at now after creating the art. Instead of being lost in the artwork, the client can check back in with the body and felt sense—grounding the artistic experience. DIALOGUE

After the client has completed the artmaking, the client and therapist place the art in a way that feels right to look at it. The client shares something about the art piece and its representation of the felt sense. Out of the client’s sharing, Focusing questions emerge. Questions can be directed to the felt sense and/or to the artwork.

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Dialogue with the felt sense

Questions are posed to the felt sense, such as: What does it need? What would it be like all healed? What’s in the way? What’s a step in the right direction? The client listens to what the felt sense says. When it answers in colors, shapes, or imagery, the client adds to their existing art piece. Dialogue with art

Questions are directed to the art itself using methods of active imagination, Gestalt, dominant and nondominant hand, and Focusing’s asking and receiving steps. Examples of questions include: What do you want to say to me? Where do you come from? What do you want me to know? What do you need? What do the different parts have to say to each other? Do you need something aesthetically? (See Chapter 4 on art therapy for specific methods using Gestalt, active imagination, dialogue.) The client listens to what the art and felt sense share. INTERMODAL EXPRESSIVE ARTS TRANSFER

Looking at the art, what is the felt sense? Is there a word, phrase, gesture, or sound that matches the felt sense? A word or phrase can become a poem or creative writing. A gesture can become a movement or dance. A sound can become music. (See example in Chapter 15 and discussion in Chapter 16.) IS IT COMPLETE?

Reflecting on the artwork, the client checks in with their felt sense to see if it feels right. Does the art feel complete? Does it need anything else? TITLE

Looking at the artwork, the client can see if there is a word or phrase that matches the felt sense. The word or phrase can become the title. REMINDER AND AFFIRMATION

Reflecting on the artwork and process, ask the client to check inside to see what they would like to carry into the week (or month, years, etc.). The art can be taken home with the client as a visual reminder and affirmation.

Part III

Clinical Approaches

Chapter 7

Clearing a Space with Art

Clearing a Space with Art is a fundamental approach of Focusing-Oriented Art Therapy and can be used with individuals, couples, groups, and families. In Clearing a Space with Art, the client identifies issues in the way of feeling “All Fine” and imagines placing them at a distance outside the body. Imagery is incorporated in helping to clear the space. For example, the client might imagine wrapping each issue up in a package and placing it at a comfortable distance or putting their concerns on a boat and letting it float out on a lake. Art is incorporated to concretize and symbolize the felt sense of the issues being set aside. After clearing the issues, the client gets a felt sense of the “All Fine Place” and symbolizes it in art. At times, clients feel they have already set their issues aside, using their imaginations, and prefer only to create the “All Fine Place.” Nicole, a graduate student, describes the painting (Figure 7.1) that came out of her experience of doing the Clearing a Space exercise in class:

Figure 7.1 Clearing a Space with Art, Nicole 111

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In the image, I am blowing bubbles and watching them float away to a comfortable distance. Each bubble represents a different issue and concern. The beach is painted with bright colors of turquoise, pink, orange, and yellow—it is optimistic. I currently have the picture in my room, and when I am stressed I find myself looking at it. Through the image I am able to connect to my “All Fine Place” and find solitude.

Clearing a Space with Art is useful for centering, stress reduction, getting distance from overwhelming feelings, and dis-identifying with them. It also helps clients to have an experiential knowing that there is a self that is separate from their issues, as well as a place of inherent wholeness. This chapter includes an in-depth clinical example of Clearing a Space with Art, a discussion, with vignettes, of working with the background feeling and “All Fine Place,” a list of art materials conducive to Clearing a Space with Art, and three variations of guided instructions adapted for a range of clinical applications.

Example: Mary Mary, a 41-year-old woman, initially came into therapy for difficulties in her marriage and confusion about her career. During one of Mary’s sessions, she came into my office feeling overwhelmed and not knowing which issues to focus on. Clearing a Space is a useful Focusing exercise to begin a session when clients feel overwhelmed or confused. I suggested to Mary that we could begin with Clearing a Space—which she agreed to. After I guide Mary using the Clearing a Space with Art I: Nondirective Imagery instructions (Exercise 7.1), she chooses different sizes and shapes of colored construction paper to represent the different issues she was carrying: blue for her sadness about the relationship, orange for her confusion about her work situation, green for money issues she was having, and brown for a background feeling of “always kind of heavy or depressed.” Mary gathers all the papers symbolizing her issues and wraps them up in a package of tissue paper held together with a bow next to the package. Mary creates a circular shape with pink, yellow, and purple feathers and a golden center of glitter (Figure 7.2). After taking a moment to look at her art, Mary shares: I took my sadness about my relationship, the confusion about my work, my issues with money, and my depression and put them in this package. It felt so good to imagine taking them outside of me and placing them

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Figure 7.2 Clearing a Space with Art, Mary Package of Mary’s issues (right)/“All Fine Place” with feathers and glitter (left)

in a package. What really amazed me was that as I wrote each issue on the construction paper, I felt my body let go of so much tension—like it just moved on out. I felt myself getting quieter and more peaceful. It was incredible to find this gold center inside this lighter place inside of me. I realized that I have this inner gold center that exists separate from what is happening in my relationship or career.

As we spoke about the Clearing a Space experience and the art, Mary arrived at a fresh insight—she said that seeing the issues wrapped up in a beautiful package helped her to see the gifts in the issues. She said if she did not have the issues, she would not be directed to find what is true and meaningful for her. Mary acknowledged that she could begin to appreciate the gift of the issues in her relationship as vehicles to help bring her to greater intimacy. Instead of feeling angry at the issues and her partner, Mary felt a sense of gratitude and hopefulness.

The power of the background feeling The first time I heard about the “background feeling” was when I was learning Focusing and someone guided me to check and see if there were a “background feeling” or an “always feeling.” As I scanned the interior of my

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being I was amazed to find an elusive, nearly invisible fabric of always feeling like I had to get it just right. The “background feeling,” or chronic always feeling, is like the wallpaper of our emotional lives, often unnoticed but always there and coloring our experience.

Example: Steve Steve, a graduate student, discovered that his background feeling was deeply embedded in his psyche. He describes his experience: When it came time to clear out the background feeling, it took much more effort. I had the image of a backhoe scooping deep into the soil to remove my background noise, yet I was unable to do it in a single breath. It took about six breaths for me to remove it. As I took each breath, I envisioned the backhoe scooping farther into the earth. If I stopped breathing, the backhoe would rest. Six breaths after I received this image, the backhoe was free of dirt and my background noise was removed. Afterward, I had a felt sense of my body buzzing from the freed space, with energy flowing through me. My art (Figure 7.3) portrays my body with lines of energy having clean space to flow uninterrupted.

Figure 7.3 Clearing the background feeling, Steve

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The “All Fine Place” It is an illuminating experience for clients to access the place within them that is “All Fine” (or at peace or present) and separate from their issues. As art is being created, there is an internal kinesthetic exploration of the colors, textures, and whole feel of the “All Fine Place.” The experience of the “All Fine Place” deepens and expands through the artmaking process. The visual art serves as a reminder of this felt experience, which helps to reawaken the awareness of and connection to the place within that is already whole.

Example: Rebecca During a workshop, a participant named Rebecca describes her inner transformation as she notices and sets her background feeling at a distance outside of her body: As I focused on what was in between me and feeling “All Fine,” I became aware of a background feeling of a low-intensity feeling of shame. I noticed it as a darkness in my body. Being friendly to the shame and darkness, and setting them aside, brought clarity to my experience of the “All Fine Place.”

Figure 7.4 “All Fine Place,” Rebecca

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I sensed myself as a woven basket—a sturdy, functional, and aesthetic container with the deepest “All Fine Place” being smooth and filled with golden light (Figure 7.4). Instead of being a background that I barely noticed, this basket of golden light has become a primary experience for me.

Art materials for Clearing a Space A variety of art materials can be used in Clearing a Space with Art (see Box 7.1) depending on appropriateness of materials for specific populations as well as client preference. Clients who are more disorganized and in need of more structure require art materials that offer a sense of control. For example drawing materials, such as magic markers and colored pencils, offer more control than paint. Simple materials like pre-cut-out shapes from construction paper can be put into a box as a way to Clear a Space, providing ease and a sense of control. Creating shapes out of clay or painting images requires a higher skill level and mastery. Higher functioning clients will appreciate a choice and range of materials.

Box 7.1 Art materials for Clearing a Space with Art 1.

Drawing materials: Pencils, pens, colored pencils, colored markers (thin and thick), oil pastels, chalk pastels, and charcoal can be used to draw the issues in the way of feeling “All Fine” and the “All Fine Place.”

2.

Paints: Acrylic, poster, watercolor, and other nontoxic paint products can be used for painting the issues set aside and the “All Fine Place.” Different size brushes, sponges, and other objects for dipping into the paint can express different felt sense qualities.

3.

Assorted papers: Construction paper, textured papers, rice paper, and drawing paper can be used to represent the client’s issues and the “All Fine Place.” Papers can be cut with scissors, hand torn into shapes, glued, frayed, layered, and so forth with specific colors representing each issue and the “All Fine Place.”

CLEARING A SPACE WITH ART

4.

Clay, dough, and modeling materials: Pieces of modeling materials can be shaped, rolled, flattened, and otherwise formed into symbols representing each issue and the “All Fine Place.” Additional objects such as sticks, feathers, and buttons can be used with the modeling materials to express various qualities of the felt sense.

5.

Found objects and construction: All kinds of found objects (e.g. wood pieces, rocks, stones, leaves, natural feathers) can be used to symbolize the issues and the “All Fine Place.”

6.

Craft materials: An array of craft materials, including yarn, twine, felt, boxes, containers, ribbons, and sequins, can be used to create representations for the issues and the “All Fine Place.”

7.

Containers, boxes, and bags: An assortment of containers, boxes, and bags can be used for clients to put their “issues” into during Clearing a Space.

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Guided imagery variations for Clearing a Space with Art Clearing a Space with Art can be done with greater or lesser structure depending on the individual and clinical population. Clearing a Space with Art I: Nondirective Imagery is useful for higher functioning clients who tend to appreciate accessing a spontaneous source of imagery arising from within themselves. Clearing a Space with Art II: Directive Imagery (eyes open or closed) is applicable to clients who feel safe enough to listen within to their inner felt experience but need the added structure of suggested imagery for setting things at a distance. The third, Clearing a Space with Art III: Concrete Imagery (Eyes Open), is the most structured approach and is geared to clients with greater mental illness, in earlier phases of trauma recovery, or with dissociative tendencies.

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Exercise 7.1 Clearing a Space with Art I: Nondirective Imagery (First, invite the client to find a comfortable position.) Take a few deep breaths, inviting your body to relax… If you feel like it, you may close your eyes…or keep them open…whichever is more comfortable for you. When you’re ready, ask, “How am I from the inside right now?”… Turn your attention like a searchlight inside to your body, just noticing whatever you find… See if you can be accepting to whatever you find there, without judgment… Now imagine yourself in some peaceful place… It may be a place you know already, or it may be one you create in your imagination… When you’re ready, ask, “What’s between me and feeling ‘All Fine’ right now?” Let whatever comes up, come up… Don’t go inside any particular thing right now… As each thing comes up, imagine placing it at some distance from you…perhaps out on a park bench…or in a box…or use imagery like relaxing on the beach and putting all of the things between you and feeling “All Fine” on a boat…or wrapping each issue or concern up in a package… As each thing arises, place it at a comfortable distance from you while you stay in your peaceful place… (Pause.) After you place each thing at a distance, check inside again and ask in a friendly way, “What’s between me and feeling ‘All Fine’ right now?” Again, with each thing that comes up, find a way to put it at a comfortable distance from you. If the list stops, gently ask inside, “Except for all that, I’m ‘All Fine,’ right?”… If more comes up, add that to the stack. Keep a comfortable distance from your stack.

Background feeling Sometimes there’s a background feeling that we’re always carrying… It may be something like always a little anxious…or always a bit depressed, or some other always feeling… Check inside and see if there is a background feeling that’s in the way of feeling “All Fine”… If so, add it to your stack… Check again… (Pause.) “Except for all of that, I’m ‘All Fine,’ right?” “All Fine Place”: Keeping everything at a distance, now, I’d like to invite you to bring your attention to the “All Fine Place”… See if there is an image that matches or acts like a “handle” for the “All Fine Place”… Check it against your body to make sure it’s right. If not, invite a new image that matches or acts like a

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“handle” for the “All Fine Place” to come… If what comes is a word or phrase, that’s fine… Be accepting of that.

Artistic expression When you’re ready, use the art materials to create something expressing your felt sense of the “All Fine Place.” Some people prefer to only create an expression of the “All Fine Place,” while others like to create the things set aside. If you received a word or phrase, feel free to express them creatively.

Clearing a Space with Art II: Directive Imagery (eyes open or closed) This variation is most often used with clients who find it relatively safe to close their eyes but need the additional safety and structure of imagery suggested by the therapist to set issues and concerns at a distance outside of the body. It is important for clients to know that they can choose to keep their eyes open or open them at any time. Examples of imagery that help a client to imagine placing things at a distance are listed below. 1.

Imagine being in a peaceful park where you are sitting on a park bench. At some distance there is another bench where you can stack all the things between you and feeling “All Fine.”

2.

Imagine you have a beautiful kite to which you can attach all the things between you and feeling “All Fine.”

3.

Imagine sending each issue or concern up in a balloon. Check to see if you want it to be connected to a string. If so, imagine that the string lets the balloon float at just the right distance from you. Or, check to see if you’d like the balloon to just float off into the sky.

4.

Imagine making a package out of each issue, which you then can set at some distance from yourself.

5.

Imagine there is a large container or vessel that can hold each thing that is between you and feeling “All Fine.” As each thing comes up, imagine placing it in the vessel.

6.

Imagine someone from your life (friend, therapist, family member, teacher, spiritual figure) who can hold each issue or concern for you.

7.

Imagine placing issues in the way of feeling “All Fine” on a boat and sending it onto a calm lake at some distance that feels right.

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EXAMPLE USING IMAGERY OF PLACING THE ISSUES ONTO A BOAT

Exercise 7.2 Clearing a Space with Art II: Directive Imagery (eyes open or closed) (First, invite the client to find a comfortable position.) Take a few deep breaths, inviting your body to relax… If you feel like it, you may close your eyes…or keep them open…whichever is more comfortable for you. Take a few more deep breaths…and when you’re ready, ask, “How am I from the inside right now?” Just listen… Give an answer time to form in your body… Turn your attention like a searchlight inside to your body and just greet whatever you find… Be accepting to whatever you find there, without judgment… Now imagine yourself in a peaceful place… The sky is crystal blue and the air is clear. In this peaceful place is a calm lake that you are sitting next to… Imagine sitting in a place carved out just for you… When you’re ready, check inside your body and ask, “What’s in the way between me and feeling ‘All Fine’ right now?” Let whatever comes up, come up… Don’t go inside any particular thing right now… As each thing comes up, imagine putting it into a boat docked at the lake. Set the boat at the right distance from you… Some like it to be separate but fairly close. Others like to let the boat out quite a bit, halfway or more across the lake. Others like to eventually let the boat go. Sense the right distance for you… Continue the process of asking your body, “So what’s between me and feeling ‘All Fine’ right now?” As each thing arises, imagine stacking it or placing it into the boat. When the list stops, you can check it by asking, “Except for all of that, I’m ‘All Fine,’ right?”… If more comes up, add it to what’s in the boat. Keep a comfortable distance from the boat holding the things.

Background feeling Sometimes there’s a background feeling that we’re always carrying… It may be something like always a little anxious…or always a bit depressed, or some other always feeling… Check inside and see if there is a background feeling that’s in the way of feeling “All Fine”… If so, add it to your stack… Check again… How is it now?

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“All Fine Place”: Keeping everything at a distance, now, I’d like to invite you to bring your attention to the “All Fine Place”… See if there is an image that matches or acts like a “handle” for the “All Fine Place”… Check it against your body to make sure it’s right. If not, invite a new image that matches or acts like a “handle” for the “All Fine Place” to come… If what comes is a word or phrase, that’s fine… Be accepting of that.

Artistic expression When you’re ready, use the art materials to create something expressing your felt sense of the “All Fine Place.” Some people prefer to only create an expression of the “All Fine Place,” while others like to create the things set aside. If you received a word or phrase, feel free to express them creatively.

Clearing a Space with Art III: Concrete Imagery (eyes open) This directive variation is useful with clients who have more severe mental illness, are in the early phases of trauma recovery, do not feel safe closing their eyes, or do not feel safe turning their attention inside to their bodies. These are general cautions for populations that tend to have difficulty with trust, ego integration, and safety. However, individual clients may enjoy and feel safe with inner Focusing (eyes closed). This needs to be assessed on an individual basis by the clinician. In this format, the therapist’s tone of voice and the phrasing of the directions help to direct the client’s attention to the inner felt sense without the client having to close their eyes and go inside.

Exercise 7.3 Clearing a Space with Art III: Concrete Imagery (eyes open) 1. Art journal: (Provide clients with a blank art journal.) See if you can notice what’s in the way of feeling “All Fine” or “okay” or “present” right now. Write a list of those things in your journal. Create a symbol for each issue or concern that you identified through writing, and draw it somewhere on the page as a way to get some distance from it. The symbol can be a color, shape, texture, or image that matches your felt sense of the concern. Create a symbol for each of your concerns. Once you have written down

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and created symbols for each of your issues, create something, using the art materials, to represent the place within you that is separate from those issues, the place that is “All Fine.” 2. Containers, boxes, envelopes: Clients write the issues or concerns on pieces of paper (colored construction paper, white paper, index cards) and place them inside a container, box, or envelope that is then set aside at a distance. After placing the concerns inside the box, clients create something using art materials to represent the “All Fine Place” which the therapist explains is the part of the self that is separate from all the concerns they placed in the container. The client can also decorate the box, container, or envelope. 3. Objects/sandplay: A variety of objects can be used to symbolize each issue or concern the client is aware of that is in the way of feeling “All Fine.” For example, a client may choose a small figurine representing her brother or a chalkboard representing school. The client can place the object symbolically on a sheet of paper or as part of sandplay. Once all the symbolic objects have been placed, the client can find something to represent the “All Fine Place” and put that where she would like it to be. The client rearranges the objects or miniatures until their configuration feels right to her.

Reminders for Clearing a Space with Art 1.

Use guided instructions that are appropriate for the clinical population (i.e. nondirective, directive, eyes open).

2.

Clearing a Space with Art is useful as a stress reduction tool unto itself.

3.

It is useful to help clients identify issues and stressors, set them at a distance, and experience an aspect of self that is separate from their concerns.

4.

Clearing a Space with Art helps clients to feel, experience, see, and know the place within themselves that is inherently whole.

Chapter 8

Focusing-Oriented Art Psychotherapy

In Focusing-Oriented Art Psychotherapy, Gendlin’s Focusing method and theoretical framework serve as a foundational guide to navigate the client’s experiential process with the integration of art therapy. When learning the application for Focusing-Oriented Art Psychotherapy, it is helpful to understand and have a grasp of the Focusing steps to navigate the experiential terrain of the client. The first case example is a vignette to illustrate the integration of the Focusing steps and art therapy in an individual psychotherapy session. Once the Focusing steps are familiar, it is easier to incorporate them along with art therapy in what feels like a more spontaneous flow. The second case, Donna, demonstrates a client’s progress over the course of one year demonstrating how Focusing and art therapy are interspersed in bits and pieces throughout each session.

Example: Sarah Sarah is a 28-year-old woman who came to see me for individual psychotherapy for help adjusting to a new job after relocating from another part of the country. She was interested in using Focusing and art therapy to work on her presenting issue. In Focusing-Oriented Art Psychotherapy, the client can either begin with Clearing a Space (step 1), or choosing an issue (step 2), where the therapist invites the client to Focus to get a felt sense of how they are in the present moment, and what is needing attention most today.

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Choosing an issue Therapist: Would you like to take a moment to Focus to see how you are and what is needing our attention most right now? (Sarah says, “Yes.”) Take a few deep breaths inside your body, feeling the support of the floor and the chair you’re sitting on. Follow your breath down inside to your body and ask, “How am I right now?” Be friendly to whatever you find [Focusing Attitude]. When you’re ready, ask, “What’s needing my attention most right now?” (Therapist quietly keeps Sarah company while she gently closes her eyes, sensing inwardly.) Sarah: (Opens eyes) It’s been really hard to move to a new city, leave my good friends and not have them here, and start a new job all at the same time. Therapist: You’re finding it really hard to move, be apart from your friends, and start a new job all at the same time [Experiential Listening]. Would you like to take a moment to Focus and see how that all feels? Sarah: Yes.

Felt sense Therapist: Follow your breath inside to your body to the place that is finding this change really hard…from moving, saying goodbye to your friends, and starting a new job… Imagine sitting down next to it and gently ask, “What’s the whole feel of this ‘finding it really hard’ place?” (Sarah quietly senses inside as I sit silently being present.)

Handle/symbol Therapist: See if there’s an image that matches or acts like a handle for the inner felt sense. (Sarah waits and then opens her eyes.) Sarah: I feel it right here, in my heart. It’s tight. I have an image of a heart locked up in a box with tears inside of it.

Resonating and symbolizing in art Therapist: Check it for a feeling of rightness… Would you like to draw it?

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Sarah: Yes. (Sarah picks up a red oil pastel and makes the outline of a heart. She begins to fill it with blue tears. Sarah draws a square box around the heart and fills it in with blue. Sarah takes a black oil pastel adding darkness around the blue box. See Figure 8.1.) My heart is locked inside a box and the tears are buried inside. I feel all of this pain but I won’t let myself really feel it. The blue around the heart is all of the sadness and the black is a depressed feeling. I feel so heavy. I wish I could cry.

Figure, 8.1 Sarah, felt sense tears held in

Therapist: Your heart is filled with tears and sadness—that is locked in a box. There’s a feeling of sadness and even depression surrounding it [Experiential Listening of art and Sarah’s verbal expression]. At this point, Sarah has gotten in touch with her felt sense about the difficult feelings about the changes and losses in her life. Her felt sense is the bodily sense—the tightness in her heart. The symbol/handle came to Sarah as an image—a heart with tears locked inside a box. Sarah expressed the felt sense and symbol in a visual art form. After Sarah and I look at the drawing of the

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heart and tears locked inside a box and talk about it, I ask her if she would like to go inside to listen more to the heart and tears that are locked in the box. She agrees.

Asking Therapist: Go back inside to the place that is finding it “really hard”…where you got the image of the heart with the tears inside the box. Imagine sitting down next to the tears inside the heart and box [keeping it company]… When you feel in good contact with it, ask it, “What makes for the tears and heart inside the box?” Or, “What does it need?” (After a couple of minutes, Sarah opens her eyes, reaches for a dark blue oil pastel and makes teardrop shapes falling down into a pool. She adds light blue to the tears (Figure 8.2). As she draws the tears, tears fall from her eyes, rolling down her cheeks. I sit being present, keeping Sarah and the teary place company.)

Figure 8.2 Sarah, felt shift, tears released

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Sarah: I remembered when I was little and my family moved a lot. I went to four different schools in seven years. I was always saying goodbye to friends. Therapist: There’s sadness and tears that were locked inside from when you were little…and they’re being released here too, with the present situation. (Sarah agrees.) Can you go back inside and ask that place what it needs.

Asking and receiving alternate Sarah: The sad place inside needed to be released. [Receiving] It feels softer inside. Even though it’s sad. I feel better. The move is difficult but I can create a new home, with new friends, as I’ve done before…and still keep in touch with the old ones. Focusing enables clients to access imagery that arises from the felt sense and the art process gives it visible form. There is an ongoing interaction between the felt sense and art process—each informing the other. As seen in the case of Sarah, both Focusing and art provide access to unconscious forces, bringing them into conscious awareness so they can be worked through. Threads of experience become connected through the felt sense and creative process, illuminating how earlier experiences can influence the present. Sarah’s inner change (felt shift) is reflected in her art—from held-in tears locked in a box to the showering of the tears. While Focusing and art therapy have their own unique principles and methods, they complement one another as they engage the felt sense, unfold the body’s wisdom, and carry the client forward in a life-forward direction.

Donna: a year’s journey Donna is a 52-year-old woman who came to see me for individual art psychotherapy to work on feelings of depression precipitated by the onset of her husband’s serious heart condition, right at the time that she had left her secure job to return to graduate school. Donna had been in verbal psychotherapy but continued to feel depressed. She felt that an arts-based approach to psychotherapy might give her access to other parts of herself beyond her keen intellect. The description of this case is divided into three phases of our work together over a one-year period, highlighting the beginning, middle,

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and termination stages. Focusing and art therapy are interwoven throughout the session in response to staying closely attuned to Donna’s felt experience. Prior to Donna entering the room, I set out simple art materials for easy use—a drawing pad, oil pastels, chalk pastels, and markers.

Beginning After Donna and I discuss relevant background information and the goals of therapy, I describe how Focusing and art can be used. In order to help Donna clarify how she is and what she would like to work on, I lead her in a Focusing Check-In, a way of listening inside that helps clients to access a felt sense about what is important to them. Focusing Check-In: Take a few deep breaths down inside to your body. Follow your breath down inside to your body. When you’re ready, ask, ‘How am I on the inside right now? (Pause.) Be friendly to what you find. See if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense. Check it for a sense of rightness. Once you have it, ask, “What’s needing my attention today?”

After a minute, Donna opens her eyes and begins to tell me about leaving her job and her husband’s illness; I notice a slight tension in her body and subtle changes in her facial color. My own sense is that she is on the edge of something important inside. This is the place when I invite a client to take a moment and to notice how it feels inside while speaking. I ask Donna, “Would you like to take a moment and see how that feels inside your body?” Donna gently closes her eyes and waits. I wait too, keeping her company while she senses inwardly. Attuning as best as I can to Donna’s inner process, I listen for the moment to continue, and then say: “See if there’s an image, word, phrase, gesture, or sound that matches, or acts like a ‘handle’ for the felt sense.” About a minute later, Donna opens her eyes and begins to describe an image. I tell her that she can draw the image that came to her. She reaches for a black pastel and makes a heavy, dark shape in the lower central part of the page. She adds a grey, round hill shape that encircles the black (Figure 8.3). Using her nondominant hand, Donna writes, “heavy, sad, blob.” We look at the art together as Donna shares that the grey colors and the formless blob match her depression. Integrating Gendlin’s Asking and Receiving steps, I invite Donna to go back inside and to be friendly to the “heavy, sad, blob,” and to listen to it: “Imagine sitting down next to it and ask it,

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‘What makes it heavy, sad, and like a blob?’” Donna is quiet, inwardly sensing, as I silently accompany her through my presence. Donna opens her eyes, reaches for a brown oil pastel, and draws a figure. After completing the figure, she draws long horizontal lines across the figure, obliterating it (Figure 8.4).

Figure 8.3 Donna, felt sense, heavy, sadblob

Figure 8.4 Donna, unheard, abandoned, alone

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At the top of the page near the center, she writes the words “unheard, abandoned, alone.” I empathically feel Donna’s pain as I witness the figure being obliterated as she draws over it. In Focusing-Oriented Art Therapy there is often an alternation between listening to the felt sense, getting a handle/symbol as an image, creating art, sharing, and checking back in with the felt sense. After Donna shares about her art, I invite her to listen more to the unheard, abandoned, alone self: “Can you sit down next to the self inside that feels unheard, abandoned, and alone…and ask her what she needs?” Donna opens her eyes: “To be seen…to be heard.” I reflect those words back, “She needs to be seen and heard.” This is important on two levels. Donna is engaged in an inner dialogue between a child part of herself and adult part. The child part can be seen and heard by the adult self. The child part is also seen and heard in the art and witnessed both by Donna and the therapist. I ask Donna how it feels to access this part of herself and to draw it, to see it and to have it witnessed by me. Donna shares that while it was painful, uncovering that part of herself feels good. There is a felt shift—from sad, heavy, and blob to the unheard, abandoned, alone, obliterated self, to something inside that feels good. As Gendlin states: Such a step feels good—it releases energy. What one finds may feel good or bad, but its emergence—the step of finding—always brings relief, like fresh air. This kind of effect does not make something painful more painful. I call it a “felt shift.” (Gendlin 1996, p.26)

During this early phase of treatment, Donna sees a connection between her current feeling from putting her needs aside in order to care for her ill husband, with a lifelong pattern of feeling unheard and invisible, stemming from being the eldest of six children. Focusing, art therapy, and witnessing help Donna to uncover the unconscious, family of origin issues, access the felt sense imagery, listen to the pain, and to help her unresolved issues to move in a life-forward direction.

Middle Our sessions typically begin with a brief review of the week, including highlights, progress made, difficulties encountered, and a Focusing Check-In (described previously under “Beginning Phase” and Exercise 6.2). A Focusing Check-In empowers the client to take ownership for the direction of their own psychotherapy. After Donna Focuses to see how she is and to

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ask what is needing her attention most today, she opens her eyes and says, “I keep trying to do things for myself but all these things get in the way—my computer crashed, my son needed me to babysit the grandchildren, and I have to take my husband to all of these doctors’ appointments. I need time for me!” I ask Donna if she would like to explore that further; she says, “Yes.” I lead Donna in Focusing to access a felt sense about what she just shared: “Take a few deep breaths into your body. (Pause.) Let yourself be aware of what you just spoke about. Ask, ‘What’s the whole feel of that inside?’ (Pause.) See if there’s an image that matches the inner felt sense.” After a few moments, Donna opens her eyes, reaches for a red oil pastel, and draws a trunk-like shape with red and orange at the bottom, exploding at the top like a firecracker (Figure 8.5). Two brown mallet-shaped objects are pressing on both sides of the trunk. She titles the drawing “Anger.”

Figure 8.5 Donna, felt sense, anger

Reflecting on the art, Donna shares, “I have all of this anger in me that feels so held in—like I’m going to explode.” I reflect back the felt sense of Donna’s anger. This is where there is an alternation, or zigzag (Gendlin 1970), between sharing, felt sense, and artmaking, attuned to the client’s

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Figure 8.6 Donna, felt sense, want

experiential process. Here, Donna shares about the art, checks in with the felt sense, and we integrate Gendlin’s Asking and Receiving steps. I invite Donna to Focus again, to imagine sitting down next to that place of anger—the place that is sick about her needs not counting—and to gently ask it, “What does it need?” [Asking]. Donna closes her eyes for about 30 seconds. When she opens them, she takes out a brown oil pastel, and draws the word “Want” (Figure 8.6) on a new sheet of paper. She then takes a yellow pastel and starts writing “OK” all over the paper. She changes to a red pastel and continues writing “OK” all over the page. Donna pauses and, looking at the paper, says, “I need to give myself permission to want!” Donna has a sudden impulse to use her hand to blend all of the pastels together. As she smears the pastels, they began to blend, at first obscuring the words “OK” and “Want.” As the words blend into color, into the paper, the word “Want” does not disappear but rather becomes even more defined. Because “Want” was drawn with the oil pastel, its dynamic, strong energy seems to pop out of the paper as the dry pastel blends and recedes all around it. Donna and I are both struck by this—it’s like magic! The art

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reflects how important it is for Donna’s “Want” to stand out and not get lost to or obliterated by old family patterns and current issues. Throughout the therapy, Donna continued to work on how to give herself permission to have needs and to meet them while also being a compassionate and caring person toward others. During one session, Donna Focused and received an image from her felt sense of herself sitting down and taking the time to listen within. After drawing the image, she wrote the word “boundary” (Figure 8.7).

Figure 8.7 Donna, felt sense, boundary

Donna had the felt sense of a protective boundary around her, one that enables her to keep in touch with herself while also being soft enough to allow things of her choosing to enter.

Closure During our last session, I invite Donna to review the course of therapy, reflecting on her goals from the beginning, the changes and challenges throughout, and this ending.

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After Focusing, she draws her felt sense image of a tree with green roots at the bottom, a trunk colored warm terracotta and brown, and branches radiating outward and reaching upward with yellow and green circular shapes at the top (Figure 8.8).

Figure 8.8 Donna, felt shift, clear solid

She writes the words “clear” and “solid.” Focusing-Oriented Art Therapy helped Donna to identify how her current life stressors were triggering unresolved childhood grief from having to give up many of her needs to help care for her family. As she worked through the grief and anger from her childhood, she also worked through her current grief related to her husband’s illness and feelings around the loss

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of time to focus on her own needs. Focusing helped Donna to hear her authentic voice within while art made it tangible and visible. Donna’s art clearly reflects many felt shifts from the amorphous shapes, blob, and covered figure in the early drawings, to the cathartic release of anger and “want,” to the peaceful person sitting and listening within, to the clear, strong, reaching upward and outward tree. As reflected in the art, Donna’s life also changed. She had a renewed sense of energy in which she began to make room for activities and work that nourished herself while caring for the needs of others. In psychotherapy, there is often a struggle between the old, entrenched ways and the new pathways leading towards greater wholeness. The old ways do not get completely eradicated, and they can reappear, especially during times of stress. The art serves as a reminder of the journey—and also of the tools to access the rich source of imagery, creativity, resource, and inner wisdom. The therapist holds the frame, through presence, empathy, listening, clinical skills, Focusing and art suggestions, but the answers and knowing arise from within the client. The client carries the tools with them to use for ongoing self-care.

Reminders: Focusing-Oriented Art Psychotherapy Focusing-Oriented Art Psychotherapy attends to: ·

the person-in-there

·

therapeutic relationship

·

experiential dimension: the felt sense in the body

·

imagination and creative process.

Methods include: ·

Focusing

·

empathic listening, artistic reflection, and mirroring

·

artistic expression.

Focusing-Oriented Art Psychotherapy can be introduced in several ways during a psychotherapy encounter: ·

Focusing Lead-In/Check-In: Early in the session, the therapist invites the client to check inside and see if there is

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something needing attention today: “Sense inside and ask, ‘What is needing my attention most today?’” After the client identifies an issue, the therapist can guide the client to get a felt sense, symbolize it, and express it in art. ·

Choosing an issue: It is not always necessary to begin with “Clearing a Space.” Sometimes clients come in knowing what they would like to work on. Or a client may start with talking that leads the way to an issue needing attention. When this happens—as is often the case in depth-oriented psychotherapy—it is important to remain closely attuned to the unfolding of the client’s process.

·

Gendlin’s Focusing method: The six steps can be used as a guide to move through the session. Clients can be taught the Focusing method. Expressive art can be integrated after the whole guided Focusing process, or introduced after specific steps, such as Clearing a Space, symbolizing the felt sense, resonating, asking, and receiving.

·

Interspersed throughout the session: The therapist listens for moments of verbal and subtle nonverbal communication in which there may be something more for the client to grasp about what they are saying, something that would become more known through connecting with the bodily felt sense. The case of Donna in this chapter exemplifies this approach. To invite clients to access their felt experience, the therapist can ask: ·

How is that in your body as you speak about it?

·

Can you sense what that feels like inside?

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Can you take a moment and sense how that feels?

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See if there’s an image that matches the inner felt sense.

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Would you like to express that in art?

Groups: Theme-Directed

Chapter 9

Stress Reduction in Adult Psychiatric Day Treatment

The first group I led integrating Focusing and art therapy was at a psychiatric day treatment center for adults at the beginning of deinstitutionalization in 1978. Many clients were transitioning from the large state hospitals after being institutionalized for as many as 50 years. Clients at the center were diagnosed with schizophrenia, bipolar disorder, schizo-affective illness, borderline personality, major depression, and anxiety disorders and typically suffered from auditory and visual hallucinations, thought disorders, and suicidal ideation. During the 1980s there was a limited amount of research and application of Focusing with this population, which indicated the need to adapt the six-step Focusing method to emphasize listening, the Focusing Attitude, and pointing reflections to the client’s felt sense (Egendorf and Jacobson 1982; Gendlin 1972; Prouty 1977). Mindfulness, relaxation, and stress management are common forms of treatment today, but were relatively unknown in the 1980s. I had been told that you can’t do “relaxation” with clients with severe mental illness and you can’t have them close their eyes. Today, with more advanced methods of researching the effectiveness of treatments, Dr. Dolores Malaspina of the Columbia University College of Physicians and Surgeons states: Not only may stress-management techniques prevent the onset or lessen the severity of schizophrenia, delay relapse in those already ill and reduce overall anxiety (Falloon 1992; Linszen et al. 1998; Van Hassel et al. 1982), but studies indicate that cells within a damaged hippocampus can regenerate when stress or cortisol is reduced. (Malaspina and Corcoran 2001, paragraph 23)

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May this chapter be a reminder and inspiration to follow creative hunches and intuition combined with clinical sensitivity to explore new applications in our field. The following outline in Table 9.1 describes the overall structure of a 12-week Theme-Directed Focusing-Oriented Art Therapy approach on stress reduction with adult psychiatric clients in day treatment: Table 9.1 Group themes and skills: 12 weeks Week

Theme

Goal

1

Introduction to Stress Management: goals of the group; psycho-educational presentation on stress management; Peaceful Place Exercise

Introduce members to group goals and each other; learn method of relaxation

2 and 3

Identifying and Releasing Bodily Tension

Learn a second relaxation exercise; mind/body awareness of stress and relaxation

4 and 5

Clearing a Space for Stress Reduction

Learn the first step of Focusing: stress reduction and well-being

6 and 7

Focusing Steps: Choosing an Issue to Work On

Learn how to work on an issue and identify steps towards change

8–12

Practice: Relaxation, Focusing, Art Therapy Skills from Previous Weeks

Reinforce learning relaxation; Focusing and art therapy methods for self-care

Group format ·

Check-In.

·

Focusing Stress Check-In: identify tension in the body/symbolize as an image.

·

Draw felt sense image of stress.

·

Stress reduction exercise.

·

Focusing: identify tension in the body/symbolize as an image.

·

Drawing what the felt sense is now.

·

Sharing.

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Week 1: Peaceful Place Exercise Goal: To create a sense of safety by explaining the purpose and goals of the group and finding a peaceful place; to help clients to become acquainted; to introduce the Focusing Attitude and felt sense. The therapist leads the group in a Focusing Check-In to notice the places of stress and tension in the body, to get a felt sense as an image and to express it in art. Afterwards, the therapist leads the group in the “Peaceful Place” exercise, followed by Focusing to get a felt sense as an image, and then to symbolize it in art.

Exercise 9.1 Focusing Stress Check-In Take a few deep breaths into your body. Follow your breath down inside to your body and notice any places that feel tense or stressed. See if you can be friendly to whatever is there. Now, see if there’s an image that acts like a handle for the inner felt sense of the stress or tension. Check it for a sense of rightness. When you’re ready, draw the felt sense image.

Exercise 9.2 Peaceful Place and “being friendly” Imagine that you are somewhere peaceful. It may be a place that you know or one that you make up in your imagination. Sense how it feels in your body…being friendly to what you find… (Pause.) Now, see if there’s an image that matches the inner felt sense. When you’re ready, draw the felt sense image. EXAMPLE: LUCAS

Lucas is a 53-year-old client who was in the day treatment for schizo-affective disorder. During the Focusing Check-In, Lucas describes his drawing of his felt sense (Figure 9.1): “My head is filled with all these worrying thoughts I feel like I’m falling off a cliff.” After the “Peaceful Place” exercise, Lucas shares his drawing (Figure 9.2) and states, “I feel more peaceful now”—which is evident in his flowing lines and the words, “more peaceful.” The felt shift is experienced in Lucas’s change from worrying and feeling like he is falling off the cliff to the more peaceful drawing, which is seen so clearly in his art. The art captures the felt sense, is stress reducing, and serves as a powerful feedback tool.

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Figure 9.1 Lucas, felt sense, stress

Figure 9.2 Lucas, felt shift, peaceful place

Weeks 2 and 3: Identifying and releasing bodily tension Goals: To teach clients a safe way to connect with their body; to identify stress in the body, learn a stress reduction tool, and see the felt sense and felt shift expressed in the art. The therapist leads the group in a Focusing Stress Check-In (Exercise 9.1) to notice places of stress and tension in the body, to get a felt sense as an image and to express it in art. Afterwards, the therapist leads the group in the “tension-release” Exercise 9.3, followed by Focusing to get a felt sense as an image, and then to symbolize it in art.

Exercise 9.3 Tension-release exercise Guide the group in a relaxation exercise to first tense and then relax muscles (e.g. hands, arms feet, legs, stomach, eyes, face). After, guide clients to Focus, get a felt sense (image), and express it in art. Variation: any relaxation exercise. EXAMPLE: ADAM

Adam, a 24-year-old client, describes the first drawing (Figure 9.3), done with a thin black marker: “I feel a hammering pressure coming towards both

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my head and feet. After the exercise, I felt it all leaving me…that’s why the arrows are pointing the other way.”

Figure 9.3 Adam, felt sense, tension

Figure 9.4 Adam, felt shift, release

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The second drawing (Figure 9.4), drawn in purple marker, clearly shows the felt shift from tension coming in to the tension leaving—with a big smile and more present eyes. The art concretizes the felt shift in Adam from pressure coming towards him in to the pressure leaving him, and the resulting open eyes and big smile.

Week 4: Clearing a Space with Art—Stress reduction Goal: To teach clients a method for getting some distance from their stressors and finding the “All Fine Place.” Clearing a Space: See Clearing a Space with Art III, Concrete Imagery (Eyes Open), #2: Containers, Boxes, Envelopes.

Weeks 5 and 6: Focusing Steps: Stress reduction by working on an issue Goal: To teach clients the Focusing steps as a way to explore problem solving stressors. (Guided “Focusing-Oriented Art Therapy Steps,” Chapter 6, are adapted here.) 1.

Clearing a Space: See Clearing a Space with Art III, Concrete Imagery (Eyes Open), #1: Art Journal.

2.

Choosing an issue and felt sense: Ask clients to choose one thing they identified in their journal from “Clearing a Space” that they would like to work on. Guide to access a felt sense.

3.

Handle/Symbol: See if there’s an image that matches the felt sense.

4.

Resonating: Check to see if it feels right.

5.

Art: Create the felt sense image in art.

6.

Asking: The therapist guides the client to sense what it would look like and feel like all resolved.

7.

Receiving and drawing the stress in art: The therapist asks the clients to use the art materials to create a drawing of the felt image of the stress or problem resolved.

8.

Finding a Step: After drawing, the leader guides the group back to see if there is a small step towards this resolution.

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EXAMPLE: LISA

Lisa is a 43-year old client with a history of bipolar disorder. She identifies being angry at her three children as a stress that she would like to address. Lisa’s first felt sense image (Figure 9.5) is a red, constricted vertical shape which she describes as a knot in her stomach.

Figure 9.5 Lisa, felt sense, anger

Figure 9.6 Lisa, felt shift, peace

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After imagining the issue resolved, Lisa’s felt-sense image is transformed into a soft, strong yellow flower with a smooth, figure eight shape around it (Figure 9.6). Lisa shares, “I felt the tension in my stomach relax and change to peace. The step that came to me is to talk to the boys about the importance of doing their chores and being a family. I also want to give the boys positive reinforcement instead of just getting angry.” Several years after I had stopped working at the day treatment center, I went back to visit the clients and staff. One client, who often heard voices said to me, “ Now instead of always hearing those other voices, I sometimes hear your voice, ‘Take a deep breath…breathing in relaxation, breathing out stress.’”

Reminders with psychiatric population 1.

Begin with grounding and body awareness exercises with eyes open. Assess client’s abilities to stay in the present moment and to have a safe connection with the body.

2.

Only invite clients to close eyes after you know they can establish a safe connection with their body and can stay in the present moment.

3.

Focusing instructions can be adapted to be concrete and structured, which is helpful to this population.

4.

·

Words can be directed to the felt sense while clients keep eyes open; for example, “Sense inside” instead of “think,” “become aware of.”

·

Give clients time to sense into a place of knowing—rather than a quick answer from the mind.

·

See Clearing a Space with Art III, Chapter 7.

Reflections: Experiential Listening, artistic reflection, movement mirroring.

Chapter 10

Emotional Healing and Self-Care in a State Prison

I was invited by Robin Casarjian (1995), author of Houses of Healing: A Prisoner’s Guide to Inner Power and Freedom, to offer a workshop on Focusing and art therapy as part of a 12-week series on emotional healing for men incarcerated in prison. The series was Phase II of a larger program called Growing Together, sponsored by Robin Casarjian’s National Emotional Literacy Project. The group consisted of self-selected members committed to personal inquiry and learning skills for emotional healing. Most of the inmates were either serving long sentences and ineligible for parole or serving life sentences. During Phase I of Growing Together, the men had addressed issues of family roots and dynamics, the wounded inner child, core beliefs, anger, unconscious and conscious motivations for committing the crime they were imprisoned for, remorse, and forgiveness. Phase II included weekly presentations by invited guests to teach a particular skill in emotional 1 healing. One of the previous sessions, included a basic Focusing workshop in which the group was taught the Focusing Attitude, listening, Clearing a Space, and the Focusing steps. My task was to built on that foundation and add art to Focusing. Although I passed the background check by the State to be able to be a presenter inside the prison, it took additional time to get the art materials approved. The media was limited to individual boxes of oil pastels and plain white paper (8½" ´ 11"). As I walked into the prison, I felt a profound sense 1

The basic Focusing workshop was offered by Joan Klagsbrun, PhD, psychotherapist and Focusing Coordinator, Boston, MA.

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of respect for Robin Casarjian’s vision and commitment to bring depths of healing work into prisons throughout the country. Before the men entered the large group meeting room, I began to create a safe and sacred space through a ritual of mindfully setting the art materials out—placing one box of oil pastels, a few sheets of white paper, and a one-page handout entitled, “Art and Focusing for Healing,” onto each person’s chair. As the men entered the room, each walked up to me, looked directly into my eyes, extended his hand to shake mine, and said variations of, “Hello Dr. Rappaport. I’m _______. Welcome to the Growing Together Group II.” I was touched by the human dignity that was palpable as our eyes met—a willingness to be seen and to see. They transmitted a sense of gratitude, along with an openness to receive something to learn. My heart softened as I felt the transformational work they had already done.

Theme: Emotional healing and self-care Workshop format: 2 hours 1.

Art as a Tool for Self-Help and Healing

2.

Warm-up to the Art Materials

3.

Focusing-Oriented Art Therapy: Name Drawings; Draw Your Higher Power or Source of Spiritual Nourishment

Art as a tool for self-help and healing INTRODUCTION

I begin the workshop with a personal story about how I discovered art and quiet inner listening during my teenage years as a way to deal with turmoil—and how I have been exploring the interface of art and Focusing since then. In order to establish a baseline regarding the men’s feelings about doing art, I ask who feels comfortable or uncomfortable with art. To redefine and teach art as an application of art for emotional healing and self-care, I review the main points of the handout, “Art and Focusing for Healing”: ·

The purpose is to find expression of what is within, whatever it is—anger, sadness, hope, despair, sadness, love, hate, peace, joy.

·

The idea is not to try and make a beautiful picture or even to get it to look like something specific. The most important thing in art for healing is to use the art to express the feelings or images inside.

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·

Feelings, thoughts, and reflections can be expressed through line, shape, texture, color, and images. The images can be abstract or concrete.

·

Accept; don’t judge. Making art can bring relief, reduce stress, affirm something, express something, and communicate something. The art is about communication. Accept it for what it is offering you. As you create art and become accepting of it, the inner healing of self-acceptance occurs.

WARM-UP TO THE ART MATERIALS

To use art for healing, it is essential to learn the language of artmaking, exploring line, shape, and color as ways to connect to personal expression. (See Chapter 4 for guided exercise.) The warm-up is designed to be exploratory, lighthearted, and fun. I remind the men that it is natural for all of us to draw and that what is important is discovering the use of art as a language. It’s not about judging or worrying about how it looks. It’s really like playing. As the warm-up unfolds, the energy of the group changes from hesitancy to engagement. After trying out how to connect lines, shapes, and colors to the expression of feelings, the men share with each other in pairs and then with the larger circle. They express their amazement that they are able to connect their inner experience with the colors, shapes, and textures and that the experience is both releasing and relaxing. ART AND FOCUSING

Name Drawings

Name Drawings are a safe way to begin exploring the use of art for expression since simply writing or drawing one’s name provides a beginning structure that everyone can do (most of the time).

Exercise 10.1 Name Drawings Take a few deep breaths down inside to your body. Just greet and be accepting to whatever you find there in this moment. Take a few moments and say your name to yourself. Hear your name on the inside. Ask inside, “So what would I like to tell this group about me?… Am I bold, or quiet… What do I enjoy?…

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What or who is important to me?” Just wait and let yourself have time for the answers to arise from within. When you’re ready, ask inside, “So what’s the whole feel of all of that [who I am and what I’d like this group to know about me]?” See if there’s an image of your name that matches or acts like a “handle” for the inner felt sense. Perhaps the name feels big, or small, is certain colors, or thicknesses. See if there are any other symbols, shapes, colors, or images that go with your name. Sense that in your body. If it’s not right, let it go and invite a new image of your name to come. When you have an inner sense of that rightness, gently open your eyes, bringing your attention to being here in the room…and when you’re ready, use the art materials to create your Name Drawing.

Figure 10.1 Name Drawing

After Focusing, the men create their Name Drawings (Figure 10.1) and then share them with each other—first in trios and then with the larger group. The men are surprised to learn things about each other that they previously didn’t know. There is a great deal of affirmation, connection, and laughter. DRAW YOUR HIGHER POWER OR SOURCE OF SPIRITUAL NOURISHMENT

Since I was an invited guest presenter for one session, I wanted to have the session end with something that the men could continue to draw on for nourishment and could teach them about the power of an image for affirmation. I had learned from Robin Casarjian that many of the men had religious or spiritual beliefs. I chose to have them focus on a “higher power” or source of spiritual nourishment. I invite them again to close their eyes or keep them open for another Focusing exercise.

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Exercise 10.2 Guided Focusing: Higher power or source of spiritual nourishment Become aware of a higher power or source of spiritual nourishment, or a safe place (for those who might not connect to the word spiritual). Describe it to yourself…see it…sense the feel of it in your body. See if there’s an image that matches or acts like a “handle” for the inner felt sense. If it’s not right, let it go and invite a new word, phrase, or image to come. When you have a sense of it, open your eyes and draw the felt image using lines, color, shapes, and images, which can be abstract or can depict something realistic.

After the Guided Focusing, the men immediately begin drawing and then share in small groups about their art. In the larger group, the men speak about how the art is able to show their feeling of spirituality—where usually it’s difficult to describe. One man in the group draws a red heart with yellow light around it, with the letters of the group name, “Growing Together,” written/drawn in different colors (Figure 10.2).

Figure 10.2 Source of Spiritual Nourishment

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He speaks about how important this group is to him and how nourishing it is. He offers me the drawing as a way of saying thank-you. A few weeks after our work together, I receive a thank-you letter from the group. I share the letter here to carry the voices of incarcerated men and women out into the wider world and to affirm that healing is possible. Dear Dr. Rappaport, We, the men of “Growing Together Phase II,” would like to take this time to express our most deepest appreciation. Your continued concern for the human race and its survival (in peace) proves that there is hope for the incarcerated man. The day you came here and taught us to express our feelings through the art of painting was a wonderful moment. Originally, I do believe that there were only two men that could draw. One of them, I knew could really draw. Now there are 20 men that believe in themselves and in their expression of that belief. The men of “Growing Together Phase II” truly enjoyed your presentation. We also would like to take this time to extend another invitation to you. As soon as our pamphlets are completed, you will surely receive some. Again, we thank you so much for your professionalism. May peace and blessing be upon you and yours. Always sincerely, The Men from Growing Together II

May this letter nourish compassion and inspire others to bring modalities for emotional healing into the penal system.

Chapter 11

Transforming the Inner Critic

In Focusing, the term “the Critic” is identified as a culprit interfering with the Focusing process (Cornell 2005; Gendlin 1996; Purton 2004). The Critic inflicts an attitude toward one’s inner experience opposite to the Focusing Attitude—being harsh, judgmental, negative, and critical, rather than being friendly, accepting, and welcoming. While the Focusing Attitude creates conditions of safety for a felt sense to form, “the Critic” fosters a toxic inner environment. For example, the Critic might undermine a Focuser’s trust in a potential “handle” for the felt sense by saying, “What kind of image is that?” Or, the Critic might undermine the whole Focusing process, reverberating inside, “This is stupid!” or “You’re not getting it right!” The Critic can also get in the way of artistic expression with a negative statement such as “You can’t draw!” or “That’s ugly! Drawing is for children.” Gendlin (1991) compares the Inner Critic to Freud’s concept of the superego: It is an inner voice that criticizes and interrupts a person’s every hopeful move (p.247)… The voice has little understanding and no compassion (p.248)… The superego is not just a “voice”—it has attitudes. It is usually negative, angry, hostile, attacking, mean, petty; it enjoys oppressing a person. (p.255)

Often the Critic is such an internalized aspect of self, that its presence goes unnoticed. Typically, clients feel the effects of the Critic—shame, depression, poor self-esteem and self-image, anxiety, or fear—without being aware that an internalized critic attack has occurred. To tame the Critic, it is important to first become aware of its existence and then find ways to manage it. Over time, the Critic becomes quieter while the Focusing Attitude becomes stronger, resulting in a kinder, gentler inner relationship. I remember hearing Gendlin talking about the Critic at a conference—which 153

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helped me to deal more effectively with my Inner Critic. He said, “Once you notice that voice, just say… There you are again. Come back when you have something new to say!” His words went right through me. Yes, that voice never has anything new to say. Gendlin (1996) emphasizes getting the Critic out of the way, if possible, by dismissing it, waving it away, or inviting it to take a seat in the waiting room, or other similar strategy. Ann Weiser Cornell (1990, 2005) takes a different tactic with the Critic. She invites the Focuser to say hello to the Critic, to come into a relationship with it, and to hear its intentions, fears, and concerns. I find a varied approach, summarized in Box 11.1, effectively manages the Critic depending on the individual as well as the nature of the Critic’s attack.

Box 11.1 Strategies for taming the Critic

Awareness Mindfulness: Become aware of the Inner Critic: recognize its voice, tones, and sentences. Say hello to it: Let it know that you know it is there.

Distancing Create distance: Find a way to separate from the Critic, such as invite it to wait for you in the next room. Use art to create a special place for it. Tell it to come back when it has something new to say. Incorporate The Critic into “Clearing a Space” with or without art.

Focusing on the Critic Be friendly to it: Take a few moments to sit down next to the Critic; keep it company. Focus: Get a felt sense of the Critic; see if there is a handle/symbol for it. Create an image to symbolize the felt sense of the Critic. Ask the Critic: What does it want for you? What is it afraid of ? What does it need reassurance of ?

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Receive: Listen to what it has to say.

Focusing on the Criticized Part Be friendly to it: Take a few moments to sit down next to the Criticized; keep it company. Focus: Get a felt sense of the Criticized Part; see if there is a handle/symbol for it. Create an image to symbolize the felt sense of the Critic. Ask: What does it have to say? What does it need? Receive: Listen to what it has to say.

Resolution What’s needed for a healthy resolution? What’s a good small step in the right direction?

Transforming the relationship with the Critic Focusing-Oriented Art Therapy offers strategies to help transform one’s relationship to the Inner Critic. Focusing helps to bring an attitude of friendliness to the Critic as well as providing steps for listening to it from the felt sense. Expressive art helps to externalize the Critic through visual imagery, which strengthens the ability to gain a healthy distance from which to observe it. The following Theme-Directed group on the Critic is a variation of an exercise co-created with Joan Klagsbrun, a psychologist and long-time teacher of Focusing.

Goals 1.

To become mindful of the Inner Critic and the other part of self that is the recipient of the criticism.

2.

To engage the witness aspect of self to observe the Inner Critic.

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3.

To bring the Focusing Attitude of friendliness to the Critic and Criticized Parts.

4.

To get a felt sense and handle/symbol of the Critic and Criticized Parts.

5.

To listen to the Critic and Criticized Parts.

6.

To envision, express artistically, and build a new relationship to the Critic and between the Critic and Criticized Parts of self.

Group format Guided Focusing: Relationship between the Critic and the Criticized Part (Exercise 11.1). Art: Create felt-sense images of the relationship between the Critic and Criticized Parts now and how you would like it to be. Art materials: Drawing materials (oil pastels, chalk pastels, markers); clay, plasticine, found objects, string, felt, construction paper, yarn, etc. Dialogue: The client begins with a question to the Critic or the Criticized Part, listens to the art, and allows the felt sense to answer. Questions and answers can be written down or spoken aloud. Helpful questions to the Critic: What is your intention in being so critical? What are you afraid of ? What do you want for me? Helpful questions to the Criticized Part: What does it feel like to be criticized? What do you want to say? What do you need? The following two examples are from graduate students in a Focusing and Expressive Therapies graduate course. After talking about the Critic as a part of self, I lead the class in a guided Focusing (Exercise 11.1) on the “Relationship between the Critic and the Criticized Part.”

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Exercise 11.1 Relationship between the Critic and the Criticized Part Let your body find a comfortable way of sitting. Take a few deep breaths into your body, noticing the breath as it comes in and moves out of your body. Feel the support of the chair that you’re sitting on, the earth beneath your feet, and being here… Feel free to close your eyes or keep them open—whichever is more comfortable for you…(Pause.) We’re going to become aware of the place inside that can become self-critical, judgmental, negative, or self-defeating. It’s important to keep some distance from this place… Imagine you are sitting in a movie theater and can sit in the chair and simply watch it from a distance. Notice how it feels in the body as you glimpse this critical part… See if there’s an image that matches or acts like a “handle” for it… Check the image for a sense of rightness… Now become aware of the part that feels criticized or under attack. What’s the felt sense of that? See if there’s an image that matches the felt sense… Check it for a sense of rightness… What’s the relationship between the two? See if there’s an image that matches the felt sense of the relationship between the two parts…and check it for a sense of rightness… Take a few deep breaths… Now imagine how you would like the relationship between these two parts to be. (Pause.) Sense how it feels in your body to have this new relationship. See if there’s an image that matches the felt sense. Take your time…when you sense that the image is right, become aware of being in this room and gently open your eyes. Expressive Art: Create two images—the felt sense of the relationship between the Critic and Criticized Part now and the felt sense of how you would like the relationship to be. EXAMPLE: ANGIE

Angie, 26, is a graduate student in my Focusing and Expressive Therapies course. In Angie’s first drawing (Figure 11.1), there is a figure cowering underneath a table while blue and black drops rain down from ominous clouds. Angie shares: “The Critic is raining down all the judgmental and

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Figure 11.1 Felt sense, critic attack

Figure 11.2 Felt shift, new relationship

unsympathetic comments, and the Criticized Part is trying to hide beneath the table.” In the second drawing (Figure 11.2), depicting how Angie would like the relationship to be, the figure stands on top of the table holding a smaller figure. The sun is shining more brightly, and the rain has stopped.

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Dialogue

Critic speaking to the Criticized Part Critic: What do you want to say? Criticized: I feel alone and unprotected from your constant wrath. I feel vulnerable and can’t stand the constant abuse. Critic: You need me so you will be successful! Criticized: I feel like you only remind me of my failures, all my shortcomings. That doesn’t help me to be successful… How does that help? What are you so afraid of ? Critic: I’m your reminder to take care of everything. I’m afraid that you will stop listening someday…and then you’ll fail…which is why I am so loud. Criticized: I feel like you take my voice away. What is your intention? Critic: For you to know your own strengths. I don’t want you giving up—that’s why my voice is so strong! Criticized: Okay—I see your intention and that’s great but we need to work differently together. Angie shares that she did not know how much pain both parts carried and how each longed to be heard. She feels it will be easier to recognize the Critic and that she will have a stronger voice to ask the Critic to raise its concerns in a respectful way—allowing them to work as a team toward the same purpose. This new inner relationship is reflected in her second drawing, in which the two figures embrace on top of the table with the full sun shining above. EXAMPLE: JANET

Janet is a 32-year-old student who also discovers an inherent good intention of the Critic, once she is able to give voice to both parts of the interaction—the Critic and the Criticized. Janet describes the felt sense of the Critic as “…a heaviness in my chest with a swelling,” and the Criticized as “…a choking feeling in my throat. The handles/symbol for the Critic is a large ocean wave, and a tethered cow in a barnyard whose udders are uncomfortably bursting with milk.”

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While Focusing on a new relationship for the Critic and Criticized Parts, Janet receives an image as a handle for the felt sense—a traveling theater piece, “The Critic Show.” She creates a three-dimensional stage out of red construction paper, with a hanging yellow curtain from crepe paper. On the stage, Janet places a blue clay figure with a gold, shiny pipe cleaner (Figure 11.3).

Figure 11.3 Janet, Critic show

Janet receives further insight about each part through the Dialogue. Dialogue

Criticized: What’s your intention in being so critical? Criticized: I need to hold you back from going so fast. People won’t follow you and your ideas will be dismissed if we can’t communicate them. Criticized: What are you afraid of ?

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Critic: Interrupting people. We have been accused of being selfish and inconsiderate a lot. Criticized: What do you want for me? Critic: Don’t be so impulsive. It leads to regret. Dialogue with the Criticized: Critic: What do you want to say? Criticized: I feel so full like I’m bursting—like the udders on a cow that need to be milked. Strangled. Critic: What does it feel like to be criticized? Criticized: Disappointing. Like I’m a failure. Angry! Critic: What do you need? Criticized: To be angry. Impulsive. To move. Confidence. Critic: What’s a good small step in the right direction? Criticized: Acknowledging that the Critic is not the only part here—there’s a hurt part. And, it takes two lips to speak. Through Focusing, dialogue, and art, Janet discovers that she actually feels cared for and guarded over by the Critic, giving her a new respect for it. At the same time, a deep compassion arises for the Criticized Part. The image of the stage helps express and carry forward both parts which needs voice (two lips). During a show, both the audience and the performer are valued because they cannot exist without the other. Janet is able to honor the voice of the Critic giving it a venue to speak, while also giving herself permission to move past its opinion. She is also surprised to discover that the Criticized Part had so much anger. Janet provided a healthy outlet for the anger through the art: “If the show is really bad, I can throw rotten vegetables at it and tell it to roll on out of town!” Janet was delighted to have this new understanding and vision for a new relationship for the two parts. She shares: It brings me some comfort to know that the Critic Show is rambling around in the vast landscape of my unconscious waiting for the next “performance”—advanced reservations not required, general admission, bring your old, rotten vegetables just in case…as with any

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show, I can carry away its message or merely see it for its entertainment value.

Variation: This exercise can be done without the dialogue. The following questions can be added into the guided Focusing and the answers can be integrated in the artwork, bridging the felt sense expressions of the relationship between the Critic and Criticized Parts: “What’s in the way of the new relationship?” “What’s needed to achieve it?” “What’s a small step in the right direction?”

Reminders for working with the Critic 1.

Know that the Critic is an internalized voice that does not necessarily speak the truth.

2.

Find ways to separate from the Critic: Give it a “time out,” have it wait in the next room—whatever works to get some distance.

3.

Get to know the Critic. Become friendly to it. Ask it: “What is your intention?” “What are you afraid of ?” “What do you want for me?”

4.

Let the Critic know that you would like to find a more compassionate solution for its worry or concern.

Chapter 12

Bridging Cultures with Focusing-Oriented Art Therapy

This chapter highlights an introductory Focusing-Oriented Art Therapy workshop I presented at the 2005 Focusing International Conference in Toronto. When I started the workshop, I couldn’t help but notice that there were a greater number of Japanese Focusers in comparison to North Americans. I extended a warm welcome, followed by a Focusing Check-In in order to help everyone settle into their body, come into greater presence, and listen inside for what their wish or hope was for being in the workshop. As I guided the group, I heard a beautiful, soft, musical voice translating my words into Japanese. Mako, a Focusing Coordinator from Japan, was translating for the seven Japanese Focusers. As each woman in the group shared her name and wish, I noticed that the dimension of time seemed to elongate as we listened from English to Japanese, and Japanese to English. The group created an atmosphere of deep listening and acceptance, naturally reflecting qualities of the Focusing Attitude—“being friendly to” and “keeping company.” I became aware of the diverse needs of the group—to go slowly enough so that the Japanese women could take in what was being spoken, and fast enough to meet the needs of the North Americans, who were ready to dive into the content of the material. Abandoning my lengthy, planned introductory talk about art therapy, I spoke more about its essence and shifted the emphasis to the direct experience of art and Focusing.

Warm-up to the art materials To use art therapy with Focusing, it is essential to first have participants become familiar with various art materials and personally experience the 163

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language of art by getting a feel for the expressive potential of line, shape, color, and image. (See the exercise “Exploring lines, shapes, and colors” in Chapter 4.)

Figure 12.1 Art warm-up #1, felt sense

Figure 12.2 Art warm-up #2, felt sense

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After the warm-up, one participant describes her experience (Figure 12.1): “My felt sense chose the right materials and colors that it wanted. I understand how well I can express my felt sense through choosing art materials. The outcome makes me feel good and satisfied.” Another participant (Figure 12.2) says, “I am usually too self-conscious to make art but the ‘warm-up’ exercises helped to free me from that restraint. I really appreciated this exercise, which gave me many ways to express my felt senses.”

Conversation Drawing After I introduce an art therapy directive, “Conversation Drawing,” in which participants pair up and have a conversation through drawing (see Chapter 4), one of the Japanese Focusers asks with excitement, “You mean we don’t have to use words?” I responded, “That’s right, there’s no talking. Just have a conversation on one sheet of paper using line, shape, color, and/or image.” The participant says, “I’d like to work with someone who is not Japanese.” Others follow suit, forming dyads comprised of the two different cultures. As the group engages in their Conversation Drawings (Figure 12.3), I sense a quiet, deep connectedness unfolding. Typically, I have people talk about their experiences immediately following a “Conversation Drawing.” However, I wanted the group to learn how Focusing can be used to express their felt sense in art and also to see how a felt shift can be seen in visual art.

Figure 12.3 Ana and Takara’s Conversation Drawing

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Focusing: expressing the felt sense and felt shift in art I lead the group in a guided Focusing Check-In after engaging in the “Conversation Drawing”: “Take a few deep breaths into the body and notice how it feels inside being friendly to whatever you find. See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense.” The group is then encouraged to create the felt sense image [handle/symbol] through artmaking. After drawing the felt sense, I guide the group back inside to the body to Focus and notice how it was after drawing. I ask them to check to see if the felt sense was the same or if it had changed (a felt shift). After completing both drawings, the pairs are invited to talk about their experience. Suddenly the challenge of language returns, with some pairs requesting a translator and others struggling to speak to and understand each other. Each pair shares their art and the excitement they feel about how much fun the exercise had been—and how easy it is to feel a sense of empathic understanding and connection using art without words.

Example: Ana and Takara The example of Ana (North American) and Takara’s (Japanese) “Conversation Drawing” (Figure 12.3) shows the way in which art can bridge language differences and how the Focusing steps can be integrated into the artistic and group process. Ana describes the artmaking part of the Conversation Drawing: “One of us began with a red line, the other followed with blue. At first we were tentative, then it started to flow; and halfway through we became a coordinated team.” Takara adds, “She came close to my line, but she never invaded my line. The more lines I drew, the more free and playful I became. When I drew the yellow monster in the middle of the paper, our conversation became more playful.” Focusing to get a felt sense after the “Conversation Drawing,” Ana’s handle/symbol comes as a sound—joyous and content. Takara’s felt sense handle/symbol comes as an image—a red tulip with yellow stars (Figure 12.4). She shares, “The tulip and stars symbolize the fun and playfulness of the experience. The tails of falling stars express the coming of the fun and playful felt sense.” Checking the felt sense after drawing, she shares, “Something covered the brightness of the tulip and stars…so I colored all over the first drawing with a soft grey (Figure 12.5). I didn’t know what this ‘covering’ thing was. I just knew it dampened down the fun, playful, and enjoyable feeling.”

BRIDGING CULTURES

Figure 12.4 Takara’s felt sense

Figure 12.5 Takara’s felt shift

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Figure 12.6 Bridging cultures

During the large group sharing, I ask Takara if she would like to go back to the felt sense, keep it company [Focusing Attitude], and ask it a question. She says “yes.” Gently guiding her to be friendly to the felt sense, I invite her to listen to her inner felt sense and ask it, “What is this ‘covering’ thing?” [Asking.] After a few moments, she says, “It’s my loneliness…I had enjoyed the fullness of connection and now there’s a separation” (begins to release tears) [Receiving.] I say, “Can you ask the loneliness what it needs?” [Asking and receiving alternate.] Takara listens inside and shares, “It wants me to give the drawing to Anna. Then she can take it home and the connection will continue.” Warmth fills the room as Takara hands the drawing to Anna. The group was moved by the power of art to cultivate the immediacy of empathic connection beyond language and cultural differences, symbolize the felt sense, and unfold its wisdom. After the workshop, I invited the participants to share their experiences about the integration of Focusing and art. One participant wrote: “I wish peace will be achieved through the power of Focusing and art.” May this book encourage steps in that direction.

Reminders ·

Art is a universal language and transcends words.

·

The felt sense transcends culture.

·

Be sensitive to cultural differences regarding sharing, feelings, and attitudes about therapy.

Specialty Applications

Chapter 13

Health and Wellness: A Cancer Support Group

Focusing-Oriented Art Therapy provides profound ways for accessing healing imagery through the body, giving it visual form through art, and hearing its wisdom. Both Focusing and art therapy have been explored separately in the roles of promoting wellness and working with illness. Studies show that the first step of Focusing, “Clearing a Space,” promotes well-being through stress reduction, relaxation, and mobilization of the life-forward direction (Grindler Katonah 1999; Klagsbrun et al. 2005). The Focusing steps have been correlated with lower depression, improved body attitudes, and stress hardiness, as well as positive behavior change with people with cancer (Grindler Katonah and Flaxman 2003). The application of art therapy in the medical field continues to expand with its specialization, medical art therapy, along with the National Institutes of Health Office of Alternative Medicine declaring art therapy as a mind–body intervention (Malchiodi 1999). Focusing-Oriented Art Therapy offers opportunities for clients to have a positive relationship with the body and discover its resources, rather than experiencing it as merely illness or pain. The Focusing Attitude helps clients to “be friendly” to their illness instead of feeling aversion to it. Focusing’s Clearing a Space helps clients to gain distance from stressors in the body and access a place inside that is “All Fine,” or separate from illness or disease. The “All Fine Place” promotes a sense of well-being and enhances life-affirming energies. Later steps of Focusing (i.e. choosing something to work on, getting the felt sense, symbolizing the felt sense, asking and receiving) help clients to be in a relationship with the illness where physical, emotional, and

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spiritual needs can be heard, as the body clarifies meaning and unfolds its wisdom. Art therapy provides a means for concretizing, viewing, and working with the bodily felt sense. Visual expression of the felt sense of the illness incorporates colors, shapes, and imagery that stimulate life-enhancing properties. It is important to note that positive visualization and artmaking are not about “curing” an illness. In the early days of visualization, many patients believed that if they visualized the right imagery and practiced it enough they would cure their illness. While many practiced these methods, some people’s illnesses went into remission, others got sick, and some died. Too many people felt guilty—that they hadn’t visualized enough or they didn’t find the right image. It is important to understand that the benefits from imagery, visualization, and artmaking occur in many ways, not to be measured by cure. For example, healing occurs when working through denial, anger, grief, and loss due to the illness, becoming more accepting of the illness, cultivating greater peacefulness inside, and learning strategies for self-care. Outlined below is the application of Focusing-Oriented Art Therapy to a support group for people with cancer. Working with physical pain presents unique challenges, as sometimes when the person wants to Focus, all they can focus on is the pain. The Reminders section at the end of this chapter includes strategies for working with pain.

Cancer support group Walking into the Wellness Community, I was immediately struck by the larger-than-life photos of survivors of cancer—with their light-filled eyes and radiant faces. As I continued walking into the community room, the atmosphere of hope was palpable. The Theme-Directed Focusing-Oriented Art Therapy group was offered as a self-care mind/body tool for stress reduction, emotional healing, and psychosocial connection. The group was to meet over a four-week period for one hour and a half sessions. The format for the group is described, followed by an example of Cindy, a 64-year-old woman with colorectal cancer.

Group format Week I: Introductions and Clearing a Space (the first step of Focusing). Week II: Source of Strength.

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Week III: The Focusing Steps: Working on an Issue. Week IV: What I Want to Carry With Me. MATERIALS

Basket of assorted drawing materials: Nontoxic oil pastels, thin and thick colored markers, colored pencils, pens, glue sticks, and scissors. Journals: Each woman is given her own blank journal book during the first session. The journal is used to capture and record the felt sense through visual art imagery and any words that carry significance. It can be used weekly in the group and as a continuation beyond the completion of the group. CD player: A variety of soothing music is used during the guided Focusing and artmaking/journaling time. WEEK I: INTRODUCTIONS AND CLEARING A SPACE

Goals: To introduce the members to each other, promote safety; clarify the group’s purpose and goals; and teach “Clearing a Space,” the first step of Focusing, as a stress reduction tool. Introductions: To the group and to each other. Clearing a Space: The first step of Focusing in which the client sets aside issues and concerns that are in the way of feeling “All Fine.” Participants see if there is a symbol or handle that matches the inner felt sense. (See Chapters 2 and 7.) Art and journal: After the guided “Clearing a Space” exercise, group members are invited to use the journal and draw or write the symbol/handle for the “All Fine Place.” They can also free-write anything that came up for them during the Focusing process. Sharing: In small groups and the large group. Closure: Brief guided Focusing on what each member received and what she would like to carry with her into the week.

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WEEK II: SOURCE OF STRENGTH

Goals: To identify a source of strength that can be experienced internally for support needed to go through the physical, emotional, and spiritual challenges of living with cancer. Group format: Focusing Check-In: Guided Focusing to help members to become present, aware, and connected to their bodily felt sense: brief Clearing a Space (see Chapters 2 and 7). Check-In: Brief check-in where each person shares something significant from the Focusing Check-In.

Exercise 13.1 Source of strength Take a few deep breaths down into your body…breathing in…breathing out. Become aware of your body where it meets the chair, of your feet touching the floor. Feel how your body is supported. Whatever thoughts are on your mind, notice them and let them pass by like clouds in the sky. I’d like to invite you to become aware of something in your life that has been a source of strength. It may be a person in your life, something from nature, a spiritual source, or something else. Describe this source of strength to yourself… Turn your attention inside to your body and notice how it feels inside as you focus on this source of strength. (Pause.) See if there’s an image that matches or acts like a “handle” for the inner felt sense. (Pause.) Check it against your body for a sense of rightness. If it’s not right, let it go and invite a new image (or word, phrase, gesture, or sound) to come. (Pause.) When you’re ready, bring your attention to being in this room, stretch, and gently open your eyes. Using the art materials, create the image of your source of strength.

Art and journal: After the guided Focusing exercise, group members are invited to draw and/or write what was relevant to them during the guided Focusing. Sharing: In small groups and the large group.

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Closure: Brief guided Focusing on what each member received and what she wants to carry with her into the week. WEEK III: THE FOCUSING STEPS: WORKING ON AN ISSUE

Goals: To teach the group an entire Focusing round with an emphasis of learning how to work on an issue. Focusing Check-In: See week II. Check-In: See week II. Focusing Steps: Introduction and explanation of Gendlin’s six-step method of Focusing: 1.

Clearing a Space.

2.

Choosing an issue and felt sense.

3.

Symbol/handle (word, phrase, image, gesture, or sound).

4.

Resonating—checking for a sense of rightness.

5.

Asking—the felt sense questions.

6.

Receiving—what the felt sense answers.

Art and journal: See week II. Sharing: See week II. Closure: See week II. WEEK IV: WHAT I RECEIVED FROM THE GROUP/WHAT I WANT TO TAKE WITH ME.

Goals: To solidify the learning throughout the group; to identify self-care tools to practice after the group’s ending; to appreciate the group members; to have a healthy sense of closure. Focusing Check-In: See week II. Check-In: See week II.

Exercise 13.2 What I want to carry with me Take a few deep breaths inside to your body. Feel the support of the chair, the earth, the sky. Breathing in…breathing out… Take a friendly attitude toward how you are right now… Take a

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moment to check inside, asking, “How am I right now?” See if there’s a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense. Check it for a sense of rightness. Now we’re going to go back in time and recall some of your experiences in this group… Remember when you first decided to take this group… Bring to your awareness what drew you here…and what you were looking for. Now remember some of your experiences…learning the “Clearing a Space” exercise, Focusing on a source of strength, learning the Focusing steps for working on an issue… Remember your sharing with one another. What stands out as highlights? Sense in your body how that feels… Ask inside, “What do I want to take with me after this group, into my life?” Just listen…and wait. (Pause.) What’s the whole feel in your body of what you want to take with you? See if there’s an image (or words, or a gesture, or sound) of the felt sense of what you’d like to carry with you… Check it against your body for a sense of rightness. If it’s not right, let it go and invite a new image (or word, phrase, gesture, or sound) to come. (Pause.) When you’re ready, bring your attention to being in this room, stretch, and gently open your eyes… Use the art materials to create the image of what you wish to take with you from the group into your life.

Art and journal: See week II. Sharing: See week II. Appreciations: Journal books are passed around the circle and each woman writes an appreciation of the group member. Closure: Brief guided Focusing on taking in the whole of the group, awareness of it being the last meeting, and finding a symbol/handle (word, phrase, image, gesture, or sound) that matches the inner felt sense of the experience.

Example: Cindy SESSION I

Cindy is a 64-year-old woman who was diagnosed with colorectal cancer. She is a vibrant, intelligent woman who has enjoyed a professional career in

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teaching. During the group introductions, Cindy states that she lives with chronic and constant pain throughout most of her body and that she is hoping to find some tools for relief. After the “Clearing a Space” exercise of the first group, Cindy shares with a partner and then the larger group: Cindy: (Holding up her journal, pointing to the images, Figure 13.1) This is a comfortable rug, a healing plant, and a light at the top of the page. The drawing conveys a sense of order, an absence of clutter, and it brings a peaceful feeling. I was able to set my “To Do” list to the side and after a brief period of time experience what I call “a total sense of relaxation.” The pain had subsided for a while. It felt wonderful.

Figure 13.1 Cindy, Clearing a Space

Cindy felt relieved to be able to experience a freedom from the pain. Cindy added the following words in her journal: “A sense of peace, stillness, floating—a time out of pain—an experience oblivious to time, sight, sound; it was wonderful.” Malchiodi (1999) describes this type of freedom from pain as a way to use art expression for transformation and transcendence. Cindy is able to use the Focusing exercise “Clearing a Space” to momentarily transcend the pain. The visual art documents the experience and serves as a reminder of the relief.

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SESSION II

During the check-in, Cindy expresses her happiness to leave her work environment to come to the Wellness Community and attend the Focusing group. In response to the guided Focusing on a Source of Strength, Cindy shares with a partner and then with the group. Holding up her journal, the group sees a small green circular shape with rays reflecting a larger green shape, colored in with a thinly pointed magic marker. Stemming from the rays are the written words, “creativity, happiness, and energy” (Figure 13.2). Describing the drawing and the experience, Cindy shares: I remembered a French film about the magical effects of a green moon. I don’t remember the details of the film, but there was a magical quality of the green moon and it had an incredible beauty. I felt the strength and magic of the green moon, taking in its energy of creativity, happiness and energy. The experience was extraordinary, as I could feel the magical energy from the green moon pouring out into my body.

Figure 13.2 Cindy, source of strength

Again, Cindy experienced freedom and transcendence from the chronic pain for a period of time. To support the members in carrying Focusing and art into their daily lives outside of the group, I offered each of the women a CD containing the

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Focusing exercise, “Clearing a Space.” Cindy appreciated the gesture but said she did not have a CD player to listen to it on. We spoke about other ways to practice it outside the group, including remembering how to do the exercise by looking in the journal, or having a Focusing partner. SESSION III

During the check-in Cindy shares that she went to a yard sale and saw a CD player for sale. She was delighted, bought it, and then asked if I still had the Focusing CD that I had brought in last week, expressing her desire for it now that she could play it. I had it with me because I held the possibility that somehow Cindy might figure out a way to have it since the Focusing exercises were giving her so much relief. The third session’s goal was to teach the group an entire Focusing round, including Clearing a Space and choosing an issue to work on. During this session, Cindy expresses the Focusing process through writing in her journal, instead of visual imagery. It is important for the therapist to suspend judgment about whether the felt sense symbol comes in an image or words (or gesture or sound). Focusing-Oriented Art therapy trusts the language of the body. During this session, Cindy’s felt sense speaks through words: 1.

Clearing a Space: I set aside my To Do List and all of the physical pain.

2.

Choose something to work on: The pain and discomfort in my body.

3.

Felt sense: Pain everywhere.

4.

Resonating: I didn’t want to stay too long with the pain since I have it all the time.

5.

Asking (the felt sense questions): Imagine what it would look like and feel like in your body if this issue were all resolved.

6.

Receiving (there is an alternation between asking and receiving): Cindy: Both mind and body would agree with each other—both have forgotten. It would feel like full energy. ·

What’s in the way? Continued discomfort and fear.

·

What’s needed? Staying in bed more of the time or resting in an easy chair.

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What’s a good small step in the right direction? Activity interspersed with periods of rest. I’m going to give myself permission to rest in bed and in the easy chair.

Cindy was able to work on the issue of the chronic pain and discomfort in her body. Focusing allows a way of sensing in the body while at the same time having an inner witness of the experience. The previous sessions where Cindy learned to set the pain to the side through “Clearing a Space,” as well as connecting with a source of strength, helped Cindy to be able to get some distance or freedom from the pain. With the right distance, Cindy was able to look at the pain, rather than be overwhelmed by it. As Cindy befriended the pain, she was able to listen to what it had to say. The felt sense let her know that what was needed was increased rest in bed and in the easy chair. The Focusing process includes a concrete step for change that comes from the bodily felt sense. In response to the question for a small step towards what’s needed, the felt sense answered, telling Cindy, “activity interspersed with rest.” As the answer arises from within, it is accompanied with an inner knowing. The bodily sense of rightness led Cindy to give herself the inner permission to have more rest alternating with activity. This inner permission is a radical change from her previous conditioned way of living, feeling pressured to complete all of her “To Do” lists, and be an active, productive, “doing” member of society. SESSION IV

The last session addresses the theme “What I received from the group/what I want to take with me.” Cindy draws in her journal (Figure 13.3) and shares: This is what I’d like to carry with me. I drew my “To Do” list, books to read, my work table, and the Sony CD player. I crossed out the “To Do” list, the bookcase, and work table as a way to clear my space. I drew my easychair to rest on while I listen to the CD player. This is my “Safe Place” which I’m taking with me.

I was moved to see the integration of the four weeks’ work in Cindy’s art showing the “Clearing a Space” from the first session (evidenced by her crossing out of things), the easychair for greater relaxation from the third session, and the Sony Walkman that could help transport her to the “Safe Place” experienced in the first session’s relief from the pain and the second session’s magic energy from the green moon.

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Figure 13.3 Cindy, what I want to carry with me

Focusing enabled Cindy to find a positive experience of her body in the midst of chronic pain. Art therapy helped to deepen the experience and served as a reminder and living memory of how to achieve moments of freedom from pain. Another group member I interviewed summed up the power of Focusing-Oriented Art Therapy: “The other powerful thing about the art is—if you draw it and see it—you can bring back the feelings with the Focusing—and carry it with you.”

Wellness strategies for pain management The experience of physical pain can interfere with one’s ability to function optimally, impacting mobility, concentration, and mood, and leading to questions about life’s purpose (why me?). While Focusing-Oriented Art Therapy makes no claims for healing pain, it offers wellness strategies for coping, finding meaning, and changing the relationship to the pain—giving a client a sense of empowerment rather than feeling totally victimized by the pain. In Focusing-Oriented Art Therapy, strategies for working with pain incorporate the Focusing Attitude, Clearing a Space with Art, and Working with the Felt Sense of the Pain.

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The Focusing Attitude and keeping it company The first step in working with pain is to bring an attitude of friendliness to the pain and say hello to it. Instead of feeling in conflict or at war with the pain, the Focusing Attitude can help one come into increased inner care and compassion. For example, you might say to a client, who is experiencing back pain: “Can you imagine sitting down right next to the pain…keeping it company… See if you can be friendly to it…say hello…yes, I know you’re there.”

Clearing a Space with Art: getting distance from the pain Clearing a Space with Art can be a useful method for getting a sense of separation or distance from pain. Art therapy helps to hold the pain at a distance by using art materials to concretize setting the pain outside the body, and accessing an inner experience that is free from the pain (the “All Fine Place”). See Chapter 7 for guided instructions.

Working with the felt sense of the pain There are times when it is impossible to Clear a Space of the pain—it simply won’t let you set it at a distance. The pain essentially says, “The only thing you can focus on is me.” Integrating the Focusing Attitude, felt sense, and Asking and Receiving steps of Focusing can help to find more of a healing relationship with the pain. FELT SENSE OF THE PAIN

Once the Focusing Attitude is brought to the pain, the therapist guides the client to get a felt sense of the pain. Getting a felt sense of the pain involves two steps: mindful awareness of the pain and getting a felt sense of the pain in the core of the body. Mindful awareness of the pain

This step involves bringing mindful awareness to the location of the pain in the body: “Take a few deep breaths down inside to your body, being friendly to whatever you find. Notice where the pain is inside your body… See if there’s an image (or word, phrase, gesture, or sound) that acts like a handle for the inner felt sense.”

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Felt sense in the core of the body

This step entails getting a sense of what the whole feel of the pain is—not just getting the felt sense of the pain in its specific location in the body, but getting the whole feel of the pain in the core of the body—typically somewhere inside the body between the shoulders and hips: “Take the pain (e.g. in your back, head, etc.) and sense the whole feel of it. Take it down to the inner core of your body, somewhere to the inside space between your shoulders and hips, and ask, ‘What’s the whole feel of this ____ (e.g. back, head, etc.) pain?’” HANDLE/SYMBOL

The therapist guides the client to see if there’s an image that matches the felt sense of the pain. RESONATING AND ARTISTIC EXPRESSION

The client checks for a sense of rightness. When the client has the felt sense image, they express it in art. DIALOGUE USING FOCUSING AND ART: LISTENING TO THE PAIN

Listening to the pain can provide a doorway to hear the body’s messages for self-care, body–mind connection, insight, and meaning. Incorporating the Asking and Receiving steps, the client listens to what the felt sense of the pain has to say. Questions are posed, such as: Imagine it all healed—being completely free of pain. What’s in the way? What’s needed? What’s a small step in the right direction? The answers are expressed artistically and may incorporate dialogue methods from art therapy (e.g. McNiff 1992; Rogers 1993).

Example: Kerri Kerri is a 32-year-old woman who came to see me for individual art therapy. Her presenting issues were that she wanted to find healthy coping strategies for managing chronic pain and also to move forward with career and relationship goals. THE FOCUSING ATTITUDE

After discussing Kerri’s history, goals, and agreed-on treatment strategies, I guide Kerri in Focusing to first develop a friendly attitude toward the pain and keep it company.

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MINDFULNESS AWARENESS OF THE PAIN

I then guide Kerri to become mindful of the pain—to notice where it is in her body and to see if there’s an image that matches the felt sense. Kerri closes her eyes, sensing inwardly. After a few moments, she opens her eyes, picks up a brown colored pencil and draws a line to create the lower portion of a face and neck, extending outward towards the shoulders. Kerri colors both sides of the neck with black and red cross strokes (Figure 13.4). On the outside of the neck, she draws two blue columns that seem like a structure holding up the neck.

Figure 13.4 Mindful awareness of pain

Kerri shares, “This is the image of the pain in my neck. It especially hurts on the inside of my neck and it feels as if there is a vice grip holding it in place.” (I reflect back the pain from Kerri’s words and art.)

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FELT SENSE IN THE CORE OF THE BODY

Next, I invite Kerri to sense the whole feel of the pain in her neck by taking it down to the core of her body—somewhere on the inside of the torso between the shoulders and hips. Kerri listens inwardly, and then draws a radiating yellow and orange flame arising from two wooden sticks, with a red, jagged shape around it (Figure 13.5). Kerry shares, “I felt this burning anger inside my chest—it’s my anger about this pain.”

Figure 13.5 Felt sense in core of the body

DIALOGUE USING FOCUSING AND ART

We go back and forth, alternating Asking and Receiving steps with artmaking: Therapist: Imagine what it would look like and feel like all healed.

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Figure 13.6 Felt shift, envisioning pain all healed

Kerri: (After a few moments of Focusing, Kerri opens her eyes and draws a face colored in yellow with three green figures dancing across the neck and shoulder area, Figure 13.6). Kerri shares, “My whole neck, face, and shoulder area feel light and free.” I invite Kerri to Focus again and ask, “What’s in the way of having this [health in the neck]?” After a few moments, Kerri continues, “I was never allowed to say how I really felt growing up. I see myself as a child always pretending to be okay. That’s why the first image is so empty. In the second image, I’m alive and free. I’m at home in myself.” We continue with using Focusing to ask what’s needed and what’s a small step in the right direction? Kerri receives the message from her body to be friendly to the pain, spend time each day relaxing and envisioning the pain all healed, and to be accepting to whatever feelings are there. In the case example of Kerri, Focusing is incorporated to help Kerri work with the physical pain by becoming friendly to it, rather than being overwhelmed or overcome by it. Getting the whole feel of the neck pain in the inner center of her body helps Kerri to access the felt meaning of the pain,

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express it in art, and then to have a felt vision of it all healed. By incorporating Focusing Asking and Receiving steps along with art therapy dialogue methods, Kerri gains insight into her childhood feelings of not having a voice. Several felt shifts are also seen in the art: from the depiction of the tight, held-in pain in the neck (Figure 13.4), to yellow and orange burning flame of anger (Figure 13.5), to the face alive with light and dancing figures around the neck (Figure 13.6). By being friendly and listening to the pain, Kerri also discovers the need to honor feelings and voice—which will help her to move forward aligning career choices with her authentic self.

Reminders for working with health ·

Be sure the client receives necessary medical attention.

·

Focusing-Oriented Art Therapy is beneficial for stress reduction, relaxation, mind–body–spirit connection, and insight.

·

Envisioning the body/mind “all healed” helps to mobilize the body’s life-affirming energies and access the body’s knowing of steps to take toward wellness. (This approach does not make claims for cure but rather helps to hear one’s needs for self-care.)

·

Bringing the Focusing Attitude to illness or pain can help to change the client’s relationship to it.

·

Clearing a Space with Art can be helpful for creating some distance from illness or pain. You can also suggest that clients imagine “taking a step back” to see if they can get a little space from it.

·

See if the pain has a message or lesson to offer: mindfulness awareness of the pain/art; get a felt sense of the pain in the core of the body/art; dialogue using “Asking” and “Receiving” steps of Focusing and/or art therapy dialogue methods.

Chapter 14

Working with Trauma

Focusing and art therapy are both tools and processes that have been used in the treatment of trauma (Armstrong 1998; Hagood 2000; Johnson 1987; Malchiodi 1997; Turcotte 2003). Both Focusing and art therapy offer ways of listening, honoring, and expressing the authentic self within that help empower the client to be the “author of her own recovery” (Herman 1992). Focusing teaches clients how to cultivate a safe connection with the body, bring an attitude of friendliness towards inner experience, and access a witness part of self that can listen even to disturbing aspects of a traumatic experience. Focusing also helps clients to separate the traumatic experience from their authentic, innocent self. Art therapy provides materials and creative expression that serve as a container to hold traumatic memories and feelings, offering cathartic release and infusing the client with life-affirming energy. Judith Herman’s (1992) three stage model of recovery—establishing safety, remembrance and mourning, and reconnection with ordinary life—serves as a useful framework for the application of Focusing-Oriented Art Therapy with trauma. It is important to note that while the model is sequential, the process of working through trauma issues is more complex—where the stages may overlap one another, or a later stage may revert back to an earlier stage, or issues addressed earlier may resurface at a later stage, and so forth.

Stage I: Establishing safety The first step of working with clients with trauma is to assess their level of safety to experience affect, and to connect and sense the body inwardly. Often in the early stages of recovery, clients with traumatic stress are overwhelmed or flooded with memories, feelings, and thoughts about the expe188

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rience. Since experience is stored in the body, it is important to go slowly, making sure the client first feels grounded and safe in the body before asking a client to Focus.

Establishing safety with the body and feeling 1.

Emotional, psychological and physical sense of safety: Priority is given to safety on all levels before implementing any methods or techniques.

2.

Listen with openness and nonjudgment: Hear what the client is sharing as it truly is—from their experience.

3.

Grounding: Prior to incorporating Focusing, it is important to know that the client is grounded and connected to the body in a safe way. Useful exercises include: Mindful breathing: Be aware of your breath coming into your body and moving out. Body awareness: Feel your feet on the floor; contact points between body and chair; shoulders, arms, hands, head, and neck. Safety phrases: Breathing in, I feel safe; Breathing out, I feel calm.

4.

Personal space and boundaries: Encourage the client to attend to their physical, energetic, and emotional needs for boundaries, such as setting the right physical distance for sitting (e.g. between therapist and client, members of a group, couple, or family). Let the client know that it is important to feel empowered to choose whether or not to participate in experiential parts of the session.

5.

Eyes open or closed: Be sure to let clients know that they can Focus with their eyes open or closed—whichever is most comfortable. If clients choose to close their eyes, let them know they can open them at any time (they do not need to wait until you suggest opening them). Often, clients with trauma need to be able to see what is happening around themselves in order to feel safe, as many experience a hyper-vigilance of watching in order to feel safe.

6.

Artmaking: Create safety by cultivating an atmosphere of nonjudgment; demonstrate, if necessary, how art can be used to express feelings using colors, shape, texture, and choice of materials. Use materials that are safe for the clinical population (e.g. do not use sharp tools with clients who are self-harming or suicidal).

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Stage II: Remembrance and mourning Once the client feels safe and can connect with the body and felt sense, the client may be ready to begin working through the traumatic experience. As Bessel Van der Kolk (as cited in Ogden 2006), a leading expert in the field of trauma, states: Traumatized individuals, first and foremost, need to learn that it is safe to have feelings and sensations… In order to deal with the past, traumatized people need to activate their prefrontal cortex, their capacity for introspection. Therapy needs to help them develop a curiosity about their internal experience. This curiosity is essential to learning to identify their physical sensations and to translate their emotions and sensations into communicable language—communicable mostly to themselves. (xxvi)

During this second phase, Focusing provides the means for friendly curiosity, identifying and keeping company with inner sensation, while art therapy provides a creative vehicle for nonverbal and verbal communication. The Asking and Receiving steps of Focusing, combined with art therapy, provide a safe means for introspection. Focusing-Oriented Art Therapy helps clients to:

Separate the trauma from the person: the right distance Both Focusing and art therapy provide ways to get a healthy distance from the trauma in order to be able to work on it without being overwhelmed or flooded by the experience. Focusing teaches how to “Clear a Space” and set “issues” at a comfortable distance. Clients experience an aspect of self, an “I” that can stand outside of the trauma in order to be present to work on it. Art therapy provides materials to contain the emotional experience and externalize it into the art process.

Keep it company Focusing incorporates the Focusing Attitude which helps clients learn how to sit down next to the wounded parts affected by the trauma and listen to them with friendliness or compassion.

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Bear witness Since trauma is often accompanied by shame, it is often deeply healing for the client to experience the compassionate witnessing that comes from an inner experience of the Focusing Attitude, as well as from the external witnessing of the therapist.

Catharsis Strong feelings and the felt sense from trauma can be sublimated and released in a safe, cathartic way through artmaking. A therapist, who is also a survivor, shares: …art is a great container for difficult feelings, especially difficult feelings, volatile feelings like anger and rage… With art I could really be with my rage—destroy the paper, rip the paper, poke the paper… I could be as destructive as I wanted to be in a safe way. (Rappaport 1998, p.40)

Life-forward direction Focusing and art therapy harness the body’s wisdom and creative intelligence that carry one in a life-forward direction. Focusing incorporates forward-moving questions, such as “What’s needed for a healing?” or “What’s a good small step in the right direction?” Art therapy accesses life-affirming properties that transport one toward growth and healing.

Stage III: Reconnection with ordinary life The third stage of healing is characterized by helping clients to distinguish the past from the present, pursue their goals, wishes, and dreams, enter into meaningful relationships, and practice self-care.

Example: Alissa Alissa is a 39-year-old woman who came to see me for art psychotherapy. Several years earlier, Alissa remembered that she had been sexually abused as a child. Alissa had already done some work on the abuse and wanted to find some new ways, beyond talking, to heal from the trauma. I explained both Focusing and art therapy to Alissa and she was interested in using them as approaches in therapy.

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STAGE I: CREATING SAFETY

Our initial session begins with clarifying Alissa’s goals for therapy, a discussion of how art therapy and Focusing can be used to meet her goals, and reviewing her history. During the third session, Alissa speaks about how if overwhelmed or lost she can get in a dreadful fear. I tell her that it can be helpful to have an image of a “Protector” that can be created in art. Most trauma survivors feel there was a lack of protection which contributed to the experience of trauma. I ask Alissa to check inside (her felt sense) and see if finding a “Protector” is something that seems right for her to do. After a brief moment, Alissa says “yes.” Alissa feels comfortable closing her eyes as I guide her in a Focusing exercise (Exercise 14.1) to access a felt sense of a “Protector.”

Exercise 14.1 Protector Take a few deep breaths into your body. Feel the support of the chair that you’re sitting on and the earth beneath your feet [Grounding]. Let yourself hear the word “protector,” and imagine someone or something that you know, or that you make up in your imagination, that can be a protector for you. You can let me know when you have it. (Pause.) Describe the image of that protector to yourself. Sense what that feels like inside your body… What’s the whole feel of it? See if there is an image that matches or acts like a “handle” for the protector… Check inside your body whether the image feels right… When you’re ready, use the art materials to create the image of the protector.

I stay quiet and calm accompanying Alissa silently while she listens inwardly. Opening her eyes, Alissa draws an outline of an angel with a smiling face, a heart outlined in red and colored in with a yellow oil pastel (Figure 14.1). Alissa shares, “I saw the image of an angel. She looks like a guardian angel for children.” After processing the art, I invite Alissa to check back in with the felt sense. I ask, “How does it feel on the inside to find her?” Alissa shares, “I like seeing the image. It’s comforting…and warm inside.” I keep the drawing in my office and set it out each week before Alissa comes for therapy, to greet her as a symbol of safety. The art serves as a consistent reminder—that this image of “the Protector” is an internalized part of herself that she is getting to know and deepening her connection with.

WORKING WITH TRAUMA

Figure 14.1 Alissa, protector

Figure 14.2 Alissa, felt sense, sad

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STAGE II: REMEMBRANCE AND MOURNING

Addressing Alissa’s family-of-origin dynamics, Alissa talks about growing up in her family and feeling alone and neglected. As I listen, I notice Alissa’s face become more flushed with increased tension. This is a place in the therapeutic encounter where the client is at the edge of something, not yet known. Taking a moment to Focus can help the client to sense more about it and hear what the body is trying to transport into awareness. I invite Alissa to take a moment and Focus: “Can you take a moment to see what’s there—in your body right now as you are speaking about it?” Alissa reaches for the oil pastels in front of her and draws a young figure with thin squiggly lines for arms and legs. The figure does not have feet and is floating above red lines, depicting a shaky ground. Blue tears are falling down the figure’s face (Figure 14.2). Alissa’s shares, “This is how I felt as a child—alone, sad, and vulnerable.” I reflect back the sadness and the vulnerability of the child within her, and in the art. To keep the felt sense company and help it to unfold, I incorporate the “Asking” and “Receiving” steps of Focusing: Therapist: Imagine sitting down next to the younger sad and shaky Alissa…see if you can be friendly to her [Focusing Attitude], and ask, “Where do the tears come from?” [Asking] Alissa: (Tears flow and move into deep sobs. I keep Alissa company, allowing a safe space for the pain to get released into. The crying stops after a few moments.) I was innocent. No one saw me or protected me. I was invisible. Therapist: There’s a deep sadness about your innocence, not being seen and protected…and being invisible [experiential reflection]. Alissa: (Breathes softer, muscles relax, face softens) Yes. I just feel for that part me. Therapist: You feel for what happened to the child part of you. Can you ask that child part what she needs? [Asking] Alissa: (After a few moments) When I look at the drawing…it’s like I had no idea she was in there. Being seen, heard, and accepted is all she needs. And to know, “it will all be okay.” [Receiving] Therapist: The adult you and I can hear her and let her know, “it will all be okay.” In a later session during this phase, Alissa begins to describe the anger that she feels about the abuse. I invite her to Focus: “Take a few deep breaths into your

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body, feeling the support of the chair and floor. Notice how the anger feels inside… See if there’s an image that matches the felt sense.” Alissa draws a picture of a face and upper torso with two outstretched fists. The eyes are open, yet empty; the mouth is jagged, the hair and fists are radiating with strong energy, in heavy black and red oil pastel (Figure 14.3).

Figure 14.3 Alissa, felt sense, rage

Alissa shares, “This is my RAGE! It’s been there for SO LONG!” I reflect back the rage I hear from her words and in the art. To help integrate the intensity of the experience and to help Alissa become grounded before leaving the session, I invite her to do a Focusing Check-In, and ask, “How am I inside now?” After a few moments, she opens her eyes and says, “Good! I feel strong!” STAGE III: RECONNECTION WITH ORDINARY LIFE

Alissa begins to feel a safer connection within herself and with others. The focus of her work moves from resolving childhood trauma to current issues. During one session, Alissa shares about the dysfunction in her work environ-

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ment. I invite her to Focus and to get a felt sense. Alissa feels a tightness in her stomach that feels held in and raging. Using a black oil pastel, she begins at the bottom of the paper, drawing something that looks like a fire pit (Figure 14.4).

Figure 14.4 Alissa, felt sense, transforming anger

Working intensely, Alissa outlines a shape that appears like mountains, coloring them in heavy red, and then layering yellow onto parts of it. As she draws, I observe her skin tone changing along with her body and face relaxing. After completing the drawing, I hold it up for her to look at. Alissa says, “I had no idea all of that anger was in there. It all got released…and I like what it turned into [the aesthetic].” Here we see the power of art to safely release and transform anger. We worked together for a couple of years, working further through the traumatic experience, the after-effects of depression, fear, and anxiety, while always building on strengths and resilience. During the last phase of therapy, Alissa changed her career to one that was more attuned to her authentic self, traveled, and was part of several supportive communities.

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As we begin to process termination of the therapy, taking in where she was when we started and where she is now, I invite Alissa to Focus inwardly to get a felt sense. Alissa opens her eyes, reaches for an oil pastel, and begins drawing a tree. She starts with wide roots and a groundline, extending into the sky—bursting with open, graceful, bright green, purple, and pink leaves extending upwards. Alissa shares that she feels she is beginning to live, feeling rooted in the earth, with nourishing elements around her to help her open and grow. I invite her to Focus again, to notice how it feels in her body, and to see if there’s a word or phrase that matches the felt sense and that may be a title for it. After a few moments, Alissa opens her eyes, picks up a green oil pastel, and writes, “LIFE” (Figure 14.5).

Figure 14.5 Alissa, felt sense, Life.

Focusing-Oriented Art Therapy helped Alissa to begin with a sense of safety within herself, and in the therapeutic relationship, by bringing the Focusing Attitude of being friendly toward the complexity of experience from childhood sexual abuse. The art provided a safe container to hold the rage, anger, sadness, and grief—while the Asking and Receiving steps of Focusing provided gentle access to the vulnerable parts of self in need of being heard.

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Focusing-Oriented Art Therapy provided an avenue to release the trauma on a sensory level while strengthening the witness and other parts of self that could stand outside of the trauma. The many felt shifts are evident in the changes seen in Alissa’s art from the tentative lines and images of fear to the bold lines and colors of anger, unfolding into images of strength, aliveness, and beauty. As Alissa worked on the post-traumatic stress from her past, she continuously harnessed the Life-Forward Direction—thereby creating inner and outer changes while embracing “Life.”

Reminders and suggestions ·

Safety comes absolutely first—before any methods, interventions, Focusing, or art. Establish safety within the therapeutic relationship, within the clients’ connection with themselves, their body, and inner experience, and in a group context.

·

Grounding: assess and teach ways to help the client to feel grounded, such as through mindful breathing, safety phrases, body awareness of the feet on the floor, etc.

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Listening is a key intervention—to truly understand and hold the client’s experience.

Chapter 15

Spirituality and Psychotherapy

Spirituality in the context of Focusing-Oriented Art Therapy refers to universal transpersonal qualities—including compassion, peace, loving-kindness, hope, light, generosity, wisdom, and transcendence—and to the spirit that lives in all living and nonliving things. It is not defined by religious belief or tradition. When I was on staff at a retreat center, we talked about psychology and spirituality as the two wings human beings need in order to fly. Psychology offers understanding and insight into our individual nature—our self concept, emotions, defense mechanisms, family and social influences, strengths, and talents—and an array of methods to work through obstacles to our optimal way of being. Spirituality provides a doorway into other recesses of our transcendent nature, and helps us develop greater mindfulness, compassion, and peacefulness. Both Focusing and artmaking access what I call spiritual energies.

Spiritual dimensions of Focusing and art therapy Spirituality has been explored both in Focusing (Amodeo 1981; Campbell and McMahon 1985/1997; Chutroo 2003; Hinterkopf 1998; Milgram 2003; Rome 2004; Saunders 2003) and art therapy (Allen 2005; Farrelly-Hanson 2001; Franklin 2001; Horovitz 2002). A discussion of the various approaches developed for integrating spirituality into these two fields lies beyond the scope of this book. I would, however, like to share with you, from my own experience and witnessing of others, how Focusing and art therapy naturally facilitate an opening to the spiritual dimension of life. The Focusing Attitude—being friendly, accepting, and keeping company—are truly the qualities of an open heart. Practiced over time, the Focusing Attitude transforms one’s relationship with oneself, others, and life 199

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itself. Initially, it takes many reminders to call on the assistance of the Focusing Attitude to change habitually negative, unaccepting, and judgmental self-talk. Often, being friendly to difficult, painful, and complicated experiences initially starts off with effort and later eases into a welcoming space of greater inner equanimity. Learning how to keep company leads to a quality of presence that helps to bring greater compassion toward the self, others, and the world. Focusing cultivates unconditional presence—leading one to honor even the most difficult felt senses as gifts supporting the life-forward direction. Clearing a Space is a simple yet profound practice—by setting issues at a distance, the “All Fine Place” inherent in everyone is revealed. To me, this “All Fine Place” opens the door to the space that spiritual traditions refer to through different names—e.g., Consciousness, the Self, Awareness, etc. One of my favorite exercises is guiding people in Clearing a Space and symbolizing the “All Fine Place” in art. Most often the images are of tranquility, peace, wholeness, and light. Artists, art therapists, students in the field, and art-therapy clients know from experience that the process of creating is inherently whole and life-affirming, even when expressing pain, terror, shame, and other difficult feelings. While creating, we access an “inner creator,” naturally connecting us with life’s primordial energy, drawing forth life-enhancing or “spiritual” properties.

Spirituality in Focusing-Oriented Art Therapy Focusing-Oriented Art Therapy is a useful method to explore spirituality. It helps to concretize an elusive domain of experience that is often difficult to describe. Through Focusing, spirituality is experienced in the felt sense of the body while art gives it an outer form through color, shape, light, and image. Each of the three main approaches of Focusing-Oriented Art Therapy offers methods for integrating spirituality.

Clearing a Space with Art Expressing the “All Fine Place” in art (see Chapter 7) helps to access the experience of spiritual qualities—such as compassion, inner peace, and tranquility. It also provides a helpful entry into meditation.

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Focusing-Oriented Art Psychotherapy Spirituality can be interwoven into psychotherapy in a direct way when a client has interest, and a therapist has expertise, in the subject. To find out if a client has interest or experience in spirituality, I include questions on my intake form that address the client’s sources of support, such as friends, family, religion, spirituality, and so forth. I also include questions about self-care, including exercise, nutrition, and other wellness practices. The intake questionnaire gives me an approximate sense of a client’s level of interest in spirituality, and from there I follow the client’s clues and my own intuition about if, when, and how to talk about spirituality and integrate spiritual approaches into our work together. In Focusing-Oriented Art Psychotherapy, spirituality can be integrated in a variety of ways, including Clearing a Space with Art, practicing meditation and other spiritual practices, discussing the role of faith, and exploring religious and spiritual sources of support. It is essential that the therapist be sensitive to clients’ personal religious and spiritual preferences and monitor countertransference. The following case example of Patricia demonstrates an integration of psychology and spirituality within a Focusing-Oriented Art Psychotherapy context. EXAMPLE: PATRICIA

Patricia, a 52-year-old woman, came to see me for individual art psychotherapy to address presenting issues of depression and post-traumatic stress disorder. Our work correlated with Judith Herman’s (1992) three-stage trauma recovery model (discussed in Chapter 14)—establishing safety, remembrance and mourning, and reconnection with ordinary life. The case of Patricia demonstrates how spiritual dimensions of Focusing and art therapy are implied in the first two phases of the therapy (drawing forth life-affirming energies that have a spiritual quality to them) and addressed directly in the later phase. During the first year of therapy, our sessions typically began with a Focusing Check-In, expressing the felt sense in art, Focusing to envision the desired change, and creating art again. After establishing that Patricia felt safe to close her eyes, I guide her in a Focusing Check-In: “Take a few deep breaths down inside to your body…being friendly to what you find. Ask, ‘How am I on the inside right now?’… See if there’s an image (or word,

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phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense.” During one session, Patricia checks the image (handle/symbol) for a sense of rightness, opens her eyes, and draws black, harsh, jagged, scratchy lines in a hexagonal shape with red barbed wire looking lines around it. In the lower right hand corner, inside the hexagon, she draws a tiny circular shape outlined in pink, colored in purple (Figure 15.1).

Figure 15.1 Patricia, felt sense of how I am now

Patricia shares, “This little part is me surrounded by all this fear and pain.” After reflecting back both the fear and pain that Patricia expresses through her words and art, I suggest the “Asking” step of Focusing: “Take a few deep breaths… Imagine what it would look like or feel like in your body to have the sense of safety that you would like to have.” Patricia senses inwardly for a few moments and then draws an amoeba shape, colors it in with a purple marker surrounding it with yellow (Figure 15.2). Patricia’s body and face soften. She shares, “I feel this expansion—I can take up space and there’s this protective light around me.” The tiny pink and purple shape representing Patricia in the first drawing (Figure 15.1) expands and fills the whole page and is surrounded by light.

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Figure 15.2 Patricia, imagining felt sense of self safe

This method of beginning with a Felt Sense Check-In, symbolizing the handle/symbol in art, getting a felt sense of it all healed, and expressing the new handle/symbol in art provides a means for Patricia to safely release the cathartic memories and expand the direction towards light [life-forward direction]. It is not that Patricia is completely “all healed,” or “all safe” as depicted in Figure 15.2. Focusing on the felt sense of safety as she would like it to be, and drawing it, help Patricia to have a felt experience outside of the trauma while accessing the life-affirming energy that is within her. After releasing and coming to terms with much of the trauma, the therapy turned toward the third stage of Herman’s (1992) trauma recovery stages, reconnection with ordinary life. Patricia was aware of my training in meditation and was interested in learning more about it. In addition to giving her resources in the community, we integrated a brief period of meditation in therapy, followed by Focusing and art. During one session, I lead Patricia in mindfulness meditation for ten minutes, followed by Focusing to get a felt sense and image that matches it [handle/symbol]. Patricia shares, “I got a sense of peace in my heart and the image of the bird came (Figure 15.3). I also heard the words, ‘Bird in heart looking back—symbol spirit of truth.’”

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Figure 15.3 Patricia, felt sense after meditating

The meditation, Focusing, and art help Patricia access an inner place of peace and truth—while being able to look at the past (trauma). In addition to working within the therapy session, I encourage Patricia to do “homework” in order to deepen her ability to witness the past, and strengthen qualities of inner peace. Patricia uses Focusing, art, and journaling in response to affirmations and spiritual poems (see Theme-Directed approach below). As Patricia strengthens the spiritual wing of the bird, it helps her to keep the past much more in the past. Patricia’s mandala (Figure 15.4) celebrates her increased safety and expanded spirit—reflected in the radiating spiral and woman with raised open, arms and many of the words—home, a richer life, joy today!, body, mind, share your wisdom, rejuvenate, meditation, breathing space, and Celebrate!

Theme-Directed approach Themes related to spirituality can be explored by reflecting on a source of spiritual inspiration, experience, or practice. After reflecting on the spiritual source, Focus to get a felt sense, find a handle/symbol (image), and express it in art.

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Figure 15.4 Patricia, felt sense, spirit

Spiritual themes, experiences, and practices to focus on ·

Inspirational quotes, poems, passages, readings, and sacred texts.

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Experiences in nature; e.g. sunset, sunrise, mountain vista, sky.

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Mindfulness and meditation practices; e.g. sitting meditation, walking meditation, mantra repetition, and breath meditation.

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Singing, chanting.

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Yoga, movement, tai chi, qigong.

It is important that the therapist offer practices that are congruent with the client’s values and preferences. Spiritual quotes and meditations can come from the client’s spirituality or religious tradition (e.g. Christian, Jewish, Muslim, Hindu, Buddhist, African, etc.).

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Exercise 15.1 Focus on spiritual inspiration Materials: Drawing or collage; poetry, quotes, and/or photos. Guided Focusing: Choose a quote, photo, meditation, chant, or other source of spiritual inspiration. Contemplate it for a few moments. Turn your attention inside to your body and notice the whole feel of it (e.g. quote, photo, poem, or other source of inspiration). Gently ask, “What’s the whole feel of this spiritual source of inspiration?” (Pause.) See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense. Check it against your body for a sense of rightness. When you have it, express the felt sense image using the art materials.

The following Theme-Directed example comes from a graduate course teaching the application of spirituality in Focusing-Oriented Expressive Arts Therapy.

Theme: Exploring spirituality through mindfulness meditation Goals: 1.

To teach mindfulness practices.

2.

To cultivate an inner connection of peace and centeredness.

3.

To strengthen awareness of the inner witness—the part of self that can watch thoughts, emotions, and sensations.

4.

To see the felt sense of mindfulness expressed through expressive arts.

5.

To promote group interaction and cohesion.

Materials: Bell for meditation, pebbles or rocks, drawing materials, chalk pastels, oil pastels, paper; optional—watercolor, acrylic paints, paintbrushes, and collage materials. FORMAT

I.

Introduction to mindfulness meditation: sitting.

II.

Pebble meditation.

III.

Focusing: felt sense after meditation.

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Art.

V.

Mail exercise: felt sense words or phrases.

VI.

Poetry and sharing.

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These meditations are based on the teaching of Thich Nhat Hanh (1991, 2002), a Vietnamese Buddhist monk who was nominated for the Nobel Peace Prize by Martin Luther King in 1967. He also teaches the application of mindfulness practice to psychotherapy.

Exercise 15.2 Mindfulness sitting meditation: 10 minutes

Sounding the bell Invite clients to enjoy their breathing as they hear the sound of the bell.

Breath meditation To align the body, breath, and mind, it is helpful for the leader to offer the following phrases, which the client can repeat silently, coordinated with the breath moving in and out of the body: Breathing in, I know I am breathing in. Breathing out, I know I am breathing out. (Repeat several times. After some time, the internal phrases can be shortened to the words “in” and “out.”). Additional words or phrases can be substituted, such as “Breathing in calm, breathing out peace.” Thich Nhat Hanh (2001) also teaches ways to work with difficult emotions: “Breathing in, I am aware anger is in me; breathing out, anger is leaving me.” I tailor the gathas (short phrases) to match the client’s needs.

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Exercise 15.3 Pebble meditation Rocks or stones are placed in the center of the circle.

Sounding the bell Invite clients to enjoy their breathing as they hear the sound of the bell.

Pebble meditation Each person takes four stones. Each rock represents a different element: flower, mountain, water, and space. The therapist invites the group members to pick up one rock at a time, to hold it, and breathe mindfully. The therapist recites aloud the following phrases two to three times, as the clients repeat them silently to themselves: 1st rock: Breathing in, I see myself as a flower. Breathing out, I feel fresh. (The client places the rock to the side.) 2nd rock: Breathing in, I see myself as a mountain. Breathing out, I feel solid. (The client places the rock to the side.) 3rd rock: Breathing in, I see myself as still water in a pond. Breathing out, I see clearly. (The client places the rock to the side.) 4th rock: Breathing in, I see myself as space. Breathing out, I feel free. (The client places the rock to the side.)

After meditating, the group is guided to access a felt sense and to see if there is an image that matches the inner felt sense. Art

Create an artistic representation of the felt sense.

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Mail exercise

After the group completes their art, the work is placed in a circle around the room. Members walk around to each art piece, taking it in, and seeing if there is a word or phrase that matches the felt sense. Each person writes the word or phrase on small strips of paper that are left face-down in front of the artwork. Clients return to their art piece and a stack of “mail.” Members look at their mail, and listen to which words or phrases resonate inside of them (Figure 15.5).

Figure 15.5 Felt sense, word, mail

They then create a poem by using the words or phrases that have meaning, omitting the ones that do not, and feeling free to add new words. EXAMPLE: MELINDA

Melinda, a graduate student in the class, describes her felt sense after the meditation: My felt sense was one of movement, transformation, and flow of energy. There was a humming or a buzzing inside of me that felt ready to move. This was such an interesting feeling because throughout the spirituality

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exercise I felt very grounded and connected to the earth through the stones, yet there was also a sense of expansiveness. The felt sense image that acted as a handle for this was a dragonfly (Figure 15.6).

Figure 15.6 Melinda, felt sense after meditating

Melinda’s dragonfly is drawn with a light blue oil pastel. White and yellow, with slight touches of blue and green, radiate around the dragonfly in a circle with a sense of a circular expansion, like a ripple in a pond. Melinda shares, “I was so struck by the words I saw in front of me because of their accuracy and poignancy. Each message had meaning for me in different ways and I felt as if I was receiving a great gift.” Combining the words from the mail exercise, Melinda writes: Nature flowing in me Don’t be hesitant—fly! A delicate treasure Intricate and strong

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Swirling, twirling, balancing Lighthearted—encircling Summer sun, summer glow send me ascending A beautiful flight Dragonfly radiance protector

Reminders ·

Do not impose your own spiritual views onto clients.

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Be accepting of each person’s own view.

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Be aware of the difference between spirituality and religion.

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Explore ways of teaching awareness and mindfulness as everyday practices that do not have to be intertwined with spirituality.

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Kindness, compassion, caring, integrity, truthfulness, generosity, and wisdom are human qualities that we can access and nourish.

Chapter 16

Expanding to the Other Expressive Arts

While this book emphasizes Focusing-Oriented Art Therapy, the basic theoretical framework and methodology is applicable to music therapy, dance therapy, poetry therapy, drama therapy and psychodrama, and intermodal expressive arts therapy. I include this chapter as a brief vision into the application of Focusing to all of the expressive arts therapies and encourage the rich exploration of the felt sense and Focusing into all of the expressive arts. I coined the term Focusing-Oriented Expressive Arts Therapy as an umbrella term that applies Gendlin’s Focusing to the expressive arts therapies. The principles outlined in Chapter 6 on Focusing-Oriented Art Therapy (establishing safety, presence, experiential listening, artistic response, the person in there, the therapeutic relationship, and so forth) are foundational to a Focusing-Oriented Expressive Arts approach. While Focusing-Oriented Art Therapy emphasizes the symbolization of a felt sense as an image, Focusing-Oriented Expressive Arts Therapy expands the symbolization into a gesture or movement, sound, writing, and so forth. The key element that informs the arts modality is the felt sense. When clients access a felt sense through Focusing, they see if there is a word, phrase, image, gesture, or sound that matches or acts like a handle for the inner felt sense. Symbolizing the felt sense opens the doorway to all of the expressive arts modalities:

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Symbol/handle

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Expressive arts modality

Word or phrase .......................... develops into.................. a poem or creative writing Image .......................................... develops into.................. visual art Gesture ....................................... develops into.................. movement or dance Sound.......................................... develops into.................. music or sound exploration

Among Gendlin’s (1996) invaluable contributions to psychotherapy is his “working on the avenues,” which I believe is an essential concept for expressive arts therapists to be aware of. Gendlin believes that, despite the numerous orientations to psychotherapy, each with its different framework (e.g. Freudian, Jungian, Gestalt, client-centered, cognitive, behavioral, and transpersonal), common “avenues” can be found across theory, such as “…images, role-play, words, cognitive beliefs, memories, feelings, emotional catharsis, interpersonal interactions, dreams, dance moves, muscle movement, and habitual behavior” (p.170). Although Freudian and Jungian therapists have different methods for working with dreams, they both use the imagery avenue. Art therapy also operates on the imagery avenue. Yoga, tai chi, and bioenergetics take place on a body avenue, along with dance-movement therapy. Although the specific theoretical approaches and methods differ, each avenue offers a particular benefit. For example, cognitive-behavioral approaches work well to address cognitive distortions and belief on the mind (mental) avenue. Art therapy, guided imagery, and dreams are useful to address issues on the imagery avenue—such as images of self-perception, envisioning a desired goal, or exploring the symbolic imagery of dreams. Dance-movement therapy, yoga, tai chi, bioenergetics, Reichian therapy, and sensorimotor therapy address the body level and are useful to work with grounding, developing greater mind–body integration, or exploring emotions somatically. We can, also, think of expressive arts therapies as operating on different avenues: visual art on the imagery avenue; music therapy on the auditory avenue; poetry and writing on the language avenue, dance and creative movement on the body avenue, and drama therapy on several avenues. Each avenue provides something that the other avenues do not. The felt sense paves the way towards an avenue and between avenues (or expressive arts modalities). Gendlin clarifies this process: If we think of ourselves as working with the client’s felt sense, all avenues are ways for carrying it forward… Since any avenue can lead to

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a felt sense, and any other avenue can carry it forward, the felt sense provides a juncture between the avenues. (1996, p.171)

Intermodal expressive arts therapists specialize in understanding each avenue, assessing when it is best to work on one avenue (modality), and when it is indicated to transfer to another expressive arts modality. A combination of the therapist’s skill, training, preference and intuition along with the client’s preference, openness and, resistance helps determine which artistic modality to work with. However, knowledge of the felt sense is beneficial for choosing the direction and choice of expressive arts modality—attuned to the client’s felt experience. For example, during a Focusing Check-In, Mark, a client in an outpatient treatment center, has a felt sense of a heaviness in his body. The handle/symbol that matches his felt sense is a weeping willow tree. It is natural to express the image of his weeping willow tree in visual art (since visual art transfers well into art). The felt sense informs the avenue taken and therefore the expressive arts modality used. After Mark completes his painting of the weeping willow, he can Focus to get a felt sense of the weeping willow tree painting, or to see how he is after painting. This time, when Mark Focuses, he has a felt sense of a teariness inside, with space. The words “Sadness in grace” come as the handle/symbol for the felt sense. Those words can be developed into a poem or a free write, or can become lyrics for a song. The felt sense is like the clutch that enables changing gears (avenues) from one expressive arts modality to another—here, from imagery to words. As Gendlin states, “Our sensitivity to many avenues enables us to modulate what we do on any one, so as to respond uniquely to the intricacy of each situation with each client” (1996, p.171). This is a central concept of intermodal expressive therapy (Knill 2004) and Natalie Rogers’ creative connection (Rogers 1993). While it is beyond the scope of this book to describe each expressive arts modality in depth and how Focusing can be integrated, I offer the following as seeds of encouragement for your continuing application of Focusing to the expressive arts. Clearing a Space: ·

Movement: Use scarves or balls to represent issues in the way of feeling “All Fine”; do authentic or creative movement expressing the “All Fine Place.”

·

Music: Focus to access a felt sense, and see if there’s a sound that matches or acts like a handle for the issues in the way of

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feeling “All Fine.” Use the voice, a musical instrument, or other sound source to set each thing aside. Get a felt sense of the “All Fine Place” and express it through sound or music. ·

1

Drama/Psychodrama: This exercise uses role-play with members of the group or symbolic objects.

1.

Clearing a Space: The client chooses group member(s) or a symbolic object to represent the “All Fine Place” and puts it in the center of the room. Next, the client becomes aware of what’s in the way of feeling “All Fine.” The client gets a felt sense of the issue and then sees if there are group members to symbolize the felt sense using role-play. First, the client demonstrates the felt sense by finding a posture, gesture, and voice (one sentence) to symbolize it—and then positions themselves at a distance from the “All Fine Place.” After demonstrating the issue, the person playing the role takes on the posture, gesture, and one sentence that the client demonstrated.

2.

Background Feeling: The client checks to see if there is a background feeling (an always feeling, such as always kind of tired, or always kind of depressed), gets a felt sense of it and symbolizes it through group member(s). As in step 1, the client first demonstrates the posture, gesture, and voice (one sentence) of the background feeling. Then, the selected group member(s) take(s) on the role. The background feeling can follow the client around.

3.

Dialogue between the “All Fine Place” and issues and background feeling: Using role-play, the issues can speak to the “All Fine Place” and vice-versa.

4.

Asking and Receiving: Incorporate asking the client, in a Focusing way, relevant questions to explore steps toward resolution; e.g. “What’s in the way of the issue being resolved?”, “What’s needed?”, “What would it be like all healed?” When the

1

The idea for this exercise was developed by a small group in a graduate course on Focusing and Expressive Therapies. Thank-you to Amanda Beck, Eric Beeman, Nancy Beardall, Terry Bond, Melanie Browndorf, Julie Casella, Amy Corral, Robin Maggio Dawkins, Beth Hackler, Ellen Jackson, Matt Kraus, Lauren Lavoie, Laurie Moskowitz-Corrois, Kristy Rapp, Aleta Robison, Shannon Smith.

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client hears the answers, the therapist can guide them to use role-playing sculpture methods. ·

Writing: Use slips of paper and write the things in the way of feeling “All Fine” and put in a basket or envelope. Write a story or create a poem about the “All Fine Place.”

Integrating Focusing into expressive arts therapy moments: Checking in with the felt sense can occur at various times throughout a therapeutic encounter: at the beginning for grounding and seeing what is in the body needing attention; throughout the expressive arts process informing the arts modality, at intermodal transfer, and when accessing the body’s wisdom for dialogue: and at the end to ground, deepen, expand, transfer, or contain the experience. See Tips for integrating Focusing into art therapy moments, Chapter 6.

Part IV

Focusing-Oriented Art Therapy Exercises

Chapter 17

Guided Exercises

Individuals and groups 17.1

“Who Am I?” collage

Art: Create a collage that expresses who you are. Materials: Magazines or pre-cut collage images, scissors, glue, and paper or box. Goal: Self-identity and sharing of self with others. Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) Follow your attention down inside to your body…in a gentle and friendly way ask, “So who am I?” Just wait…and see what comes to you…perhaps different roles you take in life come to you…perhaps your role or place in a family…your work…hobbies…things you like…don’t like… Just be accepting of whatever comes. When you’re ready, bring your attention back here…stretch…(if your eyes have been closed, gently allow them to open). Look through the collage materials and find images and/or words that match your inner felt sense of who you are. Collect them…and then follow your felt sense, creating a “Who Am I?” collage. 17.2

Collage of ten things I feel drawn to

Art: Create a collage incorporating pictures and words of ten things you feel drawn to.

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Materials: Magazines or pre-cut collage images, scissors, glue, and paper or box. Goal: Self-identity and sharing of self with others. Guided Focusing: (Begin with grounding, centering, mindful breathing) As you look through the magazine images and words, sense in your body which pictures you feel drawn to. Cut the picture out (or collect them if they are pre-cut). Once you have ten things, listen to your felt sense and create a collage. 17.3

Inside/outside me

Art: Create a self box, or bag, that represents the self that you present to others and the self that you keep more internalized to yourself. Include inner aspects that you would like to move to the outside. Materials: Magazines, scissors, glue, and a box or paper bag. Goal: Self-awareness of what is kept inside and what is presented to others; clarification of desire for changes. Guided Focusing: (Begin with grounding, centering, mindful breathing) Let your attention settle in with your breath coming into your body and out of your body… (Pause.)… I’d like to invite you to be aware of the self that you show to others and the self that you keep more inside to yourself, or to those that you are really close to. Allow the images, pictures, and memories to come up about how you show yourself to others… What do you want them to see about you?… How do you come across?… What do you want others to see about you on the outside?… Take a few moments and be with that… Ask, inside, “What’s the whole feel of that self I show to others on the outside, my presentation?… See if there’s an image that matches that inner felt sense…there might be colors, shapes, etc. Now take a moment and reflect on the inside space…the place that you keep more to yourself…or show to only one, two, or a few people…maybe things or ways of being that you’re not quite sure about showing… Keep that company for a while…see if there’s an image that matches that place inside…or words, colors, shapes. Now, check one more

GUIDED EXERCISES

thing… Is there anything that you keep on the inside that you’d like to try out on the outside?…now or soon? Just wait and see if anything comes up. If one or more things come up, check them against your bodily felt sense… Does it feel right to begin to move this to the outside? Just notice and accept what the body offers. When you’re ready, open your eyes and come back to the room. Use either a bag or box to symbolize an outside and inside. On the outside, use the art materials (drawing, paint, collage) to express the felt sense of the “you” that you show to others; on the inside, use the art materials that enable you to express the self that you show to yourself, or show only to those really close to you. If there are inside parts that you want to try moving to the outside, there’s a plastic bag to put those into. You can put the plastic bag inside the box or paper bag to begin with and then take it out to explore how and where you want it to be on the outside (during the sharing with the group). 17.4

How I see myself now/how I would like to see myself

Art: Draw or create a collage of how you see yourself now and how you would like to see yourself. Materials: Drawing materials (oil pastels, chalk pastels, markers) or collage materials (magazines, scissors, glue, and paper). Goal: Self-image; to define goals for positive change with concrete life steps. Guided Focusing: (Begin with grounding, centering, mindful breathing) Let yourself become aware of you…where you are in your life right now…what you’re doing…how you feel about yourself right now. Let yourself see your strengths…the things you feel good about…and the things you feel less good about… See if there’s an image, shapes, or colors that act as a handle for the inner felt sense. Check to see if it feels right. Let a new image come if it’s not right. Now sense how you would like to feel about yourself. Imagine feeling this way about yourself… What does it feel like in your body when you imagine feeling the way you want to feel about yourself? See if

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there’s an image, shapes, or colors that act as a handle for the inner felt sense, checking for a sense of rightness. When you have it, ask in a friendly way, “So what’s between these two…the way I feel about myself and the way I want to feel?” Give time for the answer to form. What’s needed to get from the first felt image to the second? (Pause.) And when you’re ready, ask, “And what’s a good small step in the right direction?” When you’re ready, use the art materials to create the two images with what’s needed to get from one to the other, including the step. 17.5

How I see myself/how others see me

Art: Draw or create a collage of how you see yourself now and how you would like to see yourself. Materials: Paper and drawing or collage materials. Goal: Self-perception; clarification of projections. Guided Focusing: (Begin with grounding, centering, mindful breathing) Let yourself become aware of you…where you are in your life right now…what you’re doing…how you feel about yourself right now. Let yourself see your strengths…the things you feel good about…and the things you feel less good about… See if there’s an image, shapes, or colors that act as a handle for the inner felt sense. Check it against your body for a sense of rightness. Let a new image come if it’s not right. Now sense how you imagine others see you… What does it feel like in your body when you imagine how others see you? See if there’s an image, shapes, or colors that act as a handle for the inner felt sense, checking for a sense of rightness. When you’re ready, use the art materials to express the two felt sense images. During the sharing, it is interesting to find out the similarities and differences between self-perception and others’ views. 17.6

Social atoms

Art: Create a social atom using art materials to depict how close or distant you feel to significant relationships in your life. A social atom is derived from Jacob Moreno’s work on psychodrama (1983). (Note: a social atom can be of family, friends, co-workers; groups such as Alcoholics Anonymous, church,

GUIDED EXERCISES

synagogue, book group, pets. Decide what is most appropriate for each clinical situation.) Materials: Drawing materials, assorted color materials, clay, craft supplies such as buttons, feathers, twine, yarn. Goal: To explore self in relation to others; explore losses and unfinished business with others; explore support system. Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) I’d like to invite you to bring to awareness the people, groups, and pets (if you’d like) that are meaningful to you. They can be people who are living as well as people who have passed away. As each person, group, or pet comes, sense them in your body, one at a time. What’s the whole feel of this person…or group or pet? As you take a moment to sense each that comes to you, see if there’s a color, shape, or image that matches or acts like a handle for the inner felt sense. (Pause.) Then ask, “What’s the whole feel of my social atom?” Sense how close or distant you feel to each. When you’re ready, bring your attention back here… stretch…(if your eyes have been closed, gently allow them to open). Now use the art materials to create your social atom. Start with creating a symbol for yourself, putting it in the center. Then create the other symbols. You can draw symbols or create them with the other materials. If you use objects and moveable shapes, you can try out the placement in relation to you and each other. You can move things around before gluing anything down. There’s no right way to do it. Some of you might like to draw or paint. Trust your felt sense. Variations of the social atom: Create a social atom about people in the group; a social atom developmental timeline depicting significant life stages (Lyn 1978); create your social atom now and how you’d like it to be. 17.7

How I feel in this group now/how I’d like it to be

Art: Create two felt sense images: how I feel in the group now and how I would like it to be.

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Materials: Oil pastels, markers, chalk pastels, paper. Optional: string, yarn, found objects. Goal: To explore one’s relationship to the group and to take responsibility for creating desired change. Guided Focusing: (Begin with grounding, centering, mindful breathing) Take a moment and become aware of how you feel in this group. Remember when you first became a part of it. How did you feel? What were your wishes, hopes…fears? Notice any places of feeling safe…other members you feel safe with, unsafe with…or neutral. (Pause.) Imagine you are watching a movie and can see highlights from your experience in this group over time…up until now…(Pause.) Notice where you see yourself in this group. Turning your attention inside, ask, “What’s the whole feel of my experience in this group?” (Pause.) See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for inner felt sense… Check it against your body for a sense of rightness… If it’s not right let it go and invite a new image to come. (Pause.) When you’re ready, breathe that out, and now imagine what it would look like and feel like for you to have the relationship with the group that you’d like. Be friendly to whatever comes. See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense… Check it against your body for a sense of rightness… If it’s not right let it go and invite a new image to come. (Pause.)… Option: the following questions can be integrated in the guided Focusing, or clients can proceed to artmaking and answer the questions through writing. Now ask, “What’s in the way—the difference between how I’d like it to be and the sense of how it is?” (Pause.) Now ask, “What’s needed?” (Pause.) “What’s a good small step in the right direction?” When you’re ready, be aware of being here in this room, gently open your eyes and draw the felt sense images of how you feel now in the group, how you’d like it to be, and whatever came to you about what is in the way, what’s needed, and a step to get there.

GUIDED EXERCISES

17.8

Resources toolbox

Art: Using a box or other container, create a toolbox that carries self-care tools and resources. Decorate the toolbox with felt-sense words and images. Goal: To carry what was received and learned in therapy into one’s daily life. Materials: Box or other container, paper, decorative materials such as beads, feathers, sequins, etc. Guided Focusing: (Begin with grounding, centering, mindful breathing) Take some time to become aware of the tools and resources that you received in this therapy or group. Ask inside, “What would I like to carry with me into my daily life?” Sense each resource and see if there’s an image that matches it…or color, shape, texture. Sense how it feels in your body to have these resources. Use the felt sense imagery. Create a resource box.

Health and wellness 17.9

How my health is now/how I would like it to be

Art: Create an art visualization of how your health is now and how you would like it to be. Materials: Paper and drawing or collage materials. Goal: Personal health assessment; creating vision of a healthy state, identifying obstacles in the way of attaining it and a plan for moving toward it. Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) We’re going to take a moment to focus in on your health…how it is right now and how you’d like for it to be. Turn your attention inside as if it were a searchlight… Ask in a friendly way, “So how is my health right now?” Just wait…sense your energy level, areas of tension and bodily stress, places of discomfort or pain…places of ease…vitality…whatever is there. See if there’s an image,

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colors, or shapes that match or act as a symbol for the inner felt sense of your health now. Check inside the body to see whether it matches the felt sense. If it’s not right, let it go and invite a new image or colors to come from the body’s felt sense… Now breathe that out. Take in a new breath, new life. Imagine what it would look like and feel like in your body for your health to be as you wish it to be. Visualize and kinesthetically feel yourself with the vitality, energy, state of ease, and whatever else you would like for your health…as if you had it right now. See if there’s an image, colors, or shapes that match or act as a symbol for the inner felt sense of your health now. Check inside the body to see whether it matches the felt sense. If it’s not right, let it go and invite a new image or colors to come from the body’s felt sense… When you have it, ask in a friendly way, “So what’s between these two felt images…my health now and the way I’d like it to be?” Give time for the answer to form. Ask inside, “What’s needed to get from the first felt image to the second?” (Pause.) You might want to ask another question: “What’s a good small step in the right direction?” Just listen for an answer. When you’re ready, bring your attention back here to the room, stretch out, and if your eyes have been closed allow them to gently open. Use the art materials to create the two images with what’s needed to get from one to the other, including the step. 17.10 How I spend my time now/how I would like to spend my time Art: Create two pies depicting how you spend your time now and how you would like to spend your time. The pies are divided into slices that are proportional in size to the percentage of time you spend on a given activity. Materials: Two large circles; drawing materials. Goal: To identify lifestyle issues and create a plan for change. Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) I’d like to invite you to reflect on how you spend your time now and how you

GUIDED EXERCISES

would like to spend your time to achieve greater wellness and better time management. Begin to let yourself review how you spend your time…at home… watching TV, alone, with others…how you eat or don’t eat… the kind of food you eat… Do you read?…exercise?… If you work, what is that like? See all the ways you spend your time… Bringing your attention down into your body, ask, “What’s the whole feel of how I spend my time?” See if there’s an image that matches or acts as a symbol for the inner felt sense. Once you have a sense of that, imagine that you can spend your time exactly how you’d like it to enhance your wellness and time management. How would it change?… Sense what it would feel like in your body to live this way. See if there’s an image that matches the inner felt sense of this wellness. When you have that, ask, “What’s between me and living that way?” Just listen. Ask, “What’s needed to achieve that?” Then ask, “What’s one small step I can take this week toward achieving that state of wellness and time management?” When you’re ready, bring your attention to being here in the room and open your eyes if they have been closed. Create two “pies”—one expressing how you spend your time now, including the proportions symbolized by the size of the slice…and the other pie representing how you would like to spend your time. Find a place to put your action step for the week.

Trauma Stage I: Exercises for creating safety 17.11 Safe space Art: Create an artistic representation of a space that represents safety. Materials: Paper and drawing materials. Goal: To establish inner safety and create a visual reminder of this safety for use in current and future sessions. Guided Focusing: (Begin with grounding, centering, mindful breathing) Imagine a place of safety. It may be one that you already know…or it may be one that you create in your imagination. Describe that place to yourself—the images, the

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colors, the sounds or silences, the temperature, the whole feel of it. Begin to sense the whole feel of that safety inside your body… What is the whole feel of the safety within your body? See if there is an image, or word or phrase, to describe that place. Using the art materials, create an image of the felt sense of the safe place. 17.12 Personal boundaries Art: Create a self-image defining your boundaries. Materials: Magazines, images of people, outline of a person or figure; drawing materials. Goal: Self-empowerment through body awareness and personal boundaries. Guided Focusing: (Begin with grounding, centering, mindful breathing) Become aware of your body, where you are in this room, and sense how much space you need between you and others to feel safe…or to feel more relaxed. Glue a figure/image representing yourself onto a sheet of paper. This may be a figure from a collage, a photo, or an outline of a person. Using colors and shapes, draw a boundary around you that feels like the right personal boundary to feel safe or more at ease.

Stage II: Exercises for remembrance and mourning 17.13 Identifying issues and felt sense Art: Create an artistic representation of the issues you are carrying, and place them at a comfortable distance from a symbolically represented safe space. Materials: Construction paper, collage, beads, drawing materials, clay—depending on the population. Goal: To identify issues and place them at a distance that feels manageable; strengthen self to work on issues. Guided Focusing: (Begin with grounding, centering, mindful breathing) Begin with imagining a safe space for yourself. Sense what its images, colors, and shapes would be…then create the

GUIDED EXERCISES

safe space using the art materials… Now, identify issues in the way of feeling fine, or safe. Use art materials to represent each issue and place each one at a comfortable distance from the “safe space.” You can use any of the art materials to represent the issues inside: you can draw symbols of each issue or write them down in words on pieces of construction paper; you can also tear or cut pieces of paper into shapes that represent each issue; or you can use clay, beads, or other objects to symbolize the issues… When you’re ready, place these objects or papers at a distance from the safe place that feels right… Once you’ve done this, check inside for a feeling of rightness about the placement of the issues and notice how it feels inside. 17.14 Mandala: how I feel about the trauma Caution: This exercise is to be done only with individuals and groups with an established sense of safety and integration. Art: Create a mandala that can hold your feelings about the trauma. Materials: Pre-drawn mandalas or cardboard pizza rounds; drawing materials; collage. Goal: The mandala provides a safe container to hold the experience of the trauma, with the circle serving as a container and boundary for feelings while at the same time transmitting its archetypal properties of wholeness and integration. Guided Focusing: (Begin with grounding, centering, mindful breathing) Become aware of feelings about the trauma. Notice the felt sense. See if there are any colors, shapes, images that match the inner felt sense. Become aware of a circle, a mandala that can safely hold the experience. Sense if there’s anything on the outside of the circle to add more safety and holding for the traumatic experience. Beginning with the circle, add color, shape, or texture to reinforce the strength of the circle. When the circle feels solid and strong, put your felt sense about the trauma inside the circle. Add any felt-sense images outside of the circle to support and heal the trauma.

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Stage III: Exercises for reconnecting with ordinary life See 8. Resources Toolbox exercise

Spirituality 17.15 Spiritual lifeline Caution: This exercise is for higher functioning populations that feel safe to look back at their childhood and adolescence. Art: Create a lifeline of your spiritual experiences. Materials: Roll or scroll of paper; drawing materials. Goal: To explore spiritual influences and experiences from the past and present, and future wishes. Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) As you breathe, I’d like to invite you to explore your spirituality over your lifetime. As you feel the support of the floor, the earth, and the heavens, and your breath coming into and out of your body, I’d like to invite you to go back in time…to when you were a child. Take a moment and reflect on any spiritual experiences you may have had as a child. The experience may be connected to your religious upbringing or not. Some feel a sense of spirituality in nature…or swinging on a swing…looking at the night sky full of stars…the sunset…or a flower…when there’s a moment of feeling a connection with something bigger in life…a moment of connection with the universe… If you don’t recall a spiritual feeling while being a child, that’s okay. Just acknowledge that…and create a welcoming space… Turn your attention inside your body and ask, “What’s the whole feel of this spiritual experience (if you had one or more)?”… See if there’s an image that captures the felt sense of that… Check it for a sense of rightness… Now let that go for now…and move ahead to your adolescence… recall being a teenager and see if there were any moments of spirituality…connection with the universe…with nature… with God… (Pause.) Trust what comes. See if there’s an image that captures the felt sense of that… Check it for a sense of rightness… Now let that go for

GUIDED EXERCISES

now…and move ahead to your adulthood… Recall your experiences as an adult and see if there have been any moments of spirituality…sense the whole feel of spirituality in your adulthood…see if there’s an image that matches or acts as a symbol for the inner felt sense… Now, let your imagination go into the future…imagine you have spirituality in your life just the way you want it…with yourself…with others…in nature…or wherever it works for you… What would it feel like in your body to have your spirituality just the way you want it?… See if there’s an image, colors, or shapes that match the inner felt sense… Check it for a sense of rightness. When you’re ready, bring your awareness to being here in the room, stretch out, and open your eyes if they have been closed. Draw a lifeline that expresses the felt sense of your spirituality throughout your life. The line can start at the top or bottom of the page, moving upward or downward to express the felt sense of the experience. Embellish the lifeline with images, symbols, colors, and shapes that express the felt experience of different moments of spirituality from childhood, adolescence, adulthood, and those you wish for in the future. 17.16 Where I am now/where I’d like to be spiritually Art: Draw images representing: where I am now spiritually, where I’d like to be, and how to get from one to the other. Materials: Paper, drawing materials. Goal: To identify goals for spiritual development and action steps for getting there. Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) We’re going to take some time to reflect on where you are at in your life spiritually right now and where you’d like to be. Follow your breath inside. Begin to become aware of your spirituality and how it is expressed in your life now…how you nourish or nurture your spirituality…whether it is through prayer, going to church or temple, spending time in nature, doing art, practicing sitting meditation or moving meditation. Or maybe your spirituality is

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feeling undernourished. However it is, just notice…and be accepting to how it is. Sense in your body how your spirituality feels right now. See if there’s an image or colors that match the inner felt sense. Check it for a sense of rightness. Take another deep breath, inhaling new life… Now imagine living your life in a way that nourishes your spirituality the way you would like. Describe that to yourself… See yourself doing those things right now… Turn your attention inside to your body and ask, “What’s the whole feel of that, of living my life nourishing my spirituality the way I’d like it to be?” See if there’s an image, colors, shapes that match or act as a symbol for the inner felt sense. Continue checking until you have the right image…and then ask inside, “So what’s between these two felt images…my spirituality now and the way I’d like it to be?” Give time for the answer to form. Ask inside, “What’s needed to get from the first felt image to the second?” (Pause.) You might want to ask another question: “What’s a good small step in the right direction?”… Just listen for an answer. When you’re ready, bring your attention back here…stretch out and allow your eyes to gently open if they have been closed. Use the art materials to create the two images with what’s needed to get from one to the other, including the step. 17.17 Walking meditation Art: After walking meditation, express felt sense using art materials. Materials: Meditation bell; oil pastels, chalk pastels, drawing paper; optional: watercolor, acrylic paint, yarn, feathers, collage material. Goal: To increase mindfulness; to practice carrying a state of calm and peace while moving through life. Guided Focusing: The leader invites clients to enjoy their breathing as they listen to the sound of the bell. Next, the leader explains walking meditation: “As you breathe in and out, bring awareness to your breath and to each foot as it lifts up, travels through space, and makes contact with the ground.” The pace is slow. Short gathas, or phrases, are silently repeated in coordination with the breath and a particular foot:

GUIDED EXERCISES

Left foot: Breathing in, I am aware of breathing in. Right foot: Breathing out, I am aware of breathing out. After a few repetitions, you can shorten the phrases: Left foot: In, aware of breathing in. Right foot: Out, aware of breathing out. Different phrases can be substituted depending on the clients. For example, to transform difficult feelings you might use the following gatha: Left foot: Breathing in, I’m aware that anger is in me. Right foot: Breathing out, I’m aware of anger leaving me. (Substitute feelings such as anxiety, fear, loneliness, etc.) After some time with this gatha, it often feels natural to bring in peaceful and calm feelings: Left foot: Breathing in, I feel calm. Right foot: Breathing out, I feel peace. Shortening the phrase: Left foot: In, calm. Right foot: Out, peace. Guided Focusing after Meditation: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) Follow your attention inside to your body, being friendly to whatever is there. Ask inside, “What’s the whole feel of this meditation experience?” Take your time, allowing a felt sense to form. See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense. Check it for a sense of rightness. If it’s not right, allow a new image (word, phrase, gesture, or sound) to come. When you’re ready, bring your attention back here…stretch…(if your eyes have been closed, gently allow them to open) and use the art materials to create the felt sense image of the meditation experience.

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Couples and families 17.18 Relationship now/how I’d like it to be Art: Create images representing: felt sense of the relationship now, felt sense of how you’d like the relationship to be, and how to get from one to the other. Materials: Paper, drawing materials. Goal: To clarify for couples or families what isn’t working in the relationship(s) and to get each person’s felt sense vision of how they would like it to be. Issues to address: What’s in the way of the relationship being the way you want it? What’s needed to get there? Is the couple (or family) wanting to achieve the same goals or different ones? Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) We’re going to explore how the relationship feels to you now and how you would like it to be. Begin to describe the relationship to yourself… What initially drew you to your partner?… What feels good in the relationship?… What are the challenges?… What changes would you like to see?… Sense the whole feel of how the relationship is now. What does it feel like in your body? Notice where you feel it in your body. See if there’s an image, colors, or shapes that match the felt sense. Check it against your body. If it’s not right, let it go and let a new image come. (Check with the client to determine if they are ready to move on.) Now breathe that out. Imagine what it would look like and feel like to have your relationship be as you would like it to be. Let images, thoughts, and sensations arise. Sense in your body the whole feel of your relationship as you imagine it being as you wish it to be. See if there’s an image, colors, or shapes that match the inner felt sense. Check it for a sense of rightness… Ask, “What’s in the way of having this in my life?”… Listen to your body’s answer…and ask, “What’s needed to have this in my life?”…“What’s one small step in the right direction?”… Receive what comes. When you’re ready, open your eyes and use the art materials to create the two

GUIDED EXERCISES

images. Include what’s in the way, what’s needed, and the step. When you’ve completed your drawing, share it with each other. 17.19 What I need from you/what I can offer you Art: Each person first draws their felt sense images of: 1) What I Need from You or What I Need from this Family; 2) After sharing, each person draws their felt sense image of What I Can Offer You. Materials: Paper and drawing materials. Goal: For each person to clearly identify and share their needs, and to identify what they are willing to give to the relationship. Guided Focusing: Take a few deep breaths down inside to your body. Feel the support of the floor and the chair that you are sitting on. (Use your clinical judgement as to whether to suggest keeping the eyes open or closed.) Let yourself become aware of what you need from your partner (or family). Take a few moments to hear your inner needs. Imagine sitting down next to your inner needs, listening to them. Sense the whole feel of them. See if there’s an image, colors, or shapes that match the inner felt sense… Check it for a sense of rightness. When you’re ready, bring your attention back here… stretch…(if your eyes have been closed, gently allow them to open) and draw the felt sense of the need. (Clients first share and listen to “What I Need from You.” After the sharing, the therapist invites client to Focus again)… Take a few deep breaths down inside to your body, being friendly to whatever is there. Taking in what you just heard (about your partner or family members’ needs), ask inside, “What am I willing to give?”… (Pause.) Take your time to see what comes. Notice how it feels in your body. See if there’s an image (or word, phrase, gesture, or sound) that matches or acts like a handle for the inner felt sense. Check it against your body for a sense of rightness. If it’s not right, let it go and let a new image (or word, phrase, gesture, or sound) come. When you’re ready, stretch, open your eyes if they have been closed, and draw your felt sense image of what you are willing to give. Share with each other.

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Appendix A

Supervision and Self-Care

Supervision Clinical supervision works well using a Focusing-Oriented Art or Expressive Arts Therapy approach. Noticing your own felt sense, as therapist, is a useful indicator and guide to explore intuitive hunches and wisdom, as well as countertransference reactions. “Clearing a Space” is a useful self-care tool to center yourself before seeing clients and afterwards—as a way to leave your clinical work at the right amount of distance from you. The Focusing steps and the expressive arts can be used to gain insight into a clinical situation and to work through your own blocks and resistances.

Suggestions • Clearing a Space: Before and after session. • Countertransference: Focus on client; identify an issue; get a felt sense and handle; symbolize through expressive art; ask and receive.

• Focusing questions: What’s needed? What’s in the way? What’s a good small step towards resolution? Express artistically.

Self-Care Focusing-Oriented Art Therapy can be used for self-care on one’s own and/or as part of a peer group. The peer group can be solely for self-care or combined with peer supervision.

Suggestions • Clearing a Space (with or without art): for centering and stress reduction.

• Focusing Check-In: How am I? Symbolize felt sense in art. • Focusing: What needs attention? Divide up time in peer group. • Integrate listening, artistic feedback, verbal response. 236

Appendix B

Resources

Art therapy American Art Therapy Association, Inc. 11160–C1 South Lakes Drive, Suite 813, Reston, VA 20191 Phone: 888-290-0878 Website: www.arttherapy.org Consult website for links to national and international art therapy associations, ethical guidelines, research information, and the use of art therapy evaluation tools for research. Art Therapy Credentials Board 3 Terrace Way, Suite B, Greensboro NC 27403-3660 Toll free: 877-213-2822 Website: www.atcb.org Email: [email protected] Expressive Media Inc. Website: www.expressivemedia.org Art therapy films and resources. International Expressive Arts Therapy Association PO Box 332399 San Francisco, CA 94132 Phone: 415-522-8959 Website: www.ieata.org National Coalition of Creative Arts Therapies Associations c/o AMTA 8455 Colesville Rd., Ste. 1000 Silver Spring MD, 20910 Website: www.nccata.org

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Journals Art Therapy, Journal of the American Art Therapy Association. Inscape, Journal of the British Association of Art Therapists. The Arts in Psychotherapy.

Further Reading On Art Therapy Assessments

Brooke, S. (2004) A Therapist’s Guide to Art Therapy Assessments: Tools of the Trade. Second edition. Springfield, IL: Charles C. Thomas. Cohen, B., Hammer, J. and Singer, S. (1988) “The Diagnostic Drawing Series: a systematic approach to art therapy evaluation and research.” The Arts in Psychotherapy 15, 1, Special issue: Assessment in the Creative arts therapies, 11–21. Cohen, B., Mills, A. and Kijak, A.K. (1994) “An introduction to the Diagnostic Drawing Series: a standardized tool for diagnostic and clinical use.” Art Therapy 11, 2, 105–110. Earwood, C., Fedorko, M. and Holzman, E. (2004) “Screening for aggression using the draw a story assessment.” Art Therapy 21, 3, 156–162. Frame, P. (2006) “Assessing a Couple’s relationship and compatibility using the MARI® card test and mandala drawings.” Art Therapy 23, 1, 23–29. Gantt, L. (2001) “The Formal Elements Art Therapy Scale: a measurement system for global variables in art.” Art Therapy 18, 1, 50–55. Hagood, M. (2003) “The use of the Naglieri draw-a-person test of cognitive development: a study with clinical and research implications for art therapists working with children.” Art Therapy 20, 2, 67–76. Hays, R.E. and Lyons, S.J. (1981) “Bridge Drawing: a projective technique for assessment in art therapy.” The Arts in Psychotherapy 8, 3–4, 207–217. Kaplan, F. (2003) “Art-based assessments.” In C. Malchiodi (ed) Handbook of Art Therapy. New York: Guilford Press, pp. 25–33. Oster, G. (2004) Using Drawings in Assessment and Therapy: A Guide for Mental Health Professionals. New York: Brunner-Routledge. Rockwell, P. and Dunham, M. (2006) “The utility of the formal elements art therapy scale in assessment for substance use disorder.” Art Therapy 23, 3, 104–111. Silver, R. (1991) Stimulus Drawings and Techniques: In Therapy, Development, and Assessment. FL: Albin Press. Silver, R. (2002) Three Art Assessments: The Silver Drawing Test of Cognition and Emotion; Draw a Story: Screening for Depression; and Stimulus Drawings and Techniques. New York: Brunner-Routledge. Silver, R. (2003) “Cultural differences and similarities in responses to the Silver Drawing Test in the USA, Brazil, Russia, Estonia, Thailand, and Australia.” Art Therapy 20, 1, 16–20.

Further Reading on Art Therapy History

Hogan, S. (2001). Healing Arts: The History of Art Therapy in the United States. London: Jessica Kingsley Publishers. Junge, M. (1991) A History of Art Therapy in the United States. Reston, VA: American Art Therapy Association. Junge, M. and Wadeson, H. (eds) (2007) Architects of Art Therapy: Memoirs and Life Stories. Springfield, IL: Charles C. Thomas. Waller, D. (1991) Becoming a Profession: The History of Art Therapy in Britain, 1940–82. New York: Routledge.

Focusing The Focusing Institute 34 East Lane Spring Valley NY 10977 Phone: 845-362-5222

APPENDIX B: RESOURCES

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Website: www.focusing.org The Focusing Institute lists a wealth of information including articles, trainings, Focusing-Oriented Trainers and Therapists, Focusing Partnerships, Changes meetings, access to the Gendlin Online Library, books, DVDs, tapes, and more. Focusing and Expressive Arts Institute Larry Rappaport, PhD, ARTFlBC, REAT Website: www.focusingarts.com Focusing Resources: Ann Weiser Cornell Website: www.focusingresources.com International Association for Focusing Oriented Therapists Website: www.focusingtherapy.org/index.html The Institute for Bio-Spiritual Research PO Box 741137 Arvada, CO 80006-1137 Phone/Fax: 303-427-5311 Email: [email protected] Website: www.biospiritual.org

Relevant Psychotherapy Sites Association of Humanistic Psychology: www.ahpweb.org The Society for Existential Analysis: www.existentialanalysis.co.uk World Association for Person-Centered and Experiential Psychotherapy and Counseling: www.pce-world.org

Journal and Library Journal: The Folio (go to www. focusing.org) Gendlin Online Library: www.focusing.org/gendlin PCEP: Journal of the World Association for Person-Centered and Experiential Psychotherapy and Counseling: www.pce-world.org/idxjournal.htm

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Levick, M. (1983) They Could Not Talk and So They Drew: Children’s Styles of Coping and Thinking. Springfield, IL: Charles C. Thomas. Levick, M. (2003) See What I’m Saying: What Children Tell Us Through Their Art, 2nd edition. Hong Kong: Regal Printing Ltd. Linszen, D., Dingemans, P., Lenoir, M., Scholte, W., de Hann, L. and Goldstein, M. (1998) “Early intervention, untreated psychosis and the course of early schizophrenia.” British Journal of Psychiatry 172, 84–89. Lombroso C. (1891) The Man of Genius. London: Walter Scott. Lowen, A. (1994) Bioenergetics: The Revolutionary Therapy That Uses the Language of the Body to Heal the Problems of the Mind. New York: Penguin Books. Lowenfeld, V. (1987) Creative and Mental Growth, 8th edition. New York: Prentice Hall. Lydiatt, E.M. (1971) Spontaneous Painting and Modeling: A Practical Approach to Therapy. London: Constable. Lyn, C. (1978) Unpublished Master’s thesis. Lesley University, Cambridge, MA, 02139. Malaspina, D. and Corcoran, C. (2001) Schizophrenia and Stress. Retrieved November 5, 2007 from http://www.thedoctorwillseeyounow.com/articles/behavior/stress_11/#back43. Malchiodi, C. (1997) Breaking the Silence: Art Therapy with Children from Violent Homes, second edition. New York: Brunner/Mazel. Malchiodi, C. (1999) Medical Art Therapy with Adults. Philadelphia: Jessica Kingsley Publishers. Malchiodi, C. (ed) (2003) Handbook of Art Therapy. London/New York: Guilford Press. Marder, D. (1997) “Sarah: Focusing and play therapy with a six-year-old child.” The Focusing Folio 16, 51–54. McGuire, K. (2007) Focusing In Community: How To Start A Listening/Focusing Support Group, self-published, available at www.cefocusing.com McNiff, S. (1979) “From shamanism to art therapy.” Art Psychotherapy, 6, 3, 155–161. McNiff, S. (1981) The Arts and Psychotherapy. Springfield, IL: Charles C. Thomas. McNiff, S. (1986) Educating the Creative Arts Therapist: a Profile of the Profession. Springfield, IL: Charles C. Thomas. McNiff, S. (1988) Fundamentals of Art Therapy. Springfield, IL: Charles C. Thomas. McNiff, S. (1989) Depth Psychology of Art. Springfield, IL: Charles C. Thomas. McNiff, S. (1992) Art As Medicine: Creating a Therapy of the Imagination. Boston: Shambhala Publications. McNiff, S. (1998) Trust the Process: An Artist’s Guide to Letting Go. Boston: Shambhala Publications. McNiff, S. (2004) Art Heals: How Creativity Cures the Soul. Boston: Shambhala Publications. Merkur, B. (1997) “Focusing using art with adolescents.” The Folio 16, 1–2, 51–55. Milgram, G. Rabbi (2003) Judaism and Focusing Technique. Retrieved February 2, 2008 from http://www.focusing.org/spirituality/judaism.html Moreno, J.L. (1983) The Theatre of Spontaneity, 3rd edition. Horsham, PA: Beacon House Inc. Morgenthaler, W. (1992) Madness and Art. The Life and Works of Adolf Wolfli (transl. A.H. Esman). London: University of Nebraska Press. Murayama, S. and Yuba, N. (1988) “Clearing a Space with drawing in play therapy.” The Folio 7, 1. Retrieved on September 1, 2008 from http://www.focusing.org/chfc/article_index.html Naumburg, M. (1950) Schizophrenic Art: Its Meaning in Psychotherapy. New York: Grune & Stratton. Naumburg, M. (1953) Psychoneurotic Art: Its Function in Psychotherapy. New York: Grune & Stratton. Naumburg, M. (1966/1987) Dynamically Oriented Art Therapy: Its Principles and Practices. New York: Grune & Stratton. Naumburg, M. (1950/1973) An Introduction to Art Therapy: Studies of the “Free” Art Expression of Behavior Problem Children and Adolescents as a Means of Diagnosis and Therapy. New York: Teacher’s College Press. Neagu, G. (1988) “The Focusing Technique with children and adolescents.” The Focusing Folio 7, 4. Retrieved on September 1, 2008 from http://www.focusing.org/chfc/article_index.html Ogden, P. (2006) Trauma and the Body: A Sensorimotor Approach to Psychotherapy. New York: W. W. Norton & Company. Ogden, P., Minton, K. and Pain, C. (2006) Trauma and the Body: A Sensorimotor Approach to Psychotherapy. London and New York: W.W. Norton & Co. Pinel, P. (1962) Medical Treatise on Mental Disorder or Mania. D.D. Davis, trans. New York: Hafner Publishing (original work published 1801).

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Subject Index active imagination 76–7, 108 addiction 64 “All Fine Place” 115–16, 119, 121, 171, 200, 215, 216 American Art Therapy Association 68 anger management 64 anxiety 64, 65, 139, 153, 196 art therapy 13, 14, 16, 17, 18, 19–20, 62, 64–5, 123, 213 active imagination 76–7 art as process 72 art as product 76 art as safe container 68–9 art for assessment 78–9 art therapy and Focusing 87–8, 94–9, 101–3, 107–8 art therapy in practice 71–9 artmaking 80–1, 189 body/mind integration 70–1 catharsis 69–70 conversation drawing 74–5, 82, 165 creative spirit 71 development of profession 67–8 experience beyond words 69 exploring art and feeling 82 exploring clay 83 exploring lines, shapes and colors 81 feeling expression 74 history 65–7

interaction 74–5 Interconnections: Focusing and art therapy 88–90 key concepts 68–71 materials 79–80 media exploration 72–3 objective description 76 sharing 76 spiritual dimensions 199–200 stress reduction 144 unconscious to conscious 69 whole of an experience 70 witness 70 artistic expression 119, 121 arts 13–14, 65, 67 artworks 108 asking 38–9, 59, 63, 91, 126–7, 144, 215–16 exercise 106 Ault, Robert 68

background feeling 113–14, 118, 120, 215 Steve 114 behavioral psychotherapy 14, 25, 61, 64, 92, 213 bioenergetics 213 bipolar disorder 139, 145 body-awareness exercises 30, 46 British Art Therapy Association 68

cancer 171, 172 cancer support group 172–3 Cindy 172, 176–81 materials 173

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week 1: Clearing a Space 173 week 2: source of strength 174–5 week 3: working on an issue 175 week 4: what I received from the group 175–6 Casarjian, Robin 150 catharsis 69–70, 191 centering 107 Changes 25 child abuse 191, 194, 197 children’s art 66–7 choosing an issue and felt sense 38, 57–8, 63, 124, 136, 144 exercise 105–6 clay 83 Clearing a Space 37, 57, 171, 173, 177, 179, 180, 200 exercise 40, 105 Focusing-Oriented Expressive Arts Therapy 214–15 Clearing a Space with Art 91, 103, 111–2, 144, 182, 200 art materials 116–17 guided imagery 117–22 Mary 112–13 reminders 122 Client-Centered Therapy 24 clinical sensitivity 92–3 cognitive impairment 64 cognitive psychotherapy 14, 25, 61, 62, 64, 92, 213 conflict resolution 64

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conversation drawing 74–5, 82, 165 couples 234–5 creativity 71, 200 Critic 153–4 Angie 157–9 Janet 159–62 strategies for taming the Critic 154–5 transforming the relationship with the Critic 155–6, 157 Cubism 67

Dada 67 dance therapy 14, 212, 213 depression 64, 65, 127, 139, 153, 171, 196, 201 developmental delays 64 dialogue 76, 77–8, 107, 183, 215 with art 108 with Critic 156, 159, 160–1 with the felt sense 108 disaster relief 65 dissociation 92, 117 drama therapy 14, 212, 215–16 Draw-a-Man 78 Dubuffet, Jean 67

eating disorders 64 ego 13, 78 emotional healing 147, 148, 172 empathy 91, 93 exercises acceptance and compassion 95–6 accessing a felt sense 31–2 basic Focusing-Oriented Art Therapy guided instructions 105–6

checking in with felt sense 97–9 collage of ten things I feel drawn to 219–20 conversation drawing 82 exploring art and feeling 82 exploring clay 83 exploring lines, shapes and colors 81 focus on spiritual inspiration 206 Focusing Steps 40–2 Focusing stress check-in 141, 142 higher power or source of spiritual nourishment 151–2 how I feel in this group now/how I’d like it to be 223–4 how I see myself now/how I would like to see myself 221–2 how I see myself/how others see me 222 how I spend my time now/how I would like to spend my time 226–7 how my health is now/how I would like it to be 225–6 identifying issues and felt sense 228–9 inside/outside me 220–1 mail exercise 209 mandala: how I feel about the trauma exercise 229–30 mindfulness sitting meditation 207 name drawings 149–50 Peaceful Place and “being friendly” 141 pebble meditation 208

personal boundaries 228 protector 192 relationship between the Critic and the Criticized Part 157 relationship now/how I’d like it to be 234–5 resources toolbox 225 safe space 227–8 social atoms 222–3 source of strength 174 spiritual lifeline 230–1 symbolizing a felt sense 32–3 tension-release exercise 142 walking meditation 232–3 what I need from you/what I can offer you 235 what I want to carry with me 175–6 where I am now/where I’d like to be spiritually 231–2 “Who Am I?” collage 219 Experiencing Scale 24–5 Expressionism 67 expressive arts 76

families 14, 64, 234–5 Family Art Therapy 68 Family Scribble Drawing 75 feeling expression 74 felt sense 16, 17, 18, 23, 28–9, 87, 91, 200, 212 accessing 29–30, 31–2 Ana and Takura 166–8 checking in with 96–7, 128, 135–6, 141, 174 expressing the felt sense in art 94, 166–8 Focusing Steps 38, 57–8, 63, 124

SUBJECT INDEX

Focusing-Oriented Psychotherapy 53 Getting a felt sense of the art 101 getting a felt sense of the art exercise 101–2 pain management 182–3 symbolizing exercise 32–3 felt shift 18, 23, 33–5 Ana and Takura 166–8 art and body 99–101 Focusing 14, 16, 17, 18, 20, 91, 103, 123, 139, 212 benefits 26 Critic 153 felt sense 28–33 felt shift 33–5 fitting with other psychotherapy schools 61–2 Focusing and art therapy 87–8, 94–9, 101–3, 107–8 Focusing today 25 history 23–5 integrating Focusing into therapy 56–63 Interconnections: Focusing and art therapy 88–90 life-forward direction 35 main concepts 26–8 spiritual dimensions 199–200 Focusing Attitude 26–8, 91, 153, 171, 182 establishing safety 92 Focusing Attitude in art 94 spirituality 199–200 transmitted from therapist to client 52 within the client 51–2 within the therapist 52–3 Focusing-Oriented Art Psychotherapy 91–2, 103, 201

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Donna 127–35 drama/psychodrama Patricia 201–4 215–16 reminders 135–6 integrating Focusing into Sarah 123–7 expressive arts Focusing-Oriented Art therapy 216 Therapy 15, 16–17, Focusing-Oriented 17–19, 212 Psychotherapy 25, 49, acceptance and compassion 91 exercise 95–6 experiential listening approaches 103 53–6, 91, 93 art as a tool for self-help Focusing Attitude 51–3 and healing 148–9 Person-Centered Approach benefits 102–3 49–50 bridging cultures 163 therapeutic relationship cancer support group 50–1 172–81 Focusing Steps 36, 56, 62, checking in with felt sense 123, 136, 175 96–7, 97–9, 128, asking 38–9, 59, 63, 91, 135–6, 141 106, 126–7, 144, establishing safety 92–3, 215–16 188–9 benefits 45–6 expressing the felt sense in choosing an issue and felt art 94, 166–8 sense 38, 57–8, 63, felt shift 99–101, 166–8 124, 136, 144 Focusing Attitude in art 94 Clearing a Space 37, 40, Gendlin’s Focusing Steps 104 57, 105, 171, 173, Guided Focusing 151–2 177, 179, 180, 200 health 171–2 example: Michelle 59–61 name drawings 149–50 exercise 40–2 overview 91–2 Finding a Step 144 pain management 181–7 Gendlin’s Focusing Steps and prisons 147–8 Focusing-Oriented Art psychiatric units 139–40 Therapy 104 reflection 93–4 handle/symbol 38, 58, 63, spirituality 200–4 91, 124, 144, 183 transforming the receiving 39–40, 59, 63, relationship with the 91, 127, 144, Critic 155–6, 157 215–16 trauma 188 resonating 38, 58, 63, warm-up to the art 124–6, 144, 183 materials 149, session with Kiersten 42–5 163–5 stress reduction 144–6 Focusing-Oriented Expressive tips and troubleshooting Arts Therapy 212–14 46–8 Clearing a Space 214–15 Freudian analysis 13, 65, 66, 67, 153, 213

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FOCUSING-ORIENTED ART THERAPY

Gauguin, Paul 67 Gendlin, Eugene 16, 18, 23–5, 56, 87, 91, 103, 102, 123, 128, 132, 136, 153–4, 212 Gestalt Art Therapy 68, 76, 78, 108 Gestalt psychotherapy 13, 213 grounding 93, 107, 189 group dynamics 14 Group Mural 75 Growing Together 147 Guided Focusing 151–2, 156 guided imagery 117–22, 213

handle/symbol 38, 58, 63, 91, 99, 124, 144, 183 Expressing the handle/symbol in art 94 exercise 106 health 19, 64, 171–2 how I spend my time now/how I would like to spend my time exercise 226–7 how my health is now/how I would like it to be exercise 225–6 higher power 150, 151–2 Hill, Adriann 68 holistic psychotherapy 13 house-tree-person 78 humanistic psychotherapy 13, 61 Huntoon, Mary 68

illness 171–2 imagery 117 Concrete Imagery exercise 121–2 Directive Imagery exercise 119–21

Nondirective Imagery exercise 118–19 Industrial Revolution 65 interaction 74–5 intermodal transfer 76, 108

Jones, Don 68 journals 173, 174 Jungian analysis 13, 64, 65, 66, 67, 76, 213

Kellogg, Rhoda 66–7 King, Martin Luther 207 Klagsbrun, Joan 36, 147, 155 Klee, Paul 67 Kramer, Edith 67

life-forward direction 23, 35, 191, 200 listening 14, 16, 17 experiential listening 53–6, 91, 93 guidelines 54–6 Lowenfeld, Viktor 66–7

mania 65 materials in art therapy 79–83, 116–17, 173 choosing 107 warm-up to the art materials 149, 163–5 media exploration 72–3 mental health problems 64, 65–6, 78, 117, 139 establishing safety 92–3 mindfulness 139 Miro, Joan 67 mirroring 91, 94 mourning 190–1, 228–9 movement therapy 14, 212

music 173, 212, 213, 214–15

name drawings 149–50 narrative art therapy 14, 64 National Emotional Literacy Project 147 National Institute of Health Office of Alternative Medicine 171 Naumburg, Margaret 66, 67 neurological problems 64

object relations 13, 68 Outsider Art (Art Brut) 66, 67

pain 171, 172, 177, 179–81 Kerri 183–7 strategies for pain management 181–3 peacemaking 65 Person-Centered Approach 49–50, 64, 92 phenomenological psychotherapy 13 poetry 212, 213 post-traumatic stress 64, 198, 201 prisoners 147–8 psychodrama 212, 215–16 psychodynamics 13, 61–2, 64, 68, 92 psychosis 64, 65, 92

receiving 39–40, 59, 63, 91, 127, 144, 215–16 exercise 107 reconnection 191 reflection 18, 91, 93–4 Reichian therapy 213 relationships

SUBJECT INDEX

relationship now/how I’d solution-focused art therapy like it to be exercise 14 234–5 spirituality 13, 19, 64, 150, what I need from 151–2, 172 you/what I can offer focus on spiritual you exercise 235 inspiration 206–7 relaxation 139 Focusing and art therapy remembrance 190–1, 228–9 199–200 reminders Focusing-Oriented Art bridging cultures 168 Therapy 200–4 Clearing a Space with Art mail exercise 209 122 Melinda 209–11 Critic 162 mindfulness sitting Focusing-Oriented Art meditation 207 Psychotherapy pebble meditation 208 135–6 spiritual lifeline exercise psychiatric population 146 230–1 spirituality 211 Theme-Directed approach trauma 198 204–5 working with health 187 walking meditation resonating 38, 58, 63 124–6, exercise 232–3 144, 183 where I am now/where I’d exercise 106 like to be spiritually Rogers, Carl 16, 23–4, 87 exercise 231–2 Rousseau, Henri 67 storytelling 76–7 stress management 139, 171, 172 safety 18, 68–9, 91 Adam 142–4 establishing safety 92–3, group format 140–1 188–9 Group themes and skills 140 Focusing Attitude 92 Lisa 145–6 grounding 93, 189 Lucas 141–2 therapeutic presence 92 week 1: Peaceful Place schizo-affective disorder 139, Exercise 141 141 week 2 and 3: identifying schizophrenia 139 and releasing bodily Self 13 tension 142–4 self-actualization 13 week 4: Clearing A Space self-care 148, 236 with art 144 self-esteem 64, 153 week 5 and 6: Focusing self-transcendence 13 Steps 144–6 Sensorimotor Psychotherapy superego 153 14, 213 supervision 236 shamanism 65 Surrealism 67 social action 65

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tai chi 213 Theme-Directed approach 91, 92, 103, 172 spirituality 204–11 therapeutic relationship 91, 92 clinical sensitivity 92–3 transpersonal psychotherapy 61, 64, 213 trauma 19, 64, 78, 92, 117, 188 trauma: Alissa 191–8 establishing safety 188–9 identifying issues and felt sense exercise 228–9 mandala: how I feel about the trauma exercise 229–30 personal boundaries exercise 228 reconnection with ordinary life 191 remembrance and mourning 190–1 safe space exercise 227–8

unconscious 13, 69 United Kingdom 68 United States 65, 67, 68 US Association for Body Psychotherapy 14

websites 14 wellness 19, 64, 171–2 exercises 225–7 witness 70, 191 Wolfi, Adolf 66

yoga 213

Author Index Allen, P. 64, 199 Amodeo, J. 199 Armstrong, M. 188

Beveridge, A. 66 Browne, W. 66 Buck, J. 78

Campbell, J. 66 Campbell, P.E. 36, 199 Cane, F. 67 Casarjian, R. 147 Chodorow, J. 66 Chutroo, B. 199 Corcoran, C. 139 Cornell, A.W. 23, 26, 27, 36, 153, 154 Cornell, A.W. 36

Goodenough, F. 78 Grindler Katonah, D. 171

Hagood, M. 188 Hanh, T.N. 207 Haslam J. 66 Hendricks, M. 25 Herman, J. 188, 201, 203 Hinterkopf, E. 28, 36, 199 Horovitz, E. 199

Ikemi, A. 17

Jacobson, L. 139 Johnson, D.R. 188 Jung, C.G. 66

Malaspina, D. 139 Malchiodi, C. 14, 64, 68, 171, 177, 188 Marder, D. 17 McGavin, B. 36 McGuire, K. 54 McMahon, E. 36, 199 McNiff, S. 65, 66, 68, 76, 183 Merkur, B. 17 Milgram, G. 199 Minton, K. 14 Morgenthaler, W. 66 Murayama, S. 17

Naumburg, M. 66, 68 Neagu, G. 17

Ogden, P. 14, 190 Dachinger, P. 68

Egendorf, A. 139

Falloon, I.R. 139 Farrelly-Hanson, M. 65, 199 Flaxman, J. 171 Franklin, M. 65, 199 Friedman, N. 36

Gendlin, E.T.16, 17, 23, 24, 25, 27, 29, 31, 33, 34, 35, 36, 39, 53, 54, , 88, 99, 130, 131, 139, 153, 154, 213, 214

Kellogg, R. 66 Klagsbrun, J. 171 Klein, M.H. 25 Knill, P. 17, 214 Kramer, E. 68 Kurtz, R. 14 Kwiatkowska, H.Y. 68

Leijssen, M. 17 Levick, M. 68 Levine, E. 17 Levine, S. 17 Levy, C. 68 Linszen, D. 139 Lombroso C. 66 Lowen, A. 14 Lowenfeld, V. 66 Lydiatt, E.M. 68

250

Pain, C. 14 Prinzhorn H. 66, 67 Prouty, G. 139 Purton, C. 17, 153

Rappaport, L. 17 Reich, W. 14 Reja, M. 66 Rhyne, J. 68, 75 Robbins, A. 68 Rogers, C. 24 Rogers, N. 183, 214 Rolf, I. 14 Rome, D. 199 Rubenfeld, I. 14 Rubin, J. 13, 14, 15, 68

AUTHOR INDEX

Saunders, N. 199

Thevoz, M. 67 Tsuchie, S. 17 Turcotte, S. 188

Ulman, E. 68

Wadeson, H. 70

Yuba, N. 17

Zimring, F. 24

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