More Than Words – Expressive Art Therapy and Brain Injury

Art Therapy

Hello, all. Hoping you’re okay.

A few months back, I posted a piece about Writing Therapy. But writing is not the only creative form to be used as therapy. Drama, dance, drawing and painting, all can come under the title of Expressive Art Therapy.

I was introduced to it in my third year of training via Natalie Rogers. She’s the daughter of Carl Rogers, and a pioneer in her own right. If you’d like to see her explain her contribution to the Person-Centred approach to counselling, click here.

But the  U.K’s so-called “Father of Art Therapy” was Edward Adamson. Between 1946 and 1981 he worked at Netherne Hospital in Surrey.  It was there he encouraged patients to paint, draw and even sculpt.  He also extended his work througjh the British Red Cross.

Watching Paint Dry

Very academic readers and viewers might like to watch a conference presentation published on Youtube by the Edward Adamson Collection. (Or some of it.) It’s in two parts and called: “Art in the Assylum – Edward Adamson’s Life & Work”. Part 1 (Approx. 30 minutes long) and Part 2 (Just over 30 minutes long.) Those of you less academic WON’T.

General Principles of Expressive Art Therapy
  • Therapy is process focused, rather than systematic
  • The therapist, though qualified and professional, offers support, not authority
  • The client is their own expert
  • Creativity, expression and reflection can lead to positive wellbeing

What do these principles mean?

One, that therapy looks to the client’s experience more than goals and strategies. Two, the therapist does not believe their opinion is more important than the client’s. Three, the therapist trusts the client’s motivation, openness and self realisation. Four, the client’s own way forward is shown through their art.

Art Therapy2

How Expressive Art Therapy Works with Brain Injury

Thinking of the symptoms of brain injury – poor short-term memory, lack of concentration, aphasia or dysphasia, difficulties specifying goals, how can Expressive Art Therapy help?

  1. As the saying goes, “one picture can paint a thousand words” – there is no pressure to mean things with words
  2. The focus is on what’s going on for the client in the moment, so that there is less reliance on memory
  3. Both therapist and client have something tangible to refer to as therapy takes place
  4. The activity of being creative has the potential to increase concentration, planning and other cognitive skills.

But don’t just take my word for it, here are a couple of shorter links:

“Art Therapy Helps Patients with Traumatic Brain Injury” published by NJTV News (3 minutes long)

“Art Therapy Activities: Art Therapy and Brain Injury” published by eHowArtsAndCrafts (2 minutes long)

This is it for July. Take care for now.

 

Panic Buttons for A.B.I.

This month I’ve been asked to write about panic attacks. Wow! I thought. Why haven’t I covered it before? When any of us are unable to think straight, our biology, our emotions carry us along.

Where they carry us, we don’t know until we stop, draw breath and take in what we can of our situation. Up until that point, we don’t know which direction we’re taking ourselves. We become proverbial “headless chickens”.

Before any compensatory therapy or strategy can prove useful, Step One has to be a willingness to face fears. This is most true of clients whose cognitive functioning can be problematic, even on the happier days.

TV Static

The clouding of consciousness (brain fog) is for ABI clients / patients, physical. In a lot of cases it does not go away. Emotions determine the degree of cloud cover, but it’s always there to be lived with.

Another way to describe an injured brain might be as a faulty TV set. I am reminded of Sunday mornings I spent many, many years ago – playing around with the aerial of my parents’ gogglebox – trying to get an undistorted picture of the BBC test card before “Mr. Benn” started.

As therapists, the most we can do is reduce the amount of static and suggest positions the aerial might work better. The aerial’s actual positioning to stabilise their picture behind their static is our clients’ job.

There is no real, by the book, “how to…” with this. In my view, it has to be person-centred. Here‘s a link to Part One of a counselling session (not one of mine) with a head injured client. It lasts 9 or so minutes.

N.B. The client reports being “snappy”, NOT “panicky”.

Panic Button Controls
  • DON’T FIGHT, TAKE FLIGHT. Remove yourself from the environment / situation causing your panic.
  • Find somewhere you can be safe and quiet.
  • Begin listening to your own breathing, taking slow, deep breathsABI and Panic
  • Close your eyes and, if possible, imagine you’re in your favourite surroundings, doing a favourite thing.
  • If imagining you are somewhere else is impossible for you, hold an object in both hands and look at it. Keep listening to your breathing as you notice each of the object’s details – shape, colour, texture, markings…
  • Keep practicing. Set a special time and place aside for yourself.

Reading what to do might be easy. Remembering and doing it, as we all know, is hard. It helps most to be with someone while you practice.

Click here for Part Two of the counselling session. Again, not a counselling session of mine. Part Two also lasts around 9 minutes.

Patchy Reception & Counselling

If you are perhaps wanting counselling, the following points may help you decide.

  1. It offers you a room clear of clutter and distraction – space to breathe and relax.
  2. Regular time slots (50-60 minutes) that can be used to off load – kind of scatter thoughts, feelings, experiences into and around that room.
  3. It provides someone who will support, not judge. Part of that support is in helping take control of the panic. Part is in helping you get organised.

If I was to counsel you, I’d combine listening with breathing techniques and other Mindfulness exercises. A new sense of self can grow. Because as your new self becomes less patchy, you could begin to identify your gut instincts – which situations cause panic more than others and how to deal with them yourself.

Take care for now.

Sean

 

Baring Things in Mind (Part Three)

Hello all.

Thank you to those of you who’ve got in touch. It was especially nice to get an email from a fellow counsellor with cerebral palsy. Yes, I agree we should chat more about its impact and on us as practicing therapists. I’d be very happy for this here blog to be a place to come and share.

If you find Neurolations interesting, entertaining, dare I say useful, please do spread the word. How many of us brain injured therapists are there across the U.K? It’d be great to learn how you connect your chosen form of therapy to your brain injury.

That said, I will restate my blog’s other purpose.

You may not be a professional; you may have short-term memory problems, difficulties keeping track of days, appointments, budgeting, knowing who’s who, controlling your reactions and times when strangers think you’re drunk or just plain wierd. Neuronations is also about helping you.

With all of the above in mind, I thought I’d share an idea with you this month. A work-in-progress, really.

I am always interested by close similarities and cross pollinations of psychotherapy approaches. Psychodynamic therapists and analysts talk  of “personas”; cognitive behavioural therapists refer to “schemas” and “models of behaviour”; transactional analysists speak of “ego states”. The list could go on. But let’s keep things interesting.

Can the triune brain  (lizzard, limbic system and neo-cortex together) form the basis of a new way of looking at Cognitive Rehabilitation Therapy?

I think it can. But my thinking is only based on my experience. I’m wondering how much of your own experience and concepts you can attach to the triune brain. Today I found a thought provoking video about it on Youtube: “Therapy in a Nutshell”. (Don’t you just love it when Serendipity comes along?) N.B: The video does NOT represent the hard science of how the brain works. It is a SIMPLE WAY OF EXPLAINING the brain and personality working together.

triune triangle

The world already has loads of pyschological ways of dealing with what it is to be human. Does it need another one?

The thing is, I’m not sure if any counselling approach takes physical, neurological injury into account. A whole range of books have been written about emotional and psychological disorders. Entire training sessions are given to learning about depression, eating disorders, addiction, anger management and so on. But much less so the interelatedness of brain injury and personality changes, for example.

Anything that does deal with A.B.I, as far as I’ve found so far, is just concerned with the neurological function of lobes and the effects of damage to them – almost in isolation from the rest of the brain. Useful knowledge in an operating theatre. Not so helpful when someone describes to you the loss of balance caused by loud noise but you cannot sense that with them.

Until next month, take care for now.

Baring Things in Mind (Part Two)

One of my followers asked last month if I’d used the correct spelling in the post’s tbrain in handitle. Most people say: “Bearing things in mind” – with an “e” – meaning holding things in mind.

True, but I just cannot resist putting a twist on things. I love a good pun. Besides, where my brain is concerned I am overwhelmed with multiple goings-on and meanings all in the one instance. I’m  at once expressing  I’m  wanting to uncover the mind, put it on show AND let readers behold it.

As last month was all about our so-called lizard brain – that part of us that processes what we sense, this month, I thought I’d give a case study of a client unaware of his bodily senses. With his permission, I have changed his name to protect his confidentiality.

 (James)

James was caught in a mix of family feuding, physical and emotional abuse. Though he requested anger management he came across as quite nervous.

James had no problem retelling all the incidents and background facts leading to his present situation. He had no problem getting excited about his ambitions. But when it came to recognising his excitement as he lived it, or what he was thinking in real time, he was speechless. He simply agreed with my tentative observations.

It was only after some silence in his second session he fixed eye-contact. He asked what thinking was. My description of what thinking is to me, satisfied him. He decided to give guided Focusing a go as something to do other than talk.

Guided Focusing is a series of directions that lead the focuser into and around their body starting at the toes. Sharing their experience is optional.

The idea seemed strange to James. To him, people existed in their head; their bodies just carried them around. So it was enough for him to at first do no more than note for himself his body’s physicality. And even this came hard to him. When not Focusing I introduced him to Stephen Karpman’s Drama Triangle.Karpmans-Drama-TriangleStudying it on my whiteboard was easier for him, with its systematic take on relationships. He saw himself in it.

James used his third session to separate out negatives in his past and positives in his present life.

He was happy to try Guided Focusing again. This time we combined it with the head-held, theory based, Drama Triangle. Focusing became more instrumental in this when he reported feeling ‘composed’. This was his label for his embodied experience and abstract understanding joined together. I re-worded my ‘guiding in’ script to suit.

‘Composure’ became the theme over the following weeks. James grew able to acknowledge and identify his changing emotions in relation to the different roles on the Triangle he felt himself to be as he told me about his week.

When I asked how his smirk was making him feel while he relayed what he’d like to do to get his own back on a particular person, his perception of himself switched from Victim to Persecutor. He called taking himself to his room and listening to music whenever ‘things invaded [his] head’ his Rescuer.

James struggled throughout with very hypothetical stuff. The whiteboard helped us both. Session 10 came. James decided he no longer needed to visit. He felt more confident at work (something also remarked on by his boss) less angry at home and more in control of his life.

Summary

That’s it for another month. But just before I go, to sum the Drama Triangle up, click here for a bit of “Penelope Pitstop”.

‘Who?’ some of you may ask. Don’t worry. I’m just showing my age. Best wishes to you all.

Anchoring for New Memories

Common Problems

The biggest problem after brain injury is with short-term memory loss. Memories are the records of our experience. Lacking memory does not mean we stop experiencing things. But it can mean becoming unaware of our experience. We forget when and where we are and spend our energy on piecing things together and trying to keep track. And then we get tired out.

It’s a bit like being cast adrift on an uncharted sea.

NLP and brain injuty

Without a chart, how might we map our course to our next shore? How can we tell where to go to catch the biggest fish to eat? Not just that, who last had the captain’s log? Where is it supposed to be kept? And where is this captain character, anyway?

The good news is that the chart is not the sea. Though important and useful, it is only the representation of the sea.

What does that mean in the real world? It means that the good news is this: Memories are not experience. Though they give us a sense of space and time and “self” within spacetime, they only represent the past.

We are living in the present. Strengthening our attention on where we are and what’s happening around us improves our skills at making memories. The memory you make now is a memory to recall tomorrow.

Anchoring the N.L.P. Way

Before I talk about “anchoring”, it might help you to watch a short therapy session first.  It lasts 4 minutes. And of course you can go to it again and again, any time you like. Click here to watch the session.

Here is what the therapist does:-

  • Learns from the client the “state” / mood the client wants to be in. (It’s “happy”.)
  • Learns how the client looks when she’s happy.
  • Asks the client to remember a specific time when she felt very happy.

(Note: If she had a brain injury, this would most likely be a long-term memory from long ago. But you know that.)

Next the therapist:-

  • Gets the client to put her attention into her body and almost relive the original experience.
  • Asks the client to choose a knuckle the therapist can touch. (It is the knuckle she anchors the client’s happy feeling to.)
  • She keeps her finger on that knuckle. She encourages the client to relive the memory again – to see what she saw, hear what she heard, feel again her own laughter throughout every fibre of her body.
  • The therapist takes her finger from the client’s knuckle, asks the client to choose another happy memory.laughing

As soon as the client has choosen, the therapist:-

  • Holds her finger on the knuckle again and repeats the process with the client.
  • Brings the client’s attention back to the present.
  • Chats and, now and again, touches the client’s knuckle.

Each time the client feels her therapist touch that chosen knuckle, she laughs. Her happy state is anchored.

Tool Box

Okay, so how can anchoring help make new memories? By paying attention to your body’s sensations in what you’re doing now. Use the help of a friend, carer, coleague. If only one thing today makes you chuckle or want to scream, take note of how your whole body feels in that moment. Make sure you give that feeling a label.

That label is important. It’s job is to link you to the anchor you choose and to the experience that is tomorrow’s memory.

Anchoring might not be your thing. Then again, it might prove a big help. Feel free to share how well it goes after three or more practices.

Take care. More next month.

Belly of the Beast

January is gone. Have we all forgotten our New Year resolutions? Perhaps you’re keeping to what you’ve promised yourself by keeping a written, daily note. Or maybe you’ve another way of prompting scenes and events to come back to you.

This month I am again highlighting Neuro-Linguistic Programming (N.L.P). Specifically how this model of psychotherapy works on the whole person. In fact more than that. I’m giving you a way of looking at how our species came to work the way it does, in body and mind.

This way of looking at our brain was developed by physician and neuroscientist, Paul McLean. He called it the “Triune brain”. It’s not part of N.L.P. itself. But it does help give an understanding of how Neuro-Lingiuistic Programming works.

(Evolution)NLP Feb01

Lizard = The earliest of three forms of brain that would evolve into ours. It operates simply – by its gut reactions to things. When the desert heat affects it, it can move faster. When it feels hungry, that hunger makes it hunt. In fact it lives totally by its gut reactions . It does not question why the sun is hot.

Mammalian (Limbic) = A miPuppy loved-stage representation of our brain’s evolution. Mammals are the group of animals that developed levels of social awareness… Still, not necessarily self awareness. But in their packs, dogs and wolves know one another’s scent and rank. Perhaps this is the beginning of culture.

Neo-Cortex = The outer, most recently evolved layer of the Human brain. It’s evolution allows us to wonder at the world around us and say thingNLP Feb03s like: “Perhaps this is the beginning of culture.” It allows us to, as the saying goes: “Have the world at out fingertips.” Its business is to anticipate consequences – imagine cause and effect, manipulate nature and invent things that suit our needs and wants.

(What It All Means)

Note: N.L.P. is not a science. It is a way of looking at the brain based on science.

Note: The science this here post (“Belly of the Beast”) is based on is the work of Paul McLean. (If you’re a student, trainer or just plain interested, you may like to click here.)

  • Our brain evolved three main capabilities over time – 1) basic stimulus and reaction, to 2) sociability, to 3) thoughtfulness.
  • Basic stimulus and reaction deals with reality in the here-and-now. Pure and simple.
  • Sociability added a level of sophistication. As well as react, mammals respond to one another to get and give what one another need to survive.
  • The Neo-Cortex does not deal with the real world. It creates memories of the past, learns from them, and plans future outcomes that do not yet exist.
  • Our Human brain is made of all the above – 1), 2) and 3). They all communicate and work together as a whole.

Next month: The issues and difficulties of brain injury and how N.L.P. could assist you in your ambitions.

Until then, best wishes for now. This is Sean signing off.