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Review of "Re-Membering: Putting Mind and Body Back Together Following Traumatic Brain Injury" by Ann Millett-Gallant

1/22/2017

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I am delighted to have been asked to review this exquisite memoir of a personal journey of recovery from traumatic brain injury through expressive arts therapy. Millet-Gallant is a worthy follow-up to her heroine, Frida Kahlo, with her deep dive into the imaginal realm through which she creates a new relationship with her rapidly shifting experience of life following her injury. It has been truly inspiring to track her courageous and unflinching march into the painful territories of loss, fear, and guilt, uninterrupted by self-pity or doubt and brimming with sensitive self-awareness.

I was very partial to her writing style, which seemed committed to simplicity without unnecessary detours or excessively dense descriptions, while still providing a stimulating array of colorful and creative insights that powerfully conveyed immense and complex feelings and experiences. It was a pleasurable read with a smooth and flowing pace, which is important for someone like me who doesn't often make time for reading. Her straight-forward intent to share and educate was neatly matched with her succinct accounts of selected, crystalized nuggets of her lengthy recovery.

As a professional expressive arts therapist, I greatly appreciated the value of this work for individuals recovering from significant injuries as well as for professionals working with the TBI population. Counselors and psychotherapists will find inspiration for creative interventions with their clients. Expressive arts therapists will enjoy this affirmation of how our work can access the subtle, vital layers of the psyche where adaptation and resilience take root. Most importantly perhaps, this work provides a rich introduction to the application of creativity in all of our lives, both in her literature review of the history of art therapy as well as her embrace of the therapeutic value of making art, not as a form of rehabilitation for a disability, but as a recognized function of the creative process by practicing artists.

I highly recommend this lovely model for how we can each celebrate our unique identities through the refined and mature self-understanding available to us through the expressive arts.


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An insider's perspective on the field of Expressive Therapy

6/16/2016

 
I have received numerous questions over the years from people interested in becoming expressive therapists wanting to know more about the field and job prospects.   I thought I'd go ahead and share my experiences here, which I hope will be useful to anyone considering becoming an expressive therapist.

Education
There are many different levels of expressive therapy education, but my route has been to get a masters degree in mental health counseling and expressive therapies.  The big advantage there was that I could apply for masters-level counseling jobs, which are very prevalent with good job growth, and I was eligible to become licensed as a mental health counselor.  My degree is now offered at Lesley University under the title "Master of Arts in Clinical Mental Health Counseling with a specialization in Expressive Arts Therapy."  There are numerous similar programs around the country - a full listing of schools can be found at http://www.ieata.org/resorces.html 

Jobs
Mental health counseling and expressive therapy is now employed in a wide range of settings, including inpatient hospitals, community, home, or school-based counseling, office-based outpatient counseling centers, developmental disability support programs, Veterans Administration, therapeutic schools, long-term residential facilities, substance abuse rehabilitation programs, private practice.... the list goes on.  Some positions are more structured with documentation, insurance authorizations, and integrated psychiatric services, while others may be less structured with more freedom to focus on building creative therapeutic relationships.  Whether you prefer to specialize in one population or mix it up in various settings, there seem to be plenty of opportunities.

Expressive Therapy
My experience has been that expressive therapy is very welcome in any job as an offering that supplements my skills as a counselor.  In some positions, my main role was as an expressive therapist while traditional therapy was provided by other counselors, while in other positions, I served as a mental health counselor using expressive therapy as my modality of choice.  Some positions have fewer opportunities for integrating the expressive therapies, such as in one of my jobs as an intake and assessment counselor.  There are some areas of the country where people seem less familiar with expressive therapy, so I have had to demonstrate my skills and educate my supervisors and peers about my work, which has been very well received.  In general, expressive therapy seems to be a popular and valuable skill to have in today's job market.

The Work
Being an expressive therapist is like having a front seat in the process of personal transformation, which to me, is exhilarating.  I often tell my clients that I feel like I am surrounded by unsung heroes.  Because I use the creative arts, the process is not always funneled through the chatter of mental understanding, but through the channel of images, music, poetry, or story.  This means that I am basically constantly immersed in an experiential inquiry into how we are to live, given all that is.  To me, it is a great privilege to spend my day in pursuit of our evolutionary capactities, since it helps me to live a more meaningful life.  In the beginning, being a counselor can be emotionally overwhelming or draining at times, but with more experience, it becomes easier to hold more emotional content comfortably.  I think it is important to find self-care rituals and to use them diligently, or else being a counselor can take a toll on you and others around you.  It is certainly not for everyone, but for many people, including myself, it is truly a dream job.

Best of luck!

Confidence in Unknowing

12/11/2015

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Recently I received a great question about what dance movement therapy activities would be best for adult trauma survivors.  I have received several similar questions about which activities would be best for a particular population or group, but it is usually difficult for me to know all the variables in play to be able to make a useful suggestion.  The expressive therapy activities listed on this website are mainly intended to give a jump start to therapists whose creativity wells are having a dry spell.  I believe that the best expressive activities are co-created with the client to track and follow the specific and unique trajectory of the individual or the group seeking services.  

One of the most important things I learned in my training at Lesley University is that the power of the expressive therapies does not come from a particular activity or group structure but from the ability to be present and creative in a therapeutic relationship.  Throughout my graduate studies, we were rarely ever taught prescriptive activities for particular diagnoses or conditions, such as, "Use the 'Lifeline' activity with sexually abused clients."  What we learned was how to authentically attune to a client on a heart level so we could truly partner our clients in the unfolding journeys of their lives.  While we were given extensive ethical guidelines and protocols for respecting and supporting someone when facilitating a therapy session, our adept supervisors were also guiding us to become confident in a kind of unknowing as our greatest resource for creative therapeutic relationships.  We were given the tools for self-awareness and personal development that can enable us to be cleaner mirrors for others.  I believe that this rigorous training is what enables Lesley graduates to provide exemplary standards of care in the expressive therapies.

Having competent mentors and teachers is indispensable in developing proficiency as an expressive therapist.  For anyone unfamiliar with the expressive therapies who is interested in using creative activities in a therapeutic setting, I strongly recommend seeking training in expressive arts therapy to ensure that one has adequate direction and supervision in one's work.  Conferences and workshops are also great places to ask specific questions about particular populations.   Please visit http://www.ieata.org to learn more about programs worldwide and to connect with the expressive therapies community.

To my reader, I applaud you in the challenging work that you do - don't forget to stay strong in your self-care through the emotionally demanding work of serving the transformation of others. 

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To my fellow warriors in the trenches . . .                                        thank you for your service!

6/28/2015

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I want to give a shout out of thanks to all my readers that have caused my little homemade website to get an average of 1000 hits per day!  I have received numerous notes of thanks for the activities I listed on my site that so many of you have found helpful in facilitating groups.  I visit the websites of the agencies where you work and feel moved by the sincerity of your programs. 

It is clear to me that people drawn to this website are going above and beyond to offer their passion and creativity in their work, not for any paycheck, but for the deep satisfaction of living out one's purpose in life.  I can visualize all the therapists out there, striving to be their best, doing google searches to search for ways to meaningfully engage their clients.  I can see an army of caring and concerned warriors, filled with longing to be of service and the intention to make a difference in the life of someone else. 

What a blessing to live in such a world, full of compassionate, dedicated people.  I want to tell each and every one of you: THANK YOU.  Thank you for everything you do to make the world a better place.  You may sometimes get discouraged, exhausted, or depleted, but remember that every moment of caring you send out into the world has an impact.  Take care of your precious heart and don't ever give up.  Remember that you are a blessing to those whom you serve and that others are lucky to receive your self-sacrificing efforts.

I sometimes like to imagine I'm looking at humanity from a distance, like I'm from another planet or I'm from the future looking back on what our species was about.  In the midst of all the cruelty and blind ambition that is rampant in our world, those of us dedicated to healing, justice, and wisdom are helping to tip the scales and shift our species' profile toward one of sanity and benevolence.  We are redeeming ourselves for the wrongs we have committed and restoring what has been lost or broken.  We are creating the possibility for a future we can believe in.  Knowing you are out there makes me glad to be human.

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I'm a Certified Advanced Alcohol and Drug Counselor!

6/17/2015

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As of June 1, 2015, I am certified as an advanced alcohol and drug counselor since passing the (very difficult) exam in May!  As I embark on this exciting and challenging field, I forsee an ongoing and continually deepening exploration into ways of integrating expressive therapies into addiction treatment.  I draw heavily on Prochaska's stages of change in matching interventions to the needs of recovering individuals, so I tend to incorporate expressive arts as a way of helping the client to move to the next stage of change from wherever they are.  Creative expression, ritual, and internal imagery can be some of the most potent ways for a human being to transform, and yet the process of recovery often seems like a death-defying walk on a tightrope, where one relapse could mean the difference between life and death.  Under such dire and precarious circumstances, I often find myself delicately negotiating a balance between "too much" and "too little" expressive material.  There are risks on both sides of that equation.

Looking back on how I got interested in this field, I have to give an enormous amount of credit to my mentor and supervisor, Ms. Donna Johnson.  I had never seriously considered that I would ever be interested in specializing in this field, but when I met Ms. Donna and heard her speak about addiction treatment, her passion was contagious.  One of the most important things I learned from Ms. Donna is how addiction treatment, though it has many overlaps with mental health, is really its own thing and requires a very distinct skill set and knowledge base from mental health treatment.  Ms. Donna is also an incredible model of the subtle and profound power of motivational interviewing as well as the patience, insight, and humor required to be a trustworthy guide to someone in recovery.  Her company, Addiction Solutions, is a global center for addiction, criminality, integrated care, and corporate training and consulting.  She provides supervision and education worldwide, so if you are interested in getting your credential as an addictions counselor, she is highly recommended!  Please visit www.addictionsolutions.org for more information.
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Someone Has Found A Way

10/25/2014

 
I have become an ardent fan of spoken word poetry.  I have a collection of favorites that I keep in mind when I am working with someone in a therapeutic relationship.  Occasionally, I suggest a particular poem that seems relevant because I am aware that we can crystallize feelings and internal images, not only through our own creation process, but through the absorption of apt images through films, art, and words spoken by others.

As I have surfed through hundreds of poems on youtube, it amazes me that someone has given voice to some of the most hellacious inner struggles of modern life.  No matter how troubled or alone one may feel, there is someone else out there who has traversed the same territory of pain.  Someone was able to give birth to images that are big enough to hold those immense feelings.  Someone has found a way through.

The atmosphere of a poetry slam reminds me very much of a therapeutic group.  The audience offers unconditional support, intense focus and concentration, and a readiness to laugh and cry along with the stories being shared.  There are cheers and applause for the highest value commodities: empowerment, vulnerability, creativity, courage. 

Here are a few that could be helpful in appropriate groups or clients on specific topics:
This one is a brilliant description about the development of self in spite of parental absence or neglect.
One of my favorites about survivors of sexual violation.
Finding resolve in recovering from addiction.
Empowering poem about self-image for women.
On the ability to survive a tragedy.
On spousal abuse and battered wives.
On the journey through the death of a loved one.
A celebration of life with Bipolar Disorder.
This list could go on and on, but I hope this small sample demonstrates the range of poems and their value in the expressive therapies.  

Thanks to all who have sent me thank-you notes, to those who, like me, are always in the process of learning new ways of being in service to others. 

Time, My Nemesis

4/28/2014

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A question from a reader last month was related to time management in facilitating expressive therapy groups.  To be honest, I am terrible at time management as a facilitator.  How long a group takes depends on multiple factors, including how chatty or reserved the group is, and how chatty or reserved you are!  Basically, I try to figure out how much time I have to fill, including any breaks, set up or clean up time, or introductions/ instructions at the beginning of the group and modify the activity to fill the right amount of time.

For example, for the Perfect Imperfections activity (Number 29 on the Group Activities page), I seem to remember having a group of about 10 and running out of time within one hour, since there would be many pauses and giggling, including when someone's staring contest had to be restarted when someone laughed.  One way I would modify it if I had a big group is I would have each person write only three sentences instead of five and just do three rounds of the staring contests.  Or if I had more time, I might increase the time of the staring contests on the later rounds as the game got more challenging.  For example, for the last round, they have to stare at someone for 15 or 20 seconds without laughing instead of just 10. 

Generally, a good rule for me is to plan the activity on the short side, and aim to finish early, so that way if the activity runs longer, I don't actually go overtime. Then have another short activity planned for the end of the group in case you actually finish early, such as leading an open discussion about what people noticed about the activity, such as what was easy or difficult about the activity, or how judgments about imperfections can be limiting.  Depending on the group, you might suggest a free-write on the sentences they wrote, or have them make an artistic image about their favorite sentence that expresses self-acceptance.

I am starting to suspect that finding ways of encouraging others to access meaningful material within a short time frame is one of the most challenging things about this work.  It is certainly an ongoing learning process for me.  Good luck! 

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The Synergy of Connection

2/1/2014

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This week I received a question from a reader about how to process an expressive arts activity when it is done, such as the Empty the Jug activity on my Group Activities page.  Thank you for this wonderful question that seems to distinguish the two core elements in the work I do.  First, there is the client's own content, artwork, personal discoveries or experiences, facilitated through the expressive arts process.  Then there is the sharing of that work with a therapist or in a treatment group of peers.  I believe that these two ingredients create a powerful synergy that fuels personal transformation.  

When I first started conducting expressive therapy sessions, I tended to regard the sharing part as the mere display and appreciation of what the client had created.  I rarely left enough time for it and would consistently run overtime with the session.  I came to realize that sharing and processing the work is equally important to the creation of the work itself and usually requires almost the same amount of time as the experiential segment of the session. 

I also realized that sharing can be very intimidating for even the bravest of clients, and that I had to be proactive about setting a tone of nonjudgment.  I often find myself repeating phrases like, "You can't do it wrong," and "Please leave your art critic outside the door."  I remind my clients that the value of one's expression is determined by how much it means to the person who created it. 

Sometimes I ask clients to imagine a victim of child abuse taking a black crayon and drawing a stick figure of his abuser locked up in jail.  I would then ask my client, "How much value do you think that crayon image has as a piece of art?"  Not much.  Then I'll ask, "How much value or meaning do you think it would have to that person?"  A lot.

A client not only needs protection from criticism, I feel they also need to know that no one is going to dissect their work and analyze it to death.  If they have the courage to read or share something they did, the least we can do is honor it and appreciate it wholeheartedly.  I often ask questions like, "What stood out for you?" or "What did you notice?" 

One of my favorite activities for sharing artwork in a group is to have the artist hold up their work, and each person in the room is invited to offer a word or phrase in response.  People might use descriptive words like, "colorful" or they can become more poetic like "whispers in my dreams."  After hearing all the responses, the artist is invited to give their work a title.  

For an activity like, "Empty the Jug," the client is always invited to share whatever part of it they would like to share.  With that activity in particular, I find that many clients are able to access the predominant themes in their feeling world.  Just having the opportunity to share those feelings with someone can be a meaningful experience for someone who may not be used to expressing feelings so directly.  Typically I will ask, "What was it like for you to write about those feelings?"  When they get to the third layer of the jug, I often ask, "Were there any surprises?"  For some, reflecting on painful feelings can be overwhelming, and I have supported many clients who chose to rip up their papers and throw them away as a way to wipe the slate clean, so to speak. 

Ways of processing that activity in an individual session could vary greatly depending on your counseling style and the client's preferred methods of working.  The activity could lead to an explorative discussion of the various events and feelings in the client's life.  It could also lead to an intermodal transfer where the client may be able to use color and image to create artwork about the feelings or experiences that came up in the writing segment.  Alternatively, if the client listed many negative feelings in her life, then she might be inclined to creatively explore ways of tapping into sources of inner strength, such as artwork (or music, meditation, movement, etc.) with themes of hope, resilience, or love.

Ultimately, I believe that the heart-to-heart contact between human beings, whether that is between the client and the therapist, the client and the group, or the energy field of the whole group, is what enables the client to transform a stuck pattern.  Perhaps the most important thing I do when I process an expressive arts therapy activity with a client is I allow myself to be genuinely moved by their work.  If you truly look for what is beautiful, authentic, or meaningful in someone's creative expression, you will surely find it.

By gazing at their work, listening closely, repeating back what I heard and sharing how it resonated with me, I am hoping to amplify the message conveyed in their work and let it fill the room.  And whether they wrote one word or a long poem, made three dots on a page or a complex image, I find some way to communicate, through dialogue or silence, that I am grateful that they trusted me enough to share their process with me.

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The Power of Imagination in Times of Defeat

12/21/2013

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This quote relates to a discussion that came up in one of my adult groups this week, and it was like a moment when we were peering behind the curtain of the therapeutic process. When should we apply our focus on fixing what is wrong, and when should we apply our focus on celebrating what is right? Another way of saying that would be, How much should we be fighting off what is holding us back and how much should we be grabbing onto what is pulling us forward?

My observation in my own life and in my work with patients is that our presumption is to spend more of our time focusing on fixing what is wrong than celebrating and expressing what is right. I wonder if there is some underlying cultural view that promotes this way of thinking. For example, we have all heard the phrase, "problem-solving," but we don't often use the phrase, "solution-finding." I wonder if we are generally taught to approach problems as something to be wrestled with and dominated, and certainly, this can be extremely effective. At the very least, identifying and recognizing dysfunctional patterns in one's life and finding the roots of the problem in one's personal history can springboard the process of change.  Ignoring problems in relationships or in one's mental health can also delay the needed attention until a crisis occurs.

However, I am starting to see a connection between the value of creativity in the expressive therapies and the overall application of imagination in the crafting of our lives. Celebrating what is right in one's life is an affirmation of one's power to create and succeed. Oftentimes, experiences of failure and defeat cause people to stop imagining the possible, to stop dreaming, and to stop finding ways that their unique experiences can transform the world. It occurs to me that it is exactly in times of defeat that we are afforded an opportunity to envision a new reality, one that integrates the current predicament as the seed for a never-before-seen kind of fruit.

Creativity is not just something that you do on a piece of paper or with a musical instrument. Creativity is the ability to see more than what is there, to risk doing something differently, to trust an inner impulse to reveal more than what is known. As an expressive therapist, I hope to encourage my patients to have faith in their creative power to make a place for themselves in the world where their gifts will be expressed and valued. Sometimes, the problem we are trying to solve, whether it's depression or alcoholism or panic attacks, can become a distraction from the real problem: the absence of a soul-infused story, written in a language unknown to the rest of the world, the translation of which is the task for the rest of our lives.

“In my dream, the angel shrugged and said, if we fail this time, it will be a failure of imagination and then she placed the world gently in the palm of my hand.”
- Brian Andreas

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Love Yourself

11/17/2013

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This is a poem I wrote for a teen patient a few years ago.  It is a message I wish I could convey to every person who lives with a debilitating sense of self-doubt.



Love yourself.
It's not worth it to go cowering through life
for no reason.
Look in the mirror and shout
"YEAH!"
No other proof of your greatness
should be needed.
You have come this far
sometimes laughing,
sometimes crying,
sometimes laughing and crying at the same time.
In some outrageous way,
you belong to a greater mystery
than you can possibly imagine.
No one else has your eyes
your walk,
your talk,
or your hidden, secret beauty.
I say, set out now to discover it.
No adventure in life will ever be
more exciting than
the journey to yourself.
Surround yourself in a love bubble
and walk confidently and faithfully
through this life
one step at a time.


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    Gloria Mahin

    Expressive arts therapist in northern West Virginia. 

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