February 26, 2015: Responsive Art Making in Art Therapy and Empathy

     I am going to take a little different approach this time in the blog for this week's session. This is because I was completely blown away by Lori's presentation. First of all, being a retired physician, and therefore with a huge science background, I was certainly grounded in the materialistic narrative of world view. Carried to an extreme, to me this means that the brain is the brain and it basically consists of biochemical reactions that produce electrical currents from one area of the brain to another in pathways and networks. And it would be these currents that somehow create our consciousness. Of course, after all these years in our Spirit Mind Body Group, these rigid materialistic views of consciousness have been modified by exposure to the strong Buddhist bent of this group, and to the strong intellects and spiritual knowledge and practices of the members of the group. This means that I can identify with many of our spiritual topics as they are presented. But this presentation was something totally foreign to me. Of course I had a simplistic view of using art in therapy. My view could be likened to the simplistic view of art being used in a TV crime show where a child is asked to make a drawing representing her life, or her family, or something that happened to her and then using that drawing to imply and then ascertain if some sort of crime was committed and seen by the child. A very simplistic view indeed, as I learned from Lori's presentation.

     Lori was kind enough to provide through Sharleen copies of three articles on which she based her presentation. If you have not received these in your emails, please let Sharleen know at  sharleen@itech-mke.com and she can either send you a copy in your email or either she or I could make a hard copy for you and get it too you. I am only going to present a very brief summary of some of the concepts that she considered here because they are quite complex, and I think can best be understood by reading these articles. I cannot put a link to them or copy them here because they are in PDF format and blogger.com does not let me upload them. Because Lori has already done some dramatic condensing of these concepts, for me to further summarize, we will lose significant meaning. Therefore, here are some definitions and brief outline topics. But I advise reading the whole articles. 

Summary of Lori's presentation:

     Response art is making art in response to another art piece. Don Jones was an art therapy pioneer who used art as an asylum and a way to survive. Talk therapy combined with painting has evolved over time.Art is used to form a relationship, as a way to communicate, and helps the therapist understand the client. The therapist needs to ask: "How does the art want me to work? This helps cut through the verbal because many times the client can not use words well to describe or relate. 

     Sometimes the art therapist literally and sometimes figuratively sits in the client's chair, using his art media, to recreate the client's artwork. The therapist brings in the conscious as well as the pre conscious portions. At other times, the art therapist uses the perceptions and feelings of the client to make art. Art allows whatever needs glimpsing to be seen when the words do not come. 

      Lori went into some detail about the Franklin article on mirror neurons. The article describes a part of the macaque's brains where there are what are called mirror neurons. This is thought to happen in humans as well. When we see another being move, obviously using motor neurons to accomplish that movement, there are mirror neurons that also fire up while seeing another move. These mirror neurons do not make the viewer move, but instead there is an implicit automatic unconscious embodiment of another. This provides a completely different way of experiencing the other. 

     Another way to look at art therapy utilizes the fact that a person appreciates art with their feeling. The art viewer often puts themselves into the art, empathizing with the painting and also the painter. As consciousness is concerned, I, the viewer am totally part of the art. This is called aesthetic Einfuhlung, a German word that means aesthetic empathy. 

     Intersubjectivity plays a role     Explain Definition:  comprehensible to, relating to, or used by a number of persons or conscious beings as a concept or language.

     Also attachment theory enters into art therapy. The therapist and the client share a subjective state to form an attachment. Lipp, a prominent theorist worked with a mother and child. The eye can penetrate into art to bridge the space between self and other. Art therapy works to get a felt sense of the art to help expression. The art object becomes a safer place to hold the feelings. It is not just a formulaic way to interpret what is expressed in the art creation. Rather the purpose is more to get into the art. One psychoanalyst by the name of Donald Winnicott would start a squiggle with an art medium. The patient would then complete the squiggle. The patient then gives a narrative. The art, or just the squiggle, has become a place to hold the story or the narrative. One can approach the painting if that is the medium as a message from the inner person, the client. In this way, art therapy is related to meditative practice and to psychotherapy. Transference and countertransference end up playing  a role as well. 

     Another way to use art therapy is to encourage dialogue with an art image with the image as a living being. One could ask the image "What do you want? How do you feel?" 

     In art therapy, there occurs a contemplative relationship. The artist and the subject have a reciprocal relationship. 

End of Summary.

      This is Lori's field of study and she has the wonderful benefit of having read in depth and studied the current field of art therapy and she now practices this field at St. Luke's along with her studies. She did a marvelous and very thorough job of summarizing the extensive and intensive work and conclusions of several articles written by no doubt experts in this relatively new and emerging area of study. Lori was kind enough to provide three of these articles to each member of the group who has emails listed with Sharleen. I have read these articles and they certainly made this morning's presentation more clear. However, she did very concisely present a summary of these articles. What I found most remarkable was the complexity and variability of the processes used now in art therapy. Knowing the psychological complexities of human behavior, I am amazed that these processes have become as successful as apparently they have become. Here I would like to just quote a small section of one of thee articles which describes all the communicative connections that have to take place in the therapist, in the client, and then in the figurative space between these two individuals all also influenced by the interpretative complexities of non verbal artistic creation. That this works and I have no doubt that it does, amazes me. Here is the quote: From: Art Therapy: Journal of the American Art Therapy Association.  "Affect Regulation, Mirror Neurons, and the Third Hand Formulating Mindful Empathic Art Interventions."  Michael Franklin PhD, Naropa University, Boulder, CO  April 22, 2011.

     "The layered elements that form visual empathic, responses ultimately unfold in a quick succession of subtle, albeit informed, intuitions that result from education, clinical training, and overall life experience. Because these informed intuitions emerge as automatic thoughts, it may be helpful to describe the process of their emergence, as follows:
     "The progression of empathic insight and response begins with a contemplative mindful lens, in which the art therapist's intention should be to slow down and remain present without judgements (Franklin, 1990). This initial phase attempts a neutral posture, suspending the habit of judging, categorizing, explaining, or knowing. The goal is to be mindfully present to presenting imagery and behavior, bracketing out points of bias or impulsive interpretations that might contaminate a fresh, beginner's mind. The desired attitude is that of meeting a stranger for the first time with a welcoming, unconditional presence.
    "Next, the therapist aims to receive the ongoing, multiple, communications of the client -- including verbal, visual, behavioral, and somatic cues -- within the therapist's own body. it is also important to observe facial expressions and nonverbal patterns unfolding in the environment (Schlore & Schore, 2008). Being mindfully receptive to this relational field will cultivate an intrapersonal tolerance for the ambiguous, layered information emerging in the session.
     "The therapist then directs his or her efforts toward becoming phenomenologically aware of the primary core formal elements that comprise these verbal, visual, behavioral, and somatic cues. The therapist must check transference and countertransference reactions and sort out related and unrelated personal identifications with the art and other expressions presented. Given the likelihood that the therapist's mirror neuron system has been activated, somatic cues can be used as sources of information to monitor. the therapist filters all of this information by omitting irrelevant material and distilling the primary data into the core content to be communicated. The core content becomes the consolidated emotional center of all verbal, visual, and somatic communications (Sobol & Willims, 2001).
     "The core material is sifted further when the art therapist aligns it with similarities in his or her personal history that are based in resonance rather than over identification. As with the difference between empathy (feeling within), and sympathy (Feeling for), the therapist carefully monitors the potential for merger through projective identification. At this point contertransference becomes available as a form of sublimated empathy.
     "Acting in the hold of the "third Hand" or auxiliary ego, a visual narrative is then judiciously crafted. this consolidated and symbolic communication responds to what Schlore and Schore (2008) called the "music" behind discursive language. Finally, visual intervention is offered in the least intrusive way when the therapist attunes to the client's artistic style or visual "handwriting"  (Kramer, 1986). This completes the empathic art process.
     "To summarize, in this image- and client-centered approach, isomorphic expression from the client is answered with empirically accurate, isomorphic expression from the art therapist. In essence, the art therapist receives the affect of the client from his or her art and other layered expressions, manages initial ambiguities by skillfully filtering this material through personal yet objective identifications and associations, and offers back an artistic response. This response consolidates and communicates with clarity the emotional center of the changes experienced in the session.
     "The crafting of empathic art responses requires several additional considerations. First, it is necessary to take into account one's own unconscious processes and messages. The intersubjective exchange between client and art therapist is actually an interaction of two intermingling histories. (Teicholz, 1999). The postmodern perspective is that no true objective reality exists; rather, multiple subjective realities are constructed out of personal experiences. The therapist's subjective perception is therefore crucial because it is always possible for unconscious messages to be communicated through the therapist's misattuned responses. This is why meditation practice is an important intrapersonal strategy for cultivating awareness, attention, and intention, all of which help monitor any subtle miscues. 


     Due to the complexities and the vast trove of information presented last Thursday morning, I suggested that we use this next week's Bake Off to further discuss some of these concepts. We will have more or less, a directed Bake Off, rather than the usual free for all. I do believe that several of our group had comments to make. I advise members to read the articles, and jot down questions, comments, or other narratives that might contribute to this discussion next week.

     In my usual attempt to provide something visual and not just endless written words in this blog, I thank Dave K. for sending me this you tube link. I think it demonstrates art therapy to an extreme. Of course, the creator of these amazing structures did them as a therapy for himself, but I think we can all receive some therapy from viewing what he has done.

 https://www.youtube.com/embed/oxcftjJ39BU

      Here is an idea for a future meeting:  https://www.youtube.com/watch?v=-7YFrMqbcQ8
3 minute art therapy are youtube videos made by Pamela Hayes, art therapist. Most are more primitive or crafty art than what Lori has described, but I think the idea of Winnicott carried further by his students and now Pamela Hayes who has two people exchange squiggles and then has other person make the squiggle into a drawing.

February 5, 2015: Bake Off

     Scatology 101:     At the beginning of this meeting, we made a round of the group to see if anyone had anything that they wanted to announce, any question to ask, or pearl that they wanted to share, albeit briefly. Sky was the first person, and he asked the question that has been bothering him for sometime now -- that relates to a concern about his daughter who has cystic fibrosis and great difficulty having normal bowel movements. He was shocked to read and learn all we know and all we don't know medically about the bacteria growing in the bowel. He informed us that there are at least 1500 species of bacteria that live normally in the bowel. And he particularly has questions about using Miralax as a treatment for intractable constipation.  Unfortunately or fortunately, this question led to basically scatological comments which continued through fully 1/2 of the circle of the group. Who would have thought that consideration of shitting would have led to so many wise and pithy statements? Unfortunately I didn't write the pith down, so you all will have to rely on your own memories for this topic.

      Meredith did try to broaden the topic asking us to consider the Great Amazon Basin as a huge digestive organ for the planet Earth. There are more species there than in any other habitat including the human bowel. But we humans are in the process of destroying this habitat, by logging it, burning what remains, farming this land for a while and then when it ceases to bear fruit well, moving on to more land and logging it, continuing the cycle. In a like manner in our own systems, natural substances often helped control our various functions but we are destroying those natural substances, such as herbs. We replace these natural products with medications. But often these medications have unintended consequences that could not have been foreseen.

     Mary recommended at book she is reading called "The Afterlife of Billy Fingers."

     Sharleen recommended the movie, entitled "The Painter" now playing probably at the Downer.

     The second half of the round table recalled some of the discussion during the previous week's meeting with Dr. Prosen and his work on empathy. Many members of the group had been stimulated by some of Dr. Prosen's discussion of this topic, an area that he was interested in during his entire career both in the psychiatric treatment of human beings and then in the treatment of primates particularly bonobos. I think Dr. Prosen also learned a lot about empathy from the zoo animals, and from their keepers and the researchers at the zoo.

     Comments suggested that the word empathy is a relatively new word just arising about 100 years ago. Actually the word began to be used in about 1850 but that is relatively recently. It is based on the Greek word: empatheia which means passion. It is basically em+pathos which means feelings or emotions. Further, the word was actually coined in 1858 by German philosopher Rudolf Lotze (1817-1881) as a translation of Greek empatheia. There are two definitions of empathy. the first and most often use means a direct identification with, understanding of, and vicarious experience of another person's situation, feelings, and motives. The second use defines empathy as the projection of one's own feelings or emotional state onto an object or animal. This is the way that the word is used in art appreciation. One member of our group has studied art appreciation and recognizes this use of the word, but has difficulty understanding how art can communicate a feeling to the observer without being that feeling. Art therapy is used to help people, but it seems to work best when the art is used with movement. A study was cited from the Scientific American, where a drug addict has to push a bar away when the addict has a craving for the drug. The group that was required and complied with this pushing the bar away had a better success rate at addiction cure. There was something about the kinesthetic act of pushing that bar coincident with the craving.

     The group discussed the difference or lack of difference between the meaning of the words empathy and compassion. One of the ideas most expressed about empathy is that it lacks any judgement. For example, one would have difficulty understanding a child abuser if you judge him as sick or evil.

     We also always must remember that these definitions depend on our perception of the words and of the world. And often with perception there is deception. Not only must we always be aware that how we perceive the world is almost always wrong. In addition, language is often inaccurate. Paul cautioned us that in Buddhist thought empathy and compassion would be equal and nearly the same. There is no judgement with either one. Think of the specific Buddhist practice of tonglen meditation which extends compassion to others from those closest to us and even ourselves, to inclusively the whole world of sentient beings. The word sympathy also entered the discussion. But it was felt that sympathy means having a "feeling for" whereas empathy or compassion means having a "feeling with or even feeling into."  The idea of pity also came up. In Buddhist thought pity should be regarded as the enemy of empathy. Again language creates some of the problems we have in understanding these definition differences. Language is the stuff of dualities. Many of our neuroses may be related to language. But we really don't have other effective ways to communicate to the degree that our human lives seem to require. We just must remember the inaccuracies in language and in perception and how they can complicate our human relationships.     
 

January 29, 2015: Dr. Harry Prosen: Bonobos and Empathy.

   Our Spirit Mind Body Group had the unique and enjoyable opportunity to hear Professor Harry Prosen, Emeritus Professor of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, and former Chief of the Department, and formerly Professor of Psychiatry, University of Manitoba, Canada and chief of the Psychiatry Department there.  Dr. Prosen has a multitude of other roles in his past academic career and even currently, but perhaps what he is most known for by non medical people at least on the Internet is his behavioral consultant work to the Milwaukee Zoo on bonobos. Since his work in this capacity he has received calls from all over the world about psychological and some medical problems with the great primates. In addition to his medical leadership roles as past President of the Canadian Psychiatric Association, and leadership roles in the Royal College of Physicians and Surgeons of Canada, and the American Psychiatric Association, he is currently head consultant for the Bonobo Species Preservation Society.

     Dr. Prosen first told us how he became a psychiatric consultant for bonobos. The story involves Brian, a young bonobo male who was sent from Yerkes Primate Research Center in Atlanta, where he had been housed with a male bonobo alone, not as normal which would be with his mother. Brian was very psychiatrically ill for a bonobo and was totally dysfunctional. He was engaging in a juvenile masturbation activity called fisting, in addition to other behavioral defects. With zookeepers, and administrators, various plans were outlined to try to help Brian. Eventually he was put into the enclosure with several females but they recognized his behavioral problems and were beating up on him. After much work and various brainstorming sessions, finally an older male, Lody and a very nurturing blind female, Kitty, were able to help Brian and his behavior slowly normalized. I had heard this story before, but didn't know the outcome. I was happy to learn that Brian is now the alpha male of the bonobo group at the Milwaukee County Zoo.

     Bonobos are very threatened in the wild. There may be only a couple thousand left in the Congo, where they reside on one side of the Congo River, the chimpanzees on the other side. Bonobos are matriarchal at least in the breeding colony. When males reach young adulthood they are chased out of the colony by the females and must join another colony or build one from scratch. The bonobos are considered to be one of the most empathic of all creatures and their society is characterized by much physical contact. It has been observed that bonobos solve most threatening problems by everyone having sex with everyone else. Then they see what is left that is threatening after a period of this sexual behavior. Milwaukee has the biggest bonobo colony in North America. Also Antwerp, Belgium has a large colony. Due to Dr. Prosen's observations and experience, Milwaukee Zoo is now considered an expert location for bonobos. However, Dr. Prosen reports that his tasks have not been easy. Like any other large organization, people at the Zoo have had their own ideas. Sometimes the keepers understand the animals better, but the researchers are in charge and don't always have an open mind. Many of the consultations that Dr. Prosen has received from around the world are done confidentially because some of the young caretakers are afraid to counter the researchers or the administration, or representatives of the philanthropic wing of the zoological park.

     It should be noted that the story of Brian and the story of where his initial consultation took Dr. Prosen is told in more detail in the Atlantic Monthly, of June, 2014. Here is a link.
 http://www.theatlantic.com/health/archive/2014/06/brian-the-mentally-ill-bonobo-and-how-he-healed/372596/

You may also learn more about Dr. Prosen. There is a nice Wikipedia article that is fairly thorough.

    Laurel Braitmans also tells Brian's story in her book: "Animal Madness: How anxious dogs, compulsive parrots, and elephants in recovery help us understand ourselves, a survey of mental illness in animals and its relationship to our own problems."  

     Dr. Prosen had done research in empathy and particularly in family relationships, looking at non verbal communication, and utilizing facial movements to communicate. This basis of study was a perfect baseline of knowledge from which Dr. Prosen could serve in such an expert way for the bonobos. Likewise and in the reverse, his work with these primates and for that matter a few other species of animals helped him to even further understand human empathy. A quote on empathy by Dr. Prosen: "Empathy knows no country, no species, is universal and has always been available. I discovered after arriving at the zoo that it belonged to the bonobos long before us."

     Dr. Prosen has written over 70 books, monographs, and articles, reviewed over 30 books and  delivered over 60 presentations at various conferences.

     Most recently Dr. Prosen has served as an advocate for Australian biologist Jeremy Griffith, whose several books on the human condition have led to Dr. Griffith founding a movement called the World Transformation Movement, or WTM. The most complete Griffith book on this topic has been rewritten and is now entitled "Freedom", and has an introduction by Dr. Harry Prosen. Also Dr. Prosen has worked in depth with Dr. Griffith on a planned documentary to explain the human condition in detail. I believe there is slow movement toward the production of this documentary film. The problem is that Griffith has alienated some people in high places in the religious community in Australia and that may have slowed the documentary process. I'm not going to go into the WTM in great detail here, but basically Dr. Griffith feels he has sorted out why human beings act the way they do, in so many ways contributing to the suffering of their fellow human beings.  The book explains why there seems to be evil in the world and why we cannot live in peace. I suggest starting with the Wikipedia article on the WTM and take it from there.

     Our group members seemed particularly interested in empathy and what it is, how it can be defined, how it differs from sympathy and from compassion, whether it can be taught or learned, and how we can practice more empathy in daily life.The group felt that empathy can be taught or is learned. But there is a difference between compassion and empathy though the difference is slight. It also depends on our perception and how the word compassion is being used. We all have empathy but the amount varies. Recent imaging studies have shown in which areas of the brain empathy arises. There are certainly inborn aspects of empathy. And the presence of empathy is tied up with the human condition. In the beginning, we may have empathy. Studies of infants have shown this. But in some of us as our lives are built we displace the empathy. Projection seems like empathy but it is not. For the psychiatrist, transference and countertransference are also involved. There was a general consensus that the group could spend another session discussing empathy. That may take place in the future.

     Again the group would wholeheartedly like to thank Dr. Prosen. He also offered to come back sometime and go into more detail about empathy and his areas of study.