Author Archives: RichardB

Past Talking: Poetry Therapy

29 Wednesday Nov 2023

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Poetry therapy is “the use of language, symbol, and story in therapeutic, educational, and community building capacities.” It’s effective, with a wide range of populations, from children to elders, and with a broad range of problem areas, including family violence, homelessness, death and loss, and suicide. For example, it’s used when therapists employ poetry and creative writing to work on positive youth development with middle school children or when working with veterans and their families. A collaborative poem may be a helpful tool in gerontological work, while a dyadic poem may help facilitate couples/marital therapy.

Poetry therapy, which, according to the National Association for Poetry Therapy (NAPT)—established in 1969 as the Association for Poetry Therapy and formally incorporated as NAPT in 1981—has been a recognized healing art in the United States for more than 200 years, is a means through which individuals—such as those navigating grief or living with depression or cancer—can find voice for their feelings and a medium through which to participate in the therapeutic process.

The reasons poetry therapy may succeed where other traditional therapies may not—is that it is culturally sensitive and nonthreatening and thus able to “break through resistance, validate, and promote interaction.” Through practice and research, there are three major domains of poetry therapy—introducing a poem into the practice session (bibliotherapy tradition), promoting focused expressive writing (well documented health benefits), and utilizing symbolic or ceremonial activities to aid in life transitions. It’s consistent with the strengths perspective but easily adaptable to a wide range of theories, e.g., cognitive-behavioral, narrative, systems, and psychodynamic.

The International Federation for Biblio-Poetry Therapy provides credentials for poetry therapists. Certified poetry therapists and registered poetry therapists are master’s-level credentials obtained after completion of an approved program of didactic training, experience, and supervision.

Past Talking: Art Therapy

22 Wednesday Nov 2023

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Art Therapy
According to the American Art Therapy Association, art therapy is “the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma, or challenges in living, and by people who seek personal development. Through creating art and reflecting on the art products and processes, people can increase awareness of self and others; cope with symptoms, stress, and traumatic experiences; enhance cognitive abilities; and enjoy the life-affirming pleasures of making art.”

Registered art therapists are credentialed by the Art Therapy Credentials Board of the American Art Therapy Association after obtaining a master’s degree in art therapy and gaining supervised postgraduate clinical experience.
There’s no client who can’t be helped by art therapy, Goebl-Parker says—not even the blind. That, she suggests, is because art is felt as well as seen. “Art therapists really can be anywhere; any setting in which it would make sense that there would be a therapist or a counselor is where art therapy can be helpful. For example, it’s increasingly used, she says, in substance abuse, where it can help provide the motivation for treatment.” Goebl-Parker uses it “as a way to crystalize for clients what they can get out of therapy so they can stay committed to something and to help people locate their own impetus for change.”

One of the leading strengths of art therapy rests in its ability to harness the power of the metaphor. “There’s a huge range in how it’s used,” Goebl-Parker says, noting it might be “a metaphor of the material engagement—what it feels like to have your hand in the clay bucket—or the story of the object one makes.” Children in a session may be nonverbal, but in the process of “messing around with materials” they create clear metaphors for what they’re experiencing that can later be discussed. “So people who would have a hard time doing that work verbally can work in metaphor and the materials become an adjunctive way for them to have language, to have a different kind of voice,” Goebl-Parker says.

An offshoot of art therapy that’s increasingly popular is phototherapy. “Photo therapy techniques can be used for most psychotherapy situations, and there are numerous applications for different age populations and diagnostic groups, such as adolescents, people with schizophrenia, abuse survivors, and bereavement groups,” explains Gontarz York, who describes herself as a “lifelong gerontological social worker” who finds photographs to be powerful therapeutic tools.
While phototherapy can be useful with any population, Gontarz York uses it chiefly to elicit memories for reminiscence and life review work with older adults.

“Everyday photographs, found in albums and boxes, framed by the bedside, mounted on walls, posted on mirrors and refrigerators, offer therapists wonderful opportunities to begin conversations, develop relationships, and offer older adults the opportunity to engage in meaningful interactions through reminiscence and life review.” Every photograph, she explains, is a self-portrait, a window into the inner world of the client. “As clients discuss their photographs, we receive a fuller understanding of who that person is and how they perceive their world,” Gontarz York says. “Besides being a lasting memory of lives and actions, photographs document the past and contain valuable information regarding relationships and personal values,” she adds.

Past Talking: Drama Therapy

15 Wednesday Nov 2023

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Drama therapy relies on a range of techniques to meet numerous therapeutic goals and outcomes, including, according to the Drama Therapy Association, the ability of clients to tell their stories, rehearse desired behaviors, practice relationship skills, set goals, improve interpersonal skills, achieve catharsis, appropriately express feelings, and perform the change they wish to be and see in the world.

Among the drama techniques yoked to other methods of therapy to achieve these goals are storytelling, role-playing, improvisation, performance, and the use of puppetry and masks.
Among its many uses, “Drama therapy is spot-on for working with recovering addicts,” Bailey says. “Addicts are afraid of feelings and have been numbing their feelings out for years with their substances of choice. Drama therapy is all about experiencing and expressing feelings, but it tends, especially in the beginning, to be fun, so addicts can work on slowly learning how to feel again, and feel with other people, without becoming stressed and feeling the urge to get high.”

As with other creative arts therapies, an especially powerful aspect of drama therapy rests in its ability to promote relationship building, and its nonthreatening nature encourages participation. “Drama therapy, because it generates strong bonds of trust, helps addicts work on their fears of getting close to others, asking for help, and wanting to give and take in a relationship,” Bailey says.

Another group of clients for whom drama therapy can be particularly helpful are those on the autism spectrum who have difficulty understanding and expressing emotion, Bailey says. “Drama therapy,” she adds, “provides lots of practice on these nonverbal as well as verbal communication skills. It creates trusting relationships and provides training in give and take as well as flexibility—very needed abilities for people on the spectrum.” What’s more, she says, it’s fun, so it’s easy to motivate people to participate.

A registered drama therapist is a master’s-level credential administered by the North American Drama Therapy Association (NADTA) to individuals who have completed courses in psychology and drama therapy as well as two clinically supervised internships and 1,500 hours of work experience coupled with theater experience. Candidates have either attended an accredited drama therapy master’s program or completed the NADTA Alternative Training Program under the mentorship of a board certified trainer.

Self-Control Can Be Draining

01 Wednesday Nov 2023

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The human body has a finite number of resources, and scientists are always discovering more about how these resources are shared, depleted, and replenished. Now a new study suggests that the areas in your brain responsible for self-control and forming memories are closely linked – in other words, if you’re concentrating hard on staying disciplined, you’re probably becoming less adept at remembering what’s happening.

Researchers Yu-Chin Chiu and Tobias Egner from Duke University in the US asked a group of volunteers to recognize a series of faces, both with and without the inclusion of a self-control test in the middle. They found that having to exercise self-control had a negative impact on the participants’ ability to recall which pictures they’d previously seen. The same experiment was then repeated with a new set of volunteers and brain-scanning fMRI (functional magnetic resonance imaging) equipment on hand.

The pair discovered that one area of the brain – the ventrolateral prefrontal cortex – was activated frequently during the self-control test and predicted the strength of the volunteers’ memory later on. The findings suggest that self-control and memory compete for the same resources inside the brain and support the theory that inhibiting ourselves can also cause us to forget more easily.

“The control demands of response inhibition divert attention away from stimulus encoding, thereby weakening memory traces for inhibitory cues,” the researchers conclude in The Journal of Neurosience. “These findings shed new light on the relation between the control process of response inhibition and the cognitive domains of perception, attention, and memory.”

The self-control test used was a traditional Go/No-Go task: these tasks work by asking participants to view a series of items and push a button only when certain criteria are met – in the case of this experiment, when the face shown is male rather than female. The theory is that those who are able to hold back from a button push when necessary are those with the strongest self-control (or “response inhibition”, as neuroscientists like to call it). The participants were not told in advance that they would need to remember the faces they were shown.

“The scans revealed that responding to a cue and inhibiting a response produced overlapping activation patterns in brain regions within the right frontal and parietal lobes, a network that has previously been implicated in response inhibition,” Mo Costrandi reports for The Guardian. “Crucially, ‘no-go’ trials produced greater activation of this network than ‘Go’ trials, and activity in one specific brain region (the ventrolateral prefrontal cortex) predicted the strength of the participants’ memory, such that the greater the observed network activation, the more likely the participants were to forget that face later on.”

The researchers admit their theory is still “speculative” for now, but if further study confirms the link, they believe their discovery could be used to treat people who have problems with self-control: those suffering from ADHD (Attention Deficit Hyperactivity Disorder), for example, or some form of addiction.

One scenario put forward by the pair is having to suddenly cancel a lane change on the motorway because a car is already in the spot you want to move into. If they’re right, the act of having to control and inhibit your actions would make it less likely that you would remember the details of the incident – such as the make and model of the car that was blocking your path.

Irrational Beliefs Guide

25 Wednesday Oct 2023

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Consider the following questions carefully. Reflectively answer each one briefly but completely regarding those people or things about which you are most emotionally disturbed. This assignment may be emotionally painful, but it may help you achieve needed insight so that you can end your pain.

  • Who or what disturbs or upsets you?
  • Who or what do you strongly believe should, ought, must, or have to be different?
  • Who or what do you strongly think is or awful, terrible, horrible, or catastrophic?
  • Who or what do you down, damn, condemn or believe is worthless?
  • Who or what do you believe is absolutely needed, necessary, or required?
  • What are the things you strongly believe are absolutes, extremes, or critically important?
  • Who or what do you most often or most strongly complain about?
  • What is your greatest wish that you believe you most likely won’t get?
  • What goal have you made (even unconsciously) into a demand because you not only want to but have convinced yourself you must achieve it?
  • What happened in your past from which you cannot recover?
  • What things do you find are, too hard, too much, too painful, too upsetting, or that you just can’t stand?
  • Who or what are you most likely to lose your temper over?
  • What are the biggest stresses in your life?
  • Who or what do you feel most helpless about?
  • Who or what do you feel most hopeless about?
  • What are your most strongly felt demands, wishes, or hopes?
  • What insight or awareness have you come to because of this exercise?

Neuroscience, Addiction, Theory

18 Wednesday Oct 2023

Posted by in Addiction

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Over the years I have read articles and case files of clients that suggest there is an abundance of anxiety and anxiety related disorders with people who experience alcohol and drug addiction. One of the chief components that produce anxiety is stress and according to Volkow and Li (2005) stress increases vulnerability to drug use and relapse in those addicted. They both argue that there is evidence that, “corticotropin-releasing factor (CRF) might play a linking role through its effects on the mesocorticolimbic dopamine system and the hypothalamic-pituitary–adrenal axis15-16” (Volkow, Li, 2005, p 1429). In simpler terms, stress produces CRF which affects the limbic system and the adrenals which in turn increases the stress response cycle.

In thinking about stress I stumbled across another article in the same issue of Nature and Neuroscience that talked about stress like responses, abet in a somewhat indirect manner. The article, by Antoine Bechara (2005) talks about the amygdala being out of balance. Bechara argues that addicted people become unable to make drug-use choices on the basis of long-term outcome because of hyperactivity within the amygdala (Bechara, 2005, p.1458). The amygdala which signals pain or pleasure of immediate prospects, overpowers the reflective prefrontal cortex system for signaling pain or pleasure of future prospects thus altering the decision making process. Bachara goes on to say that substance use can trigger involuntary signals originating from the amygdala that modulate, bias or even hijack the goal-driven cognitive resources that are needed for the normal operation of the reflective system and for exercising the willpower to resist drugs (Bechara, 2005, p.1458).

Knowing the basics that there is a relationship between the amygdala, drug use and stress I am willing to hypothesize that there is a circular connection here. Stress (and drug use) changes the composition of the chemicals that move through the body, this changed composition changes us more by altering the functions in the amygdala, which leads to changes in the decision making process. This combination of factors (stress-chemical composition-amygdala- and temperament) could be an over whelming force.

In fact, as long as I am going out on a limb and possibly completely limbless, I hypothesize that this stress amygdala cycle maybe related to the high/low reactive response Kagan noticed behaviorally in infants some thirty plus years ago at Harvard.

From Kagan’s perspective, temperament is an emotional/behavioral bias, independent of cognitive abilities, that affects receptivity to certain moods and emotions (Mitchell, 2006). Temperament has an effect on the neural chemistry of the brain and thus the sensitivity of certain receptors. Kagan theorized this is based on inherited factors that control the amygdala and thus the production of chemicals in the brain (Mitchell, 2006). This sensitivity, Kagan believes, is the basis of the behavioral/temperamental aspect of an individual.

In Kagan’s theory the chemical production of the amygdala alters receptor connections forming what he describes as high and low reactive (Mitchell, 2006). A high reactive is a high level of arousal to stimuli (crying), versus a low reactive which has a more relaxed reaction to stimuli. Highs have a more active amygdala, and tend to need to be in more control (control their responses and avoid the high reactive reactions).

Thus Bechara theory that drugs stimulate the amygdala maybe the same responses/reactions that Kagan saw in high reactive individuals. If one is a high reactive addict and you are surrounded by stimuli your inherent reaction is to want to control your high response because it creates tension within. The addict wants to quiet the tension, and the brain remembers that using fills that immediate need for control by quieting the reactions. But the drug use only temporally gives control as it also creates a hyperactive response in the amygdala which also reinforces that experience/feeling/thought that it’s more important to use now and not worry about later.

This hypothetical situation might manifest itself somatically by the addict contracting in response to memories of the original or current stressor stimuli for example. This contraction may have become neurologically and psychologically habituated as, “the body movements we develop when we are young are the modus operandi of dissociating” (Caldwell, 1996, p. 28). This contraction would possibly be followed by the person moving to remedy the situation by desensitization through a known movement pattern of perhaps contraction and release. This contraction/release could be a strain/release pattern, followed by a stop/go hesitation pattern as the person struggles with the need to control/quiet the self and the amygdala sends signals/memories of use that overrule the reflective prefrontal cortex. The person uses and goes into a running/drifting rhythm followed by even flow as the effects of the usage wears off.

Despite some 40 plus years of working with folks using movement and therapy I am still learning about movement and its relationship to addictions and disorders (disharmony) in general. I feel like I am also in the beginning stages of learning about neuroscience and the body with its behaviors. I get a wee bit excited when I think about the journals and articles that I have had only a chance to skim or read once and the connections with addictions as well as Kagan, Bachara, Volkow, Li, and others theories of addiction and personality. I never would have thought I would spend so much time looking at addictions but I see in adults with addictions many issues; adolescence, child hood trauma, dysfunctional families, depression, anxiety, low self esteem, disassociation from the body and from feelings. One population with many pathologies, just like every other population (humans) I suppose.

References

AHD, American Heritage Dictionary of the English Language, Fourth Edition. (2000) Houghton Mifflin Company. Retrieved February 28 2008 from Yahoo Education and Reference Dictionary at http://education.yahoo.com/reference/dictionary/entry/addiction

Ballas,C. MD. (2008). Medical Encyclopedia: Addiction. Retrieved February 27 2008 from National Institutes of Health at http://www.nlm.nih.gov/medlineplus/ency/article/001522.htm

Bechara, A. (2005). Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nature Neuroscience. Vol 8, no. 11 Novemenber 2005.

Cadlwell, C. (1996). Getting our bodies back. Boston: Shambahala.

Capello, P,P. (2008). Dance/Movement Therapy with Children Throughout the World. American Journal Dance Therapy. (2008) Vol. 30. pg: 24–36

Fisher, B. MA, DTR. (1990). Dance/Movement Therapy:Its use in a 28 day substance abuse program. The Arts in Psychotherapy. Vol 17, pp.325-331

Fraser, J. S., & Solovey, A. D. (2007). Substance Abuse and Dependency. Second-order change in psychotherapy: The golden thread that unifies effective treatments., 223-244.  

Lewis, P. (2003) Marian Chace Foundation Annual Lecture: Dancing with the Movement of the River. American Journal of Dance Therapy Vol. 25, No. 1, Spring/Summer 2003

Milliken, R. (1990). Dance/movement therapy with the substance abuser. The Arts in Psychotherapy, The creative arts therapies in the treatment of substance abuse, 17(4), 309-317.

Mitchell, N. (2006, August 26). All in the mind: Jerome Kagan, the father of temperament. Australia Broadcast Corporation, Radio National. Retrieved August 26, 2006, from http://abc.net.au/rn/aim/

TIPS, National Library of Medicine. (2008). Groups and substance abuse treatment: From Treatment Improvement Protocol Series. Retrieved February 25 2008 from Health Services Technology/Assessment Texts http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.section.78466

NIDA, National Institutes of Health (NIH), National Institute on Drug Abuse (NIDA). (2008). NIDA Info-Facts: Nationwide Trends. Retrieved February 22 2008 from U.S. Department of Health and Human Services. http://www.nida.nih.gov/Infofacts/nationtrends.html

Volkow,N. Li, Ting-Kai. (2005). The neuroscience of addiction. Nature Neuroscience. Vol 8, no. 11 Novemenber 2005 .

Rose,S. (1995). Movement as metaphor in treating chemical addiction. In F.J. Levy (Ed.), Dance and other expressive art therapies. New York: Routledge.