Tag Archives: group therapy

When and whether to give up

This post has taken a long time coming. I’ve been pulled in different directions, between the continuing struggle with portraits, and the challenge of line drawing without any shading. But In my heart there is a clear favourite. I have been working with oil paints for the first time, trying to paint a child’s portrait from an old family photograph. I have worked on it for months, rubbing out, repainting, going over and over it to try to correct the faults and bring it to life. It has consumed hours of my time but was only a partial success, as you can see.photo Then one afternoon I just gave up on it and rubbed the face out completely.

At what point do you decide to stop working at something? This is an important question, both personally, and professionally. How do I decide whether or not I am banging my head against a brick wall, or knowing the importance of  hope, just rolling with the frustrations? I have a lot of experience in working for years with particular people, and I know that genuine change is piecemeal and takes far longer than our culture thinks it should. At the same time, I work with a service that offers very brief, time limited counselling,  and  I recognise that even in this micro format, psychotherapy can make a positive impact. In this context, it is necessary to make quick judgements about which clients will benefit from the limited resources available; despite the misgivings and failures, I see this as a valuable skill for therapists to have.

In my own group I am free from the external pressure, but am still trying to make judgements about what works best for the group and its members. Years ago, there was a group member who had sat in the group for a very long time, and despite sporadic periods of talking, was largely a silent participant – or passenger. The language is important.  He showed no signs of movement within the group, or in his life outside, despite all our efforts. I reached a point where I put him under a lot of pressure to interact differently in the group …. and he never came back. This was someone who had been a part of the group for years and years, and it had a huge impact, especially on me. I had talked it through with supervisors and colleagues, had tried a range of alternatives before reaching this point – but even though I could justify my actions, I never felt good about what happened. It has stayed with me throughout my professional career. Giving up is not a comfortable choice.

So what about the painting?

The problem, I thought, must lie in the original drawing. I didn’t understand the face well enough, so needed literally to go back to the drawing board. I’m more familiar with drawing, unlike oil painting, and I can play around with the marks more readily. So I produced this, which isn’t going to get ripped up and put in the bin. photo-1

The same approach works in the group. If we can’t get to where we think we want to go by one route, then let’s rethink. Is there another way? Or are we heading in the wrong direction? And just as in the drawing, often we have to go back to the beginning. Where are the roots of the distortion, the discomfort? Let’s see if we can move forwards by understanding more about the basic structures that have shaped someone’s life, the bones that the flesh sits upon.

This sort of understanding does not come easily. There is no psychodynamic formulation that can simply be applied. All of it is hard won, just as in the portrait, for even though I might have grasped something, will it enable me to paint it again without repeating all the same mistakes? We will see!

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Portraits: How we portray ourselves and others

 

The art class has come to an end for this term, and it has finished with a collage. Some of us found it hard to shake off memories of school gluing and sticking projects, even though we were told that dried pasta was definitely not to be included! photo-1Maybe that injunction helped me into a more grown up preoccupation with language and meanings, and the relationship between portrait, portray, betray, trait and traitor[i]. I’m thinking about emotional connections rather than etymology here – the sort of links and associations that sparkle through creative conversations in the therapy room.

I thought about that apocryphal story of people in the past who feared that if they were photographed, their soul would be captured in the image. Good photographs, like good portraits, are indeed trying to capture more than a ‘likeness’, reaching towards some other dimension of the person that they see before them. Could this be a betrayal?

Portraits can be treacherous. They may reveal an unacknowledged and unwanted aspect of our appearance.  Our image of ourselves is constructed though that full frontal gaze in the mirror, where we can adjust and tweak some of the less attractive elements. My grandmother used to have one of those dressing table mirrors in three sections, so that you could see yourself in profile too . They seem to have gone out of fashion. Maybe we can only handle one version of ourselves these days, shying away from those glimpses in shop windows where the size of our nose or the double chin become so obvious.

Many portraits are designed to flatter – think of all those gloomy paintings hanging in most National Trust properties to promote the virtues of the owners and their dynasty. Great artists do something different, even when commissioned to display a success story of some particular character. I’ve been reading Andrew Graham Dixon’s book, The History of British Art, and am thinking here of Hans Holbein the Younger’s portrait of Henry 8th. Along with the grandeur, Holbein has captured the brutality and ruthlessness of the man. As Graham Dixon says, he looks like a thug.

So personality shines through. I’m not convinced that the concept of ‘personality trait’ is very useful but there is no doubt that we all have preferred and characteristic ways of negotiating relationships, and perhaps this is what can also be revealed in a good portrait.

One of the ideas that I have found helpful to work with in groups is the notion that we all carry around an image of ourselves. In our minds we have a small self-portrait that we are convinced truly represents who we are, and we behave in ways to reveal or conceal this character. Therapy groups are places where people show their self-portraits and work terribly hard to convince everyone else that these are true likenesses. What always happens is that after a while this image gets challenged. ‘That is not how we see you’, they say. ‘This image doesn’t fit with who you are, here and now. Maybe once upon a time it was accurate, but not anymore. Why are you holding on to this image of yourself?  Why do you need it?’

It is a conversation that in different forms comes up again and again for every group member, and those who work with it will in time be able to paint very different, more subtle portraits both of themselves and of others.


[i] ( If you are a Wednesday Group reader, you might like to know that Stevie wanted to add ‘milk tray’ to the list!)

Restraint, economy, and abstinence for artists and therapists

 

The balance has swung away from writing towards sketching this month. The Wednesday Group are having an extended summer break, so the characters have withdrawn to the back of my mind, and into the foreground comes this!

The Young Turk's Turban

The Young Turk’s Turban

But this is only part of the story, because I’ve been on a three day Life Drawing course. What did I learn?  The immediate answer is— some interesting techniques, much needed ideas about perspective and proportion, and how hard I can find it being a group member! The latter is hardly a new discovery, but never comfortable.  Another familiar feature turned up when I walked around the room checking out everyone’s work, as we did at regular intervals.  I was struck with how restrained my own drawings were in comparison to the strength, exuberance, colour, on other easels. Whatever fantasies I may have about riding a bike across an enormous paint spattered canvas, they were not being acted out here.

I could use the word ‘inhibited’, but I’m going to stick with ‘restrained’. I am aiming for a place where every mark carries a weight and meaning, and there is no superfluous packaging. At the same time it cannot be so tightly controlled that the drawing has no life. Just as with writing, the art has to shape the artist, and there has to be that vital reflexivity between the two.   The obsessive part of me could easily be drawn into adding details, layering and manipulating, reworking and reworking until some moment of completion arrives – but it also stirs up a sort of claustrophobia. The layers of pigment become enclosed and entrapping and I need to breathe. (Incidentally, that helps me see more clearly why water colours are so attractive, with their beautiful opacity and light – enough oxygen to survive!)

Restraint, inhibition, economy, and abstinence may all sound narrow and restrictive. Paradoxically they are also routes to keep something alive and open, and so important in psychotherapy. The idea of the therapist as a blank screen has been largely overthrown by a relational, interactive stance, and I have no desire to reinstate it;  but that does not mean restraint and abstinence are to be discarded.

Without that I could dominate every group therapy session with my own particular clever insights, or supposedly wise anecdotes; I could come up with an answer to all the queries, explain my views and share my experience; I could even find reasons to disregard therapeutic boundaries when I found them frustrating.  None of these may be hanging offences if they are deftly and rarely applied, but to use them as part of everday communication would make me a terrible therapist, I believe. Part of my job as I see it is to help create a space in which others can come to their own discoveries, rather than fill it with my own. The idea of abstinence deters the therapist from trying to take away the patient’s problem rather than engage with them in the struggle to transform, transcend or bear it.

In the therapy groups, I try to use words a bit like the marks in a drawing. I don’t want to just be an empty page, but I want the marks I make to capture something important about what I see and hear going on in the group session. The marks will change in response to other marks – it’s not just me that is engaged in this process within the group. Of course it’s impossible to get it exactly right – too much, too little, wrong tone, unhelpful choice of colour – they are all there, in the group as well as in the sketch book. I’ve learnt to be tolerant of my own supposed ‘blunders’ in the group, discovering that often they lead to useful and unexpected places. I’m not quite there yet with my drawings though!

The personality of door locks: unlocking defences

The shed on my allotment has a very basic lock, with an enormous chunky key. It could hardly be simpler, but still there is a knack to getting it to work – a slight jiggle, twist to the left before right. It has its own personality, I think.Untitled artwork But so too does the gate to the whole allotment plot, and that is a serious piece of work . Chunky, tough,resilient – but it still needs that little extra bit of coaxing. Come to think of it, my front door, the office, the side gate  – all need their own special handling. After a while these small idiosyncratic adjustments come automatically; it’s only when someone new tries to open the lock and finds it difficult that I remember there is a knack. Otherwise it is just another of those habitual fine tunings that go unnoticed.

What I do notice is the struggles I sometimes have with unfamiliar door locks, and how exasperating it can be when the owner arrives and merely puts in the key and turns it! Once I was left the key to water a friend’s plants whilst they were away and couldn’t get the door to open, with obvious and embarrassing consequences. The following year, after several lessons in door opening technique I was entrusted with a new set of plants. This time I managed to get in but somehow in the process set off the alarms which then refused to stop! Now she asks her neighbour to water the plants.

Locks, of course, are a form of defence against the intruder, which like locks themselves come in all shapes and sizes. We lock ourselves and others into certain positions to defend against aggression, fear, intimacy, and the Other.   I’ve never found lists of ‘defence mechanisms’ very useful; the transactional analysis language of  rackets seems to me livelier and more interactive and although we might not use the word, group therapy members are pretty good at spotting each other’s rackets.

What happens in these groups goes something like this: gradually as the members interact, they begin to work out what it is they are each doing to block communication and preserve their own versions of themselves, others, life and the universe. They arrive in the group locked up, and the group process may in time begin to unlock them, one lever or pin at a time.  There is a great variety of locks with a host of security features, but as far as I can see, there are ways of ‘picking’ the majority. What is needed is patience and skill. The group learns the skills, and as long as they are patient and keep returning, eventually something will click. My experience with actual locks and keys underlines their idiosyncrasy. Recognising that everyone has their own unique take on whatever ‘defences’ they employ is part of the skill of the group. We protect ourselves with similar processes that have been specifically adapted for our own unique context and experiences. I think that we are much more liable to engage with any ‘unlocking’ process if this particularity and uniqueness is recognised.

Less is more – or could be.

Painting is not something I am comfortable with, so this term’s project to produce a landscape has not been easy. Having to work on something over a period of weeks is another challenge – when it comes to paint I have an even shorter concentration span than usual. Of course, like most things that challenge us, it has produced some unexpected and interesting results.

I started with an imaginary landscape called ‘The Dreamboat’ that had an estuary, promontories, two boats, and maybe a light house.  It is still ‘The Dreamboat’, but this is what it is currently looking like. The light house was first to go, followed by one boat. Then some rocks appeared in the foreground, and the other boat vanished. Now the rocks have gone too. I’ve painted the sea over and over again, gradually discovering that I can reinvent the scene almost endlessly as I try to convey a mood or atmosphere. The subtleties of tone become increasingly significant as the features are painted out. DSCN0446-001

Less is more even when painting, I have discovered. Gradually taking away the obvious landmarks and recognisable features opens up another way of communicating. It makes me think about silence. In psychotherapy, silence is significant, and even noisier in group therapy than in individual work. I must have spent a lot of hours sitting in groups where no-one is speaking. We look around, gaze the floor, stare at the ceiling, glance at the clock and examine each other’s shoes.  Read a few episodes of The Wednesday Group and you will see the importance of footwear in group psychotherapy!

At some point someone (probably me) asks what is happening in the silence and we might struggle to put the thoughts we have been having into words. Sometimes it is the tone of the silence that is important. How does it feel, what sort of atmosphere, what does it convey? Then we are into the same territory as landscape painting, I think.  Often we end up talking about an image – someone will try to describe how they have experienced the silence in visual imagery, and we share our reactions to this imaginary scene or landscape.

How do you convey the subtleties of experience in words or images?  We are not all poets or painters, and words can be clumsy and crude, just as images too can be clichéd and lifeless. Taking away the easy phrases or formulaic images might leave us with a seemingly empty canvas or silent space.  It might, however, spark the realisation that under the surface of life there is more going on than we thought.

Imagination and psychotherapy: Drawing things out

Drawing from the imagination has always been a favourite activity of mine, but because of my skills deficit it usually ends up as some abstract doodle. Now I’m being challenged to take it further, and the results are surprising. 20130502_145822 The task in the drawing class was to use this collection of dried cordyline leaves  as a basis for some imaginative work using charcoal.

After an hour or so of various attempts, largely in the form of landscapes and ponds, this picture emerged. It seemed to draw itself, very quickly in the last thirty minutes of the class and it took me by surprise. It’s not my usual stuff at all, and I felt quite moved by it.the wig

Later it made me think about the phrase ‘drawing out’. In the conversations that make up psychotherapy, we are often drawing things out; trying to see more clearly that which has been obscured, buried, denied. Sometimes what emerges is painful and shocking, but not always. There moments when what emerges is surprising and beautiful. We can think of this as revealing something already present but hidden, or as I would want to claim, as a more creative process. In the conversation, a new possibility or image is co-created by client and therapist.  It is a drawn from the interplay of memory, intuition, experiences – and imagination.

The relationship between psychotherapy and imagination has engaged many theorists and practitioners for years. All of the writers that were influential in my development as a psychotherapist find a significant place for it – Marion Milner, Stephen Mitchell, Bob Hobson, and Winnicott, of course, are just a few that spring to mind immediately.

I think of empathy and imagination as different but related. The capacity to tune in to another’s emotional state seems partly hard wired into our neurological systems, although we could all cite examples of people who seem to have missed out on this particular piece of wiring!  But imagination takes us beyond this. When I am trying to grasp, intellectually and emotionally, the other’s reality, I am not only tuning in to ‘what is there’, but translating it into language. I use visual imagery a lot, sharing with clients the image that comes to my mind in the attempt to understand them. Sometimes it doesn’t speak to them, and is discarded. At other times the image seems to capture something significant for them, and enables them to see their own experience in a subtly different way.

This can be very powerful in group settings, where one person’s image can serve to draw out others that complement or animate each other in surprising and refreshing ways. Drawing together, whether with charcoal or with pictures in the mind,  can bring us to some unexpected and stimulating places. Imagination  is fundamental to the task of doing things differently. We can together imagine all sorts of scenarios and emotions that go beyond those familiar rehearsed experiences that often bring people into therapy in the first place. Without this creative element, we could only draw the same picture over and over again.