Tuesday, August 14, 2018

Update 8C

Trauma & Therapy

Paint Therapy:
Drawing Out Demons

14 Year Old Finds Comfort with Wings


Introduction: 

I spoke with SaraH about Update 8B and mentioned the other dreamers who volunteered for the dream interpretations. I told her that I wish we could get all five of our group to submit testimonials, dreams, or therapy treatments that they are undergoing. SaraH corrected me and said our group consisted of 12 people. She said that she was never introduced to any of the others but there were definitely 12. 

I then contacted Evelyn, the Sheriff's deputy; she remembered 7 people. I asked her if she could talk with her ex-partner to see what he remembered. After some coaxing by me, she agreed to speak with Steve, who still services the city of Santa Monica in the graveyard shift. He may have kept his job on street patrol, but he got what the deputies refer to as the "Donut Shift", Midnight to Eight-thirty in the morning. He told her that he recalled 7 people as well. However, when they compared notes, they had different names among their list of 7. 

I decided to follow up on this discrepancy in our memories and try to get a list from all our participants about what they remember. After all, this could come under the category of "Incomplete Memories", the basis for nightmares, according to our research. 

But I digress.

While I don't want to get off track, I do want to anticipate what Update 9 will entail. But let's get back to Update 8C and discuss a form of therapy that I think will work nicely to help our group of volunteers find some commonality. 

It is called Paint Therapy.



An Overview of the Tools for the Therapy for Trauma

In "Treatment for Children: The Work of a Child Guidance Clinic" by David Maclay, M.D., he discusses how "paint therapy" in a clinical setting can provide a tool for understanding nightmares, improper behavior, and adverse responses to normal situations. While Maclay concentrates his examples and case studies to children from toddler to pre-teen, he does encourage the use of drawings for therapy post-trauma as well as an adjustment medium to prevent possible troubled behavior. But, even though Maclay believes in any tool that can help the patient, he writes, "It is, however, a cardinal feature of child psychiatry that we try to explain our children's problems on psychological grounds unless we can show that there is real substance in some constitutional factor." What he means here is that the ultimate goal is to adjust the child's environment, and if drawing helps to reach that goal, then so much the better.

For instance, if Billy disrupts his Kindergarten class beyond a normal range for a five year old child, the therapist may hold a session where he has Billy draw something about his class. If, in the drawing, Billy draws himself in a corner, and the rest of the students with the teacher, the therapist now has a tool to understand that Billy's disruptions are a cry for attention based on his painting of solitude in the classroom. The therapist can then address whether or not the parents at home are giving Billy enough attention. If the therapist finds that Billy's mother is caring for a newborn baby, he has the components to make an informed analysis: Billy feels ignored at home and rebels at school, the environment where he can exert more power over with his tantrums. The therapist may find that Billy's strong-willed father does not allow Billy such power in the home where the baby requires a quiet environment.

Maclay furtther clarifies the role of the therapist: "We have laid stress on the importance of trying to explain emotional illness on the basis of environmental influences, unless an organic basis is reasonably substantiated. It thus becomes almost a matter of policy in child guidance to seek the origins of the child's problem along avenues of emotion and cultural atmosphere." Paint therapy ties the goals of the therapist with the organic origins of the trauma or roots of the bad behavior.

The primary tool we want to address today is "paint [or drawing] therapy".  Those of you who are familiar with Dr. David Maclay's studies know that he doesn't discuss this therapy until chapter 12 of his book on "Treatment" for trauma. In the first 11 chapters, he tackles the process of building a "Case Summary" for the patient. Briefly, the therapist must "diagnose symptoms", that is, list potential "defense mechanisms" objectively (twitches, stuttering, short attention span, anger, etc). Secondly, he must list the environmental factors of the patient (school, home, work, play, etc). Thirdly, list potential "emotional illnesses" (ADD, Autism, etc). Fourthly, list potential "psychosomatic illness" (tummy-ache, sleepiness, etc). Once the components are listed in a patient chart, the paint therapy can begin.

Paint therapy does not necessarily refer to "paint". The drawings can be made with crayons, pencils, pens, water colors, or any means to put figures on paper. No drawing is too big or too small. No topic is too taboo. Although (for children) the subject matter of the drawings will be discussed with the parents, there may be instances where the subject matter will remain between the therapist and the patient, especially in adults. Here's how Maclay puts it, "If the child has elected to paint, ... I ask him to paint anything he likes, not anything he sees in the room, but something just from himself." Without the confidence that these drawings will not leave the room, the child may not elect to paint or paint something not from his own experience but something from his imagination unrelated to the reason for the therapy session.

With a few case studies, we can understand this therapy a bit better.

Case Study #1
Boy, 12 and a half years old; high IQ.
Bed wetter, stealing, loner.
Parents: Mother, warm personality; father, bitter streak.
Sessions: Boy does not communicate. Paint therapy tried.
Drawing: "the boy painted a country scene with two symmetrical hillocks, a river flowing between them down to the fields below, a bridge, three rabbits, a tree and many birds."
Possible Interpretation: "The hillocks and the river could have represented breasts and milk..., a wish to withdraw into a paradise of responsibility-free childhood."
Further Sessions reveal the boy's obsession with masturbation. Possibly punished by father for "deviant" behavior. Self-gratification conflicts with memory of punishment, deepening trauma.
Drawing Reinterpretation: The hillocks were testicles, the river a penis. "The birds in the painting could have possible relevance in that in current adolescence terminology the word 'bird' was widely used to mean 'girl'."
Further sessions were more productive with a more reliable interpretation of the drawing. We now had a tool to address the symptoms of distress and guilt that the boy felt by masturbating. The boy stopped bed wetting and has improved his grades in school.
Therapy continues.

Case Study #2
Boy, 9, average IQ.
Bed wetter, temper tantrums, fear of the dark, kleptomaniac.
Parents: Domestic difficulties raising four kids.
Sessions: Concurrent with speech therapist. Paint therapy recommended to minimize oral communication.
Drawing: "In the first of these sessions he painted a duck attacking a boat."
Initial Interpretation: The therapist interpreted "the boat as his mother, father and the home situation, which he, the duck, was attacking because he felt they were not being good to him."
Second Drawing: Boy "paints a submarine striking at a boat which was raising anchor." Upon further discussion of the second drawing, the boy mentioned how sad it will be to go home after the submarine blew up all the land.
Second Interpretation: The boy has come to realize how destructive his anger becomes to his family. He is destroying the home he must come home to. The realization, however, triggered a deeper trauma involving his destructive behavior (he beat his younger sister and an older brother severely beat him in retaliation). When the third painting turned to "two cows in grassland" with several cow feces (cow pies), the boy regressed to an "anal phase". He also began sucking his thumb around his mother in front of the therapist.
Therapy continues.

Case Study #3
Girl, 14, high IQ.
Quiet, ultra-religious, afraid of the dark, recurring nightmares.
Parents: Religious, strict but fair, very protective (perhaps overly protective).
Sessions: Although shy, girl likes to talk about school and temple (Buddhist). She talks of friends fondly and often speaks of them in the future tense. She avoids speaking in the past tense. For instance, she'll talk of her friends waking for school where she'll meet them, but she will not talk about any times she has met with friends. When the therapist asks about her school friends in the present tense (what did you and your friends discuss at school this morning), she'll answer evasively, "The same thing we'll talk about tomorrow morning". Paint therapy suggested. She eagerly accepted.
Drawing: Girl drew herself as a bird with wings and talons. No human parts but for the face and part of the head; the forehead was part beak.
Initial Interpretation: Birds fly above all their worldly problems. Just as the girl speaks in the future tense to avoid the present, she sees herself as a bird can fly on a whim. Oddly, she drew herself standing on the ground, rather than flying. When the therapist asked why she wasn't flying, she responded that she was awake. She only flies in her nightmares.
Therapy continues.

The 4th and 5th case studies included drawings that were supposed to be emailed to me. Case Study #3 sent in the bird drawing in the headline pic above. Originally, I'd hope for more drawings for Update 8C. I know I'm being pushy asking the volunteers who sent in their trauma accounts to draw a picture for me, and I do realize I'm being a bit insensitive. But just as the dream interpretations was productive in a therapeutic way, I thought the "paint therapy" drawings would serve the same positive productivity. I'll try asking again a bit nicer. My psychiatrist, by the way, thinks all this dream and drawing therapy is a waste of time. Yeah, like Xanax is the answer to troubled minds and haunted souls.

Anyway, we'll continue with the Trauma & Therapy Update 9 next time, hopefully with some drawings. Thank you, readers, for your patience and your readership.

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