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January 2008

Monday, January 28, 2008

A Thoughtful Response Regarding Forgiveness

Earlier this month, I noticed much activity on another website I maintain--all clustered around the topic of forgiveness. So on the 11th of January, I wrote a post on Forgiving and Healing. As part of the post, I included an excerpt from my book, WellWriting® for Health After Trauma and Abuse. Yesterday I received a thoughtful comment from Steve T.

I have decided to publish Steve's comments for two reasons:

  1. Comments are often overlooked by blog readers as they tend not to stand out unless the word "comment" is selected at the end of an article.
  2. The comment here pinpoints a major challenge in the area of forgiveness: forgiving following abuse from another.

Most of us think that forgiveness brings value to our lives because it helps us to heal. True enough but when the insult bestowed on any person looms large, the healing often has to happen before the forgiving can even begin. Author Nancy Richards in her book, Heal & Forgive, does an excellent job in illustrating this basic truth as did Steve T in his comment which follows:

"Hi Dr. T,

Forgiveness is a 'quality' that has been urged and often commanded by spiritual leaders for eons, commonly with the same admonitions you employ above. It's probably impossible to have lived on this planet very long without having heard those warnings many times, the bottom line of course is that forgiveness must be employed for the abused's "own good". Oddly, at least in cases where genuine remorse is immediately expressed by the offender (as in cases of unintentional injury), forgiveness seems to be an entirely natural and inherent part of human nature--no such authoritarian commandment is necessary to evoke it. In cases where remorse is NOT evident (or is pretended), "forgiveness"--especially the artificial, "spiritually" sanctioned, guilt-induced variety--translates in the mind of the abuser to "You have permission to continue treating me like something people scrape off the bottom of their shoes." The evil inherent here I hope is obvious.

You and Dr. Luskin are flat-out wrong. To use a position of authority, especially, to tell an abused person that he or she must "forgive your abuser lest ye be eaten alive by your own poison" is to have fallen into an ageless, destructive trap.

"Forgiveness" as you 'encourage' it is not part of the solution, it is an especially large part of the problem. 

Please make the effort to realize that if not for the conditioning that took place during your, Dr. Luskin's and no doubt the Stanford Project itself's upbringing and 'education', you would realize that you are NOT helping abused persons by perpetuating this sort of advice, you are instead advocating for everything that is wrong, upside down and backwards, and therefore being actively hurtful by siding with the abusers.

Please reexamine the 'wisdom' of your 'remedy' for trauma victims. Yes, it's nearly universal and has been around for a very long time. So have abused, mistreated children (and women, and 'mentally ill' people, crime, war, and on and on and on)--and despite age-old advice identical to yours, all of this just keeps coming.

One plus one equals two.  I'd think that Stanford people would be able to see that.

For the sake of anyone who comes to this page I hope you one day soon see it yourself.

thank you,
Steve T., ACE score: 4"

Thank you, Steve, for taking the time to add your comments to this website and blog.

All comments on this topic are more than welcome. Please take a few minutes to add your comments to this post.

--Dr.T

Tuesday, January 22, 2008

A Book You Should Know About

Aftdiagnsis

If you help patients, clients, or friends who have just received big bad medical news, you should know about this book.

You can learn more about it by visiting my Writing Practice Prescription website. Click here to read about the book.



Monday, January 21, 2008

Bridge Drawing

A suggestion for creating a memorial book in honor of a loved one

By

Michaela J. Gagne

A Memorial Book is a valuable way to revisit the life of a loved one and highlight unforgettable memories.  It can be created and collaged with numerous photos, written descriptions, memorabilia, cards, awards, stories, etc.  A Memory Book can be a therapeutic project for the griever.  It features the positive experiences from a loved one’s life, and it provides a way for the living to constantly revisit this cherished life.  The book can be created as a gift to the deceased, a visible expression of the love that is held for this person.

Choose a book and materials that seem comfortable and appropriate for this activity.  Scrapbooking techniques may help provide inspiration for developing the format and lay-out of this book, and there is no end to the creativity that can be used to create such a treasure.   

Other Recommended Resources:

•    Bertman, S.L. (1999). Grief and the Healing Arts: Creativity as Therapy (Death, Value, and Meaning). Amityville, NY: Baywood Publishing Company.
•    Cocuzza-Zambelli, G. (1981). The use of art therapy with children in the bereavement process. In A. Evans, E. Kramer & I. Rosner (Eds.) Art Therapy: A Bridge between Worlds. Falls Church, VA: American Art Therapy Association.
•    Deits, B. (1992). Life After Loss: A Personal Guide Dealing with Death, Divorce, Job Change, and Relocation. Tucson, AZ:Fisher Books.
•    Dissanayake, E. (1988). What is art for? Seattle, WA: University of Washington Press.
•    Fitzgerald, H. (1994). The Mourning Handbook. New York, NY: Simon and Schuster.
•    Furth, G.M. (1988). The Secret World of Drawings: Healing through Art. Boston, MA: Sigo Press.
•    Glick, I., Weiss, R. S., & Parkes, C. M. (1974). The First Year of Bereavement. New York, NY: John Wiley & Sons.
•    Graves, S. (1994). Expressions of Healing. Van Nuys, CA: New Castle Publishing.
•    Hughes, M. (1995). Bereavement and Support: Healing in a Group Environment. Philadelphia, PA: Taylor and Francis.
•    Kahn, A. M. (1990). Coping with fear and grieving. In I. M. Lubkin (Ed.) Chronic illness: Impact and intervention. Boston, MA: Jones & Bartlett.
•    Kelly, K. (1992). The Psychology of Death. New York, NY: Springer Publishing,
•    Keyes, M.F. (1983). The Inward Journey. La Salle, IL: Open Court Books.
•    Kubler-Ross, E. (1981). Living with Death and Dying. New York, NY: Colliers Books.
•    Leick, N. & Davidsen-Nielsen, M. (1991). Healing Pain: Attachment, Loss and Grief Therapy. New York, NY: Routledge.
•    Levi, S., Gilad, R., & Friedman-Kalmovitcz, A. (1996). Pictorial art as a teaching strategy in death education. Nursing Times Research, 1(3), 198-205.
•    Malchiodi, C.  (2002). Art Therapy Sourcebook. New York, NY: Guilford Press.
•    Malchiodi, C.  (2006). Handbook of Art Therapy. USA: McGraw-Hill.
•    Malchiodi, C.  (2002). The Soul's Palette: Drawing on Art's Transformative Powers.  Boston, MA: Shambhala.
•    Miller, J.E. (1992). Helping the Bereaved Celebrate the Holidays: A Sourcebook for Planning Instructional and Remembrance Events. Fort Wayne, IN: Willowgreen Productions.
•    Osterweis, M., Solomon, F., & Green, M. (1984). Bereavement:Reactions, Consequences and Care.Washington, DC: National Academy Press
•    Parkes, C.M. (1986). Bereavement: Studies of Grief in Adult Life. New York, NY: Basic Books.
•    Parkes, C.M. & Weiss, R. S. (1983). Recovery from Bereavement. New York, NY: Basic Books.
•    Platt, L. & Persico, V.R. (1992). Grief in Cross-cultural Perspective: A casebook. New York, NY: Garland Publishing.
•    Rogers, J.E (Ed).  (2007). The Art of Grief: The Use of Expressive Arts in a Grief Support Group (Death, Dying, and Bereavement). New York, NY: Routledge.
•    Rogers, N.  (1993).  The Creative Connection: Expressive Arts as Healing.  Palo Alto, CA: Science and Behavior Books, Inc.
•    Sanders, C.M.  (1992).  Surviving Grief and Learning to Live Again.  New York, NY: Wiley.
•    Stack, P.  (2006).  Art Therapy Activities: A Practical Guide for Teachers, Therapists and Parents.  Springfield, IL: Charles C. Thomas.
•    Stroebe, W., & Stroebe, M.S. (1987). Bereavement and health. New York, NY: Cambridge University Press.
•    Zambelli, G.C., Clark, E.J. & Heegaard, M. (1989). Art Therapy for Bereaved Children. In H. Wadeson, J. Durkin, & D. Perach (Eds.), Advances in Art Therapy. New York, NY: John Wiley & Sons.

Editor's note: This article concludes a handout used by the author to teach art therapy to parents who have lost a child. The rest of the handout can be found in previous posts.

   

Sunday, January 20, 2008

Art and Expressive Therapy Projects for the Grieving and Healing Soul--Part Four

Bridge Drawing

A suggestion for creating an image to explore your loss, your grief, and your goals

By

Michaela J. Gagne

Fold a piece of paper into 4 sections.  Number each box 1-4 and using only images, create the following in a symbolic sense with regards to dealing with your personal grief and healing process.  There is no right or wrong in the images you create.  Abstract images and shapes can work very well.

1)    Where was I in my grief process when I had to initially deal with my loss?
2)    Where do I want to be in my grief and healing process?
3)    What is in my way to getting there?
4)    How am I going to overcome the obstacles I might have?

Hold a large piece of paper horizontally.  I suggest an 11”x 17” paper or larger, but smaller can work as well if this is not available.  Either draw or find a picture of a bridge.  The Internet is a great way to find a picture of a bridge if you are uncomfortable with drawing one.  Place the bridge in the middle of your piece of paper, leaving space above, below, and on both sides. 

Decide which direction you want to travel over your bridge.  If you are traveling from left to right, then use your images from Box #1 on the left side of the bridge and your images from Box #2 on the right side of your bridge (if you are traveling right to left, then reverse these instructions).  You may cut out and paste the images you have already made or use them to help you develop new images you would like to use in conjunction with your bridge. 

Use the images from Box #3 over, under, and on your bridge.  Place these images where they feel appropriate.

Decide where you are on your bridge.  Remember where you were and where you want to be, and draw your self or a symbol of yourself accordingly on the bridge.  Give yourself the tools you need from Box #4 to make sure you will later get to the other side of the bridge.  Feel free to add anything to any of the images or add more images.

Re-visit this drawing in the future and evaluate if you have moved on your bridge, either forward or backward, and why this has happened.  Determine if there is anything you want to change about your bridge or how you can accomplish your goals.  Journaling about your bridge can also be powerful and productive.

Editor's note: This article is part of a handout used by the author to teach art therapy to parents who have lost a child. The remainder of the handout will be published daily over the next few days.

Saturday, January 19, 2008

Sowing Seeds of Change

Polaroid Years ago I heard Shirley MacLaine sum up what she learned from her round-the-world spiritual search: "What you give is what you get."

So true. Still when and where we get what we give can be remote. Ten years ago when Physicians for a Violence-free Society was still alive and well, we developed a four-hour domestic violence documentation course. At the time, digital photography was still an infant and had not yet legitimate standing in the forensic world. Therefore, each registrant went home with a top of the line Spectrum Polaroid camera.

Recently, Dr. Rochelle Wilson from southern California wrote to report that she attended one of our courses and, "The camera I received helped commit a child molester since then."

Good work, Dr. W! Every person can make a difference to make the world a better place. Thank you for making a difference in that child's life.

Art and Expressive Therapy Projects for the Grieving and Healing Soul--Part Three

Letter and Journal Writing

A suggestion for creating a letter or journal to your loved one
or to hold the emotions you may feel about the death of your loved one.

By
Michaela J. Gagne

Choose a journal book or piece of paper that feels appropriate on which to express your feelings and thoughts.  Also choose a writing or drawing utensil(s) (pen, pencil, marker, charcoal, paint, colored pencils, pastels, etc.) that is comfortable, does not offer too much resistance, and seems fitting to you.  This process can be an on-going way to communicate with yourself or with your loved one, or can be an activity that takes place only once.  You can decide what feels right.  Art can also play a helpful role in this process.  Explore images as a means to express emotions.  Colors, shapes, scribbling, abstraction, etc. all have the ability to help provide a sense of healing.

The following are suggestions for writing a letter or keeping a journal to your loved one.  This can be a means to heal and feel a personal, ongoing connection with your loved one.  It can make emotions and experiences seem less overwhelming by containing them in a safe format.  Art, including forms of symbols and images, can also be used in conjunction with writing or as a substitute for writing.
•    What do you wish you could have said to your loved one while that person was alive?
•    What do you wish to tell your loved one now?
•    Tell your loved one about what is happening in yours and your family’s lives.
•    What do you hope your loved one is doing now?
•    Ask your loved one for strength and courage, guidance and inspiration, and a means to find it all from within yourself.


The following are suggestions for writing a letter or keeping a journal for yourself.  This can be a means to sort out your feelings, reflect on your emotions and experiences, and clarify your personal goals.  This is a safe way to express anger, sadness, confusion, and other overwhelming emotions you may be experiencing.  It is a confidential means to review your own thoughts and progress, all with the ability to revisit these entries and view your own growth.  Art, including forms of symbols and images, can also be used in conjunction with writing or as a substitute for writing.
•    Express your personal emotions daily or weekly.  Report on your daily or weekly activities as well.  Don’t be afraid to look back at what you have written in past entries and notice similarities and differences.
•    Compile a list of goals for yourself in your life, related or not related to your grief and healing process.  Be sure to add goals that are new and different hobbies, activities, and/or challenges.
•    Use free association while reflecting on your life.  Free association is writing down any single word that comes to your mind, no matter how seemingly ridiculous and disconnected.  Simply allow yourself to write without inhibition.  Only when you are finished with your list, reflect on why you might have written each word.
•    Keep track of overwhelming emotions and notice if any change occurs over time.


There is no right or wrong in your journal or letter writing.  Try to develop the courage to attempt something different during this process, including incorporating art.  Creating something new can lead to new thoughts and ideas that can be inspiring. 

Editor's note: This article is part of a handout used by the author to teach art therapy to parents who have lost a child. The remainder of the handout will be published daily over the next few days.

Friday, January 18, 2008

Art and Expressive Therapy Projects for the Grieving and Healing Soul--Part Two

The Legacy Box

A suggestion for creating a memorial vessel as a tribute to a lost one

By
Michaela J. Gagne

WARM-UP

Fold 4 pieces of paper into two sections and number the sections 1-8 (1&2 are on one paper, 3&4 on the next sheet, and so on).  In each of these sections create an image and/or write words to represent the following topics:

•    In Section 1 describe an activity or activities your loved one enjoyed doing with other people.
•    In Section 2 describe an activity or activities your loved one enjoyed doing individually.
•    In Section 3 describe the physical appearance of your loved one.
•    In Section 4 describe the personality characteristics of your loved one.
•    In Section 5 describe how you believe the world saw your loved one.
•    In Section 6 describe how you believe your loved one saw and felt the world.
•    In Section 7 describe the emotions you felt and memories you have of your loved one
•    In Section 8 describe the emotions your loved one felt and memories that person had with you and others.

CREATION

Boxes are often used in art therapy projects because of their many surfaces, various size and properties, and their internal vs. external structure.  Choose a box that feels it would be a good representation of you and your loved one.  You may already have a box that has a special meaning.  Lids for the box may or may not be used.  If trying to find a box that works, give consideration to the material (for example, maybe you feel that wood represents strength and growth, or maybe an athletic shoe box seems appropriate, etc.)  Choose a size that feels neither too overwhelming nor too constrained for you, and most importantly do not feel that there is a right or wrong choice to make with choosing your box.  Let yourself be creative!

Next, give yourself a wide array of art materials.  “Art materials” does not have to include traditional materials used by artists.  Your materials can include anything that inspires you (magazines, aluminum foil, photos, fabric, cotton, buttons, tissue paper, old newspaper, markers or other drawing utensils, glass or mirror pieces, trinkets, etc.)…the possibilities are endless!  Some form of adhesive will probably (but not necessarily) be needed, such as tape, glue, glue gun, etc.

Using the pieces of paper from earlier, decide on a way to represent the odd numbers (1,3,5,7) on the outside of your box (the external surface), and represent the even numbers (2,4,6,8) on the inside of your box (the internal surface).  For example, if your loved one enjoyed playing basketball with others, maybe gluing a shoelace to the outside (or keeping the box closed with a shoe lace) would be appropriate.  If your loved one particularly enjoyed outdoor activities on his or her own, maybe lacquering a leaf to the inside of the box cover might be fitting.  The inside of the box can also be a place to hold treasured items and memories, or even smaller boxes. 

Don’t feel that all of the sections need to be used, and other ideas can be added however you see fit.  The pieces of paper you filled in can simply be used as a guide when you might need a sense of direction.  You may not want to use the pieces of paper at all, and that is okay.  You can begin on the outside or the inside, and it can be a project created swiftly, one that is under constant construction, or anywhere in between.  Your box can always be changed if this feels comfortable for you, whether it be through adding, subtracting, and layering.  Feel free to share or not share the box and its contents with others.  Some people may want it kept private, others may feel the urge to let others explore the box.  Use your box however it feels appropriate to you.

Editor's note: This article is part of a handout used by the author to teach art therapy to parents who have lost a child. The remainder of the handout will be published daily over the next few days.



Thursday, January 17, 2008

Art and Expressive Therapy Projects for the Grieving and Healing Soul--Part One

By
Michaela J. Gagne

What is Art Therapy?

The profession of Art Therapy is dedicated to the belief that the process involved in creative expression is healing and life-enhancing.  Art Therapy and other Expressive Therapies are growing fields that utilize the arts as an alternative and/or complement to verbal counseling and therapy.  Art Therapy provides access to various parts of the brain, providing an alternate means for physical, mental, emotional, and spiritual well-being.  It provides a unique method of processing and healing through visual expression of thoughts and feelings. 

While “therapy” or “counseling” may hold negative connotations in some people’s minds, Art Therapy can be seen as simply a means for personal imagination and exploration to take place…and not a single word has to be said!  Art Therapy requires NO artistic ability, only an open mind and the courage to simply create.

Where should I be in my grieving process?  What is right or wrong?

There is no right or wrong when it comes to your feelings and the way you are experiencing loss.  One of the most important pieces in the grieving process is acceptance.  You must accept and know that you are okay with where you are at in your grieving process.  Everyone experiences grief and its journey differently.  Grief is normal and needed in order to heal and grow.

Remember: “Grief is not the process of forgetting.  Grief is the process of remembering with less pain and more joy.” (-unknown)

How can the Expressive Therapies help me with my grief and loss?

Grief can be very difficult to express with words…Often words are simply not enough.  Art offers the opportunity to express emotions non-verbally, in a manner that can be less overwhelming and more containing than verbal communication.  Art can provide a sense of comfort and a means to discover personal inner strength.

Throughout history, art in the form of concrete symbols and images has often been made in the memory of someone who has died and as a means for the living to commemorate and remember.  Creativity can be a means to maintaining a special relationship, and it can be a means for coping with the trauma of death.  Art can be used to provide a safe, non-threatening outlet to simply express.

Everyone has different ways of coping with grief.  Art and other artistic forms of expression are just a few suggestions for this healing and growth process.

Editor's note:

  • For this article, the author cites: Hill, M.A.  Healing Grief Through Art.  (2007).  Retrieved November 15, 2007, from http://www.drawntogether.com/healing.htm
  • This article is part of a handout used by the author to teach art therapy to parents who have lost a child. The remainder of the handout will be published daily over the next few days.

Wednesday, January 16, 2008

A New Concept: Patient Self Management

According to the Centers for Disease Control and Prevention (CDC), more than 90 million Americans now live with chronic diseases. These chronic diseases as diabetes, and arthritis result in a decreased quality of life, limited activity, and extended pain and suffering.

When you suffer with a chronic health care problem, you deal with many factors that compose that problem. Some of these factors overlap, augment each other, or oppose each other.  And each factor may call for its own physician or treatment. If you want to succeed in your quest for wellness, the first thing you must do is drop out of the  "I just do what my doctor tells me" school.

Join your health care team. Indeed, take over:

  • Take responsibility for self-monitoring,
  • introduce better health behaviors into your life
  • Become a collaborative decision-making partner with your physician(s).

Any why not? You have the disease, not your doctor.

Growing evidence supports your role as a collaborative team member and captain. Remember, about 90 percent of what's needed to help you improve comes directly from you, the person with the chronic health disorder.

When you become a team caption on your health care team, your care will improve as well as your satisfaction as a patient.

To learn more about the growing area of "patient self management," check out the Stanford programs on self management by clicking here.

Sunday, January 13, 2008

Writing for Weight Control?

Many of us have ongoing struggles with our weight. We find that "diets" don't work for the most part nor do most of the "gimmicks" that go around.

But here's a question: can a writing practice help you lose weight. Writing guru Julia Cameron of the Artist's Way book says, "Yes."

Check out an interview with her in Newsweek where she reports that she went from a size 16 to a size 10 once she put her program into place. Better yet, visit Amazon to take a peek at her book by clicking here.

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DrT Speaks

  • Responding to domestic violence in the healthcare system.
    Features the strategies needed to identify and respond to victims of domestic violence. Provides methods to integrate domestic violence screening into practice and the medical history. Covers medical documentation using charting, body maps, and photos. Safety assessment is stressed, as well as appropriate referral of patients who are victims of domestic violence.
  • Understanding Domestic Violence: Why we need a medical response
    An in-depth overview of domestic violence, often referred to as intimate partner violence (IPV). Addresses commonly held myths and misconceptions. Presents the impact of domestic violence on patient health and the medical system.

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  • Dr. Pat Salber's Blog
    Dr. Salber weighs in with thoughts on fat, fitness and health from a medical point of view.