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So, how do we approach this holiday that celebrates all that is primal, scary and grotesque when real life already contains enough horror, anxiety, and reminders of suffering as it is?
Personally, I am experiencing a kind of dissonance around the macabre/horror themes. Right now skeletons and bloody characters presented as lighthearted fun feels too triggering, too real. But I’m also aware of the importance of being able to “play” with the death anxiety we all share, especially in safe contexts. Although this is a universal, often unspoken fear that connects us all, naming it is completely taboo in our death-denying, youth-obsessed, toxic positivity culture. So instead, we avoid it altogether, relegate it to one holiday a year, or save it for funerals, news, and obituaries. Author Ruth Soukup remarks, “Fear is a funny thing... The very instinct designed to protect us also holds us back.” Indeed, in small doses, leaning into our fears and being “counterphobic” can offer practice in diffusing and eventually overcoming them. This includes digging into aspects of ourselves that are less desirable or “unknown.” Drama therapy theory emphasizes the importance of role flexibility on mental health: the ability to wear many hats, evolve, and exercise many aspects of ourselves as opposed to staying stuck in one, fixed role. In a safe context like ongoing therapy or through one’s artistic practice, becoming acquainted with the “shadow side” or darkness within ourselves can be a vital part of both self discovery and healing. #halloween #currentevents #arttherapy #shadowside #deathanxiety Post by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C Pumpkin design by author’s son Today, on World Mental Health Day, with so much of the world grappling from personal and global challenges that directly impact their loved ones or their own sense of wellbeing and safety, I am reminded of the power of art to express what it means to be human. And connecting to that humanity, within ourselves and one another, is inherently healing.
Susan Magsamen, the director of the International Arts+Mind Lab at Johns Hopkins University School of Medicine, reflects on the vulnerable and humbling experience of hospitalization, and how this can be “one of the most stressful experiences anybody ever has.” The Arts in Medicine department of New York City Health and Hospitals was developed in 2018 as part of a growing movement in healthcare to utilize the arts for healing. Their collection of artwork set in public spaces around hospital facilities across the boroughs helps “create an enriched environment that can lower stress, anxiety and blood pressure, improve moods and lead to faster healing.” I feel honored to be able to collaborate with NYC Health + Hospitals and the Whitney Museum of American Art and implement a deeply personal, art-centered approach to care through ongoing arts-based wellness workshops. This approach focuses on close-looking dialogue and creative resilience skill-building to help hospital employees in every role cultivate self compassion, build community and camaraderie, alleviate symptoms of burnout, and develop mindful stress management tools on the job. Photos of the program and more about the history, impact, and vision of the program are featured here: https://www.nytimes.com/2023/10/08/nyregion/nyc-hospitals-public-art.html Post by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C Creative Support for Caregivers is a virtual art therapy group using an open studio process for anyone in NJ/NY who identifies as a caregiver and is interested in developing a restorative creative practice for stress management. Whether it is someone in a helping profession, the “giver” or “caretaker” in a romantic relationship or among one’s social group, a parent of younger child(ren), older child of an elderly parent, or those “sandwiched” in between, this is THEIR creative space. Group objectives include:
Yesterday was our first arts-based workshop of the autumn season provided for a dynamic group of administrators, physicians, and clinicians at Elmhurst Hospital Center along with my esteemed colleague from the Whitney Museum of American Art. With an original screen print by abstract expressionist Helen Frankenthaler as our focal point, hospital employees embarked on a “close looking” exercise involving guided observation of the art work. This moment of mindfulness was followed by rich discussion around the materials used, background of the artist, and personal reflections about the piece. Frankenthaler is quoted as saying, “There are no rules. Let the picture lead you where it must go.” Indeed, her intuitive, open approach to art-making provided a wonderful segue for the personal art-making experience to follow and inspired our use of fluid, wet media. Participants were invited to engage in an adapted open studio process approach to art therapy, including embodied breathing for grounding, free associative writing for creativity development, art-making with playful, non-traditional mixed media, personal self reflection, and group sharing for synthesis and community building. One participant shared how the liquid watercolor kept dancing around the page each time she shifted her position, resulting in imagery and a “final” product that was ever-changing. Although challenging to try to control the drops at first, she reflected on how this constant movement and evolution of her piece was actually a refreshing and exciting example of surrendering to not knowing what to expect as opposed to trying to control the outcome. It was a beautiful demonstration of art as therapy, requiring creative problem solving, frustration tolerance, self compassion, and reframing of perspective to come to this conclusion. These are certainly skills that can also be applied to daily life while managing stressors in a demanding hospital environment. We hope that the creative experience we provide and the artwork on display in the institution itself will serve as reminders of each individual’s own creative resilience. #artastherapy #artheals #caregiverburnout #healthehealer Post by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C Original photos courtesy of Elmhurst Hospital Center Aside from back to school time for families and important holidays for many, September also marks NICU (Neonatal Intensive Care Unit) Awareness Month, established to acknowledge and educate the public around the unique challenges childbearing families face while navigating their baby’s time in and provide them with the support and resources they need. It also honors the professionals who work in these critical and demanding spaces. The reason for admission and length of stay in a NICU varies widely, sometimes due medical complications after labor and delivery, recovery from surgery, or a need for monitoring concerns around pediatric digestive conditions or respiratory issues. Some birthing people have just experienced a traumatic birth when their babies are admitted to the NICU, adding yet another layer of vulnerability and stress to the typical challenges around establishing a milk supply for breastfeeding or creating a feeding routine with a newborn. Fear for the little one’s well-being, extreme helplessness around limited access to them, confusion around what one is “supposed” to be doing, anger toward the medical system, dashed hopes around having a “perfect” birth, and anxiety around what the future brings are common here, as well as deep concerns around bonding with the baby. Some medical settings, such as the Monroe Carell Jr. Children’s Hospital at Vanderbilt University, employ creative arts therapists to help ease this massive transition for both infants and families. NICU music therapy, for example, focuses on providing safe and effective evidence-based music interventions to promote neurodevelopmental stimulation, increase infant rest and regulation, and provide opportunities for caregiver bonding. Research has shown that creating and singing lullabies also promote overall family well-being by supporting maternal health, early child development, and the attachment between parent and child. #nicuawareness #perinatalmentalhealth #creativeartstherapy Post by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C Original photograph by Gabriel Tovar via Unsplash Doctors are now “prescribing” activities such as museum visits, nature walks, volunteering, book clubs, and expressive arts practices as a more holistic approach to wellness. In the UK and some parts of the US, “social prescribing” has become integrated into medical practices to combat isolation, loneliness, and somatic responses to stress. These symptoms are often exacerbated for those in helping/caregiving professions due to burnout syndrome and a kind of desensitization that can develop as a way to cope with chronic exposure to high levels of stress and demand.
A recent Harvard Public Health newsletter quotes a London-based physician named Giurca who champions this model of care: “Instead of a health care model based entirely on pills and procedures, where doctors ask patients, ‘what is the matter with you,’ this concept makes a paradigm shift to asking ‘what matters to you.’” This person-centered approach is highlighted in the HHArt of Medicine program via NYC Health and Hospitals and the Whitney Museum of American Art, which fosters the emotional well-being of its staff to promote healing and wellness for patients, families, and caregivers. Since countless studies reflect how expressive arts engagement can improve mental health outcomes, The Arts in Medicine department utilizes visual, literary and performing arts programming throughout the Health + Hospitals system. Yesterday’s Art-Centered Practice workshop invited hospital staff members from various departments to engage in mindful observation of a mural installation on the first floor by abstract painter Helen Frankenthaler, followed by an open studio process approach to art-making and reflective writing as a form of self care. One participant shared how she had neck pain at the beginning of the session, and has been struggling with a number of personal health issues. While experimenting with the wet media inspired by the mural downstairs, she realized that it only took one stroke of a paint stick to fill her entire page with color if she also added water. The resulting image was bursting with warmth, and evoked feelings of “wholeness” for her. By the end of the session, her neck pain was gone. Her creative process had reminded her of her own personal resourcefulness and resilience, which she felt on a physical and emotional level. Post by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C Workshop Photos courtesy of Titus Rawle Healing is not linear. Or always visible. But we can still trust it’s happening. This is especially true when we are living in an Age of Anxiety, when public health and environmental variables compound everyday stressors and push our cortisol levels to new heights. In the northeast US, last week’s smokey skies and corresponding lockdown likely triggered some lingering pandemic PTSD, especially for frontline workers or pandemic parents who were finally starting to exhale after years of white knuckling through public health alerts.
Ecological anxiety rooted in concern about climate change is well warranted, but it is also easy to get swept up into cognitive distortions around a projected dystopian future for our children when it looks like we’re living on planet Mars. Whether we’d like to admit it or not, we are highly sensitive beings, heavily influenced by both our internal and external worlds. So, how do we take a deep breath, relax, and trust everything will be ok when the air we breathe is not necessarily safe anymore? When we need to dig deep and turn inward for strength, our own imaginations are rich terrain to cultivate grounding, mindful practices. When my mind starts to dwell in dark caves of fear or unknowns, I like to transport myself into calming, sensory scenes with ocean waves lapping against the shore, water trickling over smooth stones in a clear, cool stream, or leaves lazily dancing in a breeze. I find solace in the way nature’s cycles silently and steadily carry on with the passing of time. Indeed, after two days of hazy skies here in NYC, the winds dutifully cleared out the smog, allowing the summer sun to peek through again. But those dark days offered an eerie reminder of pressing ecological issues we can no longer ignore, as well as our own vulnerability as humans. It takes a certain level of trust, in oneself and the world at large, to learn to take comfort in the transience of all things, the constant movement of time, the fact that everything eventually passes. A similar outlook leads to better outcomes in therapy, too. Managing expectations around what growth will look or FEEL like in therapy is so important when one is really in the nitty gritty of the work. We all want the magic formula to instantly feel better and the gratification or public recognition of our measurable progress. But in reality, engaging in an ongoing therapeutic relationship is a highly individualized, private process. Often only the therapist and clients bear witness to positive personal change–regardless of how big or small– with hopes that this will translate outside of session. It can feel different session to session, sometimes like “two steps forward, one step back,” or a “”progression/regression” scenario, where there may be a personal breakthrough one week, followed by exacerbated symptoms or an increase in triggers the next. Yet this is still healing. Regardless of whether one is engaged in ongoing therapy due to physiological, spiritual, sexual, psychosocial, or emotional concerns, the journey is a hard, but noble one. We all need to remember to breathe as we continue to navigate this ever-changing world–together and on our own. Post by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C Original Photo by Patrick Ryan via Unsplash Although the status of the nation-wide public health emergency due to the COVID pandemic was recently downgraded, a physical and mental health crisis in this country remains. Post-pandemic staff shortages in medical institutions around the US speak to the growing gap in care, in large part because employees no longer feel safe–financially, physically, or emotionally–in these high-risk, frontline, demanding positions. In response, the Whitney Museum of American Art has recently partnered with NYC Health and Hospitals agency in offering Art in Medicine workshops for all public hospital employees inspired by artwork on loan from the museum’s collection. The hope is that by developing an “art-centered practice” infused with mindful art observation and creation, employees can develop self care and stress management skills that will help combat burnout syndrome on the job. Yesterday, inspired by the warmer weather, shifting landscape of the pandemic, and a piece of mixed media art by artist Howardena Pindell, participants were asked to creatively explore the theme of “layering.” They were provided with a range of collage and drawing supplies to engage in an Open Studio Process method of creative writing, artmaking, and self-reflection on their personal exploration of metaphorical layers they wish to examine, keep or shed. The hospital employees in attendance represented various departments within the institution, together creating their own mosaic of different personal experiences and approaches. As they played with, experimented, and engaged in the tactile properties of the materials, self compassion, creative problem solving, and positive perspective-making were emphasized. One participant remarked that she wished she had clear tape so that she could layer her tissue paper pieces in a specific pattern, and a colleague playfully reminded her to “get creative” in finding another way to create the same effect with the materials at hand. Another participant created a vibrant tissue paper flower that blossomed off the page out of the “concrete” below, with each petal representing a layer of herself she wanted to preserve and honor. Next, a volunteer shared that she first wrote all about how much responsibility she has and the crushing weight of these burdens. She then began making art and exploring the materials at hand, having “no idea what she was doing.” In the end, she realized that she was “playing” in her artwork through her swirling lines and pops of color, which is what she needed most. Their experiences represent a kind of parallel process that can happen when creating intuitively and having one’s inner experience mirror the outside world. Pediatrician and psychoanalyst D.W. Winnicott writes, “It is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self.” It was a true joy to witness others in their creative processes of discovery yesterday. Post and Photograph by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C Happy Maternal Mental Health month! Early records by Hippocrates from around 500 BC mention birthing women suffering from “agitation” and “delirium” in the perinatal period. Later medical documentation from the 14th century called it “madness” which evolved into “melancholy” and “hysteria” in the 16th century. Hundreds of years later, the field of perinatal mental health was born, finally adopting a feminist, person-centered, evidenced-based clinical lens to address what is now called perinatal mood and anxiety disorders (PMADs). Art therapy is an integrative mental health profession around since the 1940’s, (though humans have of course been using art as therapy since our cave painting days.) It incorporates trauma-informed, sensorimotor-based practices that can be extremely effective in supporting birthing people in coping with challenges along their family building journeys. The powerful intersection of these fields is only recently being written about, with this groundbreaking text "Art Therapy and Childbearing Issues" edited by Nora Swan-Foster at the top of the list. Grateful for the fellow unicorns, movers, and shakers who are paving the way in developing innovative, compassionate, and creative maternal mental health care. It’s about time! #perinatalarttherapy #pioneerwomen #maternalmentalhealthmatters Post by Sharon Itkoff Nacache ATR-BC LCAT LPAT PMH-C |