Art, Play, and Narrative Therapy Using Metaphor to Enrich

Your Clinical Practice 1st Edition

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 Contents

List of Illustrations vii

List of Tables xi
Acknowledgments xii
Introduction xiii

I First and Foremost 1

1 A Personal Metaphor 3
It’s Not the Heat, It’s the Humidity 10
Heart and Soul 19
Across the Board 26
And So to Bed 35

2 Psychological Maturity 37
Fill the Bill 39
Child’s Play 43
Betwixt and Between 47
Read Between the Lines 54
And So to Bed 64

II The Eternal Verities 69

3 Clinical Applications 71
More Here Than Meets the Eye 74
Any Port in a Storm: Case Illustration 1 78
A Whole New Ball of Wax: Case Illustration 2 91
Good, Bad, or Indifferent: Case Illustration 3 101
And So to Bed 111

4 Metaphors of Communication 113

Let’s Get the Show on the Road 114
Let Me Bend Your Ear 117
You Said a Mouthful 123

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vi • Contents

Between the Devil and the Deep Blue Sea 132

You Can Bet Your Boots 137
And So to Bed 140

5 The Wonder Box 142

Without Further Ado 143
Eloquent Silence 160
Actions Speak Louder than Words 168
Grasp the Nettle 176
And So to Bed 183

III From Start to Finish 187

6 The Art of Anger Management 189

At Your Fingertips 191
The Art of Anger Management Guidebook: Skills 1 to 48 194

7 An Expression of Grief and Loss 226

Skills 1 to 20 227
Distancing Directives: Skills 1 to 8 244
And So to Bed 244

Index 247
 Illustrations

1.1 Precursory Activity 1 4

1.2 Precursory Activity 2 5
1.3 Chaotic Discharge 6
1.4 Art in the Service of Defense 1 7
1.5 Art in the Service of Defense 2 7
1.6 Pictographs 8
1.7 Formed Expression 1 9
1.8 Formed Expression 2 9
1.9 An Enduring Storm 10
1.10 Alienation 10
1.11 The Persona 11
1.12 Eyes as Containers for Emotions 12
1.13 Turtle and Clown 13
1.14 Anxiety 13
1.15 The Magic Puppet Theater 16
1.16 The Boy Who Wasn’t Accepted 18
1.17 Family 18
1.18 Don’t Give Up 20
1.19 A Sense of Self 20
1.20 Papa Bear and Panda Bear 24
1.21 The Creature and the Cricket and Friendship 25
1.22 The Growing Tree 26
1.23 It’s a Robot, but It Isn’t 27
1.24 The Conflict Collage 28
1.25 Group Mural 31
1.26 Quiet Time 33
1.27 Congruent Communication 34
2.1 Pair Therapy First Session 40
2.2 Laura and Beth Work Cooperatively 41
2.3 I Wish . . .  43
2.4 Now I Will Kill You 45
2.5 Discharge of Drives 46
2.6 Inside and out 47
2.7 A Deserted Island 48
2.8 Donny’s Dinosaur and Roach Motel 50
2.9 Left out in the Cold 52
2.10 Treading on Thin Ice 53
2.11 A Context Is Provided 54
2.12 Storytelling in the Round 57

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viii • Illustrations

2.13 Jealousy 59
2.14 Papier Maché Sculpture 60
2.15 Progressive Collaboration 62
2.16 The Rescue Attempt 63
2.17 Hip Hop Sad 63
3.1 If at First You Don’t Succeed 73
3.2 A Free Hummingbird 77
3.3 And Don’t Forget It!!! 79
3.4 Don’t Get Conned Into What Other People Say 80
3.5 Body Outline – Adult 87
3.6 Body Outline – Child 87
3.7 Body/Mind Tracing 88
3.8 What’s in Your Mind? 89
3.9 Life, Life, and Life Again 90
3.10 Feeling Body Outline 93
3.11 The Door of Disgust 94
3.12 Harris’ Anguish 95
3.13 Fear of the Unknown 96
3.14 Standing on His Own Two Feet 97
3.15 Things Pending 98
3.16 Captain of Your own Ship 99
3.17 A Tedious Task 100
3.18 A New Path 101
3.19 Ride the Wild Wave 103
3.20 The Shark’s Lagoon 104
3.21 All Aboard 105
3.22 The Good Shark and Bad Lamb 106
3.23 The Mean Shark 107
3.24 I Need a Hand 108
3.25 College Experiences 109
3.26 How to Say Goodbye 110
4.1 Hot Pursuit 118
4.2 The Tree Man 121
4.3 A Boy Captured 122
4.4 Sergio 124
4.5 Bo Arthur 125
4.6 Mike Doe 126
4.7 “M” Chocolate 126
4.8 Guardian and Villain 127
4.9 Cover and End Notes 131
4.10 Pages 1–4 131
4.11 Pages 5–8 131
4.12 Pages 9–12 132
 Illustrations • ix

4.13 The Moral 132

4.14 Bob 134
4.15 Bo the Pot Smoker 134
4.16 Jim 135
4.17 Antagonists Have Destroyed the Calm of Mogine 137
4.18 Two Views of Our Protagonist 138
4.19 Love Transcends All 139
4.20 Sorrow and Gratitude 139
4.21 Revenge and Loss 140
5.1 My First Sandtray Cabinet 144
5.2 Which Way Is Front? 145
5.3 Aggressive Signs 147
5.4 Empty World Signs 148
5.5 Distorted World/Closed 149
5.6 Distorted World/Disorganized 149
5.7 Distorted World/Rigid 150
5.8 The Circle of Life 151
5.9 It’s Almost Like a Metamorphosis 152
5.10 Is That a Kangaroo? 153
5.11 I Love the Two Horses 154
5.12 What’s That One Horse Doing? 155
5.13 Just One Horse? 156
5.14 Chaos 157
5.15 Struggle Toward Annihilation 158
5.16 Struggle for Supremacy 159
5.17 Struggle Within Organization 159
5.18 Resolution 160
5.19 A Beleaguered Struggle 161
5.20 A Struggle Against Unseen Foes 162
5.21 A Struggle Where the Foes Appear 162
5.22 A Poisonous Struggle 163
5.23 A Desire for Family 164
5.24 The Self as Powerful 165
5.25 Three Becomes Two 166
5.26 Two Becomes One 166
5.27 Group Sandtray Therapy 169
5.28 A Story of Rescue 170
5.29 Organization Belies Interpersonal Difficulties 172
5.30 A Story of Strife Unfolds 172
5.31 Finding a Safe Side 173
5.32 Themes of a Cohesive Family Life Appear 174
5.33 Cohesion Drifts Further Away 175
5.34 I Was Rescuing the Poor People 177
x • Illustrations

5.35 I Like Things Pretty, Happy, and Natural 178

5.36 Emotional Turmoil 178
5.37 I Did Something Vicious 179
5.38 Crawly Bugs Inhabit the Home 180
5.39 Why’d You Do That Silly? 181
5.40 A Proliferation of Dolphins 182
5.41 It’s Okay That You Work Separately 182
6.1 The Scribble Drawing 190
6.2 Thank You John 194
6.3 Violence 195
6.4 This Just Burns Me up 196
6.5 My Week 197
6.6 I Lock Everyone Out 198
6.7 I Fly in the Air 199
6.8 The Fear of Loss 201
6.9 Anger and Anxiety 203
6.10 Weathering the Storm 204
6.11 Learning Assertiveness 205
6.12 Early Attachment Predominates 206
6.13 Anger and Its After Effects 208
6.14 My Needs 210
6.15 Face to Face 211
6.16 When I Am Tense 213
6.17 What Upsets You? 215
6.18 Needs and Wants 217
6.19 Acknowledgment 222
6.20 Just Kicking It 223
7.1 Grief Is Letting Go 229
7.2 The Eyes Have It 230
7.3 Safely Isolated 233
7.4 The Crying Jar 235
7.5 A Page in the Life . . .  237
7.6 My World 238
7.7 My Strengths 240
7.8 My Relaxing Place 243
 Tables

1.1 Sensory Preferences 15

3.1 Theories Compared 76
4.1 Steps to Interpretation 116
5.1 Sandtray Documentation 146
6.1 The Art of Anger Management Table of Contents 192
7.1 An Expression of Grief and Loss Table of Contents 228

xi
 Acknowledgments

I cannot express enough thanks to the following people for their assistance,
thoughtful suggestions, and patience:

Lisa Brewer Nina Guttapalle

Lauren Richardson Nikki Creel
Liz Collins Cyndie Westerhoff
Tanner Barge Annette Longa
Stephanie Soule-Maggio Barry Schoer

Lastly, I would like to express my very deepest appreciation to Anna Moore.

You believed in this book from the moment we first spoke. From your valu-
able and constructive suggestions, to your ongoing support and guidance, your
willingness to give generously helped make this book possible.

xii
 Introduction

Gentle Readers,
In an ever-evolving world, it is comforting to find one idea that inter-
connects, one concept that is not isolated or beyond understanding. A
comprehension that far surpasses anything conveyed by verbal narrative, thus
existing beyond our words. And to this I would say it is our figurative mes-
sages, a personal metaphor if you will, that encircle us; if we would just listen.
From our cumulative life experiences, to our immediate thoughts, actions,
and words, it is metaphor which can be found skulking in the corners or even
laid bare through our repetitious patterns of behavior. Whether these patterns
reveal themselves through language, creative endeavors, or activities, metaphor
has the power to increase understanding.
In my work with the concept of a symbolic abundance of ideas (Moschini,
2004) the cumulative effects of an individual’s personal expression often
add up to much more than first recognized. It is with this in mind that the
concept of metaphorical meaning has also grabbed hold of my imagination.
Yet, how a metaphor is defined often goes against the grain. Webster’s New
World Dictionary (1988) defines metaphor as “a figure of speech containing an
implied comparison” (p. 852), which I find to be rather antiseptic. On the other
hand, comparable to the metaphorical representations that I will be discussing
in this book is Kenneth Wright’s (1976) description, “metaphor is a product
of an ego that is going towards a problem and attempting to grasp it” (p. 98).
For it is within this struggle that every human can collectively empathize.
Which one of us has not felt before we have thought? Which one of us can
claim the rigid continence of Sisyphus when faced with fears that threaten to
consume? In how many ways has an experience enriched your understanding?
Unlike other books on metaphorical psychotherapeutic techniques, Art,
Play, and Narrative Therapy: Using Metaphor to Enrich Your Clinical Practice
does not rely upon the therapist’s hypothesis of a client’s struggles but instructs
the mental health professional on how to assimilate the client’s natural meta-
phorical language into the therapeutic hour. Additionally, the identification of
the client’s repetitious words, language, stories, and artwork is coupled with
treatment interventions that can aid empathic understanding, promote a col-
laborative alliance, and encourage conflict resolution.
So now we arrive at another series of questions. How does the mental health
professional conceptualize a case? What theoretical orientation is utilized? How
are treatment goals achieved? Which series of interventions are incorporated?
Each of these questions is of special significance because it is the men-
tal health professional’s chosen models of practice that define the applied

xiii
xiv • Introduction

interventions and ultimately determine the effectiveness of the treatment.

Whether one seeks to make the unconscious conscious through the explora-
tion of repressed conflicts (Psychodynamic therapy), extinguish maladaptive
behavior patterns (Behavioral therapy), develop healthy communication pat-
terns (Family Systems theory), promote the identification of irrational belief
systems and automatic thoughts (Cognitive-Behavioral therapy), or accept-
ance and value through awareness of the here and now experience, each
theoretical modality has a common and interlocking bond: all seek to expand
insight and growth. Regardless of how objectives are met, or the terminology
incorporated to define, theoretical assumptions serve as guides.
Thus, I have attempted to provide a focused exploration, regardless of
the applied treatment approach, on how metaphorical representations form
who we are, how we interact, and how we understand our larger environ-
ment. It is important to note that art, play, and narrative therapy are specific
treatment modalities and, as such, require training and practice beyond the
parameters of this book. Additionally, “because sandplay therapy probes the
depths of being, the ego of the sand player must be sufficiently sturdy to with-
stand these rough undergoings. This can be a treacherous process” (Turner,
2005, p. 17). Accordingly, it is my firm belief that mental health professionals
will incorporate the concepts presented herein in a prudent, thoughtful, and
principled manner.
This book is divided into five chapters. In each chapter the case reviews,
illustrations, and story narratives provide the reader with a mental picture of
the presented individual’s inner emotional life. As with all case histories within
this book, the information concerning therapy and clinical matters is factual.
However, the clients’ personal information, including names (where applicable),
dates, and places have been substituted to retain confidentiality.
The first chapter offers a brief overview of how a personal metaphor
engages our emotions and often symbolizes the very essence of our character;
how auditory, kinesthetic, and visual sensory preferences impact our experi-
ences; and examples of how metaphorical meaning were incorporated into
group, individual, and family therapy. Chapter 2 focuses on the transforming
nature of development on personality. As such, it explores the role of moral-
ity, ethics, relationship development, and behavior concomitant with brain
chemistry and growth. Chapter 3 incorporates an interdisciplinary approach
where case examples are analyzed from a wide range of counseling method-
ologies. From Cognitive-Behavioral theory with its action-oriented emphasis
on skills acquisition, Gestalt therapy highlighting the gaining of awareness,
to psychodynamic therapy where healing is accomplished by making the
unconscious conscious, to family theoretical models; all of these schools of
thought can be woven into the fabric of metaphoric communication. Hence,
successive case histories focus upon the interpretation of play, narrative, and
artwork whereby coping mechanisms in the form of symbolic metaphors are
explored. In Chapter 4 the verbal interplay of clinician and client brings into
 Introduction • xv

being a metaphorical communication found within the context of story char-

acters, plot, spheres of action, and denouement. In each case review the client’s
metaphorical meaning is evaluated while the shared story offers new choices
that facilitate the regulation of anxiety, fears, and humiliations. Chapter 5
explores the incorporation of sandtray therapy. As such, the sandtray min-
iatures are employed on a metaphorical level and represent personal symbols
whereby a client’s inner expression and experience can proceed unimpeded.
Additionally, interpretive methods and skills are reviewed in an effort to aug-
ment the mental health professional’s proficiency when assessing sandtray
worlds. Lastly, Chapters 6 and 7 offer two guidebooks toward the blending of
the arts and psychotherapy. As such, these guidebooks promote interaction,
group cohesiveness, and most importantly illuminate the process while pro-
viding step-by-step directives designed for mental health professionals who
wish to support the growing relational conflicts of their clients through the
incorporation of art therapy. Though written with the group therapy client
in mind, each guidebook can also be modified for treatment with individuals.
In the end, metaphor reaches toward self-understanding in a language that
is individually ours. I hope you find the blending of personal metaphor with
psychotherapy to be as enriching in your practice as I have in mine.

References

Moschini, L.B. (2004). Drawing the line: Art therapy with the difficult client. Hoboken, New Jersey:
John Wiley & Sons.
Turner, B., (2005). The handbook of sandplay therapy. California: Temenos Press.
Webster’s new world dictionary (3rd ed.). (1988). New York: Simon & Schuster, Inc.
Wright, K.J.T. (1976). Metaphor and symptom: A study of integration and its failure. The
International Review of Psychoanalysis, 3: 97–109.
 I
First and Foremost
 1
A Personal Metaphor

Once upon a time in a park there was a trash can. There was a ripped and dirty
shoe inside. It was so ugly that no-one liked him. One day a poor man came to
the park and he didn’t have any shoes. The poor man looked into the trash can
and he saw the shoe and said, “Your name is Eric. My name is Pepe. We’ll have
a lot of fun.” Pepe put on the shoe and started walking. Pepe lived in the street
with Eric. The next day Pepe was going to go walk. Pepe said, “I’m glad to have
a shoe.” Eric said, “I’m glad to have an owner.” Soon Pepe got a job. He took
Eric. He got a lot of money and he got some new shoes. He took Eric to this
man so he could fix him. When Pepe went for Eric, he was a new shoe. He was
nicer and they were happy together.

Every individual both receives and relays information in his/her unique meta-
phor. From the verbal communication of our statements to the metaphorical
communication, which is witnessed in our actions, creatively incorporating
an individual’s metaphor into the therapeutic hour can provide the move-
ment necessary for insight and growth. For personal metaphor lends meaning
to our experiences, makes sense of both our external and internal worlds,
offers respite from our fears while accentuating our conflicts, and provides a
signpost for our hopes and desires.
Silvano Arieti (1976) in his exploration of creativity stated, “poets, play-
wrights . . . know very well that words often acquire great meaning not because
of what they say, but because of what they don’t say. What is not said, and at
times is hidden, may then appear with powerful effect” (p. 89). Just as with
the spoken or written word, metaphorical language explores the unconscious
mechanisms that drive our interpersonal relationships, gives shape and form to
our personal identities, and integrates the natural language patterns of the client.
As such, it has been my experience that when incorporating evoca-
tive therapy, an individual’s metaphor can exist, in large part, through the
manner in which they integrate the art media within their final creation.
Consequently, these guiding metaphors are an unconscious product of the