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Creative Drawing, Storytelling, and Symbol Strategies

Creative Drawing, Storytelling, and Symbol Strategies. David A. Crenshaw, Ph.D., ABPP, RPT-S Clinical Director, Children’s Home of Poughkeepsie Faculty Associate, Johns Hopkins University. Introduction. Wittgenstein: “You can’t enter any world for which you don’t have a language.”

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Creative Drawing, Storytelling, and Symbol Strategies

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  1. Creative Drawing, Storytelling, and Symbol Strategies David A. Crenshaw, Ph.D., ABPP, RPT-S Clinical Director, Children’s Home of Poughkeepsie Faculty Associate, Johns Hopkins University

  2. Introduction • Wittgenstein: “You can’t enter any world for which you don’t have a language.” • “You can’t build loving relationships without a language for affection” (David Whyte, 2008, The Three Marriages, New York: Riverhead) • You can’t build therapeutic relationships without a language for healing. Distinction between healing and treating.

  3. Goal 1: Making Therapy a Safe Place • Self-Calming Rituals • Centering Stones • “Sandy Bottom” (Siegel, Kabat-Zinn) • Creating Safe Places • Build with materials in the room • Create in fantasy • An internal space • With Clay • In Sand • Make a collage • Family Puppet Play

  4. Goal 1: Making Therapy a Safe Place (continued) • Coping with Dissociation (Yvonne Dolan) • Counting second hands on a watch • Counting fingers • Counting books with blue jackets • Rule of 2/3rds (Kevin O’Connor) • Timing and Pacing • Metaphor of Family Photo Album (Joyce Mills) • Box of “unmentionables” • “Garbage bag” (Beverly James)

  5. Goal 2: Coping, Psychoeducation, and Social Skills Training • Affect Regulation • Volcano Drawings (Eliana Gil) • Storm Drawings (Rage or Terror Expression and Modulation) • Angry Monster • Fire-Breathing Dragon • Raging Bull • “Party Hats on Monsters” (Crenshaw, 2001) • Projective Drawing and Storytelling: “Blow-Up Bernie” (Crenshaw, 2008a) • “Downshifting”

  6. Goal 2: Coping • Play Strategies • “Alligator goes Ballistic” • “Passport Protected Coping Club” • Cognitive Strategies • Problem solving and develop laminated “Menu of Best Coping Strategies” • Problems solving and develop laminated “Menu of Best Coping Statements” • Safety Plan

  7. Goal 2: Psychoeducation • Learning the Language of Feelings • Feelings Map (Drewes) • Heartfelt Feelings Strategies (HFS) • Expressive Cards in the Heartfelt Feelings Coloring Card Strategies • Education about Specific Symptoms • Flashbacks (voluntary vs. involuntary subjective experience—Jay Haley) • Dissociation (when it is helpful—when it is not) • Teach about Defenses (Metaphor of “Fawn in Gorilla Suit”)

  8. Goal 2: Building Social Skills • Role Playing • Behavioral Rehearsal • Social Skills Training Groups • Empathy Training Exercises • Recognizing Social Cues • Reading Facial Expressions • Starting and Maintaining Conversations (last 3 particularly valuable with Asperger’s and Non-Verbal LD, but aggressive and traumatized child, highly anxious children as well) • Importance of Humor

  9. Goal 3: Facilitating Positive Idenity • Honoring Strengths and Validation • Personal symbol of Unique Genius (David Whyte) • Symbols representing Strengths or Redeeming Qualities • “Badge of Ability” (Hardy & Laszloffy, 2005) • Projective Drawing and Storytelling: “The Ballistic Stallion” and “The Wise Ole Owl” (Crenshaw, 2008a) • “Mountain of Strengths” (Crenshaw, 2006) • “Cumulative Strength List (Mordock) • “Superheroes” (Larry Rubin)

  10. Goal 3: Facilitating Positive Identity • Reframing Suffering as Basis of Strength (Ben Furman) • “Courage Tapes” • Stories of Sports Heroes (Crenshaw & Barker, 2008) • “Three Doors” (Door #1, Crenshaw) • Shifting Identification from Aggressor to Empowering Helper Role (Kevin O’Connor) • Developing Capacity for Gratitude • “Coins in Fountain”-An exercise in appreciation (Crenshaw) • “Giving Thanks”

  11. Goal 4: Accessing the Inner World (Creating Portals of Entry) • Directed Drawings • “Inside/Outside” (Beverly James, 1989) • “Color-Your-Life” (O’Connor, 1983) • “Boat in Storm” (Oaklander, 1988) • “Your Place” (Oaklander, 1988) • “The Cave” (Crenshaw) • “Serial Drawings” (John Allen, 1988)

  12. Goal 4: Accessing the Inner World • Projective Drawing and Storytelling • “The Misunderstood Mouse” (Crenshaw, 2008a) • “The Secret Life of Nicole” (Crenshaw, 2008a) • Clinical Use of Symbols • Symbol Association Therapy Strategies (SATS-C) (Crenshaw, 2008a) • Directed Symbol Work • HFCCS (Relational Strategies) • Child Directed Play • A Case Example: “Stitches are Stronger than Glue”

  13. Goal 4: Accessing the Inner World • Spontaneous Drawings • Clinical Example: “The Dragon in the Well for 150 Years” • Creative Writing • Poetry • Music • Journal Writing

  14. Goal 5: Addressing Issues of Loss, Grief, and Traumatic Grief • Loss and Grief • “The Magic Key” (Crenshaw, 2008a) • “The Puppy in the Animal Shelter” (Crenshaw, 2008a) • “The Bunny seeking her Mother” (Crenshaw, 2008a) • HFCCS Relational Strategy (“Person who will be in your heart forever”) • “Heart Symbol Strategies” (Crenshaw)

  15. Goal 5: Traumatic Grief • “The Linking Object” (Crenshaw, 2008a) • Based on psychoanalytic writing of Volkan (1983) • Rationale: Traumatic grief that the child can’t access, detached or cut-off from feeling. This disconnection is causing problems in the child’s functioning and other less evocative strategies have been tried. • This is an intervention (not a strategy) that should only be used under supervision or in close consultation with a colleague

  16. Goal 6: Addressing High-Risk Adolescent Behavior • Projective Drawing and Storytelling Strategies • “Fourteen going on Twenty” (Crenshaw, 2006) • “Mike’s Version of Russian Roulette” (Crenshaw, 2008a) • “Eli and Zuko in the Land of Endless Hope” (Crenshaw, 2006) • Project Approach with Adolescents (unsafe sex, dangerous driving, alcohol and drug abuse, eating disorders, self-mutilation, and suicidal spectrum behaviors)

  17. Goal 7: Addressing Social Rejection, Stigma, and Shame • Projective Drawing and Storytelling • “Jake the Boy who sit alone in the Cafeteria” (Crenshaw, 2008a) • “The Pig who Didn’t Fit” (Crenshaw, 2008a) • “Behind the Closed Door” (Crenshaw, 2008a) • “The Fair Trial” (Crenshaw & Mordock, 2005b) • Soliciting Prideful Stories with Child and Family (Fiona True, Ackerman Institute for the Family)

  18. Goal 8: Creating the Trauma or Life Narrative (Cohen, Mannarino, & Deblinger, 2006) • HFCCS (“Relational--Person who was once in your heart but no longer is”) • “The Three Doors” (Door #2, Crenshaw, in press) • Child-Directed Symbolic Play • Clinical Use of Symbols (“The 140lb. Weight on my Back”) • Projective Drawing and Storytelling • “The Tree on the Hill” (Crenshaw, 2008a)

  19. Goal 9: Facilitating Hope • “Hope can be Dangerous” (Walter Bonime, M.D. Senior Training Psychoanalyst) • “Magic Stones” (Crenshaw, 2006) • “The Three Doors” (Door #3, Crenshaw, in press) Scaling Techniques (Solution-Focused) • “House of Hopes, Dreams, and Promises” (Crenshaw, 2008a)

  20. Goal 10: Facilitating a Positive Termination • “Story of Jose and Pete on the Mountain” (Crenshaw, 2006) • Countdown • Album • Talk Show • Letter • “One Last Conversation”

  21. Difference Between “Doing” and “Being” • “Doing” is the easy part (Crenshaw, 2006, 2008a) • Conversations with Ken Hardy, Eliana Gil, and Garry Landreth • “Being” is much harder. It takes a certain maturity and ripening as a therapist to appreciate the importance of “being” as well as to realize just how difficult it is to be fully present in the midst of a child or family’s raw pain (Crenshaw (ed.) 2008b

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