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Art Therapy

The Desert of Self: Starvation of Identity in the Prison Setting

Posted on July 17, 2021
Myself Masking

A Desert Stroll

On a first walk through the gated compound, there’s no shaking the starkness of nothingness, a blank prison canvas. Marked by concrete and wire, there is no color, no personality. Numerous cinder block buildings are connected by concrete “roads.” Most days are idle and left to one’s imagination. The typical day revolves around the 3 chow times, several lock downs for count and limited programs.

Starved of Their Identities

The prison environment for inmates coupled with a history of trauma, losses and mental health crises becomes a breeding ground for decompensation. From Misluk-Gervase’s (2020) article about art therapy and the malnourished brain in individuals with anorexia nervosa, this art therapist realized I witness mental health malnourishment every day as male inmates are starved of their identities.

Focus of Clinical Attention

From the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), a list of “other conditions” are provided that may be a “focus of clinical attention.” These additional issues are beyond mental health disorders and “may affect patient care.” The DSM-5 lists code Z65.1 as “Imprisonment or other incarceration” (American Psychiatric Association, 2013). Thus, the desert of incarceration is recognized as problematic to patient wellness.

Malnourished Redefined

So, what does malnourishment look like? Marked by the effects of physical malnourishment, individuals with anorexia nervosa (AN) often are rigid in viewpoints, resistant to treatment, lacking in emotion, have increased suicide risk, strained connection with others and trauma histories (Misluk-Gervase, 2020). As expressed in the corrections setting, inmates often have inflexible opinions which culminate in violence with no regard to consequences. Incarcerated persons often refuse treatment convinced they either don’t need help, or no one can help them. Further, to cope in prison, inmates may acquire maladaptive responses to emotion, or rather the lack of emotive expression or identifying emotions. With years behind bars, inmates often cope by “staying to myself” and not sharing with others furthering a decline in prosocial behaviors.

Toxic Stress Consequences

The compassionprisonproject.org (2021, as cited in Merrick, Ford, Ports, & Guinn, 2018) looked at Adverse Childhood Experiences (ACEs) in the inmate male population and found a higher incidence of emotional, physical, and sexual abuse, emotional and physical neglect, domestic violence, substance abuse, parents living apart, mental illness and having a family member incarcerated as compared to the U.S. population. These experiences change brain chemistry with the unstable, dangerous prison life contributing to functional decline. For inmates that have been incarcerated several times, the pattern of being “institutionalized,” whereby the engrained structure of prison life makes reintegration into society increasingly difficult. Sadly, many convicts may reoffend to return back to prison, to return to “what they know.” Prison living can be a starvation of self, slowly over time.

Research has determined that physical malnourishment impacts 9 distinct areas of brain functions including: overarousal to perceived threats; compromised access to long-term memory, distorted view of self; inhibited social connection with others; impaired decision-making; the brain cannot order their needs introducing myopic views of self and surroundings; rumination on details and facts to the sacrifice of one’ worldly perspective; perfectionism and compulsory actions; and seeking out pleasure despite negative consequences (Misluk-Gervase, 2020).  

Of course, a diagnosis of anorexia nervosa in not a typical consideration within mental health evaluations in prison. Inmates are not typically affected with significant weight loss as found in AN. However, what is the significant loss of self?

Art Therapist with Conviction

Through my art therapist lens, I witness the need for inmates to reconnect with who they truly are. Inmate Jones* had served 12 years of his 25 year sexual assault crime. In his first session, we completed a mask project. With identity teed up, he indicated looking forward to meeting again and would like to share his story next time. With therapeutic trust in place, the inmate shared his story, a story he never shared with anyone all these years. He realized the night of his crime was not just one night fraught with bad decisions alongside his heavy cocaine use. Rather, he realized he had not been living right for several years. This night has haunted him, especially with the victim and her family extending forgiveness. Hinging on his frustration, I suggested to consider “Who are you now?” and  “What would it be like to accept this gift of forgiveness?” “How might it help the victims and yourself to know that healing can happen and new purpose can be gained?” I plan to have him create and bear his gift in the next session.

Presenting as depressed and downtrodden, Inmate Smith* came into session carrying a folder. A careful eagerness flashed across his face, “Can I show you some artwork?” With delight, we spent the session reflecting on his detailed work. With precision, his favorite image was a diagram of his home with all its dimensions, contents, complete with plants and items in the yard. He yearned for a return to home with his partner, yet was pitted with the idea that he may not have either to return to. For, it has been over a year since he has received any news on either. Tormented with pain, he sensed the worst has happened. Holding the space through images brought order to his thoughts. His ambivalence about living was soothed by feeling heard. Reconnection to who he really is… became the heart of his healing path.

Art Therapy Reflection

In my reflection, I created an image and poem, “Myself Masking.”

Cracked and barren
Lay the same old, same old
Gasping and dried
Knees sunk in the hot sand
Hunched and aching
My eyes tracking forlorn
Chained and uniformed.

Thirsty and starved
Crawl the same old, same old
Ain’t no way back
With cracks so wide and deep
Secrets hidden
Body, mind, soul revealed
Would get me killed.

Held and straining
Pushing down all the pain
Seeing myself
As I am now today
Only fleeting
A moment, a flashing
Myself masking.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Compassion Prison Project. (2021). How common are adverse childhood experiences (ACEs)? Retreived from https://compassionprisonproject.org/childhood-trauma-statistics/

Merrick, M. T., Ford, D. C., Ports, K. A., & Guinn, A. S. (2018). Prevalence of adverse childhood experiences from the 2011-2014 behavioral risk factor surveillance system in 23 states. JAMA pediatrics, 172(11), 1038–1044. https://doi.org/10.1001/jamapediatrics.2018.2537

Misluk-Gervase, E. (2020). Art therapy and the malnourished brain: The development of the nourishment framework. Art Therapy: Journal of the American Art Therapy Association, 38(2), pp. 87-97.

Art Therapy

Ribbons of Concrete: Road Drawings in a Prison

Posted on June 12, 2021
Ribbons of Concrete

The Puzzled Look

With the inmate patient sitting across from me, I begin our session by simply asking, “I’d like you to draw a road” from Hane’s (1995) Road Drawing. The look of astonishment is priceless with reactions as raised eyebrows, widening eyes, relaxing shoulders, perplexed head tilts and more. Inmates often do a “say what?” moment to clarify, “ya want me to draw… a road?” or through the barrier of face masks during COVID-19, inmates state, “did you say a rose?” (I’m surprised to learn that many inmates have perfected flower drawings.) With a matter-of-fact demeanor, this art therapist responds, “Yes, a road. What shapes are roads?” Then we discuss potential ideas of what roads look like. Next, a purposeful pause is put into place. For a few minutes, I witness the artmaking process start with silence held while mark making commences. Moving away from talk therapy approaches, the inmate is doing something. From unspoken quiet, all that is heard is the scratching of pen to the paper, a welcomed break from the dorm. No awkward stares, no needed scripts, just image making.

Drop the Pencil

Many times, I witness what I call a “classic road drawing,” that is, a stereotypical two vertical or horizonal lines with a dashed line in between, centered on the page, with a forceful drop of the pencil signaling, “I’m done.” With compliance, many inmates complete the task with an unspoken, “I’m in, but not sure what this is all about.” To encourage development of their road I may ask about details to consider adding or changing. Or, I encourage them to take as much time as needed with a reminder “no high art needed today.”

Get on With It

Per assessment requirements in prison, there’s also a need for the counselor to complete paperwork alongside witnessing the work unfold. As this art therapist covers the token questions of hours of sleep and eating occurrences, disciplinary reports, gain time and more, the inmate responses become more natural and relaxed. By starting with artmaking, both inmate and art therapist are eased into the experience which sets up the foundation for therapy to occur.

Something to Talk About

At session end, I ask an “oh by the way, how did your road [drawing] come out?” Using the formal elements of art, that is, the language of art, we explore the image through the use of line, color, form and shape, value, texture, space, and movement. With healthy distance, we witness the image together as a snapshot of time and begin to dialogue with the road. Here’s some conversations about the road drawings:

Sidewalk     With a drawn sidewalk, an inmate speaks about his experience as a “concrete man” describing the critical need for expansion joints to prevent cracking. His sidewalk turns into a road. Looking like a ladder, the inmate acknowledges, “I’m at the very bottom but there are supports.” We then discuss what it would be like to climb the ladder and what supports could help you as you get higher. How might adding joints in your life allow you to grow? How do you make sense of this? The inmate states, “for these 10 years (his sentence), I need to stay positive and stay on the right path.”

Rainbow Bridge     In another image, an inmate draws a large half circle bridge crossing a river with a bright smiling sun and clouds in the sky. He looks at the images and acknowledges, “freedom, when I’m on the other side.” He observes his large bridge needs some supports like railings and a sidewalk.

Multi-Lane     With this multi-lane road drawing, this inmate describes the left lane as the “right way.” The “wrong way” to the right has less lines in it with many other roads. The inmate states, “The bad side is easy. It’s so easy to veer off that way.” This art therapist notes the “right road” literally moves in the opposite direction to the left possibly suggesting the confusion of making positive choices.

Country Meets City     In this image, the inmate depicts a country road horizontally and city road vertically making a perpendicular intersection with the country road on top.  This young 22-year-old conveys his ambivalence about wanting to return home to the country but desires to see a bigger place. The image begs the question, “Will he go back to his old ways or jump onto the on-ramp?”

Widening     With a rocky start, this inmate describes a curvy narrow road that is straightening out. He later edits the road to widen it at the end because, “that’s the future” and he is pleased. When asked what advice he would give himself over this 10-year sentence, he stated, “Take your own, day-by-day.”

Hometown Map     This inmate states he will be moving out of this state when he gets out. Drawing a map of his community, he depicts neighboring thorough fares and homes in extraordinary detail. He later reflects on the image saying, “I’ll get there,” and I state, “But I thought you said you were moving out of this state?” A flash of sadness crosses his face.

Parroting     On this occasion, I mimicked and drew the inmate’s drawing as he was drawing it. I asked, “How is it for you to draw?” He replied, “Like I’m not in prison” and I retorted, “Then do that!” He labeled the parts of the road as “wide,” “narrow” “loops,” “straight,” and “not wide, 2-way street.” Then, I showed him my version of his road and asked, “wonder what it would be like if water flows down this road?” We discussed how water is fluid, forgiving, and flexing. From motivational interviewing and positive psychology perspectives, the inmate’s positive coping skills were reinforced. Most important, the inmate received a needed message from his created image.

After discussing a road drawing, there seems to be a cathartic release, yet amazement about how “dead on” their road seems to be telling a message most needed.  I acknowledge how this image could provide a pulse check today. “How am I this day? Where is my mind? How does the image inform me about my journey? What do I need? How might I better take care of myself now in prison to prepare for life on the outside?”

Art Therapist with Conviction

Reflecting upon these inmate road drawings, I imagined what it would be like to “fly over” these roads. Looking down from a bird’s eye view, I created an image and poem called “Ribbons of Concrete.”

“Ribbons of Concrete”

Ribbons of concrete
Buckle up that seat
So many roads
That you will meet.
All within this tiny grid
Just thinking ‘bout all they did.
Going straight
Not gonna hate
At crossroads
For a right turn
Hope I don’t get burned
And wind up again
With time to ponder
Plan and wonder
How to return back
To a widening path
Lit up by no more wrath.

From a positive art therapy approach, Wilkinson and Chilton (2018) asserted many benefits of focusing on patients’ strengths to achieve therapeutic goals. Recognizing an inmate’s strengths moves away from the medical model “what’s-wrong-approach.” An inmate’s identity can be strengthened by moving away from “my diagnosis” or “my history” to “my action.” Rather than prescribing targeted coping skills, artmaking demonstrates an inmate’s inherent capabilities in action. This process of self-care in-the-now of artmaking is witnessed and affirmed by this art therapist.

Roads provide a simple and approachable means for inmates to engage in artmaking (Hanes, 1995). As symbols of movement, time and direction, road images get to the heart of the matter: “Who am I? Where am I now?” Gussak (1997) pointed out, “possibly unbeknownst to the correctional staff, the inmates in prison have already ‘escaped by putting on masks’ ” (p. 68). As an art therapist with conviction, I bring up these protective masks as purposeful for safety but in no way suggesting who they really are. These ribbons of concrete, a myriad of roads, provide a welcome invitation: inmates can pause and be reminded of who they really are behind these walls.

References

Gussak, D. E. (1997). Drawing time: Art therapy in prisons and other correctional settings. Chicago: Magnolia Street Publishers.

Hanes, M. J. (1995). Utilizing road drawings as a therapeutic metaphor in art therapy. The Arts in Psychotherapy, Rehabilitation, and Education, 34(1), 19-23.

Wilkinson, R. & Chilton, G. (2018). Positive art therapy theory and practice: Integrating positive psychology with art therapy. New York: Routledge.

Art Therapy

Devil Show: Manipulation in Art Therapy Prison Work

Posted on May 17, 2021
Devil Show

What Happens in Vegas

What happens in Vegas, stays in Vegas, so the tagline goes. In no time, prison can rear up its dark side harkening things no one asks about. From a bet gone wrong, gang activity, conflicts with security and so on, violence is a by-product of prison life. After conviction, criminal activity doesn’t necessarily end once an inmate starts doing time. When laws are broken behind bars, inmates are sent to confinement.

In Your Tiny Little Cell

Confinement is essentially the jail for prison. Inmates are housed in confinement as they go through a hearing process for the rule violation and if found guilty, receive a disciplinary report (DR) and sentencing. DR’s can reduce gain time for eligible inmates and can extend their EOS (end of sentence). In confinement, inmates lose the privilege of living in an open bay or 2-man cell living quarters with open areas to walk about. In contrast, confinement entails small cells with restricted movement such as only getting phone privileges once per week. If inmates continue to break rules, an inmate could be transferred to an institution with Close Management (CM) for tighter control.

The Game

On this Friday, mental health was contacted by confinement to see an inmate claiming “psychological emergency,” that is, the inmate is stating he is suicidal or homicidal. On the walk down, I am granted permission to enter. Taking my first breath of the putrid confinement air, I begin to cough and tear up. Walking into the entrance, the seemingly normal air is not clear at all. Uncontrollably, I begin coughing and tearing. In the space, many officers are coughing with puffy eyes but walking at a normal pace with the look of “just another day in the office.” Looking up into the face of this inmate, he looks unphased. Earlier this day, this inmate was inappropriate and uncooperative when mental health checks were completed. Post-pepper spray, he was able to wash up. He stood tall, angry and matter-of-fact, awaiting his opportunity to stick-it-to security by getting a ticketed move out of confinement from his mental health visit.

Idol-ness of Prison Life

In the song “The Devil Went Down to Georgia,” the devil offers a bet to a boy named Johnny for the best fiddle playin’. To kick off this soul quest, the devil says, “I’ll start this show” (Hayward et al., 1979, May 21). In prison, manipulation is the name of the game. From the idleness of living, inmates often find maladaptive ways to spend their time. This idleness can become “idol-ness,” pointing inmates into this revered path to exploit other inmates, staff or prison services. With nothing to do, serving time can become the devil’s time.

Art Therapist with Conviction

Nothing wakes you up like the unknowing whiff of pepper spray in the morning. If you haven’t already questioned why you’re working there, an existential crisis could definitely ensue. Reflecting upon this peppery show, I created a poem and image called “Devil Show.”

“Devil Show”

Hidden to the eye
Nose finds flames – oh my!
Throat’s closing & binding
Doubling over
Eyes water
Coughing ensues
There’s a job to do.

Looking up at pain
From the burning rain
So sad to see such effort
Require the need of pepper.

Pains behind these bars
Spread to make more scars
Cycle over and over repeats
Boredom from these streets.

Creativity finds its path
But this way causes wrath
How may we implore
A way to pay debts
To be so much more.

Watching the “Devil Show,” this scheme often gets stuck in reruns: new inmate, new day but same show. From the song “The Devil Went Down to Georgia,” Johnny stated, “Devil, just come on back if you ever wanna try again, ‘Cause I’ve told you once–you son of a bitch–I’m the best there’s ever been” (Hayward et al., 1979, May 21). Like pepper spray filling a room, confinement is infused again with these droplets of deceit. Drawing the image allowed me to see the sadness of the situation. Plus, I could step back and recognize the inherent manipulation of therapeutic work in prison. Looking up into the eyes of this anger, most inmates are masking a felt idleness and depression. Gussak (2020) stated there’s a need to “rehumanize the dehumanized;” pointing out the need for inmates to regain their identity which is often stripped in this controlled setting. At the end of the day, this art therapist with conviction now knows, “Granny, does your dog bite? No, child, no.”

References

Gussak, D. E. (2020). Art and art therapy with the imprisoned: Re-creating identity. New York: Routledge Taylor & Francis Group.

Hayward, C. F., Daniels, C., Edwards, F., Marshall, J. W., Crain, J. & Digregorio, W. J. (1979, May 21). The Devil Went Down to Georgia. [Recorded by Charlie Daniels Band]. On Million Mile Reflections. New York City, NY: Epic Records.

Art Therapy

Humans are Beings: Therapeutic Caseloads in a Prison System

Posted on May 3, 2021
Humans are Beings

Beep Beep

“Another bus has arrived” is announced as I walk through medical records, “looks like there are 50.” In preparation, medical staff move charts quickly to prepare the inmates for their continuance of care. Often, when an inmate has received their sentencing for 5, 15 or 30 years or even LIFE, there’s the thought “lock ‘em up and throw away the key.” There is a perception that inmates go directly to prison, one building, one room and that’s it.

Making the Circuit

However, the process actually involves a lot of movement. Initially, an inmate is taken to a prison reception center where intake and examinations are completed for medical, mental health, education and other needs. An inmate is then assigned to an institution based on needs. The movement doesn’t stop there. Inmates are constantly moved for plenty of reasons: behavior (good and bad), programs, treatment and more. Many inmates “make the circuit” by moving among many facilities throughout their sentencing. Inmates can request transfers as they seek perceived “easier” camps, programs or locations closer to their families or friends.

Holding the Space

As an art therapist practicing in the prison setting, managing the ever-changing caseload is a challenge. The constant change of inmates can adversely impact building the therapeutic relationship. To do no harm, I view each counseling session as standalone. The session goal is that of sublimation, a means to channel intense thoughts or emotions into a positive art intervention. With a road drawing or bridge drawing exercise, inmates can redirect emotions like anger, confusion, and sadness into a concretized image. Holding the space, the image can be explored for meaning together. Ideally, we discuss what they wish to work on in the next therapy session. Then, I cross my fingers that we may meet again.

Art Therapist with Conviction

Prison settings have many complexities that can complicate the work of art therapy. As a human being working to be in connection with another human being, I have struggled with injustices and barriers for ideal care. With no doubt, the assaultive nature of inmate crimes has secured their sentences. Society assigns the cost as a loss of freedom. Gussak (2020) acknowledged so much more is lost beyond freedom, “oppressing [those] already oppressed” (p. 52). In reflection, I created a poem and image called “Humans are Beings.”

“Humans are Beings”

Next next.
Going behind the fence
Bluebird bus shows
So population grows
All lined in their blues
Wander what this camp has due.
So boredom ensues.

Same stories, same crimes
With familiar scripted lines
Begging the same questions again
No wonder the act has settled in.

Next next.
Just move ‘em along
It’s okay I’ve heard this song
“Checked out”
So no “Check in” needed
Humans are beings
This must be heeded.

Printmaking as Being

To create the image, a printmaking technique was used to stamp the image of inmates. Thoughts flooded in. The act of “stamping” was like a cookie cutter approach. Similarly, the concept of Just in Time manufacturing came to mind, wherein it’s a way of “help[ing] organizations control variability in their processes, allowing them to increase productivity while lowering costs” (Planview, n.d.). To grapple with the sheer number of inmates, sadly, I realized the printmaking process made it more efficient to create this work.

However, an interesting pattern emerged as the endless flow of people in the correctional system. Faceless behind fences, the adage “lock ‘em up and throw away the key” came up again. Then the idea was challenged: they aren’t forgotten because there is security and staff that works with them every day. Family and friends, the few that are left, are supportive too. With a closer look, some inmate images continued off the paper. Perhaps this image is only a slice of the big picture.

Printmaking allowed a way to tap into the power of communication. Harkening back to the invention of Gutenberg’s press, repetition made its impression. From the Florida Department of Corrections (2020, March 2), Secretary Mark Inch wrote to inmates stating, “With hope, we can remove hate, fear, insecurity and disappointment and grasp onto the truth that, regardless of circumstances, TODAY MATTERS.” As an art therapist, TODAY matters, holding the space is vital for the expression of hope. Making art TODAY, the pattern of inmates pointed to the hope that all humans are beings.

References

Florida Department of Corrections. FDC Communications. (2020, March 2). Secretary’s Message to Inmates and Offenders: Find Hope by M. Inch. Tallahassee, FL: FDC Communications. Retrieved from http://www.dc.state.fl.us/comm/press/main/03-02-sec.html

Gussak, D. E. (2020). Art and art therapy with the imprisoned: Re-creating identity. New York: Routledge.

Planview. (n.d.). What is Just-In-Time Manufacturing? Retrieved from https://www.planview.com/resources/guide/what-is-lean-manufacturing/just-in-time-manufacturing/

Art Therapy

Lava Tree: Anger in a Female Correctional Setting

Posted on April 18, 2021
lava tree guided drawing

Closet-Sized Interview Room

After receiving back to back mental health and group requests from a patient, I was a bit apprehensive about her coming to group this day. From an earlier individual session, Mary angrily demanded that I change jail rules so she could be moved from her current housing. She became louder and more enraged unable to speak rationally. Sitting together in a closet-sized interview room, her anger required me to conclude our session early for safety. In any correctional institution, only security designates dorm assignments for inmates. When faced with the reality of their legal situation, inmates become angry and pose challenges to safe expression in a female correctional group setting.

What Keeps Us Alive

In this group of 8 female inmates, all participants had been to the group previously and Mary attended today for the first time. To begin, we reviewed the group rules and any new members signed the rules. The session began with psychoeducation about a breathing technique. I began to ask them questions about how many times on average does one take a breath in a minute? (Approx. 15). How much oxygen is in our air? (21%) The discussion culminated with one main point about the breath: no matter what, the body will keep us alive by breathing. Further, I shared what an amazing discovery, the very essence of what keeps each of us alive is already within us. We can tether ourselves to the rhythm of our breath anytime. From my studies of mindfulness researcher and practitioner Kabat-Zinn (1994), I encouraged connection to the breath as if our life depended on it. Next, the group was led in a breathing and guided imagery meditation, asking patients to imagine a safe place in nature they enjoy, a place imagined or real and where they can be by themselves.

Resting Bitch Face

After the restful venture, members expressed they felt calm and refreshed. Mary was disengaged, maintaining her “resting bitch face.” So, I began our project by asking each person to choose an object from their imagined safe place in nature. Then provided crayons, card stock, white copy paper and scrap paper remnants. Next, I invited them to sculpt and/or draw their objects from nature in any way they wish. With joy, patients engaged with the materials in a fury of creation with conversation.

Scribble Your Way Out

Mary sat unmoving with her blank piece of white paper in front of her. I asked which hand she uses to write with. She signaled, moving her right hand. I suggested to help her get started, “use your left hand and scribble with the crayon to fill up the page.” She looked at me and did not comply. With calm, I returned to drawing alongside the group. Slowly, she began to draw.

Lava to Rock

As patients finished, a natural conversation about the images emerged. Last to speak, Mary shared about her image. She said it was a bumpy road and a tree. The road, wide at the bottom of the page, triangulated up to a flat line towards the top of the page. With reluctance, she commented the road was originally going to be a volcano. In the image, the road was filled with numerous brown dots, suggesting a bumpy ride. To its left, a large tree with lines on its trunk opened to a crown of truncated, dagger-like branches. A faint indication of light green marks was made on the branches.

For Every Season

Another patient asked, “what season is this?” Mary replied, “I don’t know.” I suggested, “maybe it could be spring, looks like the leaves are sprouting.” Time was up; we reviewed ways mindfulness and creativity can be added in moments through their day to release stress and tension back in their jail dorm. I provided praise for their creativity, openness and flexibility to the group task. Patients expressed gratitude for this group providing a break from the dorm. Then, everyone got up and gathered at the steel green door awaiting to hear the electronic sound of the lock to be escorted back to their dorm by the deputy.

Cutting the Tension

As I cleaned up the room, I witnessed the remaining images as bright and cheerful recalling stories of music, families, homes, picnics and more. Mary’s image stood in contrast with harsh textures and no story of good times. When lava cools, the magma forms rock. Likewise, Mary moved from a volcano to that of a bumpy road and tree. Possibly, the group members may have encouraged her to move away from the tension or she may have felt the pressure to conform. Perhaps, the small hints of sprouted leaves might make room for a new way.

Art Therapist with Conviction

Through my art therapy education, artmaking is engrained not only for patients but for us art therapists too. In supervision, artmaking helps to reflect on our therapeutic process with patients. Based on Elbrecht’s (2018) Guided Drawing process, I created a series of 3 images called “For Every Season” to reflect on this session. With 2 oil pastels in hand, I imagined the hostility and anger felt by my patient as lava erupting through hard up and down scribbles that truncated at the top. Physically, I felt claustrophobic, trapped by the anger. In the second image, I drew the dagger-like branches. With eyes closed, it felt like I was punching. In my final image, I imagined what I needed to move away from this pain. I chose a sunny yellow and light blue water oil pastels and calmly drew flowing circles. I stopped to scribble some earthy green leaves. With careful body attention, I was able to release the witnessed tension and come back to my calm core. In reflection, I recalled the song, Turn! Turn!, Turn! (1961): “To everything (turn, turn, turn)/There is a season (turn, turn, turn)/And a time to every purpose, under heaven.” Then I desired: “A time for peace, I swear it’s not too late.”

References

Elbrecht, C. M. (2018). Healing trauma with guided drawing: A sensorimotor art therapy approach to bilateral body mapping. Berkeley, CA: North Atlantic Books.

Seeger, P. (1961). Turn! Turn! Turn!. [Recorded by The Byrds]. On Mr. Tambourine Man [Vinyl record]. New York City, NY: Columbia Records.

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.

Art Therapy

On the Road Again: Change in the Corrections Setting

Posted on April 11, 2021
"How Are You?"

“On the road again, goin’ places that I’ve never been. Seein’ things that I may never see again,” sang country singer Willie Nelson (1980, August). In fact, inmates live this transient life. Many inmates start out “couch surfing,” and become homeless, living in tents. At the point of incarceration, most have more than worn out the welcome mat with family and friends. Doing time means “getting 3 hots and a cot,” that is 3 meals and a bed which is more consistent than when living free.

In a Blink of an Eye

With no schedule living “on the streets,” inmates come into incarceration and experience the same bouncing around, with constant dorm or facility reassignments. Some may get released; some are retained for a lengthy court trial and many go to prison. Inconsistency is the consistency. As a result, planning art therapy services becomes challenging with all the movement.

Re·​cid·​i·​vism

Over time, it’s easy for facility staff to become hardened and jaded. Especially when witnessing the reoffend cycles. These cycles are measured by recidivism, which is basically a measure of the time before relapse and reconviction. Generally, an inmate with a long rap sheet may recidivate more quickly or younger inmates may recidivate more quickly than older inmates (National Institute of Justice, n.d.). When starting therapy groups, I was doubtful about establishing regular patients. To my surprise, I maintained a steady group of inmates awaiting sentencing. Also, I witnessed many group members voluntarily return to therapy sessions months later upon rearrest.

Lather, Rinse, Repeat

One inmate had a history of heavy drug use and domestic violence. While in jail he gained back a healthy weight, but returned months later and 40 pounds lighter after a return to his usual lifestyle. Another inmate had a college degree but maintained an extensive history of arrests. Seeing the pain of pattern and witnessing the cycle on repeat can be exhausting. The fog of extensive drug use, toxic relationships, complicated lives and trauma appears as perfunctory as a morning shower, just lather, rinse, repeat.

Emotions Made Tangible

The emotional toil is heavy especially when made tangible through physical signs. Bloody eyes, cuts, bruises, busted lips, poor skin tone, missing or broken teeth, tremors, the list goes on. Further, suicidal gestures often come into this mix and must be evaluated for valid attempts or manipulation for other services. According to the Bureau of Justice Statistics, suicide is the leading cause of death in jail, with jail rates superseding that of prison and the general population (2020).

Art Therapist with Conviction

So, how do you cope in the corrections environment? As an art therapist, reflective artmaking helps by enabling painful feelings to become tangible and eventually manageable.

How Are You?

Helpless in a hopeless system
Staring into the pain of shock
How can this happen on this block?
Justice is distanced to the powerless
Caught in process & brokenness
Sea of red pooling
Encircling the soul
Shock, horror and why bestow —
None are blameless, you know.

But some lines should never be crossed
Otherwise humanity is tossed
An innocent “how are you”
Now becomes misconstrued
For stories shared in close proximity
Reveal this needless calamity
Egos and power struck down
Edging God out of this town.

Those left in the wake of wrath
Must now pick up pieces for a path
To take them out of bodily pain
In hopes to erase the mental strain
Of another complication
Too difficult a situation.

Breathe in breath of life…
Help lessen this strife…
May blood tears dry up this grime
So wrongdoings can fit their crime.

In my reflective poem and image “How Are You?,” I drew the pain that I witnessed. Bloody red paint was applied with a layered, dense wash. With the defined bulging eyeball and purplish-yellow bruising, the image is painful to look at. Art provided me some distance. More important, the image and poem provided me a voice; yet I never uttered a word.

References

Department of Justice. Office of Justice Programs. Bureau of Justice Statistics. (2020, February). Mortality in Local Jails, 2000-2016 –Statistical Tables by E. A. Carson and M. P. Cowhig. Washington DC: Bureau of Justice Statistics. Retrieved from the Bureau of Justice Statistics Web site: https://www.bjs.gov/content/pub/pdf/mlj0016st.pdf?utm_content=mci&utm_medium=email&utm_source=govdelivery

National Institute of Justice. (n.d.). Recidivism. https://nij.ojp.gov/topics/corrections/recidivism

Nelson, W. (1980, August). On the road again. Honeysuckle Rose. [Vinyl record]. New York City, NY: Columbia Records.

Art Therapy

A Parting Gift: Creating Art Therapy Images in a Jail

Posted on April 4, 2021
Life Noise

Working as an art therapist in a jail, this blog intended to give life to the things I have witnessed. At this moment, my freedom feels trapped. The initial direction at the jail was to collect images at the end of each session to use again with patients. As a parting gift, I even thought the portfolio could be returned as inmates exited the facility. Unique to art therapy practice, images become a physical reminder of the therapeutic process. In the closure phase, patients can review their images to see their growth and further instill learnings and to consider future goals.

Close Management of Images

Images must be protected from misuse according to the Art Therapy Credentials Board Code of Ethics, Conduct and Disciplinary Procedures (2021, March). Since images are considered confidential, any use must be discussed with the patient with signed consents obtained. From the Tallahassee Democrat article, “Art doesn’t lie,” stated Dr. Gussak, PhD, ATR-BC reflecting from his extensive work with aggressive and violent offenders (Brown, 2019, July 13). Most important, images are to be respected, a “birthing” made from an individual engaging with the therapeutic process. Since every person is unique, so too, the marks on the paper must be viewed from the perspective of the person.

On the other hand, art in jail can be used as a weapon to physically or emotionally hurt or extort others. Images returning back to the dorm could be viewed with pride or seen as an open wound left to the interpretation of other inmates. In an environment where it is safest to “stick to yourself,” images from group therapy may have some unintended risks.

Wrestling with Security

From a report on national jail statistics, the average length of stay is 26 days with a 53% turnover rate according to the Department of Justice (2021). With limited space and no notice when someone is released or transferred, I realized retaining the images was futile. Further, security required the images to be collected at the end of each session. In the best interest of the patients, I determined it was best to inform the group participants the images would be collected and not maintained in records (that is, images were shredded.)

Dealing with Loss

With so much deprivation behind bars, I recognized the images could be just another reminder of loss. This topic opened group discussion about the impermanence of things; acceptance for what we can or cannot control; mixed feelings about loss; and building trust in this group process in an imperfect, changing place.

The Executioner

With no hesitation, shredding the images was difficult and sad for me. I witnessed each image as I carefully inserted the creations into the slot of the paper shredder. In my response art, I created a poem and image, “Life Noise”:

“Life Noise”
I want to love them all
They all have a chance
Each worthwhile journey, a dance
Entertaining each and balancing all
Can create quite the crash & fall
Each came with honest intentions
Begging for my needed attention
A hum and a noisy creation
Ego-guised, lost concentration
As mind filled to the brim
Oh how I want to love all of them.

Art Therapist with Conviction

In reflection, I recognized my own worry as the images quickly stacked up. I saw my own sadness and loss as the executioner by shredder. Yalom (1989) imparted his clinical assumption that “basic anxiety emerges from a person’s endeavors, conscious and unconscious, to cope with the harsh facts of life, the ‘givens’ of existence” (p. xii). With gratitude, art has revealed a truth for me this day: my attachment to images. From the poem, I read this line again: “I want to love them all.” Of course I do. Images powerfully exalt meaning making over the course of a lifetime, quite the parting gift.

References

Art Therapy Credentials Board. (2021, March). Code of Ethics, Conduct and Disciplinary Procedure [PDF file]. Retrieved from https://www.atcb.org/resource/pdf/ATCB-Code-of-Ethics-Conduct-DisciplinaryProcedures.pdf

Brown, M. (2019, July 13). Professor’s discoveries: Art behind bars springs art from the heart. Tallahassee Democrat. https://www.tallahassee.com/story/life/2019/07/13/professors-discoveries-behind-bars-springs-art-heart/1713435001/

Department of Justice. Office of Justice Programs. Bureau of Justice Statistics. (2021). Jail inmates in 2019 by Z. Zeng and T. Minton. Washington DC: Bureau of Justice Statistics. Retrieved from the Bureau of Justice Statistics Web site: https://www.bjs.gov/content/pub/pdf/ji19.pdf

Yalom, I. D. (1989). Love’s executioner and other tales of psychotherapy. New York: Basic Books.

Art Therapy

Shoot the Breeze: Holding Space for Artmaking

Posted on March 30, 2021

“Shoot the Breeze”

Follow the rules
So you’re not missed
Amongst those on the list.
Line up against the wall
Follow the leader

With security in tow.
One hour a week
To take the walk
Down the halls
Through lots of locks
To find a break from the dorm
A silence begins to form
What’s that you say
“I’m good”
Ain’t that enough for the day?
Then this crew began
To reminisce about a can
A barrel precisely
For burning refuse wisely.

Then with a turn of the head
You can’t understand
Our musings said.
Silence broken
Then laughter rolled
So follow the rules
Humanity restored.

Make a Walk

This morning, I dropped off my patient list at the security tower in the jail. I stopped in a few minutes early to remind the deputy the therapy group was about to begin. He walked down the iron steps from the tower. The heavy green painted dorm door was popped and a boisterous yell ensued calling the names off my group list. Patiently, I waited with all my belongings in tow. Then, inmates began to exit the dorm and line the walls. Security performed a pat search and then escorted them in a line much like the days of elementary school. To make the walk, I followed behind the deputy to the last cinder block room. It was a painfully slow walk for me, but the inmates seemed to enjoy the stroll. They looked at new sights, sometimes seeing friends at other dorm doors shouting “what’s up.”

Cinder Block Classroom

At the end of the hall, the classroom opened to a sea of bland block walls, folding tables and green plastic chairs. To my delight, I found a room of nothingness; because some days, this room doubles as a barber shop with “fresh clippings” unswept. Today, quiet cheerfulness seems to be the mood. Inmates know they have to “turn off” dorm life and now come to “civil life.” One wrong move and they might lose the freedom to get out of the dorm, catch a disciplinary action or worse, get reassigned to confinement for their misdeeds.

No Politics or Religion

In group, inmates are directed to create a scribble with their nondominant hand. As the scratching of colored pencils begins to subside, silence fills the room. Today, there seems to be a reluctance to participate. Inmates are glad to be there but don’t want to “put themselves out there.” A lone voice speaks up. “I’d like to talk but I can’t because it’s about religion.” One of the group rules is not to discuss politics or religion. Usually when I review this rule, a sigh of relief fills the room. Many inmates have shared about the how these hot topics implode in the battleground dorm.

A Scribbled Mess

Considering the group contract, I realized this rule may be impending a freedom to share. So, I explained we are not here to banter the ‘should’s’ or ‘should nots’ about religion or politics. However, spiritual or religious ideas are important to each individual and should not be discounted. The inmate felt relieved, “so I can talk about how my image relates to my faith?” “Yes,” I replied. He stayed on topic and spoke freely about how he realized he needs to mature in his faith. Looking at his scribble, he could see what a mess he has made of his life. He is saddened about taking another trip to prison. Other group members begin to open up. Many in the room have either been to prison, are fighting a legal battle to keep from going to prison, or already sentenced and waiting on the “bluebird” (prison bus) to show.

Humanity over a Burn Barrel

As the leader, I noticed that I am beginning to shrink into the background. The discussion gets heavy. Then one inmate, who wears sunglasses (all the time) speaks up. He reminisces about how they (on the outside) hung out many a’ night by the burn barrel. Inmates began to laugh and speak lovingly about sitting and watching their trash fire. The group evolved from coldness to warm laughter. They forgot I was there. Then, out of the side of the first inmate’s eye, he turned to me and laughed, “she doesn’t even know what a burn barrel is.” He meant it with all sincerity and I responded in the moment by laughing out loud. Nothing had to be said. We all laughed. Holding the space, the art therapy hour moved a group of inmates away from their manipulative ways, a myriad of feelings were expressed and many thoughts were heard, “humanity restored.”

Art Therapist with Conviction

In my painting, “Shoot the Breeze,” I imagined our group sitting around the burn barrel. I tried on the fingerless gloves. With hands outstretched warming over the fire, I sat in the dark and witnessed the fire growing. I’m reminded of Shaun McNiff’s (2015) ‘principle of simultaneity.’ The idea is we have the choice of witnessing everything in the moment while also sacrificing some things because so much is happening at the same time. With so much going on, I knew some things could be missed and also felt honored to hold the space. When I heard, “she doesn’t even know what a burn barrel is,” I reacted to the space created by this group of incarcerated inmates. For, I laughed with them.  In a place of so much meaninglessness and emptiness, a group making art tapped into their free choice to create. Opening up about their ultimate concerns, this group discovered meaning and purpose from a little scribble this day.

References

McNiff, S. (2015). Imagination in action: Secrets for unleashing creative expression. Boston, MA: Shambhala Publications, Inc.

Art Therapy

Jail vs. Prison: It’s Not the Same

Posted on March 21, 2021

Jail and prison both house people behind bars. However, the two places serve completely different purposes. Upon arrest, a person is charged with a crime(s). Then, the person is taken to a county jail for booking and intake processing through classification, medical, and mental health services. Keep in mind, inmates are innocent until proven guilty through a court of law.

Let’s Rumble and Roll

Jails are noisy, busy and cramped. Metals doors locking, opening and banging creates its own rhythmic sound. Doors are “popped” to move in new intakes, released inmates or inmates being transferred to prison. With the roaring sound of inmates talking or shouting in the dorms, inmates are constantly being called out for services.  For instance, there could be sick calls or medication lines, visits with attorneys, public defenders, children services, or chaplains. Court processes require movement of inmates with escorts for first appearance or sentencing. Inmates may be reassigned dorms due to sickness, suicidal ideation, or getting a “DR,” a disciplinary report for breaking rules such as fighting, not following orders, attempting to establish a relationship with staff, drugs, etc.

High Anxiety

In jail, anxiety is high and sleep is deprived. From their bunks, inmates spend a vast amount of time is sitting and waiting. There’s nothing to do. Inmates may average 45-60 days in jail upon release. According to TIME, a large number of inmates experience court continuances especially with delays due to COVID-19 (Chan, 2021, February 21). If sentenced to more than “a year and a day,” the inmate will most likely be transferred to a prison.

Sigh of Relief

When sentenced to prison, inmates are given their “EOS,” end of sentence date. Depending on the offense, a prisoner may qualify for gain time, days earned for good behavior for an earlier release. Anxiety often subsides and morphs into boredom. Prisoners often experience depression guised as anger. Tick tock, the battle comes with the clock.

Life Behind Bars

Prison is dominated by rule and order. With large grounds and dorms, prisoners can use time to get their GED, learn technical skills or practice theology and to work in the prison. Prisoners with life sentences often have a grieving process then eventually create their own routine. Forming cliques, prison populations morph into “communities.” Many prisoners attempt to stay to themselves but often turn to crime inside with gangs and drug use.

Art Therapy with Conviction

In my art reflection, I created a zentangle, or random scribble within the confines of a box called “New Life in the Heap.” Below is the reflective poem.

“New Life in the Heap”

Curious patterns
Push through this heap
Life of fresh leaves
Mixed and steeped
Everyone now and then
Emerging for a puff of wind
Serpentine wriggling
Through fluffy soil
Something good can be found
Here in trouble and toil
New life exists here
Even though paths aren’t clear
Yes something good from rubbish
As it folds and cures
Feeds new life, soul matures.

Ya Never Know What You Might Get

From my image and poem “New Life in the Heap,” I am reminded each day, “ya never know what you might get” in jail or prison. When things go down, these institutions become a confusing scribble. As I filled in the shapes with color, I began to see a compost heap emerge. Often, prison is viewed as a place where people are cast away. However, these layers of refuse, trauma and crime begin to pile up. Then, I noticed in the image, a pink earthworm began to find its way to the top. According to Penn State Extension (2013, September 5), these “lowly animals” are an “important part of the soil ecosystem” often helping to stimulate life where there is no movement. How might the churn of jail and prison doors till new soil and inspire new life from this heap?

References

Chan, M. (2021, February 21). ‘I want this over.’ For victims and the accused, justice is delayed as COVID-19 snarls courts. TIME. https://time.com/5939482/covid-19-criminal-cases-backlog/

Duiker, S. (2013, September 5). Earthworms [PDF file]. University Park, PA: Penn State Cooperative Extension College of Agricultural Sciences. Retrieved from https://extension.psu.edu/earthworms

Art Therapy

Prison From an Art Therapist View

Posted on March 13, 2021
prison art therapist view

“Well-Come Mat”

Drifting tendrils of smoke
Fold upon one another
Suspended and held softly
Like that of a mother

Mind drifting upward
Opening to vast space
Shifting thoughts emerge as
Love seats its new place

Heaviness sitting above 
Thoughts burden this crown
With bulging waves of matter
What was up, is now down.

Seeing from a curious view
Putting this matter in its seat
Heart begins to fill
Connecting with all complete.

Ah, but just the beginning
Shift provided from the spirit
New perspective enlightens
So we as witness can bear it.

For love can dispel doubt
When all is welcome at the mat
Turns things around
So fears will fall flat. 

The Daily Prison Commute

Welcome to prison from an Art Therapist view. You’re invited! Enter through the heavy iron doors with me. Make sure you’re wearing your surgical mask upon entry. Once the covid-19 screening is complete, security check-in will commence. Honoring the 3-people maximum, patiently wait your turn to place shoes, jacket and all possessions into a tub.

Overheard are officer announcements reminding all of the forbidden entry items. With your belongings in a tote, place your stuff on the conveyor for an airport-like screening and then contents are tossed like a salad in search of contraband. With a wave from security, you are motioned to walk through the metal detector which often signals a bonus pat-down search. Grab your tossed tub o’ stuff and put yourself back together.

In a tight shared space, waiting lines emerge for keys, body alarms, radios and more. Some days you hear of training on the range and witness Kevlar vests, rifles and the like spiraling through. This rough sea of security, medical, programs, administration and support staff converge in this one spot with buzzing, slamming iron doors.

Artmaking begins with a Prison Walk

Beyond this space begins your walk onto the compound lined with spiraling razor wire and massive fencing. Facing east, the morning walk through the fencing always gives way to witness the warm, stunning glow of many ‘a rising sun.

You can count on both hands the number of locked doors and gates to my place of practice. With trepidation, press the button to signal security that “I’m here or we’re here” and “ready to go there, “ unlocking each door through each point. In some institutions, pressing the button is viewed as sacrilege and one is reminded that patience is a virtue. Sometimes you get locked in a vestibule between two doors. You wonder, what if no one is there? How long might I hang out? But then, common sense reminds you of the humanness of this place–in due time. 

Now, walk to the internal compound where inmates may be moving food carts or cleaning the fresh droppings from feathered friends that have found the perfect nesting ground. Approach the entry to your wing of the facility, your Shangri-la for the day. Now clocked in, what might this day have in store?

Art as a Visual Language 

In the image “Well-Come Mat,” the warm glow of day is captured as it breaks against the cold gray concrete and steel. With watercolor, I painted in the sky. Then, I used colored pencil for details. How may security or staff see the morning? Are inmates afforded this view from their dorms? From my vantage, the beauty of the sky fills less than half the image. Stepping back, the chain link creates a gridded barrier like when trying to focus an image through a camera. Looking straight up the fencing, the feeling is oppressive saying, “you ain’t gettin’ out of here.” As I squint my eyes, the image falls flat, but the sky gently warms. Inviting boredom, horizontal lines flatten, begging a peek over the other side. Up close, there are scuffs on the sidewalk and rusty stains on the building.

Dawn Break Signals

In reflection, twilight points to the desire for hope; for “it’s a new day.” Yet, the warming light contradicts the looming gray fortress. Is it possible we need the dark to experience the light? Is this the way to bear witness to dehumanization creeping in? The World Health Organization (1948) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity… and the definition has not been amended since 1948.” Within the image, a welcome mat is placed upon exit, signaling a cleansing, a preparation of going back into the “real world.”  How about “well-come?” Another way stated, “Did well-being take place?”

Artmaking as a Conviction

With conviction, I humbly present an image that began as a “felt sense,” a feeling and thought finding its way through artistic media onto paper (Rappaport, 2009). Bypassing verbal defenses, the art product comes direct from the source making the intangible, tangible. Often, images beg more questions than answers. Behind bars, art becomes perfect fodder for trying to make sense of the senseless. Artmaking as catharsis, allows for a state of flow (Csikszentmihalyi, 2008) to see prison from an art therapist’s view. To deepen an art therapy session, the presence of a masters-level Art Therapist can hold the space and guide the conversation for discovery.

Art Therapist and an Honorary Life Member (HLM) of the American Art Therapy Association (AATA) Bruce Moon (2009) coined the term “canvas mirror” or how we dialogue with the image. From my canvas mirror today, I wiped my shoes on the welcome mat and pondered how others choose to do their sole cleansing. 

References

Csikszentmihalyi, M. (2008). Flow: The psychology of optimal experience. New York: HarperCollins Publishers.

Moon, B. (2009). Existential art therapy: The canvas mirror. (3rd ed.). Springfield, IL: Charles C Thomas Publisher, Ltd.

Rappaport, L. (2009). Focusing-Oriented art therapy: Accessing the body’s wisdom and creative intelligence. London:
Jessica Kingsley Publishers. World Health Organization. (1948). Constitution of the World Health Organization: Principles. Retrieved from https://www.who.int/about/who-we-are/frequently-asked-questions