For the past two decades, science has been uncovering some important features of traumatized clients. There is mounting evidence that traumatized individuals vary widely in their ability to adapt to trauma, in part due to underlying physical factors. For instance, some see the presence of chronic emotional trauma as having the potential to cause permanent physical damage in at least the hippocampus (Sapolsky, in Why Zebras Don’t Get Ulcers (1994) argues that chronic stress is a significant cause of aging in several species). This might mean that some individuals who have gone through multiple traumas or what in the DSM V will likely be called Disorders of Extreme Stress NOS, because of a changed hippocampus, might have diminished abilities to perceive or recover from subsequent stressors.

Other studies have show that certain traumatized populations (traumatized women and combat veterans) show similar characteristics of neurological dysregulation. Susan Johnson noted (Emotionally Focused Couple Therapy with Trauma Survivors, 2002) that one implication is that such individuals may be unable to use their emotions as an appropriate danger signal to prompt adaptive action. The chronic activation in their brain systems seems to result in overreactions to non-emergencies and freezing responses in the presence of real danger. (more…)

Therapist: “Sounds like you’ve been busy.

Sonya: “I have. I feel like I’m always busy… too busy. I never have time to just enjoy life. I can’t remember the last time my husband and I had any quality time together. I worry about our relationship sometimes, but we rarely find time to talk about anything other than our kids.

Therapist: “You’re worried about your relationship, but you’re both more focused on your kids than each other.

Sonya: “Yeah. It scares me that we can’t find any time to focus on each other. We just can’t seem to make our relationship a priority.

Therapist: “You’re scared that your relationship isn’t a priority.

Sonya: “I am. I don’t know what I would do if our relationship fell apart. I can’t even imagine life without him.

If you read the above vignette and felt like Sonya’s therapist was just paraphrasing and repeating everything she said, you’d be right, sort of. Sonya’s therapist isn’t repeating her statements because she’s disinterested or bored, however. The above conversation is a perfect example of the Rogerian technique called restatement. Restatement is a basic counseling intervention and one of the hallmarks of Rogerian psychotherapy. This technique involves capturing the essence of a client’s statement and then restating it. The most rudimentary function of this approach is to provide an opportunity for clarification. If a client hears something in the therapist’s restatement that differs from what he or she meant to convey, the client can clarify and make sure he/she and the therapist are on the same page before continuing. On a deeper level, the technique can also serve as an effective way to probe clients’ statements– when clients hear their words repeated back to them, they know their therapist understands them. This understanding often encourages clients to delve deeper into the issue at hand.

Although often effective, restatement interventions can sometimes leave clients asking the question, why does my therapist sound like a parrot? Why am I paying someone to repeat everything I say back to me? How can this possibly be helpful? And even if it is helpful, why can’t I just ask a friend to repeat what I say?  To better understand how powerful a therapist’s restatement interventions can be, let’s take a closer look at one of the most basic tenants of Rogerian psychotherapy: the client is at the center of the therapeutic experience.

Rogers’ theory and approach to psychotherapy places such value on the client that Rogerian therapy and Client-Centered, or Person-Centered, therapy are terms that are used interchangeably. At its core, this means that clients are viewed as the experts on themselves. The therapist’s role is not to interpret clients’ experiences or make suggestions by giving them direct advice, but rather to serve as a mirror to the client, allowing them to see themselves, as they are, and to use this self-awareness to inspire changes.

Take the example given above. If Sonya were talking to a friend, the friend’s response to the first statement would probably have been one of commiseration. Her friend might have reviewed the events of her equally grueling day, complaining about her difficult boss, her overscheduled kids, and her forgetful husband. Alternatively, the friend might have shared some of the strategies that she uses to manage her time. In either case, the friend would have jumped into the spotlight and the focus would have shifted to the experience of two people, rather than remaining centered on Sonya. This is absolutely fine, and even valuable, within the context of a friendship, but it does not allow Sonya the opportunity to look more deeply into why her harried days are so distressing. A therapeutic relationship, rooted in Rogers’ theory, on the other hand, creates an environment and the dynamics necessary to explore issues at the deepest levels.

While at first glance, the Client-Centered restatement approach seems easy, even lazy, and it takes a great deal of training and practice to do it effectively. It requires considerable discipline to sit and listen– not to interject your own agenda, not to offer advice, not to tell your own story–but to hold up a mirror so clients can see themselves and determine whether the image they see aligns with who they wish to be. It also requires therapists to trust that clients have the answers within themselves. When clients are given the time and space allowed for by Rogerian therapy, they develop the insight necessary to move toward real, life-changing action.

Scents, Memories, and Emotions

The use of pleasant aromas to enhance well-being dates back thousands of years. Fragrant oils were ceremonially used in the Far East, as well as in ancient Egypt and Greece. Essential oils were extracted from herbs and flowers to create medicines and perfumes, to scent one’s home, and to anoint the ill and deceased.

Smell is considered to be the most poorly understood of our senses, yet most have experienced the powerful ability of familiar scents to trigger emotions and memories of times past, such as people in our lives, places we miss, or particular events, such as the holidays.

Who among us has not passed a restaurant or bakery and been immediately transported to another time when a similar dish or baked good was enjoyed, with all of its emotional accompaniments? Have we not all smelled a particular laundry detergent or perfume and thought of a loved family member or former flame? For some, even less-than-pleasant odors can call to mind a cherished memory. I have heard people say that walking into a faintly damp or musty house reminded them of the fun and friendships of summer camp, even 30 or more years later.

Today, the term aromatherapy refers to the deliberate use of plant-derived oils to enhance physical and emotional health. Although aromatherapy is still considered to lie outside the realm of medically accepted therapies and mainstream psychotherapy, interest in this area has grown substantially over the past few decades. Most of those who use aromas for healing tend to do so as part of a whole-person approach to healthcare, rather than as a stand-alone treatment. When applied thoughtfully, aromas may be incorporated into more “mainstream” healthcare practices with good results.

The Impact of Scents on Stress and Performance: What’s the Evidence?

Research related to the impact of scents, particularly essential oils, on mood has increased since the 1970s. Specifically, there have been several studies on the use of essential oils, such as lavender and rose, as well as other pleasant aromas to reduce stress. Lavender in particular has been shown to reduce self-reports of stress. In some preliminary research,  lavender was also linked to increased peripheral blood flow (an effect associated with relaxation) and a decrease in blood pressure, as well as positive changes in heart rate variability. In another trial, peppermint and lavender essential oils were associated with increased accuracy while proofreading.

The calming benefits of pleasant aromas many not be limited to essential oils, however. In at least two studies, the scent of coconut has been associated with decreased startle response, whereas an unpleasant scent (Limburger cheese) was associated with an increased startle response. A more recent study suggested that exposure to pleasant scent (also coconut) may blunt the body’s response to performing a stressful task and also enhance recovery after the stressor has stopped. It is important to note that most of these studies have had methodological challenges, including small numbers of people participating in the trials. Nonetheless, the results are thought-provoking and may make intuitive sense to those who have experienced subjective benefits from aromatherapy.

Aroma in Psychotherapy

How might this be relevant to the practice of psychotherapy? Pleasant aromas can be paired with relaxation training, such as diaphragmatic breathing, mindfulness practice, hypnotherapy, and biofeedback. Doing so may link the experience of relaxation with the scent sufficiently so that in the future, exposure to the scent alone may be enough to elicit the relaxation response.

In cognitive behavioral therapy, this pairing is referred to as “associative learning” or “higher-order conditioning,” and the goal is for the conditioned stimulus (the scent) to trigger the same response as the biofeedback, breathing, or meditation does.

I have frequently used scent as a therapeutic adjunct during all of the above types of treatments for both children and adults. Many have reported enjoying the use of this tool in session and on their own, eventually noticing that they can more quickly and effectively access a state of calm. Even something like at-home mindfulness practice involves “taking in” and being present with the scent of what one is consuming or doing. This includes experiencing fully the aromas associated with eating, drinking, or walking in nature. Thus, being mindfully present can be “aromatherapeutic” or at least “aroma-aware”—even without deliberately introducing a specific scent.

The at-home use of pleasant aroma can be as simple as adding a few drops of an essential oil to a hand or body lotion or hair conditioner, buying natural laundry or cleaning products that feature relaxing or invigorating essential oils, chewing a stick of peppermint gum while proofreading a term paper, or mindfully sipping a cup of fragrant tea.

Common Sense with Scents

When using scent in psychotherapy, it is important to take into account people’s individual preferences for and aversions to various aromas and be aware of the fact that some dislike using any scent at all. Similarly, it is important to inquire about emotional associations to scents that may be popular but could elicit unpleasant memories (“Ugh! My old boss always wore rose oil!”).

Finally, it goes without saying that one should:

1. Ask about allergies to any scents
2. Place undiluted oils on tissue or another object, rather than directly on the person, as many are harmful when applied to the skin at full strength
3. Educate oneself about the properties associated with different oils before introducing them into the work.

Additional Aromatherapy Resources

• For general information about aromatherapy, you can visit: www.aromaweb.com
• For information about training in clinical aromatherapy and the use of aromatherapy by health professionals, you can visit Dr. Jane Buckle’s website: http://www.rjbuckle.com/home.html or read her text, Clinical Aromatherapy: Essential Oils in Practice
• For a recent scientific article describing some of the studies mentioned here, see the text (available to journal subscribers and at many medical or nursing school libraries): Mezzacappa, E.S., Arumugam, U., Yue, S.I., Stein, T.R., Buckle, J., & Oz, M.C. (2010). Coconut fragrance and cardiovascular response to laboratory stress: Results of pilot testing. Holistic Nursing Practice, 24(5).

Without playing with fantasy, no creative work has ever yet come to birth. The debt we owe to the play of imagination if incalculable.
-C.G. Jung

Jung wrote about the need for finding and living our myth, our story, as he grew older, he wrote his most important works and found his own unique ways to play. We need new stories that weave playfulness, gratitude, and compassion for self and others. Re-writing your myth or story can help you understand more fully your core values. Your story reflects your uniqueness and the many gifts you have to offer others. If you fully expressed your values, how would others see you? Would it change your life in some way?

A life story re-told:

Playful Kingdom
A little girl sat reading alone and wistfully looking out the window of her bedroom –dreaming, flying to places far beyond the confines of her sanctuary. She spent as much of her time as possible outside playing—skipping, riding her bike, walking and exploring, traveling by bus around the local area, dancing and choreographing shows on the spot for the neighborhood, creating puppets, puppet shows, and theatre, observing animals and recording their behavior, making lists of local plants, and gently tending and feeding them.
When it was time to come inside, the little girl would walk up the stairs to her room and settle in for a long read or daydream or she would travel by foot to a community building in her neighborhood where she could read and even borrow books whenever she liked.

She flew out her window whenever her Spirit wanted to soar beyond the earthly bound. Her visits to various realms allowed her to remain playful in her own kingdom where life was not always easy; a large part of her kingdom was at war with itself. The little girl’s imagination, dreams, and playfulness provided her with the needed support and fearlessness to move forward.

She listened to her dreams, acted, and found she wanted more of life. Her dreams brought her news that led her down many paths both harrowing and heart-y. Because she never left her playfulness behind, the little girl’s dreams provided a landscape to travel in and return to as she wandered earth. Many fellow travelers dismissed dreams and their own unique natures in favor of others’ visions for them.

The little girl grew in power and authority. She began to blend her own unique vision with what she had learned from her teachers about dreams and their importance in creating a playful life filled with meaning.

She married and became Queen to her King. Her children and grandchildren thrived and played. Each morning dreams were told and listened to, reflected on, acted upon for the benefit of all.

Dreams foretold of changes big and small for the Kingdom. Masterful communication secured peace. Instead of fighting or retreating as in past conflicts the Queen, her King, and past foes stood shoulder-to-shoulder and met for the first time. Foe became friend. A playful path of risk-taking and foolishness replaced a deep ravine.

Now that you have read one woman’s personal mythology, I invite you to write your story in any way that feels right to you.

Some ways to get started:

• Re-write a favorite children’s book story or nursery rhyme and write yourself in as the lead character.
• If you keep a dream journal, open one of your journals and see what dream finds you again. Re-write the plot, scenes, characters, location, and conflict in the dreamscape and see what happens.
• Change the lyrics to a favorite song and add lyrics that tell the story of your life’s journey. See what happens as you play with the words, rhymes, and melody.

Questions for you to consider as your write your story/myth:

• What is your story or myth?
• What have been your struggles?
• Have you celebrated your transformations?
• Are you shedding your skin or thickening your woolen coat?
• Who are your supporters?
• What do you fear?
• What do you easily move toward?

Full permission has been given by the client to tell this story on GoodTherapy.org. All identifying information has been changed.

Images hold keys that unlock our inner experiences. Images can penetrate mental defenses that have been dispelling or diminishing the importance of feelings and experiences in our lives. During a traumatic event(s), images, sounds, textures, smells, and tastes can become hardwired in the brain to the event. At the time of a trauma, the body internalizes feelings that might otherwise overwhelm normal ego function. Later those traumatic experiences can be accessed voluntarily, or triggered involuntarily, through the senses or movement.

People usually come into therapy for help to alleviate problems, such as depression, anxiety, anger, or rage. A person may come into therapy seeking help to change the dynamic of a relationship, or to make better choices in their daily lives. Oftentimes, therapy involves working on current issues, while at the same time drawing parallels to earlier life experiences. In art therapy, a person may create a piece of artwork during a session by drawing with markers, ink, pencils, or watercolor. The person may do this while talking about events that are causing distress. The artwork can become a record of the session thereby providing a visual link to what was discussed.

Sometimes a person will bring in content from a recent dream. He/she may bring in a piece of artwork that he/she has created off site, and use that to delve more deeply into the experience. In art psychotherapy we pay close attention to the meaning images hold for the individual. The meaning of an image may be obvious or logical to the person. Sometimes the meaning of an image can evolve or change. Oftentimes an image is felt through a connection, but the meaning becomes known, later, through interacting with it.

[fat_widget_left]A man I see in therapy is making a video as part of his treatment. He came into therapy suffering from depression, anxiety, anger, and rage. He often brings his laptop or a thumb drive into session. Sometimes he addresses issues that are current in his life, and at other times he shows his work-in-progress and processes memories and experiences unearthed by his video project. Therapy is a process of trust-building, not only between the client and the therapist, but between the client and him- or herself. For this man, identifying the project that he wanted to work on and following through with it, helped him to build self-trust. Trusting that the project was going to be useful, trusting that he could execute it, trusting that he would complete it, and that he would learn something of himself helped shift his self perception of someone who never completes anything, to someone who has something to offer others through his video narrative.

This person had been traumatized throughout his childhood by relatives who inflicted physical and psychological pain upon him. A few years ago he acquired Super 8 film footage that included a clip of him when he was approximately 6 years old. In the short film clip that he transferred to video he is seen actively running around with other children. Since he was not the focus of the camera’s eye, the clip of him is very brief. He does not have other images of himself as a child, because his mother was mentally ill and incapable of operating a camera, and his father is unknown. The video clip captures his innocence, in a sense, because he wasn’t performing for the camera, he was simply being himself.

This man has looked at the short clip many times in session, while editing it into his larger video piece. He was able to incorporate other footage to create associations that refer more specifically to his experiences. He slowed down footage and sped it up. He made clips fill the screen and then vanish from sight, over a few seconds. He added a sound track of his voice, as well as music, that had personal relevance to him. He used transitions that helped him piece together events that spanned most of his life.

The few frames of Super 8 footage taken at an age when his memories were being formed, allowed him to connect to his experience and integrate them into his life. He processed his emotions and understood that his behavior was his way of numbing the pain. He was able to acknowledge his skill, having created a coping methods that, as a child, was necessary for survival. He learned that many of those early coping methods created other problems, such as drug addiction, incarceration, anger, rage and isolation. Through years of recovery and therapy he is now thriving and giving back to others, He volunteers and shares his story with those who have experienced similar traumas.

Images connect to the deeper recesses of who we are through the meaning we attach to them, both consciously and unconsciously. In therapy meaning is unique to the individual. An image can invite a conversation about meaning without a battery of forms or diagnoses that are necessary and useful for treatment, but in themselves often neglect the humanity and life experience of the person in front of us.

Mindfulness-based therapy is an approach in which the principles of mindfulness are applied for therapeutic purposes. What does this mean? My previous article discussed basic elements of mindfulness:

• Pause.
• Bring awareness to body, sensations, feelings, and thoughts.
• Connect with the breath.
• Be in the present moment.
• Adopt a nonjudgmental approach: apply compassion.

While working with clients, I developed recognition of two main components that emerge from these elements of mindfulness: I call them the two pillars of mindfulness-based therapy. These two pillars—observation, and the cultivation of compassion, acceptance, and virtues—bring about change in peoples’ perspective, and consequently in
their lives.

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Observation

Observation emerges from the first four elements of mindfulness. It calls us to place attention to the process, to bring awareness to the way that thoughts come and go, appear, develop, and disappear. One is asked to acknowledge patterns of thinking, as well as the expression of emotions in the body, the subtle changes in body sensation, and the movement of the breath in and out of the body.

Even though the content of thoughts is there and recognized, the intention is not to engage with it, cling to it, or feed it. This is similar to the way that, in therapy, the past, traumas, and personal stories are important to acknowledge, but they don’t become the center and focus of the therapy. The focus, rather, is on what is happening now, how feelings express themselves in the body, and what triggers reactivity.

This approach allows release of attachment to “my story,” “my depression,” or “my anxiety.” Observation empowers the client to choose between letting thoughts, emotions, and even real-life events control his or her life, actions, and reactions, or, alternatively, to be more active and present in his or her outer and inner life and choose how to respond to challenges that present themselves at any moment.

Observation calls to bring awareness not just to destructive patterns, but also to positive and pleasurable thoughts, emotions, and events. Here observation allows for the positive to be part of the experience of life. While observing, the emphasis is still on the process and not the content: how does a positive experience feel in the body, how does the feeling change when awareness is brought to it, how do positive thoughts appear and disappear?

The Cultivation of Compassion, Acceptance, and Virtues

The cultivation of compassion, acceptance, and virtues emerges from the last element of mindfulness. This second pillar does call for attention to content. In this case, there is an attempt to focus on and produce positive thoughts. Clients are encouraged to wish themselves well while practicing Loving-Kindness meditation and reciting phrases with positive wishes. They are invited to look at and further develop their virtues, and to focus on the good in their lives even when it is small or hidden.

The more I work with people, the more I realize how much this pillar is crucial for positive change and growth. In this practice, it is not just about observing inner activity, but rather cultivating and expanding that which is already present. Even when one is not aware of having any compassion for their self or of having any virtues, we work together to discover positive elements that do exist and develop ways to integrate compassion, acceptance, and virtues in everyday life. I have a few clients who cannot feel any compassion for themselves, but through their ability to feel compassion for others, like kids and pets, we can work on slowly shifting the flow of kindness from the heart and direct it toward themselves.

Working with these two pillars in mind, I use two opposite powers to help a client reach balance. Observation helps to reduce negativity and unhealthy patterns of reactivity and behaviors, and cultivation of compassion, acceptance, and virtues supplies the positive energy necessary to help one grow. It helps increase positive attitude, self-esteem, trust in self, and healthy activities.

Sometimes small things make the biggest difference. One place this applies is in the doctor’s office. New research published in the Canadian Medical Association Journal (CMAJ) finds that a few simple gestures of empathy in the doctor’s office greatly impact the outcome of treatment. It’s not that empathy directly impacts physical health. Rather, patients who are treated with empathy are more motivated to follow through with their treatment plan and feel more satisfied with the care they’ve received. Though medical doctors specialize in treating the body, how they approach the patient as a whole has a pronounced impact.

If empathy makes such a difference in physical medicine, imagine its importance in the context of therapy and counseling. A qualified psychotherapist will have the necessary educational and licensing credentials, but effective, sincere and client-centered therapy involves more than knowledge and experience. It involves sincere empathy and compassion on a very human level. We know that compassion is one of the earliest social traits that pre-humans evolved to possess. Compassion and empathy are closely related, and both play large roles in our cultural development, family bonds, and relationships. (more…)

Here’s some interesting new insight into the human mind: first perceptions are even harder to overcome than most people had realized. According to research conducted on an international scale, our first impression of a person, place or idea becomes our brain’s default perception. If we later learn information that contradicts that perception, our brain categorizes it as an exception, rather than using the information to alter the rule. Specifically, we associate the exception with the context of that new information; all other contexts get the ‘default’ association. Say, for example, your first impression of a new coworker is negative, but you end up having a pleasant conversation when you run into him or her at the gym and change your mind. In the context of the gym, you’ll see the person more positively, but anywhere else (be it work, or even a new environment such as a restaurant), you’ll still be guided by your first impression.

This insight is especially interesting for therapists and counselors who help clients overcome phobias, said lead author Bertram Gawronski. “If someone with phobic reactions to spiders is seeking help from a psychologist, the therapy will be much more successful if it occurs in multiple different contexts rather than just in the psychologist’s office.” A similar pattern may be relevant for people struggling with profound anxiety and even PTSD. Learning healthy coping strategies in the therapist’s office can be helpful, but the idea of concept-based perception may explain why people sometimes feel less confident in their ability to apply those strategies in their daily life. (more…)

The term “spiritual bankruptcy” is a word used in the rooms of 12-step programs to characterize addicts who have lost their connection to “higher power.” One dictionary definition describes spiritual bankruptcy as “a state of complete lack of some abstract property.” Recently, I’ve been pondering what I believe “spiritual bankruptcy” means and how it appears in the people I know personally and treat in my practice.

If I were to think of the personal qualities of someone who seems to be spiritually bankrupt, what comes to mind is despair. The spiritually bankrupt person cannot envision a future different from the present. The spiritually bankrupt person has lost his/her moral compass and makes poor choices. The spiritually bankrupt person is self-absorbed and often oblivious of the effects of his/her actions on others.

As I write this, these qualities are sounding an awful lot like how I would describe someone who is deeply depressed. And I also wonder, what’s chicken and what’s egg. Does someone become depressed because he/she is spiritually bankrupt or is it the other way around?

People become depressed for many reasons including genetics, life circumstances and temperament (sensitivity). Can we say that a person who has faith and is deeply spiritual will never become depressed? That faith and being spiritually grounded will always be the antidote to depression?

I’m not so sure. But what I do know is that those who have faith, who are connected to the God of their understanding, who have a relationship with a higher power do recover from bouts of depression faster and more completely.

The reasons for this I believe are that a spiritually connected person knows somewhere in the depths of his/her being that the depression is temporary, an aberration as opposed to a constant and permanent state of being. The spiritually connected person can look at the depression as holding value for him/her, perhaps in the form of some opportunity for deeper understanding of self and life.

In other words, the spiritually grounded person may not succumb to the same level of despair or lack of hope that someone without a spiritual connection might.

In my particular faith (Yoruba), we believe each individual has a destiny and it is his/her obligation to fulfill that destiny. Everything is part of it, including sadness, pain and even depression. Depression is not viewed as punishment for wrong doing or as some moral failure. Knowing that can be a strong hedge against losing that connection to higher power. It is a hedge against the sort of spiritual bankruptcy I started out describing in paragraph one.

We must each find our own spiritual path. Our beliefs can take many forms. We can be a part of many different spiritual and religious communities. But one thing all religions and spiritual paths have in common is the presence of the divine. A spiritual connection can help people feel a greater sense of fulfillment in life. The emphasis is on the “fill” in the word fulfillment. It is one of the best remedies for that deep-seated emptiness that many people feel. We as humans, by connecting to our spiritual selves, have the opportunity to compensate for what we never received in our families of origin and perhaps from society.

When we think of sex therapy, we generally assume this takes place with (and is for) adults or couples. This neglects the importance of helping our children understand sexuality and their bodies.

If you are a parent, an aunt or uncle, or a much older sibling, you know that when it comes to the subject of sex and children, we walk around on eggshells. Children are sexual beings from the day they are born, though, and in depriving them of sexual knowledge and their own natural expressions we do them an injustice, often stunting their sexual development and growth.

We worry about overstimulation: that we are somehow being voyeuristic when we encourage kids to talk about sex. We worry that we might encourage or victimize them by educating and informing them. As educators, we worry about not having the parental permission. We assume, also, that many children live in a world where they are protected from sexually explicit material. I think we know that even the most protected child is exposed to sexual material in one form or another. Parents cannot monitor everything, but we can provide kids with tools to make informed choices and to process what they see, hear, and read.

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It’s important to recognize that children are sexual beings. Children explore their bodies alone and with each other. This is normal behavior and should not be shamed or shunned. I am referring here to masturbation and mutual exploration (i.e. playing “doctor” or “house.”) Please note: I am not referring to sexual play between two or more youths of disparate age, or an adult with a child. Age is key here. A child is naturally inquisitive and curious about his or her body; an older individual should not exploit this. It is important to know, however, that same-age or close-in-age peer exploration is a part of natural and normal sexual development.

It’s important to recognize that children are sexual beings. Children explore their bodies alone and with each other. 

An example I make is of two girls, age 8, who are found being sexual in bed. The parents decide to punish the girls, separating them from future play dates. The parents are confused and shocked, perceiving this behavior to be wrong.

It is important to know, also, that exploration is often done with a peer of the same sex.

Punishment and shunning of normal and natural behaviors, including masturbation, may lead to shame and guilt about sexuality in adulthood, and confusion and embarrassment throughout development.

A great book to read on this matter is Sex, Therapy, and Kids: Addressing Their Concerns Through Talk and Play, by Sharon Lamb. If you are feeling ill-equipped, under-informed, or worrisome about talking about sex, it is important to know that when we’re silent, kids aren’t getting the adult guidance and help they need.

When we are silent in response to sexual material brought up by children, we mimic and reproduce the world the child is exposed to every day, one that excites and confuses him or her and provides little space for processing. As adults, it is important for us to take the lead and teach.

Seeking a trained psychotherapist in the area of sexuality can also be a great place to start.

We are in the midst of January. One way to combat the cabin fever of winter and the shorter daylight hours for those across the northern hemisphere is to turn to creative processes.

In 2010, during one of the worst blizzards in New York history, many people bundled up and went outdoors with their cell phones or digital cameras to capture the beauty of the pristine snow against the textured backdrop of the urban environment. Some captured the absurdity of humans struggling against Mother Nature in their fight to dig out and return to ‘normal’ as soon as possible.

Contrast often gets our attention. It can be very dramatic. Drama can cause a variety of experiences such as: awe, giddiness, fear, and sometimes shock.

Coping with an experience generally falls into three categories:

1. engaging in the experience
2. avoiding it
3. overcompensating for it

After the blizzard, some people gave into the experience and engaged with the snow. Some people avoided it by staying away from the region or staying indoors. Others got caught up in the ‘expectation’ that the Department of Sanitation would handle what Mother Nature was delivering. When those in charge fell short, the situation heated up, not enough to melt the snow but in finding someone to blame.

The ‘unexpected’ can cause a range of feelings in humans, from joy to fear. The ways in which people cope are specific to them, to their early life experiences, their stage in life, and their future concerns. Most people had an experience flowing somewhere in-between. In some people the unexpected contrast of the heavy snow sparked their creativity. Others felt shutdown. In extreme cases their basic survival was threatened because support vehicles could not get down snow-packed side streets. Mother Nature is not fair in how she delivers her impact. She just does. Just as a bobcat in the wild does not discern which animal to take down for its next meal, Mother Nature spares some and hits others hard without reason.

In art, the contrast between the dark pigment of charcoal against light or absence of pigment on paper can create drama that is compelling to the eye. The self-portraits of Kathe Kollwitz and Egon Schiele are good examples of this. In Kathe Kollwitz’s work, drama is created by the contrast of not only the pigment but of the pressure applied to the paper, and the use of contrasting line to define and imply action or the lack of it. In Schiele’s numerous self-portraits, intensity is created by the placement of thick, dark, lines which define and the almost absence of pigment in other areas. Schiele’s self-portraits express his willingness to expose himself literally and figuratively on paper and canvas. If you Google an ‘image’ search for Kollwitz or Schiele and self-portraits, you will find very expressive examples of contrast in: texture, line, form shape and subject matter. You may find the experience exhilarating. You may find some of the artwork off-putting. The art may trigger feelings like the snow did for many New Yorkers.

In art, as in life, all drama or complete void cannot be tolerated for too long. The experience would be overwhelming. Many people have had an experience of contrast that shakes their lives and shapes them forever, for example: the profound loss of someone or something, a traumatic experience, relationship issues, a sense that something is holding them back from living fully, or an expectation that life has let them down. Uncontrollable anxiety that flares up and takes over, or depression that has an emotional base so deep that it limits the simple pleasures in life are indicators that life is being coped with rather than lived. Most of life is lived in the flow somewhere in-between contrasting poles of drama and void, in the blended parts of life where life is fluid, where creativity and hope are accessible.

During therapeutic play with children, therapists watch, listen, and interact during moments when a child may be giving voice to images, emotion, and story.