Therapy For Study

The Ten Coolest Therapy
Interventions: Introduction
The coolest therapy interventions
Clients talk, therapists listen. That's just the

beginning. Most clinicians have a few tricks up their sensitive, rational and insightful
sleeves.
I hereby launch another big series, this one honoring a vital component

ofpsychotherapy: the therapeutic intervention. I chose the ten coolest then interviewed
the leading experts for each one.
The first thing most psych graduate students learn is how to listen. They study Carl
Rogers(link is external) and others who poured the foundation of the therapeutic
relationship with the concept of respectful, empathic and reflective listening. While this
is helpful, some clients want more than listening. They want a powerful experience, a
deep insight or some tool that provides answers. Many psychological theories address
problems on this more tangible and profound level.
Techniques are hailed as vehicles of epiphany by believers and panned as corny

gimmicks by cynics. They add dimension and texture to the work, stretching therapy
beyond a friendly ear toward a dynamic, transformative process. They're the practical
application of psychological theory that creates a turning point for many seeking
answers.
For some, techniques are what make therapy meaningful. Others just want to talk and
be heard so techniques/interventions get in the way. Which brings me to an important
point: this is all incredibly subjective. Some clients work best in a technique-
free environment, others thrive in therapy heavy on gizmos. And some gizmos work
better for some people than others. Like many elements of therapy, it's a matter of a
good fit rather than the One True Best Way to do things.
Rather than give a cursory review of all contemporary

psychotherapy techniques, I thought a list of the Ten Coolest would be more interesting.
Absurd, given what I just said about subjectivity, but interesting. Now to define cool in
this context. In order to qualify as a cool intervention, each must have the following:
 Creativity: innovation beyond convention to find a solution
 Boldness: strong conviction the technique has profound results
 Compassion: directed at healing pain or dysfunction
 Mystery: mechanism for change is not always obvious
 A Cool Name: I'm not sure why, but this tends to be true
Let's also note what I'm not talking about: effectiveness outcomes. I don't want to get
into that here. I'll let the bean counters and hall monitors from EBT make their own
boring top ten. These interventions have worked powerfully for some people some of
the time; I'll leave their validity at that. I'm a therapist and I don't even use most of them,
I just think they're cool.
I selected the list then put on my investigative reporter hat to find experts who could tell
us more about each one. If you're a therapist, professor, client or a grad student you'll
probably be able to guess a few selections, but I doubt you'll guess all ten. My hope is
this list will help broaden your idea of psychotherapy. And show how cool it really can
be.
***This series is for entertainment and basic educational purposes only. My mission for
this blog has always been to demystify elements of therapy so it becomes more
accessible to the general public. Reading these blurbs is no substitute for the dozens to
thousands of hours of training it takes to effectively and ethically apply them. If you're a
therapist and find an intervention interesting, please get adequate training before
attempting. If you're not a therapist, please seek out a clinician with sufficient training in
that specialty. Unless otherwise specified, do not try this at home!
Here are the Ten Coolest Therapy Inventions (10CTI). Click through to each full post
and interview:
10. The Miracle Question

9. The Empty Chair
8. Paradoxical Interventions
7. Voice Dialogue
6. The Hunger Illusion
5. Head-On Collision
4. Sandplay
3. Primal Therapy
2. Virtual Reality
1. Transference Interpretation
And one final post to summarize, list the honorable mentions and wrap up.
Have a different opinion? Totally disagree? Made your own Top 10? Let me know.
Be sure to read the following responses to this post by our bloggers:
The Ten Coolest Art Therapy Interventions is a reply by Cathy Malchiodi PhD, LPCC, LPAT, ATR-BC, REAT
Talking therapies
Talking therapies can help you work out how to deal with negative thoughts
and feelings and make positive changes.
They can help people who are feeling distressed by difficult events in their lives as well as people
with a mental health problem.
This information is for anyone who wants to know more about different types of talking therapy or
hear the experiences of people who have used them. It advises how to find a therapist who is right
for you and suggests where to look for more information.
The information mainly uses the words 'talking therapy' and 'therapist', although the words that other
people use may be different.
Talking is good for you
What are talking therapies?
What kinds of talking therapy are there?
Cognitive behavioural therapies (CBT)
Dialectic behaviour therapy (DBT)
Psychodynamic therapies
Humanistic therapies
Other kinds of talking therapy
What is it like to have a talking therapy and when can it

be helpful?
How do I get a talking therapy?
How do I choose a therapist?

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf
We often find it helpful to talk problems through with a friend or family member, but sometimes
friends and family cannot help us and we need to talk to a professional therapist.
Talking therapies involve talking to someone who is trained to help you deal with your negative
feelings. They can help anyone who is experiencing distress. You do not have to be told by a doctor
that you have a mental health problem to be offered or benefit from a talking therapy.
Talking therapies give people the chance to explore their thoughts and feelings and the effect they
have on their behaviour and mood. Describing what'™s going on in your head and how that makes
you feel can help you notice any patterns which it may be helpful to change.
It can help you work out where your negative feelings and ideas come from and why they are there.
Understanding all this can help people make positive changes by thinking or acting differently.
Talking therapies can help people to take greater control of their lives and improve their confidence.
Talking therapies may also be referred to as:
 talking treatments
 counselling
 psychological therapies or treatments
 psychotherapies
The various terms used to describe talking therapies often mean different things to different people.
Some people use them to describe the level of training of the professional delivering the therapy. But
sometimes there is no link between a therapist'™s training and the name of the therapy they offer.
There are no set definitions so it'™s important to ask about a therapist's level of training.
Different talking therapies are called a confusing mix of names and some therapies have several
names. Don'™t let the jargon put you off! Behind every technical term is a way of working with
people that is designed to help.
Therapies are usually divided into several broad types. But even therapists who offer the same kind
of therapy will have a slightly different way of working from each other because all therapists have a
personal style as well.
Some therapists train in more than one kind of therapy. They may decide to combine a few
approaches if that will help you best.
The National Institute for Health and Clinical Excellence (NICE) recommends certain therapies for
certain problems, but other therapies might work for you just as well.
 Cognitive behavioural therapies (CBT)
 Dialectic behaviour therapy (DBT)
 Psychodynamic therapies
 Humanistic therapies
 Other kinds of talking therapy
 Support and information
Cognitive behavioural therapies (CBT)
How do they work?
By looking at how we can react differently to our thoughts and feelings (for example, challenging
negative thoughts) and how changing the way we behave can help us feel better (for example trying
new activities).
What are they based on?
They are based on scientific methods.
What form do they take?
Sessions are clearly structured. The therapist directs the conversation. They are focused on current
problems and practical solutions.
How long do they take?
Treatment is usually short-term and for a set length of time (between six and 24 one-hour sessions).
Where are they practised?

These are being used more often in the NHS, especially for treating common problems such as
depression and anxiety.
What are they helpful for?
A range of problems including depression, anxiety, obsessive compulsive disorder, managing long-
term illnesses, eating disorders, post-traumatic stress and schizophrenia. NICE recommends CBT
for all these.
Who will they suit?
People who want a therapy that works towards solutions, with clear goals and using practical
techniques.
What are some of the variations?
Cognitive therapy, behaviour therapy, cognitive behavioural therapy, rational emotive behaviour
therapy.
"CBT was amazing -“ it was so simple. My diagnosis is bi-polar disorder and I had very low self-
esteem and lack of confidence in my future. I had about 15 sessions over a year. The psychologist
showed me how to notice what I was thinking and then how I felt afterwards, and to realise you can
choose your own thoughts. I thought they were just random thoughts there to make my life a misery.
But I learnt that at any time I could stop and say: 'Why am I thinking that?'"
"I had a CBT therapist but I think she probably used lots of different things - in fact it didn' ™t feel
like she was 'using' anything - it felt like a natural process rather than anything very medical or
clinical."
Dialectic behaviour therapy (DBT)

DBT combines some of the methods of CBT with meditation techniques. It involves individual
therapy and group therapy. NICE recommends DBT for persistent binge eating disorder and people
with personality disorders who self-harm.
How do they work?
By exploring how your personality and early life experiences influence your current thoughts,
feelings, relationships and behaviour. Once you have this extra understanding, you can practise
more helpful ways of dealing with difficult situations.
What are they based on?
Originally the ideas of the neurologist and psychotherapist Sigmund Freud, with many changes over
the last 100 years.
The therapist works with you to understand your thoughts, feelings, relationships, behaviour, dreams
and fantasies.
Usually between several months and several years, although shorter-term versions are available.
Often privately, and in some charities. They are available on the NHS in some areas.
Depression, anxiety, post-traumatic stress, long-term physical health problems, eating disorders and
addictions. NICE recommends psychodynamic therapy for people experiencing depression
alongside other complex illnesses.
Who will they suit?
People interested in self-exploration who are willing to devote lots of time and energy to it.
Psychoanalysis, psychoanalytic psychotherapy, psychodynamic psychotherapy, analytical

psychology, Jungian or Freudian analysis, focal psychodynamic therapy (NICE recommends this for
treating anorexia nervosa).
"I was quite severely depressed as a teenager. I tried various antidepressants and some CBT-based
stuff, but nothing was helping. Finally, my GP suggested that I try psychotherapy at my local mental
health unit.
"At first I was sceptical. I couldn'™t see how sitting in a room with a stranger was going to help. I
was quite a nightmare, trying to prove to my therapist and myself that the therapy would fail. But with
psychodynamic therapy, the therapist is prepared to sit and wait out that part with you. She started
helping me link the way I was thinking, feeling and behaving to what might have gone on when I was
younger and that really made sense."
Humanistic therapies
How do they work?
By taking a whole-person approach to your problem, using a range of theories and practices to help
you develop.
Where did they come from?

They were developed to offer an alternative to psychodynamic and behavioural therapies, focused
on developing your full potential.
These therapies explore your relationship with different parts of yourself (such as your body, mind,
emotions, behaviour and spirituality) and other people (for example family, friends, society or culture)
and support you to grow and live life to the full.
Therapy can be short or long-term depending on the issues you need to cover, but usually at least
several months.
Therapists working for the NHS or charities and private therapists offer these therapies.
Humanistic therapies tend to treat specific problems -“ such as depression, anxiety or addiction - as
chances for you to develop and grow. Therapists work with any issue causing difficulties in your life.
Who will they suit?
They will suit people interested in exploring their lives and looking at their problems from a wide
range of angles.
Person-centred counselling (NICE recommends this for children and young people with mild
depression and sometimes for people with schizophrenia), transpersonal psychology, body
psychotherapy, gestalt therapy, psychosynthesis, integrative psychotherapy, existential
psychotherapy, transactional analysis, psychodrama and personal construct therapy.
"I was referred to a unit that deals with people who turn to alcohol because of psychological
problems. I was in a state of constant panic and had been drinking to keep those feelings at bay.
There wasn'™t a set formula to the sessions. We'™d just go and get a cup of coffee and I' ™d
talk about what was bothering me. With person-centred counselling the therapist steers you through
finding out more about yourself and developing confidence."
Group therapies
In groups led by a facilitator (someone who helps to introduce members of the group to each other
and who helps the conversation to flow), people find solutions together and learn from each other.
NICE recommends group therapy for people with obsessive compulsive disorder and for children
and young people with mild depression. "In group therapy you don'™t just talk about yourself,
you'™re listening to other people - that takes the burden off your problems. You realise you're not
the only one."
Couples, relationship or family therapies
Couples or families work with a therapist to sort out difficulties in their relationships. NICE
recommends family therapy for anorexia nervosa, depression in children and families of people with
schizophrenia. NICE recommends 'couples therapy' if partners have tried individual therapy and this
has not helped.
Interpersonal therapy
This explores how to link mood with the way you relate to the people close to you. NICE
recommends this for people with eating disorders and various forms of depression.
Mindfulness-based therapies
A therapy that combines talking therapies with meditation. It helps people reduce stress, switch off
from difficult thoughts and feelings and make changes. NICE recommends this treatment to prevent
people who have had depression from experiencing the same problems again. Other versions of this
treatment include mindfulness based stress reduction and mindfulness-based cognitive therapy. See
our Be Mindful website for more information.
Eye movement desensitisation and reprocessing (EMDR)
A way of stimulating the brain through eye movements which seems to make distressing memories
feel less intense. It is used for a range of traumas, including past sexual, physical or emotional
abuse, accidents and injuries, phobias, addictions and fear of performing in public. NICE
recommends for post-traumatic stress disorder.
Motivational counselling
A way of talking about things you may be sensitive about that doesn' ™t feel threatening. The
therapy focuses on your hopes and ambitions and problems that could stop you reaching your goals.
NICE recommends this for people with a mental health problem who have problems with alcohol or
substance misuse.
Life coaching
This uses empowering, motivational methods to help you reach goals or make changes.
Arts therapies
These therapies encourage you to express how you feel through art (painting, drawing, music,
theatre or dance). Art can help you work out how to tackle difficulties, release emotions and
understand yourself better.
Telephone counselling
This offers an easy way of talking to a therapist if you do not want to meet a face-to-face counsellor
or if you can't find one. It is sometimes provided by employers and charities. Online or e-mail
counselling is another option.
Computerised cognitive behavioural therapy

No talking required! You work through a series of exercises on your computer screen and learn self-
help techniques for managing problems in your life. NICE recommends 'Beating the Blues' for mild to
moderate depression, and 'FearFighter' for panic and phobia.
Bibliotherapy
Health professionals 'prescribe' self-help books which you can borrow from your local library. They
will usually offer you these alongside other treatment. NICE recommend these for anxiety and
obsessive compulsive disorder, and sometimes for depression.
Ryan Howes PhD, ABPPIn Therapy
Cool Intervention #8: Paradoxical

Interventions
10CTI: Don't think about a paradox
Posted Jan 23, 2010
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You know, this contribution to the Ten Coolest Therapy

Interventions isn't very interesting. I wouldn't waste your time reading about the
fascinating and controversial world of paradoxical interventions or the interview with one
of psychology's living legends: Cloe Madanes(link is external). Kindly move along to the
next blog. Okay, read if you must, but definitely don't send it to a friend. Or leave a
comment.
Paradoxical interventions involve prescribing the very symptom the client wants to
resolve. It's a complex concept often equated with reverse psychology(link is external).
For example: the client fears failure, so the therapist asks the client to fail at something.
A man has problems with procrastination, so the therapist asks him to schedule one
hour a day to procrastinate. Your four year-old resists brushing her teeth so she's told
she isn't allowed, and may end up doing it out of spite. Or a woman who can't
initiate sex with her husband is advised not to initiate for a month. Don't think about a
purple elephant. It's asking for something in order to achieve the opposite result.
The underlying principle is that we engage in behaviors for a reason, which is typically
to meet a need (rebellion, attention, a cry for help, etc). In prescribing the symptom the
therapist helps the client understand this need and determine how much control (if any)
they have over the symptom. By choosing to manifest the symptom, they may recognize
they can create it, and therefore have the power to stop or change it.
You can see how this might get a bit dicey. If the symptoms could cause harm to the
client or anyone else, nudging the client toward it would pose an ethical problem. In fact,
much has been written to establish guidelines(link is external) for paradoxical
interventions. Only clinicians well-trained in the technique should consider using it.
It's a privilege to interview Cloe Madanes, a pioneer in the field of family therapy and a

prolific writer, speaker and fellow PT blogger. She wrote the book on Strategic Family
Therapy(link is external), a modality that looks at the balance of power within the family
and the hidden function of symptoms. Her work continues to grow and evolve - she's
recently joined forces with Anthony Robbins(link is external) to find solutions to
interpersonal conflict, violence prevention and creating a civil community (watch them
work together atwww.madanesfilms.com(link is external)). On to her interview:
1. When would a clinician use a paradoxical intervention?
A clinician would use a paradoxical intervention when there is a clear symptom or

presenting problem that the patient believes is an involuntary behavior, such
asdepression, fears, pain, even seizures.
2. What does it look like?
The therapist asks the patient to deliberately have the symptom at the therapist's office
and/or outside the office. Family members may be asked to encourage, advise or
reward the behavior. The idea is that, if a symptom is involuntary, having it voluntarily
means the behavior can be controlled and is no longer a symptom. If the person can
have it voluntarily, this means he/she can also not have it voluntarily. A variation is to
ask the patient to pretend to have the symptom. When a person is pretending to have a
symptom, they are not having the real symptom. Secondary gain or positive
reinforcement can be arranged for the pretend behavior, so that it replaces the
involuntary behavior. The involuntary behavior is no longer needed in order to obtain
the secondary gain.
3. How does it help the client?
It helps the client to be in control of his/her behavior and experiences. It's based
onhumor because the intent is for the patient to laugh at the idea of bringing on an
unpleasant symptom voluntarily and humor is always therapeutic.
4. In your opinion, what makes paradoxical interventions cool?
Paradoxical interventions are cool because they are painless and funny.
Cool Art Therapy Intervention #9:

Family Sculpture
Family sculpture-- bringing family relationships to life in clay
Posted Feb 23, 2010
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When psychologists or marriage and family

therapists hear the term "family sculpture," an expressive technique invented by
experiential family therapists David Kantor, Fred Duhl, and Bunny Duhl often comes to
mind. They think of a nonverbal method whereby a family member is asked to physically
place other family members in positions in relation to one another-- a three dimensional,
in vivo arrangement of actual people. Virginia Satir(link is external), psychotherapist and
author of the classicPeoplemaking, also had each family member "sculpt" the other in a
similar way. Satir believed that it was easier for families to accurately see their
situations rather than just talk about them. Contemporary drama therapists as well as
dance/movement therapists who often use expressive means to facilitate interaction
between individuals, would certainly support her assessment.
The family sculpture technique of Satir's time reflects Gregory Bateson's and Murray
Bowen's(link is external) ideas about systems theory of the period; family therapy (link is
external)as a movement and distinct field emerged from this concept. In contrast
to psychoanalysis, the emphasis of family therapy is more on how humans exist within
systems such as groups, communities, and cultures. In essence, family therapists tend
to view change through the lens of the systems of interactions between family members
and that relationships are important factors in psychological well-being.
Family art therapists have developed a cool variation of the original family sculpture
technique, translating it into an intervention involving simple modeling clay or Plasticine
[a non-hardening clay that comes in several colors]. Simply put, a client makes a clay
representation of each family member-- mother, father, siblings, and any other close or
influential family members. The goal is not to make a realistic image of each family
member, but rather an abstraction that reflects that individual's personality and role in
the family. When all the sculptures are complete, the client arranges them in relation to
each other, reflecting relationships and interactions. In order to give you a better idea of
just how this intervention looks, take a couple of minutes to watch a role-play with family
art therapist Shirley Riley and a volunteer:
In my experience, family sculpture is an expedient way to symbolically bring a client's

family into the session without the family actually being there. The client also does not
have the added pressure of addressing family members directly. The figures-- even the
simplest lumps of clay-- become the mouthpiece for family messages and provide client
and therapist with a visible set of relationships.
The family sculpture as an art therapy intervention has always fascinated me as a

method of getting to know my clients. It's a relatively easy means for them to
communicate the stories of their lives, from family of origin to the current family
configuration. It's also a good example of how art complements a family systems
approach to intervention, mainly because art and families have something in common--
they are ultimately defined by both their inherent composition and the relationships
between their parts.
*If you missed the introduction to this series, I recommend that you read it to get the
background for this post and learn more about the criteria for why this intervention is
"cool."
@ 2010 Cathy Malchiodi, PhD, LPAT, LPCC

Cathy Malchiodi PhD, LPCC, LPAT, ATR-BC, REATArts and Health

Show Me How You Feel Today
Draw on your feelings to get in touch with your senses.
Posted Apr 19, 2010
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When you first encounter a painting, sculpture
or photograph, you generally relate to it through your emotions. While a work of art may
or may not always contain meaning or symbolism, it usually stimulates your senses and
leads you to experience feelings. Even if you have never had a formal art class or
learned to draw, it's likely that if given a pencil and asked to make spontaneous lines on
a piece of paper, your image will convey movement, gesture, shape, and/or action-- the
visual elements of emotion.
Art therapists have a longstanding tradition of prescribing image-making to prompt

expression of feelings, often by asking people to draw, paint, or sculpt "how you feel."
It's one of the fundamental approaches in the field that distinguishes art therapy from
verbal techniques that ask people to simply talk about their emotions. Author Erica Jong
once wrote that imagery is a form of emotional shorthand. I interpret this to mean that
while we may use paragraphs of prose to describe an emotional experience, images
allow us to communicate simply and directly. At its core, art therapy embraces the
paradigm that creating images cuts to the chase when it comes to expressing feelings.
Art therapist and Gestalt practitioner Jayne Rhyne introduced me to the idea of asking
my clients to use art materials to depict emotions as a starting point for self-expression
and communication. Rhyne studied with Gestalt icon Fritz Perls(link is
external) at Esalen Institute(link is external) in the 1960s and took her cue from
his philosophy of keeping clients in the "here and now" during sessions. In line with
Perls' thinking, she suggested to her clients that they use image making to express what
they were feeling in the moment. Decades before somatic approaches to treatment
became popular, she also asked people to explore how their feelings were connected to
body sensations-- in other words, using what's going on with your muscles, your
breathing, and your posture as the basis for artistic expression. That mode of using the
expressive arts in therapy is now commonplace in art, dance, drama, and other creative
approaches to treatment and particularly with mood disorders, stressreduction,
and trauma and loss.
Art therapists, psychologists, and counselors have subsequently adapted the idea of
"how do you feel right now" in a variety of ways. Children, for example, might be asked
to draw faces expressing "mad, glad, sad, and scared" to help them communicate their
emotional experiences to the

therapist. An activity commonly called a "body scan" is another popular iteration and
involves using an outline of a body as platform for using drawing, collage, or paint to
depict where emotions are felt in the body. It's a technique that is proving to be
particularly useful with people who have posttraumatic stress symptoms because it
often helps them to visually identify distressful body sensations related to trauma
reactions. While there are other similar directives, many art therapists, myself included,
take a more free-form approach and simply ask clients to use color, shapes, lines, or
images to express feelings when appropriate to the goals of therapy.
Rhyne [1979]* actually conducted research on what she called "emotional constructs,"
studying individual's drawings of feeling states such as calm, angry, depressed, and
other emotions. Adult participants were simply asked to draw abstract representations
of various emotionally laden mind states. Interestingly enough, the results of Rhyne's
study pointed to some consistency in visual elements within feelings categories. For
example, "sad" and "melancholy" were generally expressed with downward curving
lines; "happy," "joyous," and "cheerful" had curvilinear and upward movement.
"Depressed" included downward movement, while "excited" included less constricted,
more outward-reaching lines and shapes.
But lest you begin to think that drawing your feelings is just an exercise in deciphering
your emotional state, that's not the point of exploring how you feel with pencils, paint, or
clay. Nor will just drawing "happy" or "cheerful" automatically lead to a more positive
state of mind. But because art making is a sensory experience that actually can lead to
changes in mind and body, exploring both positive and negative feelings through image-
making, accompanied by some good talk therapy, can refocus your emotional outlook in
a fashion similar to cognitive-behavioral therapy [CBT]. It's also a practice worth
repeating over time-- and you learn more about that in the next installment, Cool Art
Therapy Intervention #4.
*If you missed the introduction to this series, I recommend that you read it to get the
background for this post and learn more about the criteria for why this intervention is
"cool."
© 2010 Cathy Malchiodi, PhD, LPAT, LPCC

www.cathymalchiodi.com(link is external)
Join the growing community of art therapists from around the world at the International
Art Therapy Organization [IATO](link is external). One world, many visions...working
together to create an inclusive and sustainable future for art therapy.
Subscribe to my Twitter and get the latest art therapy news
athttp://twitter.com/arttherapynews.(link is external)
* For more information on Rhyne's research, see: Rhyne, J. (1979). Drawings as
personal constructs: A study in visual dynamics. Dissertations Abstracts International,
40(5), 2411B.

Active Imagination
Art Therapy Prime Directive: Stick with the image. That’s it. Really.
Posted Sep 30, 2010
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Source: Cathy Malchiodi
If I had to identify the one moment in the history of psychiatry that opened the door to
the emergence of art therapy as a psychotherapeutic approach, it would be the
appearance of Carl Gustav Jung's invention of "active imagination" in the early 20th
century. Coupled with Sigmund Freud's concept of free association and his work on the
importance of images in dreams, it set a path for the use of art in psychotherapy into the
21st century. That is what makes active imagination the Cool Art Therapy Intervention
#2 in this top ten list.
Carl Jung's Red Book exhibit just closed at the Library of Congress this past week; it
recorded the creation of Jung's seminal theories developed after his 1913 split with
Freud. It is also thought to be a product of Jung's own experience with active
imagination. "The Transcendent Function" (1916) is believed to be Jung's first paper on
what would later be called active imagination; he once observed that active imagination
was somewhat of an extension of Freud's concept of free association (free association
being the invitation to relate whatever comes to mind, in an uncensored way and with
non-judgmental curiosity).
Modern day Jungian practitioners refer to the practice of active imagination as a way of
accessing and consulting with one's inner wisdom. In it's simplest sense it is essentially
a process of consciously dialoguing with your unconscious. According to Joan
Chodorow and the International Dictionary of Psychoanalysis(link is external), Jung
developed the process of active imagination from personal need when he "had no
choice but to take up that child's life with his childish games." Jung's own visualizations,
dreams, artworks, and fantasies brought him crucial insight into his psyche and, in his
opinion, these image-based experiences had a life of their own. In brief, he discovered
that as long as he could translate his emotions into symbolic images
through visualization, art, play or imagination, he felt inwardly more at peace.
In reality, few art therapists use active imagination in its traditional sense (except those
who have undergone Jungian analysis or training). But almost all use a loose variation
of active imagination to help individuals find meaning in their art expressions.
Depending on the therapeutic framework a practitioner uses, it might be called a
"dialogue with the image," free association with the artwork's contents, spontaneous
journaling about an artwork or dream, witnessing one's drawing or painting, or even an
invitation to write a "rant" in the tradition of free-form poetry or prose about an image or
series of images. It can also involve using another art form such as movement or music
to explore an image, or even the creation of yet another artwork. For example, instead
of asking an individual to talk about a painting, the therapist might invite the person to
respond with a physical movement, use a drum or other instrument to develop a musical
piece, or engage in a dramatic enactment that communicates the feeling or content. In
fact, art therapy's close relative expressive arts therapies capitalizes on the use of
multiple modes of self-expression and active imagination to help individuals explore
meaning. Many in the field of art therapy agree that art making itself can be a form of
active imagination if one allows images to unfold spontaneously without judgment,
control, or intention for specific outcomes.
Jung's Red Book
Source: Library of Congress
I think that active imagination, in its broadest sense, has a much larger role in art
therapy than just allowing spontaneous images to unfold. It has a timely relevance in
contemporary practice because of recent interest in mindfulnessand techniques such as
dialectical behavior therapy, somatic experiencing and focusing that encourage one to
"stick with the image" and the body's "felt sense." These approaches are increasingly
being used as methods for addressing trauma reactions and posttraumatic stress,
among other emotional challenges and disorders. Mindfulness, espoused
by neurosciencegurus like Dan Siegel(link is external) and others, is a practice of
balancing, very much similar to the non-judgmental, watchful attentiveness found in
active imagination.
To me, active imagination is just that - a variation on mindfulness practice which is all
about developing a more acute ability to clarify one's thoughts, feelings, and sensory
experiences. The bonus in using art expression is that it brings the products of active
imagination into tangible form, something that art therapy holds central and salient to
the healing process. And as Jung implied, staying with the image just may be the
transcendent function that helps us see who we are, hold the moment, and accept what
is, rather than what ought to be.
So, what is Cool Art Therapy Intervention #1? Here is a hint: It is something that
differentiates the way art therapists work from all other helping professionals who use
art in psychotherapy.
© 2010 Cathy Malchiodi, PhD, LPCC, LPAT
http://www.cathymalchiodi.com(link is external)
Have you discovered Art Therapy Without Borders yet? Visit http://www.atwb.org(link is

external) or join the ATWB Facebook page at to learn more.

athttp://twitter.com/arttherapynews(link is external).

Magazine Photo Collage
That magazine picture is saying something to you.
Posted Feb 16, 2010
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Magazine photo collage is Cool ArtTherapy Intervention #10 and is really based on a medium
more than a particular method. In art lingo, collage simply means "to glue," and is the
assembling of different images or materials to create a new whole. It emerged as an artform in
the early 20th century in the work of Picasso, Braque, and other artists, continuing through the
present. One of the most famous photo collages and Pop Art classic, Just What Is It that Makes
Today's Homes So Different, So Appealing, is a quintessential example from the art world of how
found images from a variety of sources are used to generate something completely different than
their original intent.
Art therapists have capitalized on collage as a medium of choice for interventions and with
almost infinite variation depending on the directive given and materials used. I loosely use the
term "magazine photo collage" in my work because magazines are the most popular material
used, although books, junk mail, and photographs are sources for collage, too. And there are, of
course, millions of digital images now available today on a Google images search. Because there
are so many pictures to choose from, magazine photo collage could just as well be called "found
image collage," a phrase that covers all the possibilities for picture-selecting.
Magazine photo collage is widely used by art therapists largely because it's a forgivingmedium,
especially for individuals who are intimidated by pencils, paint, or clay. In making a collage, you
don't have to go through the agony of drawing something realistic and are spared the feeling
of embarrassment that your pictures look like a ten-year-old drew them; this is welcome relief to
most of my adult clients who bring this worry to initial sessions. It also doesn't demand an
immediate commitment like a brushstroke across a canvas. In fact, until you glue the images to a
surface, you can change your mind, experiment with composition, and add and subtract pictures
until you get it right.
Therapists often use magazine photo images as a projective technique-- that is, as a means to
simply get an individual to tell a story in response to visual stimuli [note: I am not talking
about projective tests(link is external) used in evaluation of personality]. Helen Landgarten, a
well-known member of the US art therapy community, developed a method she calls "magazine
photo collage" using, for the most part, images of people found in magazines as the stimuli for
storytelling. The field of phototherapy(link is external) actually provides a much more detailed
basis for the projective use photographs, including what can be learned from individual's
reactions to print [magazine] and digital images. Judy Weiser, diva of the phototherapy field,
refers to these as photo-projectives(link is external), a person's own unique responses to what is
seen in a magazine or photo image [more on phototherapy in a future post].
I like to think of the process of magazine photo collage as using images to create a visual
narrative that enhances the dialogue between client and therapist. It's what makes magazine
photo or found images a "cool" way for clients to express themselves and for a therapist to
prompt client communication via pictures. It can involve asking my clients to do something as
simple as collecting pictures that catch their attention and arranging them on paper or creating a
found image collage about a particular theme, such as "what would your life look like if you
were in recovery" [or any of a thousand other themes, depending upon the goals of therapy]. In
the 21st century, working with photo images also means inviting clients to find images on the
Internet and introducing them to software or websites that provide ways to modify photos or
found images and create compositions of pictures. Digital art therapy is, in part, the
contemporary descendent of magazine photo collage, offering another way to "cut, move, and
paste" without the sharps or Elmer's glue. It has made available a virtually limitless gallery of
images that can be used to create that "picture that's worth a thousand words" in therapy.
In order to give you a brief glimpse into some of the possibilities of collage from found and
magazine images, take a look at this brief film from art therapist Gretchen Miller:
And while this series is not designed to be "self-help," I do invite you to visit two sites where
you can learn more about collage-- as a hands-on medium and digital art form-- and try your
hand at making your own collages. Art can't hurt you, but a good therapist can help you deepen
your exploration of your self-expression and the images you create.
How to Create Collage Art with Magazine Elements Tutorial(link is external)
Polyvore(link is external) [digital collage program with thousands of images from fashion and
contemporary culture]
*If you missed the introduction to this series, I recommend that you read it to get the background
for this post and learn more about the criteria for why this intervention is "cool." Next post:
February 23, 2010.
@ 2010 Cathy Malchiodi, PhD, LPAT, LPCC
www.cathymalchiodi.com(link is external)
Join the growing community of art therapists from around the world at the International Art
Therapy Organization(link is external) [IATO]. One world, many visions...working together to
create an inclusive and sustainable future for art therapy.
athttp://twitter.com/arttherapynews.
Ryan Howes PhD, ABPPIn Therapy
Cool Intervention #3: Primal Therapy

10CTI: I scream, you scream...
Posted Feb 05, 2010
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Cool comes in many forms. In the case of Primal Therapy, cool
means unorthodox, controversial, and powerful enough to ruffle feathers after 40 years.
None other than Dr. Arthur Janov(link is external) himself chimes in as we dig deep to
explore one of the Ten Coolest Therapy Interventions.
First off, Primal Therapy(link is external) is the name of the modality, Primal Scream(link

is external) was the name of the 1970 book where Janov claimed mental illness can be
eliminated by therapy that involves experiencing and expressing repressed pain
fromchildhood. Sometimes this results in screaming, sometimes sobbing, whatever it
takes to express the hurt. The decibels don't matter as long as clients access and
express these raw, early emotions. Why is this so important? Take a look at this:
"The number one killer in the world today is not cancer or heart disease, it is
repression." - from Why You Get Sick and How You Get Well(link is external)
According to Janov, unexpressed pain and painful memories place undue stress on our

psyche and physical bodies, and may cause illness. Everything from hypertension,
allergies, asthma, panic attacks, heart palpitations, ulcers, phobias, depression - each
can be potentially traced to repressed emotion. Address the cause (early pain), and the
symptom will subside.
Janov was educated at UCLA and the Claremont Graduate School before working at a
Veteran's Administration hospital and the Los Angeles Children's Hospital. During his
own therapy he discovered an "eerie scream welling up from the depths of a young
man lyingon the floor" and created Primal Therapy as a result.
Working with core emotions must be revitalizing because at 85 Janov
shows no signs of slowing down. He is the author of thirteen books related to Primal
Therapy including The Primal Scream,The Biology of Love(link is external), and more
recentlyPrimal Healing(link is external). His new book Life Before Birth will be published
this year. He founded the Janov Primal Center(link is external) in Santa Monica,
California, where the work continues. He even has his own blog(link is external).
Most everyone associated withpsychotherapy has heard of Primal Therapy. Whether

they love it or hate it, Janov's work has forced the field to wrestle with the significance of
repression and raw emotion in their theoretical formulation. If this area were completely
unimportant, Primal Therapy wouldn't cause such a ruckus. Furthermore, John
Lennon(link is external) wrote a great album(link is external) after his time with Janov,
so there's that. Here's to the ruckus, and a big loud, throaty welcome to Dr. Janov:
1. When would a clinician use Primal Therapy?
Primal Therapy is used to treat a wide variety of neuroses, including the treatment
ofanxiety and depression. The aim is to return to the origins of the pain (which always
goes back to a lack of love in childhood, or a trauma at birth), relive the pain, and thus
heal it.
2. What does it look like?
Patients return to the exact neuro-physiologic state as occurred originally at the time of
the trauma. The treatment is an open-ended therapy in which the therapist remains
accessible to the patient for as long as necessary. The aim of Primal Therapy is to
restore the patients access to their repressed feelings and therefore free them from the
consequences of repression. It is a process that the patients can go on doing by
themselves once they have "access" to the buried feelings.
Each time they let themselves "feel" they reconnect themselves to the origin of the
repression and have numerous insights. They also feel better that they knew was
possible because they take the misery out of their systems.
Primal Therapy helps by returning to the origins of the problem, lifting it out of
theunconscious, making a conscious connection and thus integrating and resolving the
pain.
4. In your opinion, what makes Primal Therapy a cool intervention?
A common misnomer: it is not Primal "Scream" Therapy, but Primal Therapy, and rather
than saying it is "cool", I would rather say that it is scientific. It is one of the most heavily
researched private psychotherapies extant in the world; and the "cool" thing about it is it
is also one of the most effective modalities extant.
** Many thanks to vidi(link is external) who allowed me to use his stunning artwork
Cool Intervention #7: Voice Dialogue

10CTI: Group therapy with one client
Posted Jan 28, 2010
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Ever feel a battle raging inside you? The part that wants to
achieve versus the lazy bum? The good guy versus the rebel? The loner versus the
attention-seeker? Or maybe your critic, inner child, ideal self and saboteur get together
to play poker once in a while. Voice Dialogue may be the technique for you. The Ten
Coolest Therapy Interventions series explores this elaborate method.
Voice Dialogue is the main intervention used in a modality called the Psychology of the
Selves developed by psychologists Hal and Sidra Stone(link is external), who had such
diverse influences as Jung, Skinner, Kazantzakis and Hermann Hesse (read their full
bio here(link is external)). Their theory suggests that various parts of self coexist within
each of us and determine our thoughts, behaviors and relationships with others.
According to their website(link is external):
Each of us "contains multitudes". We are made up of many selves, identifying with

some and rejecting others. This over-identification with some selves and the loss of
wholeness that comes from the rejection of others, can create imbalances and blind
spots. This work is about embracing all the selves. This dance of the selves is an
amazing process and we see the dynamics of the world around us shift as our internal
world changes.
Rather than making choices based on a given criteria (the most rational, what feels
right, what other people want, etc.), Voice Dialogue encourages a discussion between
the parts of self at odds with one another. The understanding and expression of these
selves helps us increase our self-awareness and even function better within a
relationship. Although it does turn a couple into a group rather quickly.
I'm honored to host Hal and Sidra Stone (and their assorted selves) who help explain
this cool and complex intervention:
1. When would a clinician use Voice Dialogue?
When there is a sense that the client has a feeling that he or she has different selves or
parts. For example, let us say that John goes to a party that he doesn't really feel like
going to. Once there he has a few drinks and soon he is the life of the party. In the
middle of the night when he awakens he is a bit depressed. In his session he may say
something like: "I don't understand how I get into these things. I really didn't feeling
like going and again it is as if something just takes over and there I am again doing
something I don't really feel like doing." In a situation like this Voice Dialogue could be
a very effective intervention.
2. What does is look like?
The therapist might say: "It really does sound like there are two very different ways of
being or value systems that are operating in you. There is you the party person, the
moreextraverted self who generally needs some alcohol or drug to get him going. On
the other side is a more introverted part of you trying to come out and be heard but he
seems to have less authority than the other one. How would you feel about my talking
to these two feelings or ways of being in the world to see if this might help clarify some
of the conflict that you are describing?"
The therapist starts always with the self that is the more primary, that leads his life in the
world. For this the client actually moves over physically to a different position and the
conversation or interview begins. When finished John would go back to the center for a
discussion of the work so far. In this, or the next session, the therapist might have a
conversation with the less developed, often totally disowned self.
It helps the client in three ways. First he gets to hear in a very objective way what these
different "voices" or selves have to say, what they want and need, how they developed
-- the family forces that shaped them. Just knowing that the voices are real can be a
total revelation. A woman might say that she can't stand looking in the mirror in the
morning. To discover that she has a voice in her, the Inner Critic, that embodies all of
her self criticism can initiate a major shift in her life.
Secondly, the therapist helps to develop a new place between the opposites, a place
that can help the client hold the introversion with one hand and the extraversion with the
other. It is a new "center" of personality that we call the Aware Ego. It is this Aware
Ego Process that can learn to embrace the vast system of opposites that live within
each of us.
The third advantage is that from this Aware Ego Process the client is in a better position
to make conscious choices. A conscious choice is one that honors both sides of the
conflict no matter which choice is actually made.
4. In your opinion what makes Voice Dialogue a cool intervention?
First of all it is way of working that is fun and alive and brings in all kinds of different
thoughts, feelings and emotions. It is impossible as a therapist to be bored or tired
doing this work. It the therapist gets tired or bored it is because he or she has fallen into
a pattern of being overly responsible or overly mental or some primary self that limits
possibilities of enjoying the work.
Secondly there is the constant excitement of new discovery. Discovering and

separating from a primary self is like waking up from a dream and discovering whole
new worlds of possibility.

Thirdly, what you judge in the world are generally expressions of selves in you that have
been shut down or rejected over time. What a ride it is and how relationships do
change as you begin to learn how to catch hold of these judgments.
Fourthly, how different it is to learn how to allow your own vulnerability to live in the
world of relationship. So many people look for more meaning in their lives. Learning
how to use vulnerability in a conscious way is really the royal highway to a more deeply
felt and experienced life.

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The Ten Coolest Therapy

Clients talk, therapists listen. That's just the

I hereby launch another big series, this one honoring a vital component

Techniques are hailed as vehicles of epiphany by believers and panned as corny

Rather than give a cursory review of all contemporary

 Creativity: innovation beyond convention to find a solution

 Boldness: strong conviction the technique has profound results

 Compassion: directed at healing pain or dysfunction

 Mystery: mechanism for change is not always obvious

10. The Miracle Question

Be sure to read the following responses to this post by our bloggers:

Talking is good for you

What are talking therapies?

What kinds of talking therapy are there?

Cognitive behavioural therapies (CBT)

Dialectic behaviour therapy (DBT)

Other kinds of talking therapy

What is it like to have a talking therapy and when can it

How do I get a talking therapy?

How do I choose a therapist?

Talking therapies may also be referred to as:

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf

Cognitive behavioural therapies (CBT)

How do they work?

What are they based on?

They are based on scientific methods.

What form do they take?

How long do they take?

Where are they practised?

What are they helpful for?

Who will they suit?

What are some of the variations?

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf

Dialectic behaviour therapy (DBT)

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf

How do they work?

What are they based on?

What form do they take?

How long do they take?

Where are they practised?

What are they helpful for?

What are some of the variations?

Psychoanalysis, psychoanalytic psychotherapy, psychodynamic psychotherapy, analytical

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf

How do they work?

Where did they come from?

What form do they take?

How long do they take?

Where are they practised?

What are they helpful for?

Who will they suit?

What are some of the variations?

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf

Couples, relationship or family therapies

Eye movement desensitisation and reprocessing (EMDR)

Computerised cognitive behavioural therapy

- See more at: https://www.mentalhealth.org.uk/a-to-z/t/talking-therapies#sthash.4GaHMKEV.dpuf

Ryan Howes PhD, ABPPIn Therapy

Cool Intervention #8: Paradoxical

You know, this contribution to the Ten Coolest Therapy

It's a privilege to interview Cloe Madanes, a pioneer in the field of family therapy and a

1. When would a clinician use a paradoxical intervention?