All Hands on Deck with Palliative Care

Change Your Buddha, ©2009, 6" x 6" x 2," Fabric Collage on panel Every so often, I think that it's time to take a break from my blog. This happens when I feel like I'm reaching for topics and even though life seems to be full of them, I can't see the forest for the trees.

What I know is this: I've got a presentation for our Pediatric Palliative Care Consortium here at UC Davis Children's Hospital that's scaring the pants off me--nearly. Because instead of playing it safe and using Powerpoints to hide behind, my co-facilitator and I are going to ask people to break up into groups and interact with one another.

That's not such an unusual thing in the art therapy world, but when you switch to the academic and medical world, there is an increasing distance between the tangible and the virtual.  In a recent New York Times editorial by Richard Kearney, entitled: "Losing our Touch" he notes,

In medicine, "bedside manner" and hand on pulse has ceded to the anonymous technologies of imaging in diagnosis and treatment.

All around us, we are showered with information from ubiquitous social media (of which this blog is a part), wherein we remain at a discreet distance from whoever is providing information on the other end. Now in classes, we often face computers instead of professors. And as you gain professional status, you frequently find yourself in your own office, trying to engage a in webinar, which tends to lull you to sleep rather than enliven the finer points of a subject.

During our part of the day, I want the participants to experience as much as possible, the kind of immediacy that occurs when one is faced with a palliative care patient; the overwhelming feeling of questions that you have no idea how to answer such as : "Is this diagnosis dangerous?" and reaching deep down for some untapped source of strength.

Full humanity requires the ability to sense and to be sensed in turn: the power as Shakespeare said, to "feel what wretches feel":--or one might also add what artists, cooks, musicians and lovers feel. We need to find our way in a tactile world again. We need to return from head to foot, from brain to fingertip, from iCloud to Earth. --Richard Kearney

To this end, we've reserved a room that has tables facing each other rather than toward the front of the room. We'll divide up into groups and tackle a case that involves the anticipatory grief that patients face upon diagnosis. Then we'll take that case through the course of an illness to hospice and beyond, to bereavement.

I hope to model the kind of direct hand to hand care that we want practitioners to offer patients. To do that we want to identify inner strengths, the qualities that each of us possess which allow us to enter tough situations and to be of service, no matter how daunting the circumstances. We'll lay out a banquet of images and after explaining a simple SoulCollage technique, we'llask people this question:

What quality do you call on within yourself to support children and families in their grief?

We'll invite them pick images that speak to them, to their soul, about the qualities that give them the strength and compassion to approach and support families and children at the this crucial stage of life. Can you imagine what will happen if we share these qualities with each other?

 

Finding Renewal, or, "Self Care 101"

My tools for self-care Self-care. The word sounds a bit stiff, as if someone who liked the meaning of the two words separately, put them together and ended up with less than when they began.

Many times, this essential, bottom line topic is trivialized and minimized so that we keep it at a distance. Frequently, at a healthcare conference, it is the last topic of the day. You are filled to the brim with useful information and ideas, you’re ready to call it a day, and with a scant half hour to go, the moderator gets up to speak on self-care.

The advice is boiled down, then offered up like overcooked vegetables: Remember to breathe. Eat well. Sleep. Rest-- and of course, exercise. All good advice, but how many of us are listening?

We need to be more resourceful in how we look at self-care. It is, in fact, a form of treatment. Vital word: as in therapy, remedy, cure, to care for. Rather than leaving it to chance and the final scraps of the day, I propose that we look at caring for ourselves as if we were a patient or client under our own care. We need to assess ourselves as carefully as we would that patient.

I like to remember quotations I learned in college. One that stands out is from Shakespeare’s Hamlet: “This above all… To thine own self be true.”

I understand Shakespeare's words to mean, in this context, that each of us finds unique ways of getting whatever we need to redeem ourselves. Those ways are going to be different for each person, just as the course of treatment for the same disease can be different for each patient enduring it.

As I thought about it, I realized there were at least two levels of need for self-care—immediate response to a potentially overwhelming crisis and those activities that we can pursue in abundance, say when on vacation.

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One of my tried and true "emergency" treatments is to resuscitate myself with a cup of tea. Taking those few minutes allows my thoughts to settle and often, I regain the clarity and energy I need to meet the next wave of challenges.

If each person reading this blog wrote down all the things they do to care for themselves when they do have time, the list might be very long: making art, running, yoga, getting together with friends, reading, rock climbing, going to a movie, listening to music, swimming, dancing, hiking, hitting the beach, etc.

There may also be an intermediate level of self-care. We want to create ways to sustain ourselves while at, or after work, --an ongoing renewal-- when we don’t have the opportunity to travel to our favorite get away or sanctuary for a few days.

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Recently, I presented a workshop on self-care to our Child Life Specialists Network of Sacramento, in which I shared many of these ideas with them.

Afterwards, I introduced and led them through a SoulCollage® workshop; a wonderful and pretty quick route to renewal. We looked right into the heart of the matter: “What sustains me? What nourishes me?”

The results were astonishing. Many participant's artwork revealed aspects of themselves not readily seen. Many uncovered feelings that may have lain hidden, unexplored or simply forgotten.

One of the most surprising results was my own collage. Initially I thought it must have come from my silly side, the side that remembers the theme music from Captain Kangaroo, or spontaneously makes up nonsensical songs. What I realized the next day though, was that in fact, the dancers in their rabbit costumes extolled the power of partnership as a means to self-care. For those introverts among us, we sometimes forget that a powerful form of renewal is to share the company of others.

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In the Midst of Spring

Oak and Clove, detail,©2014, 7.5' x 9.5," Monoprint I look out the door of my studio: the redbud is in bloom and small oak saplings are popping up everywhere after our recent rains. I welcome these drops from the heavens.

My challenge is to bring the energy of spring into the hospital.

After admiring the redbud, it's off to work where I'm met with a referral that seems to be at the opposite end of the spectrum from my earlier musings: Help a family with enough children to fill a school classroom to mourn the imminent passing of a beloved family member.

I have just half an hour to come up with an intervention and enough materials to carry it out. I try to remain calm inside and talk out ideas with the palliative care social worker. Each plan has it's drawbacks but finally, we come up with one that might work. She leaves to go back to the family. I assemble the art materials.

When I arrive at the waiting room, the television is on, a laptop game is in session, a baby is crying. Where do I find an entry point?

Go straight to the heart I tell myself. I ask the children to tell me their names, their ages. They're a bit defensive, trying to keep up the barrier--I'm a stranger on their turf.

I tell them why I'm there and that we're going to make something together, something that they can keep for the rest of their lives to remember their family member.

Just to make sure they have an understanding of what is happening in that room across the hall, I ask: "do you know why your relative is here?" Hands shoot up and slowly we zero in on the answers. Like water that swirls slowly around the drain and suddenly forms a vortex, their understanding takes hold.

Both the children and their parents tear up. We talk about the tears; like rain they clean us out.

I pass paper and ink pads and markers and stickers and ribbons--even a hole punch. All of the kids make a print of their hand and draw on the paper; flowers bloom on the page, purple stick people hold hands and hearts. Some of them write messages. Then one by one, they visit their relative to add that person's print to the paper.

Its a sacred and scary thing, this printing. The children hold back at first, but once I help them put their hand on top of the hand that reaches out, they relax into it. The atmosphere builds until the last children are hugging and kissing and giving messages and the grownups want to make their own hand prints.

I'm always surprised that it's the simplest of actions which mean the most at the end of life: one hand on top of another, words whispered into an ear or scribbled across the top of the page.

 

 

 

What I'm Learning in my Fifties

Pruning, ˙2014, 5.5" x 7.5," Monoprint I recently read an article in the New York Times entitled, "What You Learn in Your Forties." A humorous article, it included such tidbits as "There are no grown-ups. We suspect this when we are younger, but can confirm it only once we are the ones writing books and attending parent-teacher conferences. Everyone is winging it, some just do it more confidently."

That got me thinking it might fun to consider what I've learned in my fifties, because, as my office mate reminded me this morning, we'll both be turning 59 this year.

The term "synaptic pruning" springs to mind. This term refers to the brain's regulatory processes, in charge of pruning the neural structures in the brain, and thus reducing the number of neurons and synapses in order to create more efficient synaptic connections. This tends to occur in younger folks...

I've experienced a similar kind of pruning in my 50's. As we grow, we make choices and those choices close off certain possibilities--while others open up. It is true that I will never climb Mt Kilimanjaro or become a lawyer, however, in the areas in which I've chosen to focus, the possibilities appear to be growing.

Pruning 2, ©2014, 5.5" x 7.5," Monoprint

I've been pondering a new series I've just started: "the ecology of place”–or, “my ecological niche”: a series using plants gathered within my immediate surroundings, to create monoprints exploring the relationship between me (the human) and my environment (my yard).

As I thought about pruning choices, I realized that it was no surprise that I’d chosen this theme. I’ve had an ambivalent relationship to staying in one place for a long time; the result of moving frequently as a child. Although I truly love my small Central Valley town, there is always a part of me that wonders "I wonder what it's like in…"

This little thought keeps me from living fully in the present, in Davis, CA on Olympic Dr., in my house, and probably in any number of places I frequent. What better way to settle in, than to make a series out of it?

I look forward to sharing this work with you as it unfolds, both in my backyard and beyond.

Returns, Reunions

"On the One Hand," ©2013, 16.5' x 14.5," cotton fabric, thread I've been stirring an idea around in my head.

Recently, I was offered a real, bonafide, 100% full time art therapy job at the hospital where I work. I would be doing essentially the same job I'm doing now but because of the extra time, I would be able to extend my services to the PICU and NICU, which so far, I serve infrequently.

Knowing that this offer would not likely occur again in my life time, I jumped.

I'd heard it was a possibility, but knowing that the coffers of the University of California aren't exactly flush, it just seemed like a wonderful dream. I also knew that if indeed it happened, it would herald a radical change to my art making practices.

At present, I've been able to spend several morning hours working in my studio, before I hit the road to work. I'm used  to considering, imagining, formulating and then sewing, making collage...creating. With the new job hours starting in September, my morning art routine will be reduced to an hour. I'll have weekends to work out too.

So back to this idea. Many years ago, when my children were young, I worked on several series which were an outgrowth of my meditation practice. I loved the idea that I'd gotten from Japanese American artist, Mayumi Oda, of beginning each day with a mandala.

One of the series was just that, a daily mandala. Another consisted of 5x7 inch wooden panels which depicted the phase of the moon as it intersected my menstrual cycle. Yet another became a series of alchemical flasks, each one holding the ingredients of life that were moving and transforming inside of me.

Guardian, ©2004, 11" x 14," colored pencil, acrylic and collage on paper

While I've been skeptical of the concept of self care in the therapeutic profession, as I look forward to a longer work day, I'm seeing it in a new light.

I want to return to the idea of practicing art as a form of meditation, using my hour as a time to make small repairs, adjustments to the soul, so to speak, that will keep me on my way. As the days grow subtly shorter, even here in the midst of summer, I'm looking forward to my own not-so-subtle changes, eager to see what the fall colors will bring.

Catching Up

TR.PEI.13 - Version 2

Sometimes it takes getting away from your predictable world to get a new perspective. This week, on Prince Edward Island, a tiny green gem of an island located in the Canadian Maritimes, I've had that opportunity .

PEI is the remnant of an ancient collision between the North American and African continents. Hard to believe, and even more difficult, that the gorgeous red sandstone cliffs ringing the island were once part of the Appalachian Mountains.

I wonder if and how such strange connections and dislocations might be happening around us all the time.

If you've read this blog for long, you know that I strive to balance my own realms of art and art therapy. It often seems that one tends to overwhelm the other.

With lots of time to sleep, beach walk and read, I've recovered stores of energy that I haven't felt for a long time. Particular truths rise to the top:

I can't help but to look at everything around me as though it were composed for a painting.

Wherever I go, my eyes are continually drawn to the children's activities.

A confirmation, in this faraway land, that I am where I need to be in all senses of the word: in the present moment as well as my life back home in Davis, Ca.

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Recently in that studio across the continent, I've been doing some work with artist, Lisa Call as a tutor. I focused on these same ideas of balance and combination--studio and hospital, watercolor and fabric, monoprinting and quilting.

Still Quadrant, ©2011, 24" x 24," paper, cotton fiber, ink

I set out to experiment using an older collage piece (see Still Quadrant above) as an inspiration and example.  I wanted to return to using straighter lines, with subtler, not so apparent angles. I also wanted to introduce drawing onto the fabrics.

I decided to use some cloth that I'd cut out and pieced but hadn't worked in earlier compositions. Using these leftovers, I began to play. I drew patterns on a cutting board/printing plate with block printing ink and then, after placing scrap pieces on the plate, ran them through a monoprint press.

I liked the dark black stripes and circles that resulted and set about creating a composition with the squares and strips of fabric.

Juxtaposition, ©2013, H. Hunter, 11" x 13," Cotton fiber and ink

I remembered how difficult it was for me to consider tossing these leftover strips of cloth. In fact, I'm often drawn to remnants and remains. I can get obsessive, but that's part of the process too.

On my return, I'm looking forward to exploring more of this recombining of ink and fabric and adding some paper in there for good measure. After this trip to the PEI, who knows where exploring "off lines," or even off continent will take me?

Socks and STEPS

Oscar in the climbing hydrangea. We have a new program that we are rolling out at Children's Hospital.

STEPS, Supportive Therapies and Enhanced Palliative Care Services,  is a pediatric palliative care program which provides medical, mental health and spiritual services with a goal of helping a child to be as comfortable as possible throughout the full course of her treatment.

At present, we are introducing the program into the pediatric intensive care unit of our hospital.  I'm happy to say that art therapy is an integral part of the STEPS program.

I'm thrilled because I've long wanted to be able to participate in this continuum that begins with diagnosis and continues throughout the course of an illness.

Recently, I've had occasion to watch parents stand in front of their infant's cribs, hesitant to touch their babies, with all the tubes protruding from their tiny bodies. Helping parents to hold their child, no matter what the prognosis, is a challenge.

Art Therapy is about solving these kinds of challenges using creative activities which facilitate awareness and build confidence. What project might help parents to gather the self-assurance required to learn delicate skills, necessary to care for their babies?

In the right hands, the humble sock monkey* can become a powerful vehicle for boosting self confidence. I took up the challenge and created my own example, Oscar. As he emerged under my fingers, I was surprised by how his personality took shape and suddenly, there he was smiling back at me.

I found that cutting, stitching, stuffing and sewing require patience, coordination, imagination and a sense of humor. So I took Oscar and trialed my sock monkey experiment with some parents of young patients.

As I watched the parents sew, some of them stitching for the first time, it was a bit like watching a child take baby steps.  Knots didn't hold, thread slipped out of the needle (multiple times!), but the parents were able to pick up again, laugh at their mistakes and sew on.

Laughing at our mistakes and persisting are some of the skills we employ as parents (those of you who are parents know, there is no shortage of opportunities to make mistakes!) Sock monkeys help parents to experience new skills and their own creativity in a relaxed, yet authentic way.

One of the founders of STEPS, Dr. Theresa Murdock-Vlautin, said that the goal of STEPS is to "enhance care in body and spirit, coordinating resources to provide support, hope, healing and wellness." I look forward to watching the program unfold and the love and wisdom which will grow in the families and in our team as a result.

*For more information about sock monkeys, check out Art Therapist, Gretchen Miller's informative posts on sock monkeys here. For an excellent how-to video, you can look at Art Therapist Kat Thorsen's video here. Many thanks to both Gretchen and Kat for their inspiration and  incredible service projects with sock monkeys.

Mending Walls and Making Change

ATCs on parade At some point in their studies, art therapy students discover the "media continuum." On this continuum, media are placed along along an invisible line moving from point A to point B line according their degree of safety and control.

A lead pencil at one end of the continuum offers a feeling of familiarity and control--and on the the opposite end spectrum, oil paint offers an unwieldy challenge. If you don't watch out, you might find your client who has difficulty with impulse control spraying the paint all over your office walls.

The key is to match the both the media and the intervention to the needs of the client. To non-art therapists, this might sound theoretical and over cautious.

It's not. In my very first art therapy bereavement group many years ago,  an angry adolescent punched a hole in the wall of the hospital in which I was working; his reaction to my misdiagnosis of media and intervention. I hadn't read the signals and had asked the group to attempt something that put this young man face to face with his grief far too early in his grieving process.

If I hadn't been convinced about the medium continuum before, if my teachers' stories seemed only to be tall tales, I became  a convert and I've employed it ever since.

I use the same principle in my own art. When I'm feeling stretched thin, I stick with materials over which I have more control. When I'm feeling expansive, my work and my materials grow too.

Right now, I'm in the process of sanding the panel edges of my "Mending Wall" series. I love this series, but I don't like finish work. It feels like all the fun and discovery is over and I'm doing the visual equivalent of balancing a checkbook.

Mending Wall 1,© 2012, H. Hunter, 12" x 12," paper, watercolor on panel

Recently, I decided to intersperse the task of sanding with our 6 Degrees of Creativity "Pocket Change" project. My deal for myself is: finish one sanded panel--make one artist trading card.

I've arranged the artist trading cards, in various stages of completion, at a discreet distance from where I sand. I can see them while I work, their bright colors shining, offering the possibility of almost instant gratification.

Mending Wall 1, edges sanded and stained

I'm beginning to love sanding. By creating a new rhythm: hard medium/easy medium/hard medium, I'm finding patience and sanding is leading to new ideas for my next series. I love the smooth, variegated surface of the wood.

Meanwhile, artist trading cards gather at the end of the table, ready to be mailed off for Beth Rommel, collector and distributor for our Pocket Change project.  Gretchen Miller, Beth and I have concocted this project to focus on the power of creating change through making something small (in the form of artist trading cards) and through engaging in simple acts of creative kindness.

You get the picture--help yourself, help others--it's not too late to join us! The deadline is tomorrow,  Tuesday, January 15. For more information on the exchange, click here.

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I also invite to share stories about your own media continuum experiences--whether you called it that--or maybe just "those darn pastels!"

Pocket Change: Or, Small (Creative) Acts Create Meaningful Change

"Even after they are cut down, a sprout may be taken from them and planted in another place, and they begin to grow again." —Mishna

Pocket Change, Badge created by Gretchen Miller

Like a lot of people I know, I've been searching for meaning among the rubble of recent events; both inside our country and out of it.

Though it is easier but necessary, to critique what is going wrong in our schools, our homes, and our countries, I wanted to stretch a little and find a project which contributes to the good in a small but meaningful way.

It began with an idea from my friend, Beth Rommel, who wanted  begin the new year with something positive, something with art, something with others.

In collaboration with Gretchen Miller and myself, we concocted Pocket Change, hosted by 6 Degrees of Creativity.

Pocket Change’s intention is to focus on the concept of creating change through making something small (in the form of artist trading cards) to exchange with one another, as well as to encourage simple acts of creative kindness with others.

I decided to try out making a few of the cards. They were fun to create--simple, without encumbrance. They remind me of mandarin oranges. You pick one up, peel it and pop it whole, or in a few sections, into your mouth and suck out the sweetness.

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photoPocket Change is all about how simple and small acts can create and instill kindness, gratitude, and change.  Think about the power of your mini artworks as a means to express and share a positive image, message, or intention with others (and the world!) that can make a difference, bring hope, or inspiration.

-Gretchen Miller

It reminds me of the Mindful Studio Practice that I offered as part of 6 Degrees of Creativity 2. The beauty of making artist trading cards is the opportunity for quiet moments in which your imagination can stretch.

But wait, there's more: the added bonus of sending these miniatures off so that someone else will benefit from your practice.

Please join us for some pocket size creative goodness and kindness to share with one another and others!  The deadline to sign up for the ATC exchange is January 15.  Learn more about the exchange details and how to get involved on the 6 Degrees of Creativity blog.

Winter Wisdom

Mindfulness at Play "Art expression itself is a way of creating something new from what you already have, but may not have fully recognized within yourself.” Cathy Malchiodi

The other day I received a newsletter from my art therapist friend Lisa Mitchell.

She's constructed a new series of workshops, including a vision board* workshop--and not just any old vision board workshop. Her descriptions note that, by using ordinary materials in unusual ways and learning new techniques, our intentions are solidified. In the process, our brain gets a workout using all our senses. The point is to bring our abstract ideas and dreams into the realm of the concrete and plausible, by incorporating them into the board.

That got me thinking about my own vision board, which I wrote about in a post, "Mindfulness at Play," at the beginning of the year. I decided to go back to the board and see what has come to pass.

As I look at the board, I see a large, peaceful Buddha's head framed by conifers and plants that remind me of our winter foliage here in California. Underneath the Buddha, from left to right, children hold a board filled with artist trading cards. To the right of the children a yoga class takes place. A teacher is helping a student with a pose.

In my post, I said that I wanted to deepen my art therapy practice; to become more present with the children, even as my own are grown. And I wanted, although I didn't write it, to have a steady yoga practice.

What's odd is that both of these desires have come to pass, but not by deliberate intention. The vision board hung on my studio wall, where it watched over me and I looked at it, day after day, while a year passed.

It has not been a straight path back to yoga--(is it ever?) Like Goldilocks, first I sampled the "big bowl," a class at our University gym. I was the oldest participant and the class, a Viniyasa practice, and I felt like I'd just had an aerobic  workout, not a yoga class.

Next, for my "middle size bowl," I tried a class offered through our hospital. The instructor offered peacefulness with a pale green scented candle. I ended up with a migraine.

Finally, for a bowl that is just right. The solution came in an unexpected fashion. Both my daughter and my sister have recently been diagnosed with auto-immune diseases that make certain movements difficult.

I remembered yet another yoga class I'd taken the previous year for people 55 and over. Led by the fearless and inimitable, Hana Raftery, majoring in exercise physiology, she had every one of us, from me to the oldest 80- something moving with ease.

I e-mailed her and set up a private lesson for my daughter and me. I invited my sister, who suggested we have it in her new house, which has a wooden floor, but would be empty for another month. Shazaam! A yoga studio!

Downward dog pose

We began by meeting once a week and now have increased it to 2 times. We've been meeting since before Thanksgiving and even though the two of them are still waiting for their respective rheumatology consults, their movements are coming more easily.

I am in hog heaven, if you can say that about a yoga class. I feel like I really have found the bowl that is "just right." And it all started with a small 8.5 x 11 vision board.

I'm looking forward to making my 2013 vision board soon and I invite you to join me and make your own. Who knows, those dreams might just be waiting for an invitation to come out and play!

*A vision board is usually a piece of matte board on which you paste or collage images that you’ve torn out from various magazines. The intention behind the vision boards is the notion that when you surround your self with images of what you want to develop or change, your life changes to fit the images.

Phase Transition*

Yesterday I had the strange honor of sitting beside a beautiful young woman who was literally pulling her hair out. I didn't understand what was happening at first. I was getting to know her and she was getting to know me, as well as what I do in the hospital. We spoke of her illness, of the fact that her hair was falling out (she didn't want it shaved), of the cartoons playing on the television. The entire time we talked, she pulled at strands of her hair, twirling small bits,  and calmly yanked them out, putting them carefully on the coverlet.

By the time I left the room, she had tucked a considerable amount of what had once covered her head into a plastic sandwich bag for safekeeping.

It was one of those scenes that goes in so deep, I wanted to run away and cry. I had an art group to facilitate, so instead, I went back to my office and stared at the wall of orderly art supplies, the bottles and tubes of color lining the shelves bringing me comfort.

I've been thinking a lot about repair; how to reconstitute myself after being torn in so many different directions all day long. Inspired by comments on this blog, from my family and local friends, I've been thinking about my art work, it's purpose and relation to the art therapy.

I'm always trying to find a "balance"--somehow comprehend the relationship of making art to practicing art therapy, but both are subtle practices and too mysterious to hold onto all at once. Instead, I've begun to think of the two as intertwined, a kind of ongoing tapestry, in which each activity informs the texture and direction of the other.

Since trying this approach, I've felt more relaxed and present (that ever present word : "present"!)

I've found myself describing my art work as a way to restore a sense of calm amidst the overwhelming flux surrounding me. I've often thought of art making and art therapy as forms of Tikkun O'lam, a Jewish phrase that means "repair of the world." What I've most recently come to appreciate again, is that while practicing both arts, I am repairing myself too! (Well, heck, I knew that, but I guess it's just on a deeper level this time!)

I've continued to adapt patchwork quilting to paper and instead of putting diverse fabrics together to form a beautiful pattern, I take sections and bits of paintings along with pieces of collected paper and put them together into patterns--with the patterns signifying more than the surface beauty. They attempt to fuse the variety of experience together into a whole. The process of the work is soothing and at the same time frustrating. I paint, cut out a square, cover a small area and then immediately tear off other areas of the work, then repeat the whole process again.

It's stretching me, this work, not letting me become complacent. Each new section has its own internal direction but is also patient, waiting quietly for me to discover what it is and turn to it--again and again.

* A "phase transition" is the process by which matter transforms via a thermodynamic system from one phase or state of matter to another.

Take 2: Palliative Care and Paper Swaps (The Whole Story)

Our pediatric department is beginning a pediatric palliative care team and as we lay the groundwork, we're introducing the idea of integrative therapies to our pediatricians.

It's not a new idea. My colleague Kathy Lorenzato, a music therapist, has been teaching and practicing Reiki, a hands-on healing technique, for over 10 years, and I have joined her for the last 4 years. As far as integrative therapies go inside the hospital, at the moment, we're it.

With this in mind, the two of us were invited to speak to our pediatric physicians on staff about art therapy, music therapy and Reiki. I made a PowerPoint to explain the use of art in palliative care and put together a resource list on other integrative therapies.

It sounds simple on the surface, but as my husband noted, trying to explain the value of therapies whose effects cannot be quantified, to a group of science oriented folks, made me more than a bit nervous.

That's where my own art therapy came into play. Over the last couple of weeks, I participated in a Paper Swap organized by Gretchen Miller of 6 Degrees 2. I mailed my offering to an artist living in Missouri and looked forward to receiving an envelope of my own in return.

Days passed while I worked on the PowerPoint and my anxiety rose accordingly. Raised in a family with a healthy number of doctors, I've had some run ins with scientific minds and I've always felt myself lacking. Although art therapy requires a certain amount of intellectual engagement, I depend more heavily on my intuition, letting passion do the heavy lifting.

One day last week at the peak of my fear, a large padded envelope arrived, postmarked Australia. I opened it carefully and sifted through the contents; feathery tissue, textured rice papers, leaves of patterned scrapbooking pages and a packet of gaily colored buttons.

I considered the colors and shapes sitting on my lap and something shifted internally. As I touched the papers, taking in the colors, patterns and textures,  my fear eased. I realized that "right here, right now" on my couch I was experiencing the tangible results of art therapy.

I went into the presentation 2 days later with an insight. Rather than seeing the doctors as a group of individuals whose opinions I wanted to change, I saw an opportunity to heal the split between my own thinking and feeling, between the intellectual and the artistic.

I stood on the podium, praying the memory stick and my own memory would work. As I looked at the slide of a patient's artwork projected behind me, I remembered the joy I felt working with him--but I also remembered the research, the effort that others had gone to, in order to document the effectiveness of art therapy. Research that is necessary for art therapy to be accepted into the treatment team's fold.

The presentation went well. The physicians were attentive, and even better, I felt the old split inside me being carefully drawn back together. When our talk ended, we gave a Reiki demonstration. Up there on the dais, Kathy, one of the pediatric residents, our Child Psychiatrist and I offered Reiki treatments to four doctors who came forward. I felt the tide beginning to turn.

A Light Touch

I've been practicing watercolor for 7 months now, with my teacher, Stacey Vetter. As is my wont, I thought that I'd be seeing certain kinds of results earlier. It doesn't really matter what I'm doing, exercising, studying, making art--I always want things to happen overnight. In this case, I wanted to see how the watercolor painting would transfer over to my collage work.

Luckily, I did notice results with the watercolor, at least enough to keep me going and, just when I'd forgotten about what it was I wanted to happen, it began to do so. I am just beginning to understand how crucial a light touch is.

Previously in my art, I've worked hard to create a series of layers whether it is in fabric, collage, paint or even pencil. I want to show the history of marks, to leave tracks that hint at the evolution of the piece.

Now, as I begin to believe in the power of the light touch, I find myself applying the same process with collage. This morning after adding a layer of gel to a panel, I stood back, gazed at it and stripped away layers that had been softened by the gel. There was a moment that I caught a reflection of the piece's bones and I liked them.

It makes me think of Reiki, that hands on healing technique that we use in the hospital to help with pain and anxiety.

As I hold my hands in different positions on a person's body, I find myself thinking "What I am doing? Is this crazy?" And invariably after I say that to myself, I see the child relaxing, going to sleep, the room quiets and even the parents in the room settle down. One of the patients I worked on described the effects as "smoothing out the wrinkles of pain."--As if while the pain subsides, ripples of relaxation take over.

I can't help but notice the correlation between Reiki and watercolor.  Watercolor too is a smoothing and rippling-the sound and feel of the paint going onto the paper, the shush shush as the brush slides over the soft, stippled paper, brushing on color. And there's something else about the relationship between Reiki and art; both require a light touch. The less you work at it, the better it is.

6 Degrees of Progress

For the past several days, I've been working on a plan for my upcoming workshop: Still Point in a Changing World. My original idea for the workshop was to offer participants an opportunity to spend time in their studios, (whatever their definition of studio might be) on a daily basis for the period of 21 days.

A common notion states that a habit requires 21 days to set. (In actuality, some habits can take longer, but I thought that this time period would be  workable range in people's lives.)

I wanted the studio practice to be akin to a meditation practice; something that they could return to day after day from whatever flurry they found themselves in and locate a point of stillness.

It was inspired too, by my own practice of  watercolor, which I'd conceived in a time of hospital fatigue.

I'd wanted to do something simple, daily and beautiful, with which I could find refreshment, nourishment and tranquility. I found it in the watercolors..

However, I realized that I couldn't just say to workshop participants : "Ok, get yourself a box of watercolors, find something to paint and just keep it up for the next 21 days." Instead, I decided to read about mindfulness and creativity and found myself covered in reference books.

At the same time, the Jewish practice of the Counting the Omer began. (This ancient practice takes place between the holiday of Passover and the later harvest festival of Shavuot).

An artist friend of mine, Laura Hegfield, introduced me to a Facebook page entitled, "A Way In," where Counting the Omer has been re-imagined as an invitation to mindfulness practice: paying attention not only to each day as it passes but also to the individual spiritual qualities which were assigned to it by the 16th century Jewish mystics.

I became fascinated with the simple words and phrases which were offered up each day like a carefully crafted ceramic bowl.

I decided to weave some of the meditations (along with others from a variety of sources) together with prompts for each of the 21 days. Each day of the 21 day workshop will offer a meditation and studio practice for artists to explore.

I couldn't wait, so I decided to start experimenting myself.  I'm working on Day 10 and you can see the results above. If you're intrigued, you can register here for my workshop and discover what the rest of the days, and the other five workshops, have to offer.

Going Through, Not Passing Over

I've been thinking a lot about holidays this year, particularly the Jewish holiday of Passover.

Passover is a time of spiritual renewal, of looking back in order to see ahead. A broad theme of Passover is freedom, something so vast, that I've scarcely tried to contemplate it; being someone who prefers to find the macro in the close-by mundane.

I'm also someone who seeks to understand what spiritual traditions have in common rather than how they differ.

The Friday before the holiday weekend, I met a child in the hospital where I work whose artwork contained just these confluences of large and small, distant and nearby, to which I would add, past and present. This young six year old girl had lost her father to incarceration and her mother to death by addiction.

When I first heard about her, I wasn't sure what to expect. Certainly not the vibrant being who walked into the playroom eager to engage in the activity I had chosen: creating a paper Easter basket.

I like this activity because by creating a series of folds and cuts in a square piece of paper and manipulating them, you can create a real container.

Flora sat down and pulled one of the folded pieces over to her place and began to copy the words, "Happy Easter," onto one of the squares. With great detail and many felt tip markers, she painstakingly created designs and drawings on each surface of what would become the inside and the outside of the basket.

I find it intriguing that at this stage, while the child is painting or drawing, the inside and outside are not yet determined. Enclosure can go either way, depending what she chooses to do. A metaphorical exercise about the public and private selves.

At any rate, after Flora had filled both sides of the paper, I stapled her basket together-but she wasn't done quite yet. she took squares of soft, pastel patterned fleece and glued one to each surface of what had turned into the inside of the box.

She proudly showed me her basket, asking, "but where are the eggs?" I went on my own egg hunt and found several colored plastic eggs. I handed them to her and she tucked them into the bottom of her basket.

It seemed to me that this small child exquisitely exemplifies the theme of Passover. She lost her original home and was forced to leave for a new one (she is lovingly cared for by a relative); she had created her own safe transitional home in the basket.

Cultivating Patience

This week I've been thinking about the patients I see at work and the health changes I'm encountering in my own life as I go through the proverbial aging process. I've made a conscious decision to not be one of those people who ruminates and makes a running commentary on their health.

And yet, it's hard to have patience with myself as I wind my way through my 50s.  Who among us can really say we have patience with ourselves? Patience with others maybe, sick children at work definitely, but not our own physical deficits.

Then one day, I had a "driveway moment" while listening to NPR's Talk of the Nation last week. Allan Lokos, a psychologist and Buddhist was speaking on patience: "...the body is changing. And we look in the mirror and we realize one day, oh, the muscle tone is not what it was. And sometimes, we can become very angry at our own body, impatient with ourselves. And I think it's very important to realize, that is the nature of the body. Everything is changing; the body is changing. So why not go with that so that we don't go to the finish line just resisting and unhappy, but going with what is natural order instead?"

Listening to the words melted something inside me, that part that has no patience with my own shortcomings. I decided if that if patience was what I needed to be able to work and thrive, then I could be kinder to myself. And by showing myself kindness, I could reflect that kindness outward to others and through my art.

Here are some of this week's watercolors, painted while I practiced patience.

Inscribing a Circle

I've been drawing circles since I was four, but my fascination with them as an art form dates back to to the 80's in front of an ashram in Oakland, CA, where, just outside the door, I saw a most astonishing drawing done in a rich array of vibrant colors all contained in a circle.

Ritual rangoli done in powdered pigments

These circles, called rangolis, were done for religious or healing ceremonies. As an artist, I ached to be able to do something like this and after some investigation, came upon the mandala (the Sanskrit word for circle), an art form with a long history across many cultures. Like the rangoli, it is art created created for ritual purposes in a circular form and these days, also employed in art therapy.

New Years Mandala, ©2008, Hannah Hunter, Collage

So, while I've been painting, collaging, and inscribing these geometric discs for years, nothing could have prepared me for the excitement about the circle that recently burst upon the art scene in the form of Damian Hirst's spots.

I started poking around and pretty soon I discovered that I could make a distinction between a circle and a spot. It's strictly my interpretation, but the way I see it is that the spot is just that: a rounded mark or splotch made by foreign matter. It seems to have arrived in a rather casual manner.

Spots tossed on a watercolor in the studio, photo by Amelia McSweeny

The circle on the other hand is a closed line, something inscribed in which all the points on the line lie at the same distance from the center. It seems intentional, elegant, something that shows up in nature, but also something that 3 and 4-year olds begin drawing as they enter into the world of representation. The circle is one of the early building blocks.

Rose Colored Egg, ©1998, Hannah Hunter, Colored pencil

I looked up on my studio wall, where all three current pieces are iterations of the circle, so I tried to dig a bit deeper to see what was so fascinating-- and, what keeps me returning to them as a form decade after decade.

Rice Bowl, ©2012, Hannah Hunter, Collage

I'm reminded of something that another blogger, Gwyneth Leech, said in a recent post, "Spots Before My Eyes...:""...there is the infinite variety of things, then there is an infinite variation of one thing." A circle suggests eternity (think of a ring), something bigger than myself, time layered upon itself, the pleasure in creating a multitude of variations on a theme.

Zodiac Season, ©2010, Hannah Hunter, Collage

The idea that each circle can both be the same yet different; it's own infinite, elegant universe is  powerful. A 3-year taps into these infinite possibilities without fear or the preconceived notions of adults. When I began this post I thought that I'd be arguing for the integrity of the circle, but now that I've experienced spots and dots á la Hirst (and, for a great post on spots, see Joanne Mattera's  "Connecting the Dots), I'm looking to get rid of some of my trepidation and preconceived notions, and hopefully, adopt some of the spot philosophy too.

I know that many of you have had fun in the studio with circles, spots and dots--if you have any stories or images you'd like to share I'd love to hear from you.

Mindfulness at Play

Have you ever felt the axis of your life shifting? Last year I was deeply focused on my artwork, with art therapy a bit out of focus.

As the year has turned, however, so has my attention. For many years, I relied on observations of my own children's developmental stages to help me understand the children with whom I worked.

Now, with my own children navigating the waters of young adulthood, I no longer have that framework to depend on. While the memories are there, I need to stay fresh in my art therapy practice.

With that in mind, I've been re-infusing my knowledge of art therapy and child development by lots of reading, particularly on the Art Therapy Alliance group threads on LinkedIn.

I've been particularly intrigued by the development of Cathy Malchiodi's "Trauma Informed Practices Institute." In her recent newsletter, she lays out some of the core foundations for integrating mindfulness practice and positive psychology into art therapy.

"Making art can help us become mindful in the moment, just like when one learns to be present in the moment through the practice of mindfulness meditation. In art therapy, we often speak of that moment in art making when "flow" occurs-- an experience of losing oneself in the experience, but at the same time being present and engaged in the process. Being in the flow state can help you become more relaxed and begin to observe yourself in new ways. Art expression itself is a way of creating something new from what you already have, but may not have fully recognized within yourself."

Observing the children on the unit, I would say that the flow state has more and more been relegated  to the world of Wii, Playstation 3 and Nintendo. While there is value in learning to control the actions of characters on screen, I have a personal bias. I think it is just as exciting and possibly more so to be able to affect actions with one's own hands in our three dimensional world.

In other words, how do we help children find their way into the flow state with art, music, dance and other forms of creative expression? That's the question I'll be asking of myself in the next few months as I craft art activities which stimulate that sense of flow. I'll also be looking forward to attending Cathy's class this March in San Francisco: Enhancing Resilience Through Trauma Informed Practices: Positive Psychology and Mindfulness Based Art Approaches.

For a treat, if you click here, you will find a podcast containing a wonderful talk with Oxford psychologist, Mark Williams and a short 3 minute mindfulness meditation that made my day.

Prelude to Mother's Day

Waters of Life, ©2003, H.Hunter, 11" x 15," Collage

It was Bring Your Child to Work Day last week, a day parents working at our hospital bring along their children, in order to explore careers in healthcare. We had speakers, tours and tables all set up to teach kids about a multitude of possible futures.

My assignment was clear: meet the oncoming wave of children, 50 or so, with a quick description of what it means to be an art therapist. A Twitter dilemma if I ever saw one. (Describe what I do in 140 characters or less.) In addition, I offered them an art therapy activity.

I wanted to engage the kids, find out what they might wish to do when they grew up, recognizing any answer is a work in progress.

To that end, I had a collection of muslin dolls, ready to be drawn upon in whatever way a child's dream might dictate. Most of the children wanted to grab the doll and go (and what would you want with a naked baby doll, I ask you?) I politely let them know the talk was part of the bargain. No art, no doll.

My invitation was often initially met with a blank stare, but when I motioned them over to join other kids at a table filled with fabric markers, more colored pens began to "tatoo" muslin skins, transforming the blank "canvas" of that doll into a future self.

It was marvelous and all types of dolls emerged--nurses and doctor dolls of course, but also singers, computer geeks and pharmacists. I was so happy that the children felt that they were able to supplement the ample information that they'd heard with a chance to internalize their knowledge. Perhaps some expressed a dormant desire, a curious inclination just waiting for the opportunity to emerge.

It's taken a long time for me to lean into my future. As a child on the playground, I was often stumped when we talked about what we wanted to be when we grew up. The presumed careers for girls, teaching and nursing, did not feel right. But sitting behind the table last week, wearing a bright pink sweater and sparkly earrings, I felt I was embodying the self that had been waiting all those years ago, an artist, who uses art as medicine.

Finding Sanctuary

Where I Live, ©2000, H. Hunter, 15" x 18", Acrylic, Caran d'ache on paper

Where do you find sanctuary?

I began to ask myself this question after a Trauma Informed Art Therapy Course I took last week in San Francisco.

When working with trauma victims, creating a sense of safety, or in other words, a sanctuary, becomes your top priority.

But how to do that? How to find safety in the midst of physical and/or emotional pain?

There are tried and true art therapy activities, but I wanted to go a bit deeper. The word "sanctuary" made me think of the Jewish practice of Shabbat. Rabbi Abraham Joshua Heschel, a 20th century theologian, wrote about Shabbat as "a cathedral in time"--a "place" in time rather than space in which a person could could learn to rest.

In other words, sanctuary could be a state of mind rather than an actual place. I began to ask people how they find sanctuary. Some of their answers:

"Sanctuary is being with my family, watching Dad make spaghetti and then sitting around the table eating it together."  "Sanctuary is when my whole family is home and I can close the blinds and we are together and the rest of the world is outside." "Sanctuary is running."  "Sanctuary is my new kitten."

I took advantage of the art groups I facilitated and asked people to make collages of their sanctuaries and the guardians of these places. What emerged surprised me:

A gorilla with wise eyes staring out of the picture surrounded by bits of colorful pieces of quilts. The eye of a tiger surrounded by spring green fronds of leaves. The plain of a desert with two yucca plants in bloom. A home built on the foundation of chocolate chip cookies.

In almost all the images, nature played a central role. It didn't seem to matter whether someone had ready access to nature, it was the time spent imagining and creating the image of a place that evoked a sense of restfulness.

It seems that with the ever increasing pace and pressures of modern life, this kind of sanctuary is more important than ever--a pause we take that allows us to touch base with something more primal and tangible. I'm curious how many of you use art as a refuge?  If not, how do you find sanctuary?