Imagining Animals
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Imagining Animals

Art, Psychotherapy and Primitive States of Mind

Caroline Case

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Imagining Animals

Art, Psychotherapy and Primitive States of Mind

Caroline Case

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About This Book

Imagining Animals explores the making of animal images in art therapy and child psychotherapy. It examines two contrasting primitive states of mind: the investing of the world about us with life through animism and participation mystique, and the lifeless world of autistic states of mind encountered in children who are hard to reach.

Caroline Case examines how the emergence of animal imagery in therapy can act as a powerful catalyst for children in autistic states of mind, or with a background of trauma, abuse or depression. She also looks at animal / human relationships, and animal symbolism, as well as three-dimensional claywork and the development of personality. Subjects covered include:

* animals on stage in therapy - anthropomorphic animal objects
* the location of self in animals
* entangled and confusional children: analytical approaches to psychotic thinking and autistic features in childhood.

The book concludes with a compelling extended case study, which describes analytic work with a child with multiple symptoms, using the various therapeutic tools of play and art, painting and clay, and the development of character, plot and narrative.
Imagining Animals offers a unique insight into the role and representation of animal imagery in art therapy and child psychotherapy, which will be of interest to all arts and play therapists working with children as well as adult psychotherapists interested in the use of imagery.

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Part I
Working with children who are hard to reach

Introduction: working with children who are hard to reach

This book brings together some apparently divergent themes that emerged in my early career as an art teacher, then work as an art therapist for over thirty years and as a child psychotherapist for ten years. The clinical work took place in the statutory services of education, social services and child and family health, but also in charitable foundations and private practice. These have not been described in detail, in order to aid confidentiality for the children and parents who kindly gave permission for their material to be included in the book.
The children described in the book encompass some different aspects of being hard to reach in clinical work, in that they have lived through situations where hope has been lost. Two of the children, Colin and Lucy, came from backgrounds of neglect with known physical abuse (Colin) and suspected sexual abuse (Colin and Lucy); both had parents living in hard drug cultures. Two of the children, Henry and Sally, had had early environments where there had been prolonged maternal depression, following traumatic bereavements. Henry was referred following delinquent behaviour, and Sally with a puzzling combination of symptoms. Several of the children had had adverse circumstances around their births; Simon had been a premature baby, born with fears for his own and his mother’s life, Wendy and Ian had been born with fear and expectation that they might be handicapped. The children in Chapter four presented differently, and are included in the book to illustrate some other aspects of closeness and separation, on the theme of duality-unity. They had sleep difficulties, and were characterised by being extremely sensitive; Rebecca, Ian, Alice and Lizzy. The work with Sally, which forms the core of Part three gives a narrative of her therapy, a child with a mother with prolonged depression due to adverse circumstances in her own childhood and bereavement trauma. Sally was referred with symptoms including: learning difficulties, autistic traits, muteness, incontinence and speech difficulties.

Theoretical Approach

The theoretical approach which informs the work with the children and their families is psychodynamic, synthesising certain aspects of art therapy and child psychotherapy. The focus is on interaction through play and the making of images in therapy. Central to this is the knowledge through my own art work, sculpture and painting, that art both expresses and finds forms for feelings but is most importantly a way of thinking and reflecting on life experiences nonverbally. Images, both metaphorical and concrete, are the building blocks of emotional learning, expressions of felt life. This develops in parallel to verbal, abstract modes of naming and thinking.
Stern (1985) writes that, poetry aside, language usually focuses on one sensory mode, thus fracturing the amodal global experience of the child. With the advent of language the infant gains entrance to a wider cultural membership, but at the risk of losing the force and wholeness of original experience. Stern explores the slippage between personal world knowledge and official or socialised world knowledge as encoded in language, because the slippage between these two is one of the main ways in which reality and fantasy can begin to diverge.
Infants’ initial interpersonal knowledge is mainly unshareable, amodal, instance-specific, and attuned to nonverbal behaviours in which no-one channel of communication has privileged status with regard to accountability or ownership. Language changes all of that. With its emergence, infants become estranged from direct contact with their own personal experience. Language forces a space between interpersonal experience: as lived and as represented. And it is exactly across this space that the connections and associations that constitute neurotic behaviour may form. But also with language, infants for the first time can share their personal experience of the world with others, including ‘being with’ others in intimacy, isolation, loneliness, fear, awe, and love.
(Stern 1985: 182)
Thus language has a dimension that can betray experience and a dimension that can give a voice to experience. In my work, emphasis is given to inner phantasy life as well as external experiences. The influences on my development as an art therapist began with the experience of working with Edward Adamson, a studio-based model; to be followed by work with Diana Halliday and Michael Edwards which gave a Jungian perspective. Later, training as a child psychotherapist in the Kleinian/British Independent tradition, helped me to think about the inner and outer world of the child, and the formation of states of mind, that we may meet in therapy. In child psychotherapy training, shared subjectivity (outside the dynamics around the image) was the main focus, working within the transference/countertransference dynamic.
The children whose clinical work is drawn upon (except Chapter five) were all referred because of my dual qualification, and were considered to be hard to reach. It was hoped that working with images and play might enable them to find a voice of their own, and it is these explorations which form the basis of the book. In the world of therapy organisations, where the boundaries are hard fought, as to who is in and who is out of the moral circle, a plural approach may seem provocative, and arouses anxiety. Britton, writing about publication anxiety, mentions anxieties about affiliation, and ancestral figures, as well as a need for affirmation of shared ideas and declarations of shared origins (Britton 1997). When confronted with a hard to reach child, in distress to themselves and their family, we need to think, what is it that might work here, or be a catalyst for change. This led to an adaptation of technique.
Art therapists work in many different settings, some of which have been described in a previous publication (Case and Dalley 1992). Here, a traditional studio setting will be contrasted with a traditional child psychotherapy room. A traditional studio setting is a working art studio in that, art materials, work in progress from different clients, sometimes the art therapist’s own work may be visible; one enters a workshop which is visually stimulating and sensuously engaging in terms of what can be seen, smelt and touched. Clients will each have a storage folder, but work may also be on display on the walls. A traditional child psychotherapy room will have a couch, table and chairs, it may or may not have a sink, doll’s house or sand tray, but it will have a box of age-appropriate toys for each child, that are for their sole use. The furnishings and walls are kept very plain with no personal items of the therapist with the intention not to excite curiosity or because items may need protection (Hartnup 1999). Some therapists prefer a bare room so that the child can structure the interaction with greater freedom. The two disciplines share a similar understanding of therapeutic boundaries but are contrasted, with the former giving an invitation to use art materials (within a relationship) and the latter an invitation towards interaction personally or through play (the box of materials). The combined approach was to take art materials and play materials for the child’s individual use; with a shared sand tray, and sink for water. This helped to reach neglected deprived children, in that these materials were for their sole use. The art materials frequently worked on a sensual level, to engage the child, where there had been deprivation. The outbursts of aggression from children who had been physically abused in the past and from children struggling with separation rage meant that if they destroyed play or art materials, then, as long as they and the therapist were kept safe, then no one else would be affected. The child enters into the therapist’s space in the therapy room. Personal items of the therapist are better left outside but it is important that a receptive environment which is warm and visually stimulating even to a small degree is available, so that a colourful rug, tissues, a blanket, clock and pictures on the walls give a visual communication of warm containment. Some children are able to work very well within a traditional art therapy studio or room, or within a traditional child psychotherapy room. Others, I suggest, benefit from a combined approach. Their own box of toys and box of art materials correspond to the inner core of the self, and are for their own use, and I resist temptations to be drawn into doing the work for them by painting or drawing; at the same time offering every support to their taking these first steps on their own.
Before outlining the chapters a brief excursion will be made into the impact of neurological research on our understanding of the development of the brain and the implications for therapy, followed by a consideration of psychodynamic theory and primitive states of mind.

The Findings of Neurological Research and Our Understanding of Trauma, Neglect and Maternal Depression

In the last fifteen years, since Working with Children in Art Therapy was first published, there has been a blossoming of research, by neurobiologists, into the workings of the brain and the way that it is formed through early experiences (Case and Dalley 1990). Pally (2000), gives an accessible overview in The Mind-Brain Relationship. Balbernie (2001) writes: ‘A baby’s developing brain is damaged when exposed to neglect, trauma, and abuse, and prolonged maternal depression’ (2001: 249). First of all, neglect, has been seen to cause actual damage to the developing brain by the failure of the needed stimulus at the right time, so that neural pathways atrophy. Further, actual trauma, which initiates primitive flight/fight or freezing responses, fosters these patterns of response over the more elaborate reflective processes, where thought takes precedence over action. Child abuse and neglect can directly shape the way that the brain is programmed during crucial early years when there is intense synapse production (Schore 2001a; Glaser 2000), and have negative long-term effects (Nelson and Bosquet 2000). The very malleability of the mind, an adaptability which aids our survival, means that it will adapt to the conditions it finds itself in, and then keep responding in these ways, as neural pathways have developed, even when no longer in the neglectful situation. This means, in adverse attachments for example, that a foster child will continue to respond as if they are with an abusive parent, even when with caring foster parents.
The quality of the baby’s emotional relationship with its mother/caregiver is crucial: ‘Research suggests that emotion operates as a central organising process within the brain. In this way, an individual’s ability to organise emotions – a product in part of earlier attachment relationships – directly shapes the ability of the mind to integrate experience and to adapt to future stressors’ (Seigal 1999: 4, in Balbernie 2001). An infant’s brain is shaped by emotional interactions with the mature brain of the caregiver (Seigal 1999), so that ‘for the developing infant the mother essentially is the environment’ (Schore 1994: 78). The brain starts life with multi-potentialities in development. The early use of the brain within the co-created environment between mother and child and the wider circle about them will foster the growth of use-dependant pathways (Perry et al. 1995). Reflections and understandings of the baby’s emotional life by the mother will be mirrored in mind development in the baby. In this way the orbital cortex which is the place of reflective thought will develop in the child: ‘The orbitofrontal cortex is known to play an essential role in the processing of interpersonal signals necessary for the initiation of social interactions between individuals’ (Schore 2001b: 36).
The orbitofrontal cortex mediates empathic and emotional relatedness; or attuned communication. It contributes to generating self-awareness, personal identity, episodic memory and the ability to imagine oneself in the future or to remember oneself in the past (Balbernie 2001). Particularly in the right hemisphere, functions develop which control emotion, and appraise incoming stimuli and interpersonal communications: in fact it is here that the emotions are managed.
However in adverse circumstances of neglect, abuse and trauma, there will be a failure in such development. This will lead to a huge range of problems and presentations such as withdrawnness and dissociation, or distractibility and poor impulse control (Perry et al. 1995). Neglect leads to a lack of sensory stimulus, whereas trauma, the overactivation of important neural systems during sensitive periods of development, leads to hyperarousal (which initially may bring help), but changes to immobility, freezing, dissociation, or fainting: a ‘surrender’ response. ‘Traumatised children use a variety of dissociative techniques. Children report going to a “different place”, assuming persona of heroes or animals, “a sense of watching a movie that I was in” or “just floating” – classic depersonalisation or derealisation reponses’ (Perry et al. 1995: 281; emphasis added).
Maternal depression is a form of unintended neglect (Zeanah et al. 1997). It is thought that babies exposed to short-term depression may recover but prolonged depression is damaging to the left frontal region of the cortex associated with outwardly directed emotions (Nelson and Bosquet 2000). Depressed mothers find it difficult to respond to the baby. For infants between the ages of six and eighteen months, having a depressed mother can lead to persisting emotional and cognitive difficulties for these infants (Murray 1997; Sinclair and Murray 1998; Balbernie 2001). Maternal depression affects mother–infant communication which plays a crucial role in protecting the child against mental or emotional disorders: ‘this position of communication is based on the specific adaptive relevance of communication in human evolution’ (Papousek and Papousek 1997: 38).
Mothers support the child’s development of symbolic capacities, and acquisition of language and this is adversely affected by maternal depression. Tronick and Weinberg (1997) posit the toxic effect of maternal depression on a child’s social and emotional functioning and development: ‘the human brain is inherently dyadic and is created through interactive exchanges’ (Tronick and Weinberg 1997: 73). A healthy mother and infant develop a model of mutual regulation which, if successful, allows the creation of dyadic states of consciousness allowing error and repair. Infants become aware of mother’s depression and become hypervigilant of mother’s emotional state in order to protect themselves; causing them to become emotionally restricted. In the dyadic mother–infant system, during maternal depression, the infant is deprived of the experience of expanding his or her states of consciousness in collaboration with mother. Instead they may take on elements of the mother’s depressed state, e.g. sadness, hostility, withdrawnness, and disengagement in order to form a larger dyadic system. In the service of growth the infant incorporates the mother’s depressed states of consciousness.
This research highlights the need for early intervention programmes. However, it is not too late for older children, which is the area of work encompassed in this book. It is possible for neural pathways to connect where previously there have been none; and it is possible for reflective thinking processes to develop in therapy but it is a slow and uphill task. Schore has emphasised that human learning takes place throughout the life-cycle; although a complete cure is unrealistic it is possible to repair some damage and improve the quality of relationship and therefore the future life of the child and their children. He maintains that ‘[T]he patient–therapist relationship acts as a growth promoting environment that supports the experience-dependant maturation of the right brain, especially those areas that have connections with the subcortical limbic structures that mediate emotional arousal’ (Schore 1994: 473, in Balbernie 2001).
Fonagy and Target (1998) suggest that there has been a shift in emphasis in psychoanalytic practice from a focus on the retrieval of forgotten experience to the creation of a meaningful narrative being considered as mutative. This echoes a move towards the interactional and interpersonal aspects of the work, working towards the development of a reflective function (Fonagy and Target 1997). Schore suggests that in therapy:
. . . nonverbal transference–countertransference interactions that take place at pre-conscious-unconscious levels represent right hemisphere to right hemisphere communications of fast-acting, automatic, regulated and dysregulated emotional states between patient and therapist. Transference events clearly occur during moments of emotional arousal, and recent neurobiological studies indicate that ‘attention is altered during emotional arousal such that there is a heightened sensitivity to cues related to the current emotional state’
(Lane et al. 1999: 986, in Schore 2001c: 315)
Resonance between the analyst and the patient’s unconscious then becomes of prime importance as they attune empathically. This suggests that the patient must have a vivid affective experience of the therapist (Amini et al. 1996, in Schore 2001c). In cases where there has been acute terror, neglect or depression, the natural environment, nature and the animal world, may act as a catalyst for the creation of images. The creation of images through art mediums can act as mediators, allowing movements towards a person to person relationship.

Psychodynamic Theory and Primitive States of Mind

In order for healthy emotional development to take place the baby needs a carer who is physically, emotionally and mentally receptive. Psychodynamic theory has made a huge contribution to understanding what happens when there is a failure of environment around the child in terms of unconscious primitive states of mind being uncontained. These then impact on all relationships and are shown in the ways that the child relates towards the therapist. If these primitive states of mind can be understood and contained, a new way of relating will develop towards the therapist and then, in relations in the external world. At this stage, thr...

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