Fears, Phobias, and Nightmares: Art Tasks for Conquering Anxiety Presenter: Vicki L. Williams-Patterson, MCAT, LPC-AT, ATR-BC Board Certified Art Therapist Licensed Professional Counselor – Art Therapy Specialization I. Basic concepts in the treatment of anxiety. A. Understanding the Anxiety-Fear continuum: Alert > Exited > Wary > Worried > Anxious > Tense > FREEZE > FLIGHT > FIGHT B. Assessing the nature of the threat: 1. Intensity & chronic nature 2. The art making process can enhance techniques that that you are already using with the added benefit of producing a concrete image that can be observed, contemplated, and re-worked. 3. Physical, emotional, cognitive, spiritual components of the threat. C. Assessing the context in which the threat took place 1. The client’s internal vulnerabilities such as damaged trust & poor selfesteem 2. The client’s external sources of additional stress such as multiple losses, disruptive social environment, and physical neglect D. Assessing the client’s general state: 1. Personality/ego strength 2. Physical and emotional health 3. Spirituality 4. Intelligence The art making process can enhance techniques that that you are already using with the added benefit of producing a concrete image that can be observed, contemplated, and reworked. The same benefit can be gained by observing any representation of artwork that is personally engaging (the art museum effect). II. Make anything! Art-making reduced both “state” anxiety & “trait” anxiety! A. Coloring a mandala design B. Free form painting - paint doodling C. Collage, especially with a positive theme D. Clay E. Drawing a still life III. Using art to facilitate the psycho-educational / cognitive behavioral process A. Images about anxiety – general education. 1. Causes (threats, phobia, expectations) 2. Common accompanying symptoms & emotions 3. Process of escalation (see section I) B. Drawing or painting anxiety – the personal experience 1. Physical sensations (shaking, sweat, numbness) Vicki L. Williams-Patterson, 2014

2. Thoughts (fears, irrational self talk, beliefs) 3. Situation (people, places, context) C. Drawing or painting coping techniques. 4. Progressive muscle relaxation 5. Cognitive reframing 6. Rational self talk D. Using clay (Play Doh, Model Magic, Air Dry Clay, Oil base/nondrying clay) 1. Make a ball; make a square relaxation 2. Eyes closed, using both hands – focused manipulation 3. Representing anything in A, B, C (above) E. Drawing response to guided imagery 1. Music 2. Safe place 3. Narrative – listening to a relaxing story IV. Mandala – still my favorite! A. Coloring a pre-drawn pattern B. Free form design within a pre-drawn circle C. Using natural objects D. Kaleido Free Ipad Ap E. White pencil/crayon/chalk on black paper F. My favorites “pizza” collage (circle with images that are appealing) V. Flow: Definition: (Cs´ıkszentmih´alyi, 1991) “ ‘flow’ as a state of complete absorption in an activity that produces an altered sense of time and release of vital energy. He called it flow because so many of the artists he interviewed used the metaphor of a current of water to describe their optimal experience.” Creating the optimal environment for the “flow” experience: 1. Acceptance: internal & external 2. Open ended with no expectations of results 3. Encouragement to be totally focused on the activity (stop talking) 4. Eliminating stress (HALT: hungry, angry, lonely, tired)

Bibliography Allen, P. B. (1995). Art Is a Way of Knowing: A Guide to Self-knowledge and Spiritual Fulfillment Through Creativity. Boston, MA: Shambhala Pubs. Bayles, D. & Orland, T. (2001). Art & Fear: Observations on the Perils (and rewards) of Artmaking. Santa Barbara, CA: Capra Press. Chambala, A. (2008) Anxiety and Art Therapy: Treatment in the Public Eye, Art Therapy: Journal of the American Art Therapy Association, 25:4, 187-189, DOI: 10.1080/07421656.2008.10129540 Cs ́ıkszentmiha ́lyi, M. (1991). Flow: The psychology of optimal experience. New York, NY: Harper Perennial Fincher, S.F. (1991). Creating Mandalas for Insight, Healing, & Self Expression. Boston, MA: Shambhala.

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Kapitan, L. (2013). Art Therapy's Sweet Spot Between Art, Anxiety, and the Flow Experience, Art Therapy: Journal of the American Art Therapy Association, 30:2, 54-55, DOI: 10.1080/07421656.2013.789761 Landgarten, H. B. (1994). Magazine Photo Collage: A Multicultural Assessment and Treatment Technique. NY: Brunner/Mazel. Sandmire, D. A., Gorham, S. R., Rankin, N. E. & Grimm, D. R. (2012). The Influence of Art Making on Anxiety: A Pilot Study, Art Therapy: Journal of the American Art Therapy Association, 29:2, 68-73, DOI: 10.1080/07421656.2012.683748 Sarid, O. & Huss, E. (2010). Trauma and acute stress disorder: A comparison between cognitive behavioral intervention and art therapy. The Arts in Psychotherapy, 37, 8–12. DOI:10.1016/j.aip.2009.11.004 van der Vennet, R. & Serice, S. (2012). Can Coloring Mandalas Reduce Anxiety? A Replication Study, Art Therapy: Journal of the American Art Therapy Association, 29:2, 87-92, DOI: 10.1080/07421656.2012.680047

Vicki L. Williams-Patterson, 2014

Art Therapy and the Use of Art in Counseling Art Therapy is a specific clinical modality regulated by the Texas State Board of Examiners of Professional Counselors under Title 22, Texas Administrative Code, Chapter 681.73. Preparation to become an LPC-AT includes, but isn’t limited to, a minimum of 21 semester hours or the equivalent of sequential course work in the history, theory, and practice of art therapy; documentation of successful completion of the Certification Examination in Art Therapy of the Art Therapy Credentials Board; and 1,000 to 2,000 client contact hours under supervision of a licensed professional counselor with an art therapy specialty designation. While the use of the term “Art Therapy” is restricted to Licensed Professional Counselors with the “AT” designation, the use of art in counseling by any Licensed Professional Counselor is permitted under the code and heartily encouraged by most Licensed Art Therapists. However, the use of any specific clinical modality should only be undertaken by licensed clinicians who have completed sufficient training and supervision in that modality. There is no official guideline for the amount of training in art therapy that an LPC should pursue in order to demonstrate competence with the modality. My suggestion is that any clinicians considering the effective use of art tasks in their counseling practice, should complete at least 180 continuing education hours (the equivalent of 12 semester hours) given by a LPC-AT, and consult regularly with an LPC-AT about their experiences (one hour of consultation per 10 hours of clinical use). Given that I am something of an “old fashioned” Art Psychotherapist, I would strongly encourage those intending to use art in their counseling practice, including Licensed Art Therapists, to regularly make self-expressive art and participate in experiential art therapy workshops. I also consider it unethical for clinicians to ask a client to engage in any art task that they, themselves, have not personally experienced. This is my expert clinical suggestion to you, my fellow clinicians. I hope that you will consider it carefully. Vicki Williams-Patterson, MCAT Licensed Professional Counselor – Art Therapy Board Certified Art Therapist

Vicki L. Williams-Patterson, 2014

Draw a design using lines, shapes and different colors inside the circle. Start at the center of the circle. When you are finished drawing, write three to five words that you think of while looking at your design.

Vicki L. Williams-Patterson, 2014