Tag Archive | art therapy

Paranoid schizophrenics I’ve known


Esteban Santiago in custody

Esteban Santiago, the lone gunman who killed five innocent strangers and wounded six more at the Fort Lauderdale airport on January 6th, had sought help from the government in November. He walked into an FBI office in Anchorage, Alaska, claiming that the U.S. government was controlling his mind and forcing him to watch Islamic State videos. Agents called police and he was taken for a mental health evaluation, but he didn’t appear intent on harming anyone, so he slipped through the cracks in the system. Two months later, he officially became a murderer.

His delusional claims brought back memories of my years working on locked wards with seriously ill patients at Hudson River Psychiatric Center in Poughkeepsie. With my hard-earned master’s degree in art therapy from New York University, I was embarking on my first full-time job in mental health, and I was especially fascinated by the elaborate delusions of those diagnosed as paranoid schizophrenic. The men on Ward 604 ranged in age from their late teens to early middle age and they were on the maximum-security ward because they were considered a danger to themselves or others. Some were assaultive, others had prison records, and there were a couple of murderers.


Abandoned Rehab Center at HRPC. I led an evening Creative Arts Club here for those allowed to leave the wards.

This was the 1980’s, and like many state mental hospitals across the country, Hudson River was rapidly being downsized as patients were discharged into the community, presumably to be managed through outpatient services and medication. But some were deemed too dangerous for discharge, and others cycled in and out through the system’s revolving doors.

Some of the paranoid schizophrenics believed they took their orders from God or the government, while a few believed they actually were God or at least Jesus. One young man believed he had turned into a woman and had sex with John Lennon. (This was in early 1980, before John was brutally murdered.) I couldn’t resist replying, in my best nonjudgmental therapeutic manner, “Oh, do you want to tell me about that? What was it like?” Unfortunately I can’t recall his reply.

I encouraged the patients to get their visions down on paper, with pencils or paint, and to talk or write about what the images meant to them. As an art therapist, I’d been trained not to impose my own interpretations aloud, but I’d learned to analyze the pathologies revealed by their artwork, to record them in progress notes and to report disturbing content to their shrinks and treatment teams. Often the imagery was violent, replete with swords, guns, blood and dismemberment. Yet not once did a patient assault me or even verbally threaten me. I was their ally, there to foster their creativity and self-expression, not to impose controls on them.


Abandoned day room, Cheney Building, HRPC–much like the one where I held art therapy sessions

Hudson River closed years ago, and I’ve often wondered what became of those patients who were incapable of adjusting to life in the community. Like thousands of others, many probably ended up in prison, homeless or dead. Deinstitutionalization hasn’t been the panacea it was touted as being, and there aren’t enough affordable community mental health services to go around.


Esteban Santiago in Iraq

Esteban Santiago was receiving psychological treatment in Alaska, but his family wasn’t privy to the details. Clearly it wasn’t enough, but maybe nothing could have stopped his deadly rampage. Since he surrendered and survived, maybe he’ll be able to shed some light on his actions.

Two days after the shooting, I began this blog post as a potential op ed piece for the Albany Times Union, but then I realized that my viewpoint wasn’t sufficiently clear, so I put it aside. A day after that, the TU introduced a new, reduced format, with certain features shortened or omitted. The two Perspective pages, with their generous space for columns, both national and local, went on the chopping block. Now they might not have space for my essay in any event, so I decided to post it here. Since I’m no longer limited to 600 words, I can be a bit more freewheeling—if I were aiming for publication in the TU, I wouldn’t have mentioned the patient who believed he’d fucked John Lennon.

I have mixed emotions about hospitalization for the mentally ill, especially those who are truly a danger to themselves or others. Deinstitutionalization was supposed to be a good thing, and those enormous old hospitals were portrayed in the public eye as hideous snake pits. But Hudson River Psychiatric Center was a fairly benign and yes, therapeutic environment. If it weren’t, I could never have worked there for 13 years, enough to get me vested in the New York State retirement system that helps sustain me now.

The patients at Hudson River inspired me to embark on my first novel, then titled The Flip Side. It was good enough to win me some personalized and encouraging rejection letters, and eventually a good agent in Manhattan, but alas, she never sold it. It remains unpublished, but who knows, I may resurrect it one of these days.

Meanwhile, I sometimes wonder what became of those fascinating guys on Ward 604. Did they eventually get discharged and adjust to life in the community? More likely they died young or landed in prison.


Main building at HRPC burning in May, 2007

TGIF Blog Party – you’re cordially invited!

CocktailParty Anon painting Wash PostFriday’s officially my day for guest bloggers, but I haven’t had time to choose someone and pull together a coherent post, so I’m throwing a party instead. As Alan Jackson and Jimmy Buffett would sing, “Pour me something tall and strong – it’s five o’clock somewhere!” Stop in, bring your favorite dish, and introduce yourself – the party will run all weekend. I’m bringing pasta with my raunchy homemade pesto featuring basil from my garden and a big box of Franzia chardonnay (when it comes to wine, I’m cheap and easy.)

I borrowed this idea from Alexis Grant, who got it from literary agent Rachelle Gardner, but in keeping with my former career as an art therapist, I’m adding my own twist with a little creative visualization. Writers, envision yourself at a great cocktail party at your favorite conference. Personally, I’m picturing the party the Mystery Writers of America throw after their Alex Katz the-cocktail-partyEdgars Symposium in New York City. Now imagine you’re introduced to someone you’ve always wanted to meet – a top agent, maybe, or your favorite author. You’ve got only a minute or two to captivate them so much that they’ll be dying to read your book.


Okay, now write down that speech and post it here as a comment! Be sure to include a link to your website or blog if you have one. But you don’t have to be a writer to join the party – readers of all persuasions are welcome too! Come on in out of lurking mode and let us hear from you. I hope we can all discover some folks we’d like to know better.

If there’s something exciting going on in your life that you’d love to share, feel free to do that too. I’ll start: I’ve been spending much of the week in Woodstock helping my daughter Stacey paint the rooms in her new house. Her daughters, Kaya, age 10 and Jasper, age 3, spent the past week with the other grandparents in Connecticut, so the moving and painting blitz could happen without distraction. But they’re driving the kids back today, and we’ll all converge on the house this afternoon. It’ll be the girls’ first night sleeping in their new home. I’m hoping Kaya will like the celadon green we picked for her room, and we’re pretty sure Jasper will love her pale pink walls. On the way there, my husband and I will pick up a fancy cake and get an appropriate message inscribed.

The day will be especially meaningful because Stacey’s husband, Adam, died unexpectedly on August 25th last year. As you can imagine, they’ve been through a difficult journey since then, and it’s marvelous that they have the chance to celebrate this new beginning. Sometimes the joys of family surpass the pleasures of the writing life.

Talking back to your inner critic – an exercise in creativity

Writing about dreamwork yesterday, I got to thinking about other techniques and exercises I’ve used as a creative arts therapist. Back in the 1980’s, I gave numerous workshops at colleges and growth centers in the Hudson Valley – “Empowering Yourself through Creative Art Therapy,” that sort of thing. I even taught at Omega Institute for a couple of years.

Here’s another exercise you may be able to use. As writers, probably most  of us have negative thoughts and voices running through our heads. Some of my own:

This work is a pile of crap . . . .I’m never going to get anywhere . . . .I might as well give up . . . . I just don’t have the talent . . .

I’m sure you can add many of your own, but there are ways to exorcise these messages. I used this one many times as a guided visualization, but you can do it on your own. If you like, you can record it and play it back to yourself, or have a friend read it to you and take turns. Here goes . . .

Get comfortable, relax and close your eyes. Focus on your breathing . . .(Here you can use any type of relaxation induction that works for you, for a minute or two.)

Picture yourself working in your ideal studio. This might be your regular writing space, or it might be a space you create in your imagination. Perhaps you’re writing, or perhaps you’re practicing another art form you love or that you’d like to try. Take some time to visualize yourself in this space. What are you creating? Whatever it is, you’re feeling very pleased with it. (Pause)

Suddenly there’s a knock on the door. You stop working, go and open the door. It’s your critic. Who is this person? (Pause) You invite them into your space to show them your work. Now imagine what they say, and what you say in return. Imagine a dialogue between the two of you . . .

Now give them a final message, say goodbye and usher them out the door. . . In your own time, come back to the present space and open your eyes.

In an actual workshop, at this point I would have people make drawings or paintings about the experience, then share in a group discussion. I might also encourage them to write down the dialogue they had with the critic and maybe expand on it and carry it further, or maybe get into some sociodrama and have them act out the scene with another person.

When people meet “the critic at the door,” they come up with many different characters. Most often it’s a parent; often it’s an influential teacher from their past. Occasionally it’s someone well known, an artist or writer, or an unknown figure of some kind. Note that the phrase “your critic” is neutral – neither positive nor negative. Critics can give either rave reviews or bad ones. With people I’ve worked with, though, 20% or less have encountered positive critics, people who say, “That’s great, I love it – keep up the good work.” For most of us, the critics are negative.

I hope I’ve given you some helpful hints on banishing your inner critics if they’re evil, and cheering them on if they’re good. I’d love to hear from you – who are your inner critics?