Phototherapy: Academic and Clinical Explorations - Feature

Afterimage, Nov-Dec, 2001 by Ellen G. Horovitz

In the mid 1990s, while pursuing my doctoral degree, I enrolled in a five-day poetry workshop led by the eminent Dr. Carol Barrett. Conducted at the UCLA campus, this was an opportunity to retreat into the poetic ministries of the written word. While going through this training, one of the exercises chosen by Barrett was to hand out two or three index cards, each containing one random line of text from myriad resources (journals, newspapers, magazines). From these cards, we were instructed to create a poem in less than 10 minutes. The poem, which I penned, became one of the most telling dips into phototherapy that I had ever written: The phrases that I arbitrarily received were "I used to come here as a child" and "But what of the things we left." This verse contained hidden clues as to how I made sense of my childhood by combing over pictures of my youth and family:

The mahogany drawer

I used to come here as a child--

that long, dank narrow space,

looming inside my mind.

I sorted through pictures of your memory;

the only thing worth preserving that I kept.

I used to come here as a child--

that mahogany, bottom drawer,

replete with glossy photos, embedded

with your history.

I used to come here as a child--

and pretend that your black and

white existence would lend glossy

texture to my tattered and broken heart.

I used to come here as a child--

and sift through the sea of photographs

that lined the walnut-stained images

of my sepia-toned hues of your color.

I used to come here as a child--

and bury myself in the comfort of your memory,

more real than any

that you left me.

Yes, I used to come here as a child--

always hoping, praying, to find you

real in those long-ago places,

now buried in your institutionalized,

and vapid mind.

I used to come here as a child--

but no longer do I visit that ebony rimmed,

mahogany container that was you.

But what of the things we left?

After I wrote this poem, I was stunned by its evocative nature and what it unleashed in my core. This concretized how photographic images reveal our history and our biology. Later, I expanded on that theory in my second text. (1)

Soon after that workshop, I found myself teaching my first phototherapy class. New to this particular venue, I scoured the research and read the more historical texts of David Krauss and Jerry Fryrear (2) and Fryrear and Irene Corbit. (3) But it wasn't until I read the work of Judy Weiser that I really understood the genre of phototherapy in which I had been operating. (4) The beauty of phototherapy, which can be understood as a variety of ideologies that examine pictures of one's past as well as creating pictures/photographs/sculptures/videos from one's current perspective, is that the work inherently has the "ability to immediately trigger memories, trigger affect, put the client back into that feeling state" in a way that no other medium can. (5) As an art therapy clinician, I have patients with complex etiologies such as Asperger's syndrome, autism, and aphasia of varying typology. Indeed, I have repeatedly witnessed the power of photographic images in accelerating recovery in these often unreachable pati ents. But, as Weiser suggests, from an historical viewpoint, it is indeed understandable: We can only be aware of ourselves to the extent that we can self-reflect; our existence at any moment is a summary of selective memory and, within the distortive nature of that process, also a partial fiction created only by what we can know of ourselves and have introjected from others. (6)

This is especially true when working with people who have temporarily lost their memory (for example through traumatic brain injury) as well as those who are enduring the cruel reality of the varying stages of Alzheimer's and dementia. Not being able to recall one's history is a callous existence that impacts not only the individual suffering from this altered state but also that person's loved ones. Truly, phototherapy can be used in the treatment of almost any kind of affliction. It is especially useful when working on death-related trauma and loss. I have been incorporating familial photographs of clients to advance mourning and loss issues for over 20 years and the evocative power of a photograph can kick through the most hardened defenses and veneers. It can be used as the medium of choice or even a jolt for digging into deeper recesses toward wellness and recovery.

The old maxim "a picture is worth a thousand words" has obvious meaning when working with non-verbal clients. Photographs coupled with music can also stimulate untold emotive responses. Just look to the power behind a musical score coupled with a photographic scene in a movie. Paired with just the right music, even a deftly woven, 30-second commercial advertisement broadcast on television can reduce the masses into mush.

Perhaps the reason behind such powerful craft lies in the archetypes that we assign to these images. For whatever reason, photographic images have been used throughout time to affect the masses from psychology (The Thematic Apperception Test--a projective test where one makes up a story about each photographic image that is presented) to current day cinematography. The image is and always will be a most powerful and therapeutic avenue for exploring emotions. Looking at a photographic image, one goes back in time to that exact place and perspective where the image was taken. Little else can move a person so close to recovering memory.