Wednesday, December 14, 2016

My Interview with an Art Therapist

The creative way some mothers are healing from postpartum issues and processing the emotional journeys of pregnancy, birth, and even infant loss & miscarriage.

What is "art therapy" and why would a pregnant woman or a woman who had suffered the loss of a child seek out this kind of therapy? Is it making art?  or is it a therapy session? These were the questions I had as mom and an artist myself.

This will be cross-posted on my other blog.

I sat down with Susan Jacobsen, a local Colorado Springs art therapist who holds a space for clients in the Cottonwood Center for the Arts. She answered my questions in the interview (full transcript below) and explains how her personal history drove her compassion for women seeking healing from trauma. Her work also helps those who are just looking to better their emotional wellness surrounding childbearing. 

After struggling through fertility issues, Susan became pregnant. Sadly, she lost her baby when doctors failed to diagnose her with HELLP, syndrome which led to serious complications.

Susan later became pregnant again and gave birth to her second son. 
"And so, as I was pregnant with Jens there was all of the angst and anxiety and fear about... Is it going to happen again? and...what's normal? ...and what's not normal?" 

She also says that many women find they need to place importance on paying attention to their own emotional wellness when they become pregnant. The way women are feeling about their pregnancies, their birth team, and their lives affects their birth. 
"I really wasn't trying to be obnoxious about it, but I thought, I'm not overriding my intuition just to not make a doctor upset."

Susan had a complicated time with her pregnancies, but she works with women going through all different types of unique experiences. 
"But, all of that had kind of led me here 
To be able to make a difference for people...women...for MOMMIES! Yes, mommies are so important. Yes, they are." says Susan. 

Susan studied art therapy before becoming a mother, and maintains licensure as a professional counselor in Colorado. Susan's studio space allows clients to play with a wide variety of art materials while working alongside her as the therapist.

Today, she continues the work, but has added another dimension to her business including 
If you're interested in attending sessions with Susan, find her online at Henry's Heart Art Therapy.

The staircase inside Cottonwood Center for the Arts
Some artwork in the therapy space

A light fixture in the therapy space

Susan Jacobsen

An album made using mixed media

M: What was your reason for starting this business? What was your background?

S: I've been an art therapist for a long time. I got married kind of late--I was 35--but shortly after, I got pregnant. I had a really normal pregnancy until...I didn't. Our first baby was stillborn due to something called HELLP syndrome. I don't know if you already know what that is or not?

M: I've heard of it, but don't remember what it stands for.

S: HELPP Syndrome is not super-common. They've gone back and forth on whether it is related to pre-eclampsia or not. It has similar symptoms, but probably a different cause. The acronym stands for Hemolysis Elevated Liver enzymes Low Platelet count.

M: That's probably why I don't remember what it stands for.

S: And it's not super-common, which is probably why they missed the diagnosis with me. My son was stillborn at 37 1/2 weeks. And then, I became very ill because part of what happens with HELLP Syndrome is your liver starts to attack the placenta. I became very sick. When your liver starts to do all of that stuff, it affects your platelet count which is what allows your blood to make blood then all those little chunks of blood cells clog up your kidneys. So, I went into kidney failure. They had to transfuse me before I could deliver. Uh, there's a whole raft of health issues that came up for me. I was in the hospital for 17-18 days, and I was in ICU on dialysis. All these kinds of things. So, that was hard.
His name was Henry, which is where I got the name Henry's Heart Art Therapy. So, it was really hard; there was the loss and the questioning... Some of what really helped me through that was my artwork. Being a therapist and being able to understand some of that--at times--was helpful and being able to understand it all. Then, we had two other miscarriages after that. We went back and forth about fertility stuff. I ended up going to a holistic kind of retreat. Four years after losing Henry I got pregnant with my second son, Jens, who is now seven. I got pregnant a month after the retreat, following their recommendation. After losing Henry, and everything that I had to do personally to come back from that, I think it made me stronger. And I think it made me a different kind of mom than I probably would have been otherwise.

M: Absolutely.
S: And so, as I was pregnant with Jens there was all of the angst and anxiety and fear about... Is it going to happen again? and...what's normal? ...and what's not normal? ...and so I really decided I am taking charge of anything I can take charge of in this pregnancy. I hired a doula, and I did a lot of research on what's what, and what are the symptoms of this and that. But, at the same time trying to keep my anxiety in check and doing things like yoga and really putting a lot of things like that and guiding into my artwork...and doing a lot of that kind of stuff just to keep myself in a good place, because, as a therapist, I know that the anxiety of a pregnant mom can affect your relationship with that baby, and I didn't want that. I didn't want Henry's death and my problems to carry over and be Jens' problem. I didn't want to do that. 

So, I did a lot of that work for myself in that process and then as Jens has gotten older--I wanted to start this business for a long time--but you know as a mom you get torn between being a mom and being there for your kids and trying to start a business... So it seemed like a better time, now. You know, he's a first-grader, (he’s a 2nd grader now) don’t know if that matters. and he's into school now so I could relax a little bit.

M: Oh, he's a first grader? My son is a first grader: Samson, he's seven.

S: So, you know I mean it's not that he doesn't need me anymore, but he's got a place that he is in the mornings. I felt like this was the right time to start that business, and really what it was was I was wanting to give back some of what I learned to other moms who are maybe going through some of the similar things...or going through anything. You know, I think that when you're pregnant you're hormonal, and you're emotional, and I think it's important to take some time to work on your own stuff during that time and let someone help you with that. When you have that baby, then your life becomes about that baby, and you don't really get the opportunity to kind of figure some of that stuff out. So that was what sort of led me to doing some of this kind of work. 

I did prenatal yoga throughout my pregnancy with Jens, and it was one of the best things that I did. And I thought, you know you could provide some of that support through what I do. I'm not a yoga teacher, I'm an art therapist, and I think it's a great fit.

M: Tell me about art would say you're primarily a therapist, and then art is how you work through things or? Would you say you're a mix of both artist and therapist?

S: That's a tricky question. It's a common question, actually. There are therapists who are therapists first and then they incorporate art into their work but they're not really trained in art therapy per se. Art therapy is kind of its own field.

M: Yeah, I have a friend who's trained in art therapy, and I've never really asked her this question. She works specifically with kids, so I've asked her things like, " Here's this thing that my kid drew. Tell me what this means." But I've never really asked her about [the work].

S: Yeah, and I think that it is an identity thing that art therapists struggle with all the time. I am licensed here in Colorado as a professional counselor, because they don't have an art therapy licensure. But I can be licensed as a counselor, because my degree--though it's in art therapy--my program at least was very clinically-based, and we took a lot of the same things that the psych folks took in addition to our art therapy coursework. We took the testing classes and all of that kind of stuff and all the like DSM diagnostic classes and all that. So, I can be licensed as a counselor which is helpful to be able if you want to bill an insurance company. Most of the insurance companies are not going to accept just an art therapy able to if you're a licensed counselor, you can do that sort of billing. So, it's sort of a benefit to being a licensed counselor. I currently don't accept insurance here, just because it's a billing nightmare quite frankly, when you accept insurance.

M: So, if a client came in and wanted to talk to you about pricing structure or all of does that work?

S: What I do is like for the pregnancy class--I call it Art of Expecting Group--I charge $25 per time, or they can buy a five-package...a five punch card kind of package, and they up saving a little bit doing that. But that includes materials. I try to set my fees low enough that people can have it somewhat affordable. It's not as inexpensive as going to prenatal yoga, for example, but I have a lot of overhead with supplies and you don't have to bring your own supplies. So, I feel like that's a good compromise for not taking insurance.

Plus, for what I do with the pregnancy group, I don't feel like it is therapy per se. It is more like supportive, expressive time, and not so much like group therapy...if that makes sense. So, I don't wanna...I mean group therapy fees for private pay can be $60 - $70 an hour. So, I don't charge that, because I don't feel like it's that kind of group.

I also do a grief group for people who have lost babies, and that group is um...I charge the same for that $20 per time. So A part of me feels like I shouldn't charge for that group, but at the same time it is still professional is still art materials, and so I feel like I can't really afford to not charge for it. And so that is something I do. But, in those groups I like to really help people figure out good ways to memorialize their child to express their feelings around express their feelings about grief like an anniversary dates being difficult... and just sort of those kinds of things. And just getting the support from each other. and that kind of thing.

I also offer an open studio time where people can just come in and do artwork about whatever, and that doesn't have to be a pregnancy issue. I charge $10 an hour, or if you stay for the whole three hours, then it's $25 so you save a little if you stay the whole time, come play for an hour with the art materials. Give me your ten bucks, and I mean it's not...I don't provide as much guidance or input that way either but it's a time to come in and see how...if you wanna test different materials and see if you wanna try them out.

M: So, do you have like a lot of mixed media stuff, primarily painting, like what are people primarily choosing to do when they come in?

S: Yeah, I do--I have a lot of stuff available. I'm an oil painter. The paintings up here are ones that I have done, and I've done a little bit of acrylic work, but I have oil pastels, I have collage materials for people who can do collage. It can sometimes be a great material for people who feel like they aren't very creative or don't feel like they can do art per se. It's a good place to start, because collage--I love doing collage, actually--I think it's fun. I think it's expressive, and you may or may not come away with something that you want to hang on your wall, but that's not really the point. You know for that kind of group, it's more about expression and that kind of thing. Like this book...

M: Well, spending time dealing with some things, huh? That's the important part.

S: Yeah, this was a book I did that was part of a -- I also have a trauma certificate, which is part of the art therapy training that we talked about sort of picking an issue...courage was sort of something they suggested because of the trauma issue.

M: Um, so tell me about our credentials.

S: ATR is that I am a registered art therapist with the Art Therapy Credentials Board which is a national board that credentials art therapists only, and then BC is the board certification through them which requires testing with them. The registration is simply you finish your grad school work, you do a period of supervised hours, and then you're registered with the Art Therapy Credentials Board as a registered art therapist. But then, if you wanted to become board-certified you have to take the lengthy exam with them, and then LPC is Licensed Professional Counselor through the Colorado Department of Regulatory Agencies.

M: Is this Jens on the photo? With the little bucket hat? My son has a little bucket has like that, too.

S: Yeah, my husband gave me that for Christmas. And that's him when he was a baby. Tiny Peanut. He was five pounds and six ounces when he was born, so that was a couple weeks after he was born.

M: [Conan] was a little guy when was born; the first two were nearly eight-and-a-half pounds, and so then he was like this little six-pound-something guy, and I was like, "What?! You're lying. Weigh him again!" And then it seemed like I blinked my eyes and went to a midwife visit, and she was like,  "He's ten pounds even." And I was like,  "No, he's not. Weight him again." 

Susan (to Conan): You must've been a good little eater. 

M: Yeah. I'll take a photo of that (brochure), if that's okay with you.

S: This is the brochure that explains some of that.

M: Oh, it has a photo. Is all of this on your website, or...? Is it the facebook page primarily or both?

S: I do have a website. I have both.

M: I didn't even look. Some journalist I am to not even look that up. You should research before, Marcia.

S: That has the website on the back; I think it's in my brochure, too, but... 

M: But, like I said, I've never interviewed anybody. I'm not a journalist. You know when you do assessments that tell you what career you could be good at in high school or whatever? Journalist was always one that came up for me, and I feel like there's no way I could ever do that. And I think that because in the back of my mind I have so much social anxiety, I'm afraid of people. But, I've worked through all of that now--I mean for the most part--I'm a lot further than I was when I was in high school, anyway. If I could've worked through some of that I could've been a great journalist. So, I went to college for art and my emphasis was graphic design. Our school was a liberal arts school, so we had to study all of the things. But that was a really awesome experience, and I don't really...I'm not a graphic designer now, but I really feel like I use everything that I learned. And then, I worked at the School of Psychology at Fuller Seminary for a couple of years and I found out about some cool stuff there like, ah therapy is not anything to be ashamed about! It's awesome! And then I had a few kids and I was like, "I'm gonna become a childbirth educator!" Well, actually after my second baby was when I decided to pursue it. So, that's why I'm like, "Oooh, your thing sounds interesting. I wanna know about that."

S: I want to do more networking with the childbirth people in the area. I don't want people to think I'm trying to take the place of childbirth classes...

M: Like a bereavement doula, or...?

S: Yeah, I don't want people to think I am trying to move in on their market. I just want to be part of the team.

M: You just do what you're gonna do, and that's great.

S: When I'm doing art in here, I usually turn the overhead lights on, because it's a little dark. It's pretty dim with just those. I think it's a nice um...

M: Can I take a picture of you with your credentials on the wall?

S: Sure! And the painting that's on the front of the brochure is the painting that's usually hanging on the wall here. They're doing a Madonna and Child artwork show here in March. It's going to be all artwork that's about moms and babies. It's going to be a juried show. So, I don't know for sure if the painting will be in, but I entered that painting in that show. (Update: the painting was not shown)

I'm not like celiac, but I have to watch how much gluten I eat, that was something I learned at the holistic retreat. The diet was no wheat, no dairy, no  processed sugars, alcohol, and caffeine.

M: I would love to go off of processed sugars, but I'm not that brave.

S: It's hard to figure out at first, "Well, what can I eat?" because so much of that stuff is in everything.

M: I switched to my primary chocolate is just bars of dark chocolate, and I will break of just like a square. And that's so much more satisfying than like anything else, and I really feel like, "Wow, I've really had my chocolate satiated. And I don't feel like, "Om nom nom nom, I need to eat more," like you do if you eat a milk chocolate or... "

S: Yeah, sugar is weird, because I feel like it does have kind of that additive affect like you want to eat more of it.

M: Like you eat carbs, and then you want to eat all of the carbs.

S: Yeah, and I'm bad about that like, it's probably not a really good thing I found out now they have gluten-free bread. So, I'm like, Oh now, I can eat toast.

M: Over at Nemo's coffee -- have you ever been there? -- NO? Well, you have to go. Well, they have a drive-thru so you don't even have to go inside, but they have like a circular vegan and gluten-free bar --which I'm not vegan and gluten-free, but I tried them one day--and they're so delicious. I don't know if they're super-healthy, but they're vegan and gluten-free! You have to try them.

S: Yeah, so many things have a lot of sugar, a lot of salt.

M: I firmly believe that fat is not inherently bad for you. I think there's healthy fat and you should have healthy fat. Like, I told my class that I taught I told them,  "Just eat the whole egg! Eggs are good for you!" They're like Really?!
S: You don't have to eat eight of them. You don't have to eat the whole carton...

M: I am very blessed to have three kids. So, we had Samson seven years ago. Then we had a miscarriage. And then, after that, I was like okay so not only did I have a horrible birth with him and then I had this early miscarriage when I was really expecting that God was going to give us another baby right now. Then, I was in the early part of my next pregnancy with my daughter, and it was a LOT to work through. And it was so much prayer and working through so many fears and things, and then the birth ended up being so amazing. It was like that day and then the couple weeks following was the best time of my whole entire life. And I was like,  this is so wonderful! Like, God answered SO many things for me! And I was just overwhelmed with...the whole world became so vivid. And after that it was just wonderful. I contemplated it and contemplated it for months after. I was just like God answered all of these prayers. So, then after that I was just like I want women to know, I can help you be not afraid, because there are so many fears.

S: Yeah, I had one lady asking me about what I did. And, she was like, "Well, why on Earth would pregnant women need therapy?"
I thought, "Are you not a mom?" There's all kinds of reasons that pregnant women need to be able to talk about things and process. 

M: It affects the birth!

S: It does, it affects the birth.
Like, I know I was so determined with my pregnancy with Jens I'm going to do the things I need to do, and if something doesn't feel right to me... I mean with our first situation with was partly a malpractice sort of thing. They should've caught the HELLP syndrome, and usually with HELLP Syndrome if you deliver as soon as it is caught it will be okay, because your body stops and so--had they diagnosed it appropriately, and listened to me when I was saying, "This is what I need," instead of saying, "No no no, you're fine, it's your first pregnancy, you're just worried."--so I was like, no no no. Second time around, if I have a thing, you're gonna check it out and listen to me. 
I really wasn't trying to be obnoxious about it, but I thought, "I'm not overriding my intuition just to not make a doctor upset.
Not that I have anything against doctors, they're wonderful people and they serve a wonderful purpose, but I was like,  "No...I'm need to listen to me, " And I did have a doctor initially that did not want, um, I mean she didn't...she...I don't know what her deal was exactly, but I had my whole medical records because I took   them to court, and my attorney had our....MY medical records which is  and has all of the complications that happened and why it happened and  So, I took that to my OB when I got pregnant with Jens and she was oh okay. She had it for three months, and she never looked at it.

M: Oh, yeah, [they don't] look at any of the things that they...

S: Finally, I was like, "You know I really wanna make sure that what happened last time doesn't happen again." So, she said -- Because I was 40 I think, when I was pregnant with Jans -- she said, "Well, you need to go to Maternal-fetal medicine anyway, because they need to check you out because you're an older mom."

M: But advanced maternal age, in and of itself, is not an indicator of anything

S: Exactly, which I learned at the retreat that I went through that it doesn't matter that much--your age--that if you're healthy and your eating healthy...that younger women can have birth complications just as often as older women. So, anyway, I was like, "Okay, whatever." I was like, "Can they do any kind of tests that indicate whether I was likely to have HELLP syndrome again?" She was like, "Yeah, there's a couple things they can do." So, I went over there and she never told them that part of my history. So, I asked the doctor at maternal-fetal medicine: I said, "What about the stuff that helps determine whether I might develop HELLP syndrome again?" She's like, "What are you talking about?" So, I tell her the whole story, and she's like, "That was not on my referral sheet." She showed it to me. She was mad. I mean, she was trying not to be mad, like trying not to throw this other doctor under the bus. But, she was like, "They didn't ask me to test for that. We can totally do that." 
They did this doppler thing to test like a blood-flow-to-the-uterus kind of test. But since I fully recovered and didn't have any residual effects from the
first time, and since the results from this test, she was like, "You have no greater chance of developing HELLP syndrome than the general population at this point." Which was a HUGE relief to me, which I'm thinking, "Why didn't this other bozo lady tell me that?" I was so angry when I was like, you know I've spent three months stressing about this when I would not have had to. And so, the maternal-fetal medicine doctor was like, "If you would like to see us, we could totally see you if you want to do that. Because we're specialists, and we deal with high risk pregnancy."  But when I go back and tell my other doctor about that, she was like, "Well, I don't know. They're pretty choosy about who they take over there. And, I don't know. They would need a referral from me. You can't just GO there. 

And I'm like, "I'm telling you she TOLD me. The doctor over there told me."

M: Well, some doctors have a bit of a complex.

S: I guess. Well, she was sort of like saying "Why can't I handle it? I can handle a high-risk pregnancy." But you obviously can't because you had my medical records for three months, and you never even read it. You don't know the severity of what happened to me the first time. And so, finally, I just decided I don't care about how she feels. I'm going to maternal-fetal medicine where they're specialists. And every one of the their doctors read my medical record. They were at Memorial [Hospital] at the time; now they're at Penrose [Hospital], I think. But they all read my charts and they all knew what happened to me before. They all knew a variety of different tests that they could do. They monitored the crap out of me.

M: Because I don't want somebody attending me in labor that doesn't know what I'm afraid of and my health history, and doesn't seem to care about my health.

S: So, I was like totally comfortable with whoever happened to be on call when labor intensified. They all know what's going on with me, and they were great about my birth plan. I had -- I don't know if you know Randy Baggins she's not a doula anymore -- she's a nurse now, I think. But she was great. She was telling me all of these things like, "You can birth in your own clothes, if you want, even though you're birthing in the hospital. Which was really empowering for me, and she--you know--they...they were just wonderful. Because I had my own birth plan, and I went over it with the doc...Doctor Martin. She looked at my birth plan, and she said... I mean I was like, "You know I'm not trying to be unreasonable, but I don't want an epidural if I don't need one. Because I researched about the epidural after the fir   st time. I didn't want an epidural again. She was like, "It's okay. You don't want pain meds, you don't have to have 'em. You know, we'll totally work within all of that. "

M: yeah, yeah

S: It's a way to go, really. And she wasn't even ... actually Randy caught him.

M: REALLY?! The doula caught the baby?!

S: Becuase I was in labor, then my labor kind of stalled out, then it started again. I had a little bit of pitocin to kinda get it started again, and then she was there and the labor & delivery nurse was there. And I was sort of stalled out.... I dilated really quickly at the end, and I was like...I'm doing the squatty bar and all this stuff, so I pushed like three times and he was out, and she caught him and she was like--later she told me--she was like, "Well, yeah, I really probably wasn't supposed to because I don't work for the hospital--but you know--it was like I was there and he was coming. And the nurse wasn't in the right room 
It was just funny, because Dr. Martin comes in and was like, "Looks like I missed the show. I came as soon as they called me. It was fine. IT was all good. And he was born at 36 weeks. I had my water broke, so I went into labor at 36 weeks, but it was fine. And he was on the NICU for a couple of days, because ...
But that was was good to kind of be able to assert myself and do it the way I wanted to do it for the most part. I mean, I was not a candidate for a home birth, because of my other issues, that was not ever really an option. And I'm not sure I ever really would have chosen that anyway, because I think that I would have been too anxious. 

M: If it would have been more stressful for you to have been at home then... Then, that can be more stressful for you to be at home, too.

S: Yeah, so I was sorta like you know for the most part you can leave me alone during the labor, and I bounce on the ball and do everything I need to do

We'll let you do that, but we're going to hook you up to the monitors and let you walk around, but you have to have the monitor on. Okay, whatever. I can live with that. I really just want a healthy baby when I'm done with this process. 

But, all of that had kind of led me here 
To be able to make a difference for people...women...for MOMMIES! Yes, mommies are so important. Yes, they are.

M: So, what was the retreat that you did? Was that here in Colorado?

S: It wasn't. They did one in Colorado, but -- when Jens was 2, we thought we were going to have another baby, but it wasn't in the cards for us. But, it um it was called the "Fertile Soul" 

M: But, is it like a fertility thing primarily, or...?

S: Um, yeah I'll show the book. Dr. Randine Lewis is her name. She, um, did this book called "The Fertility Cure" after her own experience with loss and infertility. She trained in Western medicine and Traditional Chinese medicine and acupuncture. It is all about getting your body back in balance through diet, energy work, thoughts and emotions. It’s also about opening yourself up; being receptive to what is, rather than being so caught in effort based trying to “achieve pregnancy.” Effort based trying only makes you more and more out of balance. You cannot force a miracle; you can only be embrace it. It is simple and complicated at the same time, but I know I have Jens because of just that kind of work.

this interview was conducted in March 2016

Mrs. Marcia Hyde, CCCE

"The LORD bless you and keep you; the LORD make  his face to shine upon you and be gracious to you; the LORD turns his face toward you and give you peace." Num. 6:24-26 NIV