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sions, he began to form grotesque monsters, aliens, and demons. Some of the images were frightening, even sick- ening, but Jeffrey seemed deeply satis- fied with the process and his creations.
Meanwhile, any attempt on my part to engage him in conversation about how it was for him to be with his seriously ill mother was met with shoulder shrugging, an unfeeling expression, or some comment that everything was fine and it did not bother him that much. He really needed to display strength. His clay figures became increasingly expressive, however, as he moved from the grotesque images into more nurturing and energizing images. In one session, he made a plate of scrambled eggs with knife, fork and spoon, fol- lowed several weeks later with an automobile at a gas pump, filling up with fuel. After Jeffrey worked like this for several months in the clay, we fin- ished therapy because his parents reported significant improvement both at home and at school.
Although I continued gently to test Jeffrey's willingness to talk about his mother's illness, he could not speak directly of his own deep emotions related to the abandonment that he likely experienced during her year-long course of treatment when she was physically unable to engage with the family. It was much easier for him to let the sand tray characters speak and act for him, and to vent his rage onto the clay as he punched, slapped, and shaped it into form.
While sitting with Jeffrey, it was helpful for me to remember from a neuroscience perspective how painful and frightening memories have an implicit aspect that is held in and expressed through the body, even when these memories are also explicitly, con- sciously known. This reminds me how important it is to make room for right brain processing through physical and symbolic activities, which are the lan- guage of that hemisphere. Even when these memories aren't processed with words, these releasing activities build connections between the limbic region where the pain is stored and the middle prefrontal circuits that provide regula- tion and comfort for the experience. With this in mind, I could better imag- ine Jeffrey's right hemisphere mapping the bodily expression of his anger and fear as he vigorously manipulated the clay. Neuroscience also tells us that these same regulating circuits are
strengthened when these activities take place with another person who is attuned. This helped me support him empathically and mindfully as I remembered how important it was to hold his energy, both positive and neg- ative, with equanimity. I could be openly present to the grotesque mon- sters as well as the nurturing plate of scrambled eggs.
During the course of therapy, one of my favorite quotes by Carl Jung (1916/58) came to mind several times as I watched Jeffrey's hands manipu- late the clay:
“Often it is necessary to clarify a vague content by giving it a visible form. This can be done by drawing,
painting or modeling. Often the hands know how to solve a riddle with which the intellect has wrestled in vain.”
It seemed that Jeffrey really needed to make visible and tangible in the clay his feelings of rage from his experience of abandonment. Yet, he needed to stay strong and socially acceptable in his family through verbal denial of his feelings. Unfortunately, the denial worked only to a point. Jeffrey would hold the feelings inside as long as he could, and then he would explode, causing more upset in the family. A rid- dle of sorts, it was a challenging dilem- ma for Jeffrey. He could not resolve the problem with words, but somehow his hands knew what to do with the clay. In the context of current neuro- science, the Jungian quote took on new meaning for me in terms of the "vague content" of implicit memories and non-
verbal right hemisphere pro- cessing. It underscores the wis- dom of including modalities in therapy that encourage clients to stay in their right hemi- spheres when they need to process feelings or integrate the implicit aspect of memories. Remembering the quote also helps me stay steady when I sense myself swimming in the waters of implicit memories that clients so often bring into therapy. What I am learning from cur- rent neuroscience is just how natural and healthy this urge to create form from the formless is, clarifying vague content and releasing energies trapped in dissociated neural nets. Once these constraints are released, the brain's constant intrinsic push toward integration is free to pursue its natural path. I am finding that when I make nonverbal modalities available in therapy, it is vital to be present and open to the energetic direction the client brings. Sometimes the situation requires me to be quite still, and some- times it requires me to actively engage. Either way, or anywhere along the con- tinuum between these two responses, it is most helpful if I can be fully present. It is an opportunity for me to practice
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