Working with Seniors Using the Oaklander Model

The beauty of seeing the Oaklander Method work with children is powerful enough, but to watch someone 96 years old pick up crayons and pastels is really moving! I worked for a health insurance company recently for nearly one year. My clients were referred to me by the seniors’ primary care physicians. Only about 15% of my population was not over 65. The average age of my clients was the mid 70s. I was 31 at the time. It was a privilege to work with them.

I was initially hesitant to use drawing and other more physical methods with my senior clients because of physical or health limitations such as visual impairment or arthritis. In many cases my senior clients told me that they hadn’t picked up crayons and pastels since they were children. However, I know how powerful it is to be able talk and how helpful drawing can be to get to the heart of difficult emotions like grief and depression, so I got out my crayons and paper. Some of the seniors I worked with were able to create really profound expressions on paper. Some of them found their work with drawing to be so helpful that they later bought crayons to use at home. I was told that drawing with their grandchildren was deeper and more fun for them because of their renewed appreciation for drawing. The grandkids were delighted, and exclaimed, “Grandma you like to do this, too?!” Being comfortable with drawing gave them the chance to sit down and bond with their grandkids in a way that they hadn’t before.

Sometimes I have had to do special accommodations physically for the seniors. I had an easel and they could sit on a chair that could be height accommodated to them. I tell them, as Violet does, that it’s not important to make their drawing look good or be accurate. This helps them relax and have fun, thereby allowing the quality of their expression when they started talking to be deeper and easier when they spoke as an animal or a blob they had just drawn. Even so, several were surprised and delighted with the beauty of what they drew A woman in her late 60’s talked a lot about her overall life fears and insecurities which she traced back to childhood. I asked her to “floatback” to her childhood and draw the most toxic part of when her fears began. She drew herself as a happy child in a playground at dusk, a red-eyed monster spying on her behind a tree, and her highly anxious mother repeatedly warning her the Devil would come and eat her if nightfall came upon her. On this occasion, I did not have her be the swings nor the tree. Her drawing had expressed such detail of the disturbance of having “seen the devil as a child”, detail she had never told anyone, that I felt that expression was enough. She also realized her mother had programmed her to obey by using terror tactics. This drawing reminded me of the words of a former supervisor: “Children are expert observers, yet poor interpreters.”

Several of my senior clients were so desperate due to their depression that they were willing to try anything. When I asked them to draw, they would say, “If you say so Miss Cruz.” (I told them to call me Lesley but they preferred to call me Miss Cruz). I found that, not very different from working with children and adults, the seniors’ issues were mostly from childhood. Working with their childhood issues made their 5 marriages, their lost children, etc. make more sense to them I found that I could work in a way that is not possible with children or some adults as I consistently discovered that the seniors were not resistant to the concept that their issues, for example, with their husband or their father. In many cases they had had that insight without any therapy experience. I was reminded often that I was dealing with a generation that either had believed that therapy was not widely available or believed that therapy was not for people like them.

One client told me that when they were younger they thought that therapy was for Hollywood stars and the rich. They were very open and had deep insights. This is a very compliant population. I found this surprising because while adults sometimes say yes and then have excuses why they didn’t do their between session experiments to maximize therapy benefits, 90% of my senior clients did their homework. They considered their homework assignments as serious as taking their medications.

I worked with a 67 year old woman with schizophrenia. She displayed significant magical thinking along with what I would consider visual hallucinations (butterflies and fairies in the room and such). Her drawings were amazing! She loved out of session experiments (aka: homework). I asked her to do drawings at home and she would bring them into her next session. She also liked to talk a lot so at these times I highlighted and underlined her process and how she interrupted herself. I used both drawings and Native American animal cards with her. She once brought in a Mandala Clock drawing with different images of her interacting with her numerous siblings as a child. It was through connecting with childhood memories during her dialogue as a baby whale in one of her drawings that she realized she had been overfed by her older siblings in an effort to protect her for the sexual abuse the older siblings were experiencing from their father.

One woman’s visual impairment was fairly severe. She liked drawing but it was a lot physical strain for her so I used Native American Animal cards with her. I introduced the cards to a woman in her 80’s and asked her to choose three cards, one to describe her past, another to represent her present situation, and third to display how she would like to be in the future. After completing the delightful task of giving a voice to her animal cards and talking about her life as an Owl, a Dragonfly, and an Eagle, she told me about her frustrations, her generational family history, and her difficulty in being legally and morally acknowledged by her Native American tribe and heritage.

One gentleman told me, referring to the current economy, “The real depression was after the crash of ’29. The depression people are whining about now is a joke compared to what we went through!” I worked with WWII veterans, children of both the holocausts in Europe, and the Holocaust that Cambodia suffered in 1975 that is not spoken about. As a history buff, it was an almost surreal experience to compare viewing an historical documentary or reading a book with the more profoundly personal experience of talking to someone who had actually lived through that same time in history! Hearing my client’s personal experiences of times and events I had learned about through books & films was life altering and I feel very privileged to have had this opportunity.

I worked with a veteran with very intense post traumatic stress disorder. “Which war?” you ask? He had lived through and survived the Vietnam War and Desert Storm, and has only recently been discharged after his last tour of duty in Iraqi Freedom. I found it helpful both to me and my clients that I am a veteran myself. However, I never served during wartime and thus I never saw a hostile enemy up close. I often used the lines of one of my master trainers, Bob Resnick of the Los Angeles Gestalt Institute, “I’m the expert in the therapy process, but you are the expert in your life experience. I can’t do my job without you, nor you without me.” This client became my tour guide of his journeys, as did so many others.

I worked with a woman in her 80s who was bipolar and had had severe depressive episodes for over 6 months. She wanted me to figure out what her dream meant. I told her, “I can’t figure out what your dream means, but I can help you decode your dream.” I asked her to draw her dream. She drew a couch in the desert and a huge frame above the couch. I asked her to talk to me as if she were the couch. She said, “I am a very used, old couch, and I need a home. I am in good condition and still serviceable.” I asked if any of this fit for her and the tears began to flow. She had lost her home as a result of gambling during her manic episodes. She was looking for affordable housing. She was also dealing with feeling old and useless and told me, “I don’t want to be a burden on my daughter but I can’t help it.” I asked her, “Does your dream make sense now?” “Oh, yes,” she said. She left my office empowered to work with her challenges and with a genuine smile.

I was impacted deeply by this work. These clients were 3 times my age. Because they grew up in a very different era than I did, I dealt with not only a generation gap, but also with a cultural gap. Contrary to my previous belief, only in the first or second session did my age and the generation gap come up. It was such a gift to use the model with the seniors. I use a lot of Violet’s methods with clients of all ages. The simplicity and the impact on people is amazing to witness, let alone to be privileged to coach people through it. Currently I am working with victims of violent crime using Violet’s work. I work with kids, adolescents and adults. My goal is to be an ambassador for the Oaklander method. I see the Oaklander Method as a movement, not just as a theoretical stance. I want to continue building this movement and eventually train others in the Oaklander method.

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Lesley Cruz

Lesley Cruz is a Marriage, Family and Child Therapy intern and friend of the Violet Solomon Oaklander Foundation and serves as the Foundation’s Spanish translator. Lesley has her B.S. in Human Services and her Master’s in Counseling in Marriage and Family Therapy from the University of Phoenix. Lesley has been training in Gestalt therapy at the Gestalt Associates Training in Los Angeles, including a residential program in Buffalo NY in the summer of 2009 and another upcoming program in Poland in the summer of 2010. Lesley has worked with children and adolescents conducting school based counseling, couples and blended families, in addition to that she has led bilingual parenting classes. She recently worked with the geriatric population serving the elderly/frail along with dependent adults with severe and debilitating mental illnesses. She excitedly reports the completion of her required 3000 hours and projects to be licensed by the Fall of 2010.