When Kathy, a bulimic, experiences the “life-changing activity of pregnancy, she suddenly has a better appreciation for her body or as she puts it, “how important I am to somebody else.” Kathy’s primary therapist already has helped her with social anxiety and how it is often a trigger for purging as many as 3-4 times per week. Acknowledging she has dreams of winning the marathon and staying relapse free during her pregnancy, we brainstorm how to make her secret relationship to “Ed” (“that extra person in my head”) truly repugnant.  The concept we come up with for Kathy’s Disenchantment Dreamscape is to dress Kathy in a blue rain poncho that mimics the plastic shopping bag she often threw up in, and would sneak outside her house and hide. Steaming vomit prominently placed on her chest is designed to warn Kathy about the stress that purging puts on her heart.  The result is a visual means of remembering the positives and the negatives simultaneously:

I think the picture will be helpful when I go back to see how far I’ve come. Hair blowing in the wind. When I’m moving and engaging my body, I feel the most in control, productive and positive. But then you see the vomit–disgusting! It brings back chilling memories, that day, when somebody found that bag of vomit. I don’t know how the future is working out. But from the runner’s point of view, I like the way I’m looking forward.  The flow of the poncho, moving away from my body as I’m running. It looks like I’m almost at the end, looking towards the end goal. Pretty close to the finish line. When I compromise, when I take on too much, when I don’t put those basic needs first, I sabotage myself. It’s what I remember now.

For more about cases like this one, visit The Healing Memory Project, my collaboration with art psychotherapist Lauren Lazar Stern.