Maureen Gillard, LCSW, Visiting Nurse Service of NY Haven Hospice, New York City
Lauren Lazar Stern, MA-ATR-BC, LPC, private practice, Pittsburgh
Nancy Buckmeister, MSW, Haven Hospice, Florida
Frank Wilberding, LCSW, CADC, Midwest Counseling and Diagnostic Center, Chicago
Shannon Flanagan, LCSW, Sheppard & Enoch Pratt Hospital, Baltimore
Michael Mark, Sustenance, Chicago
I continually work hand in hand with referring therapists, social workers, coaches as well as chaplains and spiritual advisors. Below five mental health professionals address how they reached a comfort level with the idea of a memory artist working with their clients; how they introduced this creative practice to their clients; and ultimately how they have witnessed positive change in their clients as a result of their work with me.
Maureen Gillard is a clinical social worker at Visiting Nurse Service of NY Haven Hospice in New York City, providing care for patients who are terminally ill and seeking palliative care. Here she speaks of my artist-in-residency at Haven, where at the time, I had worked with over 340 families, 40% of which chose to complete a Healing Dreamscape with me before or after their loved one died.
“When the patient is imminent, the family member is in a quandary. They are completely split. When they leave here, they put on their “I’m a member of the normal world” persona. When they are inside hospice they put on their “I’m a relative of a dying patient” persona. It’s expected that they will want to know, ‘How do I act in each case?’
That role-playing can drive anyone crazy. All we can do is nurture, coddle, cater and invite family members and caregivers to dive into the grieving process with our guidance. We understand that neither one’s outside life or hospice life is anyone’s complete world.
So we indulge here. That’s why we have a memory artist at Haven Hospice who allows you to be as self absorbed as you need to be. As the Other, Nancy puts together a gift, an indulgence when their world is falling apart.
During the Interview phase, Nancy encourages the family to go beyond the superficial crisis (e.g. what medication today?) to look at the bigger picture. She invites a deeper exploration of memory and the roles they’ve played or the patient has played in their lives. For example: ‘I used to perceive Mom as a …’
What Nancy is doing here is active: she asks for participation. She seeks information about memories through an interview. She meets them where they’re at… Nancy is an incredible listener, passionate about what she does and compassionate so it’s this beautiful enhancement of the work we’re already doing. The family members become active participants, and she raises the bar: asking them to be engaged, introspective and interactive.
The memory artist also has the distance to point out actions in that family’s world that were above and beyond, or exemplary. Things the family may have never thought were anything particularly special. Nancy addresses (and relieves) regrets as well.
Family members have to start processing their grief here in hospice. The more we can shore them up … the more healing we can do inside hospice, the easier the transition.”
> Read the 5-page chapter, “Dignity Portraiture,” co-authored by Nancy Gershman and VNSNY Haven Hospice social worker Kat Safavi, LCSW, M.Ed. for Robert Neimeyer’s compendium,”Techniques of Grief Therapy: Assessment and Intervention.” (2016)
> Listen to news channel NY1’s segment featuring Nancy Gershman’s volunteer art-in-residency at VNSNY Haven Hospice, with a special interview with social worker Maureen Gillard on Gershman’s bedside manner with end of life patients and family members. (2016)
Lauren Lazar Stern is a Pittsburgh-based, art psychotherapist, and a certified EMDR therapist specializing in working with girls and women who are suffering from eating disorders and body image disturbance.
“I decided to enlist Nancy Gershman to work with 10 of my eating-disordered patients because I felt that she would be able to reinforce and take the work that I was doing with them a step further, and actually this is exactly what happened. It became known as “The Healing Memory Project.” Each individual who created a Healing Dreamscape with Nancy found it to be an exciting experience of reinforcement of all the positive work we did in therapy. Meeting with Nancy gave them a second chance to review all of their insights into their downfalls and achievements which ultimately made their therapeutic process stronger and more dynamic.”
> View the traveling exhibition of Gershman and Stern’s collaborative work, “For the Brides of ED: The Prescriptive Photomontages of Nancy Gershman” at The NYU Langone Medical Center, New York City (2013)
Nancy Buckheister is a Florida-based medical social worker specializing in end-of-life and dementia/Alzheimer clients at Haven Hospice.
“As a social work intern in 2008 at Unity Hospice where I was working at the time, Nancy showed us how she and her clients put Dreamscape collages together. I saw the healing affect these Dreamscapes had upon the people Nancy was able to help. It was obvious from the cases she described that the Healing Dreamscape process “kick-started” the healing process for them.
I led a bereavement support group at that time at a senior center; a closed session with 10-12 people in varying stages of grieving. My client Shirley Heard came in very depressed and had a lot of possible suicidal ideations about losing her son Koot, and her husband Stacey before that. She did not have a lot of motivation to do anything. The depression and loss was so intense it took her a long time to really want to do anything. And no one in the group was as angry as Shirley about their child’s murder; they were already in the healing process whereas Shirley wasn’t. She was dealing with complicated grief and I could see talk therapy wasn’t helping her heal. Complicated grief is just that – it’s complicated.
She was functioning, barely – but on some level Shirley wanted to pull herself out of that dark fog to go on with life. Every individual is different and sometimes a client will share with you that they are waiting for some kind of medium or tool to help heal the distressing pictures they have in their heads. They will put down their thoughts on paper but then, like Shirley, they yearn for some way to heal “in pictures” to express that anger but also to savor more positive memories which can bring about healing.
That’s when I thought that prescriptive photomontage would be a channel for Shirley to express her anger and forgive. I felt confident that Nancy’s technique would be able to uncork that. After Nancy completed Shirley’s photomontage and sent it to me, I could tell just by what Nancy shared with me and what was inside the Dreamscape itself – that Shirley had moved on with her life. It was a complete life review – containing her first and second husbands, and the relationship of her son to both of them.
I would highly recommend Nancy’s work as a tool to start the healing process in those clients who appear stuck. Like talk therapy, music therapy, memory boxes- prescriptive photomontage can be utilized to help our clients move forward, find more pleasure and enjoy a quality of life rather than remain stuck in their world.
Because prescriptive photomontage is not about individual photographs but about multiple stories from our lives – it could also be of benefit when dealing with a family member with dementia. Some family members cannot cope with loved ones with dementia. They have a really hard time, struggling as they lose their family not once but twice.”
> Read the article on Shirley’s case, “Prescriptive Photomontage: A Process and a Product for Meaning-Seekers with Complicated Grief,” published in Annals of American Psychotherapy (2010)
Frank Wilberding is a psychotherapist at Midwest Counseling and Diagnostic Center in Chicago, specializing in addiction, self-esteem and relationship issues.
“I first met my client David Meyer in 2008 when I was a social group intern at Rainbow Hospice. David had just lost his partner of 57 years. Publicly they were viewed as “The Couple,” rather than individually. David was terribly anxious, lonely, manic and unable to cope. There were almost phobic-like presentations to his complicated grief; and I saw a narcissistic personality, and abandonment issues as well. David was requesting one-to-one counseling and a support group. Under the supervision of Dr. Barbe Creagh, CT, LCSW Bereavement Program Manager at Rainbow Hospice and Palliative Care Bereavement Services, I was to see David weekly. It was also at Dr. Creagh’s suggestion that I bring in Nancy Gershman’s service as a complementary approach to tackling his complicated grief.
About one in ten of those who lose a significant loved one experience complicated grief. Complicated grief is a condition whereby the afflicted are unable to work through the stages of grief and instead avoid it or become lost in it or enter attendant disorders such as anxiety, depression or other conditions that isolate them from a sense of themselves and their communities. One major element of loss that goes unarticulated and leads to complicated grief is the shared construction of future plans that the mourner carries, visions that will not be realized and cannot by shared with others.
For David M, the loss of his partner was connected to the loss of the shared passion for making music that supplied the motif of their relationship. Many years ago, David had left his secure position as a chemist with a PhD. to play organ in his partner’s ensemble. This shared passion was undergirded by the partner’s unrealized plan to play together at a music festival in Wales that they attended annually.
Under my care, David’s dread began to move from “we” to “I”. His focus changed – from his own feelings about loss to celebrating their 57-year relationship and keeping George’s legacy alive. At this time Rainbow assigned Nancy Gershman, a memory artist, to David’s case, in the hope that visualizing a “preferred future” where David reunites with George’s spirit in their beloved Scotland and Wales might help his adjustment to a life after loss. The intention was that David could aim towards achieving this shared dream with the implied spiritual support of his absent partner.
Nancy was instrumental in the resolution of David’s complicated grief. Through the healing power of David’s prescriptive photomontage she was able to articulate the loss of David’s unrealized future while also helping David celebrate his [unrealized] dream. The process began with several interviews with David in his home, where they reviewed old photographs. Nancy then utilized her ‘digital lassoo’ to repurpose the most positive elements in these images which formed the emotional and literal aspects of the dream that had gone un-mourned.
The resulting representation of this vision provided a transitional object (David’s Healing Dreamscape) that became the source of understanding and acceptance for David. It enabled him to carry memories forward while beginning to experience his loss and the legacy of the relationship in a positive manner.
While there are many examples of transitional objects that provide some comfort to mourners such as important letters, objects or photographs and videos, none that I can think of represent the unresolved vision of the future as the Healing Dreamscape can.
In 2010, I met with David after he had been living with his Healing Dreamscape for more than a year. He said something very beautiful about the Dreamscape then, when I asked what it represented:
“Part of what I have been mourning for is not just George but the things in the future we had hoped to experience together. Those things I hoped for are things I mourn and at the same time the things I know we will have together after I die and can be with him again. The most hoped for thing was to go to our beloved Scotland and Wales and have George conduct music at the festival with my accompaniment. This Dreamscape takes the vision and place of what I hoped for and makes it real to me. It takes the hope and makes it a reality for me. That helps me to keep George in my heart and celebrate the joy we had together and the faith that it is not over just because he passed away.”On the fourth anniversary of George’s death, David updated Nancy that of all the people in his bereavement group -with some coming to the group for 4-5 years – he was now the one that seemed to have the most positive attitude! He tells us he dreams a lot of “happy dreams,” and George is in his dreams; that they talk, and that George is in good health. He even comments, “See, I’m not ready to go now.” David also speaks of “going back over” to visit Scotland and Wales as “part of the requirement to fulfill [his Dreamscape].
The depiction of this vision has been instrumental to David M. With its ability to shape mystical longings in an accessible manner, this service is a priceless asset to anyone who has experienced unresolved losses or complicated grief.
Shannon Russell is a psychiatric social worker at Sheppard & Enoch Pratt Hospital in Baltimore. She works with adults and adolescents with unresolved interpersonal issues that cannot be addressed directly with the person in question (often a loved one) due to either the nature of the relationship or if the person is deceased.
“When I was finishing my graduate program at the University of Chicago, I met Nancy Gershman through my hospice internship. I was so impressed by her photomontage work where she integrates images from people’s lives to create a dreamlike landscape that strives to provide healing in situations where individuals have not always been able to fully make peace with unresolved issues related to family, typically. I referred my mother to Nancy, as I felt that my mother would benefit from working with Nancy to create an image that could help her to process her own unresolved issues with my grandmother, who was very sick for most of my mother’s adult life and is now deceased. I thought that Nancy’s artwork would be a really fantastic way for my mother to have a visual montage of the complex relationship that both was and never was. I also know that my mother is a creative person who really resonates to various kinds of artwork.
I was so pleased that Nancy was able to draw out my mother’s feelings and as a result, provide her with a beautiful and dreamlike piece of artwork that captured my mother’s preferred story – not only capturing the elusive positive attributes of my grandmother from a 20-year old’s perspective but also the imagined relationship Sandy had wanted with her mother, but now from an adult perspective.
When I processed the experience with my mother, I learned that Nancy took the time to transcribe their conversations about the relationship and really developed the artwork in partnership with her. My mother now enjoys the lovely artwork in her home and it provides her with an interesting perspective on a relationship that continues to be confounding but one where she finds a greater sense of peace.
As these kinds of problems prevent individuals from living fully, we work through these difficult emotions (loss, grief, anger, longing, etc.) until they lead to a greater sense of peace and wholeness for the client and in the relationship as well. I would happily recommend clients in similar situations to Nancy and feel that her work is a meaningful and unique way to further support people as they work towards resolution of complicated and unresolved issues.”
Michael Mark is a life coach, interventionist and the founder of Sustenance (Chicago), where he engages with individuals and couples. He is also an instructor and seminar leader in 12-Step/recovery.
“I found Nancy Gershman as a result of a referral from my wife, a therapist and L.C.S.W. As a practitioner myself, I have a pretty strong barometer in terms of spotting someone who displays genuine empathy with the capacity to open up space for a person to feel and process. It was clear to me in short order that Nancy was the embodiment of all these things.
We sat at my kitchen table as I began to tell her the story of my grandfather Simon, a Holocaust survivor, who escaped the camps, and made his way to America with nothing other than the clothes hanging from his starved body. He became the strong, loving patriarch of a wonderful family, spreading wisdom, laughter and support to all of us.
When he was taken from us by pancreatic cancer in 1995, no one was more devastated than my mother. Her pain persisted through the years but seemed to hit a fever pitch upon the birth of her first grandchild, my daughter Sydney. She adored her, though nearly every time she would come by to see the baby, she would talk of being so sad that Grandpa Simon and Sydney would never come to know each other.
My wish was that Nancy would create a Healing Dreamscape using pictures of my daughter and grandfather suggesting a true, present spiritual relationship which I could present to my mom for her birthday. Through a focused and informative process, Nancy toiled away, sending me version after vision, until every detail was in place. The finished product was well beyond my most beautiful fantasies. I can say with absolute confidence that if the healing power of art calls to you in any regard, you’d be well served to give Nancy a call.”