Create-An-Image Relaxation Therapy Effective Interventions For Patients Suffering From Trauma, And Emotional And Behavioral Problems Lendell W. Braud, Ph.D. The Create-An-Image Relaxation Trauma Therapy Program In 2004, Braud developed the Create-An-Image Relaxation Therapy Program (CAIR). The patients understand that they cannot change past negative or traumatic events but they can let go of the negative emotions related to those events. The patient identifies the negative emotions they want to let go of and he/she creates a personalized/symbolic image or drawing for the release of these emotions. The patient places the emotions in a personalized drawing (space ship, boat, balloon, waterfall) for later release. When the patient is in a deep state of relaxation they visualize their picture and release the negative emotions and bring in positive emotions that the patient chooses. The therapy also includes a Mind-Body Exercise to release the negative aspects that effect the mind and the body. This therapy is especially effective with defensive patients and oppositional children because the patient chooses what he/she needs to release, when he/she is ready to release thenegative emotions, and how much they are willing to release. It is important to note that this is not art therapy since the goal of this therapy is not the expression of emotions but rather, the release of these negative emotions in a relaxed state and the choice of positive emotions to replace the negative emotions. The CAIR therapy has the advantage of allowing the patient to create his/her own personalized/symbolic image for the release of emotional trauma and of course, relaxation therapy has long been used for the reduction of anxiety. All patients using this right hemispheric therapy have commented on some of the advantages of this therapy. The visual aspects of this therapy are particularly important since research has indicated the these children frequently have significantly better visual memory/ processing than auditory memory/ processing. Poor auditory skills can create difficulties with traditional “talk therapy” Dr. Braud has used the “Old Me New Me” relaxation program for over 30 years (Mimi Lupin, 1977, 2004). The results at the end of this paper include results using the “Old Me New Me” Relaxation program and the CAIR Trauma Therapy which also uses the “Old Me New Me” as the relaxation program for our patients. The” Old Me New Me” program includes physical relaxation excercises and 11 visual imagery stories like Trip to The Star and Trip to The Beach and other nature related imagery stories. The next four pictures are presented to the patient in this order to help them understand the difference between negative events which cannot be changed and negative emotions that can be released. After the negative emotions are identified, the patient chooses the positive emotions that he/she needs and the patient works to replace the negative emotions with these positive emotions. Over the years, patients have chosen a variety of positive emotions including safety/security, , joy, hope, wisdom, calmness, serenity, happiness, peace, self-esteem, self-power, trust, optimism, and clarity.   Picture #1 This picture is designed to make sure the patient understands the difference between past events they cannot change and negative emotions they can choose to let go of using the CAIR Therapy Ptogram. ****Cheryl – This picture needs to be bigger to read words easier. Picture #2 The therapist explains that trauma, abuse, and negative events impact the conscious and unconscious mind. The purple line represents the fact that sometime we repress negative emotions but they frequently effect our behavior. The patient reviews the negative emotions at the bottom of the oval and chooses the emotions they wish to release. **USE THE NEW OVAL HERE** Picture #3 ****Cheryl – This picture also needs to be bigger to read words. Can you make the words at the top bigger??   Therapy Artwork And Mind-Body Exercise: PICTURES: The following pages contain artwork from many of the patients who have attended the program. The images are powerful, showing the trauma these patients have been subjected to and negative emotions they so desperately need to release . Without the help from CAIR many of them would have had only traditional, therapy which is not always effective in the treatment of trauma and Posttraumatic Stress Disorder. MIND-BODY EXERCISE: The patient visualizes their picture and release the emotions depicted in their picture. However, we need to remember that anxiety, fear, frustration, and anger also effect the body in the muscles, blood pressure, stomach, heart rate as well as the mind and brain. Many patients have said that they like the Mind-Body Exercise which is used at the end of the therapy session. Each session the patient decides which negative emotions they wish to release. The choice of negative emotions changes over time as some negative emotions are resolved. In addition, the patient decides when he/she is ready to release an emotion so the focus of specific emotions can change. The therapist ask the patient to pull that negative emotion up from the toes, out of the stomach, the heart, the mind, and the brain and release it completely. The therapist then brings in each positive emotion one at a time. The patient chooses a specific color for each positive emotion and the colored light comes into the mind, brain, spirit, heart, stomach and down to the toes. PICTURES THAT ARE DRAWN BY INDIVIDUAL PATIENTS:  GROUP ARTWORK: The next set of pictures were designed by a group of patients to tell a story. The patients usually start their series of three pictures with a representation of “Two Socks” their therapy dog. Two Socks has beautiful golden paws so when you see a dog with golden paws it is their representation of their therapy dog. ** Put Group artwork HERE!! Be SURE to use the NEW set of pictures. Thanks VISUAL IMAGERY STORIES: All of my patients use the Old Me New Me Relaxation program that includes trips into the imagination. These stories include stores like Trip to The Star, Trip to The Beach and other nature related imagery stories. Some of my patients have also written therir own Visual Imagery Stories that are read to them while they are in a deep state of relaxation. Again, one of the unique aspects of this therapy is the fact that the patient creates their own picture or in this case their own story. Susan’s Story: This story was created by an 8 year old female that was sexually abused when she was three years old. We will call this girl Susan but of course this was not her name. Susan identified her negative emotions as anger, sadness, and fear. She decided that she would choose blocks like children’s blocks to spell out the words of the negative emotions. She put the blocks into a large purse and she had a key on a braclett around her wrist. She said that she was going to go to a high rock overlooking the ocean and dive into the ocean. When she dove into the ocean she traveled thru a tunnel where she became a mermaid. When she got to the bottom of the ocean she unlocked a treasure chest and placed the blocks in the chest and locked the chest. Just as I finished reading her the story she suddenly said, “Now The Light Has Overcome The Darkness” and she smiled. This theme over overcoming evil or darkness is some times in the childrens pictures or in this case her story which adds a spiritual aspect to their therapy. Group Story: Three of my patients come to therapy together. They decided to write a story together. The story begins with the children walking on the beach when suddently Atlantis rises up from the sea like a intricate “Sand Castle” . The water than rushes off the “Castle” is like bright bronze water running down like a waterfall. They sit on the beach and look at Atlantis and the Dolphins come and take each of the negative emotions out to sea as we name them one by one. The Sun brings down rays of light that become different colors for each of the positive emotions. The patients pick their positive emotions and pick the color of the light for each positive emotion. When the color light comes down it enters their body and flows into their brain, mind, heart, body, and spirit. Again, one of the unique aspects of this therapy is that the patient picks the images and the colors of each light. Additional Aspects Incorporated Into CAIR Which Have Proven More Effective. Mind-Body Exercise: Many patients have said that they like the Mind-Body Exercise which is used at the end of the therapy session. Each session the patient decides which negative emotions they wish to release. The choice of negative emotions changes over time as some negative emotions are resolved. In addition, the patient decides when he/she is ready to release an emotion so the focus of specific emotions can change. The therapist ask the patient to pull that negative emotion up from the toes, out of the stomach, the heart, the mind, and the brain and release it completely. The therapist then brings in each positive emotion one at a time. The patient chooses a specific color for each positive emotion and the colored light comes into the mind, brain, spirit, heart, stomach and down to the toes.   CHANGES IN THERAPY OVERTIME: At first, the patient listens to one of the Old Me New Me stories and then visualizes their picture at the end of the session while releasing negative emotions and then focuses on bringing in the positive emotions. They also use the Mind-Body Exercise. However, overtime the primary negative emotions that the patient is working on maybe resolved and the patient begins to work on other negative emotions that he identified at the start of therapy. As some emotions are resolved the patient can focus on other emotions. They may also wish to focus on new positive emotions. Overtime, the therapy can change in one or more ways: 1. The patient may wish to draw a new picture that reflects different negative emotions and different positive emotions. 2. The therapist may wish to create a specific story that emphasizes some positive aspect such as self esteem, optimism, trust, or self power. If the patient likes the story it can be used in a session. 3. The patient may wish to create their own story and the stories may be different overtime. When starting this process the therapist can ask the patient what type of nature scene they wish to use. Scenes might be a beach, forest, mountain, lake, river, meadow, or outer space. The scene might suggest some specific imagery. For example, a meadow might include flowers of different colors, a deer, a bambi, bunnies, and a squirl. The therapist encourages the patient to select the colors and animals they wish to include.   Research Studies Braud, Powell, and associates have conducted research at Residential Treatment Centers (RTC), Group Homes, and schools for over 25 years. In an early study the researchers tested abused males in several residential centers (Braud & Powell, 1997). The sample included 70 abused males. Eighty-seven percent (87%) of the residents had at least one learning disability in reading, spelling, math, and/or visual-perceptual motor ability. In addition, seventy-seven percent (77%) of the residents rated themselves as hyperactive (ADHD). Intellectual and neurological tests demonstrated that these residents had significantly better visual memory and visual processing than auditory memory and auditory processing. This result has implications for children with verbal learning disabilities and auditory memory/processing deficits. This result also has implications for the efficacy of “talk therapy” in this population. It is important to note that the results of this study have informed all of the interventions that we have developed over the last 20 years. These inverventions include the Braud Visual Motor Program, The “Math Camp” remediation program, “Operation Multiplication, the “Alphabet Soup Phonics” reading program and the Create-An Image Relaxation Therapy Program. TAKE THIS AFTER THERAPY PART OUT & LEAVE IN THE WORDS RESEARCH BUT TAKE OUT BEFORE THERAPY AND AFTER THERAPY AND TAKE OUT THE GREEN ARROW, t The author and her associates have conducted research with the “Old Me New Me” relaxation program for over 35 years. The next charts summarize this research. The first four studies 1978-2005) were conducted using the “Old Me New Me” relaxation program. The last four studies (2005-2017) were conducted using the “Old Me New Me” relaxation program as part of the Create-An-Image Relaxation Therapy. THIS CHART SUMMARIZES THE RESULTS OF FOUR RESEARCH STUDIES USING THE “OLD ME NEW ME” RELAXATION PROGRAM: SIGNIFICANT IMPROVEMENT FOUND # OF RESEARCH STUDIES Hyperactivity 4 Studies Distractibility 4 Studies Frustration 3 Studies Agression/Oppositional Behavior 3 Studies Impulsive 2 Studies Anxiety Was Measured In 3 OF These Studies And Was Significant In All 3 Studies THIS CHART SUMMARIZES THE RESULTS OF FOUR RESEARCH STUDIES USING THE CREATE-AN-IMAGE RELAXATION THERAPY: SIGNIFICANT IMPROVEMENT FOUND # OF RESEARCH STUDIES Hyperactivity 4 Studies Distractibility 3 Studies Frustration 4 Studies Aggression/Oppositional Behavior 4 Studies Impulsive 4 Studies Anxiety 4 Studies Depression 2 Studies In the last 3 studies we added two test to measure additional aspects: Child Abuse Potential Inventory Questions (Milner, 1986) to see if the potential for our abused children to be abusers might decrease. The Resiliency Scales (Prince-Embury, 2006) which measure positive aspects like trust and optimism. This test reflects some of the positive emotions our patients choose. SIGNIFICANT IMPROVEMENT FOUND # OF STUDIES Child Abuse Potential Inventory 3 Studies Optimism 3 Studies Trust 3 Studies Self Efficacy 2 Studies Comfort 3 Studies Support 2 Studies Tolerence 2 Studies Sensitivity-Decrease 3 Studies Change THESE words to words below keep arrows and title anxiety concentration worry & physiological anxiety short term memory depression trust hyperactivity optimism distractibility self efficacy frustration comfort impulsivity tolerance aggression/oppositional support oversensitivity self power child abuse potential self esteem For Information: Workshops On Learning To Use CAIR In Your Therapy Contact: Dr. Lendell Braud lendell0214@gmail.com or Phone (936) 447-4404 For Information On The “Old Me New Me” Contact: Mimi Lupin (501) 655-6278 I think the References would be good at the end.