“Keys to Emotional Growth”                             Cards and KEG4ALL App                                   Could Be The Newest Breakthroughs                      In Psychotherapy                                                      | Dr. Eleanor Avinor & Joanne Yona Silman

The emotional power a single picture can have is quite fascinating. When our eyes touch uponthe work, countless thoughts and provocative feelings suddenly course through our body. Wemay even connect these works to our own daily lives and experiences, thus creating hiddenmeanings that — to a specific person — provides significant perspectives.Recognizing the exciting potential that the utilization of pictures could have across the field ofpsychotherapy, sisters Dr. Eleanor Avinor and Joanne Yona Silman began developing a toolthat would function alongside traditional therapy and counseling, as they felt those were notenough and the client needed more. Their 11 years of work resulted in KEG — “Keys toEmotional Growth” — cards, a projective identification method designed to help improve aperson’s emotional state while he/she gains insights and is enabled to improve functioning. As apsychotherapist, Eleanor uses the method that suits the client and the problem at a particulartime.Each KEG card has two sides. One side features artwork of a specific situation, while the otherside contains guiding questions about the artwork that help to promote dialogue between thetherapist and client, such as the connections between any given figures, what the picturerepresents, and what’s important in the picture. Instead of having to explain personal situationsdirectly, clients are able to explore their problems and situations through their projections oncreative representations.Silman — who has a Masters in Systems Engineering — stated that often, many of the peoplethey work with are conflicted, feel they can’t control their lives, and have reached a seemingly-hopeless deadend. That’s why one of the KEG cards’ primary goals is to help clients come toconclusions and solutions they might not have been aware of otherwise, offering roads out oftheir depressing situations.“What’s special there is the pictures. The pictures that I drew, I drew from therapy sessions. Forexample, there’s a picture of a woman, [who] was telling me how she’s depressed and shedoesn’t know what to do, [and how] she’s not happy with her life,” Dr. Avinor said. “She talkedabout her mother being like a spider; her mother doesn’t give her any peace and quiet. I drew apicture of a bridge and a spider, and a figure walking across the bridge, [with] water under thebridge and a door at the end of the bridge.”
“She chose that picture, and she explained to me that the door is the therapy, that maybe shecan cross the bridge, go through the door, and she would be a different person. She added thatnow she’s on the bridge; she’s the figure on the bridge. That’s what I intended when I drew it.She said that the big spider behind her is the mother, the door at the end of the bridge is thetherapy and the way off the bridge.”After continuing to talk about how the mother was suppressing her, the woman eventually cameto the idea to rent with friends as a way to gain back her freedom and ease the stress that hadcome over her. Those kinds of empowering self-discoveries are what the two counselors strivefor through their tool.Dr. Avinor first came to the idea of KEG cards following her numerous years of studyingpsychotherapy, cognitive behavioral therapy (CBT), and working as a school counselor. She feltthere was a common action that many of the therapy methods she studied revolved around.“I realized they’re working around just talking. I realized that talk is not enough. Then I went andstudied art therapy. In art therapy, people have to do something. They draw pictures, theycreate things, and sometimes people are very unhappy or lonely, or depressed, they don’t wantto create something. So then I realized it’s much better if I just show the pictures.”Due to pictures having copyright, the sisters first asked friends and family to donate pictures, buteventually realized they weren’t what their clients needed and could relate to. Not willing to giveup, Dr. Avinor then started drawing the pictures herself in order to ensure they provide a uniqueexperience for an individual, in order to help them achieve healthier relationships, mindfulness,and a better functioning lifestyle. “Our KEG cards therapy is bottom-up, it starts with the client.”The KEG cards also aim to help the client understand their problems — while developing andprogressing themselves further — and not simply hone in on negatives or what brought them tothis point. “It’s not zeroing in on the bad things, it’s focusing on the good things. It’s focusing onwhat can be done, what could be done,” Dr. Avinor stated, expressing the desire to have peoplefind and imagine their own solutions. Visualizing the solutions via the pictures is a key to theirchanges.Perhaps one of the prominent benefits of the KEG cards is its ability to not be confined to onespecific psychological issue - instead, it can be applied to a variety of topics and problems, suchas self-awareness, self-esteem, body imagery, and types of communication behavior. It helpsthat Dr. Avinor and Silman drew inspiration from a number of psychological approaches to basethe cards on in their development, including Freud, CBT, and transactional analysis.“In transactional analysis, everyone has a Parent part, an Adult part, and a Child part in theirpsyche,” Dr. Avinor explained, adding that these three parts are similar to Freud’s Superego,Ego, and Id. According to her, the Parent — which tells us the should and should-nots that welearned from our own parents — has a nurturing parent, a judgmental parent, and a criticalparent among other parts and functions of the Parent..
The Adult helps us to relate to the real world, while the Child is made up of parts like the needychild and curious child, among others. These parts interact both with each other and with theParents, Adults, and Children in our lives.“To be a happy person, your Parent, your Adult, and your Child should be in equilibrium, andshould be more or less the same size. In therapy, we help the client achieve equilibrium so thatone part does not have too much power or influence on another,” Dr. Avinor said, explainingthey use pictures and roleplaying in order to give strength and voices to each part in order tobring balance.When it comes to KEG cards, a person might choose a picture of a Child that wants or demandssomething if their Child part is a continual issue. “That’s how you work with the cards in order toshow pictures of the Parent part, Adult part, [and] Child part.” Of course, a Child-Adultrelationship isn’t just explored in an individual’s psyche. Dr. Avinor has a collection she refers toas “attachment pictures,” which targets mother-child early relationships that a person hasunresolved feelings about that cause present dysfunctional personal relationships.“These are pictures of a mother and a child, a mother and a baby. You'd be surprised how manydifferent ways there are of holding a child or being with a child. You can hold a child and look ateach other. You can hold a child and hug them very, very tight, [so tight] it’s uncomfortable.”Through these pictures, a person’s attachment — or lack of — with their parents can bediscussed. The tightly gripping of a child could amount to an overbearing caregiver during youth,while other parts of a picture could signal a lack of attachment.One of the ways Dr. Avinor and Silman work with the KEG cards when it comes to traumavictims involves the SUDs system, or “Subjective Unit of Distress.” Dr. Avinor will ask the clientto choose 10 pictures, spread them around the room, and describe the trauma through them.Once the story is told, the client will be asked how distressful the picture is on a scale of one to10 — the latter usually being the first number felt — and what they can do to make the storyless distressful by changing the content of a picture, the size of the picture or its placing andposition relative to the other pictures..Dr. Avinor will then have the client rearrange or change the pictures, their sizes and content,and ask them to tell the story over again in the hopes of bringing their anxiety down. “Everytimethey tell the story, it gets more positive and more positive, until they get down to 1, 2, or 0. Theydo it for as long as they want.” Each time they tell a more positive narrative.The sisters don’t look at their endeavors as business-driven, but rather explain their intent is tocontribute to humanity. According to Dr. Avinor, people can change, but “they just need help tochange.” “This is one of the ways that we can help people develop their brain, develop theirpotential, change and be happier.”
In order to truly reach their goal of helping humanity overcome personal struggles, Dr. Avinorand Silman needed to ensure the accessibility of KEG cards is at the highest possible point. Theeasiest way to achieve that in today’s world? A smartphone app that would allow for furtherimprovement of the KEG cards. “[This] means we’re changing. Instead of just for the therapiststo use, we’re going to make it for everybody to use.”The app — titled KEG4ALL — would be much more than just a digitized version of the tool,however. The sisters believe it can serve as a companion to those dealing with sadness andloneliness - as Silman puts it, it’s a “virtual best friend.”“People don’t have good connections like they used to, they don’t have the big extended familythat lived together. Many people are lonely, and this is sort of a way of being connected. Eventhough it’s not a person, it’s a feeling of being understood.” Silman emphasized that with thishelp, people can successfully move from one step of life to the next, which will help the world tobe a much better place.While the app isn’t meant for serious psychological issues such as major depression, complexPTSD, and other disorders — all of which should be professionally treated, the sisters note —Dr. Avinor still feels it can be extremely beneficial to those who may not have the funds neededfor therapy, but still need a pick-me-up. “When people come to me for private sessions, it’s veryexpensive. In the [United] States, it could be $50 [to] $100. It’s very expensive to go to apsychotherapist. This way, they could use the application, just to help them feel better.”In addition to holding instructional courses for therapists and counselors on the usage of KEGcards, Silman and Dr. Avinor also have workshops, both in-person and online, for clients with aninteresting catch - they choose not to use a title in order to give more customization toparticipants to explore what they want.“Any problem that people have can be the content of a workshop. What I optimize to do is nothave a title, and each person works on what they want,” Dr. Avinor said. The two focus on anumber of topics, from conflict resolution to inner-person, trauma, personal development, andloneliness.They even attend before wedding meetings with families in order for the two families to get toknow each other better. “We have many ideas, but the minute we find out what [issue]somebody wants to work on and something that we can form a workshop on, then we do it,”Silman added.To learn more about Dr. Avinor and Silman’s courses and workshops, as well as their KEGcards, you can visit their website and look them up on google and on you tube on keg cardschannel.