Dr. Christine Brooks and Dr. Elizabeth Markle: Centering Connection and Creativity for Health and Wellbeing

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Elizabeth Markle: Hi, Christine. Wonderful to be with you this evening.  

Christine Brooks: You too, Liz. Thank you so much. It's great to see you as well.  

Elizabeth Markle: You know, we started at CIIS as faculty members right around the same time, almost 10 years ago or a little over, and have continued our journeys as faculty members and as innovators and scholars and practitioners in sort of parallel tracks.  

Christine Brooks: Yes.

Elizabeth Markle: And I've been so excited for this conversation to give us the opportunity to both compare and share where there's alignment in the work we're doing.  

Christine Brooks: Absolutely. I know. And being faculty and doing our work out in the world, we often don't have the time to just chat. So I'm excited that we get to do this and that we get to share this work with other people because I don't know about, I think this about you. I make these assumptions that you're really excited about the work that you do and that it's about really sharing it. You know, we both, sort of, Community As Medicine, as the core of what you do and the relational approaches that I take. It's about putting this out in the world. And so, it's so wonderful that we get to do that together today.

Elizabeth Markle: Yeah. You know, for both of these approaches, it feels like the world is ready for and excited for this kind of work. It feels like for me for 10 years, it felt like I was sort of shouting into the wind about human connection and community and belonging. And these things make a difference for human health and well-being. And suddenly we have loneliness reports and belonging initiatives and Surgeon General's attention on this work. And especially with the rise of social prescribing, I'm so excited to just dive in.  

Christine Brooks: Yes, let's do it.  

Elizabeth Markle: OK.  

Christine Brooks: Where should we start?

Elizabeth Markle: Well yeah, I wonder if you can just tell me sort of how did your journey lead you to the world of arts and health and social prescribing and maybe just tell me a little bit about your understanding of this whole social prescribing phenomenon.  

Christine Brooks: Sure. Sure. So I, my background in the arts is in theater. I was on the stage the first time at two. So that was my whole early life. And I went to performing arts university. I spent all of my time on the stage. It was really my central focus. And that was really also combined with literary arts. And so there's this way in which the arts are just part and parcel of my own being. I don't know how to do life without it being focused almost completely on creativity as a meaning making piece of my world. And so the arts were always coming with me. And then I had this moment, this big pivot in the very early 2000s, after that A.I. startup that was mentioned, that was way back in the day, where I ended up going back to graduate school and doing my work in clinical psychology. And I was fortunate enough to be in a place where expressive arts were a way that we focused and we could specialize in the work that we were doing in my graduate program. And so that was really the beginning of my own journey and my own education around arts as healing modalities. And one of the things that I've carried forward throughout my life is that art heals. That's sort of a fundamental premise that I believe in and that the world, like you said, is really catching up to. And I'm saying that, I want to rephrase that because I think this is an important distinction, in my opinion, I think that humanity, peoples all over the world have always known the healing factors of art, have always known that art heals. I think that traditions throughout the globe and peoples throughout the globe use the arts as part of their community building, use the arts as a way to communicate with one another, to share, to enact rites of passages, to be in the world and express what it is to be human and to have this journey. And so when I say that things are catching up, I guess what I mean by that is the scientific and medical communities or psychology as a field or the way that we think about, you know, we're so used to being siloed that now all of a sudden there's this, oh, the arts and community are important in the way that we frame well-being. Like it's news, but it is news because it's important that the research has caught up with what we know to be because it offers a framing of legitimacy that's really, really important when it comes to things like medical insurance and access to care and the way that we think about health and well-being within the larger scope of, not just, you know, symptomology and treating symptoms, but really thinking about wellness as the starting point and that that is something that we really want to maintain. And in the arts and health paradigm, this is a way in which we're saying the arts belong in healthcare settings. The arts belong as healing modalities. And there's an entire field of study, a field of research, a field of advocacy and national organizations and international organizations that are saying we must advocate to integrate the arts into medical care and into well-being practices, in how we approach people in their home communities. And so the arts and health movement has some really key figures in major universities, as well as the National Organization for Arts and Health and are saying, we have to focus on the healing factors of the arts through research and also through practice. And so I'm very much an active participant in that movement and it's a foundation of what we're doing in the expressive arts coaching and community building program, is, we're really using those principles as part of our foundation and part of our pedagogy. And then you mentioned social prescribing, which I know you're going to talk about with the organization that you have founded and that you're running as well. And social prescribing is this amazing movement that's saying that there are factors in our life that we know that promote wellness and in this sort of overarching social prescribing paradigm. They know that nature, art, movement, service and belonging are core factors that we can say, these are pathways to well-being and should not be ignored. While we are treating people for medical conditions, while we are making sure that people's medical care is appropriate and is holistic in scope, we also can advocate to be including some of these core wellness components in prescribing through a doctor, through a hospital, through a community health services organization. And so social prescribing is a movement that says, whether we are a public medical system like in the UK or other countries or we're a private medical system like here in the United States, we can be prescribing ways for people to be well. And I find that really exciting because it adds this whole layer to this idea that we don't have to wait for the sickness to occur. We can really approach this from a perspective of saying, what if we focus on being well? What might that look like? And how can we promote that? Not as preventative care, but as just basic fundamental healthcare.  

Elizabeth Markle: Oh my goodness, you said so much in there.  

Christine Brooks: That was my soapbox right there.  

Elizabeth Markle: I love it. I mean, I started writing things down. Art heals, right? Amen, that is simple. And you know what I'm really appreciating, Christine, is the humility in saying like, hey, we didn't invent this. It's not like we suddenly had a revelation that art heals and we need to bake it into the fabric of society. We have known this. Communities, societies all over the globe have known this. And that used to be more woven into the fabric of daily life.

Christine Brooks: Exactly.

Elizabeth Markle: In ritual, in culture that art was baked in and community was baked in. And from my perspective, we've lost some of those structures, right? As society has evolved and technology has created some really fascinating shifts and some really positive shifts, we've also lost some of that baked in, in the groundwater of daily life, nature of those practices for wellbeing. And so our task now is not to reinvent something, but actually to find new channels or new avenues for these to be accessible to people, not by wealth and not by willpower, but because they're occurring in daily life. And social prescribing, it seems like is one of those channels, one of those ways to get our systems aligned with what we know actually helps human beings be well. Am I tracking what you're seeing here?  

Christine Brooks: Absolutely. I couldn't agree more. And I love what you're saying about how this is an opportunity to almost regather in new ways and recognize. And when I'm in conversation with medical professionals, which I don't have as much opportunity as I would like, but in some of the advocacy work that I'm doing these days, I think sometimes we also have forgotten or that we've lost touch with the fact that our medical professionals are incredibly creative and are incredibly curious in their own right. And that the social prescribing movement and the arts and health movement are an invitation also to medical professionals to reclaim their own creativity and to reclaim the legitimacy of these health and wellbeing practices and normalizing them for their patients, for the people that are in their care. I know doctors who went undergrad to art school. I know nurses who have incredible textile art practices in their lives. I know dancers who become physical therapists. And so there's this way in which that split between medicine and arts and other practices of wellbeing, that divide is so artificial. And so when we remember the wholeness of both the practitioners and the people under the care, we can say, what if we just all shared about our own creative impulses? What if we all just shared about how we connect in the world and what's important to us and took those extra five minutes with each other to really learn that and maybe get off the 12 minute patient clock that so much of our healthcare has been modeled on, because the wellbeing can be happening in the room too, in those practitioner offices.  

Elizabeth Markle: Yeah. I'm imagining listeners out there going, gosh, I wish my doctor or my therapist…

Christine: I know.

Elizabeth: Had prescribed me this when I needed it or would prescribe me this now. And so I have to ask for those of us who maybe don't have care providers who are on the bleeding edge of this innovation, if we wanted to create this for ourselves in some way, what would you recommend? And we can go deeper into this later, but what's your first take at it?  

Christine: Yeah. I mean, my first take is to start small. I think we also live in a time where we have a lot of all or nothing impulses. I think we live in a time where the word optimization is something that we think we're always supposed to be doing. I'm sort of an optimization denier these days, I won't lie. Because I think when we get into that all or nothing, we can get stuck feeling defeated before we've even gotten started. And so if we don't have the access to this with our providers, asking ourselves, and we're going to do a little bit of this later, which I'm really excited about, like really, what does this look like? But my first take is, start small and say, where does my attention go? Because what we also know in behavioral health is where we focus our attention, our behavior tends to follow. And so out of those five categories, and I know you're going to offer another model in just a minute, but out of those five categories, like does your heart lead toward nature? Do you feel like there's purpose missing from your life? And how might service be useful to you in that? Like maybe some volunteering work would really help you recognize, oh my gosh, people really need what I have to offer in the world. If you're having a lack of sense of belonging, if you're part of this phenomenon that we're calling the loneliness epidemic, what are some small steps to create small moments of connection? Not, I have to find a new set of friends right at the very beginning, but maybe you're going to a coffee shop and like there's your favorite barista that you say hello to every single day. That's a form of connection. There's actually science behind how important that is in our lives. When it comes to the arts, like think of this as everyday creativity as opposed to art with a capital A. How might you have your own private dance party to one song in the morning just to like feel into your body and hear the music and have that moment? Maybe you're a doodler. Remember that your doodling during that meeting might be valuable to you. It might be a way for you to release some energy and to really connect with yourself. And if nature's calling to you, go outside, take your shoes off for two minutes, put your feet on the ground, breathe in the air, notice the leaves, notice the sunshine. We could all use a good dose of vitamin D here and there. So for me, it's about starting small and developing some micro habits before trying to like become proficient in every single part of this right from the start. When I'm working with my clients and I say start small, they often look a little bit crestfallen like, but I want to change now. And I say, this is the start of the change. Tiny increments.  

Elizabeth: Yeah, what I'm loving about that is that it's helping us not make arts or wellness practices become another should. Like another thing that we say I should do and why am I not doing it and other people are doing it. See, look on Facebook what they're doing. I should be doing it. What's wrong with me?

Christine: Absolutely.

Elizabeth: And they absolutely so quickly compound. You know, we hear that in health care all the time. My doctor said I should do this and do that. And, and people have a hard time making those changes in their lives. So I love this approach of not what should you do, but what calls to me? Right? What, what can I sense would be generative for me?  

Christine: Absolutely. Yes. And that where my attention focuses, my behavior follows, like that was taught to me by my mentor, David Daniels, years and years ago. And I just see it time and again that if we start with, What calls to me? And just start there as opposed to there being some exact right prescription, that it sticks in a much more fundamental way. And it's something that we can actually find some fun in. And I want to pivot for a moment because I know that you're doing so much of this work on the ground in an, in an, in, through an organization through open source wellness that, that you're really at the forefront of what this might look like in terms of people accessing care. And so can you tell us a little bit about what that looks like for, in, in open source and, and how you got started and, and what your organization is really seeking to offer?  

Elizabeth: Sure. Well, my journey in some ways parallels you. And really the origin story of this work has, has a professional component and a personal component. And I'll try to briefly share both of them. I am trained as a psychologist. And as part of training to become a clinician, you do these year long internships. You do a pre doc and a postdoc internship. And I did a year of training in a low income hospital system. And I did lots of things. I worked in an emergency department and I did a lot of work in primary care. And one of my jobs was to observe primary care appointments and provide coaching to the providers, often young residents, about how to navigate the emotional and psychological and behavioral aspects of care. We did a lot of training around motivational interviewing and how to help these providers get out of that should mentality. And during that time, I got really interested in what I now call behavioral prescriptions. Early on, I just called them things that doctors tell their patients they should do. And as I sat in on hundreds of appointments, I started keeping track of, what are the behavioral prescriptions that are being given? And to make a long story short, here's what I learned. No matter who the patients are, whether they're struggling with diabetes or depression or hypertension or something else. And no matter who the providers are, the same big four behavioral prescriptions are being given. And I don't think these will surprise you. Here's what patients are being told. Number one, you need to exercise more. No surprise there, right? Number two, you need to eat better. Number three, you need to reduce your stress. No problem, right? Like, sure, I'll get right on that.  

Christine: Absolutely.  

Elizabeth: And number four is, you need some social support. You need some meaningful social connection in your life. Now, these are all good advice. These are directionally correct. There's nothing wrong. In fact, it's highly data driven advice. The problem is that these prescriptions are verbally delivered at the end of that 12 minute appointment, followed by something that sounds like this. All righty then. Take care now. See you in six months. Good luck with that. Off you go. And that's the end of the conversation. And I remember talking with the person who would become my co-founder, Dr. Ben Emmert-Aronson, and saying, my God, if we told someone, like, you're going to need antibiotics, good luck finding them. Take care now. That would be so clearly unethical and malpractice. Instead, we say, like, you know, what's your neighborhood pharmacy? OK, it's going to be ready for you, it'll be dosed for you. Your payer will cover it, your insurance will cover it. It'll be ready in an hour, right? We have this incredible delivery system for medications, but we have no delivery system for the behaviors, the practices that support physical and emotional and social well-being. And so Ben and I back in 2016, which is the same year I started at CIIS, set out saying, what would it look like to create a behavioral pharmacy or a delivery system that would support patients in four big things? Physical activity, healthy food, stress reduction and social connection. And we started abbreviating that move, nourish, connect and be, as our big prescription. And part of our commitment was we're not just going to replicate the boutique wellness system because, you know, if you have enough money to shell out and the financial privilege, sociocultural privilege, you can access a lot of these things. But if you don't, it's a prescription to nowhere. And so we said, what does it look like to bring people together? I like the word you said, to regather people in supportive, trauma informed, culturally affirmative groups to practice, move, nourish, connect and be. And so we really, we started in 2016 in Oakland. We found ourselves a little community space and we started building relationships with the local clinics. Federally qualified health centers are the names for clinics that get federal funding, to provide care to people who are uninsured or underinsured. So regardless of their capacity to pay. And we started having these providers refer or prescribe their patients to our program. And this program evolved over the years to be what we now call Community As Medicine. And this is a 12 week group experience that's characterized by health and wellness coaching. That's highly experiential, meaning we don't just get people together and sit in a circle and talk about wellbeing.

Christine: Talk about it.  

Elizabeth: Yeah, a lot of talking about it in the world.  

Christine: Yup.  

Elizabeth: We actually practice these things together. So if you came and visited a Community As Medicine group, what you'd see is a group of up to 20 people and three or four health and wellness coaches practicing physical activity, practicing mindfulness, practicing healthy nutrition, and then talking really deeply with each other about what's going on in their health and well-being. And they might be dealing with very different challenges, right? Somebody might be struggling with anxiety. Somebody might be struggling with substance abuse. Somebody might be struggling with their blood sugar levels, but what they're coming into a community dedicated to supporting each other with well-being and creating safety, creating a space for vulnerability, creating joy and play and laughter. And at the end of every Community As Medicine group, every patient is writing their own prescription. So this is not what their doctor wrote. They are writing for themselves. Here's what I want to work on in the week to come. And then they're coming back the following week. So I just shared a whole lot. Did that all make sense?

Christine: It absolutely does. And it so touches on the ways in which we can think of this as fundamental to our lifestyle as opposed to something that we tack on or something that we're purchasing. I really appreciated what you said about how if you have enough resourcing, access is not really the issue at all. But there is still this sense of, like, well-being processes like this as being extra in our life. And this 12-week arc that you're talking about, the fact that it's happening over time, so it's really becoming ingrained. And in that experiential component, we know that people when they have experiential learning, they take it in, in a very different way when it's whole person or whole body learning instead of just, like we talked about, talking about it. We're not pointing at the thing. We're doing the thing. And I think that that is what makes such a difference too. When I'm working with people around the arts, especially with my coaching clients, I'll give them that first invitation of like, well, why don't we make something? Make something? We're going to do it. We're going to, oh my goodness, right? It can be scary because we see it as either something, it's too new or art is for artists, just like exercise is for athletes, right? Good food is for foodies or cooks or that. There's this way in which we think that like, oh, that's not for me, if it's not sort of part of our ongoing life already. And so I think this opportunity to be in community and recognize what is for you and what feels good and what feels right. And then that idea of writing their own prescription at the end for the week, is just so beautiful. It's this way in which people get to say this is what's important to me.  

Elizabeth: Yeah, this is what would make a difference in my life.  

Christine: I love that.

Elizabeth: Not what my doctor said.  

Christine: Right.  

Elizabeth: Yeah, I really appreciate you naming the fundamental nature of these practices. And I realized, and I shared about my professional arc, but the personal piece that makes sense to share here is that for the last 20 years or so, I have lived in various different forms of intentional community. And the phrase intentional community, people sometimes have visions of communes spring to mind. And I want to say it's not that. There are all kinds of forms of intentional community, including cohousing, which is an awesome Danish model where people have their own little homes. But there's also some shared common space. And because I've had this experience living in community, I feel like I've had this privilege to experience a lot of well-being being baked into the fiber of my life. So, for example, a night or two a month, I need to come home and make dinner for a whole bunch of people. And it's a lot of work. But there are other times during the month where I just come home and dinner is made and I don't have to put any attention on it. And if I say, guys, I need help. I'm struggling with physical activity in my life. Anybody want to walk with me two mornings a week? People are going to sign up for that. And so this is an example of my having the experience of without wealth, because I don't have it, and without willpower, because not so much either. There's a lot of support wrapped around my life for well-being. And part of the idea around creating Community As Medicine is how do we replicate the active ingredients of that support? Not everybody wants to live in community. Amen. It's a lot of work. But what would it look like to take some of those universal factors, support, empathy, accountability, validation, joy, vitality, that make these practices of well-being feel like fun and not like another should, and then bake them into systems that are very entrenched, like the healthcare system and the insurance system. How do we create access and equity by leveraging those systems? And in order to do that, you need to generate outcomes data. You need to publish peer-reviewed research. And we've really dedicated ourselves over the last 10 years to building the evidence for this model so that it can be taken to scale.  

Christine: Right. And you're touching on something that's so important and has been, you know how when we first started, you were talking about how like, you felt like you were shouting into the world of like, this is really important, for so long. And the research has really caught up. The evidence base is so deep now that these practices are somewhat undeniable. And I'll use the arts-based practices as an example. So there's been decades of research on the efficacy of arts in healing practices. There's entire fields that, you know, there's the creative arts therapies that are art therapy, music therapy, poetry therapy, dance movement, all of it, trauma therapy. And then there's the expressive arts, which is this intermodal way of being where we are using many different forms of arts and in different contexts and saying that the engagement is what is important. The process is what is important there. And there are huge bodies of research, but what was missing or where I really see that there was a bit of a tipping point in people kind of waking up and saying, oh, wow, this really does work is that the World Health Organization commissioned a meta study. And what they did was they looked at all of the studies that were being done around the arts and health and said, from all these studies, this is what we now know about what works, how it works, and how we need this in the ways that we frame healthcare. And so the World Health Organization put this huge stamp of approval on the arts. And that was this moment in time where all of a sudden, all of these organizations started springing up and programs started to be noticed all over the country and all over the world. And there was this collaborative spirit of saying, oh, if this is so effective, how do we do more of this? Right?  

Elizabeth: Yeah.

Christine: So what you're talking about, about how the research actually helps to bring these things deeper and deeper into community. I wish that weren't the model that we lived under. I wish we could just be like, no, trust me, really, it works. Because I think that we lived like that for a really long time. But it is a way in which I think that we can start to honor traditions and honor, and that we can help people to remember for themselves. I don't know if you see this in your Community As Medicine circles. I have this imagined moment in these circles where people might have that awakening moment of, I remember my grandmother's food. Or, oh, I remember what it was like to play as a kid and I want to get back to that body. Or I used to love to color in coloring books. It's like we've known these things in our lives in moments. And so how do we also re-engage with those playful and open-hearted parts of ourselves when we've gotten into these routines of adulting, if you might?  

Elizabeth: Yeah. I mean, I love your imagination of what happens and I would agree with it. The other piece I would lift is that part of what happens when we regather, when we convene in community, is that shame starts to lighten.  

Christine: Yes.

Elizabeth: Right? So going through our healthcare system can generate so much shame, right? Like, oh, there's something wrong with me. I did something wrong. This must be my fault. I don't know what to do about it, et cetera. And when we convene in community, part of what we learned is like, oh, I'm struggling with this, but he's struggling with that and she's struggling with that and they're struggling with that, like, I'm not alone. Probably not my fault. And we're going to work on it together. That is a piece of the magic that can happen here. I also loved you speaking to the legitimization of the field that's happening through research. And part of our journey over at Open Source Wellness with Community As Medicine was saying, okay, do we want to be a cool Oakland, East Bay demonstration? Or do we want to try to impact the systems and the structures of healthcare at scale? And it's daunting, but we have said yes to that. And part of how we're doing that is via partnerships with mission aligned community-based organizations like the YMCAs. So I didn't know a ton about YMCAs until the last couple of years. They're amazing. There's a statistic, like 80% of the US population lives within five miles of a YMCA. Holy cow, right?  

Christine: I was at my Y this afternoon.  

Elizabeth: Amazing. Okay. You were ahead of me. And so let's just paint the picture. Imagine if primary care providers and mental health providers could prescribe people into Community As Medicine and or other generative artistic wellbeing experiences that are delivered at the YMCAs. Right? Not everybody wants to hang out in their doctor's office all the time and do these wellbeing practices there, although some can pull that off. So part of what we are really after is national scale with local adaptation, local cultural adjustment while being in fidelity to a general model and creating an ecosystem of wellbeing where there's clinical care and then there's community care and the two are linked. Does that make sense?  

Christine: It makes so much sense. And I think for many people when we start talking about this, and I know it can feel a little bit abstract, like you were saying, that many of us have the experience of, oh, that's not my doctor's office, I don't have access to that. It becomes a question of how do I find this? Where do I go? And community organizations can be so important to this. So where I live in my community, our parks and rec system is very, very deeply embedded in the community and is not only geared toward programming for children. It's lifespan programming. And so four blocks from my own house, there's a parks and rec center that has programming every single night for kids and for adults that is movement based, arts based. They have an aerobic or cardio drumming circle two times a week where people come and drum, but it's a full workout and it's to playlists and it's out of this world. So it's also the combination of many, many forms that we're talking about. They offer wellness and nutrition programming. And so there are free and low cost, there's free and low cost programming in many, many communities. But I think it's also how do we get started with that? Or how, if I'm an individual just sort of in my own life, doing my own very busy adulting, as I imagine the vast majority of us are, that question of like, how do we get started? Start in your local community. And if you don't have the time or the resourcing to leave your house, if you have internet connection, there are incredible offerings, free introductory classes and a lot of different things. There's great ways to access different programming. I mean, even the CIIS public programs, they archive everything that's offered. So there's a ton of amazing workshops, even just through our institution alone. So it's also about dabbling a little bit or not recognizing that we might not be able to find our way into a formal offering, right, from the very start. I also think that each and every one of us can become a little bit of an activist in our own health care environments by saying to our doctors, hey, do you know about social prescribing? Or hey, what does this health care facility do about wellness programming? Like, do you guys offer anything? And it's just starting the conversation from the consumer's end, because I think we've forgotten that we are consumers in our own health care marketplace. And so if we start to have a voice, I wonder if we might be able to start some conversations in our home communities as well. It's the activist in me. I can't help myself.  

Elizabeth: I love it. I love it. Here we go. Well, you know, both of us are educators at heart, and I know that both of our programs value experiential education. So not just talking about things, but doing it.  

Christine: Yes, yes.

Elizabeth: And one of the things I know we touched base on was could we create a little, a micro dose, as it were, of Community As Medicine or arts based well-being here tonight in this conversation for each other and for our listeners?  

Christine: Yes. I'm so excited to do this. Yeah.  

Elizabeth: Okay. Well, I can offer little bits of some of the methodology that we might use in Community As Medicine, and maybe you can bring some of your lens and we can co-create this a little bit.  

Christine: Let's do it. I love it.  

Elizabeth: Okay. So then my invitation for listeners out there is to just follow along. I wish we could see you and talk to you, but we're going to talk with each other. And if you have a pad of paper and a pen, you might want to jot some things down as we go through this, and then we'll debrief at the end. Sound good?  

Christine: Perfect. I love it. Let's do it.  

Elizabeth: Okay, great. Okay. Well, if we're going to start in this Community As Medicine framework, one of the things we like to do is take a look at different domains of well-being and in a really gentle, non-judgmental way, reflect on where we feel like we are rocking it and where we feel like, oh man, there's room for improvement. You down to do like a little micro assessment here?  

Christine: Absolutely.  

Elizabeth: Okay, great. One of the metaphors we like to use is being on the court or in the stands. So if you imagine a basketball court, if you're playing basketball, you're playing the game, you're down on the court. Now it doesn't mean you're winning, right? You might be shooting and scoring and falling down and referees and all that, but you're engaged in moving towards what you value. And if you're in the stands, you might be cheering or booing or checking your phone. You're fundamentally not playing the game. And we like to use that metaphor to just help us bring to life like, ah, yeah, where am I putting my attention and engaged in creating my well-being? And where am I saying that that needs to be a back burner right now? No shame in this. Just like cannot put my attention on that one in this moment. With that said, let's look at four domains of well-being. The first one being physical activity. So if 10 fingers up was like, I'm crushing it. It doesn't mean that I'm a marathon runner. That is not the goal. It just means that what I'm doing is working for me. And maybe one finger is like, oh, the couch and I got pretty close in the pandemic. There's a lot of room for improvement. Where would you say you are right now? And I'll do it with you.  

Christine: Okay. Okay. I'm at a four right now. I just launched a brand new program this year.  

Elizabeth: That’s right, that’s right.  

Christine: So I haven't moved in a really long time, but I went to the gym today, but I am at a four.  

Elizabeth: Perfect. Loving it. Yeah. I would say I'm at a six. I've gotten into pickleball. I know. Me and the rest of the world. It's so much fun.  

Christine: Yes, no shame.  

Elizabeth: It's so much fun. It's a cliche, but it's there. I think I'm at a six. It's like room for improvement, but doing okay. Alright, so if you're out there listening, you could just jot your number down. This would be like Move and then write your number down. Okay, let's do another one around nourish. Ten fingers up would be like the way I'm nourishing my body is working for me. It doesn't mean I'm a superfoods person. It just means like what we've got going on is working. Maybe one finger is like, oh, there's room for improvement. Zero fingers would be like I've eaten nothing but Hot Cheetos and Diet Coke for the last year. Yeah. Where are you at on this one? I think...  

Christine: I am 100% a live to eat person.  

Elizabeth: Okay.  

Christine: Food is my thing, but I'm currently at an eight because I keep forgetting to eat lunch.  

Elizabeth: Got it. Got it.  

Christine: But I would be a ten. Like in terms of the way I nourish, I am a ten for sure. But my ability to nourish is at an eight.  

Elizabeth: Hey, that's really good. If we were in the same group, I'd be like, I'm going to learn from you. What is your trick? I think I'm at a solid five here. I feel like, I feel good about the food I'm eating. And then I eat so much dark chocolate on top of it that I feel like I maybe like negate the effects. It's like it's solid into the addictive terrain.  

Christine: Fair. Fair.  

Elizabeth: Yeah. So if you're out there, you might just note it like where are you? Zero to ten. How's that going? Okay. Two more. Let's do one about stress and emotional well-being. So ten would be I'm a total Zen master. Calm, cool, collected. Nothing gets to me. Yes. And zero would be like my stress and anxiety and I are close friends. We like to hang out. Where are you at on this one?  

Christine: Hmm. Yeah, I would say currently I'm at about a six.  

Elizabeth: Okay. I was in the same zone.  

Christine: Okay. Like I have, I have some really wonderful resources and skills around that. I don't always implement them as much as I would like to.  

Elizabeth: Yeah.  

Christine: It's like sometimes I know it, but to be it gets a little dicey.  

Elizabeth: I know. It's the psychologist dilemma, isn't it?  

Christine: It truly is. It truly is.  

Elizabeth: Yeah.  

Christine: So I'd say I'm a six.  

Elizabeth: I'm in the same range. Like a lot of good in my life, a lot of support and being executive director of an organization, man, some days like grant funding doesn't come through and it's a tough day.  

Christine: Yeah. Yeah. And we live in a tough time. Even beyond just sort of the day to day, we do live in a tough time. So sometimes that can get a little bit, that can have seepage and I'm not able to say, hey, I need to take care of myself in the midst of this. Some, there are some moments when it's just like super tough right now.  

Elizabeth: Yeah.  

Christine: I'm going to sit.  

Elizabeth: Well said.  

Christine: Yeah.  

Elizabeth: Yeah. Okay. Let's do one more. This is about love and support and connection in your life. So 10 fingers would be like, I'm overflowing with love, support and connection. Couldn't eat another bite. And one finger would be like, I'm hungry for more or I want a different flavor. Like I have this great partnership, but I miss seeing my family or like, I don't have as much time to be with my friends as I want to. Where would you be on this one?  

Christine: I would say I am again at about a six.  

Elizabeth: Okay.  

Christine: A healthy six. It's more of a time and location piece for me. I live really far away from a lot of the people that I care about. So, you know, I'm kind of living on Zoom fumes in a lot of ways. Like I have beautiful community here and there's a lot of love. And sometimes I feel like I'm a little bit on the Zoom fumes.  

Elizabeth: That phrase, that phrase conveys so much. Yeah. I hear you. I was going to say I'm about an eight. I live in community. I have a lot of support and I'm really, I'm on the wrong coast from my family. And especially when my family goes through hard things, I just feel like I'm in the wrong place. What am I doing over here? And that feels hard.  

Christine: I love this scale. I just have to interject here. I love the way that you frame this scale in that a lower number is not a shame-based phenomenon. Right? Like that it's not about there being a problem here. It's about noticing. So beautiful.

Elizabeth: Yeah. You can't be a 10 on everything all the time.  

Christine: No, no.

Elizabeth: It's like life happens. And, you know, I've done this with hundreds and hundreds of people and that experience of like, oh, it's okay to be struggling in some domains and to have something to offer in other domains. Well, thank you for moving through that with me.  

Christine: Yeah. Thank you.  

Elizabeth: We like to do that because it does, it helps that shame start to melt off. And then if I were to guide one more sort of little imaginal activity, you want to follow along with that?  

Christine: I am totally with you. Let's go.  

Elizabeth: Okay. Okay, great. So I invite you to just be comfortable. If you like closing your eyes, you can or not. Just whatever works to you to take your attention inside for a moment. And I will do the same. And I invite our listeners to follow along as well. So just take a moment to check in to your body, your being. Just noticing what it's like in there. We're going to go on a little journey of imagination. And I just really encourage you and everybody listening to do what works for you here. So if following along with me feels good, great. And if at any point you're like, oh, that's not for me today. Wonderful. Just come back to being present and supportive with yourself and caring for yourself in whatever way works for you. So if you want to follow along with me, I invite you to imagine that you could zoom out from your life, like you're zooming up and back and you can see your whole world down in front of you. And then using this magical zoom power, take a moment and zoom in on some domains of life where things are going great. There might be fulfillment, gratitude, abundance, love, nourishment. Let's take a moment to marinate in that. And then if it feels okay to do so, I invite you to zoom back out and then zoom in on the domains of life where things are harder. If you're human, there are probably domains of life where there's frustration, grief, loss, fear, or where you just don't know how it's all going to work out. Just take a moment to be present to that. And then if you're still following along with me, I invite you to call to mind the most unconditionally loving, supportive, benevolent being you've ever met or never met. This could be a person living or passed on, a spiritual figure, just someone who knows you or knew you, has your back, wants the best for you. And if you imagine that person, imagine that somehow that person or being knows or could sense all of what you're going through, all of what you're holding right now, the good, the hard, the fulfillment, the worry. What would this person or being have to say to you? Like if they could write you a letter or send you a voice memo, what words of perspective, of wisdom, of support would they offer you? If you're out there listening, if there's something that comes, you could jot it down. And Christine, I'll share with you that when I do this, almost every time the person who comes to mind is my grandmother. She died just about a year and a half ago. And what she has to say to me is, “Elizabeth, you are already doing enough. It's enough.” That's what showed up for me. Curious if anything showed up for you that you would feel comfortable sharing.

Christine: Oh, yeah, absolutely. A very dear colleague and friend, someone I've spent almost 25 years with now, professionally and personally, came to mind very quickly. And this is something I've actually heard in real life. And it came immediately. This person shared with me or said to me more than once, “You are a gift in this world.”

Elizabeth: Oh, potent.

Christine: I know. It's such a wonderful thing to kind of rest in and remember.

Elizabeth: Thank you. Yeah.

Christine: Well, thank her for saying it out loud.

Elizabeth: Yeah. I know it's funny about this. It's like they said it, but also I said it.  

Christine: But here I am. Yeah, it's beautiful. Yeah.

Elizabeth: Well, we've been in the Community As Medicine mode here, and I'm curious about how you would pull this forward or through from more of an arts-based…

Christine: Yeah, this is a perfect moment for that. So we've just had this imaginal realm moment, which is what we'd call it in the arts-based work. And we use a lot of symbol and metaphor in our work. And so a way that we talk about keeping something like what we learned from our friend or from our unconditional loving being, is to create a symbol or a metaphor of that message or of that person. And so when I think of this person, I think of candles and sort of like a candle that's always burning and it's got like the most amazing smell and the flame is always on, but it doesn't get too hot. The glass doesn't get too hot. It's just sort of this always burning candle. And so for me, the symbol of an eternal candle is something that has a lot of, gives me a place to anchor into. And it's got a lot of sort of meaning for me in the sense of like the light of it, the scent of it, the how it captures my attention. And it makes me remember, you're here in the moment, wake up. And so I invite you, is there an image or a metaphor that comes to mind, a symbol that comes to mind that helps you to really be like, if I think of this symbol, I will think of that message?

Elizabeth: You know, it came to mind immediately, as soon as you start talking about a symbol and it's this image of my grandmother's hands. And they are, you know, they're old and veiny and spotted, but I also associate them with so much love. And yeah, there's something about like, hey, we are all in the process of getting old. And there's something about that sense of enoughness of like, stop, be here. You're doing enough, you're being enough. Like there's something about that in the image of, or even the tactile memory of her hands that stands out for me.

Christine: Yeah. Yeah. And so using these as examples that, you know, to the people who are listening along, I really invite you to, if it doesn't come naturally to you, if a symbol doesn't immediately pop up, another way that you can approach this is wherever you are, whatever your environment is around you, look around. What grabs your attention? What grabs your eye? What do you see? So for example, when I look directly up, I see these amazing cacti that are growing in this planter. And the cactus is such a great image of resilience and strength and sort of toughness. And I really love cacti. I have them sort of all over the house. And so when I look at that, that's another image or symbol. And so if you look around your space, there might be something that captures your attention. That's another way to find a symbol. And then if it works for you, wherever you spend a lot of time in your home or what have you, find that image, print it out on your computer, or maybe you have, you know, maybe you're a frog collector or you have elephants all over your house and they're important to you. Grab that symbol and put it nearby, you know, and allow yourself to remind yourself, engage with the symbol. And Carl Jung used to talk about the fact that like when we start to work in symbols and work in metaphors, we start to see them everywhere. So notice if you start seeing the hands of the elderly, notice if hands start to have a different flavor or tone for you. I'll be noticing candles probably over the next couple of days. And that's our gateway into the message that we need to remember.

Elizabeth: I like that. That's our gateway.

Christine: Gateway, right? Our symbol becomes, I see the candle. I remember I am a gift in this world.

Elizabeth: I love it. Okay. Great. Well, is there one? Yeah. And then how would we pull this through from, okay, I have this symbol. I'm looking for it in the world. How does that then become, I'm changing my life. I'm creating wellbeing for myself. I'm making a difference.

Christine: Right. This is where I go back to the start small piece again. So instead of saying, I'm going to pick something in every single domain, when I would be working with someone and when I'm working with myself, I would say, okay, when I was doing my assessment, which of those categories did I score the lowest in? That probably would be where I started. So for me right now, it's movement. And scoring a four is not where I'd like to be. Ideally, I'd love to be more along the seven or eight line, let's say in the next couple of months. I'm not going to, it's not going to happen tomorrow. It's not going to happen by the weekend, but in the next couple of months, how can I get myself to a seven or an eight? How can I take that burning flame in me? And how can I ask myself as a gift in the world, how can I incorporate more movement so that this vessel that the gift resides in, that the gift is can get stronger and healthier and more active and more engaged? And so that's how we might take it. So if your symbol is hands, you know, what do these hands need to create in order for me to take that next step?

Elizabeth: I love that. Yeah.

Christine: How might these hands guide me? You know, whatever, whatever way it works for you. Sorry to interrupt you.

Elizabeth: No, this is great. Yeah. Yeah. You know, as we start to wrap up, I think, you know, if we were, if we were ending a Community As Medicine group, the question would be something like, if you were your whole life's doctor, not just your body's doctor, but your whole life's doctor, what would you prescribe for yourself? Right? And I can even imagine it being like, you know like, what, what is the symbol prescribed for you? What would be, what would be the guidance or the short script?

Christine: Yes.

Elizabeth: So if you're out there listening and you're inspired to write your own prescription, I sometimes hear from people six months or a year or several years after a session like this. And they say, you know, I wrote a prescription and then I taped it on my computer screen and it's been with me all along, as a reminder of what my intention is and what my commitment is.

Christine: Should we, would we like to share our prescriptions right now?

Elizabeth: Okay. Okay. Okay. Yeah. Yeah. Yeah. Yeah. Do you have yours?

Christine: I'm going to make it up on the fly, but I think it's, I think it's really there. Are you ready?

Elizabeth: Yeah.

Christine: Okay. Four days a week, I'm going to light a candle and I am going to devote five minutes of movement, whatever that looks like, to myself as a gift. I am going to gift the gift. And in those five minutes, I am going to just allow myself that time and space with my candle lit to remind me that I am worth that commitment to myself.

Elizabeth: Thank you. Thank you. Thank you. If I were your coach, I'd be writing it down and I'd be texting you in two days going, how'd you do?

Christine: Accountability.

Elizabeth: That's right. That's right. Yeah. You know, okay. Here's what comes for me. If I were my own life's doctor, my prescription would be something like, like every night, I know it's, it's ambitious. I'm just like every other client who's just feeling ambitious.

Christine: Good.

Elizabeth: In addition to the running, the running commentary in my head, I was like, okay, tomorrow I got to do this or here's what didn't get done. Or like, Oh, I forgot about that. I want to take a very intentional two minutes and put my attention on what did happen, in, in service of enoughness. And, and in looking back when my hands are old, not at what, what I failed to accomplish or what we didn't complete in our mission, but, but to take a moment to metabolize the goodness of all that has happened. You know, like I, I can't, every day feels hard, but in 10 years we've accomplished incredible work both in our, in our teaching and in our Community As Medicine work and in our arts work. And so my prescription is to just take a moment to let myself be nourished by that.

Christine: Right. It's another form of nourishment. And it really is that core component of being. And it also ties into belonging in a really interesting way. How did I belong in the world in this way that meant something to me and made a difference?

Elizabeth: I love that.

Christine: Me too. That's beautiful. Thank you for sharing that. And if I were your coach, I'd be texting you and being like, have you been gentle with yourself and remembered to celebrate what did happen?

Elizabeth: Yeah. Thank you.

Christine: Yeah.

Elizabeth: Well, I know we're sort of, sort of completing this little experiential segment. I'm curious about what it was like for you to do that?

Christine: Oh, you know, it's another one of those examples of like, I don't get to do this as much as I would love to in my own day to day life. So what a treat to be able to, to learn from how you all are facilitating Community As Medicine processes. And to know that you're doing this in the world with other people is so exciting. But to be able to experience it for myself is also a reminder that this is something we can do every single day. And it doesn't have to be overly ambitious. And it can be a moment in time that we can then just continue to build on and carry forward. And that there's a cumulative effect to this kind of work, to our own self prescriptions, if we stick with it. If we're good compliant patients, we can really see results.

Elizabeth: Oh, man, I don't know that I'm very compliant as a patient. But maybe when it's my own prescription, I will feel moved to.  

Christine: What was it like for you?

Elizabeth: Yeah, there's something touching about it, no matter how many times I do this kind of work. And what's catching my attention is the art or the symbolic piece. We have, in Community As Medicine, we call them sparks. They're like interactive lessons or topics that we'll bring each week. And we have a spark that we call toolkit for hard days. And the idea is to just help people create their own little tool basket, virtually or physically to support them through hard days. And I've been thinking about this symbol or this artistic piece that we could add to that, that I think could be so supportive of like, ah, when I'm having a hard time, I go back to my representation of what I'm here for or what sustains me or what's good in my world. So that's what I'm taking away. Thank you for that.

Christine: Yeah. Oh, thank you. Yeah.

Elizabeth: Christine, what a joy to talk with you. I can't believe we worked at the same university for 10 years and not had this conversation before.

Christine: I know, I know. And I'm so grateful we've gotten to have it. Thank you so much for being part of this conversation. I've learned so much from you and I can't wait to see where you take open source wellness next. For sure. 

Elizabeth: Likewise. Hey, if people want to learn more about your program or what you're up to in the world, where would they go?

Christine: Yeah. So the expressive arts coaching and community building program is on the CIIS website. So you can go right there and search for us. And we're there. And they can also find community mental health, the program that you teach in, on the CIIS website as well. But how did they find open source wellness?  

Elizabeth: Yeah. Opensourcewellness.org is our Web site. And there's, there's all kinds of different training programs. There's our YMCA programs. We currently have an open call for applications for YMCA around the country who want to deliver Community As Medicine and lots of resources to be found there. And, yeah, as you said, I teach in the community mental health program. So students who want to become therapists who are oriented towards issues of power and privilege and community and systems and structures. That's another place to dive deeper into this kind of conversation.  

Christine: Very good. Well, thank you so much Liz.

Elizabeth: Thank you so much. What a joy.

Christine: This brought me joy. Yes.

Elizabeth: That's right. Onwards together.

Christine: Indeed. Thank you.

Elizabeth: Bye. 

Thank you for listening to the CIIS Public Programs Podcast. Our talks and conversations are presented live in San Francisco, California. We recognize that our university’s building in San Francisco occupies traditional, unceded Ramaytush Ohlone lands. If you are interested in learning more about native lands, languages, and territories, the website native-land.ca is a helpful resource for you to learn about and acknowledge the Indigenous land where you live.

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