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Pathways to Success:
Professional Development Throughout the Career-Span

My fortune cookie read, “Your ability to juggle many tasks will take you far.” Back home in Richmond I am perhaps known as much for my contributions to the art community as for my contributions to the psychological community. I am on the board of several art galleries, curate and organize exhibits, and I am a member of an art gallery and actively exhibit my photographs locally and nationally. I am active in our local and state psychological associations, as well as APA, and regularly contribute psychological interpretations of the news for local and national newspapers, magazines and television shows. And I think it has always been like that for me. I have always set limits and built time into my practice schedule to do what I want, despite concerns for economic survival and the demands for time with my family.

In the beginning there was photography. Images. Lots of images. Photographs of my family, people I have never met, people whose existence preceded mine, people I only know through stories and photographs. Next came pictures of me, and then pictures of my brother and me. Then I began to take pictures, Pictures of my family, images that would be passed down as heirlooms, precious icons of the family, and would one day be seen by generations whose existence I preceded. Finally, I began to wonder how these photographs were related to my being as a family psychologist, and how my being as a family psychologist informs my photographic interests and activities.

My professional and personal interests merged in the evolving field of phototherapy - the use of any and all photographic materials, techniques, and activities in psychotherapy (Entin, 1980, 1982, 1983, 1985).

I am a family systems psychotherapist and engage with people in dialogues about their families to understand their family processes, which operate and shape their ideals, values, character and traditions. I have been interested in photography since my childhood and donned the mantle of family historian in preserving the visual archives of my family through the family photo album and its oral equivalent, the family genogram. The genogram, or family tree, and the family photo album are portraits of a family system (1978). They are structural diagrams of a family’s three-generation relationship system. These interests merged in the consideration of family sculpting techniques by Peggy Papp (1973) and the three dimensional photographic sculptures of Dale Quarterman: the correspondence between these two techniques is that they are both dealing with the same problem, namely, converting emotional processes and relationships into a visual or pictorial image in space. From there, in retrospect, it was only a short step to exploring the use of photographs in family therapy as a technique for facilitating, understanding and mapping the relationship patterns of individuals and their families.

In 1977 I presented a photo-essay at the Georgetown Symposium on Family Theory and Family Psychotherapy. With a colleague, Tim Whitehead, a visual artist, poet and social worker, I explored changes in his artwork after he began the study of his family of origin and visited his “family stomping grounds” in Ireland.

Afterwards, I had the audacity to suggest that I thought Bowen Family Systems Theory could be operationalized visually and you could look at family photo albums to see the translation of Bowen Theory into relationship processes (Bowen, 1976, 1978, Kerr, 1981). People wanted to know how that could be done, and I promised them I would return to the Symposium as soon as possible with the results of my efforts. The question that guided my research was “How can the concepts of Bowen family theory be operationalized and conveyed visually?”

Six presentations later, after organizing the first conference on the relationship between photography and psychotherapy, I returned to the Georgetown Symposium in 1979 and presented a slide presentation “The Differentiated Eye: The Use of Photographs in Family Psychotherapy.” The paper operationalized Bowenian concepts such as triangles, differentiation of self, and emotional cutoffs in the family.

I have used photographs to study self-concept, eating disorders and obesity within the context of the family, and how one’s self image and feelings of sexuality change as a concomitant to this process. Photographs can be used in the treatment of marital sexual conflicts and sexual dysfunction. In such cases, the size and prominence and whereabouts of family pictures and portraits might function to inhibit sexual activity. Kaslow (1977, 1979) often asks “Who is in the bedroom with you?” to shed light on sexual problems in families. Favorite pictures of one’s self, spouse, children and parents are significant in helping to understand their view of the emotional processes operating at the time within the self and family. In contrast “hated” pictures probably function in the same way. And photographs, like all art and creative processes, I believe, are autobiographical, which is another aspect of the processes that I have been engaged in studying for many years.

Studying continuity and change is always a fascinating process, especially when it is about your own life. When I was in graduate school, I could not settle into a dissertation research project, and was even criticized on my predoctoral internship evaluation for not choosing and initiating a research project. My MA thesis was on Tactile Exploration in Normal and Brain - Injured Monkeys (1962), in the Committee on Human Development at the University of Chicago. I was told I had a “flair for research,” and encouraged to go into a career in research and to continue working with primates because they were essential to human development. Having to play by their rules, I none-the-less decided to do it my way. I took the core Human Development and research courses in my second year, and then took my doctoral preliminary exams at the end of the year. I figured that if I did not pass, I always had the “out” that I only had half the required courses, and that if I passed, the following year I would be free to pursue my clinical interests.

My dissertation was on personality development and adjustment in kindergarten children within the Eriksonian framework of ego development (1967). Erik Erikson and his formulations on psychological development over the life span were very popular at the University of Chicago at that time. While his theories had many theoretical implications, its clinical applications remained to be demonstrated. I recall meeting with my dissertation advisor, William E. Henry, PhD, best known for his book The Analysis of Fantasy (1956), about the interpretation of the Thematic Apperception Technique. I told him that I wanted to operationalize Eriksonian theory and translate them into measurable concepts for the assessment of the personality development and adjustment of kindergarten children using the Draw-A-Person Test. Dumbstruck, cigarette dangling from his lips, with at least one inch of ash, as usual, he asked me how I was going to do it. I told him that I did not have the faintest idea, but that I would return in a week with a formulation, which I did.

As you are going through life, it never seems like a continuous or orderly process. Yet, what is striking to me, in retrospect, because these two research interests are separated by some two plus decades, is the continuity of process and interest: the translation of a theoretical framework into a visual representation. More generally, understanding the relationship between psychology and art, theory and pictorial form, drawings and photographs is important for me to maintain my professional balance.

These activities reflect a continuation of psychological growth and development, just as the photographic family albums reflect a continuation of generational rhythms in the family life cycle, presenting a recurring pattern of relationships linking people, the passage of time, and the organization of space far more systematically than is usually recognized.

I would like to touch upon a few important markers in my career. When I left academia to enter full-time independent practice, a friend said that since I was such a social creature and liked to be around people that I should join an organization of private practice, the American Society of Psychologists in Private Practice. Shortly thereafter I became its Membership Chair and the Society became the Division of Independent Practice. The then Membership Chair and soon to be President of ASPPP, Lewis Fields, PhD, became a good friend and mentor. When I told him about my interests in using photographs to understand family relationships, he invited me to the clinic where he consulted to present my work. It was the first step in developing my ideas for the presentation in Georgetown.

It was also through Lew’s encouragement that I got involved with professional activities, attending APA conventions, presenting my work, and getting active in governance. I have been active in local, state and national governance for over 30 years. In addition to the strong network of friends and colleagues at APA, I have presented programs in many different areas, all related to my clinical practice. These twin aspects of professional life have further contributed to my growth and development and help prevent burnout.

Another important marker in my career was a story that appeared on the front page of the Science Times of the New York Times in July 1984, entitled “Photos Speak Volumes About Relationships.” The article led to many other stories in most of the major newspapers and magazines, and to radio and television interviews about photographs and family relationships. This popular field of endeavor also burgeoned into my involvement with psychology and the media, which I have found to be a wonderful outlet for my creative impulses, and is especially welcome as a counterpoint to the rhythm of a psychotherapy session.

Two years ago, at the APA Convention, I had a heart attack on the eve of receiving the Division 42 Distinguished Psychologist of the Year Award. Bob Resnick, PhD, a long time friend and past president of APA, describes my experience as “a shot across the bow:” a wake up call. To me it was a gift, a second chance. This time, I have made health a priority. While the heart attack is obviously a defining condition of my life, I am changing my lifestyle, diet, and practice; I try not to make it a focus of my life.

I firmly believe in taking control over my own life, and my healthcare. I initiated contact with the Cardiac Rehabilitation Program and Diabetic LifeStyle Clinic of a local hospital and now exercise there 3 mornings a week, as well as walking 3 – 4 miles a day on the weekend. I have limited my practice to make sure I exercise at the cardiac rehabilitation program three mornings and no longer work evening hours.

I never thought that when I formed a Task Force on “Closing a Practice due to Death, Disability or Retirement” when I was President of the division that it might in the slightest way have any relevance to me. I consider myself very fortunate that none of the recommendations had to be implemented (P. Pitta, 1994 and P. Freiberg, 1998).

Although I have been a clinical faculty member in the Psychology Division of the Department of Psychiatry of a large mid-Atlantic university for a number of years, I have not been actively involved in their program, despite volunteering to supervise psychology interns. On occasion I have taught medical students interviewing techniques one afternoon a year or supervised psychiatric residents briefly. Last year the situation changed. I responded to a letter from the director of clinical training that an intern wanted “a supervisor with a sense of humor,” and Mary was assigned to me.

Early on, she called to cancel a supervisory session because her patient did not show up. Apparently that was standard operating procedure, all the interns did it and the supervisors said okay. As anxious, vulnerable graduate students many of us probably did it. And, our supervisors probably looked forward to those cancelled sessions as well. However, I was flabbergasted! I replied something like “I have too much to teach you about independent practice for you to cancel,” and that never became an issue throughout the remainder of her training. I could not believe that other supervisors did not think they had anything to offer these early career professionals if they did not discuss their patients. I let Mary take the lead in discussing whatever issues she was dealing with in the training, and not did not necessarily focus on her “long term clients,” my official training designation. Instead, I focused on the issues of professional practice, ethical dilemmas faced in treatment situations, difficult cases and got Mary involved in professional activities, such as student affiliate in the state psychological association and Division 42. In addition, she and her colleagues put on a symposium on supervision and mentoring at the state psychological association convention, a prelude to today’s symposium. We discussed what she was reading and doing, she invited me to present at a couple of conferences at the university that she was responsible for and I probably learned as much from Mary as she learned from me.

The delicate, often precarious, balance between work and play is an essential component in professional development, as well as in healing. We recognize the serious business of play for children, but we seldom schedule leisure time activities for ourselves. We are the potential victims of burnout, always giving, and giving more than we receive, seldom replenishing our own resources. Art provides a restorative power in our lives. Photography serves as my source of balance. I usually carry my camera with me, taking pictures for professional newsletters and archives and personal expression. This fall I am participating in 4 different exhibitions, including a solo show of my photographs. One of my photographs was recently selected for the cover of a psychology book, Handbook of Research Methods in Clinical Psychology, (Roberts and Ilardi, 2003). I find all of these activities very rewarding, hence healing and healthy. As a result of my professional interests in the study of photographs and albums, I have observed many changes in my self, my viewing photographs and taking pictures, my thinking about photographs, families, artists and creative activities and my work with families.

Bibliography

Baker, E. Caring for Ourselves: A Therapist’s Guide to Personal and Professional Well-Being, Washington, DC: American Psychological Association, 2003.

Bowen, M. Theory in the Practice of Psychotherapy. In P. Guerin (ed.) Family Therapy: Theory and Practice, New York: Gardner, 1976.

Bowen, M. Family Therapy in Clinical Practice, New York: Aronson, 1978.

Brody, J. E. Photos Speak Volumes About Relationships. New York Times, Science Times, The Science Times [front page], New York, New York, July 17,1984.

Entin, A. D. Tactile Exploration in Monkeys. Unpublished M.A. Thesis, University of Chicago, Chicago, Illinois, 1962.

Entin, A. D. Personality Development in Children. Unpublished Ph.D. Dissertation, University of Chicago, Chicago, Illinois, 1967.

Entin, A. D. The Genogram: A Multigenerational Family Portrait. Unpublished paper presented at the American Psychological Association, August 29, 1978.

Entin, A. D. The Differentiated Eye: The Use of Photographs in Family Psychotherapy. Photographic Essay presented at the Georgetown University Symposium on Family Psychotherapy, September, 1979.

Entin, A. D. Photo Therapy: Family Albums and Multigenerational Portraits. Camera Lucida, 1980, 1, No. 2, 39-51.

Entin, A. D. Family Icons: Photographs in Family Therapy. L. E. Abt and I. R. Stuart (eds), The Newer Therapies: A Sourcebook. New York: Van Nostrand, 1982, 207-227.

Entin, A. D. The Family Photo Album as Icon: Photographs in Family Psychotherapy. J. Fryrear and D. Krauss (eds.) Phototherapy in Mental Health. Springfield, Ill.:Charles C. Thomas, 1983, 117-132.

Entin, A. D. Phototherapy: The Uses of Photography in Psychotherapy. American Psychological Association, August 27, 1984. The Independent Practioner, January, 1985, Vol. 5, No.1, 15-16.

Freiberg, P. Closing Shop: Steps psychologists should consider when leaving practice. APA Monitor, March, 1998, pp. 24 - 25.

Henry, W. E. The Analysis of Fantasy, The Thematic Apperception Technique in the Study of Personality. New York: John Wiley & Sons, 1956.

Kaslow, F. W. and Friedman, J. Utilization of Family Photos and Movies in Family Therapy. J. Marriage and Family Counseling, 1977, 3, 19 – 25.

Kaslow, F. What Personal Photos Reveal About Marital Sex Conflicts. J. of Marital and Sex Therapy, 1979, 5, No. 2.

Kerr, M. E. Family Systems Theory and Therapy. A. Gurman and D. Kniskern (eds.) Handbook of Family Therapy, New York: Brunner/Mazel, 1981.

Papp, P., Silverstein, O. and Carter, E. Family Sculpting in Preventative Work With Families. Family Process, 1973, 12, 197 – 212.

Pitta, P. Closing a Practice Due to Death, Preference or Disability. Independent Practitioner, 1994, Vol. 14, No. 5, p. 210.

Roberts, M. C. and Ilardi, S.S. Handbook of Research Methods in Clinical Psychology, Oxford, UK, Blackwell Publishing, 2003.

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