OH in Clinical Therapy Work

Diane Kukulis

Bay City, Michigan, U.S.


I loved the OH Cards the moment I first saw them and have used them with clients in my private practice and in workshops/trainings I’ve been facilitating around Michigan. The clinical work I do is quite grounded in the use of images: I use sandtray work, SoulCollage, and play therapy. The use of images is very powerful. A picture is worth a thousand words.

I first came across OH Cards at the Michigan Association for Play Therapy’s 2012 Annual Conference. Myra Lawrence did a three-hour workshop using them and also took orders for purchasing the cards and a booklet she had written about ideas for using the cards therapeutically. I bought one of every deck she offered.

My first experience with OH Cards involved a group of five play therapists at a training. We were asked to have one person in the group describe a recent experience they’d not yet had the opportunity to process. A woman described a recent turn of events that involved her husband, a vehicle accident, and how the events had impacted their daily schedule. She was a busy person in a busy family and most of what she shared involved the logistics of winter travel in northern country: getting to another city in bad weather to pick up her husband, negotiating transportation due to the loss of a vehicle, etc. We in the rest of the group were each asked to search out a card that somehow described an aspect of the story we’d just heard. The images on the cards we chose brought to the forefront the unprocessed emotional content underlying the woman’s story. Each of the cards captured feelings she hadn’t directly spoken to or processed yet, but were embedded in the story and had impacted the rest of us. The image I chose was of a pack of wolves in what seemed to be a snowy background. Some of what I heard in her story was the riskiness of traveling in winter weather that can turn dangerous – like encountering a pack of wolves. I don’t know that I could have put that into words for her had I been asked, but when I saw the image it resonated. That was very powerful for each of us.

There’s something about the use of images that helps to slow down and deepen a process

In my clinical work, I find that the OH Cards help to further processes in families that might stall just short of getting at core feelings. There’s something about the use of images that helps to slow down and deepen a process that may be vulnerable to being trivialized or glossed over because of habitualized family patterns.

I most frequently use the original OH deck, the COPE deck or the SAGA deck in my clinical work. I have a large fiberglass lunch tray that I spread cards out on and ask family members to find a card that helps them describe how a moment feels or felt, or that describes what they hope for. I also use sandtray images for the same process. What I like about the OH Cards is that they show images of beings in relationship to one another, which better facilitates getting at relationship issues than working with sandtray images does. Perhaps OH Cards are a little more directive, but I think they’re also more supportive.

I’ve used OH Cards in trainings to exercise the right hemisphere and to help people have that experience of deepening the reflective process that the right hemisphere does so well. I emphasize this by telling participants that our right hemispheres are primed and ready to go at birth and that babies are powerfully impacted by the images they take in. This provides a foundation for further exploring the idea of using the right hemisphere to gain information and to communicate with clients.

There are a couple of guides I use in my work with OH Cards: Memories Activity and Work Experiences (downloadable below as PDF files). I use the the Memories Activity guide when I do presentations on “Relational Poverty and Early Trauma” and I use the Work Experiences guide in a presentation I do called “Using Art and Image in the Reflective Process.” In Infant mental health work there’s a strong emphasis on the reflective process and reflective supervision, so I’ve developed some trainings that focus on reflective capacities and process.

I find OH Cards to be most amazing at revving up the right hemisphere and promoting reflective capacities, and I get a lot of inquiries about them from participants in the workshops and trainings I do.

The two guides mentioned in the article can be downloaded as PDF files by clicking on their titles here: Memories Activity and Work Experiences.