Using BioGraffs
in a Clinical Setting
BioGraffs is incredibly flexible, and completely adaptable to your clinical needs and individual treatment plans, whatever your therapeutic modality.
Introduction
BioGraffs can be a powerful way to get your clients thinking and talking about the issues in their life from a totally new perspective. It can be an effective method for so many situations ----
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For clients who are caught up in their own stories
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To help people get distance from their story (externalize)
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To help people talk about hard topics, with you or with a partner
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To gain clarity on confusing issues
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For clients who feel stuck
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For clients when you are feeling stuck
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For couples to understand each other better
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For families that need help hearing each other
If you haven't already, take a look at the Gallery, to see some examples of BioGraffs people have made, with commentary.
The BioGraffs method is for any clinician looking for ways to expand their repertoire of approaches, and interested in exploring narrative and storytelling techniques. Internal storytelling is how people integrate and make sense out of the external events and experiences of their lives. Externalizing these narratives affords an opportunity for people to create distance from events and become the protagonist of their own choosing in the stories of their lives. It gives people a way to create a visual narrative about an aspect of their lives as a physical metaphor of experience that is separate from language. It helps people to slow down in their stories and deconstruct them externally, removing them from the mental tangle of the default mode network.
This manual introduces the clinician to the principles behind using BioGraff’s external simplicity of colored cubes as a metaphorical substitution for inner complexity. In the context of therapy, the invitation to a client is to represent experiences visually in the landscapes of identity and action, using color, quantity, form, and position, and spatial relationships. This approach can be used as a one-time exercise, or be used repeatedly and developed over the course of many sessions, or it can be used in groups. Due to its emphasis on the visual and tactile, this method is particularly useful for people with differing verbal facility, for neurodivergent clients, for couples work, or for topics that people find hard to talk about or have barriers to talking about.
BioGraffs is extremely versatile and ready to be adapted to your clients needs, your treatment modality, and your individual clinical style.
Each BioGraff is a little visual story - and unfolds in a two-phase method. The first phase is the making of the BioGraffs: it helps people slow down and separate out the parts of their experience and then think about how they interact. Use the online title selector to help you think about a prompt to give or use one of your own. You can help them figure out what the parts of the story are (assigning cube colors to big ideas) and how to tell it as a story with the help of the 8 Storyboard Style cards. This helps them externalize and untangle their thinking about this topic.
After they’ve created the BioGraff, the second phasae of the method is using the visual they have created to now retell their story. They may be telling it to you, or to partner, or to a group in a workshop, group therapy session, or support group. The visual anchors their re-telling. It allows them to expound on elements of the story without losing the relationship that element has to the other elements of the story. It helps the listener follow along and not get caught up in the parts. It helps to keep the focus on the storyteller so the listener doesn't derail their telling of their perspective. It invites curiosity to encourage the storyteller to say more.
Let’s explore the BioGraff method deeper, by first looking at an example of how it might work in practice.
Case Example
The following is an actual experience of a person using BioGraffs. The quotes are direct quotes from the recorded session, used with permission. The names and identifying details have been changed to protect identity.
I have been working for a while with Jean, and a recurring topic is the difficulties that she is having with her teenager Sawyer. Each session, Jean typically launches into a “what happened this week” story of the conflicts she and Sawyer have. She reports on the situation. Each story she tells about herself and Sawyer might differ in the details, but at their core they are similar. I want Jean to slow down and look closely at the interactions with Sawyer. I would like to get her to be more in contact with the emotions of the internal experience.
At the beginning of the next session, I suggest to Jean that we try something a little different. I get out the BioGraffs materials and tells Jean that I want her to create a visual of her relationship with Sawyer, and the title of this visual will be "Me and Sawyer in Conflict." I explain that the first task is to think of the main thoughts or feelings that come to mind when she thinks about that relationship in conflict. Each thing will get a colored cube associated with it.
Jean is skeptical of this unusual idea, but begins listing things: sadness, my ability to help, my desire to fix, disappointment in myself, and disappointment in Sawyer. That last one takes her back a bit. She seemed surprised she wrote that. She comments, “That makes me feel really bad. Yeah, I almost want to erase that, but that just came up. I've talked about this a million times and that's never come up before.”
This is a good example of how breaking a complex story down into component parts can help a client tease apart complexities and think independently about things that are mentally intertwined.
As she starts assigning colors, Jean spontaneously brings metaphor and abstraction into play. She says “my desire to fix” is red hot; she makes “disappointment in Sawyer” orange because “I really don’t like that color.” She adds “acceptance” and “patience” to her legend.
Now I ask her: “How would you arrange cubes in those colors to show how all those thoughts and feelings relate to each other? I suggest she build a mosaic, and show Jean the Mosaic Storyboard Style card. I point out how the cubes are arranged to express metaphorical relationships – could Jean try something like that? Jean begins playing with the cubes.
She puts a cluster of sadness down on the board - three purple cubes to represent each person in the family. She puts down two cubes that represent “my ability to help” above and below the family cluster, and then surrounds the cluster with a ring of red, saying “my desire to fix is all around.” She places the “patience” and “acceptance” cubes apart from the cluster and sits back to observe her work.
She comments, “This is ironic because I came in here thinking that sadness was the problem. But I don't think sadness is the problem. This is showing me that sadness is only a little part of the center. And the bigger problem is my desire to fix it.” As she talks, she touches the cubes, connecting with the feeling. At this point she realizes that she left out the “disappointment in myself” cube. She makes another circle around the “desire to fix” circle, saying, “I can't fix it. So I get disappointed and they go hand in hand and they are the most prominent killers. Jeez, that's deep. Yeah, that is deep. My poor kid!”
After regarding the arrangement a bit more, she says, “I think I've been working on the wrong thing. Because acceptance is one tiny little cube all the way out here. And if we did another BioGraff of what I would like it to look like, that would be valuable. To see the different colors, I think I would see a lot more pink, a lot more acceptance.
I now suggest that she could make another BioGraff about what she would like to see in her response to Sawyer. Jean eagerly pushes the cluster she has made out of the way, to clear room for her vision of a better way with her child. Now she makes a large cluster of acceptance (pink) surrounded by patience (blue). She does it with a lot of excitement, saying “Because I'm actually like this. This is what I want. This is what I want.”
Regarding her work again she says, “And I'm actually tempted to not even bring the other things in because they're sort of irrelevant. I feel like that stuff will fix itself if I have this stuff.”
Her final thoughts about the experience: “It is kind of mind blowing. I feel like my heart opened up a little bit in a good way, which kind of makes me a little emotional. I actually I wasn't expecting this result. The truth is that there was a lot that I couldn't figure out. I have been talking this issue to death. I talk to my friends about it. I talked to you about it. I talked to my family about it. And we're just stuck. I'm stuck. So doing this, I just see things that I've talked about a ton, but just to see them this way, it has... I mean, it's opened my heart, I'll tell you that. Like I'm having a lot of emotions, which I guess is part of the best therapy. And I also feel like my mind has been blown and I have some hope that I can work on this problem."
Figure 1 - Jean's BioGraff "How Can I Help My Anxious Kid"
Commentary
This illustrates the experiential nature of making a BioGraff. When we pick up the cubes and start representing our experience in a visual, spatial way, one-step removed from language, people get less caught up the standard every day "selfing" that happens when we talk. Ideas flow freer detached from the need to make sentences and segues. Jean connected more to her emotional sides through the five-senses way that she approached the process: the feel of the cubes, the sounds they make on the board, the colors and the shapes she made with them.
Making the BioGraff created a much more connected and integrated way of contacting her experience and communicating her experience. She "drilled down" into her experience to better access what was happening, and what she wanted.
I was an audience to her experience, but choose a moment to suggest ways to continue interacting with the cubes and the metaphors Jean had created, with the suggestion to make another BioGraff of how she wanted to be with Sawyer. This came very naturally out of Jean's comment about what another BioGraff might look like. Any suggestion about moving or changing the arrangements gives the client another opportunity to have an experiential relationship with the metaphors they have established.
Introducing the Process to a Client
Having your client make a BioGraff in a clinical session can be a very interactive and productive process, both the making of the BioGraff and the talking about it afterwards. In my experience, as soon as people start working on the task, it’s not uncommon for them to narrate their process as they go. This creates many opportunities for you to both understand their perspective, and guide them in the process. You can also assign the process as homework, by suggesting they purchase a personal kit. They can take a picture to bring to session, or recreate their work in session to discuss.
You might say something like this: "I want you to try something that might help you get a new perspective on this issue. I'm going to walk you through making a visual representation of (your depression, the anatomy of a bad day, how you feel about your mom, what you want in life, how you feel about food, or whatever it is). I think this will help you sort out all the complexities, and then talk to me about it with more clarity. Do you want to try?" Maybe a topic keeps returning in session, and a fresh perspective could be useful. Maybe your client is having trouble explaining how they feel about something, or is even having trouble accessing how they feel. You might say, “how about we try something new to explore your feelings about that in greater depth?”
Here are some more useful explanatory words: "In this visual representation, you are going to think about all the parts of your experience. You'll make each part represented by a different colored cube. You'll start by making a legend - a key to what each cube color stands for. Then you'll arrange the cubes in a pattern that represents how these things relate to each other."
I often explain the activity in terms of storytelling. I'll say, "You have a story in your head about (what it means to be a parent, how your partner supports you, what it is like to be depressed, or whatever). Let's make a visual story about that thing. First you'll think of all the parts of the story: the events, the feelings, the actions, the thoughts -- whatever is involved.
At this point, people are often confused, but assure them that all will become clear.
Picking a Title
The first step is to define the parameters of the visual story we are going to create (the prompt). We call a BioGraff prompt “a title,” to highlight that these are visual stories. People have an instinctual relationship to stories that we see as an important part of this process. To read more about storytelling and narrative therapy, check out our blog here.
For inspiration, head over to the Title Picker to browse categories and title ideas. We are adding to these all the time! If you have suggestions for titles or new categories, use the contact form to tell us about them, or write me at jen@biograffs.com.
Some examples of titles might be:
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A Bad Day in my Anxiety
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The Strengths in my Relationship
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How I Feel in my Body
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My Grief Today and in the Future
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How My Partner Gives me Strength
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Who I Want to be as a Parent
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My Favorite Sexual Flow
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A Vision of Myself Without Depression
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My Traumatic Experience
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A Good Memory of my Childhood
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A Bad Interaction with Mom
Tell them the title you want them to use, either picking one of the titles listed in the Title Picker, or using one you make up specifically tailored to their needs. Or they might want to phrase one in their own way.
Deciding on a Story Style
Now show them the Storyboard Style Cards. These will help them understand the activity much butter. They show different ways of telling a story with cubes.
Every BioGraff is a unique expression of an aspect of a person’s experience, but they do fall into broad categories of the way people approach this exercise, what we call “story structure.” After looking at hundreds of these images, we have noticed some trends -- general ways people approach this exercise of creating a visual story with colored cubes. These trends are represented on the Storyboard Style cards.
You might want to have in mind what sort of BioGraff would be most helpful for your client to make. The Storyboard Style cards can be used to quickly pick a style and show to your client as you explain the process. You might also show them all the cards and help them select which one makes the most sense for their situation. Looking at these may also help them narrow down the story they want to tell. They might have started with a title like "The Parent I Want to Be" and after looking through the cards they might decide on "The Parent I Am and the Parent I Want to Be," or "A Moment When I Was the Parent I Want To Be," or "What Happens When I'm Not the Parent I Want To Be."
The following examples explain each of the 8 Storyboard Styles represented by your enclosed Storyboard Style cards, in more detail.
Event Timeline Storyboard Style
The most common BioGraffs are like a timeline that begins with an event, usually on the left, then shows a linear progression of legend items in varying proportions. The Legend items will be things that happen, happened, or that they would like to happen. In the early years of BioGraffs, when it was the Graphic Sex Project, this was the most common type of "graph." People were essentially making an image of their prefered sexual script: what happens first, what happens next, showing order and proportion of their favorite sexual flow.
This style is useful for all kinds of events - either things that happened (My Traumatic Event, My Happiest Childhood Memory), things that typically happen a particular way (When Things Go Wrong with my Mother, A Common Anxiety Situation), or something they would like to happen (How I Will Ask for a Raise, How I Would Like to Respond to my Anxious Child).
These timeline can look very, but they are all easily readable as a sequence of events and actions:
Figure 2 & 3 - Timeline Storyboard Styles
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What You Care About Storyboard Style (Values)
Ranking is a common way people choose to make a Graff. This is a good way to have someone think about their values - what is important to them to varying degrees and how they relate to each other. The BioGraffs resemble bar graphs, where different numbers of cubes for different legend items indicate the degree to which something is valued.
Figure 4 & 5 - What You Care About Storyboard Style
Life Timeline Storyboard Style
These BioGraffs are a good way for people to think about their life over time. They could show changes in:
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Mood (My Life of Depression)
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Feelings (My Feelings for My Partner Since We Married)
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Personal Qualities (My Ability to Speak Publicly)
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Self-Image (How I Have Felt About My Body)
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Relationship History (My Dating Life)
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Trauma History (The Escalating Abuse)
Making a BioGraff like this is a good way to reflect on one's history, notice changes, see improvement. It's also a good way for you as a clinical helper to see how your client sees their own history.
Figure 6 & 7 - Life Timeline Storyboard Styles
Comparisons Storyboard Style
People can also create two BioGraffs side-by-side that show different versions of the same thing - either on the same board, or use both boards at the same time. So many things can benefit from making a comparison. For example:
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How We Argue vs How I Wish We Could Argue
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Sex When It's Good vs Sex When It's Bad
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Where I Am Now in My Journey vs Where I Want to Be
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How I Felt Steamrolled vs What I Wish I Had Done
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My Depression vs What I Would Be Without It
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Who I Am With My Addiction vs Who I Would Be Without It
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How I See My Body vs How I Would Like to See My Body
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What I Get From My Partner vs What I Need
Figure 8 & 9 - BioGraffs illustrating Comparisons Storyboard Styles
Events and Feelings Storyboard Style
This is very similar to the Event Timeline. Suggest to your client building on the recitation of the actual events, with legend items that indicate feelings or thoughts. The founder of narrative therapy, Michael White, called these the landscape of action (the events) and the landscape of consciousness (the meaning that is applied to the events). In making a BioGraff, these two elements can be explored separately. He said, "It is in the trafficking of stories about our own and each others' lives that identity is constructed. The concepts of landscape of action and landscape of consciousness bring specificity to the understanding of people's participation in meaning-making within the context of narrative frames." This is, in a nutshell, what I believe is the core function of these little visual stories. They give people a way to slow down and explore their "meaning-making."
Figure 10 & 11 - BioGraffs illustrating Events and Feelings Storyboard Styles
Mosaic Storyboard Style
These can be extremely rich with meaning and subtext, because they contain so much metaphor. People instinctively reach for spatial metaphors in the construction of their BioGraff, especially if they let go of any connection to the idea of a typical "graph." These may have an overall connotation of meaningful objects, like houses, flowers, or humans, or be simply a design, or meaningful clusters of items.
Notice how your client is using visual metaphor to communicate their story. In relation to other cubes, cubes can branch out, override, protect, cradle, stand apart, support, hide, cling to, hang off of, grow out of, spring from, layer over, depend on, be intertwined with, encapsulate, oppress, go along with, be near or far from, be underneath... These relationships can carry meaning for you about how your legend items relate to each other in your story.
Metaphors bypass the logical brain, and go straight to feeling. In discussing the BioGraff with your client, be curious. Ask questions like: tell me more about how these brown cubes are under these other cubes? why did you choose black for this item? what does this shape indicate? these cubes seem to be rising above these others - does that mean anything? what does this separation mean to you? You arranged the red cubes in the shape of a heart - what does that mean to you? These black cube seem to be suggesting a wall - is that right?
Figure 12 & 13 - BioGraffs illustrating Mosaic Storyboard Styles
Mosaic Comparison Storyboard Style
A combination of the Mosaic and the Comparison. This style is good for comparing values or outcomes, or expressing where I am now compared to where I hope to be.
In the BioGraff on the left, notice how the "now" image is more chaotic than the "goal" image. What meaning does that carry?
On the BioGraff to the right, notice how the structure of the 3 clusters expresses a sense of being enclosed and overwhelmed on the left - and an expanding flower of positive things on the right representing where she hopes to be when she is less in the grip of her grief.
Figure 14 & 15 - BioGraffs illustrating Mosaic Comparison Storyboard Styles
Creating the Legend
Now that the groundwork is laid, it's time to start with the creation of the BioGraff. The first step is to create the legend - the key to what each cube in the BioGraff stands for. Suggest to your client(s) that they think about what the component parts of the story are, as suggested by the Title.
Consider a very broadly worded prompt like, “What Happens When I Have Anxiety.” The legend items could be a list of activities (I go in my room, I pull my hair, I yell at my loved one) or it could be feelings (my heart races, my stomach hurts, I'm scared) or it could be things that trigger the anxiety (I’m asked to go to an event, my partner criticizes me) or it could be thoughts (my mind races, I imagine terrible outcomes). Or the legend could include items from a combination of these.
A more specific title might be “An Episode Of Your Anxiety Triggered By _____, And How It Progress In Your Mind.” Now the legend items might include an event (I get an invitation, the phone rings, my partner is angry) plus feelings and thoughts.
Another example: you might say something like this: "Think about a time when things with your mom went badly, and let's make a BioGraff about that. What happens? I want you to write down the parts of that story really briefly, like just a few words for each part. Is there a thing that happens - like something she says?"
Have them write along the top of the long edge and leave lots of space for the next part of the method.
You want to encourage them to use very few words to represent a big idea. "She criticizes me" is better than a long description of what she actually says, or even just "Criticism." The legend item only has to tag a mental concept that has associations for them. When they describe their BioGraff later, the short tag will call up those associations and create an opportunity to expound and explain in more detail. Tell them to label each cube with only a word or two that stands for a more complex idea.
Continue having them name parts of this story, giving each a color. The parts can be feelings they have, feelings other people have, desires, objects, things they do or other people do or say, interpretations or abstractions, thoughts, events or circumstances.
In the process of making this legend, they are telling this story to themselves and parsing out the elements - slowing down to think about each piece individually, separate yet connected.
If they have more than 10 legend items, offer the sticker dots to add to cubes.
Building the BioGraff
Now they are ready to build the image. The building phase can unfold in a few different ways, based on what you feel is the best way to proceed.
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They work on their own while you sit apart and give them space
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You might encourage them to talk out their process as they go if you are working with them one on one
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You might work together, where you are suggesting things for cubes to stand on based of your understanding of their issues, or asking questions or giving guidance as they work.
It is typical for the legend items to change in the course of building a BioGraff. People often think of important elements to add once they start creating the visual. You might also probe a bit into their item choices and make suggestions. You might notice that a legend item is very broad and could be split into two separate colors. For instance, if your client is making a BioGraff about their preferred sexual script, they might make one cube represent “foreplay.” You could ask them “what’s foreplay for you? Could you split that cube and be specific about some of the activities that are good foreplay for you?
This is the end of the first phase of doing BioGraffs. It generally takes about 10 to 20 minutes to explain the exercise to someone and have them build their BioGraff.
Talking About the BioGraff
The Re-Telling
Talking about the BioGraff is the second phase of the method.
A BioGraff is a visual story that communicates meaning. We believe the most useful first step after the BioGraff is created is for the client to tell the story of their BioGraff. Ask them to explain it to you. If it is a timeline-type BioGraff, this re-telling unfolds like a typical story. Other types of BioGraffs might be described in different ways.
One powerful element of re-telling a BioGraff is that people can talk in detail about one element of the story, without losing the thread of how that one part connects to all the other parts. This helps with people's sense that spending a lot of time talking about one aspect of their experience will overweight that aspect for the listener. For example, if someone has made a BioGraff about the death of their mother, one legend item might be a sense of relief that managing their mother's care is ended. With the BioGraff to anchor all their feelings, they feel freer to talk about this one aspect, that they might fear would seem selfish when disconnected from all the other complex feelings they have.
Another example, if they have a BioGraff about their feelings about their relationship with their partner, the positive aspects of the relationship stay in view and in play, while they talk at length about one negative aspect. This can make it easier for a partner to listen to the negative. Similar to how it is good practice to give one or two positive pieces of feedback before giving the negative, the BioGraff goes one step further and keeps the positive in view.
Curiosity
A BioGraff creates space for curiosity. Questions about meaning come easily to the mind of the receiver of the story - why this color? why this placement? what does this shape mean? This creates more opportunity for the BioGraffer to expound on their story and say more. The BioGraff creates questions that are easy to ask, and questions about their BioGraff from the listener help the BioGraff-maker feel more that their perspective has been heard and understood.
Re-Making and Adjusting
After the re-telling, look for ways for the BioGraffer to interact more with the BioGraff they have made. The cube colors are now imbued with meaning, and moving them around on the BioGraff can create powerful experiential moments. It can help people bring in all their body and senses into the experience. For example, if there are elements that are below other elements because they are repressed in some way or subservient to other elements, how would it feel to move that element out into a more prominent place?
Or you could suggest re-arranging the cubes to change the represented experience to one that is more positive or healthy.
Using with Two People
BioGraffs is a powerful activity for couples. It encourages curiosity with a goal toward understanding. The BioGraff, as a visual aid, holds space for each person's perspective and experience. It invites curiosity from a partner. It has a playful aspect even with intense subjects, so it can calm defensive reactions.
It creates space for elaboration. It forces a default to curiosity instead of confrontation, or story-topping, or correcting. It invites follow-up questions. It derails the back and forth that can turn into co-opting, so the listener can learn more about the BioGraffer and their life and their perspective.
It evens out unbalanced facility with language. For partners that talk less, it gives them an easier platform to share from. For partners that talk more, it contains their discourse into a single storyline. It uses different modes of communication other than just talking, so it doesn't privilege the adept talker.
The Re-Telling
After the creation of the BioGraffs, each partner may tell the story of their BioGraff to the other. This has similarities to the Imago-style dialogues. Each person has the floor for a period of time to re-tell their BioGraff as the "sender," with their partner (the receiver) restating what they are understanding, seeking confirmation that they got it right, asking questions, and encouraging the sender to say more. In this way, you could use the BioGraffs as an introduction to mirroring.
Alternatively, and depending on the partners, it might be productive to have each partner re-tell their partner's BioGraff as the first re-telling step. In this sense, the BioGraff itself is the "sender." The receiver tells the story of the sender's BioGraff as best they can, and the sender confirms or clarifies. The receiver then restates their understanding, expresses their validation, and asks if there is more that they are still missing.
The two BioGraffs below were made by a married couple of 20 years at a BioGraffs workshop for couples. It became a playful way to talk in depth about a difficult, common, issue of dissatisfaction over division of chores and how that relates to sexual desire discrepancy.
Figure 16 & 17 - BioGraffs made by a married couple
Using in Workshops
BioGraffs is a powerful activity for workshops of all kinds and weekend intensives.
One benefit of the BioGraffs method is that is creates even amounts of space for all participants. The storytelling style draws out the people that tend to talk less in a group. It gives them a way to think through and plan what they are going to say. It gives them a guide as they are speaking. It gives focus to both the speaker and listener. It makes it easier for the listener to follow the full story that the maker is communicating.
It also creates a natural limit to the story being shared, so one person doesn't dominate the speaking space.
Situations where making BioGraffs together can be particularly effective:
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Adolescent groups, where it is often difficult to get young people to talk
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Group therapy
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Support groups (grief, substance abuse, domestic violence support, end of life, chronic illness)
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College age mental health support
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Couples communication workshops
BioGraffs is also effective in corporate retreat settings. Find out more on our groups information page.
Conclusion
The BioGraffs method is limited only to your desire to get the most out of it. It may be an activity that you use occasionally in limited circumstances; it may be something that you use at least once with nearly every client; or it may be something that you use repeatedly with clients that have an affinity toward the method.
You might find that certain client cases are particularly well-suited to this method.
We continue to develop the BioGraffs method and will notify you when we make major revisions or additions to this online manual. We anticipate developing a forum where users can share their individual method and cases where they've found it particularly useful. We hope the BioGraffs community will continue to learn from each other and grow.
We welcome feedback, requests, and anonymized case examples so we can all learn about the rich potential of the BioGraffs method. Write us at Jen@biograffs.com