Leading by Design -Chris Cohoon ’16, TLAD
The climate here is hot. Since my arrival on June 15, the temperature and humidity have rarely dipped into the mid-eighties. Okinawa is a magical emerald mountaintop breaching the aquamarine canvas where the East China Sea meets the Pacific Ocean. Its history and culture are rich. It is the birthplace of karate, the site of one of the fiercest battles in World War II, and boasts the world’s largest population of centenarians per capita.
Due to Okinawa’s location halfway between Taiwan and Kyushu, Japan, it has served as a crossroad of commerce, culture, and conflict. The ancient Ryukyu Kingdom payed tribute to China even after they were annexed by Japan in the 1600s. Their remote location allowed them to maintain a degree of political freedom and preserve their native language and culture. During WW II, local people were pressed into service to build air fields and defensive structures, boys as young as middle school were put on the front lines and many of the girls served as nurses for the impending U.S. invasion. When the battle was over, some estimates claim as many as 140,000 (about 1/3 of the population) civilians were killed or missing.
America held onto the island after the war, until 1972, when it was handed back over to Japan. One of the conditions of the post-war treaty with Japan is that they cannot have their own military. They are allowed to maintain a small self-defense force, but the U.S. is largely responsible for defending Japan. Okinawa has remained a strategic location for the U.S. presence in Asia, playing key roles in Korea, Vietnam, and even recent conflicts. Some of the outer Okinawan islands have been in the news in the past couple of years because of China’s claim of sovereignty over them. Tensions have risen in the region with China, North Korea, and Russia all rattling their sabres. When North Korea test fired its medium-range missile, last year, one of my friends was able to see the contrail on the horizon from a block away from my apartment.
Because of these factors, America maintains upwards of 50,000 military personnel on island, along with 45,000 family members and civilian support personnel. The vast majority of those troops and family members rotate within 3-years, many sooner. One can imagine that, with a population of 95,000 at any one time (or likely close to 150,000 individuals/calendar year due to rotation), there are some bad apples that come through. A hand-full of violent crimes have been perpetrated by Americans since 1995. The local political climate has heated up a little more with each incident until it seems to have finally matched Okinawa’s subtropical weather.
The week after I arrived on the island, reportedly 65,000 people turned up for a rally to voice their concerns about the U.S. military presence. The rally was centered around a recent murder and the controversial decision to move a Marine air field to a base on the north end of the island. As I have talked with my Okinawan neighbors, they express that their anger is not so much with the U.S. presence, but with the Japanese government for treating them as other, and for not including the local people in the discussions about decisions which greatly effect them. Nearly 50% of U.S. personnel are housed on an island that makes up .6% of Japan’s land mass. U.S. bases use 20% of Okinawa’s land mass. The question, for many of my neighbors, is why there was no consideration to move the air field to the mainland.
So why does all of this history matter to my project? Because the undergirding principle for any design project is empathy. And to adequately empathize with someone, you need to understand the context. In fact, you can likely guess what my lesson covered for the first design as leadership classes on Saturday…EMPATHY!
Now I get to tell you the exciting news about my classes! We meet for 3 hours each, every Saturday. In the mornings, I have a group of Marines, and in the afternoon, a group of high school students. Because of the week’s work schedule, the marine class was smaller, with 2 marines, an Air Force airman, a chaplain, and his daughter. We have 3 more marines confirmed for next week, which is exciting. The chaplain grew up surfing and often commutes the 3 or 4 miles across the bay to work on his paddle board! He said he’s excited to learn the leading by design program so he can start one on his base down south with marines in the fall! Our high school crew reached 9, including one dad – who is a Navy dentist on the Marine Corps base.
To provide a framework for our experiential learning program, we are designing and building a stand up paddle board for each class. I was a little concerned when I arrived on island and learned that the goals of the class might have been miscommunicated and people were expecting to all build their own boards. I braced for the worst when I told them that I have never built a board, but that design is a collaborative learning process. To my surprise, all of the students left excited to learn design thinking skills, whether we successfully build a usable board or not!
So, how does one introduce a paddle board design project with little-to-no expertise about paddle boards? If you have tired of my droning and skipped directly ahead to the pictures, you know the answer. You go to the beach!! The first step in the design process is research! So, after an introduction to design thinking, students took one for the team and hit the water to try out a few different types of boards. You could tell they were gritting their teeth and gutting it out as they laboriously plodded through the tedious research. Sometimes it’s hard to get any work done when you live in paradise. But, with great resolve, the students pushed through to the end.
After the water session, we all piled into our workshop to talk about the importance of empathy as research. Okinawa (as demonstrated above) is a rich context in which to learn such a valuable skill. The two young marines arrived on island in February and new very little local history, or why there is so much talk about protests and demonstrations. This was also their first chance to venture off base and were timid to try anything but the local McDonalds to eat (consequently, after each class, we will eat lunch at a different momasan & popasan restaurant – they don’t know what world-class treats they’re in for)! I hope to incorporate some Okinawans into the class, as well. In fact, I’m just about to head to a local surf shop to meet some of the local experts while students are busy conducting surveys, interviews, and just getting to know people.
Until next time, get out and get to know your neighbors!
Chris
What is a Biofeedback /Bio-responsive Game? | Boston Children’s Hospital | Yuko Okabe, BFA Illustration 2017

Neuromotion logo
With another two weeks having flown by, I’ve encountered several enlightening, challenging, and overall eye-opening experiences. To summarize quickly here, I was able to meet and interview two patients about how they felt about a character that could support them through this game. I also met with the hospital’s Psychiatry Assistant Director of Outpatient, Dr. Lauren Mednick, as well as Director of the Developmental Neuropsychiatry Clinic, Dr. Joseph Gonzalez-Heydrich (one of the co-founders of Neuromotion along with my supervisor). I also spoke with an art / expressive arts therapist who gave great advice about unconventional therapies and how mental health therapies are perceived in society.
However, for this post, I realize I should properly illuminate some details about biofeedback games, and their place in contemporary healthcare.

Little Henry in beautiful clip-art quality.
Imagine this: a young boy (let’s call him Henry) has a hard time coping with his outbursts associated with his ADHD and anxiety disorder. With his parents exhausted from finding suitable therapeutic coping skills, they hear about this new intervention: a biofeedback game promising successful emotional regulation and strength-building.
Luckily, Henry has the chance to test this new game in the works. The small group running these test pilots meets with the young boy and his mother: they help him get set up and they give him a small heart monitor to put on his wrist.
Henry’s mom explains to his son that he has to keep calm and control his heart rate to perform well in the game. However, not really understanding (or perhaps not even listening) to his Mom’s advice, Henry delves right into the experience.
The platform has several mini-games to play. Let’s say Henry chooses the first one on the list. When it opens up on the screen, it looks like any normal game—the only weird thing is that there’s a small speedometer looking image on the bottom of the screen. It has the colors green, yellow, and red. Right now, an arrow pointed to the green zone.

Henry’s heart under stress in detailed Shutterstock quality
The game starts off easy. But pretty soon, as the game starts getting harder, Henry starts to get more and more flustered. And something surreal happens. As his heart rate rises, the game starts to spaz uncontrollably. He thinks its glitch, but he realizes that it’s too planned and consistent to be just that. Looking back at the speedometer thing, he sees it’s at the furthest point in the red zone.
Henry loses the first game, and he’s very frustrated. But his mother says, that if he stays calm, the game will work normally and won’t turn against him. So Henry plays again, doing his best to stay calm. When the game starts getting more intensive, he starts to lose control of the functions. He looks over to the “speedometer” on the screen, and it’s inching into the yellow.
So he takes a deep breath. As best he can, he clears his mind, relaxes his muscles, and keep going.

Henry’s heart once he learns to control his emotions during play!
Henry gets much farther into the game. Though the game doesn’t get any easier, he’s able to regulate his emotions better. He constantly glances over at the bottom of the screen, doing his best to stay in the green zone. Here, Henry makes the connection: he understands the relationship between controlling his emotions and controlling the game. He can visually see his heart rate change on the screen, and this gives him agency of his experience. As his heart rate rises, he loses control (like in real life). When he stays calm, he can master his experience. This would be the challenge for all the other games on the platform as well.
This is biofeedback in game form. And this is the innovation behind Neuromotion.
To provide a formal definition:
Biofeedback is a technique you can use to learn to control your body’s functions, such as your heart rate. With biofeedback, you’re connected to electrical sensors that help you receive information (feedback) about your body (bio).
This feedback helps you focus on making subtle changes in your body, such as relaxing certain muscles, to achieve the results you want, such as reducing pain. In essence, biofeedback gives you the power to use your thoughts to control your body, often to improve a health condition or physical performance.
From http://www.mayoclinic.org/tests-procedures/biofeedback/home/ovc-20169724
The Neuromotion team’s ultimate goal is to help control emotional “dysregulation” in children struggling with mental disorders and symptoms. Genuinely, they believe that in order for children to truly gain control of their emotions, they need to train their mind and body to handle stress levels; they need a platform that helps enhance motivation and create a more effective learning experience.
On the Neuromotion website, they express:
Children are expected to control their emotions better as they get older. If they fall behind in emotional control either due to out of control anger or anxiety, this holds them back from succeeding socially and academically as they should. We believe that focused practice of emotional regulation allows children discover for themselves how to control their emotions better and that repeated practice of emotional regulation strengthens the brain connections that control emotions.
… As a society we badly need such tools so we are not forced to rely so much on medications to dampen anger or anxiety in our children. Medications can reduce anger and anxiety but they do not teach a child the skills that might reduce their need for the medications. Our work is aimed at reducing the push to put children on psychotropic medications by providing effective, affordable, and accessible alternatives.
From http://www.neuromotion-labs.com/

2010 – original game prototype, called RAGE-control with a heart monitor connected to the pinky. Read more here.
My focus, to reiterate, is to think about the “outer” part of the game (which we call the metagame). There, we need to find a convincing and engaging way for child users to navigate from game to game with ease and conviction. A character can act as a guide, coach, friend, etc. to help monitor the child’s progress and keep track of goals. What we need to think about further is what would really draw a child to this game? Truthfully, some kids would be reluctant to do anything that calls itself “therapy.” How do we gain their trust? How can we be helpful as well as respectful to their age? Also, some kids with emotional issues are not even convinced they even have these problems: we have to work around these potential scenarios to reach as much of our audience as possible. Because of these questions circling over my head constantly, I have to be aware of the introduction, the delivery, and involvement of this character.

2015: Biofeedback Explanation. Read more here.
Also, one of the most important aspect of this game is to make sure the child feels like they have control of not only their emotions but of the experience. We live in a society (or just a world) where children have very few choice in situations. This becomes especially apparent when a child has sort form of disability; many schools do not have very effective policies in place to support these individuals and students and families endure through painful measures to find the best quality education. The lack of control makes it absolutely frustrating. Sometimes, children can’t help but contemplate why the adults in their lives can’t help them as much as they could.
But maybe that’s unfair to say. Adults make mistakes just as children do, but older people get more backlash for negligence or missed research. It’s just the age standard we have in society—which makes sense I suppose. In the end, what matters is that good-even great, amazing-research has been brewing in many parts of the world and Boston Children’s Hospital and Neuromotion have been tackling some of the toughest problems and solving them with care and creativity.
This reminds me: before officially starting my internship, I met the Neuromotion team back in May just to get introduced. After sitting down with my supervisor, Dr. Jason Kahn, he told me this:
You’re going to fail an awful lot. But you know, failing means you’re doing something. I can speak from experience so don’t get discouraged.
That’s probably the most comforting advice I’ve received in a while.
I’ll follow-up with another post to talk more about research and some ponderings.
Until then, have a good day!
Cheers,
Yuko
Visualizing the Invisible| Genspace | Callie Clayton | BFA Textiles ’17
Tucked away on the east(ish) half of the seven floor of an unassuming building in Fort Greene, Brooklyn, a maker-space that happens to be the world’s first government compliant community biotech biosafety level 1 laboratory is located. Opened in 2010, Genspace, (gen- latin: “that which produces”) acts as a public educational resource and facility through genetic engineering classes, workshops, talks and as a production space for anyone who wants to be a member of the lab.
For the past two weeks and coming six, I have and will continue to collaborate, learn and make through investigating how community bio-labs such as Genspace (STEM to STEAM style teaching and learning environments) allow for clear discussion of the social and ethical possibilities and considerations within synthetic biology. Through this research, I’ll be designing visual graphics in digital pattern and educational forms communicating in a broader perspective the innocuous processes and positive potential of synthetic biology projects in relation to regulation. My goals for these visuals are to generate more public understanding and knowledge around community bio-labs and genetic engineering in order to encourage their establishment through STEAM programs and increase accessibility to these spaces and education.
First arriving in the lab, I was at once surprised and comforted by the mismatch of computers, papers and lab equipment on the main table outside of the two wet labs, a space arranged in a very fluid, “maker-space”-esque manner. In talking with one of the directors, it had been decided that I would observe all the courses: CRISPR and Genetic Engineering Introductory courses, observe the iGEM (International Genetic Engineering Machine) Competition lab work activity and weekly workshops and talks throughout my two months here. Starting this upcoming (third week) I’m participating in one of the Genetic Engineering introductory courses in line with (my determined) developmental steps of involvement for my research. For the coming weeks, I will continue to participate and further collaborations with different lab course teachers at Genspace to develop educational visuals simply explaining lab protocols for advanced processes such as CRISPR. Additionally, my participation in terms of addressing discussions of ethics associated with synthetic biology for art and design versus or in accordance also with scientific research has already become apparent. For these upcoming 6 weeks, a long term goal of mine is to collaborate with lab instructors in order to further develop educational discussion and content around differing and similar considerations of ethics and synthetic biology when present in art and design and scientific research.
Re-reading what I have just written, the framework and simple actuality of what my place, role and actions within this lab space are sounds so precise and defined. It’s quite hilarious (please excuse my dry humor-warning: it will most definitely emerge multiple times within each blog post). There are an infinity of angles, thoughts and ideas cultivated each and every subsequent day in the lab.
Examples ( to develop thoughts and observations of research on through writing, visuals and text) :
- Ways biotech regulations come out of experimentation (or don’t).
- Benefits from lack of regulation of citizen science in the United States and nonpartisan policy groups based research on citizen science projects’ development.
- Scaling of perspectives in protocol vs. effects/ meaning of protocol.
- Timelines of growth rates/lab work compared to levels of public concern and lack of understanding around certain GE (genetic engineering) techniques.
- Media interpretations versus reality.
- Metaphorical examples of how specific research on one environmental change affecting one organism affects a myriad of other, scaled-out ethical considerations and organisms.
- Translating research protocol/process explorations as a design process with the commonality of “making/tinkering” for the experimental sake and developing product / art as a result- ideas of “playful making.”
- How does the act of biology lab research and connotations of science reflect emotion based connotations associated with the lack of touch?
- Exploration of ethical understandings of the word: contamination or trust through the context of synthetic biology.
- Human harm to lab organisms- enlarging microscopic processes.
- How do we make design decisions in the context of genetic engineering and so are all choices an act of design? Where limitations come into play?
- Innocuous quality of genetic engineering protocols + application.
- How GE quantitatively finds difference in the small scale yet in doing so, discovers humanity’s similarity in the large scale. ex: Sequencing your DNA, your mitochondrial DNA which is passed down maternally, is extracted; meaning that all of humanity is linked by one “Mitochondrial DNA Eve,” the originator of the DNA extracted in this protocol.
What is most worthy of my attention and focus? As a designer, I have a different perspective, what aspects of my interpretations of these lab protocols, classes and design processes is most unique and what are the opportunity costs of choosing one focus over the other?
These past two weeks have been an immersive experience of taking notes on as much as possible, absorbing, learning and understanding specific protocols, techniques such as:
- iGEM Competition Activity: Isolating tardigrades (microscopic invertebrates with four pairs of stout legs that live usually in water or damp moss, also called “water bears”-how cute haha) so to test different food sources to increase efficiency of their growth using techniques such as CRISPR (most recent form of highly specific gene editing). Ultimately, a goal of this project is to extract a gene linked with retaining water in drought-like conditions.
- Ellie Irons, interdisciplinary artist and educator (around art and environmental science) who is actually a teacher at Brown University(!) came to do a workshop on foraging for invasive weeds in the urban jungle in order to make watercolor pigments. It was exciting to see the combination of botany, chemistry in terms of oxidation color changes when crushing petals and alum additions and art all in one. Her work at: http://ellieirons.com/#/
- I went to an event called “Sketches for Science” upon recommendation from a colleague at Genspace (Karlijn is doing research on biomaterial growth with algae growth under different environmental conditions and kombucha scoby growth https://karlijnsibbel.com/ ) at a space in Manhattan. The event was led by The Leading Strand, http://www.theleadingstrand.org/#intro a collaboration between neuroscientists and designers to communicate science. Observing a mix of people with an academia background in the sciences, designers and friends, interacting and suggesting what scientific term the two artists of the night (one with a degree in neuroscience, the other design) should visualize in a 10 minute time-period, I feel I began to get a taste of what it means to “accurately” visualize: There is no such thing as fully “accurate” it seems. Everything is and always will be somewhat subjective perhaps and that’s a positive insight into the realm of visualizing science. Zoom into a process or image and it may seem to necessitate exactitude (ex: edit and deletion of specific codons) but zoom out and the application of this exactitude is subjective and unlimited. And is the big picture what is (often- I’m stressing often, not always by any means) most important?
- CRISPR Class and Workshop: CRISPR is (since 2013) the most recent and accurate (arguably depending on whether it’s a prokaryote-plasmids still work best or eukaryote-CRISPR works better) targeted genome editing tool. CRISPR was discovered as part of adaptive immunity in select bacteria, allowing organisms to respond to and eliminate invasive bacteria/viruses. CRISPR is made up of a number of genes (“Cas”) including a protein called Cas9 which is programmed by small RNA (RNA= “DNA Photocopier” which creates multiple copies of a piece of DNA in the form of messenger RNA which is then made into proteins by the cell’s ribosomes) to cleave DNA. When Cas9 is fed a specific sequence of sgRNA (single-stranded guide RNA) a double-stranded break of the target DNA eliminates a specified section of DNA. After this break in DNA has been made, the cell wants to repair itself using either NHEJ (Non Homologous End Joining) or HDR (Homology Directed Repair). Using HDR, a template of DNA desired to replace a mutation or other DNA sequence (what was cut out) is replicated by the cell when repairing the break in the DNA. Meaning the cell has repaired itself using the DNA sequence template you/scientist/whoever put into the cell and is viewed as a natural DNA break repair. This means that CRISPR leaves no trace; one can not test whether an organism has or hasn’t been genetically manipulated using CRISPR! (Note: other site-specific editing technologies working in a similar way yet are detectable with varying levels of effectiveness and are still used for a variety of function include: restriction enzymes modifying plasmids to be put into DNA of course, site-specific recombinase technology, zinc-finger nucleases, etc) Observing and learning about the technology, tool of CRISPR I’m realizing the importance of pattern, matching and visuals in order to understand each step of the process and matching the act of pipetting DNA into a solution with the purpose of that action being making guide RNA. During each class, we’ve had some exciting discussion about ethics associated with use of technologies such as CRISPR. In the case of Germline genetic modification (a form of genetic engineering which involves changing genes in eggs, sperm, or very early embryos meaning that successive generations inherit the same modified genes) what true differences exist between that act of genetic modification and invitro fertilization using selected sperm and the act of two partners naturally and/or “naturally” choosing one another because of subconscious and conscious inclinations to certain physical and personality traits? As one of the course instructors said:
“Lack of change and the maintenance of something in its “natural” state is unnatural”
so could that mean, resisting evolution of the body or health through technology is striving to maintain the “natural” that has already developed into a different form of ‘further evolved “natural”‘? Where and what are the ‘limitations’ we create for ourselves in this design problem? CRISPR information: New England Bio-Labs
5. Dr. David Putrino, P.T., Ph.D. gave a talk through “Knows Science ” a non-for-profit education and advocacy organization working to share the latest scientific discoveries with the public about the human brain’s responses during performance in relation to endurance. He spoke also about a number of research projects and collaborations to crowd-solve previously insurmountable healthcare issues using assistive technology done through Not Impossible Labs. The necessity of designers, design collaboration in each of these projects, such as “The Eyewriter” designed for an ALS patient, was emphasized by David himself when he said:
“Medicine must look outside of technology to know how to make people better.”
The necessity of designers niche-ly understanding the patient’s illness demonstrates the importance of fluid integration of design and science education. More about his work and presentation can be found at the “Knows Science” site.
6. The vast amount of content I’ve been learning / thinking / exposed to means I don’t think I can share it all in this one blog post! Quick snippet of other topics are: 3A Assembly, Sequencing my DNA, and reading research reports on Citizen Science and regulation from Commons Lab – to better understand regulation in relation to Community Biolabs and Citizen Science I definitely recommend looking at this site and reading some of the articles.
For this week and the coming ones, I plan on really focusing in on my collaboration with one of the instructors on making visuals for the process of using CRISPR in the lab, focus in on certain questions / thoughts, ethics discussion points for courses, visual systems for connecting lab steps and their effect and continue writings / text associating lab processes with design decisions. I’ll be helping out with the exhibition of Biodesign Challenge work done by university students later this week and am excited to see how design and science has manifested in their work! Looking forward to sharing more work, thoughts and updates in a week- also, look out for updates on my tumblr blog with more photos and posts Callie Clayton.
Quote for thought by a Genspace instructor:
“Form follows function, however the form is the function so if you’ve broken the form, then you have no function.”
my regards,
Callie
Some just want a good story – Bo-Won Keum, MFA GD ’17
A sentence in prison can range anywhere from a month to a lifetime. Unfortunately, in American prisons, access to books —or any kind of media at all—is treated as a privilege, not a right.
Most correctional facilities do not allow books to be sent directly to inmates from friends and family. Instead, books must be sent through “pre-approved vendors”, usually expensive booksellers and publishers. Many prisoners can’t afford to take on these expenditures themselves—most don’t even have Internet access to order books or money to pay for them. Many prison libraries are in deplorable condition, and access to these libraries are often restricted based on pre-determined factors that are beyond an inmate’s control.
The normal prison library was shut down, ostensibly out of fear that prisoners from different units would be able to communicate with one another by passing notes back and forth in the books. Not too long after that, the legal library was closed, apparently for the same reason. Because of the nature of my crime, I was initially denied any right to touch the prison computers for email or to check my commissary balance. I wasn’t allowed to enroll in the only educational course of any value to me (Spanish) because it was a self-taught class using the Rosetta Stone software.
– Testimony from Stephen Watt, who served from 2010–2012. Courtesy of The Marshall Project.
As a response, the number of nonprofit organizations that seeks to address these issues has increased with the explosive prison population. There are currently over thirty known programs donating books to prison inmates on a regular basis. Books to Prisoners Seattle is one of the oldest of such organizations, delivering reading materials and fighting for a better standard of wellbeing of the incarcerated for over forty years.
I am a returning visitor to Books to Prisoners. I came to it first last summer when I was visiting it and three other organizations in order to, as a research project, document their catalog of donated books and scan letters that they receive from inmates. These letters range from requests for simple and straightforward lists of book titles, written like restaurant orders, to lengthy and impassioned essays describing their situations. Some seek to gain knowledge in a specialized interest; some want to gain skills; and some just want to read a good story.
But no matter what the nature of the request is, each letter always remains earnest, polite, and heartbreakingly thankful.
This time, I come not as a one-off visitor, but as a long-term volunteer, working to contribute to their cause in more immediate ways. The initial proposal through the Maharam focused heavily on what I imagined would be research development on their archiving and record-keeping system—of what books were going through, of what restrictions were being imposed on the package in each facility, of demographic information related to the prisoners making the requests. A conversation with Michelle upon my arrival, however, made the steps for moving forward in this particular endeavor trickier than I had initially thought.

Books to Prisoners, Seattle WA
The restrictions imposed on packages are ways in which individual facilities control the materials flowing into the system. Prisons often ban books with erotic, violent, and politically radical content, but they can also ban hardcovers, magazines, and secondhand books. In order to ensure that packages are sent to prison inmates successfully, Books to Prisoners refers to these restrictions each time they mail an individual package out to a prisoner. While I had assumed that these lists had been compiled according to regulations that each prison had made publicly available, I found out that these lists are compiled from years of trial and error conducted by each book program. They are also unique to each book program—facility regulations imposed on Books to Prisoners, for example, can be very different from those imposed on LGBT Books to Prisoners in Madison WI.
This makes creating a national prison book program database hard.
What I can focus my attentions on right now, however, is on a couple of things. One is a pdf document about the book-packing process that we can make accessible for first-time and infrequent volunteers on the website; they can look at it to get a better sense of what to expect when they arrive and also refer to it when they get come back after a long stretch of time. Another is the document that I hope will be able to contain some of these stories. Michelle tells me about a staff effort to publish some of the letters that failed some time ago, simply because there wasn’t a lot of time, energy, and knowledge on how to develop the project. I know how to do books—I’m a graphic designer. It’s a perfect project for me to take on, especially because it feels a lot like what I was trying to do last year.
“But this feels different,” I remember explaining earnestly to two friends over dinner. “The project that I was pursuing last year was driven solely by my own interests in knowing more about the movement, and I couldn’t help but feel like I was mining information from these organizations… This at least feels collaborative. I would be proud to release this document knowing that it comes from a transparent and cooperative exchange.”
I hope this is true. I hope my actions can match the self-asserted confidence that I seem to project with these words. But a lot of those fears still remain. I think about the conversation that I had with Kevin in 123 Dyer Street, a week before I flew out to Seattle. I confessed that I was nervous of marching into the program as an outsider. I told him that I didn’t want to be accused of sensationalizing something or of creating a spectacle that champions only my efforts as a researcher. I didn’t want to come in and disregard the efforts of volunteers who don’t have the luxury of looking at this as a thing that was ‘interesting’, who come in instead with a mindset of bringing change in the most effective way possible…
But maybe what I’ve really come to terms with in the last two weeks is that having that perspective—of seeing this activity as a strange, fascinating, wonderful, perplexing, sentimental, and deeply complex thing—is okay. There is great value to bringing efficiency to a system, of improving record-keeping, of building statistics, of streamlining a production process. It’s the kind of information that can be pointed to to engage policy makers, to receive better funding and reach out to greater amounts of prison inmates in the country.
But how do we change not policies, but attitudes? How do we kindle empathy and kindness? How do we compel people to act, not because it feels like the morally righteous thing to do, but out of love for another human being?
People in prison ask for books, not because their lives necessarily depend on getting access to composition books, to thesauruses, and to copies of 50 Shades of Gray, but because they are, like any of us, trying to find meaningful ways to spend the time that is given to them. Those of us who live outside of prison walls say that we are lucky to not know what life in prison would be like, but I think we get a glimpse of it everyday when we are angry, when we are frustrated, and when we are lonely. Access to things in our lives—to music, to movies, to books, to exercise, to greenery, to health, to fulfilling relationships with people—is what prevents us from acting out. What are we left with when those luxuries are taken away from us?
***
Maybe I can explain this with an anecdote:
On my second day, as I was talking to Michelle, we were interrupted by four heads poking in the doorway.
“Hey—is this Books to Prisoners?”
Four tan, eager-eyed and hunky college boys entered the basement with their pastel-colored shorts and fraternity T-shirts. They had come on the referral of a brother who recommended the program as “a good way to get their service hours in.” (Books to Prisoners outreaches in order to get enough volunteers to run its operations; many of them come from general community service groups.) Michelle swiftly gave them a forty-five minute orientation on what they were supposed to do for the day.
As they nestled themselves into the stacks with a letter in each of their hands, I strained my ears to overhear their conversation. What would they make of experience after reading the letters? One of them says, “Dude, the fucked up thing is that a lot of them are in prison for like, one mistake that they made.” It’s poignant, and I was struck by this moment of compassion.
“Yeah,” says another in response. “I mean, maybe, but the majority of them… like, they probably deserve to be there…”
I stayed silent because the comment made me sad. People might tell me that it didn’t matter, that they still packed the books and did their service time and, effectively, made some inmates somewhere across the country happy with the selection that they were able to make. But no matter how efficient we get at book packing, at fundraising, at getting more volunteers working in the basement—if we continue to distance ourselves by looking at systems and situations rather than listening to individuals and hearing stories, than our efforts don’t really get anywhere. The narrative doesn’t change; people in prison are there because they are bad people, not because of decisions that they make or circumstances that they find themselves in.
***
(Photos have been manipulated to preserve anonymity of its subjects.)
“I’m like an astronaut who’s spent a lot of time in space but is still pondering the nature of the universe”: My Introduction to BCH | Yuko Okabe, Illustration BFA 2017
The above quote was taken from one of the responses I got from my teammates to the question, ” Would you consider games as an art form? A narrative form? Why?” Earlier in his answer, he also reflected:
Games are interesting (to me, at least) because they cause your mind to twist, to try, to explore places that aren’t intuitive right in front of you. They force your mind to grapple with things in ways that aren’t the default way… Maybe games can activate neural pathways that are there but underused? Maybe games can rewire behaviors? I think it’s fascinating.
I asked a number of questions like this to my internship teammates this past week, and all of the answers have been insightful, witty, and very honest- I wish I can share them all! I think it goes without saying that I feel very baffled and grateful for such a community that has opened its doors to the likes of a curious little Illustration student like myself.
Just to provide a bit of description, for the next ten weeks (or nine now) I will be collaborating with the Boston Children’s Hospital and their Psychiatry Department’s start-up called Neuro’motion to help develop characters and narrative to accompany their mobile therapy games. My supervisor and I came to the agreement during my Maharam application process that children would be more stimulated to engage in therapy if they had a welcoming character to accompany them on this metaphorical journey. The point is to design someone who can be a coach and even a friend; a human or creature who can track their progress and be there to give help. To go about this research, I will interview individual children as well as gain feedback from hospital staff regarding psychiatric practices and its sensitivities.
A First Week: Meetings, Introductions, and Fun People

Home space for the following weeks.
To illuminate on my initial experiences, on the very first day, I met up with my supervisor at his office space a few blocks away from the main hospital. After some quick tours and introductions, we sat in his office space which he shares with Neuro’motion’s software engineer. Both of them asked me to think of three things 1) Deliverables to the Team for Week 1, 2) How to Interview Children to Gain their Feedback, and 3) Questions for the team.
I took these tasks and organized my answers into a Powerpoint ( selected slides below). I explored themes around character design while also trying to apply some innate therapeutic senses into my reasoning. I wondered how to depict the character as “strong” and how that would compare to a character that would be either “comforting” or even more abstractly “heroic.” What sort of personality would best help guide a child through therapy? I also wondered what sort of resistance a child could have towards a main character: “Why should I listen to him/her?” “How do I trust them?” “Will they make me feel stronger?” “Will they make me feel too dependent?” Coming from an Illustration background, I’m interested in learning the finer and more sensitive points about creating this character, and how he/she/they can both represent and advocate for an audience of children struggling to control their emotions.
I’m scheduled to speak with the Children’s Hospital’s outpatient adviser next week so that she could help me organize my thoughts about how to go about interviewing and speaking with her patients. I have ideas to make it an interactive dialogue by having drawings and word associations to help the child visualize who their ideal “coach” would be like. I guess there’s also the question to how much depth the character should have. Should the character be 100% confident all the time? Should the character be more attuned to a child? Should they be deceivingly weak but end up being strong? These are my hovering questions: it’ll be interesting what feedback the kids will have!

A selection of character silhouettes I created for my first interview stages: “Which character seems strong to you? Why?”
Back in May, I actually met up with the team just to get introduced to the hospital setting so I already knew everyone in the room. Nonetheless, I was both overwhelmed and fascinated by all of the high-speed and articulate business-speak that these guys whipped out onto the table. Of course, in the foggy and looming universe we know as the “real work world,” this obviously happens all the time. But, being the scrawny collegiate with just a summer sublet and a handful of RISD workstudies to my adult name, I found (and will continue to find) these meetings super eye-opening and helpful.
When it came to my presentation, I admittedly felt a bit strange transitioning the topics from marketing and product testing results to my artsy thinking around character designs. But it was pleasant to see how interested and excited everyone became. They also appreciated the questions I had to the team and encouraged me to ask more along the way.
There’s a lot more I could reflect on, but I’d rather not overwhelm my first post. However, I would like to share a sweet video about Hospital Empathy I learned about from a required “High-Reliability, Error Prevention Training” I attended this week. Though more geared towards employees in the clinical setting, it was fascinating to get some insight and first-hand knowledge and transparency of the Hospital.

A snapshot from the video Empathy: The Human Connection to Patient Care
I will update in the coming weeks about my findings after interviewing patients. Also, here are a few Q&As from this week ( I summarized answers for my own purposes):
What are the most vital components to successful therapy? What needs to be improved upon?
- Self-efficacy
- Seeing and celebrating progress
- Supportive environment
- Building external supports
- And then slowly taking away scaffolding
- Good relationship
- Invested therapists
- Difficulties
- Hard to measure outcomes with therapy
- Hard to tell “good” therapy
- How to be a successful therapist
- Clients become skeptical
- Building external supports
How do you balance a child’s desires with what a parent/clinician/(teacher) says is best for them?
- Convince that they’re playing a positive role
- Kids’ desires and parents’ desires are one in the same
- Kids often realize, by being in therapy, that something is “wrong”
- they want to be “normal”
- Sometimes, a concordance about “presenting problem” and what is “clinically best”
What are three things a child should have to be truly happy? How has this changed since you were a child?
- To feel loved
- To feel safe
- Growth
- Intellectual
- Emotional
- Physical
- The “Self”
- Freedom and space
- Exploring interests
- Material answer
- Blocks, legos
- Access to water
- Something to read
- “80s, early 90s, kids could be bored and that let them think about things. Now it’s really hard to be bored.”
- Basic necessities
- Maslow’s hierarchy
Cheers,
Yuko
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