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Is Art Therapy?
23rd Jun 2013Posted in: Blog 0
Is Art Therapy?
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When attempting to answer the question ''is art therapy?'' we turn to the field which has taken the question most seriously. In the following discussion about the field of art therapy, we will explore the notion that art can be therapeutic in and of itself. One way to understand what art therapy is, tends to be through a consideration of what the composites of art therapy are. This hard to define concept is made up of both parts of its name as it employs one's creative potential in art and combines this with the demonstrated healing power of talk therapy. Another way to try and understand what art therapy is, could be through a consideration of the different theoretical perspectives held by the people who actually practice it. These perspectives can be grouped into two main poles on a continuum, notably art as therapy and art psychotherapy poles.  In the first, art therapy is viewed primarily as a form of psychotherapy, with early professional beginings in psychiatry at the start of the 20th century. In this camp, art therapy is a mental health profession which employs art in the service of some other main talk therapy approach, usually psychodynamic, humanist-existential, cognitive-behavioural or narrative in nature. You can read more about the definitions of art therapy here: http://en.wikipedia.org/wiki/Art_therapy and here: http://aatq.org/en/arttherapy.php

Seems to me that those attempting to define a field of practice such as art therapy will be faced with  some of the same difficulties encountered by those who attempt to define ''art'' because the term ''art'' is a non-absolute, intersubjective concept which accounts for at least 50% of the definition of art therapy.

In the second camp, art as therapy practitioners tend to have stronger backgrounds in art and many have entered their academic training programs in art therapy as artists first, developing clinical skills second. These practitioners may place less emphasis on the verbal componnent of therapy because they hold non-verbal creative process as paramount. These practitioners are also more likely to use a ''studio approach'' when working with clients in groups at the community level. Those in the art as therapy camp believe that the healing power of art lies principally in creative process itself and that engagement with this process can have not only healing effects  when used with people who experience post traumatic stress disorder, depression or anxiety to name but a few conditions. Practionners in this area find that art as therapy can have not only curative but preventative effects by protecting people against risk factors like social isolation and détachement from nature. Read more about one of the latest successes in the art as therapy movement here: http://www.mcconnellfoundation.ca/en/programs/granting-database/grant/la-ruche-dart and here: https://www.facebook.com/pages/La-Ruche-dArt-St-Henri/174341355959676 In describing those in the art as therapy camp, Rubin (1999) speculated that art therapists may be more comfortable with an intuitive approach than other mental health practitioners because as artists they "pride themselves on their innate sensitivities, and tend to be antiauthoritarian and anti-theoretical" (p. 180). cited in Randy M. Vick's article here: http://areas.fba.ul.pt/jpeneda/Briefhistoryat.pdf (p.7). People in the art psychotherapy camp tend to find that art is therapeutic principally when combined with talk psychotherapy under the explicit guidance of a trained art therapist. This position tends to imply that art and the creative process cannot be therapeutic unless an art therapist is present to mediate, witness  or administer it. This point is sticky because it is akin to suggesting that a proverbial tree can not fall in the forest unless someone is there to hear it. The art psychotherapy position can be problematic because it places the art therapist as the ''expert'' in the position of ''specialist'', standing squarely between the individual and his own self determining creative potential. While art therapists may be the most learned college of like minded individuals when it comes to an understanding of the relationship between mental health and creative process, they stand on precarious ground if ever they claim that they are the the sine qua non of therapeutic art. As an art therapist myself, i am constantly reminded of the humility that i must embrace in order to tell people that i can help them gain novel understanding of themselves  and their difficulties through art. This is  a tall order and though i think it is one i can fill, i do not tread lightly when making that claim. In order not to stray too far from that humility, i find it useful in my practice to ask: ''who is the expert in this relationship?'' and ''who knows this client better, me or the client?''. Invariably, i come up with the answer that i know many things about art and human relationships from experience and study but that the most central part of the therapeutic equation is still the client himself. It is not that i want to criticize those in the art psychotherapy school because i consider myself to be among them. Psychotherapy theory was the first intellectual sphere i was ever interested in and i would like to acknowledge everything that talk therapies bring to the art therapy table. Complete transparency is in order so i will tell you that my academic background and personal interests are balanced between the study of art, the study of education and the study of psychology (not necessarily in that order). So as a member of the art psychotherapy team, i owe it to us to ask: ''can art not be therapeutic without an art therapist in the room?'' and ''has art not been therapeutic for us in some measure throughout all time?'' ''If so, is that kind of therapy different or less important than the therapy that we claim to be facilitating as professionals in a clinical context?'' Surely, the healing power of our own creativity has been at play for longer than art therapists have been around. Though i have to concede that pioneers like Sade, Naumburg and Champernowne were some of the first to consider using art to heal all kinds of psychological ailments with a systematic and scientific methodology. There is a necessity for asking the questions above even though they make some in the art therapy community uncomfortable. These questions must be asked because i have noticed a growing trend towards minimizing the value of the art as therapy studio approach y by saying things like: ''You don't need a degree to use that approach'' and :''it's not scientific''.  In fairness, i can understand why people are made uncomfortable by these questions. Perhaps it sounds like i am suggesting that an art therapist is useless. Maybe it sounds like i am presenting art therapy as a do-it-yourself or self help kind of method where engagement with art is all that is needed for healing. Both art therapy camps will agree that our field is young and has had to fight against all kinds of established notions and predjudice about what art is to humanity. This profession has had to struggle for its survival from day one and to this day, art therapists in Quebec lose their jobs to other professionals who are members of more recognized professional orders. The profession has struggled to define itself as an arts based mental health service when  we live in an evidence based mental health climate. In spite of all of this, it is to each of our credit that art therapy has not only survived but thrived. Fear not reader for i wish to take none of this away from art therapy. It is only my mission here to make the case that art can be therapeutic in and of itself and that such an effect need not be facilitated by an art therapist in all cases. Art can  be therapeutic in the absence of an art therapist. Believe in my sincerity when i tell you as an art therapist that we do some of the most important work any human being is capable of and that an art therapist will never be useless. Yet there is certainty in me of the need for my questions because i know from experience that art itself has healing power even when there is no art therapist to be found.
art as therapy_curative power of music

The question came up 2 days ago at a conference on the relevance of expressive arts therapies today. We were asked to consider that 50% of any credit for therapeutic effect might be accorded to the art and creative process themselves.

  Some claim emphatically that art therapy is not a ''self help or do-it-yourself approach'' and while that is certainly true, the do-it-yourself movement may be the only future that mental health care has. How long are we going to continue feeding all those experts and specialists and administrators and politicians and lobbyists before we actually take our own health care issues into our own hands? After all, art therapy was originally about taking art back from the elite patriarchal art establishment and giving it back to the people. It's our job, not theirs. Health and wellfare start at the grassroots level. The D.I.Y movement may be the only future that our political and educational systems have and we are tending more in that direction than we might have expected, in large part thanks to the internet. There are increasing numbers of people asking: ''do i need to call the plumber or can i just google this?'' Crowd sourcing which you can read about here:http://en.wikipedia.org/wiki/Crowdsourcing seems to be the trend. We are increasingly learning to rely on our collective experience through observations on social media like twitter and facebook to diagnose social issues and bio-psycho-physical problems.  It is not inconceivable that the common man may one day solve his own problems without relying exclusively on an expert to do the work for him.  Actually, D.I.Y is the model our entire economy has been built on because if you can't D.I.Y then you better have money to pay someone who can do it for you. Paying money for people to do stuff for us is what makes our economy roll and it's what our taxes are for. For those who don't have money, well then it's not going to happen and you get nothing (more true in some parts of the world than others). In doing for self, we trim the fat in our economy, we become self sufficient and self determining rather than reliant on others to do for us. The so called middle man, sees his share of profit go down while the man on the street is enfranchised ever more. The benefits of therapeutic art or medical treatment for that matter are not exclusively for those who have money and that is one of the reasons why we need to respect and encourage the ''do-for-self'' mentality whenever possible, even if that means encouraging people toward the therapeutic use of art in the absence of an art therapist. Perhaps this is the role of art education with an art therapeutic orientation. The studio art approach employed by those espousing the art as therapy view is not even one degree less of a therapeutic intervention than art psychotherapy is. It is only a different approach to respond to a different kind of need. Every art therapist ought to be aiming to arm every individual with a do for self mentality which involves art and wellbeing. This does not necessarily mean that i am endorsing any do-it-yourself home based art therapy kits currently being sold on Amazon.  At least not yet...  Nor am i endorsing any art therapy technique handbooks for non-art therapists. Yet, it is conceivable that someone would publish a book which would enable a non-art therapist citizen to make more effective therapeutic use of his own creative process. I might endorse buy that book. I might even be writing the introduction as we speak 🙂    Those in the art as therapy camp appreciate the true value of art and creative process because they are far more likely to have established artistic practice of their own and to know the power of creativity inside and out. Knowing creative process inside and out means to know it experientially through the mind and the senses and not just theoretically with your left brain. In the art psychotherapy camp, people with weak backgrounds in art might believe it would be acceptable to have little artistic practice of one's own while still facilitating the creative process of a client. Yet how can we engage in any creative process with our clients without a profound understanding of that process in ourselves? Art therapists need to know who they are as painters, sculptors, dancers, actors and musicians before they can help anyone with those tools. Both art therapy camps agree that clients need not have previous artistic skills or abilities but that we helping professionals must have much skill in those areas.  There is no free pass on clinical skills for any art therapists who want to be effective, nor can we expect a free pass on the dues we must pay to creative process. As an art therapists, we must be competent clinically and artistically. Sadly, i find many art therapists are all too willing to allow art and creative process to be subsumed by other talk based models of therapy.  Is this the classic example of art being pushed around in a world dominated by reason?  Does our verbal reasoning bully our non-verbal intelligence?  Art we ashamed of the art part of art therapy? As a member of the art as therapy camp, i believe in the preventative function of art as therapy in society. I don't just believe it willy nilly because someone told me about it or because i read it in a book. I believe in it because my experience tells me so. I believe in it because millions of people share the intersubjective experience of therapeutic transformation through art.  If you accept that the roots of so many of our presenting issues lie in the soil of our social structure than it is not hard to see the need for a process of transforming that structure. No one is born with PTSD. Depression may be more attributable to social isolation, competitive attitude and apathy engrained into our socio-economic machine than to any biological causation. Community based, art as therapy programs attempt to transform the social structures which make us sick. Community based art as therapy programs emerge as an antidote or an inoculation against those structures. Art as therapy in the form of a studio approach negates the rule of competition, destroys the impact of isolation and alienation by creating public spaces where people can assemble in a warm, welcoming and non-judgemental environment.  Such spaces do away with corruption by encouraging transparency and lateral rather than hierarchical human relationships. The Studio approach is the hallmark of the the art as therapy angle and smashes to pieces the aesthetic world of appearance, replacing it with authentic human being. The studio approach is the corner stone of the art as therapy position because it replaces our narcissistic individualism with community. Make no mistake, the art as therapy model and studio approach are worth every penny as much as the art psychotherapy model is. The first is exploratory and built upon intersubjective experience while the second is evidence based, rooted in external observation. They are the right and left hands of art therapy. Until the hard genetic data is in to tell us that our afflictions are the result of pure biology, I want to devote my time to affecting change in social structure rather than helping individuals heal wounds which might have been avoidable in the first place. I do not want to help the concentration camp guard heal his trauma so he can get back to work, i want to rebuild a world in which he does not have to go to work. Let's not confuse the issue:  If you want and need art therapy, then you an art therapist has to facilitate that process. I am not about to suggest that you can just go out there and heal yourself of depression once it has set in, although some people are able to do that through resiliency. But if you want a therapeutic engagement with art and you want to help protect yourself from the boredom, isolation and apathy which lead to so many other more serious difficulties then you might be able to just take an art class or join a community art group or consult with an art therapist a couple of times and become part of an art as therapy program. If you are struggling with certain kinds of existential angst and the devestating effects of being cut off from nature, then maybe a community art as therapy shelter is right for you. We ought not diminish the do-it-yourself approach in any capacity because it really could be the only future that we have for a stronger, healthier society. At a time when corruption seems to be the norm in politics here in montreal and we still have not found an end to war, we have to wonder if maybe we are doing it wrong in the first place. Maybe the wall we put up to keep us safe has locked us in. Of course a specialist will always be useful when you need back surgery or a bridge built. A specialist is useful for all kinds of things but we get into trouble when we rely too heavily on police to reduce crime, or government to solve social issues or people working in the mental health industry to save our psyches.  The responsibility for those things rests squarely with us and we are disenfranchised when we cut up that work into pieces which we then relagate to paid professionals. Art therapy is as much a grass roots movement as it is the result of laborious research and evidence based practice. It pains me to hear seasoned art therapists knocking the do for self approach because i feel that view sells short the creative potential which each individual possesses.  That view literally disempowers people from being the principal agents of change in their own lives.  In the interests of full disclosure, it seems right that i should tell you how it is exactly that i came to know of the therapeutic value of art. As a child, my parents had always ecouraged me into the arts: into ballet first, then piano and music, then dramatic arts. I pursued all of these paths with varying degrees of high enthusiasm. Around the age of 18, i made a painting in high school art class which impressed me. As i looked at it, i can remember thinking how interesting i found the arrangement. The image seemed to evoke a story for me and i began to see movement in the abstraction but also in myself. Instantly, i became very attached to that piece without realizing that it was an important stepping stone on my path to becoming an art therapist. A path i would only really come to recognize a decade later. That summer, i painted a lot and gained something of myself which i had never reported missing. Ten years forward, after a degree in psychology and another in fine arts, i experienced a significant rupture in a personal relationship. The rupture was significant because it put my sense of purpose into question and this disorienting process tipped off a domino effect in which so many of the truths i had taken for granted appeared to crumble into half truths or bits of fiction. At the moment of asking: ''how is one to live with such a circumstance?'' i began painting again. That time was one of the most industrious periods of my creative process and i still did not have verbal awareness that something therapeutic was going on. It was sensed, only implicitly that painting was helping me feel better. It was only later that i was able to put into words that painting was reducing some of the negative automatic thinking and intrusive thoughts i had been experiencing. Painting and engagement in the creative process was lowering my stress levels and diminishing my anxiety through a biofeedback loop in which seratonin and dopamine where we being produced, resulting in higher mood states and the satisfied expectation of reward. As it turns out, basking in alpha and theta brain waves during painting had a similar effect on me as meditation or yoga does for some people. My brain was calming down. Socially, i was getting positive feedback on the products of my creation. It became clearer to me that i could control my mood states and that through the deliberate expression of my emotions, my thoughts were also falling into line.  Today, i still turn to painting somewhat compulsively but as far as compulsions go, i can think of worse. So it is through experience that i came to understand that art can be therapeutic on it's own and it is only through experience that i can be sure of anything at all.  

This girl is sublimating a fear of social situations perhaps. In doing that, is she not accessing the therapeutic benefits of catharsis and sublimation on some level, even though she may never process the experience verbally with an  therapist?

The most staunch proponnents of the art psychotherapy dimension sometimes claim that art history and art education are not relevant to the theory or practice of art therapy. Personally, i don't see that position as wholly true and especially not when working with children in a school setting. Art therapy is born from many spheres of intellectual activity and also feeds back into those fields. The artist in me tells me that artists like the Marquis de Sade brought as much to the field of art therapy as seasoned clinicians like Carl Jung did. My research into the history of art therapy as written about by Susan Hogan here: http://www.jkp.com/catalogue/book/9781853027994 and others here:http://books.google.ca/books/about/Becoming_a_Profession.html?id=8-4NAAAAQAAJ&redir_esc=y , tells me that our profession has strong roots in social work and psychiatry but just as many strong roots in artistic movements like surrealism and social movements like feminism and humanism, the fields of art education and art history. In fact, art therapy grew out of a synthesis of knowledge from those areas so how can it be that so many professionals seem to hold the view that art therapy is strictly and simply a field which emerges out of the hybridization of psychology and art. The discussion about what art therapy is goes there but it does not start nor does it end with a consideration of those things. I have heard numerous times that art therapy has nothing to do with art history and there is no room for art education in any session with any individual. Yet in an attempt to define ourselves concisely, practically and professionally, it seems to me that we may be leaving a few things out.
when we prescribe creative process or products to someone are we not prescribing at as therapy?

When we prescribe creative process or products like art materials or music to someone are we not prescribing art as therapy? Having prescribed art classes to clients on more than one occasion, i am suggesting that art is therapy even in the absence of an art therapist.

The origins of art as therapy can be traced back tens of thousands of years to the begining of art itself, back to a place where primitive people made things in caves, on clay tablets then on  pots and jewlery in order to communicate and express something of themselves. This was not the professional art therapy we know of today of course, but it was the begining of art as therapy. Throughout all recorded history, art has been exerting enormous influence on the human psyche through music, dance, image and finally through the art of word. As i write this, i stumble upon an unexpected question: if word is art, then that means that talk therapy itself is art as therapy too, does it not?'' Thus art psychotherapy which involves verbal and non verbal language could be considered art as therapy because talking is but the artful use of words. Thus, the art of psychotherapy is being practiced by client and therapist alongside whatever other art form and creative process are being used. It's all art really isn't it. Whether we are in verbal or non verbal mode, we are constantly making art. Along this line of spontaneous thought, even a pure talk therapist is an art therapist because they are skillfully using the art of work to craft a product. Who was it who said all art imitates life? While it may be hard to quantify, it has been our own harnessed creative energy which has been healing us, helping us, keeping us psychically alive and mentally sane. Getting away from the sacredness of that creativity in our lives has been a real culprit in the mental unhealth of a nation. Art as therapy proposes a means for us to collectively get back to that.

Art As Therapy is currently working at each of these levels

  When we made art in caves, were any art therapists present?  Is a therapist absolutely required for artistic activity to have a therapeutic effect? Is not the role of the art therapist to help clients uncover and renew creative potential but then to let them expand on that acquisition autonomously? Is it the art therapist's job to give a hungry man a fish or to teach him how to fish for himself?Ultimately, if we are working efficiently, we art therapists ought to be working towards our own obsolescence. Thus, in the ideal society which art therapists seek to cultivate, there ought not be a need for art therapists. Can an individual not self regulate and self administer their own measure of therapy in at least some cases?  I say that we can. I am living proof that we can because art not only saved my soul but gave me love and purpose and there was no art therapist present for that.  Actually, i stumbled on that piece of good news all by myself.

painting from the caves in Lascaux, France. Cavemen and women communicating experience through art. Transmiting self to other. The earliest forms or art education and art as therapy perhaps?

The case for art as therapy is being overstated here because i have noticed a growing trend in the dominant discourse of art therapists who seem to underestimate the preventative function of art as therapy. Yet art not only heals past wounds, it protects from future ones just as diaper rash cream heals the rash on my son's bum while protecting him from the cause of the rash which inevitably returns.  Is art as therapy diaper rash cream for the soul? While quite difficult to quantify, art has served a preventative function, insulating and protecting generations of human beings from social isolation, depression, anxiety and psychopathology. Art has been widenning the rage of human possibilities by helping us to envision change and transformation long before they actually happen. Throughout millenia, art has been working for us, helping us get our stories across through narrative play in painting and theatre or shaping our idealized future selves through works of fiction. People in the art as therapy camp don't want to lose sight of this incredible power of art but rather want to tap into it as a resource for wellness.  Let's just agree,  no optic is better than the other when it comes to the art  psychotherapy or art as therapy bi-focals. Art can be used in a relationship involving an art therapist and a client and that can have many beneficial effects which can be called art psychotherapy. Just as art can be used in a relationship which an one has with oneself, art therapist present or not, with or without a group context and that can be called art as therapy. As the article by Cathy Malchiody presents here: http://www.psychologytoday.com/blog/the-healing-arts/201304/defining-art-therapy-in-the-21st-century the art as therapy and art psychotherapy angles exist as points on a ''continuum of practice'' and most art therapists situate themselves somewhere in between. While the argument has been made here that art can be genuinely therapeutic without even the presence of a specialist art therapist, it should also be noted that when an art therapist is part of the design, the therapy flows differently and is more precisely oriented towards specific kinds of presenting problems such as ptsd or depression. It should be stated too that there is added value for an individual seeking art therapy involving an art therapist as professional guide because they benefit from the knowledge and experience of a practitioner of talk therapy who also has a deep understanding of the role of creative process in mental wellbeing. Even though there may be added value in consulting an art psychotherapist for many clients, i do not place what such practionners do above what a practioner in the art as therapy camp does. In fact, if a client sees a practitioner who is too entrenched in the art psychotherapy model and has a lack of artistic knowledge and experience, that client may be ill served just as a client who consults an art therapist with limited clinical skills will encounter limitations in therapy. Both practitioners are skilled, and both require a good deal of experience to facilitate the kind of therapy they do. It is just  a different experience and determining which one is clinically indicated depends entirely on who the consulting individual is. Ideally, an art therapist is competent working in either fashion and they can switch back and forth as is required in most therapy. Some consulting individuals may simply not need art psychotherapy as an approach initially but need a studio approach instead which does not necessarily make attempts to verbally process information. They may need a non-verbal experience which will remain non-verbal. These same clients may need experience with art media simply to reassure them implicitly that they can go into novel and foreign territory safely and emerge transformed. Talk is not always necessary for that to happen, though in most cases, i will concede that it helps.

Those in the ''art-as-therapy'' camp just like those in the ''art psychotherapy'' camp believe in the democratic right of individuals to be the self determining agents of their own mental health. Practitionners in both camps believe that people can choose to engage in the life affirming benefits of creative process. However, practionners who situate themselves more towards the art-as-therapy pole on the continuum have a stronger faith in the inherent healing power of creative potential as expressed through art alone. This implies that they accept that art in all its forms can have therapeutic effect with or without an art therapist present. Art-as-Therapy type therapists believe that involvement in creative process has therapeutic benefits such that attending to music at a concert, dancing by onself in the bathroom, singing in the shower and doodling on a napkin can all have therapeutic implications. Thus, it is the goal of the therapist in the art as therapy framework to help stimulate the creative process, to foster and nurture it while also treating it with the utmost humility by avoiding interpretations and definitions which do not belong exclusively to the client. Those in the art as therapy camp believe that talk therapy is a useful adjunct to art as therapy in many cases but that engagement in non-verbal creative process is paramount and need not always be complemented by talk therapy. Practitioners in the art as therapy camp also implicitly hold in the highest regard, the preventative function which art may serve in a given society.

Self therapy can work for some people with certain issues. It is a new way of thinking about health. Yoga and meditation may be expressions of the DIY model of therapy. Abstention from certain eating habits can also be a form of prevention.

To illustrate how art might be therapeutic in the absence of a therapist, consider the following example: A man goes to an art therapist, presenting with mild depression. The man say's he has lost his purpose and sense of meaning in life. After the initial consultation, the art therapist recommends that the man listen to specific kinds of music which lyrically addresse the presenting existential issue. The art therapist also prescribes a routine of cardiovascular exercise in accordance with medical opinion and yoga along with a community based art as therapy program such as the one offered at ''La Ruche'' or ''PAL" in montreal. The art therapist asks the man to return in 2 weeks time. In the follow up appointment the man indicates that he found the experience of studio art therapy so refreshing that he was no longer thinking about the issues which were so depressing to him earlier. He indicates that the yoga and cardio have him feeling better about his appearance and sleeping better. Is he ''cured?''. I don't know but the man says that he feels better and so long as he continues with his prescription and attends a community based arts studio, he only feels a need to consult an individual art therapist every 3 months. The art therapist theorizes that the combination of bio-psycho-social components have had a cummulative therapeutic effect. The participant and the therapist intersubjectively assess the program as successful. In another example of art as therapy in the absence of a therapist, think for a moment of how the Beatles gave voice to the repressed emotions of an entire generation. Think of how liberating it must have been to hear the echo of one's heart beat in the song of another and to find that beat reverberating in every one around you. That would have been therapeutic. Beyond merely feeling good, that experience contributed to immeasurable growth and evolution in the consciousness of a people. Though Beatlemania was a little before my time, i did get seriously turned on to Abbey Road when i was about 8 years old and it would not be an overstatement to say that the experience changed my life forever. I sang the songs everyday, memorizing each word and carrying the tone of that music into everything i did. I identified with Lennon, researched his biography and integrated him as a role model.  Therapy was done through art, with no art therapist present. Or perhaps we can consider John Lennon to be a special kind of honorary art therapist?

     

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