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ART THERAPY.
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Discusses its use for treating schizophrenics.... More...
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Paper Abstract:
Discusses its use for treating schizophrenics. History of art as a psychotherapeutic discipline. Theories and definitions of art therapy. The function art performs in therapy. Choice of art materials that work best for each patient. How the therapist uses art materials and activities as part of the treatment process. The psychotherapy dynamic.
Paper Introduction:
This research examines art therapy in group settings for subjects diagnosed as schizophrenic. The research will set forth the background and context in which art therapy has been determined to be relevant to psychological treatment for schizophrenia and then discuss the dynamics of patient response to group treatment, including the use of media and the structure of intervention and treatment techniques, with a view toward identifying the advantages and limits of art therapy for this patient demographic.
Art therapy appears to have emerged as a discrete psychotherapeutic discipline in the 1960s and 1970s. The tone of the literature of the early stage suggests that it was thought to be something of an adjunct to traditional--indeed Freudian--psychotherapeutic approaches, perhaps a helpful bridge to initi
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(1999). The materials become the "expressive modality" between thepractitioner and the patient (Linesch, 1999, p. Corey, G. Dallas Morning News. Assessing and developing cognitive skills throughart. Clark, K. As Kenneth Clark (1969, p. That is why the success that art therapy appears to have had infacilitating the process of reorganizing the schizophrenic's experience ofthe world is so encouraging. Media choice has become wide indeed in recent years, extending outwardfrom the use of such materials as paints or pottery clay to such media ascomputers and video cameras. (2 1, July). The question of therapeutic intervention experienced as intrusivenessbecomes especially vexed in the case of schizophrenics, who may becomeclients in significant part because of arrested or lagging development ofego and social skills. Waller, D.E. R. Utilization of art therapyin the hospital management of a schizophrenic patient. (1993). Principles of intensive psychotherapy.Chicago: Phoenix/University of Chicago Press. However tentative the earliest theory of art therapymay have been, evidence of its clinical utility over the last 4 years orso has mounted. Gunther (1992) reports a case of achronic paranoid-schizophrenic in which art functioned to facilitate thestructure of the therapeutic relationship itself. 34) says is a primary goal of psychotherapy: self-realization or satisfactory use of the individual's powers and values. Psychological dysfunction may emerge inconsequence of roles and relationships, just as it may emerge inconsequence of inner conflicts, which are historically associated with theone-on-one psychological-counseling structure. Petterson, M. As Sobol and Williamsexplain, that is because, as a social being, the individual human assumespsychosocial roles in and develops relationships (for good or ill) tomultiple-member systems, whether in the family, the workplace, theclassroom, or the world at large. The improvement of social and coping skills is a goal of muchpsychotherapy, whether the patients involved are schizophrenic or not andwhether the therapy is structured around a group or not. New York: HumanSciences Press. The big picture of media choice is that arttherapy clients may select materials that are best suited to expressingfeelings or ideas that might not emerge in an "unmediated" therapeuticsetting. P., & Friedman, I. Art making in family therapy. Retrieved from the WorldWide Web 2 March 2 2, at http://www.ed.gov/databases/ERIC_Digests/. Silver, R. Rubin's definition of art therapy(1982), for example, holds that both art and therapy must be involved in aclear understanding of that term. (2 ). T. To be sure,such classical-theory issues as transference and countertransference (Fromm-Reichmann, 195 ), as well as the power ratios between patient and therapist(Heller, 1985), are relevant to art therapy in particular if they arerelevant to the psychotherapeutic process in general. (2 1). 54). A. The therapeutic relationship and process can become more complicatedin a group setting. In the clinicalsetting, whether a hospital per se or a group-counseling environment, itappears to foster emotional, personality, and cognitive development indisabled or disturbed individuals (Berg, 1982), although there is muchvariation in the way art therapy is applied. That is because wherever more than two persons cometogether, irrespective of whether they are in a psychotherapeuticstructure, there exists the potential for mutual support and the emotionalpayoff that comes from positive regard for self and other. Carl Rogers on encounter groups. (1995). (1985). Art therapists help patients paint brightnew vistas. The implication of such designations is that the practice iscross-disciplinary in nature, confined neither to art as such nor topsychotherapeutic praxis in the common understanding of that term. Miller, R. In that case, thetherapist was able to channel the patient's artistic energy in a way thatenabled her to exploit opportunities to make meaningful contact with him. (1992). This research examines art therapy in group settings for subjectsdiagnosed as schizophrenic. Symbiosis and symbiotic relatedness: A bridge toschizophrenia. The whole matter of self-disclosure, as well as other aspects of thepsychotherapy dynamic, can be further complicated if group members areschizophrenic rather than mildly disturbed, although as indicated by casescited above there is evidence in the literature that schizophrenic patientsrespond to the opportunity for creative expression. My hope is gradually to become as much a participant in thegroup as a facilitator" (Rogers, 197 , p. According to Silver (2 1), arttherapy can be useful not only as a diagnostic tool but also as aninstrument of cognitive development, which implies that it can function asa bridge to increased insight as well as enhanced communication skills.Silver makes the point that emotions and preoccupations of the psyche thatcannot necessarily be expressed in language may find expression in adrawing or painting. Arts inPsychotherapy, 19, 87-92. (1992). Dunn-Snow, P., & D'Amelio, G. Wiener(Ed.). In that regard, Weiser (2 1) describes theuse of family photographs as a catalyst for eliciting communication and theevocation of emotion and sense memory from clients. (1982, January). Art has long been understood as having the effect ofopening up feelings and hidden thoughts. The expression may not stop there, for the therapistis likely to build on what the art reveals about the client's inner state.On the other hand, artistic expression that, either intentionally orunintentionally, reveals the client's inner self may have the force of anemotional breakthrough or catharsis that is conventionally associated withverbalization of feelings and thoughts. Theory and practice of group counseling. However, asPotocky's research shows, art therapy appears to have certain built-inbenefits for eliciting responses from schizophrenic patients. The difficulties that schizophrenics encounter when attempting to copewith the cosmos are in the background of therapeutic interventions, butschizophrenics may perceive threat rather than help in the interventionstructure. B. In the case of what turnedout to be the successful behavior modification of a disruptive adolescenton the verge of being expelled from school, the intervention was familytherapy that included having members of the small group illustrate theirview of the roles each had assumed (Sobol & Williams, 2 1). Potocky, M. Ulman, E. (2 1). Washington, DC: American Psychological Association. Indeed, modes of therapeuticpractice vary widely, and definitions of what constitutes art itself,whether inside or outside the therapeutic arena, are so varied as tocomplicate the definitional enterprise for the art-therapy discipline. A similar dynamic is described by Alter-Muri (1994), who focuses on the increase of self-esteem and social skillsand the decrease of delusional behavior experienced by one schizophrenicwhose art was exhibited publicly. Phototherapy techniques: Usingclients' personal snapshots and family photos as counseling and therapytools. Their main point is that the patient respondedto art in a way that allowed art to help manage and bring under control hiserotic and aggressive pathologies. (1993). Art therapy with adolescents. The result is that it has found application in a wholerange of psychological interventions and schools of practice, from person-centered to Gestalt to self-psychology to object-relations and beyond(Rubin, 2 1). Rogers, C. ED366856). Without the objectification that art fosters, a therapeuticintervention could seem "intrusive" and antithetical to the project ofbuilding an environment of safety (Dunn-Snow & D'Amelio, 2 ). Western Journal ofMedicine, 175, 54-7. (1966). Art therapy is seen as an important bridge ofcommunication and relaxation for individuals who are so isolated fromothers that they are socially and emotionally inept. Rubin (Ed.).Philadelphia: Brunner-Routledge. Equally, arttherapy has affinities with group dynamics, just as some psychotherapypractitioners have adopted the view that the "closed system" of theindividual in therapy may not accomplish for the individual what a grouptherapy setting can (Sobol & Williams, 2 1). Alternative Therapies in Health andMedicine, 7, 88-89. Accordingly, it falls to the groupcounselor/therapist, who structures and leads the group and is in aposition of power no matter how much he may desire to functionnondirectively (Heller, 1985), to see that differences can be resolved inways that will inure to the psychosocial benefit of all group participants.To put it another way, anxiety in various degrees is likely to be acomponent of the group encounter (Corey, 2 , p. Linesch, D. The strength of art therapy is that it seemsto encourage learning or discovering what the content of the human psycheis based on what the client's situation gradually reveals rather than onpractitioner structures into which the psyche must be molded. Approaches to art therapy: Theory and technique.2nd ed. However, the atmosphere of creative artappears to have encouraged more or less consistent participation.Furthermore, the creative outlet fostered increases in the schizophrenics'self-esteem and self-disclosure, as well as improved social skills bothinside and outside the group. Greensboro, North Carolina: ERICClearinghouse on Counseling and Student Services. J. Art Therapy,16, 2 1-2 5. American Journal of Art Therapy, 22, 3-9. How art teachers can enhanceartmaking as a therapeutic experience: Art therapy and art education. (2 1, January). Eros and the ego: The use of ego assessment increatively addressing a sexualized transference. Creative Arts TherapyReview, 13, 31-4 . Rubin, J. Sobol, B., & Williams, K. This is all perfectly consistent with whatFromm-Reichmann (195 , p. The Diagnostic Drawing Series and the Tree RatingScale: An isomorphic representation of multiple personality disorder, majordepression, and schizophrenia populations. Further to this point, McNiff (2 1) takes theview that art therapy is "multisensory" in nature and that the creativeprocess both enables and requires application of all of the senses to theproject of psychological development or modification. . Gladding, S. 2nd ed. 45). In the group Potocky describes, attendance at the meetings wasvoluntary and not strictly enforced, and the number of people at a meetingwould range from six to ten. D. Art therapy understood as a part of the treatment process provides anopportunity to make literally instrumental use of art materials andactivities to evoke overt patient expressiveness. Linesch describes theempowering aspect of materials in family therapy, where the family groupmight undertake a specific artistic project in the therapeutic setting andin the process reveal patterns of interaction as well as opportunities fortherapeutic intervention. Arttherapy, from that point of view, provides an opportunity for the client,either individually or in a group, to both discover and exercise creativepowers. For example, Moffat and Friedman (1973) report the case of aschizophrenic man who not only worked obsessively on producing art workswhile hospitalized but also actually sold some of the art and in theprocess found a new career. Approaches to Art Therapy: Theory and Technique. J. 225-243. 241-253. One empirical studyexplains the use of a psychometric instrument called the Diagnostic DrawingSeries. (1999). Ego-strengthening art therapy in a day hospital:Using art history to engage clients. One way in which suchmatters seem to be addressed in the context of art therapy is bystructuring a group around artistic projects and supplementing work on theart with group therapy per se (Potocky, 1993), all with a view towardacknowledging and expressing what is perceived to be devaluing thatexistence. 5th ed.Stamford, Conn.: Brooks/Cole Publishing Company. 243)says in a comment about opera, "what is too subtle to be said, or toodeeply felt, or too revealing or too mysterious--these things can also besung and only be sung." The same process operates in the plastic arts aswell. Different things to different people: art therapyin Britain--a brief survey of its history and current development. McLeod (1999) explainsbenefits associated with computer-generated art, which she says patientscan pursue either in the therapeutic setting or at their own computerswithout the sometimes awkward problems of cleanup or materials storagearising. The psychotherapeutic enterprise in general is meant to elicitresponse in the form of expression of feelings and anxieties, so that theymay be worked through and, to the extent possible, resolved. (1994, April). 226). ERIC/CASSDigest (Report No. Effective group counseling. Art Therapy, 15, 265-268. Music for healing: The creative artsprogram at the Ireland cancer center. Art Psychotherapy,1, 3 1-3 6. The plastic arts (as opposed to, say, the performing arts such asmusic or the dance) derive their mode of expression from tangible materialsemployed in creating that expression. Miller, C. . Rubin(Ed.). Weiser, J. (2 1, November/December). A. L. One published report about arttherapy quotes the founder of the Art Therapy Institute to the effect thatan art therapist facilitates patients' choice of media "to best expressthemselves" (Miller, 1999). ArtEducation, 53, 46-53. In addition toenabling the visual rather than verbal expression of concerns and states ofmind, the opportunity to engage in artistic expression has the effect ofencouraging the adolescent's consent to a therapeutic intervention thatmight otherwise have been strongly resisted (Atlas, Smith, & Sessoms,1992). Bulletin of Art Therapy, 6, 3-21. (2 1). (195 ). Afterimage, 29, 1 -15. Therapy is not enough: The contribution of art togeneral hospital psychiatry. In the case of adolescents, who may bepsychologically and emotionally inarticulate on one hand and highlyresistant to a practitioner's intervention on the other, art therapy hasbeen found to function symbolically and expressively. Art therapy appears to have emerged as a discrete psychotherapeuticdiscipline in the 196 s and 197 s. Miller's (1998) use of simple art materials and astructured mini-course in art history and Old Masters techniques formentally ill outpatients reportedly enables them to improve theirconcentration and relaxation by focusing on the project of manipulatingmedia, which in turn enables them to express feelings that would remainotherwise hidden. Thelimitation of such an approach is that this very process of discoverycreates a challenge for whoever has the job of decoding and reorganizingwhat is discovered, and of distinguishing between creativity andpsychological revelation. Morris, M. In other words, it seems that art therapyencourages a tension between clarifying the status of the psyche andpermitting it to remain mysterious and unfathomable. Itfollows that diagnosis of cases to which art therapy may be suitablyapplied must involve a therapist with skills in both art andpsychotherapeutic science. Rubin, J.A. The research will set forth the background andcontext in which art therapy has been determined to be relevant topsychological treatment for schizophrenia and then discuss the dynamics ofpatient response to group treatment, including the use of media and thestructure of intervention and treatment techniques, with a view towardidentifying the advantages and limits of art therapy for this patientdemographic. 2nd ed. Izhakoff, S. Civilisation. Another response that art-therapy clients may engage in is related tothe notion of expressing themselves but can be distinguished from it: usingart as an outlet for emotions, particularly negative or aggressivetendencies. That function isinformally understood to be that of relaxation agent in the service ofenhanced communication and interaction, often, though not exclusively,among members of a group. Philadelphia: Brunner-Routledge. To put it another way: From the point of view of the patient, whatcannot safely be said may be visually produced in psychological safety. J. One important fact about art therapy is the emphasis theorists andpractitioners place on defining the term. (197 ). Additionally, externalization of the stress makes it objective toclient as well as therapist, thus available for comment and therapeuticintervention. Art therapy: what it is and what it is not.American Journal of Art Therapy, 21, 57-58. The tone of the literature of the earlystage suggests that it was thought to be something of an adjunct totraditional--indeed Freudian--psychotherapeutic approaches, perhaps ahelpful bridge to initiating communication with patients in a clinicalsetting (Ulman, 1966). References Berg, C.D. New York: Harper & Row. By and large, the function that art performs in clinical environmentsis similar to the function it performs in the culture. (1999, April 4). Izhakoff (1993) describes a case in which thecontent of a schizophrenic patient's artwork helped clarify hisverbalizations because it revealed the nature of his ego defenses andhelped the therapist in structuring a relationship of trust for the patient(at least in the clinical setting). (1973, Winter). 54) saysthat "imagery taps into a person's earliest way of knowing and reacting tothe world" and may externalize by making visual the sources of emotionalstress. Riley (2 1, p. Heller, D. New York: Harper& Row, Publishers. Waller (1992) describes creative-arts-based therapies in general as a synthesis of psychoanalysis and arteducation. Power in psychotherapeutic practice. (1982, October). Family and group art therapy.Approaches to Art Therapy: Theory and Technique. (2 , May). Meanwhile, CarlRogers cautions therapists who run groups on the importance of thetherapist's self-disclosure: "In no basic philosophical way does thisapproach differ from that which I have adopted for years in individualtherapy. McLeod, C. (1969). Fromm-Reichmann, F. Beyond Talk Therapy:Using Movement and Expressive Techniques in Clinical Practice. Empowering creativity with computer-assisted arttherapy: An introduction to available programs and techniques. Riley, S. . Social Work With Groups, 16, 73-82. Teenagers, totems, and teddy bears: art astherapy in a public school class. Gunther, M. An art therapy group for clients with chronicschizophrenia. 261-28 . Art Therapy, 12, 118-128. Moffat, J. A. (1998). That is, the materials and their use may offer the practitioner a wayin. As Gladding(1994) explains, when in groups, "individuals accomplish goals and relateto others in innovative and productive ways." Yet at the same time, themere existence of a group implies the possibility of differences of opinionand old-fashioned personality conflict. Creative Arts Therapy Review, 14, 25-33. As the term implies, the instrument is less a feature of thetherapeutic process than a mechanism that analyzes drawings (of trees) doneby schizophrenics and other patients with a view toward diagnosing specificmental-health states (Morris, 1995).
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