Where Analysis Meets the Arts

The Integration of the Arts Therapies with Psychoanalytic Theory

Yvonne Searle, Isabelle Streng

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429923951
• Topic: Psychologie
• Subtopic: Santé mentale en psychologie

This book provides the reader with a theoretical framework that considers how psychoanalysis can enrich the clinical application of the arts therapies. Five specialist arts therapies used in contemporary psychotherapy are examined: drama, psychodrama, art, dance movement and music. Although the contributors represent a variety of orientations and practices, it is the theme of integration which makes this book most stimulated and original, demonstrating how both psychoanalysis and the arts therapies may benefit from a meeting of minds. Contributors: Jeremy Holmes; Joy Schaverien; Mary Levens; Marina Jenkins; Paul Holmes; Kedzie Penfield; Helen Odell-Miller; Jocelyn James; Yvonne Searles; and Isabelle Streng.

Chapter One
Introduction

Yvonne Searle & Isabelle Streng

The idea underlying this book is to explore the integration of the arts therapies with psychoanalytic theory. We believe that the use of the creative process is implicit within the working definition of the arts therapies, and therefore we will be adopting the term “arts therapies” rather than “creative arts therapies”.

This book intends to provide the reader with a theoretical framework that considers how psychoanalysis can enrich the clinical application of the arts therapies. The book examines five specialist arts therapies used in contemporary psychotherapy: drama, psychodrama, art, dance movement, and music. Chapter nine is assigned to the exploration of an integrative arts therapy approach.

Art and society

The concept of the arts therapies as a discipline is relatively new. Its development has occurred over the last two centuries. The roots can be found in the continual and ever-changing relationship between culture, artistic activity, and societal development. Many writers, such as Con Davis and Schleifer (1994), suggest that the arts and society are inextricably linked, and that the health of a society is reflected in the pool of artistic activity that a society creates. Similarly, as a consequence of their place in society, the arts have been accepted within mental health care.

The universality of the arts transcends the barriers of language. They have had the role of transmitting definitions and understandings of culture and knowledge from one age to another. Artists possess, and provide for observers, access to archetypal images, the repository of which is the collective unconscious, shared by all individuals in all cultures (Jung, 1933). Accordingly, artists succeed in revitalizing aspects of the psyche that are essential to individual self-integration and to the mental and emotional well-being of all individuals.

The arts have a history that plays different roles in different historical settings, and so the very process of creating art also has a history that is closely connected to the value imputed to “literature”—the value of literacy. This is the field of psychological and psychoanalytic criticism, which examines the relationship between literary meaning, interested writers/artists, and their readers /observers.

Psychological criticism emerged in the early decades of the nineteenth century with critics such as Thomas Carlyle and John Keble. It deals with a work of art, in fictional form, primarily as an expression, and it is based on the assumption that a work of art is correlated with its artist’s distinctive mental and emotional traits. Psychological criticism aims to learn about the personality of the author through the author’s works of art and, subsequently, to use that knowledge to further explain and interpret the art. In addition, psychological criticism experiences the distinctive subjectivity or phenomenology of the author through his or her art. It is this latter aspect that is of most relevance when the arts are utilized within psychotherapy.

Freud developed these concepts further and set forth the theoretical framework of classical psychoanalytic criticism, which has proliferated since the 1920s. He accounted for many developments in the history of civilization, including warfare, mythology, and religion, as well as literature and the other arts. He suggested that the arts, just like dreams and neurotic symptoms, consist of the imagined or fantasized fulfilment of wishes that are either denied by reality or are prohibited by the censor’s internalized standards of society (i.e. archetypal superego). He also said that the forbidden libidinal wishes are permitted by the censor to achieve a fantasized satisfaction in distorted forms that serve to disguise their real motives and objects from the conscious mind. Thus, the disguised fantasies, which are evident to consciousness, constitute the manifest content of a work of art; the latent, unconscious wishes find a semblance of satisfaction in this distorted form. Later, Lacan (1966) developed a semiotic version of psychoanalytic criticism, applying Freudian concepts to the operations of the process of signification. For him, interpretation begins with the idea of a text as an unending interplay of signifiers. Lacan was strongly affected by structural linguistics, perceiving the unconscious to be structured as a language.

Many contemporary authors of critical theory continue to assimilate central psychoanalytic concepts into their overall views (e.g. Burke, 1973; Wilson, 1941). In addition, novelists have incorporated notions of psychoanalytic criticism in their work (e.g. Eliot, 1994).

Art and the individual

We have seen that art has an important place in society. Each effects the other because of their closely interlinked relationship. The artist can succeed in revitalizing aspects of the psyche that are essential for the mental and emotional well-being of society. From an individual perspective, artists may also do this for their personal self-integration.

For the individual artist, there is understood to be a conflict between the need for expression and the compulsion to repress self-revelation, and this is said to be resolved by the artist’s ability to give “healing relief to the secret mental emotion, yet without detriment to modest reserve … [this disguised mode of self »expression serves as] … a safety valve, preserving man from madness” (Keble, 1844, p. 264). Chadwick (1997) notes that the gradual reduction of psychotic experiences tends to bring out a form of creativity and insight. This view suggests that when madness is contained, creativity may grow in the artist. The arts may then serve the artist as a mode of fantasy that opens the way back to reality. Conversely, split off parts of the mad self might be expressed through the arts media. For example, a number of well-known artists—including Van Gogh, Ogden, Blake, and Nijinsky—are known to have suffered from mental illness. If the art is inhibited, it is possible that the madness may become more apparent in the artist.

Freud asserted that artists have special abilities that differentiate them radically from the patently neurotic personality. In addition to the ability to mould the artistic medium into a satisfying artistic form, artists have the ability to elaborate fantasized wish-fulfilments into the manifest features of a work of art in a way that conceals their personal elements and so makes them capable of satisfying desires of others. The result makes it possible for the artists’ audience to obtain satisfaction, excitement, or danger vicariously; this can act as solace from the audience’s own unconscious sources of gratification which could have become inaccessible to them.

When art heals

Our discussion so far has enabled us to understand how art might provide pathways to the unconscious world of human beings. The repetition of symbolism through the arts is said to be the ego’s attempt to repeat actively a traumatic event that was earlier experienced passively, so that the individual can gain mastery over the event (Freud, 1920g). Jung (1964) has discussed how images that are charged with emotions gain psychic energy. He notes that repercussions are inevitable when emotions become dynamic. Creative expressions emerge from the unconscious rather than from “ordinary” rationality.

Thus, the arts are understood to play a formative and significant role as a person’s emotional life emerges symbolically in creative work. Images reveal experiences that otherwise may go unsymbolized because for a variety of reasons they cannot enter into language: they may involve pre-verbal experiences, the verbal expression may be inaccessible, or they may entail unconscious processes. Art effects a change in state from unconscious to conscious and from undifferentiated to differentiated. Images can be a link between the isolated inner world and the collective external world (Schaverien, 1995). Unconscious images can facilitate the expression of emotional issues and can free internal conflicts.

In psychotherapy, both the creative product and the creative process have therapeutic significance (Arieti, 1976). The artefacts themselves are used in various ways: to illustrate particular feelings or dynamics, to aid verbal integration, and as tools in assessment. The creative process, which is to be explored within this book, emphasizes the activity of creating the artefact, focusing on the underlying therapeutic dynamic. This imaginative process takes people directly to the heart of their anxieties and conflicts, and so making art is healing in itself. By its very nature, imagination is a symbolic process: “just as imagination takes us to the emotional core of a complex, it can also lead us through it” (Chodorow, 1991, p. 6). Understanding the dynamic of the way in which art can be therapeutic involves a theory of praxis (Blatner, 1992) that considers how therapeutic intervention can cause a shift from inner turmoil to psychological health.

When people make use of the arts in therapy, they utilize four principal defences:

1. condensation—the omission of parts of the unconscious material and the fusion of several unconscious elements into a single entity;
2. displacement—the substitution of an unconscious object of desire by one that is acceptable to the conscious mind;
3. symbolization—the representation of repressed, mainly sexual objects of desire by non-sexual objects which resemble them or are associated with them in prior experience;
4. sublimation—the process by which energy, originally instinctual, is displaced and discharged in socially acceptable ways which are not obviously instinctual.

Examples of these defence mechanisms can be found in the descriptions and case examples provided throughout the forthcoming chapters.

The arts media can offer a unique area of involvement for patients. The media are frequently utilized for expressing and determining a patient’s conceptualization of reality, drawing on the healthier dimensions of the personality, respecting aspects of feeling and thought that transcend the more problem-oriented tasks that may occupy some of the “talking therapies”. Patients are encouraged to find their paths of healing through utilization of the arts media. The arts reflect the holistic functioning of the psyche (Blatner, 1992) and thus can be brought into the service of the healing endeavour.

Historical account

The notion that the arts facilitate healing dates back to early societies (Chodorow, 1991). The arts have long been used as a natural form of healing, allowing the individual’s images to be extended and energized so that he or she gains new power. This may also be called “play”, which is in itself considered to be a function of culture from its earliest beginnings (Huizinga, 1955).

In 1790, the arts entered the psychiatric arena, when Johann Reil discussed art activities as something sophisticated and all-encompassing. He did not believe that their use should be for mere diversion. Reil’s conceptualization for using the arts as therapy was clearly ahead of his time. He proposed building special hospital theatres; he considered it therapeutic for patients to portray scenes from their “former life” by “acting them out”. However, his intention had been to exhort the audience to “ridicule the follies of each patient” (Reil, 1803, p. 287). Following this, in the 1800s a small number of asylums were designed with theatres as part of their main structure, and art work was used occasionally as a diagnostic tool. By the late nineteenth century, professional musicians were employed to play music to in-patients. Music was thought to be an entertaining diversion, thereby boosting morale.

By the twentieth century, the innovative thinking of both Jung and Moreno had contributed to the advancement of the therapeutic use of arts media. Jung (1916) examined dance, expressive body movement, painting, drawing, work with clay, and other artistic media as giving form to the unconscious. Five years later, Moreno employed his existential, phenomenological philosophy of creativity to develop the method of psychodrama as a tool for the resolution of conflict. The arts-and-crafts movement in hospitals as part of occupational therapy was boosted further as a result of the influx of psychologically traumatized soldiers at the end of the First World War (Fryrear & Fleshman, 1981).

It was not until the mid-twentieth century that the arts therapies, as therapeutic tools, entered the arena of psychiatry. They had finally moved away from their status as diversion. Each arts therapy evolved relatively independently of the others. Their growth resulted from the successes achieved by arts therapists working in health care, rehabilitation, and special educational settings. However, more time had to pass before they were fully recognized, and their gradual emergence as professional bodies did not occur until the 1960s. In addition to this progress, the development of play therapy (e.g. Axline, 1947; Oaklander, 1988) also served to inform therapists to consider working with their patients through different media.

Developing an integrative approach

As we can see, the arts therapies derive much from humanistic phenomenology. The humanities are traditionally viewed as an area of knowledge that examines unique human events, including people’s potential for creativity. Within the humanistic tradition, therapists are phenomenological, existential, and person-centred. Developed in the 1950s and 1960s, it derives many of its principles from Morenian theory (e.g. Berne, 1970; Maslow, 1968; Schutz, 1971).

Historically, humanistic phenomenology has been perceived to differ from psychoanalysis in certain significant ways:

1. it promoted a methodology based on a framework of health—psychoanalysis had gathered its data from neurotic patients and therefore had developed a framework of pathology;
2. humanistic phenomenology stressed the importance of the individual’s immediate conscious experiences in determining reality—psychoanalysis focused on the role of unconscious processes as motivators of behaviour;
3. humanistic phenomenology asserted that fully functioning individuals want to fulfil and enhance all their potentialities—psychoanalysis asserted that humans are motivated primarily by sexual and aggressive drives.

Contemporary thought asserts that the schools of humanistic phenomenology and psychoanalysis are less antagonistic towards each other in respect of their theoretical understanding and their ensuing clinical application.

The concept of integration within the field of psychotherapy dates back to the 1930s (e.g. French, 1933; Rosenzweig, 1936). However, it was to take another forty years before it became a strong and coherent force within the psychotherapy tradition. Psychotherapeutic integration has been a response to a number of factors, including the high-quality outcome research, negligible evidence in support of differential outcomes among existing therapies, increasing interest in short-term psychotherapies, a rapid rise in the number of specific therapies, and an increasing consensus that no single approach is clinically adequate for all problems, patients, and situations (Norcross & Arkowitz, 1992). Thus, there has been an increasing desire to look beyond single-school approaches and to see what could be incorporated from other methods of psychotherapy regarding personal growth and change.

Norcross and Arkowitz (1992) have described four pathways towards the integration of psychotherapies:

• (i) technical eclecticism, which seeks to improve our ability to select the best treatment for the person and the problem;
• (ii) the common factors approach (Rosenzweig, 1936) which attempts to look, heuristically, across diverse therapies to search for elements that they may share in common;
• (iii) theoretical integration, which is two or more therapies being integrated in the hope that the result will be better than the individual therapies on which they were based (French, 1933); and
• (iv) integrative psychotherapy, where theory and practice are integrated with basic theory and research in psychology and psychiatry. [Norcross & Arkowitz, 1992, pp. 5–6]

Integrative psychotherapy attempts to find pathways within a person between emotions, desires, intellectual understanding, images, perceptions, and the body. It is characterized by a dissatisfaction with single-school approaches and a concomitant curiosity to see what can be learned from other ways of thinking. Frequently, terms such as eclectic and pluralistic are used to mean integrative (Norcross & Arkowitz, 1992). However, in eclecticism and pluralism, there is a relative de-emphasis on theory and the basis for treatment selection is actuarial; this is antithetical to the integrative model. We shall see that the forthcoming chapters provide evidence of a truly integrative arts approach.

Perhaps before considering the definition of integrative psychotherapy, we should have noted that there is barely any consensus regarding the actual definition of psychotherapy. The common denominators for every type of psychotherapy are based on the idea of bringing about change in the personality and manner of a person’s relating by the use of essentially psychological techniques. A broad and commonly cited definition regards psychotherapy as “the systematic use of a relationship between therapist and patient—as opposed to ph...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• CONTENTS
• ACKNOWLEDGEMENTS
• CONTRIBUTORS
• FOREWORD
• CHAPTER ONE Introduction
• CHAPTER TWO Freud, psychoanalysis, and the arts therapies
• CHAPTER THREE Art and analytical psychology
• CHAPTER FOUR Analytically informed art therapy
• CHAPTER FIVE Dramatherapy and psychoanalysis: some links explored
• CHAPTER SIX Psychodrama, psychoanalytic theory, and the creative process
• CHAPTER SEVEN Movement as a way to the unconscious
• CHAPTER EIGHT Music therapy and its relationship to psychoanalysis
• CHAPTER NINE The landscape of the imagination: an integrative arts approach based in depth psychology
• CHAPTER TEN Integration and complementation
• REFERENCES
• INDEX