Cancer and Creativity

A Psychoanalytic Guide to Therapeutic Transformation

Esther Dreifuss-Kattan, Esther Dreifuss-Kattan

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781351206259
• Edition: 1
• Topic: Médecine
• Subtopic: Oncologie

Cancer and Creativity is a dialogue between accounts by cancer patients and survivors and a more clinical consideration and theoretical discussion from a psychoanalytic point of view of using creativity in coping with serious illness. The contributions featured demonstrate the power of creative expression as a tool for dealing with somatic, chronic and potentially life-threatening illnesses, giving patients a way of expressing and managing their individual cancer journeys and its attendant emotional sequelae.

Ten artist-patients and survivors, who were involved in several long-term art therapy groups, give accounts of their experiences with cancer and with their support group, where they create paintings, embroidery, digital photography, comic books, maps and other works to express their experiences of being diagnosed and treated for cancer. The contributors describe their symptoms andtheir relationships to physicians and family members in words and visual representations. The book also addresses the experience of the public when they are confronted with art by cancer patients. Dreifuss-Kattan's own work as a psychoanalyst and art therapist informs her approach to the art space as what Winnicott calls a "transitional space, " influenced by both the personal psychological experience and the physical environment. Dreifuss-Kattan closes her discussion with a reflection on terminal cancer care and the complex transferential and countertransferential relationship between patient and therapist. The book ends with a practical guide for both therapy groups, as well as individuals at home, to creatively address their experiences with cancer and its treatments.

Cancer and Creativity will be of great interest to psychoanalysts, psychoanalytic psychotherapists, psychooncologists and art therapists, as well as health professionals working in oncology and in palliative care.

Chapter 1

Sigmund Freud’s consultation room and the art studio

Potential spaces for creative transformation

Esther Dreifuss-Kattan and Corinne Lightweaver

This chapter compares Sigmund Freud’s iconic consultation room—located first in Vienna and then, after the start of the Second World War, in London, where patient and analyst would have been surrounded by many collected artifacts, small sculptures, images, reliefs and carpets—to the art studio-atelier, where artist-patients meet in a group with the art-psychotherapist to create art, while exploring their lives with cancer and its treatments. These artist-patients have been faced, suddenly, with new realities and visited with unsettling medical trauma. They meet in the space of the art room for creative exploration and play, ultimately to work through and, eventually, integrate their traumatic experiences. Not unlike Freud’s patients on the couch who were asked to free associate verbally with memories of their pasts in order to help them access their unconscious, cancer patients free associate by painting, drawing or making cutout collages in a safe and creative environment. The art-psychotherapist is there to catalyze this free play of the imagination, not unlike Freud, though in a somewhat less tactile and messy fashion.

When we look at furnished, intimate spaces like Freud’s consultation room, with its sculptures and couch, and the art studio, with its art supplies, pictures and social interaction, we recognize certain common features, some perhaps paradoxical. These spaces can be isolated but are penetrable as well, open for patients and artist but closed to others. While they may usually be very private, they also open to the public at other times. Moreover, within these two spaces their occupants partake of particular slices of biographical time. While Edward Soja (1989, p. 11) addresses spatiality more in geographical and social terms, he also makes us aware that life stories have their own geography, with their own milieu, with places internal to their narratives and locales where biography takes on a particular dialectic of space, time and social being. The spatialization of personal history results in a human geography. The consultation room and the art space encompass psychosocial life, connecting the enclosure of a particular spatial aesthetic to seeing, hearing, talking and creating.

In his essay “Of Other Spaces,” Michel Foucault (1986, p. 29) addresses public spaces opening onto one another, using the metaphor of the “Mirror for Utopia.” He claims that the image that you see in the mirror does not really exist, but the mirror itself is a real object that shapes the way we relate to our own image. In Freud’s consultation room there is a similar mirror in the reflections of the psychoanalyst, with his ability to show patients their conscious and unconscious state of mind, the sometimes hidden or overlooked forces affecting their life and relationships. In the art studio, conversely, the patient looks into the mirror of his or her own creations, associating and telling a story that reflects on a particular mood and personal psychological mapping, tracing in artistic media the genealogy of their mental states and uncovering an archaeology of causes. Both the consultation room and the art studio are enveloping spaces, rooms of self-representation that reach a unique depth of vision (Soja, 1989, p. 11).

Sigmund Freud’s consultation room

The well-known photographs taken by Edmund Engelman in May 1938 of Sigmund Freud’s home and office spaces in Berggasse 19 in Vienna, where Freud had worked and lived since 1891, document in detail the iconic consultation room as it stood before Freud’s escape from the Nazis. Engleman, M. (1976) Freud used the consulting room for almost 30 years, centering its space on the couch alongside the wall and opposite the window. Freud received the couch from a patient in 1890 (Welter, 2012a); it was covered with oriental rugs and another rug was hung behind the wall to protect it. With the chair behind it, the couch formed the core element of this unprecedented, but now iconic, configuration of psychoanalytic treatment. In “On the Beginning of Treatment” (1913), Freud explains that his earlier treatment of hypnosis was the origin of the patient’s horizontal position on a couch, preserving professional discretion by allowing the doctor to hide his facial reactions from the patient. Freud called it “a certain ceremonial of the situation in which the treatment is carried out” (Freud, 1913/1955). Freud set up his new working and living spaces in exile in London 1939 in the exact same way. His daughter Anna Freud, who had her own consultation room in the same house, later turned this location into the Freud Museum, as we know it today in the Hampstead area of London.

Freud modeled his office in Vienna in part after his mentor and teacher, the French psychiatrist Jean-Martin Charcot, a world-renowned neurologist and brilliant educator with whom Freud worked at the Salpêtrière Hospital in Paris when he was 29 years old. Charcot was to have an unparalleled influence on the young Freud, stimulating a lifelong interest in the arts that foreshadowed the career not only of his son Ernst, an architect, but also that of artistic grandson, the famous English painter Lucian Freud. Charcot also published a series of uncanny photographs in the early 1880s at the Salpêtrière Hospital of women with a “social disturbance” later called hysteria. These images were not artistic expressions as such, but rather “scientific experiments” using the newly invented flash to highlight a “new” pathology through a new type of pictorial documentation. Charcot’s reliance on the image in his research on hysteria would influence Freud’s professional career as much as the now familiar layout of Charcot’s consultation room (Baer, 2005).

Charcot collected Chinese and Indian antiquities that he displayed with other artifacts in his expansive living and working spaces in Paris. In a letter dated January 20, 1886, that Freud sent to his fiancée Martha Bernays, he evokes the aesthetic of Charcot’s home in a way that now seems telling:

The other section [of his apartment] has a fireplace…, a table and cases containing Indian and Chinese antiques…. The walls are covered with goblins and pictures, the walls themselves are painted terra cotta…the same wealth of pictures, goblins, carpets and curios—in short a museum.

(Freud, 1885)

Charcot’s collection of exotic objects, like the collection of Egyptian and Near Eastern antiquities in the museum in Paris created for Freud a “dreamlike world” (Letters of Sigmund Freud, p. 194). Freud echoes these sentiments in 1922 in a letter to his friend and colleague, the Hungarian psychoanalyst Sandor Ferenczi, where he expresses again this particular emotion prompted by his collecting of small antique sculptures: a “strange secret yearning, perhaps from my ancestral heritage, for the Orient and the Mediterranean and for a life of quite another kind: wishes from late childhood never fulfilled and not adapted to reality” (Gay, 1988, n. 4).

Freud bought his first antiques in 1896, two months after his father’s death, when, at age 40 he decorated his first office, shortly before he started his self-analysis (Bergstein, 2003). “I may say once that I am no connoisseur in art, but simply a layman… Nevertheless, works of art do exercise a powerful effect on me” (Freud, 1914, p. 211). In the milieu of turn-of-the-century Vienna, archaeology, a very new field of investigation, had just become an influence on bourgeois taste, recommending its objects of investigation as equally aesthetic ones for home furnishing. By 1938, Freud had collected more than 2,000 ancient objects, half of them from Egypt and the rest mostly from Greece and Rome (Corcoran, 1991). Freud writes to his friend Fliess in January 30, 1899, that: “for relaxation I am reading Burckhart’s History of Greek civilization, which is providing me with unexpected parallels. My predilection for the prehistoric in all its human form has remained the same” (Anzieu, 1986, p. 412). In a letter to another friend, the writer Stephan Zweig, he observes that he actually reads more archaeology than psychology (Freud & Zweig, 1970). Freud’s office and consultation room formed a virtual museum, dark and crowded, the floors covered with Oriental carpets that were also draped on tabletops and, as mentioned, on his couch. The walls were lined with bookcases, framed photographs, engravings, sculptural reliefs and mounted fragments. Freud’s working desk, tabletops, shelves and cabinets were filled with small-scale Greek, Roman and Egyptian figurines (Kurtz, 1986). Freud amassed this collection between 1896 and 1939, most of which were small sculptures from Egypt, Greece, Ancient Rome and China, as well as the Near East.

Most of the Egyptian figurines were shown in frontal view, conforming to ancient Egyptian canons of representation; Freud also lined up these figures on his writing desk facing him. Most of these small, sharp-edged Egyptian sculptures are shabtis and ushabti, magical objects that were mass-produced by anonymous artisans and made from metal, stone and ceramics. They are votive figures, offerings to the gods for funerary use, intended for magical and religious purposes and placed in ancient Egyptian tombs. Often inscribed with lines from chapter six of the Book of the Dead, a shabti, which translates as “answerer,” was thought to animate, and specifically to serve, the souls of the deceased, should they be called to the netherworld (http:emol. org/kabbalah/ushabti/). Freud loved these objects as they embodied a continuity with the Egyptian and Greco-Roman mythologies from which he developed some of his psychoanalytic theory. He equated the deciphering of their inscriptions to the interpretation of dreams, using these antiquities as a metaphor for the new science of psychoanalysis as it argued that dreams, fantasies and neuroses preserve atavistic mental or psychic tendencies (seelische Altertuemer) (Freud, 1916, p. 371, Kuspit, 1989, pp. 133–151). The psychoanalyst becomes an archaeologist as he excavates multiple deep layers of the patient’s psyche to uncover valuable treasures.

Freud also enjoyed the visual and tactile pleasure he received from handling small antique sculptures. He rearranged them often on his desk and at the dining table they sometimes became animated companions. It is well documented that the sculptures were not only used by Freud as decorative artifacts in his working room and consultation space but were also intimately present in his life outside of it. When Freud moved to his summer residence outside Vienna, these objects were packed up by his wife and sent along with him. Perhaps they kept him company, connecting him to his creative inner space and his home office or inspiring his intellectual, psychoanalytic pursuits (Scully, 1997).

Walter Benjamin, the German literary critic, essayist and philosopher, writes that the collector’s passion “borders on the chaos of memories” (Benjamin, 1968, p. 60); Benjamin was himself was an avid collector of books and children’s toys. Touching the pieces with his hands, Benjamin writes, the collector feels like he touches the world, acquires knowledge, recovers personal experience, and moves another’s soul. The touching of and looking at objects or images allows for a particular intimacy and closeness, a more practical remembering, a window through which to view and to understand the past. For Benjamin, handling objects can jumpstart thinking, weaving the chaos of memory into the linear passage of time, and creating a new concept of one’s past, intertwined with the threads of the present (Leslie, 1998). Benjamin discusses in his essay how artists and children also love to collect, perhaps with a naïve desire to redeem a past world as if it were like painting a picture or cutting out a figure and preserving it in a portfolio for later viewing. “Relationships to objects and images can be mysterious and speak to a deep desire for the renewal of the old with the new” (Benjamin, 1968, p. 60). Benjamin’s observations are as true for Freud as for the artists I work with in my cancer groups.

In addition to their value as touchstones that induce memories, Freud’s statuettes also may have possessed magical, totemic powers for him, as their origins suggest. He once apparently deliberately threw and broke a small marble sculpture of Venus in 1905 when his daughter Martha was gravely ill; another time he threw a sculpture in an attempt to repair a friendship that was threatened (Yerushalmi, 1991). Freud, like Benjamin’s artist or child, experienced his art collection as a source of exceptional, even miraculous, renewal, Erquickung in German, an “invigoration” (Gay, 1988, p. 171).

Like the scholar’s study or the art studio, Freud’s working space was created and invented by him: it was and is a Gesamtkunstwerk, an all-inclusive artistic creation or a synthesis of the arts, an environment to showcase his interest in literature and the arts. He writes in his introduction to the essay “The Moses of Michelangelo” that “works of art do exercise a powerful effect on me, especially those of literature and sculpture, less often of painting” (Freud, 1914, p. 211). To this end, Mary Bergstein wonders if Freud wrote most about sculpture because of the contrast between its hard, monumental durability and the “softer” concepts, such as dreams and memories, of his day-to-day work treating his patients (Bergstein, 2003, p. 3).

Freud’s first visit to Rome in 1897, together with his brother Alexander, provides an example of this “powerful effect,” and it was accompanied by major angst perhaps rooted in his upbringing. He wrote to his wife that there were heavy storms in Rome, so terrible and overwhelming that they “could have been created by Michelangelo” himself (Bergstein, 2010, p. 65). It was on this trip that Freud first visited the actual sculpture of Moses by Michelangelo in the church of San Pietro in Vincoli which would inspire the essay by the same name; the statue sits like an idol (or figurine) of sorts on Paul Julius’s tomb. (Mahagoni, 2006) Freud wrote to his friend and collaborator Fliess on December 3, 1897 that “my longing for Rome…is deeply neurotic,” though he could reminisce, four years later that his first visit had been “overwhelming for me … a high point of my life” (Masson, 1985). When, also in 1901, Freud saw the Acropolis for the first time he wrote that he was moved to feelings of “derealization extraordinary, almost hallucinatory” (Yerushalmi, 1991, p. 76). Both of these experiences of spectatorship might have brought forth Freud’s inner, somewhat repressed tensions with his late father, whose Jewish name was Jacob Moses and who, as an orthodox Jew, might not have approved of Freud’s obsession with an image of Moses or with pagan religious iconography. Freud’s particular interests in collecting Egyptian and Greek sculpture set the stage for the expansion of the lives of his descendants to a more general, transcultural identification with more universal archetypes than those of psychoanalytic technique. With the many artifacts, sculptures, ancient reliefs and prints he collected, Freud might also have wanted to signal to himself, and to his family, patients and friends a more expanded, enlightened cultural background. Already in 1865, the nine-year-old Freud entered the Leopoldstaedler Communal Gymnasium in Vienna, where he studied Greek and Latin, learning to embrace a new culture and the idols forbidden to him by his religious upbringing (Ostow, 1989, p. 483).

Sigismund, as Sigmund Freud was called as a boy, received his first Bible when he was seven years old and studied it with his father, handling it so often that it required a new leather binding when his father Jacob presented it again to him again for his 37th birthday (Ostow, 1989). Freud writes in his Autobiography: “My deep engrossment in the Bible story (almost as soon as I learned the art of reading) had, as I recognized much later, an enduring effect upon the direction of my interest” (Freud, 1925, p. 8). This sophisticated Bible was a synthesis of original Hebrew text with a German translation and erudite Talmudic commentary, an apparatus that commented on thematic references to surrounding cultures and a generous amount of woodcut engraving of Egyptian, Greco-Roman, early Christian and 18th- and 19th-century Romantic images. The illustrations also included lithographs of Middle Eastern landscapes, animals and botanicals, all executed in a nostalgic, Orientalist tradition influenced by 19th-century taste.

Freud’s early exposure to this book, the Philippson Bibel, Die Heilige Schrift Der Israeliten or “The Holy Scripture of the Israelites,” most likely also informed the manner in which Freud collected and exhibited his sculptures in his office. The Philippson Bibel is a densely, multiculturally illustrated Jewish Bible (also known as the Old Testament or The Five Books of Moses) that he explored together with his father in his early childhood and which left him with memories of warmth and excitement. The Philippson Biebel’s translator, Dr. Ludwig Philippson, was a university-educated scholar, writer and rabbi, who lived in Magdeburg Germany and completed a reformed family Bible together with his brother Phoebus in 1854.

Researchers believe that Freud’s collection of Egyptian and other ancient sculpture must have tapped into the pictorial psychic archive of his childhood, an archive formed when Freud stored these early illustrations of the Philippson Bibel in his optical unconscious. Collecting, exhibiting, sharing and handling these statuettes might have aroused similar affective, tactile excitement and satisfaction, integrating his past with the present, as well as tapping into a collective unconscious that transcends personal religion and contemporary culture (Whitebrook, 2010). Freud’s ...