Introduction to Art Therapy

Sources & Resources

Judith A. Rubin

• Publisher: Routledge
• Year: 2009
• ISBN:
  9781135900632
• Edition: 2
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Introduction to Art Therapy: Sources and Resources, is the thoroughly updated and revised second edition of Judith Rubin's landmark 1999 text, the first to describe the history of art in both assessment and therapy, and to clarify the differences between artists or teachers who provide "therapeutic" art activities, psychologists or social workers who request drawings, and those who are trained as art therapists to do a kind of work which is similar, but qualitatively different. This new edition contains downloadable resources with over 400 still images and 250 edited video clips for much richer illustration than is possible with figures alone; an additional chapter describing the work that art therapists do; and new material on education with updated information on standards, ethics, and informing others. To further make the information accessible to practitioners, students, and teachers, the author has included a section on treatment planning and evaluation, an updated list of resources – selected professional associations and proceedings – references, expanded citations, and clinical vignettes and illustrations. Three key chapters describe and expand the work that art therapists do: "People We Help, " deals with all ages; "Problems We Treat, " focuses on different disorders and disabilities; and "Places We Practice, " reflects the expansion of art therapy beyond its original home in psychiatry. The author's own introduction to the therapeutic power of art – as a person, a worker, and a parent – will resonate with both experienced and novice readers alike. Most importantly, however, this book provides a definition of art therapy that contains its history, diversity, challenges, and accomplishments.

CHAPTER 1

Previews

The Many Faces of Art Therapy

What does art therapy look like? Art therapy is, always has been, and will continue to be a multifaceted field. There are a multitude of ways in which art can be used for either understanding (assessment) or for helping (therapy). But art therapy is a paradox—it is both extremely old and very young. Art for healing is as ancient as the drawings on the walls of caves (DVD 1.1), yet the profession itself is still a youngster in the family of mental health disciplines. Art therapy is both primal and sophisticated, since making pictures appeals to a range of creatures, from apes (Figure 1.1) to artists (DVD 1.2). Because art therapy is also extremely versatile, it has many different faces. This is dramatically visible throughout the film, Art Therapy Has Many Faces (Rubin, 2004a).

Figure 1.1 Congo painting.

Preview of Coming Attractions

Some years ago, I saw a little girl and her mother for individual art therapy, in tandem with a child psychiatrist who also met with each of them weekly. Lori (DVD 1.3) would come into my art room, while Mrs. Lord (DVD 1.4) saw Dr. Mann for 45 minutes. They would then switch places as well as therapists. Afterward, Dr. Mann and I would meet and look at the pictures or sculptures done by Lori and her mom during their art sessions. Because ideas and feelings would appear in their art long before they were expressed in play or verbal therapy, Dr. Mann used to say that art therapy gave him a “preview of coming attractions.”

Art therapy is vital for those who cannot or will not talk, like aphasic or electively mute individuals. At the same time, it is extremely helpful for people of all ages, even those who are verbally articulate. Art helps people like Lori and her mother to “see” what they are feeling or thinking. Art therapy can aid artists and non-artists alike, whether they are fluent or blocked. On the DVD (1.5), a woman describes this kind of discovery process.

Short Stories—Vignettes

In order to give the reader a sense of what happens in art therapy, I begin with some brief vignettes describing in words the essence of why the field exists and continues to grow. Art therapy depends on the inherently therapeutic power of art, which is available to anyone who paints or draws or sculpts. It is likely that most people who decide to make it their life’s work have personally known its healing potential, and I am no exception. For this reason, the initial vignettes recount my own experiences. They describe how making art at critical moments helped me to cope with my anguish after the death of a friend when I was a teenager and of my mother when I was an adult.

The second vignette tells about my initial discovery of the power of art to help severely disturbed youngsters in my very first experience as an art therapist, in 1963. Since I had not yet had any formal clinical training and worked in a nondirective manner, I was astonished by the power of making art in an accepting, nonjudgmental environment to help youngsters with childhood schizophrenia express and work through their conflicts.

The clinical psychologist who was supervising me was equally astounded, as was the staff on the unit where these youngsters were hospitalized. I was invited to present my work in Grand Rounds at Western Psychiatric Institute & Clinic where the special treatment unit was housed. Harvard Professor Erik Erikson (1950, 1977), himself a painter prior to becoming a psychoanalyst, commented on all of the presentations about the case being discussed. He had no hesitation in suggesting that it was primarily in art therapy that the child was making progress in coming out of her psychotic isolation, a story that will be told in Chapter 9 (Dorothy, DVD 9.3).

The third group of vignettes is about my own children because, as our family grew, my beginning-art-therapist self became aware of how useful art expression was for them as a way of dealing with feelings and impulses that were difficult to manage. These personal discoveries about the helping power of art are followed by some examples of work with individual children, adolescents, and adults in an outpatient clinic and in my private practice. They are included here to indicate, despite their brevity, how work in the context of a trusting relationship with a (by then) trained art therapist can promote change. Like the “short cuts” from a film, they offer a taste of what art therapy is all about. Although the names have been changed, the stories are true.

How Art Helped Me at Times of Trauma

Sometimes making art became, for me as for others, a way of coping with trauma, events that are too difficult to assimilate (DVD 1.6). When I was 17, my friend Peter suddenly died. He had been young, handsome, and healthy, president of our class, ready to go on to a bright career in college and the world. And in a crazy, senseless accident at high altitude, he stepped off the edge of a Colorado mountain and crashed to his end. Numbly, I went home to the funeral, then returned to the camp where I was working as an arts and crafts counselor, and then succumbed to a high fever for several anguished days and nights.

When I awoke, I felt a strong need to go to the woods and paint. On my first day off I did, and it was good. The painting was not of Peter, but of a person playing the piano, making music in dark reds, purples, and blacks. It was a cry, a scream caught and tamed (A). It was a new object in the world, a symbolic replacement for he who was lost, a mute, tangible testament. The doing of it afforded tremendous relief. It did not take away the hurt and the ache, but it did help in releasing some of the rage, and in giving form to a multiplicity of feelings and wishes.

So too with a remembered nightmare, finally drawn and then painted, given form and made both more beautiful and less fearful (B). Years later I was to discover, much to my surprise, that drawing a dream would help my daughter to finally sleep in peace (C). It was she who asked if I might help her the way I helped other children at the clinic. How wise she was, since the dream did not recur after she drew it.

Over time I began to understand the mechanism, the dynamics, the reason behind this miracle of taming fear through forms of feeling. I think it is what the medicine men have known for so long, that giving form to the feared object brings it under your own symbolic control. This simple but powerful truth underlies much of art therapy.

Waking as well as sleeping fantasies evoked images that invited capture on canvas. A powerful, insightful revelation of ambivalent feelings toward my formerly idealized mother during my analysis stimulated a rapidly done expressionistic painting, which still evokes tension when I view it (D). As an externalization of how and what I was feeling, however, it gave both relief and a greater sense of understanding. The push and pull of conflict was translated into paint, reducing inner anguish through outer representation.

Many years later, stimulated by my psychoanalytic training, I was intrigued by the idea of “free association in imagery.” An artist friend and I decided to offer a class through the Psychoanalytic Center, in which participants would be invited to choose a medium, and then to let each emergent image follow the last, until the sequence felt complete. Modeled on the basic “method” of free association in analysis, it turned out to be amazingly powerful (Figure 1.2). For myself, the Imaging course came at a stressful time; the first class was a week after my mother’s unexpected death. I found it surprisingly helpful to my own mourning process to engage in a freely associative use of materials. A review of the drawing series that emerged that day may help you to understand how therapeutic a series of spontaneous images can be, even without discussion (DVD 1.7).

Figure 1.2 Participant in Image Association workshop reviews artwork.

The first, red and black, sharp and angular, felt like “Pain” (A), and was tense and angry in the doing. The second became “My Mother in the Hospital Bed” hooked up to the oxygen tank (B), as I had last seen her alive the week before her demise. I was surprised at how much she looked like an infant. The third began abstractly, but became a pair of breasts with large dark nipples. I titled it “Mama-Breast-Love” (C). The fourth is a child reaching up to a mother who is mostly a smiling face. When I looked at it I thought it was me saying “I Love You, I Need You” (D).

The fifth began as a stark, angular tree, then an image of a tombstone, and then I thought of sun and eyes shining, looking down from above. “Can You See?” (E) was the title that came to mind, the prelogical, wishful/fearful magical thinking that had been flowing through my usually skeptical head. The sixth was an image of my mother and (already dead) father meeting in some other life; he welcoming her, the two “Together Again” (F)—another magical thought.

The seventh arose from intense affect, a feeling of tension and pain, first expressed in the heavily scribbled red and black lines, then in the face that emerged in tears, mouth open, hungry, and angry, “Screaming” (G).

The next image began as a bleak white and gray landscape, then a night sky with a moon and a star, each of which got covered over. Then I thought of a droopy lonely figure—our eldest daughter, far away in France, having to bear her pain separated from the family—and then the thought of the rest of us (my husband and two other children) leaning sadly on each other: “Cold and Lonely” (H). The ninth was a kinesthetic impulse to make tangles of different colors; the title-thought was “All Together” (I).

The tenth began as a wavy line tree on the left, then a wavy line in the center that turned into a dance, which then turned into a person with a large glowing womb inside, then a thought of a baby in that womb. When that image “came” in a kind of “birthing” process, I felt relieved of much of the tension I had experienced throughout the others, as if something had been, at least for the moment, eased. My thought on looking at it along with the others was “Mom-Inside Forever” (J), certainly one way to cope with loss.

While I can easily share my thoughts about the images, it is more difficult to put into words my emotional experience of the process. A similar experience took place the following week with clay, the next with paint, then with collage, and with the final week’s product— for me, a painted portrait of my mother.

I was not aware of “thinking” in the usual sense, but of allowing myself to be led by the materials and my impulses. Each image came quite naturally, almost always with heightened emotion. There was a feeling of activity and internal tension, though “absorption” fits it better, and a sense of being “done” at the end. I did not feel particularly involved in the products as art; indeed, I found them unappealing aesthetically. But I did feel intense involvement in what may have been a kind of “visual thinking” process.

Most significantly, perhaps, I found the entire set of experiences to be extremely helpful in the work of mourning. Instead of the class being a burden as I had feared, it became a welcome respite for me, a chance to deal wordlessly with my grief. I believe that the use of media provided much more than a catharsis. Of course it wasn’t the whole story; I remained involved in a grieving process for some time after that class, but I was frankly surprised at how helpful it had been.

Such personal experiences of the power of art in my own life are no doubt what led me to feel so at home in art therapy, and to want so much to make the healing benefits of creative endeavor available to others.

Art Helps a Psychotic Boy Return to Reality: RANDY (12)

My first experience of working therapeutically in art was with children in long-term treatment on an inpatient unit at a psychiatric hospital. Although their diagnostic labels and probable mode of treatment would be different today, they were, and would still be, in considerable psychic pain. What follows is the story of Randy, the most verbal and high functioning of the group (DVD 1.8).

Randy suffered from an embarrassing symptom, soiling his pants, then and now known as encopresis. Although superficially in touch, he was inwardly unsure of the difference between reality and fantasy. Over a seven-month period, Randy had 23 individual art therapy sessions. He began by creating realistic images, lik...