A Theory-based Approach to Art Therapy

Implications for teaching, research and practice

Ephrat Huss

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317931843
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Art therapy literature is often based either on practice in a specific setting, art material or population, or if taking a more theoretical focus, on illustrative case studies. This book provides a theory-based approach to research, teaching, and practicing art therapy, including verbal and arts based techniques, settings, art processes and analyses, and the principles of supervision, evaluation, and research. It also offers an overview and discussion of how the different orientations of psychological and social theories are interpreted and implemented by art therapy.

The book provides an integrative perspective that anchors methodology within a rigorous theoretical background. Focusing on three sub-groups of Dynamic, Humanistic and Systemic-social theories, each chapter outlines the central concepts of varying sub-theories within a general heading, and their interpretation from an art therapy perspective. Ephrat Huss explores the respective and shifting roles of art, client, and therapist through each theory, demonstrating the practical implications for creating a coherent intervention that informs all parts of the setting, therapy, client evaluation, and supervision.

A Theory-based Approach to Art Therapy draws on the latest research in the field and will be a valuable text for art therapy theorists, educators, students and researchers, as well as for other social practitioners interested in understanding how to integrate the arts into their practice.

Section 1
Art therapy according to theory

A
Art as Decoding the Unconscious: Introduction to art Therapy Through Dynamic Theory

The dynamic meta-theories define problems and solutions as being based within inner conflicts between id, ego, and superego, and as entrenched within the defences used against these conflicts, which become calcified within early childhood. The solution becomes to reach awareness and understanding of these suppressed conflicts, by raising them to consciousness. Humanity is thus, on the one hand, riddled with inner conflicts, but on the other, is able to apply its conscious mind to interpret and to solve them. Art in the dynamic theory, broadly defined as the use of metaphor, symbols, visions, dreams, and sensual information, will be shown to have the vital role of making the unconscious, conscious. In object relations, art makes the relationship visible and creates a symbolic zone within which to enact it. Winnicott (1958, 1991) connected the content and relationship as interacting within the symbolic spaces, tightening the triangle of art therapy – therapist, client and art. Art is the vital transitional symbolic space within which people can individuate and connect to others, and within which relationships are worked through. Using ego psychology, art’s role is further developed into the proactive role of being able to negotiate between id and superego, and to enable adaptive defences such as sublimation instead of dissociation.

Jung’s theories of culturally located archetypes also enable art to heal intrinsically, outside the zone of therapy, as part of the symbolic resources of a culture. Thus, art shifts from an expression of pathology in the self or in relationships in Freud’s theory and in object relations, to a way to negotiate and to integrate conflicts in ego psychology and in Jungian theories. This in effect illustrates the shift from art psychotherapy to art as therapy, showing that the various dynamic interpretations of the basic theory provide a varied and flexible range for using art. Each sub-theory or interpretation of Freudian theory has evolved in relation to shifting social realities of modernism, the grand theories, a belief in the rational versus religious mind, in science, industry, the emergence of childhood as a discrete concept, the struggle of women to leave the home and enter the workforce, colonialism, and the changing roles of art after the invention of the camera, among others. These chapters will show how Freudian and object relations theories focus on the relationship, while ego psychology and Jungian theories focus on the art.

From the perspective of the rigid humanistic meta-theories, in which this theory can be critiqued, the client is unable to be the interpreter of his own art. From a mind-body and CBT orientation, the dynamic theory is based on myths and narratives that do not exist and thus cannot be proven, and does not focus on clients’ strengths and cognitions. From a critical social perspective, the universalistic standpoint of the theory discounts cultural constructions of reality and of art. However, if these theories are understood as a creation of a specific time and place within history, then their huge contribution to art therapy can be continued. This includes the centrality of creativity as a path to resolve problems and to reach inner experience, the creative, intuitive, and hermeneutic focuses of the therapist and client within therapy, the meanings attributed to symbols, metaphors, and elusive projective processes. According to dynamic theory, art is a central means to address and to express pain, desire, and love, which situates art therapy within its natural home in the world of fine art, humanities, and visual culture – even if Freud took such pains to define art as science. Figure 1.1 outlines the variations within this theory that will be explored within this section.

Figure 1.1 Dynamic theories: setting, process, and interpretation

Chapter 1
Art as a path to the unconscious

Art therapy and psychodynamic therapy

The contribution of the dynamic theory is the central role it plays within art therapy; it creates a rich tapestry of therapeutic interaction, including non-linear content, and the conceptualization of the relationship, form, and content as parallel and interactive zones of intervention. According to this theory, the process of therapy itself is creative, intuitive, and process-oriented. Art is given a vital role within the developing psyche.

According to the dynamic theory, humanity deals with deep inner conflicts created by sexual and primal drives, which are in opposition to the socializing demands of society. People are primal energy, and society is the ‘machine’ that represses this energy. People have to navigate between their primal drives (the ‘id’), and their conscience (the ‘superego’) with the help of the ego – which is caught between them. These inner conflicts are so painful that strong defences are created to cope with them in childhood. The defences become calcified and hinder the ability to work through emotions. However, these basic libidinal energies may also be sublimated and used in productive ways when more flexible defences are adopted. The place where inner conflicts become calcified is in the early socialization of children, as they pass through the oral, anal, and oedipal stages of development. Each stage demands a dramatic negotiation between desire and culture, in terms of level of self-regulation of oral and anal drives, denunciation of omnipotence, sexual desires, jealousy, and conquests. Unresolved conflicts from these stages become introjected and are projected on to adult relationships (Fontana, 1993; Freud, 1900, 1936, 1997; Gay, 1989 ).

Problems may be defined as the conflict between id and superego, as well as the defences used against these conflicts. The defences against pain are themselves often the symptoms, or presenting problem.

The solution is in people’s ability, while riddled with inner conflicts, to apply their rational mind to these conflicts to overcome them by understanding them. These inner unconscious conflicts and defences are raised to consciousness with the help of the therapist, and are understood, thus diminishing the conflict and making its defence unnecessary (Berry, 2000; Freud, 1900; Gay, 1989; Higdon, 2004 ).

The social context in which dynamic theories were conceived was that of a traditional society in transition to a secular society, and shifts from religious to scientific epistemologies. Thus, there was a loss of religion as an external organizing locus of control, and humanity had to control its own drives from within, with the help of the ego. The advances in science, and the industrial revolution it created, searched for a ‘science’ of the mind. Metaphors of repressed and then released energy in industry can be understood as a concept transferred to the human psyche through the id as pure energy, the ego as the breaks, and superego as pushing down the energy similar to a machine. The modernist notion of science, consciousness and understanding as enabling control over the world and the self, and as the foundation for the resolution of unconscious conflicts, were at the base of this conception. The therapist, therefore, as a ‘blank’ invisible screen but able to interpret everything from an invisible omnipotent standpoint, becomes a type of godlike figure (Kvale, 1992; Leary, 1994 ).

Macro applications of Freud’s theory of defences, projections, and regressions may be applied to whole communities as well as to individuals. For example, racism towards groups may be understood as a defence of displacement of unwanted parts of the self onto the ‘other’ (Said, 1978 ); or relations with a leader may hold elements of projections or splits onto parents. Societies can sublimate aggression into art and culture, or express it directly through war (Mitchell, 1995 ).

The role of art in this theory to access the elusive unconscious is, according to Freud’s topological theory, defined as a central method, together with dreams, jokes, and slips of the tongue. Artistic activity is thus fed by the id, and is a regressive projection of hidden desires, but it is also an important intuitive place that can access the inner self. Artists are, on the one hand, seen as lacking in superego, unable to effectively repress primary drives; and on the other, they can be understood as having a unique intuitive ability to connect to the unconscious and to express it (Freud, 1936; Leary, 1994 ).

The connection between art and emotional or psychological states was not only strengthened by Freud, but also by then-current developments in the art world (Rubin, 1999 ). This includes the invention of the camera, which helped to push art into an expressive and emotional, rather than documenting role (Hills, 2001 ). Furthermore, art was used as a way to occupy the abundance of wounded and traumatized patients in psychiatric hospitals after the two world wars, and its therapeutic value was conceptualized together with the Freudian understanding of art (Rubin, 1999; Waller, 1993 ).

Dynamic art therapy is based on the central concept of projection in dynamic theory into art therapy, with the therapist working in three simultaneous projective zones: those of the relationship, the therapy setting, and the art activity (Schaverien, 1999 ). Within the art work, the process, product, and reaction to the product are all additional projective zones; therefore the art intensifies the projective and regressive potential of the therapy (Case and Daley, 1990; Kramer, 1971; Naumberg, 1966 ). Art therapists aim to utilize art to reach unconscious content. This can be in relation to process, product, reaction to product, and projections on to the therapist in relation to art making. Art is thus considered a potentially regressive activity that encourages connection to early conflicts.

According to this theory the role of the art therapist is to encourage the expression of, and then to interpret inner childhood conflicts, desires, defence mechanisms, and projections, as they are expressed in the content of the art and the therapy relationship, and in present problems. The therapist aims to maintain a neutral persona that enables the client to project his early conflicted relationships in a transference process. The therapist achieves this by analysing their own reactions to the client, or counter-transferable projections back onto the client, with the help of supervision, in order to create a neutral screen. The art is another place where the projected relationship is expressed (Waller, 1993 ). The projective triangle of art, client, and therapist is activated as different interactive symbolic zones within which to express conflicts, defences, and projections.

If, according to dynamic theory, evaluation is based on the inner conflicts and defences in light of early childhood experiences, then the gradual unravelling of these elements into the consciousness of the client may be evaluated over time in terms of the client’s developing the ability to accept interpretations of these desires and conflicts and understand their relationship to early childhood unresolved conflicts – and the ensuing disappearance of symptoms. Evaluation is the responsibility of the therapist, rather than the client. For example, even if the client states that the therapy is not working or symptoms are becoming worse, the therapist may understand this as part of the process that includes defence against new content, and not a reason to stop the therapy. The client’s progress can be evaluated according to their ability to accept the therapist’s interpretations, according to the reduction of symptoms as well as to increased insight.

Projective art tests are a central art-based evaluative method, based on the assumption that the unconscious content will emerge with the compositional elements of the images. This includes the use of abstract projective shapes, and also more structured projective techniques, such as house–tree–people drawings; elements all considered to be projections of self (Burns, 1987; Silver, 2005; Wilson, 2001 ).

The concept behind art evaluation tests is that clients cannot self-report on unconscious elements of their personality or on defence mechanisms used, but these will be manifest within the compositional elements of their drawings. Thus, if asked to draw basic images such as a house, a tree or a person, they will project unconscious desires and conflicts, as well as defences, onto the composition of these elements. Purely compositional evaluations address elements such as overall size, location, and line and shading quality. For example, a too small drawing of a person expresses depression, while a too large drawing expresses narcissistic compensation. These may all be analysed as stress, or, as an expressions of defences against the stress.

For instance, butterflies and other positive elements in a drawing can express distraction from a problem; drawing a person of the opposite sex symbolizes sexual concerns; large eyes, paranoia; and poor compositional integration impulsivity; shading, anxiety (e.g. large mouth and buttons, as oral fixation). A focus of composition on the upper right-hand side expresses optimism, while a focus on the lower right-hand side expresses depression (content elements include bizarre placedment versus realism in form and colour, etc). Determinates of mood are analysed according to assumption that depression and withdrawal will use dark colours, or lack of colour, while impulsive and uncontrolled natures will use strong colours (Burns, 1987; Burns and Kaufman, 1972; Brooke, 1996; Cohen, 1994; Feder and Feder, 1999; Furth, 1998; Silver, 2005; Wilson, 2001 ).

However, there is much c...