Becoming a Profession

The History of Art Therapy in Britain 1940-82

Diane Waller

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135012564
• Edition: 1
• Topic: Psychology
• Subtopic: Creative Ability in Psychology
• Index: Psychology

Britain was the first country to recognise art therapy as a profession in the state health service. How did this come about? Can the British experience serve as a model for other countries?

Originally published in 1991 Becoming a Profession is the first comprehensive history of art therapists in Britain and of their struggle for professional recognition. Diane Waller discusses the work of the founding art therapists of the 1940s and 1950s and assesses their contribution in detail. She also puts art therapy in a political context, showing how the British Association for Art Therapists worked closely with the trade union movement in its campaigns to get professional recognition.

Fascinating reading for all practising art therapists, art therapy teachers and students, Becoming a Profession will also be relevant to anyone interested in the formation and development of professions.

Part I

Background to art therapy

Chapter one

Some views of art therapy

I have stated in the preamble that I consider art therapy to be a term used to describe a collection of diverse practices, held together by their practitioners’ belief in the healing value of image-making. In this chapter, I shall draw attention to the way that art therapy has been defined by many art therapists, mainly from Britain but also from the USA where the definitions appear to have influenced the practice in Britain.

This chapter will also serve to map out areas of intellectual dispute. Of necessity, it will contain several quotes, showing how each author constructs their image of art therapy.

The current definition of an art therapist

The currently accepted public definition of an art therapist in use by the Department of Health is as follows:

A person who is responsible for organising appropriate programmes of art activities of a therapeutic application with patients, individually or in groups, and possesses a degree or equivalent for entry to an accepted post-graduate training course, and also a qualification in art therapy following the completion of an accepted course at a recognised institution of further or higher education.

(DHSS: Personnel Memorandum, 6 March 1981)

There is, however, no definition of ‘art therapy’ in any document of the DHSS. The most current ‘official’ definition is that agreed by BAAT and used in a document entitled Artists and Art Therapists: a brief discussion of their roles within hospitals, clinics, special schools and in the community:

The focus of art therapy is the image, and the process involves a transaction between the creator (the patient), the artefact and the therapist. As in all therapy, bringing unconscious feelings to a conscious level and therafter exploring them holds true for Art Therapy, but here the richness of artistic symbol and metaphor illuminate the process.

Art therapists have a considerable understanding of art processes, are proficient in the area of non-verbal and symbolic communication, and aim to provide an environment in which patients feel safe enough to express strong emotions.

Aesthetic standards are of little importance in the context of Art Therapy – rather the expression and condensation of unconscious feelings that art-making engenders are at the heart of the therapeutic transaction.

(BAAT 1989)

This document was prepared for circulation to all health and social services departments and to teachers of children with special needs and advisers. We can see that there is a difference between the two statements, in that the first focuses on seemingly practical ‘activities’ and the second on ‘processes involving the unconscious’. This difference of perception has led to ongoing problems, as I shall try to show in later chapters.

Different things to different people

It has become very clear to art therapists in encountering NHS and other professionals, and also members of the public, that the term ‘art therapy’ means very different things to different people. Sometimes nurses, occupational therapists, art students, and volunteers believe they are ‘doing art therapy’ when they offer art materials to patients, encourage them to paint murals, try to analyse their drawings, set art and craft exercises, encourage the making of Christmas cards and decoration of wards.

To test out public understanding of art therapy, a small project was undertaken by a postgraduate art therapy student, in which a cross-section of the general public from Deptford, Hampstead, and Preston was invited to comment on what they thought art therapy to be about. The nearest guesses were that it ‘had something to do with psychiatry’. Others felt it was ‘about making artists feel better’, but many had ‘no idea’ (Setlogelo 1987).

Considering that the occupational group has existed in some form or other since the 1940s, it is interesting that there is such a level of confusion, not only among the public but also among professional colleagues. Myths and misperceptions abound. (See Waller and Gilroy 1986 for further discussion.)

It is necessary, then, to explore some of the ways in which practitioners have defined what they do, and to see if and how this has changed over the years.

Margaret Naumburg

Margaret Naumburg is considered to have been one of the founders, if not the founder of art therapy in the USA. She was a psychologist by background, later becoming a psychoanalyst. Her sister was Florence Cane, a well-known art educator, and Margaret too was a keen artist.

In her first published monograph, Studies of the Free Art Expression of Behaviour Disturbed Children as a Means of Diagnosis and Therapy (1947), she draws on case histories compiled between 1943 and 1945, referring to ‘free art expression’ rather than art therapy, and seeming to view the art activity and art objects as concrete versions of a dream. She offers the following comment on the value of this process:

When emphasis is placed on the release of the patient’s personality through his art, and not on any technical proficiency attained, it serves a different therapeutic purpose (from occupational therapy). For the patient it helps to release unexpected capacities which bring confidence and provide satisfaction; and to the psychiatrist it offers a revealing projective technique for both diagnosis and therapy. When the patient has been helped to overcome his inhibitions and is able to express his deepest fears, wishes and fantasies on paper or in clay, he is tapping the unconscious in the symbolic language of images, which will often bring to the surface what he dare not say in words.

(Naumburg 1947)

Later, in Art Therapy: Its Scope and Function (1958), Naumburg offered the following definition:

The process of art therapy is based on the recognition that man’s most fundamental thoughts and feelings, derived from the unconscious, reach expression in images rather than in words.

(Naumburg 1958: 511)

and

The techniques of art therapy are based on the knowledge that every individual, whether trained or untrained in art, has a latent capacity to project his inner conflicts into visual form. As patients picture such inner experiences, it frequently happens that they become more verbally articulate.

(Naumburg 1958: 511)

The emphasis, then, is on the images which arise from the patient’s unconscious and which contain conflicts. Once these conflicts are made concrete, they can be understood, which in turn would assist in their resolution. Image-making, because it taps pre-verbal feelings, is more able to produce this resolution than words.

In her later books, Naumburg developed a ‘dynamic’ model of art therapy, which made use of the transference relationship between patient and therapist, suggesting that art or spontaneous image-making was a means to furthering therapeutic communication. (See Dynamically Oriented Art Therapy: Its Principles and Practices, 1966.)

Both Margaret Naumburg and her sister Florence were influenced by the ‘child art’ movement in art education, which stressed the importance to the child of allowing spontaneous image-making to take place. Both believed that everyone had the capacity to become an artist, or at least to be visually creative. Eleanor Ulman, writing in the American Journal of Art Therapy in 1983, following the death of Naumburg aged 93, commented:

It was Numburg who was responsible – almost single-handed – for the emergence of art therapy as a profession. In the 1950s she initiated the first art therapy training courses and she strove mightily in the 1960s for the development of full scale graduate training for art therapists.

(Ulman 1983:122–3)

Ulman mentions that Naumburg’s views eventually departed from those of her sister, so that, by 1958, she was convinced that her work ‘had its roots in the transference relationship between patient and therapist’ (Naumburg 1958). She also believed that, if an art therapist was well versed in psychotherapy, then art therapy could function as an independent treatment method or an alternative form of psychoanalysis to the verbal mode.

Edith Kramer

Edith Kramer was a contemporary of Naumburg’s and an art teacher by background. She is considered by some to be the founder of art therapy, or at least as essential to its development as Naumburg. Kramer still teaches on courses in New York and elsewhere.

Kramer considered that it was the art activity itself that had inherent ‘healing’ properties, and this gave the opportunity to externalise, re-experience, and resolve conflicting feelings:

Art is a means of widening the range of human experiences by creating an equivalent for such experiences. It is an area wherein experiences can be chosen, varied, repeated at will. In the creative act, conflict is re-experienced, resolved and integrated.

(Kramer 1958)

Unlike Naumburg, Kramer did not work with the transference, but preferred to focus on the art object as a ‘container of emotions’ and she related to the patient through their art.

She herself was influenced by Freudian psychoanalysis, believing that art could be a means of sublimating feelings, but she felt this to be positive, in that, for example, out of destructive and aggressive feelings could emerge an object (drawing, painting, model, etc.) which would symbolise these feelings and thus prevent them being acted out.

Both Naumburg and Kramer were practising in the USA during the 1940s at the same time as Adrian Hill and others were introducing the concept of art therapy to British hospitals and sanatoriums. We shall see from the comments made by these early art therapists that the same divergence was emerging in Britain between those who placed emphasis on the image-making as therapeutic in itself (Hill et al.) and those who saw the art object as both integrative and healing, and also as an aspect of the transference relationship between the therapist and patient (Champernowne et al.)

Adrian Hill

In 1945, Hill’s book Art Versus Illness was published. His work will be fully discussed later on, but it is interesting to note how he considered painting to be helpful to patients:

To redress the injuries of a morbid introspection, the bitterness and resentment may have to be released by encouraging the sufferers to express their exacerbation in pictorial form, while anxiety and distress in another case may well be deflected and a more hopeful mental attitude established by inciting the very opposite type of picture making and that in the form of a sequence of paintings… never invite a recital of their physical disabilities and forebodings, but concentrate their attention on ways and means for their immediate mental emancipation.

(Hill 1945: 33)

Here we see a basic agreement with Naumburg and Kramer that feelings can be externalised through painting, but the emphasis is on distracting the patient from those feelings, or ‘morbid introspection’ as Hill puts it.

Marie Petrie

Petrie’s book, Art and Regeneration, was published in 1946, based on work she had done in the early 1940s. In the context of writing about occupational therapy, she comments:

The time has come to enlarge the field even further and to include the practice of the visual arts, more especially in the media employed by occupational therapists, or, better still, to form a distinct new branch, art therapy, requiring a separate training… the indirect remedial and diversional use of the crafts could be supplemented by the vitalising effect of the more spontaneous and personal use of colour, form and rhythm in painting and by the close contact with the earthy materials of sculpture and its laws of space, weight and balance.

(Petrie 1946: 87)

Petrie had much in common with both Kramer and Hill in focusing on the ‘healing’ and ‘integrative’ aspects of art. She left Britain for the USA shortly after her book was published and is best known there as an educator with a strong interest in art therapy.

Winston Churchill

Art as therapy received indirect support in the 1940s from Winston Churchill, the Prime Minister of Britain during the Second World War. He shared views similar to those of Hill about the restorative value of painting:

Many remedies are suggested for the avoidance of worry and overstrain by persons, who, over prolonged periods, have to bear exceptional responsibilities and discharge duties upon a very large scale… some advise exercise, and others, repose. Some counsel travel, and others, retreat.… No doubt all these may play their part according to the individual temperament. But the element which is constant and common in all of them is Change.… I consider myself very lucky that late in life I have been able to develop this new taste (for sketching and painting).… Painting came to my rescue in a most trying time and I shall venture in the pages that follow to express the gratitude I feel.

(Churchill 1948:7–13)

Here we have the suggestion that painting, as a hobby, can provide release from the burdens of responsibility and an escape from worries. We can see the beginnings of the idea that art is therapy – if therapy is taken to mean diversion and relaxation, a way of taking one’s mind away from conflict and difficult emotions. On the other hand, Naumburg and, to some extent, Kramer, believe it is important to focus on these emotions through the art work and try to resolve them with the help of an interested other (the therapist).

Irene Champernowne

As Champernowne said on many occasions, she admired and was influenced by Naumburg’s work and had a great respect for it. However, the major influence on Champernowne was C. G. Jung. In her article ‘Art therapy in the Withymead Centre’, published in the American Bulletin of Art Therapy in 1963, she wrote:

More than 25 years ago I became acutely aware of the fact that words, particularly in prose, were an extremely difficult medium through which to convey our deepest experiences of life. It was clear that the mind was filled with visual, aural and bodily images which were suitable containers for emotions and ideas that were otherwise inexpressible. The experience of these images was not only a means of communication between one human being and another, though that is something we experience here most strongly, but it is also a way of communication from the unconscious levels of experience to a more conscious understanding in the individual himself.

(Champernowne 1963: 97)

She goes on to refer to Jung’s use of art media with patients, in which he hoped that his patients would experiment ‘with their own nature, a state of fluidity, change and growth where nothing is eternally fixed and hopelessly petrified.’ (cited in Champernowne 1963: 98)

Champernowne believed that the therapist, whether art therapist or psychotherapist, needed to ‘enter the process with the patient or student and live through it’ (1971: 141). She felt in this way the consciousness of both the creator of the image (the patient) and the therapist came together and they could thus understand the message that the image conveyed.

Edward Adamson

Adamson, who was employed as a full-time artist at Netherne Hospital in 1946, felt that art activity in itself was a positive benefit for patients:

At its simplest it confers the benefits of an occupational activity: it detaches the patient from the deleterious effects of idleness and self-absorption; it imposes a discipline involving concentration and decision-making, and co-operation with and reaction to the limitations of the artistic medium. Finally, it gives the patient satisfaction in the fact that he has created something.

(Adamson 1970:153)

Adamson cautioned that, when patients were encouraged by psychotherapists to produce paintings, the results often demonstrated the patient’s wish to please, which might result in Freudian phallic symbo...