Somatic Art Therapy

Alleviating Pain and Trauma through Art

Johanne Hamel

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000372533
• Edition: 1
• Topic: Psychology
• Subtopic: Post-Traumatic Stress Disorder (PTSD)
• Index: Psychology

This book focuses on somatic art therapy for treating acute or chronic pain, especially resulting from physical and/or psychological trauma. It discusses the role of the psyche in physical healing and encourages combining of traditional medicine and holistic perspectives in treatment.

Translated from the French text, this volume provides case studies and examples from the author's art psychotherapy practice of 40 years, including the four-quadrants method. Chapters review the current treatments for chronic pain and PTSD and focus on art therapeutic methods to treat those conditions, such as art therapy protocols for PTSD. The book exposes the underlying rational of somatic art therapy, covering art therapy effectiveness, Levine's somatic dissociation, van der Kolk's somatic memory, and Scaer's procedural memory concepts. Also featured are chapter contributions from art therapists Sophie Boudrias, Mylène Piché, and Dr. Patcharin Sughondhabirom.

By providing a unique, clear and concise synthesis of available art therapy methods this text will appeal both to the general and professional public, including professional art therapists, psychotherapists, helping relation professionals, and medical practitioners.

Part I

Definitions

1 Somatic Art Therapy

Johanne Hamel

Art therapy is a form of psychotherapeutic intervention that uses the visual arts as a medium of expression. Far from being offered solely to artists, art therapy uses intervention tools such as lines, forms, colors in drawings, paintings, assemblage, or collage, which make it a practice accessible to all types of clientele. Art therapists are trained in both psychology and art before they are trained in art therapy.

A brief history of humanist art therapy

Art therapy is very recent in historical terms. In Europe first and then in the USA, the artists hired to provide activities for psychiatric patients soon realized how their action had psychotherapeutic effects, and they began to observe and scientifically document their interventions. Several professional journals were launched, and there is now a growing wealth of specialized literature on the subject. As artists had to turn to psychoanalytically oriented psychiatrists for the most part, nearly all of the art therapists trained in psychoanalysis, and most of them are currently using the psychoanalytic intervention rationale to explain their action. Some, however, use the Jungian approach, the object relations approach, the Adlerian or Kleinian approach, while others use a humanistic approach.

It was not until the 1970s¹ that Janie Rhyne (1973) introduced the Gestalt approach to art therapy based on the humanist perspective. Even more innovative, in the 1980s Rhinehart and Engelhorn² (1982) developed the Art process therapy, using a combination of the Gestalt and Jungian approaches in their intervention rationale. Instead of limiting themselves to considering only the finished artwork, Rhinehart and Engelhorn also use amplification of lines, shapes, colors, and movements as they emerge on paper to explore them thoroughly in order to bring out the inherent and unexpected psychological meaning. Art therapists specializing in the Art process therapy approach consider observation of the process as the main source of their intervention, while leaving it to the client to figure out the meaning, given that she/he is the expert on her/his own experience. This is a typically humanist perspective.

In Québec, Canada, many French-speaking art therapists were trained in this approach, first at the Institut de formation professionnelle en psychothérapie par l’art between 1995 and 2005, where the two main professors had been taught by Rhinehart and Engelhorn³, then at the Université du Québec en Abitibi-Témiscamingue, where the Art therapy process approach is taught and where programs have been developed since 1997. Concordia University was the first to offer an art therapy Master’s degree in Québec, Canada, in 1980, and its approach is mainly psychoanalytical.

Art therapists offer a unique and indispensable contribution to all clients who cannot express themselves through verbal language or whose privileged mode of expression is not language, such as children or First Nations people. However, they also deal with all the clients that psychologists, psychotherapists, and counselors are likely to encounter: psychiatric patients; teens with behavior problems; elderly people with cognitive losses; women experiencing violence or sexual abuse; community settings offering a wide range of services to all kinds of clienteles; persons with cancer and their families; persons undergoing bereavement, burnout, divorce or separation; and hospitalized children, as well as many others.

Definition of somatic art therapy

The somatic art therapy approach outlined here stems from my knowledge and my experience in art therapy, and mainly from Levine, van der Kolk, and Scaer’s theories, three authors who wrote on post-traumatic stress disorders and their dissociative states (See chapter 7). Somatic art therapy refers to the interventions and therapeutic tools that I have intuitively developed over the past 30 years.

Rinfret (2000) defines the term soma as follows, distinguishing it from the body:

“The term body refers to the physical reality of human beings as perceived by an outsider, whereas the word soma represents that same physical reality as it is experienced from within the person” (p. 44) (Free translation).

So it is a matter of subjectively feeling the inner reality and apprehending it phenomenologically. My own definition of somatic art therapy therefore is the following: somatic art therapy provides access to soma through two-dimensional or three-dimensional representations (drawing, painting, clay, etc.) of the physical sensation felt subjectively. This access makes one aware of intense emotional states embedded in one’s sensations, allows catharsis and facilitates communication of these experiences.

My methods have many affinities with Levine’s somatic experiencing (SE)⁴. SE uses the felt sense to access the traumatic response, concentrating deliberately on the intricacies of the somatic sensation. This is exactly what we do in somatic art therapy, because drawing the physical sensation requires paying attention to all its proprioceptive manifestations. Through drawing or painting, the patient gains access to the somatic procedural memory, an expression proposed by Scaer⁵ for traumatic memories stored in the right brain, implicated in the perpetuation of some traumatic reactions.⁶ Finally, somatic art therapy relies on Rhinehart and Engelhorn’s art process therapy approach⁷, which in turn rests on Gestalt and Jungian theoretical rationales and on Humanist psychology. To develop this approach, I applied art process therapy to soma work. In Part 3 of this book, the theoretical bases of art therapy and of somatic art therapy will be explained further.

The limits of somatic art therapy

I typically use somatic art therapy to work on distressing pain or physical sensations, in individual encounters which are part of a broader psychotherapeutic process or in intensive six-day workshop context conducive to deep inner work. The temenos ⁸ is obviously crucial for a successful intervention, as for any psychotherapeutic process.

Furthermore, I learned from experience that somatic art therapy works better on specific pains located in definite body areas. With respect to dull pain, such as in fibromyalgia or chronic fatigue, a long-term art psychotherapeutic journey might be appropriate, in addition to other types of interventions such as dietary changes, regular physical exercise, etc.

In some cases of chronic pain, the intervention must be long-term, as in the example of acquired dyspareunia presented in chapter 12 (C). In terms of diseases, more extensive research will be required to better apprehend how somatic art therapy could support treatment, besides interventions on the painful sensations as such.

Notes

1 Rhyne, J. (1973). The Gestalt Art Experience. Pacific Grove, CA: Brooks/Cole Publishing Co.

2 Rhinehart, L. & Engelhorn, P. (1982), ‘Pre-image considerations as a therapeutic process’. The Arts in Psychotherapy, 9, 55–63.

3 At the Eagle Rock Trail Art Therapy Institute in Santa Rosa, California, initially affiliated with Sonoma State University, then separated from it.

4 Levine, P. (1997). Waking the Tiger. Berkeley, CA: North Atlantic Press.

5 Scaer, P. (2001). The Body Bears the Burden, Trauma, Dissociation, and Disease. Binghamton, NY: The Haworth Medical Press.

6 For an example of this phenomenon, see the case study included in Chapter 11 (A).

7 Rhinehart, L. and Engelhorn, P. (1982): Op. Cit.

8 Duchastel, A. (2005). La voie de l’imaginaire. Le processus en art-thérapie. Montréal, Qc.: Quebecor.

2 Chronic Pain

Johanne Hamel

Acute pain, chronic pain and suffering, a distinction

There are many different types of pains. Very important distinctions need to be made for understanding the subject. The International Association for the Study of Pain¹ defines pain as ‘an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage’, chronic pain exceeding a criterion of six months. Acute pain is defined as short-term pain that lasts less than six months and is a predictable response to an injury or illness. Its intensity is also predictable. Chronic pain can also be a pain that has been going on for a short while, but is more intense than what is usually expected for a particular injury or illness. Chronic pain can be continuous or intermittent. The Association believes that pain is always a very personal experience and when reported by an individual, it should always be respected.

Researchers have found that there is no adequate medical explanation in most cases of chronic pain; the percentages reported vary greatly in studies and can go up to 85% of cases where the pain cannot be explained from a medical point of view.²

Chronic pain brings a whole range of psychological and psychosocial problems, including anxiety, ...