Applying Developmental Art Theory in Art Therapy Treatment and Interventions

Illustrative Examples through the Life Cycle

Beth Gonzalez-Dolginko

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000387469
• Edition: 1
• Topic: Psychology
• Subtopic: Developmental Psychology
• Index: Psychology

Applying Developmental Art Theory in Art Therapy Treatment and Interventions: Illustrative Examples through the Life Cycle weaves clinical applications of object relations-based art therapy with the Kestenberg Art Profile to understand art from a developmental perspective with the intent of applying this knowledge to support best art therapy practice.

The book starts by defining object relations-based art therapy and introducing the Kestenberg Art Profile. Chapters blend psychological theory (Freud, Erikson, Piaget) and developmental art theory (DiLeo, Gardner, Kellogg, Levick, Lowenfeld and Brittain, and Rubin) with case illustrations that offer a focus on applying typical developmental theory and art therapy with children, adolescents, and adults who have varying needs. Examples include art from people throughout the life cycle with histories of trauma in the following areas: sexual, physical, and emotional abuse, terrorism, grief and medical illness, war, natural disasters, and substance abuse. There is further discussion on neurological indicators, family issues, and the use of materials and techniques viewed through a developmental lens.

Ideal for creative arts therapists, educators, and students, the book will also stand out as a supplementary text for developmental theorists and educators, art educators, and a range of mental health professionals.

1Introduction

This book is my life’s work. The theory that informs my practice is object relations development. But I have to say that this is also my life’s work because I have been interested in babies since I was a baby. At two, I would just watch my baby sister sleep because she was so cute. Sometimes, I awakened her, much to my mother’s dismay, because she was my baby, and I wanted to play with her. My aunts loved me because I would entertain all babies and little kids at family parties, and they could just have fun. My Aunt Alice’s sister-in-law ultimately had 15 children, but when I was the babysitting niece, she probably had seven or eight. My Aunt set up a corner in her basement, put down an area rug, and had a little rocking chair for me, along with other equipment needed to take care of infants and toddlers. I was in heaven, as I rocked a baby in my arms, another in a baby rocker with my foot, and read stories to toddlers. My older sisters and cousin, grateful to be relieved of the charge, supplied me with soda and snacks before they went off giggling to have teenager fun together.

As a tween and teen, I developed a significant babysitting practice that lasted till I left for college. And in college, I continued my interest in development through my studies and work in the college’s Child Study Center. What I realized through my studies and observations was that, yes, I loved playing with, rocking, feeding, cooing with babies, but I was truly fascinated by observing their development. Raising my own children, and now as I babysit my grandsons, I delight at a baby finally grabbing a toy and then chewing on it, or finally defying gravity by getting a baby belly off the floor in preparation for crawling. And I relish all the milestones as life proceeds—saying words then sentences, reading a sentence, making the swing work in the playground without a grownup, and every other wonderful moment that unfolds at each stage.

In my own professional development, this natural fascination continued. I have always applied developmental theory to how I understood and made sense of patient art, made interpretations, and chose materials. And I taught all of this to art therapy students for decades. My own art therapy professors and supervisors, Arthur Robbins, Josef Garai, and Robert Wolf, were also psychoanalysts. The art therapy theory they offered wove psychoanalytic theory with paradigms for understanding the creative process. Object relations theory emerged significantly in their teachings as it was a good fit for studying the creative process in the transference and countertransference—the dance, the art object, the poem—as it develops between therapist and patient. I continued onto post-graduate psychoanalytic studies, focusing on object relations and attachment theory. One of my psychoanalytic professors, Michael Eigen, gave the best advice I ever got. He would tell us to look at the patient before us and imagine what kind of baby they were. Then, you have some insight into their development and know how to proceed with treatment. For example, if they are tightly strung and complain a lot, they may have been a whiny baby who had trouble getting their needs met. As the analyst, one frames interpretations so that the patient feels heard and held—what they did not feel as a baby.

My first art therapy job was in an inter-community facility (ICF) for adults with developmental disabilities. Most of the patients with whom I worked had resided in large state institutions; a small number came from family homes. ICFs were established to be a transitional residential and treatment facility for persons with developmental disabilities who previously resided in large state institutions, most of them for their entire lives. The goal was to eventually transition them back into the community. My work in the ICF gave me an opportunity to observe and study human development that occurred atypically. It spurred my belief in and research into theories of human development. To me, it was fascinating to see how the human spirit may be damaged by the environment yet transcends. I worked along with other creative arts therapists, and we all worked towards nurturing and healing that human spirit in our patients.

Life continued to bring me on a developmental path directly to Dr. Judith Kestenberg, internationally renowned child psychiatrist and psychoanalyst. One of my graduate art therapy students was doing her internship at Dr. Kestenberg’s Child Development Research Center, and I made a site visit to observe the student in the setting. I was pregnant at the time with my first child (I am blessed to have four). Before Dr. Kestenberg even said hello, she looked at me and remarked, “You are a pregnant art therapist. You will come to my Center with your baby and supervise art therapy interns.” I quickly learned that one does not say no to Dr. Kestenberg, and thus began a ten-year residency with a scholarly, and inimitable mentor.

My studies with Dr. Kestenberg and my chance to observe my own children’s development galvanized my belief in and respect for this process, and I continued my application of this knowledge base to my clinical work. I must admit that I was put off by many of the client-centered psychological and counseling theories that were being taught in graduate therapy and counseling education programs in the 1980s. The emphasis is on what is going on right now in one’s life and often dismisses the history that the patient brings to the treatment. The client would feel acceptance by the therapist, this would reflect back to them, and they would be able to move forward. I concede that many people want help with what is going on in their lives right then and there. Also conceded, people are less patient with or tolerant of long and drawn-out therapy and psychoanalytic relationships. Finally, the medical treatment model for behavioral health became short term, and treatment interventions were adjusted accordingly, calling for therapists to think about their work getting done in a constricted window of time.

Although I was only about a decade into my career at the time that this all occurred, I felt that the dismissal of a patient’s history would interfere with their ability to satisfactorily resolve whatever it is that is going on in life for which they entered treatment. How can we help a patient move forward without looking at where they came from? Again conceded, we therapists had to do this in less time, but it was still necessary. Assessing the baby before us and understanding this baby’s art presented in the session offers art therapists a way to get to some history quickly at the beginning of treatment. These observations and knowledge will inform the course of treatment and interventions.

As I offer the above advice to my students, I also urge them to study and learn what is typical in human development and developmental art. If we do not understand what is typical, we will not be able to truly see what is atypical. The ability to see what is atypical and understand where this occurred or stagnated along the developmental continuum gives us the knowledge needed to intervene effectively and efficiently. My studies of human development and developmental art are extensive and span over 46 years. Every time I observe this unfolding of human growth and development, I am filled with awe and respect. With an understanding of typical human development, an art therapist can make good decisions on how to proceed in treatment, concerning which materials to offer, framing interventions and interpretations, and recognizing developmental issues presented through the art.

Winnicott (1971b) once mused that psychoanalysis with children should not be a lengthy treatment process because children do not have years of neuroses piled onto developmental issues; therefore, he whimsically suggested that everyone should enter psychoanalysis as a child. We can conclude that it is more difficult to uncover years of neuroses and applying developmental theory to a patient’s history gives us better tools for digging. This is my main hypothesis. I apply this knowledge in my work with people of all ages. Not only with children, but rather as the book title suggests throughout the life cycle.

Even as I write this book, a whole new world is emerging. We are dealing with a pandemic and lockdown. Families are sheltered-at-home with each other—schooling, working, exercising, recreating, cooking, and eating—as a unit, a closed set. As I share my observations of the last 46 years regarding the art of typically developing children, I realize that a few years from now, children’s art may be different because of the pandemic. They may draw people with masks. That is what they are seeing when they go outside of their homes. There may be more fear represented in their eyes and facial expressions. As I walked to my car recently through two other parked cars in a parking lot, a little boy, who was sitting in the back seat with the windows opened, recoiled as I passed by, as if afraid of contact with me. This saddened me, but I realized this was our new normal.

I have seen changes in the art of children who are typically developing over the years. Social media and instant communication have affected children and adolescent art significantly, and more research is needed on this impact. One big change in children’s artmaking happened when multicultural crayons were introduced. Previously, my observation was that most children did not color in faces of people they drew. Very simply, it is difficult to color in a face and try not to color over the eyes, nose, and mouth. But then, unless the features were adeptly drawn to represent an ethnicity, human figure drawings looked Caucasian. I observed that many children still did not color in faces, except children who were more gifted artists, but they had the colors from the multicultural crayons to fill in arms and legs, which supports their cultural identity.

Honestly, faces can be hard to draw. Most kids like to draw eyes, but noses are hard, and mouths, often showing emotion or mood, can be tricky. As I say many times in this book, most people stop drawing in early adolescence. The influence of Anime was significant and probably prolonged children’s tolerance for drawing because it offered a stylized way to successfully draw faces. I am making a prediction. Young adolescents may continue to draw faces past their previous deadline to do so because they can now draw faces with masks on, thus avoiding the challenging rendering of the nose, mouth, and facial expression. In fact, masks have become a new opportunity to express personal creativity for everyone. One of my preadolescent patients wears a different mask each session from popsicles to tie-dye to hearts and flowers. All around me, I see masks that feature animal prints, batik, sports teams, big lips, and more whimsy. Perhaps this chance for people to make a creative statement is one of the good things that will come out of this pandemic.

Other changes were not so benign but are noteworthy. Trauma brings change to one’s life and is reflected in the art of children who are typically developing. Being diagnosed with a medical illness or losing a loved one will certainly change the art of children who are typically developing.

Figure 1.1Drawing from a child who lost both parents to AIDS

More extreme circumstances, which impact our communities and societies, such as a natural disaster or terrorist attacks, result in changes in the art of children who are typically developing. And I am assuming that the COVID-19 pandemic and lockdown will also result in changes in the art of children who are typically developing. This remains to be seen. Therefore, I offer decades of observing children and their art as a foundation for working using a developmental art approach to the art therapy treatment process.

Figure 1.2Drawing from a child who experienced an earthquake

Figure 1.3Drawing from a child who experienced the terror attacks of 9/11/01

Reviewing artwork with an educated understanding of the stages of typical human development and typical art development will ensure that a clinician has a full picture of the patient regarding how to begin and engage in effective creative arts therapy treatment and result in good outcomes. The typical developmental art stages occur along with physical, psychosexual (Freud, 1905), psychosocial (Erikson, 1950), and cognitive (Piaget, 1936) stages of development and will be presented that way. Margaret Mahler and Judith Kestenberg have also contributed greatly to our understanding of early human development, and their theories are included. Using all these lenses gives us a clear picture. Looking at every aspect of the whole developing typical human being, from birth to death, is essential for a psychotherapist to do because without a deep knowledge of typical development, it is impossible to truly recognize and treat patients whose paths have not been typical.

In this book, I define object relations-based art therapy and have the distinct pleasure of introducing the Kestenberg Art Profile, both with illustrated examples. Theories of typical human development and art development are reviewed with illustrated examples from: infancy and early childhood; childhood; preadolescence; adolescence; and adulthood. Human development theorists included are Freud, Erikson, Piaget, and Kestenberg. Developmental art theorists included are Kestenberg (the Kestenberg Art Profile is introduced herein), Joseph H. DiLeo (1970, 1973, 1977, 1983), Howard Gardner (1980), Rhoda Kellogg (1967), Myra Levick (1998), Viktor Lowenfeld and W.L. Brittain (1957), and Judith Rubin (1984).

Some art therapy assessments are reviewed throughout with examples, such as the Silver Test of Cognitive and Creative Skills (related to neurological indicators in the art), and the Kinetic Family Drawing (Burns and Kaufman, 1972). There is an exploration of age-appropriate and developmentally appropriate materials and techniques for use in treatment and interventions.

Life has many bumps in the road, and some result in challenges and trauma. This book contains research, theory, and clinical examples of the impact on human development due to physical differences, medical illness, and mental illness. Further included is significant research, theory, and clinical examples regarding trauma caused by physical, sex...