Exploring ‘Art as Therapy’ and ‘Art in Therapy’
It’s my pleasure to share this excellent article by Leigh Burrows (PhD) with you. As one of my students, Leigh wrote this essay as part of her coursework for the Art Therapy Certificate Course.
Robert GrayDirector and Senior Lecturer at CECAT
Registered Art Therapist and Psychologist
MA A. Th., AThR; B. Soc. Sc. (Psych.) (Hons.), MAPS.; BA. Theol. (Hons), MA Theol.
Art as Therapy and Art in Therapy
What is art therapy? An exploration of the terms ‘art as therapy’ and ‘art in therapy’ and their significance in my learning about art therapy so far.
As I began this educational and clinical art therapy certificate course, I was intrigued to read about art therapy largely falling into two broad types: ‘art as therapy’ and ‘art in therapy’ in the course director’s book (Gray, 2019, p.14). Briefly these terms seem to me to refer to the therapeutic benefits of engaging in the process artistic activities for their own sake -art as therapy- and using the artistic activities as a vehicle for therapy, going deeper, seeking meaning and endeavouring to make the unconscious, conscious -art in therapy- (see Malchiodi, 2012, in Gray, 2019). As I pondered the types I found myself directly experiencing art as therapy and art in therapy and conceptualising art therapy in this way has been of great assistance in deepening my understandings of past and present experiences both personally and professionally.
I want to begin by sharing two contrasting vignettes and a further vignette about the process of interpretation to provide a basis for my understanding of the helpful distinction of art as therapy and art in therapy, something I am also finding very useful in relation to mindfulness and its various approaches and practices. One more vignette, focusing on activity I facilitated entirely intuitively many years ago, guided by my unconscious, and now made more conscious is included towards the end of this paper.
Vignette #1 Tree watercolour: Art as Therapy
About a year ago I attended a workshop on indigenous ways of knowing. We were given the task of painting a tree in water colour. I love trees, their green, their moisture, and appreciate being surrounded by them in the Adelaide Hills, soothing me when I’m down on the harsher, more drying plains of Adelaide. I never wanted this activity to stop! I kept painting when it came time for group discussion and felt such well-being and peace. I loved the way the watery colours flowed into each other and the form of the tree was pleasing to me, with its sweeping limbs, strong roots, soft leaves and red fruit. I took pleasure from looking at it, knowing I had created it and thought how long it had been since I had sat down and taken the time to create a simple piece of art. I experienced such simple pleasure, joy and relaxation during the process of painting my tree during a very busy time of teaching that I introduced the activity very successfully into my own mindfulness intensive workshop the following week. It was a complete experience for me with nothing else needed. As therapist Wallace, (in Rubin, 2012, p.23) put it: ‘Once one takes brush in hand a calm descends’. As Gray (2019, p.25) writes, this can lead to becoming, ‘calmer, more relaxed, more comfortable’ … yet also, more alert and focused’ (with clear links for me to mindfulness).
Vignette #2 Life Script Drawings: Art in Therapy
A year later, just last week, I settled down in my garden studio to work on the life scripts drawings in module 2 of the art therapy course. I immersed myself in drawing, colouring and painting frames from two stories, one I taught myself to read from at about three and one from when I was about 11 or 12. The first one was a picture book about Andy Pandy and Teddy wallpapering their room. They got so excited about papering that they forgot to leave a space for the door and papered right over it! I remember feeling quite upset about this and having a strong inner experience of feeling trapped with no way out even though the characters do get out by removing one section of the wallpaper, which I include in my drawings.
The other story I chose was from Charlotte Bronte’s novel ‘Jane Eyre’ focusing on the part when Jane was locked in the red room for punishment, hearing Mrs Reeves and John talking about how bad she was on the other side of a red curtain. I made both pictures in the same day. I wasn’t thinking too much, in a ‘flow’ state (Csikszentmihalyi, 2014), not overly preoccupied with the quality of my work aesthetically (although it appears quite naïve to me) but deeply engaging with the pattern making for the wallpaper and texture creating for the red velvet of the curtain in the red room. I enjoyed the process of responding to the course reflective questions for each in turn and appreciated the way they invited a receptive and non-judgmental (Gray, 2019; Rubin, 2012) way of looking at what I had created that resonated with me as someone with a background in phenomenological teaching and research (Betensky in Rubin, 2012).
Vignette #3 Art Therapy Self interpretation
Why had I chosen these two as stand outs from my child and young personhood when as an avid reader I could have hundreds to choose from? It wasn’t until I looked at them together that I realised both were about being trapped in a room! In both examples the atmosphere was oppressive and there was a feeling of stuckness, of being hemmed in, restricted, unable to move out. I now saw that the wallpaper had a pattern that looked like bars and that the vertical folds of the heavy velvet curtain had a similar effect. I then remembered telling a therapist in a Steiner curative education training about 20 years ago that I had just had a dream about being trapped in a cupboard. I then had an association to the fairy tale Hansel and Gretel and how terrifying I had found it. I then recalled anthroposophist Judith von Halle’s spiritual autobiography (2016, p.3)) where she describes the experience of awakening in her body hearing the words from the television ‘They only awoke when the fire came through the roof’ at around three years old and wondering:
Had it taken so long before my consciousness entered my body and was no longer pushed back by it- until this consciousness itself no longer struggled against being imprisoned in the narrow confines of its dwelling.
This is similar to my experience of awakening in my body when my mother wanted me to have a photo taken and I was resisting it, sitting on my little chair in the garden. I realised I there were two parts to me, rather like Jung’s personality number one and personality number two or expressed perhaps in the Jung Self-box (Gray, 2019). I had such a strong awareness of one part of me being outside the body and one within it, of not being the same as my body as pre-existing or co-existing with it. This was reinforced came with a near death experience at 11 or 12 when I looked up to the light above which was drawing me to it like a moth to a flame and down to my cold body below, on the beach, and suddenly entering that body, not willingly though, a little like not being willing to have my photograph taken.
As I reflect on these vignettes the tree activity seems to me a good example of art ‘as’ therapy (Gray, 2019, p.24) since it was more about the process than the content, although I do feel that the content was important to a degree as I connected deeply with my tree, its form, trunk, roots, leave and blossoms and remember including rich greens, browns and pinky reds. The activity was simple, accessible and involved an easy process to create a product that did not really require any interpretation.
I appreciate that the house, tree person picture (Gray, 2019) can be used for diagnosis and interpretation and I have done this myself through my curative education picture diagnosis training and have seen motifs in my students’ trees such as knot holes. This time however I don’t think this was needed, and would actually have got in the way, interrupted the flow. In my own use of the activity, more than in the workshop, the ‘overall feel’ of the room, atmosphere, healing effects, the creation of a space that generates expressive engaging, played a role as well (Rubin, 2012, p.43).
I asked my students to stick their trees up on the back wall to make a forest and we stood around in a half circle and admired them, their diversity in particular. While like the idea of the ‘group mural technique’ (from von Spreti, in Gray, 2019) and think it sounds like a wonderful way demonstrate projection but I do not think it would have been appropriate in this context with this group and this facilitator, highlighting the value of understanding the difference between art as therapy and art in therapy.
The second vignette with its rich and complex images, associations, and interpretations is clearly more located in art as therapy. I was surprised by how deep the activity went and how many connections I could make between them and across my life. I now understood what Gray (2019, p.25) meant when he wrote about the significance of ‘what is actually there, what they have drawn from their unconscious and how that is then interpreted by the client, for what it is not what they think it is’. I was very taken by the clarity of the message from my unconscious in my two pictures. The communication was clearly there in front of me and I can see that while I was happy to do my own interpretation on my own it would have been enjoyable to do with someone else. This was such valuable learning to know from experience the significance of having a tangible product to look at together.
It is now obvious to me that having a representational form of previously unconscious material allowed for something else to look at than oneself or each other that was already less intense, less stuck, more dynamic and potentially transformative. (Gray, 2019) working almost like externalisation in narrative therapy and very useful for minimising defence mechanisms (Gray, 2019). I agree with Gray (2019) that this technique is ‘brilliant’ as working with the stories meant it wasn’t directly about me although of course on one level I did know it was, but the externalisation process meant that I approached the task in a very open kind of way, as a reader, a lover of stories, which in some ways relates more to art as therapy, with the art in therapy aspect creeping up on me!
I wanted to make my own associations and did not want anyone else to do this for me as recently happened with a Jungian psychotherapist who interpreted a dream, I shared with him as being about sex and death. This didn’t ring true for me and when he said it was ‘a most peculiar dream’ I didn’t find it helpful, but more of an intrusion or even invasion. As Gray (2019) writes, they may well have been his own projections. There are clearly different ways of approaching drawings in art therapy and the main thing seems to be to endeavour not to project and muddy the waters with our own ‘stuff’ (Gray, 2019) though this seems impossible to achieve completely given we influence one another energetically and unconsciously.
In any case I much prefer what Gray (2019) and McWiliams (2011) and Rubin (2012 ) recommend which is to empower clients to tap into and nurture their own inner resources and wisdom This aligns with my approach to mindfulness and my university teaching in general where I want to support my students to be empowered from within and this means I need to take seriously what they are telling me, their own perspectives about their experience of mindfulness which may be quite different to what is reported in large quantitative studies.
I was drawn to taking this particular art therapy course because it seemed to align with my personal and professional values, with a humanistic approach (Gray, 2019). Both art as therapy and art in therapy do call in my view for a person centred approach in which we are attuned to the needs of the client. With regard to mindfulness teaching and research I too have wanted to go further than manualised programs with predetermined outcomes (notwithstanding university course and topic requirements) given there is so much in my work that is interested in the quality of individual’s unique experiences rather than controlling, measuring or instrumentalising them (Gray, p.14).
This is significant in mindfulness as most studies are outcome based quantitative studies (Burrows, 2016) involving self-report surveys. I wanted to understand how people experienced mindfulness so asked my research participants the simple question ‘What happens when you close your eyes for a mindfulness meditation’. I received some highly concerning responses about people experiencing dizziness, depersonalisation, dissociation, intense sadness, difficulty sleeping and increased thoughts and heart rates, responses which the editor of the journal ‘Mindfulness’ said in a personal communication ‘contradicted the findings of hundreds of randomised trials’ (see Burrows, 2017). I see so many similarities with mindfulness, as Gray (2019, p.14) writes in relation to art therapy:
Many art therapy books that mainly focus on art as therapy neglect the complexity of psychotherapy. There is a mystical belief inherent that art will do the job whether we understand the processes or not.
It does seem important to know about the difference between art as therapy and art in therapy and to be able to make decisions about which elements from each we may wish to include or not include, and to be prepared for unanticipated outcomes and to be able to go with flow. I now wish to share another vignette from my own experience, that I have been able to reflect on, understand and appreciate in new ways in the light of my learning in this art therapy course. It centres around an activity I facilitated some time ago, or rather my unconscious facilitated as I was surprised by the outcome, and I reflect on it often, still. It connects very nicely with Gray’s (2019) writings on the mandala which quite clearly brings mindfulness and art therapy together so is a fitting vignette as I draw close to the end of this paper.
Vignette #4 Mandala Making: Art Therapy as a Continuum
I did my teacher training in a diploma of education (already having a BA) in my 30s in the mid 90s and I had a year 11 English class, a year 8 class and a special education class. It was a small school in a country town and most of the students in the year 11 class of about 10- 12 students had been together since kindergarten. There was a young woman in the class who had leukaemia and she and the class knew that she was not long for this world and would not be in the class in a few months’ time. I had a lesson plan which I chose to abandon, much to my school and university supervisors’ alarm. I decided instead to bring a fairy tale, ‘The Handless Maiden’ and a mandala activity instead of what I had prepared, something I can no longer remember.
The students’ mandalas were amazing, the atmosphere in the room was amazing. I was in awe of their work and can still see two in my mind’s eye, a young man had made his circle represent the steering wheel of his car, and one of the segments contained a beautifully rendered whisky bottle. The young woman not long for this world’s mandala in had a lush green tree with leaves reaching around the outermost circle and fiery orangey-red flames licking and leaping around the centre.
Years later I was walking down the main street of this town and someone called out to me, ‘Hey you’re that teacher that did that mandala thingy with us, aren’t you? That was the best thing I ever did at school’. Perhaps what I brought was a little risky given I was only a visitor for a term, not yet a teacher, though the year 11 teacher was present and I knew he was a lay preacher as well as a teacher, deeply cared for his students, and would be there for them after I had left and for the rest of the year. I did not get a high score for my teaching in this class it remains one of the most significant teaching experiences of my career.
In the light of my new learning about the value of conceptualising art ‘In’ and ‘as’ therapy I now see the mandala activity facilitation probably started out as art as therapy as it worked well in an English class since drawing from the fairy tale was not threatening as it was not directly about the student. It was very a very therapeutic form of mindfulness with a focus on process, for relaxation, calmness, group harmony and perhaps trust in the universe. Once again, though, the art in therapy aspect probably crept up on me, as the activity soon became a deep meditation, as a result I feel, of a combination of the young woman’s openness and spirituality due to her illness, my depth of meditation experience and practice, the close knit nature of the group, the openness of adolescents and the power of the fairy tale and the mandala activity itself. There was such great depth, even profundity in what the young woman painted, I feel it would have broken the protective magic circle (see the Handless Maiden story) if I had talked about it with her and encouraged her own (I feel unnecessary) interpretations, so in a sense this mandala activity came full circle and moved away from a full immersion in art in therapy. I suspect the open ended nature of this task frustrated the class teacher and my university teacher as they were looking for educational outcomes but I could not have been more pleased with how the lesson turned out. It lives inside me still, with its energetic quality.
It seems that in art therapy a flexible approach of ‘as’ and ‘in’ therapy, seems valuable and necessary as this balances process and product, relaxation and challenging, nurturing and stretching, as in Csikszentmihalyi’s (2014) notion of ‘flow’, which is not so challenging as to be anxiety producing or too intense but not so low key as to be boring and not fruitful. Perhaps most importantly however, this requires discernment in order to tailor the activity for the therapist, facilitator or teacher, the student or client and the context whilst being open and flexible enough to make changes as necessary. I feel I have been privileged to have been guided by my intuition on so many occasions in the past as regards informal art therapy and writing this paper has been a very worthwhile process eliciting much personal and professional growth as I move toward a more formal approach to art therapy.
Burrows, L. (2016). Safeguarding mindfulness meditation for vulnerable college students.
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Burrows, L. (2017b). Safeguarding mindfulness. Routledge.
Csikszentmihalyi, M. (2014). Flow. In Flow and the foundations of positive psychology (pp. 227-238). Springer, Dordrecht.
Gray, R. (2019). Art therapy and psychology: A step-by-step guide for practitioners. Routledge.
Halle, J. (2016). Swan Wings a Spiritual Autobiography Temple Lodge Publishing.
Rubin, J. A. (2012). Approaches to art therapy: Theory and technique. Routledge.
McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process. Guilford Press.
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