Art as Therapy

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By Professor Susan Hogan

The most common misconception held about art therapy, is that it involves the therapist interpreting the artwork, and deciphering and unravelling the meanings hidden within; on the contrary, it is the creator of the image, not the therapist, who has this pleasure. The role of the therapist is primarily an insightfully enabling one.

In all forms of art therapy participants are encouraged to explore their feelings using art materials, often paper and paint, but a variety of materials may be employed, such as collage, clay and sculpture (wood, wire, metal mesh, plasticine, found materials, including natural materials such as leaves or stones).

The role of metaphor and symbols in depicting mood states, which are hard to articulate, is important. How participants use the art materials can also contribute to the meaning of the art produced.

The art materials (their very substance) can evoke feelings in the person using them. It is possible that ‘magical’ powers can be invested in the image or object and that art works can take on great symbolic significance for the maker of the image or object.

Therefore, how the image is changed, stored, displayed or destroyed can become relevant. A series of images viewed together might be particularly enlightening, as patterns or a ‘narrative’ may be discerned.

Conversely, the process of making the image or object may be more important than the end result – it may be a pictorial struggle, perhaps an inability to resolve an image which is revealing, or the actual process of constructing it or destroying it . The end result may seem irrelevant.

In group work there may be an emphasis on the individual in the group, with each participant getting an allotted time to talk to the group as a whole about their art work.

Other approaches may be more interested in exploring interactions between group participants, as part of a process aimed at illuminating habitual ways of being, and opening these out for scrutiny, and contemplation: this is the ‘interactive model’.

The Art Therapy Environment: Managing & Using the Space

When conducting experiential work many art therapists seek to permit their groups to develop a sense of ownership of the room by putting up art works on the walls.

A number of therapists endorse the view that this is therapeutically useful; it is possible to leave the work in progress, or the group work just made, and to have absolute confidence that it will still be there on the wall the following day or week.

The work then functions as a greeting, or a welcome to the space, to participants. The art object, waiting where it was left, creates a sense of security and continuity.

The ideal art therapy room is therefore that over which the art therapist has total control. To leave works out and then to have them moved by another room user would be counter-productive and could engender feelings of insecurity and disruption, or indeed violation, in participants.

Obviously, this is a potentially serious issue, especially if works could become damaged or lost.

A compromise is to have a large walk-in-cupboard which can be locked, where art works can be left to dry, or pinned up, but many art therapists prefer an art studio to look like an art studio.

Conversely, some art works may feel too personal to be left on display, and so private storage must be on offer.

Nevertheless, art therapy participants will sometimes wish to display their work, and having this option can feel liberating for both individuals and groups. The ‘white walls’ approach feels barren and constraining; however, it may be the only option if the art therapy room is used by other professionals for multiple uses.

Interruptions to sessions can usually be dealt with by a combination of liaison with other professionals, so that they understand that the space must feel contained and safe, and that interruptions impinge on the participants’ feelings of safety and privacy, and disrupt the therapeutic process.

Informing and educating other professionals about how art therapy works is an essential part of an art therapist’s role. Secondly, a ‘session in progress, do not disturb sign’ is often remarkably effective.

Confidential Locked Storage for Art Therapy Work

Lockable storage for art works is an essential requirement for confidential art therapy work. Ideally, this is a spacious walk-in cupboard to which only the art therapist has usual access. It is preferably sufficiently large that work need not be folded to be stored. A plan-chest may be included, or participants may be issued with portfolios in which to keep their work safe.

Shelving, or a cupboard with shelves, is necessary for the storage of sculptural works. Art works embodied with strong emotions can become highly significant for the maker of the image, so the storage and disposal of art works can be of great symbolic significance within the art therapy process.

Practical Aspects

A room that opens out onto an outdoor space is ideal, so that work that needs to be sprayed with fixative can be sprayed outside, or next to the an open door if the outside space feels too overlooked to take the work outside.

A sink is a pre-requisite for a permanent art therapy facility, but for workshops a line of buckets for swilling out and lots of large plastic bottles full of water will suffice.

It is obvious that a certain amount of natural light is also useful in an art therapy room. Having to use overhead florescent lighting can become very oppressive.

A washable floor surface is highly recommended, as carpets can be very inhibiting. Ideally, a room would contain a range of working environments: an area where participants can work on the floor; an area with tables; another area with some artists’ easels and donkeys.

The room shouldn’t be too cramped. In group-interactive art therapy movement in the space is of crucial importance. Conversely, if using a studio approach, participants could work at easels.

If art work in progress is to be left out, then liaison with cleaning staff and janitors is essential to prevent work being moved when the room is being cleaned; if the room is always cleaned on a specific day, it may be advisable to ensure that no work is left out on this day, to minimise the possibility of accidental damage.

Art Materials

Having a wide range of art materials on display and easily accessible is very exciting for participants; having to hunt around in little cupboards and drawers to find things is, again, potentially inhibiting, and can interrupt the flow of the activity.

It is recommend to offer a range of materials from the most basic to the best artists’ quality (excepting cheap coloured pencils which tend to be frustrating to work with). Basic materials include water-based paints in blocks or tubes, palates of different types (some with wells for containment of fluid paints or glue, and others flat for mixing colours), a good variety of brushes, from refined thin sable to large wall painters’ brushes (brushes are available in a variety of shapes, which make different marks, so a range from square-ended to long bristled is ideal), water pots, and a mixing medium such as PVA.

Other materials consist of pencils, crayons (from children’s type to artists’ fine quality), chalks, oil pastels, chunky graphite sticks, and charcoal. Pens, from fine-line to felt-tips and plump markers, can be included, and so too erasers, including putty rubbers.

A range of paper should be provided in different colours and qualities. Sugar paper, foil, florescent, tissue, and textured papers may be included. The basic staples are cartridge paper in a variety of sizes, and large rolls of paper, so that there is scope to do something big. Masking tape, or a double-sided fixative tape of some kind, is a necessity (for joining sheets together).

Many pairs of scissors are needed, as it is frustrating if there are not enough for group exercises. Stanley knives and/or pencil sharpeners, depending on who is being worked with, as Stanley knives are not appropriate with potentially volatile clients or with children. A simple printmaking kit of some sort, with boards which can be etched into, enabling relief work, may also be make available.

A good range of sculptural materials should be on offer, including air-drying clay of some sort. It is recommend that a junk box be established, and it is possible to ask group members to bring in miscellaneous items. Staple guns (which need instruction to use, and must be clearly demonstrated and supervised), wire, wire-mesh, and glue of various sorts are also needed. String and yarn are useful.

An assortment of arts materials also gives increased scope to participants to find materials they want to work with. Art materials do have different capacities to yield different results, and some materials are much easier to contain and control than others. Discovering the aesthetic sensibility of the substances is part of the art therapy process. Certainly, art therapy facilitators need to have a sophisticated understanding of what the materials can do.

Sharing Space

Mess should be cleared up after sessions, sinks should be left clean rather than with paint residue in them, and surfaces wiped down, otherwise relations between room-users will quickly deteriorate.

If conducting an introductory workshop series that will include making large sculptural works, issues of storage, display and disposal come immediately to the fore, and can precipitate a useful discussion.

Art therapists may also exhibit non-clinical drawings or paintings to act as an inspiration. Other facilitators prefer to work with white walls and to have all art works always put away at the end of sessions; for rooms with multiple uses, this may be the only viable option.

The Space as a Form of Contract

Art Therapy is contained within clear boundaries. It takes place at a consistent time in the same place, and each session is of the same duration. Some group work may adopt a constant ‘shape’ with a certain amount of time allotted to thinking about the previous session, a specified time for art making, and a further allocated slot for analysis of the images.

For clients who have experienced a great deal of instability and inconsistency in relationships, this regular, predictable space is important. The art therapy room offers, as far as possible, the same range of materials each week. It is a secure space into which other professionals will not wander – they do not disturb sessions in progress. These important boundaries combine to create a safe space. The therapist endeavours to protect groups from intrusions of any sort.

This space set apart from normal life offers an opportunity for self-reflection, and self-observation. The art object itself provides further containment, holding aspects of the maker’s inner life, which they then explore.

About Professor Susan Hogan

Professor Hogan has research interests in the history of medicine. She has written extensively on the relationship between the arts & insanity and the role of the arts in rehabilitation. She is also very interested in the treatment of women within psychiatry.