Art in Group Psychotherapy
By David Chirko, A.B., psychological researcher/author and artist (chirkoart.ca) Sudbury, Ontario, Canada
…art is fantasy, created with a brush roaming in a psychic play world… – David Chirko (1989, December)
Author’s Note
In an interview, I explained that, with the gestalt1 approach to art, what enters consciousness is the narration of fantasies, executed with paint and canvas (Dunn, 1985, MCTV). Gestalt is defined as the whole being greater than the sum of its parts, forming a pragnanz—where the mental structures and forms are complete, simple, and meaningful (Chaplin, 1975). When balance is achieved I have triumphed, conflict free, at least in the aesthetic sense. This is how I can express my raison d’etre through what I think and feel.
Regarding psychoanalysis2 via art, I described how words, through their use in free association, operate (Chirko, 1995). For example, how displacement, identification, narcissism, sublimation, and wish fulfillment are involved in the artistic process. I maintained that art can be therapeutic, but it won’t, in and of itself, resolve personal conflict.
My first encounters with applying art to groups was in a series of workshops I conducted with grades 10 to 12 high school art classes (2013), and a children’s art segment at a playground association holiday party (2019). However, I was always intrigued with how art could be involved in the therapeutic process, with youth and adults, alike.
Preliminary Influences
Sigmund Freud believed the artistic process was the imagination, filling in nebulous, early memories. In fact, psychiatrists Leland E. Hinsie and Robert J. Campbell (1976), state that art is analyzed similar to the way fantasies and dreams are. They explain that Freud, in his Collected Papers Vol. 4 (1924-25), declared that an artist is someone who flees from reality because he cannot accept its rejection of instinctual fulfillment. He therefore seeks complete, unfettered, erotic pleasure in artistic fantasy. The authors also say that Carl Jung, in his Contributions to Analytical Psychology (1928), believed current artistic imagery employed by the artist could be traced back to a primordial image in the collective unconscious. Otherwise, the artist would be locked out of the profoundest essences of life. Freud and Jung indicated that art was representative of themes, factors, and motives of the psyche.
Where and How Art Therapy Began
Teacher and artist Elinor Ulman (1980) says “Art Therapy,” the term, was inaugurated in 1942 by British pedagogue and artist Adrian Hill. He commenced work in therapy with fellow tuberculosis patients in a sanatorium. In the United States, it was psychologist Margaret Naumburg who expanded the field in the early 1940s, under the helm of psychoanalyst and psychiatrist Nolan D.C. Lewis, at the New York State Psychiatric Institute. Psychoanalytic child art therapist Edith Kramer, and psychiatrist and psychoanalyst Paul Schilder, contributed to theory and the latter’s wife, neuropsychiatrist Lauretta Bender, to therapeutics. Ulman explains that art therapy paralleled and partially accompanied the upshoot of psychoanalysis employed in psychiatry, and now complements psychotherapy in general.
In art therapy, being proficient technically is not emphasized, and there is no need for completion of the total picture because the artist’s effects are rapidly produced. The spontaneous result of which unconscious material will, optimistically, eschew censorship, whether or not there is interpretation of this directly. However, habits, through attitudes and behavior, are broached. What the artist verbally formalizes and associates is valuable to therapeutic interpretation. The therapist therein, if plausible, encouraging a transference between them and the creator of the art. Self awareness and the latent and manifest characteristics in the art are discussed, enabling the patient to tolerate the less palatable facets of their personality. Art therapist Natalie Wallace, alluding to the work of Shechtman & Perl-Dekel (2000), states that art therapy “assists with accessing the unconscious” (2014, p. 1).
Group Art Therapy
Psychologist and art therapy professor Shaun A. McNiff (1980), explains that it was as an alternative to communicating verbally in group therapy sessions how “group art therapy” began. This was because revealing feelings for some patients was not feasible and/or they were too arduous to be expressed in words.
Usually, when the group session is underway, the creation of art is enacted by patients and presented to other group members to speak about then at, as well as after, the session. This can last from one to three hours. It can also be undertaken exterior to group and presented later for discussion. The group can be small, intimate and private, or function in a capacious, open atelier setting.
McNiff (1980) further says that developing the pure artistic ability of a client can have a positive influence on their entire personality, so art for its own sake is encouraged. The precluding of distractions emboldens the group therapy flow, with its ensuing healing effect. Variations in the members’ work and its experiential dimensions are talked about. Purpose, esteem, trust, sharing, and interpersonal learning amongst the group is ratified in the inchoative stages. Later, motives, visual perceptions, and projection of specific emotions, like fears in presenting their feelings and conflicts that have been repressed, are delved and analyzed.
Current Status and Developments
Clinical psychologist and art therapist Alexia C. Electris presents her 2016 review of a book by art therapist and artist Bruce L. Moon, entitled Art-Based Group Therapy Theory and Practice. She states that Moon advocates art therapy group leaders be more intuitive and less formulaic, exhibit an aura of self-confidence and personal power, and become artistic role models, unfazed by creative and personal risks.
Patients in Moon’s groups demonstrated how they experienced what was transpiring. For example, with green and blue chalk on mural paper, one woman drew a puffer fish with spines and other members opined about its “cuteness.” She retorted, “Well, I may be cute, but you better watch out for those spines. They will hurt you if you get too close” (p. 105). Moon commented on how “puffed up” the fish appeared. The member confessed that this was her response to peril, as she found the class threatening because the proverbial ocean felt inauthentic. She admonished that those in group be vulnerable and realistic toward each other.
Electris extols Moon for his cognizance of resistance being the difficulties in connecting and engaging. Members thus travel deeper in how they give expression to their artwork, bereft of words. He believes group art therapy is more process oriented than traditional group therapy, creatively exacting change. Creation is key here, as members must immerse themselves in this process. They then feel less isolated, thus ratifying a relationship with others via their art being viewed, bereft of anything spoken.
In Moon’s epilogue Electris avers that he maintains art therapy is unique, influential, and not a pseudo-science, if you will. This approach should be esteemed by colleagues in other professions, who might not comprehend its validity and be biased in favor of talking cures. Moreover, psychotherapy isn’t merely about symptom alleviation, but also about those battling with the spoken aspect, who can now acquire insight, understanding themselves and socializing more effectively with others.
Finally, Electris proclaims that Moon fosters individual development in novice art therapists, as they become accustomed to using their experience and intuition in examining their own art, in lieu of any formulaic involvement.
Criticism
There are disadvantages of group art therapy, that Marian Liebmann, an art therapist working in restorative justice, adumbrates (2004). They are: the compromising of confidentiality, the exorbitant number of members involved, the fact that groups can be arduous to organize effectively, the issue of less focus being placed on an individual, the matter of a group being stigmatized, the possibility members can purposely obscure conflicts, and, that some members could be frightened by others’ expertise. Pertaining to the last point, envy is part of the human condition, but whenever I was at, for instance, public group exhibits and workshops, all we artists were, on the whole, supportive of each other.
The Supporters
Wallace3 (2014, pp. 50-53) refers to studies by numerous researchers, attesting to the helpfulness and, in many instances, superiority of group art therapy. Below, are just a few of them.
Korlin, Nyback, and Goldberg (2000), in their study contend that arts groups, after four weeks of scrutiny, are advantageous when other modalities failed. Emotions, memories and experiences that cannot be readily verbalized can be located, formalized and integrated. The mood scale signified that the patients’ mood was ameliorated, as well as their emotional and cognitive processes. The hospital thereby augmented the employment of arts therapy in other departments.
Shechtman and Perl-Dekel (2000), who undertook a study that was quantitative, ascertained the differences between a verbal therapy group, which was relegated to attending to the present and personal issues; and an art therapy group, which fostered self-comprehension and interacting via expressing creativity. What they saw was that the arts group exhibited a more communicative and cohesive camaraderie.
Karterud and Pedersen (2004), examined a group of 319 patients who had personality disorders, in a short-term, intensive day treatment hospital program, during a six year period. Reviewed were ten different modalities, with sessions lasting ten hours per week: art therapy group, body awareness group therapy, cognitive-behavioral group for anxiety disorders, cognitive group therapy, “day closing” group, group for eating disorder, larger group psychotherapy, medication group, problem solving group, and psychodynamic group psychotherapy. The patients noted the exploration and application of mental visual symbols. They rated the art therapy group as the most efficacious. As per the researchers’ suggestion, the art therapy group should become germane to the treatment regimen.
Conclusion
Psychologists, many of whom are also practicing artists or have worked with such, have contributed much to the development and application of the modality called group art therapy, be it gestalt, psychoanalytic, or whatever. They have employed it on themselves, too. As an artist, I can identify with this. Of ultimate significance is that a group therapy patient’s emotions, anxieties, conflicts and visual perceptions need not always be totally verbalized to enhance their own insight, and perception of themselves by other members. This all enhances social or group contagion, whereby a member’s affects, attitudes and behaviors are spread throughout the group inter-personally. Subsequently, this promotes a more harmonious and universal understanding of whatever issues they are working on. The efficacy of art in therapy has been empirically demonstrated for generations in group art therapy, which is arguably more process oriented and often just as effective as pure talk psychotherapy, which it can complement.
Notes
1, 2 The gestalt and psychoanalyticreferences are that which comprisemy Artist’s Statement (2011), where I affirmed that art that is “…meaningful in…everyday consciousness…I call ‘Creative Communication.’ There, psychology–Gestalt meeting…psychoanalytic, wherein symmetrical technique makes meaning of unconscious impulses–fuses with the aesthetic; attracting the viewer with…harmonious use of color, texture, shape and movement.”
3 Wallace (2014) asserts “…the literature shows that…art therapists…have not assembled any…document that reports the complete history of group art therapy with psychiatric patients” (pp. 1-2). Further, that she would be doing such in the thesis for her Master of Art in Art Therapy.
References
Chaplin, James P. (1975). Dictionary of Psychology New Revised Edition. New York, NY: Dell Publishing Co., Inc.
Chirko, David. (1995, May). What Psychoanalysts Have To Say About Art, Directions Of Art! Vol. 2, No. 9.
Dunn, Sonja. (Writer). (1985, June 29). Psychology and Art [TV series episode]. Sonja Dunn (Executive Producer), Sonja and Company Television Show, MCTV, CICI.
Electris, Alexia C. (2016, December). Becoming an effective art therapist in the group format: A book review [Web article] [Review of the book Art-based group therapy: Theory and practice, by B. L. Moon, 2016]. https://societyforpsychotherapy.org/book-review-of-art-based-group-therapy-theory-and-practice/
Hinsie, Leland E., & Campbell, Robert J. (1976). Psychiatric Dictionary Fourth Edition. New York, NY: Oxford University Press.
Karterud, Sigmund, & Pedersen, Geir. (2004). Short-term day hospital treatment for personality disorders. Benefits of the therapeutic components. Therapeutic Communities, 25(1), 43-54.
Korlin, Dag, Nyback, Henrik, & Goldberg, Frances S. (2000). Creative arts groups in psychiatric care:
Development and evaluation of a therapeutic alternative. Nordic Journal of Psychiatry,
54, 333-340.
Liebmann, Marian. (2004). Art therapy for groups: A handbook of themes and exercises (2nd ed.). New York, NY: Routledge. Art Therapy for Groups: A Handbook of Themes and Exercises: 9781583912188: Medicine & Health Science Books @ Amazon.com
McNiff, Shaun A. (1980). Group Art Therapy. The Psychotherapy Handbook. Richie Herink, ed.
New York, NY: The New American Library, Inc.
Moon, Bruce L. (2016). Art-based group therapy: Theory and practice (2nd ed.). Springfield, IL: Charles C Thomas.
Shechtman, Zipora, & Perl-Dekel, Ofra. (2000). A comparison of therapeutic factors in two group
treatment modalities: Verbal and art therapy, The Journal for Specialists in Group Work,
25(3), 288-304.
Ulman, Elinor. (1980). Art Therapy. The Psychotherapy Handbook. Richie Herink, ed.
New York, NY: The New American Library, Inc.
Wallace, Natalie. (2014, May). The History of Group Art Therapy with Adult Psychiatric Patients. Indianapolis, IN: Herron School of Art and Design, Indiana University.