Discussion 7: Who do art therapists serve?

Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=uart20

Art Therapy Journal of the American Art Therapy Association

ISSN: 0742-1656 (Print) 2159-9394 (Online) Journal homepage: http://www.tandfonline.com/loi/uart20

Confronting Polarization in Art Therapy

Harriet Wadeson PhD, ATR-BC, HLM, LCSW

To cite this article: Harriet Wadeson PhD, ATR-BC, HLM, LCSW (2002) Confronting Polarization in Art Therapy, Art Therapy, 19:2, 77-84, DOI: 10.1080/07421656.2002.10129345

To link to this article: https://doi.org/10.1080/07421656.2002.10129345

Published online: 22 Apr 2011.

Submit your article to this journal

Article views: 870

Citing articles: 9 View citing articles

Art Therapy: Journal of the American Art Therapy Association, 19(2) pp. 77-84 © AATA, Inc. 2002

77

Abstract

The art therapy profession has suffered a conflictual polariza- tion since its inception, described previously as art psychotherapy vs. art as therapy and, more recently, as clinical vs. studio approaches. After reviewing the work of numerous art therapists and art therapy interns, I have found that art therapy as it is actually practiced by this sample falls into none of these narrow categories. Examples of case material show the great diversity and innovation of these art therapists’ work with many different populations. Acknowledging the extensive variety and creativity within the field, I will discuss the pos- sible causes of the continued polarization within art therapy.

Introduction

Our profession has been plagued since its beginning with a kind of myopia that polarizes us by pitting one faction against another. Initially, the polarization took the form of art vs. thera- py, with the integrative approach of Edith Kramer pitted against the insight-oriented approach of Margaret Naumburg. Both worked from a psychoanalytic framework, but each emphasized a different aspect. Judith Rubin (1999) summarizes the difference as follows:

Naumburg emphasized insight, uncovering unconscious forces through images and associations to them. Kramer focused on sub- limation through the creative process, a form of ego mastery. Many art therapists have followed in their footsteps, like myself in the Naumburg tradition or David Henley in the Kramer tradition. (p. 158)

The difference in the conceptions of art therapy generated by its two founders may be seen in their following statements. Naumburg: “By means of pictorial projection, art therapy encour- ages a method of symbolic communication between patient and therapist” (1966, p. 1). Kramer: “The basic aim of the art thera- pist is to make available to disturbed persons the pleasures and sat- isfaction which creative work can give” (1958, p. 5).

In viewing the historical development of art therapy by Naumburg and Kramer, Junge in A History of Art Therapy in the United States states:

Problems of defining art therapy have intrigued and plagued the field since its inception and have continued to be a major concern of the American Art Therapy Association [AATA]. With Naumburg and Kramer, the two major theorists, focusing on different definitions of the process, art therapists have often argued vehemently for one posi- tion or the other and have differed over whether to have a narrow or inclusive definition. While this division has been perceived by many as a political one, initially, at least, it was an argument over where the cure was in art therapy treatment. (1994, p. 129)

Of course, in a sense these seemingly opposing views are a false dichotomy. Naumburg wrote about her long-term work with adults in which she encouraged her clients to free-associate to their art to gain insight. Kramer worked exclusively, as far as I know, with children and adolescents, for whom striving for insight was hardly what was needed. She saw artwork as provid- ing sublimation and integration for them.

AATA’s first “Great Debate” at its 1982 conference was “Art as Therapy vs. Art Psychotherapy.” Having recently published a book titled Art Psychotherapy, I was pressed into service by the massive persuasions (with much flattery) of Judith Rubin to rep- resent that position. It was with great reluctance that I faced Edith Kramer, who spoke for art as therapy. As I told Judy, Edith was a founding mother who should be revered, not debated. I tried to espouse a “both/and” position, rather than “either/or.” Edith showed examples of what poor artists art therapists are.

Times have changed, society has changed, the delivery of health services has changed, players have changed, but the same old conflict that splits art therapy at its root remains. In the clin- ical realm, AATA has been involved in activities for inclusion of art therapy in existing licenses, recognition of art therapists as independently licensed professionals, and acceptance of art ther- apy certification by state licensing boards. There has also been increasing pressure to complete art therapy outcome and efficacy studies to convince managed care organizations of the value of art therapy (Stoll, 1995). In many states now, art therapists are eligi- ble to sit for the counselor license exam. Training programs have had to change their curricula to enable their graduates to qualify for the counselor license. For many programs this has meant including additional clinical courses.

Perhaps in reaction to the emphasis on licensure with its clinical requirements, a very vocal group has developed that has questioned whether we are losing the art in art therapy. For exam- ple, according to Junge:

When educational programs in California found it necessary to relate art therapy to the vastly changing and more rigidly structured state licensing laws to stay viable in the job market, the cries within the profession were loud about how the California programs had aban- doned their art, even though this was not the case. (1994, p. 281)

As a result of much work and advocacy, particularly on the part of Mildred Chapin, AATA has recently formed a committee to work on the interface of art therapy with the art world, chaired by Cathy Moon.

Nevertheless, the tendency to misunderstand and/or misrep- resent a view of art therapy that is seen as opposing one’s own still prevails. For example, Bruce Moon (1998) defines art psycho- therapy by stating that this approach “regards the process of mak- ing art primarily as a tool used to facilitate verbal expression and insight” (p. 8), and “the artwork is regarded as a means to an end, that end being verbal expression” (p. 20). He defines his own work as art as therapy using an artist-as-therapist model in which

Confronting Polarization in Art Therapy

Harriet Wadeson, PhD, ATR-BC, HLM, LCSW, Evanston, IL

Editor’s note: A version of this paper was presented at the American Art Therapy Association Annual Conference, 2000.

artmaking is “a psychotherapeutic process which may or may not involve verbalization and conscious insight” (p. 9). Once again we see the false dichotomy set forth, denying the possibility that one may work in many ways, sometimes even with the same client in the same session. But even more striking in lining up on one side or the other is the elimination of all the many possibili- ties between and outside these narrow definitions.

One reviewer of this paper claimed a lack of awareness of any such controversy within our field. One need only look at issues of this journal from the last decade for evidence. I will limit myself to a few examples from those in the studio camp.

Patricia Allen suggests that art therapy training and AATA policies foster a “‘clinification syndrome’, a process where art therapists gradually cease making art as clinical skills become the primary career focus” (1992, p. 22), and that “has led to a stunt- ing of the development of art therapy as a discipline in its own right” (p. 23).

David Henley, on the other hand, criticizes Allen’s artist-in- residence approach by noting, “The high-powered, provocative quality of the art (of the art therapy artist-in-residence) ... may have proved unsettling or intimidating to others in the (client) group, perhaps diminishing the motivational or therapeutic effec- tiveness of the atmosphere” (1995, p. 190). In the same issue of Art Therapy, which was devoted to studio art, Allen describes her open studio approach and states, “We eschew therapy concepts and practices” (1995, p. 161). Also in this issue, McNiff argues for the free spirit of art as opposed to the constrictions of thera- py: “I often wonder whether it (art therapy) is an appropriate ‘location’ for my practice of soul making” (p. 182), and

even though the mainstream of the art therapy community appears to be increasingly committed to the sacred function of art, the pres- sures of clinical regulation…and general mistrust of the imagina- tion, may ultimately restrict the free spirits of the studio so that they migrate to other places [than art therapy], more hospitable to the ways of soul. (p. 183)

In the Allen and McNiff quotes, there is even a hint of secession from art therapy.

Current Practice

Given the prevailing climate within organized art therapy, the purpose of this paper, as the title indicates, is to confront the polarization in our profession. I intend to do so by presenting the reality of art therapy work as it is conducted today. There is noth- ing like a good helping of reality to chase away illusions (or delu- sions, as the case may be). The ways in which art therapists are actually practicing raises important implications for training as well. And finally, in confronting the polarization in art therapy, it is tempting to speculate what lies beneath the manifest content of our historical conflict.

To review art therapy as it is currently practiced, I began with the theses of student interns from the Art Therapy Graduate Program at the University of Illinois at Chicago (UIC) that I direct. I reviewed the work of over 200 students in detail. I then invited colleagues to write descriptions of their work as well. Admittedly, art therapy by selected colleagues and students from one graduate program is not representative of the field as a whole. Further, one might expect these students to lean toward a clinical approach, since that is my background and most of our faculty hold clinical positions. Nevertheless, most of the work does not

embody an insight-oriented approach. In addition, almost all the work is from the Chicago area. Chicago is a large Midwestern metropolis that is highly sophisticated in the realms of both art and therapy. Although it is not representative of the rest of the country, it does offer almost every kind of population and facili- ty in which an art therapist might choose to work. And finally, the work of students does not represent that of a seasoned prac- titioner. Nevertheless, they are the future of our profession and the directions they choose tell us much about where we are headed. With these caveats in mind, I believe that the following examples of art therapy as it is actually practiced, challenge our incessant questioning of art vs. therapy.

Many of the following examples are from the Art Therapy Program at UIC, which seeks to prepare students to work in a wide variety of facilities with many different populations. These students are taught to assess the needs of their clients and to develop art therapy services accordingly. In looking over their work, I am overwhelmed by the amazing diversity they have found in the practice of art therapy. Considering what a young and small profession we are, it is immensely impressive to recog- nize the great variety of populations and needs art therapists serve. (See Wadeson, Art Therapy Practice: Innovative Approaches with Diverse Populations, 2000.) In viewing the work altogether, an interesting picture emerges of art therapy practice today. What is most relevant to the polarization between the clinical and the studio approaches is that most of the work falls neither into one camp nor the other. The burning questions, debates, and contro- versies over art and therapy become meaningless. The reality of art therapy, even as practiced by neophytes, is that at its best it is a flexible medium that can be readily adapted or recreated in situ according to the needs and abilities of its clientele. Sometimes the work of the students was mostly art as therapy. Sometimes insight was encouraged and achieved. Often the sessions embodied both approaches. Frequently art expression was a significant catharsis. Usually it enhanced self-esteem. For groups, it was often a means of communication and socialization.

Examples of Art Therapy Practice

Children And Adolescents

Acculturation

In reviewing the work of over 200 art therapy interns and professionals, I discovered that hardly any of it was strictly insight-oriented. A partial exception might be the work of Sue Lee, who met with Korean adolescents to help them deal with acculturation problems. Kyung was an 18-year-old who had come to the United States at age 10. Her parents discouraged her from making Korean friends because they wanted her to adapt to American culture as quickly as possible. For a long time she actu- ally thought she was “white.” Sue saw Kyung in a group of Korean adolescents who were not verbally expressive and had not had any previous therapy or counseling (Lee, 1993). Kyung drew a self-portrait of herself screaming with her hair half black and half curly blonde. In the middle of her body is her real self, fright- ened and trapped inside. She had tried to transform herself according to her parents’ wishes by coloring and perming her hair and wearing lots of make-up. Subsequently, she realized she would never become white. The others in the art therapy group related to her experience, sharing the stress they felt from parental expectations. Their self-portraits showed a lot of identity confu-

78 CONFRONTING POLARIZATION IN ART THERAPY

sion. The artwork produced significant therapeutic insight and Sue’s own experience as a Korean-American served as a model for the group.

Psychiatric Hospitalization

Work with other groups and individuals, particularly with children and adolescents, was far less insight-oriented. Yet, it was often more focused than a studio approach. In hospital settings, for example, admissions are usually too short to allow for the pos- sibility of art immersion and development. Ruth Evermann, who worked on a psychiatric pediatric ward where patients stayed only 1 or 2 weeks, devised meaningful and often ingenious tasks for the children to meet their particular needs. Rosa, an Hispanic 11- year-old whose parents were substance abusers and whose mother had made a suicide attempt, had also tried to kill herself and threatened to murder a classmate. She insisted that someone inside her was telling her how peaceful death would be. Ruth sug- gested she could make a life-size puppet using plastic bottles, foam padding cut into hands and feet, and decorative material that would look something like herself. Rosa said that was impossible, but as Ruth demonstrated, Rosa began to assemble the parts her- self. She made clothes and jewelry for her puppet and fixed its hair just like her own. She described her puppet as beautiful just like herself. She was discharged the next day and left with her puppet in hand. Rosa related to the puppet as a perception of herself in whom she felt pride instead of feeling an urge towards self- destruction (Evermann, 1994). In this example, directed art activ- ity enabled self-expression and enhanced self-esteem.

Sexual Abuse

Alexandra Elliot-Prisco utilized photography in working with sexually abused children and adolescents. Eleven-year-old Nancy had been molested numerous times by a family member babysitter. Nancy told Alex of her imaginary companions, Dog, Seal, Dolphin, and Kitty, who came to her when she was being abused and made her feel better. Alex entered Nancy’s imaginary world through a multimedia project in order to facilitate com- munication that would feel comfortable to her. Nancy made stand-up paper dolls from Polaroid shots she had Alex take of her in poses she selected. She then made her imaginary friends from self-hardening clay. Nancy enacted an elaborate story of peril and rescue with her figures. Through this multimedia creation, Nancy was able to reenact her trauma, giving herself a heroic outcome with opportunity to ventilate her anger and to feel supported (Elliot-Prisco, 1995).

Medical Illness

A final area I will present in work with children and adoles- cents is art therapy used to deal with medical conditions. Anastasia Limperis worked in a hospital child life program. She found that life-size Styrofoam heads used for holding wigs pro- vided the children with objects to decorate that could be com- pleted in one session and that would produce an impressive result, even by a physically compromised child. The Styrofoam surface allowed both painting and easy attachment of objects. Nancy, age 7, had been admitted for congenital scoliosis. Her spine was in danger of becoming more crooked as she grew, and she had a metal halo drilled into her head to lift its weight and hold it stationary while the vertebrae in her spine were realigned.

The mechanism extended laterally past her shoulders to her waist, keeping her torso in place. She could move her arms only from the elbows. When she saw a Styrofoam head with a crown that Stacey had made, she said she wanted to make one like it. Despite her limited mobility, she said she was having fun making it, though she wanted the face to look sad. She asked Stacey to “sink” the wire into the head, and yelled “Ouch!” when she did so (Limperis, 1996). She spoke of how she had cried when the halo was placed in her head, how much she hated the hospital, and how frightening it was at night. While decorating her head, however, Nancy said that the hospital was not such a bad place after all and that it could even be fun. By working on the Styrofoam head, she controlled the re-creation of a painful and frightening medical procedure. Her final product transformed an imprisoning, painful experience into something poignant and beautiful (Figure 1).

This work with children and adolescents illustrates some unique ways of working. Unlike studio approaches, much of the work was focused by the art therapists to meet the particular needs of the children. As expected in work with children, usually the sessions were not particularly insight-oriented. The work was uniquely what art therapy does best—respond to particular needs in creative ways that are not necessarily easily categorized. Most of the approaches facilitated catharsis, self-expression, and enhanced self-esteem.

Adults

Because adults are better able to assess their own needs than children are, it might be expected that their choices for a studio approach or insight-oriented work would be more pronounced. Especially as the restrictions of managed care have moved art therapy more and more toward social services and nonmedical facilities in general, in other words into work with nonpsychiatric populations, one would expect to see a greater polarization of art therapy into an insight-oriented or studio approach. Although some insights come with catharsis, for the most part the art ther- apy I have reviewed among adults is comparable to the work with children in that it is tailored to unique needs with its goal being

79

Figure 1

WADESON

self-expression and catharsis. Sometimes insight follows, but usu- ally that is not the goal.

Psychiatric Populations

Whereas art therapy for psychiatric inpatients has been severely curtailed due to shortened hospitalizations in recent years, this slack has been taken up by extended art therapy serv- ices at aftercare facilities. Both the quantity and the innovative quality of art therapy for aftercare make work with clients with chronic conditions one of the most interesting growth areas in the profession. Innovations have included utilization of art histo- ry for stimulation, poetry combined with art, photography, and even furniture creations.

Jutta Ohl (1992) used writing in her work at a psychosocial rehabilitation agency and helped the participants publish art/ poetry magazines which they sold. Alex, a 41-year-old man diag- nosed with borderline personality disorder, suffered from asthma and paralysis as well. He had difficulty developing relationships. He expressed his loneliness in the art that illustrated his poetry, such as “Alien to My Own Planet” (Figure 2):

I am an alien to my own Planet, the black coldness Of space and stars’ heat Are closer to me than love. . . . . The horrors of human behavior Often rival the danger of anyone From the worst of our nightmares. We don’t always get what we see. . . . Often before I go to sleep at Night, my own lullaby is one Of visiting aliens in some Field come to whisk me away.

(The Thresholds Lakeview Club, 1991, p. 20)

Other group members admitted to similar feelings and gave him positive feedback, lessening his loneliness and helping him to feel understood and accepted. The participants took great pride in the magazine issues, particularly as they were purchased.

Bettina Thorn (1998) combined writing with photography and art in a photo therapy group she established at a psychosocial rehabilitation facility. The group chose the locations around the city for their “shoots,” with each member encouraged to select at least one. Through photography, art, and writing, members of Bettina’s photo group learned new skills that fostered a sense of mastery and confidence. They increased their socialization, took risks in traveling to unfamiliar places, developed their creativity, and dealt with difficult emotions. All these accomplishments enhanced their self-esteem.

Laura Safar, a psychiatrist who completed art therapy train- ing, established a structured art history-oriented group for chron- ic aftercare clients at a private social service agency whose pro- grams are based on a psychosocial model. She showed slides of work by artists to stimulate interest in art. Most represented peo- ple to encourage expression of interpersonal issues. The clients made art in response, and the group worked on individual proj- ects using images from art books as catalysts. The final session was a slide show of a selection of the clients’ art with commen- tary by them on their creative processes. Figure 3, inspired by a Vigée-Lebrun painting, was made by Rose, a 52-year-old woman diagnosed with schizoaffective disorder. It is a self-portrait with her daughter leaning on her shoulder. Her daughter lives too far

away to see very often, and Rose said that painting her image was a way of being with her. Previously, Rose had seldom drawn peo- ple. Rather than daunting them with their originality and tech- nical excellence, art by famous artists stimulated the group mem- bers’ interest in art and encouraged their creativity. The message

80 CONFRONTING POLARIZATION IN ART THERAPY

Figure 2

Figure 3

Laura was giving her clients was that they could identify with the themes of the artists, which could stimulate their own creative expression (Safar, 1998). Although utilizing art of famous artists might seem to foster noninsightful or even nonpersonal art, in fact participants in Laura’s group used the art to deal with very personal issues.

Work with the psychiatric aftercare population of chronic patients is an especially fertile field for art therapy. In many pro- grams where clients spend most of the day several days a week, art therapy is a major part of the programming. The benefits of sus- tained artmaking are often labeled “art as therapy.” This catego- rization is too limited.

Domestic Violence

Stephanie Haddon, in her work with residents in a shelter for battered women, recognized their need to express their rage. They wanted to invite a man to their art therapy group, presum- ably to find out what made him abuse a woman. Men were not allowed in the shelter, so Stephanie made a life-size papier maché man on which they could vent their feelings. They added “a big red mouth for all the lies he tells,” a question mark at the top to ask if he has a brain, a papier maché dagger stuck in the ribs made by a woman who considered homicide before escaping her abus- er, a black heart for his evil, a chain in his hand for his need to control his wife, muscles for physical strength, and boxing gloves for his propensity to fight. “I love you” and “mine” are written in balloons to indicate jealousy. A woman who seldom spoke in the group made a wire and papier maché penis that she painted red for blood and attached it, saying, “That’s what he did to me” (Haddon, 1989; Wadeson, 2000, p. 307). Afterwards, she told the group over and over how great she felt. The shared catharsis was intense, empowering, and generally beneficial to the women.

Prostitution

Beth Black worked in a shelter for prostitutes who were try- ing to get out of prostitution. All had substance abuse problems as well as a history of sexual abuse. Her clients were extremely resistant to revealing themselves in art. They did not show up for their sessions. Recognizing that loss of childhood was a common theme, Beth worked on creating a doll from her own childhood. She made a stuffed cat from an old sock and left it in the studio. Gwen, 46, a shelter resident, asked Beth to show her how to make a doll, and in a few minutes all five women present were busy making dolls. The dolls’ significance to issues of childhood, mothering, nurturing, and femininity broke down barriers of dis- trust and competition. The women shared supplies, patterns, ideas, and help. The soft fabric objects allowed the women an opportunity to show their tender, caring sides without feeling ashamed or intimidated. They spoke of and to their dolls tender- ly, carried them on their shoulders and placed them in their laps, telling stories of their childhood and expressing their feelings about body image. Gwen had attended only one of her individ- ual art therapy sessions previously, always making excuses not to come. She spent 4 hours making her doll, talking to it as herself as she worked on it:

Now Gwen, your legs are too thin…you’re acting like a whore… you need to put some clothes on….The only thing I’ve ever com- pleted in my life was a good high. Now I’ve completed this doll and I am proud of it….It’s the first time in my life I’ve ever done any-

thing artistic. I never thought I could. (Black, 1994; Wadeson, 2000, pp. 299-300)

Beth connected with the women initially through her own art. Working together gave the group the feeling of a traditional quilting bee, hardly the usual activity for women who have engaged in prostitution.

AIDS

William Kasser developed a unique project for people who had been discharged from the hospital and were living with AIDS. The success of new protease inhibitors was changing the challenge of AIDS treatment from helping people to die to help- ing them to live with their extensive medical regimens. As a part of that effort, William visited the homes of AIDS survivors, video camera in hand. He helped them to record a day in their lives. The distancing of the video offered an opportunity for life reflec- tion, both during the shoot and upon viewing it afterwards. The project was begun with a discussion and then the development of a storyboard (Figure 4). William took direction from the partici- pants, shooting what they designated in the way they wished, or they shot some scenes themselves. After the shooting they added either voice-over or music (Kasser, 1998). The relationship these men developed with William as he entered their lives by helping them to portray their experience was a very important part of his work with them.

Homelessness

Art therapy is a central activity in working with homeless women at several associated shelters where it is practiced very dif- ferently from the more structured sessions seen in other kinds of facilities. Art therapy can happen in open areas at any time dur- ing the day for as long or as short a period of time as there is interest. There are no art therapy sessions as such. Suzanne Canby (1992) observes that often the nature of the interaction between the art therapist and the women is something like “parallel play,” in which the art therapist may sit at a table with a woman mak- ing her own art and/or chatting. An example of an evolving group project is a hand mural. An art therapist traced her hand and arm on several places of a large sheet of brown butcher paper, which aroused no interest for several days. Then a few more peo- ple added their hands and colored in the outlines. Each day it

81

Figure 4

WADESON

gathered several more hands. Women would ask each other if their hands were on it and if they could identify them. Eventually the mural was hung in a prominent place, where it engendered further interaction (Figure 5).

Jean Durkin (personal communication), who established art therapy at the shelters, led the women in making public art as well, including a large mural on the outside of their building and a large banner on the rights of women, which they unfurled at a social justice demonstration. Working in a shelter with homeless women is a challenge. Many of them abuse drugs constantly and are in poor physical health. They come to a shelter to get out of the cold, to have a meal, to get some rest. They are not seeking therapy. Yet art therapists have seen how these women may be reached through art. For this population, art therapy can provide support, understanding, connection, self-expression, and a cre- ative outlet. Jean Durkin makes it a public statement as well.

Older Adults

Another nonpsychiatric population long served by art ther- apy is older adults, both in day programs and in residential care. MaLinda Johnson (1998) offered some unique three-dimensional projects to the elderly day care clients with whom she worked. David, 52, had suffered a cerebral contusion from an accident that resulted in compromised cognitive abilities, aphasia, weak- ness of the extremities, and the end of his career as a teacher. He was reluctant to participate in drawing and remained on the side- lines observing the group. Prior to Halloween, MaLinda intro- duced a cheesecloth and fabric stiffener ghost project. The tactile nature of the materials engaged him in his creation as he mas- saged the stiffener into the fabric over a rounded form. He dropped his usual passivity and interacted playfully with his whimsical cheesecloth ghost.

Even Alzheimer’s patients can muster some creativity in working with tantalizing materials. Deborah Ruland’s (1998) nursing home clients were given a piece of paper with a circle on it and seeds to glue onto it. Most filled the circle, but Jenny made hers into a face. In the various stages of Alzheimer’s disease, patients need more and more structure and assistance as the dis- ease progresses. This work is not in the least insight-oriented. Usually the goals are self-esteem and mastery.

Developmental Delay

A final nonpsychiatric population successfully served by art therapy is the developmentally delayed. Obviously, insight- oriented work is not possible for many of these clients. Since structure is often necessary, an open studio approach is not usu- ally effective either. Nevertheless, the developmentally delayed have benefited from art therapy in various forms, such as muse- um trips to stimulate artmaking, puppet making, mask making, sensory stimulation projects, and book making (Wadeson, 2000). The most amazing project I have seen in work with the develop- mentally delayed population is The Belles of St. Mary, an animat- ed film created by Monica Dougherty (1991) and four residents of St. Mary’s of Providence, a school and residence for severely developmentally delayed women. The women who worked on the film had spent most of their lives at St. Mary’s. The com- plexity of film animation, the necessary planning, teamwork, technical skill, and perseverance are beyond the capacity of many art therapy groups, much less those with neurological and insti- tutional impairment. Over the 6 months of the project, all learned

to operate the camera and set up the animation area. They decid- ed to show a day in their lives over the four seasons and created images of themselves that they dressed in various outfits and placed against drawings of their surroundings. I was truly amazed at how charming the film is. The women worked as a team to tell their story in their own personal images and to produce a docu- mentary of which they can be proud, judged by any standards. There is much to be learned about limitations and transcending them in this project.

Most of the work with these nonpsychiatric populations is neither insight-oriented (i.e., “art psychotherapy”) or a studio approach, in which artists freely explore their own artmaking, (i.e., “art as therapy”).

These have been but a few examples culled from the many I reviewed. I hope they give a sense of the innovation and broad diversity in current art therapy practice.

Discussion

My intention has been to present a broad spectrum of what art therapists are actually doing with diverse populations. Except for day treatment programs for chronic clients and in schools, there is little opportunity for the long-term work of a psychoan- alytic model that lent itself to the sort of in-depth exploration that Margaret Naumburg described in her books. The specific populations and the kinds of facilities that provide them art ther- apy services tend to encourage more focused work than a typical studio approach. Although chronic clients may attend art thera- py sessions several times a week for years so that many develop a real investment in their art, art groups are often focused on use of particular materials, themes, or goals oriented toward specified areas of growth. Both short- and long-term work that is neither

82 CONFRONTING POLARIZATION IN ART THERAPY

Figure 5

strictly studio nor insight-oriented in its approach nevertheless demonstrates a great deal of creativity on the part of art therapists in devising structures to bring out the best in their clients.

So why does our profession seem to be in an endless con- troversy over art vs. therapy, clinical work vs. a studio approach? I believe the manifest content hides more relevant issues beneath the surface.

Inadequacy

First of all, those who push for licensure are eager for art therapy to receive the recognition and respect accorded other mental health professions. They see licensure as the ticket for increased job opportunities, higher financial remuneration, and respect among the service hierarchies. On the other hand, I have found many art therapists to be far more comfortable in the art realm of their work than in the therapy realm. Nevertheless, most work in service settings, medical, educational, or social settings, rather than in art settings. Art therapists often find themselves near the bottom of these hierarchies. Colleagues in such facilities may have more training and more prestigious degrees. Psychological language and interventions are often the currency of the realm. In such settings, however, art therapists are usually the experts in art. Therefore, there may be political reasons for emphasizing the artist identity. In addition, it goes without say- ing that many art therapists came to this profession as a result of finding their own artmaking therapeutic.

It has seemed to me that the recent vehemence regarding the advocacy of a studio approach has had a defensive quality about it. There appears to be a fear that in our strenuous striving for licensure we will lose the art part of our identity. Understandably, some of our practitioners do not want to jump through the hoops that licensure requires. To qualify their graduates, art therapy training programs have had to tailor curricula to meet nonart therapy criteria, and individuals have had to take the required courses, get the many hours of qualified supervision, and study for the licensing exam. Artists are valued for their creative pro- ductions, rather than for their training and credentials that may entail what seems like irrelevant busy work at considerable finan- cial expense. So we assert our artist identity and stave off ques- tions and criteria for proving clinical competency.

Power

A current in our sea of conflict that is more difficult to dis- cern is the struggle for power within the profession. Having been a member of AATA since its inception in 1969, I have been appalled at the bitterness I have witnessed at certain moments in our history. I can remember one prominent member accusing another publicly of being a Nazi. I recall board meetings fraught with factionalism. As chair of the Ethics and Professional Practice Committee, I had the unhappy responsibility of moderating accusations of libel between prominent members who had given much to our profession. During one of our darkest hours when there was controversy over establishing AATA’s journal, I asked our parliamentarian, who worked for a number of professional societies, if other associations carried on as ours did. She respond- ed that others were not so vicious!

What drives the power struggle among opposing forces within AATA, whether framed as art vs. therapy or studio vs. clin- ical? I have heard it said of academic politics that they are so vicious because there is so little at stake! Art therapy may be com-

parable in that many of us have had to fight hard for what little we have: low pay, minimal understanding of our work, slow advancement in our careers. We have sharpened our claws in the long hard climb to gain recognition. We have had to become assertive, maybe aggressive. Having fought so hard, are we so overly protective of our small pieces of turf that we continue to fight each other for control of our profession? Are we still trying to claw our way up, even gouging each other?

Richness in Diversity

There is concern about AATA’s decreasing membership numbers. Perhaps some have left out of discouragement with our political wrangling. I believe that the time has come for us to put aside our internal (and eternal) bickering and to recognize that one of our greatest strengths as a profession is our enormous cre- ativity. It enables us to minister to a large diversity of populations in many different kinds of settings. Our flexibility in recognizing the various kinds of needs that art therapists face among our clientele and our creative adaptations in developing the unique and innovative ways of working with them, such as I have pre- sented here, are strengths we should foster. This is unlikely to happen as long as we continue forming into factions that imply a criticism of ways of working that are different from our own.

Implications for Training

Clearly, art therapists in training need to be taught to work with a variety of populations in different kinds of settings. A two- year Master’s degree program cannot cover every possible popu- lation. Therefore, students need to learn how to be adaptable and creative in designing art therapy services. In my own teaching, my challenge is not teaching students what to think, but how to think, how to evaluate the needs of their clients and to meet them creatively. I hope the examples presented here show evidence of the creativity and resourcefulness that students and professionals used in meeting the varied needs of the different populations with whom they worked.

Conclusion

In Zen there is the concept of “beginner’s mind.” Most of the examples of the rich diversity in art therapy presented here have been the work of beginners. They approach the work with innocence and awe. Those of us who are seasoned art therapists might do well to learn from them to appreciate the wealth of needs and creative possibilities our exciting profession offers us. We are at our best when we exercise our abundant creativity. We are at our worst in our petty fighting among ourselves.

References Allen, P. (1992). Artist in residence: An alternative to “clinification” for

art therapists. Art Therapy: Journal of the American Art Therapy Association, 9(1), 22-29.

Allen, P. (1995). Coyote comes in from the cold: The evolution of the open studio concept. Art Therapy: Journal of the American Art Therapy Association, 12(3), 161-166.

Black, C. (1994). The art of survival: Art therapy with women recovering from prostitution. Unpublished master’s thesis, University of Illinois at Chicago.

83WADESON

84 CONFRONTING POLARIZATION IN ART THERAPY

Canby, S. (1992). Shelter art: Is it therapy? Unpublished master’s thesis, University of Illinois at Chicago.

Dougherty, M. (1991). Lights, camera, action! The therapeutic use of film animation with the developmentally disabled. Unpublished master’s the- sis, University of Illinois at Chicago.

Elliot-Prisco, A. (1995). Through the viewfinder: Focus on the ego of sexu- ally assaulted females. Unpublished master’s thesis, University of Illinois at Chicago.

Everman, R. (1994). Enabling relatedness through creative art intervention with psychotic children. Unpublished master’s thesis, University of Illinois at Chicago.

Haddon, S. (1989). Empowering battered women through art therapy. Unpublished master’s thesis, University of Illinois at Chicago.

Henley, D. (1995). A consideration of the studio as therapeutic inter- vention. Art Therapy: Journal of the American Art Therapy Association, 12(3), 188-190.

Junge, M. B. (with Asawa, P. P.). (1994). A history of art therapy in the United States. Mundelein, IL: The American Art Therapy Association.

Johnson, M. K. (1998). Three-dimensional art therapy as sensory stimula- tion for adult day-care clients. Unpublished master’s thesis, University of Illinois at Chicago.

Kasser, W. (1998). Video journals: Images and HIV. Unpublished master’s thesis, University of Illinois at Chicago.

Kramer, E. (1958). Art in a children’s community. New York: Charles C Thomas Publisher, Ltd.

Lee, S. (1993). Art therapy as a third language for adolescent Korean- American immigrants. Unpublished master’s thesis, University of Illinois at Chicago.

Limperis, A. (1996). Making headway: The use of pre-molded anthropo- morphic Styrofoam heads in a short-term pediatric setting. Unpublished master’s thesis, University of Illinois at Chicago.

McNiff, S. (1955). Keeping the studio. Art Therapy: Journal of the American Art Therapy Association, 12(3), 179-183.

Moon, B. (1998). The dynamics of art as therapy with adolescents. Springfield, IL: Charles C Thomas Publisher, Ltd.

Naumburg, M. (1966). Dynamically oriented art therapy: Its principles and practice. New York: Grune & Stratton.

Ohl, J. (1992). Let the public share my pain and joy: Published works by mentally ill adults. Unpublished master’s thesis, University of Illinois at Chicago.

Rubin, J. (1999). Art therapy: An introduction, Philadelphia: Brunner/ Mazel.

Rugland, H. (1999). Sparking creativity: Using guided imagery to stimu- late self-expression for behavior disordered children and adolescents. Unpublished master’s thesis, University of Illinois at Chicago.

Stoll, B. (1995). Report from the president. AATA Newsletter, XXVIII (3), 1-2.

Safar, L. (1998). The utilization of art slides and books in group art thera- py with chronic clients. Unpublished master’s thesis, University of Illinois at Chicago.

Thorn, B. (1998). Picture this: Phototherapy with chronic mentally ill adults. Unpublished master’s thesis, University of Illinois at Chicago.

Wadeson, H. (2000). Art therapy practice: Innovative approaches with diverse populations. New York: John Wiley & Sons.