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Artful Therapy

Judith Aron Rubin

John Wiley & Sons, Inc.

Artful Therapy
Artful Therapy

Judith Aron Rubin

John Wiley & Sons, Inc.

This book is printed on acid-free paper. o
Copyright © 2005 by John Wiley & Sons, Inc. All rights reserved.
Published by John Wiley & Sons, Inc., Hoboken, New Jersey.
Published simultaneously in Canada.
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Library of Congress Cataloging-in-Publication Data:

Rubin, Judith Aron

Artful therapy / Judith A. Rubin
p. cm.
ISBN 0-471-67794-9 (paper/dvd)
1. Art therapy. I. Title.
RC489.A7R833 2005
615.8'5156—dc22
2004057102
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
 Contents

Illustrations xv
DVD Contents xviii
Acknowledgments xxxvi
Preface xliii

Chapter 1 Overview 1
Background 1
A Psychiatric Hospital 1
A Child Study Center 3
An Institution for Disabled Children 3
A Child Guidance Center 4
Consultation to Other Institutions 5
Where Can You Use Art? 7
When Can You Use Art? 10
With Whom Can You Use Art? 10
Children of All Ages 12
Adults Young and Old 12
People Who Are Resistant and Suspicious 13
People with Developmental Delays 13
People with Communication Problems 13
People with Eating Disorders and Substance Abuse Problems 14
Victims of Abuse 15
People with Dissociative Identity Disorder (Multiple Personality
Disorder) 15
People with Medical Problems 16
People Who Are Bereaved 17
The Purpose of This Book 17

v
 Artful Therapy

Chapter 2 Why Add Art? 20

Art Is a Natural Way to Communicate 21
Making Art Relieves Tension 22
Much of Our Thinking Is Visual 22
A Picture Is Worth a Thousand Words 23
The Magic Power of the Image 23
Some Things Are Easier to “Say” in Art 24
Overwhelming Affects 24
Preverbal and Forbidden Memories 25
The Dark Side 25
Complex Feelings and Situations 27
In Art, Everyone Can Talk at Once 27
Some Things Are Easier to “See” in Art 28
Art Tends to Accelerate Therapy 29
Art Can Overcome Treatment Impasses 30
Hannah Reveals Her Secrets 30
Art Reduces Self-Consciousness 31
Art Is Concrete and Lasting 32
Art Enhances Integration 32
What Next? 32

Chapter 3 Inviting Art-Making 34

Getting Started 34
Buying Supplies 34
The Importance of Quality 34
The Importance of Choice 36
Basic Art Materials 37
Setting Things Up 38
Working Surfaces 38
Displaying Art Materials 38
Storing Art Materials 40
Cleaning Up 41
Learning by Using Art Materials 41
Introducing Art to Patients 42
Making a Good Case for Art 43
Reducing Anxiety 44
Deciding What to Do 45
Clarifying Your Goals 45
Diagnostic 45
Therapeutic 45
The Elements Available in Art 46
The Medium 46
The Theme 46
The Manner 47

vi
 Contents

Making Sure They Understand the Task 47

What about Resistant Patients? 48
What Next? 50

Chapter 4 During the Process 51

While People Work 51
Looking: How to Observe 51
Taking Notes 52
Decision Making 53
Interaction with You 53
Reaction to Materials and Task 54
Creativity 54
Activity 56
Body Language 56
Changes in the Art during the Process 56
Sequences 57
Modifications 57
Rose: A Story in Finger Paint 58
Ellen: A Drama in Clay 59
Mrs. Lord: A Narrative in Acrylic 61
Projection Works Both Ways 63
Listening: How to Attend 63
To Talk or Not to Talk? 63
To Do or Not to Do? 64
Conclusion 65

Chapter 5 After the Process 67

Doing and Reflecting 67
Nonverbal Reflections 67
Verbal Reflections 67
A Title 67
Writing 68
Interviewing 68
What Was It Like? 69
Framing 69
Looking Intently 70
What Do You See? 70
Open-Ended Questions 70
Requesting and Extending Associations 71
Creative Interviewing 72
What about “Why” Questions? 73
“What Does it Mean?” 73
Self-Assessment 73
Dealing with Patient Art 74

vii
 Artful Therapy

The Art Is the Person 74

Receiving Artwork Respectfully 75
Storing Patient Art 76
Displaying Patient Art 76
“Outsider Art” 78
Discovering Art as Therapy 79
Sharing Patient Art 79
With Family 79
With Professionals 80
Ownership and Disposition of Patient Art 82
Conclusion 83

Chapter 6 Using Art in Assessment 84

Projective Techniques 84
Responding to Visual Stimuli 85
Selecting 86
Arranging 87
Giving Meaning 87
Magazine Photo Collage 88
Finding and Creating Projective Stimuli 89
Projective Drawings 89
Themes 91
A Person 91
A Family 91
Standardization in Drawing Tasks 93
Enriching Projective Drawings 93
Expanding Projective Drawings 95
Conclusion 96

Chapter 7 Art Therapy Assessments 100

Introduction 100
Unstructured and Semistructured Interviews 100
Free Choice 100
Three Media 101
Visual Starters 102
Dots, Lines, and Shapes 102
Egg and Cave Drawings 103
Squiggles and Scribbles 103
The Squiggle Game (Winnicott) 104
The Scribble Drawing (Cane) 104
Requesting a Scribble Drawing 104
Stimulus Drawings 105
Some Individual Assessments 106
Brief Art Therapy Screening Evaluation 106

viii
 Contents

A Person Picking an Apple from a Tree 107

Life Line 107
Past, Present, and Future 108
Life Space 108
Art Assessment Batteries 108
Family Photographs and Videotapes 110
Understanding Kitty via Video 110
What Can You Learn from Art? 111
Art and Psychopathology 111
Judging Psychopathology from Art 112
Phenomenological Understanding 112
Creating Reveals Capacities 113

Chapter 8 Art in Adult Therapy 114

Introduction 114
Inviting Patients to Make Art 115
Free Expression 115
Topics and Themes 116
Traumatic Memories 117
Drawing on the Dialogue 118
Different Approaches to Using Art 119
General Issues 119
Psychodynamic/Analytic 120
Humanistic/Transpersonal 122
Developmental 123
Cognitive-Behavioral 125
Systemic/Solution-Focused/Narrative 125
Eclectic/Integrative 126
The Role of Art over Time 126
Stages in Psychotherapy 126
How Art Helps at Different Stages 127
Beginning Phase 127
Middle Phase 127
Ending Phase 128
Conclusion 130

Chapter 9 Art in Child Therapy 131

Introduction 131
Art Supplies for Child Therapy 131
Papers 132
Things to Draw With 132
Pencils 132
Crayons 132
Chalk and Pastels 132

ix
 Artful Therapy

Markers 133
Things to Paint With 133
Tempera 133
Water Colors 133
Finger Paints 134
Brushes 134
Things to Model With 135
Plasticine 135
Earth Clay 135
Synthetic Modeling Media 135
Modeling Dough 135
Papier Mâché 135
Tools and Bases 136
Things to Construct With 136
Two-Dimensional 136
Three-Dimensional 137
Working Surfaces 137
Tables 137
Easels 137
Cleanup Issues 138
Smocks 138
Sinks 138
Setting Things Up 138
Introducing Art to Children 139
Inviting Participation 139
Reluctant Children 140
Adolescents 140
The Importance of Choice 141
Special Considerations for Work with Children 142
Freedom and Limits 142
Looking at Children’s Art Developmentally 144
Temporary Regression 147
Conclusion 148

Chapter 10 Art in Family and Group Therapy 149

Introduction 149
Family Art Evaluation 149
Kwiatkowska 149
Rubin and Magnussen 150
Scribble Drawings 150
Family Representations 151
Family Mural 151
Modifications by Study Group Members 152
Landgarten 152

x
 Contents

Art Therapy with Couples 153

Wadeson 153
Nonverbal Joint Drawing 153
Abstract of the Marital Relationship 154
Self-Portrait Given to Spouse 154
Occasional Family Art Sessions 154
Designing Family Art Activities 155
During Assessment 157
Billy and His Mother 157
During Therapy 157
Chip and His Mother 157
Laura and Her Family 158
Bring Art to Mother 159
Family Art Therapy 159
Occasional Art Sessions in Family Therapy 160
Occasional Art Sessions in Couple Therapy 160
Multifamily Art Therapy 161
Seeing More Clearly through Art 161
Art in Group Therapy 162
Warming Up 162
Introductions 164
Art during Group Therapy 164
Art Activities 164
Pictures of the Group 167
Conclusion 167

Chapter 11 Using Other Art Forms 168

Why Other Art Forms? 168
Mixing Modalities in Treatment 168
Carla’s Story: Expressive Arts Therapy 169
Variations on the Visual Arts 172
Sandplay Therapy 172
Phototherapy 173
Amy: Panic and Polaroids 173
Some Other Uses of Photography in Therapy 174
Film and Video Therapy 174
Isaac: Filmmaking as Therapy 176
Creative Uses of Language 176
Drama Therapy 176
Creative Writing Therapy 178
Sam’s Halloween Story 178
Eleanor’s Sad Tale 179
Andy’s Alienated Poetry 180
Sally’s Writings about Change 181

xi
 Artful Therapy

A Patient’s Reflections on Writing and Art 184

Music and Movement Therapy 186
Conclusion 187

Chapter 12 Using Mental Imagery 189

Why Mental Imagery? 189
History: Imagery in Therapy 191
Personal History: Imagery in Therapy 192
Images on the Couch 192
A Study of Spontaneous Imagery 192
Ways of Using Imagery in Therapy 193
Spontaneous Imagery 193
A Series of Images 194
Inquiring about Imagery 194
Requesting Specific Images 196
Guided Imagery 196
Imagery in Cognitive-Behavioral Therapy 197
Imagery in Alternative Medicine 197
Mental Imagery and Art 198
The Don Jones Assessment 199
Free Association in Art Imagery 199
Hypnosis and Imagery 200
Meditation and Imagery 201
Using Your Own Imagery 201
Conclusion 202

Chapter 13 Assigning the Arts 204

Introduction 204
Assigning the Arts as Homework 204
Books 205
Films 207
Television 208
Theater 209
Music 210
Art and Photography 210
Patient Recommendations 212
Creating at Home 213
Creations Brought from Home 213
Creating as Homework 214
Prescribing the Arts as Therapy 215
Why the Arts Are Therapeutic 216
Grandma Layton: An Art Class Cures Depression 217
Conclusion 218

xii
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