Posted: Tuesday 27 September 2011
This is a guest post from Laura, as part of our series of blogs to celebrate the arts exhibition and festival Mindful and our new creative therapies fund.
I would be lying if I said I was enthusiastic about art therapy in the first instance. The assessment came after my fourth referral to the mental health services. Aged twenty-one, I had seen a string of therapists and psychiatrists and had unsuccessfully attempted to manage my diagnoses of anxiety, depression and borderline personality disorder without intervention.
I was disillusioned with the idea of therapy. I had pinned so many hopes on it in the past but had never been able to maintain a stable recovery once the therapy had ended.
I saw my referral to art therapy as a ‘soft option’ – I thought they were offering it to me because I was a difficult case and that after several referrals back to the community mental health team (CMHT) they didn’t know what to do with me.
Having said this, I knew that I needed to at least try; I have had enough experience of therapy to know that if you don’t make the effort to engage with it then there is little point in going.
I tried to go into my first session with an open mind. I found the assessment quite odd. In most assessments for therapy you end up explaining your life history, in this one there was very little discussion; instead I had to draw a story while the therapist gave me loose guidelines ‘draw your main character’, ‘draw their job’ etc. I was frustrated after the assessment. I just wanted to talk to someone. I didn’t want to draw pictures.
I had enjoyed art at school and had found it to be quite therapeutic. I expected to click with art therapy straight away, but it did not work that way for me. For the first few weeks, there was very little talk. I would begin to say how I was feeling but felt that the therapist cut me off and wanted me to get on with some art work, which made me feel like my problems were not worth listening to.
I enjoyed making pictures but did not feel that it was of any real benefit to my mental health. The turning point came when I managed to explain my frustrations to my therapist. I told her that I wanted to talk more, either before or during the art making, and that I wanted her to sit with me, rather than moving to the other side of the room to give me space. She took all of this on board and as she started to get to know me better adapted her method to suit me.
From there, I began to look forward to my sessions and started to trust my therapist more. As the weeks went by I started to feel safer and more able to talk about very difficult things. My therapist started to sit next to me as I made pictures and didn’t push me to start art making if I was happier talking instead. The new understanding between us really helped me start to appreciate and engage with the therapy.
The art psychotherapy room is now a very safe place for me; it reminds me of a small art classroom and I like that you can use any materials you choose: things are not locked away like they are at school.
There are, for me, two key differences between art therapy and an art class. First, you don’t have to have any artistic skill as the point is not to make a pretty picture, but to express emotion, and second, you are not told what to make or which materials to use.
My therapist will ask me if I want to make a picture and then let me choose whichever materials I want, to make any image I can think of. As the therapy has gone on I have got better at ‘drawing how I feel’, which initially seemed quite impossible.
My therapist works in quite a traditional, psychodynamic way; she is often focused on my childhood and the dynamics of my family, which can sometimes feel like she is looking for something that isn’t there, especially when she is analysing my pictures. However I’m sure that many others will agree that this is by no means exclusive to art therapists!
Art therapy would not suit everyone: if you don’t like making pictures then it probably isn’t for you. I wasn’t sure whether it would suit me and at the start was convinced that it didn’t, but like any other therapy the key to getting it right is communication.
Once I had told my therapist what I did and didn’t like, she was able to adapt the therapy to suit me. I now understand that is not a ‘soft’ therapy, but simply a way of adding an extra medium for people who can struggle to explain their feelings.
One of the dissatisfactions I continue to have with art therapy is that it is not helping me to get better in the sense that I still think and act in an unhealthy way.
I am, though, starting to understand why I think and feel certain things, which I hope will eventually bring me to a place where I no longer need to harm myself. For now, the main benefit I get from art therapy is a sense of calm, a chance to look deeper into my feelings and a way of discussing and expressing the difficulties I have in a safe environment.
Laura, @landslidegirl
I found your experience really interesting, Laura. Along with my husband, who is a psychologist and artist, now retired, we used to run 'team' workshops getting people to paint mindscapes - portraits of their minds. This was not meant to be therapy, but often seemed to have a therapeutic effect and everybody who attended the workshop - some of whom had never touched a paintbrush in their lives - succeeded in painting their mindscape and in sharing their narrative about it with the group. It helped people to understand themselves and others better, thus, hopefully, enhancing empathy and reducing prejudice. Best wishes to youl
I appreciate the value of art therapy - but we also need access to art/music/dance/drama classes without the therapy component because all arts are therapeutic in themselves and for some people the word 'therapy' can be off putting, they just want to do it without any therapeutic 'process' or for that process to be in their own way. I remember many years ago in hospital that out of all OT, the class everyone flocked to even in their nightwear was a yoga class with an outside yoga teacher. People wanted to do it because it wasn't viewed from behind a two-way mirror, because it was an ordinary teacher who taught anyone at a yoga centre outside, because that teacher didn't write a report on participants or assess them.
I wouldn't want to see all arts only ever available to mental health service users within services if they only have 'therapy' after it.
I also grates that arts have to be so 'evidence based' in research with specific outcome measures. Most people enjoy some art form, even if it's only listening to the radio or watching tv, that enjoyment doesn't need an evidence base and how can much art even be evidenced? You either like a piece of music or visual art or you don't, and maybe you feel better for listening to it or looking at it without it making any difference to your progress in terms of service defined "recovery". If it feels good - do it!
Hi Mindreader,
I appreciate what you are saying and it is certainly true that the arts in themselves can be beneficial to mental wellbeing. In my earliest depression when I was still at school I found the art room a safe haven for me to express myself. But ultimately the point of doing art at school was to pass an exam, and the point of many arts-based groups is to create a good product at the end, whether it is a good play that people will pay to watch or a good piece of music that people will want to listen to. So even though joining arts groups provided by outside agencies (e.g. dramatic societies, art clubs), which are not provided with people in mental distress in mind, might have some benefit, it might also cause anxiety.
From what I understand of the groups you describe they are provided in hospital settings for inpatients, so would be geared to avoid any anxiety caused by more professional groups. I have never been hospitalised, even though at some points I have needed to be but the facilities have been unavailable. But I can say from the experiences of friends that classes like yoga and art are certainly beneficial to patients' wellbeing and can be a great source of stress-release. It is important to remember, though, that such groups are provided alongside other services which would involve therapy, though probably not arts-based. So yes, the arts groups alone might be useful, but they aren't likely to be the only intervention patients are receiving. For me, I am an outpatient with my CMHT and art therapy is the only service I am currently using. If I was purely looking for art group because I enjoy art then obviously I wouldn't look to the mental health services to provide it. The reason I have stuck with art therapy provided by the CMHT is because of the value of the therapist, as someone to talk to and as someone to offer advice to me. The art work is, at least to me, a secondary resource when compared to the therapist.
Best wishes, Laura
I'm all for art therapy-thing is the finished product should be kept by the person who created it rather than 'filed' by the therapist to be sold at a later date at boot fares (only joking!)
Hi Laura & Linda, yes all valid points, I believe most things have a place - arts therapy [but I agree with you Linda that the end product must belong to the creator], arts without the therapy, or in professional groups or adult education, and also arts within mental health settings with and without therapy. I'd also like to see more support for survivor artists to create and use their work but Arts Council funding apps are worse than some mental health assessments! I think the stat and vol sector could do a lot more to support this, even something as simple as access to a room for a finite period of time to complete something. A lot of work doesn't get produced simply because the person can't face a paper mountain or can't secure a charity to receive even a small amount of funding - which charities should do.
My first experience of NHS in-patient art therapy was being sat in a room with two simpering women who talked to me as if I was five years old. I was then instructed to make a gift box using their sickly frilly flowery embellishments, which I did, all the while trying to avoid difficult questions from the 'therapists' such as "so why are you in here then?" I was then requested to pay for the materials I had used. Given I'd spent every last penny prior to my admission on drugs and alcohol to try to top myself, I couldn't pay anything. When I protested that I wouldn't have used the stuff if I'd known I had to pay for it, I got tuts, eye-rolls, sharp intakes of breath and disparaging comments, probably with reports back to my psychiatrist when I wasn't looking.
Funnily enough, I never went for art therapy in that hospital again.
The next bin I was in left me to my own devices and I was a constant resident in the art room when it wasn't being used, with staff just checking in on me at obs times. Much more useful to me to not be treated like a child and have everything I did or said overanalysed.
Arts therapy is fine if you're better at drawing your feelings than talking about them for example, but there's a huge difference between a therapy and carrying out an activity for the pleasure of doing it, and I think they should be kept separate.
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