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To cite this article: Theresa Van Lith (2015) Art Making as a Mental Health Recovery Tool for Change and Coping, Art Therapy:
Journal of the American Art Therapy Association, 32:1, 5-12, DOI: 10.1080/07421656.2015.992826
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Art Therapy: Journal of the American Art Therapy Association, 32(1) pp. 512, AATA, Inc. 2015
articles
Art Making as a Mental Health Recovery Tool for Change
and Coping
maintain a functioning lifestyle (Greenwood, Leach, focus on personal growth (Anthony, 1993; Deegan, 1988,
Lucock, & Noble, 2007). For example, Greenwoods 2005). Participants had widely different degrees of interest
(2011) case study found that over the course of 6 years of and experience in art making, ranging from no interest in
art therapy the continuous use of self-expression allowed a art before the onset of illness to regularly creating and
client to resolve deeply entrenched attachment issues. exhibiting artworks. In order for participants to be able to
Reported changes remained 3 years post art therapy. Green- locate themselves in any research publication they were
wood posited that long-term change was due to the clients asked to create their own pseudonyms.
focused engagement and processing of repressed feelings,
which altered implicit memory and helped to reform new Procedures
neural pathways.
Relationship building through art making also occurs A longitudinal, multiple case study was used as the
when clients in mental health care engage with others in study design. Data collection involved three interviews with
art-based group therapy (B. L. Green, Wehling, & Talsky, each of the 12 participants at 6-month intervals over the
1987; Korlin, Nyback, & Goldberg, 2000). The nonverbal course of 1 year. Each of the three interviews began by ask-
component of art making assists with human relating and ing the participant to complete a recovery assessment (Ridg-
communication processes in indirect ways (P. B. Allen, way, 2005) followed by an open-ended conversation. The
2008; Czamanski-Cohen, 2010; Feen-Calligan, Washing- interview focused on the participants experience of art
ton, & Moxley, 2008). For example, clients often work on making and engaging in symbolic meaning making, which
their own while also making art alongside others (McNeilly, was facilitated by reecting with the investigator on art-
2006). This combination of individual and communal works completed in an art therapy program during the pre-
focus can lead to informal and safe social relating, allowing vious 6 months. Betenskys (1995) phenomenological
even for small communications (e.g., I like your drawing) approach based in symbolic art expression and Barrys
that validate the maker. A social identity may form through (1996) application of symbolic constructivism were used to
feeling a sense of belonging to a particular group. For many frame the interviews (Table 1). Each interview lasted
clients this experience helps overcome stigma and discrimi- approximately 1.5 hours.
natory beliefs that impact their sense of identity (Howells After all of the interviews were completed and tran-
& Zelnik, 2009). scribed, an interpretative phenomenological analysis was
I sought to contribute to the evidence base in my conducted that involved several iterations of analysis that
study by examining in-depth a sample of clients lived moved from description to interpretation in order to draw
experience of art making during their mental health out themes (Smith & Dunworth, 2003; Smith, Flowers, &
recovery. One early nding was that art making added a Larkin, 2009). This method incorporates feelings, physical
spiritual aspect that intersected with the clinical, personal, responses, and other behavioral phenomena present in the
self-care, social, occupational, and contextual elements of accounts in addition to words. Therefore, participant valida-
recovery and provided a sense of transcendence beyond tion was necessary to ensure that the thematic analysis stayed
ones mental illness (Van Lith, 2014). For the distinctly true to their experiences. Each participant reviewed and veri-
different purposes of this article, I will present results ed the analysis from the rst two interviews prior to the
from the study that contribute evidence of how art mak- third interview, and again at the completion of the study.
ing may help clients as a tool for change and coping in Participants endorsed the themes and descriptive evidence
their recovery from mental illness. from their interviews, as discussed in the following sections.
VAN LITH 7
the study. She gradually moved from a personal and intro- are focused on a goal, resulting harmony or coherence ena-
spective approach to her art toward an emphasis on its phys- bles the self to grow. Thus, it is possible that when the par-
icality and aesthetic expressiveness. ticipants immersed themselves in art making they did not
experience a loss of awareness but rather felt a heightened
Psychologically Safe Space state of conscious wakefulness (Cskszentmihalyi, 1990).
Once participants were immersed in art making, they
Mia, Louise, and Richard identied that art making reported being able to resolve inner conicts or to problem
entailed going to a psychologically safe place. The theme I solve. Completed artworks were then seen as containing
transcend to a psychologically safe space through art ini- truth and knowledge, and as if they were mirror fragments
tially entailed for Mia a process of being absorbed in a sense of the artists internal selves (Learmonth & Gibson, 2010).
of safety that provided a reprieve from her symptoms of As a consequence of the authenticity evoked, participants
ashback (Figure 4). As she explained, art making takes saw these artworks as both precious and unique representa-
me away to a better place, where I dont worry about the tions of the changes within themselves.
everyday problems and makes me feel better about myself. Sams experience of making art to gain relief from her
Participants also described feeling greater comfort from hav- demons offers insight into how art can reduce symptoms.
ing depicted the image of the safe space, and feeling a sense The use of art making as a form of symptom reduction is
of belonging as a result. by no means a new concept (e.g., B. L. Green et al., 1987;
Richardson, Jones, Evans, Stevens, & Rowe, 2007), and
Discussion some research has suggested that goal-directed activities
may reduce the frequency and duration of hallucinations
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The four themes from art therapy client accounts (H. A. Allen, Halperin, & Friend, 1985; Fogel, 1996).
depicted above describe how art making served as a change However, in this case Sam went further in that she made
mechanism in twelve peoples mental health recovery with art not solely for temporary relief. She was able to actually
impacts on both intrapersonal and interpersonal levels. diminish her self-destructive energies that she perceived as
Additionally, art making served as a coping strategy that voices embedded within herself. She believed that ignoring
participants were able to adapt to suit their individual needs them would not be enough and instead expressed her
for the betterment of their mental health. demons to expose them.
The participants accounts indicate that art making It is also important to note that some individuals who
involves a series of stages that moved them toward a deep are in acute states may be too overwhelmed to create, and
level of concentration. Thus art making fostered implicit therefore the deep level of concentration required can be
changes through intrapersonal awareness. Siegal (2007, harmful (Springham, 2008; Woods & Springham, 2011).
2010) referred to this process as intrapersonal attunement in In the case of Sam, who had participated in an art therapy
which one is focused on the present and becomes self-aware program for several years, art therapy equipped her with the
without judgment. Creative energy and information move self-knowledge of when and how art making could be of
and become integrated between the mind, body, and social benet to her recovery.
relatedness. Siegal (2009) regarded attunement as key to Another component of art making as a change mecha-
developing a vital and resilient sense of self. Similarly, the nism is the greater relational awareness of the participants.
concept of ow theory (Cskszentmihalyi, 1990, 1996) sug- Both the artwork itself and descriptions of it enabled poten-
gests that when a persons feelings, intentions, and thoughts tial identities to emerge for the participants. Artistic sensi-
bility was drawn out from describing artworks with
increasing familiarity (Thompson, 2009). Participants
became aware of their artistry by integrating aesthetic quali-
ties into their artworks in ways that others could under-
stand. As they reected on their artworks, they became
aware of the works emotive qualities, which resonated with
their experiences (J. Green, 2009). Rather than a raw and
untranslated version of the self, their art reected emerging
self-coherence (Learmonth & Gibson, 2010).
Some participants used art making to project their ideal
selves or personied their artworks to give them a life of
their own. Art making also fostered exploration and testing
of particular parts of the self. Additionally, the process of
reecting on the same artwork at different points in time
shifted perceptions and allowed new self-insights to emerge.
Thus, the artwork likely contained a self-representation of a
shifting, emergent sense of self. This changing mental state,
embodied in the artwork, became particularly evident when
Figure 4. A Safe and Spiritual Place by Mia (Acrylic on viewed in different contexts (Melliar & Br uhka, 2010). For
canvas, 84 cm x 59 cm) example, Sean initially placed an art piece in the lounge of
10 ART THERAPY FOR RECOVERY
the rehabilitation facility where he was living at the time. health recovery. The research suggests that art making in
Sean used this artwork to communicate how his changing art therapy acted as both a mechanism for change and for
self was like a rebirth. Another resident interpreted the coping, which produced internal shifts in the recovery pro-
depiction of depression in Seans artwork and related it to cess through the expression, restoration, and gradual attain-
his own experience, which in turn helped him to under- ment of a new authentic self. As a result, clients with
stand Sean. When Sean moved to his own house, he placed mental illness may nd art making particularly benecial in
his artwork in the living room where it often became a focus the search for a more exible and adaptable approach to
of discussion about the changes he was making. address the barriers to recovery.
Art making in this study was found to be an important
coping tool in addition to being a mechanism for change.
Trust in the creative process helped participants deal with Acknowledgments
stressors and gave them a means to bounce back. Coping
strategies that are culturally and personally relevant are inte- This article is based on a doctoral dissertation completed at
gral to developing resilience against external and internally La Trobe University, Melbourne, Australia.
perceived pressures (Wong & Wong, 2006). This usage
of the art-making process was self-determined and self-
designed as the participants sought mastery and acquired References
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