Arts Issue
In a society where the most diverse forms of therapy prevail, Art-Therapy has emerged. Another way of looking at the world, but especially of looking inwards and healing what hurts the most. As Carl Jung once said: "Those who look outside, dream. Those who look inside, awaken."
According to the dictionary, therapy is defined as: a part of medicine that teaches how to treat diseases and apply medicines; a method or procedure used to treat a disease, injury, or pathological condition; treatment of illnesses or mental disorders. The term comes from the Greek therapeia, from the verb therapeúo, to provide medical care, to treat. It was used in medicine by Hippocrates and Galen, who referred to medical and surgical therapy to designate the care of the sick in order to obtain a cure for their illnesses. From Greek, the word passed into Latin and, consequently, into modern languages with the broad meaning of any means or procedure used to treat the sick, giving rise to compounds such as pharmacotherapy, physiotherapy, hydrotherapy, radiotherapy, psychotherapy, etc. Today, this is a common term, especially used in the world of mental health. Portugal is considered to be the second country in Europe with the highest prevalence of psychological health problems in the population. A document shared by the Order of Psychologists estimates that one in five Portuguese citizens suffers from a psychological health problem. It's therefore not surprising that there are so many types of therapy on the market - from Freud's Psychoanalytic Therapy to behavioral therapy, the sky is the limit for those who need to "look inside". Less common - or at least not as popular in Portugal - is Art-Therapy, which, as the name suggests, means therapy through art. "In its apparent simplicity, Art-Therapy, with enormous depth and complexity, is a therapeutic relational space where creator/patient, creative act/creation and Art-Therapist/Psychotherapist interact forming a triangulation where the potential space is established where the processes of self-knowledge, reflection, transformation and adaptive change take place." The explanation comes from Catarina Capinha, Art-Therapist.
We are talking about a method that uses a variety of artistic mediators (such as plastic expression, music, drama, literature, play...) in the context of a specific therapeutic process. This results in a therapeutic relationship based on the interaction between the subject (creator), the artistic work (creation) and the Art-Therapist/Psychotherapist. "The use of imagination, symbolism and metaphors enriches the process," she adds. Before we go any further, it's important to note that Art-Therapy is not a substitute for psychiatric treatment in mental health cases that require it. Nor does any conventional verbal therapy: "In the most severe mental health situations (for example, in hospitalization), the logic of Art-Therapy intervention arises in the complementarity of intervention with other disciplines (such as medicine, psychiatry, occupational therapy) from a multidisciplinary perspective," explains Catarina. What sets Art-Therapy apart is the making of art in therapy, using the healing potential and personal exploration that it allows. Each creation is a representation of the Self, allowing the creator to look at themselves (like looking at their face in a mirror) and find themselves in the details, the narratives, the weaknesses, the monsters, the dreams that emerge in the creation and throughout the therapy in the successions of creations, going far beyond verbal communication. The method has been recognized as a beneficial and effective form of treatment since it was first described by Adrian Hill in 1942. Hill personally experienced the impact and therapeutic quality of art and art-making when he was recovering from tuberculosis in a sanatorium in 1938. During a long period of hospitalization and while practicing painting, he noticed the interest and reaction of catatonic and chronic psychiatric patients in a relational awakening. He had them paint and, over a period of months, recorded the reactions and impacts that later, in 1945, gave rise to the first foundations of Art-Therapy in his first book Art versus Illness. In 1946, he became the first official professional Art-Therapist at Netherene State Psychiatric Hospital in the UK. Later, he was president of the British Association of Art-Therapists and paved the way for the acceptance and practice of Art-Therapy and the formalization of the profession.
In Portugal, the Portuguese Art-Therapy Society was created in 1996, following the work of the Research Center at Miguel Bombarda Hospital, founded in 1994 (with a focus on creativity and psychopathology). It is a treatment method suitable for all mental disorders, as well as psychosomatic situations. What's more, it's for everyone: "It is suitable for children, adolescents, adults and the elderly. Creative potential is innate to the human being. Internal musicality, the ability to move, dance, paint, model, and other creative acts are common to human beings at any stage of life. Creativity is universal, belonging to the human phenomenon and not just to a few talented beings. Therefore, any human being, at any point in their life, can benefit from Art-Therapy," says the Art-Therapist. She adds that, in Portugal, interventions have been carried out with cancer patients, the prison population, elderly people with dementia, children in foster care, teenagers with risky behavior, victims of domestic violence, drug addictions and even the visual impaired, with very positive results. Art-Therapists, on the other hand, come from various areas of specialization: from the arts to medicine, nursing, psychology, speech therapy, kindergarten teachers, professors… Everyone goes through an interview process, curriculum selection and individual assessment prior to the training and, upon positive admission, begins a gradual process of specialization and training specific to each degree of Art-Therapist and Art-Psychotherapist - which involves theoretical and experiential training and a personal therapeutic process in individual and group Art-Psychotherapy. The length of treatment will depend on the mental health problems of the participants and the aims and purpose of the intervention: "For example, if we're talking about a specific group intervention with the aim of developing skills, it could be anything from a few hours to 30 sessions a week over the course of a year. As for individual intervention, the duration is appropriate to the problem brought by the patient and also to the personal characteristics of change and evolution throughout the process," says Catarina. It should be remembered that artistic creation is not only innately common to all human beings, from the very beginning of life (babies scribble circular shapes even before they speak, listen to music and the heartbeat before they are born, sway their bodies to the rhythm even before they walk), as it is recognized as one of the first forms of communication, relationship and transmission of knowledge and traditions, dating back to the Cave Art of the Paleolithic era (with images of animal hunts, for example). It is also a symbolic language that transcends the barriers of language and culture. "These characteristics facilitate communication, the testing of object relations and the reorganization of internal objects, meaningful emotional expression and greater self-knowledge, thus liberating the capacity for thought and creativity," maintains the Art-Therapist. She concludes: "In Art-Therapy, the role of the creative process in change is central, and the aim is to encourage clients to use creativity as a means of understanding themselves and others, and to resolve existential problems."
The day-to-day life of an Art-Therapist varies greatly, depending on the context in which they work: social institutions, hospitals, companies, schools. And it can be as rewarding as it is challenging, says Catarina Capinha: "The Art-Therapist always brings added value and a fresh look of creativity and innovation to any context due to the characteristics they have developed throughout their training. They integrate easily into work teams and are well accepted in the places where they work, and they all share a strong empathic capacity accompanied by a keen sense of ethics and professionalism which, consequently, is combined with a sense of gratification at the possibility of helping others." She says that the potential of the different mediators have, therefore, different effects on each individual. In fact, each individual's preferences are just as important for therapeutic reflection as what repels them: "We can plan a thematic intervention with a potentially frustrating mediator in order to create a situation in which the participant has the opportunity to deal with that emotion and creatively overcome that feeling." Some of the testimonies of art therapy patients shared by the art therapist include: "Art-Therapy has helped me to feel comfortable in the skin I'm wearing... Seeing myself in different shapes, colors, movements", "Art-Therapy represents (re)meeting myself in a particular space and time, which is as much mine as it is shared. It represents a creative dive into an already known Self, an unknown Self, a Self yet to be discovered... A Self full of possibilities," or: "Through Art-Therapy I have found a way of communicating what sometimes seems incommunicable. With spontaneity for ourselves and for others. It's the adult relearning to 'play' and the child not losing the naturalness of naturally being." For Catarina, it is deeply gratifying when patients trust her to share their creations, their difficulties, allowing her to be with them in their moments of greatest doubt, fear, sadness, lack of meaning in life, but also to witness the potential of human creativity and resilience to overcome life's greatest challenges, transforming and adapting. We quoted Jung above, who believes that looking inside is crucial to awakening to who we are; George Bernard Shaw adds that if mirrors are used to see the face, art is (also) used to see the soul.
*Originally translated from the Arts Issue, published November 2023. Full credits and stories in the print issue.
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