Art Therapy: Some Aesthetical and Ethical Considerations

In my previous post, I parrot a claim made by art critic Jonathan Jones that art does not heal the sick.  As my friend Tom Borthwick reminded me, this statement skirts the truth by ignoring the burgeoning medical field of art therapy.  To be sure, the healing property of art is even the focus of one of my favorite films from last year:  Marwencol, an excellent documentary from director Jeff Malmberg about a man, Mark Hogancamp, who uses narrative, photography, dolls, and miniature models to overcome severe physical and psychological trauma.

Art therapy is a fascinating subject, as it seems to exist in two worlds at once.  As a form of therapy, its successful application in both physical and mental health settings is undeniable.  Citing numerous credible sources, Wikipedia summarizes:

Studies have demonstrated the efficacy of art therapy, as applied to clients with memory loss due to Alzheimer’s and other diseases; stroke residuals; cognitive functioning;traumatic brain injury; post-traumatic stress disorder (PTSD); depression; dealing with chronic illness; and aging.

But what role does art play in all of this, and is this art eligible for aesthetic scrutiny (another issue raised in Marwencol)?  The American Art Therapy Association defines art therapy in the following manner:

Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of individuals of all ages. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-awareness, and achieve insight.

Thus, art therapy exists primarily as a form of psychotherapy, and the “art” in its name relates more to the creative process than to the finished product.  To get a better understanding of the process and purpose of art therapy, I spoke with my friend Alicia Rodriguez, who is currently finishing her thesis work in art therapy at Pratt Institute in Brooklyn, NY.  She adds:

As therapists, we are trained to notice the various elements of any art piece rather than evaluate them.  Art therapy focuses on the therapeutic nature of the process and looking at a final product with an observant eye rather than a judgmental one.

According to Ms. Rodriguez, when the final product does come in to play, it will be examined primarily for “psychological information rather than visual characteristics.”  As to whether or not the work should be critically appraised for aesthetic value, she offers this opinion:

A critical approach to art is not a necessity, as too much of a critical eye can prove detrimental to the therapeutic process.  Having a basic understanding of the aesthetic qualities visual art provides, how it evokes emotion, and being able to analyze “good or bad art” are skills worth having. However, when making art for the therapeutic benefit, placing a critical eye on the work often undermines the artist’s intent. What proves more valuable is observing the artist’s process and inquiring about the various aspects of the work while suspending judgment.

Despite the emphasis on the medical and therapeutic benefits of art therapy among its practitioners, exhibits in museums and galleries of work produced in art therapy sessions seem to be cropping up more and more frequently.  This begs the question in regard to the aesthetic value of such work, and it also ignores certain ethical issues that need to be considered when art of such a personal, private, and sometimes confidential nature is put on display.  For this reason, I will now attempt to determine the aesthetic potential of “art” produced in a therapeutic capacity while also addressing some of the ethical issues raised by its public exhibition.

Let us first return to James Joyce’s definition of art: “Art is the human disposition of sensible or intelligible matter for an aesthetic end.”  If Joyce were to test whether or not art therapy met the standard of his definition, he would probably conclude that it would not.  If the purpose of art therapy is “to improve and enhance the physical, mental and emotional well-being of individuals,” then objects created in this capacity are not created for an aesthetic end; thus, they are not art.

However, as I have already made clear, I think that the aesthetic end of an artwork is not determined by the artist’s stated purpose.  It is determined, rather, by three things: “context, tradition (i.e., established evaluative criteria), and audience (i.e., critical appraisal).”  So, once again, based on this definition of art, what are the aesthetic possibilities of “art” produced in a therapeutic capacity?

First, we need a proper artworld context in which to display the work.  Gallery and museum shows clearly meet this need and, it turns out, are quite plentiful. One such show was Healing Mind: Art Therapy and the Body in London.  Another was Reflections at the Museum of Modern Art in New York.

With an artworld context established, we now need to determine (as a critical audience) in which artistic tradition the work in question belongs.  Only then will we be able to know the best established evaluative criteria to apply to the work.  But as Ms. Rodriguez points out, this can get a bit tricky:

It is hard to clump all art created through art therapy into any one category, as the profession is so vast and can be used in such a variety of ways.

Some attempts have been made to classify work produced in art therapy as outsider art (i.e., “art created outside the boundaries of official culture”).  Ms. Rodriguez suggests that this might apply to some of the work produced in art therapy, but it certainly does not apply to all of it:

The very idea of art therapy is to provide a creative space for free expression–to remove the confines of cultural norms and mores. I have seen several works of art that could be defined as “outsider art” come out of art therapy sessions, yet I have also seen several traditional images emerge as well.  It really depends on the circumstances surrounding the session, such as:  What kind of art background does the client have?  What approach is the therapist taking?  And what are the personal goals of therapy for the client?  If a client wants to let go of outside restraints, his or her art may take on a freer and looser quality and lean more towards an outsider art feel. Reversely, if a client wants to organize his or her chaotic life, the imagery may take on a more constricted and traditional feeling.

Clearly, then, multiple artistic traditions can be in play in any one exhibit.  The Reflections show at the Museum of Modern Art, for example, featured an eclectic assortment of work from a wide variety of art therapy patients, including some directly inspired by a neighboring Salvador Dalí exhibit.  That work, then, would perhaps find a place in a surrealist tradition, and we would subsequently be able to apply the evaluative criteria appropriate for that school of painting in our critical appraisal; we would be able to see the work as art and judge to what extent it succeeds in that regard.  But we would need vastly different evaluative criteria to judge the other works in the exhibit.

Interestingly, art therapy is thought to have its origins in the surrealist and expressionist traditions, where artists such as Edvard Munch and Frida Kahlo used these styles of painting as a means of expressing deep inner feelings.  However, since today’s art therapy patients do not necessarily have a background in either art technique or history, we might not be able to identify a specific tradition.  In that case, “outsider art” might indeed be the best label.  But this only proves that a single art therapy show featuring multiple artists might just turn out to be aesthetically jumbled, superseded by other (perhaps more admirable) goals, such as raising awareness and funding.  But whatever the goal, aesthetic or otherwise, what role do the actual artists have in the exhibition of their work?

According to Ms. Rodriguez:

Displaying personal art, which was created under the context of a therapeutic process, is often left up to the patient.  Nevertheless, many facilities that do not fully understand the art therapy process will push therapists to hold shows and/or provide patient artwork to sell for fundraising efforts.  These types of situations compromise the therapeutic benefit of art therapy sessions, as once clients know their work will be displayed, their mind frame shifts from creating art for themselves to creating art for others.

It’s a delicate issue, and we must tread carefully.  Surely, raising awareness and funding is important.  And some of the work produced in art therapy will undoubtedly be great artistic successes and worthy of display.  But do we display this work at a potential cost to the patient/artist’s well-being and therapeutic progress?

Ms. Rodriguez continues:

Art that is created for therapeutic benefit holds significant meaning to the artist beyond its aesthetic values. The art created in art therapy sessions can serve multiple purposes, yet the main motivation behind the piece was to aid the patient in some sort of healing process.  Putting the art on display, even with permission from a client, will inevitably expose that process on some level.  That being said, some clients may need to display their artwork to complete their process, in which case it is the therapist’s job to help them achieve that goal.

Thus, it seems clear that we can critically appraise the work of art therapy for its aesthetic value.  Although broad shows of multiple artists will require each work to be critically appraised using a different set of evaluative criteria, these works do have the potential to meet the aesthetic expectations of an established artistic tradition, even if that tradition is outsider art.  However, this does not mean that we should critique the work of art therapy for its aesthetic value.  Where the primary goal of art therapy is to assist and nurture the patient in a personal and therapeutic manner, any outside judgments can be most unwelcome and can undermine the work of both the patient and the therapist.  Ultimately, it must be their decision (and their decision alone) whether or not to display the fruits of their therapy to the sometimes unfriendly eye of aesthetic scrutiny.

Further reading:

Reel therapy: can films make us feel better?

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4 thoughts on “Art Therapy: Some Aesthetical and Ethical Considerations

  1. By the conclusion of this “consideration,” it seems to me that the most reasonable approach to judging art produced through therapy is on a strictly case-by-case basis. If the creator had a background in art, produced the piece with at least some level of conscious consideration for that background, and agreed to have the piece publicly displayed and/or sold for profit, then yes, the piece should be critically examined according to the aesthetic merits of art. If these conditions fail to be met, however, then I would argue against such critiques of the work. I guess my primary distinction here is between therapy made by artists and therapy made by non-artists. A non-artist may accidentally create an aesthetically “viable” work of art during an art therapy session, and that piece may be displayed, critiqued, and/or sold, but such a piece should no more be judged as intentional art (according to Joyce’s standards) than a finger-painting done by a gorilla, elephant, or computer. In contrast, a trained professional artist may create something during therapy that they would not consider “art” and would not wish to have displayed, critiqued, or sold as art. In one case we have art without an artist; in the other, an artist without art. (The question of whether an artist can unintentionally create art can be addressed elsewhere by better minds than mine.)

    As an artist myself (a poet), this discussion also raises the interesting issue of whether artists normally and naturally (i.e. subconsciously) create art for therapeutic purposes. Certainly there are strong individual cases– the majority of Frida Kahlo’s oeuvre, James Agee’s semi-autobiographical novel “A Death in the Family,” Donald Hall’s volume of poetry “Without,” John Lennon’s album “Plastic Ono Band” (with songs like “Mother” and “My Mummy’s Dead”). Each of these works were at least partly inspired by therapeutic purposes (desires for healing and/or understanding), yet they were all commercially displayed, critiqued, and sold. Some of what I consider my own best poems deal with investigating emotionally charged issues of personal identity, and it goes without saying that all great art attempts to inquire into (if not answer) the questions of ultimate identity and purpose. When I write a poem that teaches me something new about myself and/or the world, that makes me feel more “whole,” “informed,” or “connected,” is that result not therapy (whether said result was sought or not)? Certainly art therapy works from an audience perspective— art that helps and heals the viewer/reader/listener. Perhaps there should be yet another distinction drawn: art created by an artist *not* during therapy which may or may not provide a therapeutic effect to an objective audience (including the artist him-or-herself), versus art created by an artist *during* therapy which may or may not provide a therapeutic effect to an objective audience (including the artist). I include the artist as an “objective” audience member on the grounds that a professional artist should be able to examine and critique his or her own work objectively, regardless of how the work was created (i.e. during therapy) or any personal therapeutic effect it may have produced.

    Perhaps that final distinction involves the crux of the matter– editing. Objective evaluation by the artist *prior* to display/sale. A non-artist who accidentally creates an aesthetically pleasing piece during therapy may recognize the achievement (by merit of a general acquired aesthetic understanding) as an audience member, but did not deliberately create the piece in order to produce the results, and probably could not repeat the process successfully a second time. Accidental art by accidental artists (therapy patients or not) certainly exists, but deserves a separate category of aesthetic criteria by which it should be judged.

    • I completely agree that therapy-produced art should be judged as art on a case-by-case basis. I also think that your interpretation of Joyce’s definition is apt; work produced by an unskilled patient who has solely therapeutic intentions would be no different than unintentional “art” made by an animal or a computer. This is why I have trouble with the “aesthetic end” portion of Joyce’s definition–it fails to account for the appropriation of a non-art work into an artworld (which is indeed a human disposition). This is precisely what happens in Marwencol. Mark Hogancamp took photographs of the scenes he created with dolls and models, completely unaware of how skilled the photographs would turn out to be. Eventually, the photographs were discovered, published, and displayed in an art gallery. Hogancamp was taking photographs for a purely therapeutic purpose, but he unintentionally created art. Thus, I think a person can unintentionally create art.

      As to the second part of your comment, I love the distinction you make between “art created by an artist *not* during therapy which may or may not provide a therapeutic effect to an objective audience (including the artist him-or-herself), versus art created by an artist *during* therapy which may or may not provide a therapeutic effect to an objective audience (including the artist).” The therapeutic effect of art on an audience is something I did not consider here.

  2. Second [continued] reaction:

    Can something be called art if it only (and that’s a strict “only”) has an audience of one? In other words, if a work is created during therapy and successfully provides the kind of healing that only art can deliver, but only provides it to the person who has created it, whereas no one else on earth who experiences the work finds it either artistic or therapeutic, is it still art? If Emily Dickinson’s hoard of poems had never been discovered and published, and had in fact perished with her death, would they still have been great poetry? Can art exist in a cell (whether monkish or prisonish), or in a vacuum? Must there be a shared consensus of values between two or more people? If Picasso was the last person on earth and kept painting, would the post-apocalyptic works still be art? (And if he did, would that not count as the greatest argument in favor of art as therapy?)

    • This a great question. I think that art *can* have an audience of one, but I do not know if the art should be judged as such solely on its ability to provide a kind of “healing.” Also, I do not know if art can exist in a vacuum. I feel that it requires an audience (even an audience of one) in order to reach an aesthetic end. Picasso, in your example, would only be producing art for as long as he is around to recognize it as such. Once he’s gone, the art would cease to be art.

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