The relationship between art and therapy

The process of art therapy is based on the recognition that manís most fundamental thoughts and feelings, derived from the unconscious, reach expression in images rather than words. (Naumberg 1958: 511).

Mark-making is part of the nature of the human race. Indeed some perceive it as a necessity; to create is to survive. To make something that didnít exist before is the evolutionary path humankind has chosen. Freudians might speak of this necessity as a drive, an instinct. Put a pencil into the hand of a young child and see what happens. Watch adults doodle as they make a phone call. Energy is released. The same child who may not have the verbal language, or the adult who may be too inhibited to use words, can through their mark-making begin to communicate, using the language of symbols.

In the traditional understanding of art making the activity is usually directed towards a goal ó the end product. The work is judged by aesthetic considerations whether it is for public exhibition or to be viewed in private. In the therapeutic setting the person and the process is of primary importance and the finished product of secondary consideration.

The Therapeutic Alliance
The therapeutic setting is a one-on-one relationship of therapist and client (though group work is also possible) with the clear understanding of the aims of the treatment that is, to bring about beneficial change in personality or emotional life.

An Art Therapy Session
If the therapist uses a non-directive approach, a wide range of art materials is provided. Both the choice of medium and subject being made by the client. A session usually consists of two stages:

1. the art making, which can involve the use of paints, pencils, clay separately or together. In the case of children a sand box with small objects such as dolls and cars, is often provided.

2. a period of verbalisation during which the art work, the choice of materials, the process, the subject and the feelings evoked, may be discussed.

This non-directive process could be looked upon as a form of free association using art. A directive approach might involve a theme suggested by the therapist which would be relevant to the clientís area of conflict. ĎMothersí is an obvious theme for a young person with traumatic interpersonal relationships.


Every original art production by the patient is in some degree an aspect of that person. No-one else can create the same result on paper or canvas. Art therapy offers an area where the patient can proclaim his identity and it offers an atmosphere where he can be himself ... Art offers a medium which can give both communication with others and confrontation with the self. (Laing 1974:17)

The art work being tangible, provides a focus for interpretation. However, interpretation should be through discussion and exploration. Glib and authoritarian interpretation of the use of materials and symbols by an insensitive therapist are most unhelpful and are more likely to block a client rather than assist her. Empathy with the client, patience and an understanding of the art process are some of the therapistís skills. An understanding of the nature of modelling clay was instrumental in my accepting the futile and frustrating efforts of a small boyís determination to build, what was an unstable structure. As the tension mounted his frustration turned to anger and he attempted to pound the clay into the desired structure while at the same time he began a verbal tirade. First against the clay, then the school and finally against the all powerful social services which had removed him from his motherís care.

For the first time he was able to verbalise his feelings of anger, hopelessness and lack of power in the face of authority. He was able to put into words his fear of what the future might hold. The sensuous feel of wet, sticky, messy clay on his hands probably caused him to regress to an emotional level where such feelings were not guarded against and defended. On another level it is possible to speculate that he was unconsciously symbolising his life as unstable and was trying to restructure it.

As I sat and watched I sensed him coming to an understanding that I was not judgemental, rather someone who understood his feelings and that neither he nor his feelings were being rejected; that there was a place where it was safe to bring such feelings the art therapy room.

This realisation in itself was the start of the healing process.

If only we can wait, the patient arrives at understanding creatively and with immense joy, and I now enjoy this more than I used to enjoy the sense of having been clever. I think I interpret mainly to let the patient know the limits of my understanding. The principle is that it is the patient and only the patient who has the answers. We may or may not enable him or her to encompass what is known or become aware of it with acceptance. (Winnicott 1971:102)

On a different level Freud speaks of the professional artistís striving to communicate and their need for otherís understanding. It explains why the successful painting or poem causes a vibrational response in the viewerís/listenerís soul.

In my opinion what grips us so powerfully can only be the artistís intention in so far as he succeeds in expressing it in his work and in getting us to understand it, I realise that this cannot be merely a matter of intellectual comprehension; what he aims at is to awaken in us the same emotional attitude, the same mental constellation which produces in him the impetus to create. (Freud 1914: 212)


Pein, R. (1994). Images that heal. In Children for Africa: Second African Conference on Child Abuse and Neglect. Cape Town: Pretext. pp. 259-260