Au P~~c~hotlw~tr~~. Vol. 6 pp. 47-W. Pergamon Press, 1979. Printed in the lJ.S.A

ADLER’S THEORY OF PERSONALITY AND ART THERAPY

IN A NURSING HOME*

GILBERT LEWIS, MCAT.

Manchester House Convalescent Center Media, PA

According to Alfred Adler (1930) man is so- cially oriented. He maintains that man’s goals of development are related to society, and his striv- ings are creative. Life is lived, and development is controlled by actions of which man is con- sciously aware. Development is directed toward self-realization, a process which can be planned and controlled. Motivation, an upward creative drive, serves as compensation for what Adler (1930) calls the inferiority complex:

. . . it runs parallel to physical growth and is an intrinsic necessity of life itself. It lies at the root of all solutions to life’s problems and is man- ifested in the way in which we meet these prob- lems. All our functions follow its direction. They strive for conquest, security, increase, either in the right or the wrong direction. The impetus from minus to plus never ends.

The style of life associated with an individual is both the cause and result of a creative effort. We do inherit some traits, but all problems are related strivings toward social regard, work and sexual love. These strivings exist potentially in everyone.

In old age, in order to surmount physical and mental problems, man must view, he must be objective, and he must accept the changes of this period in life. This is no easy task for those living in a nursing-home environment. The Ansbachers (1964) emphasize that goals must change appro- priate to current abilities in every period of life,

otherwise achieving desired goals will be se- verely hampered, if not altogether defeated.

Feelings of inferiority common to the aged can be overcome and may be an impetus to compen- sation by achievement in an area more suited to actual skills. When over-dominant or over- submissive roles are used as defenses for feelings of inferiority, the personality becomes warped. An overabundance of self-pity in some older people is a result of socially derived ideas related to the denial of old age and the myth of the greater value of youth.

The central goals of life are work and the so- cial status attendant on it, and these become the primary losses of old age. When an individual is without work, the balance of life is upset. Death of friends and family, too, must be compensated for. What some may view as an inevitable fate-placement in a nursing home-may actu- ally be an ideal solution for others, following the loss of caretaking person(s). The nursing home can be the environment in which some people readjust following an illness. For some it may be a temporary-care facility only (following a seri- ous illness), but for many it becomes a new home.

Strongly expressed inferiority feelings pertain to past personality traits, current physical de- ficiencies and loss of friends and family which, collectively, represent more serious problems than at any earlier age.

Maddox (1963) supports Adler’s belief in motivation toward compensation and as an ongo-

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00904'092/791010047-04$02,00/O Copyright ' 1979 Pergamon Press Ltd.

GILBERT LEWIS

ing need which continues far beyond any specific age. The level of activity is determined by morale, ego integration and socialization which, he claims, are interdependent. In terms of therapy, activities for the aged need not be spe- cialized or related to any previous career, but they should serve to replace lost skills. A posi- tive correlation exists between level of integration and degree of activity regardless of age. And in- tegrity may be reinforced by shifting to previ- ously undeveloped interests.

Adler (1930) defines creative power as the ability to meet life’s demands, and, in several studies on aging in society reviewed by Geist (1968), specific periods throughout the life cycle are described in relation to active creative striv- ings as these are manifested in the general popu- lation.

Intellectual creativity may reach its peak at age sixty, but scientific and artistic creative achievements continue beyond that age. There is general disagreement among theorists as to whether there is a commensurate decrease in creativity with age. Butler (1967) claims that the ability does not diminish but rather becomes inhibited. Creativity derives from a wish to change life experiences, to master and reinte- grate problems, or to discharge emotion. As examples of compensation for loss, one could cite the late (and admittedly his most brilliant) quartets of Beethoven-composed when he was deaf-as well as Freud’s structural theory and analytic ego psychology following the death of a son and his own first cancer operation.

Probably the most detailed study of specific types of creativity and the life cycle has been made by Irving Taylor (1959). He outlines five dispositions to creativity which diminish at times during the life cycle but which can be re-used in old age. The first stage is called expressive spon- taneity, a motoric expressive childhood mode which diminishes in the late thirties and tapers off in the fifties and sixties. Technicul creativity follows as a refined ability to draw or paint, shift- ing to interest in gadgets or cars during the twen- ties and thirties, diminishing in the forties, and re-emerging in the fifties and sixties. Two other stages of creativity, inventive and innovative, are generally applied to various work-oriented goals. The last is called emergenitive originality and OC- curs after age fifty as a disposition to creative

ideas on a higher level or by way of condensation of previous creative abilities combined to be in- novative in some new direction. Creativity does not decline with age, but rather with need. There may indeed be a link between aging, longevity and creativity.

Too little has been written or done in research to show that art therapy theory might systemati- cally apply in any situation; but its application is in fact appropriate to a nursing-home population. Communication through the use of art media facilitates re-establishment of relationships in an environment which Kiibler-Ross (1975) claims prompts the same reaction as the fear of death.

Many theorists agree that some type of creativity exists at certain levels in everyone, re- gardless of age. With proper encouragement this creativity may be reactivated; Butler (1967) maintains that it need only be uninhibited to re- emerge. Compensation for feelings of inferiority can be made on various levels in circumstances which accept present capabilities. Self-pity gives way when the individual discovers new capabilities or re-uses old ones in a new way. Group art therapy intervention alters the process of withdrawal from social concerns. The new- found ability in group activity, regardless of the production, builds confidence. Experiences can be presented in drawings and paintings open to discussion by members of the group, and, in nonverbal ways, resocialization occurs where a “generation gap” may have existed before among the residents. The use of the term “gen- eration gap” may seem odd in this context, but it is not unusual to find residents in their nineties, for example, who-prior to art therapy-never spoke to those in their sixties. Once in a group, though, many begin to relate to one another.

Despite the many advances in technology and medicine, there is little to recommend these ad- vances over the individual’s need to feel useful. Besides food, clothing and shelter, little in this environment is shared except the common expe- rience of psychological and physical isolation. For some the walk to the art room is the only time out of their bedrooms.

As an opportunity to reintegrate experience, art materials offer a means of experimenting with new ways of working and, with the aim of draw- ing from a real object, may actually serve to re- stimulate the senses. One small group of men in

ART THERAPY IN A NURSING HOME 49

their seventies and eighties met for the first time in an art therapy session. The goal was to re- socialize; the assignment was to draw three oranges.

First the fruit was passed around, examined, sniffed, and the skin texture and weight dis- cussed. After making an arrangement of the oranges, the fruit was drawn. In order to com- pensate for poor vision, an outline was drawn first, then the shapes filled in. Following com- pletion of the drawings, each person was asked to show his production to the others. Pursuant reactions included both positive and negative feelings about being in the nursing home, ex- pressions of dislike about drawing, and com- plaints about not having been given enough time to draw. After discussion and examination of the art, the fruit was eaten. During this activity, further views were shared including the common opinion that the nursing home’s food was “terri- ble.”

Mr. A’s drawing (Fig. 1) was described by Mr. B as a bird grasping a wire, and the drawing clearly reflects the maker’s emotional and physi- cal condition at the time. For several days he had refused to eat solid foods, and his attendance at the session was the only time he spent away from his room. Two of the three oranges in Mr. A’s picture merge with the top of the precariously balanced table. Impatient to eat the fruit, he drew quickly and with such force that, in several places, he rubbed holes through the paper.

He offered no comment on his drawing except to say that he liked oranges. When the orange sections were served, he swallowed his in one gulp.

Mr. B’s picture (Fig. 2) shows three evenly spaced oranges within the rectangular table sur- face. He spent a lot of time examining the oranges and commented that the skins had many holes. He had been a loner all his life; his oranges share the space, but at a respectful distance from each other. Like Mr. A, he attended no activities except the art therapy sessions. He had been a farmer, and the fruit was of renewed interest to him (since one seldom encounters uncooked food in a nursing home). The three oranges had actu- ally been, arranged in a triangular pattern, but he drew them all in a row, symbolizing perhaps peas in a pod or his own room with its three beds.

The assignment presented various challenges:

Fig. 1.

Fig. 2.

to forestall eating the fruit until after the draw- ings were completed, participating in the display and discussion of the artwork, and sharing the orange sections. For each of the four residents participating, the experience provided different reactions, though the reward (fresh oranges as dessert) was shared by all.

Mr. A and Mr. B were roommates who had known practically nothing about each other be- fore this art therapy session. In fact they knew each other only by last name for the months they lived together. The discussion triggered some (shared) memories of Mr. B’s life on the farm and

GILBERT LEWIS

Mr. A’s early childhood with reminiscences of his aunt’s kitchen garden. Their conversation developed further on other topics of mutual in- terest.

After several months (one member of the group died, another joined) residents had begun to attend other activities and to visit each other at other than mealtime. Subsequently group mem- bers decided what work they wanted to do in the sessions, and they arranged their own produc- tions for display afterwards. Re-motivation had occurred on many levels and according to ability in spite of organicity or medication which may have interfered with certain functions. We pro- vided residents large paint brushes and bright colors to compensate those with poor eyesight. Pictures were made using photographs in collage process and designs were made by tracing ob- jects: both approaches intended as compensation for unsteady hands. Feelings of inferiority were alleviated by making pictures which were praiseworthy. ~_

Vincent van Gogh once wrote to his brother (Dunlop, 1975), “Life from birth is not flat, but a constant moving, changing process.” As more research is done in art therapy, this statement may well prove true. The aspects of creativity are demonstrated repeatedly in sessions accord- ing to the stages described by Taylor (1959), and Butler’s theory (1967) that abilities are not lost in

old age is proved time and time again. Graphic creative qualities reflect Adler’s (1930) socially creative goals. Indeed, creativity does not di- minish with age, and abilities cnn be reactivated through. art therapy in an environment sym- pathetic to current capabilities.

REFERENCES ADLER, A. (1930) Individual psychology. M. C. Murchison

(Ed.), PSychologies of 1930. Worcester. MA: Clark Uni- versity Press.

ANSBACHER, H. L. & ANSBACHER, R. R. (Eds.) (1964)AUred Adler, Superiority cd Social Inrerest: A Collection oj Lrrrer Writings. Evanston, IL: Northwestern University Press.

BUTLER, R. N. (1967) The destiny of creativity in late life: Studies of creative people and the creative process. In S. Leving and R. J. Kahana (Eds.), Psychodynamic Srudies of Aging. New York: International Universities Press.

DEWDNEY, I. M. (1973) An art therapy program for geriatric patients. Americun Journul of Arf Therapy. 12, 249-254.

DUNLOP, I. (1975) Van Gogh. Chicago: Follett Publishing Company.

GEIST, H. (I%@ The Ps.vchologicnl Aspecfs of the Aging Process with Sociologicrrl Implicrrrions. St. Louis. MO: Warren H. Green, Inc.

K DBLER-ROSS. E. (1975) Declth. rhe Firlo/ Sfuge oj.Growth. Englewood Cliffs, N.J.: Prentice-Hall.

MADDOX, G. L. (1%3) Activity and morale: A longitudinal study of selected elderly subjects. Social forces. 42, 19S- 204.

TAYLOR, I. (1959) The nature of the creative process. In P. Smith (Ed.), Creuriviry: An Examination of the Creutive Process. New York: Hastings House.