DIV. 10 AMERICAN PSYCHOLOGICAL ASSOCIATION VOL. 2 ( 2 )

Psychotherapy and the Arts Paul M. Camic & Lawrence E. Wilson, Co-3

l lol l is Sii'lcr - The Future Moves in Much Closet Courtesy o f the Estate o f Mollis Sigler

Fig I : Student engaged m creating a plaster mask

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Fig 2 • Completed student mask,

Fig. 4: Graduate students pr ior to a street performance.

Fig 3: Completed student mask

Gi aduate students learning technique with faculty member Susan Imus, Dance/Movement Therapy Department, Columbia College Chicago.

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Bulletin of Psychology and the Arts Vol 2 (2)

Contents Psychotherapy and the Ar ts - Paul M . Camic & Lawrence E. Wi lson, Co-Edi tors

50 Building and Blending: Creating Places for the Arts in Psychotherapy

Paul M Camic & Lawrence E. Wilson 51 Philosophical Foundations of Expressive Arts Therapy: Towards

a Therapeutic Aesthetic Stephen K. Levine

56 Creating Outside the Lines: Enlarging Psychological Research through the Arts

Shaun McNiff 59 C.I.S.M.E.W.: The Arts in Clinical Training

Paul M. Camic 65 Erasing the Gridlines: An Interdisciplinary Studio Course for

Therapists Who Use Art Lawrence E. Wilson

67 What will we do today? A clinical psychology graduate student's experience of the creative arts in therapy.

Laura M. Gaugh 69 Art Therapy and the Elephant

Harriet Wadeson 14 Perspectives on the Profession of Dance/Movement Therapy: Past,

Present, and Future Robyn Flaum Cruz

78 i The moment of possibility: Current Trends in Drama Therapy Ted Rubenstein

82 Music as a Therapeutic Medium: An Introduction to Music Therapy

George L. Duerksen 85 Van Gogh's Ear Talks!!: Creativity, Suffering and Aesthetic

Language Kimberly McCarthy

89 After the Fact:Psychotherapy Is a Performing Art Sarah Benolken

90 Authentic Movement and Witnessing in Psychotherapy Wendy Wyman-McGinty

93 Division 10 News 93 Message from the President-Elect

Jerome Singer Message from the Past President

Sandra Russ Message from Bob Sternberg

Robert J. Sternberg Announcements

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Lawrence E. Wilson Paul M. Camic

Vol 2 (2)

Building and Blending: Creating Places for the Arts in Psychotherapy

Paul M. Camic Columbia College Chicago & University of Chicago

Lawrence E. Wilson McDougal Littell Publishers & Chicago School of

Professional Psychology

There's an old Chinese curse: "May you live in interesting times," the implication being, of course, that uninteresting times are preferable to those filled with action, with argument, with ad­vances in community and cultural achievements, with change. We'd like to suggest that we are living in an interesting time right now,

aesthetically, when scientific discussions about the motives and objectives of artistic activity have the potential to remake the way we think about art and the way we use it in our personal and professional lives.

This special issue of the Bulletin of Psychology and the Arts presents what we believe is an interesting and enthusiastic exploration of psycho­therapy and the arts. Print media being limited in what it can record, our front and back covers only contain only visual documentation. This does not reflect a limitation in the content of this issue or in the views of the editors. In introducing this special issue, we would also like to offer deep appreciation to Cheryl Johnson-Odim, Dean of the School of Liberal Arts and Sciences, and Steven Kapelke, Provost, Columbia College Chicago for their generous offer to underwrite the costs of color printing for our inside and outside covers.

Up to the present time, psychotherapy, as a domain within doctoral train­ing in psychology, has been entirely oriented towards a verbal, mostly lin­ear and narrative mode of practice. Focusing on verbal discourse to the exclusion of other modes of communication and expression has limited the development of psychotherapy unnecessarily. Human beings communicate through movement, sound, visual images, and written language as well as through linear and verbal processes. To suggest that "healing" or "cures" can occur only through a verbal-based therapy is to disavow or discount the importance of the arts ethologically in Hominid_development. Art is amenable to promoting progressive adaptation and differentiation through developing aesthetic form as well as content (Rose, 1996).

The practice of psychotherapy in psychology is a recent one, arguably beginning seventy or so years ago. With the exception of Carl Jung, few major theorists in psychology or psychiatry have incorporated movement/ dance, sound/music, words/writing, enactment/drama, and images/visual art in their therapeutic work. It is as i f verbal-based therapies have always been thought to be more scientifically advanced or theoretically superior than those that utilize the arts. Empirically this has not been shown to be the case, yet psychology has developed what appears to be a deepening bias in favor of verbal, linear, and more recently, prescription-like inter­ventions. This bias reminds us of the license plates for the State of Mis­souri which proclaim they are "The Show Me State"; clinical research in psychology has often rejected what cannot be seen and counted, thus lim­iting what therapies and interventions are deemed acceptable.

We are certainly not suggesting a return to the times when treatments went unchallenged and therapists were not held accountable for their work. The quality of clinical work and the rigor in evaluating outcomes of the work remain essential. In this special issue we seek to explore opportuni­ties and to expand possibilities for incorporating the arts into the practice of psychotherapy by psychologists and other mental health practitioners. I f psychotherapy can be thought of as a method of learning—and we are all aware of the discussion surrounding diverse learning styles and different intelligences (Gardner, 1983; Sternberg, 1988; Olson, 2000)—then differ­ent modalities (eg., visual, kinesthetic, auditory, verbal) and different me­dia, such as those now integrated in the primary and secondary educational curriculum (Goldberg, 1997; Burnaford, Aprill, & Weiss, 2001), in the arts and arts education (Berger, 1972; see Smith, R. A., 1990) and in the arts therapies (Lusebrink, V. B., 1990; Landgarten, 1993; Jennings, Cattanach, * Mitchell, Chesner, & Meldrum, 1994; Newham, 1994; Gilroy & Lee, C5^ 1995; Levy, 1995), can also be adopted and applied to the process of -fsjl

Bulletin of Psychology and the Arts learning, discovering and healing, in psychotherapy.

Western cultural traditions have generally placed greater value on verbal communication to the near exclusion of other modes of expression and communication. Our cultural valuing of verbal interaction has significantly influenced our decisions about what constitutes therapeutic interventions. The "talking cure" was placed by Freud at the pinnacle of the communica­tion pile perhaps because he was more comfortable with talking as a road to the unconscious. Certainly the talking cure would appear to fit into a scientific paradigm much more readily that any arts-oriented therapy would. Freud, as well as the early behaviorists, all sought approval from their physi­cal and biological science colleagues and desperately wanted to be thought of as scientists, not philosophers, and certainly not as artists. Although there are exceptions, most mental health and behavioral problems do not respond consistently to verbal-based therapies, regardless of the theoreti­cal orientation which influences the therapy. We are not presenting the arts in therapy as superior to verbal-based therapies—or as equal alternatives— but as interventions that can be incorporated into current clinical practice to expand the clinical repertoire of psychologists and other mental health practitioners .

The scientific method of discovery of the laboratory is quite often not applicable to clinical work. This does not diminish the scientific method, but it does call for a re-examination of what is considered "scientific" (Eisner, 1981). Through the expansion of the research methods used in psychology (Camic, Rhodes, & Yardley, 2002), and through what Eisner has discussed as connoisseurship in education (1991) and in psychology (2002), we be­lieve an opening for the arts-in-psychotherapy and an artistic examination of psychotherapy (Lawrence-Lightfoot & Davis, 1997; McNiff, 1998) is both possible and desirable.

We also believe in the importance of inquiring into the differences and similarities in the experience of an artist making art versus someone in an arts therapy situation making art. I f we consider the art-maker's "gratifica­tion" factor as an important part of the overall picture, there seems to be a continuum of four significant pleasurable moments in the process of creat­ing: the pleasure of the moment of inspiration, the enjoyment of the pro­cess, the satisfaction of completion, and the exhilaration of display. Are these moments the same for a Georgia O'Keeffe or a T.S. Eliot as for a novice sculptor or a client presented with the chance to express an emotion in paint or clay or movement? I f so, are we justified in continually differen­tiating between "high" and "low" art, between professional and amateur, between artist and artisan? I f not, then why does expressive arts therapy work, and what is actually happening when we use art in therapeutic prac­tice?

We would like to suggest a different way of looking at the'cluster of phenomena we have traditionally called "art," one which is inclusive, in­terdisciplinary, and multimodal. The first section of this issue examines the foundations of creative and expressive arts therapy and introduces discus­sion about the arts in clinical practice within professional psychology. For the purposes of beginning our discussion we look at a multimodal philo­sophical foundation provided by Levine_who furnishes an anchor for ex­pressive arts therapies within the Western philosophical and aesthetic tra­dition. He also introduces expressive arts therapy as a domain distinct from the arts therapies of art, dance, drama and music and addresses the impor­tance of considering aesthetic theories when using the arts clinically. McNiff further discusses the philosophical and aesthetic foundations of the cre­ative arts therapies while calling for an arts-based research paradigm to answer some of the questions current quantitative and qualitative social science methods cannot. Both Levine and McNiff approach the discussion of psychotherapy and the arts from the perspective of creative and expres­sive arts therapy researchers and clinicians. Camic proposes that the arts can be integrated into the doctoral curriculum of clinical and counseling psychology programs and supports this proposal by documenting the evo­lutionary importance of the arts in human development and in identifying some of the psychological mechanisms relevant to the arts in psychotherapy. He concludes his piece with a demonstration curriculum integrating the arts into doctoral clinical training. In answering the question "How can psychologists, who are not artists, use the arts in therapy?", Wilson, an artist and arts educator, describes his interdisciplinary arts studio class for clinicians and illustrates the benefits of acquiring and expanding artistic knowledge, as well as speculating about the new insights possible when such knowledge is fused, not merely layered, in clinical practice. The con­cluding article in our first section is by Gaugh, a clinical psychology doc­

toral student, who enrolled in Wilson's class and went on to complete a ' concentration in expressive therapies and creativity. She discusses her

V clinical experiences as a graduate student incorporating the arts in a

Bulletin of Psychology and the Arts therapy practicum.

The second section of this special issue involves articles by senior aca­demic and clinical researchers in the arts therapies of art, dance, drama and music. While not an exhaustive list of the currently available arts therapies, wc chose to include those arts therapies with established graduate educa­tion curricula, a history of documented clinical work spanning at least 30 years and a body of published research. The first article in this section is by Wadeson, a well-recognized art therapy researcher, theorist, clinician, and director of one of the nation's leading programs in art therapy. She pro­vides a discussion about current practices in art therapy as well as a brief history of the field. Cruz, a leading national figure in dance/movement therapy research, discusses the history of dance/movement therapy, current

• practices in DM/T and the populations this therapy serves and concludes by proposing new avenues for collaboration between psychology and DM/ T. Rubenstein, a psychologist and drama therapist who is clinical director at an agency specializing in the therapeutic use of the arts, introduces drama therapy and provides a clear discussion of its joint philosophical roots in theater and psychology. He illustrates the range of the field through clini­cal examples and offers a candid discussion about the need for more rigor­ous research. Duerksen, director at a preeminent school of music education and music therapy, introduces the therapeutic benefits of sound and music and furnishes an extensive overview to the field of music therapy.

The third section provides three examples of how we might come to consider the arts, psychotherapy, creativity and healing from very different perspectives. McCarthy, creativity researcher, educational and community psychologist, provides a candid examination of suffering, the creative pro­cess and the arts within the context of a terminally ill artist and her work prior to dying (front cover, this issue), the author's own chronic illness and the use of painting as a response to that illness (back cover, this issue), and her research which looks at the suffering of extreme poverty, racism, and classism with the theater group, Los Angles Poverty Department. In an examination of both the science and the art of psychotherapy, Benolken likens the work of the psychotherapist to that of the actor where both must attend to their performance and to the client/audience. Using her back­ground in theater and psychology she draws upon both the process of sci­entific discovery and the methods of artistic inquiry to shape a psycho­therapy informed by both. Perhaps more shared by humans than any other building block of the arts is authentic movement. Psychologist, Jungian analyst, and dance/movement therapist, Wyman-McGinty provides an in­troduction to authentic movement and a detailed case study of its use in psychotherapy.

These three sections provide an introduction to the philosophical, theo­retical, aesthetic, clinical and scientific foundations for using the arts in psychotherapy. Although this may be considered controversial, as editors we believe that all mental health practitioners and researchers, regardless of discipline, can make use of the arts in their work. How a music therapist uses sound and music in therapy may be different from that of a clinical psychologist or drama therapist. The use of visual art and movement in a counseling psychologist's practice is likely to have a different focus than that of an art therapist using these same modalities. To echo what Dr. Pat Allen (1995), faculty member of School of the Art Institute of Chicago and developer of the Open Studio Project has stated, the arts are available to everyone; no one profession or group has sole control over the arts; they are there for all to use. As you read this issue we invite reflection, discus­sion and critique. We think it is possible for psychology and the art thera­pies of drama, dance, music and art to forge new relationships with each other and with professional artists. The use of the listserv of Division 10 is one forum for this. We also invite your comments at an e-mail address we have set up for this special issue at pclw@earthlink.net.

References Allen, P. (1995). Coyote comes in from the cold: The evolution of the open

studio concept. Journal of the American Art Therapy Association, 12, 161-166.

Berger, J. (1972). Ways of seeing. London: Penguin Books. Burnaford, G., Aprill, A. & Weiss, C. (Eds.) (2001). Renaissance in the class­

room: Arts integration and meaningful learning. Mahwah, NJ.: Lawrence Erlbaum Associates.

Camic, P.M., Rhodes, J. E. & Yardley, L. (2002) (Eds.). Qualitative methods in psychology: Expanding perspectives in methodology and design Washing­ton, D. C: American Psychological Association,

Eisner, E. W. (1981). On the differences between scientific and artistic ap­proaches to qualitative research. Educational Researcher, 10, 5-9.

Eisner, E. W. (1991). The enlightened eye. New York: Macmillan. Eisner, E. W. (2002). On the art and science of qualitative research in psy

chology. In P. M. Camic. J. E. Rhodes & L. Yardley (Eds.), Qualitative methods in psychology- Expanding perspectives in methodology and de- ' lJ

Vol 2 (2) sign. Washington, D.C.: American Psychological Association.

Gilroy, A. & Lee, C. (Eds.) (1995). Art and music therapy and research. London: Routledge.

Goldberg, M. (1997). Arts and learning. White Plains, N. Y.: Longman. Jennings, S., Cattanach, A., Mitchell, S., Chesner, A. & Meldrum, B. (1994).

Handbook of drama therapy. New York & London: Routledge. Levy, F. J. (Ed.) (1995). Dance and other expressive therapies. New York &

London: Routledge. , Lusebrink, V. B. (1990). Imagery and visual expression in therapy. New

York & London: Plenum. McNiff, S. (1998). Art-based research. Jessica Kingsley: London & Phila­

delphia. Newham, P. (1994). The singing cure: An introduction to voice movement

therapy. Boston: Shambhala. Olson, I. (2000). The arts and critical thinking in American education.

Westport, CT & London: Bergin & Garvey. Smith, R. A. (Ed.) (1990). Cultural literacy and arts education. Urbana &

Chicago- University of Illinois Press.

Lawrence E. Wilson 2310 Thayer Street Evanston, Illinois 60201.1412

Paul M. Camic Department of Liberal Education Columbia College Chicago 600 South Michigan Avenue Chicago, Illinois 60605.1996

Philosophical Foundations of Expressive Arts Therapy: Towards a Therapeutic Aesthetics

Stephen K. Levine York University, Toronto

Introduction Expressive Arts Therapy (EXA) is an intermodal approach to the arts

therapies. A sensory "modality" should be distinguished from an artistic "discipline." In a way, all the arts therapies have an intermodal aspect; each draws upon diverse sensory and communication modalities; and often prac­titioners employ a variety of artistic disciplines as well. What is distinctive about EXA is that it makes intermodality into both its method and its phi­losophy. Expressive Arts Therapists are trained as specialists in the intermodal use of the arts in therapy. They learn how to help clients move from one mode of expression to another ("intermodal transfer")* when ap­propriate, and they use different forms of expression in responding to cli­ents' work ("aesthetic response"). The practice of EXA has been studied and its history and methodology discussed (Knill et al, 1995; S. Levine and E. Levine, 1999; McNiff, 1981).

What distinguishes expressive arts therapy from the other arts therapies is not only its method but also its philosophical framework . EXA is based upon an aesthetic approach to therapy. It places the arts at the center of its theory and practice. This distinguishes it from more psychologically-ori­ented approaches. Inasmuch as the arts therapies have entered the field of therapeutic practice subsequent to the emergence of psychology as a disci­pline, it is only natural that they have tried to fit themselves into psycho­logical frameworks. Thus, for example, we have Freudian, Jungian, and Humanistic approaches to the arts therapies; these approaches are thereby validated within existing psychological theories. This has undeniable ben­efits, since the psychologies in question tend to be well-developed in both theory and practice. Moreover there are many areas of convergence be­tween the arts therapies and psychology which make it only natural for connections to be noticed. Such convergence has been commented upon by expressive arts therapists as well (S. Levine, 1997; E. Levine, 1995).

Basing the practice of the creative and expressive arts therapies upon psychological theory, however, runs the risk of neglecting or diminishing the specific aspect that distinguishes these therapies: their essential involve­ment with the arts. To begin with psychology means that aesthetics will always need to be placed in an existing perspective; it will always be sub­sidiary to that perspective rather than serve as the basis of the work. This secondary theoretical status of the aesthetic dimension is reflected in thera­peutic practice, in which the arts therapies are seen as helpful but adjunc­tive methods. Consequently, there is often a tension between arts thera­pists' view of their own work and the roles which they are given within institutional settings.

Moreover, the adjunctive role of the arts therapies in relation to psychol­ogy has important theoretical and practical implications. I f one begins with a psychological approach, the arts wilt be seen as reflections of • psychological processes. A painting, for example, will be understood

^ as an outer expression of an inner feeling. Therefore it should be pos-

Vol 2 (2) sible for the art therapist to interpret the meaning of the painting in terms of the client's inner psychological state. This approach, which seems rea­sonable enough at first glance, nevertheless runs the risk of reductionism by looking for the meaning of the art-work in something outside of itself. We can see the danger of this in psycho-biographical approaches to the arts, which tend to sec the artist's work as "nothing but" a reflection of his or her life.

In order not to fall prey to reductionism, we must try to understand the essential nature of the aesthetic dimension without basing it upon another realm of existence. Expressive arts therapy rejects a reductionist approach to the arts and places aesthetics at the center of its theory and practice. To understand the centrality of aesthetics for expressive arts therapy, we need to revision certain key steps in the history of Western philosophical think­ing about art. In doing so, we will see that it is primarily in contemporary thought that the therapeutic aesthetics of expressive arts therapy finds its place.

As long as we take for granted the traditional framework of philosophi­cal understanding, the aesthetic dimension of existence will be relegated to a secondary role, i f it is recognized at all. This is because traditional theory is founded upon a devaluing of the senses, the basis of aesthetic experi­ence. The use of different arts disciplines in expressive arts therapy, on the other hand, is based upon an understanding of their rootedness in the sen­sory modalities of the body.

The body is the medium of human expression; all of the arts disciplines owe their power to their ability to draw upon particular sensory modalities, either singly or in combination. Each art discipline achieves its goals by transforming sensory experience into imagination. On the basis of this imagi-nal transformation of the senses, meaning emerges in a sensuous, embod­ied form. The origin of the work is in the body's capacity for expression and in the power of the imagination to transform sensory experience into artistic form.

Several questions emerge from this perspective. What is sensory experi­ence? How are the different senses brought together in the expressive body? What is the imagination, and what is the relationship of imagination to sensing and to memory? What is artistic form, and what kind of meaning emerges from it? Finally, and most importantly, what is the relationship of the arts to human suffering? How can the arts have a therapeutic effect?

Aesthetics in the Philosophical Tradition I f we look at traditional philosophical approaches to the arts, we wi l l see

that the arts have primarily been understood as modes of representation. In the philosophy of Plato, which has served as the foundation of Western thought, art-making, poiesis, is understood as a form of imitation, mimesis. The basis of aesthetic understanding, for Plato, is that art is an imitation of sensible reality, the spatio-temporal world of change. This changeable world, in which things come into being and pass away, is itself only an imitation of an unchanging world of form. Thus the arts, for Plato, are imitations of an imitation and therefore can have no relationship to truth. They belong to the realm of seeming rather than being; they lead to illusions and false opinions rather than stable, unchanging knowledge. Moreover, the arts stir up the passions and appetites. As directed to the emotional aspects of the psyche, they lead people away from reason, the part of the soul that knows what is best for the person and therefore should be in control. Therefore, Plato bans the arts from the just city described in The Republic.

Plato's criticism of the arts is not based on a denial of their power. Rather, it is precisely because the arts have such a powerful effect that they can lead the citizen away from his proper role in an ordered polity. The image of chaos and collective disorder haunts Plato's Republic. These dangerous conditions can only be kept at bay by an ordering of the whole based upon knowledge of what is.

In the Platonic dialogues, we can see the beginning of the split between art and science which has come to characterize the Western tradition of aesthetics. The arts are seen as antagonistic to knowledge; they have noth­ing to do with truth but are rather relegated to the realm of the emotions and the imagination. Philosophy wants reality not illusion, being not seem­ing. From the traditional philosophical perspective, the arts work through images which appeal to the emotions and therefore lead away from rational knowledge. Most importantly, the arts are enemies of order; their reliance on the senses and the material world means that they can never attain to the formal perfection which belongs to true being. There is, as Plato says, an ancient quarrel between philosophy and poetry, which can only be resolved by the dominance of rational thought (Plato, 1961).

It is not until Nietzsche that we find a philosopher willing to give the „ arts a fundamental place in the search for truth. Nietzsche's The Birth % ^ of Tragedy is an attempt to challenge the premises of traditional West- -f\3

Bulletin of Psychology and the Arts ern philosophical thinking and to establish a new basis for knowledge in artistic practice. He does this by counterposing the philosophical tradition rooted in Plato with a new understanding of the origins of tragic art (Nietzsche, 1967).

In terms of the scholarship of Nietzsche's time, tragedy was understood as a literary art, one in which the poetic language of the drama gave form to the chaotic events which overturned the protagonists' lives. For Nietzsche, however, this emphasis on the formal perfection of tragic discourse over­looks what was most striking in the actual performance of tragic drama: the song and dance of the chorus. The language of the protagonists was founded upon the music of the chorus; and this reflects the origins of tragedy in the dithyramb, the communal song and dance in praise of the god Dionysus.

Tragedy for Nietzsche was first and foremost a Dionysian art, as the performance of the plays at festivals dedicated to that god would indicate. Nietzsche contrasted the individual protagonists, speaking in measured verse, with the collective singing and dancing of the choral throng. He described the former as following Apollo, the Greek god of light, logic, law and individuality. The chorus, on the other hand, could be seen as devotees of Dionysus, the god of the vine, of communal intoxication and orgiastic celebration.

Nietzsche's theory of the origin of tragedy has been subjected to a great deal of debate and criticism. What is most important, however, is not the validity of the historical account he gives but the new mode of thinking that he employs and the way in which it changes the role which the tradi­tion of philosophy assigns to the arts. Philosophy, for Nietzsche, is essen­tially Apollonian. It is based on the primacy of the individual, of reason, form and order. In its thinking of what is as eternal, unchanging form, it neglects the chaotic world of the body, of sensible experience, time, and death. It tries to escape from this world of change into an eternal realm of the unchanging; but in so doing it reveals a powerful will that is ignorant of its own action.'

Tragedy, on the other hand, is able to show the inherence of the Apollonian, the logical world of the individual, in the Dionysian, the cha­otic striving of the collective. In fact, the Apollonian world of art, for Nietzsche, is itself an effect of the Dionysian wil l , an attempt to look exist­ence in the face and accept it for what it is: a chaos in which all things come into being and pass away, in which there is no permanent foundation for thinking or being, only change. Temporal existence causes suffering; art gives us a way to affirm our suffering and to find joy even in destruction.

Given Nietzsche's perspective on existence, his understanding of think­ing must also change. I f Being is chaos not cosmos, i f its essence is time rather than eternity, how can we think it? Concepts and definitions seem to fix Being and thereby lose its temporal quality. Therefore, for Nietzsche, it is not to concepts that we must look for truth but to images. Only the im­age, with its basis in the concrete and sensible, can claim to grasp the es­sence of truth. It is for this reason that Nietzsche uses the figures of Apollo and Dionysus, not as illustrations of his thoughts, but as modes of thinking themselves. Thinking becomes imaginal for Nietzsche; the thinker must become an artist i f he is to come close to truth.

The Valuation of the Arts in Post-Modern Thought The themes of Nietzsche's thinking recur again in the work of Martin

Heidegger, whose writings have become a source for contemporary post­modern thought. In Being and Time, Heidegger's most systematic work, he attempts to think through the consequences of conceiving Being not as eternal form but as temporal change. Human being must be thought as finite and therefore temporal in order to be understood. This means that for Heidegger there is no other world in terms of which the thinker can find the principles of existence. Rather the human being is to be thought of as a "being-in-the world." He or she is the being who is there (Da-sein, being-there), one who is situated at this time, in this place. What is characteristic of Dasein, unlike other beings, however, is that it knows that it is there; it has an understanding of Being and, ultimately, of its own being as finite and temporal. Dasein knows it wi l l die; it is a being-towards-death. This knowledge produces dread (Angst), the fear of nothingness which is al­most too terrible to be borne. Dasein must decide whether it wil l accept its own finitude or flee from it into the anonymous realm of the impersonal "one" (Das Man, the "they"-self which pertains to everyone and is not my own, in the way that my death can only be my own). I f Dasein can accept its own Finitude, its existence will become authentic (eigentlich, one's own or proper way to be). Otherwise it will suffer from an inability to be itself, from what we might call an ontological pathology (Heidegger, 1962).

Both in the form and content of Being and Time, there is little that explicitly pertains to the arts. It is not until Heidegger's essays in the

! jv 1930's that he begins to view art as directly bearing upon human exist-

Bulletin of Psychology and the Arts ence. In the essay, "On the Origin of the Work of Art," Heidegger sees the authentic art-work as setting up a world in which humans can dwell (in the way, for example, that the Greek temple was able to accomplish, by becom­ing a center of meaning and activity for the community). This setting-up of a world, for Heidegger, is possible only insofar as the work also sets itself back into the earth, the "material" out of which it is made. The work re­veals the earth as the bearing ground which itself can never be mastered or revealed. Thus the work is a conflict or "r i f t" (Riss) between world and earth; it is both revealing and concealing. In the enactment of this conflict, the truth of an historical people comes to take a stand. Art, for Heidegger, is the "setting-itself-into-work" of truth. In the truth which the work re­veals, a people can find a home, a dwelling-place upon the earth (Heidegger, 1971).

Heidegger's conception of truth as unconcealment, formulated in Being and Time, rather than as correspondence to reality, gives the possibility of re-thinking the relation of art to truth. Art for him is a mode of revelation; its proper work is to show what is, to bring it into appearance. Thus art cannot be understood as mimesis in the sense of an imitation of existing reality. Rather, art brings that reality into manifestation and, in so doing, enables it to show itself for what it is in a way that had previously been concealed.

I f Heidegger, following the phenomenological method, thinks of truth as a phenomenon, something that appears, it makes sense for him to turn to the arts as primary modes of manifestation. When Being is conceived of within the horizon of time, truth cannot be thought as corresponding to a timeless state of affairs. Rather, truth is always becoming; it is a continual process of unconcealing, a showing in which what is comes to manifest itself. This manifestation in the work is itself not something eternal (as i f art could escape time and mortality) but rather an event which happens only insofar as there are those who care for what has come to be revealed. The work requires preservers as well as creators i f it is to take its place in the world. Once the historical actuality of the work is gone, it becomes a museum piece, of interest only for its trace of an earlier life.

In his later essays, Heidegger returns again and again to the works of the poets, particularly Holderlin, for traces of this world-revealing power of the work of art. For Heidegger, the contemporary world has lost its capac­ity to "hold" the work; rather the world has become a technological world of "enframing" (Gestell) in which all things have value only insofar as they can be "placed" within the project of technical domination. Heidegger wonders, as Hegel did, whether art can today have the world-historical power of revealing truth that it once had.

This nostalgic quality of Heidegger's thought is largely absent from the post-modern philosophy which otherwise follows him. Post-modern thought (for example, the work of Derrida and Lyotard) can be understood as an attempt to think in a non-foundational way, to take seriously (and play­fully) the absence of a stable, unchanging realm of truth upon which one can ground one's thinking. From a post-modem perspective, there is no eternal unchanging world of form to which thinking can aspire. Therefore there are no principles which can serve as legitimating grounds for dis­course. Post-modernity, as Lyotard says, is suspicious of meta-narratives. It rejects the assumption that there is a single framework of understanding which can be taken for granted as providing a basis for thought (Lyotard, 1984).

This absence of a ground gives an abyssal quality to post-modern think­ing. On the one hand, it is drawn to the images of disaster, destruction and horror contained in recent history. The Holocaust becomes the emblem of post-modernity's rejection of reason as ground. I f for Hegel it was still possible to believe in the working of the "cunning of reason" in history, despite the historical tragedies of which he was well aware, post-modernity's consciousness of the "totalizing" quality of the Holocaust makes it impos­sible (or obscene) to imagine any purpose or meaning to it at all. Thus the nothingness which for Heidegger is part of human existence as finite being becomes an historical actuality, as the taken-for-granted authority of tradi­tion disappears.

On the other hand, the absence of ground gives an unprecedented free­dom and lightness to thought. Nietzsche advised his successors to laugh at the terrors of existence; post-modern philosophers have embodied a ludic spirit in their work, a playful quality in which wit, joke and word-play are seen as more valid than theoretical proposition or moral judgment.

The arts are valued in post-modernity, therefore, either for their ability to find new forms for the encounter with the abyss or for their capacity to dance and laugh on its edge. The post-Holocaust poetry of Paul Celan i. and the "tragic-comedies" of Samuel Beckett are two exemplary modes %£~ of post-modern art. What is interesting is that in both cases traditional ^ J «jA

Vol 2 (2) forms are broken. Fragmentary and seemingly chaotic works are presented in which a more appropriate kind of truth for our time becomes apparent. I f art is to be healing in a post-modern age, it can only be an art which gives up its claim to be a representation of what is, a claim which led to the conclusion that the only legitimate goal of the arts was the restoration of order. In a disordered world, art-making must find forms in which the chaos of contemporary experience is given a place. The traditional understanding of poiesis has to be re-thought in order to be able to account for the healing capacity of the arts today.

Embodiment and the Work of Art One place to begin such a re-thinking is with an understanding of sen­

sory experience. Within the traditional philosophical perspective based on the primacy of unchanging form, it is understandable why bodily experi­ence, which seems to deal only with the chaos of sensory impressions, should be given an inferior place in the hierarchy of Being. However, once we accept that we are beings-in-the-world, we come to realize that it is through our bodies that we have our primary access to the world in which we live. Maurice Merleau-Ponty, in The Phenomenology of Perception, follows Heidegger's understanding of Dasein as being-in-the-world by showing how our existence is grounded in our bodily being.

Merleau-Ponty speaks of "the lived body" ('7e corps vecu") to describe this bodily being-in-the-world. He thereby distinguishes this lived body from the body as an object of scientific knowledge. It is valid and neces­sary to objectify the body and to acquire an analytic understanding of its functioning; but we must remember that this scientific understanding is founded upon the more primary awareness that we have of our bodies in sensory experience. I f embodied existence is primary, then the scientific conception of the body cannot be used as a foundation for the understand­ing of the proper meaning of our experience. Rather, the objectifying analysis of the body should be seen as the result of a particular operation of under­standing undertaken for the specific purposes of explanation and control (Merleau-Ponty, 1962).

One consequence of Merleau-Ponty's perspective on the lived body is that, through phenomenological reflection on bodily experience, we come to realize that this experience is not the chaotic welter of impressions which it has traditionally been understood to be, on the basis of the assumption of a pre-given objective reality. I f we begin with an objectified concept of nature and view the body within that perspective, we wil l tend to see the body as the passive recipient of sensory impressions which have no mean­ing of their own and which therefore require an act of judgment in which they are brought together according to a principle or law. But i f we attend to our own bodily experience, we immediately realize that it is always al­ready intentional; bodily experience reveals a meaningful world. Sensing takes place within an understanding of the world in which I exist. What I sense always makes sense; there is a pattern or structure to sensory experi­ence. I do not experience the world as a meaningless chaos of sense data; rather the world is given to me through the senses as charged with signifi­cance. The world has sense; perception is the revelation of this sense.

However this sense is always local. It is the particular sensible reality that manifests itself to me, not an unchanging form which can be detached without any loss of meaning. In aesthetic experience as well, the qualities of the work always have a local and specific meaning. There is never, for example, color in general; there is the local color in a painting which has an effect only in relation to the other colors and shapes in the work. More­over the work of the artist as a whole is itself embodied in a sensory man­ner. It expresses a style, not a formula. We recognize it immediately, but we cannot reduce it to a set of principles.

The traditional philosophical understanding of artistic experience as imposing abstract form upon senseless matter, therefore, has to be rethought. The artist was seen as forming matter by reference to an idea which he or she held beforehand in an intellectual understanding. But i f matter as sen­sible already "makes sense," then the role of the artist is not to act as a creative deity making order out of chaos. Rather it is to allow the "sense" of the work to emerge from its "materials." In art-making, we often have the experience of forms arising from the brush-stroke, the movement, the words. The intention with which we begin is always transformed by our encounter with the materials of our artistic discipline. Often there is the experience of "receiving" the work rather than of "making" it. The work is given to us; it is a gift which comes only when we can be open and recep­tive to it. We cannot know in advance nor control what will emerge, though of course afterwards we can use our understanding in a critical, reflective way to edit and revise.

The work always exceeds our prior intention. It arrives as a surprise which brings new insight and awareness. It is never a "representation,"

Vol 2 (2) in the sense of a mere reproduction of a pre-existing reality. Nor does it represent a prior mental state. The genuine work brings a "surplus of mean­ing" which results in new understanding. For this reason, the work cannot be inteipreted backwards to reveal the psychology of its maker. There is always a gap or space between the psyche and the work; this gap makes it possible that the work can give us something new, that it can transform our experience rather than merely reproduce it. Certainly interpretation is still possible; but it can only be a "hermeneutic" interpretation which aims to show the emerging meaning, not a psychologically reductive one which tries to tie it to something already known.

The phenomenological perspective on sensory experience also reveals the shaping activity of the lived body at the primary level of existence. There is a proto-artistic component to bodily experience. The pre-reflec-tive bodily experience of actively encountering a world filled with sensible meaning makes it comprehensible how art can emerge within human expe­rience. It is not necessary to postulate a special category of "genius" to account for the work of the artist; rather, one could say that there is an element of genius in all of us at the most basic level of our bodily being-in-the-world, as we actively reveal the shape of our experience rather than passively endure it.

Moreover sensory shaping is thoroughly intermodal. I do not experience myself as receiving discrete data through the different senses and then by means of a synthetic judgment combining them into a coherent whole. Rather the world is given to me within a sensible horizon that is open to every modality of the senses. What I see is also given as what 1 can potentially touch, what I can taste or smell as well. There is a unity of perception in bodily experience that gives the groundwork for its development into di­verse artistic media which refer back to a common core of experience.

At the same time, this unity is not an identity. Each of the senses, as Jean-Luc Nancy has reminded us, "touches" on the others but is not the same as the others (Nancy, 1996). The senses provide a network of signifi­cance with multiple cross-references rather than a blending into one iden­tical meaning. This makes possible the specialization of art disciplines, as the possibilities of each mode of sensory experience can be explored in relative isolation from the others. It is only necessary to remember that the specialized development of the arts is no more "natural" than their combi­nation. We cannot even say that there is a one-to-one correspondence be­tween a sensory modality and a specific art-form. The arts as we know them have developed in concrete historical and cultural settings which have motivated the specific forms with which we are familiar.

The arts shape sensory experience through imaginative modalities. Imagi­nation finds the form for sensory expression that organizes it in an active, meaning-giving way. The imagination can thus give a higher level of sig­nificance to sensory experience. A level of meaning emerges which tran­scends the sensory; the work conveys a message which can be taken away and reflected upon. At the same time, this message is embodied through sensory expression. It too is a local meaning and can never be totally de­tached from its embodiment. For this reason, there will never be any final interpretation of a work of art; there is always more to it than reflective analysis can understand.

This relative detachment of embodied meaning is based on the distinc­tive relation of works of art to the sensory world. The work takes sensory experience out of its immediacy and presents it to us in a wider horizon. In the dance, my movement is shaped so that it makes sense in its own right. It stands out from the flux of movement in the world as something to be viewed from a distance, distinct from the movement that goes on around it and from my own movement experience. The concept of aesthetic distance is intrinsic to imaginative shaping. Even if, for example, the style of move­ment is familiar and resembles everyday movement rather than a highly stylized form (e.g., ballet), it nevertheless differentiates itself from my body's ordinary movement habits and capacities by being marked off and "framed." It no longer goes beyond itself towards a network of purposes but demands that we regard it for its own sake.

At the same time, distance is not indifference. The work has no aesthetic value unless it "touches" us, affects us on a sensory, emotional, and intel­lectual level. It is precisely because aesthetic distance is achieved that the imagination can create works that come closest to our sense of self, that "move" us in the core of our being. The mediated character of the work permits it to achieve a level of immediacy that transcends normal sensory experience (except for those moments in which, for example, nature "touches" us in the perception of beauty). "Experience," in the emphatic sense, is often the result of an encounter with a work. These are moments we remember as among the most powerful in our lives, to be rivaled only by such primary existential events as birth, love and death.

Bulletin of Psychology and the Arts What is it about the work that gives it the power to move or touch us?

Perhaps it is the very sensory character of the work that renders it so pow­erful. The work "re-presents" the world only in the sense that it makes it present again; i.e., the work makes the world manifest in a fully concrete, sensible way. Even a literary work has this effect; we hear the sounds of the poem; we imagine concretely the characters in the novel. No abstract state­ment can have this immediate impact. The work gives us the world again as a living reality. I f I can fully enter into the world of the work, I experience myself as living in it with a heightened sense of actuality. I am compelled or fascinated by the work; it has a hypnotic quality that draws me into it and produces a fascination that I am reluctant to give up. In fact, we could go so far as to say the work affects us so deeply that we experience our­selves as changed by it. The world of everyday life looks different when we return to it from the world of the work; and we are not the same as when we entered into it.

Ar t and Suffering The power of the work is particularly evident when we look at the rela­

tionship of art-making to human suffering. In every culture we see the arts being employed as vehicles for both celebration and mourning. Blake's Songs of Innocence and Experience can be seen as emblematic for the ar­tistic encounter with the world. We begin in innocence but inevitably ar­rive at experience, which means loss, suffering and death. In the case of innocence or experience alike, moreover, we are motivated to "sing," to celebrate and mourn through the arts. This is one of the paradoxes of artis­tic expression: the representation of suffering brings a kind of joy. Through tragic art, for example, we are able to "hold" the experience of the suffer­ing of the hero in a way that would perhaps not be bearable were we to undergo it in our own lives. Again, this does not mean that we experience this suffering less fully; rather it is only through the imaginative form that we can encounter it for what it is without turning away.

It is important to emphasize that artistic representation is not literal re­production. Mimesis in the arts is not an attempt to produce an identical copy of that which is to be shown. Rather artistic mimesis is always a trans­formation of experience, a metamorphosis which imaginatively recasts ex­perience in radically different forms precisely so that its utmost signifi­cance can be felt. This understanding of artistic transformation has impor­tant implications for the use of the arts in therapy. There is a tendency in contemporary trauma theory, for example, for suffering to be conceived of as something which needs to be remembered in its literal actuality. The work of therapy is designed either to re-enact the traumatic experience or to remember it by representing it in narrative terms.

Expressive arts therapy, understood within a phenomenological frame­work, conceives experience itself as containing an active shaping-reveal­ing component. Even trauma is experienced differently by different people, depending upon their characteristic shaping of the world. This can be seen in what is sometimes referred to as the resiliency or resources of the trau­matized person. The same traumatic event will lead to enormously differ­ent outcomes, depending upon the experience of the victim. This does not minimize the horror of the trauma; it only reminds us that even under the worst circumstances, there is an experience which is being undergone, not just an effect which can be understood objectively.

Moreover the memory of the traumatic event is not a literal representa­tion. Memory is always an interpretive process, in which an experience already shaped by the perceiver is re-shaped through recollection. This does not mean that memory is "false;" rather that "true" memories are those which allow us to have a deeper relationship to the remembered event, in order to discern its significance for us at this time. The most effective form of memory is not the recitation of the "facts" but the imaginative reshaping of experience in such a way as to allow its full power to affect the self and others. This is, as Aristotle recognized, the function of artistic mimesis and the basis of its capacity to heal. Healing in this case does not mean the elimination of suffering but the ability to find a form for it with which we can live (Levine, 2001).

Of course the greater the trauma the more the challenge to the arts to present it properly. The massive scale of human suffering in our epoch has challenged the capacity of artistic representation. The philosopher Theodore Adomo once said that, "After Auschwitz, there can be no poetry." By that he presumably meant that not only can there be no poetry about Auschwitz but that the very enterprise of art-making implies a hope for the overcom­ing of suffering which is a betrayal of the depth of the pain experienced by the victims of the Holocaust. Compared with the gas chambers, of what

value is a poem? 54 f And yet the ensuing years have brought a proliferation of art-works

i j ^ . specifically designed to represent the Holocaust, both by those who

Bulletin of Psychology and the Arts have undergone the experiences themselves and by others who only wit­nessed from afar. Is there an experience of suffering so total that any attempt at representation is doomed to failure? Or is it rather that in the face of new forms of suffering, new modes of representation must be developed as well? It seems that we have no choice, i f we are to go on being human. What is characteristic of human being is poiesis, the act of knowing by making, shaping our reality through sensible and imaginative transformation.

Indeed we could say that one of the greatest sources of human suffering is the inability to give shape to our experience. The client or patient in therapy often has a feeling of helplessness; their sense-making capacity is blocked, and they feel that they merely passively undergo their experience. The use of the arts in therapy can then restore a sense of capacity, an " I am able" that is usually lacking in their experience. Moreover artistic mimesis can enable clients to form a different relationship to their experience. Imaginative re­shaping may not only provide a feeling of empowerment but may also help to achieve new significance on an embodied level.

There is a tendency in this direction in the narrative turn in post-modern psychology; but often narration is understood therein as primarily cognitive and linguistic, the telling of one's story in a new way. Expressive arts therapy allows for the story to be told in a fully embodied manner, thus recalling the earliest roots of story-telling in the oral tradition. For the narrative act to be healing, it must be experienced fully, on the sensory, emotional, and cogni­tive levels. In this sense, therapeutic understanding can be said to be performative. There is a performance of healing which takes place through (he use of the arts in therapy. Performance requires bodily presence on the part of the performer; the detachment of a purely intellectual understanding must be overcome.

Similarly performance requires an engaged and responsive audience to be complete. The therapist must be a "witness" to the performance, not in the sense of a disinterested observer but as someone who lets themselves be fully affected on all levels by what is presented. The effectiveness of the presentation often requires aesthetic intervention on the part of the thera­pist; he or she must help the client find the appropriate form for their expe­rience. This often means not being content with the initial expression of feelings but re-shaping that expression until it touches the "effective real­ity" of the client (Knill, 1995), i.e., until it has an impact that "affects" them. This approach has sometimes been called a "work-oriented" or "oeuvre-oriented" approach to expressive arts therapy. (Knill, 1999)

The usual distinction between process and product does not help to grasp this method. Psychologically-based approaches to the arts therapies tend to emphasize the self-experience of the client in the process of creating. There is often a neglect of the work that emerges from thjs process. The work itself is valued primarily for its ability to reflect the client's inner state. In a more artistically-oriented approach, on the other hand, the work is seen as tran­scending the initial motivation that brings it into being. Certainly the client may have something in mind; but as the work develops it tends to take on a life of its own. Its value, in fact, consists in what it brings that was not previously present, that arrives as a surprise that takes the breath away. Art-making is not self-expression; but neither is it divorced from the experience of the maker. In fact, the value of the work depends on the extent to which it speaks to that experience. In this sense only, the product can be said to be judged by the process, i.e., by the impact it has on the client's experience.

Therapists, i f they can achieve a state of openness to what is emerging, will themselves be lead to an aesthetic response; they will be moved to re­spond to the client's work through an artistic expression of their own. Again, this differs from the ordinary conception of "witness," where the witness is understood as confirming the validity of the experience of the client by "re­flecting" or "mirroring" it. Just as the work does not "mirror" the inner psychological state of the client (it does not reproduce it but transcends it in the direction of a new emergent meaning), so the response of the therapist is not a reproductive witnessing. In a work-oriented approach to expressive arts therapy, witnessing means responding, shaping a response through an aesthetic form. This giving and taking between client and therapist is in fact a specific version of normal human interaction; we never passively mirror or reflect each other but are always modified by the acts of the other. Human interaction always requires response. Aesthetic responsibility demands that we respond to an art-work in the language of the arts, rather than through an interpretation which stems from another region of being.

Conclusion Expressive arts therapy is based upon an aesthetics of human existence.

The human being is conceived as an active shaper of their world, one who takes the materials of the world that have been given to them and re- j shapes these materials into meaningful form. Human existence is po­etic; i.e., poiesis is the basis of our acts of meaning-giving and receiv-

Vol 2 (2) ing. This poetic capacity is based upon our primary bodily inherence in the world. As beings-in-the-world, we can never get outside of this world in order to master or comprehend it. Rather we have only the limited capacity to understand things from our point of view and to shape them within the limits of our powers and their malleability. This means that our work wil l never be finished.

Within a therapeutic framework, we can never say that we have been healed or cured, only that we are on the way to healing. The therapist is a guide on a journey in which he or she is also a participant. We are therefore responsible for our work, both the art-work and the "work" of therapy it­self. The therapeutic experience does not only use art; it is itself an aes­thetic experience that calls upon the full range of our human capacity for sensing and sense-making. Only such an experience can do justice to the suffering that leads our clients to ask for our help.

Expressive arts therapy is not so much a particular technique of thera­peutic action as it is a general approach to the practice of therapy. Whether it employs more than one artistic modality in a session or not, it always carries with it a sense of the human being as engaged in the world through the senses, as capable of imaginatively transforming that world and as sen­sitive and responsive to the effects of their own and others' work. Therapy takes place within the great collective enterprise of being human in which we affect each other through our very existence. Our professional identifi­cations are less important than the recognition that no one is exempt from that claim of mutual responsibility. We must celebrate and mourn together. In our songs of innocence and experience, we will find our way.

References Heidegger, M. (1962). Being and lime. New York: Harper and Row Heidegger, M. (1971). The origin of the work of art, in M. Heidegger, Poetry,

language, thought, pp. 15-87. New York: Harper and Row. Knill, P. (1999). Soul nourishment, or the intermodal language of imagina­

tion, in S. Levine and E. Levine {Eds.) Foundations of expressive arts therapy: Theoretical and clinical perspectives. London: Jessica Kingsley.

Knill, P. (1995). Minstrels of soul: Intermodal expressive therapy. Toronto: Palmerston Press.

Levine, E. (\995).Tendtng the f ire: Studies in art, therapy and creativity. Toronto: Palmerston Press.

Levine, S. and Levine, E., (Eds.), (1999). Foundations of expressive arts therapy: Theoretical and clinical perspectives. London: Jessica Kingsley.

Levine, S. (2001). Mimetic wounds: Trauma and drama in psychotherapy and the arts, Poiesis- A Journal of the Arts and Communication, 3.

Levine, S. (1997). Poiesis: The language of psychology and the speech of the arts. London: Jessica Kingsley.

McNiff, S. (1981). The arts m psychotherapy. Springfield, IL: Charles C. Thomas.

Merleau-Ponty, M. (1962). The phenomenology of perception. London:Routledge.

Nancy, J.-L. (1996). Why are there several arts and not just one?, in J.-L. Nancy, The muses. Stanford: Stanford University Press.

Nietzsche, F. (1967). The birth of tragedy. New York: Vintage Books. Plato, (1961). The republic, in E. Hamilton and H. Cairns (Eds.), The col­

lected dialogues of Plato. New York: Bollingen Foundation. Resources

Expressive Arts Therapy has its roots in the formation of the Expressive Therapy program at Lesley University (then Lesley College) in Cambridge, MA, in the early 1970's by Shaun McNiff, Paolo Knill, Norma Canner and others. Lesley has trained hundreds of expressive arts therapists at the MA level since that time and has recently developed a doctoral program in the ex­pressive therapies. In the last decade, the California Institute of Integral Stud­ies in San Francisco has begun an MA program in EXA; and the European Graduate School (EGS) in Saas Fee, Switzerland, has started both MA and PhD programs in EXA in cooperation with the International Network of Ex­pressive Arts Therapy Training Centers. EGS Press publishes the journal, Poiesis: A Journal of the Arts and Communication, which often contains work by or relevant to expressive arts therapists, as well as the books by Knill and E. Levine mentioned in the bibliography. There is also a professional organiza­tion, the International Expressive Arts Therapy Association (1EATA), that reg­isters practitioners, holds conferences and provides a focus for professional work in the field. The following is a list of Internet contacts for those who wish further information:

California Institute of Integral Studies: www.ciis.edu European Graduate School: www.rhone.ch/egs EGS Press: egs@interlog.com IEATA: www.ieata.org Lesley University: www.lesley.edu

Stephen Levine 18 Wells Street Toronto, Ontario M5R 1P3 Canada

Vol 2 (2)

Creat ing Outside the Lines: Enlarging Psychological Research through the Ar ts

Shaun McNiff Endicott College

A New Frontier for Research As an artist with a long history of studying the creative process I ask why

is it that we do not use the methods of artistic inquiry to learn more about artistic phenomena? Why have we attempted to explain the dynamics of creativity with psychological systems that do not speak the language of art, that do not resonate with the object of inquiry? In philosophy the situation can be likened to an attempt to restrict the examination of aesthetic experi­ence to the rules of logic. Reasoned analysis is a wonderful tool, my Jesuit mentor used to say, but it can only go so far. We need other ways of reflec­tion to engage the total spectrum of experience.

Analytic examinations tend to progress along linear and singular tracks, exclude everything outside the pre-detennined boundaries of inquiry, and operate according to established rules. The creative imagination is in many ways antithetical to logical analysis, although it makes good use of reason as a reflective guide and critic of its musings.

Imagination is an integrating intelligence that encourages us to operate outside the lines of the more conventional discourse, to consider illogical relations, to follow visions and intuitions, and incorporate all of our expe­rience, including reason, into a mix of ingredients that find their way to synthesis. Where many problems are best examined according to the strict rules of logical analysis, others invite a less circumscribed and more pro­cess-oriented inquiry.

As contrasted to the step-by-step sequence of analysis, the imagination leaps, seizes, and transforms. Where linear modes of problem solving cal­culate exact progressions, imagination entertains unlikely possibilities, cooks with a broad spectrum of ingredients, and creates ideas through new com­binations and relationships.

Beginning with Thomas Hobbes in the mid 1600's imagination was viewed as a connecting and integrating power which functions organically as contrasted to mechanistic chains of thought. Creating through new com­binations of phenomena, imagination embraces contributions from the arts, science, reason, perception, memory, and emotion. For 150 years after Hobbes, imagination was viewed as a mediating intelligence, a "middle place" between perception and reason (Akenside, 1744), and as an "inter­mediate faculty" (Coleridge, 1817). However, the past century's one-sided orientation to linear scientific specialization has reversed these earlier gains.

Through the "practice" of creative art therapies, disciplines that are them­selves combinations of arts and sciences, the integrating intelligence of the creative imagination has resurfaced. However the creative arts therapies eager to gain recognition according to the prevailing psychological culture have yet to seize the opportunities suggested by practice. The genius of imagination does its work every day in the creative arts therapy studio, but most practitioners continue to think about what they do and describe out­comes through linear psychological systems.

Accommodation to the established psychological culture cannot be dis­missed as irrelevant for disciplines hoping to establish a foothold in the mainstream. My discipline of art therapy and the other creative arts thera­pies have relied exclusively on behavioral science research methods be­cause we hope to justify ourselves according to the values of the dominant culture (McNiff, 1998). We want to integrate with the mainstream health systems and so we have naturally chosen to translate what we do into com­munications that others will understand.

However, i f we examine the contemporary spectrum of research meth­ods, we are likely to find new partners who more closely resonate with the dynamics of the creative process. The innovations of classroom teachers in practitioner research are especially supportive of art-based inquiry. Karen Gallas, critical of education's reliance on professional researchers who are distant from the classroom milieu, envisions the classroom as a place where a teacher can establish a "research community" gathering and interpreting data to improve teaching and learning. Since the arts convey the thinking of young children, Gallas recommends that teacher-researchers look at these expressions without preconceptions and with the goal of "perceiving new patterns" that will inform human understanding (1994).

Many of us in the arts have never considered that research can be con- or c& ducted according to the principles of artistic inquiry and we do not

Bulletin of Psychology and the Arts view our ways of knowing as having the ability to generate new knowl­edge. We paradoxically describe how the use of art in therapy enables a person to heal with the help of creative energies and imaginative insights, but we do not apply this belief to the creation of knowledge. Art therapy is by definition an integration of artistic and psychological processes, yet the artistic aspect stays off to the side when it comes to the discourse as to the nature of research.

There is something to be said for staying focused on accepted methods of inquiry in order to "cross-over" and attract attention from the larger psychological community. Systematic studies according to established rules also require focus and discipline. Don't mix frameworks, Rudolf Camap advised (1950), unless you want confusion. Knowledge tends to grow through a process of accumulation within the boundaries of different frame­works, all operating according to their respective conventions. New disci­plines and perspectives on experience have generally adapted themselves to established traditions as a way of entering the academic discourse. Yet, the creative arts therapies need to be in the world of psychology but not completely of it. Total merger dilutes the unique qualities of the minority partner.

It is time to consider a post-assimilation era in the creative arts thera­pies. While accommodating to the mainstream, we can also strive to ad­vance artistic ways of knowing. A discipline created through an integration of parts can continue to be more than one thing. I f art can help a person transform the most vexing personal problems, conflicts, and doubts into affirmations of life, then why can't it do the same for our understanding of the human condition? I f the arts in therapy enable us to gain access to insights and ways of relating to situations that emerge from outside the lines of analytic inquiry, why do we keep this intelligence in a secondary role providing data for the more primary process of psychological analy­sis? Art therapists and supporters from mainstream health professions af­firm the unique therapeutic processes of the creative experience, yet these intelligences are not appreciated as ways of contributing to our more for­mal understanding of human experience.

Like psychology, art therapy research has adhered to the principles of scientism that have dominated the pursuit of knowledge for the past cen­tury. Scientism is the belief that true knowledge about life can only be gained through linear, cause and effect science. The new physics of the twentieth century has been dissolving scientism by revealing a radically different basis of reality. But psychology has been slow to align itself with this more dynamic and imaginative perspective on reality as a field of con­stant interaction and creative transformation. The quantum view of the world is actually very close to the way in which we perceive the dynamics of creativity.

In 1979 I participated in the invitational Conference on Creative Art Therapies sponsored by the American Psychiatric Association. The APA was extending support to the creative arts therapies that were described in the conference report as "struggling for recognition." In his address to the conference Israel Zwerling, a psychiatrist, shared his observations of the arts in therapy. He described how it might be the use of the right hemi­sphere of the brain that enables the creative arts to "more directly tap" emotional realms rather the cognitive dimensions in which traditional thera­pies tend to operate. He said, "the creative arts therapies evoke responses, precisely at the level at which psychotherapists seek to engage their pa­tients more directly and more immediately than do any of the more tradi­tional verbal therapies" (Zwerling, 1979, p. 843).

Beginning with the early discoveries of Sigmund Freud and C. G. Jung, the arts have been viewed as opening realms inaccessible to language. Yet we continue to overlook how the creative process might "more directly tap" areas of experience that we seek to understand through psychological inquiry. Can we apply what we know from therapeutic experiences with the arts to the larger context of human understanding? Artistic processes do tap areas of experience forever isolated from linear conceptual analysis. The arts not only gain access to these realms but they express them and bring them to new levels of synthesis.

In his address Zwerling said, "The question: 'To which category of therapy do the creative arts therapies belong?' plainly can be answered only by the context in which they are used" (Zwerling, p. 844). The same applies to the application of the creative process to psychological inquiry and the ques­tion as to what category of research they belong. The relevance and effi­cacy of the arts depends completely upon the nature of the problem being

examined, the particular context, and the goals of the researchers. In keep­ing with Carnap, and perhaps quantum physics, an experience can only

be understood in terms of the specific situation or relationship and L*V according to the perspective of the viewer.

Bulletin of Psychology and the Arts Although my bias against dualistic systems and a preference for the inte­

gration of disciplines have prevented use of the bicameral theories of the brain in my studies of creativity, we might follow the logic of Zwerling's analysis and ask, are we ready to consider psychological inquiries that uti­lize both hemispheres of the brain? Can we open to a new context of dis­covery that makes use of creative expression as a way of learning more about itself? Can we more directly research these phenomena through their own languages of expression? Are the creative arts therapies willing to step outside the box of traditional psychological thinking, the very box that we have wanted to enter as valued partners? And most importantly, might this expanded inquiry into the nature and effects of creative experience expand our understanding of other realms of experience?

"The Thing Things": Connections to Phenomenology It 's Radical Re-visioning

At the beginning of the twentieth century when the quantum view of a deeper world of relationships began to take shape, Edmund Husserl cri­tiqued the reigning scientism of philosophy. Like the quantum physicists, Husser! was deeply committed to science. He addressed the dogmatism of theories and tired perspectives on experience that blocked access to a deeper way of looking at the world.

Phenomenology's call for a return to the things themselves suggested paying closer attention to experience and implementing less biased ways of observation, what might be viewed as a purer science. In keeping with ancient Buddhist teachings, our attitudes about life block perception of what is happening in the present moment. Phenomenology attempted to "bracket" our theories and explanations with the goal of paying closer at­tention to the object of inquiry.

Husserl suggested a "life world" (Lebens^velt) that existed outside the scope of language and explanation. Martin Heidegger, building upon HusserPs description of an "originary presentive intuition" as the basis of knowing, called this realm the "givenness" (Gegebenheit) of experience (Moran, 2000, pp. 10-12.). These primary states might be equated to the particles and waves of energy investigated by quantum physics, phenom­ena that were at the turn of the century outside the existing bounds of knowl­edge. At the present time the experiences of the arts similarly lie outside the domain of traditional psychological descriptions and measurements.

Artistic methods of inquiry are aligned with the basic tenets of phenom-enological thought. What matters in both areas is paying close attention to phenomena. Everything depends, as Jung suggested, on how we look. In encouraging ways of "looking psychologically," Jung said, "Give it your special attention, concentrate on it, and observe its alterations objectively" (Chodorow, 1997, p. 170).

Art does not have to be disconnected from science. Both modes of in­quiry closely observe phenomena in ways that lead to transformations of matter and consciousness. An obstacle to new knowledge in both art and science is scientism that requires us to operate exclusively within the lines of a governing paradigm.

1 must acknowledge that in my experience the great majority of people are eager and willing to stay within the lines of the prevailing psychologi­cal theories and methods of inquiry. The average person is not typically eager to embrace the unknown and to perfect the practice of disciplines that are not sanctioned by mainstream institutions. John Keats described this ability as Negative Capability, the willingness to be immersed in un­certainty, as we say today, the willingness to think outside the box.

The process of creative inquiry can be arduous and full of conflict. Open­ing to new areas of creation inevitably leads to a temporary loss of control, confusion, and maybe a certain destruction of habitual patterns.

In keeping with Nietzsche's assertion to "break, break, break" in order to create anew, Steve Levine describes how creation requires that we "go through the experience of disintegration" in order to refashion ourselves (1992, p. 22). The average person has little desire to take on this type of dissolution. I do not always enjoy it myself, but the nature of my work requires a sustained openness to the forces of creative transformation. Ex­perience has taught me that the deeper movements of creation require a certain degree of destruction. 1 have also discovered, as reported in Trust the process (1998), that i f we stay with the necessary conflicts of creation within a safe and supportive community, the process will always deliver us intact and transformed to "the other side" of experience.

1 repeatedly releam how losing my way in the creative process is neces­sary to new discovery. 1 need to go outside the lines of the familiar to find the new. As with the classic Dionysian cycle of being torn apart and put back together again, we are transformed and re-energized when we "re­turn" from creative activities where the experience prevails over the plan. It is the troubling and difficult experiences that continuously call ••;

Vol 2 (2)

out for reflection and interpretation. From the start, phenomenology has been a radical school of thought. As

with all progressive movements there is no single approach that character­izes the history of the whole. However, within all of phenomenology, from Husserl to Derrida, there is a consistent insistence on re-framing the basic ways we view the world with the goal of getting beyond conceptual veils that obscure how things really are. Letting go of familiar perspectives on life can be unsettling. As T. S. Eliot observed, "Humankind cannot bear very much reality."

Creative discovery requires a willingness to embrace experiences that do not fit neatly into what we already know. In the most adventurous forms of art-based research, we may not have a sense of the ultimate outcome at the beginning of the study. As an artist friend said to me, the problem with some painters is that they want to be at the end when they are at the begin­ning. When painting is practiced as a process of inquiry, the composition will emerge.

The most open-ended forms of artistic inquiry always start with the blank canvas. For some, the open space is perceived as an intimidating emptiness while others see it as an inviting spaciousness, ready to receive whatever appears through the process of painting. A gesture is made on the canvas and others build upon it. I f the painter is able to let go of preconceptions, something completely new will emerge. The emanation of unexpected im­ages reinforces Husserl's sense of a "life-world" that exists outside the boundaries of thought.

The new arrivals invite us to look at them without explanatory concepts or labels that block perception of their physical qualities. Expression, Rudolf Arnheim emphasizes, is a characteristic of the physical structure of the image (1954, 1972). Similarly, Heidegger in describing how phenomena express themselves according to their particular qualities, declared that "the thing things." He lays down the challenge to art-based research to allow "the thing.. .a free field to display its thingly nature character directly"( 1971, p. 25).

Objects and images express themselves independent of the theories and thoughts that we have about them. We have been so focused on trying to determine what a painting "means" according to our conceptual views of the world that we fail to open to its purely visual and kinetic qualities and energies. Our mediating concepts block more direct relationships with phe­nomena.

Images will always bear the signature of an artist's style and personal history with the medium just like children carry traces of parents. The pro­cess of creation is always connected to a context of some kind and these factors are among the many topics that invite further understanding through art-based research.

Although training in the creative process requires the ability to embrace openness and undefined situations, students in both art and psychology also need to learn how to operate within the lines of methods that enable them to systematically investigate an issue according to universal rules and consistent procedures. The tenets of behavioral science are unarguably valu­able contributors to the advancement of knowledge. The problem lies in the one-sided insistence that these methods are to be applied to every prob­lem and life situation and the willingness to overlook what emerges from outside the parameters of the method.

The following examples will hopefully demonstrate how the enhance­ment of the practice of creative expression may require modes of inquiry that operate outside the lines of procedures currently sanctioned by behav­ioral science.

Samples of Practitioner Research My experimentation with art-based inquiry has been focused on practi­

tioner research. I am primarily concerned with the process of researching what we do with the arts and my goal is the improvement and expansion of practice. Art-based inquiries take us closer to experience, closer to pure scientific observation, and they tend to involve a truly empirical process of experimentation. This orientation assures that outcomes can ultimately be measured by standards of practicality and usefulness.

The strongest rationale for adventurous art-based research may be its ability to further the training and ongoing education of those who use the arts in work with others in therapy, health, education, and other settings. Before one undertakes the responsibility of guiding others through the depths of the creative process, it is wise to personally experience and contemplate the terrain, to undertake studies that augment our practice and understand­

ing of the creative process. Tremendous opportunities are lost in educational programs when stu­dents do not immerse themselves in the phenomena being studied.

Vol 2 (2) Frankly, most of our art therapy training programs spend considerably more time operating within behavioral science paradigms than exploring the dy­namics of artistic processes.

It has been my students who consistently teach me the most convincing lessons about the importance of art-based research. I just observed the work of an undergraduate student who completed a research project focused on the movement basis of painting. The outcomes of the study not only in­clude an understanding of the kinetic foundations of painting but the stu­dent and her supervisors observed how the expressive vitality and original­ity of her paintings improved over the course of the study. The student researched a movement-based approach to painting that will help her and others express themselves more freely. In the project entitled "Painting with My Shoulder, " the researcher explores how body awareness enables the artist to paint from every aspect of her "physical sel f (Eschauzier, 2001). Although every phase of the student's study emanated from the blank canvas, the consistent focus on the movement theme anchored the explora­tion into the unknown.

Where art therapy has historically focused on the mental aspects of ex­pression and painting from the unconscious "mind," this student's focus on painting from the "shoulder" offers a refreshing new perspective that re-frames the conceptual and operational basis of art therapy. We tend to look at paintings in terms of messages and meanings couched unconsciously in verbal communications and concepts. Within the art therapy field very little has been done to understand the way in which kinesis, the circulation of energy, and mind/ body integration generated by the painting process, affect healing.

This straightforward study initiated by an undergraduate student can be widely expanded in future inquires by other researchers. Different kinds of movements with varying materials might be examined. Sustained and rep­etitious movements can be compared to dissimilar gestures. The effects of long vs. short durations of movement can be compared. Subjects may de­scribe their responses to different kinds of movement, the way in which their sensibilities changed or did not change during the process, the effects that particular exercises might have on their expressive spontaneity, and so forth. Similar comparisons may be made with the way in which we per­ceive different movement qualities within paintings. Methods of inquiry might combine artistic experimentation with behavioral science techniques of data gathering and analysis. The range of possibilities growing from the elemental focus on movement and painting is endless.

In another art-based study a doctoral student surprised me with the rich­ness of possibilities involved with the process of painting mandalas and responding to them with the goal of understanding the "experience of draw­ing mandalas" (Laplante, 2000). The quality of the work was significantly influenced by the researcher's personal artistic skills that enabled her to offer a completely fresh and insightful treatment of the ubiquitous mandala motif. The study also involved co-researchers who like the primary re­searcher painted a series of mandalas and reflected upon them within inter­views. I had dismissed mandala drawing as a stock and over-used art therapy exercise and I was taken aback by the intelligence and artistic sophistica­tion of the study that helped me see this very familiar activity in new and expansive ways.

I learned that my perception of the mandala as an artistic cliche resulted from the way it was being treated by other people. The study taught me how the way in which the researcher organizes and conducts the inquiry has a significant impact on its ultimate value. The artfulness of the research and its presentation will affect the quality of the outcome.

The study revealed that the process of making mandalas and the reflec­tions upon them generated personally meaningful reactions in the partici­pants. The researcher described how the "mandalas became the sanctuaries in which the soul life of each of us was nurtured" (Ibid., p 152). The depth and variety of responses also reinforced the evocative powers of the mandala motif when approached with artistic freedom. These discoveries could not have been made or documented without a serious and sustained commit­ment by the participants to artistic expression as a way of inquiry.

My own recent interests in art-based research have been focused on un­derstanding the effects of responding to paintings and three-dimensional artworks with movement, sound, performance, and ritual. My 1992 book Art as medicine documents methods of responding to artworks through imaginal dialogue. After many years of using descriptive narratives to com­municate what happened during the process of making a painting as well as using this type of language to convey what we see in paintings and how they affect us, I discovered that narrative has great limitations. I- fi

Of course the narrative mode will always convey volumes of infor- ^ rnation and it is a vital way of understanding perceptions and convey- -f\S

Bulletin of Psychology and the Arts ing them to others, but it generally keeps us located in more distant per­spective of description. We discovered through our experimentation with imaginal dialogue that significant shifts in perception, in our feelings to­ward images, and in the energetic effects of the images of us, occurred when we engaged them through the more intimate and poetic speech of dialogue.

In the tradition of Jung's practice of active imagination, we used cre­ative expression to enlarge our experience of the image. When paintings and sculptures were poetically personified as living things, we learned much more about their expressive qualities.

People who questioned the sanity of this way of talking "to" and "with" images were reminded that we were practicing "poetic" rather than "lit­eral" speech. We noticed how the more poetic dialogue went further and deeper and seemed to engage the heart in a more complete way when we stopped talking "about" images and began interacting "with" them. Over­all the process of imaginal dialogue sustained the artistic process from the making of the images through the reflection upon them.

The dialogue process aroused a different kind of feeling state and cre­ative energy and it had a distinct effect on the participants. Rather than making art and shifting into the more removed and conceptual reflection upon the work, poetic dialogue kept us in the creative zone or condition. As Jung said, we imagined the images further through our responses.

A distinctly vital and palliative energy became a primary feature of the process. 1 believe the therapeutic outcomes of the work had more to do with changes in emotions and group atmosphere than it did with the in­triguing insights offered the process of dialogue. The atmosphere of imagi­nation dissolved the usual conceptual and problem solving goals of therapy.

In To the lighthouse, Virginia Woolf describes the animating effects of "a rain of energy" that permeates the air "like a fountain and spray of life" (1927, p. 58). I have only begun to realize after three decades of practice that art's primary medicine is the energy of the experience that animates groups and individuals.

As 1 continued to experiment with imaginal dialogue, I discovered how it has certain limitations in groups where my goal is to engage everyone in the expressive energy of art. Most people have to make a considerable effort to shift from literal to imaginal speech. Although the results are al­ways surprising and useful when access to the imaginal realm is reached, it is also a highly focused and individual activity.

When working with groups of people I can only demonstrate the dia­loguing process with one person while others observe. The process of pen­etration also takes time and highly focused attention. In my group work I have begun to give more attention to improvisational responses to artworks with movement, sound, performance, and ritual. This way of responding through the body brings a "lightness" and fluidity to the work that differs from dialogue.

Experimentation with dialogue helped me to understand where it can be used most effectively and where other methods are preferable. 1 also began to realize that while imaginal dialogue significantly expands the scope of descriptive speech, we are still limited by the linear frame of narrative and words.

I discovered how the interpretation of images through bodily gestures and sounds actually enables us to more completely perceive, express, and amplify the energetic qualities of the artworks. The bodily expressions of people in my groups help me establish a deeper connection and under­standing of the expressive features of their pictures and sculptures. The artworks also inspire and motivate fascinating bodily expressions that emerge in relation to the images. One artwork generates another in an on­going sequence of expression. People report a distinctly different kind of energy generated by the ritual expressions and the attention given to them by group members acting as witnesses. They consistently describe how the group environment becomes "sacred" and "filled with creative energy."

Over the years participants in my groups have felt that the full engage­ment of the body, performance, sound, and ritual generates a stronger cre­ative energy in the studio space that in due course acts upon them. They describe how the environment stimulates personal changes and a sense of healing. Healing is defined as the transformation of troubling feelings and conflicts into affirmations of life as well as an acceptance of the present conditions of life.

I am realizing now that these more recent experimentations with the ar­tistic process sustain and intensify the phenomenological process of giving

attention to an image or experience. As we respond to artworks with the total range of our senses and our expressive faculties, the experiences

affect us in more complete ways. The outcomes of the process are thus "V,- proportionate to and multiplied by what we give to it. The work is

Bulletin of Psychology and the Arts enhanced by the most complete circulation of creative energy that moves in unexpected and highly individual ways within the members of the group. The distinctly personal relationships that individuals have with the cre­ative process accounts for much of its positive effect upon them. This mode of practice fits within the quantum vision of the world as an ongoing inter­play of energies and entities whose natures constantly change as a result of the interactions.

In my studios 1 welcome troubling and negative experiences. I do not want to give the impression that this work is always pleasant and sancti­fied. People are often afraid of expression, intimidated by bad experiences in the past, and sensitive to the necessary perils of creation. Yet this very engagement of tension and fear within the creative process is what often accounts for the deepest movements within the studio environment. I f I can create a safe environment for people, we consistently find that conflict becomes an agent of creative transformation. This discovery is consistent with the insistence of Carl Rogers that when given support and freedom healthy groups will find their way to equilibrium.

In a recent group a woman made an artistic object with materials from nature and later took the risk of doing a completely spontaneous and un­planned enactment with it before the group of thirty-five people. She per­formed ritual movements and sounds while holding the object in an inti­mate position.

After the work was completed, she described how she entered a state of being like nothing previously experienced. " I don't have words for it," she said. "It was totally new and energizing and deeply moving." She tapped into the realm that Zwerling described as outside our descriptive concepts and language, a state of experience that may be likened to HusserPs "life-world" and Heidegger's "givenness". The creative process moved outside the lines of our regular experience with the world.

Art-based research offers opportunities to explore these frontiers of ex­perience, to expand inquiry in a way envisioned by the early phe-nomenologists. The need to go beyond our habitual perceptions of the world, as expressed one hundred years ago by Husserl, is still present today.

Experimentations with artistic inquiry have revealed that there are deeper and more comprehensive ways of perceiving life experiences and express­ing our reactions to them. These ways may not be for the majority of people, but they can find a place in the world of research, especially within com­munities where artists are engaged with deepening our understanding of the human condition. As artists involve themselves in art-based research they will not only contribute to the making of new knowledge but they will perfect and expand their own creative capacities and skills.

Growth of art-based research wil l contribute yet another way of viewing and understanding human experience. The implementation of this type of inquiry will be obstructed i f arguments as to the truth or falsity of the out­comes are conducted only within the realm of prevailing psychological standards and measurements. Of course art-based research must submit itself to scrutiny, careful assessment, and the evaluation of outcomes, but this realm needs to be judged according to its own criteria of usefulness, aesthetic quality, and effects upon people.

The ultimate value of art-based research may simply be the presence and refinement of another way of paying attention to experience, a way that will collaborate with psychological research methods to initiate a more complete understanding of the creative process and our relations with the world. Experimentation outside the lines of established inquiry will always enrich what happens within them and generate a more complete view of our human potential.

References Akenside, M. (1744). The pleasures of imaginations. London: R, Dodsley. Arnheim, R. (1954). Art andvisual perception: A psychology ofthe creative

eye Berkeley and Los Angeles. University of California Press. Arnheim, R. (1972). Toward a psychology of art. Berkeley and Los Angeles.

University of California Press. Carnap, R. (1950). Empiricism, semantics, and ontology. Revue Internationale

de Philosophie 4. Chodorow, J. (1997). Jung on active imagination. Princeton, New Jersey:

Princeton University Press. Coleridge, S. (1907). Biographia literana, 1817. J. Shawcross, (Ed.), Lon­

don, Oxford University Press. Eschauzier, 1. (2001). Painting with my shoulder. BFA Capstone Project,

Endicott College, Beverly, MA. Gadamer, H. (1994). Truth and method. Second, revised edition; Translation

revised by J. Weinsheinier and D. G. Marshall. New York, Continuum. Gallas, K. (1994). The Languages of learning: How children talk, write, J^.

dance, draw, and sing their understanding of the world. New York, Teach­ers College Press. ^ j

Vol 2 (2) Heidegger, M. (1971). Poetry, language, thought. Trans, by A. Hofstadter.

New York, Harper and Row. Laplante, M. A. (2000). Drawing the mandala: A spiritual path to whole­

ness. Doctor of Ministry Dissertation, St. Stephen's College, Edmonton, Alberta. Levine, S. (1992). Poiesis: The language of psychology and the speech of

the soul. Palmerston Press, Toronto. Moran, D. (2000,) Introduction to phenomenology. London and New York,

Routledge. McNiff, S. (1992). Art as medicine: Creating a therapy of imagination. Bos­

ton, Shambhala Publications. McNiff, S. (1998). Trust the process: An artistic guide to letting go. Boston,

Shambhala Publications. McNiff, S. (1998). Art-based research. London, Jessica Kingsley. Woolf, V. (] 927). To the lighthouse. New York, Harcourt, Brace and World. Zwerling, 1. (1979). The creative arts therapies as 'real therapies,' Hospital

and Community Psychiatry, 30, 841-844.

Shaun McNiff Provost and Dean, Endicott College Beverly, Massachusetts 01915

C.I.S.M.E.W.: The Arts in Clinical Training Paul M. Camic

Columbia College Chicago and

University of Chicago Medical School

Introduction Discussion over what constitutes appropriate clinical training curricula

in doctoral level psychology programs sometimes reminds me of the re­ported disputation between Galileo and the Roman Catholic Church hier­archy of the early 17lh century: both involve the introduction of new ideas into belief systems that are highly resistant to discovery, innovation and creativity. The 17,h century debate, which concerned deeply held Aristote­lian beliefs of an earth centered universe versus Galileo's empirical obser­vations that supported a sun centered solar system, are like late 20lh century polemics in clinical psychology surrounding the difficulty in accepting that our original conception of clinical training is not fixed and permanent. Professional psychology's row over what model of clinical training best suits doctoral level education has not adequately addressed however, what should truly constitute the "clinical" part of clinical and counseling psy­chology training. Perhaps because of our innate conservatism, desire to be scientific and fear of muddying the field, this debate has gone underground.

In this article I present a rationale for the use of the arts as one option to expand graduate training opportunities in clinical and counseling psychol­ogy. As the current curricula in most graduate programs leaves little room for new programming, I will first briefly identify some of the specific prob­lems inherent in the training philosophies of North American doctoral pro­grams, as well as major components of the curriculum which, like Aristote­lian physics and Ptolemaic astronomy, need to be relegated to history texts and not contemporary clinical instruction. This will be followed by a ratio­nale for incorporating the arts in professional psychology and conclude with suggestions for a demonstration curriculum that incorporates the arts in doctoral level training. Seen in another way, incorporating the arts in clinical/counseling programs can be viewed as one means to further clini­cians' and clinical researchers' interdisciplinary clinical training, as we have seen over the last decade with the expanding influence of neuroscience, anthropology, sociology, and cultural studies in graduate psychology edu­cation. Before proceeding, two caveats; by clinical training I refer to doc­toral level Ph.D. and Psy.D. programs in clinical and counseling psychol­ogy, including community clinical, clinical developmental, and clinical-counseling programs. As Moses and Aron debated the best word for god, in Schoenberg's opera Moses undAron set in 13,h century B.C.E., the term "the arts" often causes much confusion i f not resistance when considered in connection with psychotherapy and counseling. Unfortunately the En­glish language contains no term to adequately describe art as a process and not a product. It is the process of the arts that is the focus of therapeutic arts modalities. In the Netherlands for example, training programs in the arts and psychology are titled "creative therapies" thus avoiding the confusion with professional fine and performing arts. For the purposes of this be­ginning discussion about the arts and clinical training within psychol­

ogy, an acronym, CISMEW, will be employed-somewhat seriously, £/V somewhat tongue-in-cheek- to separate the professional fine and per-

Vol 2 (2) formance arts with those used in clinical practice. The term refers to the work's heart, the process of the arts, and not the final product, as we are so accustomed to spotlight in our culture today when speaking of the arts. CISMEW, creating images, sound, movement, enactment and words, while somewhat of a tongue twister, takes us away from discussions of formal artistic training, styles of expression and congressional funding priorities and places our sights on the creative process involved within sound mak­ing, image producing, movement, ritual, and much later in expressive writ­ing, all of which were the forerunners to the arts as we know them today (Dissanayake, 1988).

The Beginnings of Clinical Work in Psychology Space permits but a brief history of clinical and counseling psychology's

role in psychotherapy over the past several decades. Most of us are prob­ably aware that clinical psychology emanated from German and American laboratories and was not at the outset seen as an applied psychology. Early behavioral research in university laboratories and later in child guidance clinics, provided initial evidence of how psychological theories can be ap­plied to human problems in the form of an intervention. It was at this point that the divergence from psychology's philosophical roots and the quest toward making psychology a science began in earnest. For much of its early history clinical psychology was seen as a research field. During the Second World War psychometric testing became more widely valued and clinical psychologists begin to enter mental health facilities. In the last half of the 20,h century, clinical psychologists expanded beyond the roles of researcher and psychometrician in universities and government agencies, to those of diagnostician and psychotherapist in hospitals and community clinics. In these new roles behavioral and psychoanalytic theories of treat­ment held sway initially, followed by existential, humanistic, and cognitive approaches.

Counseling psychology is a more recent addition to clinical work having its roots in the guidance and counseling domains of university counseling centers and schools of education. Its psychotherapeutic theories histori­cally have been influenced by humanistic and existential philosophy but currently reflect psychodynamic, cognitive, and behavioral perspectives as well. Counseling psychology's approach to intervention has been far less based on reductionism as seen in the "medical model" so prevalent in clini­cal psychology and has sought to look at the strengths of a person, group, or system and expand upon them. Persons holding clinical and counseling doctorates from APA accredited programs, with requisite clinical training experience, can be licensed in all American states and Canadian provinces, thus providing a vast array of accepted clinical services throughout North America. Along with the enormous increase of doctoral trained psycholo­gists over the past 30 years there has been a marked decrease in psychiatry residency programs that offer training in psychotherapy. Current managed care and insurance reimbursement schemes have also contributed to a de­cline in psychiatry as a provider of psychotherapy services. Clearly clinical and counseling psychology hold a leadership position in training psycho­therapy clinicians and clinical researchers on this continent. Precisely be­cause of this leadership position, I believe that psychologists can be the ones to further utilize the arts in the process of healing and personal growth, two important goals of psychotherapy.

Philosophies of clinical training Depending on whether clinical psychology is seen—as a science, or as

an art and science, or as an art—will influence the major philosophical approaches to clinical training. Likewise, incorporating the arts in clinical training will be influenced significantly by the program's training model. There arc presently four main training models employed by North Ameri­can clinical and counseling psychology programs. The first and most promi­nent model, especially among Ph.D. programs in clinical psychology, is that of the scientist-practitioner. The tenets of this model include the pri­macy of research training within graduate education as a foundation from which to build other skills and abilities. Training in research methods is almost exclusively that of theoretical positivism or postpositivism which holds an ontological search for truth (or at least what is probably true) as its objective. The epistemology of these two paradigms is both dualistic and objectivistic with postpositivism gently modifying dualism into "pos­sibilities and probabilities" and labeling this critical realism (Cook & Campbell, 1979). The values of the researcher-scientist are excluded from discussion and their influence denied. The voice of the investigator is that of a disinterested scientist and the aim of the inquiry is explanation through prediction and control.

The scientist-practitioner model and its attendant research paradigms „ n have served clinical psychology well. It has allowed clinical psychol- % ogy to sit at the same academic table with biologists, chemists, geolo- -f%^

Bulletin of Psychology and the Arts gists, physicists, and others from the physical and biological sciences. The model has also allowed clinical psychology research to gain significantly in stature and prestige in the eyes of federal and private funding sources, medical schools, and policy makers, and probably most important, the sci­entist-practitioner model has produced work that has contributed to the betterment of humankind. However, there are two significant problems with this model of research training in a clinical training program. The first, and one that is more extensively addressed elsewhere, is the exclusive exami­nation of knowledge through verifiable or non-falsifiable hypotheses es­tablished as fact or probable laws (Gage, 1989; McGrath and Johnson, 2002). The philosophical foundation of this model is one of human beings having a universal nature that is quantifiable, controllable and predictable, in or out of a laboratory environment. Yet in the one hundred or so years of clinical psychology research few universals have been found. This model of research significantly shapes a model of clinical training, the second problem that will now be addressed.

Clinical training occurring in doctoral programs that rigorously adhere to the scientist-practitioner model of training tend to put practica and sup­porting clinical instruction courses in a dusty corner of the overarching curriculum. The emphasis of these programs is to teach students to do re­search, publish their findings, and secure an academic appointment. Yet, graduates of these programs are eligible to sit for state and provincial l i ­cense examinations as professional psychologists with all the rights and responsibilities of becoming a licensed psychologist who can have a clini­cal practice. A graduate of a leading west coast clinical psychology pro­gram recently told me how little he learned about doing clinical work when in graduate school (Larson, D. G., 1995, personal communication) and how psychotherapy experience was left to his internship and postdoctoral years. I have heard the same complaint from many clinical interns during supervisory sessions over the past fifteen years as well as from colleagues working in these programs. Aside from the ethical concerns involved in these situations, when clinical training actually occurs, the positivism model of research overly determines the clinical perspective of faculty and stu­dents. In a carryover from the researcher's search for truth or probable truth, the clinician's worldview can become skewed (Prilleltensky & Fox, 1997). Psychological problems become quantifiable and we lose useful rich description (Kvale, 1996); treatment becomes based on diagnostic cri­teria which lacks any consideration for a Likert type scale range of symp­toms; tolerance for ambiguity and uncertainty is diminished, and diagnos­tic training results in learning specific treatment formulas as opposed to how to be with a client (Giorgi, 1970). In an environment such as this, it is not surprising the arts or CISMEW have not yet found a meaningful place in clinical work or research.

After much spirited debate in professional psychology circles and for­mal APA committees, the inflexibility of this training philosophy was aug­mented by additional models that questioned the notion of "scientist" as a goal of clinical training. While not disparaging of the critical importance of scientific training it is arguable whether training in scientific psychol­ogy best prepares students to work with the problems of human beings. This is also not to say that art, the artistic process, or the therapeutic ben­efits of the arts in therapy (Long, 1998) cannot be studied scientifically using quantitative and/or qualitative methodologies (Ansdell & Pavlicevic, 2001; Kaplan, 2000) but it does raise the question of what is more impor­tant in psychological research, the questions we raise or the "sacredness" of our methodologies (see McNiff, this issue).

The xscholar-practitionre model was one result of those debates. Popu­lar in many Ph.D. programs in counseling psychology as well as some in clinical psychology, the scholar-practitioner model de-emphasizes the role of the active scientist. Instead, it presents a philosophy of training that seeks to balance clinical work and research training in graduate school, which will supposedly result in clinical-academic careers and full time cli­nicians who are more fully cognizant of how to access research findings as a result of their training. It is under such a model that a concentration in expressive arts and creativity was developed in an APA accredited clinical psychology program in 1996. An offshoot of this model is the practitioner-scholar, a model popular with some Psy.D. programs. Here the emphasis is on training clinicians who can apply research findings to their clinical work.

This brings me to the last model to be addressed in this article, that of the practitioner. The doctoral trained psychologist version of the medical doc­tor, the practitioner model of training is unabashedly found at most Psy.D. programs. Going back to my metaphor of 17lh century Rome, one is re­minded of the seriousness and ferocity by the believers in an earth cen­

tered universe. Some reading this article may also vividly recall the % j \ hubris of some of our scientist-practitioner colleagues when they spoke

Bulletin of Psychology and the Arts of the sacredness of their philosophy of training during the debates of the 1970 and 80s. The stubbornness of Pope Urban VI I I not to grant clemency to Galileo was reflected almost 400 years later in Ph.D. clinical psychol­ogy program directors' responses to the idea that there may be another way to carry out clinical training. During these debates the lack of empirical evidence in support of a research laden clinical training curriculum-as a superior model of training-from the advocates of empiricism was chilling indeed. The very idea that a doctoral training program in clinical psychol­ogy need not place as much focus (or even very much focus) on research training was as blasphemous it seemed as the Dutch and French scientists who vocalized their support of Galileo. The philosophical debates con­tinue but eventually David emerged along side Goliath and the APA de­cided that both sides won and the practitioner model of training became an altemative-a sort of separate but equal-partner in training North America's future clinical psychologists.

The differences of opinion about the place of clinical training within doctoral education in clinical/counseling psychology have not been resolved. A Likert scale of clinical psychology doctoral training programs is upon us: the scientist-practitioners (1), scholar-practitioners (2), practitioner-scholars (3), and practitioners (4). Just as only four items are not ideal for instruments utilizing Likert style measurement, so neither is it ideal that clinical and counseling psychology hold philosophies of clinical training that arc obsolete. It is in expanding the notions of what is clinical that clinical and counseling psychology training can incorporate the arts as part of clinical practice and research investigation.

Curricula Concerns Although present-day graduate curricula contains many required and

elective courses, not all of these courses or practica are necessarily useful in training the clinician in the second century of modern American psy­chology. It is through a reexamination of the curriculum that a place for the arts in clinical training can be forged. One such area that requires profes­sion-wide self examination and critical reflection is the teaching of projec­tive testing. A colleague who directs a clinical psychology program on the east coast came up to me after a paper presentation (Camic, 1999a) and passionately suggested that it was time to rethink clinical assessment and specifically diagnostic psychometric assessment. This individual's concern lay in the continuing lack of empirical support and clinical utility for pro­jective instruments coming at a time when professional psychology is be­ing questioned by insurance and managed care providers. Other psycholo­gists and health care professionals also share this concern (Lillienfeld, Wood & Garb, 2000) yet al l practitioner model clinical training programs and the majority of those programs following other models of training require ex­tensive coursework and practicum in projective testing and assessment. The resistance to letting these instruments become part of our past history underscores a lack of innovation in clinical training. One widely used test that needs to be reconsidered as a clinical tool is the House-Tree-Person Drawing Test, an instrument engaged in assessing unconscious issues and psychopathology in children and adults. One of the major problems of the HTP is its failure to take into consideration normal developmental drawing abilities (Lowenfeld & Brittain, 1970). Many North American adults have drawing abilities that—without formal artistic instruction—remain similar to the drawing ability of an average ten year old (Edwards, 1989). The scoring criteria of the HTP views drawing as a representation of uncon­scious processes and does not consider aesthetic understanding (Gardner, 1994), creativity (Neuman, 1959; Goswami, 1999), visual perception (Bruce, Green & Georgeson, 1996), or cognition (Solso, 1994) as factors that in­fluence drawing. Simply seen, the HTP drawings become an artifact of psychopathology or at best, personality.

Two other projective instruments also bear questioning. The Thematic Apperception Test, with foreboding black, white and gray images of 1950s middle class Caucasian Americans, is supposed to assess unconscious re­sistances, ego strength, and repressed emotions, most notably related to anger and sex. Scoring this test, which is highly dependent on how a client visually interprets the drawing on each card, does not take into consider­ation the quality of the client's aesthetic response (Aiken, 2001), aesthetic attitude (Gardner, 1973), process of visual thinking (Arnheim, 1969), or formal artistic training and experience. Aside from the TAT's history of poor reliability and validity as well as questionable clinical utility (Gieser & Morris, 1999), when using visual images as stimuli in psychometric test­ing, without considering the factors cited above, the TAT delivers an in­complete, i f not worthless appraisal.

A third psychometric instrument that employs visual stimuli is no doubt £p the world's best known, the Rorschach Inkblot Test. Although also \ having little empirical support (Wood, Nezworski, & Stejskal, 1996)-i\f

Vol 2 (2) and questionable clinical utility, the Rorschach remains the most time con­suming instrument for a graduate student to master and one of the most cumbersome to score and interpret, not withstanding the advances devel­oped by Exner (1993). In examining the many training and scoring manu­als for the Rorschach (e.g. Beck, Exner, Rappaport, Kloppfer) not one al­ludes to what Arnheim (1969, pp. 80-96) calls "the past in the present". Arnheim discusses the importance of not seeing a perceptual act as an iso­lated, stored experience of the past as many psychologists do (p. 80). He contends while the influence of memory on perception is powerful, it is also limited, and we cannot put perceptions in the present (a response to a Rorschach or TAT card) into "cubbyholes" constructed in the past (the in­terpretation of a response to the Rorschach and TAT material as uncon­scious projection). Rorschach interpretive systems do not consider how the visual percept came into being in the first place. Percepts have to origi­nate somewhere and i f we agree with the current interpretive systems of these instruments, we are also accepting that all perception of visual stimuli have their origin in the past. This becomes reductionistic and does not answer the first question of how percepts come to be, nor does it answer how present environmental stimuli shape percepts.

The Rorschach assumes the "healthier" respondent wil l not consider the primary organization of the stimulus (the inkblot) to be too elementary or too complex to warrant attention, thus perhaps missing some important point of the card's organization, and be on the slippery slope to a psycho­analytic interpretation. The assumption made by this test is everyone should have something to say about the stimuli and healthier clients will give more usual, common and perhaps what some would consider, boring responses. More creative or unusual responses are coded negatively, implying that deviation from the Rorschach's visual norm is pathological.

In addition to not taking creativity into consideration, the Rorschach, TAT, and HTP have no mechanism by which to examine the process of how a client develops a response. Does the child drawing a picture of a house (HTP) see the house in her mind's eye first? Is she guided by instruction from school art classes? Do her cognitive abilities influence her drawing style or drawing abilities? Or perhaps is it her favorite picture book that she is remembering as she draws? In working with an older adult, what does he aesthetically perceive upon viewing Card V on the Rorschach? How does he reconcile the visual image on this card with his past experi­ence of images? What factors lead him to see it that way? Does the image remind him of something from his past or does it seem more like a novel abstraction in the present? In addition to the concerns about validity and reliability and the lack of attention to an artistic understanding of the visual images in these tests, the various interpretive schools of the Rorschach , TAT, and HTP have also not examined the aesthetic encounter (Csikszentmihalyi & Robinson, 1990) as a factor in determining scoring and interpretation schemes.

One way to better understand how clients may come to regard visual images in projective testing might be to examine what is known about how artists approach a visual problem or challenge (Brown and Korzenik, 1993; Jones, Runco, Dorman, & Freeland, 1997). I f the process of making visual art is considered a serious and valuable endeavor by psychology then per­haps clinicians, who use projective techniques involving drawing and vi­sual images, can look to artists and art educators as interdisciplinary col­laborators (Sarason, 1990). In a system focused on uncovering pathology, deviancy and negativity the strengths of a client can be easily overlooked. Clinical programs that highlight uncovering illness as a primary function of training need not ignore creativity, visual and poetic thinking, imagery and visualization as well as art making, as areas for both research and clini­cal work.

Why bring CISMEW into Clinical Training Programs? With the many advances in neuroscience, neuropsychological assess­

ment, and psychopharmacology of the last two decades, as well as the myriad psychotherapies currently being practiced, why bother including the arts in clinical training? Certainly a legitimate question and one that 1 have been asked many times over the past several years. For the purposes of this spe­cial issue my discussion about clinical work is limited to the practice of psychotherapy. Other clinical endeavors such as assessment, consultation, testing, and psychoeducation, may also benefit from integrating the arts into their practices but that discussion will be left for another time (Camic & Wilson, in preparation). 1 suggest that there is significant theoretical, historical and empirical support to include the arts in psychotherapy train­ing in psychology. This support is seen in the evolutionary utility of the arts, in identifiable psychological mechanisms which occur in arts expe­

riences and in the role aesthetics play in emotion and cognition.

Vol 2 (2) Evolutionary Utility

Although not agreed upon by all ethologists or evolutionary psycholo­gists (Bradshaw, 2001) there is significant evidence that the arts have etio­logical utility (Aiken, 2001, 1998; Dissanayake, 1988, 1992, 2000). They have existed in various forms using different materials for perhaps 800,000 years (Bahn, 1998, p. 87) but certainly for the last 200,000 years during the time of Homo Erectus (Bahn, 1998, p. xv. ), well before modern Homo Sapiens appeared. In every prehistoric, ancient, and contemporary culture there is evidence of what we have come to call "the arts" (Marshack, 1991; Dissanayake, 1992; Bahn, 1998). Well before shamans, scientists, or psy­chologists created their professional roles, the arts existed (Dissanayake, 1988; Pinker, 1997). The evolutionary utility of the arts has, however, dif­fered throughout history. Using Dissanayake's hypothesis and her exten­sive research suggesting the arts came about to make the ordinary special (Dissanayake, 1988, 1992), it is possible to trace the development of the arts as an important component of human evolution. Making the ordinary special can be seen across time and culture through synchronizing move­ments into dance, combining sounds in such a way as to create emotional remembrance, putting words together to create poetic meaning, making marks on trees, cave walls and tools to record tales of the day, and integrat­ing sound, movement, words, and visual images into rituals and ceremo­nies. Humans have evolved to create culture, perhaps as part of the need to socialize and belong together with others. The arts, seen ethologically as behaviors which involve participating, creating, observing, and respond­ing, are one aspect of culture that allows humans to recreate initial feelings of mutuality between mother and infant, and facilitate the need for belong­ing, Finding and making meaning, and gaining physical competence, all of which are evolutionarily important (Dissanayake, 2000). These components, which are proposed by Dissanayake as a biobehavioral foundation for the arts are also seen as a way to expand the theoretical and research base for art therapy (Kaplan, 2000) and as a conceptual link for incorporating the arts in psychotherapy (Camic, 1999a).

When considering evolutionary utility of a behavior such as the arts, most of the attention of evolutionary psychologists and ethnologists is di­rected either toward the art product or what art making activities may gain externally for the artist (e.g. higher status in a social group, better options for mate selection, etc.) (Dissanayake, 2000). What needs to be considered more fully is the emotional affect the art making process-which includes visual, kinesthetic and auditory triggers or cues-has on the artist (Allen, 1995). A better understanding of what occurs psychologically (cognitively, emotionally, perceptually, etc.) for the artist when making art, may help provide needed information of how incorporating the arts into psychotherapy training can benefit clients. Although it is impossible to establish exactly what emotional responses humans, living thousands of years ago encountered as they created art work, it is likely art making served at least two purposes: the need to understand the unknown and elaboration of the ordinary and usual. Emotions are involved in both of these purposes. The tension and anxiety associated with the unknown may have been re­duced through movement and sound making, which in time became ritual­ized by virtue of the strong emotional (internal) response that these activi­ties triggered for each participant. Likewise, the ordinary things of day to day life such as tools and living spaces invited visual elaboration, perhaps with markings, design and color, which enhanced their emotional-aesthetic appeal through evoking ethological releasers (Coss,1968). The artist's emotional responses when making art, including the moments when inspi­ration coalesces into aesthetic solutions (Aiken, 1998; Browne, 1980; Csikszentmihalyi, 1988; Piirto, 1992; Rank, 1989/1932; Wilson, 2001, personal communication) are the beginnings of a continuum which also includes the audience's art viewing experience. (Kreitler & Kreitler, 1972) This is an important consideration when using CISMEW as part of psycho­therapy.

The client-creator is simultaneously making, experiencing, viewing and evaluating their work in the presence of a therapist. Emotional, cognitive, behavioral and aesthetic responses occur concurrently in this therapeutic environment. Unlike in professional arts, most of the focus of CISMEW's work is attending to the process of creating, with an explicit goal to assist the client in resolving a conflict and gaining greater understanding of a problem, these being the "products" or end result of the work. The end result of present day arts-oriented psychotherapy may be similar to the benefits early Hominids experienced in elaborating and making special thousands of years ago: gaining control over fear, reducing uncertainty; increasing emotional competence and establishing social relations. Com-paring early Hominidelaborating with contemporary clients' CISMEW, %P^ helps to possibly clarify the important evolutionary role of the arts in -f>J\,

Bulletin of Psychology and the Arts healing, community building, and cognitive development. This also sug­gests that the aesthetic, psychological, and biological mechanisms related to creating and making arts in contemporary professional arts may have both similarities and differences from that of the arts in psychotherapy. The focus of the work by psychotherapists using CISMEW with clients is dif­ferent than the work done by artists in their studios; it is only through researching the psychological and aesthetic processes involved in both en­deavors that we can come to better understand how the process of art mak­ing contributes to the well being of clients.

The feelings and emotional responses that are experienced when creat­ing (using any of the arts) are different from the external reactions from others to one's creative endeavors (Gedo, 1996). I may feel deep satisfac­tion at completing a poem which expresses my visit to an island off the Maine coast. Working on the poem may allow me to see a new geological formation or observe waves in a neoteric way. Writing the poem may leave me feeling more connected to the island, my sense of self and my purpose in the world. These are all significant internal (cognitive and affective) responses that make it likely I wil l write more poetry. After completing a dozen or so poems I may decide to attend the open mike night at the local library and the kindly audience listens to one or two of them. There is some warm laughter, nodding of heads, and a few smiles. While these responses may provoke a positive impact on me—and encourage me to come again or perhaps submit to the local literary magazine—it is my earlier, internal responses that will bring me back to writing. Intermittent reinforcement from others (an external response) may or may not increase the volume of my work. This type of reinforcement is likely however, to influence where and how 1 publicly recite or publish my poems; it is not likely to affect my emotional responses which come from writing about an early morning sun intermingling with the night's leftover fog, to create a kind of floating netherworld pierced by the shrill screams of gull-demons.

Evolutionary theory is limited when psychological needs and emotional responses are considered only as mechanisms or cues that have prompted H. sapiens on what to do about food, shelter or sex (Dissanayake, 2000). While an understanding of mechanisms is critical developing a broader understanding of changing evolutionary needs would also unify the bio­logical and the cultural as E. O. Wilson has done with the concept of consilience (Wilson, 1998). Consilience takes into consideration ethology, biology, economics, sociology, psychology, religion, and the arts in the context of examining a changing environment throughout the evolution of H. sapiens. The theory of consilience provides a foundation which allows us to abandon the necessity of reducing ancient or current art making prac­tices from a separate stimulus-response set and to see it as behavior within a broad cultural context. In connecting making special or what later she comes to call elaborating, Dissanayake (2000) proposes a bioevolutionary theory supporting the interrelatedness of art (elaborating) and love (inti­macy) that considers psychological needs and emotional responses as evo­lutionary evidence for understanding why the arts exist. Her theory lends strong support for the importance of art in human evolution, but more closely related to this special issue, supplies valuable insights into psychological functions and emotional responses that are seen in all the arts, providing a theoretical and practical basis in which to make use of the arts in psycho­therapy.

Psychological Mechanisms For the arts to be a part of psychotherapy practice in professional psy­

chology, in addition to seeing the arts as evolutionarily important, psycho­logical mechanisms need to be identified as a part of the art making or CISMEW process. Present space limitations do not allow a thorough enough examination of this issue yet there are three concepts which lend additional theoretical and empirical support for incorporating the arts in clinical training which are briefly introduced below. These are not by any means exhaustive but hopefully wil l serve as introductory comments encouraging further exploration and discussion.

The Model of Homeostatic Motivation (Kreitler & Kreitler, 1972) pro­poses that observing and making art first creates both tension then relief within an individual, before bringing about a restoration of emotional bal­ance. For the purposes of psychotherapy I would add it is not always a "restoration" of emotional balance that is possible or desirable, but occa­sionally the creation or establishment ©/"emotional balance, perhaps for the first time. In describing this as a motivational model the authors contend, "The art experience is motivated by tensions which exist prior to its onset,

but (is further) triggered through the productions of new tensions by the work of art" (p. 16). The initial tensions are "a major motivation for

art...which exist in the spectator of art prior to his exposure to the r̂ V work of art. The work of art mediates the relief of these preexisting

Bulletin of Psychology and the Arts

(diffuse) tensions by generating new tensions which are specific (to the art work)" (p.19). (For further discussion of this rather complex hypothesis see Kreitler & Kreitler, 1972, pp. 20-22). This model proposes that moder­ate rises in tension, which occur in art observing behaviors, are regarded as pleasant and that very high or very low levels of stimulation are unpleas­ant. Thus depending on an individual's prior experience, cultural back­ground, knowledge of art, etc., certain art experiences wil l be under or overstimulating and not likely to be found pleasant or desirable. It be­comes the role of the stimulus within the

I suggest that this same mechanism is intensified when making art (as opposed to observing) and can be employed therapeutically (Camic, 1999a). As a client creates a visual piece (see Wadeson, this issue), participates in authentic movement (see Cruz as well as McGinty, this issue), develops an enactment of an emotional problem (see Rubenstein, this issue) or makes sounds (see Duerksen, this issue), specific tensions are increased within the C1SMEW (art making) experience and together with the therapist's interventions, help to diminish the initial tension (i.e., the initiative reason for entering therapy). In a psychotherapy which utilizes any of the arts, attending to the optimal level of activation (Fiske & Maddi, 1961) for the client is a key role of the therapist. Without going into too much detail about the nuances of the therapeutic work, the therapist according to this model, acts to both restrict sensory stimulation and induce sensory stimu­lation, as necessitated by the client and his/her problems, hoping to bring about an optimal level of stimulation (Schultz, 1965). It is within this opti­mal level of stimulation, also seen in many other forms of psychotherapy, where the most productive work is likely to occur. The mechanism of ten­sion reduction through tension induction is not a new concept, first being described by Tinbergen (1951).

The initial motivating tensions which bring a client to therapy can be relieved in part by an optimal increase in tension through CISMEW, thereby diminishing or relieving these initial tension(s). These new tensions brought about by CI SMEW are specific tensions, as described by Kreitler and Kreitler (1972), which can be addressed within the context of therapeutic art making in psychotherapy. As early H. Sapiens experienced the tensions of seasonal changes, births and deaths, illness, encounters with wild ani­mals, threats from enemies, the rising sun and the onset of darkness, full moons, and other interactions with their environment, they responded through elaboration by creating ritual and ceremony which involved orga­nized movement, rhythmic sound, dramatic performance, and visual dis­play (Dissanayake, 1988; 2000). These emotional and aesthetic responses and are also encountered by contemporary psychotherapy clients as they deal with their own burdens, problems and worries through creating im­ages, sounds, movements, enactment and writing, likewise engaging in elaboration (art making) to reduce tension from internal and external stresses.

In addition to the homeostatic model which addresses basic motivational principles, the theory of cognitive orientation brings an additional dimen­sion to our understanding of art making within psychotherapy. This theory attempts to explain

"...that a stimulus turns into a cue only after it is subjected to a series of processes designed to determine its meaning and the relations of this mean­ing to the relations of other concomitant stimuli, external and internal" (Kreitler & Kreitler, 1972, p. 23). The theory of cognitive orientation, as applied to therapeutic art making, involves the following three components: it is a process interwoven with the relief and tension sequence evoked by making art; meaning elaboration occurs when experiencing the content of the art, which includes empathic identification with the art, along with the integration of various aspects and levels of making, observing and reflect­ing; the freedom experienced by the client from others not judging her/his work by professional standards (Kreitler & Kreitler, 1972).

In applying the theory of cognitive orientation to CISMEW it is the en­counter with the art medium (clay, paint, movement, development of a char­acter, etc.) which is initially experienced as a stimulus by the client. This stimulus disrupts homeostasis and evokes an orientating response (Lynn, 1966). The orientating response includes a number of psychophysiological changes (heart rate, galvanic skin response, pupil dilation, breathing, brain wave activity, etc.) which facilitate the obtaining of information about the art medium, emerging art piece and oneself. The percepts originating at the beginning of the client's work are not likely to be conscious (Bucci, 1995). Through continued exploration of the art experience (perhaps verbally but not necessarily so) changes in homeostasis occur activating additional per­cepts. Activation of additional percepts by continuing to work with visual objects and/or temporal arts experiences is part of the process of mean­ing elaboration. The therapist facilitates this process by not placing demands on the client through for example, interpreting the client's

Vol 2 (2) work psychoanalytically or aesthetically, and by not reducing visual or tem­poral arts, created in therapy, to totems or symbols of an external reality. The art making becomes a part of the therapy and is not a symbol for some objective "truth" external to the art. This latter concept is open to much debate among expressive arts therapists as well as psychologists using the arts in therapy.

It is the various sensory qualities of the object (or experience for the temporal arts), i f optimally stimulating, which activate percepts. Continu­ing to create art is inclined to lead to more complex art making behaviors which trigger further emotional and cognitive responses. These responses require the integration of several meanings, related to both the beliefs of the client and the stimuli of the situation. For example, the client asks, What is this that 1 have painted (or sounds I have formed or spontaneous movements I have made)? In answering this question the client must con­sider a complex set of meanings drawn from their immediate experience and from their history. The answer to this question further directs the ac­tion of the client. This process is explained within the theory of cognitive orientation which emphasizes behavior as being guided by what a person believes about him/herself, others, and the world around them. Cognitive orientation for H. Sapiens continues to evolve and change over the course of thousands of years for the species, and over the course of many weeks of psychotherapy for an individual client.

Thus far 1 have discussed psychophysiological, motivational, and cogni­tive mechanisms that may be involved in art making that occurs in the context of psychotherapy. I wi l l conclude this brief discussion of psycho­logical mechanisms by returning to the work of Ellen Dissanayake (2000). Dr. Dissanayake is not a psychologist nor an expressive arts therapist but her work has significant implications for both disciplines. Extending the work of Bowlby (1969), Ainsworth (1989), and Stern (1985) she provides some of the missing conceptual links as to why the arts were developmen-tally important to early Hominids and how they remain so today. Particu­larly relevant to our discussion is her contention that the arts are evolution-arily rooted in the spontaneous ability of mothers to produce rhythmically coordinated patterns and signals, and for infants to recognize and recipro­cate them (Dissanayake, 2000, p. 42). These patterns and signals, referred to as "mutuality" by both Rose (1996) and Dissanayake (2000), and their corresponding affective resonances between mother and infant (Rose, 1996), set the foundation for physical and emotional health throughout life. Ac­cording to Dissanayake, and I concur, humans evolved to require the signs of mutuality—respect, affection, comfort, recognition, praise, emotional support and attention—just as they require water and food. Mutuality is the essential building block of our humanity, she believes, and the essence of culture, also something humans have evolved to need.

Dissanayake provides significant cross-cultural evidence which supports the existence of four essential human capacities and psychological needs: belonging, finding and making meaning, 'hands-on' physical competence, and elaborating, all of which stem from mother-infant mutuality and can be found in all cultural groups. She differs from most evolutionary psycholo­gists in considering psychological needs and emotional responses not only as mechanisms that prompt us in what to do, but also as "felt indicators of value that suggest how and why our lives can and should be more humanly fulfil l ing" (p. xv). The arts hold a developmental ly important place for Dissanayake and her work provides additional theoretical support for mak­ing use of the arts in psychotherapy.

Her concept of mutuality is made up of two characteristics, rhythms and modes, which are patterns that evolved to help sustain the relationship be­tween mother and infant through years of dependency. The features of rhythms and modes include sounds, facial expressions, and movements. These are vocal, visual, and kinetic signals respectively, that are tempo­rally and spatially patterned, dynamically varied and multimodally presented and received (Dissanayake, 2000, pp. 129-166). These properties also char­acterize ritual ceremonies, the precursors to the arts as we know them to­day. The rhythmic-modal behavior which she identifies in rituals and in art is also a component of most psychotherapies, manifesting in empathy, reflection, support, mirroring, reinforcement, understanding, and deep car­ing on the part of the therapist. Incorporating the arts in psychotherapy allows clients to engage in elaboration (Dissanayake, 2000, pp. 129-145), a behavior identified as having evolutionary significance, within the con­text of client-therapist mutuality. As clients engage in CISMEW, a thera­peutic form of elaboration, they find and make meaning through both physi­

cal, hands-on behavior and cognitive operations. Other areas beckoning exploration will need to be left to another time.

One of these involve the relationship between art experience (in the &ft arousal, curiosity, and exploration in making and observing one's own

Vol 2 (2) work), to the art work's collative stimulus variables such as novelty com­plexity, heterogeneity of elements, surprisingness, etc. (Berlyne, 1965,1967). The second involves a more in-depth discussion of emotion and aesthetic response (Aiken, 1998). The importance of emotion in psychotherapy is of course obvious and equally, the aesthetic response has a clear connection to the study of art and nature. The biophysiological and psychological mechanisms of aesthetic response, seen by Aiken (1998, 2001) as an emo­tional response, are specifically valuable to CISMEW for both gaining a richer understanding of art making within psychotherapy and for appreci­ating the significance of arts therapies for other populations that are cared for by psychologists (eg. medical patients (Long, 1998; Camic, 1999b).

A Demonstration Curriculum Psychotherapy broadly defined seeks to heal emotional injuries, increase

understanding of self and others, develop a capacity for self-reflection, reduce symptoms, change behavior, alter thinking patterns, inhibit mal­adaptive emotional responses, and encourage adaptive emotional responses. More recent evolutionary theories (Dissanayake, 1988,1992, 2000; Aiken, 1998) lend support for the utility of art making as a series of behaviors with emotional and cognitive benefits for the maker of the art as well as audi­ence. Although the function of art making may have changed from ceremo­nial rituals to present day professional art production, arts therapies and nonprofessional artists making art for themselves, art making remains both a response and a cue, coming from and creating emotional responses in the maker.

The goals of psychotherapy can be enhanced through the arts, that which ] call CISMEW, and clinical and counseling psychology can work together with the arts therapies to develop clinical and research protocols to better understand the psychological, physiological, neurological, biological and aesthetic components of this incredible process. In order for psychology to sit at the same table as the arts therapies however, a curriculum that ad­equately prepares doctoral students for using the arts clinically is essential. With utmost respect for drama, dance, music and art therapies—and all psychology can learn from them—professional psychology must develop a curriculum specific to psychological practice.

At the time of writing only one APA approved clinical program has such a curriculum; the Expressive Therapies and Creativity Concentration at the Chicago School of Professional Psychology (see their web site for addi­tional information: www.csopp.edu ). This program offers clinical courses utilizing music, drama, visual art and dance which are specifically designed for clinical psychology students. There is also an introductory interdisci­plinary arts studio class taught by an artist (see Wilson this issue) which introduces the plastic arts, performance, music, movement, creative and poetic writing. Additional courses include the psychology of creativity and a capstone course in expressive therapies. This six course sequence, open to advanced students, can be completed over a one-year period and assists in integrating the arts and CISMEW into clinical work (see Gaugh this issue). The faculty are a team of psychologists, arts therapists, and artists with extensive graduate school instruction within their own disciplines. As a demonstration project this program has produced high levels of student satisfaction, doctoral dissertation research, and expansion of the clinical "tools" available to psychologists.

In order to expand clinical training which includes the arts as a minor area of study /concentration in doctoral education, I would suggest consid­ering the following areas as important components of any such education: Hands-on experience within an interdisciplinary art studio course which exposes students to movement, writing, performance, visual art, and mu­sic. Without the experience of 'playing in the mud' a student will not un­derstand the power and potential of the arts (Wilson, 1998; Camic & Wil­son, in preparation); an ethological-historical overview of the arts through­out Hominid history utilizing the work of Aiken (1998) and Dissanayake (1992; 2000) among others; an introduction to the biophysiology and psy­chology of clinical aesthetics, which examines how the arts can be utilized in psychotherapy practice drawing from work in dance/movement, music, drama, and art therapies (McNiff, 1981; Levine and Levine, 1999, among others); research methods that investigate a variety of approaches to study­ing the arts in psychotherapy (McNiff, 1998; Camic, Rhodes, & Yardley, 2002); supervised clinical practicum work utilizing theories and approaches from the arts therapies and psychology (Warren, 1993; Wiener, 1999). These courses might be titled, Interdisciplinary Art Studio in Psychology, Etho-logical and Anthropologic Perspectives of the Arts, Clinical Aesthetics and Art Making in Psychotherapy, Alternative Methods of Research, and Practicum in Expressive Arts Therapy, respectively. $

In developing a rigorous doctoral curriculum in psychology and the %£ arts, one needs to consider evolutionary factors inherent in making art, -f\$%

Bulletin of Psychology and the Arts a historical and anthropological examination of the arts, emerging brain-behavior research, and clinical research within psychology and the arts therapies. In addition to these areas of study, I have found it essential, based on my nearly two decades of experience in graduate education and clinical practice, to include an art-based experiential component in the cur­riculum. This is probably the most difficult concept for most psychologists to accept, yet I believe it to be crucial i f we are to train clinicians and researchers who will make interdisciplinary contributions to the field.

Special thanks to Linda Edelstein, Ph.D. and Lawrence Wilson^ M.F.A. for their helpful comments regarding an earlier draft of this article.

References Aiken, N. (1998). The biological origins of art. Westport, CT. & London:

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Paul M. Camic Department o f Liberal Education Columbia College Chicago 600 South Michigan Avenue

Erasing the Gr id l ines:

A n Interd isc ip l inary Studio Course fo r Therapists W h o Use A r t

Lawrence E. Wilson

McDougal Littel l Publishers, Evanston, I l l inois &

Chicago School o f Professional Psychology

I am not a psychotherapist. 1 have never been a psychotherapist and have no plans o f becoming one, but in the last f ive years it has been my privilege and my pleasure to have developed and taught an intensive

Vol 2 (2) interdisciplinary arts course to graduate psychology students. M y back­ground is in theatre and the visual arts; I graduated f rom a classical theatre training program, and, after a decade o f performing, returned to graduate school for an M A , and later an M F A , from Columbia College Chicago's program in Interdisciplinary Arts, the oldest in the country. A t the t ime I was hired by the Chicago School o f Professional Psychology (CSPP), to teach in the Expressive Arts Therapy and Creativity Concentration devel­oped by Dr. Paul M . Camic, I was the only professional artist on the faculty o f a psychology graduate school in the United States. CSPP was the only school in the country to offer an experiential studio course designed to introduce graduate students and mental health practitioners to the artistic modalit ies. This studio is the f irst o f a six-course sequence wi th in the Con­centration in Expressive Arts.

Before coming to my class, the participants receive the fo l lowing course description and rationale:

Interdiscipl inary Arts Studio Course Descript ion:

Participants w i l l develop expertise in the f i ve modalit ies o f art ist ic expression (movement, sound, word, performance, and visual arts) through experiential exercises, discussion and class projects. The tradit ional boundaries between artistic disciplines w i l l be discussed, as we l l as the differences between "mul t i -d isc ip l inary" and " in ter -d isc ip l inary" approaches. We w i l l examine the use o f these modalities in community development, therapeutic settings, and f o r personal enrichment. No f o r m a l artistic t ra in ing is required f o r this class. Course Rationale:

Becoming prof icient in as many o f the art ist ic modalit ies as possible is v i ta l f o r health pract i t ioners work ing wi th the ex­pressive therapies. For the pract i t ioner focusing within a single modality, therapeutic opportunities may be lost, as not every client may respond wel l to therapy based solely on visual art, or movement, or music. I n addit ion, the process o f combining two or more modalities in a single piece o f art ist ic expression embodies incredible therapeutic possibilit ies. I n transcending the boundaries between tradit ional artistic disciplines, one tran­scends previously-distinct patterns o f thought and behavior, result ing in an examination o f the barriers to expression.

" N o formal artistic training is required for this class.. ." I t is very impor­tant that I include this statement, as many participants enter w i t h the inhib­i t ing notion that only those w i th degrees f rom an established training pro­gram or those who have served an arduous apprenticeship under a master are entitled to create artifacts or events which might be included in the category referred to as "art ." Yet they all come wi l l i ng and eager to ex­plore, to discover, to encounter...and I have never yet had a student who not claim, however shyly, some degree o f expertise in at least one o f the modalities o f art-making. "Oh , yes, I love to dance," (or sing, or wri te, or paint, or perform) "but 1 could never show it to anybody. I 'm just an ama­teur." But the root o f the word "amateur" is " love, " and what better reason can a person have for creating? And in gently introducing the f ive major modalities, in the particular order used in this course, my students might suddenly find themselves participating in , and enjoying, aspects o f art-making which some had always considered closed to them. This process o f opening, wonderful in itself, can lead to something even more special, as we shall see.

The Seven Sessions Upon entering the classroom ( in addition to discovering a large circle o f

fabric-draped chairs instead o f the traditional rows o f desks, as wel l as a huge table stacked wi th an enticing variety o f art-making materials), par­ticipants f ind the word " I N T E R D I S C I P L I N A R Y " upon the chalkboard, and are asked, before introductions or even the most preliminary o f class­room exercises, to write down their reaction to that word: what they think it means, why they think so. The notebooks are then put away, and the fun begins.

Because it is fun. It is play. It is my way o f introducing people to the f ive traditional modalities o f artistic expression, in non-threatening, accessible, participatory, and inspirational style. 1 identify these modalities as move­ment {not dance), sound {not music), word {not wr i t ing, not f ic t ion, not

poetry), visual {not "ar t " -^one o f the things 1 try to do in this class is to subvert the usual categorization o f this word, that o f "pigment on a flat

surface"), and performance {not theatre). The distinctions are impor­t s - tant. It 's the difference between exclusive and inclusive—how many o f

Vol 2 (2) us identify ourselves as dancers? But we all move... Very few of us identify ourselves as painters, but most of us participate in the world visually. It's the opposite of the art-belongs-on-a-pedestal syndrome, and it works. I don't have the theoretical background to explain why it works, but I have long observed that it does.

The first session's focus is on movement, and, using techniques and ex­ercises from my training in theatre, dance, and yoga, the students drape themselves with fabric, move to music, close their eyes and explore their ordinary classroom by fingertip, mime emotions or hobbies or secrets, play children's games—and then it's a rush back to the big art-table to get their reactions down in chalk, crayon, and paint on paper, because part of the effectiveness of the process, I believe, is the proceeding from the familiar to the unfamiliar. And, yes, because it's nice to have an artifact or two by the end of class, something visual to base a discussion on, something to hang on the refrigerator when we get home. Later on, the reactions will not involve traditional art-materials, or wil l involve them in previously-unsus­pected ways. Students are also given the assignment of attending a "move­ment" event (formal or informal, deliberate or accidental, professional or amateur) in the coming week and to write a two-page reaction paper on the experience.

The second session's main concentration is on sound: stretching and exploration exercises done to unfamiliar folk music, improvising a Javanese gamelan with everyday materials, improvising ballets to favorite songs, crayon-drawings done with eyes closed and atonal symphonies playing. This week's reaction paper is to seek out and respond to a sound-based event—concerts large or small, a memorable moment on the radio, the ca­cophony of early morning traffic.

The third class-meeting works with word, with improvised and "found" poems, with visual collages torn from magazines and newspapers, with altered rules for charades and investigations of simple formal forms of po­etry. In assigning students a paper on their reaction to a word-based event, there are always some puzzled faces. What constitutes a word event? A poetry reading? Yes, and also a billboard, a newspaper, a piece of graffiti. They're beginning to realize that the traditional gridlines between the artis­tic modalities are sometimes arbitrary.

The fourth class is committed to visual art—not that they haven't been creating visual and tactile reactions to their movements, sounds, and words every day before this, and being exposed to new techniques and new varia­tions of familiar practices, but this is the session in which students are required to begin to incorporate multiple modalities in their work: words embedded in their paintings and collages, 3-D sculptures which move and make sounds, poems written in reaction to a painting rather than the other way around. It is usually this session in which something clicks, in which the "eureka!" moment happens, when students realize that a l l art-making is inherently interdisciplinary and can never really exist in a "pure" form— poetry can be visual or auditory; dance is theatrical in nature; sound and movement are natural partners. Their reaction papers to a "visual" event might range from looking at a stained-glass window to/witnessing a bi­cycle accident. Sometimes slowly, sometimes all at once', the most inhib­ited neuropsychology student or the behaviorally-oriented student with a biology background is creating puppets, donning swaths of fabric to dance around the classroom, discovering strengths and depths through the em­powering "breakthrough" moments experienced in class, and this is great, because—

Because the fifth session is performance, and this is the word and the modality which has terrified ninety percent of my students over the years. " I can't—I'm not an actor—I could never do this in public!" But they can, and they are, and they do. We discuss the religious beginnings of the West­ern tradition of theatre, and compare it to those from Japan, China, and Indonesia. We talk about the use of masks in many cultures, about Carnival as well as comedy and tragedy. WE discuss the opening chapters of Stanislavsky's Building a Character, and how a performer (and, by exten­sion, an art-maker working with any of the modalities) might start with a concrete artifact to develop a character or persona. Fresh from weeks of personal successes in combining multiple modalities into single objects or events, the traditional ending to the fifth session is to put on our new home­made masks and parade around the neighborhood, stopping traffic, terror­izing dogs, and making little kids laugh. Very few decline to participate. Those who do are given documentation duty, which is always a vital part of any artistic event. Their reaction papers to seeking a "performance" event reveal a new appreciation for the interdependent web of movement, sound, words, and visuals. &

It is also during this fifth session that the students are given the f " " parameters for creating their final project for the course. I tell them to -fiJ

Bulletin of Psychology and the Arts create an event, an object, or an installation which combines at least three of the five modalities, and which should engage as many of the five senses as possible. I also tell them my personal artistic mantra: "Whispering is better than shouting"—that, paradoxically, the more specific and private the focus, the more universal and accessible will be the result (the converse is rarely true. Students who strain to produce something big and important and meaningful usually end up with something trite and boring).

The sixth session is a work period, with classroom materials and advice available for all. Participants are encouraged to collaborate as well as to cooperate in the planning and execution of their final pieces. The thinking and rethinking which occurs during this period lead to another realization for the students: that art-making does not and cannot exist in a vacuum. Not only are we almost always dependent on other people to help create or present the art (technicians, exhibitors, supernumeraries, co-stars), we are also vitally dependent on having an audience, however tiny it might be. In this sixth session we discuss the ways and means of "taking care" of an audience—will they sit or stand? Can everyone see? Is the sound-level appropriate? Is it your intent to create a welcoming space or an immediate feeling of discomfort and alienation? Are you endangering your audience physically or emotionally? I f so, have you given them the option of not participating? We also discuss the various forms of documentation avail­able—obvious ones like photography and video, and less obvious choices like memoir, memory, and reaction drawings or writings.

The seventh session is almost totally committed to the viewing of/par­ticipating in/discussion of the final projects. Everyone is given their fifteen minutes of "fame" and each person uses it in a unique manner. The pieces might be static installations combining visual imagery, scents, and music, or perhaps someone might elect to include a favorite poem or some origi­nal writing. Students have developed participatory exercises of their own to share, or variations on children's games, or set up a nostalgic storytelling moment, or gone all-out and created a multi-media extravaganza of bright lights, pulsing sound, and leaping dancers.

An important part of every one of the seven session are the discussions amongst the participants about how they might actually use these ideas, exercises, and techniques in their work. When I included "personal enrich­ment" in the course description, I was thinking about ways in which art-making might help mental health practitioners in their personal and profes­sional development, and it is always interesting to hear vignettes from train­ing, internships, or professional practice in which interdisciplinary art-making techniques might be successfully employed (for a view from a past participant in this course, please see Laura Gough's article in this issue).

The Quantum Leap During the last half hour of the final class, I ask the participants to open

their notebooks to a clean sheet of paper and to write down their definition of the word "INTERDISCIPLINARY," and then to read both this day's definition and the one from the first day of class. No one has ever come up with the same definition of the word on the last day as they wrote down on the first. There has been a change—before this course, there's a tendency to think more in terms of "multi-disciplinary" rather than "inter-disciplin­ary." People tend to have less of a problem with artists being good at sev­eral different sorts of art—someone might be good at music, and also a decent dancer, and secretly writing poetry on the side—but too often the creative work is pigeonholed, each type filed into its own category and rarely cross-pollinating. As I said in my course rationale, I do feel that it's very important for therapist who use art to achieve a satisfying-to-them level of proficiency in as many of the modalities as possible, in order to expand their vocabularies of expressive possibilities—a client who might not be able to speak aloud of their pain might be able to mime it, or draw it. But I have seen, over and over, the wonderful works which happen when students are encouraged, cajoled^ and ultimately required to combine mul­tiple modalities in a single piece of art, how "I can't" turns into "maybe 1 could" and then into " I can" and " I wi l l . " It's also exciting to see students overturn the chauvinism of a lifetime's schooling which declares that art belongs on that pedestal, in that frame on a gallery wall, in that darkened theatre after purchasing expensive tickets. I f these "quantum leaps," these changes of state, are beneficial for student and professional therapists, then I must also honestly believe that the interdisciplinary techniques which they have learned from me will be of benefit to the clients which they will have in the future. Thus far, reports from our graduates have only con­firmed these benefits.

Resources Programs

Chicago School of Professional Psychology, Expressive Therapy and Cre-I jV attvity Concentration: www.csopp.edu

Bulletin of Psychology and the Arts Columbia College Chicago, Department of Interdisciplinary Arts:

www.colum.edu Suggested Reading

Bumaford, G., Aprill, A., & Weiss, C. (Eds.) (2001). Renaissance in the classroom- Arts integration and meaningful learning. Mahwah, NJ.: Lawrence Erlbaum Associates.

Collom, J.. & Noethe, S. (1994). Poetry everywhere. New York: Teachers and Writers Collaborative.

Cleveland, W. (1992/2000). Art in other places: Artists at work in America's community and social institutions. Amherst, MA.: University of Massachu­setts, Artists Extension Service Press.

Koch, K. (1970). Wishes, lies, and dreams: Teaching children to write po­etry. New York: Harper.

Morice, D. (1995). The adventures of Dr. Alphabet: 104 unusual ways to write poetry mjhe classroom and the community. New York: Teachers and Writers Collaborative.

Smith, R. (1996). The artist s handbook. New York: Knopf. Stanislavsky, C. (1949/1989). Building a character. New York & London:

Routledge.

Lawrence E. Wilson 2310 Thayer Street Evanston, Illinois 60201

Vol 2 (2) dance/movement therapy, drama therapy, music therapy, and creative writ­ing in therapy. Like most beginning students, I quickly learned that "life outside of school" was a humorous concept created in the confused and optimistic mind of someone also struggling with the notion of "24 hours in a day". The concept was not impossible, but certainly requiring a reframe of the separation of school and life.

At about the same time when the realization struck full force, 1 was given the opportunity to begin a series of courses on the integration of the arts and psychotherapy. These courses were designed as both a certificate pro­gram and a concentration as a portion of the doctoral program. Approached as an opportunity to expand therapeutic tools and explore the integration of the arts and psychotherapy, these classes offered an introduction to the complexities of dance/movement therapy, drama therapy, music therapy, and using art media in therapy. An overview of the use of writing and film and was also briefly examined. The main premise was to allow for an introduction to the use of the arts as different therapeutic modalities, to be incorporated into a clinical psychologist's practice. It was not an attempt to create clinicians who, armed with a few techniques, felt they could take over the realm already occupied by expressive arts therapists. Through these classes, I began to look at the balance of therapeutic need, develop­mental level and ability to communicate through the use of symbol, meta­phor and experience.

The creative arts courses called for development of perspective about modalities of music, art, drama, dance and, movement in an initial and exploratory manner. Participation formed a key component, allowing the students to observe and experience the elements of each modality at work, helping to concretize and catalyze learning. The experiential component seemed to be key in building of this understanding.

Rubin (1982) comments that in the creative arts therapies, components of process and content become the focus of sessions. Attention is drawn away from the notion of finished product and into the experience of creat­ing and then studying responses evoked by that experience. Rubin further notes that although participants may find an art therapy session entertain­ing and educative, therapists should be primarily concerned with using this symbolic and behavioral context to better understand the client's therapeu­tic goals. She explains that art therapy may be used in a diagnostic or therapeutic context, but that it can only be seen as art therapy when the therapist is well versed in both therapeutic notions of inter- and intrapersonal dynamics and the media, uses, symbolism and creative processes of art.

McNiff (1999) comments that art therapy students engaged in personal expressions of creative inquiry over purely technical observation and out­come-based research seemed more in touch with the creative process un­derlying the notion of therapy. In other therapy technique courses role-playing can appear to be a contrived and artificial means of practicing tech­nique. In the creative arts program, the symbolic nature of the work pro­vided a richer exploration of the process of using these techniques in therapy, without significantly compromising verbal boundaries. The student was protected by the confines of space and time and the nature of the work being a class, but able to take on the experience of both observer and par­ticipant. The design of the courses allowed students to be able to become aware of the power of the images, movements and sounds of text and case examples, but also of their own creation. This in turn allowed for a more personal experience of how the arts can be utilized to suit a client's indi­vidual needs for expression, particularly when that expression seems be­yond words.

The introduction to several different modalities of expressive arts therapy also allowed students of clinical psychology to expand the repertoire of theory and technique in terms of work with clients. Although the brief nature of exposure to each modality could not allow for the creation of experts in any particular mode or combination, it provided the opportunity to find out which aspects of each division were most comfortable for the student. In so doing, participating in the program as a whole gave a glimpse into several directions in which treatment might channeled, providing an expanded repertoire in terms of knowledge about each subspecialty. The clinical psychologist might then use aspects of one or another modality in session, able to blend techniques and concepts as seemed to best suit the needs of the client and the ability of the therapist. As work progressed, or clients entered the process who seemed particularly suited to one form of expression over another, the student would be able to work in consultation with a specialist trained in that particular modality, or to make more appro­priate referrals given their observation of the client in treatment.

Taking courses that specifically focused on art, dance/movement, drama, and music in therapy also provided students with the ability to

expressive therapy as a concept, let alone as distinct fields of art therapy, -AJ tK fbv blend work in different media and mode. Rogers (1999) suggests that

What Wi l l We Do Today? A Clinical Psychology Graduate Student's Experience of the Creative

Arts in Therapy Laura M. Gaugh

Chicago School of Professional Psychology

"What wilt we do today?" This question is posed frequently in various forms and voices to me by the children with whom I have begun my train­ing in clinical psychology. It is at the core of my exploration of the each group or individual session. It also tends to be a beginning and ending question I ask of myself in an effort to discern the elements of process and content throughout. And what wil l we do today?

Today we may be animals, exploring sensations of growling, pouncing, flapping wings or sinking mysteriously into impermeable shells. Today we may be performers, directors, puppet-masters; watching stories unfold be­fore and around us. Today we may be sculptors and explorers of the tactile world, making marvelous, grotesque, unusual, and familiar forms from clay and found objects. Today we may be movers and dancers, testing the bounds of Rudolf Laban's notions of body, space, force, and time (Joyce, 1994). Today, we may be musicians, manipulators of sound as we take our quest through melody, harmony, pitch, timbre, texture, rhythm, and tempo. To­day they are children, exploring their ability to create, and through cre­ation, expressing and beginning to work with the issues that brought them to participate in psychotherapy. Today I am opening windows and provid­ing frameworks, tools, and media for experience, as I am beginning an­other day into my own journey in the process of becoming a psychothera­pist,

Expressive therapies allow for the creative experience and communica­tion of emotions through visual arts (painting, drawing, sculpting, and use of other media), movement, written word, music and sound, and improvi­sation, in a supportive environment (Rogers, 1999). The experience can then be further realized during the analysis of the meaning in that which has been produced and experienced. As expressive arts therapy is applied to work with children, it also allows the therapist to work within a realm of the child's own imagination and play, which are fundamental vehicles for communication of feeling and experience in childhood (Levine, 1999.)

Applying these approaches to expression to work with inpatient groups and outpatient individual clients over the course of the past year has proved to be an incredibly rewarding and challenging experience. Not only was I given an opportunity to learn more about the incorporation of the arts in therapy with children, I felt I was able to approach each child with specific tools more directly suited to their preferred mode of expression. This pa­per is a brief presentation of my own experiences as a clinical psychology student studying and working with the theories and techniques underlying the incorporation of creative arts in therapy with children.

The Applied Creative Arts in Psychology Program 1 entered a doctoral program in clinical psychology with the pre-suppo-

sition that I would leave my interest in expression and communication through the arts to my life outside of school. I had little exposure to

Vol 2 (2) the overlap of several forms of artistic expression can allow for further enhancement of an experience over that which is often understood with one modality alone. Thus, she suggests that utilizing one modality such as movement or role-playing and following with another such as painting, drawing, or creating music can increase the intensity of insight and growth throughout the creative process. She describes the enhancement and flow of creativity in one form of artistic expression to that of another as a "cre­ative connection". Her explorations of the creative connection were with people interested in personal growth, rather than the healing of specific psychotherapeutic issues. However, it seems plausible that movement from one modality of expression to another might be useful in work with many different types of clients who are struggling to find ways to communicate psychological wants and needs. They would be able to test out different modes, discovering with which forms they felt the best fit. This could then be translated to therapy sessions, by focusing on different elements of each modality as they seemed best suited to each client's particular wants and needs.

Working with professionals trained specifically in dance/movement therapy, drama therapy, and music therapy provided an introduction to dif­fering expressive therapies. It allowed students to begin to explore ele­ments of utilizing the creative arts as part of treatment. It also helped build familiarity with the work that therapists in each division of the creative arts might use with clients. As students of the program developed a sense of their own levels of comfort and experience with each modality, they also developed a better informed sense of when and to whom to make referrals as clients expressed interest and need for further and more advanced work specific to a modality.

Applications in Training Drawing from these experiences as a student in the program, 1 entered

clinical training this year with a sense of curiosity in regard to the direc­tions I might be able to move in therapeutic work. I worked this year in both an inpatient and outpatient setting, with groups and individuals. My cases consisted of children, ranging in age from 4 to 12, and encompassing a relatively diverse spectrum of diagnoses. In inpatient groups, I found children struggling with violent and aggressive behavior and complica­tions of multiple diagnosis including Attention Deficit- Hyperactivity Dis­order, Bipolar Disorder, Major Depressive Disorder, Autistic Spectrum disorders, Anxiety Disorders, Obsessive Compulsive Disorder, fetal expo­sure to alcohol and other substances, abuse, neglect, and trauma. The group on the unit at any given day might range in size from 2-12, incorporating clients of significantly varied developmental and cognitive levels, and any combination of behaviors, processing, and creative potential. Needless to say, this constantly changing and differing group of children was at times overwhelming, and often daunting in terms of decision about what they could handle as a group given their individual differences.

From the beginning, I found myself drawing heavily on my experiences from the creative arts program in an effort to keep the children engaged and help them to work toward their individual goals. The question of "what will we do today" came up often and in many different ways. I worried each week that a specific direction in art or movement might be too com­plicated for the children at earlier levels of overall (and specifically cogni­tive) development, or too simplistic for the children who were edging to­wards the capacity for more abstract thought. Overtime, 1 learned to gauge each child throughout the group, simplifying technique and direction for the children in earlier phases of development, and increasing the roles for the children with a more advanced capacity for self-control and cognitive processing.

The children frequently responded well to the incorporation of move­ment techniques throughout session. The groups almost always included children with difficulty managing physical reactivity to increases in emo­tional intensity, not to mention hyperactive and impulsive activity. Given that these children were otherwise expected to remain seated in groups throughout the day, it is not surprising that they reacted favorably to the ability to get up and express bodily and vocally in ways that they were not typically allowed to do. When the group members had difficulty maintain­ing the boundaries of personal space, we could create boundaries for them to practice moving safely out of hula-hoops, tape circles, and carpet pat­terns.

Following movement and more physical activity such as role-play and vocal and bodily improvisation, I incorporated elements of self-expression through drawing and sketching. I quickly realized that the realm of man­aging artistic expression with severely disturbed children was above and #7o beyond my capacity and training. However, using judgment gleaned T from the coursework about choice of artistic media and level of direc- -fi$

Bulletin of Psychology and the Arts tion provided, I was able to at least incorporate individual exploration on paper of reactions to the vocalizations, the movement, the role-play, and story making.

Working in different elements of the creative arts with these children in inpatient groups helped me to develop a sense of their needs, their chal­lenges, and their progress and capacity for healing that I felt I would other­wise not have been able to see through the traditionally cognitive-behav­ioral focus of much of the rest of their treatment. It was amazing to see how creative, imaginative and curious these children were, as well as how much insight they had into their needs and concerns through differing forms of self- expression. Although they exhibited different levels of ability to manage the sessions, and not every child responded in favorable ways to the course of intervention, there were always others who seemed to flour­ish. In many ways, I felt the groups incorporating elements of expressive therapy allowed a safe, structured, supportive environment in which they could finally act like children.

My individual outpatient work provided further opportunity to encour­age different means of creative expression with children who exhibited less severe symptoms and were therefore more able to work at different levels. My individual clients ranged in age from 6 to 11, and were referred primarily for symptoms of anxiety and depression complicated by concur­rent non-verbal learning disabilities or other learning and processing is­sues. This work included building of parenting skills and understanding of management of difficult behaviors, given the child's struggles with memory and learning. It also focused on building self-esteem and management of frustration and challenges specific to their learning and processing issues.

These were children who struggled constantly with verbal expression of their emotions and reactions to frustration, sadness, fear and anger. Their challenges in learning and building social relationships created a myriad of difficulties in their interactions with peers and caregivers as well as in their ability to build a sense of accomplishment and mastery at school. One goal of treatment was often to help the child learn to express their feelings in appropriate ways. They seemed ideally suited to incorporation of elements of creative arts in therapy as a means of allowing them the freedom to explore and communicate their feelings in non-verbal ways.

The individual sessions were a forum in which 1 was able to introduce and refine techniques to meet the child's interests and needs, to a much greater extent than in the inpatient groups. Both the nature of individual work and the child's level of self-control over behaviors help us to work more intensely through different modalities. As an example, a few of my individual clients reacted strongly to creating puppet-shows, beginning with designing and decorating the theatres and working into creating and iden­tifying each puppet before they spent future sessions creating both sponta­neous and intricately planned stories. More characters and details appeared as each story unfolded, and we took on the details as the elements of their own lives change and require different means of approaching their con­cerns and needs.

We took on the interactions in their own lives as they suggest familiar fairy-tales and rhymes with twists and turns unfamiliar to the brothers Grimm and mother Goose. For one child, our cow occasionally jumped over Chicago's famed Sears Tower and not the moon, meeting a variety of friend and foe in adventures along the way back to earth. For another shy and self-conscious young client, little red riding hood met not a wolf, but a pack of age-mates who required decisions about how to interact with or avoid them.

While spontaneous comments on process and comment on the part of the child occurred along the way, windows for further interpretation of symbolism and metaphor were opened in my own observation. As 1 was continually enrolled in the expressive arts courses in addition to case su­pervision throughout the year, I was able to formulate these interpretations based on information gathered from the program, from other elements of my training in psychology, and from consultation with the expressive thera­pists teaching the courses themselves.

And so we explore as many ways of expressing as they and I combined can determine. Today we may be balls of anger, rolling around a gymna­sium floor. Some of us are concrete, armored or clawed creatures, some thunder clouds, some more abstract manifestations described in their move­ment, activity, and color. Today we may show what it means to relax, from a page full of blue and green images to a descriptive pantomime of a warm summer day. Today we are inventors of tools to help them overcome their fears, concerns, and problems. As a student continuing her journey through psychology and creative arts, I leave you with an extension of the same

question with which we began: What are you going to do today, and \f\- what does it mean for you?

•1

Bulletin of Psychology and the Arts

References Joyce, M. (1994). First steps m teaching creative dance to children (3rd ed.).

Mountain View, CA: Mayfield Publishing Company. Kramer, E. (1998). Childhood and art therapy (2"d ed.). Chicago: Magnolia

Street Publishers. Levine, E. G. (1999). On the playground: Child psychotherapy and expres­

sive arts therapy. In S. K. Levine, & E. G. Levine (Eds.), Foundations of expressive arts therapy: Theoretical and clinical perspectives (pp. 257-273/ London, England: Jessica Kingsley.

Rogers, N. (1999). The Creative connection: A Holistic expressive arts pro­cess. In S. K. Levine, & E. G. Levine (Eds.), Foundations of expressive arts therapy: Theoretical and clinical perspectives (pp.] 13-131). London, England: Jessica Kingsley.

Rubin, J. (1982). Art therapy: What it is and what it is not. American Jour­nal of Art Therapy 21, 57-58.

Laura Gaugh Chicago School of Professional Psychology 47 West Polk Street Chicago, 1L. 60605

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Art Therapy and the Elephant Harriet Wadeson

University of Illinois at Chicago

An old Indian fable tells of the six learned blind men who argued over the nature of the elephant. One felt its side and said the elephant is like a wall. Another, feeling its tusk said the elephant is like a spear. The third felt its trunk and said it's like a snake. The fourth found the leg to be like a tree, the fifth touching an ear said the elephant is like a fan, and the sixth seized the tail and described the elephant as a rope. Each blind man was partly right, though all were wrong.

Six human service providers who work with art therapists attempt to explain what art therapy is. The first, who is a teacher at an elementary school, says art therapy helps her attention-deficit disordered children to settle down and concentrate. The second, who works with abused and neglected children, says that art therapy gives them a means to express the traumas that they cannot put into words. The third, who works on a hospi­tal psychiatric unit, says that her patients overcome their isolation by paint­ing their hallucinations and delusions so that the art therapist can share their private worlds. The fifth, who works with families at an outpatient clinic, says her families have gained insight through their drawings of their relationships and have made changes in their family dynamics. The sixth, who works at a nursing home, speaks of drawings for life review and so­cialization with the other residents. Al l are correct about what art therapy is. But each has a different picture. None has the big picture.

This paper is an attempt to illustrate art therapy's great diversity, to show the elephant's massive bulk, tough skin, squirming trunk, sharp tusks, skinny tail, flapping ears.

Changes in the Ar t Therapy Picture The picture art therapy presents today is far different from its early de­

velopment just a few decades ago. Then, art therapy was centered prima­rily in psychiatric hospitals, hospital psychiatric units, psychiatric clinics, and special schools for children with emotional disorders. In more recent years, the profession has expanded to address many other societal prob­lems. AIDS became the plague of the twentieth century at a time when we believed medical science had advanced beyond such catastrophes. Baby boomers reached middle age and began worrying about Alzheimer's dis­ease for the increasing numbers of elderly living to advanced ages. Women's issues of family violence, victimization, childhood sexual abuse, and rape have continued to resist prevention. Crime, violence, and substance abuse are the everyday milieu for inner-city youth. Coupled with these problems is the changing face of health care delivery services and, to some extent, social services as well. In the light of these societal changes, art therapy continues to evolve and grow, often to accommodate the changes, some­times to separate itself from them.

Historically, art therapy has been a hybrid profession, uniting as it does the worlds of art and human services. This union has produced practitio­ners whose work spans the spectrum between the two, and at times the fabric of the field appears to come apart at the seams in a schism between the two. These historical antecedents are embodied in the work of art therapy's two "founding mothers," Margaret Naumburg and Edith Kramer. The former developed an insight-oriented approach, which has since been labeled "art psychotherapy;" the latter a studio approach, termed A3 UtXifc-

V o l 2 (2)

"art as therapy." In viewing the development of art therapy, Junge and Asawa in A History of Art Therapy in the United States (1994) state:

Problems of defining art therapy have intrigued and plagued the field since its inception and have continued to be a major concern of the American Art Therapy Association. With Naumburg and Kramer, the two major theorists, focusing on different definitions of the process, art therapists have often argued vehemently for one position or the other and have differed over whether to have a narrow or inclusive definition. While this division has been perceived by many as a po­litical one, initially, at least, it was an argument over where the cure was in art therapy treatment, (p. 129)

In a sense these seemingly opposing views are a false dichotomy. Naumburg wrote about her long-term work with adults in which she en­couraged her clients to free-associate to their art to gain insight. This ap­proach has come to be labeled "art psychotherapy." Kramer worked exclu­sively, as far as 1 know, with children. Striving for insight was hardly what these troubled children needed. She saw artwork as providing sublimation and integration for them, which has come to be termed "art as therapy." In more recent times, the "art psychotherapy" vs. "art as therapy" dichotomy has changed somewhat, at least in its exterior trappings. As art therapists are seeking licensure, many states are including art therapy in their coun­seling licenses. To qualify, however, certain clinical courses in addition to those usually included in art therapy training are required, and art therapy Master's Degree programs are complying by adding them. Against this movement, a very vocal minority within the field is advocating a greater emphasis on art and a studio approach.

The power of art therapy, however, is that both directions are vital and valuable. As a safe vehicle for catharsis, creative art expression enhances connection with feelings. Their expression may be a relief whether under­standing is advanced or not. Forming images taps unconscious reservoirs, and communicating in a spatial matrix can provide a picture of a more total experience than the linear nature of language permits. The permanence of the created object, as well as the possibility of distancing oneself from it, allows art therapy clients to approach difficult material gradually and to view their expressions over time. The physical and especially the creative activation of art-making engages clients often more deeply and pervasively than talking alone.

Because art therapy has become such a multi-faceted profession in work with such diverse populations as are seen today, there is enormous variety in the work, some of which emphasizes certain aspects of its healing poten­tial, while work with different populations might embody other aspects of its effectiveness. In order to present a picture of some of the profession's possibilities, a variety of applications of art therapy follows.

Art Therapy Applications I believe these examples speak for themselves in several ways. By vari­

ous means, they show how the art making facilitates insight, catharsis, in­creased expression of feeling, a sense of mastery, connection with others, and enhanced self-esteem. They also illustrate a spectrum of the popula­tions and settings receiving art therapy services. In addition to traditional drawing, painting, and sculpting with clay, art therapists have been devel­oping innovative art projects and combining visual art with other expres­sive modalities. The first examples are some of the newer cohorts seen in art therapy. Immigrants

Ethnic diversity is a major characteristic and a growing consideration in our urban centers. Immigrants to this country face problems of disloca­tion, culture shock, language barriers, and sometimes poverty. Sue Lee, a Korean-American herself, worked with Korean adolescents who had im­migrated to the United States with their parents. She was able to speak with them in their native tongue (Wadeson, 2000). The transition to Ameri­can life is especially difficult for adolescents who are undergoing signifi­cant developmental transitions as well. Most of them struggle alone and have little guidance since they have been raised to be humble and to avoid expression of emotions.

Sue thought an art group would be especially helpful for these adoles­cents because they were not verbally expressive. The group was composed of 4 adolescents who were from middle-class backgrounds and had been brought to the United States by their parents in early adolescence. Sue shared some of her own difficulties in being a Korean-American with the group.

Sue structured the group to include the following art projects in order: Family of origin; Feelings about retaining Korean culture in America; Most stressful issue as a Korean-American immigrant;

Fig. I- Conflict over her Korean heritage by an 18-year-old young woman.

Vol 2 (2) Identity issues through self-portrait masks; Feeling of belonging by creating a safe space; A group ending project.

The group members participated cooperatively in the projects, but Sue found them to be much less talkative than other groups she had led. They responded to questions and spoke only when they thought it was necessary.

Kyung, an 18 year-old young; woman who came to the United States at age ten, was discouraged by her parents from making Ko­rean friends be­cause they wanted her to adapt to American culture quickly. For a long time she thought she had actually become

"white." In drawing her stress in being Korean-American, she depicted herself screaming with her hair half black and half curly- blonde; see Fig. 1. In the middle of her body is her real self, scared and trapped inside. She had tried to transform herself according to her parents' wish for her by coloring and perming her hair and wearing lots of makeup. Ai l the other art group members related to her experience. They all felt torn by their parents' expectations. Many of these parents were under stress from work­ing hard to support their families, often holding several jobs. They did not want their children to undergo similar hardships, so they tried to force them to become successful in the dominant society. Some of the young people felt guilty because their parents had told them that they had immigrated to give their children greater opportunities, and they reminded them of how hard they were working for them. Group members related their own pain and confusion. They discussed their lost identities as expressed in their self-portraits and talked about supporting one another to fi l l in the blanks they all had in their lives. Prostitutes

Many of the populations with whom art therapists work are those that are marginalized in our society, often as a result of poverty and limited opportunities. One such group is composed of prostitutes who are seeking to change their lives. These women come from backgrounds of sexual abuse, substance abuse, and violence. Chicago alone is estimated to have 35,000-40,000 women engaged in prostitution, not including those under eighteen who are also out on the streets soliciting (Wadeson, 2000). Beth Black worked at a shelter for women who wished to give up prostitution. The home operated for both crisis intervention and long-term care, having drop-in as well as residential services.

When Beth began art therapy there, the women informed her that they did not speak about themselves to one another. This example demonstrates the creative efforts of an art therapist to engage resistant clients. Beth dis­covered that of the 27 women with whom she eventually worked, all had a history of sexual abuse beginning as they entered puberty. All had been homeless and all had poly-substance addictions. All claimed to leave their bodies when they "turned a trick." Beth observed various symptoms asso­ciated with post-traumatic stress disorder—low self-esteem, depression, dissociation, and suicidal ideation. Recovery for them was one of the great­est challenges of their lives, including as it did battling substance addic­tion, reconstructing lost memories of childhood, and finding a new career. The latter often meant accepting work at wages far below what they were earning as prostitutes. For many there were complications of arrest records, the stigma of prostitution, and enormous shame and pain.

On the first day of group art therapy, no one came. Beth took some art material out to the backyard and made a mask. One by one, the women became intrigued by what she was doing, and soon 4 were making masks of their own. Beth found it necessary to learn about the individual masks before she could come to know the women further. These women had spent many years hiding their true selves. Most had kept their prostitution secret from their families. The subculture of prostitution does not allow for trust, as competition for territory and dates erodes the likelihood of trust among peers. One woman said, "We are hookers, liars, and thieves" | ^ (Wadeson, 2000, p. 298).

Beth had thought that after the mask-making her group would con- -f*JPU

Bulletin of Psychology and the Arts tinue. But once again, no one came. Recognizing that initiation into adult­hood at an early age and a painful lost childhood were common themes, Beth worked on creating a piece from her own childhood, a stuffed cat made from an old sock. She left it in the studio. At the next open studio session, Gwen, a resident, asked Beth to show her how to make a doll too. In only a few minutes, all five women present were busy making dolls. They were stuffed with batting from old pillows and decorated with but­tons and yarn. Clothes were made from patterns drawn by hand and cut from fabric. The dolls' significance to childhood, mothering, nurturing, and femininity broke down barriers of distrust and competition. The women shared supplies, patterns, ideas, and help. All the dolls turned out to be female. These soft fabric objects allowed the women the opportunity to show their tender, caring sides without feeling ashamed or intimidated. They spoke of and to their dolls tenderly, carried them on their shoulders or placed them in their laps, never left them behind, and made certain they were safe. Clearly these women identified with their dolls and gave them the care they had not received themselves. The dolls also led the women to telling stories of their childhood and expressing feelings about body im­age. Making the clothing promoted discussions of fashion and what they wore on the streets.

Gwen, 46, had attended only one art therapy session, always having an excuse to miss her individual sessions. She began prostitution when she was 16 and had a history of alcohol and cocaine abuse and arrests for shop­lifting. She spent 4 hours making her doll, talking to it as herself as she worked on it: "Now Gwen, your legs are too thin...you're acting like a whore...you need to put some clothes on" (p.299). When asked about her experience, Gwen said, "The only thing I've ever completed in my life was a good high. Now I've completed this doll and I am proud of it...It's the first time in my life I've ever done anything artistic. I never thought I could" (p. 299-300). Nor had she ever sewn before. Later she called her doll "the whore and drug addict." Gwen's doll gave her confidence to make some more. Her second doll portrayed her ethnic side. It was more complicated, with African clothes. Her third doll was even more complex. This doll is a male with removable clothes fastened with snaps and buttons. As Gwen worked on her successive dolls, she examined aspects of her own identity, speaking of herself as a mother in relation to the first one, as an African American in the second, and about her relationships with men in the third.

It was through her own art that Beth connected initially with the women. Fabric is a traditional medium for women. The slow and repetitive process of sewing can be very soothing. Working together gave the group the feel­ing of a traditional quilting bee, hardly the usual activity for women who have engaged in prostitution. Battered Women

According to Stephanie Haddon, conservative estimates put the number of women beaten by husbands or boyfriends in the United States during a single year at 12 million {Wadeson, 2000). In developing an art therapy program for a battered women's shelter, she used the art to help the women to:

reorganize their lives during a time of crisis; overcome the effects of victimization; learn about domestic violence; tap into personal resources for support and healing.

The shelter provided emergency housing for battered women and their children seeking refuge from an abuser. It was a "safe place" for women who lacked financial, family, or community resources necessary to leave an abusive situation on their own. Many of the women were depressed and lacking in motivation when introduced to art therapy. They entered the shelter at a time of crisis, and their immediate priorities were concrete and external, e.g., legal advocacy, employment, and childcare. Most were not ready for art therapy until they had made some attempt at restructuring their lives. Stephanie incorporated art therapy into a weekly support group for residents and walk-in clients who had left or were considering leaving an abuser. The group focused on concepts of the cycle of violence and the abuser's power and control. Through the articulation of these con­cepts, the women were educated toward the goal of empowerment. The artwork allowed them to express painful material that might not have been verbalized otherwise. The power of the image could make concrete the reality of their experience and lessen the likelihood of their minimizing the intensity of their abuse in the future. Art making served a cathartic pur­pose as well, giving the women a safe way to release their anger.

Il was clear to Stephanie that the women were seeking an opportunity to ventilate their rage. This became evident in their wish to invite a

HLjv man to the group, presumably to find out what made him abuse a woman.

Bulletin of Psychology and the Arts Since men were not allowed in the shelter, Stephanie supplied a life-size paper-mach6 man. First, the group was asked to list the characteristics of their abusers. They named the following: liar, jealous, possessive, inse­cure, unfaithful, and violent. They were then asked to express these char­acteristics with paper-mache or paint. The figure was then introduced for them to work on. They created facial features, including "a big red mouth for all the lies he tells" (p. 306), and a question mark at the top asking i f he has a brain. Marie, a woman who had contemplated homicide before her escape from her abuser, made a paper-mache dagger that she stuck in the ribs. She added a black heart for his evil and a chain in his hand for his need to control her, muscles for physical strength and boxing gloves repre­senting his propensity to fight. " I love you" and "mine" are written in balloons to indicate hispossessiveness and jealousy. Jan, who seldom spoke in groups, carefully constructed a wire and paper-mache penis she painted red for her blood. She attached it and said, "that's what he did to me" (Wadeson, 2000, p. 306). Afterwards, she told the group several times how great she felt. When they had finished with "the man," the group wanted to move on to their needs and leave the abuser behind. Sharing this very intense experience with one another made the catharsis even more beneficial.

Like the women giving up prostitution, battered women leaving an abuser are taking an enormous step in reordering their lives. Many have young children dependent upon them and few resources for support. Art therapy can help them to confront their painful realities and set about restructuring their lives. Particularly significant for them is the anger they have and the opportunity to ventilate it that art can provide in a safe way. Social Protest

Jean Durkin sees her own mission as an art therapist at several shelters for homeless women as extending beyond the individuals and groups with whom she works to the neighborhood, the city, and hopefully to the world at large. One example of public art is a mural the women painted on the outside of the agency's building. Jean describes it as their "making a mark on an outside wall, making a public, self-determining, willful, self-identi­fiable image that will last a very long time" (Wadeson, 2000, p. 276).

The benefits of joining others in making and exhibiting art for social awareness and protest have been substantial for the women with whom Jean works, the student interns she supervises, and for herself. Jean recog­nizes that "having hundreds of supportive onlookers applaud and praise the art you have created is a rare experience for anyone" (p. 310), but she and her clients have had that experience at rallies and marches. Although she is aware of the dangers in the unpredictability of crowd reactions at such events, she has seen significant therapeutic benefits in the planning, preparing, and participation in these social action demonstrations.

Each year her agency supports an annual march and rally sponsored by a peace and justice organization and supported by approximately 50 other such organizations. Jean and her group created a banner to highlight women's rights. More than 20 of the women worked on the preparations. They wanted to focus on several issues: the right to appreciate all women as beautiful, the right to walk safely in the streets at night, the right to equitable pay, the right to live without verbal abuse, the right to have better communication between genders. Seven panels representing these issues were created with acrylic paints, felt, and found objects applied to 3' X 4' pieces of muslin. They were edged in green and sewn together to form a 3' X 30' banner that could be folded together like a map and then unfurled dramatically.

The banner was begun with the central panel depicting the beauty of women. Jean drew seven ovals on the unprimed muslin surface after se­curing it to the table with masking tape. She started to paint a face in one of the ovals. She was soon joined by 3 of the women and one of her in­terns. They painted together and discussed what makes women beautiful. Jean often engages the women in this non-verbal way by simply beginning a project that others then join. They painted faces of women of various ages, ethnic backgrounds, and showing different emotions. Another woman had her own ideas about the verbal abuse panel, so Jean followed her lead. Because of its success, this woman then felt confident to work on the equi­table pay panel with minimal help on the rough draft design. Another woman needed only a little help in making the image of a woman walking alone at night without fear. This image had special significance to the participants, as several women had recently been murdered in the neigh­borhood. They began accompanying each other when walking from the shelter at night.

At the rally, it was a big moment when a dozen of the women unrolled <, the banner before hundreds of supportive onlookers. One of the shel-

Vol 2 (2) posed, to which the others and the crowd responded. Afterwards, she said, "The reason I led it so good was because it was from my heart.. .The expe­rience gave me more confidence to do things" (Wadeson, 2000,p. 312).

Art such as this banner is both therapeutic and political. It is a signifi­cant expression for the artists, comparable to the individual expressions of grief in the AIDS Names Quilt, and it is a political statement made to the society at large in an empowering effort to bring about social change. Women, even the most disadvantaged, can find a voice and rally for their rights. Art made in the service of social protest is a piece of the whole in helping women to change their lives and change their world. AIDS Patients

In 1990 Russell Leander set up the "art room" on a hospital AIDS unit at a time when most AIDS patients died of the disease. The unit's population was composed largely of Caucasian mid-socioeconomic level homosexual and bisexual men who had contracted HIV through high-risk sexual activ­ity. There was also a growing percentage of heterosexual male and female intravenous drug users who contracted the illness from contaminated needles. Russ recognized that "combating anxiety and the loss o f ' se l f in an institutionalized setting called for a space that provided an escape from sterile lighting, cold linoleum, paging systems, and the smell of disinfec­tants" (Wadeson, 2000, p.347). The space Russ was given for art therapy was an empty hospital room with florescent lighting and a window that faced a brick wall. He set about "de-institutionalizing" the room by gelling the lights with deep pink cellophane, covering the bare walls with panels of warm colored burlap, and hanging silk plants from the curtain tracks on the ceiling. Russ furnished the room with comfortable chairs, a supply cabinet, and a long worktable. Because many of the patients spent sleep­less nights, the art room was left open twenty-four hours a day, and there were no locks on the supply cabinet. Art Therapy and Video

During the first year of his work on the AIDS unit, Russell Leander made a video that showed the art room he set up and the art of some of the patients with their voice-over discussing their work and the importance of art therapy in their lives. Many of these people are now dead. The video, which is professionally made with musical accompaniment, is an impres­sive testimony to what art therapy can bring to this suffering population.

Perhaps influenced by Russ's use of video, William Kasser also used video, but in a different way and for a different purpose (Wadeson, 2000). In 1997, William began his internship on the AIDS unit under Russ's su­pervision. By this time there were important changes in AIDS treatment. The virus could now be made undetectable in the infected person's blood with few or no opportunistic HIV-related infections. William points out that this shift in disease prognosis causes a major shift in the expectations of those living with HIV or AIDS. What was once a death sentence may now be replaced by daily struggles with disease management. Whereas earlier art therapy goals were to help people with AIDS to have a more peaceful and less frightening transition from life to death, William's work has been directed toward living with HIV.

Even with the success of the new protease inhibitors, some patients fail to comply with their medication procedures because of costs and the strict demands of these regimens. In addition to taking an abundance of medica­tions daily, most people living with HIV must have monthly blood tests and make frequent trips to the doctor. William undertook to assist people living with HIV to reflect upon the nature of their lives under these condi­tions.

As a now familiar lens to record life events, video also helped William's clients to distance themselves from their daily lives to offer a more reflec­tive perspective. He invited each participant to record a day in his life. They were given the option of doing their own filming or in directing Wil­liam in the filming. They began by listing the circumstances of their lives and the activities of a typical day. These were then visualized on a storyboard to serve as the plan for the shoot. They selected music and/or voice-over for an accompanying soundtrack. Each reviewed the rough-cut and the soundtrack and selected changes for the final video footage, which was then given to them. Obviously, a major benefit of the video-making pro­cess was the relationship each participant developed with William as he entered their lives, followed their directions, and heard and saw their reac­tions to the conditions of their lives.

Jim is a thirty-two-year-old Caucasian homosexual diagnosed with HIV two and a half years previously. He and his partner of several years had recently moved into a new apartment. At the same time he began a new

medicine combination as a participant in a new protease inhibitor study. The drugs had reduced the amount of HIV in his system, giving Jim a

ter women spoke into a microphone calling out a reading she had'com--j\,f^Oi|./v more positive attitude toward life, along with a very stringent daily

Vol 2 (2) regimen of oral medications that required a strict adherence to prevent v i­ral resistance. Jim was feeling stressed by his job, living with his partner, housework, and nausea from the new drug program. He found himself becoming obsessive about household cleaning. These concerns were the focus of his video. His storyboard was specific in its images of his broom, pills, etc. He enjoyed directing William in shooting himself sweeping, the TV, his partner. Jim was an enthusiastic participant and did some of the shooting himself. Upon viewing the rough-cut later, he commented that "It probably helped me address some issues I was getting hung up on" (Wadeson, 2000, p. 358). At a time when he was feeling overwhelmed by the new conditions of his life, the video process helped him to put his reactions in a more balanced perspective. Since making the video, Jim reported that his compulsive behaviors of sweeping and cleaning mirrors have abated.

William's project was very interesting in a number of ways. There is a paradox of immediacy and distance. Shot mostly in the men's own homes, the video brings the viewer (including the protagonist) into intimate con­tact with the subject. Yet the process of viewing allows one distance. Mostly, William took direction from the men in recording a segment of their lives. There was much discussion as these men brought William into the inti­macy of the world they inhabited. For them, the connection and catharsis were significant. The fact of the video project itself was very significant to them as well, giving importance to their daily lives. And finally, the rela­tive permanence of their creations, that would likely outlive them, particu­larly for people facing imminent death, gave them an opportunity to "make a mark" by leaving a record of themselves behind. Care for Care-Givers

As is evident from the connections between art therapists and clients implicit in the work described above, treatment of HIV/AIDS patients is extremely demanding emotionally. To provide support for workers who treated AIDS-infected children in a hospital Child Life Program, Stephanie Zentz created an AIDS Caregivers' Art Therapy Group. She states that stress results from adjusting to multiple losses, recognizing one's own mortality, fear of contagion, helplessness, anger, irrational unfulfilled res­cue fantasies, decreased job satisfaction, and possible stigma associated with the AIDS population, which may result in professional stress. Early on in her work with HIV-positive children, Stephanie recognized the stress she was bringing home after a day of work, often feeling she was riding an "emotional roller coaster" (Wadeson, 2000, p. 361). She began utilizing her own art and journaling to process her reactions. Out of this experience grew the idea of forming an art therapy group for interested staff.

The group was composed of various health-care professionals and vol­unteers. Stephanie's art therapy supervisor created a 3-D piece in relation to 8-year-old Amy, who, unlike some of the children, knew of her AIDS diagnosis and had planned her own memorial service. She had worked with Amy for three years and had witnessed her suffering from her illness as well as many losses of family members and friends to AIDS. After one of her sessions with Amy, the art therapist needed to express her feelings about her struggles in working with Amy at a time when her condition had worsened to the extent that imminent death was possible. She selected a small box, covering it over with black tissue paper and placed pieces of colored tissue paper and feathers inside it. As she closed the sides, giving it a house-like appearance, the colored paper and feathers squeezed out of the box. Finally, she wrapped string around the box in all directions. She

described the piece as representing her reac­tion to Amy's resistance in their previous ses­sion. The colored tis­sue and feathers are the strong emotions held in­side Amy. Because so much was held in, Amy was difficult to reach. The string represents the defenses wound tight around the feelings

h'lg 2-Portran of death bvan art therapist worbng with to hold them in as Amy HIY-pouiive children. continued to survive the multiple losses in her young life. The art therapist wanted to cut the string and picked up scissors, pretending to do so, but she recognized Amy's need for her defenses. This art piece helped both its creator and the rest of the group to vent their frustrations and sadness.

The caregivers' group became very supportive for its members and j \ | X

Bulletin of Psychology and the Arts a relief from their trying days at the clinic. In addition to loss, grief, and worry about particular patients, members shared with one another through their art each one's unique view of death and mortality. For example, a portrait of death showing a central skeleton, Fig. 2, is more severe than idealized images of heaven others drew. Around the central bust of the skeleton are three mourning figures. Black paint is dripped around them. At this hospital, art therapy served not only the patients, but also their stressed and often grieving caregivers. Elderly

Art therapists work with the elderly in both nursing homes and in daycare facilities. Clients range from those who function well to people in ad­vanced stages of Alzheimer's disease. For older adults interested in and capable of personal reflection, art can add a useful component to a life review. Even clients with Alzheimer's disease may benefit from art therapy, helping them to experience some sense of self-esteem, in spite of their extensive losses. Nevertheless, as their condition deteriorates, they need more and more help, so the art therapist may cut out pieces for a collage, help with the gluing, etc. Obviously, older adults do not come to nursing homes or day centers for therapy. As a result, some may be quite resistant in art therapy groups. An example is David, who at 52 had suffered a cerebral contusion from an accident that resulted in compromised cogni­tive abilities, aphasia, and weakness in his left extremities. He had been a teacher until the accident had cut short his career. He lived with his wife and attended a day center where MaLinda Johnson conducted group art therapy (Wadeson, 2000). David seldom attempted any of the art projects, but remained on the sidelines observing. Prior to Halloween MaLinda introduced a cheesecloth ghost project. David put the cheesecloth on his head playfully and said "boo" several times. The group members were to paint the cheesecloth with fabric stiffener, but David continued his interac­tive playfulness and dipped his cheesecloth into the bowl of stiffener. He massaged it in the bowl before draping it over a plastic form to create the ghost shape. He molded the saturated cloth further, exerting control over the materials. The tactile nature of this three-dimensional project engaged David so that he became invested in his creation and dropped his typical passive response to the group. After the cloth had dried, he removed it from the form and added eyes and a mouth; see Fig. 3, He was pleased with his whimsical ghost and was eager to show it to his wife. Following

this project, he began work­ing in clay.

MaLinda has found that al­though adult daycare clientele may suffer physical and men­tal disability, sensory func­tions are still intact. Those with cognitive impairment may have difficulty interpret­ing all they see, hear, touch, and smell, but they can still derive pleasure from their senses and use them to com­municate. David's striking projects brought him feelings of pride, accomplishment, and heightened self-esteem. The active participation encour­aged by the sensory stimulat­ing media brought him closer

to the functional level of the other members of his group, despite his lim­ited use of one arm, and his active participation brought increased social­ization. Psychiatric Aftercare Services

Debra Paskind, who worked for many years at a public psychiatric hos­pital, reports that the average length of stay there has decreased from 90 days to 14 days (Wadeson, 2000). Compensation for this curtailment has been developed by extended art therapy services at aftercare facilities. Both the quantity and the innovative quality of art therapy for aftercare make work with the chronic population one of the most interesting growth areas in the profession. In the past, art therapists had the luxury of working with hospitalized psychiatric patients for several months, and in some cases even years, and were, therefore, able to see the impact of their work in the change and growth in their patients. Now hospitalizations are crisis oriented, and

those who cannot function adequately are no longer cared for in hospital until they can. People who in former years may have been hospitalized

?y now may spend a number of full days each week, sometimes for years,

Fig. S-Ghost made with fabric stiffener on guaze by a 52-year-old man after a cerebral contusion

Bulletin of Psychology and the Arts at aftercare facilities. Art groups provide the major programming for some such facilities. The opportunity to work with participants over a long pe­riod of time has enabled art therapists to try creative new approaches. Some of these have been within the realm of traditional art therapy, whereas oth­ers have reached beyond traditional borders into art history, photography, poetry, and other writing.

Bettina Thorn combined photography, writing, and art in a therapy group at a psychosocial rehabilitation facility. Each member was given a dispos­able camera with 27 exposures and shown how to use it. They assisted one another and together chose locations throughout the city for photo shoots. Socialization was encouraged further as they selected the best bus routes to travel. In many instances, the sites were personally meaningful, and mem­bers discussed the memories they stimulated. After the film was processed, they received 2 copies of each print, one to work on and one to keep un­touched. Bettina directed the group in working with their pictures as fol­lows:

1. The first directive was to alter the photo through artwork in any way. 2. Next they were asked to create a story from a photo. 3. The third activity was to select a photo to copy and enlarge by Xerox

and to give it to another group member to embellish. 4. Members were asked to select a photo that expressed a feeling and to

add to it with artwork to enhance the feeling. Members of the photo group learned new skills that fostered a sense of

mastery and confidence. They increased their socialization, took risks in traveling to unfamiliar places, developed their creativity, and dealt with difficult emotions. All these accomplishments enhanced their self-esteem (Wadeson, 2000). For example, one isolated member became much more interactive with the others after giving the group travel information. In collaging her photo taken at a cemetery, instead of becoming overwhelmed by her feelings, as was usually the case, she was able to express her sadness over her mother's death, a very difficult issue for her. Children

Ruth Evermann, who worked on a psychiatric pediatric ward where pa­tients stayed only one or 2 weeks, devised meaningful and often ingenious tasks for them to meet their particular needs. Rosa, an Hispanic 11-year old whose parents were substance abusers and whose mother had made a suicide attempt, had also tried to kill herself and threatened to murder a classmate. She insisted that someone inside her was telling her how peace­ful death would be. When angry or frustrated, she banged her head. As Rosa was pacing and keeping her eyes on the floor in their First session, Ruth opened a cabinet and let some foam rubber padding roll out onto the floor. Rosa stopped pacing and watched it unfold. Ruth gave her some and asked her to trace her hands and feet on it and cut them out. At the next session she explained how she could make them into a life-size puppet using plastic bottles and decorative material. Ruth suggested that she could make something like herself. Rosa said that was impossible, but as Ruth demonstrated, she began to assemble the parts herself. When she had fin­ished it, she measured it to her own size, danced with it, and finally posed

it in a chair; see Fig. 4. She made clothes and jew­elry for it and fixed its hair just like her own. She described her puppet as beautiful just like herself and said she wanted to show the puppet to her mother and to the other kids on the unit. She was discharged the next day, and left with her puppet in hand. Rosa related to the puppet as a perception of herself in whom she felt pride instead of self-destruction (Wadeson, 2000). In this example, directed art ac­tivity enabled self-expression and enhanced self-es­teem.

Alexandria Elliot-Prisco utilized photography in working with sexually abused children and adoles­cents at an outpatient clinic. Eleven-year-old Nancy had been molested numerous times by a family mem­ber baby sitter. Nancy told Alex of her imaginary companions, Dog, Seal, Dolphin, and Kitty, who came to her when she was being abused and made her feel better. Alex entered Nancy's imaginary world through a multimedia project in order to fa­cilitate communication that would feel comfortable to Nancy. She made paper dolls from Polaroid shots she had Alex take of her in poses she selected. She

then made her imaginary friends from self-hardening clay. After creating a painted background, Nancy enacted an elaborate story of peril and rescue with her figures; see Fig. 5 (faces have been covered with drawn -n j

Fig. -1-1 jfe-size puppet by an 11-year-old \uiadal girl.

Vol 2 (2) faces to protect confidentiality). Through this multi-media creation, Nancy was able to reenact her trauma giving herself an heroic outcome with op­

portunity to ventilate her anger and to feel supported ( W a d e s o n , 2000).

M a r j o r i e Hamilton also worked with s e x u a l l y

! x m M W M ^ i l L M $ a b u s e d Fig 5-Polaroid paper doll dramatization by an 11-year-old sexually abused girl vounssters

In a group of 3 boys, 8, 9, and 11, with goals of aggression management, frustration tolerance, development of problem-solving skills, and building of social skills, she devised a project of creating a board game together to facilitate and improve peer interaction. Because sexual abuse victims are often defensive about being told what to do and fear being controlled, it was important to give the boys the bulk of control in developing the game. They were told that the goal of the game should have something to do with understanding sexual abuse and how to feel strong, powerful, and good about yourself. The development of the game involved much negotiation and some compromise as the group dynamics shifted and developed. In the end the boys were very proud of their creation, a pirate board game with clay pieces and gold coin rewards made from clay. Some of the cards that were to be drawn when landing on particular spaces were related to abuse and peer relations, such as, "Give an example of a bad secret"; "When might it be alright for a child to say 'no' to an adult?"; "Tell a bully to STOP" (Wadeson, 2000, p. 96). Making the game taught the boys to nego­tiate, work as a team, solve problems together, and to accept the ideas of others. They played their game together, with other children, and with their therapists. Other groups at the agency played it as well. Both Marjorie Hamilton and Alexandria Elliot-Prisco devised unique ways to work with very vulnerable young people who have been sexually abused.

A final area I will present in work with children and adolescents is art therapy used to deal with medical problems. Anastasia Limperis worked in a hospital Child Life Program. She found that life-size Styrofoam heads used for holding wigs provided the children an object to decorate that could be completed in one session, even by a physically compromised child, and that would produce an impressive result. The Styrofoam surface allowed both painting and easy attachment of objects. Nancy, 7, admitted for con­genital scoliosis, whose spine was in danger of becoming more crooked as she grew, had a metal halo drilled into her head to lift its weight and hold it stationary while the vertebrae in her spine were realigned. The mechanism extended laterally past her shoulders to her waist, keeping her torso in place. When she saw a Styrofoam head with a crown that Stacey had made, she said she wanted to make one like it. Despite her limited mobility, she said she was having fun making it, though she wanted the face to look sad. She asked Stacey to "sink" the wire into the head, and yelled "Ouch!" when she had done so (Wadeson, 2000, p.l 32). She spoke of how she had cried when the halo was placed in her head.how much she hated the hospi­tal, and how frightening it was at night. Both of them held the hot glue gun to affix feathers and yarn to the crown. Nancy then said that the hospital was not such a bad place after all and that it could even be fun. By working on the Styrofoam head, she controlled the re-creation of a painful and fright­ening experience. Her final product transformed an imprisoning, painful experience into something poignant and beautiful.

Susan Gasman provided art therapy for patients on a child oncology unit. Thomas, 16, had been living with acute lymphocytic leukemia since age 10. She saw him in the outpatient clinic. It was difficult for him to draw because of IV lines in both hands. He had come for a spinal tap, a painful procedure in which cerebrospinal fluid is withdrawn from the spi­nal canal by a needle inserted between the vertebrae. He was nervous about the procedure and began talking about inventing a machine that could scan spinal fluid with laser technology, which he then proceeded to draw from four different angles. Thomas used the art experience to relieve some of the tension he felt in anticipation of a painful procedure. When his doctor saw the picture, he was surprised that Thomas had so much anxiety from past spinal taps, yet had never told him so directly (Wadeson, 2000).

Art Therapy Collaboration In treatment with many of the populations discussed above, art thera­pists work closely with other members of interdisciplinary teams. On

'trv hospital psychiatric units, for example, psychologists, psychiatrists, and

Vol 2 (2) other primary care personnel refer patients to art therapists. In other set­tings, art therapists collaborate with administrators to establish art therapy as a regular part of the treatment program. For example, several psychiat­ric aftercare facilities in Chicago make art therapy a central activity in their programming (Wadeson, 2000, chapter 8).

In addition to treatment, another productive area of collaboration is re­search, particularly on the part of psychologists who have joined forces with art therapists in designing research to study art expression and out­comes influenced by art therapy. There are three journals pertaining to the profession that have published such research:

Art Therapy, Journal of the American Art Therapy Association The American Journal of Art Therapy The Arts in Psychotherapy The American Art Therapy Association has published A Guide to Con­

ducting Art Therapy Research,(Wadeson, Ed., 1992), which is currently being updated.

For psychologists and other human service personnel who work with art therapists or who use art with their clients or would like to do so, there are many sources of information about the field, such as:

The American Art Therapy Association, www.arttherapv.orp Junge, M., and Asawa, P. (1995): A History of Art Therapy in the United

States Rubin, J.A. (1978): Child Art Therapy Rubin, J.A. (1999): Art Therapy: An Introduction Wadeson, H. (1980): Art Psychotherapy (art therapy with psychiatric

patients) Wadeson, H. (1987): The Dynamics of Art Psychotherapy (underlying

principles) Wadeson, H. et al., Eds. (1990): Advances in Art Therapy Wadeson, H. (2000): Art Therapy Practice: Innovative Approaches with

Diverse Populations There are also annual conferences held by the national and local art

therapy associations and abundant specialized workshops offered by art therapy training programs, local art therapy associations, and individual art therapists.

Although there is no prohibition against non-art therapist practitioners using art making in treating clients, for in-depth art therapy, usually the services of an art therapist are required. For example, when children at a sexual abuse treatment center were observed to express themselves more readily in art than in other ways, I was called in as a consultant to work with the staff in helping them to use the artwork most effectively. Never­theless, what I was able to teach them in weekly consultations for a year was limited compared to the two years of intensive training art therapy graduate students receive. I believe that human service personnel can add much to many treatment venues by introducing art therapy, and it is defi­nitely to their advantage to understand the many facets of this creative profession. Nevertheless, the complexities of art therapy challenges re­quire a practitioner thoroughly trained in the profession. Therefore, col­laboration with an art therapist team member is the most effective treat­ment approach.

Conclusion This paper has presented but a few examples of what art therapists are

doing today. Other populations and facilities utilizing art therapy include jails, services for the developmentally delayed, substance abuse programs, special schools, inpatient medical and psychiatric units, and family mental health centers (Wadeson, 2000). Hopefully these vignettes give an idea of the challenges art therapists face and some of the innovative solutions they have created.

What is art therapy? Separately, the blind men reply: It is the lonely child locked in a wordless prison creating sunshine with crayons. It is the pieces of a woman shattered by rape, slowly melding together in a clay form of her intact body. It is the spiraling visions clashing and parting on paper painted by a man in a hospital who sees what others do not. It is the feeble scratchings of an ancient woman whose words have failed, making her mark.

What is art therapy? Together the blind men grasp the whole: It is the legacy of the dying, the plottings of the living, the pain made visible by those in between.

What is art therapy? It is the rivers of separate circumstances, private privations, and lonely hauntings flowing together in tides of shifting re­flections streaming toward a deep sea of intermingled humanity.

What is art therapy? It is the fixity of stars in which the evanescent £ dust of living is coalesced in images.

Bulletin of Psychology and the Arts References

Junge, M., and Asawa, P. (1994J. A history of art therapy in the United Slates Mundelein, 1L: The American Art Therapy Assn.

Rubin, J.A. (1978). Child art therapy. New York: Van Nostrand Reinhold. Rubin, J.A. (1999). Art therapy: an introduction. Philadelphia: Brunner/

Mazel Wadeson, H. (1980). Art psychotherapy. New York: John Wiley & Sons. Wadeson, H. (1987). The dynamics of art psychotherapy. New York: John

Wiley & Sons. Wadeson, H., et al., Ed.s (1990). Advances in art therapy. New York: John

Wiley & Sons Wadeson, H. (ed.), (1992). A guide to conducting art therapy research.

Mundelein, IL: American Art Therapy Association. Wadeson, H. (2000). Art therapy practice: innovative approaches with di­

verse populations. New York: John Wiley & Sons.

Harriet Wadeson Director, Art Therapy Graduate Program (MC 036) School of Art and Design University Of Illinois 110 Henry Hall, 935 West Harrison Street Chicago, Illinois 60607.7038

\|/ \|/ \|/ \|/ \|/ \|/ \|/ \[f \|/ \\f \|/ \J/ \|/ Perspectives on the Profession of Dance/Movement Therapy:

Past, Present, and Future Robyn Flaum Cruz

COPE Behavioral Services Tucson, Arizona

Introduction Dance/movement therapy (DMT) developed as a formal psychotherapy

practice in the 1940s (Bartenieff, 1972), and although European and other international influences contributed to its development, the professional practice of DMT began in the United States. By 1966 a professional orga­nization, the American Dance Therapy Association (ADTA), was started with 73 charter members. The membership of the ADTA included 955 professional and 255 nonprofessional members in 2000, with international members in Argentina, Australia, Canada, England, France, Germany, Hong Kong, Ireland, Israel, Italy, Japan, Korea, Mexico, Norway, Puerto Rico, Scotland, Spain, Sweden, Switzerland, and The Netherlands. In addition, there are currently national dance/movement therapy organizations in many international locals including Italy, Japan, Germany, and France.

Regardless of location, dance/movement therapists integrate the dancer's special knowledge of the body, movement, and expression with the skills of psychotherapy, counseling, and rehabilitation to help individuals with a wide array of treatment needs. Social, emotional, cognitive, and/or physi­cal problems can be addressed through DMT via group and individual ses­sions in many different types of settings from hospitals and clinics to schools. The fact that dance/movement therapists are immersed in the language of the body, rather than focusing solely on the verbal, lends characteristics to their work that set it apart from other types of therapy. The bias of Western culture for cognitive, verbal processing and the proliferation of body-ori­ented therapies of recent years might cause some to think of DMT as an "alternative" therapy. But the origins and practice of DMT have more in common with psychodynamic psychotherapies than with alternative thera­pies, and although frequently classified as adjunct therapy, DMT was ar­gued to be appropriate primary therapy some years ago (Zwerling, 1979).

Historical Development of DMT Interestingly, the origin of DMT was directly related to changes in the

dance art form that began at the end of the nineteenth century. The most notable characteristic of these changes was the introduction of the notion that dance, could be an expressive and communicative art form capable of moving people deeply and seriously, rather than a mere entertainment (McDonagh, 1976). The modern dance movement of the early twentieth century extended this idea and focused attention on the symbolic potential of the human body in motion free of the stylization that characterized clas­sical ballet, the only serious theatrical dance recognized at the time. Ac­cording to Bartenieff (1972), early modern dancers sought to reestablish the human communicative element in dance that existed when dance ritual was an integral spiritual and social element of societies. In Europe and the United States, dancers such as Isadora Duncan, Ruth St. Dennis, Ted Shawn, and Mary Wigman paved the way for a generation of modern

dancers including Martha Graham and Hanya Holm (McDonagh, 1976). ^X f> The first modern dancers produced three students, Marian Chace, Mary

Bulletin of Psychology and the Arts Vol 2 (2)

Whitehouse, and Trudi Schoop, who would independently take key ele- health' strive to keeP abreast of the mf1ux of new information in the field ments of modern dance and pioneer the use of dance and movement with EarJy on<the psychiatric community expressed .nterest m and fostered special populations - creating the area of clinical practice known today as DMT and thls may have been due m Part>to the fact that movement distur-DMT (Chodorow 1991) bances and abnormal movement patterns had long been recognized as symp-

It is important to note that modern dance could not simply be applied tomatic of mental illnesses (Davis, 1972). With particular regard to schizo-directly to clinical populations, Chace, Whitehouse, and Schoop each spent phrenia, movement abnormalities had been regarded as an integral aspect many years of contemplative teaching and performing to develop the skills and "mportant symptom of illness since the early part of the century, and by necessary for DMT to coalesce. Familiarity with elements of modern dance the *940s movement patterns in schizophrenics had begun to be studied forms such as the importance of expression, communication, and the dancer empirically (Silberstein, 1987). Although today we have a more complete as part of a community, allowed Chace, Whitehouse, and Schoop to de- understanding of movement abnormalities in severe mental illnesses that vclop skills such as observation, interpretation, and the manipulation of SIve ful1 recognition to the role of neurology (see Cruz, 1995/1996 for a dance elements such as rhythm and space to serve patients' needs. In June m°re complete description), when DMT was m its inception, psychoana-of 1942. Chacc was invited to work with patients at St. Elizabeth's Hospi- !ysts considered movement symptomatology to be communicative of psy-tal in Washington, DC, and she described her process of arriving at that chodynamic concerns (Deutsch, 1947). Psychoanalytic influences on the p0jnt ' field continue to be visible in the psychodynamic orientation of many dance

Dance therapy, as a discipline, did not move into the mental hospital therapists and particularly in the work of Chodorow (1986). full blown and as a bright idea to be sold. Its roots were in work that ln the 19"' century, Darwin's work established facial and body move-had been going on for many years prior to this in the community. ..At ment patterns as a subject worthy of scientific investigation and had a sig-the moment that 1 became interested in the reasons for seeking dance nificant impact on psychology (Dixon & Lerner, 1988). In the 1940s as an outlet by the non-dancers coming to the school, 1 added another anthropologists and ethnologists began describing movement as a tradi-dimension to my interest and teaching. 1 began to use my training as tional code regulating and maintaining human relationships, and this line a means of communication and body awareness rather than as a teacher of research became a body of nonverbal communication information ex-of art forms. As pupils m this group made application and then par- tensive enough for an annotated bibliography that was relevant for DMT ticipated in the first class, I observed and empathized with the needs (Davis, 1972). Birdwhistell (1970) developed a method of analyzing body being expressed (Chace, 1975, p. 9, 10). movement that accompanied speech, while other researchers investigated

Due to the symptoms of the patients, the "dance for communication" postural movements, facial expression and eye contact as part of the inter-(Chace, 1975, p. 12) sessions Chace began at St. Elizabeth's were not classes action process. Posture and movement as communicative elements in the with prescribed movement, but rather groups that used the spontaneous therapeutic interaction were studied (Scheflen, 1964), and while using evalu-movement expressions of the patients and group rhythms to meet indi- ation of nonverbal communication, as part of the clinical assessment of vidual and group goals. She observed her patients closely and extracted psychological states was not new, a new emphasis on using this informa-dance elements that could be used to make contact with and communicate tion to serve therapeutic goals did emerge (Davis & Hadicks, 1990). The with them. The practice of DMT remains rather similar today. Movement nonverbal communication research literature both supported and expanded is regarded as complex, individual, and expressive communication; pre- the understanding and interpretation of movement expression and obser-scribing particular movements would disrupt the process of assessing indi- vation with regard to interaction, and was central to the development and vidual expression similarly to telling clients in verbal therapy what to say. acceptance of the DMT profession. The body and movement become the language of therapy though which Today, dance/movement therapists use various theories of psychodynamic assessment and intervention take place in DMT. , and growth-oriented psychotherapy as frames of reference for their work,

By the mid 1960s, a second generation of dance therapists had begun and integrate these with an informed and specifically trained understand-working. In addition to establishing the ADTA as a regulating body for the ing of nonverbal communication. However, there is not a centrally estab-new profession, they began to formalize DMT training standards and de- lished and accepted theory or rationale regarding the efficacy of movement velop graduate degree training programs at several universities. A master's in psychotherapy that serves the profession; the diversity of populations degree is required of all dance/movement therapists and educational pro- and applications of dance therapy beyond traditional psychotherapy may grams approved by the ADTA include studies in psychopathology, human have contributed to this fact. Bartenieff and Lewis (1980) proposed a gen-development, movement observation, research methods, and DMT foun- eral theory about the function of movement, theorizing that the body and dations and practice. A supervised internship in a clinical setting is also its movement mediate between internal processes and the external envi-required, and students must have had extensive experience with multiple ronment, serving a coping function for satisfying and coordinating demands dance forms prior to their graduate work. Currently, there are ADTA ap- in either sphere. Most dance/movement therapists use this theory as a proved DMT graduate programs in the United States at MCP Hahnemann working model and add to it the idea that all movement, including posture University (Philadelphia, PA), Antioch/New England Graduate School and body structure (as the body develops according to its use), reflects (Keene, NH), Columbia College (Chicago, 1L), and the Naropa Institute states of psychological health and illness. Chace (1975) described a ratio-(Boulder, CO), and the program at Pratt Institute (Brooklyn, NY) has can- nale for DMT, "since muscular activity expressing emotion is the substra-didacy status. Eight other universities offer graduate work in DMT, five turn of dance, and since dance is a means of structuring and organizing institutions offer post graduate courses, and eleven colleges and universi- such activity, it might be supposed that dance could be a potent means of ties offer undergraduate coursework in dance/movement therapy. Interna- communication and reintegration of the seriously ill mental patient" (p. tionally, there are 13 programs: two each in Australia, Israel, Austria, and 71). DMT provides a therapy environment in which various aspects of Germany, and single graduate programs in Sweden, The Netherlands, En- relationship to self and others can be explored and experienced. But what gland, Argentina, and Italy. In the US, a credentialing process with two is more, there is no requirement to verbalize the material of the therapy, so levels distinguishes between dance/movement therapists who are prepared material can be discovered and addressed even i f it is not verbally acces-to work in professional settings within a team or under supervision (DTR) sible to the individual. Similarly to other arts therapies, it is this symbolic, and those who are qualified to teach, provide supervision, and work in nonverbal access to therapeutic material that distinguishes DMT from ver-private practice (ADTR), Continuing education units are necessary to keep bal therapies. a credential active. In recent years, dance/movement therapists have been engaged by the

During its early development, the practice of DMT was influenced by wealth of new neuropsychological research that has theoretical implica-the prevailing theories of psychodynamic psychotherapy of the 1940s, tionsforDMT. Interdisciplinary approaches such as that of Schore (1994) 1950s, and 1960s (Chodorow, 1991). In addition, the resurgence of re- integrating research from the areas of child development, neurobiology, search on nonverbal communication of the early 1960s and 1970s (Schmais, and psychoanalysis on affect regulation support the efficacy of nonverbal 1980) and the growing awareness of the importance of the body in mental interventions. Such work is gaining notice by dance/movement therapists disorders in the 1960s (Silberstein, 1987) offered other influences on DMT and wil l hopefully be explored further for its potential to help establish a practice. Developments in the knowledge base concerning disturbed men- scientific foundation for DMT. tal states and behavior were not lost on first- and second-generation dance/ Assessment in DMT movement therapists. They strove to understand and integrate the avail- A great contribution to DMT was the introduction of a system of ob-able information on conceptualization and treatment of mental d i s a b i l i - ^ ^ % serving, analyzing, and describing movement behavior devised by Rudolf ties with their nonverbal approach. Indeed this tradition continues as %Z£# Laban. Laban was both a dancer and architect and his elaborate theory dance/movement therapists, like other professionals in behavioral - i \ , fUOl/v of movement, techniques of movement observation, and system of

Vol 2 (2) movement notation spread through Europe after World War I I . His system of movement notation to preserve choreography is known as Labanotation, and he had many students who carried his work to England and America where his theories had a profound effect on dance and dance education (Thornton, 1971). His system of observation and notation describes the spatial and dynamic aspects of movement rather than only the actions per­formed, seeking to convey the qualities of the movements. The distinction between the action of movement and the qualities with which movement is performed is a key concept. This distinction allows analysis of movement behavior apart from action that can be used to describe functional and ex­pressive movement as well as posture and the body at rest. Bartenieff, Lamb, and others adapted Laban's concepts into a system of movement assessment known as Effort/Shape (Dell, 1977).

The basic concepts of the Effort/Shape system including effort, shape, space, and body context proved to be essential to DMT. They served as a basis for the development of diverse movement observation scales, and essentially provided a movement language that is shared by dance/move­ment therapists. The Movement Psychodiagnostic Inventory (MPI, Davis, 1970; Davis, 1991) is a Laban-based scale originally designed for observ­ing and noting the movement patterns of hospitalized psychiatric patients and used today to investigate involuntary movement disorder associated with severe psychopathology (Cruz, 1995/1996; Berger, 2000). Kalish (1975) developed and normed a body movement scale for autistic and atypi­cal children that was influenced in part by the Laban descriptive language. North (1972) also used the Laban system to develop an assessment of per­sonality for children, and the Kestenberg Movement Profile (K.MP, Kestenberg, 1979) noting developmental movement patterns and using a Laban base, has been applied to a variety of assessment populations with a focus on clarifying treatment issues (Kestenberg-Amighi, Loman, Lewis, & Sossin, 1999). The variability of these applications demonstrates the usefulness of Laban's system.

Because DMT developed as an applied practice based on the assump­tion that movement reflects aspects of inter- and intra-personal functioning that include pathological conditions, Laban's work provided a key compo­nent of DMT by offering a systematic method of observing and describing the visible dynamic of movement devoid of particular movement tasks. This has proved useful in training, clinical practice, and research. DMT training programs teach movement observation using Effort/Shape and many dance/movement therapists obtain further training and certification in Ef­fort/Shape at the Laban Institute in London and the Laban/Bartenieff Insti­tute in the US.

Practice and Professional Issues The populations with which dance therapists work have become wide-

ranging and include such groups as medically i l l children (Goodill & Morningstar, 1993; Mendelsohn, 1999) women with breast cancer (Dibbell-Hope, 2000; Serlin, Classen, Frances, & Angell, 2000), individuals with eating disorders (Krantz, 1999), and individuals with Parkinson's disease (Westbrook & McKibben, 1989). While dance/movement therapists re­port working in the areas of wellness and personal growth, palliative care, medical illness, developmental disabilities, and addictions, 60% of dance/ movement therapists recently surveyed still classified their work as psychi­atric (Cruz & Hervey, in review). Work with other populations such in­fants and parents, children with autism and developmental disabilities, and the elderly has been ongoing since the 1970s.

While dance/movement therapists have expanded the populations with which they work, there has not been a corresponding increase in the amount of research on DMT. The early DMT literature was largely composed of theoretical formulations and practice descriptions (see for example, Chase, 1953) and as the profession evolved, research oriented publications were added to the literature. Although results of studies on the effectiveness of DMT using a variety of methods can be found, the case study has been noted to be the most popular DMT research method (Ritter & Low, 1996). And while no efficacy studies have been published, effectiveness studies with multiple populations have been published. While research reflecting development and expansion of knowledge related to practice is available and some of this will be reviewed a little later in this article, the troubling fact remains that this is not a large body of literature.. An issue of some concern to dance/movement therapists is that DMT research may not be keeping up with the demands of practice and healthcare policy, (Cruz & Hervey, in review). Some of the explanation for this state of affairs is that DMT training programs focus on preparation for clinical practice rather than on research or the combination of the two, and remain limited to master's degree training programs. Master's theses abstracted in two volumes (Fisher & Stark, 1992;Chaiklin, 1998) create a large group of -f\

Bulletin of Psychology and the Arts DMT literature, but with all o f the attendant problems of design and execu­tion that one might imagine when research is not a focus of training. Dance/ movement therapists who desire doctoral degrees must take these degrees in other specialty areas and while some who do so remain in and contribute to the profession, others do not. For the maturity of the profession, it is vital that more dance/movement therapists obtain doctoral degrees with the attendant exposure to and experience with the spectrum of research methods that this implies. It is also hoped that the option of taking a doc­torate in DMT will be available in the near future.

DMT Research While the following discussion on DMT research is brief and far from

comprehensive, it is hoped that a flavor for the range and potential of re­search from dance/movement therapists is conveyed. Although a greater proportion of the extant research is practice oriented, examining the effec­tiveness of DMT and describing interventions with particular cases, some of the research has focused on investigating the potential of the movement-based assessment tools unique to DMT for diagnostic and other purposes.

Aggregated evidence for the effectiveness of DMT, although based on a relatively small number of studies, has demonstrated treatment effects of DMT that are comparable to other psychotherapies (Cruz & Sabers, 1998). In fact, when effect sizes were examined among meta-analyses for DMT, verbal psychotherapies, cognitive behavioral therapies, meditation tech­niques, and exercise for psychological problems DMT fared rather favor­ably. Effects of DMT on anxiety, self-concept, body awareness, were in­cluded in the studies. Based on this evidence, which included studies from as early as 1974, DMT can be argued to be an effective treatment for indi­viduals with a wide array of symptoms. Cruz and Sabers recommended that this information be used to lobby for the introduction and continuation of DMT positions in different clinical settings.

A study of DMT with older adults diagnosed with neurological trauma helps to demonstrate some of the flexibility in application of DMT, par­ticularly, as neurological rehabilitation and interventions that are appropri­ate with older adults are increasingly important topics. In a study of older adults with neurological injury (non-progressive neurotrauma), Berrol, Ooi, and Katz (1997) used experimental and wait-listed control groups in five centers across the country. Participants received DMT two times per week and the researchers documented gains in measures related to quality of life for the experimental group in excess of those measured for the control group. Individuals who received DMT made significant gains in physi­ological measures such as walking, and had significantly improved cogni­tive performance over the control participants. In addition there were changes in the frequency of social interaction with peers and involvement in social activities for the experimental group in spite of the fact that all participants had severe limitations due to the nature of their neuropathol­ogy.

Several studies have been conducted examining the potential of DMT based movement indicators for diagnostic purposes. Lausberg (1998) stud­ied the movement behavior of individuals with bulimia nervosa and anor­exia nervosa using inflammatory bowel disease patients and healthy indi­viduals as controls. Participants completed a movement assessment and although no significant differences were found among the patient groups, the healthy control participants were distinguished from the patient groups on several movement indicators including motor tasks and use of weight, space, and body involvement. Lausberg concluded that severity rather than type of psychopathology might have been a factor. However she also pro­posed that univariate analyses were not effective in uncovering differences among patient groups and that multivariate analyses might be more effec­tive. Indeed, due to the complex character of movement Cruz (1995/1996) proposed that expecting a single movement indicator to differentiate pa­thology was unrealistic.

Using the MPI (Davis, 1991) with raters blind to diagnosis, Cruz (1995/ 1996) found that patterns of involuntary movement indicators, distinguished using multivariate techniques, discriminated between patients with schizo­phrenia and those with personality disorders. While it may seem that dis­tinguishing between these groups based on motor behavior might not be that difficult for untrained raters, interestingly, it was not degree or severity of motor disorder but pattern across indicators that proved to be important. Evidence for the validity of the MPI as a measure of motor disorder was found in the patterning of MPI items along the hyperkinesia - hypokinesia continuum traditionally used to classify motor disorder. However, a group

of MPI items could not be ordered along this continuum and the MPI may represent a finer level of distinction of motor disorder than has been

traditionally defined. In a related study based on movement character­istics in individuals with borderline and narcissistic personality disor-

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ders, Berger (2000) found that these two groups could be distinguished w i th 86% correct classification using the M P I and again using a mult ivar i ­ate statistical technique. It is fair ly easy to argue that untrained observers would not distinguish between these diagnostic groups based only on mo­tor behavior. The surprising f inding across these two studies is that a level o f diagnostic specificity was obtained based purely on motor behavior i n ­dicators for diagnoses that are typical ly made based on extensive interview and history taking.

A final study for discussion offers another interesting application o f the observational and assessment tools that have emerged from Laban's work. Lotan and Yirmiya ( in press) used elements o f the K M P (Kestenberg, 1979) to investigate the role o f body movements during the process o f fal l ing asleep. In order to help explicate sleep problems in toddlers, their move­ments were analyzed as they were fal l ing asleep. The movement variables predicted the length o f the fal l ing asleep phase significantly better than other variables associated with the fal l ing asleep phase including duration o f pacifier or thumb sucking and presence o f objects in the bed. In addi­t ion, there was a relationship between the presence o f parents in the room and the type o f movement exhibited by the children. Parents who spent more time in the room had toddlers who exhibited fewer soothing move­ments than those whose parents were not in the room. What is most out­standing about this study is that advanced technology was used in the f i lm ­ing and computer analysis o f the toddlers' movements. The KMP, which was developed for and is still largely used by highly skilled observers (Koch, Cruz, & Goodi l l , in press), was combined wi th technology capable o f ex­actly measuring amplitudes o f qualitative changes. The use o f technology to improve on observer ratings represents a true advance that w i l l eventu­al ly have an impact on D M T research. Whi le the movement language used in D M T assessments and instruments is unique and can make a real contr i­bution to research o f many types, the fact that these instruments must sti l l be coded by trained raters cause their use to be costly and t ime consuming. Introducing technology that mimics and even improves upon human raters would certainly push research in D M T forward. Further, the application o f D M T instruments to research in areas such as developmental psychology and psycholinguistics could make real contributions in these areas.

The possibilities for research collaboration between dance/movement therapists and psychologists in various specialty areas are particularly ex­ci t ing. Productive collaborations have already proven useful in develop­mental psychology, especially in the areas o f motor development and par­ent-child interaction (see Kestenberg-Amighi, Loman, Lewis, & Sossin, 1999), and neuropsychology (see Lausberg, Davis, & Rothenhaeusler, 2000). However, the true potential o f such research partnerships has yet to be tapped. A simple review o f the specialty areas in psychology reveals a broad range from forensic and engineering psychology to rehabilitation and school psychology. The language o f the body and movement provide a rich source o f data that is seldom used in to inform research outside D M T . Introducing the D M T vantage point to research in other areas would al low cross-fertilization o f ideas and information. Indeed, exploit ing move­ment data in collaborative research can enhance our understanding o f ques­tions related to many interactive, expressive, and intrapersonal elements o f

•human experience. Summary

The growing international presence o f D M T is heartening to those o f us w i th a passion for the profession. But the fact remains that D M T is a small and specialized area o f clinical practice and the intimacy wi th the dance form that is required for entry into the profession, although necessary, may contribute to slow growth o f the profession. Whi le the field o f psychology can accept students from all walks o f l i fe, traditionally, dance/movement therapists must first be dancers. D M T offers a rewarding professional op­t ion to dancers who are attracted by psychology and human service, and in addition there is stil l much work to be done to extend the profession. Re­search and scholarship are needed to improve clinical practice, to explore theoretical underpinnings, and to extend D M T observational tools into mainstream science. Since the 1940s, the profession has f lexibly accom­modated trends in healthcare and changes in the understanding and treat­ment o f different disabling conditions. The richness o f D M T with its unique focus on the language o f movement and the body has much to offer main­stream research and healthcare, and I hope that in the future, D M T makes its own impact through contributions to research and clinical practice.

Resources Web Sites

http://www.adta.org American Dance Therapy Association http://www.ncata.com National Coalition o f Arts Therapies Associa­

tions - ; \ f U U

Vol 2 (2) Books

Levy, F. J., Fried, J. P., & Leventhal, F. (Eds.) (1995). Dance and other ex­pressive artsjherapies. London: Routledge.

Naess Lewin, J. L. (1998). Dance therapy notebook. Washington, DC: Ameri­can Dance Therapy Association.

Sandel, S. L., Chaiklin, S., & Lohn, A. (Eds.) (1993). Foundations o f dance/ movement therapy: The life and work o f Mar ian Chace. Washington, DC: American Dance Therapy Association.

References Bartenieff, 1. (1972). Dance therapy: A new profession or a rediscovery o f an

ancient role of the dance? Dance Scope, Fall/Winter, 6-18. Bartenieff, L, and Lewis, D. (1980). Body movement: Coping with the envi­

ronment. New York: Gordon and Breach. Berger, M.R. (2000). Movement patterns in borderline and narcissistic per­

sonality disorders. (Doctoral dissertation, New York University, 1999). Dis­sertation Abstracts International, 60, (9-B) 4875.

Berrol, C. Ooi, W. L., & Katz, S. (1997). Dance/movement therapy with older adults who have sustained neurological insult: A demonstration project. American Journal o f Dance Therapy, 19, 135-154.

Birdwhistell, R L. (1970). Kmesics and context: Essays on body motion com­munication. Philadelphia, PA: University of Philadelphia Press.

Chace, M. (1975). Marian Chace: Her papers. H. Chaiklin (Ed.). Washing­ton, DC: American Dance Therapy Association.

Chace, M. (1953). Dance as an adjunctive therapy with hospitalized mental patients. Bulletin o f the Menninger Clinic, 17, 219-225.

Chaiklin, S. (Ed.) (1998). Dance/movement therapy abstracts: Doctoral dis­sertations, master's theses, and special projects. (Vol. 2). Washington, DC: American Dance Therapy Association.

Chodorow, J. (1991). Dance therapy and depth psychology: The moving imagination. London: Routledge.

Chodorow, J. (1986). The body as symbol: Dance/movement in analysis. In N. Schwartz-Salant and M. Stein (Eds.) The body in analysis, pp.87-108. Wilmette, Illinois: Chiron.

Cruz, R.F. (1996). An empirical investigation of the Movement Psychodiag-nostic Inventory. (Doctoral dissertation, The University o f Arizona, 1995). Dissertation AbstractsJnternational, 57 (2-B), 1495.

Cruz, R.F., & Hervey, L.W, (in review). The American Dance Therapy Asso­ciation research survey.

Cruz, R.F, & Sabers, D.L. (1998). Dance/movement therapy is more effec­tive than previously reported. The Arts in Psychotherapy, 25, 101-104.

Davis, M. (1972). Understanding movement behavior: An annotated b ib l i ­ography. New York: Arno Press.

Davis, M. (1970). Movement characteristics of hospitalized psychiatric pa­tients. Proceedings o f the Fifth Annual Conference o f the American Dance Therapy Association, 25-45.

Davis, M. (1991). Guide to movement analysis methods pa r t i ' : Movement psychodiagnostic inventory, (available from [Martha Davis, 1 West 85lh Street, New York, NY 10024]).

Davis, M., & Hadicks, D. (1990). Nonverbal behavior and client state changes during psychotherapy. Journal o f Clinical Psychology, 46, 3, 340-351.

Dell , C. (1977). A primer f o r movement description (2nd ed.). New York: Dance Notation Bureau.

Dibbell-Hope, S. (2000). The use of dance/movement therapy in psychologi­cal adaptation to breast cancer. Arts in Psychotherapy, 27, 51-68.

Dixon, R.A., & Lerner, R.M. (1988). A history of systems in developmental psychology. In M.H. Bornstein & M.E. Lamb (Eds.), Developmental psychol­ogy: An advanced textbook (2nd ed.) (pp. 3-50). Hillsdale, NJ: Lawrence Erlbaum Associations.

Deutsch, F. (1947). Analysis of postural behavior. Psychoanalytic Quarterly, 16, 195-213.

Fisher, A. C , & Stark, A. (Eds.) (1992) Dance/movement therapy abstracts: Doctoral .dissertations, master's theses, and special projects through 1990. (Vol. 1). Washington, DC: American Dance Therapy Association.

Goodill, S., & Morningstar, D. (1993). The role o f dance/movement therapy with medically i l l children. International Journal o f Medicine, 2, 24-27.

Kalish, B.I. (1975). Developmental studies using the Behavior Rating In­strument for Autistic and Atypical Children (BRIAAC) [Summary]. Proceed­ings o f the Ninth Annual Conference o f the American Dance Therapy Associa­t i o n ^ . 131-136).

Kestenberg, J.S. (1979). The role o f movement patterns in development (Vol. 2). New York: Dance Notation Bureau Press.

Kestenberg Amighi, J., Loman, S., Lewis, P., & Sossin, K. M. (1999). The meaning o f movement. Developmental and c l in ica l perspectives o f the Kestenberg Movement Profile. Amsterdam: Gordon Breach.

Koch, S. C , Cruz, R. F, & Goodill, S. W. (in press). The Kestenberg Move­ment Profile: Performance o f novice raters. American Journal ofDance Therapy.

Krantz, A. M. (1999). Growing into her body: Dance/movement therapy for women with eating disorders. American Journal o f Dance Therapy, 2 1 , 81 -103.

Lausberg, H. (1998). Does movement behavior have diagnostic potential? Discussion of a controlled study on patients with anorexia nervosa and bu­

limia. American Journal o f Dance Therapy, 20, 85-99. tsfY Lausberg, H., Davis, M., & Rothenhaeusler, A. (2000). Hemispheric spe-

Vol 2 (2) cialization in spontaneous gesticulation in a patient with callosal disconnec­tion. Neuropsychologic!, 38, 1654-1663.

Lotan, N., & Yirmiya, N. (in press). Body movement, presence of parents and the process of falling asleep in toddlers. International Journal of Behav­ioral Development.

McDonagh, D. (1976). The complete guide to modern dance. New York: Doubleday.

Mendelsohn, J. (1999). Dance/movement therapy with hospitalized children. American Journal of Dance Therapy, 21, 65-80.

North, M. (1972). Personality assessment through movement. London: Macdonald & Evans.

Ritter, M., & Low, K. G. (1996). Effects of dance/movement therapy: A meta­analysis. Arts in Psychotherapy, 23, 249-260.

Scheflen, A. E. (1964). The significance of posture in communication sys­tems. Psychiatry, 27, 316-331.

Schmais, C. (1980). Dance therapy in perspective. In K.C. Mason (Ed.), Dance therapy: Focus on dance vii (5lh ed.), (pp. 7-12). Washington, DC: American Alliance for Health, Physical Education, and Recreation.

Schore, A. N. (i 994). Affect regulation and the origin of the self: The neuro­biology of emotional development. Hillsdale, NJ: Lawrence Earlbaum.

Serlin, 1., Classen, C, Frances, B., & Angell, K. (2000). Symposium: Sup­port groups for women with breast cancer: Traditional and alternative expres­sive approaches. Arts infsychoiherapy, 27, 123-138.

Silberstein, S. (1987). Dance therapy and schizophrenia: A vision of the fu­ture. The Arts j n Psychotherapy 14, 143-152.

Thornton, S. (1971) A movement perspective of Rudolf Laban. London: Macdonald & Evans.

Westbrook, B. K., & McKibben, H. (1989). Dance/movement therapy with groups of outpatients with Parkinson's disease. American Journal of Dance Therapy, 11, 27-38.

Zwerling, I. (1979). The creative arts therapies as "real therapies." Hospital andjCommunity Psychiatry, 30, 841 -844.

Robyn Flaum Cruz Director of Research COPE Behavioral Services, Inc. 7101 Camino De Fosforo Tucson, AZ 85718

•J * •*• •*• •*• «£• •*• •*• •*• •*• •*• •*• •*• •*• The Moment of Possibility: Current Trends in Drama Therapy

Ted Rubenstein Institute for Therapy through the Arts a program of

The Music Institute of Chicago

Introduction Al l of us pretend and most of us like it, but only a few of us admit that we

like it. Even fewer of us get to do it for a living. As grown adults our cynical selves find pretend and play acting to be for "actors" (who are really those "odd, weird theatre-people") or for children. As we socialize into adulthood, wc hear messages that say pretend and play is not "appro­priate" for big kids or even worse, signs of some kind of problem. And so, we neatly fold and pack away our superman cape, our musketeer sword, our princess dress, and seek out a more grown-up garb. Gone from our vocabulary are the phrases, "Let's say you are - and 1 am" or "Pretend that..." For some though, those days of epic-journeys told with garbage pail armor and kitchen utensil weaponry are sorely missed. The field of drama therapy attempts to reawaken that spirit in all of us. In so doing drama therapists aim to harness the creativity of pretend to help individu­als understand themselves and their world.

The field of drama therapy is relatively new, but drama itself is not. The systematic use of role-play as a psychological treatment is an emerging concept; the mastery of roles is not. The analysis of relationships through enactment is new but playing together is not. A formal system for playing back significant life events for the purpose of validation and healing is relatively new, telling stories and listening to them is not.

The first time a village or tribe gathered together to hear about the hunt, learn the ways of the tribe, drama therapy was born. The first time select members of the tribe enacted confusing or frightening events in the tribe's life or simply tell the story of the village drama therapy was born. In the early part of the 20lh century Jacob Levy Moreno was using drama and spontaneous play in group settings for the purpose of health and healing. His work later emerged into the field of Psychodrama. The first drama therapist, as that occupation is understood today was probably Marian Chace, a professionally trained dancer who worked with patients at St Elizabeth's hospital in the I950's. She used dance and storytelling first to help patients with Christmas theatrical productions, later she .f>J

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helped patients create parodies of hospital life. By 1956 she was helping patients perform stories about their lives. She called these shows, "self-revelatory" performances. Then in 1958 she began doing what she called "spontaneous drama" sessions. She believed that in the self-revelatory performances and spontaneous dramas the patients were able to "gain dis­tance from their plight." (Chace, 1954; Chace, 1955, Johnson, 1993). • Twenty years later, in 1979 the National Association for Drama Therapy

was formally organized. It was at about this same time that formal training programs for drama therapy began to emerge at New York University and at the California Institute of Integral Studies. Today there are nearly 500 individuals who are members of the National Association of Drama Therapy, and 120 who carry the title of Registered Drama Therapist, RDT (Angela Comfort, personal communication, May 30, 2001).

According to NADT, drama therapy is the systematic and intentional use of drama/theatre processes and products to achieve the therapeutic goals of symptom relief, emotional and physical integration, and personal growth. Drama therapy is an active, experiential approach that facilitates the client's ability to tell his/her story, solve problems, set goals, express feelings ap­propriately, achieve catharsis, extend the depth and breadth of inner expe­rience, improve interpersonal skills and relationships, and strengthen the ability to perform personal life roles while increasing flexibility between roles. Drama therapy is in fact a wide spectrum of approaches and activi­ties. Drama therapy is a set of action-oriented techniques that incorporates one or multiple elements of the theatrical art form.

Drama therapy is not therapy for dramatists. It is not a specialty of psychotherapy that caters to and addresses the problems of actors and the­atre artists. Drama therapy is not the use of "drama" to facilitate change for the body politic, although theatre and some forms of drama therapy do espouse societal change (Gracia & Sternberg, 1989; Boal, 1992). Drama therapy is not recreational drama or community theatre.

Drama therapy can best be thought of as a continuum. Each point on that continuum is defined by understanding the relationships between an actor and audience, a performer and spectator. On one end of the con­tinuum is a point defined by a trained performer and a paying audience, the performer playing for the audience. The audience is relatively passive, watching the performer present the internal strivings and needs of a fic­tional character. The performer may have little in common with the char­acter he portrays and less in common with the audience who watches. The audience is shrouded in darkness, the performer bathed in light. The per­former and audience may never meet again and the audience may only know the fictional character presented and the persona of the performer as he/she takes an exhausted, grateful and relieved bow. A client and a thera­pist, collaboratively exploring the internal process of the client, define the point at the other end of this continuum. At this end of the continuum, client is performer and therapist is the witness. They share an ongoing relationship that transforms over time. The client shares their authentic strivings perhaps directly or within a metaphor. Both therapist and client are active participants in the creation.

Consider John, a professional actor who begins rehearsing the part of Hamlet. As he does so he begins to get in touch with his own personal 'strivings that are similar to Hamlet's struggle. As John rehearses he real­izes that Hamlet's ambivalence, even anger toward his stepfather is not too distant from John, the actor's, ambivalence and anger towards his father. As John the actor begins to explore these feelings he uses his training to harness these feelings so that he is able to craft his playing of Hamlet into a believable, interesting performance. During the rehearsal process how­ever John's valence toward the father-son struggle diminishes. The feel­ings that John first identified in his real relationship were enough for him to establish what in the theatre is called, "sense memory and "emotional memory." During the rehearsal process suppose that John discovers that the character's ambivalence is intensifying but his own is decreasing. John, the professional actor, cannot say to his director, "all right, I understand my relationship with my father now and therefore I can no longer play Hamlet."

I f John wants to continue his career as an actor, he will have to use his training in the acting method to continue playing Hamlet for as long as audiences are willing to pay to see him. John's experience is not drama therapy although it might be considered theatre that was, by serendipity, therapeutic. I f John is professionally trained then he can sustain the be-lievability of the part not through reliving his relationship with his father

night after night but rather by using all that his craft has to offer. John's 70 jB personal history with his father may and can be essential to helping John

create a masterful Hamlet. At some point however, John must use his craft, not his past, to play Hamlet.

Bulletin of Psychology and the Arts

Consider Jack, a non-actor client of drama therapy, who also has feel­ings of anger towards his father. The drama therapist uses a variety of techniques to help John enact and understand the depth of his ambiva­lence. The therapist helps Jack find the roles and stories that help Jack reach an awareness or insight into his relationship. When one story no longer serves it is discarded. I f using the metaphor of Hamlet is helpful then so be it but i f it fails to help Jack then it would be quickly abandoned for something else.

In theatre, the direction of meaning flows from the actor to the audience. The actor conveys meaning and expends energy to convey that meaning for the sole purpose of providing the audience an experience. The direction of energy and meaning is unidirectional. In drama therapy, meaning and en­ergy flows in a circular fashion from the therapist to the performer and back again. When drama therapy is done in a group, as it often is, the energy and meaning may flow toward the group and back toward the per­former. The group may be an audience and may identify with the performer's experience but the performer's experience is foremost.

This is not to say that an artist seeks to please an audience. The theatre artist seeks to influence, impress, embolden, repulse, educate, infuriate, challenge, entertain, delight, awe or in some way communicate an idea to an audience. Theatre's overriding purpose is to move an audience. In drama therapy the therapist helps the client explore, understand, validate and change their internal experiences and processes. For centuries plays, play­wrights, actors and directors have striven to communicate a truth about the human condition. The drama therapist works in collaboration with the client to find and express a client's experience. In live, mainstream, con­sumable theater, the experience of the audience is everything and the expe­rience of the performer is only relevant as it moves the audience. In drama therapy, the experience of the performer is everything and the experience of the group that watches, i f a group watches, is only relevant as it may offer insight and validation to the performer.

Looking again at a continuum from theatre to drama therapy we find a point next to live commercial theatre that is defined as therapeutic theatre. Therapeutic theatre, loosely defined, is a play that is performed by profes­sional or semi-professional actors for a targeted audience with a specific message. Perhaps the most famous therapeutic theatre is found in Hamlet. In the middle of the play, Hamlet charges a group of players to play the Murder o/Gonzago, a thinly veiled recreation of Hamlet's father's un­timely murder. The play is to be performed in front of the suspected perpe­trator, Claudius. Hamlet's intention is to see i f Claudius will react to the play and therein "to catch the conscience of the king."

Theatre companies such as Stop-Gap Theatre in Los Angeles, Interven­tion Theatre in Chicago, and Imagination Theatre also in Chicago, to name only a few, are designed to create important messages about psychological and/or sociological problems for audiences that might share or struggle with these same problems. These plays are meant to be reflective of the audience's concerns but the performers do not know whether or not any­one in the audience actually has these problems. Typically these groups suspect that there wil l be someone on the audience who can relate to the story. These plays intend to metaphorically, "catch the conscience" of us all. By and large these theatre companies perform to school groups and wi l l tell stories about issues facing adolescents such as alcohol abuse, sui­cide, or violence. The groups mentioned above may or may not use inter­active tools such as stopping the action at critical moments or even having the audience identify the "best course of action" for the characters. Most of the groups then offer some kind of "curtain talk" or discussion with the audience after the show. It is at this point that people in the audience may identify themselves as having similar problems.

Moving along the continuum are companies that employ individuals with psychological, sociological or physical problems as the actors and writers to create and portray a fictional story. This play is then performed for an assembled group of people with similar psychological, sociological or physi­cal problems. Groups like the Free Street Theatre and The Happiness Club perform plays about overcoming violence, gang activity, and substance abuse. The performers are "at risk" kids and they typically perform for groups of "at risk" kids. In this particular model of drama therapy the audience is able to identify with not only the story being told but at another level with the performers because they know that the performers are actu­ally struggling with the same or similar issues.

Moving along the continuum away from performance focused theatre is the drama therapy model that is done in groups with people with similar issues however there is no performance element. The enactments are m 79 largely about issues of central concern to the assembled group and the j ^ group functions as the performer and audience. In a technique called '7^ ^ '

Vol 2 (2)

Playback Theatre, first developed by Johnathon Fox, an individual in a group is asked to tell a real story about their life (Fox, 1986). The other group members listen to the story and then re-enact it or play it back for the storyteller. This work is done throughout the country both in therapeutic group settings and in schools (Fox, 1986).

At the another point on the theatre to drama therapy continuum are mod­els and techniques that may or may not take place in group but are the enactments of one person's concerns. Depending on the theory and ap­proach these enactments are created with fictional roles or with allegorical figures representing internal or external processes. For example, an indi­vidual may play a fictional role with a metaphorical relationship to their issues. In another model group members play "anger" and "disappoint­ment" while the individual of focus for that day (usually called a "protago­nist") may debate with and confront these allegorical characters and feel­ings.

In summary, the differences between theatre and drama therapy are found in the relationship between the performer and the audience and in the di­rectionality of energy and meaning. Professional actors and directors serve the text, the role and the audience. Clients in drama therapy serve their own processes and insights.

But understanding who is served does not define the field, only who benefits. What is drama therapy? Is drama therapy merely a cache of techniques or is it a set of theory-based approaches? Is drama therapy a set of principles that rivals or challenges traditional verbal techniques or is it an alternative, an adjunct? Is drama therapy only a "catch all" term that basically describes the noble attempt to provide artistic experiences to those individuals who do not have such experiences or is it a new way of looking at change that enriches the enterprise of therapy? Is drama therapy some­thing to do when nothing else wil l work or does drama therapy engage the spirit and body at a deeper level?

These are the questions that practitioners in the field of drama therapy actively debate. These are the questions that, for now, can only be an­swered anecdotally and subjectively. For now, drama therapists can, with intensity and devotion say that drama therapy is not an alternative but an adjunct, it is not a catch all but rather a set of theories that are continuing to develop. Drama therapy is neither a challenge to nor a poor substitute for verbal therapy. Rather, drama therapy is a way of approaching a client that can only enrich the experience and enterprise of therapy.

Models of Drama Therapy At a recent national conference for NADT a panel of the leading theo­

rists, writers and practitioners in drama therapy gathered to discuss spe­cific cases. Not one of them eschewed the use of more traditional methods, nor did they suggest that bringing issues to a verbal, cognitive level is antithetical to drama therapy. Rather, they seemed to agree that enacting, pretending or creating roles helps the healing process. (Johnson, Dintino & McCommons, 2000).

Al l of the models that are discussed in drama therapy share one theoreti­cal concept called "distancing." Distancing is a multi-dimensional term that has literal and metaphorical meanings. Distance is that space formed between the performer and the audience. It is also a space that is formed between the performer and the material. Literally, drama therapy takes place on a stage or in some space that is outlined, established, consistent and is separate from any area where verbal processing or informal chatting takes place. Metaphorically, distancing is used to help the performer, thera­pist and audience gain emotional and intellectual space from the material so that it can be analyzed from different perspectives. When somebody enacts a role from a fictional story that is similar to real life issues then the role creates distance from those same real life issues.

Distancing can be achieved in a variety of ways. During an enactment the therapist or the client may say something or do something that is a non-sequitur that for a moment causes a disruption in attention. The therapist might ask the client to use props or costumes, which can create distance. This distancing allows the client to say, "even though that character sounded a lot like me it was not me." The client can feel more safe, more contained when creating distance between themselves and the material presented. Distancing can also mean playing out a scene, perhaps even a scene from the client's real life, stopping the action at moments that might have a high affective charge. The therapist may or may not encourage the client to talk about the "next move" or alternative approaches for handling the situation. By stopping the action just at the moment when the enactment might be

getting "real" the client is basically reminded of the pretend nature of the enterprise. This stopping or interruption has the added effect of prevent­

ing clients from re-living traumatic experiences. Putting the scene, ifr-that moment in life, on stage allows the individual to distance them-

Vol 2 (2) selves from that moment and examine it with fresh, less emotionally charged eyes. The use of distancing in its literal sense and its metaphorical sense is an underpinning to all of the theoretical foundations of drama therapy.

All theories of drama therapy are informed by and subsumed under the prevailing psychological theories. One of the major theories of drama therapy is referred to as role theory and is based on the work of Robert Landy. According to Landy, "the self is not visible. It only takes on a visible form through a role" (Landy, 1986, p.91). In Landy's approach the construction of self is in fact an amalgam of the multiplicity or confedera­tion of roles that one encounters, gravitates toward and internalizes (Landy, 1986; Blatner, 1995). Developmentally, the child begins to take on roles as he or she begins to separate self from other. According to role theory in drama therapy, the role is the container for self, others, systems and the perceptions of all three (Landy, 1990). Treatment therefore is the system­atic exploration of the role. A story is told. The heroes and villains of the story become those roles, whether those roles are King Lear or Rumpelstiltskin. The focus is not an archetypal role per se but rather draw­ing from the wealth of roles already created by literature, folklore, and myth. Once the story is told and the roles identified, the client chooses or is encouraged to take on one of the roles that may have metaphorical mean­ing for that individual. The therapist helps the client find that role in the story that resonates with the client. Using the veil of role, the client begins to talk about the feelings, strivings, and social networks of the character. The therapist encourages the client to embody the role as defined by the client. The session concludes with the client "De-roleing" and then ver­bally reflecting on the experience. During this verbal processing the client and therapist identify ways in which the "pretend" roles and observed ways of being through role might be integrated into the client's life. At this point what had occurred on the stage is brought to consciousness. By integrating various roles the self or the "me" emerges intact (Landy, 1996).

A contemporary of Robert Landy is David Read Johnson who devel­oped the Developmental Transformation theory of drama therapy. The developmental approach rests on the belief that drama and development share a common link, transformation. Characters begin a journey through a series of plot twists and turns. Characters ascend through the dramatic structure by shifting their goals, adjusting their aspirations and perhaps becoming enlightened along the way. In some ways this is similar to the therapeutic enterprise. The unfolding of action and character is strung together by a series of transformations. These transformations then be­come the "development" of plot, action and character.

Dramatic action always takes place in a specific time and place that is created by the theatrical elements of set, lighting, costume and music. These are the "given circumstances" or world of the play. This is a shared reality between the performers and the audience. Without these transformations the play would wither and die. Human development is also dependent on a series of transformations, of shifting needs all of which take place in a set system or holding environment. In order to survive, living organisms must transform and adapt to specific environments.

In forming the developmental drama therapy theory, Johnson outlines five factors that animate the developmental process; 1) the degree of struc­ture or organization, 2) the medium of expression, 3) the degree of com­plexity, 4) the intensity of affect which one can tolerate in any given situa­tion without overwhelming anxiety, 5) the degree to which one perceives others as active, whole and autonomous (Johnson, 1982).

According to the theory, individuals, groups, discrete units of a thera­peutic treatment or a series of therapy sessions, follow a progressive course that begins in a state of rudimentary internal organization. At this level the individual's organization is structured exclusively from the environment. As development progresses an internal organization begins to emerge and the individual is no longer as reliant on the environment or external sources to provide structure. The therapeutic method that emanates from the theory is an improvisational theatre approach that involves a series of client and therapist interactions. Derived in part from a basic improvisational tech­niques developed by the theatrical artist Viola Spolin, roles and settings vary at a pace that is set by the client and the therapist. These interactions become, in a sense, enacted free associations, all contained in time and space by the "here and now" but exclusive to the therapist and the client. This time and space container is referred to as the "playspace". "Playspace" is both a physical entity as well as a construct, a shared reality between therapist and client. The playspace is an enhanced physical and imagina­tive space that can be the theatrical equivalent of a therapeutic holding environment. The agent of change in this approach is the relationship that exists between client and therapist as well as their relationship to the playspace (Johnson, 1991). " ^

Bulletin of Psychology and the Arts Using the relationship, contained within the "playspace", the therapist

invites the client to amplify or heighten affective experiences through the dramatic enactment. Feelings and thoughts come to the surface and are given a voice and character. Once these feelings are in some ways concret­ized the therapist and the client are able to study these experiences as well as generate alternative ways of coping (Johnson, 1991; Johnson, 1982).

Renee Emunah, the director of California Institute of Integral Studies in Los Angeles, California, offers an eclectic approach that borrows from both Landy and Johnson. Emunah's approach is divided into five phases or stages. The first phase is reminiscent of developmental transformation but emphasizes a move from simplicity to complexity (Emunah, 1994). In phase two the client is encouraged to identify roles and begin to engage in fictional scenes with the various metaphorical characters interacting. In phase three the client and the therapist move, collaboratively towards mak­ing connections between the fictional roles and more real-life relationships and circumstances. In phase four and five the relationship between client and drama therapist continues to deepen. It is in these phases that the work begins to resemble psychodrama in which not only are real-life circum­stances played out but also transference, counter-transference, and various parts of the self or internal process are addressed. As Emunah states, "the drama becomes a catalyst for real life change and the real life change be­comes the material for drama" (Emunah, 1999 p. 117).

Applications of Drama Therapy The possibilities for the application of drama therapy are seemingly end­

less. The increasing and changing role of managed care in the delivery of health care, the expansion of psychological services and the proliferation of new technology positions drama therapy to explode with possibility. Many drama therapists throughout the country are reaching out to meet this potential "big bang". One drama therapist is even contemplating an offer from a major league baseball team (Personal communication with Alice Forrester, May 30, 2001). Others are looking for ways to integrate empirical research and ideas from other disciplines and fields in order to prepare the field for a new role on the center stage of mental Jiealth. Three examples of current work being done in drama therapy with implications toward further research are described below.

Alice Forester (current NADT President) and Jane Smith, CSW, are at­tempting to integrate chaos theory, drama therapy and group theory for the treatment of children with attention deficit disorder/hyperactivity disorder (ADHD). Smith and Forrester are working with a group of five boys all diagnosed with ADHD at a clinic in an urban children's hospital. The focus of this group is to use the Developmental Transformation method, described above, to facilitate socio-dramatic play with the intent of helping the group members develop internal loci of control (Forrester & Smith, 2000; Smith, 2000). Forrester and Smith integrate Johnson's developmen­tal transformation theory with chaos theory as it applies to group processes. Based on Bud McClure's book, Putting a New_Spin on Groups; the Sci­ence o f Chaos, Forrester and Smith are attempting to use the dramatic play to magnify the group process, only in this case the enactments focus on the group's move from order to chaos and back to order.

McClure's work, focusing on verbal, task oriented groups, suggests that groups change through a conflict to resolution matrix. According to McClure, group life is textured with a repeatable pattern of transformation shifts from unity to disunity and finally into a new unity. Therefore, growth in a group is non-linear and unstable. A small change in the group occurs. This change may have nothing to do with the primary focus of the group at that time. This change or disruption in pattern is magnified which then creates disorder and disorganization, which in turn leads to second order change which results in a new organization. The new organization cannot be predicted from the previous levels of organization nor can it be pre­dicted from the initial disruption to the pattern. Only after chaos ensues and is given sufficient space and time, not contained, can the new pattern begin to organize.

Smith and Forrester see remarkable similarities between these theories and the group process they observed with boys with ADHD. The groups is always in flow and therefore group cohesion does not come from the force of intervention but from the accurate timing of encouraging a group's natu­ral unfolding (Smith, 2000). Smith and Forrester have applied the core of the developmental transformation theory, which suggests that each and every disturbance in the group is magnified or enacted. For example, two boys in the group began playing a game of hockey to the exclusion of the other

group members. Another boy, feeling left out, started to try to "mess up" the game. Smith describes joining in with the feelings of "messing-up"

the game, which to a certain extent magnified the feelings of other r\- members of the group. The therapists then expanded and heightened

Bulletin of Psychology and the Arts

the activity of "messing up" until the entire group was engaged in some physical or vocal representation of "messing-up". In so doing, Smith con­tends that she was able to move the group from being stuck into chaos and then to unstructured play. From this unstructured play a new group pattern emerged (Smith and Forrester, 2000; Smith, 2000). Smith and Forrester arc continuing their research and are currently working on expanding their research to include other drama therapists throughout the country (per­sonal communication Alice Forrester, November 2000, May, 2001).

The use of film has always been a powerful tool in drama therapy but more as a static, instant feedback loop. Brandy Brawner in San Francisco incorporates the use of film making in his work with violent offenders at the San Francisco county jail. Using clients as his actors, directors, and film crew, Brawner has made an independent feature film entitled, "Chi­mera House." This films looks at a "family" of delinquent teens forced to live together by the court system. The piece was a semi-biographical docudrama that captured not only the struggles and aspirations of these individuals but is a metaphor for the issues faced by the thousands of chil­dren moving through the American legal system each year (Brawner, 2000).

What is unique about Brawner's approach is not that clients film their stories but that they function as the editors and cinematographers. Using digital editing software the clients are able to control and craft the entire process. The work is about the whole process of filmmaking and not just taking pictures. Clients' can "edit", "re-shoot" and create new dialogues. They are even able to create montages of personal experience and superim­pose images from other media to tell their story. By using the cinema graphic images and techniques the clients are able to explore alternative perspectives and even practice, using on-location footage, various situa­tions that they may find themselves in upon release from the program.

Similar work such as this is being done with the Chicago Institute for the Moving Image (CIMI). Led by David Bychkov and Joshua Flanders the C1MI aims to research what they call, "Kinotherapy", which they define as the use of cinema to resolve psychological disorders. They contend that i f cinema reveals the language of the brain, it also offers filmmakers the chance to change the language of the spectator's brain. CIMI focuses on integrat­ing a visual vocabulary with the process of editing. Similar to Brawner's work, clients take an active part in creating the films about their story. Current research projects currently underway by CIMI include a film festi­val of films made by deaf film makers, slated for March 2002, and a project using silent film with individuals with schizophrenia.

A third example of current, research-based work is being done at the Institute for Therapy through the Arts (ITA), also in Chicago. The ITA is using an integrated expressive arts therapy approach for the treatment of childhood obsessive-compulsive disorder (OCD) that is based on a cogni­tive-behavioral therapy (CBT) model described by John March and Karen Mulle. A treatment protocol has been designed and is currently being used in a pilot study with 15 clients, ages 9 to 11 years old. The initial sessions begin with music therapy, which provides the client a structured experience for identifying feelings of anxiety. During this phase the clients learn to identify their internal experience through both words and sounds while at the same time enjoying a safe, predictable environment. The chil­dren are asked to write and identify music and musical phrases that express their experience. Music is also used to soothe anxiety once it is manifest. The client learns both how to use music to describe experience but also how to use music to relax. Once the client has established a sound vocabu­lary they begin putting those sounds into words. To facilitate that process the children are asked to draw a thermometer, as suggested by March and Mulle, to identify their feeling states (March & Mulle, 1998). The children point to or draw on a sketched thermometer their feeling states. March and Mulle argue that children are less able to identify internal feeling states through traditional paper and pencil measures. The anxiety thermometer is a visual, daily record of the client's anxiety level both during session and throughout the week. Using drama the client is then invited to concretize both their anxiety and the OCD. The child is encouraged to create body sculptures, characters, masks, or life size puppets that represent their inter­nal feelings of anxiety. Through the use of enactment the child is then encouraged to create body sculptures, characters, masks and/or puppets that embody their OCD. This approach, as indicated in March and Mulle, asks that the child separate himself/herself from the OCD process in at­tempt to gain some internal loci of control. Externalizing and concretizing the OCD process through play gives the children an experience of mastery (March & Mulle, 1998). Children involved in these sessions have opted to use auxiliary actors to play "their OCD", others have made film ver sions of their OCD with auxiliary actors or even themselves playing the part of the "OCD". Other children have made life size or half - -?

V o l 2 (2)

size puppets that represent their OCD process. The children are then asked to give a name to their "beast" that is in the OCD process. Once the beast has been named the client and therapist play out a series of enactments in which the child attempts to tame and/or exert control over the beast. Each time the child is victorious the process and tools that were used are identi­fied for the child and become part of a list of "strategies" or "tools" that the child can conjure when it is apparent that the OCD process has begun. This list may be written down or has been drawn symbolically, depending on the preference and functioning of the child.

After the children have gathered enough tools or strategies they are shifted into a drama therapy group where they can put their tools into practice. Each group is comprised of other children with OCD. Together the group tells stories and then re-enacts these stories. All of the stories told are metaphors of overcoming and/or gaining control over these disruptive pro­cesses. The enactments must be collaborative and the group must reach compromise on everything from sets to specific scenes. Each dramatic problem must be solved by group and with group consensus. The group, more often than not, creates moments of anxiety for each child. It is at the moment of anxiety that the child is reminded of their tools or strategies. While the drama group is in session a parent led support group is also in session. Subjective measures of internal anxiety states show initial im­provements in at more than half the cases (Rubenstein & Lantry, 2000). The approach and protocol continues to be refined with more comprehen­sive results to be presented in late fall or the early part of 2002.

Professional Identity From a developmental point of view one might see the field of drama

therapy as well out of its childhood certainly and perhaps coming into its adolescence. One need only look at the themes of the past few conferences to see the yearnings, strivings, even rebellions that are churning within the profession. Less than 10 years ago the conference theme was "Winds of Change," in 2000 the conference was entitled, "Ordering the Chaos" and the conference for 2001 is entitled "Measuring the Metaphor." Over the past ten years, drama therapy has come from a storm brewing to seeking out disciplined ways of measuring and documenting outcomes. The two issues that seem to occupy the field at this time are professional identity and research. This is reflected in the topics discussed at the national con­ference as well as the spate of new literature on the topic of research and identity.

The issue of professional identity is perhaps the topic that sparks the liveliest debate among drama therapists. It is not accidental that in a field that helps others define their roles the practitioners themselves are some­times suffering from role confusion. Indeed, the drama therapist functions in something of a paradox at all times. Drama therapists work in and em­brace a spontaneous, creative art form and yet they long to find systematic, empirically proven techniques in order to provide the best possible ser­vices.

Drama therapy is meant to be playful and spontaneous but with a pur­pose. Some drama therapists see themselves as artists who are therapists with an ambivalent relationship toward science. Others see themselves as therapists who are trained in the sciences but think artistically.

Some of this confusion is bred in the training of drama therapists. In order to legitimately practice drama therapy, to practice to the level that is acceptable to the National Association of Drama Therapy, one must have a masters degree in either drama therapy or have achieved an equivalent level of training through an alternative training route. Regardless of the particu­lar alternative training method, all registered drama therapists have a master's degree with some degree of training in counseling. All drama therapists also have some training in theatre although many come to the field with an undergraduate background in theatre as well as some profes­sional credits.

Leaders of groups that do therapeutic theatre call themselves drama thera­pists. Therapists who use the developmental method or role theory also call themselves drama therapists. It might seem like a combination of gran­diosity, chicanery, or just plain hyperactivity i f drama therapists try to wear so many costumes all at once. Or perhaps in order to secure a niche drama therapists are pulled in multiple directions. School systems ask that drama therapists direct plays, hospitals ask the drama therapist to function as a case manager/ recreational therapists and colleagues ask each other to func­tion as artistic therapists who are therapeutic artists.

The issue of professional identity reaches beyond finding something comfortable to call ourselves. The definition of the field and its best standards and practices must be clearly defined and enforced for the ben­

efit of the client. Clients demand and are entitled to a clear and rigor-vFLft- ous explanation of who a drama therapist is, how he or she is trained

Vol 2 (2) and what he or she w i l l do. For the benefit o f the general public, this issue must be addressed by all drama therapists and once defined must be en­forced. The issues o f professional identity are so germane to the practice o f drama therapy that a national committee has been formed to study the issue throughout the next twelve months. It was only fifteen years ago that Robert Landy wrote about "the moment o f balance" in drama therapy. He identif ied it as a moment when the client reaches insight. A moment charged wi th infinite possibility (Landy, 1996). In that moment the client is able to see the wor ld and their experience in a different way. It is a single moment that can lead to others. The enterprise o f drama therapy seems to be poised at its own moment o f balance. Whi le the idea o f drama therapy is paradoxical and the research is at present slippery, the confluence o f story and enactment, pretend and healing, tel l ing and listening, play and work, practice and theory is charged wi th infinite possibility.

References Boal, A. (1992). Games fo r actors and non-actors. London: Routledge. Brawner, B. (2000) Digital video computers and drama therapy. Paper pre­

sented at the meeting o f the National Association o f Drama Therapy, San Fran­cisco.

Chace, M. (1955). Hotel St. Elizabeth.: A unique experiment in therapy. Americas, 7,_ 33-36.

Chace, M. (1958). Stimulation o f creative forms in patient productions. Bul­letin o f the National Association f o r Music Therapy, 7, 9 —10.

Diamond, S. (2001). The 21st Annual NADT Conference. Dramascope, ConferenceJssue. Washington, DC: National Association of Drama Therapy.

Emunah, R. (1994). Acting f o r real : Drama therapy: Process, technique and performance. New York: Bruner/Mazel, 79-83.

Emunah, R. (1999). Drama therapy in action, in D. J. Weiner, Beyond talk //?era/j>'._Washington, DC: American Psychological Association.

Ferguson, M. (1980). The work of llya Prigogine. Dromenon, Spring-Sum­mer, 2 9 - 3 3 .

Forrester, A., & Smith, J. (2000). The chaoplexit of dis-equilibrium: Devel­opmental transformations with traumatized children. Paper presented at the meeting of the National Association of Drama Therapy, San Francisco, CA.

Fox, J. (1986). Acts o f Service: Spontaniety, Commitment, Tradition m the non-sCipted theatre. New Paltz, NY: Tusitala Publishing.

Gardner, H. (1973). The Arts and Human Development. New York: Harper Johnson, D. R., Dintino, C , & McCommons, W. (2000). Three perspectives

on drama therapy with clients in chaos. Paper presented at the meeting of the National Association o f Drama Therapy, San Francisco, CA.

Johnson, D. R. (1982). Developmental approaches in drama therapy. The Arts infsychotherapy, 9, 183-189.

Johnson, D. R. (1991). The theory and technique o f transformations in drama therapy. The Arts in Psychotherapy, 18, 285-300.

Johnson, D. R. (1993). Marian Cbace's influence on drama therapy. In S.L. Sandel, S. Chaiklin, & A.Lohn (Eds). Foundations o f dance/movement therapy: The life and work o f Marian Chace. Columbia, MD: Marian Chace Memorial Fund of the American Dance Therapy Association.

Landy, R. (1990). The concept o f role in drama therapy. The Arts in Psycho­therapy, 17, 223-230.

Landy, R. (1996). Essays in drama therapy: The double life. Bristol, PA: Jessica Kingsley Publishers.

March, J., & Mulle, K. (1998). OCD in children and adolescents: A cogni­tive behavioral treatment manual. New York: Guilford Press.

McCIure, B. A. (1998). Putting a new spin on groups. The science o f chaos. Mahwah, NJ: Lawrence Erlbaum Associates.

Rubenstein, T. I., & Lantry, H. (2000). Naming the beast: An integrated ex­pressive arts therapy approach for the treatment of childhood OCD. Paper pre­sented at the meeting o f the National Association of Drama Therapy, San Fran­cisco, CA.

Sternberg, P., & Garcia, A. (1989). Sociodrama: Who s in Your shoes?_Hew York: Praeger.

Resources for more In fo rmat ion Journals

International Journal o f Action Methods: Psychodrama, Skill Training and Role Playing, www.http;//heldref.org/html/body/index.html

Arts in Psychotherapy, An InternationalJournal, .Elsevier Science Inc., 655 Avenue o f the Americas, New York, NY 10010

Drama Scope, Lanell Finneran, RDT, MT, NADT Communication Chair 1743 E. 400 Rd, Lawrence, KS 66049 Other i,

National Association for Drama Therapy, http://www.nadt.org/ New York Univers i ty , Master 's Degree in Drama Therapy, h t tp : / /

www.nyu.edu/education/music/drama/dramther.html Cal i fornia Institute o f Integral Studies, Program in Drama Therapy,

infofaiciis.edu Renee Emunah, Director Institutes and Agencies Provid ing Drama Therapy S e n ices

ActingOut P.O.Box 196 Keene,NH 03431 Email: actingout@monad.net -fO

Bulletin of Psychology and the Arts The Institute for Therapy through the Arts 6160 N.Cicero #122 Chicago, I L 60646 773-685-3911

The Drama Institute o f Los Angeles 1315 Westwood Blvd. L. A., CA 90024-4901 310-478-7188 Fax:310-589-0209 info@dramatherapyinstitutela.com

The Drama Therapy Center on the Web www.dramatherapycenter.com

The New Haven Drama Therapy Institute 19 Edwards St. New Haven, CT 06511

Omega Theater P.O. Box 1227, Jamaica Plain, M A 02130 www.omegatheatre.com

Roundabout Cornerstone House, 14 Wil l is Road, Croydon, CR0 2XX, U.K. http://homepages.nildram.co.uk/~rndabout/

Stop Gap Theatre 1570 Brookhollow Drive, #114 Santa Ana, California 92705 http://www.stopgap.org/

Ted Rubenstein The Institute for Therapy through the Arts 6160 N.Cicero #122 Chicago, I L 60646

+ + + + • • • • • • • • • Music as a Therapeut ic M e d i u m : A n In t roduct ion to Music Therapy

George L. Duerksen

University o f Kansas

Music as a Therapeutic Medium Music therapy uses musical s t imul i , musical activity/participation, and

client-therapist interaction in musical context to pursue therapeutic goals. Several characteristics o f music underlie its usefulness in the therapeutic process. Bruscia (1998) differentiates between music as therapy and music in therapy. I n music as therapy, the music i tself serves as the primary agent o f therapeutic change. The therapist's expertise is used to prescribe and facilitate the appropriate music and musical experience for the client. In music in therapy, the music is used to facilitate client-therapist relation­ships and other treatment modalit ies. The musical characteristics described here support both music as therapy and music in therapy.

There are few persons for whom music o f some sort does not have a strong attraction. Preferred music provides a locus for therapeutic act ivi ty and can motivate and structure extended participation in therapeutic rela­tionships. It can also structure individual behavior, self-perception, per­ception by others, and group behavior (Sears, 1968). Music helps f i l l basic needs for sensory stimulation and elaboration and for pattern and form. Rhythm in music has unique potential to energize and bring order (Gaston, 1968). I t provides a way to control the auditory environment and the self, and it may be used to stimulate or sedate.

The use o f music for nonverbal and verbal communication is especially important. With in a culture, music by i tself can convey mood and emotion. The wordless meanings o f musical st imul i allow closeness without words or threat and provide communication and projection o f feelings in a healthy and socially acceptable form (Merr iam, 1964; Gaston, 1968; Radocy & Boyle 1996).

Verbal communication set to song, or in the presence o f music, al lows individuals to express what they are hesitant to say, or cannot say, wi thout music. Musical st imuli may el ici t responses ranging between basic physi­ological reactions to elements such as vibration or rhythm and the pro­found affective communication labeled as aesthetic (Gaston, 1964). Music provides a means o f expressing feelings in a healthy and socially accept­able way, al lowing individuals to vent emotions they might otherwise sup­press. In some cases, it permits and encourages psychological and physical contact. Music can be an effective reinforcer (Duerksen, 1986, Radocy & Boyle, 1996).

For some applications, music therapy is practiced on a one-to-one basis. In this context music is used to stimulate and structure individual behavior, integrating cognitive, affective, and psychomotor functioning. The com­

plexity o f the structure can be adjusted as therapeutically appropriate R~ a (Gaston, 1968; Sears, 1968). Properly selected st imuli and activities can

help reduce feelings o f isolation, divert attention, and encourage imagi-^ r l / > nation.

Bulletin of Psychology and the Arts

Music can also serve the purposes of group therapy, and the music thera­pist uses its adaptability to organize constructive interaction among group participants. The sense of achievement in making music can lead to the development of self-esteem, and musical achievement can help win the esteem of others. Participation in group music activity requires the indi­vidual to take part in a larger pattern of structured interaction. Thus music provides a favorable context in which both individually and socially inte­grated behavior may be practiced and reinforced (Sears, 1968).

A Brief History of Music Therapy Professional practice of music therapy began in the United States prima­

rily as an approach to treatment of psychological problems. Today's music therapists work in multiple settings to serve clients who face a wide variety of challenges. As an allied health profession music therapy focuses on the assessment, development, remediation, and maintenance of mental and physical health.

Many pre-1 iterate and literate cultures have used music as an element in treatment of mental and physical health (Waterman, 1955; Merriam, 1964; Lomax, 1968; McAllester, 1971). Professional music therapy practice in the U.S.A. developed in the 1940's (Davis and Gfeller, 1999). During World War 11 music programs were organized for returned servicemen in hospi­tals (van de Wall, 1948). These programs were designed primarily for rec­reational and educational purposes (Robb, 1999). Heuristic observation revealed therapeutic outcomes resulting from program activities, and inter­est grew in development of music therapy as a profession.

In the late 1940's several U. S. universities established music therapy degree curricula. A professional organization, the National Association for Music Therapy (NAMT), held its first meeting in 1950. Subsequently the NAMT established a relationship with the National Association of Schools of Music (NASM), an accreditation agency. Together these groups began setting standards for music therapy curricula in NASM member schools. Individuals who successfully completed these approved curricula were eli­gible to be listed on the NAMT register of qualified music therapists, and in 1985 there were over 2000 Registered Music Therapists (RMT).

In the 1960's a second professional music therapy organization was founded. First called the Urban Federation of Music Therapists and later the American Association for Music Therapy (AAMT), this group approved curricula at other universities. Individuals who completed those programs earned a professional qualification titled Certified Music Therapist (CMT). In 1998 the NAMT and AAMT united to form the American Music Therapy Association (AMTA).

In the early 1980's an independent Certification Board for Music Thera­pists (CBMT) was formed to develop and administer a national Board Cer­tification examination. The first Board Certification examination was ad­ministered in 1985. Since that time the qualification Music Therapist-Board Certified (MT-BC) has become the primary professional credential in the field. Individuals who successfully complete music therapy curricula in AMTA approved universities are eligible to sit for the Board Certification examination. Renewal of Board Certification may be accomplished through continuing education or re-taking the examination every five years.

The AMTA has 3,286 members, including students and 175 international members (AMTA Member Sourcebook 2001). In July 2001 the CBMT roster listed a total of 3465 Board Certified music therapists (J. Schneck, personal communication, July 13, 2001).

Growth of the field in Britain, other parts of Europe, Australasia, Canada, and South America has paralleled the profession's development in the United States. Professional organizations and university degree programs have been developed in many countries.

Music therapists serve clients who present a broad variety of treatment needs. The profession's early emphasis on mental health continues, but work has expanded into many other areas. Music therapists work in a vari­ety of settings, including mental hospitals, community mental health cen­ters, general hospitals, forensic institutions, nursing homes, rehabilitation centers, hospices, schools, special education, and private/group practice. While many applications focus on remediation, an increasing number con­cern wellness, maintenance of good health, and quality of life. Music therapy nttempts to help the recovery of those who have incurred mental or physi­cal ills and to help individuals with developmental/genetic disabilities cope mul achieve. Applications for those with sensory and psychomotor dis­abilities are common. In gerontology treatment goals range from health rwiintcnance for the well to helping persons with dementias and their Oiircgivcrs. Interest in music therapy in medical procedures is evident. In Ihcir work music therapists combine musical skills and knowledge with understanding of the influence of music on behavior, psychology, conn-Wiling, education, habituation and rehabilitation mul mcnifll find physical <f\

Vol 2 (2) health.

Initial entry into the profession currently is at the bachelor's degree level. There are currently 69 AMTA approved college and university undergradu­ate music therapy curricula (AMTA Member Sourcebook 2001). Twenty-five of these schools offer master's programs; nine also offer the doctorate.

Undergraduate study integrates development of musical skills and knowl­edge, comprehensive understanding of music therapy foundations and prin­ciples, social, behavioral, biological, and educational sciences, and didac­tic training in clinical applications. Current curriculum standards focus on a list of essential competencies, experiences, and opportunities needed for initial entry into the profession (NASM Handbook, 2001). In addition to* the musical skills and knowledge specified for all music majors, functional keyboard/improvisation, functional voice and percussion, conducting and arranging, and ability to play fretted and informal instruments are empha­sized. The behavioral/social science component emphasizes general psy­chology, abnormal psychology, child psychology, the psychology of ex­ceptional children, social conflict, group dynamics, culture and personal­ity, and the family and other social groups. The music therapy foundations include history and philosophy, techniques for observation, assessment, and measurement, treatment planning, methods and materials, professional role and ethics, the psychology of music, and the influence of music on behavior. The AMTA Professional Competencies (AMTA Member Sourcebook 2001) are used for curriculum planning. The undergraduate program includes extensive pre-clinical experience and culminates with an internship in an AMTA approved clinical setting.

Master's study typically has focused on research, administration, or ad­vanced clinical techniques. At its fall meeting in 2001 the NASM plans to adopt new standards that will describe the master's degree as imparting depth and breadth beyond entry-level competencies. The curriculum will be required to help qualified music therapists to develop advanced compe­tencies in one or more area such as music therapy theory development, research techniques, supervision, college teaching, administration, and various advanced clinical specializations. The doctoral degree is designed to develop even more advanced competence in research, theory develop­ment, clinical practice, supervision, college teaching, and/or clinical ad­ministration. Program emphases vary from institution to institution.

Research in Music Therapy Music therapy straddles many disciplines, including anthropology,

ethnomusicology, aesthetics, the psychology of music, teaching and learn­ing, and many different schools of psychology and treatment ("Music Therapy," 2001). Research in many of these disciplines provides knowl­edge useful to the profession. Hodges (1996) reviews and summarizes re­search dealing with musical behavior, including physiological and affec­tive responses to music and the influence of music on behavior.

A growing body of clinical and laboratory research specific to music therapy expands and reinforces the profession's knowledge base (Wheeler, 1995). The Journal of Music Therapy, a quarterly refereed serial, pub­lishes many research articles. Music Therapy Perspectives publishes origi­nal research and other information relevant to clinical practice. The Ameri­can Music Therapy Association publishes both of these journals.

An early literature review (Soibelman, 1948) pointed out the need for controlled research in the milieu where music therapy is employed and with the subjects for whom it is intended. Much of the literature at that time was anecdotal and reported opinions and beliefs. The empirical stud­ies that existed were primarily by music and industrial psychologists.

While the research literature has grown since that time, much work re­mains to be done. Examination of the contents of the Journal of Music Therapy from 1981 through 1993 indicated that 94% of the articles re­ported descriptive or experimental research, 2% reported case studies, and 3% historical studies. Content dealing with mental retardation accounted for 15% of the articles, emotional disturbance 9%, medical 6%, elderly 7%, hearing impairment 5%, orthopedic handicaps 4%, communication disorders, chemical dependency, and learning disabilities 2% each. Six­teen percent of the articles focused on music therapists, and 24% concerned individuals who were regarded as being normal (Gfeller, 1995).

The bulk of the profession's research has been done in the universities that offer graduate study. Increasing research is being done in clinical set­tings. A few examples from recent literature provide n brief sample of some current areas ofresearch interest.

Meta-analysis of 55 studies of music as a ihcrnpcitlic intervention in medical and dental treatment identified mean music effect size for» vnri« ety of dependent variables. In 54 of the 55 vnrinhlcR ftruilyzed, music

conditions enhanced medical objectives whether mensured by physi-V v ologicnl. psycholof/jciil/sctf-report, orbchnviorn! ohscrvnlion, The Inrg-

Vol 2 (2) est effect sizes were primarily for variables that reflect improved manage­ment of pain, stress, and anxiety (Standley, 1986, 1995).

A small sample experimental studied of use of the technique known as Guided Imagery in Music (Bonny and Savary, 1973, Goldberg, 1995) in treatment of cancer patients. The results showed that a series often weekly sessions had significant positive effects in improvement of mood and qual­ity of life measures, but no significant influence on lowering Cortisol levels (Burns, 2001).

Meta-analysis of 21 studies of music therapy for dementia found that overall, the effect of music/music therapy was highly significant. However, subsequent analysis indicated the need for subsequent testing of varying treatment protocols to identify the most effective techniques and their un­derlying mechanisms. (Roger, Chapin, and Brotons, 1999). Guiding prin­ciples for using music therapeutically, with specific considerations for older adults with specific suggested treatment protocols for pursuing specific goals are being clinically tested (Clair, 1996, 1991). A five-day series of reminiscence music therapy sessions with small groups of elderly persons with dementia showed in a significant decrease in depressive symptoms of participants (Ashida, 2000). An experimental study compared the effects of music and conversation sessions on speech content and fluency of twenty residents of a facility specializing in Alzheimer's care. The results demon­strated that speech content and fluency were significantly better following the music therapy sessions than conversational sessions with a therapist. (Brotons and Koger, 2000).

Several studies have shown that Parkinson's Disease patients can syn­chronize their gait movements to rhythmic stimuli and improve their walk­ing patterns, step cadence, stride length, and symmetrical muscle activa­tion patterns in their legs (Thaut, 1999). A music therapy voice treatment protocol was tested on four female Parkinson's disease patients who dem­onstrated voice and speech problems. Caregivers and spouses ratings of speech intensity level and intelligibility increased significantly in pre-post treatment measures (Haneishi, 1999).

In a case study piano improvisation activities were used to develop in­teraction and participation in a blind boy with behavioral disturbances. The process demonstrated increased spontaneous interaction and partici­pation with the therapist and increased participation in classroom activities (Shoemark, 1991).

Selected classical music used as background during verbal disclosure of significant personal events/experiences and related thoughts and feelings by university undergraduate students. The results showed that the music had an effect on the disclosure topics chosen, promoted cognitive sugges­tion and expression, and increased the enjoyment of listening to classical music (Jensen, 2001).

Music interventions with pediatric oncology patients restricted to an iso­lated environment showed that the music interventions elicited significantly more engaging behaviors than other hospital activities and that the music environment possessed a significantly higher frequency of environmental support elements than other activities typically experienced by the sub­jects. However, the positive behavioral effects of the music interventions were not maintained in the hospital experiences that followed the music sessions (Robb, 2000).

Clinical case studies (Aldridge, 1996) by music therapists in an Euro­pean medical hospital document applications of creative music therapy (Nordoff and Robbins, 1971, 1977). This treatment approach involves ac­tive musical improvisation and interaction between the patient and the music therapist. The qualitative descriptions of the treatment process and results demonstrate the personal nature and individual variability of patient inter­action with musical structure. The case studies reported by Ansdell (1995) describe creative music therapy activities with groups as well as individu­als.

A review of research and theory underlies development of a taxonomy and description of clinical music therapy intervention techniques for adults with mental disorders (Unkefer, 1990). The model developed used termi­nology and diagnostic labels that conformed with DSM-111-R, which was current at that time.

Growing interest in both qualitative and quantitative research promises continued development in the field. The interests of clinicians and research­ers seem to be converging as the demand for verified knowledge grows.

Future Directions Assessment and evaluation techniques are receiving increased attention.

Many checklists, rating scales, and similar instruments are being published The development of rubrics to anchor and describe characteristics of dif­ferent scale levels in measures of complex behaviors presents a chal­lenge for the profession. Lipe and York (2000) point out that the pro- 4%

Bulletin of Psychology and the Arts fession needs to broaden its assessment approach to develop and include more psychometrically based measures. Gregory (2000) developed a use­ful list of the test instruments used by Journal of Music Therapy authors between 1984 and 1997. This list includes both published tests, and mea­sures that were developed by the researchers specifically for their particu­lar studies.

Emphasis on collaborative research seems likely to increase. A research project currently funded by the National Academy of Recording Arts and Sciences is investigating the effect of active music therapy interventions on anxiety and coping behaviors of children with cancer, looking at client and family satisfaction. This study is a collaborative effort by music therapy clinicians in eight hospitals and music therapy professors in two universi­ties. The comparisons of musical and medical assessments described by Aldridge (1996) suggest interesting opportunities for collaboration. As the profession seeks to increase its repertoire of verified treatment protocols and their therapeutic outcomes, collaborative work among music thera­pists, psychologists, and physicians seems to hold promise.

Trends in music therapy seem likely to continue reflecting trends in healthcare and education. Managed care, demands for accountability by the public and third party reimbursement systems, changing hospital ac­creditation emphases, growing interest in alternative and holistic health care, and the continuing move toward de-institutionalization and inclusion alt promise to influence the profession. The growing body of reliable knowl­edge should help identify and clarify the profession's roles in pursuit of mental and physical health.

Resources American Music Therapy Association Website: www.musictherapy.org Certification Board for Music Therapists Website: www.cbmt.org Music and Scientific Information Computer Archive Website:

www.musica.uci.edu References

Aldridge, David (1996). Music therapy research and practice in medicine: From out of the silence. London: Jessica Kingsley Publishers.

American Music Therapy Association. (2001). AMTA member sourcebook 2001. Silver Spring, MD: Author.

Ansdell, Gary (1995). Music for life: Aspects of creative music therapy with adult/clients. London: Jessica Kingsley Publishers.

Ashida, S. (2000). The effect of reminiscence music therapy sessions on changes in depressive symptoms in elderly persons with dementia. Journal ofMusic Ttherapy, 37, 170-182.

Bonny, H. L. & Savary, L. M. (1973). Music and your mind. New York: Collins Associates.

Brotons, M. & Koger, S. M. (2000). The impact of music therapy on lan­guage functioning in dementia. Journal ofMusic Therapy, 37, 183-195.

Bruscia, K. E. (1998). Defining music therapy, (2nd ed.). Phoenixville PA: Barcelona Publishers.

Burns, D. S. (2001). The effect of the Bonny method of Guided Imagery and Musicon the quality of life and Cortisol levels of cancer patients. Journal of Music Therapy, 38, 51-65.

Clair, A. A. (1991). Music therapy for a severely regressed person with a probable diagnosis of Alzheimer's disease. In K. E. Bruscia (Ed.). Case stud­ies in music therapy (pp. 571-580). Phoenixville PA: Barcelona Publishers.

Clair, A. A. (1996). Therapeutic uses of music with older adults. Baltimore: Health Professions Press.

Davis, W. B., & Gfeller, K. E. (1999). Music therapy: A historical perspec­tive. In W. B. Davis, K. E. Gfeller, & M. H. Thaut, An introduction to music therapy: Theory and practice (2nd ed.). (pp. 15-34). New York: McGraw-Hill.

Davis, W. K. (1999). Music therapy for mentally retarded children and adults. InW. K. Davis, K. E. Gfeller, & M. H. Thaut, An introduction to music therapy: Theory and practice, (2nd ed.). (pp. 63-88). New York. McGraw-Hill.

Duerksen, G. L. (1986). Music therapy. In The new Grove Dictionary of American music (Vol 3, pp. 313-315). London: Macmillan.

Gaston, E. T. (1964). The aesthetic experience and Biological man. Journal of Music Therapy, 1, 1-7.

Gaston, E. T. (1968). Man and music. In E. T. Gaston (ed.). Music in therapy (pp. 7-29). New York: Macmillan.

Gfeller, K. (1995). The status of music therapy research. In B. L. Wheeler (Ed.), Music therapy research:Quantitative and qualitative perspectives (pp. 29-63). Phoenixville PA- Barcelona Press

Gfeller, K. E., & Thaut, M. H (1999). Music therapy in the treatment of mental disorders. In W. B. Davis, K. E. Gfeller, & M. H. Thaut (Eds.), An in­troduction to music therapy: Theory and practice (2nd ed.). (pp. 89-117). New York: McGraw-Hill.

Goldberg, F. S. (1995) The Bonny method of guided imagery and music. In T. Wigram, B. Saperston, & R. West (Eds.), The art and science of music therapy: A handbook, Chur, Switzerland: Harwood Academic Publishers.

Gregory, D. (2000). Test instruments used by Journal of Music Therapy | authors from 1984-1997. Journal of Music Therapy, 37, 79-94.

Haneishi, E. (1999) The effects of music therapy voice treatment on

Bulletin of Psychology and the Arts speech and voice problems and mood of individuals with Parkinson s Disease. Unpublished master's thesis, University of Kansas, Lawrence.

Hodges, D. A. (ed,). (1996). Handbook of music psychology (2nd ed.). San Antonio, TX: I MR Press.

Jensen, K. L. (2001). The effects of selected classical music on disclosure. Journal of Music Therapy, 38, 2-27.

Koger, S. M., Chapin, K., and Brotons, M. (1999). Is music therapy an effectiveintervention for dementia? A meta-analytic review of literature. Jour­nal of Music Therapy, 36, 2-15.

Lipe, A. and York, E. (2000). Guest editorial. Music therapy perspectives, 18, 11-12.

Lomax, A. (1968). Folk song style and culture. Washington DC: American Association for the Advancement of Science.

McAllester, D. P. (Ed.) (1971). Readings in ethnomusicology. New York: Johnson Reprint Corporation.

Merriam, A. P. (1964). The anthropology of music. Evanston, IL: University of Chicago Press.

Music therapy. (2001). In S. Sadie, (ed.), The new Grove Dictionary of Mu­sic and Musicians (2nded.). Volume 17. (pp. 535-540). London: Macmillan.

Radocy, R E. & Boyle, J. D. (1996). Psychological foundations of musical behavior. (3rded.). Springfield IL: Charles C. Thomas.

National Association of Schools of Music. (2001). Handbook Reston, VA: Author.

Nordoff, P., & Robbins, C. (1971). Music therapy in special education. New York: John Day.

Nordoff, P, & Robbins, C. (1977). Creative music therapy. Individualized treatment for the handicapped child. New York: John Day.

Robb, S. L. (1999). Marian Erdman: Contributions of an American Red Cross hospital recreation worker. Journal of Music Therapy. 36, 314-329.

Robb, S, L. (2000). The effect of therapeutic music interventions on the be­havior of hospitalized children in isolation: Developing a contextual support model of music therapy. Journal of Music Therapy, 37, 118-146.

Sears, W. W. (1968). Processes in music therapy. In E. T.Gaston, (Ed ), Mu­sic in therapy (pp. 30-44). New York: Macmillan.

Shocmark, H. (1991). The use of piano improvisation in developing interac­tion and participation in a blind boy with behavioral disturbances. In K. E. Bruscia (Ed.), Case studies in music therapy, (pp. 29-38). Phoenixville PA: Barcelona Publishers.

Soibelman, D. (1948). Therapeutic and industrial uses of music: A review of the literature. New York: Columbia University Press.

Standley, J. M. (1986). Music research in medical/dental treatment: Meta­analysis and clinical applications. Journal of Music Therapy, 23. pp. 56-122.

Standley, J. M. (1995). Music as a therapeutic intervention in medical and dental treatment: Research and clinical applications. In T.Wigram, B. Saperston, & R. West (Eds.). The art and science of music therapy: a handbook. Chur, Switzerland: Harwood Academic Publishers.

Standley J. M., & Prickett, C. A. (Eds.). (1994). Research in music therapy: A tradition of excellence. Silver Spring MD: National Association for Music Therapy.

Thaut, M. H. (1999). Music therapy in neurological rehabilitation. In W. B. Davis, K. E. G feller, & M. H. Thaut, An introduction to music therapy. Theory and practice (2nd ed.) (pp. 221-247). New York: McGraw-Hill.

Unkefer, R. F. (1990). Music therapy in the treatment of adults with mental disorders: Theoretical bases and clinical interventions. New York: Shirmer Books.

van de Wall, (1948). Music in hospitals. In D. M. Schullian & M. Schoen (Eds.). Music and medicine (pp. 293-321). New York: Henry Schuman.

Waterman, R. A. (1955) Music in Australian Aboriginal culture: Some so­ciological and psychological implications." Journal of Music Therapy, 5, 40-49.

Wheeler, B. L. (1995). Introduction: Overview of music therapy research. In B. L. Wheeler (ed.), Music therapy research: quantitative and qualitative per­spectives (pp. 3-15). Phoenixville PA: Barcelona Press.

George L. Duerksen Director, Division of Music Education and Music Therapy University of Kansas 1530 Naismith Road, 446 Murphy Hall Lawrence, KS 66045-3102

a £ 3 £ 2 £ 2 £ 3 £ 9 £ 2 £ 3 £ 3 £ 2 £ 9 £ 2 £ 9 £ <n> <ro cro cro <n> cro cro cro at) cro <n> cro cro Van Gogh's Ear Talks!!

Creativity, Suffering. And Aesthetic Language Kimberly McCarthy

Columbia College Chicago Everybody wants to get on the Van Gogh boat. There's no trip so hor­

rible that someone won't take it. The idea of the unrecognized genius slav­ing away in a garret is a deliciously foolish one. We must credit the life of Vincent Van Gogh for really sending this myth into orbit. I mean, how, many pictures did he sell? One! He couldn't give them away! He has to

Vol 2 (2) of his life that the rest of art history wil l be retribution for Van Gogh's neglect. No one wants to be a part of a generation that ignores another Van Gogh. In this town [NY] one is at the mercy of the recognition factor. One's public appearance is absolute. Part of the artist's job is to get the work where others can see it... When you first see a new picture, you don't want to miss the boat. You have to be very careful. You might be staring at Van Gogh's ear. (Rene Ricard as quoted in Charta, 1999)

I love this quote. It's a beautiful summarization of the slippery yet se­ductive nature of creativity and suffering. Creativity despite suffering. Cre­ativity because of suffering. Creativity used to combat suffering, and cre­ativity evoking suffering. It encapsulates various types or degrees of cre­ativity and suffering: the Superstar Creative Genius, the Outsider Artist and the Everyday Joe. In one fell swoop we have Van Gogh, unhappy, yet still painting, ear intact, to Van Gogh urgently working the creativity/suf­fering paradox, ear tearing slowly, and lastly Van Gogh, finally, a Superstar Creative Genius, only now dead, minus one ear.

The above quote is taken from the film Basquiat, the story of the short but star-filled life of painter/graffiti artist Jean-Michel Basquiat. He died at age 27 of a heroin overdose. While he didn't cut off his ear, he did cut off his life. But it wasn't because his paintings didn't sell. Quite the opposite. Basquiat is credited with being the first black artist to enter into the upper echelons of the white, male-dominated, high art world (Charta, 1999; Hoban, 1999; Kawachi, 1997; Marshall, 1992). Within two years Basquiat crossed the lines between Outsider Art to Superstar Creative Genius, his entire career lasting about a decade. That Basquiat suffered is clear, but which of the above types of suffering sent him over the edge is not...

Traversing the path between Outsider Art and Superstar Creative Genius can be an existential quest for some, and motivation for suicide for others. Is Ricard saying that, regardless of your status, creativity, suffering, and attention are inseparable? That society had better pay attention to creative people and their work or soon the streets wil l be scattered with body parts? That we'd better "see" the unusual or that which we ignore so carefully. Does the future of Creative Arts Therapies consist of enhancing and ex­panding our clients' suffering for the purpose of creative enlightenment? Does the future of creativity research lie in looking for cut- off ears and following their bloody paths to the owners?

The general definition of Outsider Art is the art of the untrained or self-taught, and is also sometimes referred to as Naive Art, Folk Art, Art Brut, among other labels (Atkins, 1990). It tends to be more decorative and non­functional than high art, with a tendency to reflect individual psyches rather than communal history. In the strictest sense, Outsider Art refers to self-taught artists on the outside o f mainstream society, e.g., prisoners, psychotics, the diseased and the dying. In the case of Basquiat, some crit­ics and fans framed his suffering and self-abuse as a sacred vow indicative of creative genius (Hoban, 1998). Herein lies the problem between creativ­ity and suffering.

I believe some suffering is inherent in creativity along the lines of Rollo May's (1975) ideas regarding the encounter, fear, and courage in working with the unknown. Escapist creativity is that which lacks the encounter; the creator has remained detached from the creative process. Glorifying suffering facilitates escapist creativity which in tum can result in confor­mity. But as Ricard might point out, it's certainly one way to cut out the competition (sic). It's also a way to limit one's perception, the very point of the opening quote, and certainly does nothing to combat suffering. HoUis Sigler, (1948-2001): Photo-Realism to Naive Ar t (Outsider Art?)

Sigler's entire career has been a testament to the communicative graces of art, and in the Breast Cancer Journal she reminds us that art can accom­plish this in a way that nothing else can, and that sometimes, preciously and rarely, it wil l do very much more. Sometimes art can be a matter of life and death. (Yood as quoted in Sigler, Love, & Yood, 1999, p.18)

The picture on the cover of this Bulletin is from the Breast Cancer Jour­nal (Sigler, Love, & Yood, 1999). The painter is Hollis Sigler. She died of breast cancer. She was first diagnosed in 1985; it metastasized to her bones in 1991. She had once asked her assistant James Yood in reference to her life: "Did I do a good job?"

Leaving Hollis' memorial service, ruminating over her amazing accom­plishments in spite of the cancer (she taught up to the very end, weighing perhaps seventy pounds), 1 wondered: how did she do it so well? We hnd talked a number of times over the last six or seven years, I vvns n round to see the changes in her life and body. Thinking of other people I know in similar conditions, I realized many of them used their suffering M motlvn* . tion for some type of pro-life action. They dealt with the here-nnil«nmv

of their life without shame and with dignity. Walking home nflcr )li6 be the most modern artist that everybody hated then. He was so ashamed i \ F & 3 u v memorial I thought sarcastically, feeling sorry for myself, "Mnyhe

Vol 2 (2) should write an article 'For Those of Us Who Don't Handle It So Well. '" In the fall semester 2000 my autoimmune disorder dipped and went public. I have had to modify my work objectives and commitments to deal with my fickle body. The upshot of this illness is that I've started a new research project looking at creativity, suffering, and aesthetic language, of which this short article is a start.

Hollis knew I was a devout fan. I admit I was shameless. I wasn't aware at first that she was a renowned artist. Hollis was unbelievably accepting and open. I think she understood the motivation behind my crazy passion for her work and my groupie-like affection. In truth, I didn't know her day-to-day life; some might say I didn't know her at all. But I do know that she knew we shared a certain knowledge. We are both members of the same club: The Chronic Illness Club.

Before my health had taken its fourth dip, I excitedly ran up to Hollis, passionately proclaiming that I had decided to buy my first piece of real art and that it had to be hers. 1 asked the price of her paintings. There was a long moment of silence, a distinct, intense pause, as we looked each other in the eyes. Hollis modestly, and I do mean modestly, said: "$20,000." I choked laughing and blurted out: "Well, it looks like 1 won't be buying one of your paintings!" And then Hollis said to me, "Copy one of mine." I wonder i f you, the reader, are as stunned as I was. ,

In the brief moment before she told me the price, 1 believe Hollis, in her sensitivity, could see my sincerity and deep desire to have one of her paint­ings. It wasn't necessarily the canvas or even the images that I wanted, that I needed. It was the sentience, the secret code which they relayed, a code which is transmitted non-vocally, implanting in the soul of the viewer a nugget of hope, of courage, of mournful acceptance or determined resis­tance—a code particularly powerful for Club Members and their families. Just what the nugget might contain for each individual cannot be predicted, but what is certain is that it wil l affect us. We will be changed. Rollo May (1975) refers to this as "the encounter," the complete absorption of the self with an idea or other.

Hollis said "Take one of my painting classes and copy one of mine." 1 did. Using her style, I created the painting on the back cover of this bulle­tin. The only training I ever had in art was through a park district summer program around the age of eight, so I certainly qualified as an Outsider Artist. It was Hollis and her work that said to me that it's okay to paint from your heart. I admired her courage and felt I should walk my talk; after all, on one level, we were both outsiders. I f she could do it with cancer, I certainly could. I f nothing else 1 had to try.

Looking at Hollis' paintings, one might concur they were painted by a very young but talented art student. The recognizable images are simply drawn and look like they were done with crayons. In fact, Hollis first turned to crayons when she shifted from Photo-Realism in 1976 (Sigler et al., 1999). She wanted to explore untapped resources of feeling and emotion, to return to a more natural and organic style. Sigler described her style to me as Naive. ArtSpeak (Atkins, 1990) defines it as self-taught art, often appearing childlike, innocent and spontaneous, tending toward bright col­ors, abundant detail, and flat space. Aside from the self-taught part, the rest seems fairly descriptive of Hollis' work to me. Hollis' work shouts the truth through a whisper.

Looking at her painting on the cover, most of the images are easily rec­ognized except perhaps for the ribbon over the door, with the phrase "The Future Moves in Much Closer." The odd thing is the phrase is written back­wards, facing the mountains. The sky is blue and the carpet is green, like grass. But in-between is the desolate desert, not a cactus or tumbleweed in sight, and the sharply-pointed, very high mountains. The walls are bare. The only decor is the plant in the left comer and the TV/entertainment center, its doors open. Notice the direction of the chairs. There's a red and black liner, a green spacer, and a green frame. Red and green are comple­mentary colors: they intensify each other. So the coloring of the frame, spacer and liner work to create a feeling of heightened awareness. Personal information is written on the liner and factual information about cancer on the frame. The title "The Future Moves In Much Closer" gives me the feeling the mountains are moving in and will eventually bury the room. I'm reminded of the old adage "dust to dust." Or does the future lie further into the house? Hollis once said (Sigler et al., 1999, p. 21): "It was a revelation to me, just as it had been to [Audre] Lorde, how 1 had treated everything in life as i f it were permanent." The two empty chairs are there waiting for someone to use them—or has someone just left? A waiting-room, literally? Other viewers' interpretations might differ, as mine might on another day, But this was exactly one of Hollis' intents. She wanted her work to touch people in our shared emotional spaces.

The absence of people in her paintings, except for "The Lady" and

Bulletin of Psychology and the Arts "Nike," is so that the viewer might project themselves more easily into the basic model, and add or subtract icons relevant to his or her life (Sigler, et al., 1999). The specifics aren't essential. It's the relation to a life-changing experience that is important. As James Yood (Sigler, et al., 1999) noted, the amazing thing about Hollis is that she looked mortality in the face and saw it as an opening between promise and despair.

The Everyday Joe, Outsider Art , and Skid Row, Los Angeles The painting I created in Hollis' class is a reflection of my experience of

having lived on Skid Row, Los Angeles for a month. What brought me there was a research project with a theater company based in Skid Row, and a 3-week Change/Exchange workshop held by LAPD learning about their program and work. While there I struggled with a razor's edge similar to Hollis,' wondering: were the feelings I had in response to the scary en­vironment, or was it because 1 was in a scary environment that I now felt it was okay to experience said strong feelings? Was it really as bad there as I thought, or was I condescendingly projecting the worse-case scenario on a culture I didn't understand? It was a very powerful experience.

Along the bottom of my painting, carved into gesso (a kind of molding glue/clay material), is the title: "The emoter: alone: 2:00 a.m.: Skid Row Hotel Room." The stick figure, the Emoter, is sitting on the end of the bed, head in hands, emoting. There's a tall closet in the top left comer, and a sink, a small refrigerator and a small dresser along the right side of the room. In the middle is a tall, slide-up window with a strong set of old burglar bars.

In reality, this was my room in the SRO (single room occupancy hotel). About 50 yards away was the street. In-between was a locked, fenced-in basketball court. Between the fence and the SRO were electronic alarm sensors. My room was at the end of a hall of nine rooms reserved for women only. At night we'd look out our windows watching all the people—the streets were always full, crack-smoking lighters flickering like fireflies. In the painting, parts of the room are disconnected, floating in different planes of space. Surrounding the room is the unknown. The orange reflects strong emoting, like radiation or an aura. Hollis actually painted a few strokes on that canvas, which makes it even more meaningful for me.

The scene, sitting on a bed in the middle of the night, was inspired by an actual event in the SRO which had strict rules and heavy security (metal detectors.at the door along with armed security at all times. I quickly real­ized after a few days in Skid Row, the continual hyper-vigilance for danger and the desire for trust. The air was always thick with this feeling). A fight had broken out between two men in the main open room—while there were nine women residents, including myself, there were almost eighty men. Within seconds guys were yelling, moving towards the altercation. The guards and staff rushed in, and I flew to my room. I could hear yelling and fighting, as well as the arrival of the police, who eventually resolved things with some arrests.

I sat on the end of my bed, American Express Gold Card in hand, terri­bly torn with the awareness of how lucky I was to have one, painfully aware of what it would be like i f I didn't have a dime. All the while I anxiously mapped out different ways I could make it out safely to the major hotels in the jewelry district, about four blocks away—only one of which was safe. I wouldn't be able to take my suitcase, so I packed my pockets with important essential items and sat there saying, "Okay, I'll stay for one more minute," and "Okay, just one more minute," and gradually every­thing calmed down.

The theater company called the Los Angeles Poverty Department, or LAPD, founded and directed by John Malpede in the 80's, was the thing that was so interesting that 1 chose to live on Skid Row. It was LAPD's creative process of improvisation which hinted at the possibility of provid­ing every member in a group a meaningful experience rather than just one or two people having the experience with the others facilitating it (see McCarthy & Steingraber, 1997). I have long been interested in the role of uncertainty in creativity: whether there is any, how might it function, how people who already live in a highly uncertain environment deal with or experience uncertainty in the creative process, and i f and how that might parallel or heal their daily lives.

With LAPD, given the transient nature of the population and language differences, scripts were completely out. There was very little money, so sets were also out. LAPD worked out of a very small reception area of a Legal Aid Office in Skid Row, and a larger, standard rehearsal space on the margin of Skid Row. At the time, LAPD consisted of eight to ten commit­ted members who had started a soap opera series. Of the committed mem-bers, about four or five were previous Skid Row residents and had moved

oo J out an(j onto better things because of their participation with LAPD. There were some non-Skid Row people who just liked the group, and

Bulletin of Psychology and the Arts Vol 2 (2) there were also, at the most, two paid personnel. The rest of the cast were inclusive sense first requires the respect of African people as language residents of Skid Row, the precise numbers changing with every perfor- manipulators of the highest order. Understanding the complexity of lan-mance. guage in African cultures, the overlapping texts, tongues, and dialects, can

The series was entitled "The Buffalo Bob Show," modeled after the das- deepen the appreciation of Basquiat's sophisticated use of language. From sic children's television program featuring Buffalo Bob and his wooden understanding the in-joke to the alienated, from the colloquial to the schizo-puppet Howdy-Doody. The content for the series was improvised during phrenic, Basquiat's use of words function like any conversation one might rehearsal, where a general storyline for that week would be set. Of course overhear in any urban American neighborhood. The same canvas can have this storyline often changed, depending on who showed up to perform and some profound sentence juxtaposed with profanity and gutter talk, chants who showed up in the audience—observers sometimes got up and started and spells, incantations and curses, cheers, and raps. Tate feels that acting in the series. Whether they were aware it was a play or not was not Basquiat's art is very much like the music of Theolonius Monk, in that always clear, primarily because of histories of alcohol or substance abuse. both used childlike gestures but layered them in highly sophisticated, corn-While I was there I saw, over the course of four weeks; how Buffalo Bob plex, intellectual, aesthetic statements. When asked why he frequently was challenged by his boss for problems on the job due to his drinking and crossed out words (note the title of this essay), he answered that the viewer foul language. Buffalo Bob always blamed it on Howdy, saying he was the would be more likely to read the words and take them in (Basquiat video; one with the problem. Eventually Bob lost his job and went to the Betty **Hoban, 1998). Like a skilled musician, Basquiat knew where to effec-Ford Clinic. There he/Howdy tried to arrange for liquor to be brought to tively place silences. him/Howdy and tried to break into the medication room. When confronted Bell Hooks (1995) writes that Basquiat's paintings challenge those who by the Clinic personnel, Bob threw a TV through a window and ran away equate "seeing" with "looking." Viewing his work through a Eurocentric where he and Howdy lived on the streets. Bob was clearly in denial. gaze one can see familiar aspects of Western artistic traditions. The more

LAPD would travel around and perform at different SRO's and rehab inclusive view of Basquiat's work (and life) demands that the viewer be clinics in Skid Row, as well as occasional performances outside of Skid willing to see and accept the tragic dimensions of black life. The privacy of Row. While the story was unfolding, one of the LAPD regulars returned black experiences needs to be recognized in language, but for the horrors after missing several weeks. This regular had signed up for one of the paid of black life, language has been terribly limited (Baldwin as cited inHooks, experiments offered by nearby medical research hospitals. Unfortunately, 1995). "Basquiat's work gives that private anguish artistic expression. ...he this experiment resulted in a reaction severe enough to mandate a stay in had to assume the blackness defined by the white imagination and the black-<he hospital, with the LAPD regular nearly dying. The group was very con- ness that is not unlike whiteness." (Hooks, 1995, p. 39 & 43). cerned and interested in this experience, as a number of them also earned One thing that happened in Basquiat's time period of the 80's was the money as experimental participants. view of the arts and the artist as an investment, a commodity. Basquiat first

Not surprisingly, this event was soon reflected in the play's storyline, became famous for his art, then for being famous, and then for being infa-Buffalo Bob having a similar experience as part of the series. In future mous (Marshall, 1992). Unfortunately, people grabbed onto the last two, storylines, Buffalo Bob would start pimping off Howdy as a prostitute to ignoring the seriousness and significance of his art. Recall the earlier dis-purchase drugs, and that would evolve into organ harvesting for cash— cussion of aggrandizing self-abuse,and the issue of outsider-ness takes on Howdy's organs, of course! The day I last attended rehearsal, there was a new meaning (e.g., Kamikaze pilots). serious and focused discussion regarding the pros and cons of volunteering Which brings us to the powerful irony of Basquiat's work: it was based for a experiment at one of the nearby hospitals, an experiment designed to on the politics of dehumanization, both white and black (Hooks, 1995). He stop the participant's heart for several minutes, in exchange for several skillfully reflected back, to much of his audience, his pain and anger as the thousand dollars. chosen Black man in the massively white dominated high art world (Hoban,

Outsider Artist to Superstar Creative Genius: 1998; Tate, 1992). The commodification of Basquiat as "the primitive ghetto Jean Michel Basquiat (1960-1988) culture." Bell Hooks (1992) recounts with great disappointment how on

SAMOe as an alternative to Joe Normal and the Bourgoisie Fantasy attending the commemoration showing of his work in 1992, she could find (Basquiat, as cited in Kawachi ,1997) no one who would talk about his work. Instead they talked about him, his

The above sentence was spray-painted somewhere in lower Manhattan lifestyle, his fast rise and fall, and his tragic death, seemingly unaware of by painter/graffiti artist Jean Michel Basquiat (Hoban, 1998). The signa- relationship between Basquiat, the person, and the very subject of his art-ture SAMOg, always with the copyright sign, accompanied all of his graf- work, which is the politics of dehumanization. flti and appears in many of his paintings. Basquiat and high school friend But despite Hooks' experience, there are those who have been deeply Al Diaz came up with the idea of "SAMO@" or "same old shit" in 1978 and touched by his work (Ricard, 1992). Artistic heroism was the evolution of used it as the signature for the mysterious and poetic sentences they left all the 80's, and Basquiat was a hero who had dared to develop outside the over Manhattan (Hoban, 1998). These earned them quite a reputation—in commercial system. Jean-Michel never viewed himself as a graffiti artist fact the Village Voice offered a $100 reward for information leading to the but as a serious painter. His main concern was with the process of history identification of SAMO^. itself. Real artists, as opposed to "accidental" artists, see themselves within

Basquiat was first discovered by Rene Ricard, poet and writer for Art the historical context of the art world. But working within a context in Forum (Hoban, 1998; Ricard, 1992). He greased the wheels for Basquiat's which you see no one like yourself (e.g., white-dominated high-art world) first public exhibition of one piece at the 1980 "The Times Square Show." can be both devastating and aggrandizing. It takes a strong person to enter He was one of the few individual mentions in the Art in_America review that world and to communicate. and one of the few artists at the "New York/New Wave" show with a room Rollo May (1975) states that courage is an essential aspect of creativity, of his own featuring some fifteen pieces. In 1981 Ricard (1992) published Basquiat was definitely a pioneer both in his position in the art world and an article on Basquiat in Art Forum, "The Radiant Child," officially usher- the manner in which he addressed that position. Ironically, it was the white ing him onto the Superstar path. Basquiat signed on with his first full-time middle-class audience that Basquiat's work first spoke to. They were his art dealer Annina Nosei and his paintings averaged $7,500 and up. In 1983 first buyers. Perhaps they could see the "Everyday Joe" in his works, the he became the youngest artist ever (age 23) to be featured at the Whitney Everyday Joe they lived and breathed. Museum's Biennial Exhibition. One year later he was collaborating with Suffering and Aesthetic Language Andy Warhol, whom he greatly admired. In 1985 he was on the cover of Reviewing some of the literature on suffering, pain, and torture, one the New York Times Magazine. Two years later he overdosed on heroin and thing is clear: sharing one's pain is essential for healing (Scarry, 1985; Tal, died. 1996). The problem, however, is that there are social triggers which work

Basquiat stated that "royalty," "heroism" and "the streets" were the sub- to prevent this. The goals of the state are most often interested in preserv-jeet matter of his work (Kawachi, 1997). Making good art was Basquiat's ing the status quo while the survivors' goal is change (Tal, 1996). weapon against racism (Charta, 1999; Hoban, 1998; Marshall, 1992). He Bearing witness to one's suffering springs from a refusal to give in to was inspired by a diverse range of topics and sources such as New York external pressure, a refusal to repress or revise an experience. Bearing wit-city, cartoons, symbols of oppression and genocide, commodities of trade, ness is a goal of change. In May's terms (1975), this is called the willing-junk food, black athletes, boxers and musicians, and books such as African ness to choose action rather than apathy, and this takes courage. Suffering Rock Art, Leonardo da Vinci, and Gray's Anatomy. 1 find the Symbol and trauma work to displace our preconceived notions about the world Sourcebook particularly interesting in that Basquiat used many of the j f ^ k (Tal, 1996). They are experienced outside the boundaries of "normal" "Hobo Signs" symbols therein. Perfect for the disenfranchised. l feZ# human experience and within an altered state of awareness. Telling

Greg Tate (1992) writes that to understand Basquiat's art in the most f J U ^ l / v one's story of suffering serves as both validation and release, and/wo-

Vol 2 (2) Bulletin of Psychology and the Arts vides a ground for social change. Basquiat by choice (to some extent), Hollis by no choice of her own. Both

The only problem is that pain destroys language (Scarry, 1985), and se- Sigler's and Basquiat's art are deceptively simple but upon further exami-vcre pain is world- destroying. Pain eludes language in its ability to evoke nation and thought reflect profound ideas and social commentary. I think a split between one's sense of reality and the reality of other people. It can the power of Sigler's art is that it captures Scarry's Categories 2 and 3. evoke a sense of loneliness and fear that is amplified because of the scar- Category 3 is a given. But Category 2 may perhaps be what gives her art city of accurate language. When we speak of love, there are a multitude of the added punch. In providing a space for people to enter through imagina-sources we can draw from (e.g., books, theater, dance, music, film), but try tion, Hollis has provided the possibility for experience (reciprocal self) to describe a pain in your head to a doctor, and language can run dry. Scarry which doesn't have the individual signature of the "other" (artist), but can (1995) offers a very persuasive analysis regarding the paradox of language have, i f you think about it. Her paintings soften the realities of cancerthrough and pain. Both arm-chair and serious philosophers wil l find her analysis incomplete drawings (e.g., Where are the people? Are they dead?) and ear-extremely insightful and thought-provoking. Particularly powerful is her toon-like rendering. Reading the frames provides challenging facts about question (Scarry, 1985, p. 12): "How is it that one person can be in the cancer and the liners provide information about the experience of having presence of another person in pain and not know it—not know it to the cancer. Life and death, however, are at the crux of her work. Ideally ac-point where he himself inflicts it, and goes on inflicting it? " [italics added] knowledging the painful possibility of cancer wil l lead to pro-life action,

Again I'm drawn back to May (1975), in particular his idea of moral either personal or political, courage or the ability to see suffering in others. In my classes I've added Skid Row improvisational theater allows the participant some control "to see suffering in ourselves," since 1 believe this completes Scarry's ques- over how much awareness they want or new behaviors they want to try. tion, the circle between perception and continued action. According to Whenever there is altercation, attention is drawn back to the play, and act-Scarry, to have pain is to experience certainty; to hear about pain is to have ing is used as a way to face fears indirectly. According to theater director doubt. Pain is something that cannot be denied nor confirmed. Since we Peter Brooks (1968, p. 140-141), with theater it is always possible to start describe pain in medical and legal terms, the literary emphasis of our Ian- again: "In everyday life, ' i f is a fiction, in the theater ' i f is an experiment, guage pain and suffering is doubly important. Medically speaking, we tend In everyday life, ' i f is an evasion, in the theater ' i f is the truth." Belief in to describe pain as a weapon. The problem with this is it takes it out of the this truth leads to the experience of theater and life as one. This lofty objec-body and into the external world where it may be appropriated and objec- tive sounds like hard work. Playing requires hard work. But when work is tified. The focus can then be moved from discussing the pain to discussing experienced as play, it is not work any more. As Brooks continues, "A play the discussion of pain. The person with the pain has lost power over his or becomes play." The theater improvisation processed used by LAPD fos-her ability to accurately communicate their experience. Moreover, the lis- ters the kind of reciprocal relationship Scarry is talking about, including tener has lost power over his or her active, empathic listening. the one between defense mechanisms, the self, and truth.

One example of the power given to objectified pain is its continual refer- Looking at Basquiat and his suffering, the Eurocentric view of his work ence in religious texts and experiences. According to Scarry, the self-flag- recognizes it as a Category 2 object. It is a painting which has been made cllation of the religious ascetic is a way of emphasizing the body so that by someone, but there's no clear motivation on the receiver's part (the attention may be drawn from the world and more easily focused on the viewer) to recover the details of the work that would complete the circle of unworldly, contentless force. It is not an act of denying the body and sepa- understanding. This sounds like the "art as commodity" discussion earlier, rating it from attention. She states that physical pain is an intentional state The magic of creation is exchanged for the indeterminacy of gambling in without an intentional object. Herein enters imagination which is an inten- the art market. The commodity (the art) is dependent upon the artist, who tional object without an experience-able intentional state. The difficulty in now becomes the commodity. The novelty associated with the artist, in this describing pain is that it requires the making of originally-private and inte- case, is not excessively challenging, given the bias of the Eurocentric view, rior reaction into something exterior and shareable (Scarry, 1985, p. 285): but also because of the very fact that he's in such a high position because of "By transporting pain out onto the external world, that external environ- his willingness to mingle within the Eurocentric world. Artist as commod-ment is deprived of its immunity to unmindfulness of and indifference to- ity is artist as object and, as Scarry notes, a nonreciprocating object is more ward the problems of sentience." Creativity, according to Scarry, includes easily appropriated and seen in the manner in which the viewer wants to both the creating of the object and the object's recreating of the human see it. This makes it easier for us to be in the presence of someone in pain being. The object is then seen as a "freestanding" creator in that experienc- and not know it to the extent that we are oblivious of our role in perpetuat­ing it, whether through creating it or "seeing" it, we recreate ourselves. ing that pain. This really is the subject matter, the primary message of

Scarry provides three categories useful in discussing this reciprocal na- Basquiat's work, ture. Category 1 refers to the unrecognizable and unrecoverable objects or It seems like a "tolerance for ambiguity" is one of the most often cited super-real objects, e.g., God. The object is devoid of personal and general characteristics of creative people. Perhaps Jung is right, that creative people human signatures that tell us it is humanmade. Category 2 refers to those are the visionaries of society. They lead the pack. They put their belief in objects that do not have individual signatures, not recognizable as invented creativity ahead of suffering—or is it their belief in creativity which helps at first sight but i f we think about, are recoverable in that a general human them overcome suffering? Is it perhaps a misguided view of creativity as a signature can be recognized, for example, the Golden Gate Bridge. Cat- suffering hero, or does the uncertainty of chronic problems or illness train egory 3, the one of most interest to us, refers to the unreal. Those objects one to better cope with the uncertainty in creativity? And in acknowledg-that are not only recognized as having personal signatures and are recover- ing their suffering, seeking a language for it and succeeding because they able, but that are also self-announcing (e.g., films, poetry, music). When use an aesthetic language, they can move forward and help others to move playing a CD we often say, "This is Bartok." Those objects that fit Cat- forward. Maybe this is what Van Gogh's ear would say. egory ldo not reflect us as readily as Category 2 objects but in some way References enhance the objects of Category 3 in terms of the magic of creativity: ere- Atkins, R. (1990J. ArtSpeak. New York: Abbeville Press, ating out of sheer pleasure. Brooks, P. (1968). The empty space. New York: Macmillan

Conclusion Charta. (1999). Jean-Michel Basquiat. MUano, Italy. In terms of suffering, Sigler and some Skid Row individuals suffered J1obfn' £ V ™ } - Basquiat: a quick killing in art. New York: Penguin Books.

r , • •„ d . . , . , , . , - , . . . , - , Hooks, B. (1995) Artonmy mind: visual politics. New York: The New Press from chronic illness Basquiat had a very troubled childhood which cer- Kawac'hi>} (]^7) {mKmgfor ade?ade: JeanMichdB L Japan: tainly prepped him for suffering as an adult. They all faced some type of fCorinsha Press & Co Ltd discrimination. For Sigler it was the taboo of cancer. For Basquiat and Marshall, R. (1992)' (Ed.) Basquiat. New York: Whitney Museum of Ameri-some of the Skid Row individuals it was racism and classism. Sigler was can Art. struggling to live. Some of the Skid Row people were yearning to die. May, R. (1975). The courage to create. New York: W W. Norton & Co. Basquiat and Sigler's aesthetic trajectories seem to meet: Basquiat went McCarthy, K., & Steingraber, S. (1997). Self-connection shared. Integrating from Outsider to Superstar; Sigler went professional artist to Naive/Trained- collaborative and autonomous impulses within feminist projects. In E. Peck & Outsider artist. Some Skid Row individuals struggled in the Outsider Art- ^ ^ ^ ^ ^ v ! ^ " gr0und'JemimSt col!abora"on ' " the academy. ist arena, but most fell into the Everyday Joe category: attempting to achieve ^ ^ R (]992) (Ed.) World Crowne.: Bodhisattva with clenched mudra. or achieving an ability to maintain some stability in life but not enough to ,n R Marshall, (Ed.) Basquiat (p. 44-4$). New York. Whitney Museum of consistently act or finish their creative activities (e.g., illness, parole), yet American Art. continually seeking out creative activities. £<iq% Scarry, E. (1985). The body in pain: the making and unmaking of the world.

Whereas Hollis was a professional artist first who went Outsider, so \ z z j ? New York: Oxford University Press, to speak, Basquiat was an Outsider who went professional. Both died, - f t f u U l j * Sigler, R, Love, S., & Yood, J. (1999). Hollis Sigler s breast cancer

Bulletin of Psychology and the Arts

journal. New York: Hudson Hills Press. Tal, K. (1996). Worlds of hurt: reading the literature of trauma. New York:

Oxford University Press. Tate,G. (1992). Black like B. In R. Marshall (Ed)Basquiat(p. 56-59).New

York- Whitney Museum of American Art.

Kimberly McCarthy Department of Liberal Education Columbia College Chicago 600 South Michigan Avenue Chicago. Illinois 60605.

X X X X X X X After the Fact: Psychotherapy Is a Performing Art

Sarah Benolken New York, New York

In preparation for this article, 1 asked a number of colleagues how they would define the word "art." The most frequent answer was that art is whatever the maker says is art. This definition may reflect contemporary values, at least in the visual arts, but doesn't leave much room for discus­sion. The dictionary definition of art (Mish, 1988, p.105) is a little more helpful. According to Mish, art is procedural knowledge, or skill, devel­oped through experience, study, and observation. Art also signifies the conscious use of skill and imagination. But while the word "skil l" con­notes technical proficiency, "art" suggests a non-rational and mysterious power of invention through imagination.

Art and science are not antonyms. The dictionary meaning of science is "knowledge covering general truths or the operation of general laws as obtained and tested through scientific method" (Mish, p. 1051). The differ­ence between science and art might be conceived as a difference between types of knowledge. Science could be described as factual knowledge, and art as procedural knowledge. Even this may be a questionable distinction, however. We can obtain an inkling of how close these terms are by consid­ering that the archaic meaning of "fact" is "performance" or "doing" (Mish, p. 444). But no matter. A line in the sand, arbitrary or not, has already been drawn between science and art, and we want to declare ourselves scientists. But we are not simply scientists, and we do not invariably act as scientists. Even though we may not like to publicize it, there is an art to scientific psychological experiment. Eminent researchers possess profound experiential knowledge of the process of experimentation. Great social scientists use great and mysterious powers of imagination to invent and test problems and concepts never before conceived. I submit that there is even more art to the practice of psychotherapy, informed by scientific psy­chology though it may be. Since my background is in theater, I can best understand the art of psychotherapy as a performing art.

Like the actor, the psychotherapist's whole mind and body, in relation to another person, in actual time, within the context of a specific environ­ment, is the instrument of the psychotherapeutic process. Psychotherapy requires constant attention to and simultaneous interpretation of the Jame-sian fringes of one's own consciousness - fleeting and irrelevant thoughts, sudden flashes of episodic memory, physical sensations, and feelings. Si­multaneously, one must attend with equal commitment to the client's thoughts, memories, and emotions expressed through gestures, posture, and tone of voice - the entire armamentarium of human communication, both verbal and nonverbal. The therapist also needs to remain aware of the context in which the therapeutic dialogue occurs. There is a room, more often than not decorated and arranged by the therapist, which reveals or dissembles the therapist's character, aspirations, and expectations. Both participants are communicatively costumed. Both are situated in a particu­lar geographic location at a particular moment in history. Each carries a particular socioeconomic, cultural, occupational, gender, and generational identity. Context influences and defines the human interaction in psycho­therapy.

The practice of psychotherapy requires repetitive efforts by the therapist to contain awareness of all of this information, to share it with the client, and to use it in the service of mutually agreed-upon goals for the client. While one can learn about the implications of various types of contextual realities, or about the implications of various types of human problems, from studying social scientific literature, scientific knowledge alone docs not enable the psychotherapist to integrate and express all that needs mtc gration and expression within the psychotherapeutic interaction.

The mimetic nature of learning in psychotherapy practice links it ^ < with the art of acting. Other than by direct practice, one learns most '7',;-' ^ u

Vol 2 (2) about the actual doing of psychotherapy through mimetic experience. In supervision, when the therapist talks about clients with a presumably more experienced colleague, different levels of awareness and different styles of communication are modeled by the supervisor for the supervisee to com­prehend through imitation. This mode of learning is intensified and per­sonalized in the therapist's own experience as a therapy client. Therapists can also learn numerically by viewing videotapes and reading transcripts of actual therapy sessions conducted by eminent psychotherapists. Books by master therapists (e.g., Bugental, 1987) describing the ways in which therapists may speak to their patients or interpret internal and private expe­riences are a fourth source of numerically understandable information about both internal and external communication processes in psychotherapy.

But this is not the sole connection between psychotherapy and the per­forming arts. Like actors, therapists are required play roles and adopt char­acters. The role of "therapist" must be uniquely adapted to the needs and expectations of each client. The therapist also has repeated occasion to reflect the client's own character back to them, as well as various charac­ters in the client's personal drama. These tasks require therapists, like actors, to express a wide range of emotions of varied subtlety.

A psychotherapy performance can have the quality of a jazz improvisa­tion, a waltz, Greek tragedy (with the therapist usually in the role of the chorus, the messenger, or the seer), or a karate contest. It can take on the qualities of any purposive and intentional performing arts process. Psy­chotherapy merits identification as an art because it requires performative skills that can only be developed through practice. But what about the place of creative imagination in psychotherapy? How do psychotherapists use imagination to create, i.e., "to bring into existence something new" (Mish, p. 304)?

Empathy is the best-known and most widely studied aspect of creative imagination in psychotherapy. Empathy in psychotherapy means accurately and appropriately imagining the client's point of view or state of mind at a given moment. It also refers to the communication of such imagined un­derstanding in a way that passes muster with the client. This can "bring into existence something new" for the client who has never before felt understood, as well as for the client who becomes newly aware of his or her own point of view or state of mind as a consequence of the therapist's empathic communication. Empathy can be manifested as rational, intel­lectual understanding, but psychotherapists value and aspire to master more intuitive, non-rational forms of empathy as well. Empathy can appear as something akin to telepathy, as exemplified in, say, the empathic mastery of Harry Stack Sullivan in his work with young men suffering from acute schizophreniform psychoses (see Kvames, 1976 for a description).

The more intuitive and less rational manifestations of empathy lie well beyond the present reach of scientific psychology. Here we are in territory that is certainly not science. To some extent empathy can be taught, mainly by mimesis and observation, but some psychotherapists are better empathizers than others, and some are extraordinarily and mysteriously gifted. It should be noted that actors create dramatic characters through a variety of empathic processes. Some are better at creating character than others, and we call some actors geniuses because of their mysterious cre­ative powers in this regard. The creation of dramatic character can be taught, at least to some extent (Stanislavski, 1950), and i f clinical psychol- . ogy ever frees itself from shamed denial of its artistic dimensions, psycho* therapists would probably benefit from studying actors' methods of build­ing and expressing empathic knowledge.

An equally important way in which psychotherapists use imagination is imagining the client's future potential. This kind of imagining is expressed in the suggestion of a variety of new and untried options in regard to think­ing, feeling and acting for the client to consider. PsyehothGffipy enn cronte creativity within the client by repeated modeling of ercntive thinking,

Is the "something new" that can be created in psycholhernpy a novel* original, and appropriate product of some sort, ns in the convenHonfll wofil* ern view of art, or is it more akin to the CftRlern vision of «rt m 0 fltflig of personal fulfillment in connection with cssentinl find primary reality (Uubntl, 1999)? Can creative imagination in psyclMthcr«py infiU'lWttlP M b pm~* spectives? I think it can, Although we don't Ilk*' to ^Ik flf>0»* Oiir clig'njji' lives as products of psychothcrnpy, therapy ann Hdntihily lnftpir'0 f» fllJOM! H* make novel, originnl nncl appropriate life flhnlflfiN, I f fOnifOW i* g^ig in engage in n satisfying love rclatiowihip ft»r (ho flffit itnm in ihfslr jjjfe, pinf.fi a courageous occupmionril change, osonpo IVom IptSfpflrpnnfll (Pfiuf9t iir

realize some other kind of nii'Muml Achiflvomflfll i\H ft rcpjfl nf fiiypfiO' thonipy, we feci great Niiijfil'riaiion wilt) whttl wn t>£$M Ibo prflfjlifil of mfp

work. However, absent tho modhiMivo raynrii fnrtbp nibpribui \i$u itf />• the core of the psychothcrnpy procpun, oroViliv*? reioilifi ihr unllkpfy ((•

Vol 2 (2) occur. Just as in the art of acting, the creative product is indivisible from the empathic creative process from which it is constructed.

References Bugental, J. (1987), The art of the psychotherapist. New York: W.W.

Norton & Company. Kvames, R.G. (1976). A Harry Stack Sullivan case seminar: Treatment of a

young male schizophrenic. New York: W.W. Norton & Company. Lubart, T. (1999). Creativity across cultures. In Robert J. Sternberg (Ed.).

Handbook of creativity (pp.339-350). New York: Cambridge University Press. Mish, F.C. (Ed.). (1988). Webster s ninth new collegiate dictionary. Spring­

field, MA: Merriam-Webster.

Sarah Bcnolken 24 East 12 Street, Suite 503 New York NY 10003

Authentic Movement and Witnessing in Psychotherapy Wendy Wyman-McGinty

West Los Angeles, California Authentic movement is a form of expressive psychotherapy in which an

individual uses spontaneous self-directed movement to give form to un­conscious experience, allowing them an opportunity to relate to the uncon­scious more directly. The movement occurs in the presence of the analyst who acts as a silent witness to the patient's explorations. The patient is asked to wait for an inner impulse, to allow oneself to be moved from within, rather than consciously directing or planning the movement. The movement itself, as well as any images, feelings and associations can then be explored as a communication from the patient's unconscious.

For both witness and mover, there is an opportunity to observe the inter­action between somatic experience and the development of a symbolic pro­cess. As a movement sequence develops, one can observe the somatic as­pect of symbol formation as an individual begins to link up affective expe­rience with a visual image. The role of the witness is to serve a holding function, a potential space in which to receive and reflect about the patient's experience. Overtime, as this function is internalized, the patient learns to self-witness. Finally, as a form of training, the process of authentic move­ment can help clinicians become more aware of the somatic unconscious in themselves as well as in one's patients. We will explore some of the ways in which authentic movement can be integrated into analytic practice, with particular emphasis on the role of the witnessing relationship in psycho­therapy.

The Roots of Active Imagination and Authentic Movement Authentic movement has its roots in the psychology of C. G. Jung and

his pioneering work in active imagination. Chodorow (1997) describes how Jung developed this unique way of relating to the unconscious through imagination and symbolic play. Chodorow suggests that Jung intuitively recognized the importance of symbolic play as a means of helping the indi­vidual find his way into the meaning of unconscious experience. As Jung experimented with working with the unconscious in an imaginative way, he found that the images and fantasies which emerged represented his un­conscious fears and emotions, what he later came to call the complexes (Chodorow, 1997). This personal knowledge of the importance of creative artistic expression as a means of working with the images of the uncon­scious confirmed for Jung the inherent healing power of symbolic play. Jung saw active imagination as having two parts; allowing the unconscious to come up and developing a conscious relationship towards what was revealEd. Later, after years of observation and study, Jung began to put some of these ideas into clinical practice, by encouraging his patients to utilize some form of artistic expression to give form to their inner images and experiences. Jung called this approach active imagination, to signify the relationship of an observing ego capable of relating to unconscious material through symbolic expression. Jung's fundamental belief in the natural healing function of the imagination is an important precursor to understanding the role of the creative arts therapies within an analytic con­text—namely, the idea that unconscious conflicts could be expressed and worked through within the context of the creative process. Jung believed that symbolic material could be interpreted from a reductive point of view (finding the relationship to its origins in childhood) as well as in a con­structive way (understanding what the material might suggest in terms of future development). * ,

Although Jung did not develop the idea of movement as a form of s qq active imagination (he tended to use drawing, painting and writing), he recognized that some of his female patients used spontaneous dance/ ' ^ '

Bulletin of Psychology and the Arts movement as a means of giving expression to the unconscious. (Chodorow, 1991). In another reference to the importance of movement as a means of expressing unconscious material, Jung observed that he was able to com­municate with a regressed patient by reflecting and mirroring back her ges­tures (Jung 1961). It is interesting to note that this technique of mirroring gestural movement was later developed by dance/movement therapists working with the chronically mentally i l l in the late 1950's. Although this pre-dates his work on active imagination, it suggests that Jung intuitively recognized that the importance of what patients were trying to communi­cate on an unconscious level through the body.

A Brief History of Active Imagination and Authentic Movement Authentic movement, as a form of active imagination, was pioneered by

Mary Whitehouse, a dance therapist in Los Angeles committed to the Jun-gian approach to the unconscious. She studied at the Jung Institute in Zurich, and tried to integrate the concepts of active imagination with her develop­ing work in dance/movement therapy. Whitehouse worked with analysts,' psychotherapists, dance/movement therapists and individuals interested in exploring the unconscious through movement. She called her approach movement-in-depth, and emphasized the importance of learning to wait for an inner impulse to move rather than "making" movement. She used the term authentic movement to distinguish it from ego-directed or planned movement (Whitehouse, 1979 in Pallaro, 1999).

One of Whitehouse's students was Adler, a dance therapist who has clari­fied the role of the witness in authentic movement (Adler in Pallaro, 1999). Chodorow, a Jungian analyst and dance therapist who also studied with Whitehouse has been instrumental in developing authentic movement within the context of clinical practice, particularly as a form of active imagination (Chodorow, 1991, 1999 a, b, c, d). Woodman (1980, 1982, 1983,1985) another Jungian analyst, has focused on the ways in which authentic move­ment can be helpful for women with eating disorders and other addictions. Wyman-McGinty (1998), a Jungian analyst and dance/movement therapist has addressed the nature of symbolic experience and the witnessing rela­tionship in authentic movement. Dosamantes-Beaudry (1974,1980,1982-83, 1984) has written extensively on what she calls 'movement psycho­therapy', an experientially based modality which utilizes the patient's bodily-felt experiences a means of working with unconscious experience. Lewis (1984), Chodorow (1982, 1986), Dosamantes-Beaudry (1987, 1992), and Pallaro (1996) have contributed to our understanding of the somatic aspect of the countertransference in dance/movement therapy.

Authentic Movement in Analytic Practice Within the context of analytic practice, authentic movement is used as a

means to support patients in developing their relationship to the uncon­scious. The timing of the decision to introduce authentic movement is indi­vidual, and it is important that it not be seen as the analyst taking over the patient's experience. I tend to suggest authentic movement as an experi­ence which can deepen a patient's awareness of what is going on in his body, particularly when someone is struggling to communicate something for which there are not yet words, because it is not yet available as mentalized experience (McDougall, 1989). Trauma and pre-verbal experience are two such examples. Like other expressive art forms, authentic movement can also be used to give form to the creative imagination.

For those new to this process, I typically begin by asking the person to find a comfortable position sitting, standing or lying down. Through voice and physical presence, I create a sense of a quiet protected space in which the mover can begin to turn his attention inward. I might suggest some introductory movements such as stretching, rolling the head from side to side, raising and lowering the shoulders, and tightening and releasing dif­ferent muscle groups in order to heighten an awareness of one's physical-ity. 1 then ask the mover to close his eyes, and to focus on his breathing in order to begin to shift the focus inward. I ask that he gently allow himself to notice any images, feelings and bodily sensations, and I allow himself to wait until there is an inner impulse to move—this helps the individual be­come aware of a sense of being moved from within, rather than enacting or producing movement in a more ego-directed way. Enacted movement tends to have very little affect, whereas inner-directed movement is character­ized by a sense of involvement and focused attention on the part of the mover. For both observer and mover there is a qualitative difference.

Although movement by nature is physical, the goal of authentic move­ment is not catharsis, but rather being able to hold the tension of staying in relationship to the images and affects that are generated rather than being taken over by them. The work is done with one's eyes closed, in order to

help the individual heighten his awareness of internal experience. The patient is asked to wait for an inner impulse, to allow oneself to be

lyv moved from within, rather than consciously directing or planning the

Bulletin of Psychology and the Arts movement. Focusing inward seems to support the development of reverie, a place of relaxed but conscious attention, in which images and feelings can emerge and begin to become linked within the context of a holding environment {Winnicott, 1951). The intention is to support the person in creating a potential space in which what is as yet unknown to the ego can gradually come to consciousness via the body (Wyman-McGinty, 1998).

My work as a witness at this point is largely inner, as I try to create a container within myself in which to receive the mover's non-verbal com­munication. I attend to my somatic countertransference, tracking my own bodily feelings, images and associations that emerge in response to wit­nessing my patient. In general I do not-want to be intrusive, or distract the patient from his own process, but rather wait to hear what my patient has to say. Rather than interpret someone's experience, I treat the movement as any other expression of material from the unconscious, such as a dream. 1 try to stay with the patient's associations, images and affects before offer­ing any of my own observations.

Authentic movement in clinical practice ] have found that when patients begin to focus attention on their internal

bodily-felt experience, it seems to evoke material from the personal uncon­scious, including pre-verbal experiences in the form of affective or somatic memory. Bollas (1987) suggests that somatic memory may be recovered when the patient is able to link affective experience to a mental image. For example, when the ego is unable to bear certain affects because they would be experienced as too overwhelming, image and affect are split in order to make the unbearable bearable (Wyman-McGinty, 1998). When this occurs, the affect goes into the body where it generates psychosomatic symptoms, as well as anxiety states, depersonalization and dissociation. In these situ­ations, the body holds what the mind cannot. For patients who have expe­rienced severe early trauma, the danger of returning to a state of "disinte­gration anxiety" (Kohut in Kalshed, 1996, p.34) is so great that it creates a catastrophic archetypal split in the psyche. Kalshed (1996) notes in these situations that the disowned unbearable affects are banished to the body because they are yet able to acquire symbolic representation. Authentic movement seems to help patients retrieve feelings which are not yet con­scious, although we might say that they are known to the somatic aspect of the unconscious. When patients begin to focus inward, on their physical body, unconscious materia! often emerges in the form of an image or bodily feeling which serves to conserve the original experience (Wyman-McGinty, 1998). Chodorow (1991) notes that certain memories appear to be stored kinesthetically and are able to be retrieved through body movement. Draw­ing on Stern's work in infant observation (Stern, 1985), Mitrani (1996) proposes a model for the development of body memories. The infant's ear­liest fantasies are thought to be initially recorded as body-memories be­cause they are pre-verbal, and therefore unrepresented mentally. The pro­cess of moving from the somatic level of expression to the development of thought and language requires the presence of a containing object who is able to mirror and reflect back to the infant an understanding of his physi­cal expression. This is very similar to the role of the analyst/witness who tries to contain and encode the patient's non-verbal experience. Mitrani notes that in analytic practice, these kinds of communications from a pa­tient may present as body memories trapped in the realm of the unthought, and therefore unmentalized experience (Mitrani, 1996). When the analyst can help the patient find ways to work with this material more directly, the patient is free to move towards the development of a mind-ego from the original body-ego (Freud, 1923; Mitrani, 1996). I suggest that it is the containing and metabolizing presence of the analyst/witness which allows the patient to relax defense mechanisms at such a primitive level. Through a physical and emotional presence, the analyst attempts to create a sense of trust and safety in which the unconscious material of the patient can begin to unfold in the context of a relationship between two people. The empha­sis is on the patient's non-verbal experience. Language is momentarily suspended as both analyst and mover allow the expression of the body to become primary, evoking somatic memory, whether in the form of a visual image and/or a bodily sensation which can then be explored as a communi­cation from the patient's unconscious. What was previously experienced on a somatic level is now available as something which can be taken into the mind, thought about and eventually integratEd.

Clinical experience suggests that the affects released in authentic move­ment may be difficult for patients to integrate, particularly when there is an acute sense of shame and fragmentation. They may express a fear of "being too much", of overwhelming or annihilating oneself or the analyst, of collapsing, dissolving or spilling out of one's body, suggesting tears in A the psychic skin, a sense of not holding together as an intact self (Anzieu, % l : 1985, 1990). This is particularly evident in cases of trauma in which - a J u ^

Vol 2 (2) the ego has had to split off what are felt to be unbearable affects in order to insure psychic survival. Authentic movement can intensify this process, because the defensive affects are now being expressed in the presence of the analyst/witness. The patient's struggle to bear so much unmetabolized affect in the body, and the splitting which occurs as a defense against this tension,-is constantly re-enacted in the transference. Not only does the pa­tient have to bear painful feelings which have been devalued and repressed, but he must also endure the shame of being seen by another. It is the patient's growing ability to tolerate these painful states of mind which leads to a sense of ego consolidation and a more cohesive sense of self (Wyman-McGinty, 1998). As these painful states of mind can be named and made available for analysis, a relationship can begin to be made to these aban­doned and neglected parts of the self. Rather than being deleted or rel­egated to the body where they become mute, and their pain communicated only symbolically, they can begin to be consciously lived and integratEd.

A Case Study A professional woman with rheumatoid arthritis who was able to work

symbolically, and to bear the tension of holding extremely difficult and painful feelings, used movement and the images of the unconscious to ex­plore her relationship to her illness. She often experienced me as being too active, too quick with my interpretations, 'cutting her off at the pass'. I wondered aloud i f perhaps it felt as i f I were taking over her experience so that her experience couldn't get born and 1 tried to pay more attention to why 1 felt compelled to be so responsive. Although she complained of her mother's emotional passivity, and part of her wanted a more active mother/ analyst, my behavior reminded her of her father who would interpret her experience to her and left her very little room in which to express her spon-taneous self.

In terms of my countertransference, I felt held in place, not allowed to speak. She would get agitated and angry i f I didn't get something just right. She reported that we could have 50 minutes of a good session which had a few moments of my misunderstanding her and this would make our work feel ruinEd. She realized intellectually that this was not true, and was able to articulate very early states of acute loneliness and of being left by a mother who was not able to respond her emotionally in the most basic ways. Being bright and resourceful, she would figure out ways of coping outwardly, but the more fragile, helpless or dependent parts were then split off. It was the times when she felt me helping her (or wanting to help her) that seemed to trigger her anger. 1 wondered i f it was humiliating to need an other, particularly a woman. When we talked about her feelings of let­ting me in, she had the image of a condom. While I experienced that often she did hold herself erect and stiff, the sense was that a condom could come on and off and was used for protection. As she worked in movement, the image and body experience that developed was that of being inside a walnut shell. She felt that she could come out, but that she would be vul­nerable. There was a recognition that with her own mother she wasn't able to "form in my own way". I felt that the walnut shell also represented her armored self, now carried by the arthritis. She made the connection be­tween her arthritis and the underlying psychological conflict. She experi­enced the arthritis as both a kind of freezing (her coldness towards others, shutting down, not having needs) as well as a heating up (her explosive rages). In this way she internalized the negative mother who kept her cap­tive. Her body became the battlefield.

In this example, authentic movement offered a way to begin to explore the rage and vulnerability which underlay a frozen quality and served a protective, defensive function. Using authentic movement to explore both her sense of numbing and freezing as well as the explosive rages created a larger internal space in which she could begin to make contact with a third element, the walnut shell which held her together, and protected a less formed 'true self. This example illustrates Jung's concept of the transcen­dent function, the ego's capacity to hold the tension of the opposites until an image emerges which holds a third possibility. In this case, forming a relationship to the hidden and more protected part of herself created a larger space in which the feelings of rage, vulnerability and numbness could be­gin to be explored and metabolized within the context of our relationship.

The role of the witness Witnessing is an inherent part of the analytic process. Whether we are

listening to a person's life story, attempting to unravel the meaning of a dream, or attending to the images, feelings and responses our patients evoke in us, we are engaging in a process of witnessing. We seek to know and understand what is being communicated verbally as well as somatically. To the best of our ability, we try to be fully present in the moment, in­

cluding being aware of any countertransference issues that are stimu­l i lated in us in response to what we see and hear. In our interpretations,

Vol 2 (2) clarifications and reflections we are bearing witness to the importance of what is being experienced and conveyed by our patients. There is also a reparative aspect to witnessing. By actively "bearing witness", we confirm the importance of the material presented by our patients.

Working with the creative imagination, through movement, can serve an integrating and organizing function, particularly when patients may be strug­gling to express feelings for which they may not as yet have words. Au­thentic movement, like other forms of active imagination, can give form to an inner experience, by providing a means of shaping and containing inner experience in such a way that it can be communicated to another. Move­ment, uniquely, offers a means by which the images, bodily feelings and accompanying associations can begin to be linked up in their original con­tainer, the physical body. Why, when so much of analysis is about being able to put one's experience into words, to communicate about intrapsy­chic activity, would we want to introduce a form in which words come second? A way of working in which at least temporarily, one is asked to focus all attention on the physical body? I suggest that at times we are limited by our words. Patients may use language to distance themselves from an emotional experience. Movement can be of value by helping pa­tients focus more directly on the underlying feelings in the body. Talking about an experience without a connection to the underlying affect supports a kind of dissociation. Often in cases of trauma, patients may find it diff i­cult to stay with the material without becoming fragmentEd. Authentic movement can be one way of containing the trauma. I have found that the movement in these situations tends to have a more literal and enacted qual­ity. Later, over time as the individual is able to go more deeply into the underlying affects and their associations, the movement becomes less lit­eral and more expressive. Whether or not we elect to use authentic move­ment in clinical practice, we need to find ways of including the patient's experience of the body, as well as our experience of our own body in the room, i f each of us is to be more fully present. This is especially critical with patients who have sustained trauma at a bodily level.

Issues of Transference and Countertransference in Authentic Movement

In authentic movement, one of the primary goals is to help the patient make contact with the pre-symbolic aspect of the psyche. Witnessing au­thentic movement, with the emphasis on seeing and feeling into the non­verbal experience of the mover, replicates aspects of the mirroring rela­tionship inherent in the mother-infant dyad in which the mother is able to communicate an understanding of his internal world at a bodily level (Wyman-McGinty, 1998). Initially the witness attempts to create a poten­tial space inside of her mind and body in which the experience of the mover can gradually unfold and become known. It is the ability of the witness to create a secure holding environment in which the inner world of the patient can gradually unfold and become known, which is the fulcrum of the wit­nessing relationship. Like Winnicott's 'good-enough' mother who is able to communicate to the infant an understanding of its inner world, the wit­ness utilizes her somatic countertransference (Bernstein, 1984; Chodorow, 1982, 1986, 1991; Pallaro, 1996) as a means of forming a relationship to what the mover is expressing. This includes becoming aware of her bodily sensations, as well as any images, feelings and associations that are evoked in response to the movement (Wyman-McGinty, 1998). The witness devel­ops a kinesthetic attunement, a bodily way of sensing what the mover is experiencing. In this process, the witness is actively trying to create a quiet receptive state inside her own body and mind in which to receive the expe­rience of the mover.

Dosamantes-Beaudry (Dosamantes, 1992; Dosamantes-Alperson, 1980, 1987) describes "kinesthetic identification", a form of empathic understand­ing in which the dance/movement therapist tracks the somatic experience of her clients. This is particularly important when the patient is beginning to make contact with feelings which have been difficult to tolerate and have been actively kept out of the mind, what Tustin (1986) referred to as autistic barriers. We use kinesthetic attunement whenever we are operating at the level of the somatic counter transference. We seek to understand what is being stimulated in us at a body level when we are sitting with our patients, whether or not they are moving. It is this kind of attunement which can lead to the development of kinesthetic empathy.

Witnessing draws from Bion's (1961) notion of maternal reverie, as a mental state in which conscious and unconscious communication is trans­ferred between people. Harris notes that the body's potential for metabo­lizing and registering emotional experience must also be included in our understanding of unconscious communication (Harris, 1998). Witness­ing encourages the analyst to focus both on her bodily responses to a patient, to become aware of non-verbal communications from the pa- ^\j

Bulletin of Psychology and the Arts tient, to make room for more primitive parts of the psyche to emerge. When a patient has undergone trauma such as a rape, movement can become a safer way to begin to express the rage, fear, sense of fragmentation, disso­ciation, isolation and despair that initially there are no words for. Often the incident is gone over in movement numerous times before it can begin to* be integratEd.

It is important to reflect about what expectations this work fosters in terms of the transference. It takes a certain amount of courage to allow oneself permission to express oneself through movement. The deske to be seen and the relief at no longer feeling so alone, coupled with the shame at feeling so exposed, can be a difficult set of opposites to tolerate. Both sets of feelings need to be addressEd.

In my own clinical practice, I have found it helpful to think of the wit­ness as someone who is working to create a potential space available for mutual exploration. Within this space, the contents of the unconscious can begin to emerge in an atmosphere which is non-judgmental and contain­ing. Over time the witnessing relationship can begin to be internalized, with the eventual goal of self-witnessing and self-reflection. Lucchi (1998) who has studied authentic movement and witnessing as a training modality for psychotherapists, suggests that learning to witness heightens therapists' somatic attunement totheir clients internal bodily-felt experiences, helps clinicians to differentiate self from others, and enhances one's capacity to work symbolically. Witnessing, which focuses specifically on attending to the somatic aspect of the countertransference, can be of value in helping therapists develop an understanding of and relationship to the unconscious at a pre-verbal, pre-symbolic level. By attending carefully to the images, feelings and bodily experiences of our patients, we may leam to become more aware of the subtleties of the unconscious at a somatic level. Authen­tic movement can be one way in which to create a bridge by which the unconscious may be given voice within the context of a relationship be­tween two people.

References Adler, J. (1999). Who is the witness? A description of authentic movement.

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Anzieu, D. (1985). The skinego. New Haven, CT.: Yale Universities Press. Bernstein, P. L. (1984). The somatic countertransference: The inner pas de

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Bon, W. (1961). A theory of thinking. Internationa! Journal of Psycho­analysis, 43, 306-310.

Bollas, C. (1987). The Shadow of the Object; The psychoanalysis of the unthought known^ New York: Columbia University Press.

Chodorow, J. (1982). Dance/Movement and body experience in analysis. In M. Stein (Ed.), Jungian analysis (pp. 192-203). La Salle, Illinois: Open CourtJungian Analysis

Chodorow, J. (1986). The body as symbol: Dance/Movement in analysis. In N. Schwartz-Sal ant & M. Stein (Eds.), The body in analysis (pp. 87-108). Wilmette, Illinois: Chiron.

Chodorow, J. (1991). Dance therapy and depth psychology\ London: Routledge.

Chodorow, J. (1997). Jung on active imagination. London: Routledge. Chodorow, J. (1999a). Dance therapy and the transcendent function. In

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Chodorow, J. (1999b). Dance/movement and body experience in analysis. In Pallaro, P. (Ed.), Authentic movement (pp 253-266). London: Jessica Kingsley Press.

Chodorow, J. (1999c). To move and be moved, in Pallaro, P. (Ed.), Authentic Movement (pp.267-278). London: Jessica Kingsley Press.

Chodorow, J.(1999d). The body as symbol, in Pallaro, P. (Ed), Authentic Movement (pp. 279-300). London: Jessica Kingsley Press.

Dosamantes-Alperson, I. (1974), Carrying experiencing forward through authentic body movement. Psychotherapy: Theory, Research, and Practice, IK 211-214.

Dosamantes-Alperson, 1.(1980). Contacting bodily-felt experiencing in psy­chotherapy. In J. E. Shorr, G. E. Sobel, P. Robin, & J. A. Connella (Eds.), Imagery. Its many dimensions and applications (pp. 223-236).

Dosamantes-Alperson, 1. (1982-83). Working with internalized relation­ships through a kinesthetic and kinestic imagery process. Imagination, Cog­nition, and Personality. 2., 333-343.

Dosamantes-Alperson, I. (1984). Experiential movement psychotherapy. In. PL. Bernstein (Ed.), Theoretical approaches in dance/movement therapy. Vol. 2, (pp. 257-291). Dubuque, Iowa: Kendall/Hunt.

Dosamantes-Alperson, 1 (1987). Transference and countertransference is­sues in movement psychotherapy. The Arts in Psychotherapy. 14, 209-214.

Dosamantes-Alperson, I. (1992). The intersubjective relationship between therapist and patient: A key to understanding denied and denigrated as-

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Freud, S. (1923). The ego and the id. New York: Random House. Harris, A. (1998). Psychic envelopes and sonorous baths in Aron, L. &

Anderson, F. (Eds.), Relational perspectives on the body (pp 39-64). Hillsdale, New Jersey.

Jung, C. G. (1961). Memories, dreams, reflections. New York: Vintage Books.

Kalsched, D. (1996). The inner world of trauma: archetypal defenses of the personal spirit. London & New York: Routledge.

Lucchi, B. (1998). Authentic movement as a training modality for private practice clinicians. Unpublished Doctoral Dissertation, California Graduate Institute, Los Angeles.

McDougall.J. (1989). Theaters of the body. New York: W.W.Norton. Mitrani, J. (1996). A framework for the imaginary Clinical explorations

in primitive mental states of being. Northvale, NJ: Jason Aronson. Patlaro, P. (1996). Somatic countertransference: The therapist m relation­

ship". In Conference Proceedings, Third European arts therapies confer­ence, vol }• The arts therapist., Hatfield, UK: School of Art and Design, University of Hertfordshire.

Schwartz-Salant, N. (1982). Narcissism and character transformation. Toronto, Canada: Inner City Books

Schwartz-Salant, N. (1986). On the subtle-body concept in clinical prac­tice. In N.Schwartz-Salant, & M. Stein (Eds.), The body in analysts. Wilmette, Illinois: Chiron.

Vol 2 (2) Stern, D. (1985). The interpersonal world of the infant: A view from psy­

choanalysis and developmental psychology,. New York: Basic Books. Tustin, F. (1986). Autistic barriers in neurotic patients. New Haven: Yale

Universities Press. Whitehouse, M. (1999). C. G. Jung and dance therapy. In Pallaro, P. (Ed.),

Authentic movement (pp.73-101). London: Jessica Kingsley Publishers. Winnicott. D. W. W. (1951). Transitional objects and transitional phenom­

ena. Playing and reality. New York. Basic Books Woodman, M. (1980/ The owl was a baker's daughter. Toronto: Inner

City Books. Woodman, M. (1982). Addiction to perfection: The still unravished bride.

Toronto: Inner City Books. Woodman, M. (1983). Psyche/soma awareness. Quadrant, 17, 25-37. Woodman, M. (1985). The pregnant virgin. Toronto: Inner City Books. Wyman-McGinty, W. (1998). The body in analysis: authentic movement

and witnessing in analytic practice. Journal of Analytical Psychology, 43, 239-260.

Wendy Wyman-McGinty C. G. Jung Institute of Los Angeles 10349 West Pico Blvd. Los Angeles, CA. 90064-2694

Message from the President-Elect Jerome Singer Yale University

I want first of all to express my thanks to the Members of Division 10 for honoring me by electing me . Even in a troubled time like this it is impor­tant to sustain the great value for humankind of the arts and of culture and creativity. My goal in my forthcoming years of service to the Society will be to show how the best features of psychology,systematic research and theory can help us to understand and to improve the various forms of artis­tic achievement. I believe that the accomplishments in structure and con­tent from the the arts can also guide us in formulating theory and method in psychology. Our first step w i l l be to bring together research psychologists,artists of various sorts and I hope psychologists who have also made contributions in literature ,the visual arts,music and performance at our next APA Convention in Chicago. Your suggestions are most wel­come.

\

Message from the Fast President Sandra W. Russ

Case Western Reserve University I want to review the activities of Division 10 over the past year, During

the time that I served as President. Colin Martindale was selected as Editor of the new Bulletin of Psychol­

ogy and the Arts. The two issues of the Bulletin have been of very high quality. Our appreciation goes to Colin for his expertise and very hard work as editor.

I had appointed a Task Force whose mission was to find a way to Bridge the gap between between research and applied activities in the arts. Lauren Seifert chaired the Task Force which is now the PAIR Task Force ("Pro­moting Applications Integration with Research"). Lauren gave a report from the committee at the Executive Committee meeting at APA. One of their recommendations was to carry-out a survey of the members of Division 10 about their applied and research interests. The Executive Committee ap­proved this recommendation and you should be receiving the survey in the mail soon. The committee also recommended a symposium on this issue at APA 2002. Our thanks to the committee whose members are, in addition to Lauren, Jan Airman, Brian Betz, and Will Wadlington.

The Division is also establishing a student committee who will be Fo­cusing on increasing student involvement in the Division.

Frank Farley was Program Chair this year and put together an Excellent program at APA. The paper sessions and symposia were excellent and well attended.

At the Executive Committee meeting and Business meeting, we made a number of decisions.

The Newsletter will now be on the Website. Stephanie Dudek will be the editor of the newsletter. The Newsletter will include material that is not in the Bulletin. The Executive Committee felt that there was a need for a

separate Newsletter that contained information about the Division and its members. The name change for the Division was discussed and the

members at the Business Meeting voted for another revision to the

Vol 2 (2) Bulletin of Psychology and the Arts

name . The proposed name of the division is "Society for the Psychology of Aesthetics, Creativity and the Arts'*. The ballot for the vote by the entire membership wil l be arriving soon. There wil l be a mail ballot that wil l also include a vote on several other issues. We need a vote on changing the Newsletter to a Bulletin and also on making permanent the ad hoc commit­tees that have been in place the last few years and have been working well.

The Executive Committee also voted for a dues increase. For members, the annual dues will be $25 (increased from $ 17) and for students the dues will be $15 (increased from $10). We are also asking dues exempt mem­bers to pay $20 for the Bulletin i f they wish to receive it. The reason for the dues increase is to provide funding for the new Bulletin and for activi­ties that the Division may undertake in the future. We also explored other ways to increase funds. We are beginning a book series. Bob Sternberg has graciously offered to edit the first book with the royalties going to the divi­sion. Also, we are xploring the possibility of sponsoring CE offerings at APA.

The Executive Committee also decided to initiate a student research award. This award will be a recognition for student research in the area of aesthetics, creativity, and the arts.

As you can see from all the activity, we have a proactive Executive Com­mittee and membership. It is important that this activity continue and that new initiatives develop. Our new President, Frank Farley, and President-Elect, Jerome Singer, have exciting ideas for the future and for the 2002 APA meeting.

I greatly enjoyed being President of Division 10. I want to thank the Executive Committee for being such a good group to work with. And I want to thank the members for the honor of serving as President of this important division. As we enter a difficult time for our country and the world, aesthetics, creativity, and the arts wil l be especially important to nurture. I look forward to working with you in the future.

Message from Bob Sternberg Robert J. Sternberg

Yale University Hi. As Past-Past President, I have only a brief statement. 1 have sug­

gested that Division 10 raise money by starting a book series, with the royalties for the books going to Division 10. I am working with Elena Grigorenko and Jerry Singer on editing the first such book, which wil l be on domain-specificity in creativity: Is creativity the same thing in the arts, sciences, business, and other fields? I f so, why? I f not, how is it different? We wil l be seeking authors to write for this book this coming fall.

I ran for the Presidency of APA and have just learned that I won the election. I want to take this opportunity to thank all of those who supported my candidacy. As a Past-President and continuing member of the Execu­tive Committee of Division 10 (as Chair of the Awards Committee), 1 be­lieve I wil l represent the interests of Division 10 in a particularly compel­ling way.

Announcements Executive Committee Meeting

At its 2001 meeting in San Francisco, the Division 10 Executive Com­mittee voted to increase dues in order to keep pace with inflation. Dues for members have been increased to $25, and dues-exempt members must now pay $20 i f they wish to receive the Bulletin of Psychology and the Arts, which wil l no longer appear at the Division 10 web site. Unfortunately, this information was not communicated to APA in time. Members will soon be receiving mail ballots concerning changes to the Division 10 by­laws. These will be accompanied by forms that can be sent to APA in order to pay any dues owed. Dues were also slightly increased for student and affiliate members, but the dues statements received by such members from APA indicated the correct amount.

It is standard practice for divisions to charge dues-exempt members for bulletins and journals. The Executive Committee also voted to separate the Bulletin of Psychology and the Arts and the Division 10 Newsletter. Stephanie Z. Dudek has been named editor of the newsletter. At least for the moment, the newsletter will be at the Division 10 web site fwww.apa.org/ divisions/divlO) but wil l not appear in print form. The bulletin will carry

only crucial items from the newsletter. The Executive Committee reiterated its support for the following

^ amendments to the bylaws.

Bulletin of Psychology and the Arts Vol 2 (2)

Proposed Bylaws Changes The Division 10 Executive Committee has endorsed the following amend­

ments to the Bylaws. Members will receive mail ballots in due course. The listserv provides a nice forum for discussion of the proposed changes.

1. The word 'bulletin' should replace 'newsletter' throughout the by laws. Rationale: This is merely a formality. The Newsletter still exists but has been incorporated into the Bulletin.

2. The ad hoc committees established in 1999 (see p. 48) should be made permanent and the current Committee on Nominations, Members, and Fel­lows abolished. Rationale: The ad hoc committees have worked very well. At present, the only official committee of the division is the Committee on Nominations, Members, and Fellows. This gives far too much work to a single committee. Apparently, this committee has had neither a chair nor members for a number of years.

3. The name of the division should be changed from 'Psychology and the Arts' to 'Society for the Scientific Study of Aesthetics, Creativity, and Psy­chology of the Arts'. Rationale: The current name does not accurately re­flect the interests of members of the division, whereas the proposed new name does. It is also felt that the new name will help in getting new members.

Forthcoming Conferences The 10th Anniversary Conference of the European Society for the Cogni­

tive Sciences of Music, Liege, Begiurn, 5-8 April, 2002. Information at musicweb.hmt-hannover.de/escom/english.htm.

The 19'h International Conference on Literature and Psychology, Uni­versity of Siena in Arezzo, Italy, 4-9 July, 2002. Information at www.clas.ufl.edu/ipsa/intro.htm.

The 17lh Congress of the International Association of Empirical Aesthet­ics, ' 4-8 August, 2002, Takarazuka, Japan. Information at www.iaea2002.gr.jp or www.ume.maine.edu/~iaea.

The 8"1 conference of the International Association for the Empirical Study of Literature, Pecs, Hungary, 21-25 August, 2002. Information at www.arts.ualberta.ca/igel.

Division 10 Internet Resources Members are encouraged to join the Division 10 Listserv. To join,

send email to Sarah Benolken (benolken@aol.com V The listserv pro­vides a valuable forum for ongoing discussions as well as announce­ments of interest to members.

The Division 10 web site, managed by Jonathan Plucker, is at www.apa.org/divisions/div 10 The site contains announcements of in­terest to members, information about division awards, links to sites of interest, listings of recent dissertations, books, and articles relevant to the division, a version of the Bulletin of Psychology and the Arts, and information about the division including a downloadable and printable membership application form. I f anyone has ideas about the site or information to be added, contact Jonathan Plucker, Indiana University, 201 N. Rose Avenue, Bloomington IN 47405 (Emai l : jplucker@indiana.edu).

Division 10 Newsletter Editor: Stephanie Z. Dudek

The goals of the Division 10 Newsletter differ from those of the Bulletin in the following important ways.

1) The Newsletter is concerned with news about members, about your own activities, your publications, your needs.

2) My goal is to publish news of interest to members about information that you consider important to share or about which you want to invite com­mentary from your colleagues.

3) Information about your preoccupations, your concerns and your own publications is particularly welcome.

4) I f you have books for review or books you want reviewed, please send them to me at my office, S.Z. Dudek, Department of Psychology, University of Montreal, cp 6128, Succurale A, Montreal, PQ, Canada.

5) Perhaps the most important goal of the Newsletter is to offer you a venue for your own writing. I cannot accept short stories bu the Poetry Corner exists inviting you to send original poetry for consideration by your editor. But please do not send more than five poems at any one time.

! will also be glad to review your books of poetry i f they are already published. In that case, send them to be at Department of Psychology, Uni­

versity of Montreal cp 6128, Succurale A, Montreal, PQ, Canada. Deadlines for submissions to the Newsletter are October 15 and Feb-

' ruary 15 of each year. ,, ?V The Newsletter may be found at www.apa.org/divisions/divl 0.

Vol 2 (2)

Officers of Division 10 President Frank Farley (2001-2002)

President-Elect Jerome Singer (2002-2003)

Past-President Sandra W, Russ (2000-2001)

Sec reta ry-Treasu rer Constance Milbrath (1999-2002)

APA Council Representative Nathan Kogan (2001-2004)

Members-at-Large to the Executive Committee Stephanie Z. Dudek (1999-2002) Paul Locher (2000-2003) Ruth Richards (1999-2002)

Bulletin Editor Colin Martindale (2001-2003)

Newsletter Editor Stephanie Z. Dudek

Ad hoc Committee Chairs (2000-2001) Awards: Robert J. Sternburg Fellows: Frank Farley Membership: Sarah Benolken Nominations: Colin Martindale Publications: Sandra W. Russ

Bulletin of Psychology and the Arts Colin Martindale, Editor Scarlett Davis, Associate Editor and Publisher

Board of Editors Sarah Benolken, New York NY Paul Camic, Columbia College Diana Deutsch, University of California, San Diego Leonid Dorfman, Perm State Institute of Arts and Culture

Gregory J. Feist, College of William and Mary Norman Holland, University of Florida Paul Locher, Montclair State University Pavel Machotka, University of California, Santa Cruz Mark Runco, California State University, Fullerton Dean Keith Simonton, University of California, Davis Jerome Singer, Yale University Robert J. Sternberg, Yale University Will Wadlington, Pennsylvania State University Ellen Winner, Boston College

Bulletin of Psychology and the Arts

Past presidents of Division 10

Paul M. Farnsworth

Norman C. Meier

Paul M. Farnsworth

Kate Hevner Mueller

Herbert S. Langfeld

R. M. Ogden

Carroll C. Pratt

Melvin G. Rigg

J. P. Guilford

Rudolf Arnheim

James J. Gibson

Leonard Carmichael

Abraham Maslow

Joseph Shoben, Jr.

Robert B. Macleod

Carrol] C. Pratt

Harry H el son

Rudolf Arnheim

Irving L. Child

Robert L. Knapp

Sigmund Koch

Marianne L. Simmel

Rudolf Arnheim

Frank Barron

Michael A. Wallach

Frederick Wyatt

Daniel E. Berlyne

Julian Hochberg

Edward L. Walker

Joachim Wohlwil l

Pavel Machotka

Ravenna Helson

Nathan Kogan

Salvatore R. Maddi

Stephanie Z. Dudek

Brian Sutton-Smith

Henry Gleitman

Dean Keith Simonton

Colin Martindale

Kenneth J. Gergen

Lawrence L. Marks

Nathan Kogan

Margery B. Franklin

Howard E. Gruber

John M. Kennedy

Robert S. Albert

Martin S. Lindauer

Ellen Winner

Gerald C. Cupchik

Mark Runco

Louis A. Sass

Robert J. Sternberg

\ Sandra W. Russ

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Ho l l i s Stgler - We Have So ld our Souls to the Dev i l Cotirtesv of the Estate of Mol l is Stgler

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