Is Art Therapy a Heuristic Interpretive Device?

In May this year I was woken from my slumber on a Sunday morning by my radio alarm and the ironic, dulcet tones of Will Self - an English novelist, journalist, political commentator and television personality - addressing a very contemporary battle of ideas.

He refers to this simmering conflict as ‘Psy Wars’. This, coincidentally, relates to the comments I made in a previous post about the current position of art therapy in hospice and palliative care. It is in fact the huge question facing the protagonists involved in defending and promoting what can seem like opposing philosophical positions when defining the human psyche and how to respond to its infinitely complex manifestations and expressions. The body versus mind duel seems to be intensifying, with opponents measuring up to each other with gusto and ever-increasing rhetorical verbosity.

Will Self reminds his audience that research in the UK shows that between 1998 and 2012 the annual prescription of antidepressants has increased to a staggering 25 million tablets. The medicalisation of the mind and the troubled soul is a major contention within this debate. Many attempts have been made to advance a holistic approach to the mind, but it is perhaps a reflection of the medical might that still exists within British health care institutions that the ‘medical model’ often overwhelms the ‘psychosocial model’. Of course I do not assume that such ‘models’ are entirely separate categories residing in irreconcilable domains of existence. It is perhaps more to do with economic expediency and a consequently reductive view of the human condition: body over mind rather than body with mind. Self refers laconically to the musician Morrissey’s lyric: ‘Does the body rule the mind or does the mind rule body? I dunno.’ These lines taken from his song ‘Still Ill’ released in 1984 reflect not only the preoccupation of the professionals and academics but quite possibly a refrain amongst those who are suffering some physical and/or mental distress in the population as a whole (that person is often generically referred to as either the ‘client’, ‘patient’ or ‘service user’ in the British health and social care system). Self is certain we don’t know the answer to this question and believes it is unlikely that we will ever know. Such is the corporeal dilemma of the human condition irrespective of any spiritual or religious inclination, which is also a theme that seems to cause added consternation within some quarters of the psychological and psychotherapeutic collegiate. Psyche and spirit are arguably interchangeable terms, but at this point I do not wish to increase the heat within the debate but only to acknowledge that spirituality is a significant aspect of the holistic perspective and requires as much sensitive attention as other facets of human experience. Self is right to acknowledge that Christian ideas of the immaterial soul continue to influence Western philosophy.

Self goes on to promote a view that care of the psyche or the mind could be considered as a process of applying ‘...heuristic, interpretive devices’, that don’t necessarily sit within any categories, and avoid exacerbating an already potentially divisive form of body-mind dualism. I think Will Self has a point. I am interested in the application of the heuristic process within art therapy and the view that there is an ‘interpretive stance’ (Shapiro and Carr, 1991, p75-87) adopted by the practicing art therapist in response to the triadic relationship of client, therapist and the image contained within the artefact. The ‘interpretive stance’ is an attitude and a response to the detailed nuances of an individuals account and expression of suffering and psychic distress by formulating a hypothesis and testing that continuously within the developing therapeutic relationship. It is the discipline of self-critique and reflexivity: the reflective examining of attitudes, beliefs, thoughts, feelings and physical responses in order to achieve an accurate understanding of the clients needs. I tend to think of this as the collaborative dialogue between myself and the client. We are working together to get to the heart of the matter - to arrive at some mutual understanding and agreement as to the cause of distress and a way to alleviate it. We live in a period when there is a plethora of approaches to psychology that influence the theory and practice of psychotherapeutic interventions with diverse conclusions about the most effective way to reduce psychic pain in all its varying manifestations. I think there is a strong case for an interdisciplinary approach. Introduce art and you widen that perspective even further as a recognition that human beings throughout history have communicated their experience using symbols, signs, metaphor, poesis and language (to name but only a few cultural faculties).

Is art therapy a heuristic interpretive device? I certainly think that interpretation is unequivocally the domain of the psychotherapist. Interpreting what the client is communicating and experiencing is a skill that has to be developed and refined. It is an aspect of analytical thinking that gathers information and endeavors to reflect on this in order to, for example, differentiate as clearly as possible the thoughts and feelings of the therapist and those of the client. The interpretive stance conjoined with the inner process of exploration, discovery, learning and transformation for both the therapist and the client is amongst the many sophisticated methods employed in art therapy. Ensuring the autonomy of the client is maintained and validating their inner ability to arrive independently at moments of insight, learning and adaptation is undoubtedly an ethically driven aspect of psychotherapeutic practice. As for art therapy being a process of employing ‘devices’, I am not too comfortable with the mechanistic implications of such a term. Psychotherapy is a form of mutual learning for all parties. Heurism and interpretation could be considered as modes of performance and improvisation within the developing and unfolding therapeutic relationship (See Hauerwas, 2004, for an interesting exploration of the relationship between performance and improvisation in the arts and expressions of faith). It is a stance that recognizes that the client’s inner world can often appear mysterious, and requires the creative use of language to make sense of, and derive meaning from, what we observe, hear, feel and think about the client’s engagement with art therapy.

I can feel the pressure within the current climate to nail my colours to the mast. I am trying, perhaps in vain, to resist the temptation to reduce my practice to a set of prescribed formulas that proscribe alternatives. However, I don’t see this as a battle, although now and then I am drawn into rather fruitless skirmishes. The challenge is perhaps to do with the question of how the increasing levels of mental distress amongst the population as a whole can best be alleviated and how all modalities can support this humanitarian task. This is without doubt a philosophically and politically charged period in the UK for mental health practitioners. In recent years state funded mental health services, certainly in England, have been subject to severe financial cuts. For art therapists there is the pressing requirement to be more specific about what we do and establish an evidence base. Perhaps the different psychological professions and disciplines engaged in their respective therapeutic projects across our nation require an heuristic interpretative device applying to their intentions and motivations. Dialogue is at the heart of our practice so perhaps there needs to be a commitment from all parties to more genuine, mutual discussion and less ”...jaw, jaw”, as Will Self is apt to describe the current state of affairs.

References

Hauerwas, S (2004) Performing the Faith: Bonhoeffer and the Practice of Nonviolence. London: SPCK

Self, W. Psy Wars. BBC Radio 4 A Point of View. Broadcast 22.05.16

Shapiro, E, R and Carr, A, W (1991) Lost in Familiar Places. New Haven & London: Yale University Press.