Along with many art therapists, I sometimes struggle to articulate exactly how art therapy works. In response to this question recently posed by Cathy Malchiodi, I am going to attempt to explain it via a case study. Details have been changed to protect the identity of the client, who has since passed away.
Many years ago, I worked extensively in nursing homes. One resident was in the late stages of an illness that was greatly exacerbated by his diet. Many battles ensued between him and nursing staff over his constant intake of food that worsened his condition. The attending psychiatrist asked me to work with him to address this problem. I imagined that our work would focus on his body image (as he was morbidly obese), his declining health and the struggles with nursing staff.
This case ended up being a lesson for me in person-centered planning. He had no interest whatsoever in focusing on what I considered to be the primary problems. He was, however, very interested in painting even though he had never done it before. During our first session, he pulled out a book of postcards that depicted various nature scenes on the West Coast. The time he spent living in that part of the country was the happiest time of his life and he wanted to capture these images in paint. I brought him a set of acrylic paint, some brushes and paper and we were off and running.
Over the course of time, nursing staff started to notice that he was quite gifted as a painter. He painted all weekend instead of eating all of his favorite snacks. Nurses checked in to admire what he was working on instead of to scold him for what he was eating. A few even commissioned works from him. While he painted, he reminisced about his time on the West Coast and his younger days.
We never spoke of his diet, his weight, his battles with nursing staff. We talked about line, shape, form, color, harmony, and composition. I listened while he told me of adventures from his youth, his life and loves. I accompanied him on his journey. By the time he was discharged from the nursing home, his relationship with the staff was a positive one and his diet had improved.
So how did art therapy work in this case? Art became a healthy coping skill, allowing this client to engage in a positive activity to manage his feelings, rather than burying them in food. It became a conduit in his relationships with others, allowing them to see his strengths rather than focusing on his deficits. Art was the language that joined us together in our relationship. He benefited from the time and attention I gave him and from my willingness to follow him where he needed to go in therapy.
This case was a good lesson for me. I had to let go of my ideas about what this client needed and not impose my treatment priorities on him. And guess what? He found exactly what he needed.