Art therapy can be a way for people with physical or emotional pain to heal.

Janette is six years old, her brown eyes weary with the haunted wisdom of a child who has seen more than any six-year-old should ever see. She witnessed her father, in the frenzy of an alcoholic rage, kick her pregnant mother in the stomach and saw the police come and drag her father out of the room, and she was there when her bruised and tearful mother returned from the hospital and told her that she wasn't going to have a baby sister after all.

It can be difficult for a six-year-old or 60-year-old, for that matter to find the words to articulate the pain of these memories. But children and adults who've been exposed to unspeakable trauma, as well as those suffering from depression, anxiety, or other serious mental or physical illnesses, can reap enormous benefits from the healing process of art therapy a therapy which uses paint and paper, glue and scissors, images and colors to symbolically express the depth and intensity of emotional pain.

Art as a Gateway to the Subconscious

The American Art Therapy Association (AATA) defines art therapy as "a human service profession that utilizes art media, images, the creative art process, and patient/client responses to the created products as reflections of an individual's development, abilities, personality, interests, concerns, and conflicts."

Although human beings have used art as a mode of expression for thousands of years, art therapy was not recognized as a distinct profession until the late 1930s. That's when Margaret Naumberg, who is considered the "mother of art therapy," advocated using art as a gateway to the subconscious in conjunction with free association and psychoanalytic interpretation.

Artist Adrian Hill took credit for inventing the term "art therapy" in 1942. While recovering from tuberculosis in a sanitarium, he felt that his own foray into art led to his emotional recovery. Introducing painting to his fellow patients, he found that they used artistic expression not only for enjoyment but also as a vehicle for expressing fears and emotions.

Recognizing that artwork could be useful in helping patients express internal conflicts, the psychiatric staff at the Menninger Clinic in Kansas began to employ art as therapy. The first journal in the field, The Bulletin of Art Therapy , was published in 1961, and the AATA a national professional organization that regulates educational, professional and ethical standards for art therapists was established in 1969.

Where Art Therapy Can be Useful

According to the AATA, art therapy is based on knowledge of human developmental and psychological theories and is an effective treatment for people with developmental, medical, educational, social, or psychological problems. Art therapists must possess a minimum of a master's degree and undergo a supervised practicum and postgraduate internship. They are registered (the credential "ATR") and/or board certified ("BC") and practice in a variety of settings, including:

  • Community mental health centers and psychiatric clinics
  • Hospitals, rehabilitation facilities, and hospices
  • Correctional and forensic facilities
  • Nursing homes and senior centers
  • Schools and early intervention programs
  • Disaster relief centers and homeless shelters
  • Drug and alcohol rehabilitation programs

Art therapists can practice solo or may be part of a treatment team that includes physicians, psychologists, nurses, social workers, counselors, and teachers. Art therapy, done in individual or group sessions, can be used with patients of all ages, races, and ethnic backgrounds who have any one of a number of physical and emotional disorders, including:

  • Schizophrenia, depression, and other mental illnesses
  • Post-traumatic stress disorder caused by natural disasters, upsetting events, or abuse
  • Eating disorders
  • Substance abuse
  • Chronic pain, medical problems, or terminal illness
  • Family issues

"Beginning with scribbles and lines, children express their feelings and needs through art even before verbal language is learned," says Noah Hass-Cohen, MA, ATR-BC, MFCC, of the Los Angeles Institute for Art Therapy. "Art therapy provides a nonthreatening place to release feelings and pent up emotions and may be especially useful for children and adolescents in times of family and individual crisis and/or change."

Inside Art Therapy

The two different poles of art therapy are termed "art psychotherapy" and "art as therapy."

Proponents of "art as therapy" suggest that the process of creating art itself is curative and that verbal reflection, discussions or interpretations about the art itself is not necessary. According to Cathy A. Malchiodi, author of The Art Therapy Sourcebook , creative activity increases brain levels of serotonin, a hormone associated with feelings of well-being, and gives rise to the alpha brain wave patterns typically seen during periods of relaxed alertness.

Advocates of "art psychotherapy" believe that artwork is most useful when used as a tool to elicit feelings, fears and fantasies, which can then be worked through in traditional talk therapy.

Regardless of their orientation, most contemporary art therapists integrate a variety of approaches, individualizing the treatment to best meet the needs of a specific client.

Different Techniques for Different Issues

Special techniques are often particularly useful in helping patients express their feelings, develop social skills, solve problems, reduce anxiety or resolve emotional conflicts. In the unstructured approach, patients might select from a variety of materials and media (paint, pastels, clay) and use them however they choose, allowing unconscious material to rise to the surface. Then the therapist might ask the client to draw a family picture, which can help elicit complex family dynamics such as unhealthy patterns of relating or poor communication skills.

Groups of people struggling with similar issues, such as cancer survivors, might work together to create a collage or mural that can then be used to stimulate discussion of coping strategies.

Ava Charney-Danysh, ATR-BC, finds art therapy very useful in her work with children and adults who have eating disorders. "Obsessions with food and weight are often attempts to cope with unresolved emotional issues such as depression, rage, powerlessness and loss," she explains. "Art therapy is a special tool that can help provide access to those hidden feelings that contain the key to our struggles."

New York City art therapist Sandy Izhakoff works with neurologically impaired adults in nursing homes and in senior citizen centers. She uses art therapy techniques such as free-drawing, mask-making and finger-painting to help even nonverbal patients perform ]]>life review]]> , express regrets, resolve unresolved losses, and come to terms with issues such as aging, grief and fear of death.

How It Might Work

The theory behind art therapy is based partially on the fact that creativity and healing may come from the same place.

"At the deepest level, the creative process and the healing process arise from a single source," says Rachel Naomi Remen, MD, assistant clinical professor of family medicine at the University of California at San Francisco School of Medicine.

According to the experts, art therapy is not merely "arts and crafts," or purely recreational. It is multi-sensory and teaches people to use objects purposefully and to communicate their pain with the outside world.