art exhibitions as a therapeutic intervention for adults with mental illness md 2
TRANSCRIPT
ART EXHIBITIONS AS A THERAPEUTIC INTERVENTION FOR ADULTS WITH
MENTAL ILLNESS
by
Melissa Diaz
©2011 Melissa Diaz
A thesis
submitted in partial fulfillment
of the requirements for
the degree of Masters of Professional Studies
(Art Therapy and Creativity Development)
School of Art and Design
Pratt Institute
February 2011
Exhibiting Artists with Mental Illness ii
ART EXHIBITIONS AS A THERAPEUTIC INTERVENTION FOR ADULTS WITH
MENTAL ILLNESS
by
Melissa Diaz
Received and approved:
_________________________________________ Date____________________
Thesis Advisor –Ann E. Smith, Ph.D., RDT-BCT
_________________________________________ Date____________________
Chairperson – Jean Davis, MPS, ATR-BC, LCAT
Exhibiting Artists with Mental Illness iii
TABLE OF CONTENTS
ACKNOWLEDGEMENTS……………………………………………………………..v
LIST OF FIGURES……………………………………………………………………..vi
ABSTRACT…………………………………………………………………………….vii
Chapter
1. INTRODUCTION………………………………………………………………1
Installation Artist as Art Therapist: Art Exhibitions Therapeutic Value
Literature Review
Mental Illness
Art Therapy
Art Product: Role of Art Object in Art Therapy
Object Relations Theory
Exhibition Space as Therapeutic Environment
Holding Environment and Transitional Space
Play Space within Transitional Space and Holding Environment
Therapeutic Environment as Third Hand
Art of the Mentally Ill
Art Exhibitions in Art Therapy
Exhibition Space within Treatment Facility
Therapeutic Benefits of Artist Identity
Therapeutic Elements in Organizing an Exhibition
Brining the Art to the Public
Conclusion
2. STATEMENT OF RESEARCH PROBLEM…………………………………..38
Research Question
Definitions of Terms
Limitations/delimitations
3. METHODOLOGY AND PROCEDURE……………………………………....45
Research Approach
Research Methodology
Research Procedures
Setting
Population
Exhibiting Artists with Mental Illness iv
Ethics
4. FINDINGS………………………………………………………………………53
Open Coding
Axial Coding
Figure 1: Paradigm Model
Description of Categories
Community
Art Making Process
Identity
Previous Forms of Treatment
Outcome of Art Product
Emotional Involvement toward Exhibiting
Control Over Life
5. DISCUSSION………………………………......................................................60
Development of Mastery
Intervening Conditions
Long History of Art Making
Community
Art Making Process
Identity
Previous Forms of Treatment
Outcome of Art Product
Emotional Involvement toward Exhibiting
Control Over Life
Mastery
Discussion of Implications
Further Studies
6. CONCLUSION…………………………………………………………………94
REFERENCES……………………………………………………………………...96
Appendix……………………………………………………………………………106
Exhibiting Artists with Mental Illness v
List of Figures
Figure 1. Paradigm Model, Axial Coding on p. 57.
Exhibiting Artists with Mental Illness vi
Abstract
This study explored the therapeutic value of adults with mental illness participating in art
exhibitions. The researcher interviewed participants of studio art and gallery programs
that utilize the developmental model as a way to decrease stigma and encourage
empowerment through use of artist identity. Grounded Theory methodology was
employed as way to identify a central phenomenon, grounded in interview data. Based on
five in-depth, open-ended interviews, Mastery emerged as the central phenomenon. This
finding relates to use of creating and exhibiting art as a way to gain a sense of mastery of
one’s life. The researcher hopes this study can engender destigmatization while
increasing the incorporation of the artist identity and art exhibitions in art therapy
treatment.
Exhibiting Artists with Mental Illness
1
Art Exhibitions as a Therapeutic Intervention for Adults with Mental Illness
Installation Artist As Art Therapist: Art Exhibitions Therapeutic Value
During the formative stages of my thesis writing process, it became clear to me
that I was in transition; feeling ambivalent towards the desire to create art and my need to
continue writing. It was at this time I also felt torn about my thesis topic. Did I want to
create an auto-ethnographic narrative related to my experience as an installation artist, or
continue with my current topic of researching the impact of art exhibitions on artists with
mental illness? I have often looked to my experience as an installation artist to support
my efforts to become a therapist. During the toughest moments of my art therapy
training, I found refuge in either creating an installation or reminding myself of the
principles I use in art making to reiterate my role as an art therapist. I realized the true
essence of my artistic expression is melding objects together in space. Why then could I
not do the same for my thesis work? By describing my work as an installation artist I can
further explain my journey to my thesis topic.
When creating an installation I work on site, at the exhibition space, often times
under a tight time constraint due to the soon pending opening. Fueled by the energetic
adrenaline of these time confines, I find myself lifted into a realm of attunement with the
space, constructing in a state of mindfulness, leading to acute awareness. I work in an
improvisational, intuitive manner, incorporating time, space and energy. I grapple with
boundaries and alternative realities; in essence I can create habitats that resemble real
environments, yet do not actually exist in the tangible world.
Exhibiting Artists with Mental Illness
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Constructing large scale visceral environments allows the viewer to enter into, and
engage with the space. I see these environments as homes and safe spaces, acting as
Winnicott’s (1971) concept of transitional space, a realm existing between subjective and
objective reality. I extend this concept of art space as transitional space to exhibition
space as well, therefore proceeding with my original topic became more relevant to me
and my own lived experience of exhibiting.
I stumbled upon installation art through naiveté and frustration. I had never seen
an installation nor studied this genre of art, but during the sophomore year of my BFA
program, I began to yearn for a more embodied art experience. As a painting major, I was
feeling confident about my progress with the medium; using art as a form of personal
therapy, I created large self-portraits depicting spectrums of feeling states. However, I
began to feel confined and stunted by the boundaries of the canvas. I moved from self-
portraiture to images of birds as self metaphor. I painted birds in flight, amidst or tied in
clumps of yarn, I draped bunches of yarn around the canvases, creating more of a three-
dimensional painting. I soon realized how trapped and stifled these birds appeared,
representing a metaphor for how I felt about painting. The only element that felt truly
satisfying was the clumps of yarn mounded on the canvases.
I decided I needed a big change; I achieved this by transforming my painting
studio cubicle into a three-dimensional painting. This cubby space, regularly used for
storage and work space, became a sanctuary where I felt transported into another world.
Before I even realized it, I was immersed in creating an ongoing installation piece. This
medium allowed me to share my artwork and process in a new way; now others could
Exhibiting Artists with Mental Illness
3
literally step into my world of creation. I found an escape from the rigidity of the canvas,
unlike painting and drawing, this art expression lied in the actual install of the piece.
Installation art’s site-specific nature required exhibitions in order to thrive;
therefore exhibiting my art became a crucial component to creating my works. I used
exhibitions to construct installations that formed a shared energy between art, artist, and
viewer. Inviting the audience into the installation space incorporated the viewer as a part
of the creation. Once within the space, the viewer becomes a co-creator; this is similar to
elements of co-creating found in therapeutic space between patient and therapist.
I began organizing group and solo exhibits at my university and in the
community; this filled my final year of undergraduate studies with an extremely active
exhibition schedule. After each exhibition, I began to feel more confident and
empowered. Within the exhibition space, I sensed my true self emerging, allowing me to
share intimate pieces of myself through artistic metaphor. The external validation I
received during these exhibitions led to increased self-esteem and artist identity. I still
look to my artist identity to find strength, by transforming external space, I transform
inner space within myself.
These early exhibition experiences further propelled my curiosity towards the
relationship between art, artist identity, healing, and wellness. This interest continued
throughout my art therapy training; having realized the therapeutic value exhibitions have
had in my life, I wondered about the effects exhibitions could have on art therapy clients.
At my second year internship, I was fortunate enough to experience the function of a
permanent art gallery incorporated as a part of the art therapy program in an adult
Exhibiting Artists with Mental Illness
4
psychiatric hospital. At this internship site, I witnessed the transformative experiences
that exhibiting in the gallery created for the clients.
I also had the opportunity to give individual art therapy sessions to one of the
continuing day treatment patients, 47 year old schizoaffective patient, Keith, had attended
the program for the past 15 years. We worked together once a week for four months.
Although this was his first experience with individual art therapy (mine as well), the
client was also a regular to group art therapy. Our work together involved using an art as
therapy approach, as coined by Kramer (1971), a therapeutic approach based in the idea
that the art making in itself holds therapeutic value and opportunities for transformation.
I approached these sessions from a non-interpretive stance in order to form a non-
judgmental and non-threatening environment. I worked in this framework for several
reasons, I was aware that Keith was experiencing some mildly forceful, interpretive, and
often impersonalized therapeutic approaches in his other therapies. His art and style was
even being challenged for maladaptive qualities by therapists involved in his treatment,
yet not involved with art therapy. I was also aware that Keith enjoyed making art; his
dedication to art making was evident by his overflowing art studio folder. Therefore, I
aimed to create a therapeutic opportunity that would not conflict with the team, yet offer
a contrasting environment where Keith was free to form his own conclusions regarding
his relationship with art making.
Our work together was a delicate, slow moving process, which was primarily
rooted in developing a trusting relationship. Our first sessions were filled up by Keith
spending much of the time talking, almost laboriously, with a moderate nervous tone,
about topics mostly related to more superficial surface layer material. These sessions
Exhibiting Artists with Mental Illness
5
were not only filled with talking, but also with constant drawing while talking. I aimed at
conducting myself as a model; drawing alongside in sessions, I tried to form a grounded,
cohesive environment free of hierarchical presence.
As our work together progressed, and a bond of trust grew, I gently encouraged
Keith to venture into new materials since he only worked in pencil and paper and we had
a studio rich in a variety of materials. I sensed the time was right for more substantial art
materials; I was curious if the shift in material could mirror a therapeutic shift. As Keith
replaced paper for canvas, I noticed a shift in pride and confidence, expressed in his
verbalizations about his works, a more relaxed use of the medium, and less superficial
dialogue replaced by moments of concentrated art making. I witnessed Keith progress
from a more nervous self-soothing use of material to a much more confident use of
material.
I began to hang Keith’s canvases on one of the studio walls. I soon sensed his
admiration, as he viewed them in the studio, and even brought others in to see these
pieces. I understood this shift to be a development in his identity as an artist. Keith also
started to take these pieces home to hang in his house and show family members. I saw
this gesture as a development in confidence of his artist-self. His artwork mirrored our
relationship; as I witnessed the art move from a less rigid, idiosyncratic mode, Keith
became more comfortable and less rigid towards me in session. It was a slow process,
and by no means a remedy for his mental illness, yet I witnessed subtle shifts due to
empathic support and regard for his artist identity, working in a way to honor the healthy
parts of Keith.
Exhibiting Artists with Mental Illness
6
Throughout our sessions a reoccurring topic was the pending annual art exhibit.
Keith expressed his anxiety about the opening reception; however, the anxiety was
juxtaposed with a sense of excitement and pride. This pride was demonstrated by regular
check-ins to admire his framed piece for the show, followed by his proactive approach
toward informing staff members of his participation in this exhibit. As we continued our
work together, not only did Keith hone in on his artist identity, but also stated that he was
feeling less anxious about the opening. We often spoke about strategies to manage his
anxiety during the opening.
However, this exhibition was taking place at an awkward time for the facility.
The program had recently undergone many changes, involving splitting up the continuing
day treatment program into two groups; this left many clients, including Keith, feeling a
bit unsafe, unsure of their standing in the program, and saddened by the loss of certain
friends. Shortly after this modification was the opening of the art exhibition, and the end
of the academic year. This closing of the year meant several interns and externs involved
in Keith’s treatment were beginning to start the termination process with Keith. These
changes and pending events culminated in much anxiety and nervousness for Keith.
These feelings often became overwhelming for him, so overwhelming suicidal ideation
would arise. Consequently, the week of the exhibition Keith was admitted to the inpatient
unit. Although he seemed more stable than on his prior inpatient admission during our
work together, I was concerned with the timing being so close to the opening of the
exhibit and the end of our work together. I was distressed to learn about this
hospitalization, yet I still felt we did powerful work together and that Keith’s art
aesthetics, confidence, and interpersonal skills had grown.
Exhibiting Artists with Mental Illness
7
Unfortunately Keith’s admission coincided with my last week at the hospital. It
was challenging to leave this internship after making such a powerful therapeutic
connection with Keith. Parting ways was even more painful having to say good-bye on
the inpatient unit, instead of the outpatient art studio. Two weeks after my internship
ended, I was informed that Keith took his own life shortly upon discharge. I was
devastated. Keith’s death left me wondering whether or not the idea of exhibiting his
artwork contributed to his choice to commit suicide. I questioned if an art exhibition
could benefit this population, and if it was worth researching. I was not sure how to move
on from losing a client to suicide.
After much pausing, mourning, and finally regrouping from this loss, I revisited
my enriching encounters exhibiting, created art, and remembered my experience being
with the other day treatment clients at the art opening. At the opening reception I
witnessed the therapeutic encounter that unfolded for these clients. I recalled the proud
stances, the visual transformation of empowerment that filled the room, and the confident
responses clients gave when questioned about their artworks. This also brought to mind
many other exhibitions I have attended, the essence of a shared experience emanating
throughout the space. I was then further fueled to continue with this topic.
I realized my work with Keith was still valid and important and that I saw
improvement and connection in our work together. I also felt, what better a research
question than one I have not found the answers to. My combined experience as an
exhibiting artist and my work with mentally ill exhibiting artists compelled me to share
the stories of individuals with mental illness who have exhibited their artwork. In
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8
essence, I am interested in exploring the therapeutic value of exhibiting and exhibition
space for adults with mental illness.
Literature Review
This literature review will cover key elements related to exhibiting art as a
therapeutic intervention for adults with mental illness. The use of exhibiting art as a
therapeutic intervention can act as a bridge between studio and exhibition space building
upon the therapeutic process developed during artistic creation. Within the exhibition
space, gallery, museum, or alternative showing space, the art is seen in a different context
from its creative conception. Now brought into a realm where the art product created in
art therapy can contribute to the fine art continuum, the exhibition space can act as
holding space, mirroring back the works of art to the clients in an environment where the
artwork can continue to thrive.
This literature review will begin by defining mental illness, and then briefly touch
on deinstitutionalization and normalization as treatment options for the mentally ill. I will
then give a brief history of the spectrum of theoretical modes of practicing art therapy,
with the concepts of art as therapy and art psychotherapy as the primary paradigms in art
therapy.
Particular attention will be paid to the lack of writing on art exhibits during the
inception of art therapy and the emergence of studio art therapy as an art focused
approach. I will then address the art object/product in relation to art therapy, and its
relevance to object relations theory. This will be followed by a description of object
relations theory, examining object relations used in art therapy, and its application to art
exhibition space. Next I will discuss the therapeutic environment, addressing the concepts
Exhibiting Artists with Mental Illness
9
of transitional space and holding environment as they pertain to the art exhibition
environment. Then, a brief historical account of art of the mentally ill will be given.
Lastly, this literature review will examine pertinent research done in the field of art
therapy directly related to exhibiting client artwork and mentally ill adults participating in
art exhibitions.
Mental Illness
In an effort to explain the various modes of treatment of the mentally ill, I aim to
first define mental illness, followed by treatment options specifically related to
normalization, deinstitutionalization, and art therapy. Mental illnesses have many varying
treatment options, however my main focus will be the method of normalization as it is
related to art exhibitions as a therapeutic modality. This portion of the literature review
will by no means cover all contributions in research on mental illness; instead this section
will serve as platform for basic understanding of the population. According to the
National Alliance of Mental Illness (2010), mental illness is described as a brain disorder
that affects one’s thinking, feeling, moods, and ability to relate to others. Rosenfield
(1992) described the mentally ill population as a group that feels they have little control
over their life circumstances and environments.
Rosenfield (1992) suggested that successful psychosocial rehabilitation programs
for the chronically mental ill are rooted in the normalization approach as a means to form
practical help for living in the community (p. 301). Wolfensberger and Thomas (1983)
described normalization as a way for socially marginalized individuals to obtain and
maintain culturally normalized and valued activities. The normalization philosophy is
rooted in the tenant that the mentally ill are not viewed as sick, but rather as socially
Exhibiting Artists with Mental Illness
10
marginalized (Vick and Sexton-Radek, 2008, p. 4). Rosenfield proposed that quality of
life is linked to mastery and empowerment by normalization. Mastery is defined as a
“possession or display of great skill or technique” (Merriam-Webster Dictionary Online,
2010). Successful programs promoting a higher quality of life acknowledge the strengths
of patients over the illness, while minimizing differences and hierarchies between staff
and patients (Rosenfield, 1992, p. 301). Rosenfield further stressed the importance of
vocational rehabilitation where patients have an active role in their treatments, decision
making, and opportunity to participate in socially valued activities and jobs. In essence,
through a greater sense of mastery in life, one could increase feelings of empowerment
and overall quality of life. Through the lens of the normalization approach, it is plausible
that art exhibitions can be considered a valued activity aiding in the healing process by
mastery of the art, empowerment through the exhibition experience and vocational
experience as artist.
Empowerment as a treatment approach for people with mental illness, can be
defined as an approach that emphasizes the client having choice and control (Linhorst,
Hamilton,Young, and Eckert, 2002, p.425). Goffman (1963) emphasized the
empowerment approach as a way to de-stigmatize the mentally ill. There are many
varying options as to how a person with mental illness could go about utilizing an
empowering activity, including a strong foundation in art as tool for personal growth and
shift from stigmatize roles. Spaniol (as cited in Malchiodi, 2003) reiterated the concept of
empowerment developed through artistic activity; she further postulated the use of artist
identity as an empowering option to combat negative stereotype and stigma (p. 270).
Linhorst, Hamilton, Young, and Eckert cited participation in treatment planning through
Exhibiting Artists with Mental Illness
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collaborative decision making as an empowering approach. Spaniol further developed a
concept of recovery, suggesting that the possibilities of recovery for the mentally ill are
rooted in growing out of the boundaries of the illness by achieving a sense of self-hood
through development of meaning and purpose in life.
Concurrent with themes addressed in the normalization approach, Bachrach
(1987) supported collaborative deinstitutionalization, suggesting that creating a sense of
mastery should be a primary goal in psychotherapy for deinstitutionalized chronic
mentally ill. Deinstitutionalization is a term that varies in meaning depending on context,
for purposes of this study I refer to Lamb and Bachrach’s (2001) definition of
deinstitutionalization “…as the replacement of long-stay psychiatric hospitals with
smaller, less isolated community-based alternatives for the care of mentally ill people” (p.
1039). Lamb and Bachrach further stressed that the term is often mistaken as merely a
form of downsizing; while downsizing is a component, the essential element of
deinstitutionalization is the development of alternative outpatient services for the
mentally ill. Bachrach (1976) described the three components necessary for
deinstitutionalization as: 1) transferring those hospitalized into the community 2)
development of supportive services for noninstitutionalized mentally ill, and 3) to
redirecting possible new admissions to alternative facilities.
Bachrach (1987) also explained deinstitutionalization from a sociological
perspective: he suggested institutions can impact how society views and cares for the
mentally ill by setting an example of a “set of social patterns” (p. 2). Therefore,
deinstitutionalization has the potential to impact social change, by restructuring the social
system, highlighting potential to alter social control as determined by how the mentally ill
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are viewed and their status in society (Blachrach, 1987, p.7). Art exhibitions as a
therapeutic modality have the potential to not only contribute to personal growth and
sense of self, but also function as an impetus for social change and de-stigmatization of
the mentally ill population. Mango (2005) asserted that public misconception about the
mentally ill cannot be alleviated unless clients and people with mental illness are willing
to share their stories.
Art exhibitions as a therapeutic modality have the potential to not only contribute
to personal growth and sense of self, but also function as an impetus for social change
and de-stigmatization of the mentally ill population. Mango (2005) asserted that public
misconception about the mentally ill cannot be alleviated unless clients and people with
mental illness are willing to share their stories. Keil (1992) suggested that once one
accepts one’s diagnosis of mental illness one is no longer a foreigner in the world of
mental illness, and through acceptance one can move toward the road to rehabilitation.
Robbins (as cited in Rubin, 2001) found that when working with clients who fell in the
continuum of mental illness, “therapy…cannot be in making the unconscious conscious”
(p. 59), rather the therapeutic approach should focus on building instead of revealing,
aiding in integration and cohesion. Art exhibitions have the potential to aid in building
and reinforcing the artistic experience conceived in studio/session. The concept of
building can contribute to a sense of hope and healing. Pendelton (1999) described the
use of art therapy with the mentally ill as a place to “honor and nurture the health within”
(p.32). Spaniol (as cited in Malchiodi, 2003) described a useful way to work with the
mentally ill was through treating them as fellow humans instead of “mental patients” (p.
269). I am postulating the possibility of art exhibitions as a therapeutic intervention,
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13
mirroring concepts of normalization and deinstitutionalization, while honoring the
mentally ill client as a fellow participant in the realm of creativity.
Art Therapy
There are several ways in which to practice art therapy, I will be providing a brief
explanation of three main art therapeutic ideologies, art psychotherapy (Naumburg,
1987), art as therapy (Kramer1971), and studio art therapy (Allen, 1995; Henley, 1995;
McGraw, 1995; McNiff, 1995; Moon, 2002; Timm-Bottos, 1995; Wix, 1995) as an
example of the slim use of art exhibitions as an art therapeutic intervention. Art therapy
consists of a spectrum of approaches with art psychotherapy (Naumburg, 1987) on one
end of the continuum and art as therapy (Kramer, 1971) on the other. Vick and Sexton
Radek (2008) illustrates the origins and impact of these paradigm models:
…the continuum stretching from “dynamically oriented art therapy” to “art as therapy”
continues to be used as a dominant model in art therapy practice. Although serviceable
and surprisingly adaptable, it is still a paradigm linked to the medical concepts of
identifying and treating pathology. (p. 4)
Naumburg (1987) developed dynamically oriented art therapy, which parallels
psychoanalytic use of art as a means of free association. In this mode of art therapy,
spontaneous images are created in session while the art therapist encourages free
associations, so that the art is used as a vehicle to verbal articulation (p.6). Naumburg
believed that the client gradually moves his cathexis with the therapist to a dependence
on his own art (p. 3). This description of the client’s cathexis to the art could be used as a
powerful therapeutic tool if the art is revisited post-session, allowing for the possibility of
the cathexis to continue outside of the moment of creation, lending itself as a supportive
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bond in the exhibition space. However dynamically oriented art therapy did not reference
post-session revisiting of the art works. Naumburg refrained from using the term works
of art, instead she described the art produced in session as “symbolic speech” (p. 6). This
terminology not only negates the role of aesthetics but also decreases power of the art
product in art therapy. In this explanation art therapy is seen as a means to move from
symbolic to verbal.
Kramer (1971) on the other end of the art therapy spectrum, conceived art as
therapy. The act of creating itself is thought of as therapeutic; the art therapist provides
conditions to nurture and support the creative process, including technical support and
emotional support. In art as therapy the therapist acts as the auxiliary ego for the client,
using Kramer’s conception of the Third Hand, an un-intrusive way to support and help
the creative process along for the client (Kramer, 1986). Art as therapy relies primarily on
supporting the ego and identity formation. I am postulating that if identity formation was
extended to the artist identity, exhibition space could possibly act as additional auxiliary
ego; this concept will be discussed further in the environment section of the literature
review. In a similar vein, Henley (1995) conceptualized the art studio as a therapeutic
intervention, acting as the Third Hand.
In the studio art therapy practice, “the participants are viewed as artists over
patients, and are seeking to use art making as a process for self-expression, exploration,
and healing” (Malchiodi, 2003, p. 211). From this perspective, the studio aims to create
non-hierarchical environment, where the clear focus is dedicated time for art making.
Allen (1998) emphasized a different set of rules for psychotherapy and art therapy,
explaining that art loses its effective qualities when confined to the rules of
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psychotherapy. Allen (1995), co-founded the Open Studio Project (1995), one of the first
open studio practices, where the focus was on deepening consciousness, through
maximizing the art experience. Allen (as cited in Rubin, 2001) explained her concept of
the open studio as a place where the therapist can make art alongside the participants,
where the clients are seen as equal, and “concepts such as diagnosis and treatment are
given up” (p. 182). Malchiodi (2003) cited The Creative Growth Center as the first studio
in the United States that focused directly on exhibiting the artwork of disable people.
This facility continues to inspire hope through exhibiting client art, demonstrating that
“art can reclaim many individuals who have been labeled hopeless cases” (p. 217).
Through the exhibition experience the client/artist is partaking in a community art
experience.
Vick and Sexton-Radek (2008) further highlighted a shift in art therapy towards
more community, studio based programs, moving away from the medical model striving
for redefinition of the field. Some art therapists believe more of an alliance should be
formed between the art world and art therapy world, asserting that often in art therapy
“maker and audience are one” (Lachman-Chapin, et al., 1998, p.237) and suggesting that
art therapists make an effort to connect with art galleries. Allowing for a real audience to
view the works has the potential to open up opportunity for further introspection of the
art piece, and possible elongation of the therapeutic experience. Malchiodi (2003)
declared that what was important was finding art activities that motivated the creative
process, enriching the person’s involvement in the work (p. 183). From this viewpoint,
art exhibitions as an intervention can be considered to be part of the creative process. The
Open Studio movement opened up the door to further exploration of art in art therapy.
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Timm-Bottos (1995) explores community focused art therapy. She proposed that
through interaction and sharing, the community can be utilized as an agent of change and
health. Timm-Bottos founded Art Street, originally an open studio created for the
homeless population; she stressed the importance of a community element of the studio
space as an external validation for creative abilities (p. 186). Vick and Sexton-Radek
(2008) researched the divergence between community-based art studios in Europe and
the United States, and found that European studies did not claim to be practicing art
therapy, yet they still claimed to practice art therapeutic tenants; his findings displayed
United State’s studio’s social service and sociological missions, in contrast with Europe’s
studios that lean more towards vocational based goals.
My research will consider whether or not it is possible to develop an opportunity
for the integration of the European and United States studio goals, creating a supportive
holding experience for growth in social change, art and art aesthetics, job opportunities in
the arts, alleviating stigma, and promoting self-esteem. From this perspective, each goal
could perform in a cyclical, overlapping way, reinfusing one another. Exhibition space
can be thought of as a reinforcement of art therapeutic benefits found in session or studio.
Art Product: role of art object in art therapy
The process of creating art inevitably results in an art product. In order to discuss
exhibition space, which is the holding environment for the art product, the art product
itself must be contemplated. Varying viewpoints on the art in art therapy will be
examined in this section; particular attention will be paid to formed expression, the
transitional object, and postmodern ideals. Kramer (1971) referred to the art product
produced in art therapy sessions as formed expression, art in the full sense of the word,
Exhibiting Artists with Mental Illness
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including sublimation and attention to the aesthetic product. Kramer defined sublimation
as, “a process where in drive energy is deflected from its original goal and displaced onto
achievement” (p. 68). She further explained sublimation as longer lasting than impulsive,
direct gratification, made possible through a conducive, nurturing environment. Kramer
believed that formed expression was unlike other forms of symbolic representation in that
art was more than just a discharge of impulses moving beyond formless chaos, unique to
stereotypical works, imbued with self-expression and communication (p. 63). It was
through the use of formed expression that Kramer highlighted the product element with
the process oriented ideas of art as therapy. There are varying views on the use of art
object from therapeutic session or studio to exhibition space.
The art product can also be thought of in a more postmodern sense, where art is
aligned with conceptualism over formalism. Alter-Muri and Klein (2007) referred to
postmodernism as a point of reference for the art therapy community to expand their view
of artworks. They reiterate that in the postmodern view art exists on a continuum with
multi-meaning, blurring the boundaries between fine art, arts and crafts, and outsider art.
This view highlights the role of aesthetic in art therapy, questioning traditional notions of
art therapy’s process over product approach, where artworks created in art therapy are not
viewed as art (p.84). In disagreement with the postmodernist view, Lentz (2008), director
of the open studio, Project Moving Onward, art created for a therapeutic means has no
business leaving the art studio. While Lentz accepts, and in fact promotes, people of all
mental capacities exhibiting artwork, he differs in idea of intent for the creative object.
Art viewed from a postmodern perspective can broaden the idea of acceptance of
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exhibitions of art of the mentally ill. Further, from this perspective, the art object can
exist as a therapeutic tool for the client and the viewer.
Spaniol (as cited in Malichiodi, 2003) stressed that not only do art activities build
identity, but their concrete products can also furnish a form of self-identification.
Winnicott (1969) elaborated on the idea of the object relations, extending it to a
progressed development, he referred to as object usage. Winnicott explained object usage
as distinct from object relatedness in its qualities of being a real actual object in the
tangible world. Furthermore Winnicott stressed the importance of the analyst taking into
account “the nature of the object, not as a projection, but as a thing in itself” (p.712). If
the idea is extended within the realm of art object, a relationship between object and
patient can also be made. Allen (as cited in Rubin, 2001) suggested that there is not only
a relationship between client and art therapist but that the primary relationship
experienced is between the individual and the creative process. In Arnheim’s (1980)
study of the art as therapy approach, he found that the art object can fill in as substitute
for the absent “real thing” (p. 249). This study incorporated the idea of the art object
standing in for absent objects.
For art that lives within the exhibition space, possibilities for art object as
transitional object arise, where the art object can function as other, yet not other-self, yet
not self-transitional phenomena (Winnicott, 1971, p. 50). Winnicott (1953) conceived the
transitional object as an object that is not part of the infant’s body, yet the infant does not
conceive it fully in external reality (p. 2). This object can be anything, such as a blanket
or toy that the infant finds important and meaningful beyond the reality of what it is.
Thompson (2009) reiterated this transitional experience as it unfolds in the art gallery,
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finding that “the art object…in the gallery occupies this realized space in a physical sense
and a temporal mode that permits revisiting the me and not me aspect of the self” (p.11).
Art as a transitional object holds potential to link therapeutic encounter from studio to
gallery, thus offering the client a transition to the gallery for further opportunities of
therapeutic engagement. The theory of transitional objects can also aid in understanding
the fusion of phantasy and reality in works of art created by the mentally ill (Pickford,
1967, p. 11). The art object has the exclusive power to promote the uniqueness of the
creator through exemplifying what is new in existence and will only exist in that form
(Franklin, 1992, p. 80). In congruence with Franklin’s view of the art object, Allen (as
cited in Rubin, 2001) found that the art object itself can provide a sense of self- identity.
According to Lejsted and Nielsen (2006) “a piece of art undoubtedly reflects a
particular patient’s experiences, whether or not they are a part of the illness” (p. 510).
The art product is a crucial component in the process of creativity, holding possibilities
for identity and self-worth. Alter-Muri (1994), wrote about her individual art therapy
work with a mentally ill client who exhibited his art, described the finished art product in
this context as providing a sense of self-worth, self-confidence, and identity as an artist
(p.223). Henely (1992) described his work with an inpatient psychiatry client that
involved care for the art therapeutic process, as well as the artistic integrity of the art
work/object. This lead to the client’s self-identification as an artist, which aided in
increased self-esteem and self mastery (p. 157). The art object is a powerful component
to be considered in its own right during the art therapeutic process, exhibiting art gives
the art an incubator for further nourishment and growth of personal identity.
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Object Relations Theory
Object relations theory is based on the attachment concept that humans are object
seeking beings, forming relationships as a means to develop personality. Melanie Klein
was a prominent source in the development of this school of psychology. Klein branched
off from Freud’s developmental theories, creating a theory of phases, through use of
direct observation and psychoanalysis of children. Klein (1931) expanded on Freud’s
concept of “internalized objects,” finding that a child initially views objects, such as the
mother or breast, as part objects. By part objects Klein explained that the child splits
objects into “good” and “bad,” based on levels of gratification and nurturing representing
the “good,” and destruction or danger representing the “bad”(Greenberg and Mitchell,
1983, p. 125). This experience of splitting is formed through projections and
introjections, where the good is taken in during introjections, and the bad is projected
outwards. Klein (1935) referred to this experience as the “paranoid position,” where the
child wants to keep good and bad objects separated. Both internally and externally, the
child attempts to protect good objects for fear of the bad objects tainting them.
Klein (1935) suggested that after the third month of life, the child forms the
capacity to integrate good and bad objects, resulting in a whole object and a real “other.”
“The other is no longer simply the vehicle for drive gratification but has become an
“other” with whom the infant maintains intensely personal relations” (Greenberg and
Mitchell, 1983, p. 126). According to Corey (1996), early developmental object relations
are the foundations that form current relationships in reality and fantasy. If there is a
disruption in early development, and whole objects are not achieved, defenses such as
splitting may maintain through adulthood, leading to forms of psychological impairment.
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Mahler, Pine and Bergman’s (1975) research further exemplified the
understanding of development of the capacity to differentiate self and other. Mahler
(1975) postulated three main phases of development that take place within the first three
years of life, resulting in a sense of identity and object constancy. These developmental
stages begin with normal autism, a blissful unity with the mother, which begins in utero,
followed by symbiosis at about 3-4 months, a stage of nondifferentiated attachment,
where the child feels he is one entity with the mother. At 5-6 months the child begins to
move towards more independence and differentiation, going through the subphases of
hatching, practicing and rapprochement, culminating in separation individuation. The
process of separation individuation forms a sense of identity, autonomy and object
constancy. For purposes of my research, I will focus primarily on the stages of symbiosis
and separation individuation, comparing how these phases relate to studio and gallery
space.
Mahler (1967) described symbiosis as a metaphor for the biological term meaning
two species living and sharing together. She defined symbiosis as an undifferentiated
fusion state between the mother and child, “in which inside and outside are only
gradually coming to be sensed as different” (p.741). In this symbiotic state, the child
projects any unpleasurable experience onto the symbiotic relationship; the mother
responds by providing a “holding behavior” or nurturance in the symbiotic experience (p.
741). Similarly, Robbins (as cited in Rubin, 2001) described the art in object relations art
therapy as a container that holds, organizes and mirrors, while the relationship to the art
allows for a safe forum to explore the world of objects (p. 59). The object relations
approach can be particularly useful when working with mentally ill clients, due to a
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correlation found between pathology and deficient early object relations (Horner,1979).
Horner explained that failing to differentiate during symbiosis can result in confusion
regarding inner and outer reality. Robbins reiterated that every developmental problem
offers a unique clinical experience, therefore the art therapist must be willing to
differentiate and change art frames in order to “transform pathological space into
therapeutic space” (p. 61). Harmonious with Robbins perception of the function of art, I
am postulating that the process of creation, when one is immersed in art making in the
studio, can act as a form of symbiosis. In this symbiotic state with the art, the artist is
engaged in a sense of oneness with the art object. Different levels of reality can be
experienced through the non-verbal process of art, in which the art organizes object
relations and mirrors them to the patient (Robbins, as cited in Rubin, 2001, p.60).
Therefore, I am suggesting that due to this symbiotic experience, there are possibilities
for a sense of separation individuation to be formed in the exhibition space.
Mahler explained separation individuation as a three part process taking place
from 5-24 months. The first subphase experienced is hatching, where the child begins to
differentiate, developing a sense of self-awareness (Malchiodi, 2003, p. 55). In this
hatching period, the child begins to actually pull himself away from the mother to get a
look at her, studying the mother, seeing her as separate. The child then moves into the
practicing subphase, the child literally becomes mobile and explores the world around
him. By utilizing the mother as secure home base, the child can now practice new
experiences with the world, delighting in his new discoveries (Crain, 1992, p. 303).
Rapprochment follows practicing, here the child becomes increasingly aware of the
mother’s presence, checking in to make sure the mother is there for protection, while at
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the same time feeling ambivalence toward further exploration and staying with the
mother (Mahler, Pine and Bergman, 1975, p. 96). Checking in can also be experienced in
a therapeutic realm. Thompson (2009) recognized checking in with the artwork in the
gallery space as an opportunity for rediscovery of self. Separation individuation is fully
realized when the child sees others as fully separate; the child has maintained an
internalized image of the positive experience of the mother, that Mahler refers to as
“emotional object constancy” (p. 109).
Now, having gained a sense of autonomy, the child can extend her sense of self
and identity. For purposes of my research, I am postulating the art exhibition experience
as a form of separation individuation, where one can practice the role of artist, gaining a
sense of autonomy and possible artist identity by utilizing the space and art as a holding
environment. Similarly, therapists utilizing the object relations approach extend that they
must participate as the holding environment, holding the client like a good mother would
(Stark, 1999, p. 29). Winncott (1968) developed the concept of holding environment,
which will be examined at length in the following section of this literature review. For
purposes of this section, I am referencing the holding environment as a component to
object relations theory.
To elaborate on previously stated concepts, object relations art therapy employs
art expression as a means to organize and integrate inner and out reality, repair early
attachment deficits and promote autonomy for the client (Robbins, as cited in Rubin,
2001). Malchiodi (2003) also noted that “art creates a setting in which individuation and
separation can be witnessed, practiced, and mastered through creative experimentation
and exploration” (p. 54). While Henley (1995) actually specified the setting, suggesting
Exhibiting Artists with Mental Illness
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studio space as a holding environment, operating as a secure home base, thus enabling
practicing and exploration of the art space (p. 189). Therefore, I am suggesting the use of
exhibition space as therapeutic intervention creates potential for the art to function as
object; the client can then revisit the art object post-session, therefore, reiterating a sense
of object constancy, increasing therapeutic continuity. Winnicott (1969) noted the
“development for capacity to use an object is made possible through a facilitating
environment” (p. 713).
Exhibition Space as Therapeutic Environment
The therapeutic environment and space are powerful components within the
therapeutic process; this middle ground is often thought of as shared between therapist
and client. I am suggesting the exhibition space could embody the holding environment,
engaging as transitional space, and container, while utilizing Third Hand nuances,
creating possibilities for continuation of therapeutic engagement beyond the art making.
Moon (2002), studio art therapist, postulated the idea of conceptualizing the studio space
as installation art; this concept requires examining space not merely by viewing it, but
experiencing the space. My research aims to address how adults with mental illness
experience and participate in the exhibition space. Mcniff (1997) directly referred to the
effect the environment plays, expressing that authentic representation of self can be found
when one engages with his or her environment.
Holding Environment and Transitional Space
Winnicott (1971) developed the concept of transitional space, referring to the
space between objective and subjective reality, a space for play, development of creative
self, and emergence of a true sense of self. Additionally, Winnicott (1953) noted that only
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the true self can be creative and feel real (p. 148). Malchiodi (2003) extended art making
as transitional space because it is a way to “bridge subjective and objective reality and
practice attachment and relationship with the world around you” (p.54). Winnicott (1953)
formed the idea of a holding environment, describing it as a space where the infant is
unknowingly protected by the mother. This holding environment must be present in order
for the child to enter transitional space. In hopes to repair early object relationship
shortcomings, holding environments are also created within the therapeutic encounter
(Robbins, as cited in Rubin, 2001, p. 62). For the purposes of my research, I am
examining art exhibition space as a possible holding environment, with potential to
transform the art created in studio or session. I am further exploring potentials for this
holding environment to create movement from inner and outer psychic and physical
space uniting in exhibition space as transitional space.
Winnicott (1969) asserted the use of holding environment to transitional
phenomena, where the individual gradually begins to play and gain the capacity to
independently move into the “external world” (p.711). Robbins (1987) referenced the
therapeutic holding environment as an empathic, related space bridging communication
between therapist and client (p. 28). In Deco’s (1998) description of the acute inpatient
open studio, she posited a flexible holding environment, allowing for the individual to
engage and withdrawal as needed (p. 101). I am postulating that the exhibition space as
therapeutic intervention can act as transitional space in that, the space and viewer could
represent Winnicott’s (1971) idea of external world, or outer space, while the process of
art creating and actual art object as transitional object could parallel the inner world. If
the viewer is valued as participant in the space, and if the exhibition space is effective as
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a secure holding environment, it may be possible for an extension of ego-relatedness to
develop within the space via the viewer’s involvement in the space (Alter-Muri and
Klein, 2007). Winnicott (1958) described ego-relatedness as the capacity to be alone
while others are present, so that the presence of the other is important to each person (p.
416). Robbins (as cited in Rubin, 2001) related the present other to the therapist, where
the therapist engages in therapeutic play with the client, so that the play creates the
holding environment (p. 62).
Play space within transitional space and holding environment
This section will focus on possibilities for therapeutic play engagement during art
opening receptions. According to Winnicott (1971), play is a creative experience found in
the space-time continuum. Winnicott further theorized playing as found within
transitional space and a foundation for cultural experience. For purposes of my research, I
am suggesting art exhibitions as a cultural experience not only create possibilities for
therapeutic play, but also allow the mentally ill artist to become immersed in a culture
outside of psychopathology. Exhibitions hold the transformative potential to shift into
Winnicotian playspace through gallery opening as a part of exhibition participation. I am
postulating a parallel between play within the transitional space and art opening within
the exhibition space. Additionally, Winnicott affirmed that play in itself carries
therapeutic value.
It is play that is the universal, and that belongs to health: playing facilitates
growth and therefore health; playing leads into group relationships; playing can
be a form of a communication in psychotherapy; and, lastly, psychoanalysis has
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been developed as a highly specialized form of playing in service of
communication with oneself and others. (Winnicott, 1971, p. 41).
Exhibition space conceptualized as play space has the potential to act as a communicative
intervention in the way Winnicott conceptualized play as a therapeutic intervention.
Therapeutic Environment as Third Hand
Henley (1995) extended the concept of therapeutic holding environment by
exploring the concept of the art studio used as art therapeutic intervention, and posited
that the studio space is a part of the therapeutic experience. Henley compared the studio
to Kramer’s (1986) Third Hand, finding that the studio functions as a nonverbal
therapeutic intervention by facilitating the art expression in the client (p. 189). Henley
postulated that studio space acting as Third Hand in its ability to set the stage for “further
intervention and therapeutic change” (p. 190). Kramer (1986) described the Third Hand
as a nonverbal, un-intrusive intervention through medium or technique, which is sensitive
to clients’ intentions, an alternative to verbal interventions for broaching clients’ issues.
Furthermore, the Third Hand technique does not impose unwanted preference to the
client or distort intent or image of the art works. I am proposing that gallery/exhibition
space can act much like Henley’s perception of the studio space as a part of the
therapeutic experience. The gallery space can be the non-verbal intervention, working as
Third Hand intervention can aid in the holding experience of the exhibition participant.
This can aid in the therapeutic experience of exhibiting artwork, enacting an extension of
the therapeutic engagement from studio or art therapy session to exhibition space. Here
the therapeutic process can continue to flourish outside of session.
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Art of the Mentally Ill
Throughout history, art of the mentally ill has been a source of intrigue and
curiosity for both art and psychology communities (Prinzhorn, 1972; Pickford, 1967;
Foster, 2001). The Prinzhorn Collection, serves as a pivotal example of exhibiting art of
the mentally ill dating as far back as the early 20th
century. In 1919, Prinzhorn, art
historian and psychiatrist, was appointed overseer of Heidelberg Psychiatric Clinic’s
collection of art of the mentally ill; here he established his collection of art works by the
mentally ill (Foster, 2001, p. 4). Prinzhorn continued building his collection, gathering
works from several European asylums, resulting in a collection with over 6,000 works of
art (Spaniol, 1990a). Prinzhorn’s collection along with his publication, Artistry of the
Mentally Ill (1972) inspired many European modern artists, such as Paul Klee, Max
Ernst, and Jean Dubuffet (Foster, p. 9).
Inspired by the immediacy of the raw image, Dubuffet (1942) coined the term
Art Brut, meaning raw art, or rough art, established to describe art created outside of the
boundaries of the official culture, with attention to pure, and authentic artistic impulse,
representing the depth of the artist. In 1949, Dubuffet hosted one of the first Art Brut
exhibitions, Compagnie de l’ Art Brut. In 1985 pieces from the Prinzhorn collection
toured four American museums, awakening the American public to the visual potency
and symbolic imagery of Art Brut. Following the Prinzhorn tour, art by people with
mental illness has begun to enter mainstream American art in various supportive galleries
and exhibitions.
Paralleling European’s Art Brut, the term outsider art was established in the
United States by Roger Cardinal in 1972. Outsider Art encompasses art made by the
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mentally ill and people marginalized in society (Spaniol, 1990a, p. 72). Terminology such
as “outsider art/art brut/visionary art/folk” is highly debated in the field of art of art
therapy (Vick as cited in Malchiodi, 2003, p. 2). One such example is Spaniol’s view of
the term outsider art having the potential to increase social stigma of the mentally ill.
While Lentz (2008) defended the use of the term outsider, proposing that the term
outsider art as a term can actually “harness the potential power of otherness” (p. 14).
Although the art community continues to debate on a universally accepted label
for art of the untrained and mentally ill, it is clear a bridge between artist and
psychopathology exists and has existed throughout history. Classic historical artists such
as Vincent Van Gogh, Edward Munch, Paul Gauguin and Jackson Pollack all suffered
from psychotic breaks and depression (Vernon and Baughman, 1972). Vernon and
Baughman found that “artistic expression is often a non-verbal manifestation of
unconscious affects or feeling and a means for the artist to be better understood” (p. 420).
Cohen (1981) explained that people with mental illness can use art as a way to find a
balance between fantasy and reality. Pickford (1967) suggested that psychotic fantasies
can be brought to a secondary relationship with reality, by projections and realization in
the art form. Vernon and Baughman (1972) further maintained, “Communication
between the artist and observer occurs at unconscious levels resulting in the deepest of
human interaction” (p. 420). The artist may test his dangerous thoughts and ungratified
phantasies by exhibiting art expressive of them in public places, here phantasies are
brought to exterior by projection, allowing the ego to realize even the most dangerous
phantasies can be harmless (Pickford, p. 18).
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Art Exhibitions in Art Therapy
The following section will examine art therapy literature regarding exhibiting art
as a part of the art therapeutic process. Within recent years there has been more art
therapy research and literature written on exhibiting client art, client’s artist identity,
empowerment via art product, and bridging the art and art therapy community. I am
exploring the potential of exhibiting artwork as a way to elongate the therapeutic
encounter and refuel the momentum begun in the process of creating. In Pendleton’s
(1997) writing she described her experience with art therapy in psychiatric day treatment,
affirming that “the artworks produced are reinforced when exhibited, contributing yet
another cycle of therapeutic affirmations” (p. 35). This section of the literature review
will cover psychiatric hospitals with art programs, and the research of art therapists who
believe exhibiting art is a useful component of art therapy with the mentally ill
population.
Exhibition Space Within Treatment Facility
Although not directly employing art therapists, psychiatric facilities such as
Brazil’s Pedro II Psychiatric Hospital and America’s Creedmoor Psychiatric Hospital
serve as landmark examples of exhibiting art of the mentally ill as a therapeutic modality.
Both of these facilities have not only welcomed art expression as a prominent therapeutic
tool for their adult psychiatric programs, but also incorporated museums and gallery
space in their psychiatric treatment facilities.
The Museo de Imagens de Inconsciente (Museum of Images of the Unconscious)
was established in 1952 in Brazil’s Pedro II Psychiatric Hospital, by psychiatrist Dr. Nise
de Silveira. As a part of the Art as Therapy program established in 1940, the museum
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provided regular exhibitions of patient work and a source of great art inspiration for
Brazil. Acclaimed by Brazilian art critics, the artworks of Pedro II were recognized at an
exhibition commemorating the Brazil’s five-hundredth anniversary (Holston, 2004, p. 8).
Some patients such as Isaac Liberato and Carlos Pertuis received world-renowned fame
and recognition from both art critics and psychologists alike. For some of these patients
Pedro II was a lifesaving experience aiding in mastery and a sense of pride through
development of their artist identity (p. 12). The healing potential of this facility is still
ever present, even more so with their incorporation of the Museo Vivo (Living Museum).
Set apart from the museum’s main gallery, this space, available for patrons to view,
serves as an open studio where outpatients come and go, creating throughout the day (p.
13).
Similar to Brazil’s Pedro II art inclusion, The Living Museum of Creedmoor was
formed from a 40,000 square foot, abandoned kitchen/dining building in Queen’s
Creedmoor Psychiatric Center, by Bolek Greczynki and Dr. Janos Marton. The museum
has been running for the past 26 years, showcasing more than 800 patient/artist’s work
throughout the years. Marton (as cited in Goode, 2002) explained how the Living
Museum provides a realistic framework to exhibit artwork, further substantiating the
identity transformation from mental patients to artists. The Living Museum of Creedmoor
is the first museum in the United States solely dedicated to exhibiting art by people with
mental illness. Both Pedro II’s Museo de Imagens de Inconsciente and Creedmoor’s
Living Museum, serve as landmark examples of ways to incorporate exhibiting art and
artist identity into treatment procedures.
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While the development of art therapy differs from the examples given above,
many art therapists continue to seek and create new advancements in the field. Thompson
(2009) cited the therapeutic value to his incorporation of a permanent gallery within an
urban psychiatric facility. He found that the gallery promotes a more hopeful sense of
identity through artistic sensibility and de-stigmatization (p. 162). Thompson described
this mode of working as the gallery model; this term refers to the addition of an art
gallery, serving as a modality for the art therapy program. Thompson proposed the
gallery mode as a platform for showcasing the art product in its own right, therefore
welcoming further introspection. From a humanistic perspective of art therapy, Betensky
(1977) suggested that looking at the art product separates the object from the creator; this
separation serves as a crucial element in exploring the relationship between an
individual’s objective and subjective reality. Furthermore, exhibiting in the gallery, unites
process and product, promotes de-stigmatization of the mentally ill and empowers
patients through artist identity (Thompson, 2009, p. 159).
Therapeutic Benefits of Artist Identity
Mango (2005) identified artist identity as a tool for increased sense of self-worth
and self-esteem for the participants of the 1999 exhibit Art on My Mind, Achievements of
Artists Living with Mental Illness (p. 217). According to Franklin (1992) self-esteem can
be understood as a self evaluation of a core of personal worth and appreciation for self (p.
79). Exhibitions offer the opportunity for the client to test out the role of artist, fueling a
sense of artist identity. This role is reiterated by placement of artworks outside of the
studio and into museum or gallery space; here the artworks join the realm of the art world
and art history continuum. Elevating the artwork to a more socially significant space,
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such as a museum, can aid in shifts in the client’s perception of self. Rosenfield (1992)
found that status serves as a crucial component for developing feelings of power, a key
component in mental health services, which enhance quality of life (p. 309).
In an effort to educate and promote de-stigmatization to the public, Art on the
Mind took place at The Bronx Museum as a part of Mental Illness Awareness Week.
Positive feedback from the community resulted in external validation for the exhibiting
clients. This experience aided in a sense of empowerment and increased enthusiasm in
the art therapy sessions that followed (Mango, 2005, p. 217).
Focusing on empowerment through artist identity, Alter-Muri (1994) chronicled
the implementation of art exhibitions in an individual art therapy treatment plan for a
mentally ill client. She found that when her client, Mr. Q, felt his art was admired he
gained a sense of importance through artist identity (p.221). Alter-Muri further posited
her client’s use of artist identity aided in decreased delusional thoughts of grandeur,
indicating a sense of self of esteem, but also identity, that was now grounded in reality.
Pendleton (1999) examined artist identity in art therapy participants of an
outpatient day treatment facility; she concluded that artist identity increased clients’ sense
of accomplishments and allowed the clients to view themselves in new, more positive
lights. It was Pendleton’s hope that this sort of positive experience could permeate the
entire treatment experience. In congruence with Pendleton, Vick (2000) suggested
through the Creative Dialogue (1999) exhibition, which featured both client and intern
artworks, that lines expert and helpless patient blurred and left room for new levels of
empathic understanding. Vick found that exhibitions allow for “an otherwise
marginalized individual to share his or her art with others” (p. 217).
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Schindler and Pletnik (2006) conducted a study in role development as an
intervention with individuals diagnosed with schizophrenia; they found that despite
complications regarding their mental illness, social life and economic status, participants
were willing and able to develop skills and meaningful roles, including role of artist.
Through use of individual art therapy sessions, Schindler and Pletnik found that art
therapy increased a sense of role of artist, fueling an artist identity, which contributed to a
more relatable role of family member. This case study found that the patient displayed
increased self-esteem as a result of praise and acknowledgment of exhibited artworks.
Schindler and Pletnick (2006) spoke to the empowerment enhanced through use of role
development as a therapeutic intervention as a means to “regaining roles and skills” (p.
128).
Lentz (2006), director of open studio program Project Moving On, firmly believes
that an effective exhibition program for people with mental illness must promote role
development that aids in vocational encouragement as well as self-esteem (p.14). Spaniol
(1995) spoke to the concept of role development towards artist role as a way to form an
achieving self, which aids in a positive self-identity. Additionally, Spaniol suggested
strengthening of self-hood as a key component to the road to recovery for people with
severe mental illness (p. 270). Through these examples, art therapists who incorporate
exhibitions and artist identity in treatment found that “for those who build art making into
their lives, the positive social identity of artist often furnished an empowering alternative
to the negative stereotype of the mental patient” (Spaniol as cited in Malchiodi, 2003, p.
270)
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Therapeutic Elements in Organizing an Exhibition
Spaniol’s dedication to exhibitions for people with mental illness culminated in a
Manual, Organizing Exhibitions of Art by People with Mental Illness (1990b); this
resource explains useful steps and procedures for setting up these exhibitions. For
example, the manual suggests group meetings for registration of artworks; this type of
registration aids in participation by providing clear directions to the group. This group
format alleviates the individual from a possibly overwhelming solo experience. In
essence, this registration intervention reiterates a therapeutic stance throughout the entire
exhibition process. In Henley’s (2004) article regarding the use of art critique in art
therapy, he explained the possibilities for anyone showing their artwork to experience
feelings of anxiety and intimidation (p. 79). While these feelings should be
acknowledged, if the gallery space is utilized as a continued therapeutic holding
environment, it can help minimize the client’s feelings of anxiety, rejection or loss.
Spaniol (1990b) maintained that one of the vital components in exhibitions with
individuals with mental illness is the idea of empowerment utilized throughout the entire
process.
Organizing Exhibitions of Art by People with Mental Illness (1990), documented
the step-by-step process from conception to opening of the 1989 exhibition Art and
Mental Illness: New Images. In Frostig’s (1997) review of this manual, it is described as
“a pioneering effort to establish an ethical format that both celebrates the artistic
accomplishment of people with mental illness and communicates the roles that art can
play in healing process of one’s life” (p. 131). In keeping with the theme of
empowerment throughout the exhibition process, the exhibition featured a running slide
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show of works contributed but denied for the actual exhibition. According to Spaniol
(1990b) these exhibits must be handled with the utmost of delicacy, keeping in mind both
stigma and bias of the mentally ill. In this way creating an exhibition featuring only
works of current patients or ex-patient work becomes more complex than the duties
involved in putting together exhibitions in general. Special awareness and precautions
must be considered for such elements as, the title of the exhibit, the type of opening
reception and sensitivity towards representation of those who may not be able to fully
verbalize themselves clearly. Alter-Muri (1994) proposed that exhibiting art is not
appropriate for all clients; the risk of unknown reactions to something as personal as
one’s artistic expression can be a major setback in treatment (p. 223).
Bringing the Art to the Public
Vick and Sexton-Radek (2008) identified that entering the gallery space holds the
potential to offer altered perceptions by participants and viewers long after the exhibition
(p .6). Further, Lentz (2008) maintained that outcomes for vocational empowerment and
social role valorization are made possible when the artwork gets out of the studio and into
the culture at large (p. 14). Bringing the art outside of the studio space allows it to exist in
a new and unforeseen way; now the art can interact with others besides a therapist or
fellow group member. Pendleton (1999) found that second level of self-esteem can be
formed through experience artworks outside of the creation experience, and viewing them
exhibited in publications, studio walls, or gallery space. The outcome of exhibitions for
people with mental illness is two-fold; the artist can experience a new perception of self,
while the viewer can experience a new perception of the artist or mental illness as a
whole.
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37
Spaniol (1990b) explained that the Art and Mental Illness exhibition aimed to
“increase public awareness and understanding about those who experience mental illness,
reduce stereotype and the resulting in social stigma” (p. 22). Further, Spaniol (1990a)
stressed one key mission for the exhibition was to highlight the art and artists and not just
mental illness itself (p. 74). This idea holds potential for use of exhibition space as a
therapeutic modality, and a humanizing experience in treatment.
Conclusion
In closing, while exhibiting art has the potential to engender therapeutic benefits,
the uniqueness of the individual and their relationship with their artwork must not be
forgotten. Treatment of mental illness is a vast topic in which many therapeutic
modalities are applied. Normalization ties in with the de-stigmafying efforts of exhibits
of art for the mentally. While a connection between mental illness and creativity appears
to have a long history of correlation, the actual exhibiting of the art is another realm the
creative process. It is within the exhibition space that possibilities for a different kind of
therapeutic experience with the art can be made, via potential for holding environment,
transitional space, play space, and external validation further opportunities for artist
identity and empowerment can unfold. Therefore, art therapists can take the chance to
focus not only on client’s psychiatric disabilities but also on the creative strengths of the
clients.
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Statement of Research Problem
Art Therapists have written about their experiences witnessing, contributing, and
aiding in art therapy related exhibitions with people with mental illness. They have
demonstrated clinical vignettes of the effects of exhibitions and conducted case studies
relating to exhibiting as a part of treatment. Despite this important research, the lived
experience of the artists participating in these types of exhibitions had not been shared
from their points of views.
Spaniol (as cited in Malchiodi, 2003) emphasized the life and death seriousness in
finding effective approaches to treating people with mental illness. She stressed the
difficulty in creating “hope-inspiring methods” within the current climate of mental
health in the United States. Spaniol is referring to the harsh realities in which treatment
can be brief and limited in hospital settings. Art therapy offers a creative component to
treatment by validating the use of non-verbal expression as a form of therapy. However,
restrictions, and limitations within art therapy still exist. These limitations include, large
groups held with people of not only varying diagnosis, but also vast differences in
developmental stages, recovery stages, emotional states, and cognitive capabilities. How
can art therapy further excel in aiding treatment for mental illness and can art exhibitions
serve as an additional beneficial option to art therapy treatment for people with mental
illness?
Furthermore, Vick and Sexton-Radek’s (2008) research on community-based art
studios stressed the need for growth within the field of art therapy, “Moving from a
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39
narrow medical model to services that address broader social, vocational, and
rehabilitation dimensions demands a redefinition of the limits of the art therapy field” (p.
10). There is a need for continued expansion and incorporation of new methods within
the field of art therapy. Lachman-Chapin et al. (1998) stressed that the profession has
been focusing on the mental health world for far too long, suggesting a shift toward the
art world could add a source of enrichment for the profession (p. 234).
Research Question
How does participating in art exhibitions affect adults with mental illness?
Definition of terms
Medical Model: Psychotherapeutic approach that treats pathology or symptoms instead of
the whole individual; a clinical way of viewing treatment.
Normalization: Psychosocial rehabilitation model that emphasizes achieving and
maintaining valuable social roles; full participant in the features of daily life.
Empowerment: Factors that increase strength and power; a process to gain mastery over
one’s life.
Empowerment Approach: Model of treatment that focuses on minimizing the differences
and stigma between staff and clients; lessening the hierarchy to promote a collaborative
form of treatment. A model in which staff focuses on clients’ strengths over weakness
and illness.
Developmental model: Model of treatment grounded in a rehabilitation approach with
vocational aspects.
Art Exhibition: An exhibition of art objects (sculpture, painting, etc).
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40
Therapeutic Intervention: Intervening with intent to modify an outcome promoting
healing and wellness.
Art Therapy: Art therapy is a mental health profession that uses the creative process of art
making to improve and enhance the physical, mental, and emotional well-being of
individuals of all ages. It is based on the belief that the creative process involved in
artistic self-expression helps people to resolve conflicts and problems, develop
interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-
awareness, and achieve insight (American Art Therapy Association, 2009).
Art as Therapy: The act of creating itself is thought of as therapeutic; the art therapist
provides conditions to nurture and support the creative process, including technical
support and emotional support.
Open Studio Art Therapy: Approach to art therapy where participants are viewed as
artists as opposed to clients or patients. The art therapist acts a facilitator, and fellow
contributor to the space, often creating alongside the participants. Art therapists provide
guidance and prevent overwhelming anxiety, yet they do not implement directives. Often
more professional art materials are used in the open studio approach. Participants are
encouraged to think of themselves as artists.
Mastery: Possession or display of great skill or technique; knowledge that makes one
master of a subject (Merriam-Webster Dictionary Online, 2010).
Mental Illness: A brain disorder that affects one’s thinking, feeling, moods, and ability to
relate to others.
Major Depression: Unlike normal emotional experiences of sadness, loss or passing
mood states, major depression is persistent and can significantly interfere with an
Exhibiting Artists with Mental Illness
41
individual’s thoughts, behavior, mood, activity, and physical health. This medical illness
interferes with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable
activities. Major depression is also known as clinical depression or unipolar depression.
Symptoms of depression may include loss of energy, prolonged sadness, decreased
activity and energy, restlessness and irritability, inability to concentrate or make
decisions, increased feelings of worry and anxiety, less interest or participation in, and
less enjoyment of activities normally enjoyed, feelings of guilt and hopelessness,
thoughts of suicide, change in appetite, and change in sleep patterns (National Alliance of
Mental Illness, n.d.).
Bipolar Disorder: Medical illness that causes extreme shifts in mood, energy, and
functioning. Bipolar is characterized by the presence of an episode with manic features
(manic, mixed, or hypomanic) in addition to a depressive episode. Bipolar Disorder is
also referred to as Manic Depression. A Manic episode is described as an activated period
of bipolar which may include either an elated, happy mood or an irritable, angry,
unpleasant mood, increased physical and mental activity and energy, racing thoughts and
flight of ideas, increased talking, more rapid speech than normal, ambitious, often
grandiose plans, risk taking, impulsive activity (such as spending sprees, sexual
indiscretion, and alcohol abuse), and decreased sleep without experiencing fatigue. A
mixed state is when symptoms of mania and depression occur at the same time. During a
mixed state depressed mood accompanies manic activation. Depressive episode described
in symptoms of major depression (National Alliance of Mental Illness, n.d.).
Schizoaffective Disorder: Related occurrence of both mood disorder episode (major
depressive, manic or mixed) and symptoms of schizophrenia, such as delusions,
Exhibiting Artists with Mental Illness
42
hallucinations, disorganized speech, disorganized behavior for at least two weeks. There
are two subtypes of schizoaffective disorder, bipolar subtype or depression subtype
(National Alliance of Mental Illness, n.d.).
Post-Traumatic Stress Disorder: Anxiety disorder, featuring a development of
characteristics symptoms associated with exposure to an external traumatic stressor.
Symptoms include, intense fear, horror, flashbacks or re-experiencing of the traumatic
event, avoidance of associated stimuli, numbing such as dissociation or self-medicating,
excessive emotions, overwhelmed feelings and increased arousal such as irritability
(National Alliance of Mental Illness, n.d.).
Limitations/delimitations
Since the selection process was on a volunteer basis, only female participants
were interviewed. This could have lead to a skewed sense of information. Further
limitations were found in the inability to secure interviews with exhibiting artists with
mental illness that are also part of an art therapy program.
Recruitment for this study was conducted on a volunteer basis, five females
volunteered. This study did not intend to conduct interviews with only female
participants. According to the World Health Organization (WHO) (n.d.)
Gender determines the differential power and control men and women have over
the socioeconomic determinants of their mental health and lives, their social
position, status and treatment in society and their susceptibility and exposure to
specific mental health risks.
Further WHO (n.d.) found that women are more likely to seek help for, and
disclose their mental health problems to their primary care physician; while men are more
Exhibiting Artists with Mental Illness
43
likely to seek a specialist and are the primary inpatient care users. This finding offers
insight into gender differences related to disclosing mental health information and could
explain why only female participants volunteered for this study. Lastly, it was noted by
WHO (2010) that when severe mental illness, such as schizophrenia or bi-polar, are
involved, there are not distinct gender differences in the rates of those affected. This
finding lessened the limitations of having all female participants, when each has a
persistent and moderately to sever mental illnesses.
The second limitation was due to time constraints and difficulty getting clearance
into hospital facilities. I did not get to interview any adults with mental illness who
exhibit their artworks and have participated in art therapy. My original intent for this
thesis was to compare and contrast the responses from participants in art therapy and
those that were not. However, the study was tailored and altered to fit the constraints,
resulting in a different, yet beneficial viewpoint. If I conduct further research on this topic
I would incorporate additional artists in art therapy programs.
Delimitations were found in the open ended nature of the interviews with lead to
rich, full bodied responses. Delimitations were also found in the willingness of the
participants to share their stories and the ability to meet in a familiar atmosphere, gallery
at Facility A. Due to my choice to conduct open ended interviews, the data was dense, yet
rich in quality. However, the length of the recorded data between all five participants
came to about just over 11 hours. Due to the transcription process and methodology of
this research, I couldn’t compile more data, or take on any more participants. In future
studies I would aim to conduct similar research rooted in data analysis via scale based
Exhibiting Artists with Mental Illness
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questionnaire and interviews done at exhibitions. These types of research tools would
allow for more participants and a mixed, qualitative and quantitative study.
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Methodology
Research Approach
The qualitative research approach, grounded theory was chosen for this research,
formulated by Glaser and Strauss (1967). Qualitative research is defined as:
An inquiry process of understanding based on distinct methodological traditions
of inquiry that explore a social or human problem. The researcher builds a
complex, holistic picture, analyzes words, reports detailed views of informants,
and conducts the study in a natural setting (Creswell, 1998, p. 99).
Qualitative inquiry is rooted in understanding the nature of the participants lived
experience and how they construct, understand and explain their experiences from a
unique subjective view-point. The Grounded Theory approach is based in the idea of
emergent research; therefore the theory is shaped by the data (Glaser, 1998).
In the Grounded Theory approach the theory is developed out of the central
phenomenon found in the data. This study aimed to develop a theory about the use of art
exhibitions as a therapeutic modality for adults with mental illness, grounded in the
interview data of 5 participants with mental illness that create and exhibit their artworks.
I compared the data (interviews) to one another, culminating in an analysis of how the
data leads up to a formulated theory. The data was analyzed through a system of coding;
through this approach I found categories/themes across the interviews, this lead to
emergence of a core category, evolving to the root of the formed theory regarding art
exhibitions as a therapeutic intervention for mentally ill adults. The data was sequenced
Exhibiting Artists with Mental Illness
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to form a path towards a theory. In this sense, as data interpretations accumulated, the
theory was discovered.
Data collection for Grounded Theory research consists of a process of note-
taking, coding, memoing and sorting. The interviews were recorded for transcription
purposes. The note-taking process took place post interview upon listening to and
transcribing the interviews. Coding was the prime method of creating categories,
memoing consisted of my own personal thoughts, beliefs, ideas, concepts, and feelings in
response to the coding process; memoing aided in linking together the categories found in
the coding process.
Grounded Theory is rooted in a theory being formed from responses of the
research participants, thus hypothesis testing does not occur, instead the hypothesis is
formed based on data received. Data analysis for Ground Theory requires three types of
coding procedures, open coding, axial coding and selective coding. The data is coded for
each interview by reading each transcription several times, and searching for similarities
and differences between the transcripts. In this way the findings of each interview are
compared to one another.
The coding process begins with open coding, this is how phenomena is found in
the data, beginning with the first interview transcription, developing a core category. The
second interview is compared to the first, and subsequent transcripts are coded using a
“comparative method” that compared data set to data set (Glaser and Strauss, 1967).
Similar experiences found throughout the transcripts are grouped together and given a
conceptual label. These concepts are then grouped together into categories. Coding aims
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to break down the data and reform it in a new way, so that a coherent theory is formed
(Strauss and Corbin, 1990, p.16).
This process of reformation or axial coding makes connections between
categories discovered during opening coding (Strauss and Corbin, 1990, p. 96). I coded
with attention paid to inconsistencies within individual transcripts and across the
transcripts. In essence, as the data was coded, core categories emerged; these categories
were based on common themes found between the transcriptions. Axial coding makes
connections between the categories; the central phenomenon emerges during axial
coding, and its relationship to all categories is explored.
The categories are then grouped together by relationship to one another, resulting
in selective coding which is the process of integrating the categories to arrive at a core
category, the basis for the theoretical framework of the research. According to Strauss
and Corbin (1990), “The process of selecting the core category, systematically relating it
to other categories, validating those relationships, and filling in categories that need
further refinement and development" (p. 116). By selective coding, a story is formed
between the relationships of the categories. Therefore the core category is the category
that has been mentioned frequently throughout all data, and validates other categories and
subcategories. Lastly, the theory was formed as a result of sorting the data. Sorting
provided a format for writing up the findings in the Results and Discussion sections of
the thesis. Sorting involved grouping all memos, which had been taken throughout data
analysis, as they relate to similar categories that validated the theory, thus a sequential
map was created of how the theory was developed (Strauss and Corbin, 2008, p.279).
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Glaser (1998) explained that adequacy of the research can be tested by how the
research and theory aids the participants and helps them gain a better understanding of
their experience. I also extended this sentiment to the field of art therapy, suggesting that
through Grounded Theory research it may be possible for the participants and the
community to gain a better understanding of different art therapeutic interventions that do
not necessarily include direct art making, but rather the lived experience of an event.
Research Methodology
I used the Grounded Theory approach because it is unlike other hypothesis-
testing methods; instead it is participant-based research rooted in uncovering the central
phenomenon by understanding the research situation. Also this type of action research
was particularly fitting for this study since participants were not tested against a
preconceived hypothesis; this allowed for additional sensitivity to stigma against people
with mental illness. Further, I found that Grounded Theory paralleled the emergence of
art exhibitions to art therapy field.
Research Procedures
The central methods used in this study included interviewing the participants and
recording their responses. I used a digital recording device to record the interviews and
all dialogue during the interview sessions. I transcribed all of the recordings by playing
the recordings and typing out all verbal communication. Four out of the five interviews
were administered face to face; the goal of this type of interview was to create an
atmosphere where I could explain the research procedures while creating a humanizing
experience in which participants could speak more freely and ask questions.
Interviewing in person was also utilized as a method to enhance accessing the theory
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found through viewing, listening and experiencing the story of the individual. However I
made an exception to include the fifth participant; an opportunity arose during
recruitment to interview a participant that lives abroad. I felt this participant’s artistic
background and active exhibiting career would be an asset to the research. The fifth
interview was conducted via Skype™ with a participant affiliated with one of the
recruitment facilities. Skype™ is a computer software program that enables free video
and voice calls to be made internationally over the computer. Digital recording device
was used to record the computer’s output.
I conducted semi-structured interviews, which entailed a questionnaire (see
appendix A) of mostly open ended questions, which provided for the openness in
sequence of questions and adjustment of questions according to the participants response
(Steinar, 1996, p 124). The interview situation used in this qualitative method aimed to
create a conversational atmosphere that helped clarify the experience of the participant
and the participant’s understanding of their experience (Soklaridis, 2009). I conducted
interviews with a series of questions in order to create a structure sensitive to the
participant’s level of ability to speak freely, thus questions were used if prompting was
needed. Semi-structured in-depth qualitative interviews were used to gain as sense of the
social atmosphere of the eternal exhibition space as well as the internal experience of the
participant. Both external and internal experiences were analyzed in relation to identity,
empowerment and therapeutic significance.
Setting
Research participants were found through research facilities that specifically
promote and partake in exhibiting art of the mentally ill. The participants were obtained
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from two facilities that work to decrease stigma of mental illness by use of artist identity.
One facility is an art gallery affiliated under a larger umbrella facility that promotes
vocation, work opportunities and education for people with mental illness; for protection
of privacy this facility will be referred to as Facility A. The second facility in which
participants were obtained will be referred to as Facility B.
Facility A is a part of a psychosocial rehabilitation program that does not conduct
therapy treatment onsite. Instead, the facility’s goal is based in bettering the lives of the
mentally ill by providing opportunities for working, learning and contributing to the
community. The main goal is to find means of eliminating stigma against people with
mental illness. The gallery is artist run and only showcases works by artists with mental
illness. Further, Facility A provides an environment for artists with mental illness to
partake in exhibitions at the gallery, take classes, volunteer in the gallery, and contribute
their input to the community of artists affiliated. Lastly, this facility offers opportunities
for artists to sell their artwork, expose their artwork to the local art community and
participate in exhibitions and art fairs outside of the gallery.
Facility B is a large art studio within a psychiatric hospital providing inpatient and
outpatient services. This studio functions as a work space and museum for clients with
mental illness. This studio program is directed and founded by a psychiatrist and is
offered as a part of treatment, aiming to decrease stigma and promote artist identity for
the psychiatric patients at the hospital. Long term members of the studio maintain their
own studio spaces in which they can store and create artworks.
Facility A hosted an exhibition for Facility B, I recruited participants via contact
with Facility A; two participants were artists of Facility B and were showing in this
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particular exhibition. As mentioned previously, one of these two participants no longer
attends the studio and currently lives abroad, yet remains affiliated with Facility B’s
exhibitions and the collective of artists associated. The other three participants were
artists of the gallery, Facility A. Four participants were interviewed at Facility A and the
fifth participant was interviewed via Skype™, as mentioned above. The director of
Facility A was aware of these interviews. One participant, an outpatient of Facility B,
was a contributing artist to the group exhibit Facility A was hosting. This participant
utilized Facility B for the studio space, exhibition space and a commissioned painting
position.
Population
The research was conducted with 5 participants. Each participant was an adult
18+ with a mental illness and had exhibited their artworks in the past or is currently an
exhibiting artist. Each participant is affiliated with a program that promotes mentally ill
artists. Mental disorders among the participants included Schizoaffective, PTSD, Major
Depression, and Bi-Polar.
Ethics
I received approval for research project by Pratt Institute Internal Review Board
(see Appendix B). I received proper, signed informed consent forms from each
participant (see Appendix C). I did not know or therapeutically work with any of the
research participants prior to conducting the research.
I began the recruitment process by contacting the director and staff of Facility A
and the director/head psychiatrist at Facility B via email recruitment letter (See Appendix
D). I was informed by both to attend an Exhibition at Facility A which featured the artists
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52
of Facility B. I proceeded by attending two of Facility A’s weekly information meetings,
in order to explain the research project and recruit participants. I announced the study at
the meeting and accepted interested volunteers that met the criteria, three from Facility A
and two from Facility B. The participant living abroad from Facility B was contacted via
email; contact information was obtained at Facility A’s exhibition for Facility B.
At the beginning of each interview meeting, I informed the participant about the
use of the interview as a part of a graduate art therapy thesis requirement. I also asked the
participants if they had any questions regarding the study, their involvement and the
usage of data. Prior to recording, participants were informed that they are free to disclose
as much or as little as they desire and that every level of their participation is completely
voluntary. The recordings were heard and transcribed only by myself to insure privacy.
Names and identity used in the research were changed for participant confidentiality
protection. Participants received a consent form, and were allotted time to read over and
decide if they wanted to be involved. I verbally reminded the participants that they have
the right to withdrawal at any portion of the research.
In order to minimize risks, four of the five interviews took place at the Facility A,
where both members of Facility A and B had or were currently exhibiting their art.
Location was chosen so that the participants would be comfortable, due to proximity and
familiarity and support of staff and peers post interview.
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53
Findings
The data for this study is based on five interviews of adult women with mental
illness who create and exhibit artwork, ranging in mediums, such as painting, drawing,
collage, assemblage, and performance. Four out of the five interviews took place at
Facility A, a gallery affiliated under a larger psychosocial rehabilitation facility that aims
to improve the life of individuals with mental illness. The gallery is a co-operative, artist
run space, showcasing art by people living with mental illness. During the time of data
collection for this research, Facility A was hosting a visiting artist exhibition, featuring
the artists of Facility B. Facility B is a studio based program, operating as a museum and
studio work space, located on a psychiatric hospital grounds. One interview was
conducted electronically because the participant lived abroad, yet was a past member of
Facility B and a contributing artist to this particular exhibition. Each participant had a
diagnosed mental illness, diagnoses include: Schizoaffective Disorder, Post-Traumatic
Stress Disorder, Bipolar Disorder, Major Depression, and Anxiety disorder. The
participants ranged in age between 30’s-60’s and are all at varying levels of involvement
in exhibiting their art.
The interviews were semi-structured and open-ended in nature; this
conversational method lead to varied interview lengths, from approximately 30 minutes
to 2 hours in length. I aimed to create a conversational setting; thus, the participants were
Exhibiting Artists with Mental Illness
54
allotted as much time as they needed to share their stories. The disparity in interview
times resulted in entirely unique accounts from each participant; each participant shared
differing amounts of detail regarding history of mental illness and relationship to art.
Each interview began with a debriefing about the use of this study, my role as a
student, and an explanation of confidentiality. I also informed each participant what type
of interview I was conducting and what to expect. I informed each participant that I had a
questionnaire (see Appendix A for questionnaire) on hand as a guide if needed, but that
the interview would be conducted conversationally, and that they could speak freely
about what is most relevant for them to share. The questions from the questionnaire were
utilized as a prompting tool to further engage in dialogue or reinitiate the dialogue, after
allowing for a gap of silence. The questionnaire was also referenced when I felt a
pertinent area regarding the impact of exhibiting art did not emerge during the open-
ended discussion.
In order to make sure criteria for participation was met, I began each interview by
asking the participant their age and diagnosis. The interview proceeded with a more open
question, “Can you describe how you first became involved in creating art?” This
question began the dialogue for each interview; each participant described a rich account
of her use of creativity and art starting at a young age. This similarity in life experience is
where I began memoing and open coding, in search for thematic similarities.
Open Coding
Open coding began with finding core categories that stood out when comparing
the interview transcriptions. The data is then named, and initial categories are developed
and grouped together by similarities. These beginning stages of coding involved
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55
considering the data in minute detail, searching for linkages between each of the
transcriptions. Since this was the first stage of the coding process and analysis of the data
many concepts emerged before further narrowed down in the axial and selective coding
stages. The categories that initially emerged included: 1) history of art background, 2)
return to normalcy, 3) attachment feelings towards the artworks, to sell or not to, 4)
impact of living with a mental illness: acceptance/integration, 5) sense of awareness of art
as self treatment, 6) how the viewer perceives work/opportunities from exhibiting, 7)
components necessary for personal, subjective process of art making: studio
space/content of the art, 8) different roles and levels of involvement in exhibitions space
and exhibits, 9) speaking to the viewer about your artwork, 10) feelings of pride during
exhibitions, 11) past types of treatment programs: opinions on the mental health system,
12) community experience of exhibiting, 13) identity, 14) solitude, 15) giving back to
community, 16) views on outsider art and quality of work, 17) art therapy, 18) cathartic
discharge when creating, 19) seriousness about art. After this open coding phase, these
preliminary categories were compared with the memoing notes that took place during the
data collection period. These notes of my emerging thoughts and ideas throughout the
study served as a helpful comparative reference point, contributing to the narrowing
down of many, to fewer more saturated concepts.
These concepts were formed by integrating categories; certain categories found
during open coding served as an umbrella category, in which other categories could be
condensed within, as a contributing element. The resulting categories were named: 1)
attunement with art making throughout life, 2) sense of community, 3) art making
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process, 4) identity, 5) previous forms of treatment, 6) outcome of art product, 7)
emotional involvement with exhibiting, 8) control over life.
Axial Coding
Once these eight core themes were identified, the next phase of coding, axial
coding, was conducted. The process of axial coding involves creating connections
between each category in order to arrive at the central phenomenon. The process of axial
coding is best understood through forming a paradigm model (Strauss and Corbin, 1990).
The paradigm model (see Figure 1) aids in the understanding of the relationship between
the phenomenon and its causes, context, consequences, and strategies.
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Figure 1. Paradigm Model, Axial Coding
Sense of Mastery
Context & Intervening Conditions:
Long term history with art making, previous forms of treatment, art as self-care
Consequences: Possibilities for monetary gain, attachment to art product, new community, de-stigmatization, gains in control of life and treatment, more positive self identity, views on outsider art, return to a time of feeling normal
Strategies:
Level of involvement in art exhibitions, artist community, artist identity, mentoring, teaching
Causes:
Art creation, art exhibiting, gallery space, studio space, resiliency, art as apersonal coping mechanism, integration of mental illness long-term artist ID
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Description of Categories
Attunement with art making throughout life
The First category refers to each participant describing her history of art making
throughout her life, beginning in childhood. This finding supports the long history of
connections between art and mental illness.
Community
The second category represents two forms of community, the community gained
when working in a studio, or participating in group exhibition and the art community.
Art making process
Each participant gave a unique description about her art making process and what
that process meant to her. This category also refers to how the art making process can be
used as a self-healing tool.
Identity
This category represents several themes mentioned throughout the interview; here
identity conveys identity experiences with artist identity, mentally ill identity, and
positive self identity.
Previous forms of treatment
Treatment modalities were common themes found during the interview process;
participants described varying interventions, treatments, and treatment facilities that were
beneficial, or not beneficial to their wellbeing. The discussion of previous treatments led
to discussions about their current forms of treatment.
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Outcome of art product
This category stands for feelings and experiences that occur once the art product
is completed. Outcome is understood as what happens after the process of creating the
piece, if it is exhibited or sold, and the feelings that surround the piece post-production.
Emotional involvement toward exhibiting
This category symbolizes feelings about opening receptions, feedback during
exhibitions, and how involved one becomes in the actual process of putting together an
exhibition. This category also speaks to the importance of exhibiting in general.
Control over life
Participants expressed common feelings surrounding control over their lives and
treatment of their mental illness. Art was found as a source of control.
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Discussion
I began this research with an overall curiosity about the potential therapeutic
powers exhibiting art can have on adults with mental illness. Centered in a qualitative
approach, I entered the research with ideas for possible intervening elements such as:
transitional space, holding environment, Kramerian third hand, and self-esteem through
artist identity. While some of these factors were found to be contributing components, the
research unfolded as a rich tapestry of interconnected responses, beyond what definitions
and therapeutic terms can describe. My experience of the interview process is where the
core foundation of this thesis lies. The shared spaces and holding environments
experienced during the interviews highlighted the participants as exceedingly more than
variables in a thesis study, rather real human beings willing and wanting to share in a
dialogue about their lives. Each interview emphasized elements of art making, art
exhibiting, and artist identity as a force for overcoming substantial obstacles and barriers,
exemplifying resiliency and a testament to human survival.
The single most cohesive similarity among all interviews was the thank you that
took place at the end of each interview. Each participant conveyed gratitude towards me
letting them openly share their stories. The participants showed a willingness to candidly
tell me about their lives, and a dedication to meeting with me; this revealed how
important it was for them to tell their stories. Each participant took their involvement
seriously and expressed feeling honored in to participate in this research. In return I felt
humbled and honored that all of the participants were willing to disclose intimate aspects
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of their lives to me. The sense of connection felt during these interviews cannot
accurately be expressed by words or printed type. Manen (1990) expressed the sentiments
of researching lived experience, stating that: “Writing abstracts our experiences of the
world, yet it also concretizes our understanding of the world” (p. 128).
The personal experiences of the interviews only remain in the memories of the
participants and me. While these actual interview experiences are over, the data gathered
remained to form a more universally conveyed message, the central phenomenon, and
development of mastery.
The phenomenon and themes found were based on five interviews with five
different women, ages ranging from thirty years to fifties with one or more than the
following diagnoses, Schizoaffective, Post Traumatic Stress Disorder, Major Depression,
and Bi-Polar. Each participants name has been changed to a pseudonym for protection of
privacy.
Development of Mastery
Mastery can be defined as “skill or knowledge that makes one master of a
subject” (Merriam-Webster Dictionary Online, 2010). For purposes of this study, mastery
referred to an individual having a skill or knowledge, which makes them the master of
their own lives. Rosenfield (1989) found that an individual’s sense of actual power
contributes to a sense of mastery. Mastery emerged as the central phenomenon because
each major theme found during data analysis related to the ways each participant used art
to gain a sense of control over their own world. Rosenfield (1989) suggested mastery as a
key element to a great life satisfaction.
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Intervening Conditions
Strauss and Corbin (1990) described intervening conditions as conditions that
either facilitate interventions or constrain them. The conditions found that facilitate art
making and participation in art exhibitions are a long term history of art making, art
making used as self-care and long-term feelings of possessing an artist identity. Since
each participant described their long term relationship with art making, it was apparent
that art making was a sustainable and essential piece of their identity.
The relevance I found regarding a history of art making between all participants is
related to their use of art as a way of being, knowing the world and knowing one’s self.
Based on the overall interview data, the process of art making was described as a way to
communicate, feel a sense of recognition, escape from challenging moments, express and
discharge emotions and make sense of feeling states.
Long history of art making
The first category, referred to each participant’s life long history with art making.
Each participant was asked how their relationship with art began. To my surprise, all
respondents described early accounts of art making as a young child. Each interviewee
recounted vivid and detailed examples of their first ever encounter with art making. I
wrongfully assumed that due to my thesis topic the participants would begin speaking
about art as a part of their current life or the inception of their exhibition history. All
participants recounted their relationship with art before the onset of a psychotic break, or
diagnosis; this demonstrated to me that creating art was engrained in their identity and
served as a coping skill post diagnosis.
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These responses indicated that art making was a relevant process that impacted
each participant’s identity. Vernon and Baughman (1972) connected mental illness and
creativity by referencing the biographies of Van Gogh, Gauguin and Pollack. They
determined that, “rather than having the defenses to repress or destructively sublimate
primary process and affectivity, these persons were able to express this material” (p.
420). All of the artists mentioned above were said to have had severe mental illness or
experienced periods of psychopathology (p. 413). Vernon and Baughman suggested these
artists were able to tap into primary process and expel it through the process of art
making. This explanation implies that people with mental illness are inclined to utilize
creativity as a way to cope with challenging primary process material and develop a
relationship with art as a way to understand and vent such primitive material. Primary
process thinking is developed in childhood, before the secondary process when speech
and logic begin. This pre-verbal, pre-logical, dreamlike primitive form of cognition
contains primitive impulses and drives expressed in symbols and images (McWilliams,
1994, p. 25). Spaniol (as cited in Malchiodi, 2003, p. 270) noted that some people with
mental illness found their artistic nature to be a benefit of the illness. Further, Dubuffet
(1989), creator of the term Art Brut, expressed that rather than a source of
symptomology, psychopathology can be seen a pure and crucial component to the
creation of art.
Similarities in participant responses were also found within the description of art
making as a way to communicate as a child, according to one participant, “Art was all I
could do.” This individual described using art as her main mode of communication. Two
other participants mentioned a sense of darkness that was released in artworks created
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during childhood; additionally two participants also referred to art making as a way to
cope with challenging experiences as a child. Three participants referred to a strong
connection to images of animals they created at a young age; I found this connection
representing a sense of otherness, not quite human. Lentz (2008) spoke about this idea of
otherness by interpreting the term outsider as a positive word that celebrates the idea of
otherness instead of rejecting it (p. 14). Further, Lentz maintained that the term outsider,
in relation to outsider art, communicates how artists with mental illness “operate beyond
the traditional norms and practice of visual art, devoted to producing artwork that has the
capacity to communicate when language fails” (p. 14).
Each interviewee described their connection to art making as deeply rooted from
early childhood, this finding validated much writing on the evidence of a connection
between mental illness, art and creativity. MacGregor (1989) contributed to the wide
spread correlation between art and psychology with his book, The Discover of the Art of
the Insane. This book served as a historical account of the relationship between art and
psychology spanning over the past 300 years. MacGregor wrote about the relationship
between artists and madness, art as a treatment and use of artwork as a component to
diagnoses.
Each participant’s long-term and basically lifelong connection to art making
further substantiated the historical evidence of the connection between art, creativity and
mental illness. While advocating for a middle ground between outsider and mainstream
art, Prinzhorn (1972) found exhibiting art as a way for a person with mental illness to
“actualize the psyche and thereby build a bridge from the self to others” (p. 12).
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Identity
Identity refers to the way the participants see themselves and how they identify
themselves. This theme relates to sense of self, stigma related to identity and artist
identity. Jenny in particular discussed identity as it related to her artist identity and
identifying with having a mental illness. Vick (2008) suggested that by entering the
exhibition space as artist, the health care recipient can be seen in a different role to
family, friends and staff (p. 218). This type of role shift can affect the identity of a person
with mental illness and lead to de-stigmatization. Dawn adamantly spoke about the
stigmatization of mental illness identity, asserting that people with a mental illness are the
“only people that can get yelled at for being sick.”
Previous to being diagnosed and treated for a mental illness Jenny had developed
a long standing artist identity. Having created art ever since she could remember, being
an artist characterized who she was. She also spoke about not really wanting to be a part
of the “ill scene;” this is a term Jenny coined for exploited outsider art. She referenced
how currently folk and outsider art created by people with a mental illness, is not seen for
its artistic talent, but rather for its kitsch appeal. In essence, Jenny felt that the current
fascination with art created by people with mental illness fuels a concept of rewarding the
artists without artistic merit, but rather more simply because it is art created by an ill
person. Similar to Jenny’s opinion, Lachman-Chapin et al. (1998) wrote about the trend
of romanticizing the painful lives of outsider artists, warning about the negative effects of
highlighting mental instability (p. 237). Jenny explained this type of phenomenon,
stating, “a celebration of something that is not there…a celebration because someone said
so.” That statement seems to imply that there is a celebration or attention paid to
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stigmatized people being able to do something. Vick and Sexton-Radek (2008) suggested
that a shift in art therapy practice towards a more studio based method would entail a
shift from valuing all client art regardless of merit to dialogues about artistic aesthetics
(p. 9). Jenny also explained this sentiment by stating, “I don’t want to be labeled or boxed
in.” This participant in particular emphasized her need to feel like a unique individual and
not lumped in as another patient, or a set of symptoms. Jenny does not hide that she has a
mental illness, yet does not want to be stamped as an outsider artist.
Another participant, Alice, found that showing her work doesn’t define who she is
as an artist. Although Alice has participated in numerous exhibitions and plans to show
more, she reiterated that exhibiting does not make you who you are. I surmised from our
conversation that by these comments, Alice meant that one should not create artwork
solely for exhibiting; art should be created as a personal therapeutic process as well, not
just to put on display. Alice also mentioned her curiosity towards exhibiting at other
galleries because she wanted to get feedback from additional viewers and artists. Thus, it
was not that Alice did not believe in exhibiting her work, rather she felt just showing
your artwork alone doesn’t define your identity; it is in her creative process that artist
identity is found. Additionally, Alice touched on how she identified with being an artist
with a mental illness, she stated:
It’s wonderful if a show enforces your art, and doesn’t define you, and being
mentally ill, my mental illness is a part of me, I think I’m very lucky to have it; I
perceive and see things in a different way, sometimes I perceive wrong,
sometimes it’s good.
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Similar to Alice’s response, Spaniol (as cited in Rubin, 2001) noted that some artists with
mental illness find artistic creativity to be a benefit of the illness (p. 270).
Barbara demonstrated a clear sense of pride in being an artist. Even her demeanor
exuded a sense of putting her artist self to the forefront. Upon first meeting Barbara she
was standing by her paintings, openly sharing about her works to entering viewers.
Barbara’s artist identity is also shown by the vocational effect exhibiting art has had on
her life. Barbara not only has sold paintings and worked on music album covers, but she
also is a part of a commissioned work program, in which she creates paintings for money.
Barbara described her feelings about what it means to be an exhibiting artist, she stated,
“I feel confident, more not less than, its being established and I can be famous, I can
teach other people. Someone’s really interested, I can follow up on that too. After that I
want to be more active.” Visual art as a therapeutic tool can be used to strengthen a sense
of self-hood; thus, the art product can aid in identity building (Spaniol as cited in Rubin,
2001, p. 274).
Previous forms of treatment
Various different treatment facilities and modalities, those which were helpful and
those that were not, were mentioned from each participant. Receiving treatment,
including pharmaceutical, psychotherapy both individual and group, inpatient hospital
stays, day treatment and vocational services, are all forms of treatment that a person with
mental illness will most likely experience throughout life. Three of the participants
mentioned experiences in which their mental illness and disabilities were not validated or
taken seriously. The lack of professional validation of their true experiences left these
participants feeling blamed for their illness. One participant explained her feelings of loss
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and confusion when she couldn’t “just pick herself up by the bootstraps.” Inevitably these
experiences set up these participant for consistent failure in their well being.
One participant, Jenny, spoke about her experience in an inpatient psychiatric
state hospital, stating, “People want to deal with you…all these strangers trying to make
you a new person.” She reflected on many challenging, hurtful and frightening
experience she had during several different inpatient stays. She expressed that many of
the modes of treatment within inpatient psych left her feeling disrespected, stripped of
self-confidence and individuality. Jenny has identified herself as an artist for most of her
life; it was during a prime period in her art career that she first was hospitalized. Due to
this deep immersion in the arts, Jenny described the intense frustration and sadness that
was felt from being away from her artwork, studio, and collective of artist friends.
Jenny’s description of these types of facilities brought attention to the dehumanizing
practices that often occur within the mental health care system. Spaniol (as cited in
Malchiodi, 2003, p. 268) affirmed that the state of health care in the United States
discourages therapists from providing “hope-inspiring approaches;” this is due to brief
treatment, sometimes limited to one or two sessions within the hospital and a few months
in day treatment. Spaniol (as cited in Malchiodi, 2003) further stressed “Individual art
therapy is nearly obsolete, and people are often seen in large groups with various
diagnoses, emotional states and cognitive abilities, and at widely different stages of their
recovery” (p. 268).
Jenny explained the beneficial treatment experience she received at Facility B;
she conveyed this treatment experience as a helpful due to the amount of space and time
give for her to be alone in her art making process. As opposed to more prescribed groups
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or forms of treatment, just knowing the psychiatrist in charge was there if needed, yet
having space for independent exploration allowed for development of a sense of security.
At Facility B Jenny could work on art making at her own time and pace with her choice
of materials. In this studio environment, Jenny found she was able to revisit her artist
self, affirming that she felt like herself again. The shift in treatment was in tune with a
person-centered, humanistic approach to creative arts therapy; according to Rogers this
approach encourages “the belief that every person has worth, dignity, the capacity for
self-direction and an inherent impulse toward growth” (as cited in Rubin, 2001, p. 164).
This return to a positive sense of self was in stark contrast to the effects she described
from the treatment on the inpatient psychiatric unit, described as “feeling you’re not
worthy because you lose your identity.”
Furthermore, Jenny summed up her grievances with the mental health care
system, by stating: “That’s why people go crazy. There are systems for the aftermath, but
there is no prevention in mental health, only treatment for after a breakdown, but not
enough support system for people who might go crazy.” This sentiment and her
experience at Facility B, fueled Jenny to create an art space for people with mental
illnesses in England; the space provides a refuge for artists, is equipped with occupational
therapists and acts as an alternative to hospitalization.
Another participant, Barbara, explained how the consistency, structure and
stability of Facility B were helpful components to her overall treatment. She recounted
her return to Facility B after a short hospitalization. She was concerned she would not be
allowed to go back after her stay in the hospital. To her surprise, Barbara was welcomed
back and able to pick up where she left off with her artwork. This dependability brought
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about the awareness that she had somewhere to come back to; a further sense of trust and
belonging was developed by knowing that the professionals at Facility B would not turn
their backs on her.
Sandra mentioned various pharmaceutical treatments she endured, elaborating on
the ill effects many of them have had on her health. She recounted one extreme occasion
in which her medication induced a heat stroke; feeling faint, Sandra had to leave work
early and stumbled upon Facility A, seeking a place to rest. Having no idea Facility A
was a gallery for people with mental illness she was welcomed, given a glass of water
and called a cab to the hospital was called for her. These kind gestures led Sandra to
return to Facility A, this time discovering what it was and soon incorporating herself
within the gallery. Here she was encouraged and empowered to begin exhibiting her
artwork.
Dawn met many friends through her treatment history. These friends too have
mental illness. Having friends that also have a mental illness helps her gauge when she
might be putting herself in a dangerous situation. Dawn described her experiences with
manic feelings that lead her to solicit strangers via the internet for nude modeling. She
proceeded, explaining these situations as dangerous and unpredictable. Dawn found that
since friends have an understanding of mental illness themselves, they can better
recognize when she seems to be going in a manic state. She expressed, “My friends are
also mentally ill and will call me on that stuff…so it’s important to keep them in the
loop.” Kramer (1971) formed the term sublimation in art as therapy to illustrate the
process of primitive urges transforming into socially acceptable behaviors that are in-
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sync with ego needs (p. 68). Dawn’s check in with her friends mirrors this concept of
sublimation.
Although Dawn’s friendships represent a positive gain from treatment, she also
noted the stigmatization of people with a mental illness. She poignantly asserted that
people with a mental illness are the “only people who can get yelled at for being sick.”
This statement represents the type of injustice and stigma found in some treatment
facilities. Spaniol (as cited in Rubin, 2001) suggested the benefit of being an authentic
therapist that treats clients in a real and genuine way, treating them as fellow humans
instead of mental patient (p. 269). This type of interaction leads to therapeutic alliance
and encouragement for the client’s growth.
Alice was the first person that I interviewed. When analyzing the data, I realized
that she did not specifically reflect on previous forms of treatment or current treatments
for her mental illness. However, she did speak about several topics that paralleled a sense
of treatment for her mental illness. Alice spoke at great length about several schooling
experiences throughout her life. She initially expressed traumatizing times she had early
on in school; teachers did not understand her learning disability and ridiculed her. Alice
sees this time in life as partially responsible for her PTSD. Alice was then sent to a
boarding school with a rigid structure. It was at this school that she had proper attention
and concern given to her learning needs. She also spoke about the structure and the sense
of boundaries aiding in her communication and understanding of tasks and procedures.
This care seemed to develop a sense of an achieving self in Alice. One teacher in
particular spent dedicated time working with Alice on her reading and writing.
According to Vick ( 2008), “Giving voice to individuals who might otherwise remain
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unheard is an act of political and personal empowerment” (p. 216). She then went on to
college Alice characterized herself during this time as having a reputation for being the
abstract artist amongst many realists. The development she experienced during boarding
school appeared to serve as a molding device, allowing Alice to create artwork with
confidence in her own style.
Community
The theme of community refers to the effects of interpersonal interactions the
participants have had with individuals and artists within either studio or exhibition space.
This theme developed from the feedback each participant shared about their connections
with others through the process of art making or exhibiting and the sense of belonging
exemplified in some of the responses.
Jenny described her experience getting to work in an art gallery as a part of her
participation with Facility B. The return to a gallery space brought back a sense of
returning to self for Jenny. Having been deeply immersed in the arts community before
her admission it was an important step in her treatment to feel that she could belong again
after hospitalization. She recounted the reassurance gained by knowing once she was a
part of Facility B, she is always a member; this long lasting membership mirrors a stable
object that each client can always revisit, contact, or use as a way to refuel. This sense of
acceptance can aid in mastery by acting as the Rapprochement phase in object relations
theory; this phase is when the child checks in with the mother, seeing her as a source of
protection. This ability to comfortably check-in can lead to healthy separation from the
facility, while paving the way for individuation and recovery.
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Dawn gave quite a different perspective about how community affects her
wellbeing and feedback. She explained the importance of exhibiting her work, and
importance of having her friends and family see her work as a way to help her stray from
dangerous situations that emerge during manic periods. Dawn detailed how she wants to
be able to be able to share her artwork with her community of friends and family, and in
order to do so, she knows the content level has to be appropriate enough for her loved
ones to not show concern for her well being or fear of her art.
Sandra recounted her first experiences as a part of a college level arts school; the
theme of community arose from her description of this space as a “home and haven.”
Not yet diagnosed, she spent her mid-twenties confused about her feelings and what was
wrong with her. Sandra spoke about this art school serving as her only solace during that
period of her life. Due to life circumstances, depression, and injuries from her work
place, Sandra was making art less and less. Due to these injuries, she could not paint
without feeling extreme pain and was devastated by the shift in art production. Sandra’s
return to art was brought about by her accidental run in with Facility A. Initially, when
Sandra began to volunteer at Facility A, she did not tell anyone she was an artist. By the
accepting and kind presence of the community at Facility A, Sandra became comfortable
enough to share about her history with art making. This disclosure was met with great
excitement and encouragement to continue. Soon after revealing herself as an artist,
Sandra found herself exhibiting in an annual event for Facility A. Although art making
continues to be a physical challenge for Sandra, the community of artists at Facility A
encourage and support her to move forward with the arts. Schindler and Pletnick (2006)
conducted a case study in role development, finding that the role of exhibiting artists
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helped their participant gain confidence to engage with the group by verbally sharing his
thoughts and interests. By exhibiting his artworks, this participant gained positive
feedback from his peers; it was this feedback that brought about confidence and thus a
gain in interpersonal skills. Similarly, the support Sandra received from her peers at
Facility A aided her in continuing to be a part of the group and to try new art mediums.
Another form of community is the community gained when exhibiting your
artwork, often a community of supportive peers. Barbara touched on the element of
community when she spoke about attending art openings. She explained that she likes to
see other artists’ work and how they speak about their work. She went onto describe the
pride she feels when receiving positive feedback from visitors of an exhibition. This
exchange reflects the community at large, and the feelings felt from putting artwork out
into the community. Spaniol (1990a) referenced the community building element she
witnessed at the 1989 exhibit Art and Mental Illness: New Images. Spaniol found that for
those who have not exhibited prior, “it was the first awareness of belonging to a
community of artists who shared similar issues and concerns” (p. 76). Barbara spoke
about her artist community and the enriching experience she has when attending
openings; she felt a key component to these positive experiences is having the
opportunity to talk to similar artists and receive feedback. Barbara also explained that art
openings force her to speak about her artwork:
I like to talk about it but, fills a void, the piece fills a void in my life, so I
wouldn’t know what to say off the top of my head, but then I just did it, and it was
not easy, but I challenge myself, because I challenge myself, too finish it and
speak about it.
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This exchange between Barbara and the viewer adds an additional piece to the art
making process; in a way the art piece is not even finished until seen and spoke
discussed. According to Spaniol (1990a), participants that exhibited in the past can utilize
exhibiting and openings as an opportunity for networking and creating support systems
(p. 76). In return for putting her work into the community and participating in that
community, Barbara experienced pride, a boost in confidence and a sense of
achievement. This network and experience of the community found through exhibiting,
relates to the sense of play discussed in the literature review of this study. Winnicott
(1971) suggested transitional space as a place for practicing “attachment and
relationships to the world around them” (p. 54).
Community was also reflected in the participation within an artist studio or
collective, but also the roles within these groups. Alice spoke with great pride about her
position at Facility A. Having been one of the founding participants, Alice took on a great
deal of leadership responsibility, even serving as a mentor to other members. As a part of
Facility A, Alice taught several different art making workshops throughout the years. As
an art teacher she was influenced by her experience in art school and took the position
quite seriously. It was clear from the manner in which Alice spoke about teaching, that
identity as a teacher brought her a sense of pride and accomplishment. She explained the
reactions her students had after seeing a piece of artwork exhibited, “There’s great joy in
all of a sudden discovering yourself. I can do something I never I expected.” Although
this statement was intended to describe the reaction of her students, it also mirrors the
effects Alice experiences from teaching. Alice’s longstanding bond with the gallery
served as a comfortable community in which she understood and took pride in her role in
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the group. Her position as one of the heads of the directors of the gallery; this made her a
familiar figure to everyone who attended the gallery.
Art Making Process
The method in which the participants created their artworks was an integral piece
of each conversation. Although this research is geared towards the therapeutic benefits
found after the art making process, the art product and related exhibitions would not be
justified if personal process were not explained. One participant spoke at length about the
importance of her art making process; she adamantly emphasized process over product.
In reference to exhibiting her artwork, Alice stated, “Feels good but doesn’t define your
work or who you are.” This participant in particular spoke in detail about how she creates
with discarded materials, finding beauty in transforming the ugly, thrown away and dirty.
She described her method as a process that goes in waves, moments of creating,
destroying, and conceptualizing (never giving up, trusting in the art process, and
therefore trusting in self), Alice explained that she is not concerned when she is not
technically producing, because even when thinking and synthesizing she is still in the
process.
Dawn reflected on a tumultuous time in her life that brought her back to art
making after a long break from creating. A sense of deep turmoil brought her back to art;
she used art making as a way to release intense feelings of anger and sadness; after
creating this piece she explained feeling, “a sense of feeling free, feeling right.”
Malchiodi (1999) found that the “energy mobilized in the process, and the contemplative
nature of art at once soothes, relaxes, energizes and lifts one up to a 'natural high'” (p.
145). Dawn also mentioned her use of creating art on the train as way to curb her anxiety.
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She found that creating allows her to let go, thus putting her into a meditative state where
she is more equipped to handle anxiety provoking situations.
Sandra explained that being immersed in her figurative art classes as a way to
gain peace and pleasure. The overall sense conveyed from the interviews was the element
of art making used for self-care. Each participant expressed art making as a way to access
a sense of peace and a cathartic release. They also conveyed an awareness of needing art
making for their health and wellness. In Malchiodi’s (1999) study of art therapy with
chemical dependency treatment, she found that one art therapist interviewed felt that
“patients just want to do art so they don’t have to think about all this other stuff” (p. 145).
This finding reflects sentiments expressed by the participants in this study, that art
making can serve has a healthy escape and a way to be in control of your world.
Jenny spoke about what art making feels like for her stating that the act of
creating it is much more important her than exhibiting. She expressed she finds the
enjoyment in working out the art making, and finding that once it is out, it is not hers
anymore, it is out of her body and into the world. Jenny indicated that the most important
elements of art making are getting the idea, working out the idea, and then letting it go.
Outcome of art product
All the participants spoke specifically about their relationship with the art
object/product after the art making process. Each participant possessed a different sense
of attachment to their art products. According to Lusebrink (1990) the art product is an
important part of looking at the relationship between objective and subjective reality
further in art therapy. From this perspective, the art object itself can help facilitate
therapeutic goals. Bentensky (1973) explained the art product and its structure as a
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representation of the personality of the creator. When the artist then reflects on the
structure and offers a description, an opportunity for integration between inner experience
and artistic representation can arise (Lusebrink, 1990, p. 13).
The actual art product is the key element to contributing to art exhibitions, and the basis
of this study.
My first interviewee, Alice, mentioned on several occasions that the product did
not matter to her; she explained her main interest and reason for making art was the
artistic process. She in fact repeated her sentiments regarding process and product so
many times, that a strange paradox began to occur; Alice was reciting the motto of old
and generic views of art therapy, process over product. However, the difference here was
that Alice was an actively exhibiting artist. Although she described her passion for the
process of creating over the actual outcome, she yearned to share the outcome or art
product with people through exhibiting. Alice used art to convey personal and political
messages, therefore she was able to separate or individuate from the product, allowing for
the art to exist on its own.
Dawn also uses her artwork to convey messages and social commentary.
Therefore the outcomes of her art pieces are personally relevant, while conveying a
universally understood commentary. She explained that she creates artwork that pushes
the envelope and speaks about stereotypes and stigma portrayed by the media. Dawn was
inspired by a book about stereotypes in the African American community; this book
stated that in 1997 more young black men were in colleges than in jails. This particular
fact moved Dawn to create a mixed medium series related the finding. Dawn expressed
her motivation is to expose the negative stereotypes depicted in the media. She described
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these works as “in your face, yet pretty.” During the interview, I mentioned that it seemed
Dawn was creating a visual metaphor for all stigmas; I sensed from our interview that she
felt similarly about stigma against people with mental illnesses. Dawn replied, continuing
the content of her paintings:
There’s a preconceived notion of how the world sees them and it’s sad and in this
country is this true? It’s not the government fault, it’s the media’s fault, it’s all
pieces of this, it all comes down to, are you crazy when you think it’s not the way
everyone’s telling you? If you believe you’re just as capable as everyone else, just
as worth it, I’m just as smart, just as intelligent, just as resilience. Those are the
truths. The truths that you are a gang banger that you belong in jail, just because
everyone’s telling you it is, doesn’t make you crazy if you don’t believe it!
Dawn uses the art object as her voice, conveying personal feelings, and inviting others to
think and question societal dilemmas.
Jenny shared a similar view as Alice, exclaiming her need for artistic process over
the actual make up of the product. As both a performance artist and painter, Jenny
depicted her experience with these art forms as vastly distinct from one another. During
her poetry readings, she cannot separate the process and product element, inherent in the
work of performance, they are seamlessly integrated. However, she explained her
paintings to be a means of releasing emotions while creating and receive money for the
outcome. Jenny spoke about her painting as the business side of her craft.
Another interviewee, Barbara also spoke about her relationship to her art product,
but from a contrasting point of view. Barbara mentioned her art as filling a void in
herself. Barbara spoke about her art process, but mainly spoke about how the finished art
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product affects her. She experiences not only the creating process by also the art piece as
a piece of herself. Barbara expressed that it made her feel good when other artist from
facility B would see her art pieces and compliment her good work, “It made me feel so
proud of myself that I accomplished that.” Due to this feedback, her art piece served as a
way to connect to others and receive external validation. The validation fuels Barbara to
continue creating art as a way to gain a boost in self-esteem, motivation and happiness.
Some of the interviewees also mentioned the relevance of selling their work, and
their feelings about selling. Barbara mentioned selling artwork as a motivating factor.
While Sandra found selling artwork to contribute to a sense of confidence that the art is
“worthy,” yet felt like letting go of each piece was like letting go of a piece of her heart.
Barbara too shared this sense of attachment to the art pieces, both participants finding
them as an extension of themselves. Barbara stated that when she knows a buyer has
hung up her art piece, she knows they “didn’t destroy her.” This statement exemplifies
how the art object itself can act an extension of the creator. Winnicott (1971) referred to
this type of experience as a “transitional phenomena”, the experience of “self, yet not
self” (p. 50).
In an effort to sell, Dawn marketed her artwork on a social networking website.
She explained that the pieces sold at such a fast rate, she didn’t have a chance to promote
them further on an art website. Jenny also sells her artwork on the internet; she has her
own website to showcase her works. These efforts to sell work reveal a sense of financial
and vocational ownership. Rosenfield (1992) found that vocational services, such as work
and employment, are important parts of treatment in regards to life satisfaction for people
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with mental illness. These responses confirm that selling artwork can serve as a
vocational tool, leading to financial gain and a sense of empowerment.
Emotional involvement toward exhibiting
This category represents the participant’s responses and reactions towards
participating in art exhibitions. The category emerged because each participant spoke
about art exhibitions in relation to what extent they are involved in the process and how
exhibiting affects their feelings about their art work and their creative process. Rogers (as
cited in Rubin, 2001) referenced the term creative connection to explain a creative
process in which one art form unfolds into another; therefore using the arts in sequence
can reveal inner truths with new depth and meaning (p. 165). In this way, the making of
art unfolding into the exhibiting of art can be seen creative connection.
While Alice spoke at great detail about the importance of exhibiting her work
earlier on in her adulthood, she found that at this current time in her life that, “exhibiting
feels good but doesn’t define the work and who you are.” However, Alice shared some
conflicting sentiments about exhibitions, while she explained that she doesn’t care about
showing her art work, that it is more about the process, she also stated in a later interview
that she is interested in showing in galleries other than Facility A. During a second
interview with Alice, she had decided to actually leave her position at facility A and
instead work in another department of the umbrella facility. Alice explained this
departure as a need to separate from Facility A in order to move forward and gain
additional feedback by exhibiting at other venues. Alice confidently described her
decision about the departure as a decision she had to make, that she was very happy about
it and it was good for her art. She expressed that she needed to make this shift for herself,
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and that she wanted to continue showing her work at Facility A and also at other
galleries. Alice’s ability to execute this healthy separation mirrors the
separation/individuation phase in object relations theory. Separation individuation
represents a period when one has found confidence from healthy attachments and can
separate from symbiosis to autonomously further their identity (Mahler, 1975). Alice’s
positive associations with exhibiting her artwork at Facility A and the community formed
by exhibiting at the gallery, help Alice to separate and to make connections with other
galleries. This situation also highlights the artwork functioning as a transitional object.
In this sense, by exhibiting previously, the artwork is filled with meaning, and can serve
as a source of support to move into a new phase of exhibiting.
During Barbara’s interview, she spoke about her exhibition experiences with
beaming pride. She proudly mentioned she had participated in so many exhibitions, she
could no longer remember how many. Barbara touched on many aspects of her
involvement in exhibiting her artwork, and how they affect her emotions and motivation.
Barbara has participated in several group and solo shows; she recounted her first
exhibition with Facility B as a source of great accomplishment. These prideful feelings,
boosted her confidence, and motivated Barbara to take part in several aspects of
exhibiting, such as creating calendars, and artwork for a music CD. She discussed being
at the openings as a part of her artistic process; she explained how talking about her art
pieces can be a bit intimidating, but she overcomes that feelings and talks about her work
as a way to finish the piece. This second part to her process exemplifies a bridge between
subjective and objective space, found in the transitional space (Winnicott, 1971) of the
exhibition.
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Sandra viewed exhibiting as sometimes anxiety provoking, but yet a way to boost
self-esteem. She recalled her first curated exhibition with Facility A,
It never meant much to me but seeing it through his eyes, started looking at it in a
different way. It was an abstract, and I thought maybe I can do something abstract
that I might like, different. These pieces were stored away, put away and never
looked at. When I first heard the positive feedback, I thought these are not bad,
started looking at work in a different way. I don’t know why it took me so long to
appreciate the work.
The positive feedback Sandra received from her peers aided in shifts in feelings towards
her own work, and therefore feelings about herself. This feedback encourages her to
exhibit her artwork.
Dawn’s participation in exhibiting her work is layered, not only does she
participate in group exhibits as a part of facility b, she always holds exhibiting in her
home and exhibits her work on the internet. She discussed the use of social commentary
in some of her works. Dawn described how she uses her artwork to speak to the
prejudices in society. By creating social commentary art pieces, Dawn is already
anticipating exhibiting, and thinking of sending a message to the viewer. Therefore her
involvement in exhibiting begins during the art making process.
Also, as mentioned previously, Dawn utilizes exhibitions as a way to stabilize her
moods. When she feels manic, she finds it helpful to talk to people about her work and
exhibiting, forces her to listen. When Dawn is feeling down, exhibiting brings her up, by
offering encouragement found from positive feedback and interest in her artwork. This
therapeutic element found through exhibitions, mirrors Kramer’s (1986) concept of the
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Third Hand, as used by Henley’s (1995) study, relating studio space to the Third Hand.
This concept explains the environment acting as a therapeutic component.
Jenny explained her multi-layered connection with exhibiting. She has been
exhibiting for most of her life and enjoys being a part of the process from beginning to
end, including creating her own events. Jenny spoke about how much she enjoys
executing the events, finding the venue, creating the atmosphere, getting the acts
together, showcasing in an alternative way in a sense. While she also shows in galleries
and juried shows, Jenny described being most fond of aiding in producing the entire
experience. This involvement reflects a sense of control and ownership in the exhibiting
process. Jenny also expressed the differences she feels when performing live poetry
compared to exhibiting paintings. She explained that when creating the painting it is hers,
but when it is up on the wall at a show, she lets it go; the artwork then becomes a part of
the viewer. Jenny emphasized the importance of having an artistic idea, working it out
and then letting it go. She explained how her poetry performances differed because it was
her reading in real time, not acting, but letting go and discharging the idea in real time.
Jenny depicted her poetry performances by asserting, “I don’t detach, it’s me, I don’t
perform it as an actor, it’s me, I don’t do actors. It’s good because it challenges me not to
be as shy as I am.” Spaniol (1990a) regarded having an active role in the exhibition
process as a great source of empowerment for the artist (p. 78).
Control over life
The Category describes the overall theme that was gathered from all interviews.
After analyzing data grounded in the participants responses, it became clear, via
comparison, that the one major component found within each response was the sense of
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control each participant gained by art making. Rotter (1966) explained control as life
outcomes being rooted in the consequences of one’s own actions. In essence this concept
of control emphasizes life circumstances based on an internal locus of control, over
external control. Spaniol (as cited in Rubin, 2001) noted loss of control as a one of the
greatest losses that accompanies a mental illness.
Although conveyed and felt in varying forms, art and art making prevailed as a
source of control in each of these individuals lives. Rosenfield (1992) noted that
“Previous research found that low perceptions of control personal control correlates with
lower psychological well being” (p. 300). This theme was used as the precursor to the
formation of the central phenomenon of this study, Mastery. Further, Rosenfield linked
low sense of self to lack of control over life circumstances. Perceived control was found
as a key component in occupational therapy treatment for people with long term mental
illness (Eklund, 2007, p. 535). Lastly, this section also reflects the control all participants
have on their amount of involvement in with creating and exhibiting their art. Both
Facility A and B do not require exhibiting to participate in the program, therefore it is the
client’s choice; this ability to choose represents a degree of actual power these
individuals have over their life. One contributing factor to a sense of mastery is an
individual’s actual power (Rosenfield, 1989).
Sandra found that in very tumultuous times in her life creating art was her only
solace. Sandra explained that during the most confusing times pre-diagnosis, she could
look to creating art as a constant in her life. Art was a stabilizing tool for Sandra, she
could control her creation, and get lost in the process; this served as a grounding tool for
times in her life when things seemed out of control. Sandra described a time before she
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was diagnosed and was not sure what was happening with herself. She was losing job and
experiencing unexplained sadness, yet she could still find a peace during art making. She
explained that when she had art in her life she found meaning.
Jenny spoke at length about issues related to control over her life. One major
theme that came up within out interview was control over her treatment. When Jenny was
able to attend Facility B as a major component of her treatment plan she was able to take
control over the type of treatment she receives and thus regain feelings of being back to
her old self. Feen-Calligan (as cited in Malchiodi, 1999) suggested the mastery over
traumatic events when patient begins to take an active role. Jenny stated that the
treatment she received at Facility B helped her gain back will power. She also reiterated
throughout the interview how difficult it was to have “people wanting to deal with you.”
Jenny explained how many of her encounters within the mental health system left her
feeling helpless, because “strangers were trying to make her a new person.” This type of
forced treatment can leave an individual having no control over their life circumstances.
Jenny stressed how many inpatient admissions left her feeling stripped of confidence and
uniqueness. When put in these situations, Jenny yearned to gain back autonomy over her
life decisions. Facility B offered to Jenny a way to return to a way of living she knew,
while also offering her more actual control over her treatment and in essence paved a
road to her recovery. Jenny extended the sense of control she gained from Facility B, by
giving back to the mental health care system and starting an art space for people with
mental illness. This space serves as an alternative to hospitalization, offering music and
arts; through this giving gesture Jenny offers opportunities for others to gain a sense of
control in what can be out of control times.
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As mentioned above, Barbara described the feelings she had around selling her
artwork, and the confidence gained when she receives positive feedback about her
artwork. She also explained how these elements of showing her work, fuel her to move
forward and continue creating; this push forward demonstrates Barbara having control
her life, control over money she earns and control over events she participates in.
Dawn uses art exhibitions as a way to gain tangible control over manic periods.
As noted earlier, Dawn explained how exhibiting her art aids her in making safer
decisions as to creating her work. She also noted that when she exhibits her artwork she
is put in a position where she has to speak to the viewers; this helps bring her up during
times of depression. Choosing to exhibit for these reasons exemplifies how Dawn takes
control over her life circumstance and makes decisions to be an acting agent in her own
life.
Alice touched on the theme of control by making choices about her roles within
Facility A. Alice spoke great deal about the pride she takes in teaching a class at Facility
A; and in the second interview conducted due to a recording failure, Alice had
completely changed her role at Facility A. She decided to no longer work at Facility
because she wanted opportunities to get distance from Facility A, offering more changes
to exhibit her art in other venues. Alice also finds control through her art making process.
Alice spoke about her creating process as ebbs and flow of actually creating and periods
of synthesizing and thinking about the work. She works primarily with found
object/trash, using this material as a way to represent transformation. She aims to
continue to grow and change with her artwork, not to get stuck creating the same images.
The way Alice describes her process shows a level of internal control related to her
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decision making during the creative process. Her process also speaks to a sense of
metaphor for transforming self.
Mastery
Control over one’s life is a pathway to mastery. Mastery is defined in several
ways, for purposes of this study, I will be using two definitions in conjunction with one
another. Mastery can be defined as possession of a great skill or retaining enough
knowledge to be master of a subject (Merriam-Webster Dictionary Online, 2010).
Rosenfield (1992) proposed that mental health programs should focus improvement of
quality of life for treatment of the mentally ill. She suggested methods for vocational
rehabilitation, financial support and empowerment result in a sense of actual power over
one’s life. This power culminates in gaining mastery or perceived control, infusing
together as an increase of subjective quality of life. For purposes of this study, I am
correlating vocational activities with exhibiting and creating art, financial support with
selling artwork and empowerment with experiences exhibiting art, feedback received
about art and positive feelings while creating art.
Essentially, Rosenfield(1992) found that empowerment via actual power, and
perceived power contribute to a sense of mastery, which then results in greater life
satisfaction; therefore treatment for mental illness should involve tools to gain these
elements. These findings were discovered through Rosenfield’s study of the
empowerment approach to treatment. Whether the empowerment is experienced from
selling, sharing the artwork with a community, meeting new people, gaining new
opportunities, gaining feedback or watching an art piece come to fruition, I found
empowerment as a crucial component in exhibiting art. If art therapy utilizes this
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empowerment approach for art exhibition interventions, art exhibits can be seen as an
effective therapeutic tool.
Similar to Rosenfield’s (1992) findings, Eklund (2007) found a strong
relationship between self-mastery and satisfaction with daily occupations; the study
defined occupations as daily occupations and activity level. The participant’s accounts of
their activities from creating the art, to participating in events speak to a sense of daily
occupations. The participants also mentioned stigma and its damaging effects.
Stigmatization places people with mental illnesses into a disadvantaged group, thus, self-
mastery becomes increasingly important (Rosenfield, 1997, p. 665). According to Keyes
(2020) “positive functioning consists of six dimensions of psychological well-being: self-
acceptance, positive relations with others, personal growth, purpose in life, environmental
mastery, and autonomy” (p. 208).
The sense of mastery gained by art making and exhibiting is exemplified most
poignantly by the resilience that was expressed by each participant. As the researcher, I
was most astonished by the amount of recorded footage I received. Through the
transcription process an undertone of resilience became clear to me. Resilience is defined
as being able to rise above adversity, and not let the adversity to define you (Marano,
2003). Resilient people do not avoid struggle, rather the individual is able to struggle and
continue to function. Each participant demonstrated resilience and the will to move
forward. Akin to the concept of resilience is the concept of recovery. Recovery means to
rise above afflictions and transcend the limits of the illness (Spaniol as cited in Rubin,
2001, p. 270). Recovery does not mean that mental illness disappears, rather it implies
that one manages to build a meaningful life despite struggles due to mental illness. By
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this definition each participant’s responses illustrated a stage of recovery closely
associated with participation in art therapy. Art exhibitions are a part of a matrix of
positive adaptive tool these participants have utilized. This study found that art exhibition
is a beneficial therapeutic intervention, as it relates to community, identity, control over
life, and an overall a sense of mastery. The additional themes, previous forms of
treatment, art making process, and outcome of art product, exemplify tools for gauging
control over one’s life.
Discussion of Implications
This study found that exhibiting artwork had a positive impact on each of the
participant’s lives. Each participant spoke about the positive associations they had about
exhibiting their art, and the motivating features of exhibiting. If art exhibitions aid in
developing a sense of mastery, the implementation of art exhibitions in conjunction with
art therapy may engender beneficial therapeutic effects for adults with mental illness. The
art experiences of the adults with mental illness in this study have contributed to a sense
of mastery and control in their lives. Mastery can be experienced in different ways,
through mastering a work of art, conquering fears during an exhibition, feeling motivated
to continue creating, or by receiving positive feedback from art peers and viewers.
The findings indicate exhibiting artwork can act as a motivational feature for
adults with mental illness. Exhibiting artwork is rooted in reality and seen as a culturally
significant event. Art exhibitions offer opportunities for the outsiders to be insiders, and
can be a reflective tool for testing out various pieces of self. Based on these findings, this
study supports the usefulness of art exhibitions as a part of art therapy treatment for
people with mental illness.
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Although exhibiting art had a different meaning for each participant, it was clear
that all the participants were eager to exhibit their stories and to help shed light on this
topic. This demonstrated to me that exhibiting artwork and the experiences these
participants have had with treatment environments that encourage exhibiting have led
them to become advocates for the arts, people with mental illness, and mentally ill artists.
In a way they put themselves on exhibit, to share who they are and what they represent.
Additionally, this study found that the participants emphasized the importance of
treatment facilities that provided a humanizing and accepting environment. Furthermore,
opportunities for decision-making, vocational activities (i.e.: open studios, exhibitions),
and economic empowerment, are all factors in helpful treatment environments and in
exhibiting. Finally, beyond the exhibitions themselves, it is crucial the client artists are
taken seriously. Effectual treatment and incorporation of exhibitions should mirror the
seriousness the artists feel about their work, by nurturing their artist identity and sense of
dedication.
Each participant expressed their positive feelings about exhibiting, with
consideration to their feelings about the process of creating, and the impact being able to
make art has on their lives. The findings also suggest art making itself gives purpose in
these peoples’ lives. The participants expressed that creating art served as a refuge,
transformative experience, therapeutic escape, and a source of pride. Creating art holds a
very important place in each participant’s life.
Further Studies
Findings suggest that further studies should be conducted on the topic of art
exhibitions as they relate to treatment for people with mental illness because they might
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help to further clarify the benefits of exhibiting. Further, it may be beneficial for the field
of art therapy and for the populations involved for more studies to be conducted using
qualitative grounded theory methodology, an approach in which a theory is grounded in
the interview data. Grounded theory utilizes qualitative data analysis procedures to
understand a process and interactions. The theory is then developed based on the
phenomenon found in the data analysis. I found this methodology especially beneficial
for this population because the theory is participant derived. I felt utilizing this type of
method was less biased because it did not test against a hypothesis. I found the lessoned
bias to be particularly important for an already stigmatized population. Essentially, these
kinds of studies can give clients and patients a say in future treatment procedures.
Additionally, the rich and in-depth amount of interview content I received could in no
way be justified and utilized to its best and most helpful ability to the community via only
graduate thesis. It is my goal to continue studies in this area and I aim to revisit the
participants interviewed in this thesis to continue writing based on art identity and
resiliency.
Further, a comparative study between exhibiting artists with mental illness
involved in art therapy programs and those who are not could bring forth important
realizations about the incorporation of art exhibitions in art therapy treatment. This
information could be helpful in expanding views of art therapy practice and bridging the
gaps between the art world, art therapy world, treatment facilities such as those in this
study. Also, further studies regarding art therapy with artistic traditions, such as
exhibitions, can bring art therapy out of its niche in the art world, and the art in art
therapy can be further acknowledged. That type of study could aid in Vick & Sexton-
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Radek’s (2008) suggestion to amend outdated notions that art therapy only utilizes “child
like materials, lack of seriousness for the art, and interpreting all the art works” (p. 8).
The profession can be enriched by shifting some of the focus from the mental health
world, to the art world (Lachman-Chapin et al., 1998, p. 234).
Lastly, if I were to conduct this study again I would utilize mixed methodology,
combining both qualitative and quantitative in an effort to produce statistical research for
a more substantiated study while still sharing the direct experiences of the participants.
Therefore, the lived experiences of the participants would be highlighted, allowing for a
rich understanding of their life circumstances, while a scored questionnaire would be able
to aid in finding more quantifiably measurable correlations.
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Conclusion
Imagine a world where boundaries are flexible, where facilities such as those
mentioned in this thesis and art therapy facilities are operating in unison. In this world,
art therapy can further honor the art object to best suit the artist, offering opportunities for
further creative exploration beyond the moment of creation. The participants in this study
described the powerful affect art has had on their lives. Whether artwork is used for
cathartic release, social commentary, exhibiting, monetary purposes, artist identity
formation, or the empowering sensation of mastering a skill, each participant
acknowledged the importance, seriousness and dedication they have to the arts. All the
participants in this study participated in a developmental model, studio or gallery art
program. This study brings to question the possibility for art therapy treatment, reaching
across the continuum of art as therapy and art psychotherapy to function flexibly, as
needed together with studio model programs. While the open studio approach to art
therapy has recently become more prevalent, governing models in art therapy are still
dynamically oriented art therapy (art psychotherapy) and art as therapy. However, these
models inherently link to the medical model due to their use for treatment of pathology
(Vick and Sexton-Radek, 2008, p. 4). This linkage perpetuates the identity of mental
patient and illness, discouraging more positive identity associations. However, I am not
suggesting elimination of the more traditional art therapy paradigms, because they not
only hold historic value, but also still continue to engender therapeutic effects. I am
suggesting that melding together developmental model studio/gallery programs with
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more traditional art therapy models, has the potential to highlight each modality’s
strength, creating a cooperative vehicle of healing.
This type of merger would require increased attunement on the part of the
therapist to the ebb and flow of therapeutic space, and actual environment. Therefore the
art therapist would have to remain flexible and able to represent artist, studio facilitator,
and art therapist, shape-shifting as needed. Principles in installation art, where creator can
become observer and observer can become creator, serve as a poignant example for this
type of healing sphere. Utilizing these principles offers opportunities to cross boundaries
in a therapeutic way and to eliminate hierarchical forces. Therefore, room for shared
creative expression can permeate the space; now the art, healing, viewer, artist, client,
therapist, psychiatrist, director, are on a level playing field within the transitional space.
Here one can remember to play, remember we are all human, and acknowledge within the
mutual experience of art-making the transience of the human experience and the
continuum too easily traveled between mental illness and well-being.
Artist, Joseph Beuys articulated embodiment in art as a powerful tool for change.
He suggested the possibility of social organisms transforming into a work of art; thus, the
entire process of this work of art combines production and consumption, forming quality
(Beuys, 1974). Beuys, conceptualized the social sculpture, representing society as a large
work of art, in which each person can creatively contribute to society. Through the lens
of Beuys, artistic contributions allow individuals to share in the engagement of social
change. I see this type of social change comparable to expansion within the canon of art
therapy practice, with potential for innovative shifts in ideology, roles, and community
engagement.
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Appendix A
Interview Questionnaire
Age______ Mental Illness______
1) How did you begin your relationship to art?
2) How many exhibitions have you been a part of?
a) Were they group or solo shows?
3) How long have you been showing your work
4) Describe some feelings about having your artwork displayed
5) Describe to the best of your ability an experience of an art opening you attended
with your artwork displayed.
6) Describe to the best of your ability some feelings you had before the exhibit.
7) Describe to the best of your ability some feelings felt after the exhibit.
8) Describe what it was like to see you work displayed on the wall outside of the
studio space.
9) Did your art look or feel different at the exhibit?
10) Did you receive feedback about your art work when it was exhibited and what
was some of the feedback you received?
11) Did you talk about your art work to viewers, how did that feel?
12) How did you feel returning to your artwork after the exhibit, either in following
art therapy sessions or in the studio at your own time?
13) Would you participate in more exhibitions?
14) Do you feel different after exhibiting? Do you view yourself differently after
exhibiting?
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Exhibiting Artists with Mental Illnesss
1