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ART EXHIBITIONS AS A THERAPEUTIC INTERVENTION FOR ADULTS WITH MENTAL ILLNESS by 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

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Page 1: Art Therapy Thesis MDiaz

ART EXHIBITIONS AS A THERAPEUTIC INTERVENTION FOR ADULTS WITH MENTAL ILLNESS

by

Melissa Diaz

A thesissubmitted in partial fulfillment

of the requirements forthe degree of Masters of Professional Studies(Art Therapy and Creativity Development)

School of Art and DesignPratt Institute

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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

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TABLE OF CONTENTS

ACKNOWLEDGEMENTS……………………………………………………………..vLIST OF FIGURES……………………………………………………………………..viABSTRACT…………………………………………………………………………….vii

Chapter

1. INTRODUCTION………………………………………………………………1

Installation Artist as Art Therapist: Art Exhibitions Therapeutic ValueLiterature ReviewMental IllnessArt TherapyArt Product: Role of Art Object in Art TherapyObject Relations TheoryExhibition Space as Therapeutic EnvironmentHolding Environment and Transitional SpacePlay Space within Transitional Space and Holding EnvironmentTherapeutic Environment as Third HandArt of the Mentally IllArt Exhibitions in Art TherapyExhibition Space within Treatment FacilityTherapeutic Benefits of Artist IdentityTherapeutic Elements in Organizing an ExhibitionBrining the Art to the PublicConclusion

2. STATEMENT OF RESEARCH PROBLEM…………………………………..38

Research QuestionDefinitions of TermsLimitations/delimitations

3. METHODOLOGY AND PROCEDURE……………………………………....45

Research ApproachResearch MethodologyResearch ProceduresSettingPopulation

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Ethics

4. FINDINGS………………………………………………………………………53

Open CodingAxial CodingFigure 1: Paradigm ModelDescription of Categories

CommunityArt Making ProcessIdentityPrevious Forms of TreatmentOutcome of Art ProductEmotional Involvement toward ExhibitingControl Over Life

5. DISCUSSION………………………………......................................................60

Development of MasteryIntervening ConditionsLong History of Art MakingCommunityArt Making ProcessIdentityPrevious Forms of TreatmentOutcome of Art ProductEmotional Involvement toward ExhibitingControl Over LifeMasteryDiscussion of ImplicationsFurther Studies

6. CONCLUSION…………………………………………………………………94

REFERENCES……………………………………………………………………...96

Appendix……………………………………………………………………………106

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List of Figures

Figure 1. Paradigm Model, Axial Coding on p. 57.

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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.

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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. 

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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

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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

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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

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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.

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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.

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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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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

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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

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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

options for a person with mental illness to utilize 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 collaborative decision

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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.

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, mirroring concepts of normalization and

deinstitutionalization, while honoring the mentally ill client as a fellow participant in the

realm of creativity.

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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

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

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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

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

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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.

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

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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,

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

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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

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.

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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,

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).

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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.

Object Relations Theory

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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

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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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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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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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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

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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,

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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

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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 severe 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

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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

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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. I

received proper, signed informed consent forms from each participant. 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. I was

informed by both to attend an Exhibition at Facility A which featured the artists of

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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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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

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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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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

perhaps 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 this 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 (as

cited in Rubin, 2001) this approach encourages “the belief that every person has worth,

dignity, the capacity for self-direction and an inherent impulse toward growth” (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. 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-

sync with ego needs (p. 68). Dawn’s check in with her friends mirrors this concept of

sublimation.

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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

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

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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.

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

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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

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

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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, it 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, to finish it and speak about it.

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 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

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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 within transition space, 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

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

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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.

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.

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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

representation of the personality of the creator. When the artist then reflects on the

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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

these works as “in your face, yet pretty.” During the interview, I mentioned that it seemed

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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

product affects her. She experiences not only the creating process by also the art piece as

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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

with mental illness. These responses confirm that selling artwork can serve as a

vocational tool, leading to financial gain and a sense of empowerment.

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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,

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

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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.

Sandra viewed exhibiting as sometimes anxiety provoking, but yet a way to boost

self-esteem. She recalled her first curated exhibition with Facility A,

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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

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.

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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

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

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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 and 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 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

was diagnosed and was not sure what was happening with herself. She was losing jobs

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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 our 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 previously, 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

(2002) “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 help shed light on this topic.

This demonstrated that exhibiting artwork in combination with encouraging treatment

facilities, have led these participants to become advocates, for the arts, for people with

mental illness, and for 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 attention

to the process of creating, and the impact creating 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

help to further clarify the benefits of exhibiting. Further, it may be beneficial for the field

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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, and 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-Radek’s

(2008) suggestion to amend outdated notions that art therapy only utilizes “child like

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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; one can acknowledge that

the mutual experience of art-making, the transience of the human experience and the

continuum 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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References

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

concept. Art Therapy: Journal of the American Art Therapy Association, 12(3),

161-166.

Allen, P. (2001). Art making as spiritual path: The open studio process as a way to

practice art therapy. In J. A. Rubin (Ed.), Approaches to art therapy: Theory and

technique (pp. 178-188). Philadelphia, PA: Brunner-Routledge.

Alter-Muri, S. (1994). Psychopathology of expression and the therapeutic value of

exhibiting chronic clients’ art: A case study. Art Therapy: Journal of the

American Art Therapy Association, 11(3), 219-224.

Alter-Muri, S. and Klein, L. (2007). Dissolving the boundaries: Post-modern art and art

therapy. Art Therapy: Journal of the American Art Therapy Association, 24(2),

82-86.

American Art Therapy Association (2009). Who are art therapists?. Retrieved December

5, 2009, from

http://www.americanarttherapyassociation.org/upload/whoarearttherapists2009.pd

f

Arnheim, R. (1980). Art as therapy. The Arts in Psychotherapy, 7(4), 247-251.

Bachrach, L. (1976). Deinstitutionalization: an analytical review and sociological

review. Rockville, MD: National Institute of Mental Health.

Bachrach, L. (1987). The homeless mentally ill. Washington, DC: The American

Psychiatric Press.

96

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Betsensky, M. (1973). Patterns of visual expression in art psychotherapy. Art

Psychotherapy, 1, 121- 129.

Betensky, M. (1977). The phenomenological approach to art expression and art therapy.

The Arts in Psychotherapy, 4, 173-179.

Bueys, J. (1974, November). Art Into Society - Society Into Art. Performance at The

Institute of the Contemporary Arts, London, England.

Cohen, F. W. (1981). Art therapy: Psychotic expression and symbolism. The Arts in

Psychotherapy, 8, 15-23.

Corey, G. (1996). Theory and practice of counseling and psychotherapy. Pacific Grove,

CA: Brooks/Cole.

Crain, W. (1992). Theories of development and applications. (3rd Ed.). New

Jersey: Prentice Hall.

Creswell, J. W. (1998). Qualitative inquiry and research design: Choosing among five

traditions. Thousand Oaks, CA: Sage.

Deco S. (1998). Art psychotherapy groups. In Skaife, S. and Huet, V. (Eds.). Between

pictures and words. London: Routledge.

Dubuffet, J. (1989). Earth and terrain: Assemblages, texturologies and materiologies:

Paintings and works on paper from 1955-1962. New York: Arnold Herstand and

Company.

Eklund, M. (2007). Perceived control: How is it related to daily occupation in patients

with mental illness. American Journal of Occupational Therapy, 61, 535–542.

97

Page 104: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Feen-Calligan, H. (1999). Enlightenment in chemical dependency programs: A grounded

theory. In C. Malchiodi (Ed.). Medical art therapy with adults. (pp. 134-161).

London: Jessica Kingsley.

Foster, H. (2001). Blinded insight: On the modernist reception of the art of the mentally

ill. October, 97(Summer), 3-30.

Franklin, M. (1992). Art therapy and self-esteem. Art Therapy: Journal of the American

Art Therapy Association,9(2), 78-84.

Frostig, K. (1999). “Book Review: The Handbook of School Art Therapy.” Art Therapy:

Journal of the American Art Therapy Association 16(2), 91-93

Glaser, B. and Strauss, A. (1967). The discovery of grounded theory. Chicago: Aldine.

Glaser, B. G. (1998). Doing grounded theory: Issues and discussions. Mill Valley, CA:

Sociology Press.

Goffman, E. (1963). Stigma: Notes on the management of spoiled identity.

New York, NY: Simon and Schuster, Inc.

Goode, E. (2002, July 30). A conversation with/Janos Marton; A protected space, where

art comes calling. The New York Times, pp. 1, 5. Retrieved from

http://www.nytimes.com/

Greenburg, J. R. and Mitchell, S. A. (1983). Object relations in psychoanalytic theory.

Cambridge, MA: Harvard University.

Henley, D. (1992). Exceptional children, exceptional art. Worcester, MA: Davis

Publications.

98

Page 105: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Henley, D. (1995). A consideration of the studio as therapeutic intervention. Art Therapy:

Journal of the American Art Therapy Association, 12(3), 188-190.

Henley, D. (2004). The meaningful critique: Responding to art from pre-school to post-

modernism. Art Therapy: Journal of the American Art Therapy

Association, 16(3), 112-120.

Holston, M. (2004). Paintings of the psyche: An innovative hospital program and

museum in Rio has nurtured highly acclaimed artists while revealing the healing

power of art. Americas, (English edition), 56(2), 6-13.

Horner, A. (1991). Object relations and the developing ego in psychotherapy. Northvale,

NJ: Aronson.

Keil, J. (1992). The mountain of mental illness. The Journal of the California Alliance for

the Mentally Ill, 3, 5-6.

Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in

life. Journal of Health and Behavior Research, 43, 207–222.

Klein, M. (1931). A contribution to the theory of intellectual inhibition. International

Journal of Psychoanalysis, 12, 206-218.

Klein, M. (1935). A contribution to the psychogenesis of manic-depressive states.

International. Journal of Psychoanalysis, 16, 145-174.

Kramer, E. (1971). Art as therapy with children. New York: Schocken Books.

Kramer, E. (1986). The art therapist's third hand: Reflections on art, art therapy, and

society at large. The American Journal of Art Therapy, 24(3), 71-86.

99

Page 106: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Lachman-Chapin, M., Jones, D., Sweig, T. L., Cohen, B. M., Semekoski, S. S., and

Flemming, M. M. (1998). Connecting with the art world: Expanding beyond the

mental health world. Art Therapy: Journal of the American Art Therapy

Association, 15(4), 233-244.

Lamb, H.R., and Bachrach, L. (2001). Some perspectives on deinstitutionalization.

Psychiatric Services, 52(1), 1039-1045.

Lejsted and Nielsen (2006). Essay: Art created by psychiatric patients. The Lancet, 368,

10-12.

Lentz, R. (2008). What we talk about when we talk about art therapy: An outsider’s guide

to identity crisis. Art Therapy: Journal of the Americna Art Therapy Association,

24(1), 13-14.

Linhorst, D. M., Hamilton, G., Young, E., Eckert, A. (2002). Opportunities and barriers

to empowering people with severe mental illness through participation in

treatment planning. Social Work, 47(4), 425-434.

Lusebrink V. B. (1990). Imagery and visual expression in therapy. New York and

London: Plenum Press.

MacGregor, J. M. (1989) The Discovery of the Art of the Insane. Princeton, NJ: Princeton

University Press.

Mahler, M. (1967). On human symbiosis and the vicissitudes of individuation. In The

Selected papers of Margaret Mahler, Vol. 2: Separation-Individuation. Northvale,

NJ: Jason Aronson.

Mahler, M., Pine, F., and Bergman, A. (1975). The psychological birth of the human

infant. New York: Basic Books.

100

Page 107: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Malchiodi, C. (Ed.). (2003). Handbook of art therapy. New York: Guilford Press.

Mango, C., (2005). Art on the Mind. Art Therapy: Journal of American Art Therapy

Association, 18(4), 216-219.

Mastery. 2010. In Merriam-Webster Online Dictionary. Retrieved May 7, 2010, from

http://www.merriam-webster.com/dictionary/hacker

McGraw, M. (1995). The art studio: A studio based art therapy program. Art Therapy:

Journal of American Art Therapy Association, 12(3), 175-183.

McNiff, S. (1995). Keeping the studio. Art Therapy: Journal of the American Art

Therapy Association, 12(3), 179-183.

McNiff, S. (1997). Art therapy: A spectrum of partnerships. The Arts in Psychotherapy,

24(1), 37.

McWilliams, N. (1994). Psychoanalytic diagnosis: Understanding personality structure

in clinical process. New York: The Guilford Press.

Moon, C. (2002). Studio art therapy: Cultivation the artist identity in the art therapist.

London: Jessica Kingsley.

National Alliance on Mental Illness (n.d.). What is mental illness: Mental illness facts.

Retrieved Decemeber 5, 2009, from

http://www.nami.org/Content/NavigationMenu/Inform_Yourself/

About_Mental_Illness/About_Mental_Illness.htm.

National Alliance on Mental Illness (n.d.). Mental illnesses: By illness. Retrieved

Decemeber 5, 2009, from

http://www.nami.org/Content/NavigationMenu/Inform_Yourself/

About_Mental_Illness/About_Mental_Illness.htm.

101

Page 108: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Naumburg, M. (1987). Dynamically oriented art therapy: Its principles and practice.

Chicago: Magnolia Street.

Pendleton, J. (1999). Painting a path to well being: Art therapy as a link to mental health

treatment. Art Therapy: Journal of the American Art Therapy Association, 16(1),

31-36.

Pickford, R. W. (1967). Studies in psychiatric art. Springfield, Illinois: Charles C

Thomas.

Prinzhorn, H. (1972). Artistry of the mentally ill (Rev. Ed). Berlin, Germany: Springer-

Verlag.

Robbins, A. (1987). The artist as therapist. New York: Human Science Press.

Robbins, A. (2001). Object relations and art therapy. In J. A. Rubin (Ed), Approaches to

art therapy: Theory and technique (pp. 54-65). Philadelphia: Brunner-Routledge,

Rogers, N. (2001). Person-centered expressive arts therapy. In J. A. Rubin (Ed.),

Approaches to art therapy: Theory and technique (pp. 163-177). Philadelphia,

PA: Brunner-Routledge.

Rosenfield, S. (1989). The effects of women’s employment: Personal control and sex

differences in mental health. Journal of Health and Social Behavior, 30, 77-91.

Rosenfield, S. (1992). Factors contributing to the subjective quality of life of the chronic

mentally ill. Journal of Health and Social Behavior, 33(4), 299-315.

Rosenfield, S. (1997). Labeling mental illness: The effects of received services and

perceived stigma on life satisfaction. American Sociological Review, 62, 660-672.

Rubin, J. (Ed.). (2001) Approached to art therapy: Theory and technique. Philadelphia:

Brunner-Routledge, 2001.

102

Page 109: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Schindler, V. and Pletnick, C. (2006). Developing the role and skills of an artist in adults

diagnosed with schizophrenia. Art Therapy: American Journal of Art Therapy,

23(3), 126-131.

Soklaridis, S. (2009). The process of conducting qualitative grounded theory research for

a doctoral Thesis: Experiences and reflections. The Qualitative Report, 14(4),

719-734.

Spaniol, S. E. (1990a) Exhibiting art by people with mental illness: Issues, process and

principle. Art Therapy: Journal of the American Art Therapy Association, 7(2),

70-78.

Spaniol, S. E. (1990b) Organizing exhibitions of art by people with mental illness: A step

by step manual. Boston: Boston University Center for Psychiatric Rehabilitation.

Spaniol, S. E. (1995). Art is all the feelings trapped inside: An interview with Marilyn

McKeon, Art Therapy: Journal of the American Art Therapy Association, 12(4),

227-230.

Spaniol, S. E. (2003). Art therapy with adults with severe mental illness. In C. Malchiodi

(Ed.). (2003). Handbook of art therapy (pp. 268-279). New York: Guilford Press.

Stark, M. (1999). Modes of therapeutic action: Enhancement of knowledge, provision of

experience, and engagement in relationship. Northvale, NJ: Jason Aronson.

Steinar, K. (1996). Interviews: An introduction to qualitative research interviewing.

London: Sage.

Strauss, A. and Corbin, J. (1990). Basics of qualitative research: Grounded theory

procedures and techniques. Newbury Park, CA: Sage.

103

Page 110: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Strauss, A. and Corbin, J. (2008). Basics of qualitative research (3rd ed.). Los Angeles,

CA: Sage.

Timm-Bottos, J. (1995). Artstreet: Joining community through art. Art Therapy: Journal

of the American Art Therapy Association, 12(3) 184-187.

Thompson, G. (2009). Artistic sensibility in the studio and gallery model: Revisiting

process and product. Art Therapy: Journal of the American Art Therapy

Association, 26(4), 159-166.

Veron, M. and Baughman, M. (1972). Art, madness and human interaction. Art Journal

31(4), 413-20.

Vick, R. (2000). Creative Dialogue: A shared will to create. Art Therapy: Journal of the

American Art Therapy Association, 17, 216-219.

Vick, R. (2003). A brief history of art therapy. In C. Malchiodi (Ed.). (2003). Handbook

of art therapy. New York: Guilford Press.

Vick, R. and Sexton-Radek, K. (2008). Community-based art studios in Europe and the

United States: A comparative study. Art Therapy: Journal of the American Art

Therapy Association, 25(1), 4-10.

Winnicott, D. (1953). Transitional objects and transitional phenomena. The International

Journal of Psychoanalysis, 34, 89-97.

Winnicott, D. W. (1968). Playing: its theoretical status in the clinical situation.

International Journal of Psychoanalysis, 49, 591-599.

Winnicott, D. W. (1969). The Use of an Object. International Journal of Psychoanalysis,

50, 711-716.

Winnicott, D. W. (1971). Playing and reality. New York: Basic Books.

104

Page 111: Art Therapy Thesis MDiaz

Exhibiting Artists with Mental Illness

Wix, L. (1995). The intern studio: A pilot study. Art Therapy: Journal of the American

Art Therapy Association, 12(3), 175-178.

Wolfensberger, W. and Thomas , S. (1983) PASSING (Program Analysis of Service

Systems’ Implementation of Normalization Goals): Normalization criteria and

ratings manual (2nd ed.). Toronto, Canada: National Institute on Mental

Retardation.

Wolin, S. J. and Wolin, S. (1993). The resilient self: how survivors of troubled families

rise above adversity. New York: Villard Books, 1993.

World Health Organization (n.d.). Gender and women’s mental health. Retrieved

Novemeber 7, 2010, from

http://www.who.int/mental_health/prevention/genderwomen/en/index.html.

105

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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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