Lynn Kapitan, Editor
“I have to keep telling them, ‘Take the patient’s histo- ry. Listen, please. Listen and find out what the patient thinks is wrong.’ But all they want to do is pull out their palm-tops and start ordering up the lab tests,” a physician lamented to me about his medical students. A week later, an art therapy student shared a similar complaint about a peer who wistfully suggested that diagnosis and treatment would greatly improve if we would just plug a client’s symptoms into a computer and read out the results. Both the medical and art therapy students were confusing dis- ease with illness: Disease refers to malfunctioning biologi- cal or psychological processes, whereas illness is the psycho- social experience of disease and the meaning it holds for the sufferer (Bennett, 2001). In The Empathic Healer: An Endangered Species? Bennett (2001) explained that objec- tive methods may assess the presence of disease but to appreciate a person’s illness we must use our human capac- ity for empathy.
I think about this distinction on the night I facilitate an art therapy session for outpatients in a chronic pain support group. Steven (pseudonym) is in physical decline due to nerve damage resulting from a car accident years before. I have no diagnostic readout handy, though I know about the many treatments he has undergone. But I am not a medical doctor and Steven does not seek treatment; he seeks healing, an inner process of mobilizing resources to achieve whole- ness—whether or not his chronic pain can be cured. I give him brightly colored tissue paper to create a series of free- formed collages on cardstock. He is so absorbed in the pro- cess that later he tells me how time seemed to slow down, his chronic pain temporarily suspended as he relaxed into the pleasures of the creative process. We look at his abstract artworks and he now sees them as meaningfully linked. Gently we unfold a symbolic narrative that reflects his cur- rent state and empathically witnesses the meaning he gives to his images. Steven’s chronic disease is a partner in our journey that night; together we address its destructive course in his life and imagine what is needed now — not to cure his disease but to free up the forces of healing so that he may put his life in balance.
How else could I understand this person’s frame of ref- erence if not through my subjective use of empathy? How
else could I connect our different experiences and perspec- tives? How do I formulate treatment if I cannot sense that Steven may be suffering not just from physical pain but also from survivor’s guilt? Or if I fail to imagine what it was like to lose his identity as an independent male and provider for his family? We call upon empathy to understand something in another that is not ours; empathy is the process we use to “visit a foreign place” (Bennett, 2001, p. 29). Steven and I created a space between us and filled it with meaning, each reaching toward the other and aesthetically imagining into perceptual and emotional experiences of our encounter. If “illness is a complex mix of attitude, belief, and behavior” (Bennett, 2001, p. 51), then appreciating illness from Steven’s perspective by opening up a channel for the flow of empathy is of utmost importance for addressing his healing.
Art Therapy and the Healthy Brain
The lead articles in this issue contribute to a conversa- tion on the relevance of such subjective aspects of art thera- py in an age marked by technological and neurobiological medical advances. While some professions have become more reductionistic in the drive for efficacious treatment, others are utilizing findings from neuroscience to develop their ideas about empathy, learning, and consciousness. We are starting to appreciate the fact that all mental processes involved in art therapy derive from brain activity. Studies reveal the brain to be a surprisingly malleable, dynamic organ that shapes and is shaped by experience not only early in life but also throughout the life span. Learning, which is a product of experience, produces alterations in gene expres- sion and subsequent changes in brain architecture and func- tion (Kandell, 1998) that can be therapeutically harnessed. Thus, we may theorize that art therapy exerts its healing effects by inducing new learning at the structural level of the brain that is in a constant state of becoming.
Art therapy has an important role not only in restoring humanism to health care through aesthetic empathy, as Michael Franklin discusses in his article, but through the skilled imagination that empathy requires. Imagination, it turns out, is healthy for the brain. With respect to the opti- mal therapeutic environment for healing from trauma, Perry (2008) asserted that art therapy is perfect for changing brain structures: Unlike talk therapy, art therapy helps to build new networks through imaging, patterning, somatic sensory cues, touch, and movement. Vija Lusebrink, in this issue, theorizes the brain structures that may be in- volved in moving along each of the different levels of expres- sive therapy experience, and suggests that art-based assess- ment may assist art therapists in devising more accurate interventions that maximize beneficial neural processes.
These ideas consider art therapy’s effects on the neuro- biological level of function. According to Perry (2008), art therapy is good for the brain because it involves the follow- ing key aspects: Art therapy provides experiences that are relevant and appropriately matched to developmental needs, as Lusebrink asserts. Art is pleasurable for most peo- ple and therefore rewarding. Experiences that provide pos- itive rewards attract and increase healthy brain activity. Linney Wix, in her article, affirms the value of repetition in studio art making as well as rhythmic qualities, both of which resonate with neural patterns. Art therapy elicits cul- tural expression that is respectful toward people, their fam- ilies, and cultures. Above all, the brain responds to art ther- apy because it is relational. Because we are psychosocial beings who are hardwired for relational learning, the inter- personal environment of art therapy creates a foundation of security that is necessary for brain development.
Art Therapy as a Catalytic Agent
Art therapy is founded on an empathetic relationship that extends both interpersonally and through interactions with artworks; thus, we assume that it has a biological impact, given the dynamic, reciprocal relationship between the brain and the facilitating environment. In his study of the brain’s self-healing capacity, Bennett (2001) posited that therapy produces alterations in the brain by evoking an emotional state that destabilizes rigid or habitual neural pathways. In this issue, Gillian Furniss’s study of Jessica Parks, a professional artist and adult with autism, affirms that relationships with others based on the underlying pres- ence of affect was a significant factor in Parks’s develop- mental progress. The therapist, and perhaps the art activi- ty as well, become for the brain “a representative of the environment and catalyst for necessary change” that opens up “the prospect of stabilization at a higher level of func- tion” (Bennett, 2001, p. 151). The experience of being with an empathetic, validating person sets these corrective forces in motion.
What if art therapy, then, functions like an antibiotic —a catalyst that works by interfering with an agent that is challenging a person’s immune system, thereby helping to mobilize the person’s capacity to restore homeostasis and health? We know that the medications used in psychiatry work similarly to restore function by stabilizing abnormal
neurochemical activity. As we come to understand how the nervous and immune systems interact, the mitigating ef- fects of art therapy may become clearer. Perhaps we can understand my patient’s Steven’s relief of suffering when we consider my empathic role and the artworks he produced as more catalytic than corrective, and when we reflect on how Steven capitalized on the healing potential locked within his neural circuitry or available within his current life context.
Taking this idea further, we can imagine the art therapy studio as a catalyst in establishing healthy brain-like “social circuitry” for the life spaces and immune systems of partic- ipating individuals, groups, and organizations. Linney Wix proposes that the studio is a rich place of possibility not only for art making and engaging with the therapist and other people, but also as a locus of intersecting ideas, hy- bridity, interdisciplinarity, and new “meeting points…in art therapy thought and practice” (p. 181). I agree with her argument that the studio has been neglected in art therapy and its benefits not fully exploited. But what if we thought of the studio the same way that we think about how the brain functions? A full embrace of the “studio of possibili- ty” might produce alterations not only in the brain but also in the art therapy profession by creatively destabilizing our habitual thought processes and inducing new learning on the structural level of the profession itself.
Art therapy contributes skilled uses of subjectivity and imagination to health care, both in the human relation- ships we are hardwired for and in the protective value that studio art making may offer to our individual and collec- tive immune systems. As we learn more about the biologi- cal, neurological, and even molecular levels of disease, we must not focus too narrowly and forget the suffering per- son before us who seeks our imaginative, empathic re- sponse. The ability of an art therapist to creatively imagine into another’s state of being is at the heart of art therapy and the most effective and humane environments where healing takes place.
Bennett, M. J. (2001). The empathic healer: An endangered species? San Diego, CA: Academic Press.
Kandell, E. R. (1998). A new intellectual framework for psychi- atry. The American Journal of Psychiatry, 155(4), 457–469.
Perry, B. (2008, November). The healing arts: The neuro-develop- mental impact of art therapies. Paper presented at the 39th Annual Conference of the American Art Therapy Association, Cleveland, OH.
Kaynak : https://www.researchgate.net/publication/241720292_The_Empathic_Imagination_of_Art_Therapy_Good_for_the_Brain