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Healing the Inner Child through Portrait Therapy: Illness, Identity and Childhood Trauma

Authors:
  • Independent Researcher, Artist & Art Therapist & Co-Editor In chief of the International Journal of Art Therapy

Abstract and Figures

This is a co-written case study by art therapist Susan Carr and patient-researcher (PR) Susan Hancock, one of seven people who participated in Carr’s PhD research project. Susan Hancock is a former university lecturer who was diagnosed with incurable cancer shortly after retirement; her publications include The Child that Haunts Us: Symbols and Images in Fairytale and Miniature Literature (2008, published by Routledge). In her PhD project, Carr researched portrait therapy as a collaborative art therapy intervention for people living with Life-Threatening and Chronic Illnesses (LT&CIs) who experience illness as a disruption to their sense of self-identity. Portrait therapy reverses the ‘terms of engagement’ within art therapy, using the art therapist’s ‘third hand’ to create portraits for patients, yet co-designed by patients. The focus of this article is an exploration of the role portrait therapy plays in helping people living with LT&CIs to explore and heal childhood trauma. We examine the therapeutic implications of transforming traumatic memories and argue that through a process of mirroring and attunement, portrait therapy enables people to develop an increase in their creative capacity to adapt to the way illness impacts upon their inner child and to gain an increased sense of self-identity coherence.
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Please use the above link for a free copy of my Healing the Inner Child
through Portrait Therapy paper.
Thanks
Susan
... My PhD -developing Portrait Therapy (2015, 2018) -was therefore inspired by working with clients, and involved developing an art therapy intervention for patients living with life threatening or chronic illnesses. Portrait Therapy reverses the traditional terms of engagement within art therapy and uses the art therapist's artistic practice or 'third hand' (Kramer 1971(Kramer , 1977(Kramer , 2000Carr 2014Carr , 2015Carr , 2017Carr , 2018 to create portraits for patients; however, in a series of 'negotiations', the patients co-design their own portraits -directing how they wish to be portrayed. ...
... p.145). Creating a play space through building sculptures in clay can therefore help clients to reconnect to their 'inner child' (Carr 2017), where memories of making mud pies, modelling animals and figures in Plasticine®, Play-Doh® or pastry, come to the fore, and they are once again given permission to play. ...
... Following the sessions, service users felt better able to contain their emotions, to appreciate positive memories while also sharing negative memories, to accept the trauma that been part of their life history and to make plans for the future. Their findings echo other similar studies focused on children with experiences of trauma (Carr & Hancock, 2017;Mills & Kellington, 2012), and veterans (Jones et al., 2017;Lobban & Murphy, 2017, 2020. The authors also addressed another key gap in the literature, the need for follow-up procedures Uttely et al., 2015). ...
... Papers published on the subject of art therapy and trauma, and post-traumatic stress (e.g. Carr & Hancock, 2017;Chong, 2015;Elbrecht, Liz, & Antcliff, 2014;Gibson, 2018;Greenwood, 2011;Hass-Cohen, Findlay, Carr, & Vanderlan, 2014;Homer, 2015;Jones, Walker, Drass, & Kaimal, 2018;Learmonth & Gibson, 2010;Lobban, 2016;Lobban & Murphy, 2018;Naff, 2014;O'Brien, 2004;Skeffington & Browne, 2014;Smith, 2016;Stace, 2014;Testa & McCarthy, 2004;Tripp, 2007), provide important insight into the issues faced and examples of innovative interventions developed. However, modified approaches to support trauma and complicated grief caused by COVID-19 are required, and research is much needed in this area. ...
... Portraits mirror the self and other, allowing the viewer to re/consider and question senses of identity and self. Carr and Hancock (2017) describe Wright's ideas on mirroring and attunement in portraiture and self-identities, stating that the painting's surface is 'derivative, or "analogue" of the mother's expressive face in infancy', acting as 'a responsive and mirroring extension of the self' or 'surrogate adaptive mother' (p.8). Mirroring and attunement as developed by Stern (1985) are important processes in the healthy maturation of the infant in communication and socialisation through learned responses that are first experienced between baby and caregiver. ...
Chapter
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This chapter in the first international book on the subject: Art Therapy in Museums and Galleries: Reframing Practice, edited by Ali Coles and Helen Jury, looks at how the two Rembrandt self portraits in the National Gallery in London give insight into, and further inform the review of artwork that takes place at the end of a series of clinical sessions in Art Psychotherapy. The chapter explores the contexts of space, place and time, and how as Art Psychotherapists we hold in mind the artwork of the client or patient throughout the clinical work, to help make meaning and to strengthen subsequent understanding of psychological presentation. It presents the case for artists' artwork informing clinical practice and how, in this case, the impossibility of viewing the two Rembrandt self-portraits together in the same room allowed for thinking to develop about the elements and connections being made by keeping in mind one image, when in the presence of another. The importance of journalling as a method for informing ideas and revealing connections that can be made through internal discourse, is explored. The role of time is considered too, in the context of how it appears to alter when pieces of artwork are viewed together, each representing a different aspect of the client or patient's presentation. The capacity to recall the visual significance of a piece of artwork is one aspect of the Art Psychotherapist's work, alongside the significance of the non verbal process of artmaking, and these factors inform the chapter and its relevance to contemporary Art Psychotherapy practice.
Article
"Letter to the Inner Child – Expressive Writing in Literary Context. The paradigm of expressive writing and its well-known benefits in the field of improving mental health are well known since the end of the twentieth century. In my essay, I would like to explain the connections of this approach with the highly influential works of John Bradshaw as well as the concept of self-healing through expressive writing with the help of the example found in the classical Hungarian epistolary novel Fanni hagyományai. Keywords: expressive writing, mental health, inner child, Pennebaker, Bradshaw "
Article
Background Post-traumatic stress disorder is a debilitating mental health condition that can occur when individuals are exposed to traumatic situations [American Psychiatric Association. (2013 American Psychiatric Association. (2013). Trauma- and stressor-related disorders. In Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.[Crossref] , [Google Scholar]). Trauma- and stressor-related disorders. In Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub]. Art therapy has been growing in popularity and acceptance as a therapeutic intervention for trauma over the last 10 years [Nanda, U., Barbato Gaydos, H. L., Hathorn, K., & Watkins, N. (2010). Art and posttraumatic stress: A review of the empirical literature on the therapeutic implications of artwork for war veterans with posttraumatic stress disorder. Environment and Behavior, 42(3), 376–390. https://doi.org/10.1177/0013916510361874], however, there is a sparsity of rigorous, methodologically sound evidence supporting its use. One step towards developing rigorous effectiveness studies is to firstly consolidate an understanding of the elements of art therapy. Method A comprehensive systematic search of the literature was performed. Data was extracted to best understand the elements of art therapy using the elements articulated by Borrelli et al. (2005 Borrelli, B., Sepinwall, D., Ernst, D., Bellg, A. J., Czajkowski, S., Breger, R., & Ogedegbe, G. (2005). A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research. Journal of Consulting and Clinical Psychology, 73(5), 852. https://doi.org/10.1037/0022-006X.73.5.852[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]. A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research. Journal of Consulting and Clinical Psychology, 73(5), 852. https://doi.org/10.1037/0022-006X.73.5.852) which include: Design, Training, Delivery, Receipt, and Enactment. The elements were mapped and narratively described. Findings A total of 44 studies met eligibility criteria and were included for data extraction and coding. Publications reported study design, treatment enactment, and treatment receipt; however, gaps were seen in the reporting of provider training and the delivery of treatment, prominently the lack of reported treatment delivery guidelines. Conclusion This study demonstrated that there is a lack of consistency in the reporting and use of practice guidelines regarding art therapy for trauma, which severely impacts the ability to determine best practice. However, considering that art therapy is focused on consumer exploration with therapist support, it is possible that the lack of guidelines is intentional, rather than incidental. Exploring practitioners’ intent around selection and use of practice guidelines is needed to better understand this phenomenon. Plain-language summary Post-traumatic stress disorder is a debilitating mental health condition that can occur when individuals are exposed to traumatic situations. Art therapy has been growing in popularity and acceptance as a therapeutic intervention for trauma over the last 10 years, however, there is still hesitation when considering art therapy as a valid treatment for trauma. Given that funding bodies and medical advisory institutions around the world are increasing their focus on trauma treatments that can demonstrate effectiveness, we need to have a better understanding of what represents good practice for art therapy before we are able to investigate the effectiveness. Without benchmarks for what best practice art therapy looks like, we cannot perform the high-quality studies needed to investigate the effectiveness of art therapy as a trauma treatment. This study performed a systematic search of the academic literature to best understand the elements of art therapy practice for trauma with the aim of consolidating and understanding practice consistency and standardisations in five elements: Design, Training, Delivery, Receipt, and Enactment. A total of 44 studies were included. This study demonstrated that there is a lack of consistency in the reporting and use of practice guidelines regarding art therapy for trauma, which severely impacts the ability to determine best practice and, in turn, to perform studies of effectiveness. However, considering that art therapy is focused on individual exploration with therapist support, it is possible that the lack of practice guidelines is intentional, rather than incidental. By extension, having one singular treatment protocol may not be effective for this type of intervention, as it is impossible to create a treatment manual for such an individualised treatment. It is recommended that the intent behind art therapy practitioners’ reporting and use of practice guidelines is further explored to better understand this trend.
Article
This art-based collaborative research study explored the perceptions of four group art therapists who engaged in the practice of creating art alongside their clients. It aimed to explore the challenges these art therapists perceive to be associated with their practice of in-session artmaking through a series of in-depth interviews incorporating discussion and artmaking. Analysis included coding of interview transcripts, reviewing art, and isolating video and audio clips which were first organized into video summations and then refined into a culminating video. Outcomes included three contemporary risks associated with creating alongside clients and four skills therapists in this study developed to mitigate these challenges: (a) multitasking, (b) shifting awareness, (c) letting go of control, and (d) media awareness. The study provides a practical discussion of how experienced art therapists apply this practice and suggests skills that may be needed to successfully manage potential challenges. It also adds the term “companioning artmaking” to the literature. This inclusive term describes the practice of creating art in the presence of group members to be with and beside them while acting as a role model and companion.
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Portrait therapy entails an art therapist co-creating portraits of patients diagnosed with life-limiting illnesses and exhibiting it in a museum art gallery. A description of portrait therapy practice draws on the portraits, collages, and prose poems of two patients, along with feedback from exhibition visitors and patients’ families. For patients, portrait therapy provides control over how they are seen, opportunity to reevaluate life, and enable a sense of continuity. For visitors, portrait therapy raised awareness of suffering, identified shared human emotions, and facilitated bereavement.
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(KOR)본 연구는 영국에서 축적된 미술치료학 연구의 지적구조를 규명함으로써 영국 미술치료 학의 연구영역과 세부내용을 파악하고, 국내 연구에의 시사점을 도출하는 데에 그 목적이 있다. 연구대상은 영국미술치료사협회에서 출간하는 「International journal of art therapy: inscape」의 1권 1호부터 23권 3호(1996-2018) 사이에 게재된 논문 202편이다. 연구도구는 Excel, SEMI, COOC, WNET, NodeXL 프로그램을 사용하였으며 연구대상 논문에서 추출 한 144개 단어의 개별출현빈도와 동시출현빈도를 바탕으로 유사도 계수를 산출하고, 네트워 크를 시각화한 뒤에, 연구영역별로 연관된 논문의 내용을 정리하는 방법으로 지적구조를 파 악하였다. 본 연구의 결과는 다음과 같다. 첫째, 주요 연구주제를 군집화한 결과, 7개의 상 위 군집 안에 41개의 하위군집이 분포된 것으로 나타났다. 둘째, 위의 결과로 17개의 의미 있는 연구영역을 구분할 수 있었으며 지적구조의 세부내용을 살펴본 결과, 조현병, 학습장 애, 자폐 스펙트럼 장애, 외상 후 스트레스 장애, 경계선 성격장애에 대한 연구를 다수 찾아 볼 수 있었다. 그리고 아동화와 이미지를 탐구하거나 새로운 미술치료 이론을 고찰한 연구 도 다수 찾아볼 수 있었다. 이러한 결과를 바탕으로 국내 미술치료학 발전을 위한 시사점을 논의하였다. (ENG)This study aims to identify research domains and detailed contents of art therapeutics in the United Kingdom by investigating the intellectual structure, and deriving implications for research in South Korea. The research targets were 202 original papers published in the “International Journal of Art Therapy: Inscape” from volume 1, number 1 to volume 23, number 3 (1996-2018). This journal is published by the British Association of Art Therapists. Excel, SEMI, COOC, WNET, and NodeXL programs were used as research tools. Based on the individual appearance frequency and simultaneous appearance frequency of 144 words extracted from the targeted research papers, the similarity coefficient was calculated. After visualizing the network, the intellectual structure was identified by the organizing contents of the papers related to each research domain. The results of this study are as follows. First, after grouping major research subjects, it was revealed that 41 subgroups were distributed in seven high-level groups. Second, 17 significant research domains were classified. After examining the detailed contents of intellectual structure, many studies on schizophrenia, learning disability, autism spectrum disorder, post-traumatic stress disorder and borderline personality disorder were found. Moreover, many studies had researched children’s drawings and images, and investigated new art therapy theories. Based on these results, implications were discussed for the advancement of art therapeutics in South Korea.
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