Commonly referred to under the generic title of the arts therapies, the four disciplines of art therapy, drama therapy, dance movement psychotherapy and music therapy each have their own distinctive identities and histories. They all share a common belief that each individual is innately creative and that creativity itself is therapeutic. All creative potential evolves from the common experience of “play” and all of the arts, especially in respect to their initial expression in early childhood, come out of, or can be seen as a part of, play itself. Accordingly, we can add another profession to the four already mentioned: that of play therapy.
So how is play and the creative expression of play, through the arts, therapeutic? This is a complex question, but I think we can begin to answer it in an uncomplicated way. Let us start by looking at one important aspect of play, especially through the arts, the aspect of expression. All of the arts are inherently expressive, and to be able to express oneself is, in its way, a form of communication. Children use this expressive media in order to express, amongst other things, their inner emotional states. In order to fully grasp the importance of this in respect to therapy, we need to consider the opposite of expression, which is repression.
We know that repressed emotions have a habit of recurring as symptoms, frequently much later in life. Children with communication difficulties, perhaps associated with a severe learning disability or other condition such as autism, sometimes have great difficulties in finding appropriate means for emotional expression. The difficulty goes deeper because language, of course, is not just a means of expression, it’s a major means for making sense of experience itself. It provides the means for making sense of our experiences, including the highly charged experiences of our emotional lives. The arts can, for many of these children, provide a form of alternative language that can begin to help them to shape their emotional worlds.
All of the arts and play therapies would agree that the first stage of any therapeutic work is to provide the child with a means for expression and creativity, whether through the visual arts, drawing, painting and modeling, drama, dance and movement or music. In the case of play therapy, the primary medium would be, as one would expect, play itself, and this might use any or all of the arts or the use of toys as expressive objects in their own rights. As I have already suggested, for some children with learning difficulties, for example, and who’s development of language is delayed or impaired, the arts or play can become a primary or only form of emotional expression providing a vital outlet for their inner emotional lives.
The therapist can sometimes take a very active role in these early expressive stages of the therapy. Let me give you a simple example shared by a colleague and very experienced art therapist, Trevor Jeavons.
Trevor was referred a child with SEN who had started to develop symptoms following the death of his mother in a road accident which was actually witnessed by the child himself. Not only was his school-work suffering, but he was also experiencing regular nightmares. Shy and rather uncertain about leaving his father behind in the family centre waiting room, the seven-year-old nevertheless accompanied Trevor into the art therapy room.
Art therapists are very careful about how they organize the therapy space they work in, and they ensure that there is as wide a range of art materials available as possible. So, this little boy was immediately introduced into a world of potentially endless creative possibilities, but his apprehension and shyness got in the way of him being able to make use of any of them. Picking up on the child’s anxieties, Trevor chose to make the first move. He took hold of a lump of plasticine and started to mold it into interesting, but abstract, shapes. This soon caught the boy's attention. Looking towards the child then back to the form being molded in his hands, Trevor started to form a relationship with the child and the boy became more relaxed and more interested in what is happening to the plasticine figure. Then the boy looked towards Trevor and said “That’s it!”
Trevor asked “What is it?”
“It’s the monster” the boy replied. Somehow, the molded plasticine shape had caught the child’s imagination and he had made an association between it and an image from his nightmares.
Looking at the child, Trevor asked what he should do with the monster, but the boy simply shook his head, saying “I don’t know”. Trevor smiled, put his other hand into his pocket, extracted his keys, went over to his desk and opened the locked draw. Making sure the child followed his every move, he placed the “monster” in the draw and locked it away. The child simply smiled, the session was over and he was reunited with his dad.
The following week, dad had only one thing to say to the therapist which was “I don’t know what you did last week, but it did the trick, he has slept soundly for the first time in ages, no more nightmares”. The child had learned some valuable lessons about the power of symbolic expression. Of course he did not have to intellectually understand that the nightmare itself was a type of symbol for the “monstrous” thing that has happened to him. He already understood that someone else was willing and able to share this monstrous thing with him and keep him safe from the “monster” (by locking it away).
At the start of the second session of therapy there was no more apprehension and the boy couldn't seem to wait to get into the art therapy room. And what was the first thing he did once inside? He went over to the desk and looked at the draw and then up at Trevor. His therapist understood what was being asked for; he took out his key and opened the draw so that the boy could see that the “monster” was still safely contained. A silent, but highly potent, meaning had been shared between therapist and client and, for now, the “monster” was kept at bay, until the boy could develop the emotional maturity to more fully work through his bereavement in the years to come.
Trevor Jeavons is now retired, but he is currently working on a book about his pioneering work with children with SEN. From the mid 1970s onwards, he worked closely with Scope (then called the Spastic Society), and in 1979 he took up the post of Head teacher at a new special school with a nursery and a resource center for Buckinghamshire Education Authority. Between 1993 and 2006, Trevor was the Senior Art Therapist at the Department of Child and Adolescent Psychiatry for the NHS in Milton Keynes. The following passages are taken from his forthcoming book:
How can a person who has never been able to hold a brush or scribble a line begin as an artist? I no longer work specifically with physically and multi-handicapped children but have experience and writings from the past and thought that it might be useful to look back at my notes. Some of what follows includes jottings that I made around 1965 while working full time with disabled young people:
Let us consider a boy in a wheelchair who cannot hear, talk or walk; his hands are paralysed, he has little control above the waist and absolutely no control below the waist. He also has learning difficulties. He has never painted or sculpted, perhaps rarely chosen what he would like to wear and, although he can reject food as he is fed, there are no opportunities for choice even in feeding. If only this boy could paint, sculpt and draw, there would be opportunity for choice and experience of texture, form, colour and line. Why should he not have a chance to produce his own creative work? How should we approach such a person?
Sit opposite and try to befriend him. He does not hear but he can see. Get some colourful paint and play with it, getting your fingers covered in paint, letting him see that this is fun. Wheel him up to a high table and sit next to him. Provide a paint dish and some nice paper. Stick your nose in the paint; bob your head and dot lots of spots over the sheet. Then put one of your very wet, messy fingers near to his nose. He does not seem afraid and the paint goes on. With any luck he copies you, bobs his head and makes some coloured dots. The pattern goes up on the wall. Applaud enthusiastically and put his name on the corner of the painting. He has made a start, smiling broadly. This is a true story; his name was Paul and he was nine years old.
Perhaps, after you have shown how, he can bite from a piece of expanded polystyrene tile or packaging, creating a crude shape; naturally, we have to take care here. He can then nose-paint this, or try with a brush held between his teeth. This will also go on display. He is now, not only a painter, he is a sculptor. He has found some freedom. Access to special computerised equipment, especially computer graphic programs, now give wonderful opportunities, but when I began this work in the early Sixties there were no such things.
It is a common misinterpretation that the artist’s role is that of a communicator of ideas and images to others. I believe that the basic function of imaginative creativity is to communicate with oneself. The most lasting expressive work has been created primarily from a desire to satisfy the severest of all critics, the artist himself, and these creations have rarely harmonised with the current trends. Where is the value in coaxing a child to make pictures determined by ourselves? There is no real boost to self-esteem and the adult-led end product might have a sophistication that would confuse the child.
The old concept of language development was that when speech is available the child can express his or her inner thoughts. Now we know that the early sounds and attempts to copy feed back and stimulate the advancement of thought. The spoken word and the inner language make for intellectual development. It is not generally understood that similar things can happen with concepts of line, form and colour. As the child manipulates with finger or toe, and if he clearly sees results in puddles of colour and crude scribble, his concepts advance, enabling him to further develop graphic symbolism. If a child with learning difficulties produces scribbles of paint and heaps of rubbish glued to a board that do not conform to our own aesthetic ideals of pictures and models, remember that they may well be developmentally important to him.
It seems to me that when a child is involved in the creative process, however primitive, the result, if really from him/her, is remembered. Unlike much of his/her class work, there is more chance of retention and meaning because, firstly, the processes gone through are necessarily within the child’s present ability and, secondly, the resulting concrete success becomes a meaningful internal as well as external image. As a developing personality repeatedly externalises an internal idea or creates a partly accidental scribble that is completely his/her-own, he/she accepts a new image to progress from. The emergence of an expression surely becomes, if perceived by the creator, a unique and personal stepping stone to the next stage of development. So it is that seemingly meaningless creations, which have little value to us, can have developmental value for the child.
Arts therapists, like Trevor Jeavons, work within a very wide range of settings, including the NHS, in schools and, increasingly, in private practice. Perhaps these disciplines used to be considered “alternative” in the past, but, in reality, they are now well established professions, and practitioners need to be trained at Masters level and registered with the Health Professions Council (HPC). More information can be found on the HPC Website (under Arts Therapies) or from the various professional bodies listed below.
Janek Dubowski is the Head of Subject for Psychological Therapies, School of Human & Life Sciences, at Roehampton University, London. The University has qualifying programmes in art therapy, drama therapy, dance movement psychotherapy, music therapy and play therapy. More information can be obtained from the University website or the other sites listed below:
Roehampton University, London: