PART I
Expanding the Therapeutic Role
CHAPTER 1
Art Therapy as a Tool for Social Change
A Conceptual Model
Dan Hocoy
Introduction: How the twain meet
The relationship between art therapy and social action is not entirely self-evident. Although conceived from feminist origins and nurtured by progressive political leanings (Junge 1994), art therapy in contemporary practice (Elkins and Stovall 2000) still diverges significantly from political activism and direct interventions for social justice. Conversely, social action does not specifically address the psychological and intrapsychic wounds of individuals. So, how exactly does the healing profession of art therapy intersect with the political praxis of social action? Is there a theoretical framework that might undergird a coherent relationship between these enterprises? As art therapy has struggled to find an adequate theory just to reconcile art and therapy (Rubin 1987), it is not surprising that there exists no conceptual model that integrates the work of social action with the practice of art therapy in a comprehensive fashion. Yet, an overarching framework that recognizes this inherent relationship and articulates its concepts, principles, and orientation would be of value.
Hocoy et al. (2003), psychotherapists who have worked in art therapy in one capacity or another, have struggled with this very issue and developed a general framework for how Western therapeutic practices might be reconciled with social action; the application of this framework to art therapy is presented here.
The image and social action
One way in which social action and art therapy are linked is through the versatility and power of the image. Social action is ultimately predicated on the relationship between personal and collective suffering, and the image has the unique ability to bring to consciousness the reality of a current collective predicament, as well as the universality and timelessness of an individualâs suffering. Moreover, images can concurrently heal personal-collective wounds while demanding a response to injustice.
The image is regarded as having the potential to mediate between the individual and the collective. Cassirer (1955) believed that consciousness is mediated and transformed through symbolic forms, and the image âis one means through which the âIâ comes to grips with the worldâ (p.204). For Carl Jung, the archetypal image, an expression of a universally recurring theme that transcends time and culture (Schaverien 1992), allows connection to the collective unconscious. An awakening to a shared predicament can be transformative in itself, as well as serve as a basis for social action. For instance, the images of the Mexican muralist movement of the early 1900s, which embody Kuhnsâ (1983) âenactments in a cultureâ (p.53), brought awareness of a collective plight and served as a language of solidarity, empowerment, and revolution for a largely illiterate population.
According to Jung, the image can be transformative in two basic ways: (a) through the healing derived from conscious awareness of a previously denied aspect, and (b) by tapping into the healing potential of the psyche â specifically, the central archetype of the Self (Wallace 1987). Evidently, these capacities of the image apply on the collective as well as the individual level. With regard to the first transformative process, Schaverien (1992) explains:
[The image] is the means through which the subjective and objective nature of the patientâs experience is mediated. The [image] is no mere handmaiden in the service of psychotherapy, instead it is a formative element in the establishment of a conscious attitude to the contents of the unconscious mind (p. 11)⌠Through the seeing of the imageâŚthe patientâs relationship to unconscious material begins to change. (p.21)
In terms of the second transformative process, Wallace (1987) describes the Self as a vast, unbounded healing factor that is accessed through the image and that âcompensat[es] for any imbalance that might ariseâ (p.114). These healing functions may be manifest in Augusto Boalâs (2000) Theatre of the Oppressed, in which the frozen gestural images of participants (resulting from exercises to address oppression) bring forth creative improvisation from the unconscious and, conceivably, from the Self in addition to conscienticization (i.e. collective consciousness).
Jung (1961) also alludes to a third way that the image can heal:
The images of the unconscious place a great responsibility upon a man. Failure to understand them, or a shirking of ethical responsibility, deprives him of his wholeness and imposes a painful fragmentariness on his life. (p.193)
Jung suggests here that an image may be a representation of an alienated aspect of the psyche and asserts there is a âmoral obligationâ (p.187) to understand such messages from the unconscious and to effect reparation. Clearly, then, the image can serve as a call for individual and collective action to address marginalized aspects of human potential. Examples of this may be seen in the photographic images of Sebastiao Salgado (1997, 2000, 2004), which document human plights including struggles for land rights, poverty, displacement, and genocide and implicitly charge the viewer with an obligation to address these instances of injustice. Interestingly, there exists empirical research supporting these dynamics; Kaplan (1994) found evidence of a relationship between the nature of the images one spontaneously produces and the likelihood one will engage in social action.
Art therapy: Whom does it serve?
As with any social institution, art therapy âderives from a specific set of cultural assumptions, values, and constructionsâ (Hocoy 2002a, p.141) and contains within it the biases of the society of which it is a product. Although art therapy may be less culture-bound (e.g. Kalish-Weiss 1989) than other societal enterprises and often acts in countercultural fashion, it is still inescapably shaped by the viewpoint and socioecopolitical arrangements of the culture from which it originates. The structures that undergird contemporary society developed from a particular set of power relations and tend to privilege some individuals at the expense of others; these structures are usually taken for granted because they have been the consistent ground of our existence and are as invisible as the air we breathe (Greenfield 1997). Yet these invisible societal arrangements perpetuate a social order that contributes to disparities in status and resources, ruptures in relationship and experience, and disdain for difference and diversity, as well as a host of other inequities.
These shadow elements of society manifest in its institutions and citizens, and inescapably reside in the endeavors of art therapy and the psyches of art therapists (Hillman 1975, 1992). Without examining how the worldview and social order of the dominant culture are embedded in its practices and philosophy, art therapy can unknowingly reinforce structures of domination and contribute to continuing injustices. Even the âhealingâ traditions can be in service to dominant culture interests, complicit in neocolonial power arrangements, and tools of assimilation and social control (Szasz 1984). Junge et al. (1993) ask:
As art therapists are we too often helping people adjust to a destructive society? Are we ourselves co-opted by the status quo and, understandably, yearning to be inside, adapt, make do, and continue to cope with a fatally injured mental health system? (p.150)
For art therapy to be a force of individual and societal liberation rather than an unwitting vehicle of social compliance, the therapy itself must be liberated from the invisible structures and biases inherent in it. Yet:
A part of our history as art therapists that may impede us is thatâŚ[t]ypically, we are not trained asâŚsocial and cultural analysts or critics, but as those who through the art therapy process help people cope and adapt [to unjust systems]. (p.150)
Difficult questions need to be asked: whom or what in society does art therapy privilege or serve? In what ways might a profession, in which 87 per cent of its practitioners identify as âCaucasianâ (Elkins and Stovall 2000), be blind to established hierarchies of power, especially ones predicated on race? In what ways might art therapy participate in oppressive perspectives and dynamics of marginalization? Whose definition of health, normality, universality, human nature, Self, and psyche informs it? Does it contain within its practice an examination of its enculturating role as well as processes to mitigate the transmission of ideology and social structure?
History yields many sad examples of movements that began as liberatory and ended as controlling and repressive. At the same time, many schools of psychology [and types of therapy] intending to assist individuals in finding new potentials, stop short of critiquing and engaging the social limitations which make transformation impossible. Thus, often the mental health establishment helps to personalize, marginalize, and medicate what is essentially a protest against a dehumanizing and repressive social milieu. (Lorenz and Watkins 2001, p.295)
Homophobia as working example
To illustrate the various aspects of the conceptual model presented here, the issue of homophobia is used as a working example. In the case of homophobia, we can observe how societal biases against homosexuals have been institutionalized and transmitted through the various mental health traditions â including the American Psychiatric Association (APA). Until relatively recently, homosexuality was formally designated as âabnormalâ and an expression of âpsychopathologyâ (Friedman 2002). Homosexuality was defined as a type of sociopathic syndrome in the APAâs Diagnostic and Statistical Manual of Mental Disorders (DSM) until DSM-II (APA 1968) and regarded as a sexual deviation or paraphilia until DSM-III (APA 1980). It was not until DSM-III-R (APA 1987) that ego-dystonic homosexuality was deleted as a mental disorder. Homophobia remains a pervasive societal problem (Franklin 2000), and there are still homophobic biases in professional therapeutic communities as Rauchfleisch (2003) and Twomey (2003) have documented in regard to Swiss and British psychoanalysts, respectively.
In this one instance, we can see how the values, assumptions, and ideology that privilege heterosexuals and the traditional nuclear family have been perpetuated, both consciously and unconsciously, even by âtherapeuticâ professions. By reinforcing oppressive societal structures (e.g. policies about marriage, spousal benefits, adoption, high-school sexual education, and so on), institutions of healing have served the interests of the majority voice of heterosexuals while marginalizing a significant portion of humanity. It is clear that any human enterprise, left unexamined, can be complicit in societal injustice and an instrument of the dominant voice.
The relationship between individual suffering and societal structures
Martin-Baro (1994), a proponent of liberation psychology, has been instrumental in making the connection between the suffering or psychopathology witnessed in clients and the cultural and socioecopolitical structures of society. Dominant culture frameworks for normality and psychopathology such as the DSM frequently mask the relationship between the symptoms that are expressed by individuals and societal imbalances. These frameworks tend to situate the problem within the individual rather than within the broader collective context, and treat âthe pathology of persons as if it were something removed from history and society, and behavioral disorders as if they played themselves out entirely in the individual planeâ (Martin-Baro 1994, p.27). Situations like apartheid demonstrate that societal structures can directly result in diminished psychological well-being (Hocoy 1999a, 1999b, 2000). Less extreme conditions such as poverty, inadequate housing and education, unemployment, and social discrimination have also been indicated in lower mental health (Kleinman 1988). Archetypal psychotherapist James Hillman (1992) makes the link between individual and collective illness explicit:
My practice tells me that I can no longer distinguish clearly between neurosis of self and neurosis of world, psychopathology of self and psychopathology of world. Moreover, it tells me that to place neurosis and psychopathology solely in the personal reality is a delusional repression of what is actually, realistically, being experienced. This further implies that my theories of neurosis and categories of psychopathology must be radically extended if they are not to foster the very pathologies which my job is to ameliorate. (p.93)
Junge et al. (1993) warn, âAll too often [art] therapists heal what is already wounded and do not attend to the milieu which wounds and re-wounds again and more deeplyâ (p.149). A more contextualized perspective, consistent with both feminist (Alcoff and Potter 1993; hooks 1984) and systems or ecological (Goldenberg and Goldenberg 1991) approaches, also avoids the additional psychological damage of blaming the victim for the suffering she or he experiences.
The separation of individual psychological states from socioecopolitical realities betrays a certain orientation in worldview, one specific to a cultural paradigm premised on individualism and a particular configuration of the Self (Cushman 1990). The image of human existence as a web in which multiple levels of experience and order intimately interconnect often falls into the blindspot of a worldview for which the unit of social organization and responsibility is confined to that of the singular individual. It may not be an ac...