I found myself in the throes of a psychotic episode in early 2011, most likely triggered by undue stress. I was working near-full-time as a classroom music teacher at an alternative private school in Brooklyn, utterly worked to the bone as I attempted to teach unruly children. I was simultaneously taking music education courses at a college in Queens, working towards earning certification to teach classroom music in public schools. I also had ten violin students, all of whom I taught individually on a weekly basis. It was far too much to manage.
I hit the breaking point when I attempted to do a standard homework assignment for college. As I wrote a paper on Beethoven’s Eroica Symphony, my mind strongly told me I was in fact the reincarnation of Beethoven himself. This held monumental consequence, and I believed I was some pivotal person in human history not yet acknowledged.
I made phone calls, telling people I was Beethoven. The absurdity of the statement elicited non-judgmental laughter from some, processing it as a benign joke. Others told me I needed to see a psychiatrist, but I ignored this advice and attempted to continue with my life uninterrupted. But the obsession grew, and I could not hide it. While on a lunch break at the Brooklyn school, I confided to my boss that I was Beethoven, and her dramatic reaction elicited a hyperventilating panic attack within me.
It was in this frantic state when I arrived at the inpatient psychiatric unit at NYU Langone Hospital.
When I had my first breakfast in the small cafeteria with the other patients, I sat alone, buried in my Beethovian thoughts while bearing a Beethovian scowl on my face, inner dialogue racing. When mealtime ended, a voice sounded from down the hall.
“Art therapy everyone! Art therapy!”
Not knowing what to expect, I followed others who walked into a smallish room, recent drawings hung on the walls. On the table, oblong pieces of tan paper and oil pastels were set up, ready for our use. I took a seat and sleepily blinked.
“Hello, I’m Abigail, the art therapist here. How is everyone feeling today?” She had a friendly and professional air about her. Others answered her benign question.
“Hrm.” Someone grumbled, looking sleepy, a large hospital blanket wrapped around their shoulders.
“Good to hear.”
She spoke at a slow and deliberate rate, with a non-threatening tone.
“So for this session, we’re not going to do any project specifically. But… I have some magazines here. I encourage you all to find a picture that speaks to you. Take some time to look around. Then you can create something based on what you see in the picture you choose. Draw however you feel, and don’t worry about what happens on the paper.”
Her instructions were nonrestrictive.
“You don’t want to use the magazines, that’s fine too. There are no rules here. Are there any questions before we start?” There were none, but I appreciated that she offered the question.
She put on a recording of J.S. Bach’s Cello Suite No. 1 in G Major, the famous opening prelude, at low volume. I flipped through the pages of a magazine and chose a portrait of a woman, some standard makeup ad. Taking a black oil pastel in my hand, drawing my first strident line…it had a satisfying grip on the paper. This was an expensive set of oil pastels with many colours to choose from. I realized that I wasn’t working with depressing Elmer’s glue and dried macaroni on paper plates like I had done at other hospitals.
As I formed the outline of the person’s face, drew the flowing hair, filled in flesh colour for skin…it didn’t look quite like the picture I copied from the magazine, but instead took a form of its own. The face conveyed a personality and spirit as would a real person, and my hand was merely guided as I brought the woman to life. Memories spontaneously occurred to me, and I recalled how I had been teased for being ugly as a child, awkward as a teenager, how no one wanted to date me in college.
Recalling these memories allowed me to forget about my thoughts of Beethoven for a bit. My picture revealed a beautiful woman, and a powerful chord struck within me. I didn’t need to be Beethoven in order to be great. I was good enough already.
I began to cry.
“What are you feeling right now?” The art therapist asked me.
“I…This is the best drawing I have ever done in my life. I didn’t know I could draw this well.”
“It is beautiful, I agree. What does it make you feel?”
“I don’t know.” There were private, wordless feelings within me that I could not describe.
After sufficiently crafting the woman’s face and hair, I worked on the space behind her head. I created a lovely shade of cerulean-teal, blending my favourite shades of bright blue and green together, crisscrossing strokes. These colours swept a wave over the picture, giving it movement, and the face now popped out.
The picture started to settle, and it eventually felt finished.
I now felt a bond to what I had drawn, because it had been inspired by my difficult life experiences. While I felt ugly inside, the picture was not. I realized that I in fact wasn’t ugly at all.
At the end of the session, Abigail facilitated a conversation where we each got to talk about what we created. One woman showed a crude picture she drew of a pack of cigarettes.
“I want to smoke. I’ve been here for three weeks.”
Another person showed a simple picture of a star.
“It doesn’t really mean anything.”
Abigail stepped in.
“It looks great! I like the bright colours you used. Red, green and white. You also pressed very hard with the oil pastels, so the colours are vibrant.”
“Yeah, I like colours.”
Then it was my turn.
“I don’t have much to say. But I like what I drew.” My thoughts were very complicated, and I didn’t want to share. And that was honoured.
NYU took their art therapy seriously. Groups were scheduled twice daily from Tuesdays through Fridays, and thrice on Saturdays. With each group, the art therapist facilitated different projects, giving us different media to work with. One day, we crumpled colourful tissue paper and slicked it on paper with Mod Podge, creating three-dimensional art pieces. We drew mandalas, and I drew an abstract rendition of Michael the Archangel. One time, an artist from the Museum of Modern Art (MoMA) visited and did a presentation, and then facilitated a project. The art supplies we used were all of high quality, and that improved my morale in groups, thus enhancing the therapeutic effect of art therapy groups.
After each session, I’d proudly take my new piece into my room at the hospital and tape it on the wall. After a few days, I had a little art gallery going on. Each piece I drew represented a part of me that was very personal, with no words to describe. During this time when I felt broken and distorted, my gallery gave me a view of myself that was positive and affirming.
The Benefits of Art Therapy in Mental Health Settings
Art therapy is a powerful modality that allows people to express emotions in a nonverbal way. When a person experiences complicated feelings that cannot be described in words, art therapy helps these feelings to emerge through visual means. While standard talk therapy employs logical thinking and rationalizing, art therapy accesses the subconscious mind and the power of intuition.
Deep-seated feelings of fear, self-hatred or other difficult emotions find a voice as artwork is created, allowing for the release of distress. Artwork becomes a visible and tangible product that represents not only feelings but a process of personal transformation.
An art therapist must create a safe and non-judgmental environment in the studio. When people create art, they tap into something deep-seated and personal within themselves. They must not feel fearful of being judged for the artwork they create, because this can impede the therapeutic process. An art therapist never critiques a person’s work based on its quality, and nothing is ever deemed “bad art.” No previous skill or experience is needed to fully benefit from art therapy, and everyone is equally encouraged.
Before a person creates work, an art therapist will first facilitate a conversation, to help them focus on the artistic task that is to follow. They may guide them through a process of relaxation, encouraging them to breathe deeply and focus on relaxing the body. Or in my case, within a group therapy setting at the hospital, the therapist checked in with patients, asking how they were feeling, and also orienting them for the assignment for the session.
Art therapists are trained to understand the subconscious elements of the artistic process. They then apply this knowledge as they create assignments for patients. For example, with the mandala project that I created at the hospital, the therapist utilized the shape of a circle, where we drew inside of it. When drawing my feelings in the space of a circle, this specific shape served as a holding place that completely contained my emotions, encouraging me to feel safe.
As a person creates work, the therapist encourages them to “trust the process.” The media they choose, the colours of paint selected, the way they brush strokes on the page, the ideas and feelings they have as they create…these are all personal decisions that a person makes for themself. Having this power of choice can help a person feel more in control, while also in a safe environment.
A therapist may or may not talk to a person as they create their work. If there is conversation, the therapist can ask a person how they are feeling as they create, or maybe ask why they chose a certain colour or brush. The process is very gentle, and the person remains in complete control.
When a piece is finished, the art therapist can facilitate a discussion for the patient(s) to talk about their work. In the case of my group session at the hospital, the discussion was brief, likely due to time constraints. Each of us said a small bit about our work, and this helped us wrap up the experience gleaned from the session.
When greater time is allowed, especially in a one-on-one session, the discussion can get more in-depth. The art therapist can guide a person as they evaluate the finished picture, perhaps asking the picture questions and intuitively gleaning answers from it. Using intuition accesses a deep-seated source of intelligence that normally goes unacknowledged. It allows the subconscious to speak through metaphors represented in the artwork, and this voices the needs and strengths of the person that were previously unknown.
Art therapy benefits mental wellbeing in additional ways. It creates a positive and affirming environment, which helps a person feel less anxious and more confident in expressing themself. Art becomes an outlet for releasing emotions, helping to alleviate stress. It also celebrates the strengths that a person already has within themselves, boosting confidence. Overall, the creative process invites mindfulness, where a person is focused on the here and now as they make choices in how they create artwork.
Frequently, art therapists work in mental health settings, such as inpatient psychiatric hospitals (as I experienced), outpatient clinics and community centres. They frequently work alongside other clinicians in treatment teams, where the entire team works together to comprehensively determine treatment plans for patients. Outside of the purely mental health realm, art therapists also work in schools, homeless shelters, senior centres, residential treatment centres and correctional facilities. They also can work in private practice.
Based on my own personal experience with art therapy as a patient, I believe it is a powerful modality. Art therapy allows me to express a part of myself that I normally need to hide in the real world. I lose the fear of rejection and judgment from others, and I am able to feel confident in myself for being a unique individual. In the art studio, I feel safe and supported, and hopeful that I will have a brighter future.
I encourage psychiatric facilities to strongly integrate art therapy in their services. Doing so can help address the needs of patients in a holistic way, which can complement the clinical services that they already receive. As it did for me, it can give patients greater hope and encouragement in their resilience and capacity to recover and be well.
Art Therapy in America
To become licensed in the United States, art therapists first need to earn a masters degree from a program approved by the American Art Therapy Association (AATA). To gain admission into graduate school, a student must have completed undergraduate courses in psychology and studio art. Relevant job experience and an art portfolio are also needed. When studying in graduate school, students learn about how to use the creative process to access the subconscious self. They also learn about the history and theory behind art therapy, assessment techniques within an art therapy framework, group facilitation, and working with different populations. Students also continue attending studio art classes, learning to use various media as would patients in art therapy sessions.
The Art Therapy Credentials Board (ATCB) is the organization that awards certification in the United States. In order to become credentialed, art therapists must first earn art therapy work experience under a qualified supervisor. Hours required differ depending on which state a person practices in. After finishing preliminary supervision hours, a person becomes a Registered Art Therapist (ATR). After a few more years of experience, they can earn board certification (ATR-BC) by passing a national examination. This is the highest level of certification.
- American Art Therapy Association. (2017). Credentials and licensure. Retrieved from https://arttherapy.org/credentials-and-licensure/
- American Art Therapy Association. (2017). Definition of art therapy. Retrieved from https://www.arttherapy.org/upload/2017_DefinitionofProfession.pdf
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- Eisdell, N. (2005). A conversational model of art therapy. Psychology and psychotherapy, 78(1), 1-19.
- Ford-Martin, P. (2019). Art Therapy, 137-139.
- Gendler, J. (2019). The possibility of assessment tools in expressive arts therapy. Master’s thesis, Lesley University
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- Olotila, L. (2. April 2020). Art therapy exercise – Exploring emotional needs. Retrieved from https://www.youtube.com/watch?v=TcGPc80f2VM
- Son, Y. (22. May 2019). How to become an art therapist in 2019 (5 steps). Retrieved from https://www.youtube.com/watch?v=o1VfgvhBUew