Art in Psychosocial Care

Introduction

The organizations like Atelier 10, and Atelier Gugging in Vienna, Austria discussed in this essay, are 2 of many psychosocial initiatives that can be found in Vienna today. Both initiatives are similar only in the sense that Art— in particular, visual art— is the theme of the organizations.  This essay explores the work of these two institutions, their philosophy and the possible impact these have on psychosocial intervention.

 

Atelier 10 and Atelier Gugging

The modus operandi of both Atelier 10 and Atelier Gugging, involves the production and exhibition of art produced by a small group of artists with mental disability.  Apart from apparent similarities, these two organizations are strikingly different.

 

Atelier 10 was founded by Caritas in 2012. Situated in an up-market fine-art enclave in the city of Vienna. The look-and-feel of its 1000sqft premises gives no indication that it is a non-profit, charitable organization.  Atelier 10 is managed by one full-time Art Director, who insists that his purpose is to select promising artists who are afflicted with psychosocial difficulties, assist them by providing them time and space to create art, and curating these art works for presentation in their art gallery. The art is chosen strictly, and only artists capable of producing world-class work would be selected.  There is pre-concerted effort to establish this art gallery as a mainstream art gallery and not that which is associated with a social care organization.

 

Atelier 10 does not house the artists, but rather provides them with a place to work and a pension.

 

Art Gugging is an “Art Brut” or “outsider art” museum. It is run by a private foundation supported by the government of lower Austria.  It is situated away from the city on sprawling 870 sq yard grounds.  The museum was founded in the 1960s by Psychiatrist, Leo Navratil (1921-2006) who transformed the premises from a psychiatric hospital into a place to house artists who are psychiatric patients (or “kunstlerhaus”) and provide for these artists a space to work and exhibit their masterpieces.  Unlike Atelier 10, Art Gugging is steeped in history and is known worldwide as a home for art created the mentally disabled.  The Kunstlerhaus is home to about 10 patient-artists, and they are equipped with the services of nursing and medical professionals.

 

On visiting both premises, both organizers emphasized that their role in the lives of the artists is to provide daily structure and not art therapy. The art activity is purely a creative process and work.  Both galleries seem keen to challenge public perception on mental illness with relation to art creation.

 

During our interviews with the spokesmen of both organization we  learnt that their  purported role is in psychosocial intervention which is not specific to providing psychotherapy.

 

Art in Psychosocial Intervention

Psychosocial intervention is a collection of initiatives done (mainly by) government and non-profit agencies with the intent to facilitate the integration of people with disabilities into the general population.  In Austria, this goes in line with the health authorities aim to improve the quality of life for all persons through the principle of solidarity, by means of a compensating system for balancing our differences between persons with higher need of protection and the general public (Bundesministerium für Gesundheit, 2013).

 

In the best of times, funding of the psychosocial model of a country is resource limited. Perhaps for this reason, as well as ethical reasons, policymakers have to work towards achieving positive impact from these social welfare activities.  In order to understand the impact of a psychosocial model, there has to be a psychological understanding of these social problems. This is “more important than the sum of individual initiatives that specifically come under a psycho-social label.” (Pupavac, 2001).

 

What can be said of the impact of the Atelier 10 and Art Gugging models of psychosocial intervention?  What can be said of the achievement of both organizations?

 

For sure both Atelier 10 and Art Gugging have produced excellent works of art.  This leaves us to question the link between mental illness and art. Many books and reviews have been written on this topic, and the conclusions are varied (Silvia and Kaufman 2011).  There are many researchers that believe that mental illness and creativity are totally unlinked (Schlesinger, 2009), since psychosis and other forms of mental instability hinder creative work (Rothenberg, 1990).  Having been an artist myself, I would tend to agree with this point of view that creating art requires a certain degree of focus.

 

There are others who disagree with the above points of view, that through case studies that here is a link between creativity and pathology (Post, 1994 and Nettle, 2001).  Seeming to contradict myself, as an artist, I also agree with this point of view. This arises from my experience of experiencing loss of emotional quality of my art following a series of Gestalt therapy sessions.

 

While it is not within the scope of this essay to answer these questions, I would offer my observation on the art as I see them while in visiting Atelier 10 and Atelier Gugging.

 

The works in Atelier 10 seems to be more similar to that which one would find in an international art exhibition: formal, stilted but professional. This could simply be that at the time of our visit, the art was arranged in such a way to give me that impression.

 

The works at Art Gugging gave the impression of playful simplicity. They were accessible and likeable.  There is familiarity in some of the works, and I am not thoroughly convinced of the claim that these are pure “outsider art” as described in the article by Cardinal (2009).

 

Art is a unique experience, which belongs to the art creator and the observer. It is therefore difficult to understand what role art really has in psychosocial intervention.

 

Art in the context of Atelier 10 and Atelier Gugging is used as an instrument (or a commodity) to provide work to people who otherwise would not be able to find a place in society and at worse, be isolated and institutionalized.

 

Conclusion

As a form of psychosocial intervention, art is used as a means of creating work, and hence structure for the mentally disabled. This is proven to be a success in Atelier 10 and Atelier Gugging.  While these organizations have changed the lives of the artists supported by the efforts, there are still opportunities for accessing the real impact of this mode of psychosocial intervention in society at large: one of which is addressing going beyond providing structure to providing healing. Many artists remain with the institutions for life and don’t get to integrate with society, or become economically viable.  This perhaps requires a paradigm shift in thinking of these organizations as a means to integration rather than an end.

 

 

References

Bundesministerium für Gesundheit. (2013). The Austrian health care system: key facts updated version 2003. (pp. 8).

 

Cardinal, R. (2009) Outsider art and the autistic creator. Phil. Trans. R. Soc. B 364, p. 1459-1466.

 

Nettle, D. (2001). Strong imagination: Madness, creativity and human nature. NY: Oxford University Press.

 

Post, F. (1994). Creativity and psychopathology: a study of 291 world-famous men. Br. J. Psychiatry 165, 22–34.

 

Pupavac, V. (2001). Therapeutic governance: psycho-social intervention and trauma risk management. Disasters. 25 (4). (pp. 358-372). Oxford: Blackwell Publishers.

 

Rothenberg, A. (1990). Creativity and Madness: New Findings and Old Stereotypes. Baltimore, MD: Johns Hopkins University Press.

 

Schlesinger, J. (2009). Creative mythconceptions: a closer look at the evidence for the “Mad Genius” hypothesis. Psychol. Aesthet. Creativity Arts 3, 62–72.

 

Silvia, P. J. & Kaufman, C. K. (2011). Creativity and mental illness. In Kaufman J. C. & R. J. Sternberg (Eds.).  The Cambridge handbook of creativity (pp. 381). NY: Cambridge University Press.

Mourning and Making Reparation through Art

From a development standpoint, this ability to mourn a loss develops in the infant that has moved on from the paranoid-schizoid position onto the depressive position (remembering that the word depressive here has nothing to do with depression). It is a healthy development.

The more integrated infant who can remember and retain love for the good object even while hating it, will be exposed to new feelings little known in the paranoid-schizoid position : the mourning and pining for the good object felt as lost and destroyed, and guilt, a characteristic depressive experience which arises from the sense that he has lost the good object through his own destructiveness. (p.70)

Together with the ability to mourn is also the ability for feeling loss and guilt. This means also that there is a capacity for love that overcomes hate, and there is less projection of destructiveness on to another. In a infant this ability is a milestone in ego integration. He loses his hallucinations of being omnipotent, and can accept dependency.

Mourning and symbolization through creation of art…

The pain of mourning is experienced, leading to drive toward reparation. These, Segal adds, are the basis of creativity and sublimation (turning negative experiences into creative objects). In other words, creating art in various forms is a means of symbolic reparation of loss.  These reparative activities are done because the individual is able to feel concern and guilt towards the other and the wish “to restore, preserve and give it eternal life”. This is in the interest of the self preservation, “to put together what has been torn asunder”, to reconstruct what has been destroyed, to recreate and to create.

Quote about Vincent Van Gogh. Photo taken from Van Gogh Museum, Amsterdam on Dec 2017.

“After his hospitalization in the asylum in Saint Remy Van Gogh felt like a “broken pitcher” that could never be mended. Even so, in between bouts of mental illness, he worked on steadily and courageously to become an even better artist. Painting and drawing, moreover, gave structure to his days and ensured that he did not fall prey to the loneliness plaguing the other patients.”

Sublimation helps the individual put his destructive impulses into creative work. At this point the genesis of symbol formation can be seen. The ability to symbolize is a very important development in human ego development. It is also a means for us to communicate metaphorically, thus allowing us to create and maintain contact with another person/or with society in an empathic way. Religions, for example, are founded on symbols. The healthy individual can also differentiate the symbol he/she has created from the reality from which the symbols are derived.

The depressive position is never fully worked through. The anxieties pertaining to ambivalence and guilt, as well as situations of loss, which reawaken depressive experiences, are always with us. Good external objects in adult life always symbolize and contain aspects of the primary good object, internal and external, so that any loss in later life re-awakens the anxiety of losing the good internal object and, with this anxiety, all the anxieties experienced originally in the depressive position. If the infant has been able to establish a good internal object relatively securely in the depressive position, situations of depressive anxiety will not lead to illness, but to a fruitful working through, leading to further enrichment and creativity. (p. 80)

The Neuroscience of Symbolization

Neuroscience explains brain activity difference between non-schizophrenic and schizophrenic patients in their ability to symbolize.

Tretter, F. (2017). NEUROSCIENCE AND PSYCHOTHERAPY. Private lecture at the Sigmund Freud University, Vienna Austria.

The above diagram shows a the gamma oscillation image from the brain of a non-schizophrenic person (left) and that of a schizophrenic person (right) when they are showed the black-white image of a face. The gamma oscillation on the right shows more brain activity, which is interpreted as the individual being able to derive a picture of a human face from the black-and-white shapes. The schizophrenic brain shows little activity, implying that the individual does not recognize the image as a face.

 

My Thoughts on Mourning and Gestalt Therapy

Reading this chapter by Segal on the depressive position has inspired me to thing about this subject in relation to gestalt therapy. Mourning brings with it lots of sadness and underlying guilt. In the text above, this guilt is attributed to the imagined destruction of the integrated love object.
If we observe people in mourning, there is always this element of regret. There is also a need to make reparation. This is often symbolic and aesthetic in nature. The whole process of the funeral services is in a way a symbolic way of bidding farewell to the dead. This helps the living to heal psychically.

In patients that have problems with the mourning process (e.g. those who cannot move on, those who could not feel sadness, but rage instead, or those who get chronically depressed) are usually stuck in a situation where they aren’t able to fully experience the loss. This could be because of their personality structure, from which the defense is against painful experiences. There is tremendous fear to go to those dark emotions.

The work of mourning in therapy is the work of reality testing. For the client to come to terms with loss. This reawakens deeper feelings of loss experienced in infancy. It requires reworking of loss in the internal object. This process is needed to regain the ability of the patient to come back to reality, learn to love again and build up confidence again.

In therapy, these are worked through. For this to happen, there needs to be a lot of trust in the psychotherapeutic alliance. The therapist and client would spend hours together uncovering the defenses that hold back the client from mourning. The technique of therapy is client centered, with a lot of focus on the phenomenology (non verbal experiences) in the therapy session.

From this article I also see the link between creativity and mourning. Using art in therapy (not to synonymous with art therapy) is also common practice among Gestalt therapists. Creating art is a reparative measure, and together with therapeutic contact and communication, it facilitates openness to emotions and ultimately the freeing from depression and despair. This is a reinforcement of the technique.

 

Read also:

In  Sagentini’s Art  of the mother, the artist uses his art to sublimate the mourning of the loss of his “good mother”.

 

Bibliography

Segal, H. (2012). Introduction to the work of Melanie Klein. Karnac Books.

Other Sources

Carveth, D. (2016). Introduction to Kleinian Theory 5. Retrieved from: https://www.youtube.com/watch?v=VxdWHU1wrBY&t