Art Psychotherapy
Art expressions, especially drawings, offer important information on development in children, particularly young ones of 10 years and below. For instance, variances in artistic development could be used to assist people in understanding the emotional experiences, and sensory and " cognition integration of a child. Children could use art therapy to express their feelings and emotions. Art therapy is an integrative healing modality that can attend to both outer and inner realities (Malchiodi, 2011). In addition, art therapy offers a means through which inner experiences are expressed with the intent to bring about life changes, such as enhanced interpersonal relationships. Art therapy is linked to attachment theory, and the attachment styles of children can be repaired via the use of art therapy to inform the art-therapeutic relationship. The purpose of this paper is to assess how a child’s early relationships and experiences can inform the art therapeutic relationship.
The theories of human development offer a framework that is used for thinking about human growth, development, and learning. When a child is developing, relationships are formed based on their experiences and attachment to the parent or the caregiver. Brook, Lee, Finch, and Brown (2012) noted that the attachment theory is a useful tool for understanding how parents can best assist their children to develop. The theory posits that early attachment of the child to the parents builds a strong foundation for the future. In addition, the bonding influences the development of the child academically, emotionally, and socially. The attachment theory offers basic strategies that could assist parents develop good relationships with their children from an early age. A child’s early relationships and experiences are informed by the attachment to the parent, especially the mother. Bowlby’s primary conclusion was that to grow, “the infant and young child should experience a warm, intimate, and continuous relationship with his mother (or permanent mother substitute) in which both find satisfaction and enjoyment” (Bowlby, 1951, p. 13). Thus, a child grows mentally healthy when there are warm experiences and relationships with the mother. This explains why some of the children are closer to their parents, while others are isolated.
James (2008) pointed out that “an attachment is a reciprocal, enduring, emotional, and physical affiliation between a child and a caregiver” (p.2) and the period between birth and age of three is the most crucial as experiences and relationships are formed. Attachment patterns have been associated with the development of toddlers and infants and they are dependent on experiences entrenched in attachment relationships. Attachment theories have influenced art therapy and inspired distinctive approaches to practice. For example, the Bird’s Nest Drawing (BND) and story is an example of an art therapy assessment of attachment security. Yoon, Betts, Harmon-Walker, and Kaiser (2016) described that the attachment theory is an empirically grounded framework that is used to understand human development and relationships. Children with insecure attachment could be understood through the use of the early attachment styles to show certain behaviors such as impaired social, neurobiological, and psychological functioning over time (Schore, 2001). Subsequently, art therapy as described by Yoon et al. (2016) could be used to gain an understanding of these relationships and develop a sense of security.
Family drawings have been used historically to offer information related to family dynamics and functioning. Nonetheless, for some of the children, drawing one’s family could positively provoke avoidance and anxiety, which are elements related to security issues. The BND could be used to measure attachment security. This involves an art therapeutic relationship that entails drawing a bird’s nest and subsequently writing a story about it, to express the attachment visually while representing concepts of nurturance, safety, protection, and security using metaphor. The advantages of using process- and performance-based testing are that it is well established in the psychological assessment literature (Finn, 2012). In addition, it can be used to provide information that the client is not able to make a report directly. Subsequently, the presentation of the problems via drawings acts as a form of non-verbal communication that provides a verbal description and helps build a rapport between a child and the therapist.
In art therapy, Hass-Cohen and Findlay (2015) described several approaches that are essential in the understanding of human relationships such as the cognitive-behavioral approach, social-ecological approach, and psychodynamic approach. As such, the “paradigm shift from behavior to cognition, to bodily based emotion has acted as an integrating force for forging stronger connections between the disciplines of psychology, social neuroscience, and psychiatry, all of which are now focusing on affective phenomena” (Schore 2001, p. 4). Such a connection is useful in having an understudying of the relationships required for art therapy. Through the experiences of children and their attachments, therapists use art therapy to understand as well as respond to the needs to promote secure attachment. The experiential nature of art therapy provides a mutual attunement in sessions with children and their families. It is a primary concept in effective attachment work.
According to Bowlby, attachment theory when external difficulties and conflict disturb the interaction of infant-mother interaction then there is a possibility of delayed development. Children usually derive pressure from the proximity of their parents and caregivers. The child varies on the amount of space with the parent depending on the amount of security needed. In addition, Bowlby (1979) described the attachment theory as "a way of conceptualizing the propensity of human beings to make strong affectional bonds to particular others and of explaining the many forms of emotional distress and personality disturbance, including anxiety, anger, depression, and emotional detachment to which unwilling separation and loss give rise" (p. 127). Thus, attachment relations are a source of both love and conflict between the parties involved. When children are part of the attachment behaviors they experience the need to avoid separation as well as loss. Loss and separation are both traumatizing experiences for the child since the assumption made is that the infant relies on parents for security and care. Based on art therapy, drawing could play a major role in establishing the problems faced and as a result, it could be used to promote adequate therapeutic relationships. The response of the therapist to the child could further develop a secure base in the art therapy, and subsequently help the child work through difficult emotions.
Siegel (2012) offered another perspective that could be used to provide clarification on the role of creative arts therapies when treating attachment disorders in children from a sensory perspective. The “critical micro-moments” of relationships with clients are important and this entails the client’s posture, tone of voice, facial expressions, motion, eye contact, and motion which offer clues to the person’s psychobiology. The use of sensory-based cues could be used to identify and formulate strategies required to address the disrupted, disorganized, or insecure attachment. Siegel (2012) also proposed the application of experientially-based methods, including drawing pictures, because this could assist clients become aware of emotions, sensations, images, and relationships. Therefore, the relationships of a child when growing up could be portrayed through drawing and this could help inform therapeutic relationships. Arts therapies provide normalizing experiences for a child (Malchiodi, 2008). Thus, simple activities like drawing a picture of a moment could be an effective means because it can use imagination to recall details of sensory memories.
Nonverbal communication is the most fundamental type of communication and it plays a major role in the manner in which a caregiver and infant primarily connect during their first years of life. The majority of creative arts therapies entail talk, and these are described as non-verbal approaches (Schore, 2003). This is because they comprise self-expression via an activity, which later becomes the primary source of communication between the child and the therapist. For children, non-verbal is an important means of communication and it plays a critical role in art therapy. This is because children could use other cues other than words and sounds to accurately convey their feelings and experiences (Schore, 2003). In addition, the thoughts as well as feelings of a child are not strictly verbal or limited to storage as verbal language. Malchiodi (2013) noted that expressive modalities are predominantly useful in assisting persons in communicating aspects of stories and memories that are not available via conversation. Malchiodi (2008) further pointed out that memories emerge via touch, imagery, and body movements that are carefully guided. For some persons, conveying a story via a more expressive modality such as art could easily tolerated than verbalization. For instance, a child who has been severely traumatized during the development process could repeat experiences via art activity, especially when the memories are predominantly complex (Malchiodi, 2008). In addition, non-verbal expression through art could be a corrective experience.
Art therapy is founded on the idea that the artistic process of making art is not only healing but also life-enhancing (Malchiodi, 2011). It also forms nonverbal communication of feelings and thoughts. It is related to cognitive development theories which focus on the development of the thought processes. Like other types of psychotherapy and counseling approaches, art therapy is applied to t encourage personal growth, help in emotional reparation, and increase self-understanding. Additionally, it is one of the modalities that can be used to assist children in creating meaning and realizing insight. It can also be applied to create relief from emotions, resolve problems and conflicts, and realize an increased sense of well-being (Malchiodi, 2008). Art therapy is based on the belief that people can fully express themselves in a creative way to express their experiences and relationships as children. Caregivers can regulate emotional responses and subsequently influence the child's regulation via an interactive process (Schore & Schore, 2008). Art therapy applies attunement and alignment within interactive creative processes. The art materials are then selected based on the client's needs to solve the development issues. In addition, the art materials possess qualities that match the emotional states of the child, to identify the attunement within a continuum of experience (Hinz, 2009).
The development process of children is delayed by biological, social, and environmental factors. For instance, children born with disabilities or impairments tend to have delayed growth. Other factors include negligence by caregivers/parents and illness. Such factors influence the development of speech and cognitive abilities among children. In addition, children with delayed speech development risk the acquisition of other social-emotional, cognitive, and school-related problems (Groß, Linden, & Ostermann, 2010). It is via understanding such causes that art therapeutic relationships are informed. For instance, art therapy such as music could be used to trigger some parts of the brain that are responsible for language development, thus triggering a series of events that improve speech. Subsequently, the child’s experiences could be improved by music which could promote a measurable effect on speech development via the treatment's interactions with important aspects of speech development as well as the ability to form and retain relationships (Groß, et al., 2010). Therefore, music therapy could be used to offer supportive therapy for a child with delayed speech development.
The ability for people to be part of the world and interact with it is a crucial component in living a connected and meaningful life. For children with developmental delays and challenges, the incapacity to receive, respond to, and act accurately on information provided by the surrounding environment could result in poor engagement (Malchiodi, 2008). In addition, it could affect their lives and have both pervasive long-term and immediate effects on their abilities, well-being, and opportunities. Art therapy is then used to effectively promote delayed behavior and trigger responses that could help effective engagement. Nonetheless, for a child with delayed communication and cognition abilities, the incorporation of an expressive accompanied by a physical component could lead to better therapeutic outcomes (Malchiodi, 2013). Thus, the experiences of the child help build strong art therapeutic relationships by building holistic care based on the child’s needs and areas of development. The Vasarhelyi method of child art psychotherapy (CAP) could be used to ensure that a child expresses her experiences with the therapist. This psychotherapy modality is based on art, which acts as a bridge between the unconscious thoughts of the child and their hidden connections with the image (Saba, Byrne, & Mulligan, 2016). The images when drawn by the child provide pictorial communication, which is a form of non-verbal language.
The CAP approach is based on the supposition that children with delayed communication skills often find it easier to express their emotions and thoughts via the use of drawings (Saba, et al. 2016). When the CAP is used a child is encouraged to express her feelings via artwork to develop a personal formulation of their feelings. The experiences of the child help the therapist facilitate the development of their formulation. It also provides an “Empty Space” for both physically and emotionally affected children, which assists in the creation of the formulation of personal pictorial material without the influence of the therapist (Malchiodi, 2013). When being undertaken, the therapist can allocate time so that the child can create an image. Afterward, the therapist joins the child and asked to describe the image to understand their feelings, relationships, and past experiences. The sessions are crucial to understanding the current conflicts of the child, which cannot be expressed freely through verbal communication.
In conclusion, a child’s early relationships and experiences can inform the art of therapeutic relationships. Children who have delayed development processes are affected emotionally, socially, and psychologically and need art therapy to improve their language and thought processes. It is the past experiences and relationships that inform art therapeutic relationships. Art therapy is composed of art expression which acts as a form of non-verbal communication. Children with attachment issues while growing up are not in a position to express their fears and insecurity in a normal way. Nonetheless, art therapy such as drawing could potentially improve the child’s development process by using art to accurately convey their feelings and experiences. Expressive modalities such as creative art and music are crucial in helping children communicate elements of stories and memories that not be told verbally, because of delayed communication. Children with development delays are not in a position to articulate their thoughts, emotions, sensations, or perceptions, but art could be used. For those children who have experienced abuse or trauma when growing, it is the only way to “tell a story without talking”, especially when afraid or unable to speak about particular feelings or events. The sensory-based approach allows the children to have the ability to experience themselves and at the same time communicate on visual, tactile, and kinesthetic levels. Artistic expressions, especially drawings, offer important information on development among children, particularly those with delayed language development. For instance, differences in artistic development assist therapists in understanding one or more things about a child’s emotional experiences, sensory integration
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