The field of Western psychology has made many advances since its official experimental days in the late 1800s in Germany in terms of research, theory and treatment methods. The first person to call himself a psychologist and who laid the foundation for experimental studies, Wilhelm Wundt, would actually be proud of what we know now and have accomplished.
Since Wundt’s times, we have developed, adapted and implemented psychological pedagogy globally ranging from the ground breaking work of Sigmund Freud on psychoanalysis, the popularization of ‘behaviorism’ by B.F. Skinner in which we can now quantify and measure overt human behavior to a host of interdisciplinary approaches of studying the human mind. In the latter, concepts such as ‘cognitive behavioral psychotherapy’, biofeedback and ‘acceptance and commitment therapy’ have now become buzzwords for treating a host of disorders, including acute stress disorder in the immediate aftermath of a traumatic experience, mild and severe symptoms of depression and schizophrenia.
Yet, as someone trained in Western psychological instruments in the US, specifically on using art as a therapeutic tool (also called ‘art therapy’) for the treatment of various cognitive and emotional issues in people of all ages and backgrounds, I see some issues with our advancement and application of psychological treatments today.
We have forgotten our healing roots: the case of art therapy
First, we seem to have forgotten our healing roots. That is we have forgotten that our natural way for self-expression is how we heal. And how we heal is by dancing, singing, making art, and even doing yoga. I would go a step further and argue (and it has been written about) that these creative outlets (also referred to as ‘expressive therapies’ and ‘alternative therapies’) develop before we can speak as children. In fact, for stereotypically developing children, they are able to ‘speak’/‘baby talk’ around age 11-13 months. But when given a crayon or a marker at that age, children will initially make random scribbles but try to control and name/talk about what it is that they are drawing. Their drawings often depict the physical environment in which they live in as well as their social and emotional selves. It is their ability to put their world on paper that lets them try to find the words to describe what it is that they are experiencing. In some instances, words are not enough, and the image can speak a thousand words.
Moreover, our creative tools have been in use in various cultures across the world for centuries for the sole purpose of enhancing our health and wellbeing. Dr. Cathy Malchiodi, art therapist and leading expressive arts therapies researcher reaffirms that “In most cases, these practices [i.e. the ‘expressive arts’] materialized in the form of rituals, conventions, procedures, and ceremonies in response to individual and collective experiences” such as that of trauma and loss. These processes have helped individuals and communities to bounce back from various cognitive and behavioral issues and achieve some form of ‘psychological and social equilibrium’ (ibid).
Moreover, scientific research has shed light on the benefits of using the creative arts for healing various psychological and physical issues and injuries. For instance, neuroscience has been helpful in shedding light on the effects of art therapy in helping clients who have suffered from trauma, attachment related issues and significant losses to rebalance their brain functions (Kapitan, 2014). In particular, research has shown that art therapy helps to integrate both hemispheres of the brain by facilitating and enhancing issues such as attention, communication and logical reasoning/understanding. Hass-Cohen (2015) emphasizes “Imagery can be generated through sensory, perceptual, emotional and cognitive processing and contributes to the integrated subcortical and cortical functions which allows inner experiences to be consciously expressed as a source of creativity” (Hass-Cohen, 2015, p.21). In other words, the gray area during an art therapy session between verbal and non-verbal spaces allows for sensory experience of the art materials and for personal meaning making/verbal discussion. A balancing of both processes helps to support “neural integration and stress reduction” (Hass-Cohen, 2015 p. 331). More importantly, through the art making process, Siegel (2006) says that neurons get fired/activated and are eventually altered in one’s genes/DNA. The alteration promotes brain plasticity or ‘neuroplasticity’. For a child (or anyone) who has suffered trauma for instance, art therapy is particularly crucial for rewiring the brain in a healthy way. Siegel (2006) states: “Neural connections set up early in life create the foundation for how the brain will participate in information processing as the child grows. Ongoing stimulation of neural firing continue to mold the interconnected architecture of the individual throughout the lifespan” (p. 8-3).
And from a non-scientific stance, we have a myriad of anecdotes of clients being helped using creative therapies. People—children, adolescents and adults—from all walks of life and backgrounds have attested to achieving some form of mind-body, intrapersonal or relational affects. Personally as an art therapist having treated special needs children and children with trauma related disorders in clinical and non-clinical settings in the US, the Philippines and now the Netherlands, I have had children (and parents) tell me that they saw an increased ability to identify and express both positive and negative feelings through visual and verbal associations, as well as enhanced skills for problem solving, sharing and cooperation, accepting different points of view and social interactions. Much of my success (and probably for other therapists) can be attributed to the fact that “art therapists [serve] as the clients third hand’ (in the words of the art therapy pioneer Edith Kramer), helping to attune and empathize with my clients at whatever stage he/she is at developmentally and with whatever issue they are dealing with.
Our Western method to treatment may be outdated/require find tuning.
A second issue that I see as being problematic in our current Western approach to treatment is our continued reliance on a ‘one method fits all’ paradigm. Meaning we tend to see clients experiencing trauma, cognitive delays or attention deficit issues in the same way and use the same recycled tools. We forget that people are complex and that we need to constantly update our tools to fit individual needs; some of the tools that we are using may need fine tuning or to be completely disregarded. (Sometimes theory does not translate well into practice.) This is to say that for every client, clinicians/therapists must see them like a book, with every page being unwritten. The client is the author of his/her own story and the therapist can assist in writing it. That said, we must promote an individualized and holistic approach. In the former, individuals need to be looked at from multiple perspectives—i.e. their macro-micro systems, various schools of psychology, etc.; and in the latter, they need to be treated with adapted methods that also take into account their cultural bearings, including the way they are perceived by their culture, norms and healing methods for wellbeing.
Cultural sensitivity means more than what we are trained to think.
Lastly, which is tied to the last issue, I see many Western therapists claiming to be ‘culturally’ sensitive when they are in fact not. In particular, I have witnessed therapists in the Netherlands for example working with non-Western clients using interpreters (or no interpreters at all). While having an interpreter can be helpful in the immediate sense, especially in cases where there aren’t any non-Western trained therapists (or psychiatrists), in the long-term the results won’t be as bountiful. In fact, you will be wasting yours and the client’s time and resources (i.e. financially). People heal best when they feel connected, and often that connection can be as simple as sharing the same language, cultural background, even skin tone. The feeling of connectedness gives rise to feelings of trust which is essential in the therapeutic relationship from the beginning to the end of the treatment. Without trust, the client will not open up about his or her experiences, resulting in possible frustration, further injury and financial issues in the treatment process.
Moreover, I see too many therapists forgetting the essence of community in their ‘culturally sensitive approach’. More often than not, next to receiving personal attention, clients especially from non-Western backgrounds also want a deeper connection with their families and communities. Giving them the tools to do so is important but so is creating an open, trusting space in which clients themselves can share and get the support for what they are going through from their families or communities. Online and offline support platforms can be useful extensions of community support. These coupled with individual therapy can help to ameliorate the general healing process. In a world where we want quick fixes for our money’s worth, it is important, if not essential, for clients to be able to access therapists that share more commonalities with them and who understands the value of community.
A concluding remark
All this is to say that creative therapies have for a longtime formed part of our universal understanding and approach to healing. We have been using them for our personal and communal health and wellbeing way before we can even talk. We have the scientific evidence as well as personal anecdotes on the mind-body, intrapersonal or relational affects. In the words of ethnologist Dissanayake (1995), “Art is a normal and necessary behavior of human beings like other common and universal occupations such as talking, working, exercising, playing, socializing, learning, loving, and caring…” (p.18). Now is the time for us to capitalize on using the creative therapies. We can do so by fully acknowledging and integrating them into our clinical and community practices for a more robust (mental) health infrastructure. In the process, we must take care to update our pre-existing cultural sensitivity methods and train more non-Western therapists so that clients with non-Western backgrounds can have access to therapists who speak their language, know their culture, sense of community, to name a few. In due time, clients will properly heal in both the short and long-term.