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Art as Therapy
Collected Papers
Edith Kramer
Edited by Lani Alaine Gerity

Jessica Kingsley Publishers

London and Philadelphia
 First published in the United Kingdom in 2000 by
Jessica Kingsley Publishers Ltd,
116 Pentonville Road,
London N1 9JB, England
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA

www.jkp.com

© Copyright 2000 Edith Kramer

Preface © Copyright 2000 Lani Alaine Gerity

All rights reserved. No paragraph of this publication may be reproduced, copied or

transmitted save with written permission of the Copyright Act 1956 (as amended),
or under the terms of any licence permitting limited copying issued by the
Copyright Licensing Agency, Saffron House, 6–10 Kirby Street, London
EC1N 8TS. Any person who does any unauthorised act in relation to this
publication may be liable to prosecution and civil claims for damages.

The right of Edith Kramer to be identified as author of this work has been asserted
by her in accordance with the Copyright, Designs and Patents Act 1988.

Library of Congress Cataloging in Publication Data

A CIP catalog record for this book is available from the Library of Congress

British Library Cataloguing in Publication Data

A CIP catalogue record for this book is available from the British Library

ISBN 1 85302 902 5

ISBN pdf eBook 978 1 84642 982 8
 Contents

LIST OF FIGURES AND TABLES 7

ACKNOWLEDGMENTS 8
PREFACE BY LANI GERITY 9

PART 1 Introduction – Personal History as Artist

and Art Therapist
Chapter 1 Credo, as an Artist and as Art Therapist 15
Chapter 2 A History and Lineage of Art Therapy as Practiced
by Edith Kramer 20
Chapter 3 Art Therapy and Language, A Revisiting of
Orwell’s ‘Politics and the English Language’ 26

PART 2 The Profession of Art Therapy

Chapter 4 ‘Exploration of Definition’, by Edith Kramer and
Elinor Ulman 33
Chapter 5 The Unity of Process and Product 36
Chapter 6 Art Therapy and Sublimation 39
Chapter 7 The Art Therapist’s Third Hand: Reflections on Art,
Art Therapy and Society at Large 47

PART 3 Clinical Work

Chapter 8 ‘An Art Therapy Evaluation Session for Children’,
by Edith Kramer and Jill Schehr 73
Chapter 9 Leadership and Cultural Tradition 94
 Chapter 10 Case History of Angel: Art Therapy
and the Disturbed Gifted Child 112
Chapter 11 Art and the Blind Child 132
Chapter 12 Case History of Christopher 138
Chapter 13 ‘The Importance of Lines’, by Kerstin Kupfermann
with a discussion by Edith Kramer 146

PART 4 Art Therapy, Ethology and Society

Chapter 14 ‘Reflection on the Evolution of Human
Perception: Implications for the Understanding of the Visual
Arts and of the Visual Products of Art Therapy’ 169
Chapter 15 Art Therapy and the Seductive Environment,
by Katherine Williams, Edith Kramer, David Henley
and Lani Gerity 201
Chapter 16 The Etiology of Human Aggression 218
Chapter 17 Inner Satisfaction and External Success,
by Edith Kramer, Martha Haeseler, David Henley
and Lani Gerity 223

PART 5 Art and Art Therapy

Chapter 18 ‘The Angels of St. Wolfgang’: Representation
of Infancy and Childhood in the Art of the Renaissance
and of the Baroque 241
Chapter 19 ‘A Critique of Kurt Eissler’s
Leonardo da Vinci’ 246
Chapter 20 Survival Under Extreme Conditions:
Reflections on The Book of Alfred Kantor: An Artist’s
Journal of the Holocaust 262

LIST OF CONTRIBUTORS 266

SUBJECT INDEX 267
AUTHOR INDEX 272
List of figures and tables
Figure 7.1 Phoenix in flight after Zilzer’s intervention 53
Figure 7.2 A place to rest after Zilzer’s intervention 55
Figure 7.3 Drawing after a workshop sign 64
Figure 7.4 Drawing after the bulletin for an AATA conference held in New York 64
Figure 7.5 Drawing after a tree used for the 1982 AATA Conference 65
Figure 8.1 Jaime’s first pencil drawing 79
Figure 8.2 Kenny’s drawing of the student 83
Figure 8.3 Kenny’s painting of the student with the stop sign 85
Table 8.1 Outline of observational considerations 91
Figure 9.1 Martin’s Indian 95
Figure 9.2 One of Carl’s kings 98
Figure 9.3 Jerry’s prisoner 100
Figure 9.4 Walter’s prisoner 102
Figure 9.5 Clyde’s monster 105
Figure 9.6 Harry’s last monster 107
Figure 9.7 Matthew’s monster 108
Figure 10.1 The cover of Angel’s ‘Self-biography’ 121
Figure 10.2 Angel and his father 122
Figure 10.3 Angel as Superman 123
Figure 10.4 Dr. Fossum 124
Figure 10.5 Angel’s ‘art teacher’, Edith Kramer 125
Figure 10.6 Overcoming fear 125
Figure 10.7 Superman picking up a house 126
Figure 10.8 Clark Kent transforming into Superman 127
Figure 10.9 One of Angel’s more recent drawings of a mother and baby asleep 131
Figure 11.1 Karin’s elephant 136
Figure 11.2 Christopher’s beginning of the head of Eve 136
Figure 12.1 Early stages of Christopher’s sculpture of a human head 140
Figure 12.2 Final stage of Christopher’s sculpture of a human head 141
Figure 12.3 Christopher’s sculpture of self at seven years of age 142
Figure 12.4 The prophetess 144
Figure 13.1 Eva’s scratchboard images 155
Figure 13.2 Eva’s painting of sail boats 156
Figure 13.3 Lost in space 159
Figure 13.4 The crib and the building blocks 160
Figure 14.1 Two suns with human faces 185
Figure 14.2 John’s baseball 187
Figure 14.3 John’s new art 188
Figure 14.4 Raymond’s sun with a smiling face 193
Figure 14.5 Raymond’s new sun 193
Figure 18.1 After a Schwanthaler infant cherub 243
Figure 18.2 After two Pacher latency aged angels 243
 Acknowledgments

I welcome this occasion to thank a great many people for their help and
cooperation in preparing this collection for publication. I thank Gladys Agell,
editor of the American Journal of Art Therapy, for her generous and kind permission
to publish papers that first appeared in her journal. I also give thanks to Claire A.
Levy, who owns the copyright of the articles published in the Bulletin of Art Therapy,
(later the American Journal of Art Therapy) between 1961 and 1983 as well as
copyright of ‘Art Therapy Viewpoints’ (Schocken Books), for her kind and generous
permission to include material from these publications in my Collected Papers.
I owe much gratitude to my colleague Lani Gerity for her competent and
devoted help in selecting and editing these papers. She was also willing and able to
decipher my handwriting and convert it into typescript. Without her, the book
would have never materialized. I thank my colleagues Martha Haeseler, David
Henley, Katherine Williams and Lani Gerity for their collaboration on several
panels presented at the American Art Therapy Association annual conferences. I am
also grateful to Jill Schehr and Kerstin Kupfermann for the collaboration efforts
published here.
I thank my colleague Vera Zilzer who contributed essential ideas to the article
on the ‘third hand.’ Throughout some 20 years of friendship, her critical mind and
eye have greatly enriched my understanding of art therapy and of my own art.
I am grateful to Gabriel Fernandez and to the Reverend Carliss Smith for
permission to include material from their adult artistic productions in this book.
Finally I must thank all the many young people with whom I have worked
throughout the years. They have taught me my profession and given me joy in my
work.

Edith Kramer
May 2000
New York City
 Preface

There is a cautionary tale by C S Lewis about the importance of attention and

mindfulness which comes to mind when reading Edith Kramer’s collected
papers. In Lewis’s story ‘The Shoddy Lands’ an Oxford don found himself
literally seeing the world through the eyes of someone else for a short time. It
was a disconcerting experience for Lewis’s narrator, as the eyes he was
looking through had an extremely narrow and close focus. The world
beyond the limits of the self was a blurred and vague place, a ‘shoddy land,’
while personal attributes were very sharp and detailed. Lewis described the
don’s great relief at being able to return to his own perceptions, his own
broader interests in the textures and variations of the world around him, and
he began to wonder how someone else would experience the world seen
through his eyes. Would they enjoy looking at the things he enjoyed looking
at? Would they take delight where he took delight? Would it be a
broadening experience for them or a narrowing experience?
In reading this book, we are given the opportunity to see the world
through the eyes of Edith Kramer, to follow her ideas and observations as she
takes us through a variety of essays. While reading through these papers, I
couldn’t help but notice the depth, clarity and range of thought that went
into them. This collection gives us a sense of history, placing the art therapist
in a context which includes not only what we do clinically and how that has
developed but also the context of cultural and artistic development, of our
relationship to the history of psychoanalysis and society, and our place as
humans in natural history, the evolutionary psychology perspective. If C S
Lewis’s Oxford don had found himself enjoying Kramer’s focus and
attention to the world around her, his would have been a celebratory tale
rather than a cautionary one.
In the first section of this book we find Edith Kramer’s personal history as
artist and art therapist, her passions as well as the history and lineage of art
therapy as she practices it, the hows and whys of developing this field. In this
section we also find her passion for language and thought, her concerns
about how the growing depersonalization of our clinical language may
affect how we think about the people we work with.

9
10 ART AS THERAPY

In the second section, Kramer examines the profession of art therapy,

with an exploration of definitions, an emphasis on quality of work and on
inner unity of process and art product with its miraculously integrating
effects on the creator. She discusses the sublimation of the artist and empathic
understanding of the art therapist. Kramer instructs us on our need to
cultivate an area of artistic competence distinct from our artistic struggles and
predicaments. It should be a conflict-free sphere wherein technical skill,
pictorial imagination, ingenuity and capacity to improvise are employed
solely for empathic service to others, the ‘Third Hand.’
The third section describes clinical work, how the ideas of the previous
section can actually be channeled into our work in the art room. We find here
some beautiful descriptions of how evaluation can be done so that it is both
informative to the therapist and informative and therapeutic for the child,
giving him a taste for what art therapy might be like. In these chapters we
follow the struggles of the boys of Wiltwyck to find their own cultural
identity and style, to find resolution to conflicts, and their need to create
monsters and kings. We follow two case histories from childhood into
adulthood. One of the cases is of a blind child, so this section pays attention
to the developmental needs of blind children in general, which is then seen in
the work of Christopher. The last case in this section shows us the
importance of art as container, safe haven and refuge for an woman who had
been severely sexually, physically, and psychologically abused as a child.
In the fourth section of this book Kramer examines the evolution of
human perception as a way to understand better visual arts and visual
products of art therapy. There is an emphasis in this chapter on the ways
technology and human aggression have evolved and their effects on popular
Western culture. Kramer discusses our increasing dependency on external
sources for our satisfactions, our increasing alienation from ourselves, from
others, and from the world around us, and the need and potential for art
therapy to provide alternatives to this alienation.
In the fifth and final section we are treated to the art therapist’s views on
art, from the developmental and historic examination of the depiction of
angels in the Austrian pilgrimage church of St. Wolfgang at Wolfgangsee, to a
critique of psychoanalyst Kurt Eissler’s book on Leonardo da Vinci. The last
chapter of this section and of the book discusses the work of Alfred Kantor,
his art-making and its relationship to his survival of the concentration camps
of Terezin and Auschwitz. This short chapter gives us a window into the
world of the Holocaust survivor, as well as a hint at some of Kramer’s own
 PREFACE 11

understated feelings about the Holocaust and about living through that
period in history. Ending with this chapter gives us, the readers, a sense of
returning to the beginnings of art therapy, to Kramer’s teacher Friedl Dicker
teaching art to children in Terezin, helping them keep hope and dreams
alive, and then not surviving Auschwitz herself. There is something in this
chapter that teaches us about the possibility of finding meaning in sorrow
and suffering, and finally a strong sense of resolution and reconciliation
through the making of art or through helping others to make art.
While reading this book we gather from the content and from the process
as well, from the quality and depth of the writing, that the essentials for
art-making (or for writing a book, or enjoying our lives) are the same
qualities that go into making an art therapist. We need attention, focus, a love
of the language of art and image, and an enjoyment of playing with ideas.
Kramer reminds us that we have in our possession as art therapists a kind of
philosophers’ stone. If we are willing to take the time and effort to work
toward a unity of process and product, we have in the work we do the secret
of attention which transforms base metals into gold. Kramer is fond of
quoting Orwell’s concerns for the fate of language from unthinking accept-
ance of simplifications and degredations. C S Lewis’s story ‘The Shoddy
Lands’ spoke of a similar concern for the fate of our ability to notice and
enjoy the world around us. But here Kramer guides us through a very rich,
thoughtful, and deep landscape.
Some of the work in these pages came from panel discussions which
originated in the sharing of ideas over a pot of tea (two thirds Earl Gray and
one third Lapsang Souchong – Elinor Ulman’s favorite tea). This exchange of
ideas is a wonderful thing to take part in, so I would invite you to make
yourself a pot of ‘Elinor Ulman tea,’ find a comfortable old couch in which to
sit for a time, and begin a dialogue with Edith Kramer on art and art therapy.
Enjoy looking at the multitude of things she enjoys looking at. Take delight
where she takes delight, find outrage, sorrow, and strength where she finds
these things, and feel a broadening of your experiences in the process.
Due to the constraints of publishing, not all of the pictures from the
original sources could be reproduced here, but we have carefully docu-
mented the original sources so that those who wish may find them quite
easily.
Lani Gerity
May 2000
Hamilton, Ontario, Canada
 PART 1

Introduction – Personal
History as Artist and Art
Therapist
 CHAPTER 1

Credo, as an Artist
and as Art Therapist1

Credo as artist
I see my tasks as an artist of our time to be twofold and interwoven: to
celebrate that which is perishable and endangered, and to nourish and
cultivate the capacity for experiencing. This faculty is imperiled as our
perceptual apparatus, programmed to distill meaning from the complexity of
the natural environment, is bombarded by the cacophony of meaningless
auditory, visual and kinetic noises of the industrial environment. Assaulted
by the screams and whisperings of seductive promises, admonitions and
threats of the advertising industry and of politics. We must learn to disregard
these stimuli.
The urban environment perforce renders us somewhat autistic. We avoid
eye contact in crowds for fear of making contact with a madman or a
criminal. Working in windowless rooms, where temperature, light, and air
are controlled by powers beyond our reach, we become habituated to stoic
resignation. Survival increasingly depends on suppressing stimuli. But being
protected from overstimulation has as its price an ever-increasing incapacity
for emotional response to perception – a kind of living death.
Not submitting to such death entails facing these stimuli and making
sense of them, even though they may be disconcerting or repellent. As
experience is translated in imagery, the monstrous becomes comprehensible.
For example, no plants can grow on soil poisoned by industrial waste, yet the
huge cylindrical bodies of chemical tanks, exposed to wind and weather, take
on formal dignity that can stand up against the beauty of the wilderness they
have invaded.
Urban life is full of contradictions, and our figurative work reflects it.
Turning to as yet undefiled woods and meadows, we celebrate the timeless,

15
16 ART AS THERAPY

but also the fragile and endangered. Our perception of nature is no longer
tranquil. The act of perceiving is a slow process. It cannot be hurried by
employing mechanical devices. The painter must be on the spot. Docu-
menting a split second of existence via the camera cannot replace the inte-
gration of messages that reach us, not through the eye alone, but through the
totality of an active and receptive mind. I never use a camera. I paint on site,
or else I make sketches on site and use them for more complex work in paint,
collage, sculpture and mosaic.
The pedagogic methods of the Bauhaus have been formative in my under-
standing of the visual arts. However, my style has remained consistently rep-
resentational. Personal expression remains subordinate to the task of inter-
preting the subject with respectful comprehension.

Reflections
Artists who matured at the beginning of the twentieth century, before World
War I, were in full possession of the artistic heritage of the Western world. A
Picasso, a Matisse, a Kokoschka, a Paul Klee had internalized Western art
from the Greek, the Etruscan, the Roman art, down to the discoveries of
Impressionism. They could, on this basis, also accommodate Oriental art, as
well as African masks. Their heritage gave them unprecedented sovereignty.
The impetus of their trust enabled younger artists to follow in their footsteps,
pushing the limits of art further into the surreal, the abstract, the raw.
To us, the artists of the end of the twentieth century, the art of the Western
world has become history, in Europe as well as in America. We can admire it
and study it, but we no longer own it. The weight of accumulated wisdom
that empowered the revolution of modern art is no longer with us. Lightweight
novelty frequently replaces discovery. It is interesting that some of the most
powerful art of our time embodies the tragedy of Western culture’s perdition,
as Anselm Kiefer’s forceful and often jarring work attempts to portray the
historical, mythological and literary themes of post-war German culture.
In the face of the gap that separates our present from the culture and art
that came to an end with the termination of World War II, how should we go
on?
Our historical situation is unfavorable. Art has always flourished best
when it served some social function. Being amoral, art may serve religion,
serve to enhance the power and prestige of kingdoms or aristocratic strong-
holds, or celebrate the self-respect of a rising middle class. It can celebrate the
cruelties of Assyrian kingdoms, as well as the sufferings of Christ, or the
 CREDO, AS AN ARTIST AND AS ART THERAPIST 17

Madonna’s joyful love of her infant. It cannot serve a lie. A cruel system that
proudly asserts its cruelty can bring forth magnificent art. Systems such as
Stalin’s Russia or Hitler’s Germany, that deny the suffering they cause and
demand of artists to create a false front, inevitably bring forth mediocre,
empty art.
Our Western democracies require different kinds of lies. Imagery must
promote consumption at all cost. There seems to exist no social function that
would require the contribution of art that is not deceitful, yet the hunger for
genuine art persists even in our culture.
In the opening chapter of my (1971) book Art as Therapy with Children, I
presented the idea that the absence of art in everyday life, and the unfulfilled
longing for art experiences, has contributed to the rise of the profession of art
therapy. In addition, art therapy seems to constitute a rare area wherein the art
indeed serves a social function. Inasmuch as art and psychotherapy both
imply a search for inner truth, the endeavor is not inimical to art. Evidently,
we cannot expect that art as therapy will bring forth much great or good art.
It is unlikely, though, to bring forth pretentious or deceitful productions.
To artists in search of some field wherein their skills, imagination and
artistic integrity can be useful, art therapy constitutes an acceptable
profession.
In my own life, I have kept my art and art therapy quite separate. My expe-
riences as a practicing art therapist have reassured me that art is not an
entirely esoteric, narcissistic pursuit: that it can make sense, provided that I
approach my task modestly and respectfully.

2
As art therapist
I perceive myself as a specialist who combines the general qualifications of
being a competent artist with specialized capacities in the field of psycho-
therapy and education.
The theoretical framework of my understanding of child psychology is
based in the main on Freudian psychoanalytic thought. The emphasis,
however, is on the idea of art as therapy rather than on psychotherapy which
uses art as a tool. My therapeutic medium is as old as mankind. Since human
society has existed the arts have helped man to reconcile the eternal conflict
between the individual’s instinctual urges and the demands of society. Thus,
all art is therapeutic in the broadest sense of the word. The artist who applies
modern psychology in the field of art has to adapt his methods to the
medium so that the therapeutic value of art is heightened by the introduction
18 ART AS THERAPY

of therapeutic thinking, not destroyed or weakened by the introduction of

concepts and methods that might be incompatible with the inner laws of
artistic creation.
It is not always easy for the art therapist to reconcile the therapist’s
approach with her function as an artist and teacher. In her function as a
teacher who introduces disturbed children or adults into the realms of art,
she has to be ready to accept the limitations of the individuals in her care. She
has to be interested in progress on any level. She has to be flexible enough to
accept and understand a diversity of styles and to find ways of helping each
person according to his individual needs. As therapist she has to accept the
unbeautiful manifestations of sexual and aggressive impulses in the raw,
along with the results of confusions and incomplete sublimation. But this
attitude of acceptance, which is essential in all therapy, must not dull the
artist’s capacity for discrimination. The teacher has to preserve her integrity
as an artist in order to be able to distinguish between the fake and the
genuine, between blocks and limitations, regressions and progress, super-
ficial pretense and genuine communication.
Even though my therapeutic approach includes awareness of psychic
processes that may remain unconscious, the therapeutic maneuvers I am apt
to employ seldom include uncovering unconscious material or the interpre-
tation of unconscious meaning.
Art therapy is conceived primarily as a means of supporting the ego. It
harnesses the power of art to the task of fostering a psychic organization that
is sufficiently resilient to function under pressure without breakdown or the
need to resort to stultifying defensive measures. Thus conceived, art therapy
constitutes an element of the therapeutic milieu that complements or
supports psychotherapy but does not replace it.
While art therapists encourage unconventional form and content in the art
of their patients they are also intent on fostering artistic eloquence. The
spoken words in psychotherapy and the play and talk in clinical therapy are
typically formless and fluid. Content rather than form is essential. In art
therapy form and content are equally important and the order and structure
with which artistic creation endows experience constitutes a powerful aid in
sorting out and mastering experience. To quote Susan Langer (1962): ‘The
primary function of art is to objectify experience so that we can contemplate
and understand it’ (p.90).
 CREDO, AS AN ARTIST AND AS ART THERAPIST 19

References
Kramer, E. (1971) Art as Therapy with Children. New York: Schocken Books.
Kramer, E. (1977) Art Therapy in a Children’s Community. New York: Schocken Books.
Langer, S. (1962) Philosophical Sketches. Baltimore: Johns Hopkins University Press.

Notes
1 This is an altered and condensed version of an article first published in the American
Journal of Art Therapy 36, May 1998.
2 Part of this text is adapted from Kramer, E. (1977) Art Therapy in a Children’s Community.
New York: Schocken Books.
 CHAPTER 2

A History and Lineage

of Art Therapy as Practiced
by Edith Kramer1

I am gratified to find that the generosity and openness to the new and uncon-
ventional which I encountered when I first came to this country in 1938 is
still alive in 1996 even within academia.
Although I have participated in training art therapists on a graduate level
since 1959, I am myself devoid of any academic degree. When I initiated my
first art therapy program at Wiltwyck School for Boys in 1950 (see Chapter
9), Margaret Naumburg had already written her first books and introduced
the term ‘art therapy’ – but there existed no academic training program for
art therapy.
I was fortunate to be among the few individuals who carried on the good
work initiated by Naumburg in the United States and Adrian Hill in England.
My friend and comrade in arms, Elinor Ulman, whom Norwich University
has also honored with a doctorate, was also engaged in this pioneering effort.
It is sad to be now the sole survivor of this little group.
That no formal training existed in what was to become my bread-
and-butter profession had many advantages for a person like myself. Being a
committed painter, I would have found it nearly impossible to endure the
frustration of having to devote several years of my life to a study that would
have curtailed the time I could devote to my art.
Also, my studies would have burdened me with debts that would have
made it necessary to work not just to feed myself and pay the rent, but to pay
back my student loans. Young art therapists must now contend with these
matters, and it can be a very painful predicament.
Instead of undergoing formal training, I could build upon ideas and infor-
mation that came to me in the late 1920s and the 1930s in my native Vienna,

20
 A HISTORY AND LINEAGE OF ART THERAPY AS PRACTICED BY EDITH KRAMER 21

where I grew up within a Bohemian environment that included actors, visual

artists, politically engaged idealists and psychoanalysts. At that time, psycho-
analysts were a revolutionary group, at odds with established ideas and
mores, quite different from the psychoanalytic establishment of the 1960s
and 1970s in the US.
And so I became acquainted in my early youth with psychoanalytically
informed education and with child analysis as practiced by Anna Freud, Erik
Erikson and other early child analysts. I also read the early papers of Ernst
Kris, the art historian who became a psychoanalyst and first combined these
disciplines in his seminal book Psychoanalytic Explorations in Art (1952).
Within the field of art education, I knew Viktor Lowenfeld’s early work
with the blind. I even saw the original sculptures made by blind young
people under his guidance. To you, Lowenfeld is mainly known as the author
of Creative and Mental Growth (1957). My own work with the blind was
informed by his ideas.
I was also fortunate in my mentors in the fine arts and in being a disciple
of several masters rather than an art student at a university. Most influential of
them was Friedl Dicker. She had been a student of Johannes Itten in Vienna
and later followed him to the Bauhaus in Weimar, where she both studied
and taught. Dicker’s name is not well known in the US. I feel, though, that art
therapists ought to know something about this woman, her ideas, and her
fate.
Dicker was a highly gifted artist in her own right and also an inspired
teacher of children and of adults. From 1934–1938, Dicker taught art to
German-speaking children in Prague. Among them were several children of
political refugees from Germany who had found temporary haven in the –
then still democratic – republic of Czechoslovakia.
I assisted her in this work and learned about her methods – these
combined elements of Itten’s ideas with Lowenfeld’s concepts and with her
own ideas. Being Jewish, Dicker was later confined in the concentration
camp of Terezin from 1942–1944. There she devoted herself to teaching art
to the children at the camp. Even though Dicker and most of these children
were murdered at Auschwitz, their art as well as a few of the lectures Dicker
gave in Terezin about teaching art to children survived, testifying to the
sustaining and healing power of art.
In this sense, Dicker can be counted among the ancestors of art therapy
along with Naumburg and Adrian Hill. Indeed, her work seems closer to us
than theirs. Working under extreme conditions, her task was akin to our
22 ART AS THERAPY

work with the endangered children of our inner cities, children living in
violence, without hope and direction, destined to perish emotionally and
(often) physically.
Here I must correct a misunderstanding that seems to crop up repeatedly. I
was never in any concentration camp. I escaped all that in 1938. I observed
Dicker’s work in Prague, under much more benign circumstances.
Much of my heritage is in art, art education, and psychoanalytically
informed psychotherapy. Equally important in enabling me to practice art
therapy was my Freudian psychoanalysis with Dr. Annie Reich, a Viennese
who was willing to take on a fellow refugee for a pittance. Psychoanalysis
gave me personal experience of the power of unconscious processes and the
power of transference and countertransference. I attained the self-knowledge
essential for dealing with the pitfalls that arise out of one’s own psychic vul-
nerability. I learned to recognize transference phenomena in the individuals
in my care, so that I would not paint myself into a corner, and that I would not
be tempted to abuse the power transference lends to the therapist.
Even though so much came to me informally from my childhood and
youth in Austria, it could only come to fruition in the US with its openness to
new ideas, with its many universities that were willing to allow a person who
had ideas but lacked degrees to teach students.
I began teaching in 1959 after my first book had been published and have
continued to teach to date. During these 37 years, art therapy has expanded
enormously. Art therapists work in schools, hospitals, and rehabilitation
clinics. They work with elders, with prisoners, with the physically and
mentally handicapped – the field is expanding constantly. Art therapists
write articles and books. Young art therapists know more than we old-timers.
It is on the basis of so much achievement that I venture to voice concern, not
just about the training of art therapists, but about certain trends within the
intellectual life of our time, both in the US and Europe.
In the early days, art therapy enjoyed benign neglect. We sat in on rounds
and conferences and learned from them. Occasionally, we reported on our
work. No one on the staff knew much about art therapy. We could develop in
splendid isolation. Elinor Ulman and I concurred that we kind of enjoyed
that state.
During my seven years at Wiltwyck, the 15 years at Jacobi Hospital’s
Child Psychiatric Ward, and 14 years at the Jewish Guild for the Blind, no
one made any specific demands except that I work well with the children in
my care and maintain good working relationships with the staff. No one
 A HISTORY AND LINEAGE OF ART THERAPY AS PRACTICED BY EDITH KRAMER 23

asked for reports. The only advice about keeping records came from my wise
friend and protector, Dr. Viola Bernard, who cautioned: ‘Do write things
down … You may think that you will never forget, but you will!’ And so for
seven years, I wrote a diary every night I worked at Wiltwyck School. Those
illegible scribbles comprehensible only to myself were indeed invaluable for
writing my first book in 1958, Art Therapy in a Children’s Community, later
published by Schocken in 1977.
And so I continued to write diaries. I noted misgivings, victories, failures,
mistakes, and surprises. No one prescribed the form the diary had to take.
It is good that art therapy interns are now asked to write reports – that
they are supervised during their internship by experienced art therapists. But
I am worried about the kind of writing, the strait-jacket forms to be filled out,
lists to be checked. In particular, I have misgivings about requirements to
state treatment goals at the onset of therapy. How can one predict what may
happen or what a patient ought to achieve?
The essence of art and of psychotherapy is flexibility and openness. It also
implies tolerance for periods of disorganization and turmoil as ingrained
habits of defense lose their hold and new organization is only in the making.
Where is the space for listing such subtleties?
Art therapy is one way to discover strengths and/or weaknesses. To use
such findings we must be inventive and open to the unexpected. You might
arrive at a goal you may never have foreseen! And so I ask: What happens to
the inner-directed individual within today’s system?
For example, what about multiple choice exams? Are they destructive to
original thinking? Are inner-directed individuals at a disadvantage in the
system? Or can they flourish outside that system? Art therapists have done
well without multiple choice exams – will we remain capable of differen-
tiated complex thinking if we submit to them?
I am also concerned about the pseudo-scientific language we are induced
to use in professional life. ‘Newspeak’ is all around us! (I advise all young
people who have not read Orwell’s 1984 to read the appendix on Newspeak .
According to Orwell, Newspeak was created with the aim of reducing the
number of available words, eliminating ambiguities, multiple meanings, and
subtle differentiations, so that the tools for independent thinking would be
eliminated.)
Consider how many words have died by the term reinforce! (Friend and
fellow pioneer Elinor Ulman said she only knew of reinforced concrete!)
Confirm, drive home, support, insist, accept, single-out, persuade, instill
24 ART AS THERAPY

confidence – consider the difference between saying a five-month-old male

and saying a baby boy of five months old, a 21-year-old female and a young
woman of 21, a 95-year-old male, and an old gentleman of 95.
Worst of all are the terms ‘adaptive’ and ‘maladaptive’. The terms derive
from natural history where they make sense, for the maladapted species dies
out. But no… the evolution of species of increasing complexity hinges on
mutations and requires chaos, so that qualities that may in themselves be
maladaptive may combine with other maladaptions, bringing forth
unexpected new configurations.
As I read and hear about adaptive or maladaptive behaviors, I ask the
question: adapted to what? We work with adolescents who had to adapt to a
life of crime and violence. Reformed, they may perish, being maladapted to
an evil system. There are indeed individuals who need to be helped to come
to terms with the world they live in. We should help them – not to adapt, if it
kills them, but to find ways of adjusting without sacrificing their integrity.
As Temple Grandin states in Thinking in Pictures (1996): ‘If I could cease
being autistic by snapping a finger, I would not do it. For then I would no
longer be myself.’
What to do about all this? In your professional life, you may have to adapt
to practices you can’t change – you may have to use some Newspeak as you
fill out forms or write reports on the job. I advise you to use simple vernacular
English when you think about your work and about the individuals (not the
‘clients’) in your care! I advise you to speak English when you discuss your
work with fellow therapists.
I also advise you to fight for part-time jobs; to educate administrators to
the strange phenomenon that two part-time persons work more efficiently
than one full-time person when it comes to artist-therapists, so that you’ll
have time and energy for your own art; so that you will be able, out of your
own commitment, to generate enthusiasm for making art in the individuals in
your care.
I advise you to maintain yourself maladapted to all in our society that
would stifle independent thought and action. You have before you an old
lady who has been comfortably maladapted all her life, and yet, because she
has been so maladapted, is now being honored with a doctorate.
 A HISTORY AND LINEAGE OF ART THERAPY AS PRACTICED BY EDITH KRAMER 25

References
Gradin, T. (1996) Thinking in Pictures: And Other Reports from My Life with Autism. New
York: Vintage Books
Kramer, E. (1977) Art Therapy in a Children’s Community. New York: Schocken Books
Kris, E. (1952) Psychoanalytic Explorations in Art. New York: International Universities
Press, Inc.
Lowenfeld, V. (1957) Creative and Mental Growth. Third edition. New York: The
Macmillan Company.

Note
1 This commencement address was given in August 1996 to the graduates of the Masters
of Arts in Art Therapy Program, Vermont College of Norwich University, and was sub-
sequently published in the American Journal of Art Therapy 35, November 1996.
 CHAPTER 3

Art Therapy and Language, A

Revisiting of Orwell’s ‘Politics
1
and the English Language’

Some of you may question why I, with my heavy accent, born and educated
in Austria, should have taken it upon myself to speak about the quality of
language in art therapy; and this, when I am known as one of the most ardent
exponents of the central function of art in art therapy.
But then again, it is not so surprising. I grew up in a tradition of respect for
language, for in the contemporary Vienna of my youth, intellectual life was
dominated by Karl Kraus, an implacable enemy of sloppiness, sentimentality,
mendacity and faulty grammar, wherever these things appeared in print.
Kraus was convinced that language was an infallible indicator of the spiritual
and moral state of society, that the decline of civilization brings about the
degradation of language, while, in turn, deformed and degraded language
compounds the process of social disintegration. He mercilessly persecuted all
abuse of language via his journal Die Fackel (The Torch), a publication he
financed and edited single-handedly from 1899 until the rise of Hitler in
Germany in 1933.
In England, Kraus’ ‘torch’ was carried on by George Orwell, whose
exquisite 1946 essay, ‘Politics and the English language,’ should be required
reading for writers in any field (Orwell and Angus 1970). Orwell’s profound
concern for language culminated in his masterful exposition of ‘The
Principles of Newspeak’ – the appendix, but probably the enduring core of
1984, his greatest work. ‘Newspeak’ is undoubtedly upon us, soon to replace
standard English, reduce vocabulary, narrow and distort meaning, and rob us
of the instrument for thinking new thoughts.

26
 ART THERAPY AND LANGUAGE 27

In a modest way, Elinor Ulman, founding publisher of the first journal in

the country devoted exclusively to art in psychotherapy, rehabilitation, and
education was an editor in the tradition of these incorruptible men. To the
two we have spoken of, we should add E B White and his teacher William
Strunk, author of The Elements of Style (1979) – another indispensable aid to
writers. Elinor wrote four exquisite pieces about this battle, which constitute
more required reading (Ulman (1992). I will report on the unholy alliance
between Newspeak, ‘Therapese’, and ‘Educanto’ in the war against the
English language, and what we, as art therapists, can learn from it. Educanto,
Elinor Ulman’s invention, denotes the jargon rampant among educators,
characterized by euphemisms and bad grammar.
One group of abuses originates in the rage to inflate simple statements by
using scientific or rather ‘scientificalistic’ terminology instead of everyday
words, even when these fancy words carry less information, convey imprecise
or contradictory meaning and lack evocative power. The preference for using
the nouns male and female belongs to this group: a three-month-old male
could be an elephant or a tomcat for all we know. I have to make a mental
effort to imagine a baby boy of three months old. I do not see an incredibly
ancient lady in my mind’s eye when I read that the client is a 95-year-old
female – she would not be quite as aged if I were speaking of a giant tortoise.
Thus language has lost power as well as precision.
More confusing and absurd is the preference for fancy prefixes such as
‘bi-’ and ‘tri-.’ ‘Bi-weekly’ can mean every second week or twice a week; ‘bi-
annually’ ought to mean every second year. I believe that the ‘bicentennial’
does not yet occur at 50-year intervals. I am reassured that Art Therapy: The
Journal of the American Art Therapy Association now will be a quarterly. I should
hate to see our organization reduced to an issue triannually appearing every
third year. The rage to use these prefixes seems born of a readiness to sacrifice
clarity to the trappings of a spurious erudition – a kind of mathematization of
language that no mathematician would approve.
Take the word ‘skill.’ In my mind it pertains to abilities that can be
acquired and perfected with diligent practice, such as typing, driving a car,
ice skating, operating a computer. But ought we to speak and to think of
‘conceptual skills’ or, God forbid, of ‘social skills?’ Or are we reducing the
wonder of intellectual discovery or the complexity of living together to the
mechanics that may lubricate these functions but don’t help them to unfold
and grow? I hope we endeavor to stimulate curiosity and a passion for under-
standing that invites young people to embark on intellectual adventures. Do
28 ART AS THERAPY

we not also hope to help individuals feel empathy for others, to develop a
capacity for friendship or comradeship, to bolster their ability to
compromise, to be considerate or to defend themselves when attacked? Or
do we think only of acquiring the habit of saying, ‘Thank you,’ and ‘Please,’
‘Excuse me,’ ‘Good morning,’ and ‘Good day,’ as we help people to learn
social skills? I see the wasteland of contemporary education when I read of
social and conceptual skills.
I have been working up to two words entirely born of Newspeak:
‘maladaptive’ and/or ‘adaptive’ behavior patterns – words greatly favored by
educators. In Big Brother’s world, adaptive behavior is unequivocally
desirable; maladaptive patterns are to be extinguished. The question to what
situation or demands the individual has to adapt does not arise. Eichmann’s
behavior was eminently adaptive to Nazi Germany. From Socrates to Moses
to Jesus Christ to Freud or Einstein, the behavior of individuals of moral
fortitude and independent thought was more often than not maladaptive
within their environment. Indeed on more modest terms, the ideas of art
therapy pioneers were eminently maladapted to the establishment in which
they strove to make a place for art therapy. Diplomacy, the ability to
compromise and to adapt to different circumstances was necessary, but a firm
decision to stick to one’s own ideas was essential.
I hope and trust that readers of this book are individuals sufficiently
maladapted to be committed to battle for the human rights of the individuals
in their care, to defend them against a system that would reduce them to
numbers devoid of individuality, that would make them adapt if it kills them.
Inasmuch as we adopt Newspeak words in our thinking and writing we are in
danger of losing the fine distinctions that enable us to think about the people
in our care and about our own actions in a differentiated and precise manner.
Newspeak is all around us and it is difficult to resist.
As art therapists, we are trained to perceive subtle distinctions in artwork,
to observe how each individual uses art materials, to respond to the subtlety
in people’s work and behavior. Being visual people, we have less practice and
often less interest in words. Maybe we are inclined to defer to the verbal
people who dominate our society, to imitate their way of speaking and
writing. Maybe we are inclined to believe that the way these highbrow
people express themselves is better than our unsophisticated language.
The battle between Therapese and English is unending. The exponents of
Newspeak are in power. When I advise my students to write man, woman,
child, they say, ‘But we are required to use male and female when we write
 ART THERAPY AND LANGUAGE 29

reports for our internships.’ They tell me terms such as ‘social skills’ are on the
charts that they fill out at work. All I can tell them is to avoid Newspeak when
they think about their work, to ask themselves in what way is this boy who
lacks social skills unable to get along with his peers? Is he too shy to speak up,
or does he interrupt when others talk? Is he involved in fights or is he
terrified of violence? In which way exactly has his or her behavior improved
or deteriorated? Avoid Newspeak when you talk with colleagues and when
you write.
Reading professional literature can be deadly to one’s style as well as to
one’s mind. Indeed, whenever I set out to write, I am careful to read for infor-
mation before I begin. Once I am writing, I deliberately avoid reading any
professional literature other than Sigmund Freud, Anna Freud, Winnicott
and nowadays, Oliver Sachs, so that I will not be infected by Therapese,
Educanto, or Newspeak. Today I should add ‘Technobabble’, a close relative
of Newspeak, to the list of enemies of the English language. I leave it to the
new generation to battle with this emerging evil.
Let’s not resign ourselves to the narrowing of mind and spirit that occurs
when we succumb to the prevailing tendency to replace English with a
lifeless artificial language lacking in the quality we strive to uphold in our
profession.

References
Orwell, S. and Angus, I. (eds) (1970) The Collected Essays, Journalism and Letters of George
Orwell, Vol 4. Harmondsworth: Penguin.
Strunk, W. (1979) The Elements of Style. Third edition. New York: Macmillan.
Ulman, E. (1992) ‘The war between therapese and English.’ American Jounal of Art Therapy
30, 3.

Note
1 From the American Journal of Art Therapy 32, November 1993.
 PART 2

The Profession of Art Therapy

 CHAPTER 4

Exploration of Definition
Edith Kramer and Elinor Ulman1

This chapter constitutes an attempt at clarification, with the hope that

muddied intellectual waters will be made more transparent.
‘Transference’ is the oldest of the terms under discussion, and from art
therapy’s earliest beginnings – with Margaret Naumburg – it has been used
in a confusing way. Even in a filmed interview of 1975, Naumburg referred
to transference as forming the basis for a relationship of trust between patient
and therapist. However, transference by definition consists of the attribution
to another of qualities he does not have (or of reacting in an exaggerated
fashion to qualities he may by coincidence share to some extent with absent
others). Thus, transference can form the basis only for relationships of the
utmost precariousness. Trust, if it should seem to be present, will inevitably
be followed by the most embittered (and perhaps quite unjustified) disillu-
sionment. (Disillusionment must first occur because the demands implicit in
positive transference are not only impossible to fulfill but the frustration of
those demands is also an essential element of treatment.)
While Naumburg ought not to be held too strictly to account for a remark
made casually in the course of an interview, throughout her writings there
are many references to the importance of events that take place between her
and her art therapy patients ‘within the transference relationship,’ a phrase
whose meaning is never precisely defined. The interactions she describes,
however, often seem to be closer to the ‘therapeutic alliance’ as conceived by
the neo-Freudians and others, than to the psychoanalyst’s concomitant effort
to foster the patient’s transfer to his own person of attitudes originating in
quite other contexts. In psychoanalysis, the source of these attitudes remains
throughout a substantial part of the treatment, unconscious; the gradual dis-

33
34 ART AS THERAPY

entanglement of this complex web lies at the center of the psychoanalytic

process.
Quite aside from the possibility of training art therapists to carry out such
a procedure, we must ask whether this is an appropriate goal. Art therapists
who are really expert in their own province can offer something that psycho-
analysis and other kinds of specialists in the ‘talking cures’ cannot: the
opportunity to experience the kind of functioning that is possible only in the
process of making artworks and to gain the insights that may be obtained
through this kind of experience and in no other way. With this end in view,
the art therapist must indeed understand transference thoroughly and know
how to deal with it. Her aim will be to behave in such a way that transference
interferes as little as possible with the making of art that contains and
expresses basic conflicts. Her common ground with the psychoanalyst will
lie in the above mentioned therapeutic alliance rather than in that other
aspect of the analytic relationship constituted by the deliberately developed
transference.
No more than others can the art therapist successfully serve two masters.
Certainly she must deal with words and with all the complexities of human
interaction, but if her interest in the process of psychoanalysis or other
primarily verbal therapies comes to outweigh her passion for ther-
apy-through-art she will do well to change her profession.
Confusion about the more recently introduced terms, ‘art psychotherapy’
and ‘primary therapist’, likewise seems to stem from an understandable but
mistaken wish to be all things therapeutic to all clients. In her prepared
remarks [for the plenary session in discussion], Kramer went on to point out
that an art therapist may become a primary therapist for no better reasons
than default; even when many modes of treatment are available, it may be the
opinion of a therapeutic team that art therapy is the single therapy of choice
and therefore an art therapist may be assigned chief responsibility for a
particular patient, whether he is seen individually or in a group; or the art
therapist may reasonably serve as the person responsible for guiding and
coordinating several different modes of treatment. In neither of these circum-
stances need the art therapist abandon her own area of expertise to imitate
methods that others can use as well as or better than she can.
‘Art psychotherapy’ is a term that becomes dangerous when it is used by
art therapists who overtly or covertly hold the opinion that their position in
the psychiatric hierarchy will improve in inverse ratio to their interest in art
and in direct ratio to their use of the techniques of the talking cures. The art
 EXPLORATION OF DEFINITION, BY EDITH KRAMER AND ELINOR ULMAN 35

therapist, like other mental health professionals, needs to be prepared to

administer psychological first aid in times of crisis. Also, like others, she
needs to recognize her own limitations. She must not behave like a layman
who, in a case where surgery is obviously needed, rushes in to perform an
operation, an action that might readily transform a minor emergency into a
fatal one.
In urging art therapists to stick to their field and to leave certain kinds of
therapeutic function to others, we have, of course, been assuming the highly
desirable availability of a mental health team encompassing a broad range of
specialties. In actuality, circumstances arise where whatever mental health
professional is available must leap into the breach and attempt to perform
services beyond those she is best equipped for. To follow the surgical analogy
further: Emergency appendectomies have been successfully performed at sea
by laymen guided by an anatomy book and, if they were lucky, radioed
instructions, but this did not make the layman a surgeon. Art therapists who
seek their identity outside the area where they can truly excel actually
condemn themselves to being second class citizens forever.
In our field of unique competence we hardly welcome intruders. We
know from bitter experience that even the best psychotherapists may be
sadly inept when they attempt to use art materials in the context of treatment,
and that occupational therapists who supply patients with art materials are
seldom able to conduct art therapy sessions.
Successful teamwork demands mutual understanding and mutual respect.
To homogenize the therapies will not only reduce all of them to mediocrity
but will in the end also limit the range of available procedures so severely that
the search for the ‘treatment of choice’ will be doomed to sure failure.

Note
1 This is a condensed version of an editorial published by The American Journal of Art
Therapy 16, October 1976.
 CHAPTER 5

The Unity of Process

and Product1

Oversimplification and imprecision in our thinking that may seem negligible

in themselves are apt to have far-reaching consequences. Half-truths entering
our vocabulary and thereby our thinking ultimately influence the practice of
art therapy and lead us astray.
I want to address myself to one such oversimplification and its conse-
quences: the dictum ‘Art teaching is concerned with products, but in art therapy
we are interested in process.’ This implies a dichotomy of product and
process. But in art, product and process are one. Whenever we judge that a
product which serves no practical use but which constitutes an equivalent for
experience has the quality of art, we imply that it has evocative power and
inner consistency; the work lacks nothing and contains nothing superfluous.
Either taking away or adding would diminish its quality.
Work of such profound inner unity cannot be planned, plotted or faked. It
can come about only through complex processes which engage the creator’s
manual, intellectual, imaginative and emotional faculties in a supreme effort
of integration. Surely all persons engaged in art in any capacity, be it as artists,
art teachers or art therapists, hope for this miracle, which we cannot force but
for which we can prepare the way and set the stage.
What then are the reasons for stressing processes and denying interest in
products? In part we may be reacting against the rampant malpractice of
plotting for products, using methods that circumvent the creative process and
replace it with prescribed procedures which, if followed obediently, will
result in pseudo-products that can create the illusion of art. Much of art
education and most of art in recreation subsists on such practices.
Students and patients who have been subjected to this kind of instruction
need to be exhorted to forget about manufacturing products. To prevent their

36
 THE UNITY OF PROCESS AND PRODUCT 37

futile striving for a kind of preconceived perfection that is both guaranteed

impersonal and guaranteed bad art, we assure them that we do not care what
their work looks like. We implore them to put their ideas down any old way,
to have courage, to be spontaneous. Further, as art therapists we accept the
fragmented, the chaotic, the abortive, the incomplete. We expect to assist in
many processes that fail to culminate in art. Our interest in understanding
such processes and working with them is indeed more keen than is the art
teacher’s interest in her student’s incomplete efforts. It is also common
knowledge that adults, whether or not their ideas about art are valid, must
often be urged temporarily to suspend critical judgment, for excessive preoc-
cupation with the final goal of artwork actually stands in the way of its
achievement.
We are in trouble when we are taken in by our own propaganda and end
up believing that we really do not care what the patient’s work looks like;
when, devising exercises to counteract rigidity and alleviate anxiety, we end
up plotting activities that are so contrived that it would be impossible to
achieve any finished product; when having lost confidence in the art
material’s power to stimulate the desire to give form, we invent games and
gambits that encroach on the patient’s autonomy and smother his initiative as
effectively as any stereotyped arts and crafts project; when, in order to induce
‘spontaneity,’ we encourage chaotic manipulation of art materials.
This leads me to another widespread error in thinking, an error which is
twofold. First, there is the inclination to confound undisciplined, aimless
manipulation of art materials with spontaneity. Actually, spontaneous art
expression requires that one imagine and depict what is uppermost in one’s
mind, and this demands both the suspension of habitual defense and a high
degree of moral courage and self-discipline. Untrammeled scribbling and
messing are as unlike spontaneous, expressive use of art materials (and
unlikely to lead to it) as aimless chatter is unlike free association in psychoan-
alytic treatment.
Second, there is the erroneous belief that art therapy is concerned almost
exclusively with spontaneous art expression – that is, with the use of art
media that evokes the raw material of art but inevitably stops short of art as I
have defined it. Such spontaneous production is invaluable in gaining access
to the patient’s inner life and therefore is a legitimate part of art therapy, but it
is by no means the whole of it. Art therapy includes, as well, the task of inte-
gration. At best, this is a labor of love, but all the same it is arduous, not spon-
taneous.
38 ART AS THERAPY

This brings us back to the false dichotomy of process and product. When
concentration on process results in systematic neglect of or disrespect for its
natural culmination – the product – the patient is deprived both of his goal
and of the reward for his labors. The processes that are fostered in such
incomplete endeavors must remain primitive and abortive and thus they
cannot serve as models of healthy functioning.

Note
1 This chapter was first published in Ulman, E. and Levy, C. A. (eds) (1980) Art Therapy
Viewpoints. New York: Schocken Books.
 CHAPTER 6

Art Therapy and Sublimation1

Since Paleolithic times, humans have created configurations which serve as

equivalents for life processes. We call those configurations works of art. The
process by which this happens is as mysterious as all basic processes of life.
Art is a method of widening the range of human experiences by creating
equivalents for such experiences. It is an area where experiences can be
chosen, varied, and repeated at will. All artistic experiences take place in a
world of symbols. It is an artificial world, but it has the power to evoke
genuine emotions. The feeling of reality which works of art inspire is not nec-
essarily related to their greater or lesser naturalistic verisimilitude, but
depends on their power to evoke emotions within the audience. Indeed,
creations which attempt too close an imitation of life forms, like waxworks or
artificial flowers, cease to be art. Their value is at best sensational; basically
they are unpleasant. They make us uneasy because the distinction between
art and reality is no longer clear. Works of art can be enjoyed without guilt
and anxiety just because they take place in an abstract framework of symbols
and conventions which isolates them from reality, so that experiences which
take place within this framework do not stimulate an urge for acting out.
Because this is so, people can commit themselves to becoming involved in
experiences which include deep unconscious content. They can derive
pleasure from them without fear that such adventures might impair their
adjustment in reality and weaken their necessary defenses. Indeed the burden
of repressions and renunciations is made easier by such artistic experiences.
In this respect works of art resemble dreams and day-dreams. Dreams and
fantasies can often be enjoyed with a minimum of guilt, even when they
contain asocial and forbidden wishes, because the dreamer or day-dreamer is
certain that his fantasy will never become action. But fantasies and dreams
are creations by the individual for private use. They are formless, not meant

39
40 ART AS THERAPY

for communication. Works of art, on the contrary, are formed, and their com-
munication is pleasurable for the artist and the audience.
We find that form and communication belong together. The artist com-
municates with his or her audience in a language of symbols and conventions
that are commonly understood. We can understand style and the changing of
styles as the result of the interaction between the artist and his or her society.
Thus, societies which change slowly, for example, the culture of old Egypt,
produce a static, slow changing style of art, while our Western world, which
for the last 2000 years has been changing and developing with ever-
increasing speed, has seen constant changes and transformations of style.
When social changes take place so rapidly that the development of a style
cannot keep pace with the changing state of society, art is apt to become
formless. Left without a form in which to cast his or her message, the artist
evolves a private language and, with this, art ceases to be communication in
the true sense of the word.
Thus art depends on society and contributes to society. We find that art
adapts itself readily to the services of any field which happens to be an
important factor in the cultural life of a people. According to the changing
historical situation, art contributes to magic, religion, politics, the crafts, and
many other fields. In some instances, such a state of amalgamation is reached
that it becomes nearly impossible to distinguish the several elements. Magic
and art form such a unity in totem poles and masks. Craft and art become one
in medieval tapestry or in Indian pottery. We find that art enhances the effec-
tiveness of any function to which it contributes while, in turn, art flourishes
best as it contributes to other fields. But this holds true only as long as such a
unity remains a productive, well-integrated factor in society. Art is exceed-
ingly sensitive to social chasm, falsehood and hypocrisy. For instance,
religious art degenerates as soon as the religious life of a people declines. The
quality of a craft declines when improved methods of production make a craft
obsolete. Art becomes lifeless and empty when it serves an outdated,
fossilized power system. In such historical situations art becomes isolated
from its official social functions and is reduced to serving the individual. We
can see such developments in the flourishing of Roman portraiture during a
period when the official formal art consisted of lifeless imitations of Greek
sculpture, or towards the end of the nineteenth century when the term ‘l’art
pour l’art’ (‘art for art’s sake’) was coined to express the artist’s isolation from
society.
 ART THERAPY AND SUBLIMATION 41

Because of the interdependence between art and society it often is

difficult to recognize and to isolate the elements of art within the fabric of
society. But whatever the intricacies of each special situation might be, one
factor remains constant: art contributes pleasure, pleasure chiefly derived
from unconscious sources.
At present we lack an understanding of the process by which artistic
pleasure is generated and communicated. All that we can attempt at this point
is a brief presentation of a number of concepts which seem particularly
relevant to the subject of this study.
The artist is a person who has developed the capacity of resolving
conflicts between the demands of his impulses and the demands of his
superego, between reality and fantasy, through the creation of works of art.
Through them he communicates his inner experiences to his audience in a
sublimated culturally and socially productive form. The audience shares the
artist’s inner experiences on several levels, so that the audience experiences at
once something of the primitive asocial impulse which the artist had to
master, and the triumph of the successful transformation of the raw material
into a work of art. In the ideal case, the spectator experiences a kind of minor
miracle, as the artist’s creative work makes it possible for the participant to
achieve vicariously and with comparatively little effort a degree of subli-
mation which is ordinarily beyond the individual’s reach. The success of a
work of art with an audience depends, therefore, not only on the artist’s
creative capacity, but equally on his audience’s capacity and need for subli-
mation and, with them, on many cultural and social factors. But before we
investigate this problem any further, we have to define more clearly the
concept of sublimation which we have been using all along.

The concept of sublimation

We call sublimation any process in which a primitive asocial impulse is trans-
formed into a socially productive act, so that the pleasure in the achievement
of the social act replaces the pleasure which gratification of the original urge
would have afforded. For example, there is a beginning of sublimation when
a small child prefers the joys of building a tower with his blocks to the
aggressive pleasures of throwing them about, or finds the achievement of
filling his spoon with food and finding his own mouth more rewarding than
messing with his food. The child is stimulated towards such a choice by the
mother’s wishes, as she rewards achievement with love and admiration or
shows disapproval of instinctual behavior. This lays the foundation for the
42 ART AS THERAPY

development of the superego. But the achievement is performed by the

child’s ego. We may say that there is sublimation whenever instinctual
behavior is replaced by a social act in such a manner that this change is expe-
rienced as a victory of the ego. Naturally the picture is not always clear. The
child’s feelings may be divided between a feeling of loss and defeat as an
instinctual wish is relinquished, and a feeling of victory and pleasure as the
ego achieves greater mastery over the environment and over the impulses.
There is at the root of all sublimation instinctual renunciation, and every step
towards further sublimation is paid for by further renunciation. So all subli-
mation contains an element of frustration and precariousness.
An instinct which spends itself through complete gratification will not be
available for sublimation. Only when the original aim of the drive is blocked
can the inherent energy become available for new purposes. However, this
denial must not be too absolute. An instinct which is denied all direct gratifi-
cation will be repressed so deeply that it will not be available for modification
and transformation. For example, if the voyeuristic and aggressive sexual
curiosity of a small child is frustrated entirely, the enjoyment of all visual
impressions may become blocked, so that no receptiveness for the plastic arts
and no talent for painting can develop. On the other hand, if the denial is not
too absolute, the child might deflect its voyeuristic activities from their
original aim, become a keen observer, develop a sensitivity for visual impres-
sions, and may use his aggression in transforming the passive act of seeing
into the active act of producing visual images. The original curiosity will
always continue to exist (all artists are voyeurs to some degree), but it will lose
its single-minded infantile obsessiveness as more and more energy is invested
in creative work. Naturally this outcome does not depend only on the quality
of the denial, but equally on the love and admiration which the child obtains
for his creative efforts. It depends, last but not least, on the child’s talent –
that elusive quality which makes certain paths of sublimation seem easy and
natural, even inevitable, for some individuals, so that a minimum of encour-
agement suffices in making them productive, while others seem to have little
capacity in the same direction.
Sublimation, then, is a process in which a instinctual aim is denied direct
gratification. The original aim is replaced by a new, socially productive aim
through a process which includes repression and reaction formation. The
instinctual energy which is not discharged becomes, at least in part, available
to the ego, and is used in the development of skills and accomplishments
which give the individual greater mastery over his environment and improve
 ART THERAPY AND SUBLIMATION 43

his capacity for positive relationship so that he becomes a more valuable

member of society. The gratification which this accomplishment affords
replaces instinctual gratification. The process begins early in life, before the
establishment of the superego. It is an important factor in ego and superego
formation.
I prefer to speak of socially productive acts, even though we often find in
literature the term socially acceptable acts, defining sublimation. The fate of
Socrates, of Jesus Christ, the reception of Rembrandt’s paintings or of the
work of the Impressionists amply demonstrates that ideas and works that
were indeed the results of heroic acts of sublimation were often initially
rejected by society.
With maturity and the establishment of the superego, sublimation
becomes the ego’s most economical method of reconciling the demands of
the superego with instinctual demands. As the ego succeeds in forming a
superstructure through which forbidden sexual and aggressive drives can
find some measure of gratification through socially productive acts, gratifi-
cation becomes possible with the approval of the superego. The ego succeeds
in its function as an integrating force and is rewarded by a feeling of peace
and achievement. Pleasure is gained from superego and id, two forces that are
ordinarily antagonistic. This reconciliation is not static. It is a continuous
process of maintaining a balance between conflicting forces. It requires a
continuous expenditure of energy. Finally, this balance does not include the
individual’s inner world alone but, for ultimate peace of mind, society has to
approve of the individual’s efforts. Sublimation seldom exists in a pure state.
We find in every individual a mixture of repressions, reaction formations,
neurotic symptoms, and other mechanisms along with genuine sublimation.
Our detailed description of the mechanisms of sublimation makes the process
appear unduly complicated and difficult to achieve. Granted that human
beings are by nature complicated, and that the ego’s task is not an easy one,
sublimation seems to be the most natural or rewarding function of the ego. It
is the ego’s task to reconcile and integrate conflicting forces with a minimum
of displeasure. Through sublimation, pleasure is gained without arousing
excessive anxiety from within or hostility from without. The achievement of
this rare state of balance constitutes the ego’s greatest victory. Indeed human
beings are so addicted to this kind of pleasure that they suffer intense frus-
tration if channels for sublimation are blocked.
Our work with children who have been deprived in early childhood of
experiences which lead to sublimation or later have been deprived of
44 ART AS THERAPY

physical and emotional opportunities for sublimation, shows that frustration

in this area leads to disturbances that are as serious and as painful as those
that are the result of denials of instinctual gratification. And this cannot
surprise us if we consider that ultimately only aggressive or autoerotic gratifi-
cations can be enjoyed without some vestiges of sublimation. All positive
personal relationships are bound up with the modification of instinctual
behavior for the sake of the relationship.

Sublimation in art
Artistic sublimation begins as the artist replaces the impulse to act out his
fantasies with the act of creating equivalents for his fantasies through visual
images. Those creations become true works of art only as the artist succeeds
in making them meaningful to others. The complete act of sublimation, then,
consists in the creation of visual images for the purpose of communicating to
a group very complex material which would not be available for communi-
cation in any other form. Form and content become an inseparable whole.
The need for this kind of communication has many sources. For one, there
is the repressed material itself which pushes to the surface and demands ful-
fillment. Then, there is man’s paramount narcissism which cannot suffer that
any part of his person has to remain hidden and unloved, so that he is moved
to exhibit his hidden self through his creations. In doing this the artist
sacrifices part of his primitive narcissism by transferring his love onto his
creations, which he endows with all the beauty and perfection he is capable
of so that they may be admired and loved as he wishes to be loved himself.
The final reason, which embraces all the other reasons, is man’s great need to
overcome the isolation which is part of human life. Through art man can
partake in the inner world of other men without losing his integrity as an
individual, and find security and pleasure in this communion.
We can see that works of art always remain emotionally charged. Conflict
is formed and contained, but only partly neutralized. Art differs here from
most other forms of sublimation. For instance, when aggressive energy is
sublimated in constructive work like carpentry, the result will not be a
monument to the carpenter’s aggression, but a useful, emotionally neutral
object like a table or a chair. Or, the result of the scientist’s curiosity will not
be an expression of this curiosity, but objective truth. But every work of art
contains a core of conflicting drives which give it life and determine form and
content to a large degree.
 ART THERAPY AND SUBLIMATION 45

For example, all great portraits contain the artist’s intuitive knowledge
and understanding of his subject along with an interpretation of the subject’s
position in society, so that the spectator who may never have seen the living
person obtains through the portrait the intuitive knowledge and awareness
of another human being. The portrait, then, is born of the desire to possess
and preserve the essence of a human being. The instinctual root of this desire
is the small child’s wish to incorporate and devour the beloved object. It finds
its earliest cultural expression in cannibalism, head hunting, the smoking of
heads, embalming practices and so forth. In those primitive forms love and
care are exercised in the preservation and the adornment of the trophy, but
the initial possession is possible only through an act of destruction. In
portrait painting intuitive understanding, observation and technical skill
replace those primitive methods. So that, in the ideal case, far from feeling
threatened and robbed by the artist, the person whose portrait is being
painted becomes more aware of himself and feels more fully alive as some of
his essential being is eternalized in the picture.
The energies of primitive libidinal and aggressive impulses are used in the
developing of technical skill, power of observation and depth of under-
standing. But the basic need for possession and incorporation remains active
and is fulfilled, although in a transformed manner. Indeed the depth of
intuitive knowledge which is the essence of great portraiture could not be
obtained without the help of those unconscious wishes. In the artist’s com-
passionate or merciless or dispassionately objective interpretation of the
individual we can feel an echo of the mixture of love and aggression which is
at the root of it all. And we can observe an unconscious awareness of those
processes in the reaction of the public towards portraits, which often is a
mixture of awe and revulsion, admiration and distrust towards artist and
portrait.
This digression into the psychology of portrait painting illustrates the
artist’s precarious position. While his craft demands a strong ego capable of
great perseverance, concentration and precision, his raw materials are
untamed instinctual drives, so that in order to remain creative the artist has to
remain sensitive to the unconscious forces within himself and in others, and
has to permit his impulses to come close to the surface. This explains why we
often find in artists the highest level of sublimation coexisting with
instinctual and impulsive behavior. The balance between sublimation,
repression and instinctual gratification varies with individual artists. The
artist may be impulse-ridden or ascetic; he may be a slow, steady worker or
46 ART AS THERAPY

alternate between periods of heightened productivity and blocking. But a

certain tolerance towards direct instinctual gratification in some form or
other seems inevitable. A person who has established very rigorous, inflexible
defenses against his impulses, or a person who has resolved his conflicts so
well that there remains little pressure from the unconscious, will probably not
become an artist.

Note
1 This is a condensed version of the chapter ‘Art and society’ from Kramer, E. (1977) Art
Therapy in a Children’s Community. New York: Schocken Books.
 CHAPTER 7

The Art Therapist’s Third Hand

Reflections on Art, Art Therapy
and Society at Large1

In this chapter I will pursue ideas that have been my concern throughout a
long career in art and art therapy: the relationship between art, art therapy
and society at large. This chapter falls into three main parts. Part one is
devoted to the realm of the ‘Third Hand,’ a metaphor I have coined to
describe an area of the art therapist’s functioning wherein artistic
competence and imagination are employed in the empathic service of others.
Clinical examples of both success and failure in the use of the Third Hand are
given.
The contemplation of obstacles encountered in the attempt to serve
others with empathy and skill leads to a group of themes discussed in the
second part, titled ‘Alienation and art therapy.’ My investigation focuses on
conditions inherent in our highly industrialized society that affect artists,
therapists and patients alike – conditions that increasingly deprive people of
opportunities for vigorous, constructive action that confirms their sense of
autonomy and selfhood. These conditions engender a pervasive sense of
depersonalization and alienation that affects all of us to some extent. Besides
coloring the quality of the psychic distress that prevails in Western industrial
society, alienation also influences the character of contemporary art. I will
discuss how the alienating effects of the modern world interfere with art
therapists’ capacity for empathic pictorial communication.
The inquiry into the influences of social conditions on the professional
conduct of art therapists leads to the third part, ‘Pictorial communications
and self-betrayal.’ In this section I view critically some images meant to
embellish the art therapy profession’s communications to the public at large.
Samples are offered from an extensive collection of pictorial self-betrayals,

47
48 ART AS THERAPY

showing the alienating influences of society on the art therapist. I conclude

with ideas on ways of training the Third Hand, and suggest that such training
must include cultivating awareness of the social forces that form and deform
our pictorial language.

The Third Hand

To support processes whereby feelings take on visual form is a central task of
art therapy. Paralleling any specific maneuvers the art therapist undertakes in
the name of therapy must be the effort to enable each client to produce
pictorial communications that eloquently and truthfully communicate
experience – eloquent, of course, within the limitations of the client’s
capacities and situation.
To assist in processes whereby pictorial communications of very personal
material become therapeutically fruitful, art therapists must cultivate special
faculties. They must, to paraphrase Theodore Reik’s (1948) metaphor of the
psychoanalyst’s ‘Third Ear,’ cultivate a ‘Third Eye’ trained to perceive the
multifaceted messages embodied in artwork produced in the course of art
therapy – messages that may defy translation into words. However, a Third
Eye alone is not enough. In conjunction with this special vision, art therapists
must also command a ‘Third Hand,’ a hand that helps the creative process
along without being intrusive, without distorting meaning or imposing
pictorial ideas or preferences alien to the client. The Third Hand must be
capable of conducting pictorial dialogues that complement or replace verbal
exchange.
Like other artists, art therapists must attain fundamental graphic, painting,
and sculptural skills and understanding. But unlike other artists, who may
concentrate solely on developing their own style, art therapists must learn to
subordinate personal style when working with clients. Thus, art therapists are
free to pursue their personal artistic goals and visions when they work in
their studios, but must adapt to the style and imagery of their clients or
patients when they function as art therapists. They must cultivate an area of
artistic competence distinct from their own artistic struggles and predica-
ments, a conflict-free sphere wherein technical skill, pictorial imagination,
ingenuity and capacity to improvise are employed solely for empathic service
to others.
Art therapists working with neglected, delinquent children frequently
find themselves confronted with contradictory behavior. Initially the
children are eager to join the art therapy group and try out the attractive art
 THE ART THERAPIST’S THIRD HAND 49

materials offered. However, confronted with the actual task of painting a

picture, their chief concern is not to commit themselves. Expecting failure
from the beginning, they will try at all cost to prevent the therapist and
themselves from ascertaining just what they can and can’t do, creating a
deadlock.
Seeing that the teacher or therapist can paint well, some children will
distort the learning process into a dogged attempt at appropriating her skill,
much as if it were a material possession which the therapist refuses to part
with. Such a child will not just attempt to make the therapist help him, but
will try to make her act in his stead, and carry out his intentions as if she were
his alter ego, capable of reading his mind, or even capable of giving form to
his vague and incomplete ideas. This attitude is akin to the concepts of the
very young child who still feels one with the mother and is unable to distin-
guish between the self and the outside world. At this period everything good
or bad seems to come from her, every frustration caused by her withholding
of fulfillment, and every pleasure the result of her love and bounty.
Vestiges of this magic interpretation of the teacher’s or therapist’s powers
and function would be part of any relationship between student and teacher.
So much remains unconscious and indefinable in the transmission of skills,
knowledge and attitudes which we call teaching, that a feeling of the magical
or miraculous is part of all learning that goes beyond the mechanical storing
up of facts. The mastery of skills or discovery of truth affords a sense of the
miraculous, and so, in the last analysis, every teacher remains something of a
witch or wizard to the student.
Like the teacher, the art therapist will mean many things to the children in
her care. She may be the envied possessor of magical skills, the voice of
conscience and reason, the guide towards pleasure and success, or the hated
intruder who is bent on embarrassing and defeating the child. The great
hindrance in the creative process is the neglected child’s low tolerance for
any kind of failure, the slightest mistake will easily convince a child that his
effort is wholly worthless. One of the art therapist’s main occupations
consists of rescuing pictures that would be destroyed for minor reasons.
Again and again it has to be demonstrated that mistakes are not irreparable
and that the therapist is willing and able to help at all times.

Jacky
Nine-year-old Jacky had received little care or training of any kind. When art
materials were offered, he was at a total loss. His few independent attempts to
50 ART AS THERAPY

draw produced the kind of oval and circular shapes characteristic of a child’s
earliest scribblings. In his helplessness Jacky expected the teacher to draw
and paint for him. His behavior was alternately demanding and defiant and
frustrations enraged him and he would verbally abuse me.
A change occurred before Thanksgiving: Jacky came to the art session
wanting to paint a big turkey on a platter, to be hung up in his group’s living
room. Jacky could be persuaded to draw the platter. Here he could use the
oval shapes which came easily to him. I had to draw the turkey, but Jacky was
ready to draw potatoes and radishes, and here again he could use his round
shapes. Fired by success and the thought of good food, he also added carrots
and celery, a glass of milk and rolls. He colored the picture with great
enthusiasm and without smearing and developed more skill than he had
seemed capable of previously. Jacky painted several replicas of the turkey.
Each time I had to help with the bird, but Jacky did the rest.
For once I had not worked instead of Jacky. Rather he and I had
cooperated on a common task. Soon Jacky ventured beyond turkeys and
foods, and painted castles, boats, stars and other things. He acquired the form
perception and muscular control necessary for his new subjects. With success
Jacky’s behavior changed. He was less demanding, became cooperative and
his rages and verbal abuses diminished. It is interesting that Jacky was just as
much enraged by the wrong kind of help as by no help at all. On several
occasions a young student tried to help Jacky with his pictures. The young
woman had not yet acquired a reliable Third Hand. Her drawing was too
small and complex for Jacky’s understanding. He was bewildered and
needed her constant help. This enraged him to a point where he abused and
tortured the student throughout the art session.

Frank – a change of style

This example tells of a deliberate act of intervention. Ten-year-old Frank, an
ardent painter, was locked in a desperate struggle for a change of style. He
was dissatisfied with his child-like schema for depicting people and with the
simple solid colors he was using in his large, powerful paintings. He wanted
to draw with more ‘wriggley lines’ and to learn to ‘shade’ his colors. Frank
was in the second half of latency, an age when the intellectual and emotional
widening of horizons normally gains momentum. This development is apt to
find reflection in the child’s art. Means of representing space and depth are
discovered, and more modulated individual representation replaces earlier
schemata.
 THE ART THERAPIST’S THIRD HAND 51

For Frank these normal developmental changes occurred at a time when

his relationship with his parents was undergoing a painful revolution. Frank’s
mother had deserted her family when he was seven years old. Frank’s father
had placed Frank in a home for dependent children, from which he was later
discharged to Wiltwyck School for Boys because of severe emotional distur-
bance. From his seventh year on Frank had maintained absolute allegiance to
his father and total rejection of his mother. When Frank was nine years old
this position became untenable because his father, who had made grandiose
promises of speedy reunion, disappeared and failed to communicate for more
than a year. Frank’s mother, after having found a new livelihood, began to
visit Frank regularly and, undaunted by his refusal even to speak with her,
persisted in her attempts to win her son’s confidence.
At ten years of age Frank had come to terms with the realization that his
adored father was not as reliable as he had pictured him and that his mother
was not as evil as he had envisioned her, that both parents were fallible –
neither all good nor all bad. At this impasse the art room became the stage
whereon Frank’s inner struggles were enacted. The transition from schematic
rigidity to the realism of preadolescence became symbolic of a similar
change in Frank’s relationship to his mother and father. Frank could neither
accept his old rigid style nor could he endure the more modulated style of
painting he would have been fully capable of, for he experienced such work
as ‘too messy.’ Locked in a double bind, Frank reduced the art room to a sea of
torn paper and disrupted his peers’ work with daily temper tantrums. He
could use neither advice nor help, yet he constantly berated me for being a
bad teacher who helped no one.
Then one memorable afternoon he began the session by drawing the
outline of a rocket ship. He painted the rocket a solid gray and the sur-
rounding sky a flat light blue. Dissatisfied with the schematic simplicity of
the painting, he added red, orange, and yellow to the sky, explaining the
rocket was approaching the sun. Soon these hot colors spread onto the
rocket. As he added more and more hot colors and the oozing paint began to
obliterate the rocket’s outlines, Frank anxiously exclaimed, ‘The sun is
melting my rocket.’ I responded to his distress with action: with a brush filled
with heavy white paint I outlined the rocket and also restored a sufficient area
of original background so that the sky and rocket could be perceived as
separate. At this point Frank took the brush out of my hand. He modified my
rigid white outline and redefined the orange and red colors, which had
threatened to obliterate his rocket, so that they appeared as reflections of the
52 ART AS THERAPY

sun on the rocket’s shiny surface. He managed to create a painting that

depicted a rocket whose black, gray and white shades suggested polished
metal, the surface of which reflected a distant conflagration covering part of
the sky. Visible also was an expanse of cool blue sky separating rocket from
sun.
Frank was elated. He felt that he had finally painted a successful
‘grown-up’ picture. A breakthrough had indeed occurred, for Frank was able
to maintain the gains of that afternoon. His colors became more modulated,
his lines softer, his characterizations of people more based on observation.
He began to think of himself as an artist. At the same time Frank became
more accepting of his mother.
When Frank’s father re-entered the scene after a year’s absence, it was
possible for these three people to come to terms. Frank’s father and mother
cooperated in finding a suitable home for their son. Frank became reconciled
to the parents’ separation and to his placement. The self-confidence gained in
his artwork helped in his adjustment to school and foster home.
It would be idle to ask whether the events in the art room had helped to
bring about inner change or whether they were the visible manifestation of a
change that had occurred imperceptibly. We can assume that the acts of
painting and inner change were interdependent. Yet it is noteworthy that a
woman’s help in rescuing an aggressive phallic symbol from melting and thus
losing its identity was crucial in liberating Frank’s creative energies from a
paralyzing double bind. It is also noteworthy that this very help gave him the
needed sense of freedom and autonomy and that his former incessant
demands for help and dissatisfaction with any help offered ceased once the
right help had been given at the right moment, in the right manner and with
few words.
The examples of the Third Hand with Jacky and Frank came from my
own experience with children. The next two cases illustrate successful use of
the Third Hand with adult art therapy clients seen by Vera Zilzer at the
Lincoln Day Hospital in the Bronx, New York.2 Zilzer practices a kind of art
therapy that she calls bringing about ‘small changes.’ Such changes help
patients to complete work in progress in a manner commensurate with their
own concepts and aspirations, work that would be out of reach without some
small pictorial contribution from the art therapist. Such contributions are
executed in the patient’s own drawing style or, as Zilzer would have it, in
each person’s ‘handwriting’; and each contribution is small enough to be
readily assimilated and not felt as criticism.
 THE ART THERAPIST’S THIRD HAND 53

Art therapy sessions are held daily in a spacious studio where a sizable
number of patients, sometimes as many as 12, can work side by side – not as a
group, but as individuals with a common interest in art. Each person is free to
choose subject matter and art material, and Zilzer addresses herself to each
patient individually. A variety of art materials is available. However, Zilzer
has found colored pencils offered in abundant variety to be particularly
congenial to the majority of her patients. The medium requires patient appli-
cation, but it rewards even the unskilled with highly differentiated color
effects when several colors are superimposed – effects that could not be
attained by using crayons or pastels. At the same time the struggle for control
entailed in working with wet tempera is avoided.

Phoenix in flight
Adam, a chronic schizophrenic in his twenties, was able, with the support of
the day hospital’s program, to live at home. He had been working diligently
on a colored-pencil drawing of a large golden-brown bird with black wings,
flying high against a sky-blue background: a phoenix. But since the bird’s

Figure 7.1 Phoenix in flight after Zilzer’s intervention

54 ART AS THERAPY

wings nearly touched the paper’s edges, any movement of them would be
constrained, and thus the sense of flight was lacking. Moreover, the bird’s tail
was cut off altogether.
Zilzer looked at the completed drawing. ‘Let’s give it a frame,’ she
suggested. Turning away from Adam, she quickly stapled the picture onto a
larger sheet of white cardboard. Then, using a soft lead pencil, she faintly
drew on the framing white paper the outline of a tail that harmonized with
the curved forms of the bird’s body and wings. Then she handed Adam’s
picture back to him. Zilzer’s drawing was so faint that Adam could easily
have disregarded the lines or erased them had the suggestion implied in
Zilzer’s drawing been uncongenial. Adam, however, chose to integrate the
addition. He energetically colored the tail in the same brown that he had
used for the bird’s body, and he colored the rest of the white paper in the
same blue he had used for his sky. Thus the frame, in effect, disappeared, and
the extended sky gave breathing space to the phoenix, now whole and truly
in flight. No words were exchanged, yet a message was conveyed and
integrated (see Figure 7.1).
Adam had created an image of rebirth and liberation. It would remain a
symbol not to be fulfilled in real life. We note that the bird has no feet that
would enable him to come to rest, though two tiny protuberances below the
belly could be interpreted as representing claws. Zilzer wisely refrained from
any pictorial or verbal suggestions concerning the bird’s coming to earth. But
even the symbol of flight had been out of reach. To have mentioned the
absence of a tail and sufficient space for flight, even while offering assistance,
would have been to confront Adam with how mutilated and confined he felt.
Such a confrontation would have been beyond his endurance. Simple
acceptance and praise of his original drawing would have confirmed that
everyone, even Zilzer, had given up hope for any change. The art therapist
had to find a way of giving support that could be integrated without
dialogue – a way of giving support on a preverbal, essentially symbiotic level
without, however, establishing a symbiotic dependency. In this Zilzer
succeeded.
Experiences such as Adam’s cannot bring about any fundamental changes
in a chronic patient. However, inasmuch as schizophrenics habitually live in a
world of symbols and fantasies rather than in the world of reality, the
symbolic experience of rebirth could help sustain Adam’s remission and give
more substance to his limited existence.
55 ART AS THERAPY

A place to rest
Mrs. Smith was a severely depressed, middle-aged black woman. Her three
grown children no longer shared her home. This left her extremely isolated
and despondent. She had a great need for personal dignity and kept herself
well-groomed and well-dressed in spite of her depression. But she found it
difficult to accept her black skin and was given to drawing pretty white ladies
with blond hair and blue eyes – defensive, unattainable ego ideals that could
bring no comfort (and which probably even helped maintain the depression).
Her decision to make a picture of herself and her children at the beach was in
itself a victory. She wished to represent herself at ease in the grass. However,
she could not manage to make her body touch the ground. It remained
floating. Unlike Adam, she was able to ask for help. Zilzer obliged by adding
the outlines of a little bench to support the floating figure. So encouraged,
Mrs. Smith was able to complete her picture (Figure 7.2). She even ventured
to give herself and her children their own dark skin color. At this juncture,
Zilzer intervened once more, offering an orange pencil to use along with the

Figure 7.2 A place to rest after Zilzer’s invervention

56 ART AS THERAPY

dark brown Mrs. Smith had chosen. The mixture would do justice to the
golden glow of Mrs. Smith’s skin. Again the intervention was made in the
patient’s ‘handwriting’ and in keeping with her developmental level. To raise
the groundline and so place the body directly in the grass, for instance,
would have been a maneuver beyond the patient’s pictorial understanding.
The addition of a piece of furniture could be integrated. The completed
picture still speaks of the isolation and depression. The three children remain
floating, and Zilzer wisely made no move to ground them. The three flowers
at the left (symbolic images of the children) are grounded, but much distance
separates them from the tree. It appears as isolated as the mother. Close to
mother and well-grounded sits a black cat, and above the mother hovers a
huge dark bird. Powers of darkness still seem very close. Everyone is very
still: there is as yet no interaction. But there is for Mrs. Smith a place to rest
and give form to her longings and aspirations.

Failures in intervention
The preceding examples tell of success. But we must also consider failure or
flawed empathy.

THE BIG FIST

Raymond came to the art room crying bitterly because a big boy had hit him.
Raymond’s most serious symptom was his masochistic need to provoke
hostility, abuse and rape. Undoubtedly he had been hit because he had
invited aggression, and following his pattern he had not defended himself
but had retreated, nursing his injuries. Evidently art therapy could not help
Raymond to resolve his masochistic needs. Also, Raymond was too weak to
fight his enemy in reality.
Feeling both helplessly irritated by Raymond’s behavior, and sorry for
the little boy, I tried to console him by suggesting that he should paint a big
fist. Raymond stopped crying and painted a huge fist and a horrible bloody
eye, with the fantasy of hitting the big boy in the eye. Since the aggressor was
a much-hated bully the group commiserated with Raymond, and several
boys also painted fists hitting bloody eyes. The art session deteriorated into a
sadistic orgy. Even the paintings of excellent painters lost all resemblance to
art. They were so vulgar and obscene that none of the boys cared to preserve
his work when the mood had died down. The children’s paintings were not
artistically inferior because of the cruelty and aggression which they
contained. On other occasions some of them had painted monster pictures
 THE ART THERAPIST’S THIRD HAND 57

that expressed much deeper cruelties and more murderous fantasies than
their big fist pictures. The paintings were artistically worthless because they
were shallow and formless. The boys had shared in an entirely conscious
sadistic fantasy. In expressing their ideas, they had lowered their standards of
achievement. Instead of sublimation there had been regression.
My invitation to show the big fist had only emphasized Raymond’s help-
lessness and his orgy of sadistic fantasies could only lead to new masochistic
acts. The group’s commiseration with Raymond’s plight had satisfied his
need for acceptance and compassion, but at the price of a collective
regression to Raymond’s emotional level, which made the experience thera-
peutically futile or harmful.
I had been seduced. In order to console the child I had catered to his
sado-masochistic symptoms. I ought to have calmed the child and then
suggested to him that he paint a picture, not as revenge, but because he
enjoyed painting. If Raymond had painted a picture after calming down, it is
unlikely that it would have had direct bearing on the incident. If, however,
Raymond had painted a sadistic picture in response to the incident, this
would have had different emotional meaning. Raymond’s painting would
have expressed his own strength and comeback, not illusory strength
borrowed from the therapist, and might have been more valuable for
Raymond.
Raymond’s story illustrates the futility of an attempt to channel
aggression by consciously diverting it into symbolic action. Such an escape
will lead to regression and remains therapeutically valueless or harmful.
It is noteworthy that the art therapy program was at the time sufficiently
well established, so that the group felt that the session had deteriorated and
all the bloody eyes were duly relegated to the garbage pail.

Alienation and art therapy

Failures in the use of the Third Hand such as those described in the last
vignette are inevitable hazards of therapeutic work. However, self-
knowledge and good supervision can help to reduce the destructive effects of
lapses caused by a therapist’s personal problems. I am more concerned in this
investigation with problems that transcend the personal – problems endemic
to our industrial society. Because they are so pervasive, the phenomena I refer
to are largely unrecognized – and unhappily so, since they affect not just
those in need of the services or art therapists, but art therapists themselves as
well.
58 ART AS THERAPY

What has gone wrong?

In earlier writings (Kramer 1993) I suggested that our modern age is char-
acterized by a hidden hunger for art. This is linked to the absence of art in the
fabric of our daily life. I suggested that such phenomena of the twentieth
century as the proliferation of art courses for amateurs, indefatigable tourists’
pilgrimages to the sites of the arts of past ages and, yes, the advent of art
therapy are a response to this hunger. But something has gone wrong. The
basically sound desire for art in our lives has led too often to deplorable
results.
We humans have always been capable of endless carnage and destruction.
But only in our age have our constructions – our architecture, vehicles, and
objects of daily use – spread ugliness and desolation on the face of the earth.
We cannot escape from a vicious cycle where hotels and condominiums rise
to house people who have come to enjoy the beauty of an unspoiled area – an
area, that, in turn, is degraded by the very presence of these buildings and the
hordes of people they attract.
Throughout our pre-industrial history, the objects of daily life were made
by hand. A kind of overflow of the joy and pride in making things and in
possessing them led people to embellish their handiworks with countless
variations (on innumerable surfaces) of imagery drawn from the imaginative
and spiritual storehouse of their culture. Thus, folk art linked everyday life
with the enduring and transcendent values of the culture, and had the effect
of confirming the existence of the everyday world and our place in it, lending
reassurance and stability to life.
Folk art has now all but disappeared. Instead, the persisting appetite for
imagery is being exploited by the packaging industry. We are forced to
acquire the necessities of life encased in outsized wrappings (destined to
become trash) covered by admonitions and enticements designed to seduce
or coerce us into buying a product or adopting an opinion. Pictorial imagery
remains subordinate to the written word and deforms the letters. Like it or
not, we are made to drink coffee from plastic cups declaring ‘I©New York’ or
some other nonsense. It requires effort and devotion to free our kitchens and
cupboards from the cacophony of visual noises issuing from boxes, cans and
plastic wrappers.
Far from confirming our existence and aspirations, our machine-made
world assaults us, bores us, reduces us to ciphers. To some extent we are all,
perforce, rendered autistic. Assaulted by chaotic visual, auditory and
olfactory stimuli that yield no useful information, we learn to shut them out.
 THE ART THERAPIST’S THIRD HAND 59

We school ourselves to passive endurance in traffic jams and immobilized

subways. Working in windowless rooms where heat and light are controlled
by central powers beyond our reach, we become habituated to stoical resig-
nation. Seldom are we allowed to act both vigorously and constructively. Our
perceptual systems, exquisitely designed continuously to furnish us with
complex information about the world around us, are becoming a burden and
a source of irritation.
Psychoanalysis has taught us much about the psychic injuries incurred
when sexual and aggressive drives are denied channels of gratification. We
have yet to fathom what may happen to us when another part of our
instinctive heritage, the appetite for gathering and interpreting information
on our surroundings, is starved. We see the crudest effects of such starvation
in the stereotypic rocking of permanently stabled cattle or of autistic
children. The more subtle effects on our minds and bodies when artificial
sameness replaces continuous change – for instance, when fluorescent light
replaces sunlight or when paved roads replace natural pathways – is not fully
known. Nor do we know all that may happen to us when survival depends
increasingly on suppressing stimuli rather than on perceiving them.
One of the ills of our time, the increasing inability to experience anything
strongly, may be linked to the habit of suppressing stimuli. Protection from
overwhelming stimulation is paid for by loss of emotional response to
perception – a kind of living death. Inasmuch as a craving for experience
persists, crude and excessive stimuli have to be manufactured in order to
penetrate our protective shell. Habituation to such stimuli further dulls the
capacity to respond to ordinary experience, and a vicious cycle ensues, so that
humans appear alienated from the environment as well as from themselves.

Alienation
More perceptive than others and traditionally functioning as a mirror of
society, artists began responding to alienation before it became a widely
recognized phenomenon, and they continue to do so. Those who have
responded by attempting to master alienation and to present man’s individu-
ality as it persists within or in spite of the modern environment are in the
minority.
Some artists – for example, Alberto Giacometti – mirror our world’s
isolation and despair. Others depict its brutality, painting in ‘exhilarated
horror’, as Francis Bacon put it. Artists like Andy Warhol seem to have
acquiesced in the boredom and repetition of the commercial world;
60 ART AS THERAPY

apparently they see it as inescapable – indeed as the central subject of con-

temporary art. The work of artists like Jasper Johns exemplifies the reduction
of the profundity of pictorial symbols to the one-dimensional simplicity of
signs. Men like Robert Smithson, who created the Spiral Jetty in Utah, seem
to mirror the arrogance of modern man, ruthlessly imposing his will onto the
face of the earth.
Common to most of these artists whose styles differ so greatly is the incli-
nation to repeat their statements over and over again so that they appear at
once inescapable and blunted by repetition. (The despair embodied in any
one of Giacometti’s groups moves us deeply, but a one-man show leaves us
numbed.) Simple acquiescence in the demands of galleries who would
typecast their artists for easier marketing cannot fully account for the
phenomenon. Inner compulsions as well must be at work. Psychoanalysis
teaches us that repetition usually indicates the working of defense
mechanisms. Whatever the overt statements of the artists I have mentioned –
be it protest against, acquiescence in, or confirmation of the status quo –
these statements seem to be amalgamated with the (unconscious) defense
mechanism characteristic of all victims: identification with the aggressor. The
ubiquitous manifestation of this mechanism may be a measure of the extent
to which our society victimizes artistically gifted individuals.
The danger inherent in this mechanism of defense is apparent: victim and
aggressor become indistinguishable. This tendency of victim and aggressor
to become one may explain the eerie process whereby protesters are
absorbed and digested by the world of commerce and galleries – that is, their
protests are transformed into marketable commodities. (The artists
mentioned earlier are cases in point.)
The mechanism of identification with the aggressor seems to be an
essential component of another phenomenon of modern life: graffiti – the
pictorial productions that have filled the void left by the demise of folk art.
The phenomenon is also of special interest to art therapists, who frequently
encounter graffiti-artists among their clients and must learn to understand
them.
As in any highly energized endeavor, the rage to make graffiti is
overdetermined. The need of the powerless and insignificant to leave an
imprint on the world is undoubtedly one motive. That graffiti are made
almost exclusively from the alphabet seems at first glance merely an
expression of general impoverishment. It is as if nothing but their names is
 THE ART THERAPIST’S THIRD HAND 61

left to distinguish one person from another. But perhaps the almost exclusive
use of letters has other causes as well.
Graffiti originated among the semi-literate and the illiterate. (The fashion
has also been taken up by more educated and privileged young people in
search of adventure, but I will not discuss their contribution in this context.)
On the whole, the pattern was set and is being perpetuated by those who
have failed to attain the literacy that would enable them to rise in the world.
Perhaps as young people graffiti-makers found themselves coerced into
attending school, where they were unceasingly offered reading material they
could not or would not take in, as would be the case if the reading material
was of or from a different culture. (This practice is like that of an earlier time
whereby children who had not eaten their supper were served the same food
for breakfast and lunch the next day – the food becoming more unpalatable
with each serving.) No wonder then that the letters take on a bloated,
menacing, and destructive countenance as the illiterate make them their own,
identifying with the powers that hound and destroy them.
Inasmuch as they epitomize the ills of our time – depersonalization,
repetition, violence, and the hypertrophic proliferation of letters to the
detriment of pictorial images – graffiti frighten us and make us angry.
However, many graffiti exhibit vitality, rhythm and a sense of composition.
These qualities attest that graffiti are also rooted in the persistent need to
create form, even while the inclination to decorate is perverted into the
impulse to deface. Graffiti-making attracts the artistically endowed among a
population that lacks opportunity to cultivate such gifts in other ways. Partic-
ularly on the outside of subway cars and on walls surrounding empty lots we
see the beginning of a new folk art in the raw.

Comment
Can art therapists help young graffiti-makers to rise above mere identifi-
cation with the aggressor, help them to find forms that could define a more
differentiated sense of self ? The question leads to the broader issue of art
therapists’ training. How does the art of our time and the training prepare
artists who would be therapists for their calling? We find that it prepares
them admirably for dealing with manifestations of depersonalization,
depression, fragmentation and images of total annihilation. This is essential,
for art therapists must be ready to accept and validate their patients’ or
clients’ states of mind as manifested in their art. Often the art therapist’s
function is mainly to help give form to fantasies, dreams, hallucinations – to a
62 ART AS THERAPY

gamut of pathological imagery. For some clients the benefit of art therapy
remains confined to providing opportunities to give form to such content.
Yet as art therapists we can never abandon all hope for change. And our
work confirms that changes can occur. As we float with the schizophrenic we
hope that some day the tip of a toe may touch the ground. We hope that
where there was only a stump or a claw, a hand may grow – conceivably a
hand capable of holding something or somebody. We hope that the empty
gaze or a piercing defensive stare may change to eyes that can see. We hope
that aggressively bloated initials may give way to forms that truly tell of their
maker.
But what about the art therapist whose own figures are incompletely
grounded, who cannot draw a hand that holds, who cannot convincingly
represent actions and feelings? Could such an art therapist know even what
exactly to hope for in a patient’s drawing, being unable herself to imagine
where or how a foot could touch ground or what a hand would look like
when it works or when it clasps another hand?
Among the drawings that applicants for art therapy training are required
to produce in the admissions workshop of the university where I have taught
for years we seldom find fragmentation or gross distortions of body image,
but again and again we find figures insufficiently grounded. We find that the
majority of applicants cannot draw hands and feet in action; that the
applicants have great difficulties in making their figures look at something or
somebody. Insufficient training alone cannot account for these inabilities.
Rather I see in them a symptom of the mild autism I described earlier. The
mental health professions could not survive if they had to be staffed by
people totally free of the pathology of their time.
To illustrate my point I will described drawings by two applicants for art
therapy training. Two were drawn by applicant A, a nurse who was seeking
additional training in art therapy. She was admitted with the understanding
that she would take art courses to make up for her lack of artistic skills. In one
drawing she depicts two children in her care, sitting with their Christmas tree
and toys on the children’s ward. In the second we see ‘A’ herself, terrified
because a toy has exploded. The children sit rigidly; the artist cannot make
them appear to play or even look at their toys. Nor is she able to turn her own
head and eyes towards the explosion. Only a frontal stare is available to her,
and yet she is able to draw well-proportioned figures of children and herself
and to suggest her nurse’s uniform convincingly.
 THE ART THERAPIST’S THIRD HAND 63

Applicant B also lacking art training drew a picture depicting herself

looking doubtfully at the nursery school teacher to whom she is about to
entrust her frightened little girl for her first morning at school. The drawing
was inept and proportions immature, yet each person’s eyes, facial expression
and gesture convincingly conveyed what is happening among these three
people. Although the student had much to learn technically, she seemed free
of the mild autism I have described.
Both students successfully completed their training, for luckily when dif-
ficulties are recognized they usually can be overcome. But such recognition is
often lacking. Lack of self-awareness within the profession constitutes the
closing theme of this chapter.

Pictorial communication and self-betrayal

Since art therapy has become an organized profession, it has reached out to
the public at large in assorted publications (flyers, bulletins, programs,
announcements) often embellished by artwork members of the profession
have made themselves or approved (when designed by commercial artists).
Those who have made or approved the artwork in these publications have
demonstrated a perturbing lack of awareness of the full implication of the
works’ pictorial messages. It is as if everything art therapists have learned
about the interpretation of artworks applied only to patients’ art and was
forgotten when it came to their own work or that of colleagues or com-
mercial artists in their employ. Below I offer some questions about how we
envision and depict the things closest to us and our work as art therapists.

How do we see what we do? Rorschach revisited

When I received an intentionally ink-spattered program for an art therapy
conference, I felt myself transported back to the early 1950s when the
statement that I was an art therapist invariably elicited comments such as, ‘Oh
yes, a great release. Do you use a lot of fingerpaint?’ The designers of the
conference program had helped to perpetuate this simplistic and out-dated
notion of art therapy: they have represented art therapy as just a means of
releasing aggression. Or were the designer and those who sent out the
program not aware of the blatant aggression directed against the recipients,
whose names and addresses were ink-bespattered, who were forced to read a
program framed by such blots?
64 ART AS THERAPY

How do we see patients?

Figure 7.3: Drawing after a workshop sign

Another example of this lack of awareness was a sign in which art therapy
patients were depicted as sad, overly simple, featureless creatures bearing
little relation to actual humans. This sign was directed to prospective students
and mercifully probably never reached any future patient. For the message is
clear: patients are faceless ciphers – handless, helpless, misbegotten. Again it
is conceivable that some commercial artist was entrusted with publicity, that
the sin is one of omission, of inattention to pictorial messages. But what does
this say about art therapists’ awareness of pictorial messages – surely a crucial
skill in the profession?

How do we envision bridging differences?

Figure 7.4: Drawing after the bulletin for an AATA conference held in New York
 THE ART THERAPIST’S THIRD HAND 65

The cultural, racial, and social differences of greater New York can be
bridged. The logo designed to celebrate an art therapy conference in New
York wants to convey this hopeful message. Yet the bridge, beginning and
ending in limbo, suggests not an arched structure elegantly traversing space;
rather it suggests a clothesline on which the black contours of an endless city
are precariously perched, or maybe an awning that hides the lower portion of
the buildings that make up the city. In the center, the Empire State Building
(still New York City’s penis symbol in spite of the higher Twin Towers) seems
about to pierce the highest one of the range of mountain-breasts that hovers
over the city. A grandiose rising sun (or is it setting?) dominates everything.
Did the message miscarry because the artist knew the desperation of this
great city, knew of the near impossibility of bridging our deeply divided
world? Did such knowledge of the tragedy of our time cause the artist to
belie the logo’s professed optimism? Instead of suggesting the unifying
power of great architectural structure, the logo portrays incongruity, precari-
ousness, and grandiosity.

How do we see our art therapy organizations?

Figure 7.5: Drawing after a tree used for the 1982 AATA Conference
66 ART AS THERAPY

Even more disturbing incongruities characterize the logo devised for another
conference held by AATA in 1982 – a tree. The professed message was clear;
‘Standing like a tree, art therapy is verdant.’ But this tree anxiously clutching
the ground cannot grow, for a rigid, triangular configuration entirely unlike
the organic roots and trunk interferes; it severs base from crown. No wonder
that the leaves – drawn in yet another style, reminiscent of art nouveau – seem
to shrivel inwards. The tree’s crown appears to have been clipped by a giant
pair of scissors into a circular shape. The arc of mutilated stems and leaves
produced thereby is antithetical to the majestic effect of a tree’s crown.
What caused these incongruities? What made artists forget what they
have learned from the writings of Emanuel Hammer (1968), Buck (1981)
and Bolander (1977) about the psychological significance of the various
parts of a tree and their interrelationship?
The most impressive elements of the symbol are the tree’s roots and trunk.
They seem darkly alive with anxiety, and anxiety that is well-founded. For all
of us must anxiously wonder whether art therapy or any of the helping pro-
fessions will survive in a political climate devoted to profit and military
power and hostile to the poor and sick. But it is hard to admit to anxiety. The
trunk’s anxious gesture is not allowed to unfold. The logo forbids it graphi-
cally by capping the unruly trunk. Then an artificial crown is substituted
above in place of full, natural expression.
I suggest that massive denial of anxiety shaped this logo; that the
repressed returned to distort and contradict the optimistic message; that the
same denial that formed the tree also blinded both the artist and those who
approved of the design to its pictorial meaning.

Happy holidays?
What happened next to the tree was even sadder. It was uprooted and stuck in
a pot – thus its troubling roots in anxiety denied entirely. Then the leaves of
the crown were further clipped to resemble the triangle of a spruce tree. The
addition of a stereotypic wreath further commercialized the image, and in
this guise the tree was sent out as a holiday greeting card. Perhaps this image
has another message. Christmas is a good time for happy people whose
wishes are being fulfilled; whose families are united, loving, and prosperous.
It is a time of desperation for the isolated, poor, bereaved and institution-
alized. Pressured to help manufacture symbols of Christmas cheer, art
therapists are depressed by the desolation underlying such attempts. Was the
 THE ART THERAPIST’S THIRD HAND 67

empty and absurd holiday greeting an unconscious expression of this

distress?

Comment
The images discussed in this section (selected from a large and growing
collection) appear to exemplify three major problems of our culture. First, the
conference program demonstrates the inclination to indulge in aggressive
gestures and to ascribe a healing effect to doing so. This practice confounds
simple discharge of affect with self-expression. Second, the image of the
patients tells of the depersonalization and alienation pervading our social
services. Third, the bridge, the tree and the greeting card show the malign
effect of unwarranted optimism and denial of unwelcome truth.
It is not easy to withstand these tendencies, for great social forces uphold
them. But art therapists can and ought to pay closer attention to the pictorial
language of their own communications to the public. To do so will save us
from betraying ourselves and the values we stand for.
I found it impossible to soften the polemical tone of my discussion of
these interpretive lapses on the part of art therapists. Certainly art therapists
cannot be expected to be immune to the ills of their society, but this particular
kind of blindness cannot safely be glossed over; its implications for art
therapy education are too important.

Conclusion: Implications for the training of art therapists

I suggest that the faltering of the Third Eye when it looks upon one’s own
work and that of one’s colleagues is closely linked to the absence of a
well-trained Third Hand. Had the pictorial productions in question been
subjected to the scrutiny and self-discipline that is central to the Third Hand,
such lapses would not have occurred.
Diagnostic training has always been an essential component of art
therapy education, but training in the use of the Third Hand has remained
haphazard. Undoubtedly much learning occurs informally as gifted super-
visors, themselves endowed with an inspired Third Hand, convey their skills
and wisdom to students in the course of internship. Much is learned in group
art therapy courses where students experience to what extent psychic
processes beyond their control determine form and content of their own pro-
ductions. My own university offers a required course, ‘Art for art therapists,’
that endeavors systematically to develop students’ pictorial empathy, their
68 ART AS THERAPY

flexibility and versatility. Other training programs may offer similar

instruction. But this is only a beginning. Much remains to be done, much to
be studied in an area that has been sadly neglected by the profession.
Some of the faculties of the Third Hand can be acquired in graduate
course work. We can, for example, endeavor to fill certain gaps in most of art
teaching – concerned as it is with the formal elements of art, often to the
neglect of the emotional component. For art therapists must be able to draw
and sculpt well-grounded figures in action, to tell pictorial stories that con-
vincingly represent events and convey how each person in the story felt
about them. They must be able to depict eye contact, draw hands that can
hold, and feet that can stand firmly. They must be able to impart a feeling of
weight and substance to things or people, and they must be able to use color
expressively. Training such faculties verges on art teaching, though emphasis
would be on experiencing and conveying experience convincingly rather
than on formal academic training.
Inasmuch as such work entails directing attention to one’s own body and
facial expression and to the gestures and expressions of one’s fellow men, it
counteracts the inclination to retire into a protective shell, to shut out stimuli
to the point where the capacity for experiencing is diminished. Art therapists
so trained, while still free to choose to reflect in their own art the alienation
that prevails in society, would be less likely to become its unknowing victims.
Furthermore, beyond acquiring such faculties – and this can be an
arduous process – students must learn to recognize a great variety of pictorial
styles and to adapt to them. They must learn to enter their patient’s or client’s
imagery respectfully, in an unobtrusive and non-disruptive fashion. Course
work can prepare students only in part for these tasks. Much can be acquired
only during internship where future art therapists encounter the various
pictorial styles at first hand. In the field they see work that is commensurate
with the skills of moderately gifted, untutored people; images cast in the
graphic language of comic strips – a language that diminishes the figures’
humanity through typecasting and conventional distortions; primitive work
conceived on an infantile level that may or may not coincide with the artist’s
chronological age or level of development. I must not omit the more unusual
encounter with some highly gifted individual whose work commands
respect, whose talent is superior to the art therapist’s. With such a client one
must be cautious about interceding for fear of clumsily interfering with the
creative process.
 THE ART THERAPIST’S THIRD HAND 69

To communicate pictorially in such a variety of styles requires much flexi-

bility and empathy. Art therapists must, in Vera Zilzer’s terminology, adapt to
each individual’s pictorial handwriting. This much can be and should be part
of any art therapist’s training. It prepares the student for a life-long quest for
effective pictorial communication and pictorial intervention. For throughout
our professional life we must ask ourselves again and again: What change for
the better can be reasonably expected in the artwork of each person in our
care? What could be the first small step in this direction? Could a small
pictorial intervention set such change in motion, and what should it be? Such
questions can never be answered in an unequivocal manner, and we must
always be prepared for surprises.
My reflections have ranged over a wide field. In an effort to define the role
of pictorial communication and pictorial intervention in art therapy and to
understand the difficulties entailed in cultivating an effective Third Hand, I
have presented clinical vignettes, reflections on the cultural climate of our
time, and examples of pictorial communications published in the name of our
profession that have miscarried. I have suggested that certain additions to art
therapy training programs be made and raised questions that must be
addressed. I can conceive of seminars and study groups where experiences
could be exchanged and pooled: where drawing, painting and sculpting with
the Third Hand would be not just discussed, but practiced. We would then
begin to learn systematically about the powers of the Third Hand.

References
Agell, G., and others (1981) ‘Transference and countertransference in art therapy.’
American Journal of Art Therapy 21, 1, 3–24.
Bolander, K. (1977) Assessing Personality Through Tree Drawings. New York: Basic Books.
Buck, J. N. (1981) The House-Tree-Person Technique. Los Angeles, CA: Western Psycholog-
ical Services. (Originally published in 1948.)
Hammer, E. (1968) Use of Interpretation in Treatment: Technique and Art. New York: Grune
and Stratton.
Kaplan, F. F. (1983) ‘Drawing together: Therapeutic use of the wish to merge.’ American
Journal of Art Therapy 22, 3, 79–85.
Kern-Pilch, K. (1980) ‘An illustrative case of art therapy with a terminally ill patient.’
American Journal of Art Therapy 20, 1, 3–11.
Kramer, E. (1962) ‘Art therapy and the severely disturbed child.’ Bulletin of Art Therapy 5,
1, 3–20.
Kramer, E. (1993) Art as Therapy with Children. Chicago, IL: Magnolia Street Publishers.
Kramer, E. (1998) Childhood and Art Therapy. Chicago, IL: Magnolia Street Publishers.
70 ART AS THERAPY

Lachman-Chapin, M. (1983) ‘The artist as clinician: An interactive technique in art

therapy.’ American Journal of Art Therapy 3, 1, 13–25.
Reik, T. (1948) Listening with the Third Ear. New York: Farrar Straus and Co.
Rosner, I. (1982) ‘Art therapy with two quadriplegic patients.’ American Journal of Art
Therapy 21, 4, 115–20.
Simon, R. M. (1982) ‘Peter: A severely disabled patient’s triumph through art.’ American
Journal of Art Therapy 22, 1, 13–15.

Notes
1 A version of this chapter was originally published in the American Journal of Art Therapy
24, February 1986.
2 The material in this section is presented in cooperation with Vera Zilzer, ATR, and is
published with her permission.
 PART 3

Clinical Work
 CHAPTER 8

An Art Therapy Evaluation

Session for Children
Edith Kramer and Jill Schehr1

In the practice of art therapy, diagnostic evaluation and therapeutic effort can
never be separated. In the turmoil of art therapy sessions the messages
conveyed by work in progress call forth an intuitive response that is informed
by the immediate situation as well as by past experience and academic study.
Ultimately, however, we must contemplate productions at leisure, analyze
them from many viewpoints, and plan ahead. In work with children, we have
found that the art therapist’s multiple tasks are facilitated if a specially
designed art therapy session precedes the child’s admission to the art therapy
program.
Such a procedure was initiated in 1974 by Edith Kramer with the
assistance of Jane Fields, ATR, under the auspices of the Department of Child
Psychiatry of the Albert Einstein Medical College, Bronx, New York.
Kramer’s use of this procedure was documented in a film produced by the
American Art Therapy Association (1976.)
The evaluation session is conducted in the same spirit in which we
ordinarily work with children. But working conditions are organized more
systematically, the aim being to gain as much information as possible within
the single session.
The reader should understand from the outset that the procedure
described below is not intended to be comparable to the clinical psycholo-
gist’s battery of tests. It is designed for use by art therapists experienced in
working with children. We have found that in such hands it can be highly
informative, complementing the multidisciplinary team’s clinical findings.
The present paper is intended to encourage other art therapists to work in a

73
74 ART AS THERAPY

similar way so that a body of clinical experience can be developed as the

eventual basis for a replicatable evaluation procedure.
The procedure makes use of the opposing forces inherent in all art
activities – on one hand, the pull toward regression; on the other, the urge to
progress in the direction of formed expression. The child is offered opportu-
nities to work as he pleases with pencil, tempera paint and ceramic clay. Each
of the three media tends to elicit specific kinds of behavior, so that a child’s
responses to each of them provides valuable information. We have used the
method successfully with children aged from four to 15.
On principle, the procedure is suitable for individuals who have made the
transition from mere manipulation of art materials to the making of configu-
rations that have symbolic meaning for them and who are either adventurous
enough, child-like enough, or both, to welcome the opportunity to handle a
variety of materials. The procedure is not recommended for adults or older
adolescents who would, more often than not, feel imposed upon if required
to work with tempera paint or clay at a first art session.
The evaluation differs from a regular art therapy session mainly in that
efforts are made to have the child use all three of the available art materials.
Thus the art therapist acts neither as a passive observer nor as an investigator
bent upon finding out as much as possible about the child. Children are not,
for example, asked to draw their families, since such a request is likely to be
felt as highly intrusive by children whose family relationships are severely
disturbed. In the evaluation session, just as in therapy sessions, art therapists
present themselves as knowledgeable and supportive people, neither
intrusive nor interfering, but ready to offer technical advice, encouragement,
or whatever else may be needed to help each child work productively.
This attitude is consonant with the process of artistic creation. The
making of art is a process that necessarily includes the artist, his material, and
an audience receptive to the work’s message. The child’s first audience is
usually the admiring parent who welcomes and appreciates the product.
Without such a parent the product would not attain its full meaning and
might not come into being. Like this earlier ideally benign and receptive
audience, the art therapist is an integral part of the productive process. Far
from distorting the production, the skillful offering of support and help is apt
to bring more profound and truthful artwork into being.
The special character of the art therapy session can perhaps be
understood better if we compare it with more familiar clinical procedures.
When we ask a child to take mental ability tests, the tester’s participation is
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 75

necessarily limited to general encouragement; anything more would distort

the resulting findings. Also, such testing can result in a sense of failure. Even
the brightest individual is asked questions he cannot answer or given tasks to
perform that he cannot complete because of time limitations.
To take another example, when we observe children in a playroom setting
designed to encourage imaginative play, there is no failure or success, no
product beyond immediate gratification. We invite children to become
immersed in a private world, a world that does not welcome the adult’s inter-
vention. The observing adult again is required to maintain a passive attitude,
to join in only when invited by the child and only on the child’s terms.
On the other hand, the child who is offered art materials is invited to
engage in an adventure where he may encounter difficulties or even defeat,
but at the same time is given the opportunity to discover new possibilities and
to surprise himself with productions in which he can take pride. The art
therapist must be alert to every opportunity to encourage effective expression
through art.

The evaluation session

The evaluation should be held before regular art therapy sessions begin.
Each child is seen individually. At least one hour should be allowed for the
procedure; an hour and a half is preferable. The art therapy room should be
neat, set up for work with a single child only. Other children’s work should
be out of sight. After the child has entered the room and been given time to
explore if he wants to, he is asked to draw a picture of his choice with soft
pencil, eraser and 8 1/2-by-11-inch white bond paper which is ready for
him. Any paper larger than the specified size would distort the results,
because a thin pencil line gets lost on a large sheet of paper.
After completing his drawing, the child is offered a choice of paint or clay.
The use of both of these materials (in addition to pencil drawing) is
encouraged, but we do not insist on change for change’s sake when we find
the child becoming deeply engrossed in work with any one of the materials.
Poster paints are set out in an ice-cube tray or similar container that allows
for mixing paints. The following colors are offered: one compartment each of
black, red, orange, ultramarine blue, turquoise and purple; two compartments
each of yellow and white. Orange and purple are offered because these colors
cannot be successfully produced by mixing poster paint. Turquoise is offered
because brilliant green can be achieved only by mixing yellow with turquoise
rather than ultramarine blue. Green and brown are omitted because they can
76 ART AS THERAPY

be produced by mixing some of the available colors. Also provided is an

empty tray for mixing colors, 18-inch by 24-inch paper, and bristle brushes
of various sizes (1/8 inch, 3/8 inch and 3/4 inch). Gray paper is recom-
mended because all paints, including white, are clearly visible on gray. This
setup gives those children who are receptive the opportunity to experience
one or several minor miracles as they mix green, pink, brown, or shades of
other colors. Trays are, of course, refilled when necessary. It is important for
the child to sense that materials are abundantly available.
For sculptural work ceramic clay and simple clay tools are provided. One
can improvise tools by offering pencils, tongue depressors, or the like. A
container for mixing clay slip and one for water are also needed. In the
absence of a sink in or near the art room, a basin of warm water should be
provided. Hand lotion, aprons, newspaper, sponges and so on should be
available as well.
Ordinarily children would have to defer painting their sculptures until
after they have been fired. But since choice of color frequently yields
important information about the emotional meaning of clay products, the
children are encouraged to paint their pieces immediately – even though this
practice contradicts the workman-like procedures that should be maintained
in art therapy sessions.

Observing and recording the session

A detailed protocol of the session should be written immediately after its
conclusion, before memory fades. It is helpful if another art therapist or an art
therapy student is available to take notes during the session. Such notes
should deal less with the art products, which remain available, than with
behavior, the sequence in which the child produced his art, or conversation
during the session. The protocol is based only on any such notes and the art
therapist’s own observations. Finally, the protocol, a summary of it, and the
artworks are made available to the clinical team.
Since evaluation sessions are relatively unstructured and informal, the
observations that can be made will differ greatly from case to case. Therefore
no effort has been made to develop a formal set of guidelines for evaluating a
session. However, we have found it helpful to organize our thinking by
focusing on specific areas of the child’s functioning. The outline we present
has been used to good advantage, but is not intended as more than an aid to
systematic thinking. The observer should feel free to consider issues not
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 77

listed or to omit consideration of questions that do not apply to the child

being observed.
Typically, line drawing elicits intellectually controlled expression and
storytelling, which may deal with fact or fantasy.
Paint stimulates the expression of affect and mood. This may enrich the
evocative power of the child’s production, but also can lead to a loosening of
defenses whereby the ego is flooded with uncontrolled affect. Or again, a
child may ward off such dangers by mobilizing particularly rigid defenses –
that is, the child may either refuse to use color at all or use it only to fill in his
drawings in a pedestrian way.
Clay invites regression to playful behavior that easily takes on an oral,
anal, phallic or genital character. Because clay is a cohesive material, it also
lends itself to sustained efforts – even on the part of severely disturbed
children – to integrate fragmented parts into whole sculptural works.

Typical and unusual experiences

Art therapy evaluations have been used since 1974 as a part of the intake
procedure for both outpatients and inpatients at the Department of Child
Psychiatry of Albert Einstein Medical College. It was found that even though
children used art materials in other diagnostic procedures, their production
in art therapy was usually more highly invested, more imaginative and more
complex. But naturally there were exceptions.
For example, seven-year-old Maria perceived the art therapy session as a
test to be handled with extreme caution; no reassurance could sway her from
this position. Her production was stereotyped and meager, culminating in a
neatly built clay snowman painted entirely white. In contrast, when towards
the close of a stressful psychiatric interview the psychiatrist offered to play a
squiggle game with her, a technique made famous by Winnicott (1973),
Maria responded with great delight. Her drawings were richly imaginative,
resourceful, and well integrated – quite different from the frigid and rigid
productions of the art therapy session. The psychiatrist considered Maria an
excellent candidate for art therapy, and indeed she subsequently blossomed
in an art therapy group. She painted with great gusto; evidently her
ego-strength, self-esteem, and emotional freedom increased.
More often, it was the other way round. Also it was not unusual for art
productions made in other settings and those produced in the art therapy
session to complement each other. Matthew is a case in point.
78 ART AS THERAPY

During a diagnostic family interview with the psychiatric social worker

all members of Matthew’s family were instructed to make a joint drawing of a
floor plan of their home and to draw the people in it. Twelve-year-old
Matthew contributed an oversized figure of himself that nearly filled the
whole living room floor. However, he chose to draw with a tan-colored pastel
that was nearly indistinguishable from the brown wrapping paper on which
the family drew. Thus he appeared at once enormous and invisible, quite in
keeping with his actual family life, where he felt abjectly insignificant, a total
failure, and yet knew that his disturbance overshadowed the whole family’s
functioning.
In his evaluative art therapy session, on the other hand, Matthew modeled
a large, solid clay figure of a man with strong biceps. He painted the man’s
body a bright red. He also constructed a clay fence painted orange, yellow,
and white and placed it protectively in front of his strong man. The
production was child-like, at an eight-year-old level at best. But it showed
unexpected solidity and indicated latent capacity for independent func-
tioning and spoke of the child’s longing for his own territory. The family
interview and the art therapy evaluation together thus told us much more
than could either one alone.

Three illustrative cases

To give a further idea of the method in action, three art therapy evaluation
sessions are described in detail.

Jaime
Jaime, an eight and a half-year-old boy of Puerto Rican descent, oldest child
of an intact marriage, was referred for intake at the outpatient clinic.
Complaints included academic failure, facial tics, difficulty remembering
words, stuttering, constant fights at school and at home, enuresis and diffuse
anxiety.
Presented with paper and pencil, Jaime drew a tiny man at the very
bottom of the paper (Figure 8.1, at bottom left) but abandoned the drawing
when he realized that he had placed the head so low that there would be no
space for his man’s legs and feet. He tried once more at the bottom right and
succeeded in drawing a whole man with a tiny head. But again he was dissat-
isfied. He turned the page over and attempted a skyscraper, but it remained
suspended in midair.
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 79

Figure 8.1 Jaime’s first pencil drawing

Jaime’s face lit up when he was offered tempera paint. Placing the gray paper
in the vertical position, he drew a tall oblong in firm red brushstrokes. Then
he divided the area inside the oblong into four pairs of oblong shapes, using
black vertical and white horizontal lines. The whole was designated an
apartment building and the pairs of rectangles windows, one pair on each
floor. Each pair of windows was painted in a single, solid color: unmixed
blue, yellow and purple, and a brown created by mixing (with a little
prompting) purple and orange. He then declared that he knew how to make
pink and did so, taking great pleasure in mixing a strong shade. However, he
seemed reluctant to claim the color as his own. He went so far as to suggest
that if a stranger came into the room and admired the pink, Jaime would say
that the art therapist had mixed it. He was relieved when this hypothetical
sacrifice was firmly refused by the art therapist’s assuring him that she would
most certainly tell anyone who asked that Jaime had made the pink himself.
(It is conceivable that Jaime’s offer to concede ownership of the pink to the
woman art therapist may have been, in part, motivated by a reluctance to be
associated with a color that has a feminine connotation.)
Jaime was at a loss about where to use the pink. All the windows had
already been covered in. For the sky he could conceive only of the conven-
tional white clouds and a yellow sun. To imagine an entirely new addition to
80 ART AS THERAPY

the picture seemed beyond him. He finally used the pink to write his name
vertically alongside the building, and so confirmed his ownership of the
color. We might question whether the pink color and placement of the name
parallel to the building’s walls might also imply an element of passive
surrender. In effect, the name clings to the symbol for father instead of being
planted on its own firm ground.
While Jaime was painting he chattered about his father’s job as superin-
tendent of an apartment building. He told a story about replacing his sick
father on the job, but admitted that this was a tall tale. Admiration for father
and identification with him, as well as fantasies of superseding him, were
thus clearly expressed. In the light of this talk, we can see the four pairs of
windows, each pair identically colored, as expressing a kind of twinship –
that is, identification that comes close to a primitive merging with the
admired person.
Jaime used the clay playfully at first, making and remaking several rudi-
mentary, mask-like faces. Later he constructed a cylindrical container,
complete with two handles, and a lid with a handle. He worked quickly and
skillfully. He explained that this was a garbage can, and squashed it gleefully.
He could not be induced to make a lasting object out of clay. He concluded
the session in high spirits, asking when he could come back for more art.
In reviewing the evaluation session we found that its most interesting
aspect was Jaime’s responses to the three art materials. Pencil and paper
brought forth feelings of insignificance and defeat. Both of the people he
drew are tiny and misshapen. The first one sinks below the page into the
void. The second one achieves only a precarious foothold at the paper’s edge.
Even when Jaime retreated to a simpler theme of a skyscraper, he could not
make it stand on the ground.
Though Jaime cannot rise to the demands made by line, he does respond
readily to the pleasure offered by color. Once he has been given the oppor-
tunity to use a whole tray of it, his performance improves dramatically.
Jaime’s colorful apartment house is well constructed and rests firmly on the
ground, albeit attached to the paper’s bottom edge. Mixing color does not
lead to regression; indeed, color is used in service of taming affect – red is
toned down to a vivid pink.
However, even the pleasure of color cannot help Jaime progress beyond a
certain point; his range of ideas and shapes remains restricted. The rich color
and the solidity of the apartment house make it easy to overlook the lack of a
door and the absence of any structure on the roof (no chimney, TV antenna or
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 81

other protrusion). Both painting and drawing show evidence of a rather low
level of intellectual functioning. But the painting tells us of a vitality and
inner strength of which the drawing gave us no inkling.
Clay brings about a resurgence of self-denigration on Jaime’s part, as
evidenced by his choosing to make a garbage can. However, he has attained
some mastery as he successfully constructs and then gleefully smashes the
receptacle. We recall that the janitor-father must deal daily with cans like this
one. By destroying an object that is closely associated with his father, Jaime
loses the power to act constructively. He is reduced to an endless doing and
undoing with clay.
Throughout the session Jaime’s attitude toward his work oscillates
between self-denigration and pride. He uses the art therapist in the main as an
impersonal source of supplies, but her presence is real enough for him to
engage in cautious testing and he feels relief when he finds that he need not
bribe or appease her.
Jaime did not learn anything new during the session – he already knew
how to mix pink. He was oblivious to spoken suggestions and would not
venture beyond the familiar. However, he seemed cautiously hopeful most of
the time. He could be expected to become less constricted and more able to
take in new ideas in future art therapy sessions.
In sum, we see a needy child functioning mainly on a phallic level, one
still struggling with Oedipal conflicts. The relationship to father seems to
entail both identification and an inclination to passive surrender. Jaime
responds very well to symbolic giving, provided that it consists of proffered
material that affords an opportunity for emotional experience. (He
responded immediately to the expansiveness and the appeal of color.) He can
use such gifts to muster his own inner resources, to help himself by means of
symbolic action. However, he cannot at this point make use of incentives that
are offered more indirectly though potentially helpful verbal suggestions or
encouragement.
Jaime was seen for eight months in art therapy sessions with a small group.
Plans for other therapeutic intervention failed to materialize. In art he used
paint and clay almost exclusively. Inner division was often expressed through
the juxtaposition of pink and black. Even though many of Jaime’s problems
remained unsolved, his academic performance improved and behavior
disorders abated during this period.
82 ART AS THERAPY

Kenny
Kenny, an eight-year-old boy, was first hospitalized on the pediatric unit of a
large city hospital with second degree burns covering 25 per cent of his body.
The burns were sustained during a fire in his home. The fire’s cause was unde-
termined; Kenny was home alone with his younger brothers and sisters at the
time. Their mother had been absent from the home for days and was conse-
quently charged with criminal neglect.
The burns that covered Kenny’s back, neck, arms and hands – requiring
two operations and a body cast – had been successfully treated during his
three-month stay on the pediatric ward. However, during this period, staff
became concerned about Kenny’s psychological reaction to the trauma. He
had become difficult to manage and also evidenced breaks in reality testing.
He was therefore transferred to the inpatient children’s psychiatric ward for
evaluation and treatment of what appeared to be a chronic disturbance
stemming from years of neglect and abuse.
Kenny was not a complete stranger to the art therapist. He had been on
the ward for some time, and his case had been discussed in staff meetings.
This must be kept in mind to understand the art therapist’s responses to
Kenny’s behavior and productions. Kenny was aware of the art therapy
program and had been asking for his turn to come for his special art session.
He was a small, wiry black child with a coy expression and elfish smile that
contrasted with his darting eyes and suspicious manner.
He entered the art room in constant motion. The materials were set up,
and Kenny was asked to make a pencil drawing of ‘anything you would like.’
Initially, Kenny showed no interest in the art materials, preferring instead to
focus all his attention on the art therapy student who was observing the
session. The anxiety manifested in his restlessness was also indirectly
verbalized as he complained that this student was ‘ugly’ because of a large,
red birthmark on her cheek that Kenny called her ‘scar.’ After fearful giggling
about this, he sat down and slowly drew a picture of a person (Figure 8.2).
His smirk and careful observation of the student soon revealed that he had
chosen to draw a portrait of her. By creating a likeness of this feared person
Kenny managed to keep a watchful eye on her. His skillfully detailed
drawing appeared to help him control his anxiety.
Kenny chose to use clay next. At first he playfully explored its consis-
tency. However, his behavior soon regressed as he smeared the clay, smelled
it, and called it ‘doo-doo.’ The unstructured character as well as the consis-
tency of the clay proved to be overwhelming for Kenny; his response to the
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 83

Figure 8.2 Kenny’s drawing of the student

clay revealed the possibility of faults in his reality-testing. The intensity and
irrationality of his protests as he dropped some clay onto the floor, yelling,
‘The floor is bad – it made the doo-doo fall,’ signaled to the art therapist the
need to intervene. She quickly modeled a figure of a boy and at the same time
she explained to Kenny that clay is a kind of earth that is mined at riverbanks,
that it can be used to make all sorts of things. This calmed Kenny and
attracted his attention. He called the clay figure a ‘bad boy.’ He began playing
with the figure and revealed that the boy was bad because he peed in his bed.
He put the clay boy into a clay bed and this led to a discussion about how this
boy felt about not being able to control his ‘pee.’ The art therapist reminded
Kenny that he too had trouble about wetting his bed, and that his doctor was
going to prescribe some medication to help him. Kenny seemed relieved.
With this discussion concluded and the clay boy placed to rest, Kenny
was ready to use the clay again. He initially pounded out a ball of clay,
announcing that he was going to make some pancakes. This plan soon
changed as he collected some smaller clay balls and called them apples.
While placing these apples on the flat pancake shape, he excitedly discovered
that he could make an apple tree by adding a trunk. When asked if he would
like to paint this apple tree, he sat back to think of what colors he would
choose. Tempera paint was placed in view, and he lapsed into a long
discussion about the color of his apples. ‘Apples are red,’ he stated, ‘but aren’t
they brown sometimes?’ Kenny announced emphatically that he would have
no brown apples on his tree, as that would mean they were wormy. Upon
84 ART AS THERAPY

making this decision, he turned his attention to his palette of colors. ‘Green
for the leaves’ was missing, and when he was led to discover how he could
magically make this color from yellow and turquoise, his face broke into a
joyful smile. His pleasure soon faded as he studied the other available colors.
Defiantly he announced that he would not use black because it was ‘bad.’
Once assured that he could use whatever colors he wished, he set out to paint
his apple tree.
Kenny had a hard time deciding on his colors. There was much vacillation
and deep concentration on and concern for this highly invested tree. The
trunk was originally painted green, as was the leaf area; the apples were all
red. At this point they had no stems. Kenny was displeased with the tree in
this state, being unable to decide what color to paint the trunk. Finally he
painted the trunk black and added stems to the apples, painting the stems
brown. He said of the stems, ‘These can be brown but not the apples.’ The
final product received much praise as Kenny beamed with pride and delight.
Note that the apples’ stems were not attached to the tree’s crown and the tree
could not stand on its trunk. Thus the product gave the impression of a
long-handled saucepan holding apples.
At this point the art therapist encouraged Kenny to use his colors on
paper. He quickly painted an image on the paper using black paint and then
wrote the name of the observing art therapy student above it. Clearly, he was
repeating his pencil portrait with the paint. However this time his affect
changed noticeably as he dipped his brush into the red paint to color the
‘scar’ on this image. After placing the red mark on the face, he used his
paint-filled brush to smear out the student’s name, while tearfully saying,
‘I’m ugly – my face is ugly, that’s why I want to kill myself,’ and quickly
painted the stop sign. There was a dramatic change from Kenny’s high activ-
ity-level when he first entered the room. Now he was slow-moving and sad
(Figure 8.3).
Since the art therapist had met Kenny earlier and knew he was receiving
psychotherapy, she was able to address him directly, speaking to him about
his sadness and suggesting that his doctor might be able to help him with it.
Had this been her first meeting with Kenny, she would have focused on
Kenny’s production, pointing out that he had painted a stop sign, an action
that showed both his desire to put an end to his sad mood and his capacity to
bring forth an appropriate signal.
While the art therapist was speaking to Kenny, he sat slumped in his chair.
Working slowly, he picked up his brush and painted his own name on his
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 85

Figure 8.3 Kenny’s painting of the student with the ‘stop’ sign

painting, then announced he had finished. As he was leaving, he visited his

apple tree and requested that it be kept safe in a closet in the art room.
Reviewing Kenny’s behavior and production during the evaluation
session we concluded that he was a seriously endangered child, but one who
commanded much inner strength, resilience and intelligence.
We see him at the outset masking his underlying depression by hyperac-
tivity. It is not surprising that the art student’s red birthmark would be
especially horrifying to a child who had been disfigured by burns. However
Kenny defends himself against his fear in a healthy manner by mustering his
capacities for observation and graphic rendering. He produces a remarkable
likeness of the student. His drawing departs in its heightened awareness of
detail in the head from the ordinary figure drawing of eight-year-old
children. The arms, turned toward the figure’s body, are also advanced. The
hands, however, are rudimentary, consisting as they do of three fingers each.
Having bound anxiety sufficiently Kenny is ready to investigate the clay,
but its anal connotations arouse fresh anxiety. At this juncture, but for the art
therapist’s intervention, the session might easily have broken down,
86 ART AS THERAPY

revealing no more than the child’s susceptibility to anal regression and

proneness under stress to loss of the capacity for reality-testing. We note that
the intervention remained on a symbolic level. Kenny was not forbidden to
throw clay on the floor. He was told that clay is not ‘doo-doo’. Rather, it was
demonstrated to him that the clay had other possibilities, that it could take on
symbolic human shape. Kenny’s inner strength revealed itself when he
responded to the invitation to enact his troubles symbolically rather than in
delusional behavior. Instead of continuing to perceive the clay as excrement,
he used it playfully to enact the clay boy’s disgrace. He progresses from an
anal to a phallic level. The bad boy is punished for wetting rather than for
soiling, and Kenny is pacified when reminded of his doctor’s promise to help
him with his own wetting problems.
Here we may question whether the dramatic regression was connected to
Kenny’s hospitalization for burns, with its concomitant loss of control over
body functions and the trauma this would imply for an eight-year-old child.
Whatever the anal play may have meant to him, once Kenny’s mind was set at
rest he was ready to use the clay to produce a good object. As he formed and
then colored his apple tree he reached his highest level of functioning. He
began by separating good from bad: rotten brown apples from good red ones.
He enjoyed making green from yellow and blue and categorically rejected
black as a ‘bad’ color. However, he ended up integrating all colors, using
brown for his apples’ stems and black as the color of the trunk. Thus he suc-
cessfully transcended his inclination to splitting. The session might have
ended on this note of victory.
However, when Kenny was invited to use the colors to paint a picture –
rather than a solid clay structure – his mood changed radically. He was no
longer able to project his feelings of ugliness onto the student. Rather, he tells
us, ‘I am black and scarred and ugly and I want to kill myself.’ He had never
before been able to permit these feelings free expression. But even at this
point he could help himself by evoking external controls. He drew a stop
sign, and later he was able to turn for comfort to what he himself had made
out of clay. The good apple tree is preserved and protected, and the session
ends on a hopeful note.

Tom
Not every evaluation session yields informative products. Tom’s work is not
shown because the most interesting aspect of this session was his unusual
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 87

behavior. Apparently on the spur of the moment he invented an expedient

that enabled him to concentrate on his work.
Tom was a grossly overweight but sturdy, muscular six-year-old who
presented a puzzle to the diagnostic team. He was evidently retarded and
hyperactive, but the extent and nature of his impairments could not easily be
determined by conventional testing procedures. There was an enormous dis-
crepancy between his coherent speech, his understanding of social interac-
tions and comprehension of the therapeutic relationship, and his extreme
immaturity in any area requiring skillful action or cognitive exertion.
Because of the staff ’s unusual interest in Tom’s behavior his art therapy
evaluation was conducted in the presence of the entire therapeutic team. Tom
seemed quite at ease in a room full of adults and evidently expected good
things from his encounter with us. He was more than willing to become
engaged with the art materials.
His drawing seemed commensurate with mild retardation. Having some
notion that paper and pencil are for schoolwork, Tom did his best to comply
and his careful, cramped, nonsense configurations seemed acceptable as an
illiterate six-year-old’s idea of ‘writing.’
Tom’s handling of paint and clay, on the other hand, was like that of a
two- to three-year-old. Oblivious of color differences, he was intent on
dipping his brush indiscriminately into the different containers. Gesticu-
lating with his loaded brush, he produced a series of squiggles on his paper,
never spreading the paint to produce color masses. However, unlike a two- or
three-year-old, Tom had a good idea that more ought to happen with art
materials. Tom’s paintings lacked the nonchalance of a younger child’s per-
formance; they seemed labored and driven as he tried hard to transcend mere
manipulation.
He was somewhat successful when he attempted to paint a car. Four
squiggle wheels appeared in close proximity and a squarish shape nearby
could be interpreted as the car’s body. It was when he attempted to paint a
person that he reached the height of confusion. He began by painting a
mouth and teeth, entirely omitting the eyes. He seemed not to see what he
had already put on the paper and repeatedly obliterated parts of his work as
he added new elements. In the end two barely recognizable mouths, as well
as a few other fragments of a person or persons, were scattered over the paper.
The running comments that accompanied Tom’s painting became increas-
ingly flooded with disorganized, TV-inspired fantasies of witches,
spidermen, batmen and the like.
88 ART AS THERAPY

At this seeming impasse Tom made an extraordinary move to help

himself. He began by manipulating the light switch. This was evidently done
without any mischievous intent; it seemed to become a means of achieving
both focus and sequence. He repeatedly went to the light switch, turned off
the light, and in the resulting semi-darkness steered himself to the table and
the art materials. He then manipulated them for a short time with intense
concentration, steered himself back to the light switch, turned on the light
and triumphantly held up his product for inspection. Then he went back to
re-establish semi-darkness. In this manner he completed some painted con-
figurations and later made a crude face out of clay. After this triumph of con-
structive action he became hyperactive and had to be rescued and pacified,
much as one would calm a three-year-old. As the art therapist washed Tom’s
hands in warm water, he happily played with water and soap and helped
clean the art therapist’s hands in reciprocal play. He delighted in using hand
lotion liberally and concluded the session in excellent spirits.
We were naturally curious to know whether Tom had any previous fasci-
nation with light switches. His mother declared that she had never noticed
anything to suggest such an interest. It seemed to the observing team that
Tom had invented this device then and there to deal with his difficulties in
establishing sequences and in focusing upon a task in the presence of distrac-
tions. By moving repeatedly from turning off the light, to working, to
turning the light on again, he organized his actions within a strict sequence
while he simultaneously reduced the influx of stimuli by darkening the room.
A follow-up session conducted four months later gave evidence that his
behavior was an attempt to deal with such difficulties; suspected problems
with visual perception appeared to be unimportant. By this time a regime of
medication to control hyperactivity had been successfully established. He
appeared much calmer and even though he readily recognized the therapist
and the art room he paid no attention to the light switch.
Tom’s handling of paint had progressed to a three- to four-year old level.
However, he still had difficulty organizing the configurations ‘face’ and
‘man’ and tended to obliterate his work. On the other hand he was more
aware of his difficulty and asked for help. When the art therapist offered to
tell him to stop when she saw he was in danger of obliterating his work, Tom
agreed eagerly and was indeed able to stop what he was doing upon
command. But he still had serious trouble organizing a face, and he was still
flooded by disorganized fantasies.
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 89

On the whole it appeared that Tom had gained sufficient ability to

suppress extraneous stimuli so that he no longer needed to resort to the
extraordinary measure of obliterating an over-stimulating environment by
establishing darkness. Medication had successfully calmed him without
dulling his eagerness for experience. It seemed that he might now be able to
resume the developmental ascent that had been impeded by his hyperactivity.
The possible extent of developmental gains that he might achieve could not
be predicted.
Tom’s story dramatizes the need of the child who is hyperactive or neuro-
logically impaired or both for structure and control of stimuli. It was only
under the circumstances of the art therapy evaluation that he had been able to
demonstrate to us that he was able to take specific measures to liberate
himself from distractions from without and disruptions from within, so that
he could experience the freedom and magic of art materials.

Summary of findings
The three cases presented above demonstrate how the art therapy evaluation
depends on the art therapist’s role as facilitator of the creative process, as well
as on the magnetic power of the art materials.
Latent strength was perceived in all three children. In Jaime’s case the art
therapist’s findings tallied with those attained by conventional methods. The
session was useful mainly because it supplied Jaime with one enjoyable
experience during a long, stressful day at the clinic and this enabled him to
look forward to his subsequent visits.
In Kenny’s case the art evaluation not only confirmed the team’s assess-
ment but also revealed more profound depression and suicidal potential than
had been apparent in either his everyday behavior or in the psychological
evaluation. Greater inner resources than had been apparent in the conven-
tional evaluation procedures also became apparent. It was probably Kenny’s
first introduction to ceramic clay and this helps to explain the primitiveness
of his initial response. The art therapist had to demonstrate to him the possi-
bilities of the material by making a figure for him. This done, he quickly
responded to the invitation to symbolic action by setting out to create an
apple tree, a benign maternal symbol. Apparently the opportunity to use the
art materials, together with the art therapist’s active participation, had helped
Kenny to mobilize his inner strength and so become able to provide himself
with a good object of his own making. In this attempt, he had to face his
profound sense of worthlessness. Feeling like a rotten apple, he at first tried to
90 ART AS THERAPY

omit all brown and black and so create an entirely good object. The supreme
victory was achieved when he succeeded in incorporating the ‘bad colors’ as
emotionally neutral elements of his tree (elements that did not impair the
tree’s goodness) – a remarkable feat of integration.
Jaime made similar use of a good opportunity when he was presented
with a full tray of tempera paints. The good object he created for himself was
masculine, a tall building such as those his father took care of. However the
feminine element is not entirely omitted and his creation was not totally free
of conflict. Jaime created the color pink (a color our society associates with
femininity) and expressed both his pride in the vital beauty of his color and
his inclination to submission by using the pink to write his name parallel to
the paternal apartment building. Even though the art therapist did not have
to intervene as actively as in Kenny’s case, it was essential that she take a
definite stand at this juncture. She had to assure Jaime that she would not
compete with him or rob him of any of his powers, such as authorship of the
pink paint; that he was accepted and respected in all his complexity and with
all his inner contradictions.
Self-denigration appeared in the end in both Jaime’s and Kenny’s
sessions. Nevertheless, work with art materials became highly invested, and
both boys looked forward to good experiences in the future. The sessions
both revealed the boys’ despair and mobilized their inner strength.
In Tom’s case his chaotically hyperactive behavior had thwarted the
clinical team’s attempts at diagnosis and prognosis. The art therapy session
brought forth much latent strength. It showed that Tom would respond to
the art materials’ magnetism and that he had a fairly good idea of how they
should be used, even though his hyperactivity foiled his attempts at using
them constructively. His own inventive way of controlling stimuli showed
that he was eminently motivated to combat his disabilities.
After medication had been initiated, the second art therapy session gave a
clearer picture of the extent of Tom’s developmental lag and showed him
ready to accept outside help in wrestling with his hyperactivity.

Usefulness of the evaluation procedure

On the whole, we have found that the art therapy evaluations are most
effective in spotting areas of ego-strength. The procedure presents us with a
concentrated sample of creative functioning in the three basic media of the
visual arts. Thus we can learn about the child’s capacity to give himself
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 91

Table 8.1: Outline of observational considerations

1. The three media

The developmental stage at which the child is functioning in each medium
should be noted and compared with the child’s chronological age. Discrepancies
between the developmental level evidenced in one medium as compared with
another constitute particularly valuable data.

a) Drawing: Motor coordination; evidence (if any) of perceptual problems;

evidence (if any) of thought disorder.

b) Painting: Affect, response to color (e.g., anxious, eager, able to handle the
excitement of color, overwhelmed); color preferences; emotional response to
the mixing of color. Does the child respond to the esthetic quality of color?
Is he able to generalize from the experience of mixing color (e.g., blue and
white make light blue; therefore, red and white make light red or pink)?
The ability to generalize gives evidence of the child’s capacity for
conceptual thinking.

c) Clay modeling: Capacity for integrative work; tendency towards specific

kinds of regression (undifferentiated, playful, oral, anal, aggressive and so
on); capacity to reintegrate after initial regression; reluctance to dirty oneself
with the materials.

2. Character of the artworks

a) No product: Withdrawal; playful experimentation or play; destructive

behavior; doing and undoing.

b) Product in the service of defense: Conventional stereotype; personal

stereotype; bizarre stereotype.

c) Product in the service of primitive discharge: Chaotic; aggressive; obliterating.

d) Attempt at formed expression: Successful (a product with evocative power,

inner consistence); nearly successful; failed (when and how did it fail?).

e) Comparison of the artworks in the three media offered: Similarity; dissimilarity;

incongruity. Do any of the materials stimulate unusually marked progress or
regression?

f) Formal quality of the artwork: Empty, full, dull, original, fragmented,

integrated, static, dynamic. Does color dominate over form? Form over
color? Does the work indicate skill or talent?
92 ART AS THERAPY

g) Subject matter: Is there any contradiction between overtly stated subject

matter and the message actually conveyed by the work?

3. Child’s attitudes during the session

a) Toward the art therapist: Cooperative, withdrawn, rebellious, suspicious,

ambivalent, clinging, ingratiating, charming, distractible, anxious, intense,
and so on; changes of attitude in the course of the session.

b) Toward his art work: Highly invested, indifferent, proud, denigrating,

destructive; change of attitude during the session.

c) Toward the art materials: Preferences, dislikes.

d) Toward suggestions or offers of help: Oblivious, negative, understanding and

accepting, enthusiastic responses to new discoveries, dependent but able to
make constructive use of help, dependent – a bottomless pit of need.

4. General

Did any learning take place? Are there clues to the child’s capacity to muster
inner resources through artwork? Do observations concur with or contradict
the findings of other team members? Did art activity contribute to
expression of personality traits not otherwise in evidence? Is the child a
candidate for art therapy?

symbolic gratification by using the art materials that suit him best, even while
his pathology and life situation remain as yet unchanged.
Naturally we also meet children who present us with emotional deadlocks
and offer no clues to therapeutic strategies. We sometimes perceive, as well,
areas of weakness, specific danger points and modes of regression. However
we have found that our negative observations have tallied more often than
not with the whole team’s findings and have only occasionally contributed
new elements to the general diagnostic picture.
The evaluation sessions have proved outstandingly valuable as a screening
procedure for art therapy, one which at the same time provides an effective
beginning session for the child. The success or failure of our attempts at
helping, as well as the children’s own ways of helping themselves, inform us
of the kind of support that may be needed.
The session itself may even serve as a turning point. The children we work
with have usually had little inspiration and guidance in learning to take
 AN ART THERAPY EVALUATION SESSION FOR CHILDREN 93

pleasure in their own functioning. The gleam in the mother’s eye (Kohut
1966), rewarding them for a creation and thus spurring them on, has been
absent or rare. Often we are among the first to provide it. However, such is the
resilience of childhood that even among the severely damaged, a single
experience can often awaken latent ego-strength that otherwise might have
been overlooked. Such an awakening can be a harbinger of gains to be made
in systematic treatment in art therapy, play therapy or psychotherapy. To
make these possibilities evident is a particularly valuable contribution of art
therapy evaluations with children.

References
American Art Therapy Association (1976) ‘Beginnings and assessing clients for
treatment.’ (Color film). Baltimore, MD.
Kohut, H. (1966) ‘Forms and transformations of narcissism.’ Journal of the American Psycho-
analytic Association 14, 243–72.
Winnicott, D. W. (1973) Therapeutic Consultations in Child Psychiatry. New York: Basic
Books.

Note
1 This collaborative chapter was originally published in the American Journal of Art
Therapy 23, October 1983, while some of the first half is revised from parts of a chapter
on ‘Art therapy’ by Edith Kramer and Elinor Ulman, which appeared in C. R. Reynolds
and T. B. Gutkin (1982) (eds) The Handbook of School Psychology. New York: John Wiley
and Sons. Reprinted by permission of the publisher.
 CHAPTER 9

Leadership and Cultural Tradition1

The following events occurred at Wiltwyck School for Boys, an interracial,

nonsectarian treatment home for emotionally disturbed, economically
deprived boys of greater New York, aged eight to 13. I conducted an art
therapy program at the school from 1950 to 1957. The reader must
remember that the events described in this case occurred in the early 1950s,
before the advent of the civil rights movement and the upsurge of racial pride
characteristic of today’s African-Americans and of other minorities as well.
This was long before the idea of multiculturalism was thought possible. It
was a time when blending into the dominant culture was more the ideal.
Martin’s parents were ahead of their time, and Martin had to suffer for their
progressive attitude toward their African heritage.
The art of any larger group of children shows in miniature all the charac-
teristic features of art at large. We see the ascendance of fashionable painters
with a large crowd of imitators, the development of small schools of painting
satisfying the needs of a few. We see great talents isolated because they are
too far advanced to influence the group, unusual personalities who go their
own ways. We see the development of techniques and skills, of traditions and
legends.

Martin, the Ethiopian

Martin and both of his parents were born in the US. The family had
originally come from Ethiopia, and the parents had preserved the Coptic
religion and other cultural traditions. The family idealized Ethiopia against
the reality of their life in New York City. When Martin came to Wiltwyck
School at 10 years of age, he widely advertised his Ethiopian descent. He
drew maps of Africa with Ethiopia conspicuously outlined and colored in the
national colors, and he painted pictures of Ethiopian people in native dress.

94
 LEADERSHIP AND CULTURAL TRADITION 95

He aroused a storm of anger and hostility. The African-American boys

especially equated Ethiopia with Africa and considered all mention of
African descent as insulting, derogatory remarks against their race and color.
Martin loved to paint. Also he craved success and recognition. After an initial
period of despair he compromised by painting Indians instead of Ethiopians.
In the early 1950s, painting American Indians constituted a way out of
the dilemma of the African-American minority situation. They hesitated to
paint negroes, but felt free to paint an Indian’s skin color, and often disguised
their ego ideals in the shape of Indian chiefs. But while the meaning of such a
disguise was at best dimly perceived by the average Wiltwyck boy, it was for
Martin a perfectly conscious disguise. He knew that he wanted to paint
Ethiopians and was only bowing to necessity. There was no hypocrisy in his
change of subject matter, as Martin did not lie to himself. He carefully
explained to me that his Indians were ‘really’ meant to be Ethiopians.

Figure 9.1 Martin’s Indian

96 ART AS THERAPY

The quality of his work did not suffer from this compromise, as it probably
would have suffered if Martin had denied his own ideal and adopted the
group’s values (see Figure 9.1). Martin’s position was vindicated when a real
Ethiopian king, Haile Selassie, visited the US. At this point Martin created a
vogue for painting African kings that was eagerly adopted by his school
mates.
Eventually Martin’s feelings about Ethiopia changed. He did not give up
his ideals, but he accepted the reality of his life in the US and had less need to
idealize a past of which he had no personal knowledge. His need to use art
for creating ego ideals that could include black people remained, but he now
painted African-Americans, idealizing them in a realistic manner. His portrait
of his mother (reproduced on the cover of this book) is a good example.
Freed from his single-minded preoccupation, his subject matter became
more varied, so that he was the originator of many fashions and fads in the
school.

Discussion
Martin’s story shows an artist’s work being rejected because of his cultural
background. The artist chooses a subject matter which touches upon
prejudices in a group. A negative emotional reaction to the subject matter
makes the audience blind to the artistic value of his work.
Historically such situations occur frequently when two cultures mingle.
There is usually an initial period of mutual misunderstanding and disorien-
tation, and consequently a decline of the arts. The ultimate outcome depends
on the relative cultural and economic strength of the two groups, on the
degree to which their two moral codes are at variance, on a time factor and
other conditions.
It might happen that a people which conquers a culturally strong group
by military power adopts the culture of the conquered people, as happened
when Ancient Greece was incorporated into the Roman Empire.
Insofar as one can compare an individual case with historical events, we
might say that Martin constituted a culturally strong minority within a group
who conquered this group by the strength of his talent, his intelligence and
the power of his convictions. This could not have happened if Martin had
given up his convictions instead of expressing them in disguise. If Martin had
capitulated before group pressure, he would have lost his past, his ideals and
his integrity as an individual. His creative capacity would probably not have
survived such a loss. If, on the other hand, Martin had insisted on his convic-
 LEADERSHIP AND CULTURAL TRADITION 97

tions with a martyr’s zeal, and had survived physically, his style and subject
matter would probably have become stereotyped and repetitious. He would
have remained isolated, and it would have become very difficult for him to
develop as a person and as an artist.
In spite of his talent and intelligence, Martin could not have survived the
initial period of his adjustment unaided. The device to hide the meaning of
his paintings under the disguise of American Indians was of his own choice,
but he could not have maintained it without sharing the secret with the art
therapist. Nor could Martin and his schoolmates have resolved their ideo-
logical conflicts without adults who helped to clarify the true relationship
between Ethiopia, Africa, and African-Americans. The therapeutic aim was
to help the child to adjust as an artist and as an individual in the group,
without robbing him of his cultural heritage, and to make the positive values
which Martin had to offer become a part of the cultural life of the group.

Kings
Of all new subjects which Martin introduced at the school, his Ethiopian
kings made the most lasting impression.
The fashion of the kings was perpetuated by Carl, an African-American
child. Temperamentally he was Martin’s opposite. He painted slowly, with
much attention to detail. His colors were muted and soft. His painting
seemed set in a minor key. Carl was tremendously attracted to Martin. He
imitated him and competed with him. When Martin was discharged, Carl, as
the next best painter, inherited Martin’s position. Even then he continued
measuring himself against Martin. Carl was a child who expected failure.
Many of his paintings showed a hero who is being slain.
Carl had much reason for this tragic sense of life. His father was a
delinquent who was seldom out of prison. The family existed on the verge of
destitution with little hope for change. Carl’s longing for ideals and cultural
values could not find fulfillment at home. He felt menaced by his father’s
violence and the brutalized home situation which evoked his own dormant
aggression. He lived under a cloud of depression. Because of his personal
history, problems of racial discrimination became highly charged emo-
tionally. Beneath the question of whether African-Americans could assume
leading positions in society at that time loomed the question of whether he
could rise above his father. The desire to be re-born white screened the desire
to be rid of the delinquent father and his own delinquent tendencies.
98 ART AS THERAPY

When Carl took over Martin’s African kings, their image became charged
with Carl’s conflicts, and what had been an episode for Martin, became for
Carl a major preoccupation. Carl perfected the kings, gave them their final
iconic form. Figure 9.2 shows one of Carl’s most beautiful kings. It is quite a
self-portrait, a fine-featured melancholic man who carries his honors with
quiet dignity. The monocle in his right eye gives a strange asymmetry to the
face, as if some part of the personality remained ambiguous. The picture is
painted on gray paper. Except for the yellow-golden jewelry all colors are
subdued. Dark blue, dark purple, a little red and a spot of bright green at the
open collar give a dignified overall effect. Space is handled beautifully; the
straight line of the scepter gives balance and interest to the composition. The

Figure 9.2 One of Carl’s kings

 LEADERSHIP AND CULTURAL TRADITION 99

painting fulfilled Carl’s need for beauty, dignity and success. Yet there is no
exuberance in the work. It is fulfillment within the limitations of a basic
depression and deep resignation.
Carl’s imitators closely followed the pattern which he had established.
Although choice of color and arrangement of ornament and shade of skin
color varied, the basic form remained unaltered. Among the innumerable
kings that were painted in that period, there was not one who did not wear
the same type of crown, not one without monocle in his right eye. It would
have been impossible to induce a child to paint a monocle-less king. He
would have been incomplete. There was among the many kings only one
with a monocle in the left eye, painted by a left-handed child.
Carl had taken the monocle from comic books, where they are worn by
rich men. Originally he had used it in a painting of a white man in evening
dress. From there he carried it over to the kings. To Carl the monocle
probably had unconscious significance. It might have symbolized the split
between good and bad and the shady hidden side of his character. Some of
the symbolic meaning might have carried over to the others. But the persis-
tency of the monocle is above all a phenomenon of group behavior. We are
observing how tradition is formed and perpetuated.
As the painting was cast in its final form, it was adopted by the multitude
and perpetuated without further changes. Every detail from then on was an
attribute of the symbol king, and only a very strong and independent mind
would have questioned any detail or attempted to alter it. Because of the fast
turnover in population the form was preserved, not for a century, but for only
two years.
Among the children the symbol of the king continued to serve as a means
of expressing problems of self-esteem and self-evaluation. The license to
paint African kings or kings with dark skin persisted. Carl’s need for culture
and beauty was also retained in a subtle way. As an object of identification the
king remained on a higher, more civilized emotional level than, for instance,
the Indian chieftain as the boys imagined them. The king carries a scepter,
not a raised tomahawk. His crown is the work of complex craftsmanship,
unlike the chieftain’s headgear which retains the character of a trophy.
Indeed, the children who chose to paint kings were as a rule more mature
emotionally and, in turn, the painting of kings had a civilizing influence on
the children. Therapeutically the king had been valuable at first for Martin,
later for Carl, and in the final analysis for the whole community. However,
100 ART AS THERAPY

traditions cannot be perpetuated beyond their natural life. Eventually the

painting of kings went out of fashion.

Prisoners
The next example is the history of an episode which lasted barely three
weeks and involved just a small group of boys. The originator of the fashion
of painting prisoners was Jerry. At the time of the episode Jerry was
recognized as one of Wiltwyck’s ablest painters. He had a great need for
display. He affected a somewhat theatrical, blustering, he-man attitude.
Strutting about with a thrust-out chest, clenched fists and an exaggerated
frown, he also developed a peculiar abrupt and blurred kind of speech.

Figure 9.3 Jerry’s prisoner

 LEADERSHIP AND CULTURAL TRADITION 101

Jerry’s behavior was reminiscent of the stereotyped picture of a volcano

which he used to paint when he first came to the school. His volcano, a
conical gray mountain on a tropical island with palm trees, showed an
eruption of red flames topped by a thick black cloud. No destruction was
visible, and the volcanic mood did not pervade the rest of the landscape
which was peaceful and pretty. The volcano erupted for display rather than
for destruction, just as Jerry’s tough behavior seemed to be motivated by a
need for narcissistic gratification rather than by hostility.
Jerry was the first to paint a prisoner (Figure 9.3). Although gangsters and
hold-up men, scenes of romantic escapes from medieval castles and
dungeons were painted frequently, nobody had painted a modern prisoner
before. To delinquent children who live in a delinquent environment, prison
is a serious menace. The subject is therefore usually avoided.
Jerry’s prisoner is shackled and guarded. Behind him rises the gray stone
wall which symbolizes his confinement. The prisoner’s person dominates the
painting. Guards and fellow prisoners are dwarfed. His position is that of a
man waiting. There is a certain nonchalance in his posture. His facial
expression is deadpan. With his usual taste for clothes, Jerry has transformed
the prisoner’s uniform into a costume, using the black and white stripes to
their most decorative advantage. Even the number tag seems an ornament.
The formal composition is beautifully balanced. The combination of gray
and black and a brilliant white have a calm, almost abstract beauty. The warm
flesh color of the prisoner’s face and hands and a few spots of warm brown
give life and interest to the composition. The prisoner is protected by a calm,
nonchalant attitude and by his elegant beauty. He is superior to his situation
and has no need to rebel, or to repent. Jerry’s position as a leader of fashions
in painting, along with the example of a painting of a prisoner which did not
arouse anxiety, encouraged a number of boys to follow his example.
Walter followed Jerry’s lead, but Walter’s painting expresses all the
emotions which Jerry’s avoids (Figure 9.4). Some of the characteristics of
Jerry’s composition are preserved. The prisoner holds the center of the stage.
He is large, almost life size, while his fellow prisoners and the guard are
depicted as tiny figures. The resemblance ends here. Walter’s background is a
deep black. The ground is painted in wild red brushstrokes. The black stripes
of the prisoner’s suit merge with the background and convey the feeling that
the prisoner emerges out of darkness and belongs to darkness. The
horizontal lines which traverse his body give the impression that the prisoner
is eradicated by black lines. The fact that the prisoner’s limbs are only partly
102 ART AS THERAPY

visible (feet and hands are outside the picture) conveys a feeling of help-
lessness, almost mutilation. The face is expressive; a broad, tightly-closed
mouth contrasts with small, weak eyes, without pupils.

Figure 9.4 Walter’s prisoner

Walter had much reason to feel strongly about prisoners. His father was
serving a long sentence and had been in and out of jail all of Walter’s life.
Walter did not admit this. He told boastful tales about his father’s wealth and
power. Jerry’s prisoner gave Walter the courage to express his concern about
his father’s fate symbolically.
Fletcher was another child who was inspired by Jerry’s prisoner. He
painted a bird’s eye view of the prison and its fortifications. Prisoners were at
work breaking stones, loading them into pushcarts, and carting them off.
Fletcher was an habitual runaway, who pilfered and committed acts of
vandalism. His salvation was his love of constructive work. He was an
excellent carpenter and builder. His clear logical mind, manual skill and
passion for work made him the school’s master craftsman. Fletcher described
his addiction to work in these words: ‘Other boys try to get out of work; I am
 LEADERSHIP AND CULTURAL TRADITION 103

a boy who tries to get into work.’ Fletcher had no ability to play; idleness
inevitably led to delinquent acts.
In his painting Fletcher depicted the one thing which could make prison
life bearable to him: hard labor. Fletcher had good reason to be concerned
with the life of prisoners. In spite of an understanding of right from wrong, in
spite of a talent for leadership and constructive work, his tendency for asocial
acts persisted. Fletcher could easily end up in prison, and there he would
certainly survive only if he were given enough work.
Bernard depicted the prisoner as a monster. Against a deep red back-
ground loomed the head and long torso of a prisoner. His long arms reached
to the bottom of the page. The hands were out of the picture. Although
facing the viewer the prisoner’s face was without mouth and nose. His right
eye was almost covered by a large scar. The left eye was square inside a
rectangle, placed in the middle of the forehead more like a Band-Aid than an
eye. Another large scar traversed the prisoner’s left cheek. The painting had
the character of an apparition from a nightmare, expressing neither anxiety
nor guilt or rebellion. It expressed a feeling of depersonalization and incom-
pleteness and evoked unease in the viewer. The prisoner was beyond human
empathy or moral code.
Bernard came to Wiltwyck when he was barely 10. He was undersized
and sexually underdeveloped in that his testicles had not yet descended. With
his blond hair, blue eyes, and rosy complexion he looked like a little doll.
Bernard was an expert thief, specializing in picking ladies’ pocket books and
lifting wrist watches. He did not wish to grow up, but planned to remain
small and cute and live by theft. Even after he had ceased stealing, Bernard
took pride in his skills. One of his favorite jokes consisted of lifting a wrist
watch without the owner noticing and then innocently asking for the time.
The prisoner painting showed Bernard’s deep feeling of estrangement
from mankind. Successful stealing was equated with proof of potency and
completeness, and failure with mutilation and loss of face. In Bernard’s
prisoner no attempt was made at working through the guilt and anxiety of
delinquency. Rather it showed the terrible results of being unsuccessful.

Discussion
Among the children who painted pictures of prisoners, Jerry was the only
one who found a solution for the fears and conflicts which were attached to
the idea. Jerry’s equilibrium was based on a kind of withdrawal into
104 ART AS THERAPY

narcissism and emotional shallowness. Jerry’s example encouraged his

schoolmates to tackle a subject which they had reasons to avoid.
Walter’s prisoner constituted a first step in coming to grips with a fact
which he would have to face eventually. Although the painting did not mean
a full admittance of reality, it constituted an attempt at sounding out the many
contradictory feelings centered around his father.
Fletcher reassured himself by depicting the one aspect of prison life
which he could possibly accept. The painting expressed the sin-
gle-mindedness which had been Fletcher’s salvation in the past but
threatened to become a danger in the future. In his future life Fletcher would
have to submit to periods of idleness and boredom at school, and later as a
working man. To date he had failed to develop methods of coping with the
panic and hostility such situations aroused in him. Conceivably the painting
even expressed the hidden desire for the security of the rigid discipline of
prison life. To the observer the painting confirmed what was apparent in the
child’s general behavior – that Fletcher was suppressing his emotional
problems by an obsessive concentration on work. There remained the need to
help the child to work through those problems in order to make an
adjustment which would admit of other pleasures and experiences besides
building and carpentry.
Bernard’s painting showed very graphically that underneath his cute
exterior and his superficial adjustment there remained a feeling of deperson-
alization and incompleteness which life at the school had not altered.
The episode of the prisoners was brief. We see how each child came up
against problems and feelings for which there was neither solution nor recon-
ciliation within his reach. It is therefore not surprising that the subject was
dropped after a time. The experience remained valuable, because many
problems were brought to the surface although they could not be resolved
beyond a certain point. Because the prisoner was not a symbol which meant
more or less the same to everyone, as does a king, but was part of reality with
different meanings for each individual, no rigid form for painting prisoners
evolved.

Monsters
It is to be expected that part of the production of disturbed children should
be given over to bizarre and fantastic subjects and that evil and uncanny
themes should play an important part in those productions. Devils, dragons,
ghosts and monsters, and the fabulous creatures of science fiction, embody
 LEADERSHIP AND CULTURAL TRADITION 105

the forces of evil for the children. It would be a mistake to believe that the
painting of fantastic subjects would be free of convention and stereotypes.
There exist definite stereotypes for the representation of men from Mars,
devils and even monster faces which have to be adhered to.

Clyde
When Clyde’s mother died after a long illness he painted monster faces
exclusively for many months. These were painted swiftly, under enormous
pressure. They were too incoherent to lend themselves to imitation. Figure
9.5 was painted when Clyde had attained a certain measure of control over
his emotions and with it his artwork had become more intelligible. Figure
9.5 expresses the very essence of fear of the dark: a rectangular sheet of paper
is covered with black. Upon this surface appears a pair of large, round white
eyes surrounded by short yellow-white rays. Two parallel rows of brush-
strokes suggest teeth and mouth; other lines and dots combine to form nose,
eyebrows and two angry lines on either side of the mouth, all in white.
The features do not seem to be part of a solid head. They seem to float
upon the dark, forming a face but ready to change into different configura-
tions or to disappear at any instant like an hallucination or a bad dream.

Figure 9.5 Clyde’s monster

106 ART AS THERAPY

The treatment of single features as separate units is characteristic of

paintings of the miraculous and irrational throughout the ages. Especially in
the masks of ‘primitive’ peoples, organs such as eyes, nose and mouth are
often charged with individual symbolic meaning, so that the mask does not
represent the unity of a face, but rather a stage on which the dramatic
interplay between the several features is enacted. Distortions and displace-
ments can be understood as expressions of this drama.
It is also interesting that white drawings on black almost always express a
precarious balance between the rational and irrational. The effort to impose
form upon a black surface necessarily remains an unequal struggle in which
the formless and hidden prevails over the visible and rational.
Clyde’s painting was a great success with his school mates. It was
impressive and it was easy to copy. Children with a need to express the dark
side of life adopted the form and contributed variations. It is interesting that,
once the form is found, the painting of nightmares often has a positive effect
on the painter’s mood. Habitually depressed or belligerent children become
amiable and cooperative while painting their monsters. This indicates that
their painting means more that just release for their feelings. It shows that
through painting the children obtain temporary mastery over their conflicts
so that the burden of anxiety and aggression is eased for them.

Harry, master of monsters

Harry came to the school at the age of 11. He was an overweight boy,
withdrawn, polite and anxious to please. He was intelligent and an avid
reader. Often he seemed lost in day-dreams, sitting quietly sucking his
thumb. Within his first year he lost all excess weight, became slim and agile,
and began participating in activities. Harry liked painting from the
beginning. He had a way of giving even commonplace subjects an
out-of-this-world touch. Even a Santa Claus by Harry, complete with all con-
ventional attributes, would somehow take on an indefinable quality of
belonging to another private world.
Harry attained fame and leadership through a series of monster heads.
The first was inspired by Hans Christian Andersen’s fairy tale, ‘The Traveling
Companion’. In this story a wicked princess has a gigantic monster for a
lover. In the end the giant is beheaded and the head shown to the princess.
On a huge sheet of brown wrapping paper Harry painted a dead white, bald
head with several gold and silver horns protruding from the skull. Two eyes
were green, and there was a third red eye in the middle of the forehead. The
 LEADERSHIP AND CULTURAL TRADITION 107

monster had yellow lips and teeth, and the cavity of the mouth was black.
The nose was a complicated form with two large curled nostrils which almost
gave the impression of a head within a head. Black lines around mouth and
eyes added expression to the face. Everything was neatly outlined in black.
The background was painted in loose red brushstrokes. In spite of its mon-
strosity and cruelty the painting possessed a bizarre kind of beauty. Harry
was inordinately proud of his masterpiece, and could not wait to have it
exhibited in the dining room. In an attempt to ascertain whether Harry had
any idea that the painting was gruesome I suggested that it should be taken
off the dining room wall for Easter when parents and baby brothers and
sisters would be visiting, because some of the little children might be
frightened by the monster. Harry seemed taken aback. He evidently did not
conceive of his painting as frightening.

Figure 9.6 Harry’s last monster

Unfortunately Harry’s monster painting is not available for reproduction, but

Figure 9.6, Harry’s last monster painting, gives a good idea of his style.
Harry’s monster created a sensation. Seeing a school mate give clear and bold
form to ideas which usually remain buried evoked a shocked kind of
admiration from the group. It inspired a number of children to follow suit.
Monster paintings became fashionable. It never took on a rigid form
108 ART AS THERAPY

comparable to the fashion of kings; nor was the trend as widespread or as

lasting.

Matthew
Matthew had come to Wiltwyck about a year before the monster episode. He
was then ten and a half years old. He suffered from a permanent sort of
diarrhea that led to frequent soiling. The symptom had persisted through
Matthew’s childhood and seemed to be psychosomatic. In art therapy
Matthew made minute drawings of fish and weapons, carefully shaded with
pencil. The drawings showed intelligence, skill and a strong sense of compo-
sition. Later Matthew tried painting larger pictures of the fish and weapons
he had drawn so well. He seemed to be reaching out for greater scope and
freedom, but somehow was paralyzed. Whenever Matthew used color he
soon grew dissatisfied and impatient and ended by smearing and splashing
paint until his drawing was obliterated.

Figure 9.7 Matthew’s monster

 LEADERSHIP AND CULTURAL TRADITION 109

Things reached a point where Matthew predicted disaster the minute he

touched a paint brush. Even so, Matthew continued to come to art sessions
although he spent most of his time standing around unhappily.
When Harry painted his monster, Matthew immediately set out to paint a
monster, too (Figure 9.7). He was in high spirits, worked without hesitation,
and used color freely. Altogether Matthew painted three monsters in quick
succession, and after this he painted a fantastic castle of his own invention.
This ended the episode and Matthew went back to realistic painting.
Matthew’s monster loses much through reproduction in black and white.
The monster’s face was painted in three colors. The skull was a light olive
green, below the eyes ran a strip of lighter green, and the lower part of the
face was painted a kind of mustard color. The right eye was black with a red
iris, the left eye was red. The nose, which looks somewhat like a cow’s head,
was dark brown and orange. The strange designs below were yellow, purple
and orange. The lips were red, teeth white, cavity of the mouth the brown
wrapping paper, and the third eye below the mouth was blue with a red iris.
Behind the head was some sort of weapon with a black handle and
red-brown blade. The monster’s expression was pained and cruel. The red
lips and sharp gleaming teeth seemed ready to devour the spectator. The eyes
had an evil, ambiguous expression. There are actually five eyes in the face,
since the two orange spots on the nose also seemed to be eyes. The motif of
many eyes, a nose that appeared to be an animal head, and the wide open
mouth and sharp teeth appeared in all three of his monster pictures.

Discussion
Harry and Matthew both had very disturbed mothers. Harry had painted his
first monster after visiting his mother in a mental hospital. It was believed
that, Matthew’s mother had somehow encouraged the diarrhea and soiling
problem, a symptom which belonged to Matthew’s infancy. One might
conjecture that in both cases, in order for the boys to live with these
disturbed mothers they had to ingest some of the mothers’ primitive
concepts and patterns which the children should have outgrown normally.
Harry, at 11, seemed unevenly developed. He was advanced intellectually
and possessed a sense of humor. He was able to master the mechanics of
everyday life. He was overly polite, anxious to please, and afraid to show
negative feelings toward persons in authority. On the other hand Harry
seemed to have no concepts of the nature of other people’s feelings and
110 ART AS THERAPY

reactions, and there was a withdrawal into a private world where neither
moral values not the laws of nature had much meaning.
Harry painted his monsters with calm deliberation. Each head maps out
his concepts and ideas with the precision of a scientific illustration. The
paintings are frightening to the spectator because of the archaic and cruel
ideas which they embody, but Harry did not master anxiety through painting
monsters. He had established an inner balance which kept his fantasy world
pleasurable and free of anxiety no matter what the content would be. His
anxiety was directed outwards. Harry was over-anxious to please and afraid
of doing wrong, but felt no qualms about inventing the most fiendish plots or
painting the most gruesome scenes. His clear and cold representations of
fantasies that normally remain buried and chaotic helped other children who
were haunted by vague feelings and fantasies of the same nature to give form
to their ideas.
Matthew’s alternating depressions and regressions during painting must
have been caused by such fantasies because monsters freed him of a painting
block. That it was possible for Matthew to free himself to such a great extent
through just one episode of painting monsters adds weight to the conjecture
that Matthew’s disturbance was induced by his mother but had not taken
deep roots in his personality. Matthew’s later paintings of boats and weapons
show assertion of his manhood and independence. His subsequent devel-
opment towards a greater realism and awareness of the world around him
was in keeping with the emotional and developmental level of a child of his
age, enhanced by more than ordinary talent and sensitivity.

The little boys’ monsters

It is interesting that the majority of the other children who copied Harry’s
monsters belonged to the youngest, most immature group. Although none of
those children were under eight years old, their developmental stage and
their painting was hardly above a four- to six-year-old level. Many of these
little boys would ordinarily not permit themselves to paint according to their
own level and concepts but tried to imitate the older boys. For this group
Harry’s example meant more freedom to paint on their own emotional level.
Most of the monsters were supposed to be ghosts, giants, or other fearful
creatures. To express cannibalistic aggressiveness by painting lots of teeth, or
show fantasies of power and potency through multiplication of eyes,
enormous noses, or protruding horns was in keeping with the children’s
developmental level. Those paintings were less monstrous as the mode of
 LEADERSHIP AND CULTURAL TRADITION 111

expression was a sign of immaturity, not of regression. The paintings were, in

a sense, still in the state of innocence. Harry’s painting caused revulsion and
uneasiness because of an uncanny combination of a mature intellect and
strong talent and archaic concepts and patterns.
Harry’s influence did not last very long. When monster painting went out
of fashion the community reacted with a vague sense of guilt and uneasiness
about the episode. Harry’s painting was now criticized with remarks like, ‘All
you can do is paint monsters.’ The criticism came at a good time. Harry was
getting ready to question his own behavior and ideas. He was beginning to
explore what it felt like to be a boy among boys. He gradually lost interest in
painting.

Note
1 A great deal of the material presented in this article was first published in Kramer, E.
(1977) Art Therapy in a Children’s Community. New York: Schocken Books.
 CHAPTER 10

Case History of Angel

Art Therapy and the Disturbed Gifted Child

Few situations are as immediately gratifying and as profoundly troubling as

work with a highly gifted, severely disturbed child. The joys of working
with a child who responds to artistic stimulation, technical help and
emotional support with outstanding productions and with growth are
immense. Yet, as her understanding of the child’s pathology grows, and as
she becomes better acquainted with his situation, a sense of doom is apt to
cloud the art therapist’s pleasure in her work. Often the conditions of the
child’s life are so unfavorable that it is hard to believe his talent can survive
outside the shelter of the therapeutic milieu.
Angel’s life may have taken such a turn. Instead I can present an encour-
aging story. Facing considerable difficulties he matured as an intact
individual and his artistic gift also matured.
Angel was brought to the hospital at the age of four years and three
months. The chief complaint was that he had stopped speaking and seemed
to understand neither Spanish, the language of his parents, nor English, and
that he did not recognize anyone except his mother. It was reported that he
watched TV constantly and seemed to believe he was Superman; he climbed
onto window sills and appeared to be getting ready to fly. He had also
become dangerously aggressive toward his two younger half-siblings, a boy
aged two, and a six-month-old baby girl. Angel was born out of wedlock
when his mother was 16 years old. She soon married a man who was not the
child’s father and moved with him and Angel from Puerto Rico to New York.
Angel’s difficulties were reported to have begun with the birth of his
half-brother and to have worsened when his baby sister was born. Beyond
these meager facts little could be ascertained about his early development.
His mother was unable to recall events or dates. It seemed that she was too
immature or too disturbed to cooperate in Angel’s treatment.

112
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 113

Angel’s home life, it appeared, had always been chaotic. There was much
coming and going of relatives all living together in crowded quarters. There
seems to have been no intentional cruelty in his upbringing but rather a
casual kind of neglect of Angel’s feelings and needs, balanced to some degree
by equally casual warmth and affection on the part of mother, grandmother,
step-father and assorted relatives.
Because Angel’s massive withdrawal, disturbed identity feelings and life
endangering gestures seemed ominous, he was admitted as an inpatient to
the child psychiatric ward of Jacobi Hospital.
The first six months on the ward brought many symptomatic improve-
ments. Although Angel obviously lived to some extent in a world of fantasy,
his total withdrawal at home seemed to have been a temporary reaction to
immediate stress. He soon made friends with the ward personnel and
emerged as an appealing, warm little boy.
He learned to speak English but never recovered whatever Spanish he had
previously known, retaining, however, a Spanish accent.
Angel’s most persistent symptom was his involvement with Superman. He
continued to spend much time watching TV and devised a homemade
Superman cape which he wore constantly. He often stood before a mirror,
saying, ‘Not Angel, Superman!’ When he occasionally relinquished the
Superman identity, he explicitly declared: ‘Today I will be Angel.’ He
received intensive psychotherapy, seeing his doctor three times a week in
individual sessions. He responded well and his therapist considered his
long-term prognosis to be excellent.
In an intelligence test given in the first year Angel achieved normal, in
some areas high-normal scores, but was considered to have higher potential-
ities. Rorschach and Thematic Apperception Tests yielded fantasies centered
around a tiny creature who magically overcomes a huge threatening one, but
ultimately meets disaster himself. Angel’s capacity for reality-testing was
lower than it should have been at his age.
Several months after his admission to the ward Angel began to draw, and
soon drawing became his major preoccupation. His favorite subjects were
Superman, Popeye the Sailor, and other figures from TV and comic books.
Angel’s works were masterful simplifications of the cartoon images. His
repertoire was not limited to the comic book type of drawing. He could draw
anything he pleased, but his heart was in his drawings of Superman and
other imaginary heroes. He drew with astonishing speed and decisiveness,
114 ART AS THERAPY

and his output was enormous. He gave his pictures away to anybody for the
asking, and loved to see his work displayed all over the hospital.
I became an art therapist at Jacobi Hospital when Angel was six years old.
Children were seen twice a week in groups of three to four, each session
lasting from about one to one and a half hours. We used ceramic clay, crayons,
pastels, tempera paints, paper and scissors.
Angel was at this time the undisputed master-artist on the ward. He drew
almost continuously. Indeed it was felt that drawing was Angel’s preferred
defense and that his state of mind could be gauged by the intensity of his
drawing. When he was upset, drawing became more obsessive; when he was
at ease he could relinquish his preoccupation to take part in ward activities
and school work.
By this time Angel had given up wearing his Superman cape. It seemed as
if drawing Superman had replaced direct impersonation, and in this sense his
use of drawing could be considered progress in spite of its obsessive
character.
Angel’s Superman drawings had one unusual feature. While most children
concentrate solely on the flying Superman, Angel was also much occupied
with Clark Kent’s transformation. He often depicted the moment when
Clark Kent sheds his eyeglasses and business suit and turns into an omni-
potent flying being (see Figure 10.8, p.127). Later we learned that Angel had
harbored the idea that his father who worked in a factory that produced
eyeglass-frames had made Clark Kent’s glasses.
When Angel discovered that I was a ‘real’ artist, he began making use of
my skills. His approach was unusual. He did not ask me to draw for him, or to
help him with specific problems. He only wanted me to draw his portrait. A
pattern developed which remained virtually unchanged throughout his first
year with me. Immediately upon entering the art room, he kept up a steady
chant, ‘please draw me,’ until I was ready to comply. Then he climbed upon a
high cabinet and struck an heroic pose. I was supposed to sketch this pose
lightly, draw his features, but leave out his hair and the details of his clothes.
He then made the sketch over into a picture of one of his heroes, Tarzan,
Hercules, Superman and later the Beatle Paul McCartney. In this process
Angel’s bold crayon strokes obliterated my tentative lines.
Once Angel’s wish had been fulfilled he was usually able to work on his
own for the rest of the session. He often reciprocated by drawing my portrait.
He also drew the other children and obligingly depicted them in the guise of
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 115

assorted heroic characters. Outside the art room Angel continued to work on
his own.
When I asked him why, when he could draw so well, he needed me to
draw him, he replied, ‘I cannot see myself.’ This is strange reasoning for a
seven-year-old. At this age most children rarely look at things in order to
draw them. They depend on schematic representations that are modified
slightly to fit different situations.
It seemed as if Angel needed my sketches mainly to alleviate profound
insecurity about his very existence. Once I had graphically documented my
perception of him, Angel’s adaptations of my drawings made his fantasies of
being Tarzan, Hercules or Paul McCartney more real and more gratifying.
My participation in Angel’s graphic reincarnations lent them a higher
degree of reality, for naturally they looked more life-like, and also the
identity between Angel and his drawings was dramatized. In this sense I
supported his delusional world by participating in it. On the other hand, just
because of my participation, Angel’s heroic drawings took on the character
of disguises through which his actual self could be perceived. Our cooper-
ation freed Angel from depending on sterile, commercial models, binding
him instead to a living artist who was ready to help him become independent
of her. Angel created a drawing of the art therapist drawing him which illus-
trated the situation perfectly. Angel seemed to be posed on my shoulders, still
partially fused with me but ready to leap beyond me. His face (an excellent
likeness) was intent and determined, but his limbs, hands and feet were small
and weak, while my arms were muscular, and the pencil in my fist was big and
phallic. The superior strength still resided with me, and Angel was growing
by using me as a springboard.
Ordinarily one would expect that such a dependency would block a
child’s artistic development but somehow Angel was able to integrate my
contributions without losing his artistic individuality. His need to introduce
elements of reality into his pictorial fantasies by incorporating my realistic
sketches ultimately led to observations of reality on his own part. When he
drew his friends in the guise of various heroes, he looked at them, and
achieved remarkable likenesses and life-like gestures. This growing capacity
for observation and realistic rendering became an autonomous skill that
could be used outside the magic circle of Angel’s fantasies. He learned to
draw any object he saw, and developed an understanding of visual
phenomena such as foreshortening, overlapping and modeling far beyond
his age. My portrait, drawn when Angel was seven years old, demonstrated
116 ART AS THERAPY

the vitality and precociousness of his graphic work when it was serving a
living relationship rather than a fantasy.
Considering Angel’s severe disturbance, his drawing was remarkably well
integrated. He tended, however, to draw figures with disproportionately
large shoulders and torsos tapering down to weak legs. This appeared to be
an expression of his situation. Virtually abandoned by his family (they rarely
visited him) he existed in limbo, with no solid ground under his feet. When
he took over my drawings his legs attained normal size and his feet were
solidly planted.
It is interesting that Angel’s precocity was limited to drawing. He seldom
used paint and could not handle it competently. He did not seem to
experience any pleasure in colors and color combinations. When on rare
occasions he attempted to embellish his drawings with color, the result
looked as if a younger child had tried to color in an older child’s work and
had done a bad job of it.
Angel’s clay sculpture was adequate but not exceptional. His subject
matter was more child-like; he made piggy banks, animals, ash trays and the
like. He had little patience for finishing his work.
We may ask what was the inner meaning of Angel’s Superman fantasies
and their derivatives, why did drawing become the preferred vehicle for their
expression, and how did drawing attain some measure of autonomy from the
fantasies.
Angel’s fantasies were concerned with heroic figures of a kind that appear
regularly in the fantasy life and the art of latency boys.
The giant with magical powers embodies the adult whose strength,
knowledge, and sexuality appear miraculous and unfathomable to the small
child. The unfulfilled childhood wish for adult power and potency is the
driving force behind children’s fascination with heroic figures. The character
of the different heroes and the manner in which they are depicted reflect the
child’s concepts of the adult and of adult sexuality, and this in turn depends
both on his psychosexual development and on the actual character of the
adult figures in his environment.
For example, a child who is able to depict good, solid, heroic figures
without being exclusively obsessed by them is probably one for whom the
tension between his desire for adult power and his feeling about his natural,
slow maturation is not unbearable. Such tension is likely to be just intense
enough to act as incentive for growth. We can assume that the child is
struggling with a partial resolution of the Oedipus situation, but that his rela-
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 117

tionship to his parents is sufficiently gratifying to make being a child

tolerable, even pleasant, in spite of unavoidable conflict.
Angel’s unrelenting obsession with his heroes demonstrates just how
frightening and painful the helplessness of childhood was for him. To save
his life, Angel has to grow up. And so we see the usual heroic imagery of
latency enormously magnified in Angel’s fantasies. The content of his
pictures in itself indicates no severe disturbance. There are no bizarre
elements and no particularly ominous sado-masochistic features; unusual are
the intensity of the wish and the attempt to find a way of obtaining
immediate fulfillment. Angel desires instant adult potency and can’t settle for
less. His drawings have the character of reincarnations rather than the usual
connotation of ego-ideals.
It seems logical that drawing, which is the swiftest mode of represen-
tation, became Angel’s preferred form of pictorial expression. The need for
speed and repetition could easily have led to a stereotype, to frozen formulae
that could be produced by rote, or even to the development of some private,
schizoid, symbolic shorthand. This did not happen. Instead, the pressure of
his obsessive need led to the development of an unbelievable virtuosity in
rapid, realistic, linear representation.
And so it came to pass that the obsessive wish for immediate adult
potency which had impeded Angel’s development in all other areas of life
brought about a nearly miraculous growth in the field of his greatest natural
endowment. Although Angel was only seven his style of drawing had
jumped the schematic phase of latency and reached a preadolescent style
comparable to the work of a well-endowed 12-year-old. Although this
growth derived from Angel’s pathological needs, the resulting skill acquired
autonomy. Angel could use his capacities to draw what he saw, remembered
and understood beyond the realm of his obsessions.
After a year of art therapy, when Angel was seven years and three months
old, his hero drawings seemed to be holding a middle ground between rein-
carnations and ego-ideals. The character of the ego-ideal oscillated.
Sometimes Angel aspired to be a famous artist like Leonardo da Vinci,
sometimes he was Paul McCartney, an enormously rich and adored enter-
tainer. Often he aspired to the brute strength and invulnerability of Super-
man-like persons such as Hercules or Samson.
It is interesting to compare Angel’s drawings and the fantasies which he
wove around them with the material elicited in a psychological test that was
given when he was six years and six months old. As compared with tests
118 ART AS THERAPY

made at the time of his admission, at age four years and three months, in this
new test Angel showed greater orientation to reality – idiosyncratic and
autistic associations had entirely disappeared along with his previous preoc-
cupation with death and violence. What used to be Angel’s typical Oedipal
story – an omnipotent though tiny creature who defeats the big one and then
meets catastrophe himself – was no longer in evidence.
In Angel’s drawings the fantasy of an omnipotent figure persisted, but it
became a big person who does not meet with destruction. However, even
during the time when he fantasized about a tiny person who overcomes a big
powerful one, but ultimately meets disaster, his drawings told a different
story. Clark Kent turns into Superman, but Superman does not disastrously
turn back into Clark Kent. Could it be that Angel was able to ward off the
tragic element of his fantasy in his art, because as a draftsman he commanded
very real power? Although he was a helpless, neglected child he possessed in
his art a precious gift and through it he surpassed not just his contemporaries
but most of the adults around him. While we cannot credit Angel with a
conscious, intellectual knowledge of the meaning of his endowment, we can
assume an intuitive feeling of some great power at the core of his being that
helped maintain his personal integrity and his capacity for ultimate recovery.
The extent of an artist’s powers were brought home to me during a fateful
event. I was working on the ward in 1963 when President Kennedy was
assassinated. I first heard of it from the children, as they came running to the
ward from the hospital’s school, terrified, full of the catastrophe. On the ward
one of the practical nurses, a black woman from Texas who usually was one of
the most stable, competent, and motherly caretakers had an hysterical attack.
She could not stop her sobbing and crying, tearfully repeating over and over
again that the President ‘should never have gone to Texas. Nobody knows
what Texas is like!’
Among the children pandemonium reigned. They reenacted the assassi-
nation over and over again, shooting each other and falling down dead. I felt
quite helpless, unable to restore order or sanity. Finally I got hold of Angel
and asked him to draw a picture of how the president was killed. He immedi-
ately set about drawing a cops and robber-like scene. The children’s mood
changed radically. Rather than enacting the assassination, they all began
drawing pictures and dictating stories about the president’s death. The theme
dominated the children’s productions for several sessions.
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 119

Angel at the Catholic children’s home

When he was seven years old Angel had improved to the point where
remaining on a hospital ward could no longer be therapeutic. At this time,
however, the mother deserted the family, leaving an understandably chaotic
situation which made discharge to his home undesirable. After a search
lasting six months, Angel was placed in a Catholic institution for normal,
dependent children. By a stroke of good luck the home was situated near the
hospital and, with the home’s cooperation, it was arranged to continue
limited supportive treatment for Angel.
During the first year Angel was treated once a week by his hospital psy-
chotherapist. His occupational therapist also saw him in weekly sessions. I
was eager to continue art therapy but it did not seem advisable to add yet
another individual session. Instead, a small group of five children with a
special interest in art was formed at the home. The group met once a week for
art sessions.
Angel appeared to adjust well to his new home. He was liked by staff and
children, and although he was small and not a fighter he was not bullied or
terrorized by the others. He was accepted, although he somehow remained
an outsider. His fame as an artist was soon firmly established, and he did well
at school. He suffered, however, from much free-floating anxiety. He was
afraid of dark places and of empty rooms, and complained of nightmares.

Art sessions in the children’s home

Weekly art sessions in the new setting could not attain the importance and
intensity of art therapy at the hospital. Angel enjoyed the art sessions, but as
usual he remained apart from the group. Since he had known me before and
since the sessions had been instituted because of him he was in a favored
position, but he did not try to monopolize my attention. At first he asked me
to draw his portrait as of old, but did not insist on it. He could accept me as a
teacher who gave him suggestions or helped him in difficulties, and who
generally encouraged him.
When I resumed my visits after the first summer vacation he spent at the
home, he proudly told me that he had learned to swim and dive. Then he
drew three pictures to show me what he had learned. In the first picture he
was about to shed his jacket. In the second one he leapt into the pool. In the
third he was afloat in the pool but another child was drowning and the
lifeguard, an enlarged replica of Angel, jumped into the pool to save the
drowning child.
120 ART AS THERAPY

In the course of the year, Angel drew several stories about himself and
actual or at least plausible achievements such as a feat of mountain climbing
or a dance. Nevertheless, most of his drawing continued to depict super-
human, often brutal deeds. His subject matter had been enriched by
Christian iconography, and from the idea of God and Devil a dawning
concept of good and evil emerged.
One such picture depicted the fight between the Good Angel and Lucifer
turned devil. It is interesting that the story from the life of Jesus which
fascinated Angel above all others was Christ’s temptation. To this child who
had always dreamt of flying it seemed almost inconceivable that Christ
renounced the power of flight when the devil offered it to him.
At the same time Angel developed a burning interest in Greek mythology;
the deeds of Hercules, Theseus and Odysseus had to be told and retold. One
drawing created from these tellings depicted Hercules as a baby strangling
the snakes while his father comes to the rescue, torch in hand, but Hercules
has already saved himself unaided – a perfect representation of Angel’s wish
for a superhuman, invincible babyhood.
A psychological test given when Angel was eight years old sums up both
his progress and the persistence of his pathology. Angel achieved an IQ of
112. His concept of spatial relationships, ability to manipulate objects with
his hands, and fund of general information suggested a capacity in the
superior range, but his common-sense judgment was found to be quite
immature when compared with his high intellectual capacity. Concerning his
ego-ideals, Angel was not able to fill the prescription for a male that he had
written for himself. He identified with a fantastic brute of a man. He set such
impossible goals for himself that he was in fact self-castrating.
To conclude, even though a hollow artificial symbol of masculinity was
the driving force that brought about the blossoming of Angel’s art this
faculty constituted his greatest strength. There was no fragmentation nor
were there any bizarre elements in his production. He developed an
increasing capacity to perceive reality and to broaden his subject matter.
During his first two years at the home, art therapy sessions were held on
the premises. In the third year it was felt that Angel needed to broaden his
horizon and therefore I took him each Saturday afternoon on sketching trips
to various points of interest such as the Metropolitan Art Museum, the UN, or
the Bronx Zoo. At other times we held art sessions at my studio.
Angel was ten years old when he declared during a time at my studio that
he wanted to write his ‘self-biography’ (Figure 10.1). He determinedly set
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 121

out to dictate his life’s story to me and to illustrate it. He also insisted that I
add my recollections of him to his own account. This led us to look at his old
drawings and choose two of them to illustrate his early style of work. In the
following session Angel added a passage on his hopes and worries about the
future and drew a picture of his future home.

Figure 10.1 The cover of Angel’s ‘self-biography’

Angel had now produced all the material needed for his book. He could not,
however, have completed it without some technical help. His original
drawings were made on sheets of paper of different sizes, some of them too
large. I therefore photographed them all and had eight-by-ten inch prints
made. I also typed the story, which had been taken down in longhand. Since
both narrative and illustrations were well conceived and entirely his own,
and the whole undertaking was an important step in Angel’s development, it
seemed worthwhile indeed to help him succeed in completing his book.
Angel composed a dummy, working with scissors and paste to put photo-
graphs and text together. He added some new illustrations as he went along.
A number of Xerox copies were made for him from this dummy.
122 ART AS THERAPY

As Angel dictated his story he remarked, ‘Isn’t it marvelous how much I

remember of my past!’ His account is indeed essentially truthful and
coherent. It constitutes a remarkable achievement.

Figure 10.2 Angel and his father

I was born on March 18, 1957, in San Juan, Puerto Rico. Nothing really
happened until I was two years old, and then it all began. I ran away, and then
my father found me and gave me an ice cream cone (Figure 10.2).
My father was playing baseball with other people one day. One guy hit
the ball too far and it came to me. I thought it was something to eat and tried
to lick it. My father came and took it away. After the game I had my picture
taken with a baseball cap.
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 123

We moved to New York when I was three years old I think.

When I was three my brother was born and I was mad because I wanted to
be the only child in the family.
When my brother grew older I began to hit him. I pretended I was
Superman (Figure 10.3) and that he was the bad guy, and I hit him real hard
when we had fights, like Superman does. I said I hate a little brother, because
he always bugs me!

Figure 10.3 Angel as Superman

A sister was born two years after, but she was alright for she played with other
girls instead of bothering me.
When I was four years old I came to Jacobi Hospital because of what I did
to my brother. I met Doctor Fossum (Figure 10.4), a nice man over there just
like a social worker. He is a talking doctor; he helps you with your problems.
When I wrote this book at the age of ten, I was in Kennedy Home at the
Bronx, and Dr. Fossum came to see me every week on Friday, in case we have
something to talk in private.
124 ART AS THERAPY

Figure 10.4 Dr. Fossum

And then I met Miss Kramer (Figure 10.5) when I was six years old. I already
could draw. I am a very good drawer, and reading is one of my hobbies too,
but I did not read until I was in Kennedy Home.
When I started drawing I first drew stick men, and then I drew circle men
and then men that looked like the cartoon of Dick Tracy.
Every time there was no art lessons and I was not in school the nurse
would take some drawing paper and crayons and coloring books, and I
would do some of both of them. And then when four years passed, I went to
Kennedy Home. And then when I got there Miss Kramer came on
Wednesdays but now it’s changed to Saturday. And Mrs. Morton comes on
Tuesday and Dr. Fossum comes on Friday.
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 125

Figure 10.5 Angel’s ‘art teacher’, Edith Kramer

And then when I was nine I got into the seven feet swimming pool and when
I got on the diving board I got scared and I overcame the scaredness (Figure
10.6).

Figure 10.6 Overcoming fear

126 ART AS THERAPY

And then at ten I made up a song. Here it goes in the tune of ‘The Whole
Wide World in His Hand.’
I got a big family, oh yes (repeat two more times)
And they do something all day
I got a little brother, oh yes (repeat twice)
And he keeps bugging me all day
I got a tiny tiny sister, oh yes (repeat twice)
And she plays house all day
I got a big father, oh yes (repeat twice)
And he complains all day
I got a little mother, oh yes (repeat twice)
And she keeps house all day
Miss Kramer’s story: I am Angel’s art teacher. I am helping him to write his
self-biography. He asked me to write my impressions of him when I first met
him when he was six years old.
At this time Angel could already draw very well, and he was proud of it.
On the walls of the hospital I saw many pictures of Superman which Angel
had drawn.

Figure 10.7 Superman picking up a house

 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 127

When I told Angel that I was an artist he asked me to draw something for him
and so I drew his portrait. He took it and added a long black necktie to the
drawing and then he drew a picture of his father beside it and gave him a long
black tie too. He explained that his daddy would let him wear his tie next
time he came for a visit. I thought this little boy likes his father very much and
thinks a lot about him.
Next Angel drew a picture of Superman picking up a house (Figure 10.7). I
wondered in my mind what house this was, but I did not at this time ask
Angel about it. Now, as we were talking about the story Angel explained the
house was Jacobi Hospital, and that Superman would throw the house, but
that he would run fast, and catch it again, and put it where it belongs.
Next Angel drew Clark Kent taking off his coat and his glasses and
turning into Superman (Figure 10.8). Now, Angel explained that he thought
when he was six years old, that his father made Clark Kent’s glasses. He got
the idea, because his father was at this time working in a factory where frames
for eyeglasses were made.

Figure 10.8 Clark Kent transforming into Superman

128 ART AS THERAPY

Angel continues: Next I am anxious about my nearby future. About when I

am going home for good and when I am becoming a real artist.
When I do go home I will wait until I am about 18 and then I am going
away. I will move to the country. I will move to a lake where I can swim and
fish. And I plan to get married. And have two children, a boy and a girl, one
of them named after me. I can build a little shack to be my studio.

Comment
Angel’s story of his infancy, where father protects and feeds him and mother
is not mentioned, reflects real experiences. Mother seems never to have been
able to give her children much care and warmth. Angel’s stepfather, who had
known him since he was a baby, always treated him as if he were his own
child and had been, insofar as he was able, a kind and faithful parent to him.
It is interesting that in his account of the etiology of his Superman fantasy
Angel stresses jealousy of his younger brother, an element to which, in my
earlier account, I gave relatively little weight. On the other hand, Angel says
nothing about his need for omnipotence, a motive which I had stressed. It
seems likely that Angel was unconscious of the latter aspect of his distur-
bance because the need for omnipotence persists, while he could admit to the
sibling rivalry because it had been successfully worked through in psycho-
therapy. At ten years of age Angel still maintained a stream of fantasies about
the heroes of television, and in times of stress he withdrew into his fantasy
world.
Angel’s presentation of his development as an artist and of the three
people who worked with him for so many years needs no comment. The
likenesses of his doctor and of the art and occupational therapists are
excellent.
In his song about his family, Angel permits himself to express negative
feelings in a jocular form, but he also improves on the real situation by
bringing back his mother and thus restoring the family’s unity. At the time
the song was written mother did not keep house for her husband and
children. On home visits Angel stayed with his paternal step-grandmother
who kept house for his step-father and Angel’s two half-siblings.
Angel’s conquest of the water is the major success story of the book. On
the title page we see him coming up after a high dive, and the whole book is
dedicated to his swimming teacher. When Angel learned to swim and dive,
his early fantasies of possessing the power of levitation were to some extent
fulfilled. The transformation of the shivering little figure on the diving board
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 129

into the victorious diver recalls his earlier drawings of the transformation of
Clark Kent into Superman. Thus Angel accurately portrayed his state, poised
between fantasy and reality but moving toward the conquest of the real
world.

Reflections
Angel’s autobiography constitutes an eloquent testimonial to the value of
continuous treatment geared to a child’s special needs. It testifies to the
importance of continuity in the therapeutic relationship, to the need for
teamwork, and last but not least it shows how art therapy can help the feeling
of identity to crystallize and the sense of past, present, and future to develop.
Children who live for a long time in institutions suffer from changes of
personnel. Counselors, social workers, teachers, therapists come and go. The
child can draw little sustenance from an endless succession of personalities
even though each of them may be well-meaning and competent. If he allows
himself to be drawn into strong relationships he finds that his attachments
inevitably end with loss. After a while he learns to hold himself aloof. He
keeps his relationships shallow, and so it comes to pass that a great many
children who live in institutions grow up to be empty people even when the
adults who took care of them were kind and well-trained. Ultimately these
conditions erode the child-care worker’s and therapist’s professional zeal and
capacity for empathy so that they are also in danger of becoming hollow
shells.
An encounter such as this one with Angel is, therefore, a sustaining
experience also for therapists, who must as a rule face tragedy and can seldom
contribute to the good outcome of a situation which is not without hope. It
remains tragic that Angel’s story is exceptional not only because of his rare
gifts but because the kind of help which he received is unusual in our public
institutions.
Soon after completing his self-biography, vacation time presented an
opportunity for discontinuing our weekly sessions. I continued to keep in
touch with occasional visits.
When Angel was ready to enter high school he moved to a group home.
He won a place at the High School of Art and Design and developed out-
standing skill in drawing from nature.
The fantasy of grandeur and fear of a disastrous downfall that was evident
in the psychological test given when he was five years old persisted in his
130 ART AS THERAPY

high school years, though he was able to defend himself by taking a

humorous position. In a little collection of humorous stories he depicts
himself having written a bestseller attaining fame. Being unable to follow his
first success with another successful book he turns into a bum.
Angel did well in college, earning his way by means of restaurant jobs. It
was in the middle of his junior year that I wrote asking his permission to
reprint the ‘Self-Biography’. Angel’s reply to my letter was in part as follows:
It was very interesting and very revealing to read about my past in
detail… It came at a very opportune time and I needed to read that in
order for me to open some doors in my head that were closed at the
time…
College and I will be parting our ways after this semester… I need
something more than school at the moment… After I made dean’s list,
the challenge of a liberal arts education suddenly disappeared…
He also enclosed the following poem, apparently inspired by the look into his
past afforded by reading my comments and his own story about his early life.

Nothing but the light

By the time he could kick he was constant motion
legs pumping piston-fast accelerating over all
obstacles –
in fact he was so fast he could outrun the wind
No matter what, he would go his way oblivious to
all
that was captured inside that little head of his
But when he sat down to recollect himself,
visions of his past pleasures floated by so quickly
all he could
see was the tail-end of his future running toward a
star at the
end of the sky
Before he could think
he was up chasing what he would hope to find
ahead
 CASE HISTORY OF ANGEL: ART THERAPY AND THE DISTURBED GIFTED CHILD 131

Calling upon that little extra he thought he must’ve

used years
ago, he pumped – pumped so hard he was nothing
more than a blur
and when he was a grasp away…
He just plain fizzled out

Soon after this letter Angel joined the Navy, where he made a successful
career. He married and is father of a daughter in her early adulthood and a
school-aged boy. He never gave up working on his art, taking art materials
along on his missions. Having entered the Navy as a very young man, he is
soon to retire. He intends to devote much time and energy to his art. Figure
10.9 testifies to his enduring gift and increasing capacity to depict relation-
ships.

Figure 10.9 One of Angel’s more recent drawings of a mother and baby asleep.
 CHAPTER 11

Art and the Blind Child

The desire to give symbolic shape to ideas and experiences through art is a
part of childhood. Blind children are limited to three-dimensional represen-
tation, but their need for art and their joy in the work of their hands is as great
as that of seeing children.
The blind child’s opportunity to attain control of his own person and of
his environment is greatly restricted. Even in the most familiar surroundings
there are constant small changes of which the child remains unaware. Even
though hearing, smell and sense of vibration compensate for the lack of
sight, the world remains to a large extent elusive and fraught with hazards.
For security, information and understanding the child must rely heavily
on the spoken word, but even that has its difficulties. Since he learns the
language of the seeing, most information reaches him intermingled with
expressions that remain unintelligible. Those of his experiences and
sensations that are peculiar to blindness, on the other hand, are seldom put
into words by the seeing.
The sensitive parent or teacher does her best to empathize with the child
and to take both his limitations and his special sensory experiences into
account as he communicates with her. Education must nevertheless be
focused largely upon interpreting a seeing world to the child and training
him to function in it. By necessity the blind child learns to accept information
on faith. He becomes used to relinquishing his own ideas, to disregarding his
own perceptions whenever they do not tally with the concepts of the seeing.
He is in danger of becoming overly compliant and passive, of losing touch
with himself. The fantasies and ideas which are thus sealed off from the
process of maturation are apt to persist in their original form and to exert a
regressive influence upon the child’s personality. To strengthen the feeling of
identity and to develop initiative and independence it is important to give the

132
 ART AND THE BLIND CHILD 133

blind child every opportunity freely to express his very own ideas. In this task
the art therapy program is important.

Materials
The chief materials used in the art therapy program are ceramic clay
containing fine grog which gives it more body and diminishes the danger of
explosion in firing. Wax, papier mâché and other materials that lend
themselves to three-dimensional work are used at times.

The hand
The hands, particularly the fingers, are important organs of perception for
the blind and this function takes precedence over the hand’s function as a
tool. The children are trained to perceive objects with a light touch, being
careful not to damage them as they feel them. This creates a conflict which
makes it hard for some children to use their hands forcefully in sculpturing.
However, when they have learned to use them both to perceive and to give
form the children’s hands move with rare grace.

Space
The blind person who perceives space by touch includes in his concepts all
spaces that he feels with his hands. The inside of a mouth, the hollow of a
tree, the underside of his sculpture are, to the blind, integral elements of his
work. To fully comprehend a blind artist’s ideas the seeing should not only
look at the work, but feel it.

Size
The blind are inclined to work on a large scale because details must be big
enough to be distinguished by touch. Moreover, in a world in which much
escapes them and where they are forced to form many concepts via
down-scaled models, handling substantial life-sized objects increases the
feeling of reality and is in itself valuable.

Developmental pattern
In all children’s art schematic representations precede more realistic work.
Emotional meaning largely determines the size and manner of representation
134 ART AS THERAPY

in the beginning and to some extent influences art throughout life. Since the
experiences of blind and seeing children are not exactly alike, the pattern of
development differs in detail. A number of differences are particularly
striking.
The seeing child whose earliest perceptions are dominated by the sight of
the mother’s face usually begins the representation of human beings with the
face, conceived as a large round shape complete with eyes, while other
features make their first appearance somewhat later. The blind child depends
on hearing the mother’s voice. To him the face has little significance; he is apt
to represent the ears exaggeratedly large, attached to a relatively small head.
The mouth is usually represented according to the sensory experience as a
deep hollow space. The expressive function of the lips, which figures so
largely in the work of seeing young children, is usually not part of the blind
child’s early concepts.
The eyes are an emotionally loaded area. Their representation depends
largely on the child’s feelings about his eyes. Some blind children
over-emphasize eyes, others omit them.
Free motility is, under normal circumstances, one of the most precious
early achievements, and so many children represent legs and feet earlier than
arms and hands. The blind child must learn to restrain his impulse to run, and
this is apt to influence his representation of legs. They are often undersized or
show inadequacy in some other way.
Arms and hands on the other hand are the blind child’s most important
means of experiencing and mastering the world. They are often made
enormously long. It is interesting that the toes are frequently represented as a
kind of additional set of lesser fingers.
Clothes, which figure largely in the work of seeing children, are neglected
by the blind child whose sculptures express primarily his own bodily
sensations. For example, the blind child will rarely model a shoe; instead, he
sculptures his feet and toes as he feels them inside his socks and shoes.

Teaching method
The method of working with the children is based on the recognition that
there can be no short cuts in art. It is essential to elicit each child’s own ideas
and help him to give them form. Only when we accept them unconditionally,
however bizarre or limited they may seem, is it possible for the child to grow
beyond them.
 ART AND THE BLIND CHILD 135

This is no easy task. Having been conditioned to accept information on

faith, many of the children are apt to drop their own ideas and to become
paralyzed as soon as they feel even the slightest criticism. The children’s first
attempts are often chaotic and hard to make out. To make the child aware of
the very idea of creating sculpture the teacher has to help at every step, yet
she must do her utmost to understand and even to anticipate the child’s
intentions and must be careful not to tamper with his concepts. She must
make herself the unconditional ally of the child’s intentions. Even the
sequences in which a sculpture is made, however illogical it may seem, must
be respected.
Sam, for example, began each sculpture upside down. He first made a
body to which the legs were joined, feet upwards. Only after he had
completed the feet and toes was he ready to turn his figure right-side-up. The
monumental ‘horned owl’ made by 14-year-old Christopher also began this
way with a huge body to which a pair of strong legs and feet were joined,
sticking upwards. It took considerable ingenuity to find a way of reversing
the position and planting the owl solidly so that Christopher could complete
it.
Size presents another difficulty. The blind child needs to work large
enough for him to have the sensation of volume and solidity. The making of
large ceramic sculpture involves difficult procedures, but we cannot wait until
the child is ready to master these. Instead we must improvise constantly,
finding ways to hold together the most improbable structures and finally to
make them safe for firing.
Only after the blind child has experienced again and again that his ideas
can take on tangible shape and that they can be made solid and permanent is
it possible slowly to introduce him to the discipline of the craft of ceramic
sculpture.

Examples
Karin
Karin, blind since she was eight months old, knew that elephants are huge
animals possessing a magnificent trunk. She therefore endowed each of her
elephant’s four legs with big hand-like feet, each possessing five fingers. She
also adorned her elephants with strong hair made of rolls of clay (Figure
11.1).
136 ART AS THERAPY

Figure 11.1 Karin’s elephant

Figure 11.2 Christopher’s beginning of the head of Eve

 ART AND THE BLIND CHILD 137

Christopher
Nineteen-year-old Christopher began the clay head of his statue of ‘Eve’ by
fashioning two deep hollows in which to place her eyes. He also built a
complex oral cavity, taking great pleasure in constructing the inside of the
mouth (Figure 11.2).
All this was to become invisible when eyes and eyelids were placed in the
two hollows and lips and chin were constructed over the gaping mouth. Yet
the sculpture’s intense life is bound up with a working process wherein the
hollow spaces that are invisible to the sighted are an essential element of the
blind young man’s concept of a woman’s face.

Further Reading
Burlingham, D. T. (1961) ‘Some notes on the development of the blind.’ Psychoanalytic
Studies of the Sighted and the Blind. New York: International Universities Press.
Burlingham, D. T. (1964) ‘Hearing and its role in the development of the blind.’ The Psy-
choanalytic Studies of the Sighted and the Blind. New York: International Universities Press.
Burlingham, D. T. (1965) ‘Some problems of ego development in blind children.’ The
Psychoanalytic Studies of the Sighted and the Blind. New York: International Universities
Press.
Fraiberg, S. and Freedman, D. A. (1987) ‘Studies in the ego development of the congeni-
tally blind child.’ In L. Fraiberg (ed) The Selected Writings of Selma Fraiberg. Columbus,
OH: Ohio State University Press.
Lowenfeld, V. (1952) The Nature of Creative Activity. London: Routledge and Kegan Paul.
Lowenfeld, V. (1957) Creative and Mental Growth. New York: Macmillan.
Willis, D. M. (1965) ‘Some observations of blind nursery school children’s understanding
of their world.’ The Psychoanalytic Study of the Child, Vol.20. New York: International
University Press.
 CHAPTER 12

Case History of Christopher

Christopher, an out-of-wedlock African-American child, was born with

defective eyesight. His tunnel vision deteriorated during his childhood, so
that at age seven he was entirely blind. Christopher’s father had disappeared
before his birth. His natural mother never took him home from the hospital.
Instead Christopher was placed in a foster home soon after birth where he
remained throughout his childhood and adolescence.
A number of operations were performed in an attempt to save his sight.
They were unsuccessful and left him with an intense distrust of medicine.
Mrs. Miller, Christopher’s foster mother, was able to care for him well
during his infancy. However, she was a pragmatic person and seemed unable
to explain things to her foster child. Christopher recollects how he was taken
to hospital without any preparation, to find himself in bed with his eyes
bandaged. Mrs. Miller visited, bringing toys and candy, but she never
explained why he was in the hospital or what the doctors were attempting to
do.
Growing up in Harlem, New York, with three foster brothers and two
foster sisters Christopher soon had to learn to fend for himself. At home he
was subject to extremely brutal handling by his resentful foster brothers. On
the ghetto streets Christopher had to learn to defend himself and to protect
his sisters in spite of his lack of eyesight. One of his sisters told me what a
good protective brother Christopher had been. ‘If he got hold of any fellow
who was bothering me he choked him until he turned blue.’
Christopher’s active aggressiveness was unusual for a blind person. The
blind are as a rule apt to be compliant and passive-aggressive. Child care
workers accustomed to working with the blind were at a loss how to deal
with this recalcitrant, aggressive, ‘demon child.’ Thus he was expelled from
every educational program for the blind. As a last resort before committing
him to an institution he was admitted to the Guild School, a day school func-

138
 CASE HISTORY OF CHRISTOPHER 139

tioning as the therapeutic arm of the Jewish Guild for the Blind’s psychiatric
clinic. There he responded well to compassionate firm handling. He became
attached to his teachers, was able to learn Braille and his behavior improved.
I began working as art therapist at the Guild School when Christopher
was 12 years old. (For an account of my work with Christopher at the Guild
School see Kramer 1993.) It appeared that Christopher had excellent tactile
perception and memory and much talent and enthusiasm for working with
clay. His earliest subject matter was dominated by identification with the
aggressor. He sculpted many wild well-defended animals. The masterpiece of
this period was a large three-horned rhinoceros.
A change occurred when the family left Harlem and moved to a
one-family house in the Bronx, where life was somewhat less violent. Chris-
topher became interested in the wild birds he heard singing in the backyard.
He sculpted a tree from ceramic clay that harbored six pairs of nesting birds
in its branches. His passionate interest in birds culminated in a five-foot high
sculpture of a blue heron (a picture of which can be seen in Kramer 1993).
After he left the Guild School at age 14 Christopher’s school life was
fraught with difficulties. He remained rebellious, unable to comply to con-
ventional discipline and teaching methods. He particularly resented
sculpture classes for the blind that were limited to making casts from
commercial molds. Instead he worked at home making wax sculptures of
animals.
Christopher’s home life remained difficult. Mr. Miller had died before his
sons reached adolescence. Mrs. Miller, a hard-working practical nurse, was
unable to control her sons, who soon became delinquent and drug
dependent. To sustain their habit they even threatened and robbed their
mother. Mrs. Miller’s daughters never became delinquent, but the older one
soon gave birth to a baby girl which she had to raise at home without the
father’s assistance. The family depended heavily on the steady income that
came to them from fostering Christopher, but this did not give him any
status. His position in the family remained marginal. He was frequently
ill-fed and ill-treated. However, when his social worker wanted to find
another, better foster home for him Christopher absolutely refused to be
moved. To him Mrs. Miller was mother and he only left home when he was
able to set up house by himself.
During the ups and downs of his school days I never lost touch with
Christopher. He continued to make wax sculptures of animals and consulted
me about them in long telephone conversations. When at age 17 he was
140 ART AS THERAPY

entrusted with a seeing eye dog so that he could travel I invited him to come
to my studio every second Saturday evening to work at sculpture. These
evenings began with a nourishing meal. He then worked for two or three
hours and went home by subway.
Christopher was at that time ready to sculpt a human head. From his work
we see how the blind must orient themselves by establishing powerful forms
that appear exaggerated to the sighted (Figure 12.1). We also see Christo-
pher’s capacity to integrate them into an impressive sculptural whole that is
comprehensible both to the sighted and to the blind.
Christopher had at this time converted to the Pentecostal religion. He had
acquired a ‘spiritual mother’ and relied heavily on his religion for emotional
sustenance and control.
Three casts of his head were needed, one for himself, one for the spiritual
mother and one for myself. Accordingly I made a rubber mold from which
several copies could be cast.

Figure 12.1 Early stages of Christopher’s sculpture of a human head

 CASE HISTORY OF CHRISTOPHER 141

When Christopher felt the first cast I had made he was devastated. It was not
right at all! The head absolutely needed more work. He worried whether I
felt that he was an ‘ungrateful bastard’ for being dissatisfied. I assured him
that he was just a typical artist. Artists are never satisfied with their work.
Since the original clay head had remained intact and workable, I offered that
Christopher continue to work with it. If the alterations he made would
indeed be a substantial improvement I would be willing to make a new mold.
Accordingly Christopher set to work. The new version was infinitely
stronger and clearer than the first one (Figures 12.1 and 12.2).

Figure 12.2 Final stage of Christopher’s sculpture of a human head

The event was typical. Christopher frequently undertook changes, often very
radical ones while he worked at his sculptures. These were constructive even
when they entailed such radical action as taking a kitchen knife and cutting
off a nude’s breast. ‘Don’t worry,’ he would say, ‘I will make a better breast.’
Christopher’s actions in real life were not so benign, nor was the fate of his
142 ART AS THERAPY

completed sculptures secure once they had left my studio. During the 15
years he worked with me he made one serious suicide attempt. He also went
through an unhappy and violent marriage that ended in separation. In an
excess of rage he destroyed a plaster cast of a nude 5’5’’ tall on which he had
labored for three years. In a storm of self-hate he destroyed a plaster bust that
embodied his self at seven years of age (Figure 12.3).

Figure 12.3 Christopher’s sculpture of self at seven years of age

How close he was to violence can be fathomed from the following account.
He told me that he had stabbed an empty metal can with an ice pick in order
to find out if he could kill a man. He declared that he had found that he
would not be able to kill.
 CASE HISTORY OF CHRISTOPHER 143

Because of his severe emotional troubles, repeated attempts at psycho-

therapy were made. None of them worked out. After a brief honeymoon
period Christopher stayed away.
Christopher also could not tolerate attending regular sculpture classes
even when provisions were made to facilitate his participation among sighted
students. Even though his sculptural concepts and his artistic style were
entirely his own, he depended on my total acceptance and my encour-
agement in order to sculpt.
Of the several individuals of the helping professions that approached
him, I was the only one he accepted, probably because I treated him as a
fellow artist, never as a patient. He himself protected the relationship, con-
sciously avoiding temptations of transference reactions. For instance he never
touched my face or my person except for my hands, when we worked
together. (Once he felt my ankles in order to sculpt the ankles of his nude.) He
frequently brought friends to his sessions, some of them quite gifted, who
also made sculpture. He saw to it that they were entirely respectful and
well-behaved at my house.
Within this framework it was possible to clarify a number of issues, when
he was ready for it. We decided that his sculptures embodied the soft, tender
side of his personality. We also found that he had an inclination to form
friendships with people who had experienced the same kind of troubles that
he had lived through. This identification brought no relief because each of
the partners desired the same kind of support from the other. Consequently
both remained frustrated, because being themselves needy they had nothing
to give. Christopher had at that time a friend, Bob, who had grown up in a
warm, loving family. Bob therefore was able to give Christopher the kind of
support and sympathy he craved. The friendship endured.
Both men were active in the Pentecostal movement. Christopher, who
had a charismatic personality, eventually became a well-known itinerant
Pentecostal preacher. He and his friend Bob, an excellent auto-mechanic,
travel throughout the US. Christopher earns enough money to pay his
friend’s salary and maintain a car and a home base in Texas. His duties as a
preacher leave him little time or opportunity for sculpting.
During a lengthy sojourn in New York, he visited my loft and sculpted the
figure of a ‘prophetess’ in wax (Figure 12.4). He had not lost his sculptural
capacities.
Throughout Christopher’s adolescence and young adulthood, religion
and art complemented one another. The severe, uncompromising, funda-
144 ART AS THERAPY

mentalist religion he had embraced gave structure and control, while art gave
him inner freedom and pride in solid accomplishments.

Figure 12.4 The prophetess

No success can fully compensate for the sense of deprivation blindness

entails. Nor can love and admiration coming late in life undo the emotional
injuries of infancy and childhood. Christopher has been able to turn depri-
vation into assets. I could tell Christopher truthfully that his blindness was an
asset in his sculptural work, that it gave his sculptures a kind of life that could
 CASE HISTORY OF CHRISTOPHER 145

be felt by touch, that no sighted sculptor could ever hope to achieve. As a

preacher his congregations felt that his blindness gave him a precious inner
light.

Discussion
When among one’s patients one encounters an exceptionally talented
individual one feels compelled to help beyond and above one’s ordinary
duties. To help Christopher I had to be willing to give of my time. I also had
to be a competent sculptor. Indeed I had to acquire skills in building armature
and in casting that I lacked. I also had to be an art therapist. Otherwise I
could not have been able to steer my way, circumventing transference and
countertransference, nor could I have accepted his destructive and
self-destructive acting out. At the same time I had to refrain from behaving
like a therapist. Unless I treated him as my student rather than as a patient, I
would have lost him. Nevertheless I had to be alert to any insights that came
from him, without offering more emotional help than could be given within
our circumscribed relationship.
Christopher’s story convincingly tells what ‘art as therapy’ can mean.

References
Kramer, E. (1993) Art as Therapy with Children. Chicago, IL: Magnolia Street Publishers.
 CHAPTER 13

‘The Importance of Lines’

Kerstin Kupfermann, with a discussion
1
by Edith Kramer

Eva – by Kerstin Kupfermann

Drawing was important for Eva, a creative, sensitive, intelligent woman in
psychotherapy. Unconscious fantasies and traumas were reconstructed, using
drawings as a foundation, particularly those depicting preverbal memories.
Her drawings helped Eva fully to recognize, and for the first time experience
with genuine feelings, her painful past. I felt privileged to support her in her
struggle to adapt to the world of reality.
Painstakingly, while looking at her drawings, Eva for the first time
allowed herself to experience emotional reactions and work them through.
Thus, she was able to overcome the ‘repetition compulsion’ (Freud 1911–13)
of childhood horrors and begin to cope with her life in a non-destructive
way.
This case poignantly demonstrates how crucial it is for therapists to
attend to and appreciate the dynamic conscious and/or unconscious content
reflected in patients’ artwork, which often constitutes the only link to their
childhood and preverbal memories. Artwork can thus help people establish
contact with the unspeakable; undo repression, defensive structures, and
resistances; and allow painful associated feelings and conflicted memories to
emerge so they can be worked through for the purpose of regaining mental
health.
Eva was 24 years old when she began psychotherapy. We met in a
workshop on childcare for mothers who were substance abusers – she was a
counselor and I was the workshop leader. At the end of it, she said to me: ‘I
want you to be my therapist!’ When I asked why, she responded, ‘Because

146
 THE IMPORTANCE OF LINES 147

you understand about the importance of something – a nightgown or so – for

a child to hold onto to feel safe.’
I would not have thought therapy necessary for Eva who, judging from
her comments and contributions to the workshop, seemed so composed and
well-adjusted. I suggested that we begin with a consultation. During that
session the depth of her need for help became clear to me. Eva, like her
mother, Sylvia, had learned to perform socially with perfection but under
that surface lurked despair, confusion and a feeling of emptiness. Thus began
eight years of psychoanalytically-oriented psychotherapy.
Eva often referred to herself in the third person, such as when leaving a
session: ‘I have to go home and continue to take care of Eva now.’ Her tone of
voice could switch in an instant from that of a whiny little girl to that of a
mature woman, depending on what she was talking about.
Since the age of eight, Eva had attempted suicide often, sometimes
severely injuring herself. She was impulsive and displayed uncontrolled fits
of anger, at times physically attacking others. She often became depressed
and had a tendency to somatize her emotional problems. Eva, like other
members of her family, had a serious drug problem. Yet, with all her troubles,
she was a bright, sensitive, reflective and caring person.
Eva’s primary motivation for beginning psychotherapy was that she
wanted to be able to function without drugs. She said she felt hypocritical
because she was using drugs while counseling young people not to do so. She
also hoped to gain a sense of personal identity, beginning by terminating a
lesbian relationship with her so-called therapist with whom she lived.
Eva wanted to control her self-destructive behavior. I could sense a core of
strength in her and felt that she was a true survivor – someone who would
search out solutions to keep herself afloat.
At the onset of therapy, I explained the analytic rule of free association
and the importance of reporting dreams. To counteract her experience of
being fragmented, I resorted to the technique of complete interpretation,
taking into account not only the transference, but immediately connecting it
with what I had learned about her experiences and expectations. This
technique had an immediate cohesive effect: Eva said her life felt less chaotic.
For example, one hot summer day, she arrived for the session shivering
with cold, wanting to remain in the waiting room, afraid that I would lock
her in my office – a transference reaction. Eva was concerned about her own
bizarre behavior, particularly at work, where the agency staff looked at her
strangely when she insisted that they put on the heat in the building. She
148 ART AS THERAPY

associated her fear of being locked in my office with a time in her childhood
when her furious mother had swept the contents out of the refrigerator,
pushed Eva inside, and locked it. Star, a Native American woman who was
Sylvia’s lover, secretary and housekeeper, as well as Eva’s nanny, opened the
refrigerator in time to prevent Eva from freezing or suffocating to death.
Sylvia, a famous professional singer, had become furious when Eva inter-
rupted her lovemaking with Star, their routine before Sylvia left for her
evening performance. When I made her aware of the connections between
her present distress and her past experiences, Eva calmed down and her
shivering stopped. With her trust in me restored, and good reality-testing
reinstated, Eva was able to return to her job at the agency and function
normally.

Eva’s background
Eva’s life story was fraught with catastrophes. While listening to what she
called her ‘Scenes from hell,’ I wondered at times about the validity of her
recollections, and hoped that they were not just distorted but entirely untrue.
However, medical records, school reports, legal documents, as well as contact
with relatives and other people from her past revealed that most of her
memories were accurate.
Eva was delivered by Cesarean section and was subsequently made to feel
that she had destroyed her mother’s life. Sylvia, a heroin addict, instilled in
Eva overwhelming feelings of guilt for this ‘crime.’ Sylvia’s husband, Frank,
was a drug dealer on whom Sylvia relied for her drugs. She consumed pills
like candies, and made Eva take them too so that the child would sleep while
she was away at her singing engagements. There seemed to have been a
fusion of identity between mother and daughter, an enmeshment which may
have caused the mother to project onto Eva her own problems regarding
separation.
There were also signs of the mother’s genuine wish to take care of Eva in a
different way than she had been taken care of by her mother, Katherine, who
was involved in illegal gambling and often had to move quickly with her
family to avoid the police. Thus, as a child, Sylvia often found her home
empty when she arrived there from school. In panic, she would gather up her
siblings and collect clues as to her parent’s whereabouts. Giving pills to Eva
may have been an effort to numb the child to an awareness of painful
separation. Gradually, Eva, like her mother, began to rely on pills as a way of
relieving psychic pain.
 THE IMPORTANCE OF LINES 149

Eva was sexually abused by Sylvia, Frank and their friends until she was
about eight years old, at which time Frank was imprisoned. Even when Sylvia
did not actively participate in the abuse, she never prevented it. Eva told me
that her mother used to say, ‘“I love you but I don’t like you” – and she would
say it with such hatred in her voice.’
Eva always considered herself to be ‘the cancer of the family – the bad
seed.’ Sylvia’s manager, Erick, had in fact fathered Eva, and Frank seemed to
sense that he was not Eva’s biological father. This might explain why Eva was
more severely abused than her siblings.
Sylvia, Frank and their friends would abuse Eva to arouse themselves,
then push her out of bed and force her to sit naked on the floor with her legs
spread wide apart. Sylvia’s bedroom was walled with mirrors so Eva was
confronted by the activity in her mother’s bed. Sometimes she was pushed
into a closet and left there, often for an entire day. To console herself, Eva
wrapped herself in her mother’s nightgown. When Sylvia discovered that it
comforted her, she ripped the nightgown to pieces and threw it away, as if
she resented Eva having any comfort or security.
Sylvia also destroyed her treasured toys, like the dolls she was given by
Erick on his frequent visits. Eva did manage to hold onto one thing – one of
the syringes her mother used to inject heroin – by hiding it in her sock, shoe,
or hair until adulthood. Eva finally had a funeral service for this object,
which represented her mother, after psychotherapy had helped her to accept
her mother’s death.
In early childhood, Eva was cared for during her mother’s rehearsals and
performances by an older sister and sometimes by her grandmother,
Katherine, of whom she was very fond. Katherine was obese and she over-fed
Eva from her three refrigerators. Eva had fond memories of Katherine
bringing her to the park to play and on several occasions she rescued Eva
from having to accompany the family to the police station after they were
arrested.
Eva also was cared for from the age of three until she was eight years old
by her mother’s companion, Star, who never abused her. Star brought
structure, meaning and fun to Eva’s life, engendering in her feelings of
security, predictability and trust. Eva fondly remembered their weekly walks
to the park to watch the seals play; they would buy a balloon and a pastry on
the way home. Star taught Eva to read, ride a bicycle and ice skate.
Eva went to a summer camp where performers frequently sent their
children. At first, she was among the youngest campers there and became the
150 ART AS THERAPY

‘pet.’ Eva remembered being awakened in the morning by Sylvia’s singing

because recordings of the campers’ parents were often used to amuse and
comfort the children.
At home, life was different. When not performing, Sylvia was mostly in a
drugged state, ‘sleeping’ behind closed doors. Sharply punctuating her
‘absences’ were the almost daily physical battles between Sylvia and Frank
that at times involved Eva as well. Frank had unpredictable outbreaks of rage
and psychomotor epileptic seizures during which he foamed at the mouth
and fell to the floor with eyes rolled back in his head. The police at times
avoided him. When called, they approached with sirens blaring to give him a
chance to run away before they arrived. Everyone except Sylvia, addicted to
sado-masochism, avoided confrontations with him.
Eva’s home was in shambles following incidents of rage between her
parents. She related with admiration how Sylvia skillfully restored order,
gluing whatever could be repaired with Duco cement which she also used on
Eva, to glue back strands of hair she had cut or to close cuts caused by Frank’s
knife attacks on the child. These cuts were often infected because Eva had
been dunked into a bathtub filled with steaming hot water mixed with his
urine and fecal matter. Eva was told that Frank would drown her if she ever
told anyone about the way she was treated. As an adult, Eva used Duco
cement to protect herself from penetration.
Eva was rarely allowed to visit with children so she had little chance to
compare her home life to that of others. Instead, she remembered always
feeling bad about herself, thinking of herself as the ‘bad seed,’ asking for for-
giveness, promising Sylvia and Frank that she would improve, but being
uncertain in what way she could do so. They made abusive demands,
including that she perform oral sex on both of them, which she said made her
feel as though she were choking to death. Sylvia occasionally became
remorseful and told Eva that she would be better off in an orphanage. Eva
feared having to face new, and perhaps worse, conditions, so she pleaded
with Sylvia to let her remain at home. She received medical care only from
her mother’s physician, who was well paid to hide the evidence of abuse.
Eva related two incidents that she described as more painful than the
physical abuse. When she was eight years old, she was sent off to her grand-
mother’s so that she would not be present when journalists and photogra-
phers came to prepare a feature article about Sylvia. Eva was told that she
looked too sad to be included in a family photograph – that her mother’s
image and reputation, and consequently her career, might be damaged by
 THE IMPORTANCE OF LINES 151

Eva’s presence. When Eva discovered that a classmate of hers had been asked
to appear in the picture as her stand-in, she tried to hang herself, but was
discovered and rescued by neighbors.
When she was 13 years old, Eva’s mother forced her to undergo extensive
plastic surgery on her face so that she would more closely resemble Sylvia.
Throughout her childhood, Eva’s mother had insisted that Eva could only
become worthwhile and beautiful if her face were changed. Sylvia finally
arranged the surgery after discovering that she had a malignant melanoma on
her own nose. Because local anesthesia was used, Eva could hear when pieces
of bones from her chin were dropped into the receptacle for garbage. She said
she felt that what little sense of identity she had was lost.
Sylvia arranged a party to celebrate Eva’s transformation, and called it her
‘new birthday.’ Sylvia’s friends raved about the likeness between mother and
daughter. When Eva later brought this to psychotherapy, I reassured her that
her own emotional expressions would gradually transform this artificial copy
of Sylvia’s face into a face that truly belonged to her, one that reflected her
mind and her unique personality.
That same year, Eva’s mother died from cardiac complications following a
hysterectomy. It was difficult for Eva to accept her death, particularly because
relatives and friends kept up the illusion that Sylvia was still alive. She was
laid out for burial in the dress she had worn at her last performance and her
recordings were played throughout the week of Shiva, the period of
mourning in the Hebrew religion.
Eva felt that Sylvia continued to live through her, and Frank, then out of
prison, reinforced this perception by calling Eva by his wife’s name, and
insisting that they live together as husband and wife. When she refused, he
rented out their house and later sold it along with all of Eva’s belongings,
including a treasured drawing board her mother had given her.
The courts placed Eva in the custody of her older married sister when
Frank showed no interest or capacity to care for her, but Eva felt it was worse
than living at home. After a year, Eva arranged to live with a high school
teacher and her family, a woman who had recognized Eva’s artistic talent. Eva
paid for her room and board by doing household chores and baby-sitting.
After completing high school, she attended art school for six months but left
because of incidents involving drugs at the school, where she felt like an
outcast. She returned to her hometown and tried to reconcile with Frank,
who broke her nose. She did not continue to see him.
152 ART AS THERAPY

Eva married a photographer, but the two were divorced after a year. It was
impossible for her to adjust sexually to the marriage. She returned to school,
completed a bachelor’s degree in counseling, and got a job. She lived with
various people and had one serious love affair with an older, married man.
Their relationship broke up when Eva moved in with a newly employed psy-
chotherapist at the college.
Eva was told by this woman that she would be cured only by
re-experiencing the horrors of her past. These sessions took place on campus
during the night when no one was nearby to hear Eva’s screams. She came to
doubt this type of ‘technique’ when she noticed the therapist’s excitement.
Eva held a job as a counselor in an agency that dealt with youthful
substance abusers. She was considered a devoted and effective counselor,
conscientious and hardworking – in her own words, a ‘workaholic.’ Eva had
a dog to which she was also devoted. She alternately treated it lovingly and
abusively. Eva, at times, felt that the dog was Sylvia reincarnated, because her
mother had told her that she would come back as a dog after her death.
Eva made weekly visits to Sylvia’s grave, talking to her through a metal
pipe she had inserted into the ground. She maintained a strong conviction
that Sylvia was not dead and said she expected to see her mother on the
street: ‘One can never trust her.’ On the anniversary of Sylvia’s death, Eva
would return to the hospital where her mother had died and demand to see
her, often becoming violent and accusatory toward the staff. When she began
psychotherapy, Eva was terrified that if she began to talk about her
childhood, Sylvia would come back and punish her as she had done when
Eva, as a child, began to disclose to a teacher how she got the bruises and cuts
on her body.

Drawing to survive
Since early childhood, Eva had always drawn pictures, but her mother had
ripped them up in fear that their content might reveal something about their
home life that would be damaging to her career. Eva managed to find ways to
defy her mother, learning drawing techniques for camouflaging content
which she knew her mother would not accept.
Eva could record her experiences in drawings. Hundreds of drawings that
she had produced prior to her psychotherapy kept her from being totally
overwhelmed by past experiences. When she began bringing her drawings to
our sessions, Eva was not fully aware what they depicted. Only as she showed
them to me and began talking about what occurred to her while studying
 THE IMPORTANCE OF LINES 153

them, did she gradually become aware of their connections to her past.
During the course of our work together, Eva brought in drawings she had
made prior to her psychotherapy and also about 100 which she had made
while she was in treatment. She never drew in my office, always in her own
home.
Our sessions were highly structured so that Eva would feel safe and secure
that I would not allow her to act on her sexual or aggressive impulses; our
communication was to be in words only. If she appeared to be under the
influence of drugs, I asked her to leave because productive work could not
occur. Given a choice of seating, Eva picked a rocking chair and placed it
close to the door so that she could catapult herself out of the room at the end
of the session. Our parting was difficult for her.
A strong therapeutic alliance was immediately formed. She idealized me
for several years before she could dethrone and cathect me with bad parental
images and work these through. In fact, she temporarily became addicted to
me as a replacement for her drugs, which she stopped using after 18 months
of psychotherapy. She never missed a session, and circled the block where my
office is located several times a day to reassure herself that therapy was not
just a dream.
Eva attempted suicide after our first month of psychotherapy. She had a
transferential experience of my leaving on vacation as being rejected and
abandoned by her mother. We took steps to make her feel safe during my
future absences. I made a recording of my voice telling her all that she had
accomplished in her therapy and what was left to be done in order to provide
Eva with a sense of accomplishment and continuity. I also included music on
the tape and read poems that related to her. This tape provided a link similar
to the one with her mother’s tapes which she had listened to when Sylvia was
performing abroad. I also made a sleeping bag that she could crawl into
should she feel overwhelmed by her fears. This was reminiscent of the
nightgown of Sylvia’s that Eva had wrapped around herself as a child. The
sleeping bag and the music represented early transitional objects and as it
turned out, also became a reminder of Star, because Native American women
use a bag called a papoose to carry their babies. These objects also served as a
reminder of her relationship with me. I stressed that in contrast to her
childhood, she was no longer a helpless victim and that our relationship
would continue as long as she needed it.
From the beginning, I tried to create a corrective social and emotional
experience. Empathic listening, supportive validation of her feelings, clarifi-
154 ART AS THERAPY

cations, and interpretations gave Eva a sense of my being attuned to her – a

state of symbiosis that she had always longed for. However, for her to
experience the symbiosis without anxiety, I reassured Eva that I could only
make my interpretations because of what she had told me about herself. It
gave her a feeling of security that I had attempted neither fusion nor
intrusion that could threaten her brittle ego boundaries. Thus I prevented her
from feeling a fragmentation of her sense of self.
Eva’s perceptions were, in general, fragmented. Because of the constant
sexual stimulation which was so much a part of her early life, everything
became sexualized for her. At the onset of psychotherapy, Eva said that
nothing ever appeared to her as what it really was. Everything had a way of
turning into a penis or a vagina – even her perception of her parents.
Eva repeatedly used the expression ‘put on the lines’ when she got partic-
ularly upset in therapy, recalling her past. It stemmed from the time when, as a
very young child, she would seek a sense of safety by pushing her back
against the bars of the crib, reassuring herself that she had a back. She did this
in panic situations, in fear that she would fragment. At the beginning of
therapy, it was at times important for Eva, when experiencing chaos, to feel
my spread-out fingers stroking her back – a re-experience of how as a child
she induced feelings of safety by pushing her back against the crib bars. This
sensation evoked a soothing feeling, assuring her that her body did exist and
that she was not in danger of fragmentation (Kupfermann and Smaldino
1987).
In time, Eva gained enough control and strength to begin to sublimate her
primitive, sadistic, aggressive impulses that she had previously directed
toward her own body. After Eva had brought her drawings to therapy
sessions for some time, she became aware not only of how they related to her
traumas, conflicts, feelings and self-image but also to the way she treated
herself. She began to feel the healing impact and effect of her drawings.
Rather than destructively cutting into her skin or trying to commit suicide by
cutting herself, Eva began to use the technique of ‘scratching’ in her
drawings: cutting lines into the scratch board, covered with black ink, as can
be seen in Figure 13.1. This constituted major progress in dealing with her
feelings.
In the course of psychotherapy, Eva began to develop a better self-image.
She observed others, reflected on their behavior, and integrated what she felt
were desirable characteristics. Around this time she created a picture called
‘The Dala Horses,’ a benign painting of multiple images of the popular
 THE IMPORTANCE OF LINES 155

Figure 13.1 Eva’s scratchboard images

Swedish toy horse. The picture she made has a humorous double meaning:
how she experienced me as a person with energy (like a Swedish work horse)
and that she had called herself ‘work horse’ on a business card she designed
when she was thinking of seeking work as a commercial artist.
Eva began enjoying herself more, and sailing became one of her favorite
activities. In Figure 13.2, she painted a star on one of the sails of the boats,
symbolic of the woman who used to take care of her as a child and guide her,
the good mother whose caretaking attitude she now could identify with in
the interest of self-preservation and enjoyment in life.
When her psychotherapy was coming to an end after eight years, Eva asked
to make a few videotapes which she hoped might help others in ‘putting
156 ART AS THERAPY

themselves together,’ even if their past had been as traumatic as hers. On a

tape she titled, ‘The importance of lines in my life,’ which featured her and

Figure 13.2 Eva’s painting of sail boats

some of her drawings, Eva began by talking about the importance of placing
oneself in a milieu conducive to growth and putting oneself together ‘in one
piece’ – psychotherapy.

Summary
I have found that if a person who is experiencing difficulties in daily func-
tioning that stem from past experiences has a talent, this talent can serve as a
powerful agent in regaining mental health. In Eva’s case, her strength was in
her art. She was able to express at the outset of therapy, for example,
preverbal memories and feeling states in her drawings and paintings which
she could not fully convey in words. Later in psychotherapy, her talent
became less a way of communicating and working through traumatic experi-
ences than a source of pleasure, reflecting the capacity for sublimation, ‘no
more messes.’ Eva, it seems, possessed unusual strength, a strength that
enabled her to survive abusive treatment with a relatively sound mind.
 THE IMPORTANCE OF LINES 157

Discussion – by Edith Kramer

Sexual abuse of small children has, until recently, gone mostly unacknowl-
edged. It originates from universal cannibalistic, anal, sadistic and perverse
fantasies of early childhood origin that arise between the first and fourth year
of life. If all goes well, these fantasies are in due time transcended and
absorbed into normal adult sexuality. If not, adults may be driven to act out
their fantasies upon children of the age during which their own child-like
fantasies were formed.
To the small child who is sexually victimized by an adult, it must appear as
if his or her own innocent fantasies have monstrously come to life, swelled to
inconceivable power by adult passion and sexuality. Such children’s
emotional and physiological equipment is naturally unprepared and
inadequate for such experiences. However, because they have indeed
harbored fantasies which resemble the adult abuser’s actions, children so
abused are apt to conceive of themselves not only as victims but also as
accomplices. Irrational guilt, sexual overstimulation and a compulsion to
repeat the trauma must be dealt with in the course of psychotherapy.
When Eva first told Kerstin Kupfermann of the outlandish, horrendous
abuses she had endured as a child, the psychotherapist recalled that she
almost hoped that the patient was fantasizing. However, Eva’s reports could
in essence be verified. Frank, the man who functioned as Eva’s father, seemed
to have been unrelentingly sadistic to her, his wife’s youngest child. Eva
reports no redeeming features about him. Her mother, profoundly
ambivalent toward Eva, seems to have been unable to perceive her child as
separate from herself. Eventually, Sylvia even had her daughter’s face
surgically altered to more closely resemble her own.
Sylvia also seems to have been unable to conceive of her daughter quite as
a living being. For example, she used Duco cement not only to repair broken
china, but also to glue together her daughter’s wounded flesh.
How then did Eva manage to survive physically, retain sufficient
command of her mind to complete high school, earn a bachelor’s degree,
hold a job? How could she, after a period of sado-masochistic acting-out
under the tutelage of a so-called ‘therapist,’ finally choose a competent psy-
chotherapist for herself and sustain treatment?
The child’s environment had not been entirely malignant. Her mother’s
personality contained pockets of constructive functioning. She was, in spite
of her drug habit, a disciplined performer who maintained high standards of
artistry. There was also Star, the Native American caretaker, sexually subser-
158 ART AS THERAPY

vient to Eva’s mother, but a protective, kind and competent caretaker to Eva.
Also, there was respite from abuse during the summers at camp.
Finally, beyond what we must surmise as Eva’s exceptionally resilient
physical and mental constitution, there was the gift of symbolic living in art.
Drawing pictures constituted a sanctuary of self-communication where the
unthinkable and unspeakable could be given form.
The drawings represented in this paper (a tiny selection of innumerable
similar works) impress as inextricable mixtures. Pornographic imagery,
obsessive, compulsive repetition as well as elements of sublimation coexist.
We learn from Eva that certain repetitive features of her art embody
maneuvers she had discovered as a child to help herself endure pain and
disgust when she was being abused.
Counting constituted one such maneuver. Eva said ‘… once I stumbled on
counting, it gave me a way of lasting…’ We learn that Eva’s counting was
linked to the sense of safety she had experienced as a small child when she
felt the bars of her crib as she pressed her back against them. We can follow
up the connection between an experience with tangible objects and the
abstraction of numbers and lines which allowed her to be reassured not just
by the crib bars, but by anything that was countable and/or linear.
A picture entitled ‘Counting’, for example, represented a huge erect penis
covered with and surrounded by innumerable precisely drawn lines.
Apparently, these somehow contained the image and made it less threatening
to Eva.
Eva also used circular shapes to retain a sense of unity, continuity, and
selfhood. Whenever she succeeded in imagining a circular form in space she
‘did not get lost in everything…’ In ‘Lost in space’ (Figure 13.3) we see at the
very center a tiny, beautifully drawn figure of a little girl who has her back
turned toward us. She is sitting cross-legged upon a snake-like shape that
terminates in the upper left as a penis shape. The girl and the area on which
she sits are free of the lines, dots, and rounded black shapes that obsessively
cover the rest of the picture. It is also reassuring that the several gigantic
penises are turned away from the little figure.
Scarcely visible among all this is a small circular shape upon which the
child’s gaze is concentrated. There is an incredible contrast between the live,
sensitive quality of line in the drawing of the child and the obsessive, rigid,
brutal style which permeates the rest of the picture. Eva was able even before
she began psychotherapy to draw herself as an alive, complete person, even if
only seen from the back. It almost seems as if Eva discovered in childhood the
 THE IMPORTANCE OF LINES 159

kind of self-hypnosis techniques practiced in cultures whose initiation rites

put individuals in extreme pain or states of deprivation. Yet, none of these
survival techniques sufficed to protect Eva from lasting damage. Flooded by
years of relentless sexual overstimulation, her perception of reality was
impaired. In the beginning of her psychotherapy, she complained that
everyday objects continuously turned into sexual organs before her eyes.

Figure 13.3 Lost in space

‘The crib and the building blocks’ (Figure 13.4) embodies both Eva’s
sexualized, fragmented world and her attempts at reconstruction. She
explains that the gray lines represent the bars of her crib, invaded by
snake-like penises. We recall that feeling the bars upon her back as she
pressed herself against them provided her with a sense of safety and
160 ART AS THERAPY

intactness. But the bars in front of her eyes provided no safety. Looking
through them, she saw her parents’ violent fights. As she said, ‘…whenever
they were not hurting me, they were hurting each other.’ In her painting she
does not depict fights. Instead, she has drawn numerous building blocks
adorned with images of various body parts. Conceivably, these could be
assembled to construct a whole person, if only a sufficient number of images
of non-sexual body parts could be found.

Figure 13.4 The crib and the building blocks

As a child, Eva loved to play with building blocks. She now used these benign
toys as metaphors for the task of constructing a whole self. The blocks are
skillfully drawn in perspective. Nevertheless, confusion reigns. The blocks
seem to be floating, and occasionally to interpenetrate. The laws of optics are
reversed: blocks in the background are much larger than those nearby. Yet in
order to assemble a whole picture, the blocks ought to be all of the same size.
 THE IMPORTANCE OF LINES 161

We see that Eva usually experienced the bars of her crib as confining,
which contributed to her fragmented perception of her violent and
sexualized environment. In another picture, however, she created a benign
world, seen through the white bars of her crib. The bars symbolized the
framework of reasonable rules and limitations established by Star, Eva’s
beloved caretaker who helped her acquire skills and a sense of self. Even
though it appeared rather rigid, it constituted a victory. It is one of the few
pictures that she created that was free of sexual imagery and all the black dots
– the ‘cancer cell’ – that invaded most of Eva’s drawings.
This kind of combination of graphic perfectionism and spatial confusion
appeared frequently in Eva’s art. One example of this was the cover of a
booklet she made which she called ‘Scene in hell’. It was a skillful example of
op-art, a style that depends on precise drawing used as an assault on the
system of visual perception. Contradictory clues of spatial relationships were
simultaneously offered to the onlooker. Therefore, the image kept moving
and it was impossible to determine its position in space. The cover prepared
us for the confusion, the fragmentation to be found in the booklet’s hellish
pages. Eva had made the book before she began psychotherapy. Telling her
story just to herself or an anonymous audience, was not sufficient to prevent
her self-destructive acting out. Later on, with the aid of psychotherapy, art
could become a means of replacing deeds with communication.
One such artwork which Eva brought to a session was a drawing done on
a scratch board which she had covered with black ink (see Figure 13.1). At
this time, she had compulsively scratched and cut herself. The scratched-in
images in her drawing stood out white against the inky black, while Eva’s
face and arms were entirely free of injuries. The image as a whole thus consti-
tutes an act of sublimation. Acting-out was replaced by a complex multi-
faceted communication which relied on the act of vigorously incising lines
onto a hard surface.
Within the picture, displacement, defensive maneuvers, transference
phenomena and sublimation coexist. In the center is a baby holding a giant
hypodermic needle above her head. The baby’s white outlines are drawn
with superb sensitive realism. The figure is reminiscent of the little girl of
‘Lost in space’ (Figure 13.3), but while that child has turned her back to us,
the scratch board baby is facing us, though we cannot see her face because it
has been relentlessly scratched into an undifferentiated white mass. The same
has happened in the lower right half of the picture, where a mother holds her
baby in beautifully drawn arms. The faces of both mother and baby have
162 ART AS THERAPY

been scratched out. Eva also appears as a misshapen being clutching her
bizarre transitional object, a hypodermic needle, swelled to gigantic propor-
tions. Her features can be discerned within a midst of scratches. Well-defined
eyes are turned suspiciously to the left. In the upper right area appears the
face of the plastic surgeon who had performed surgery on her face, complete
with a surgical head-lamp. Somewhat below the center of the page, a small
black nude – lacking hands and feet – seems suspended in space. She appears
to be hollow. A scratched-out white area extends from her crotch to her
stomach.
The similarity in the shape and size of three hypodermic needles and
three crutches is noticeable. Both crutch and needle signify illness and imper-
fection. The crutches tell us of Kupfermann’s temporary impediment (she
had injured a leg and was temporarily on crutches) and the needle of Sylvia’s
doom. Equating them, Eva may have made a first step in relinquishing her
mother’s needle which constituted a destructive crutch in her mother’s life.
Kupfermann’s crutch helped her to regain health. Even though the drawing
tells of injuries Eva sustained in early childhood, it is free of the black dots
that obsessively intrude upon most of her artwork. It is indeed entirely her
own and constitutes an act of liberation.
In Eva’s imagery, black dots symbolized cancer cells. We recall that her
parents conceived of Eva as ‘the bad seed,’ ‘the cancer of the family.’ The evil
that permeated the parents’ life was unloaded upon their youngest child, who
could therefore be abused with impunity. Helplessly exposed to the powerful
projections of her parents, Eva was forced to introject their image of her, the
cancer cells, which continuously invaded her artwork. Sometimes the cancer
cells, as well as the stylized penises and vaginas and the defensive ‘countable’
black lines, were drawn in a brutally rigid style, quite different from the
quality of lines Eva used when she depicted her own ideas, thus giving the
impression of parental introjects invading her artwork.
Disturbing as they are, the endlessly repeated intrusions were essential in
working through Eva’s experiences of being treated as ‘the bad seed,’ of
repeated narrow escapes from death at the hands of her parents. They had to
find symbolic representation again and again until their impact gradually
diminished.
Eva’s art gradually changed in character. The kind of pictures she did
toward the end of her psychotherapy were no longer sexualized but
depictions of reality. The ‘Dala Horses’ was an example of how, later in her
psychotherapy, Eva was able to produce more benign artwork. It showed an
 THE IMPORTANCE OF LINES 163

assemblage of the famous eighteenth-century Swedish toy horses. The over-

lapping and interpenetration of the horses, the placement of small horses
before the larger ones, was reminiscent of the earlier image of building blocks
in Figure 13.4. There were elements of chaos and confusion in both pictures.
However, the Dala horse picture resembled a card Kupfermann once sent Eva
from Sweden, depicting Dala Horses from the Province of Dalarna, with the
different sized horses presented this way. So, while Eva’s original blocks must
have all been of one size, Dala horses came in many sizes. Also there were no
sexual imageries in the Dala horse picture. The total effect was pleasing. It
seemed that transference has been active, linking Eva’s building blocks, a
benign element in her horrendous childhood, to the toys her Swedish psy-
chotherapist may have played with as a child.
A linking to Eva’s childhood can also be found in Figure 13.2. We see
nine sailboats in a blue bay, white sails silhouetted against darkly wooded
hills. One of the boats is distinguished by a five-pointed star. Eva declared
that the boat symbolized Star, who provided guidance in her childhood. The
manner in which the sail is singled out is reminiscent of flower paintings
typical of severely disturbed individuals. We frequently find one of the
flowers different from the others. It may have a black center, it may be
altogether painted in darker colors, it may be smaller, lacking a leaf – in some
way different from the rest, just as the one who made the picture feels that he
or she is not quite like other people. But while these flowers are more often
than not somehow diminished, the sail with the star looks more powerful
than the others. Yet it also appears somehow threatening. Star had been an
anchor of safety in Eva’s endangered childhood, she had brought sanity and
pleasure into the child’s world. Eva’s mother also was a star – a famous singer.
Star, the Native American woman, might have superseded the threatening
image of the star mother, so that the star became a benign symbol. Yet Star
had also been the lover of Eva’s hated, feared and adored mother; one who
had catered to the mother’s sexual needs, so the symbol on the white sail may
have multiple and contradictory significance.
Thus even when Eva celebrates her newly won emotional health, links
with her cruel childhood can be found. A total break with it would not even
have been desirable. It would have left Eva quite empty. It is encouraging that
the elements included belong to the more benign aspects of her childhood:
building blocks that suggest that a scattered world can be put together to
make sense. A person who, even while she belonged to mother, was able to be
protective and caring to the child.
164 ART AS THERAPY

Conclusions
I have discussed just a few of Eva’s pictures. In preparation, Kupfermann and I
looked through the innumerable works done by Eva before and during
treatment – a grueling undertaking. Most of the work repeated the tale of
Eva’s pathology. The exceptions, some of which have been discussed in this
paper, have the quality of the miraculous just because of their rarity.
I have never worked with Eva, who needed no art therapist to open the
door to symbolic living. An exceptionally talented individual, she discovered
the importance of lines on her own. Later on in her psychotherapy, she came
to understand the meaning of the drawings she had been driven to make.
In this context, Ernst Federn’s observations are interesting. A psychoana-
lytically trained social worker, he worked for years within the Austrian penal
system where prisoners are encouraged to engage in artwork. Space and
materials are available, but there are no art therapists at work within the
prison system.
Federn, who worked with severely disturbed individuals, many of whom
were serving life sentences, observed that those who are able to do artwork
have a better prognosis than those who don’t, regardless of how crazy and
pathological the artwork may be.
Visual, auditory and kinesthetic experiences precede the acquisition of
language. This may be one reason why the visual arts as well as dance and
music can give form and structure to experiences that happened too early to
be cast into words. Or else, the arts may constitute a language that can tell of
happenings so outlandish, cruel, guilt-laden and forbidden that they must
not or cannot reach verbal consciousness. Often experiences of the latter kind
– though they occurred later in life – touch upon preverbal material. When
visual images so replace the spoken word, it is essential that artmaking be a
highly invested pursuit, engaging the creator’s skill, concentration and time
in a supreme effort. Work thus produced attains a life of its own, feels real. Art
therapy can be a powerful aid in maintaining emotional balance. It can also
serve to complement verbal psychotherapy, as this paper documents.2

References
Federn, E. and Nunberg, H. (eds) (1962–1975) Minutes of the Vienna Psycho-analytic Society.
New York: International Universities Press.
Freud, S. (1911–13) ‘Remembering, repeating, and working through.’ In J. Strachey (ed,
trans.) The Standard Edition of the Complete Psychological Works of Sigmund Freud (Volume
12). London: Hogarth Press.
 THE IMPORTANCE OF LINES 165

Kupfermann, K., and Smaldino, C. (1987) ‘The vitalizing and the revitalizing experience
of reliability: The place of touch in psychotherapy.’ Clinical Social Work Journal 15, 3,
223–235.

Notes
1 Kerstin Kupfermann, MA, DES, previously on the staff of Margaret S. Mahler’s clinic,
Masters Children’s Center, New York, is an Assistant Clinical Professor at the State
University at Stony Brook, NY. Dept. of Psychiatry and Behavioral Science. She is also
a seminar leader and supervisor at Long Island Jewish-Hillside Medical Center’s
Schneider Children’s Hospital in New York, The Campus of Albert Einstein College of
Medicine, and on the board and faculty of the New York School for Psychoanalytic
Psychotherapy and Psychoanalysis. She is in private practice and a member of the
International Psychoanalytic Society and The Association for Child Psychoanalysis.
She has written many articles, among them ‘Cancer as a factitious Disorder,’ and
co-authored the book The Power of Fantasy with Lucy Freeman.
This article was originally published in the American Journal of Art Therapy 34,
February 1996.
2 Kupfermann’s note: I would like to express my deepest thanks to Eva for what I have
learned while working with her in her psychotherapy and for her permission to publish
my work with her. This is a credit to her concern for others and her desire to help those
who can relate to her situation. My gratitude also goes to Peter Purpura, PhD, and John
LaValle, CSW, for their valuable, stimulating, psychoanalytically-oriented comments
regarding the publication of this case.
 PART 4

Art Therapy, Ethology,

and Society
 CHAPTER 14

Reflection on the Evolution

of Human Perception
Implications for the Understanding
of the Visual Arts and of the Visual Products
of Art Therapy1

In this chapter I will pursue a long-standing interest in the relationship

between psychoanalytic understanding of human psychic processes and
ethology, a discipline that has immensely broadened our comprehension of
the mental activities and behavior of animals.2
My digressions from the straightforward investigation of the psycho-
dynamic process in art and art therapy are motivated by the conviction that
understanding of the exclusively human realm of symbolic living is
enhanced by consideration of the mental processes developed earlier in
evolution. No matter how dramatically symbolization and conceptual
thinking may have transformed older mechanisms of acquiring information,
recently acquired faculties are built on those preceding them. Evolution
cannot start from scratch. Learning from failures in the developmental
process must await the capacity for conceptual thinking. Therefore, evolution
eradicates failures and develops only through success.
Unable to reverse any step, the evolutionary path is necessarily
convoluted. For example, mammals returning to life in the sea adapt their
body shapes to hydrodynamic conditions but cannot return to breathing via
gills or to a cold-blooded circulatory system. At best, evolutionary
adaptation may lengthen the time the mammal can subsist below the surface,
or adaptations may occur that protect circulation from the extreme pressure
and temperature changes in the sea. Such irreversibility accounts for the
seemingly impractical, illogical, yet incredibly ingenious and beautifully

169
170 ART AS THERAPY

adapted qualities that characterize physical structures and the behavior of

living things. These properties attain their peak in mankind, evolution’s most
adaptive and successful as well as most improbable and accident-prone
invention. Becoming familiar with the evolutionary origins of our mental
functions may help us to come to terms with some of the human absurdities
with which we must contend in ourselves and our fellows.
I investigate aspects of visual perception and response to perception
among the lower species, and I trace this influence on the visual arts. This
chapter concludes with a discussion of these reflections in relation to art
therapy. Insights gained by this investigation are modest. Nothing entirely
new emerges, and no existing understanding is superseded. However, as
concepts derived from ethology are integrated with psychoanalytic theory
our understanding is broadened.
For information about how animals use perception to survive, I rely on the
work of ethologists who are dedicated to studying living things in their
natural environment (Lorenz 1966). My investigations are focused solely on
animal and human behavior. No attempt is made to address the mechanisms
of optical perception.
I distinguish between two diametrically opposed modes of responding to
perception: on the one hand, the capacity to perceive and recognize specific
territories and pathways; on the other, the ability to recognize categories of
objects by their salient characteristics. I consider the attachment to specific
territories that arises in connection with territorial perception as distinct from
the appetite for simple, easily perceived configurations that accompanies the
perception of categories. The latter has led to the evolution of signal systems
in social species and to the inclination for eager response to clear signals.
These observations lead to several lines of thought. First, I propose that
the two modes of responding to perception influence the structure of art so
that the abstract elements of art correspond to the perception of categories,
while specific, individual components correspond to territorial perception.
Examples from the fine arts as well as children’s and patients’ work are
discussed from this point of view. Second, I discuss the phenomenon of ‘su-
pernormal objects’, a term used by ethologists to designate dummies that
present exaggerations of properties found in natural objects toward which a
species responds with innate reaction mechanisms. The animal’s eager
response to such abstract simplified objects foreshadows human emotional
response to works of art. The phenomenon complements Winnicott’s (1975)
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 171

observations of the function of transitional objects as the basis of human

symbolic living.
Third, human instincts include a variety of innate reaction mechanisms to
visual configurations. The response to the configuration ‘face’ and the
phenomenon of ‘mutual facial signaling’ are discussed. Examples from the
fine arts and from art therapy provide illustrations. I propose that these innate
reactions to certain shapes or their arrangements contribute to the emotional
power of art and that these powers may be harnessed in the service of art
therapy.

Two modes of reacting to perception: Territorial perception

and perception of categories
Among the many functions that the visual arts fulfill in human existence, the
various experiences generated, the appetites gratified in the act of perceiving
are a constant element. We could call this a celebration of the act of seeing.
Though the understanding of visual art depends on the mind, only visual
perceptions provide access to art. The ancient system of interpreting percep-
tions and responding to them that enables each species to navigate within its
environment and to reproduce takes on unprecedented functions. Yet, these
must be built on functions for which the system was originally programmed.
Specifically, we contemplate two entirely different modes of perceiving and
responding.

The recognition of territory: Memory and recognition

Any creature capable of voluntary motion and needing to find its way within
a territory must have the capacity to recognize and to remember territory and
pathways. It must be able to store perceptions and retrieve them precisely
when familiar territory reappears. These memories must be detailed and
precise. Any bee, fox, or bird would be ill-served if it were to confuse its own
hive, lair, or nest with that of another.
Among those social species capable of forming individual bonds, the
capacity for recognition, originally evolving in the need to recognize
pathways and territory, extends to the recognition of individuals. Indeed,
ethologists perceive bonds between individuals as extensions of territorial
attachment. Feelings of safety and well-being within familiar territory are
also experienced in the presence of an important partner. The partner is then
defended as fervently as territory. Ethologist Monica Meyr Holzapfel calls
172 ART AS THERAPY

the partner who is a personal friend ‘the animal with the home valency’
(Lorenz 1966, p.211). The faculty of individual recognition, once
developed, has a broad range extending beyond species, so that bonds
between diverse domestic animals, as well as attachments to human
caretakers, become possible.
The ability to retain memories and activate them to recognize territories
and pathways must evidently be as old as goal-directed motion. Recognition
of individuals is of more recent origin. Observations of social birds, wolves,
dogs, and others reveal such memories to be durable, conceivably lasting a
lifetime. Suspended in time, they may remain latent indefinitely, yet ready to
come into play whenever any familiar individual or territory is again encoun-
tered.
Those are, perhaps, the only situations when memories are available to the
lower species. Voluntary recall of former experiences as a purely mental
exercise can have little survival value before the faculty of reflection has
evolved. We can assume that voluntary recall and conceptual thinking
evolved simultaneously. However, the inability to evoke the memory of the
absent does not imply that the individual does not suffer from the absence of
an important other. Among monogamous birds, such as geese, intense
distress following the loss of a mate is well documented, as is the search for
the lost individual (Lorenz 1966).3 Indeed, this suffering may be intense
because absence is absolute and consolation via memory impossible.
Even for humans, retrieving memories without the aid of external clues
remains a more difficult task than matching memories with a perceived
object (for example, a forgotten name may be recognized if we look through
our address book and encounter it there). Retrieved memories are, as a rule,
but faint shadows of the complete, emotion-laden memories of past events
that can be activated under special conditions.4 That they exist in such
fullness is confirmed by hypnosis, by experimental stimulation of the brain,
and by phenomena encountered in brain pathology caused by strokes and
injuries (Sacks 1987).
This barrier to intense experience of the past may be a blessing. If each
memory were to intrude into daily life with its original intensity, it would be
unbearable. To be beneficial, vivid experiences must be reserved for
well-prepared and protected situations such as artistic or religious
encounters.
Inasmuch as any animal’s life depends on the capacity to navigate within
its territory, perception of specifics is essential. Committing territories and
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 173

pathways to memory; noticing changes that may have occurred; recognizing

familiar landmarks, constitute a continuous, arduous process. Among those
social species capable of forming individual bonds, the need to memorize
specific characteristics extends to the recognition of individual members of
the animal’s society. Essential for the animal’s survival within the social
hierarchy, it parallels the universal need to recognize territories and
pathways. We can therefore perceive recognition both of territory and of
individuals as manifestations of ‘territorial perception’.

The perception of categories: Innate reaction mechanisms

Living creatures must respond not only to territories and individuals, they
must also respond to innumerable elements in the environment belonging to
categories such as food, potential mate, competitor, enemy, or climatic
change. An organism cannot always rely on learning to recognize such
categories, nor can a response be developed by trial and error. Recognition
and response must be quick and unerring. The animal relies not on personal
memory but on memories of the species filtered through innumerable gener-
ations that retain essential characteristics only.
Experiments with artificial dummies have taught us that, in recognition,
the perceptual system is able to filter out any incidentals and respond to those
qualities which define the category in the most economical manner. For
example, small birds that are the standard prey of raptors respond to any
object resembling a broad-winged, short-necked bird as an enemy. Thus, the
small bird instantly seeks shelter. A cardboard dummy held above such a bird
elicits the same response as a live eagle or buzzard. Indeed, the simpler and
more clear cut the shape, the more immediate the response (Lorenz and
Leyhausen 1973). Both perception and response seem instinctive. To locate
shelter, the bird must of course rely on its perception of the immediate envi-
ronment. Similar adaptations can be observed in most instinctive behavior.5
The ability to descry those characteristics of a given category unerringly
and simply is particularly well developed when a creature has limited oppor-
tunities to perform an essential function. Dear to ethologists is the example of
how a female tick must, soon after fertilization, ingest mammalian blood.
Any mammal – squirrel, dog, or man – is equally welcome. Two clues: the
odor of butyric acid (in sweat) and a mammalian body temperature between
96 and 98 degrees Fahrenheit identifies the target and is all the tick needs to
begin to draw blood. Evolution has endowed the tick with the apparatus to
174 ART AS THERAPY

respond quickly and adequately to its perception (Lorenz and Leyhausen

1973).
While the recognition of categories is often inborn, there are also
instances in which this knowledge is acquired. An example of fast and
ineradicable learning is imprinting among birds: among many kinds of birds,
species knowledge is learned shortly after hatching. Any large, moving
object is imprinted as parent bird and followed by the fledgling. Among
many species the newly-hatched thus learn not only which individual to
accept as a parent, but with which species later to mate. Imprinting is
frequently irreversible, and in natural conditions nearly foolproof. Who else
but the parent bird is in the nest? Keepers of domestic birds exploit the
mechanism of imprinting to facilitate hatching and parenting. For example,
domestic hens are given duck eggs to hatch because duck parents are inclined
to lead their young into inaccessible places, while hens are apt to stay in the
yard.
There is a broad spectrum within which separating out the characteristics
of any species is possible. Konrad Lorenz (1966) describes the results when a
hand-reared jackdaw was imprinted on him. As the bird matured sexually, he
‘fell in love’ not with a bearded man like Lorenz, but with the kitchen maid.
He courted her ardently and, when she took a position in another village,
followed her to remain there throughout the mating season. The fledgling
learned to recognize his parent, Konrad Lorenz, whom he exclusively
followed, to generalize to the human species, and eventually attempted to
mate with a human in maturity. The qualities defining ‘human’ were
unerringly selected. The uncanny capacity to find the characteristics that
define a category may also be observed outside the imprinting process,
whenever recognition of a category is learned. The task must nevertheless
require considerable energy, for the ability to search out characteristic
features among a multitude of distracting attributes is accompanied by a pre-
dilection for clear, easily distinguishable configurations that facilitate recog-
nition.

Supernormal objects
Naturalists capitalize on the inborn penchant for simple clear signals and the
eager, intense response elicited by dummies that exaggerate aspects of objects
toward which an innate response may exist. They are then able to determine
the necessary elements by a process of elimination. Ethologists have named
such dummies ‘supernormal objects’. The evolution of signals and responses
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 175

to signals among social species is built on the same phenomenon: unusually

clear visual, auditory, olfactory or gestural signals that rarely occur acciden-
tally in nature are perfected to dovetail with instinctive responses.6
Parasitism exploits the same appetites by perfecting what amount to
natural supernormal signals, exaggerated attributes that are bigger, clearer,
more attractive than those of the host species. The strategy of the parasitic
cuckoo bird is a good example. The feeding behavior of adult birds is
normally stimulated by the fledglings’ gaping beaks. The stranger in the nest,
in this case, the cuckoo bird, is therefore endowed with an extraordinarily
large and colorful beak. Gaping, the parasite seduces the parent birds to feed
it more eagerly than their own nestlings. Similar seductive supernormal
qualities are developed by parasites that invade ant colonies and supersede
the queen by exuding sweeter excretions than those produced by the queen
ant. Lorenz described how, in the proximity of industrial areas, birds who
habitually build nests from twigs are tempted into using pieces of wire
instead. It is much easier to construct nests with those artificial hard and
straight twig-like objects than real twigs and so they are eagerly utilized, but
are deadly cold in the winter.
Common to all supernormal objects is their seductive power. Stimulating
hectic activity, they divert the responding animal from its ordinary course of
action, leading it into a dead end. Lorenz describes the insatiable appetite
that supernormal objects stimulate as having the quality of a vice or
addiction.
Can we compare works of art to supernormal objects made by naturalists,
or to the quasi-supernormal configurations of parasites? Common to both is
the power to stimulate moods and appetites. Neither works of art nor super-
normal objects can lead to the behavioral sequence which the normal object
would have helped perpetuate, such as successful mating, rearing of off-
spring, or ingesting the proper food. However, the simplistic exaggeration of
attributes of supernormal objects seems more comparable to advertising or to
pornography than to the complexity of art. In pornography, we see images of
women whose secondary sexual characteristics, breasts and buttocks, are
exaggerated, so that, if such a woman existed, she would elicit revulsion
rather than desire. However, for certain individuals, exaggerations of form
may function as supernormal objects eliciting response.
This ersatz quality distinguishes pornography from art. Art offers experi-
ences of a kind that usually contribute to social cohesion. This occurs when
the arts celebrate religious beliefs, contribute to magical rituals, or extol and
176 ART AS THERAPY

confirm an existing culture or power structure. (On the other hand, human
complexity and propensity for social upheaval and change may engender
situations where certain art forms become symbols of social upheaval.
Consider the moral indignation aroused by Impressionism and the fervent
destruction of images of saints by Protestants.)
Works of art seem to partake of characteristics of supernormal objects
inasmuch as they are misleading. They seem akin to signals produced by
social species because they constitute an integral element within the fabric of
society. Common to social signals, parasitic counterfeits, and supernormal
dummies are their abstract clarity and powerful appeal.
Particularly interesting to our quest are instances when signals are part of
bonding mechanisms among higher social species, wherein territorial
perception and perception of categories interlock. The greeting ceremonial
among geese, for example, serves the dual function of inhibiting aggressive
behavior between friendly individuals and cementing their mutual bond.
The ceremonial itself is instinctive (Lorenz 1966). Two individuals face each
other while their beaks are pointedly diverted from head-on confrontation
(which would signal hostility). Instead, beaks are redirected against a real or
fictitious enemy at the partner’s side. (Because birds have peripheral vision,
the ceremonial partner remains in the visual field.) After a real or fictitious
victory, the partners engage in a rigidly ritualized triumphant display. This
ritual, however, may be performed only between geese who have formed a
bond. The ceremonial and bond are one. Its frequent repetition is essential to
each partner’s well-being. The greeting behavior implies the dovetailing of
innate reaction mechanisms dependent on the perception of signals, with ter-
ritorial recognition embodied in the recognition of the specific partner.

Signal, symbol and recall

Signaling among higher species appears to be the foundation upon which
the invention of symbol formation rests. The signal’s abstract, simplified form
foreshadows the symbol. Symbols, however, have multiple meanings. Unlike
signals which elicit specific responses, symbols open the door to a host of
feelings and ideas. Such flexibility would be impossible without the capacity
for voluntary recall and a mental life that comprises past, present and future.
This, however, seems beyond the mentation of species other than human
beings, even though apes and conceivably dolphins and elephants seem to be
endowed with some ability to think of objects outside their immediate field
and to think about past experiences.7
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 177

The combination of two separate mechanisms contributes to the capacity

for symbol formation: on the one hand, the perceptual apparatus’ ability to
abstract salient characteristics from a multitude of incidental attributes; and,
on the other hand, the capacity for individual recognition and bonding
between selected members of the same species. This, in turn, generates
entirely new sensations of pleasure in the partner’s company and of suffering
akin to grief when the partner is lost. The partner’s presence becomes
essential for each individual’s well-being and for each partner’s status within
the social hierarchy. These needs and sensations exert pressure toward
developing the capacity for recall, a faculty that could facilitate search and
diminish suffering. No such faculty appears in any species other than humans
or conceivably apes, probably because the available mental capabilities are
inadequate.8 To learn about the transition from signal to symbol, from
individual recognition to recall, we turn to the human infant.

The social smile

Observation of the innate mental activity of the human infant has recently
increased. Researchers have found that the neonate is not a passive receptor
of stimuli, but engages actively with the environment from the beginning of
life. The neonate’s instinctive seeking of the nipple and the onset of sucking
when it is found are well documented (Lichtenberg 1983). Tactile perception
is the main stimulus for hunger satiation. It seems conceivable, though, that
visual perception later also arouses nursing instincts. The mandala, the
universal symbol par excellence, recalls the Gestalt of a breast.
Most innate human reactions cannot be investigated via experimentation
with supernormal objects. Learned and innate responses are too inextricably
enmeshed. Eibl Eibesfeldt (1973) has isolated innate elements of human
behavior by studying identical behavioral patterns in diverse cultures. The
infant’s ‘social smile’ is one innate reaction mechanism documented by the
use of dummies. Roughly between the third and sixth month of life, the
infant is inclined to smile at any human face that is bending over her (Spitz
1965). Indeed, a particularly vivid smile may be elicited by a dummy
consisting of a large cardboard oval embellished with two (or more) dots
(eyes) in the upper half, when it is made to nod above the infant’s face. Ahrens
(Lorenz and Leyhausen 1953) found that a multitude of dots constitute an
additional supernormal attraction. The strongest response was elicited when
six dots were offered. We can assume that the universal symbolic attraction of
178 ART AS THERAPY

the mandala derives its potency both from the roundness of the maternal
breast and the nearly round shape of the schema face.
The period of undifferentiated response between the third and sixth
months is followed by selectiveness as the infant recognizes its mother’s face
and inscribes it into its schema. The mother’s face is then preferred. But the
response to supernormal configurations remains active. For instance, fasci-
nation with eyeglasses or any glittering object seems related to the infant’s
response to its mother’s eyes, surely the brightest object a baby might have
encountered on the mother’s person, before the invention of jewelry or of
spectacles. Mobiles, dolls and other toys whose amplified forms are akin to
supernormal objects retain their fascination throughout childhood and
beyond.
The infant’s fascination with the schema of face soon widens to fasci-
nation with facial expressions. As the baby slowly differentiates from mother,
playful seeking of eye-contact and turning away, playful mirroring of exag-
gerated expressions is endlessly and gleefully practiced. It seems compel-
lingly evident that the ability to produce expressions, to respond to them, and
to decode them, is innate, needing only stimulation from the parenting adult
to unfold.9 Equally compelling is the observation that the signals responded
to reside in all the mobile elements of the face: eyes, eyebrows, and mouth. In
addition, it can be observed that any large mass situated above the head, such
as a dark hat or some colorful ornament, easily fascinates or frightens.
Facial expressions undoubtedly carry enormous weight in conveying
mood. That mother’s mood profoundly influences her infant’s well-being is
common knowledge. Are we to consider primitive masks with their extrava-
gantly exaggerated facial features to be akin to supernormal objects? We will
return to this question.

Art and transitional objects

The original fascination with and pleasure in any human face does not persist
unclouded. The infant’s preference for mother culminates at approximately
eight months in a more or less pronounced tendency to a negative, even
fearful response when, disappointingly, instead of the expected mother, a
stranger’s face appears.10 Fortunately, as longing for mother increases, new
ways of enduring her absence are discovered. Around the fifth month of life
the infant ‘invents’ the transitional object, or some transitional phenomenon,
and so maintains connection with the absent mother. Winnicott (1965) char-
acterized this phenomenon as a ‘benign illusion’, a space between the inner
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 179

world and objective reality, destined to expand and to embrace humanity’s

exclusive domain: the whole symbolic cultural world. Thus we may consider
the phenomenon of the transitional object as the basis upon which art in the
full sense may unfold. Both transitional objects and works of art serve as a
bridge between the inner and outer world. Common to both is the quality of
benign illusion. Nevertheless, there seems to be no direct development from
the transitional object to art, for two essential elements are missing. First, the
element of form, as the transitional object is a found thing, and its appeal is
sensual. The infant makes no attempt to alter or simplify its appearance better
to evoke mother. The second element of symbolization is also missing. The
transitional object does not carry the multiple meanings that characterize
symbols. It remains exclusively linked to one important person, though innu-
merable moods may be unloaded onto it.
We also cannot quite equate the emotional connection established via the
transitional object with voluntary mental recall. The object’s consolatory
power remains attached to the physical presence of the all-important object
and the infant becomes upset when the object is lost or withheld. However,
once recall becomes possible, transitional objects facilitate restitution.
(Keepsakes, such as rings, lockets, snapshots, or other portable reminders
fulfill similar functions for the adult.)
The intermediary position of the transitional object is emphasized by
Winnicott (1965) who states flatly, ‘Animals [too] have transitional objects’
(p.110). Indeed, a dog left in some unfamiliar place will await its master’s
return more patiently if belongings saturated with the master’s scent are left
with the animal. The dog, one might say, treats this thing much like a transi-
tional object, being consoled by it and ready to defend it jealously. It
functions as a kind of moveable territory. Leyhausen’s description of a captive
fishing cat’s (a wild species) beloved rubber ball as ‘holed like a sieve’ –
taking ‘an almost indescribable shape,’ becoming ‘impossible to clean and
quite irreplaceable’ – is similar to descriptions of some children’s transitional
objects (Lorenz and Leyhausen 1973, p.235). Mammals, then, under certain
circumstances, extend territorial value onto portable things. The invention is
not exclusively human.
Consistent with the transitional object’s intermediary position is the time
of its advent: in the fifth month, before object-permanence (Piaget 1936) is
achieved, and much earlier than the advent of mental recall. Within the first
year of life, perception of categories exemplified by the infant’s smiling
response and by the mirroring phenomenon is evident. There is territorial
180 ART AS THERAPY

perception embodied in individual recognition of mother and other

important individuals and pleasure in their presence, as well as grief in their
absence. The invention of transitional objects and phenomena has also
occurred. All these distinct elements of mental functioning are ready to suffer
the sea-change that will open the door to later symbolic living. We
understand the nature of the change in terms of psychoanalytic theory, which
complements rather than contradicts ethological findings and studies of
human infancy.

The schematic and the individual in the visual arts

Symbolization seems to depend more on the capacity for abstraction than on
the emotion-laden recall of the specific. Abstraction and generalization also
dominate the realm of logical thinking. The balance between the abstract and
the specific is more evenly distributed in the arts. Unlike scientific research,
where the observation of specifics, informed by established theories, leads to
the recognition of further general principles, art narrows from broad concep-
tions to specific creations. Each step narrows the choice of future steps until
the result seems inevitable and unalterable.
In any work of art, we encounter an abstract ordering principle, a schema
of style providing backbone and structure. Individual features are inscribed
into the schema, giving it life and interest. We find this duality in any art,
though the proportions between schema and individuality may differ greatly.
For example, in Cro-magnon cave paintings, animals are characterized
clearly by horns, tusks or other generic features. Each animal’s stance and fate
are convincingly and individually depicted, documenting the cave-artist’s
power of observation and artistic mastery. Schematic and individual elements
are beautifully integrated. Humans, on the other hand, are usually repre-
sented impersonally and schematically. The reason for this division remains
unknown. We can assume that the cause must have been connected with
some cultural value. These superb cave artists would undoubtedly have been
equal to depicting men with as much individuality as animals. Indeed, we
may take it for granted that the artists of any highly developed culture
possess comparable artistic powers. The form that these powers take and
their limits are determined by the physical and intellectual resources of each
culture and above all by the prevailing Weltanschauung, or world-view.
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 181

Innate signals and cultural symbols

The impersonal pattern or style that we recognize as both an organizing and
a limiting agent in art impresses us as a composite. We distinguish simple
configurations that appear again and again within diverse cultures and art
forms. Among them we count the circle and its extension in the mandala and
the sun-shape; the schematic configuration face; schematically exaggerated
facial expressions; and shapes such as the triangle, the square, the cross and
the spiral. The signal value of color should probably also be counted among
the universal elements of style. These widely distributed configurations seem
to address the categorical mode of perception directly. We may understand
their compelling power as a function of the instinctual inclination to respond
intensely to abstract supernormal signals.
Superimposed onto those universal Gestalten (shapes and configurations),
or paralleling them, we find in the art of each culture meaning that derives
from the culture’s world-view. We are impressed by the power of cultural
norms and beliefs to channel artistic energy; to determine subject matter and
form; to exclude subjects and manners of representation so that they are not
only avoided but become inconceivable for the artists of the culture.
In human society, developing and changing traditions replace the
infinitely slower evolutionary processes whereby instinctive behavior
evolves and changes. We cannot confound the cultural process whereby
meaning is established with instinctual mechanisms. Yet the way in which
significance is slowly distilled within societies is analogous to the process
whereby signals are perfected within the evolution of the lower species. We
also may assume that the division between categorical and territorial
perception which is quite absolute for animals has lost its rigidity in human
perception. Nevertheless, we may assume that culturally established
symbolic meaning in art touches upon responses that originate in categorical
perception.
Alternatively, specific and individual elements of any work, those that
give warmth and life to art, must touch upon attitudes toward the world
which belongs to territorial perception. Such pictorial elements lack coercive
social power. Rather, they stimulate more private feelings and passions. This
corresponds to the territory’s role in animal life – territory is private property.
It must be individually remembered. Its distinguishing features are of the
utmost importance for survival. Attachment to territory constitutes the
prototype of all forms of attachment.
182 ART AS THERAPY

Illustrative examples
There is a well known Zen painting ‘Six Persimmons’11 that can be seen as an
illustration of these ideas. The circle, the painting’s universal element, is
repeated six times. Radiating calm and centered balance, this universal
symbol can be seen as an abstraction of the breast as perceived by the
suckling infant. The response to the form seems instinctive. The circular
shape in this painting is modified to suggest persimmons. Philosophical sig-
nificance is superimposed onto universal meaning. The painting’s symbolic
elements extend both to universal infantile experience and to the spiritual life
of those Chinese adults who have embraced the Zen philosophy. The
placement of the six spheres, the subtle variations characterizing each fruit,
and the consummate economy of the brush strokes and the values achieved as
the ink is applied give life and warmth to the painting; territorial perception
is engaged. The manner in which the three elements of universal meaning,
cultural symbolism and individual treatment of each element complement
and enhance each other gives the work its nearly miraculous vigor.
The balance between the schematic and the individual which we admire
in ‘Six Persimmons’ need not be cast solely in the interplay between abstract
and representational elements. The magnificent rose windows that constitute
a central element of Gothic cathedral architecture exemplify a balance
between abstract categorical elements and both abstract and representational
territorial ones. Seen as part of the cathedral’s facade, the rose windows’
mandala shapes exert their centering and calming power. The masonry’s
abstract interplay of forms derived from the circle, different in each rose
window, gives variety and life to the circular structure. Perceived from the
cathedral’s interior, each rose-window’s stained glass imagery depicting an
element of the Catholic faith informs and instructs.12 Yet even here the repre-
sentational elements seem overshadowed by the intrinsically abstract
arrangement of the transparent areas and the radiance of their colors, so that
the abstract configuration calmly unifies the intricacies of the Gothic archi-
tecture.
Throughout the history of art, the proportions between these two modes
of representation vary. Schematic elements may dominate as in the geomet-
rical style of archaic Greek vases which attain their life from subtle variations
of the geometric forms, or they may be submerged in a wealth of individual
features as in Baroque art.
Art declines in the absence of either of these complementary elements. It
rigidifies into lifeless sterility when schematic elements reign supreme, for
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 183

instance in official Egyptian art of the 26th Dynasty or in the statuary of

Imperial Rome. Art may disintegrate into overloaded sentimentality in the
absence of structure and of formal economy, as in late Baroque art, in
nineteenth century genre painting, or in Norman Rockwell’s calendar art. Or
it may become overloaded with sado-masochistically tinged detail as in illus-
trations in publications aimed at today’s adolescents.

The plight of contemporary art

The task of successfully combining the schematic with the individual is par-
ticularly difficult for today’s artists. No generally established style or
generally accepted social function of art exists; therefore, artists find neither
abstract formal structure nor a body of generally understood imagery to give
direction to their work.
Has the rise of abstract art in our time been in part stimulated by a need for
abstract symbolic structures that our culture no longer sufficiently provides?
The abstract backbone of the visual arts of most high cultures has been
embodied in its architecture, in ‘ethnic space’ in Susanne Langer’s (1953) ter-
minology. Today, oversized architectural boxes, barely adequate to shelter
the people condemned to work or live in them, provide neither air, light, nor
ethnic space. These buildings vastly outnumber those structures which make
creative use of numerous technical possibilities theoretically available to
modern architects.
Are Joseph Albers’ elaborations on the square, or Jasper John’s personal
modifications of banal symbols such as flags and targets, attempts on the part
of the artist to fill a cultural void by individual efforts? Is the same unfulfilled
need an element of Mondrian’s abstractions? Does absence of ethnic space
constitute a driving force in the vast illusionary spaces created by Mark
Rothko?
Artists such as Jackson Pollack or Jean Dubuffet seem to have responded
to the absence of culturally given significance as well as the absence of
abstract structure by largely abandoning abstract structure and retreating
into intensely private imagery. Liberated from the confines of culturally
established norms, artist-magicians such as Paul Klee found ways of telling of
psychic processes in pictorial language that would have been unimaginable in
any previous time. That both individually created abstract structures and
intensely private imagery find an echo in public acclaim shows that these
artists’ search touches upon generally prevailing longings and perplexities of
our time.
184 ART AS THERAPY

To summarize, we may say that art constitutes a symbolic world wherein

both categorical and territorial perceptions that derive from ancient
mechanisms are active. Backbone and structure are provided by stylistic
elements derived from the categorical mode. Territorial elements give life,
warmth, and individuality.

Implications for art therapy

Can insight into the duality of perception help us understand the art of
troubled individuals or to work with them in art therapy?
In the preceding passage, I discussed certain distortions of pictorial art. I
contemplated the art of periods of cultural stagnation when generally held
beliefs and ideas had lost conviction such as late Egyptian art, late Baroque
art and nineteenth century genre painting. The art of such times was charac-
terized by one or both of two extremes: empty formalism and rigidity, or loss
of structure and artistic economy; and, common to both, a sense of coun-
terfeit. Only in the retreat of private spheres can art survive such periods.
(See, for instance, the exquisite portrait sculpture of Imperial Rome
blossoming during the decline of its official art.) I then discussed the effect of
the cultural void within which artists of our time must produce and examined
the inclination either to replace the missing elements by individually created
abstractions or to retreat into private imagery.
The pictorial productions of severely disturbed individuals frequently
show similar tendencies in distorted or grossly exaggerated form. At one
extreme, we find the schizophrenic ‘picture-salad’ where a profusion of dis-
connected imagery reigns in the absence of an organizing principle. We find
the other extreme in paranoid, secretive, formalistic systems. The imagery is
usually abstract, deceptively precise but alogical.

Examples: Extremes of disorganization and rigidity

Suffering from a psychotic episode triggered by a minor operation,
12-year-old Donald was admitted to the child psychiatric ward of a city
hospital. During this episode, his art production was divided between two
kinds of pictures. One group consisted of a great number of individual
drawings placed at random on 18’’ x 24’’ sheets of paper. Each of these
drawings was recognizable if somewhat bizarre, testifying to considerable
graphic skill but showing no topical or formal connection to any of the other
drawings placed on the same paper. The other group consisted of geometric
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 185

drawings done with compass and ruler, representing designs for constructing
telescopes. These drawings (not available for reproduction) were precise but a
telescope could not have been constructed by following these plans. When a
combination of therapeutic interventions led to remission, Donald ceased
producing picture-salads and geometric drawings. Instead, he developed a
talent for portraiture.
Carl, a middle-aged man suffering from paranoid schizophrenia of long
duration, was given to the depiction of secretive, formalistic images of a
religious nature. Figure 14.1, an image dominated by two suns with superim-
posed faces presiding over idiosyncratically arranged geometric structures,
impresses us as an attempt to impose some private order on a fragmented
world.

Figure 14.1 Two suns with human faces

186 ART AS THERAPY

At times, both extremes combine in productions where idiosyncratic

structure is overloaded with rampant detail so that both modes of perception
are addressed, but not integrated. At its best such work attains a desperate
power and sincerity akin to art in the full sense.
Lucy Estrin, acclaimed outsider artist, made and displayed her dolls in a
number of exhibitions. Married in the United States, she subsequently lost all
her relatives in the Holocaust and felt guilty as the sole survivor. She became
further isolated by deafness, which forced her to give up her profession,
nursing. From then on, she spent most of her time producing creatures.
The dolls were invariably formed around empty coffee-cans. Into each
can she put a number of hard objects so that it would make a sound if shaken.
All the creatures appeared to be seated on the cans, unable to stand upright.
Head, body and limbs were made of stuffed material. Sometimes there were
four or six arms or legs. Around this basic structure grew a luxuriant wealth of
sewn, embroidered and crocheted embellishments. Lucy preferred to use
discarded buttons, beads, plastic straws, remnant materials and the like for
ornaments. All dolls had names and histories. Even though some were sold,
the doll family grew, relentlessly overflowing closets and wall space, creating
a world entirely of Lucy’s making.
The wealth of detail, imagination, and craftsmanship lavished on the
dolls masks their intrinsic sameness. Helplessly stuck on their pots that
appeared also to function as rattles, they seemed arrested in the anal phase.
Yet making the dolls gave meaning to Lucy’s life and undoubtedly helped her
to maintain a sufficient foothold in reality to live out her life in her family’s
care.

Successful intervention
The following are reflections on a successful intervention in art therapy with
an institutionalized young man who was mentally retarded. John had
Down’s Syndrome. This was an instance where graphic production, initially
formless and ‘territorial,’ acquired structure and with it the quality of art
(Henley 1986).13
John’s use of art materials had been for years stereotypically limited to
magic markers which he habitually carried in large supply. Whenever he was
given paper, he avidly covered the entire surface with a densely linear woven
network using only one color. His weavings had considerable graphic
complexity, unlike the scribbles typical of those people who are retarded and
who persevere once an action is initiated and thus are apt to cover paper
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 187

entirely with undifferentiated scribbles. John was unable to tolerate any

empty space on his paper. He guarded his work jealously. For example, when
his art therapist stapled one of his drawings to white cardboard to display it,
John took it from her. He immediately covered the white frame with an
additional network and put the piece into the folder which contained all his
artwork.
Even though John did not speak, he understood a good deal of language.
Passionately devoted to baseball, he always carried a large collection of
baseball cards in his breast pocket. David Henley had known John and his art
for several years, but had not regularly worked with him in art. One
memorable day, Henley cut out a circular shape about 8’’ in diameter. He used
stiff paper of the kind John valued highly for drawing and offered it to him.
John accepted the gift and stored the circular paper in his folder. A week later,
during a session with his regular art therapist, he spontaneously took out the
paper and drew on it, using red and blue markers, a radical departure from his

Figure 14.2 John’s baseball

188 ART AS THERAPY

habitual monochrome. The result was recognizable as an image of a baseball

(Figure 14.2). John had followed the circular paper’s circumference with a
narrow band of his habitual weavings. He had embellished the white, round
plane with a roughly circular red area set in a blue field shaped in the
hour-glass configuration characteristic of the seams of a baseball. John had
used his customary interlaced design to arrive at the red and blue areas, but he
had been able to allow sufficient space to remain white so that the drawing
could convey the idea of a baseball.
From then on John’s artwork changed. Although the baseball remained
his only representational product he was permanently liberated from the
compulsion to cover entire surfaces with intricate lines. In the abstract com-
positions he now produced, areas covered with weavings were juxtaposed
with open space. Shapes were varied and unexpected and seemed to have
been created by deliberate choice. Figure 14.3 is a good example of the
graphic dignity of John’s new art.

Figure 14.3 John’s new art

John could not speak. His artwork, however, testified to hitherto unexpected
mental faculties and to a sense of form. However, we will never know what
prompted the change or what his new productions represented in John’s
inner world.
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 189

Those who observed John’s initial behavior felt that drawing helped bind
anxiety. Guarding them jealously, John treated his drawings much like transi-
tional objects. But unlike a small child who simply adopts his transitional
objects, John gave his objects vibrancy and insistently meaningful surfaces.
Did John’s weavings signify a way of establishing symbolic territory in his
dispossessed, institutionalized existence?
Henley’s action had been spontaneous and intuitive. He remains unable to
explain what prompted him to offer a circular shape at that particular time,
beyond a desire somehow to introduce a change. Any analysis of what
transpired must remain conjecture. The effect of Henley’s gift must be seen
within the context of a well-established relationship of trust and mutual
liking. Henley was sensitive to the intrinsic graphic quality of John’s work
and undoubtedly John felt this. He may also have felt that unlike the rest of
the staff, this art therapist had expectations for him and had not given up on
him.
The gift of a circular shape may have conveyed more than one meaning.
On the surface it represented a baseball, a symbol of masculine aspirations of
success and potency. But the ancient significance of the mandala may have
also reverberated in the gift – John brought the gift to life during a session
with an art therapist who was a woman. He made it into a symbol recog-
nizable as a baseball, using considerable mental powers to imagine the
baseball seams’ intricate shape. Yet he celebrated his baseball with a circular
red area reminiscent of the maternal nipple. The coming together of feminine
and masculine symbolic significance within the protective orbit of both a
man and a woman therapist may have been essential for John.
Even though the two works are miles apart in artistic quality and spiritual
profundity, we may see certain parallels between John’s baseball and the mas-
terpiece of the ‘Six Persimmons’. In both instances, the mandala shape
dominates the image and the circle has been modified to signify a specific
cultural symbol. In John’s baseball, feminine and masculine elements
converge: the round ball with the red dot in its center has become the young
man’s proud possession, used for masculine, culturally accepted pursuits.
Having carried conjecture to its very limit, we remain unable to tell why and
how John’s miracle came about.
The fact remains that this nonverbal young man’s graphic activity
changed. Initially, John had seemed solely intent on taking possession of his
paper, creating territory by covering it with lines. After the episode of the
baseball, he was able to create impressive abstract configurations by setting
190 ART AS THERAPY

deliberately shaped densely covered surfaces against the negative space of his
white paper. The work attained, within the limitations of John’s mental
powers and talent, the quality of art in the full sense. In addition, John’s story
shows that the coming together of territorial and categorical qualities in art
may be within reach even for individuals whose mental functioning is
severely limited.

Applying the concepts of two modes of perception to art therapy

Ernst Kris (1952) understood the alogical pictorial imagery of a person with
paranoid schizophrenia as attempts to restore a shattered universe by con-
structing a new order that included the delusional, paranoid perception of
the world. As art therapists, we find Kris’s ideas helpful for understanding
our patients’ productions.
Carl Jung (1964) would explain the use of symbols and geometric config-
urations as evocations of the healing powers inherent in archetypical imagery
such as the mandala. Unfortunately, Jung did not distinguish sufficiently
between widely distributed, culturally determined symbolic heritage and
components that may derive their compelling potency from more ancient
instinctive sources.
Another element may be added to those ideas. It is conceivable that the
person with paranoid schizophrenia turns, in isolation and the search for
structure and order, to configurations that are part of our instinctive heritage.
These signals maintain their compelling power even when society’s mores
and demands no longer reassure or coerce. Were Donald or Carl, who had
lost their social orientation, compelled to turn to heavenly bodies that served
all of life as compasses long before social life came into being? Should we, on
the other hand, conceive of Lucy’s dolls as a kind of territory made by her
own hands? (Lucy also made rugs which had a similar meandering, colorful
quality.) As Lucy’s relationships to people became tenuous, did she draw
sustenance from the reassuring ambiance of such a territory? Conjectures
such as these are not meant to supersede psychoanalytic understanding. Even
if Lucy’s dolls should on some level stand for territory, they undoubtedly
represent anal babies. To comprehend her compulsion to manufacture them
we must discover her life history, listen to her comments and draw on under-
standing acquired in the practice of art therapy. The same principle applies to
any case material. My reflections could at best add one more element to an art
therapist’s understanding.
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 191

For example, the concept of supernormal objects might explain the

enormous energy expended in human society on creating abstract visual
symbols. We might see it as akin to the energy expanded in the evolution of
the peacock’s tail or the stag’s antlers or, more modestly, the red of a robin’s
breast. This concept might explain the conviction that magical powers reside
in simple signs and gestures and the enduring belief in their effectiveness,
convictions that are ready to surface whenever secondary process thinking
falters. Given the ubiquitous mechanism of projection, these convictions
seem rooted in reality. Clear and simple signals effectively regulate much of
the life of social species.
Human infants experience the compelling power of signals most vividly
in infancy during the social smile phase, when any smiling face or any con-
figuration suggesting a smile almost irresistibly and automatically elicits the
infant’s smiling response. We can assume that other innate signals remain
active later in life and continue subliminally to influence human behavior. For
instance, submissive gestures such as raising one’s open empty hands above
the head or bowing one’s neck are far less reliable than the signals available
to predators such as wolves. The patterns are comparable. Just as the
submissive human emphatically shows that he has no weapon, the
submissive wolf inhibits his adversary from using his deadly fangs by dem-
onstratively averting his own mouthful of teeth. The gesture is effective even
though it involves exposing an unprotected neck to the victor (Lorenz 1966).
Humans can be far less certain that their submissive gesture will be heeded.
The fervent wish for signs and gestures that would bring about desired
behavior persists. Such wishful thinking is not entirely irrational.
Gestures such as crossing oneself, knocking on wood and making the
sign against the evil eye persist even in our scientific age. In the arts, we
observe the influence of the supernormal phenomena, in particular in those
art forms that include configurations that seem analogous to supernormal
objects. Primitive masks belong to this group of creations. The universal
appeal of circular mandala and sun-shapes seems to be rooted in the innate
response to mother’s face and to the breast in early infancy. Somewhat later in
infancy, the facial mirroring between mother and infant seems a way of stim-
ulating and practicing the inborn capacity for sending and receiving facial
signals.
These experiences are reflected in primitive masks where facial features
are highly stylized, distorted and magnified according to culturally given
norms. Endowed with magical or religious power, such masks are used
192 ART AS THERAPY

mostly during important communal activities. Their specific functions may

vary greatly, but usually include creating specific moods within the cultural
group, moods that are meant to extend beyond the group of origin to
influence the supernatural through the mechanism of mood contagion.
The individual who dons a mask and so enlarges and exaggerates his
features does not implore or beg like a helpless child. The shaman impresses
and coerces others by the power emanating from the extravagantly inten-
sified facial signals as well as by the compelling force of music and dance.
Identification with the aggressor enters largely into these rituals. The
conviction of their effectiveness, however, may also have roots in the infant’s
mirroring at a time when the huge adult’s face – confronting the baby,
smiling or playfully frowning, but sometimes also looking sad or angry in
earnest – has the power to elicit corresponding facial signals from the infant.
This is a period when moods are intensely contagious, a time of extremes
when the infant feels omnipotent when partaking of mother’s power or
helplessly overwhelmed by moods emanating from mother.

Wiltwyck School for Boys: Monster faces

In children’s art we see in the suns and sun faces that so regularly preside over
their pictorial worlds the symbolic expression of the potency that parents
and parental moods exert throughout childhood. The sunsets that frequently
appear in adolescent art may likewise symbolize the waning of parental
powers.
When sun faces or other expressive countenances such as faces of
monsters, ghosts or devils expand to fill a picture’s entire surface, they seem
reminiscent of primitive masks.
Eleven-year-old Raymond’s artwork was devoted mainly to painting the
sun, moon and stars. From his comments, I understood that he conceived of
the moon as masculine, and the sun as maternal. Figure 14.4 was painted
when he had just informed me that one of his favorite foods would be served
at lunch. He drew a smiling sun face with charcoal, painted the whole surface
yellow and found that the charcoal drawing could be seen through the trans-
parent yellow paint. Tracing the faint charcoal lines with black color, he
created a radiant image. With its crooked smile, it looked quite like
Raymond. The painting was given a place of honor above the dining room
clock at Wiltwyck School for Boys. Soon after, Raymond was discharged to
his parents only to return after a few weeks. One of their complaints was that
he ate too much. Raymond immediately set out to paint a new sun for the
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 193

dining room (Figure 14.5). The sun had changed. Its empty eyes appeared
frightened and disoriented and the smiling mouth was replaced by clenched

Figure 14.4 Raymond’s sun with a smiling face

Figure 14.5 Raymond’s new sun

194 ART AS THERAPY

teeth. When Raymond returned a second time after a brief period at home his
new sun was grim. The mouth and teeth were distorted beyond all
anatomical possibility. The outlined oval between the dark blue eyes was
reminiscent of the ‘third eye’ that often appears in adult schizophrenic art.
The nurturing environment of Wiltwyck School had brought out the benign
qualities of Raymond’s orality (Figure 14.4). The withholding parental
home brought on destructive, devouring oral aggression.
Ten-year-old Clyde was a haunted boy. Shortly after Clyde’s admission to
Wiltwyck School because of truancy and petty thefts, his mother died. When
he left home, she had predicted that he would not see her alive again. In art
therapy, he produced innumerable large monster faces. As Clyde’s distur-
bance diminished, monster paintings became less frequent and gave way to
imagery characteristic of the phallic concerns of a gifted 11-year-old.
Matthew and Harry were both highly gifted preadolescent boys. Most of
their artwork was anchored in the phallic phase, detailed, varied and full of
adventure. Yet from time to time, each produced huge magnificent mon-
ster-faces reminiscent of primitive masks. (Figure 9.6 by Harry and Figure
9.7 by Matthew are examples – see pp.107, 108). Each of the boys had
grown up in the care of a mother who had paranoid schizophrenia. Each had
had to adapt to his mother’s pathology, to ingest some of her illness along
with parental care. The monster faces seemed to reflect the monster-aspect of
their mothers. In this sense, their monster paintings could be understood as
instances of defense via identification with the aggressor. The same
mechanism was undoubtedly also active in Raymond’s monster-suns and
Clyde’s nightmare-face. In addition, these examples were characterized by
exaggerations and alterations of facial elements that tended to disrupt the
organic unity of the face, making for unusual and grotesque images.

Franz Xaver Messerschmidt

In this context, it is interesting to compare our boys’ monster paintings with
the ‘character heads’ of Franz Xaver Messerschmidt (1736–1783). During
his psychotic illness, this well-trained sculptor produced over 60 ‘character
heads’ executed in the realistic baroque tradition. In his famous psychoana-
lytic investigation, Kris (1952) characterized the facial expressions as
defensive grimaces thinly rationalized as realistic facial expressions. Kris’s
research revealed that Messerschmidt had been in the habit of grimacing
before a mirror and of using his own face as a model for his heads. Both
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 195

grimacing and sculpturing grimacing heads served as defense against a per-

secuting demon.
In spite of his regression, Messerschmidt never abandoned the realistic
mode. Violently distorting his sculptures’ features, he only occasionally came
close to transcending the anatomically possible. His heads sufficiently fitted
into the stylistic pattern of the late Baroque art to be exhibited among the
work of his contemporaries.
To the art therapist, the rigid repetitiveness and the uneasy combination
of the realistic and the grotesque in Messerschmidt’s art appears esthetically
repellent. Beyond the uneasiness that psychotic art usually generates, the
insistently realistic style grates on the works’ emotional content. But
precisely because Messerschmidt’s art remained realistic, it convincingly
exemplifies the link between facial signaling and mirroring.

Discussion
Except for Raymond’s benign smiling sun (Figure 14.4), identification with
the aggressor is apparent in all of my examples. In addition, these
sun-monsters and grimacing sculptures reverberate with a phase of life when
the infant has only begun to differentiate from the mother; when mental life
lacks the capacity for reflection; when the concept of cause and effect has not
yet been formed. This is a world wherein psychic processes are dominated by
the primitive mechanism of mood-contagion; where self and other merge;
where orality and primary process thinking dominate.
The appearance of such images in the course of art therapy could serve as
a clue to the nature of the experiences the client wrestles with and could help
in therapy. However, this does not imply that individuals who produce this
kind of art, whether adult artists functioning in a primitive society or con-
temporary children or adults, must be locked in the oral phase. It may also
mean that they are dealing with specific material emanating from this stage of
development. In the case of Messerschmidt, Kris (1952) convincingly
diagnosed fear of oral and anal penetration as well as defenses rooted in the
oral phase, shown by sculptures featuring bared teeth, others showing a
tightly clenched mouth, or a wide open mouth with impressively sculptured
tongue and teeth.
Raymond seemed orally fixated. His suns seemed to represent himself
merged with the parent-sun, a union that was at first benign but that
appeared increasingly malignant with each new painting. The other two
196 ART AS THERAPY

boys functioned mostly on a phallic level and had attained some individu-
ation.
Matthew and Harry seemed to be in control of their monster paintings.
When they worked at them, a sense of mastery and detachment was apparent.
These paintings’ resemblance to primitive masks is remarkable. To my
knowledge, neither of the boys had the opportunity to study or copy such art
– certainly no such examples were within their reach when the pictures were
painted. Rather, I must assume that kindred psychic mechanisms resulted in
kindred formal qualities. The idea of a sun endowed with a human face as
well as the idea of demonic beings sporting extravagantly distorted, unrealis-
tically colored features are cultural givens, providing the basis for individual
modifications.
Assuming that there exists a linkage among facial signaling, primitive
masks and the monster faces we encounter in art therapy, and assuming that
the mirroring phase contributes to the phenomenon, how can we explain the
formal quality of these works? No matter how overwhelming mother’s face
may have appeared, it cannot have taken on the features found here. Actual
experience may account for the affect in these works but not their formal
quality.
Rather, I recognize in these characteristics the tendency to create super-
normal configurations, exaggeration of those characteristics for which an
innate response exists. If facial signaling were innate, eyes and eyebrows,
mouth and teeth as well as the mass of hair above the forehead would be
features selected for supernormal creations. The common inclination to select
just these facial features may explain the similarity between primitive masks
and the monster creations encountered in art therapy. The great variety
within this common realm both of masks and of monster creations testifies to
the human freedom of invention for which there is no counterpart in other
species. New forms can be perfected by lower species only through the
evolution of new species and subspecies.

Questions and concluding remarks

I must ask where these reflections, meanderings over a wide field embracing
animal behavior, human infancy, the fine arts, and the art of disturbed
children and adults, have led us. Is the pleasure of increased understanding
the only reward? Can the ideas presented give rise to further research? Can
they help in the practice of art therapy?
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 197

My reflections were initiated in the spirit of disinterested inquiry, without

any practical goal in mind, but with the idea that any increment in theoretical
understanding eventually finds practical applications. Understanding the
interplay between territorial (specific) and categorical (innate or culturally
given) elements in the visual arts may engender respect for the organizing
function of schemata that may serve as containers of individual meaning. We
may also become increasingly tolerant of the need for repetition. Art
therapists battling against repetitive stereotypes tend at times to overlook the
healthy desire for order and orientation embedded in pathological efforts.
Strategies might then be directed towards replacing deadlocked stereotypes
with more flexible organization. Invitation to dissolution of schemata in
favor of unrestrained experimentation might be offered cautiously.
A healthy need for private space and the reassurance that emanates from
individual territory may contribute to pathological withdrawal and bizarre
self-protective behavior. The need may be overlooked when art therapists’
efforts are bent on encouraging socialization by strategies that could be
experienced as invasion of individual territory.
Art therapists following Carl Jung’s ideas may concur with this avowed
Freudian’s respect for Jung’s idea that certain configurations, foremost the
circle and its elaborations, have universal significance. The hypothesis of the
inherent healing power of the mandala is supported by the supposition that
the infant’s search for the nipple is innate and that infants are endowed with
an innate appetite for a shape signaling security and the end of search. As
Carl Jung formed his concepts of the collective unconscious and of
archetypes before the advent of the field of ethology, he was not moved to
distinguish between innate mechanisms and the cultural elaborations based
upon them. With today’s understanding, we may identify most of his
concepts of the collective unconscious with the heritage of innate signaling
and innate responses. Functioning beyond consciousness, they are indeed
common to all humankind, and constitute an area of the unconscious mind
distinct from that relegated to the unconscious through repression. We may
also distinguish innate signals from those cultural creations that seem almost
as if they were innate because of long history and wide distribution, but owe
their existence to symbolization. Such distinctions could prove valuable in
therapeutic work.
Ideas concerning the function of visual symbols in art and art therapy
presented in this article are not wholly new. Only one group of ideas has
brought something new to our attention. They are based on the under-
198 ART AS THERAPY

standing that prehuman mental activities continue to influence human

psychic functioning, considerations that are at present gaining recognition in
many areas. Thus, the concept of intraspecific signaling was introduced,
followed by the concept of supernormal objects and supernormal responses,
leading to the idea that the compelling influence of art may be in part rooted
in the supernormal phenomenon.
Simple signals that have evolved within the various social species can
unlock essential behavior, and these signals command automatic obedience
(for instance, the wolf ’s submissive gesture). Such innate reaction
mechanisms persist in humans. Specific evidence of their existence is found
in the infant’s smiling response and in facial signaling.
The ineradicable belief in the magical effectiveness of certain signs,
gestures and rituals is understood as projections rooted in real experience,
inasmuch as all humans have experienced the power of innate reaction
mechanisms at least in infancy. This understanding should make us more
tolerant of seemingly irrational fears, expectations, and defensive maneuvers
we encounter not just in our clients but also in ourselves.14
Awareness of the continued influence of innate mechanisms on human
life encourages the search for signals beyond the mandala and various sexual
symbols. Other simple configurations, for example the triangle, the square,
the cross and the spiral, may also have innate signal value, as do facial signals.
I have presented only reflections which may generate ideas that can give
direction to research. In this sense, this chapter may constitute a beginning.
Being by temperament and training a person of ideas, I present them in the
hope that they will stimulate others to further inquiry.

References
Eibesfeldt, E. (1973) Der Vorprogrammierte Mensch. [The Preprogrammed Man.] Vienna:
Molden.
Henley, D. (1986) ‘Approaching artistic sublimation in low-functioning individuals.’ Art
Therapy 3, 2.
Jung, C.G. (1964) Man and his Symbols. New York: Doubleday.
Koehler, W. (1976) The Mentality of Apes. New York: Liverwright.
Kramer, E. and Wilson, L. (1979) Childhood and Art Therapy: Notes on Theory and Application.
New York: Schocken Books.
Kris, E. (1952) Psychoanalytic Explorations in Art. New York: International Universities
Press.
Langer, S. (1953) Feeling and Form. New York: Scribner and Sons.
Lichtenberg, J.D. (1983) Psychoanalysis and Infant Research Part I: The Neonate. Hillsdale, NJ:
Analytic Press.
 REFLECTION ON THE EVOLUTION OF HUMAN PERCEPTION… 199

Lincke, H. (1981) Instinktverlust und Symbolbildung. [Instincts and Symbolization.] Berlin:

Severin and Siedler.
Lorenz, K. (1967) On Aggression. London: Methuen.
Lorenz, K. (1970-71) Studies in Animal and Human Behavior. Cambridge, MA: Harvard Uni-
versity Press.
Lorenz, K. and Leyhausen P. (1973) Motivation of Human and Animal Behavior: An Ethological
View. New York: Van Nostrand Reinhold Co.
Patterson, F. and Linden, E. (1991) The Education of Koko. New York: Holt, Rinehart and
Winston.
Piaget, J. (1936) The Origins of Intelligence in Children. New York: International Universities
Press.
Sacks, O. (1987) The Man Who Mistook his Wife for a Hat and Other Clinical Tales. New York:
Harper and Row.
Spitz, R. (1965) The First Year of Life: A Psychoanalytic Study of Normal and Deviant Development
of Object Relations. New York: International Universities Press.
Winnicott, D. (1965) The Maturational Processes and the Facilitating Environment. New York:
International Universities Press.
Winnicott, D. (1975) Through Pediatrics to Psycho-Analysis. New York: Basic Books.

Notes
1 This piece was originally published in the American Journal of Art Therapy 30, May 1992.
2 I have addressed such problems previously in my book Childhood and Art Therapy
(Kramer and Wilson 1979) in the passages on ‘Human and animal play’ and on ‘The
ethology of social controls and the problem of pleasure in sublimation.’
3 See Lorenz (1996) On Aggression, Chapter 11. Also see the traditional American folk
song ‘Go tell Aunt Sadie [sometimes Aunt Rodie] the old gray goose is dead… Goslings
are weeping.’
4 This observation does not invalidate the tenet that only those past events that had been
originally emotionally invested may be retrieved and that remembering implies
emotional investment of memory traces.
5 For a detailed study of the interplay between rigidly instinctive behavior and adapta-
tion to real situations, see Lorenz’s (1971) study of the egg-rolling behavior of geese in
Studies in Human and Animal Behavior.
6 Such signals may be highly conspicuous, for example, the peacock’s tail or the song of
the nightingale; or more intimate sounds and gestures evolved in rearing offspring,
such as the nestling’s gaping or the mother hen’s clucking sounds.
7 Koehler (1976), known for his work with chimpanzees, found that only the most intel-
ligent chimpanzees were able to recollect the existence of a helpful box in an adjacent
room. Recent experiences with hand-raised gorillas who have been taught American
Sign Language demonstrate their ability to ‘talk’ about past events such as sadness over
the death of a cat or pleasure in presents received (see Patterson 1981). Assuming that
symbol formation and voluntary recall evolved simultaneously, could the cultivation of
the gorilla’s latent capacity for symbolic language have awakened a latent capacity for
200 ART AS THERAPY

voluntary recall? Or should we imagine that gorillas in the wild are also able to think of
past events?
8 We cannot conceive of mental recall existing in the absence of object permanence in
Piaget’s sense. Their search for the lost companion indicates that object permanence is
already within the mental capacity of social birds, and undoubtedly present among
social mammals such as canines. In humans, the faculty emerges in the eighth month.
The ability to retrieve memories at will, however, does not appear before 18 months. It
seems, therefore, unlikely that any animals whose intelligence remains below that of the
one and a half-year-old human would be capable of voluntary recall.
9 The intuitive impression is validated by the work of Eibl Eibensfeldt (1973) who exten-
sively studied and filmed mirroring between mothers and infants in diverse cultures,
finding identical facial signals throughout.
10 Eibesfeldt (1973) has observed ‘stranger anxiety’ among toddlers of all the cultures he
studied. He considers it an inborn trait with survival value. As toddlers move independ-
ently, they are no longer continuously protected by mother. They would incur harm if
they were to follow possibly hostile strangers indiscriminately. The two presumed
origins of ‘stranger anxiety,’ disappointment at the appearance of someone other than
the desired mother, and preprogrammed fear of strangers as a protection against harm,
seem complementary rather than mutually exclusive.
11 ‘Six Persimmons’ (brush and ink) attributed to Mu Ch’i, thirteenth century. The persim-
mons were chosen in opposition to the conventional subject matter of traditional
Chinese painting. The artist could represent them with the child-like innocence and
directness which Zen philosophy extolled.
12 For example, the three rose windows of Chartres Cathedral. The stained glass of the
North window deals with the Old Testament; the West rose widow represents the Last
Judgment; the South rose window depicts the Coronation of the Virgin and the Reign
of Christ.
13 Case material and artwork were contributed by David Henley, ATR, who also contrib-
uted to the theoretical analysis of the case.
14 Psychologist Harold Lincke (1981) pursued kindred ideas in his book Instinktverlust und
Symbolbildung. He linked symbol formation to the phenomenon of imprinting. He
suggests that symbols derive their irrationally compelling power from instinctively
rooted impulses – ‘id commands’ (‘Es-Aufrage’) in his terminology – that have been
displaced onto ideas that have thereby acquired emotional significance. Lincke’s
theories and ideas presented in this article are complementary. For example, inasmuch
as the mechanism of imprinting implies an open area wherein all kinds of objects may
acquire profound significance, and inasmuch as such open-endedness may lead to error
and confusion, imprinting foreshadows the unlimited possibilities of symbol formation
as well as its dangers. This corresponds to the phenomenon of supernormal objects and
supernormal responses and to the mechanisms of intraspecific signaling. It foreshad-
ows the abstract, abbreviated quality of symbolic configurations, their compelling
power, and the danger of miscarriage inherent in those mechanisms. Both lines of
inquiry contribute to the understanding of the prehuman roots of the essentially human
capacity of symbolization.
 CHAPTER 15

Art Therapy and the

Seductive Environment
Katherine Williams, Edith Kramer,
1
David Henley and Lani Gerity

The seductive environment – by Katherine Williams

For several years when my daughters were small, they would disappear
upstairs to the attic for hours at a time to enter ‘Popperville,’ an evolving
world of their own creation. Several neighborhood children and the
characters they created also inhabited this town, which was built out of
wooden blocks, cardboard boxes, shelves supported by bricks and construc-
tions of their own making, and was peopled with figures of all sorts. Interest-
ingly, as it grew, and the need for organization and governance became
apparent, it was presided over by two female mayors. As the inhabitants of
the town matured and new citizens moved in, a school was created, and tiny
books were made out of scraps of paper sewn together, complete with illus-
trated text. Initially the barter system prevailed, but as merchandising grew, a
currency was established – as I remember it, five lentils equaled a black-eye
pea, and several black-eye peas were worth a kidney bean. Tiny colorful
paper currency was also created. A hospital was established in a corner under
the eaves when the town doctor and nurse could no longer handle
Popperville’s medical needs. Eventually, the children grew, went to a school
out of the neighborhood and got home too late to play, so Popperville was
packed away.
Recently I came across some of the remnants – the little books, infini-
tesimal letters written between citizens who maintained a correspondence, a
few cardboard structures, some paintings that had hung on the walls, and a

201
202 ART AS THERAPY

smattering of the little inhabitants of the town. I thought I would set up a

mini-version of the town to have ready when my friends’ children visited, but
soon discovered that, even though my children are not yet 30 years old, their
childhood was several generations ago in terms of general interest and focus
of today’s youth. Granted, a makeshift town created by a middle-aged
woman without the freshness of involvement of its true creators does lose
something in the translation. But when these modern-day children contem-
plated this little world, they were not tempted to enter into it, make a mark on
it or engage in its development. They were not lured by the art supplies and
blocks and boxes placed there to entice them to continue the civic expansion
or even the diminishment of this little world. They asked for computer
games, which I do not have, or at the very least, a movie to watch.
My friend Carol recently took The Journey Course, a program for working
with adolescents, with David Oldfield, Director of the Midway Center for
Creative Imagination in Washington, D.C. When he was first developing his
course, Oldfield routinely made presentations to my Adolescent Art Therapy
class. The design of Oldfield’s course is based on the Jungian theme of the
journey – it involves guided imagery, artwork and storytelling. Some of the
goals are to provide an opportunity for the adolescents to see they are on
their own journey, the trajectory of which they can influence.
When Carol was describing her experience in this course, she mentioned
that she had been bothered by what she felt was Oldfield’s cluttering of the
guided imagery with suggestions, such as, ‘Now you have come to a vast field
beyond the forest, and as you walk out into the light, you see someone
coming toward you in the distance. Who could it be? It could be a long lost
friend, it could be the dark figure you saw in the forest, it could be…’ This
surprised me, since years ago, I had been impressed by his ability to give just
minimal structure to the journey, allowing the participant’s imagination to
prevail. When Carol asked him about this, he replied that he had been driven
to offer more options because today’s adolescents do not seem to trust their
capacity to generate original ideas; rather, they have been trained by video
games to expect alternatives to be presented to them which they may then act
upon.
I belong to a peer supervision group of psychologists who work primarily
with children and adolescents. In most cases, the parents of these children are
well-educated and fairly affluent and their children attend excellent public
schools. These parents, however, have grown up with the television as ersatz
parent, have established relationships with the television entertainer who,
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 203

unable to have a real relationship with them, must seduce the children in
order to keep them watching.
Now these children have become the parents we work with. Many seem
not to know how to have a relationship with their children that isn’t based on
procuring new goods or attempting to alleviate stress and surmount obstacles
with synthetic solutions. They don’t trust that just being themselves and
being present would be a gift to their children – they themselves are often
empty, afraid to set limits, and struggle with their children to work out
solutions. They have grown up with the remote control in their hands so they
can switch to another channel when something is boring or difficult. These
parents seemingly do not believe that they could possess the solutions within
themselves or that the process of struggling with oneself or one’s child or
with a problem in the environment might be growth-producing in itself.
I mention the children of some of my friends and the parents and children
from the suburban area in which my colleagues practice because I think it is
important to note that emptiness prevails in these surroundings. The envi-
ronment is not seductive only for poor children living in the inner city where
they are virtually on their own – where ten-year-olds carry guns and grasp at
the immediate gratification of expensive shoes, where death is everywhere
and where research has shown that most children actually meet the clinical
criteria for post-traumatic stress disorder (Garbarino, Kostelny and Dubrow
1991). This, of course, renders these children especially sensitive to the
heightened seductions of the contemporary environment, but we must
remember that all of our lives and the lives of our children are unfolding in a
world where our physical and psychological survival is at stake and we are all,
in our own way, subject to the lure of the bright environment, replete with
supernormal objects.

2
Edith Kramer
When I was invited to participate in a symposium on children and
technology, I questioned whether I had anything to contribute, having
worked with children before the advent of computers and video games. Yet,
looking back at my observations between 1950 and 1975, I find that an
ominous development was then already in process. Even at that time, children
– rich and poor – were brought up, amused and comforted, largely by paid
help who resided in a box. They had in this television entertainer an
ever-available slave who could be called and dismissed at will. Unable to
establish any personal relationship to the children they served, these enter-
204 ART AS THERAPY

tainers had to rely on persuasion and seduction. The demand for continuous
entertainment meant that no structured stories could be presented. Instead,
an endless sauce of action, violence and practical jokes was offered. Good
guys and bad guys were nearly indistinguishable. Television’s heroes were, in
the main, mindless brutes endowed with magical tricks and powers that
made them winners. Ego-ideals generated via television lowered, rather than
heightened, the quality of children’s aspirations. Even at this time, years of
relying on television as a substitute for human relationships had left an
imprint on children’s personalities. Ever-present access to escape diminished
the impetus for finding solutions to their difficulties. Rather than becoming
neurotic under strain, these children were apt to develop amorphous
dependent personalities that lacked inner resources. Addicted to synthetic
gratification, they seemed to be both deprived and spoiled, capricious,
convinced that they could get something for nothing. Working with them,
we had to prove not only that we were not monsters and brutes, but also that
we were not lying salesmen. Thus, wherever I worked, television’s insidious
influence would be felt in many ways in children’s personalities. The
television screen itself offered no serious competition for children’s
attention. Whenever I came bearing art materials, television remained second
best. In general, children preferred activity and adventure to passive con-
sumption.
The advent of computers and video games seems to have altered the
balance and brought about a fundamental change in children’s behavior. Like
the young of all higher species, children are innately curious, playful, craving
playmates, endowed with inexhaustible energies, eager for life. One cannot
dig a hole, erect any structure, do anything accessible to children without
them crowding around, watching avidly, eager to help, to get into the act. To
channel children’s energies without destroying their vitality has always been
an endless task for the adult world. To help children calm down, to wait, to
go to sleep, we told stories that were attuned to children’s thirst for adventure,
to their magical thinking, their unbridled fantasies. Fairy tales, imaginative
stories, tales of adventure served to give structure to children’s inner world so
that protean fantasies became imagination.
Adults bearing art materials were welcome. At best, play, art, academic
learning and gradual participation in adult work complemented one another
in the process of maturation. But all this required a certain amount of adult
supervision and participation. Today’s adults have an easier time. Video
games are keeping children still, occupied, out of trouble even better than
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 205

television. What are the seductive powers of these games that they can
override children’s innate appetites for action, adventure, companionship of
peers, and put out of commission their inexhaustible energies?
The phenomenon of seduction and addiction seems to be older than
mankind. An excursion into the natural history of behavior might help us
understand what is happening to our children. We find in the behavior of all
species capable of voluntary action and motion two diametrically opposite
modes of responding to the environment. On the one hand, there is the
capacity to perceive and recognize territories and pathways and, in the case
of socially living species, of other individuals.
The opposite holds true for the perception of categories that are essential
for the survival of the individual or the species, such as food, enemy, potential
mate, climatic conditions and the like. Recognition is parsimoniously
organized, directed to those properties that reliably define the category. The
animal must be able to recognize the things it must respond to, such as food
or enemy, within the large, often confusing environment. For example, a
worm does not sport a red dot so that the bird can more easily find it. Nor
does the owl send out signals to warn the mouse of its approach. Only certain
dangerous beings carry warning signals. The rattlesnake rattles: ‘Don’t mess
with me. I am deadly’, and the wasp signals its painful sting in black and
yellow.
To discern salient characteristics within the environment is arduous work.
Thus, along with the capacity to perform such work, arises the appetite for
configurations that are easily and clearly recognizable, as well as an incli-
nation to respond eagerly to such clarity. As a rule, the clearer the configu-
ration, the quicker and more eager the response.
Naturalists capitalize on this phenomenon when they investigate the
innate reaction mechanisms of various species. Dummies, so called ‘super-
normal objects,’ are built to exaggerate various features for which reaction
mechanisms may exist. Such experiments usually leave the animal unharmed.
Decoys constructed on the same principle are produced in order to facilitate
hunting. Just because its shape is simplified, a decoy duck attracts ducks more
effectively than a live one.
Within the natural environment, certain kinds of parasitism have evolved
on the same principle, perfecting what amounts to natural supernormal con-
figurations. The strategy of the parasitic cuckoo bird is a good example. The
feeding behavior of birds is normally stimulated by the fledgling’s gaping
beak. The stranger in the nest, the cuckoo bird, is therefore endowed with an
206 ART AS THERAPY

extraordinarily large and colorful beak. Gaping, the parasite seduces the
parent birds to feed it in preference to their own young (Lorenz 1978).
Lorenz considers feeding cuckoo birds a vice among birds.
As man alters environments, tragedies of a similar nature may inadver-
tently occur. In industrial areas, birds who habitually build nests from twigs
are tempted to use pieces of wire, which are easier to handle than natural
twigs. Lorenz (1978) describes the frantic eagerness of birds who have
become habituated to such super-twigs to seek out these deadly, cold nesting
materials as a kind of vice or addiction. Can we compare the nesting birds’
addiction to the wire as building material in preference to twigs with
children’s attachment to the technology of video games in preference to more
complex forms of play? Endowed with the capacity for conceptual thinking,
humans are not as rigidly programmed as are birds. We are free to invent any
number of social signals, and free to alter or discard them. The coercive
power of social signals is no longer absolute, nor is it reliable. However, it
seems that appetites which evolved before the advent of humans remain sub-
liminally active in us.
It seems to me that video games function in a manner that is comparable
to the appeal of supernormal objects. Games are designed to gratify
children’s normal appetites for competition, for their need to win, their
propensity for violent, boundless fantasies. The figures on the screen have
been designed by professionals, and are endowed with fantastic, improbable
powers invented by adult minds. Manipulating the screen mannequins
requires little energy or courage, yet compared to the improbable feats
enacted on the screen, the child’s own playful actions and inventions appear
negligible, so children become habituated to the screen’s easy gratifications.
However, as children play with these games, many of the functions which
play fulfills within the process of maturation remain inactive. Competing on
the screen, children have no incentive to develop the physical agility, courage
and strength that can help them win an actual fight. Nor do they learn to
form friendships, build alliances, make compromises. They do not learn to
endure disappointments or physical pain. They have no opportunity to test
themselves in innumerable ways within the social and natural environment.
Play, normally an aid to growth, leads to stagnation. The seductive power of
video games is not limited to the urban environment, where harsh and
dangerous streets limit children’s scope for play and adventure. Even in the
country where the outdoors invites, we find children oblivious to its appeal,
glued to their mechanical games.
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 207

Children’s art flourishes best when adults support their natural inclination
for the symbolic living in art. Imaginative play and social play unfolded best
when children were left to themselves. Indeed, children were glad if adults
left them alone to play. Now we can no longer say, ‘Go in the garden and
play’ (even when there is a garden). The children have not learned how to
play with others. They don’t know how to invent activities or find
playthings.
To disentangle children from the fascination of video games, we must not
attempt to compete, for we’ll surely lose. We must offer what technology
cannot: companionship and tangible experiences. Fortunately, most children
prefer the company of benign and imaginative adults to mechanical devices.
Still, it is not easy to deal with children whose expectations of immediate
gratification have made them impatient and distracted. The inclination to cut
short any activity before the first enthusiasm flags permeates even our educa-
tional system. The experience of tapping unexpected resources of energy –
getting ‘a second wind’ – is largely denied to today’s young people.
Children need more companionship and guidance than ever before, yet
there is less and less adult time and attention given to them. In addition, as
Katherine Williams described, many young parents have been conditioned
by the same seductive powers that menace their children. Even when they
sense that something is wrong, they often feel helpless and empty, and are
inclined to try to fill the void with goods. They need themselves to discover
the real world beyond the commercial seductive environment.
Indeed, children gain valuable skills by playing video games, which
prepare them for many aspects of modern life. Parents justly admire their
children’s heightened agility in handling machinery which may help them to
make a living. Thus, we cannot simply discard the games or forbid them. We
can, however, counteract their unreality by offering real experiences. To raise
a bird, puppy, or kitten teaches more about animal life than watching even the
most excellent films about exotic wildlife. Such secondhand information
becomes more real when it is paired with tangible experiences with animals,
so that information can become knowledge.
Physical experiences in the arts constitute another counterbalance against
seductive technology. A new kind of reality is born when hands and minds
work as one, when experience is given form in paint, wood, clay, stone…
when the materials resist, obey, declare their own laws. Computer art fails to
generate such a flow between body and mind. When we attempt to lure
children away from video games by engaging them in making com-
208 ART AS THERAPY

puter-generated pictures by manipulating a mouse, we have not left the

realms of technology. Hand and mind remain divorced.
I suggest that art therapists may be able to help children as well as their
young parents to transcend the seduction of technology by introducing them
to tangible art materials. They can work with paper or with stone, use a
hammer and chisel or a quill pen. The tension between the freedom inherent
in art-making and the unforgiving qualities of art materials and tools holds a
fascination of its own.
Birds confronted with metal super-twigs cannot learn to resist their
deadly appeal, but as human beings we can offer enough warmth and under-
standing to help our children withstand the lure of seductive technology.

Rebelling against the future – by David Henley

Seduction in the environment need not take the form of malevolent manipu-
lation or exploitation. Male birds, for example, flash colorful plumage or
perform dances which are meant to attract a mate or intimidate a rival.
Similarly, male humans may be aroused by the painted luminescence of full,
parted female lips which to Morris (1967) mimic the swollen vagina of a
female. Even the most basic of forms can assume irresistible proportions (or in
ethnological terms, supernormal proportion) such as the circular aureole of
the mother’s breast, which, for the hungry or cold infant, ensures life-giving
sustenance.
For the adult male, the female’s display of breasts and nipples through
revealing attire offers the promise of sexual fulfillment as well as the potential
for comfort and nurturance. In each scenario, the attraction, whether based
upon brilliant color or fullness of form, somehow contributes to our capacity
to survive. As such, visual or other sensory triggers are essentially amoral
forces which have shaped the natural world for eons. Their propensity to
generate intense responses has perhaps enabled us to diverge from purely
survival aims and evolve into ‘homo aestheticus,’ the creative beings that we
are (Dissanayake 1992).
Imagery, in its purest form, is viewed as a reflection of natural evolution
that remains universally rooted, regardless of cultural expectations or norms.
However, in this discussion, the culture of technology is identified as another,
more virulent force which has supplanted natural selection as an agent of
change. I propose that in contemporary culture, enticement and seduction of
media have been co-opted to serve the uncontrollable forces driving society,
such as corporate advertising in the West, or the use of propaganda in
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 209

Communist countries. Each has twisted technology and media beyond the
balance of nature, virtue or taste, thus bringing about a decline in cultural
values that now pervades almost all developed countries. I am most
concerned with how these distorted values have affected children, particu-
larly those with emotional, cognitive, or perceptual disabilities, who are most
susceptible to the manipulations of the media. For our culture of technology
and media has succeeded in confusing fantasy and reality as never before.
Hence, many of the problems presented by my child clients in art therapy are
exacerbated by what I consider to be the dehumanizing, isolating effects of
technology and media, and have proven difficult to surmount in therapy.
In preparing this essay, I could find no greater contrast to my example of
the infant seeking the nurturance of the breast, than a maternally deprived,
emotionally disturbed 13-year-old boy who created a drawing based on a
computer game involving simple little pie shapes moving over over the
screen, gobbling everything they could. This boy’s drawing had three beau-
tifully drafted disembodied heads caught in freeze-frame, the largest about
to attack and engulf a single full figured man. It is perhaps a fitting metaphor
for a child trying to survive in the ghettos of Chicago amidst the harsh
realities of absentee or abusive parents, dangerous peers, and drug- and ver-
min-infested housing. Video games offer a cyber-sanctuary where one can
magically survive through feats of clever, nimble trickery. The drawing
perhaps provided the child with an insulated moment where the neglect and
abuse of his daily life could give way to vicarious pleasures. Here he could
bite and consume others without consequence, perhaps displacing his unful-
filled maternal (including oral) needs on to the exercising of control over
animated games. To fathom the devastating emptiness of such games, we
might compare the devouring ‘nothing-but-mouth’ images which cannot
even digest what they swallow with the fairy tale of Hansel and Gretel which
also deals with orality – fear of starvation as well as of devouring greed. The
tale includes the impetus for maturation which brings the children home,
laden with treasures (Bettleheim 1977).
One need not look far for other instances where the need for attachment
to and relationship with others has been replaced or skewed by media and
technology. A generation ago, clinicians specializing in children, such as
Bettleheim (1977) and Lowenfeld (1982), decried the use of illustrations
conceived of and drawn by adults in children’s story books, asserting that
they intrude upon the young reader’s delicate imaginations. Both would be
aghast to know that today, imagination is no longer even necessary. Every
210 ART AS THERAPY

conceivable fantasy, from dinosaurs to superhero villains, has been perfected

through extraordinary advances in computer animation.
In my current practice, which is limited to children of latency age, the
foremost presenting problem revolves around the atrophy of imagination.
Just as David Oldfield describes in his guided imagery work, the capacity to
invent original scenarios and visualize and imagine specific characters all
seem beyond the ability of these children. Instead, stereotypes from media
and technology often overwhelm those children who are most vulnerable to
confusing reality with fantasy, such as those with mental retardation,
psychosis or autism.
For instance, the ubiquitous renderings of Freddie Kreuger and Jason, the
psychopathic killers of countless shock films, offer the exhilaration of experi-
encing sadistic horror while providing opportunities for desensitization and
mastery through repetition. As in fairy tales, these villains offer children a
means to ward off their inner fears by projecting them into outer world
experience. Fears also are defended by identification with these aggressors,
which might explain why, in art therapy, children often obsessively evoke
these characters. However, in contrast to the fairy or cautionary tales that
convey the moral of achieving one’s goal through wit, ingenuity, courage and
compassion, commercial media readily succumbs to gratuitous or sensational
violence.
My fears for these children echo those of Kramer (1992), who warns that
the lure of easy entertainment and technological novelty may replace
vigorous activity to the extent that any capacity to relate to others may be
reduced to purely electronic means. I have encountered this in my current
practice with children suffering from attention deficits, where most treatment
goals focus upon restoring the children’s lost ability actually to engage in
fruitful, imaginative play. They seem to lack the ability to read facial or body
language of both peers and adults, making social interaction stressful and
ineffective. Their own affects seem inappropriate as they strain to make
themselves understood.
For example, a child with Attention Deficit Disorder, in depicting himself
entertaining a friend during a play-date, drew only a solitary computer game
player, his back to the audience. When asked where his friend was in the
composition, the child replied that the friend was looking over his shoulder
watching him play the game and thus could not be seen.
Children with more debilitating pathologies react with even greater
distortion and confusion. A disturbed child with schizoid features, who also
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 211

found relating too upsetting a proposition, withdrew completely into a

cyber-sex fantasy. He drew a picture which married computer technology to
sexual gratification, much as Woody Allen did with his ‘Orgasmatron’ in the
1973 film Sleeper. Hardly a sexually mature lover, the boy in the drawing
appeared powerless and infantile in the face of a bizarre array of technology,
sex and relationships. According to the artist’s ‘program,’ it was unnecessary
for him or his partner even to have eye contact, let alone physical intimacy. As
he commented, one need only be ‘on-line’ to achieve orgasm, which he con-
ceptualized most concretely, given his depiction of her ‘getting her rocks off ’
which looked as though she was jumping on a little pile of rocks and all this
through the manipulation of the computer software. Feeling was supplanted
by software as well. The moderator in the computer was depicted as an arch
villain who offered the audience an opportunity for ‘interactive’ partici-
pation, allowing them to effect changes in the intensity of the virtual orgasm
by punching the proper keys (Henley 1993).
When Joseph Campbell was asked to define the myth of contemporary
culture, he lamented that it could only be technology. Indeed, the latter case
seems to be yet another contemporary version of Hansel and Gretel, with the
archetypal villain now an artificial intelligence which has achieved
self-awareness.
As this myth continues to reinvent itself, art therapists must stand ready to
engage in the metaphor if we are to be therapeutically effective. Hence, when
a child with autism who is repelled by human contact is able to endure
watching people interact on video, this medium can be further employed to
help this child become better able to handle social situations. Within months
of participating in this ‘video therapy,’ a child client of mine began to
introduce human figure elements into his drawings, which had previously
been limited to mechanical objects, although not as sentient beings but as
figments of electronic media. Here technology enabled the child to become
accustomed to social behavior, providing the necessary desensitization that
led him beyond his autistic orbit (Henley 1991).

Conclusion
The tone of my commentary on the effects of media and technology has been
admittedly pessimistic. However, it should be emphasized that the
phenomena I have presented constitute symptoms of a wider, more profound
decline in a culture which prizes technology – malleable, amoral, supposedly
controllable forces – and if used wisely, may be capable of making powerful
212 ART AS THERAPY

medicine. My pessimism stems from an observation that our fixation on

advancing technology has outpaced our ability to improve the humanitarian
aspects of life. I find it hard to believe that technology has enhanced the
emotional adjustment of children under my care, or whether easy access to
information contributes to their capacity for meaningful interactions.
Despite instances where computers have assisted in communication between
individuals, I believe that the costs outweigh the benefits. Kirkpatrick Sale
(1995) perhaps best sums up these concerns:
Beware of the technological juggernaut, reckon the terrible costs,
understand the worlds being lost in the world being gained, reflect on
the price of the machine and its systems on your life, pay attention to the
natural world and its increasing destruction, resist the seductive catas-
trophe of industrialism. (p.197)

Lani Gerity
Even before Edith Kramer asked me to participate in this discussion, I was
puzzled by what appeared to be a trend I was seeing in the artwork of
children – quickly drawn faceless creatures armed with weaponry of all
kinds, from Teenage Mutant Ninja Turtles doing martial arts in sewers to the
escapades of humanoid creatures called Power Rangers. There is an over-use
of one color, usually a magic marker, in these drawings. Because there is so
little investment, changing colors seems unnecessary and using paint too
labor intensive. How did this come to be?
Jack, a 38-year-old agoraphobic that I saw in a large mental health clinic
in New York, was raised by a single working mother who was described as
volatile, seductive and unpredictable. As a child, television was a much more
stable and predictable source of comfort for Jack, and as an adult it continued
to be more stable and predictable than his environment, the lower east side of
New York City. What was so compelling in this relationship that, on his very
limited public assistance income, he bought a television set for every room in
his apartment as well as a hand-held model to use outside his home? His
artwork held some clues. In one of his rather typical drawings, we see
confusion between interior and exterior: a Christmas tree, a television set, a
bleeding hand trying to change the channel, all appear to be outside an
apartment building. He placed a window in the wall of the building, curtains
in the window, and a person half hidden between the window and the
curtains. In front of the Christmas tree sat a pyramid structure that seemed to
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 213

represent both the pyramid on the dollar bill and the CBS network logo.
Most of the space, however, was filled with diagonal lines he described as
‘radio waves’ which conveyed a frightening emptiness. In another picture he
simply drew a bolt of lightning setting fire to the ground. The scene was
contained by a black frame with rounded corners giving it the appearance of
a television screen.
In Jack’s work the influence of television was obvious: extreme, almost
hyperactive flooding of imagery in the corner of one picture, contrasted with
the near-emptiness (almost a depiction of an alpha brain wave state) of the
rest of the picture. In the lighting bolt picture the lightning bolt and fire
provided a hyperactive flooding while much of the paper also left with alpha
brain wave emptiness inside the black television like frame. These drawings
spoke to me of the influences of television on the mind, but Jack had other
influences as well, memories of a different sort.
There were calmer times in Jack’s life when his mother would read fairy
tales and Bible stories to him. And there were memories of summers spent at
YMCA camp where he learned to respect the wild places in both humans and
nature. Whenever he was able to recall these stories and memories, Jack’s art
became more coherent, softer, as when he helped make large backdrops for
the puppetry group (our center’s version of ‘Popperville’). Puppetry
stimulated interaction between the patients, a sense of history, continuity, and
helped Jack to return to real life.
Pearce’s (1977) research gives us some explanation as to the differences
we see in Jack’s work. He suggests that the neo-cortex is not yet being used to
its full potential, that we are not at the goal or end of our evolution. He inves-
tigated the human infant and what was needed fully to develop its
neo-cortex. He followed this evolution from the primitive reptilian brain, to
the addition of the limbic system or old mammalian brain, to the final
addition of the neo-cortex, built and dependent upon the previous two parts.
What do children need to enhance the development of the neo-cortex?
Pearce (1977, 1992) suggested that children need storytellers – the verbal
stimulation for which they provide the imagery. Image-making involves all
aspects of the brain, from the most primitive to the most developed. Today, it
seems that just when children need the stimulus that storytellers provide,
they are instead watching television, which provides verbal stimulus but also
imagery. This feeds the infant or child with a single paired effect, flooding
the brain with a counterfeit of the response to the stimuli. The result is a loss
of structural coupling between mind and environment. Few metaphoric
214 ART AS THERAPY

images or symbolic structures develop, few higher cortical areas of the brain
are called into play. So it’s not that children are reluctant to draw because
they are afraid the work will not be as good as images they see on television,
it is that children have not had opportunities to develop inner imagery. There
will be little metaphoric ability to transfer symbols to the neo-cortex for con-
ceptualization and subsequently, no development of the neo-cortex’s main
purpose, to generate symbolic conceptual systems.
The greatest danger inherent in having paired stimulus and response
provided for the brain is the brain’s habituation. Habituation is the natural
condition of the two more primitive parts of the brain, the reptilian and
limbic systems, with their hard-wired response to concrete information and
supernormal objects. Unable to adapt to novelty, these primitive systems
avoid it. It’s the neo-cortex that seeks novelty. A new story told to a child
locks all three systems to establish a flow of imagery matching new stimulus.
Repetition stabilizes innovative action. Each new story engages all three
parts of the brain, continually enlarging the number of neural fields involved
in new image patterns.
Television, however, as a source of both image and sound, can be assimi-
lated by a single set of neural fields. The same neural fields that initially
worked out the paired stimuli can assimilate all further stimuli of a like order.
We habituate to television within a few minutes of viewing, because a
response is not required. So the 6000 hours of television the average child in
the US sees by the age of five might as well have been the same program for
all the stimulation it provides the neo-cortex. Habituation pacifies the brain,
puts it to sleep, because the stimulus demands no output of energy, while it
occupies the mind so that no other stimuli are needed or sought. Once the
most primitive part of the brain can handle stimuli, it doesn’t need to carry
signals any higher. The rapid turnover of imagery and apparent novelty of
programming fools the novelty-seeking neo-cortex. Thus we have difficulty
turning away even when we might not like the program.
A woman acquaintance of mine sadly told me of her attempts to entice her
nephews into canoeing or hiking while on a family camping trip. The
children’s father, who did not trust in the ability of the wilds to interest his
sons, had brought along $100 worth of quarters and the boys spent the
family vacation in a video arcade. They said canoeing and hiking would be
boring. It seems that the boys were using their limbic and reptilian systems.
Their neo-cortexes may have been so underdeveloped that they were
frightened by the idea of exposure to other sources of stimulation.
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 215

Tragically, a failure to develop imagery leads to a lack of imagination

which leaves most of the brain unemployed. Children so deprived can sense
only what is immediately bombarding their physical system and are restless
and ill-at-ease without such bombardment. Children who cannot imagine
cannot learn, and they lack hope. Because they cannot imagine an alternative
when direct sensory information is threatening or unpleasant, they are often
defensive, feeling victimized by the environment. Imagination provides
resiliency, flexibility, endurance, and the capacity to forego immediate gratifi-
cation in the service of long-term strategies.
According to Pearce (1977, 1992), children’s programming typically
contains 16 acts of violence per hour, stimulating a fight-or-flight response
which is then repressed. When the television is turned off, this repressed
energy bursts forth in disorganized, frantic behavior associated with anxiety
and hyperactivity. Often the only way to stop these behaviors is to turn the
set back on. Children learn that television can alter their mood, much like a
drug, precluding their need to understand their feelings and thus acquire
self-knowledge. They begin to believe that they cannot tolerate life without
these props. Ordinary life with its mundane feelings and thoughts may be
confusing to the underdeveloped neo-cortex and it may also be too slow for
those habituated to the cycle of anxiety and empty reptilian brain activity
that television provides.
In The Age of Missing Information, McKibben (1992) described a fasci-
nating experiment that compared information from television with infor-
mation from nature. He videotaped 24 hours of programming on 100
channels. He summarized the information he gleaned from these hours of
television as a very simple concept: You are the most wonderful person on
this planet and you deserve to have as much of whatever they are selling as
you can get. Self-esteem is being tied into consumption.
But meeting non-material needs, like those associated with self-esteem,
with material goods is bound to leave the individual feeling less than
satisfied. You need more, the television says. I suspect on a subliminal level
the unconscious might be thinking: The television is flattering me, it’s not
telling me the truth, therefore the idea that I am a wonderful person must be
false. Thus, television is taking on the role of the withholding mother,
promising to make the child feel better, promising to boost the viewer’s
self-esteem, but failing to fulfill the promise.
McKibben’s experiences in nature were more complex. He said he could
feel a realistic view of our place in the universe, that although we are small,
216 ART AS THERAPY

we are a part of something quite beautiful – even elegant. He noticed that

natural systems are cyclical and beautifully interdependent. There is no
concept of waste. When an organism is at the end of its life cycle, it becomes
food for something else. Thus everything in the wild setting is connected.
This brings us back to Jack’s art. This addicted man was able to transcend
his addiction to empty, repetitive reptilian brain activity and was capable of
using his neo-cortex to depict complexity in life when he recalled times that
his mother read to him or summers spent at camp. These pictures give me
hope, and we should be providing children with as many such opportunities
as possible. McKibben mentioned while on a book tour with The Age of
Missing Information that he had taken some local children camping in their
own Adirondack mountains. These children have lived their whole lives in an
area of the US that is designated by law as ‘forever wild.’ They sat up late into
the night to watch the stars move in the sky and were awestruck. They had
never seen stars that way before. Their experience had been confined to their
homes, cars, television, school and the fast food restaurants of Old Forge.
The aunt’s failed efforts to entice her nephews away from the video
arcade in favor of hiking and canoeing illustrated a two-fold tragedy. On the
one hand there is the mental impoverishment brought on by the children’s
video game addiction, and, on the other, the father’s distrust in his capacity to
generate a sense of adventure and family unity.
This brings us back to Katherine Williams’ observations. Parents of the
children in our care have themselves grown up in the seductive environment.
The advent of more sophisticated technology has increased the power of the
seduction, but the phenomenon is not new. The parents have been seduced as
their children are now being seduced.
Paul Klee’s advice to art teachers is valid also for art therapists: ‘Lead your
students to Nature, into Nature! Let them learn by experience how a bud is
formed, how a tree grows, how a butterfly opens its wings, so that they will
become as rich, as variable, as capricious as Nature herself.’ (Haftmann 1967,
p.113)

References
Bettleheim, B. (1977) The Uses of Enchantment. New York: Random House.
 ART THERAPY AND THE SEDUCTIVE ENVIRONMENT 217

Dissanayake, E. (1992) Homo Aestheticus. Seattle, WA: University of Washington Press.

Gabarino, J., Kostelny, K. and Dubrow, N. (1991) ‘What children can tell us about living
in danger.’ American Psychologist 46, 4, 376–383.
Haftmann, W. (1967) The Mind and Work of Paul Klee. London: Faber.
Henley, D. (1991) ‘Therapeutic and aesthetic applications of video with the developmen-
tally disabled.’ The Arts in Psychotherapy 18, 5, 441–447.
Henley, D. (1993) ‘Art of annihilation: Early onset schizophrenia and related disorders of
childhood.’ American Journal of Art Therapy 32, 99–107.
Kramer, E. (1971) Art as Therapy with Children. New York: Schocken Books.
Kramer, E. (1992) ‘Reflections on the evolution of human perception: Implications for
the understanding of the visual arts and of the visual products in art therapy.’ American
Journal of Art Therapy 30, 126–142.
Kramer, E. and Wilson, L. (1979) Childhood and Art Therapy: Notes on Theory and Applica-
tion. New York: Schoken Books.
Lorenz, K. (1978) Vergleichende Verhaltensforschung. [Research on Comparative Behavior.]
Wien: Springer Verlag.
Lowenfeld, V. (1982) The Lowenfeld Lectures. University Park, PA: Pennsylvania State Uni-
versity Press.
McKibben, B. (1992) The Age of Missing Information. New York: Random House.
Morris, D. (1967) The Naked Ape. New York: McGraw Hill.
Pearce, J.C. (1977) Magical Child. New York: Penguin Books.
Pearce, J.C. (1992) Evolution’s End. New York: Harper Collins.
Sale, K. (1995) Rebels Against the Future: Lessons for the Computer Age. Reading, PA: Addi-
son-Wesley Publications.

Further Reading
Montessori, M. (1979) Spontaneous Activities in Education. New York: Schocken Books.
Tinbergen, N. (1983) Autistic Children: New Hope for a Cure. London: Allen and Unwin.

Notes
1 A version of this chapter was first published by the American Journal of Art Therapy 35,
May 1997.
2 Some of these ideas first appeared in the Preface to the second edition of my book
Childhood and Art Therapy (Kramer and Wilson 1979).
 CHAPTER 16

The Etiology
of Human Aggression1

In this chapter I will investigate the consequences of the absence of any

instinctively anchored inhibitions against killing one’s own kind in our
species.
A true story was published in the New Yorker in March 1997. In Chechnya,
six Red Cross workers who were tending the sick in a hospital were murdered
in their beds by a group of masked men. In response to this outrage a message
from Red Cross headquarters contained this passage: ‘All our endeavor is
based on the belief that, even in war, man retains a fundamental minimum of
humanity… Without it, we would have to admit that nothing distinguishes
man from beast.’ It is remarkable how ineradicable is the idea that animals are
driven by beastly, murderous impulses against their own kind; that hostility
must result in killing the opponent. Even Ernest Seton Thompson, an
extraordinarily observant early naturalist, imagined that a leading wolf
would kill a disobedient member of his pack (see the story of ‘Lobo’,
Thompson 1898). Thompson observed correctly that male wolves cannot
attack or discipline a female (this was Lobo’s downfall). He did not realize
that Lobo the leader would have severely disciplined a male, but would have
stopped short of killing him.
It is only since Konrad Lorenz’s seminal book On Aggression (1966) was
published that it became widely known (but evidently not at Red Cross
headquarters) that any socially living species endowed with deadly hunting
gear must possess reliable inhibitions to use claws, fangs, beaks, as weapons
in any dispute with a member of his own kind. Any species lacking in such
inhibitions would soon be extinct. (We seem to be an exception to this rule, as
we create world wars, holocausts and other atrocities with no sign of
extinction – so far.)

218
 THE ETIOLOGY OF HUMAN AGGRESSION 219

We must remember that territorial conflicts are not aimed at permanently

incapacitating the loser, but at rendering him non-breeding for the season, or
causing him to seek a distant territory so as to prevent overpopulation. No
species can afford to castrate its males. It suffices temporarily to discourage
them.
Defenseless species who do not hunt and whose survival depends on
flight need not evolve any inhibition to kill their own kind, so that carnage
results when flight is impossible. For instance when deer are kept in too close
confinement, males may use their antlers to kill.
Biologically, mankind belongs to the defenseless beings. Konrad Lorenz
saw our dilemma in the combination of physical defenselessness and the
invention of artificial weaponry for which we are instinctively unprepared.
According to him, mankind’s fall occurred when the first humanoid picked
up a stone and aimed it at an adversary.
Since Lorenz published On Aggression in 1966, we have learnt from Jane
Goodall’s (1986, 1990) observations that the capacity for insightful cooper-
ation suffices to equip primates in their raiding parties and murderous
warfare. Bare hands, teeth and cooperation are all chimpanzees use to do
damage. They use stones to crack shells, or they hurl them in display but they
do not insightfully use any object as a material weapon. Though their main
food is vegetarian, they enrich their diet by cooperative hunting. This
prepares them for warfare. Goodall’s observations concerned a group of
chimpanzees that lived peacefully together, until it split into two groups and
the newly established groups engaged in territorial warfare. During this time
individuals who had known one another and had even formed friendships
unhesitatingly killed each other. An event one of Goodall’s students (1986)
observed is reminiscent of situations in former Yugoslavia: a male
chimpanzee encountered a female of the hostile group carrying her infant.
Unable to escape with the burden she attempted to pacify the male twice by
submissively touching his thigh. The male took a handful of leaves and
wiped the spot she had touched and attacked her murderously. He seemed,
with this gesture, to have made her into an ‘Unperson,’ to use an Orwellian
term. The female and her infant died of their injuries. Because chimpanzees
lack any quickly effective physical weapons, warfare is cruel. The loser is
bitten, stomped upon, and slowly dies of multiple injuries. Goodall observes
that even though killings are painful, chimpanzees seem to lack the imagi-
nation necessary to take sadistic pleasure in their adversaries’ suffering.
220 ART AS THERAPY

Evidence of man’s extraordinary sadism is overwhelming. However we

must also see the other side of the coin: imagination does not only make us
sadistic, it also enables us to feel empathy and compassion even with indi-
viduals whom we do not personally know.
To return to the Red Cross, it is a conservative society founded in 1863.
The Red Cross does not aim to abolish wars. It modestly attempts to uphold
certain codes of conduct in warfare that seem to be among the oldest artefacts
of human morality. Whenever warfare was honorably conducted, warriors
distinguished between combatants and non-combatants, moral and immoral
weaponry, civilized and barbarous usage of prisoners and the wounded.
Whenever wars were fought, these codes were repeatedly broken, and yet
attempts to uphold and restore them were made again and again. It is inter-
esting that codes of honor seem to be respected more reliably whenever com-
petitors are equipped with similar weaponry, so that a balance of power exists
that is reminiscent of the balance between competing members of a species
where weapons are parts of their bodies. Medieval knights were chivalrous
both in tournaments and in combat. They were like tanks: only highly skilled
experts could fashion their armor, and assemble and disassemble it. Chivalry,
however, pertained only to fellow knights. Peasants were slaughtered
without compunction and so were infidels. Chivalry died with the invention
of guns that pierced their armor.
When the US was in sole possession of the atom bomb, it was used. Since
several powers possess it, all parties refrain from using it. While self-
preservation is the main reason for this, I can imagine that more ancient
instinctual powers are also at work, upholding restraint.
To conclude, attempts at civilizing warfare are made repeatedly, but they
break down. Can art contribute anything at all to upholding social responsi-
bility anywhere, in war or peace? I want to present one area wherein art seems
indeed able to help tame irresponsible human destructiveness.
Voluntary recall, which seems only to occur to a limited extent in the
mental life of other species, has brought about the existence of extravagant
mental scenarios in humans, so extravagant indeed that most of them must
remain unconscious, if we are to survive. This mental world constitutes a
realm wherein neither the irreversible passages of time, nor the laws of cause
and effect or the finality of death prevails. Instead there exists a cauldron of
protean imagery, buffeted by raw passions of desire and fear. In psychoana-
lytic terms we speak of primary process functioning. Evidently this kind of
irrational, mad thinking constitutes a deadly danger to the individual and to
 THE ETIOLOGY OF HUMAN AGGRESSION 221

society. Nevertheless, this cauldron remains the source of all mental energy,
of creativity, and also of conceptual thinking. We cannot refute it. We must
tame it, transform it, use it constructively. In this precarious situation the arts
constitute a realm wherein protean fantasizing is stabilized so that it becomes
imagination. This intermediate area constitutes a kind of sanctuary, exempt
of the severity of the reality principle. Equivalents are created that have the
power to evoke genuine experiences without stimulating the impetus for
acting in the real world. In this manner the range of possible experiences is
greatly broadened. Material that would otherwise have to be rigorously
repressed is transformed into a source of energy and of pleasure.
If we were to judge an age or culture by its art, the age or culture would
appear much more benign than it had actually been. This does not mean that
art must be saccharin or moralistic. Indeed the carnage and cruelty embodied
in religions, mythologies, rituals and wars are depicted and even celebrated
in the art of mankind. However from Picasso’s Guernica, to Christ’s Passion,
to the defeat of the Amazons depicted in the Greek reliefs, to the slaughter of
bison in the Lascaux Cave, everywhere exquisite formal qualities prevail.
These qualities redeem the cruel events depicted, without diminishing their
tragic quality and their power profoundly to move us. I still remember the
awe and surprise I experienced, when I, still a child, saw Michael Pacher’s
(1435–1498) Flagellation of Christ at the Kunsthistorische Museum in Vienna.
The drops of blood on Christ’s body were spaced carefully and beautifully
painted, creating a kind of design. And yet just because the blood was placed
and painted exquisitely this was not simply a man bloody with whippings.
One profoundly felt the unique suffering of Christ.
As artist and as art therapist I am worried of certain tendencies among
today’s artists. Inasmuch as they concern themselves at all with the world we
live in, they are inclined in their art simply to reflect cruelties and horror in
the raw. They rely on shock effect. But shock soon wears off and must be
topped by more shock, and so on ad infinitum. These artists are inclined to
circumvent the artist’s task to give form, to create symbols that can endure.
This seems to me to come about when art no longer supports religion, but
replaces it. As religion loses power and conviction a profound human need
remains unfulfilled. All religions contain elements of cruelty. These elements
seem both to fulfill our craving for cruelty and for murder and to formalize
and contain these destructive needs. Paired with powerful laws of morality,
religions support social stability by providing structure both for the libidinal
and the aggressive elements within the human psyche. In the search for a
222 ART AS THERAPY

replacement of religion’s stabilizing force art is apt to be made into a kind of

substitute religion and this endangers its quality and compromises art’s
function.
Undoubtedly our society needs deeply anchored beliefs that would have
the power to control the post-industrial juggernaut that threatens to destroy
the earth. Unfortunately the arts do not possess such powers. Art and art
therapy can do no more than help individuals to resist the seductive appeal of
commercialism, to make them responsive to the majesty of the natural world
and therefore more ready to defend it.

References
Goodall, J. (1986) The Chimpanzees of Gombe: Patterns of Behavior. Cambridge: Harvard
University Press.
Goodall, J. (1990) Through a Window. Boston, MA: Houghton Mifflin.
Lorenz, K. (1966) On Aggression. New York: Harcourt, Brace and World.
Thompson, E. S. (1900) ‘Lobo.’ In Wild Animals I Have Known. New York: Charles
Scribner and Sons.

Further Reading
Ignatieff, M. (1997). ‘Unarmed Warriors.’ The New Yorker, March 24, 1997.
Lorenz, K. (1955) ‘Ueber das Toeten von Artgenossen.’ Jahrbuch der Max Planck Ges.

Note
1 This chapter is based on a presentation I gave at the 1997 American Art Therapy Asso-
ciation Annual Conference.
 CHAPTER 17

Inner Satisfaction
and External Success
Edith Kramer, Martha P. Haeseler,
David Henley and Lani Gerity

Edith Kramer
Ideas formulated in Chapter 15 on ‘Art therapy and the seductive environ-
ment’ have motivated its authors to contemplate another aspect of the envi-
ronment: our society’s emphasis on external success to the negligence of the
inner satisfaction that can reward productive work.
My own observations go back to a distant time, when I arrived in the US
as a young refugee from Nazi-dominated Europe. I soon landed a job as shop
teacher at the Little Red School House, a private progressive school in New
York’s Greenwich Village, at that time still the stronghold of the city’s
Bohemia.
Living and working in the village did not constitute much of a culture
shock for me, who had been raised in Vienna’s Bohemeian circles. The
atmosphere was familiar, with one exception. It soon seemed to me that the
two sides of the same coin, the ego-ideal and superego of my acquaintances,
had the power to enforce hard work and moral standards and to punish trans-
gressions with guilt feelings. However, when its demands were indeed
fulfilled the superego omitted to reward the individual with loving approval.
It seemed to me that the inner voice that should have said ‘I am proud of you,
I admire what you are doing, I love you!’ was missing. I had made my obser-
vations in the early 1940s, at the tail-end of the Great Depression. The work
ethic was then still intact. Hard work and determination was expected, but
the satisfaction that would reward the individual for his or her efforts had to

223
224 ART AS THERAPY

come from the outside. Unless some recognition came forth through praise
from persons in authority or via academic honors or financial success, people
seemed to lose confidence in the value of their achievements. The children
and adults I knew at that time were healthy, well-functioning individuals. Yet
they seemed to lack self confidence. I found that I had to be careful venturing
any criticism, not just in dealing with children, but also in exchanges with
colleagues and fellow artists, lest I hurt their feelings. People seemed rather
vulnerable.
The mentors of my youth had been much harsher to me that I could allow
myself to be in dealing with my American contemporaries. They had
expected that we, their disciples, could stand up against criticism. We
rebelled at times, argued back or we searched our souls. We were not inclined
to lose confidence in ourselves or in our work.
When I described these observations to my fellow authors, they assured
me that my descriptions still applied, that nothing had substantially changed
in the intervening 50 years. We asked ourselves what could be the cause of
this lack of balance in the American sense of self. To cast the question in psy-
choanalytic terms: What were the reasons for a prevailing superego structure
that could enforce behavior but failed to reward obedience with loving
approval?
It occurs to me that we may be confronted with the dark side of the
‘American Dream’: myths cast long shadows. Even though this country no
longer welcomes immigrants, even fears them, the myth of unlimited oppor-
tunities still influences the American perception of the world.
The myth originated during times when European immigrants left a
confining situation behind. In the old world many of them had lived in abject
poverty and unrelenting drudgery. Even among better situated individuals,
class and family systems limited expectations. A shoemaker could take pride
in making excellent shoes. A cook could be known for serving exquisite
meals. No shoemaker could dream of owning a string of shoe stores; no cook
of owning a franchise for restaurants exclusively serving her specialty. The
individual who worked well and led a virtuous life could count on only
modest rewards from the world at large. In the main gratification had to
derive from a sense of inner satisfaction, bolstered at best by admiration from
a small circle of family and friends. These conditions fostered a vivid inner
life that harbored a superego that had the power to punish and to give loving
approval.
 INNER SATISFACTION AND EXTERNAL SUCCESS 225

The situation was quite different in the new country. Undreamt-of riches
and honors could indeed be attained. This motivated the newcomer to con-
centrate all physical and mental energies upon the holy grail of worldly
success. In addition the obligation to bring the rest of the family to the US
and to provide for them made it imperative quickly to earn as much money as
possible.
This fostered a character structure that was driven by the unrelenting
struggle for wealth and recognition. The compulsion to try harder reigned
supreme leaving little room for inner satisfaction.
The relationship between immigrant parents and their American-born
offspring was another cause of inner insecurity both for the parents and their
children. As children entered school they usually outstripped their parents’
command of the English language. They were also inclined to adopt cultural
mores and values that contradicted the parents’ moral code as well as their
standards of appropriate behavior.
Consequently the modifications and partial rejection of parental
standards that in the Western world accompanies adolescence tended to
occur much earlier. When the parental sun sets too early, when cultural differ-
ences devalue parental ideals and moral standards, ego-ideals must be found
elsewhere. Of recent origin, without connection to the individual’s
childhood experiences, they remain flimsy and insecure. To live up to them
requires much support and encouragement from outside.
My observations concerned the psychology of immigrants from the
Western world. My colleagues have observed similar perplexities among
today’s Asian immigrants.
They register a change in the motivation that causes people to strive for
external success. Superego demands seem to have lost much of their power.
Instead individuals are driven to exhaust themselves working long hours by
the insatiable need to obtain goods and recognition. Everything has to
happen quickly. The time allotted for any required task is short, too short.
Even in childhood the time allowed for any activity is short. Children, partic-
ularly disturbed ones, are supposed to suffer from ‘short attention span.’
Therefore periods of work or of creative activities should be short. Any task
should be planned so that it can be accomplished within 50 minutes or less.
Educators, indeed our culture as a whole, seem to mistake what Maria
Montessorri (1965) called ‘false fatigue’ for genuine exhaustion.
Montessorri developed her methods working with retarded, handicapped
226 ART AS THERAPY

and economically deprived young children. Just the populations who are
supposed to have a very short attention span.
She describes how children, at the beginning of their day at the nursery
school, are typically inclined enthusiastically to engage in various activities.
Soon their interest seems to flag, they seem at a loss, frustrated, ready to give
up. If the inexperienced teacher should mistake this behavior as a sign that
the children are tired, that they need either a rest or the stimulus of some
communal activity, the group, so Montessori predicts, will remain restless for
the whole day. The teacher ought to tolerate the children’s temporary unrest,
she should help them to persist in their activities. They soon will gain new
energy and complete what they had set out to do. Finally they would be truly
tired and ready for a well-earned rest. Montessori described the
phenomenon of the ‘second wind,’ the unexpected resources of energy that
become available after one overcomes the first feelings of fatigue or distress
and persists in one’s task. This holds true for climbing a mountain as well as
for painting a picture. Indeed all important achievements are attained via the
second wind.
Our culture seems to have forgotten this. Educators and even art therapists
take their bearings from commercial entertainers. As soon as interest for any
subject or project flags, something new is offered. There is little tolerance and
no time for turmoil, helplessness, temporary regression, even though these
moods are unavoidable elements of any productive work. Educators seem to
lack the confidence that living through periods of unrest and frustration will
be rewarded, that unexpected inner resources will emerge, providing energy
for successfully completing the difficult task, probably because they
themselves have never been given time and opportunity to experience the
pleasures of the second wind.
This brings us back to our theme of inner satisfaction versus external
success. It seems to me that inner satisfaction is felt most intensely when a
task has been fulfilled via the second wind. For this experience reassures the
individual of valuable inner resources to be cherished.
We must ask how we as art therapists can provide for such experiences
and conduct sessions in a manner that can generate inner satisfaction. Also
we should ask ourselves what maneuvers we should avoid because they
would diminish the likelihood that inner satisfaction could be felt.
 INNER SATISFACTION AND EXTERNAL SUCCESS 227

Inner satisfaction and psychosis – by Martha P. Haeseler

I will discuss the concept of inner satisfaction in light of my experience
working in a long-term outpatient group program with people diagnosed
with schizophrenia and other major psychiatric illnesses. I am interested in
the importance of the reception of the art piece by others in helping the artist
experience inner satisfaction.
The concept of inner satisfaction implies that we are able to be satisfied,
replete, fed by something that originates from within ourselves, rather than
something that comes from outside ourselves. Many of us can experience
inner satisfaction when we have received, in the formative years, a large
enough dose of the unconditional approval of the original good-enough
mother, who for the rest of our lives can be present to us as a sense of benign
oneness with the world (Winnicott 1971), a sense that our actions and
essence have meaning and value. Given an adequate environment in which to
grow, we can create within ourselves a storehouse of resources upon which
we can rely.
Cultural factors may also play a role in our capacity to develop a sense of
inner satisfaction. For example, for the woman with an eating disorder, the
relentless hunger may be driven not only by a disturbance in primary object
relations but also by a distortion in how society views women’s bodies and
sexuality. We can list many factors – such as the loss of intact families, com-
munities and religion, the persistence of cultural and economic discrimi-
nation and television – which may contribute to a sense of inner emptiness
and yearning for something missing. We can look around us to see people
trying to fill the emptiness and acquire a sense of worth and integrity by
excessively turning to things outside of themselves, such as material posses-
sions, status, image and drugs and alcohol.
Kohut postulates that, in the absence of the good-enough mother, we
spend our lives running after approval from others (Lachman-Chapin 1979).
Of course, we have all received narcissistic injury, and most of us need to see
ourselves mirrored in the eyes of others; we tend to the ongoing adult chore
of maintaining our self-esteem and identity in relation to those around us, not
in a vacuum.

Psychosis
If nurture and culture play a part in an individual’s ability to develop a sense
of inner satisfaction, what part is played by altered brain chemistry? How can
we help people with psychotic disabilities gain inner satisfaction from
228 ART AS THERAPY

relying on inner resources? Some people, such as psychotherapists and

authors Kay Redfield Jamison (1995) and Frederick Frese (1993), lead
creative and fulfilling lives despite having major psychiatric diagnoses. Many
others, however, seem to experience few satisfactions in their lives, from
within or from without. Many have real dependence on others; some cannot
work and need help with daily living. Some are homeless, disenfranchised,
with nothing to call their own, and little sense of accomplishment. They may
rarely encounter positive responses from others and often withdraw into a
world of the imagination. They may regard others with fear and suspicion,
partly because of real hurts related to the stigma of mental illness, and partly
because the boundary between self and other so easily dissolves. How can
there be inner satisfaction when there is no difference between inner and
outer, between self and other? The self is often regarded with loathing and
doubt. The feeling of helplessness is only partially modified by delusions and
grandiosity. Instead of experiencing the world as if in the presence of a
benevolent other, they may perceive themselves to be the persecuted but
chosen sons or daughters of an all-powerful God of destruction.
Consider hearing voices. Within oneself, barely mediated by reality, is
both the self and the other. Sometimes the internal voice is friendly and the
person prefers it to the voices of other people with their potential for hurt.
Most often, the voice is critical and attacks the most sensitive area; one of my
most gifted artists hears voices telling him to cut out his eyes. Enemies are
perceived both within and without. Harry Stack Sullivan (1962) described
schizophrenia as ‘serious impairment of the dependability of…self and the
universe… [an experience like]…that undergone by an individual attempt-
ing to orient himself on awakening in the midst of a vivid nightmare’ (p.243).
For many who come to us as clients the single most debilitating factor
may be loss of hope. This includes loss of the expectation that their hungers
will be met and loss of their sense of potential to do anything about it; loss of
the faith that anything that comes from outside of themselves will be
beneficial to them; and loss of the sense that they have anything of value to
offer to others.

Benefits of group art therapy

For people with psychotic illness to develop a sense of inner satisfaction, a
sense that there are inner resources on which they can rely, I believe they must
experience themselves to be in harmony with real others. They must first
develop the sense that there is an inner that is separate from an outer, a self
 INNER SATISFACTION AND EXTERNAL SUCCESS 229

that is separate from an other, and that separation might not result in
engulfment or annihilation. The art therapy group can provide the safe
container in which separation is tolerated and others can be seen as poten-
tially benign and helpful, and the self can be seen as resourceful and worthy.
For artists in a psychotic state, sometimes the art does not bridge over to
the viewer; the imagery may contain special meaning that is not recognizable
from viewing the work. The artwork may be the recipient of painful content
which the artist wishes to discard. Katherine Killick describes a version of
projective identification which she calls ‘intrusive identification… a way of
forcibly evacuating unbearable anxieties into the art object… [and then the
artist is afraid that] that which has been projected out will be forced back into
him’ (Killick and Schaverien 1997, p.42). I was shocked when a client with
whom I am working threw away about 60 drawings after selecting some
pieces for an art show. However, I understood that he had an inner need to
discard those works. Sometimes the artwork does not stand in for the thing, it
is the thing. A client used to draw a picture of a fantasy lover, a famous
musician, as a way to be with the musician. When a work of art is viewed by
others it has a chance of being seen by the artist in a different light, from the
point of view of another, as a part of the real world. The connection to
another person which this promotes perhaps allows the artist to
acknowledge, tolerate and gain distance from the affect and imagery
expressed in the picture. The knowledge that the picture is something
outside of the artist’s self while containing the self, something to which
others can resonate, helps the artist feel a commonality with others as well as
to gain a better grasp of others’ reality. For many of my clients, the inner satis-
faction of creativity was not possible without being in the presence of benign
others, the group and the art therapist, who would receive the work. Few of
my group members do artwork at home, even though they would like to, and
speak of empty hours filled with symptoms.
I have also encouraged clients to show their artwork beyond the art
therapy group. The group has done artwork to be displayed in public places,
and has had an art show in a community center. Clients have expressed
surprise and pleasure that others value something that they have done. In this
way, my clients have come to recognize that they are contributing in a
meaningful way to their community.
230 ART AS THERAPY

Summary
I believe that inner satisfaction grows out of satisfactory relationships with
others. When people with psychosis can experience themselves as part of a
reciprocal, interactive network with others, they can feel connected to the
human race, have some grounding in the reality that is shared by others, and
then derive inner satisfaction from what they themselves can contribute to
that system. Within this container, they can develop the sense that what they
create belongs to them, that they can derive satisfaction from it, and that they
can share it with others. They can develop a sense of themselves as having
resources and worthiness within.

On the quality of artistic satisfaction – by David Henley

Kyle
Kyle, a three and a half-year-old child, was working with crayon on scraps of
dry-wall board (sheetrock). One panel had a multitude of images done in a
range of styles, or more accurately, ‘stages’ of drawing. These ranged from
seemingly aimless scribbles that were heavily worked, to a more controlled
configuration, with long, single lines which encapsulated and framed the
compositions, and finally more representational figures. The latter included
simple circular head-like forms along with more developed figures such as a
full-faced and limbed person. His work demonstrated how children operate
freely between representational modes, with developmental schema ranging
from 15 months to that of a three and a half-year-old level.
The boy worked on dry wall because his father was building his house
(literally around the child) and thus he had access to a multitude of scraps
which he drew on constantly. Quite often the child drew while the father
worked, which perhaps stimulated or modeled for the child, creative – or at
least, constructive – behavior. In such an atmosphere where the home was
still a work in progress, image-making became an intrinsic, daily activity, one
that provided freedom to express ideas, affects and motor impulses.
Completing this process was a steady stream of narration that accompanied
the creation of the images. Talking to no one in particular, the child babbled
on constantly, bringing his pictorial ideas to life with a range of private sound
effects and word associations.
For this bright, intact child, venturing into his inner world of sensorial
pleasure and impulse resulted in images that are developmentally immature.
Zig-zagging scribbles, little squiggly or meandering lines fill the paper
 INNER SATISFACTION AND EXTERNAL SUCCESS 231

without any intention to inform or enrich the viewer. They remain an inner
dialogue with the self. Yet, when this piece of gypsum was brought into
preschool as a kind of ‘show and tell’ activity, the child inadvertently began
to rework the drawing in accordance with the demands of this different envi-
ronment. More formed figurative images were added which were then
elaborated upon during the verbal component of the school activity. The
drawing illustrates how, even at a very early age, intentions slide back and
forth. Depending upon the demands placed by the environment, the art may
change in form and content. In this case, different developmental levels are
simultaneously engaged, resulting in images of diverse sophistication and
narrative. We see that even a little child is subject to the kind of processes that
shape the adult artist’s production: the inner passions and impulses that fuel
creative work and the demands of the environment, the public.
Gombrich’s (1960) assertion that the viewer completes the work of art
and only then can it be fully experienced applies to Kyle’s situation. As long
as he is alone, abortive squiggles and lines that accompany his monologue
suffice. When his work is to be presented at school he must make a supreme
effort to be understood, and so his drawing matures. If all goes well, showing
his work will broaden Kyle’s pictorial vocabulary and stimulate more differ-
entiated vigorous production. If he should try too hard to please or if his
teacher’s demands and expectations should be too narrow his work might
lose vitality and be reduced to stereotyped production.
In Kyle’s work we see already the fine line all artists must tread. The artist
who creates art for his inner satisfaction regardless of audience attention or
judgment can be considered to be true to himself. He must however guard
against an autistic-like process done only for the gratification of inner needs
that may result in chaotic, bizarre, aggressively raw productions. He also must
resist the temptation to produce art centered on self-promotion, atten-
tion-getting, manipulation and propaganda that would bring forth work
lacking integrity.
To conclude, an integral factor in analyzing or criticizing a work of art
lies in gauging the artist’s intentions. The issue often revolves around the
quality of satisfaction that the artist derives from the art process and the
expectations regarding how the work will be received by the viewing
audience. This quality of satisfaction can be conceptualized as being on a
spectrum or continuum. On one extreme end lies one’s own ‘inner’ satis-
faction from creating art while the other end is occupied by ‘external’ payoffs
from those in the artist’s environment. Analyzing the dynamic interplay
232 ART AS THERAPY

between these two motivational forces allows the analyst or art critic to
glimpse the forces that bring art into being.

Lani Gerity
Where do we look for satisfaction in our lives? Is it in the getting of stuff, in
the acquisition of one more idea, one more book, or one more degree? Or do
we look within our creative centers, within what Kramer (1996) calls ‘the gift
of symbolic living?’ (See chapter 13, p.155).
Psychiatrist Mark Epstein (1995) has observed that like the Hungry
Ghost in Buddhist teachings, we continually look externally for satisfaction,
but rarely find it. According to Buddhist tradition the wheel of life has six
realms into which one can be born. One of these realms is populated with
Hungry Ghosts. These creatures have withered limbs, bloated bellies and
long thin necks. They are not quite real in human terms, so as they walk
among humans, they go unseen, unacknowledged. They embody a fusion of
rage and desire, tormented by unfulfilled cravings and insatiable demands.
Epstein noticed an increase in individuals embodying this same rage and
desire in his psychiatric practice. Individuals complaining of low self-esteem,
feelings of alienation, longing, emptiness, and unworthiness. He suggests
that it’s not just borderline personality disorder patients but all of us who are
a part of modern Western culture that are affected. Feeling at times unlovable,
we wander about looking for something or someone to ease these Hungry
Ghost feelings.
Kanner and Gomes (1995) wrote something similar about the narcissistic
wounding of children today. They observe a sense of worthlessness that
occurs when the seductive environment of advertising creates a problem – a
feeling of inadequacy in the self – and the solution – the purchase of endless
objects and comforts. They described this process as contributing to a
shallow ‘consumer identity’ that is obsessed with instant gratification and
material wealth.
I will examine how and why we are trained from a very early age to live as
Hungry Ghosts, trained to feel inadequate and confused. I will then look at
the art therapist’s task: to counter this confusion, to ground the child and
encourage exploration of an inner landscape. It is within this landscape that
symbolic living occurs and feelings of inner satisfaction can develop.
To examine the hows and whys of this Hungry Ghost training or the
development of the ‘consumer identity,’ we can observe any normal child’s
relationship to television. Based on what they have seen on TV, most four-
 INNER SATISFACTION AND EXTERNAL SUCCESS 233

year-olds can tell you where to look outside of yourself for happiness; from
shampoos, to cereals, to the newest Barbie.
As children watch TV, they are being taught the art of consuming things.
The main object of television is commerce, creating a market for products.
While a child is watching television, the advertiser is entering her inner
world through the imagery presented, her mind is filled with exciting and
happy images of someone else’s making. These images elicit her feelings of
happiness, displaying them externally in a group of ecstatic little girls
playing with the newest version of Barbie. The message she receives is that if
she wants to feel her happy feelings, she will need this newest Barbie. What
was an internal feeling is now being associated with something external that
she doesn’t have, but now suddenly needs very badly in order to reclaim her
feeling of happiness.
The advertising industry has the task of creating discontent. It may seem
that its task is to get the child to buy a new Barbie, but the fact is that it is the
continual buying of Barbies that is critical to the advertiser, so continual dis-
satisfaction must be created among consumers. Jerry Mander (1978) wrote
that thousands of very sophisticated and well-paid psychologists, behavioral
scientists, perceptual researchers and sociologists are working within the
field of advertising to make sure that we will continue needing stuff. Mander
says, ‘Like miners seeking new deposits of coal in the mountains, these social
scientists attempt to mine the internal wilderness of human beings’ (p.129).
McNeal (1999), who teaches marketing in a university in Texas, suggests
we view children with an economic lens, as a market of great power and
wealth. His research of preteen children in the US indicates that in the early
1990s children were spending $14.4 billion a year. By 1997 the figure was
$24.4 billion, and by 2001 their spending may reach $35 billion. The figure
for household spending which children influence went from $132 billion in
the early 1990s to $188 billion in 1997. He predicts that by 2001 children
will influence the spending of $300 billion.
This sounds more like a gold mine than a coal mine. But how do they get
the gold out of the mine? First they need to understand what children really
want, and then sell this back to them. In order to understand children, they
need to get into their minds, to find their deepest needs and wants. McNeal
feels the most reliable method in getting information from children is to have
them draw for you. He says that a child may tell you what he thinks you want
to hear, but that the child’s artwork is always truthful. McNeal’s (1999) The
234 ART AS THERAPY

Kids’ Market: The Myths and Realities is liberally sprinkled with full color
projective drawings, the meaning of which he explains to the reader.
Another methodology for getting into the minds and culture of children
is anthropological research. In one of the workshops of ‘Play-Time,
Snack-Time, Tot-Time: Targeting Preschoolers and Their Parents,’ a
conference given in New York in March 2000 by The Institute for Interna-
tional Research, Margaret Owens used her extensive clinical training and
experience in group process and individual interview techniques to teach
advertisers how to use qualitative research methodologies. They learned to
facilitate ‘innovative sessions’ with toddlers in order to get into the toddler’s
mind and elicit the kinds of ‘imaginative responses’ that advertisers search
for.
Once the advertiser determines what children really want, then he can sell
this back to them. Often this is only an idea which can be associated to a
brand, like coolness to Tommy Hilfiger, freedom to Pepsi, popularity to
Barbie. But how does the advertiser do that? At this same conference, repre-
sentatives from PBS gave papers on how ‘brands’ like Thomas The Tank
Engine, Teletubbies, Sesame Street and Elmo’s World, had ‘stolen the hearts’
of our children. The participants would then be able to plunder hearts as suc-
cessfully as Public Broadcasting Service (PBS). The creators of ‘Mr. Rogers’
Web Site’ taught participants how to create a website that can hold the
attention of the preschool market, since increasingly the Internet seems to be
the place where children are spending time.
One of the more disturbing selling techniques comes from advertising
executive Nancy Shalek. In an article from the LA Times, Ron Harris (1989)
described Nancy Shalek’s suggestion that in order to sell something to a
child one needs to open up this child’s inner world, their emotional vulnera-
bilities, that if the advertiser just tells children to buy something, they will
resist, but if the advertiser tells them that they’ll be a loser, or a ‘dork’ if they
don’t buy this thing, then children pay attention.
How will it be possible to withstand the intrusions of these clever, calcu-
lating people? When we were children, we may have sorted out our wants
and needs and used our imaginations, our symbolic life to defer immediate
gratification or to solve problems. It seems that now advertising mines the
child’s inner wilderness for their ‘real wants’ and creates solutions for them as
well. How can children recognize their own feelings as separate from the
needs created by these mercenary miners? What kind of intervention would
induce them to begin to look within themselves for satisfaction?
 INNER SATISFACTION AND EXTERNAL SUCCESS 235

Zipes (1997) has suggested that it is the job of art to find new ways to
reach out to people, to stimulate their thinking, and to ‘provide deep
pleasure.’ Object relations theorist Thomas Ogden (1986) spoke of the
ability for psychoanalysis to create greater space between the symbol and
what is symbolized. It is in this ‘potential space’ that meaning and possibil-
ities are discovered and played with, it is in this space that ideas can be exper-
imented with, where we find possibilities and where we find hope. I believe
that as art therapists we can help the people we work with to create a greater
space between the symbol and the thing symbolized, to begin to find their
own ability to provide themselves with inner satisfaction within that space.
In looking for examples of deep pleasure in clinical material collected
from a day treatment center in New York City, I was struck by work done in
the pottery room. Many of the more difficult, borderline patients seemed to
turn up in pottery after having been thrown out of a verbal group for hostile
acting out. In the pottery room they would be able to focus on their work and
interact without hostility. Pottery could almost be seen as transformative for
these patients. The most destructive urges could somehow be absorbed by
the clay. A patient explained that, ‘Clay is very forgiving, you can cut off an
arm and attach it many times and it will always forgive you’ (Gerity 1999,
p.81).
While working with body image representations and traumatic memories,
a 48-year-old woman survivor of child sexual abuse expressed the
importance of clay to her personal growth.
…the day I put my hands into the clay and started creating a head of a
person who is very dear to me, something magical happened. I felt a
connection to a deep part of myself. I could put everything into this clay
– my love, my anger, my fears – and create a thing of beauty. My soul was
validated in an object I could touch, feel, look at. I felt a deep sense of self
worth, and even self-love. And this, after all is the goal of my rehabilita-
tion – to learn to cherish and love myself – from this everything else
flows. When I created the clay head, I said, ‘wow, I can do this. I didn’t
think I could. Maybe there are other things I can do.’ (Gerity 1999, p.14)
In this hope-filled quote we can sense this woman is making a connection
with her inner wilderness, her interior world. We can sense a very real satis-
faction in being able to put all of her feelings into the clay, and we can
recognize her realization of strengths and possibilities. These patients,
normally the most difficult to work with, while using clay were also clearly
working on integration, feelings of wholeness and well-being.
236 ART AS THERAPY

The role of the art therapist wasn’t always clear in the pottery room, as
often there were no active or dynamic interventions that one could pin-point.
The patients worked independently while the art therapist for the most part
stayed in the background. I suspect the role of the art therapist may be found
in Winnicott’s ideas (1971) about transitional space. He says that a child has a
fundamental need to learn to play alone in the presence of the mother, and
can do this only if the mother provides a good-enough transitional space.
The mother’s task is to create this space where the child does not feel the
pressures of internal needs or drives and does not feel intruded on by the
demands of the environment. The mother can leave usable objects around
without forcing them on the child. In exploring the space, the child will
choose and create a use for some of these objects, a creative act in itself. The
mother watches the child play, her eyes and face function as a warm, friendly
mirror, reflecting this beloved image of the child to the child. (This may also
be seen as the gleam in the mother’s eye, Kohut 1966.) Although Winnicott
focused on the relationship between mother, child and the play space, we can
see parallels in art therapist, patient and pottery room.
I think the pottery room was this same kind of transitional space. One of
the good-enough art therapists was always there, with plenty of clay and
tools to find and experiment with. The friendly mirroring was important, but
more importantly, the work itself reflected back to the patients that what they
were doing was good, that who they were was good, providing them with the
much needed sense of inner satisfaction.
And what about the normal child who seems to be getting a good
education in the realm of the Hungry Ghosts, absorbing the images of
popular culture and the demands of advertising? Her inner landscape is
confused and blurred with external imagery and pressures, mined by those
thousands of highly skilled psychologists and social scientists. What are we
to do for her? It seems that advertisers’ work tends to reduce the child’s
potential space, leaving little room between symbol and the thing
symbolized for their own creative solutions and imaginings, leaving the child
passive and dependent. I think having awareness gives us some strength and
I imagine we can discover our task in the shadow of what these social
scientists do, that what we do is the mirror image of what they do. If it is their
role to plunder the inner life of the child, then it is our role to help the child
create higher ramparts and learn to defend what is hers. If it is their job to
create confusion between what is internal and what is external than it is our
job to clarify these things. If the advertisers’ imagery intrudes in the child’s
 INNER SATISFACTION AND EXTERNAL SUCCESS 237

inner landscape, it is our job to help the child begin to recognize and
appreciate her own imagery over and above the advertisers’ imagery. If the
advertiser flattens and depletes the inner landscape, it is our job to teach the
child to enrich the soil and to discover life, wonder and satisfaction within.
We can help the child create a transitional space where she is protected
from these external demands, where she can explore symbolic living through
art-making, and where she can practice moving more comfortably within
and between the areas of the self, of other and of culture.

References
Epstein, M. (1995) Thoughts Without a Thinker. New York: Basic Books.
Frese, F. J. (1993) ‘Coping with… Twelve aspects of coping for persons with schizo-
phrenia.’ Innovations and Research 2, 3, 39–46.
Gerity, L. (1999) Creativity and the Dissociative Patient: Puppets, Narrative and Art in the
Treatment of Survivors of Childhood Trauma. London: Jessica Kingsley Publishers.
Gombrich, E. H. (1960) Art and Illusion: A Study in the Psychology of Pictorial Representation.
New York: Pantheon Books.
Harris, R. (1989) ‘Children who dress for excess: Today’s youngsters have become
fixated with fashion. The right look isn’t enough – it also has to be expensive.’ Los
Angeles Times, November 12.
Jamison, K. R. (1995) An Unquiet Mind. New York: Alfred J Knopf.
Kanner, A.D. and Gomes, M.E. (1995) ‘The all-consuming self.’ In T. Roszak, M.E.
Gomes and A.D. Kanner (eds) Ecopsychology: Restoring the Earth, Healing the Mind. San
Francisco, CA: Sierra Club Books.
Killick, K. and Schaverien, J. (1997) Art, Psychotherapy and Psychosis. London and New
York: Routledge.
Kohut, H. (1966) ‘Forms and transformations of narcissism.’ Journal of the American Psycho-
analytic Association 14, 243–72.
Kramer, E. (1996) ‘Discussion of “The importance of lines”.’ American Journal of Art
Therapy 34, 62–71. (See chapter 13)
Lachman-Chapin, M. (1979) ‘Kohut’s theories on narcissism: Implications for art
therapy.’ American Journal of Art Therapy 19, 3–9.
Mander J. (1978) Four Arguments for the Elimination of Television. New York: William
Morrow.
McNeal, J. U. (1999) The Kids’ Market: The Myths and Realities. Ithica, NY: Paramount
Market Publishing.
Montessorri, M. (1965) Spontaneous Activity in Education. New York: Schocken Books.
Ogden, T.H. (1986) The Matrix of the Mind: Object Relations and the Psychoanalytic Dialogue.
Northvale, NJ: Jason Aronson.
Sullivan, H. S. (1962) Schizophrenia as a Human Process. New York: W. W. Norton.
Winnicott, D. W. (1971) Playing and Reality. London and New York: Tavistock Publica-
tions.
238 ART AS THERAPY

Zipes, J. (1997) Happily Ever After: Fairy Tales, Children and the Culture Industry. New York
and London: Routledge.

Further Reading
Bottome, P. (1957) Alfred Adler. A Portrait from Life. New York: Vanguard Press.
Deri, S. (1978). ‘Vicissitudes of symbolization and creativity.’ In S. A. Grolnick and L.
Barkin (eds) Between Reality and Fantasy. North Vale, NJ: Jason Aronson.
Grunebaum, H. and Solomon, L. (1982) ‘Toward a theory of peer relationships, II; on the
stages of social development and their relationship to group psychotherapy.’ Interna-
tional Journal of Group Psychotherapy 32, 3, 283–307.
Stayner, D. A. (1998) ‘Restoring community living through supported socialization.’
Paper presented at the Inaugural Conference of the Division of Prevention and
Community Research, Department of Psychiatry, Yale University School of Medicine.
Sullivan, H. S. (1940) Conceptions of Modern Psychiatry. New York: W. W. Norton.
Winnicott, D. W. (1986) Home is Where We Start From. New York: W. W. Norton.
 PART 5

Art and Art Therapy

 CHAPTER 18

‘The Angels of St. Wolfgang’

Representation of Infancy and Childhood in the
1
Art of the Renaissance and of the Baroque

The pilgrimage church of St. Wolfgang at Wolfgangsee in Austria is one of

the most charming examples of high Gothic rural architecture. Built in 1141
and rebuilt in 1429, the church attained its final shape in 1683 and never-
theless retained its Gothic character. The world famous ‘Pacher Altar’ created
by the great Tirolean woodcarver and painter Michael Pacher (1435–1498)
dominates the church. The altar, begun in 1471, completed and installed ten
years later, combines high Gothic and Renaissance elements. The winged
altar’s core represents the crowning of the Virgin. It is carved in virtually
indestructible native Cebra pine and is heavily gilded.
Pacher’s altar is flanked on the left by another remarkable altar created by
the Bavarian Baroque sculptor Thomas Schwanthaler. The complex edifice
was completed within a year and installed in 1676. The double altar
comprises two major scenes: the holy family on the left and St. Wolfgang
extending blessings on the right. A representation of the crowning of the
Virgin is placed above. It has been told that Schwanthaler’s altar was
originally intended to replace Pacher’s work, which was considered
outdated. Schwanthaler, however, prevailed upon the administration of the
monastery to preserve Pacher’s altar, while he contented himself with his
own altar’s present location. If the story is true, it would testify to an unusual
act of respect and modesty. Baroque artists were in general convinced of their
style’s superiority to anything previously created.
Among the most delightful elements of both of the altars are the winged
angel-children that surround the adult protagonists. Their character differs
greatly. Pacher’s angels seem to represent winged little boys approximately
eight to 12 years old. Schwanthaler’s cherubs look more like infants of two to
three and a half years old. Or, to use psychoanalytic terminology, we see in

241
242 ART AS THERAPY

Pacher’s angel-boys children in latency and preadolescence. Schwanthaler’s

infant cherubs seem just to have attained individuation, and are at the very
beginning of the Oedipal situation. As the eye travels between
Schwanthaler’s cherubs and Pacher’s boy-angels, the fateful transformation
which is part of everyone’s childhood comes to life.
If we choose to follow individual development rather than historical
sequence, we must begin by contemplating Schwanthaler’s cherubs, all
related to Aphrodite’s little son Eros, and decidedly pagan. Weightlessly
swarming over heaven, they appear filled with boundless energy. For
example, there is one that carries the model of St. Wolfgang’s church in his
hands. Another cherub balances a heavy ax (see Figure 18.1). Two little
cherubs flying about the Virgin as she is crowned seem playfully curious.
One cherub is hiding in her mantle’s folds as he upholds it. Another seems to
be peeping underneath her mantle’s hem as he lifts it up. On the whole, the
cherubs appear innocently seductive and carefree.
In contrast, Pacher’s angels appear to be dutiful acolytes, aware of their
responsibilities. We see two pairs of little boys studiously reading their sheet
music as they are singing praise (see Figure 18.2). Others are reverently
upholding the Virgin’s heavy mantle, while somewhat older boys are
extending a heavy golden curtain behind Christ and the Virgin-mother. In
Pacher’s angels, we recognize children who have lived through the tragedy of
the Oedipal phase, established superegos, and reached the moratorium of
latency. They appear burdened, but not beyond endurance. They have
reached the comparatively peaceful period when children have an oppor-
tunity to acquire the ego-strength needed to weather the storms of adoles-
cence. This period lasts several years.
Schwanthaler’s cherubs embody a brief state of enchantment. Disap-
pointment, guilt, and necessary renunciations are soon to follow. Would this
be, in part, why the vitality and charm of Baroque cherubs has endured even
to the present day? For, on the whole, Baroque religious art has no great
appeal to contemporary susceptibilities, in spite of, and maybe because of, its
great technical accomplishments.
The rediscovery of antique sculpture and the concomitant interest in
anatomy had revolutionized the representation of the figure in the Renais-
sance. The discovery of the linear perspective of foreshortening and the
vanishing point had replaced hierarchically determined proportions and
placement in pictures. Proportions and spacial order were represented
according to the laws of optics. The miniature adult Christ child perched on
 THE ANGELS OF ST. WOLFGANG 243

Figure 18.1 After a Schwanthaler Figure 18.2 After two Pacher latency
infant cherub aged angels

the Romanesque and early Gothic Madonna’s lap was transformed into a
lordly infant in his first year of life. However, the separation of heaven and
earth remained largely intact.
For example, Pacher, an artist rooted in the Gothic tradition but
cognizant of Renaissance achievements, placed the crowning of the Virgin
clearly in a Gothic heaven. The paintings on the altar’s wings represent
events that are occurring on earth. Here, the discoveries and achievements of
the Renaissance are fully utilized. The painting of the infant Christ’s circum-
cision provides a good example. Pacher’s masterly drawing of the high
priest’s hands engaged in the delicate operation celebrates surgical skill. The
representation of architecture and the positions and gestures of the attending
figures testify to Pacher’s pleasure in the mastery of linear perspective and
foreshortening. Baroque Catholic art employs the same knowledge and
technical skills differently: it aims to create illusions. As the faithful behold
the life-like substantial legs of some saint, or even Christ or the Virgin disap-
pearing into a realistically depicted cloudy sky painted onto the Baroque
cupola or even onto Gothic arches – skillfully disguised in the illusion of a
244 ART AS THERAPY

cupola – they are persuaded, or ought to be persuaded, of the miracle’s

reality. Do they not see it happening right above their heads? Also, they are
informed of the action’s emotional significance by an extensive vocabulary of
gestures and facial expressions, perfected by the Baroque masters.
Baroque sculptors developed the skill seemingly to de-materialize the
hardness of marble and wood. Altars appear filled with weightlessly floating
figures, windswept garments, ascending clouds, all fashioned of stone and
other hard and heavy material. The Baroque capacity to create illusions is
indeed impressive, but it fails to move us deeply.2 We resent the manipulation.
The more than life-like heaven appears profane. Why then are the cherubs
exempt from rejection? What makes them lastingly enchanting even in the
late Baroque? I suggest that the illusions embodied by these winged infants
contain emotional truth. They symbolize a state of being that all of us have
experienced when we were the cherub’s age.
If we take Schwanthaler’s cherubs as examples of the genre, we find a
mixture of realistic and fantastic qualities. Their faces are quite life-like,
except for a very slight exaggeration of those infantile characteristics that are
apt to induce an instinctive inclination to act protectively tender to the young
(Lorenz 1971). The cherubs’ puffed cheeks and bucked foreheads stop short
of the saccharine. The cherubs also are just a little more deliciously pudgy
than most three-year-olds and much more in command of their bodies than
any child of this age could be. Their activities belong entirely in the realm of
fantasy. Not only are they able to fly, they also perform feats far beyond any
young child’s powers. In addition, they command the right to fly all over
heaven. Not bound by any hierarchical laws, they may fly above the Holy
Trinity or peep beneath the saint’s skirts.
All this corresponds to the state of mind of the individuated young child
who has learned to walk, passed through rapprochement, acquired language
and the capacity to retrieve memory, learned to use the first personal pronoun
and who, indeed, feels boundlessly powerful. Having learned so much in a
short time, such a child sees any desired capacity as apparently within reach.
As these infants embark upon their first fateful love affair, nothing seems to
prevent fulfillment. They will possess the desired parent, if not today, then
surely tomorrow!3
Psychoanalysis has taught us that the developmental phases are best tran-
scended without damage if an initial period of gratification precedes the
renunciations and transformations which must follow. An initial state of
illusion of omnipotence and sexual powers is therefore essential for the
 THE ANGELS OF ST. WOLFGANG 245

Oedipal child’s eventual acceptance of reality. Perhaps just because it was

given to the perpetuation of illusions, the Baroque also had the power to
create images of the one benign illusion we all must experience in order to
transcend it. Unlike growing children, the cherubs can remain in their
blissful state without any inkling of the impending fall. As we contemplate
them, something of our lost infantile pleasure is restored, unclouded by guilt.
However life-like, the cherubs are imaginary beings, safely inhabiting the
realms of art.
The cherubs’ descendence from the infant Eros of Greek mythology is
also interesting. The adult’s capacity to love and the choice of sexual partners
indeed largely depends on the fate of the first infantile love affair. In this
sense, it is fitting that a little child should command the fateful arrow causing
adult sexual passion. As we contemplate the cherubs and the angel-boys of
St. Wolfgang, we are given the opportunity vicariously to experience both
the onset of the Oedipal phase and its conclusion. Our inner life is enriched
as we dip into forgotten and repressed childhood fantasies without fear of
regression.

References
Lorenz, K. (1971) Studies in Animal and Human Behavior, Volume II. Cambridge, MA: Harvard Uni-
versity Press.

Further reading
Hemple, E. (1952) Das Werk Michael Pachers. [The Work of Michael Pacher.] Wien: Verlag Anton
Schroll & Company.
Pfarl, P. (1984) ‘Die Wallfartskirche von St. Wolfgang am See,’ [The pilgrimage church of St
Wolfgang at Wolfgangsee] O Landesverlag Ges.m.b.tl. Linz 3. Auflage.
Widder, E. (1983) ‘Schwanthaler-Altar St. Wolfgang,’ [Thomas Schwanthaler’s aller at the St
Wolfgang church] Verlag Hofstetter-Innsbruck.

Notes
1 This chapter first appeared in the American Journal of Art Therapy 31, May 1993.
2 My description is one-sidedly confined to certain aspects of Catholic Baroque art. We must not
forget that El Greco’s profound mysticism is also part of the early Baroque, 1541–1614, and
that Baroque techniques empowered Rembrandt’s magic, 1606–1669; nor should we omit the
magnificent grotesques of the late rural Baroque.
3 Baroque sculptors have populated heaven exclusively with boy cherubs. A vigorously
masculine thrust animates most of the figures. Girl cherubs, if they existed, would probably act
somewhat differently, but they also would fly, feel omnipotent and on the verge of fulfillment.
 CHAPTER 19

‘A Critique of Kurt Eissler’s

Leonardo da Vinci’ 1

Reading Kurt Eissler’s (1961) book on Leonardo da Vinci is an inspiring and

stimulating experience. Whether or not the reader accepts all of Eissler’s
hypotheses or his methods of investigation, the work contains a great wealth
of ideas and observations.
In preparation, it is indispensable to read or re-read thoroughly Freud’s
(1910) Leonardo da Vinci and a Memory of his Childhood, a task that has its own
rewards, for even if some of Freud’s conclusions may seem questionable
today, reading the essay remains a great intellectual and esthetic pleasure.
We learn from Eissler’s introduction that his work began as polemic
directed against Meyer Schapiro’s (1956) essay, ‘Leonardo and Freud: An art
historical study’. The evaluation of Schapiro’s criticisms led to a more general
appraisal of the methodology of historical biography. His interest aroused,
Eissler continued his inquiries into the enigma which Leonardo’s life and
work present. The paper became a book consisting of two parts, ‘Polemics’
and ‘Historical notes’, of which Eissler writes that the original polemic
intentions give color at times also to the second part. His book, according to
Eissler, consists of ‘disconnected suggestions for convenience often set forth
dogmatically, that may or may not prove valuable to the future biographer of
one of the most enigmatic personalities that has so far appeared in Western
culture.’ In addition, there are four lengthy appendices.
Eissler, then, has written a book mainly for the use of future writers. It is
left to the reader to sort out Eissler’s ideas in general. The task is not easy, and
while part of the difficulty lies in the subject matter, one still would wish that
Eissler had given more time and care to organizing and editing.
Short of writing another book in response to Eissler’s many suggestions,
the reviewer has two choices: either to recommend the book highly to the
studious reader and refrain from any attempt at critical description, or to con-
centrate on a few items only and follow them as they appear throughout the
book. Having chosen the second course, I soon found myself so deeply

246
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 247

engrossed in Eissler’s ideas and so stimulated in my own thinking that the

intended review began to take on the character of an essay. As it stands, this
paper will be at best an incomplete and biased guide through the complex-
ities of Eissler’s Leonardo and will be irritating to others who would have
made different selections or would have judged differently.
The spirit of Freud’s Leonardo permeates Eissler’s book. To find a guiding
thread to lead us, it may be best to show first the several trends in Eissler’s
approach to Freud’s essay. Eissler defends Freud’s methods against Meyer
Schapiro’s (1956) criticisms; he appraises Freud’s hypotheses in light of
recent historical research and recent psychoanalytic thinking; he elaborates
and extends Freud’s ideas; finally, he develops ideas which depart from
Freud’s.
To bring the reader up to date, I begin with Freud’s assumptions that have
proven erroneous or are highly questionable according to present day
historical knowledge.
First, the indisputable error in translation: the fateful bird in Leonardo’s
childhood memory was not, as Freud believed, a vulture, but a kite. Leonardo
wrote: ‘To write thus clearly of the kite would seem to be my destiny, because
in the earliest recollection of my infancy, it seemed to me that when I was in
the cradle that a kite came and opened my mouth with his tail, and struck me
within upon the lips with its tail many times’ (MacCundly 1956, p.1122).
This misunderstanding renders invalid those of Freud’s constructions that
are based on the mythological significance of the vulture, a positive mother
symbol according to Freud’s researches. A clue to the symbolic meaning
which the kite may have held for Leonardo can be found among his
collection of fables. One of them describes the kite as ‘an envious mother
who deprives her children of food when they seem too fat to her’ (Eissler
1961, p.19). In the light of this story, the emotional climate of Leonardo’s
memory is reversed, hostile rather than loving. The homosexual symbolism
remains unchanged.
Second, Freud presumed that Leonardo had exclusive possession of his
loving and lonesome mother Catharina during his first years. Recent findings
indicate that Catharina married in the year of Leonardo’s birth.
Freud also surmised that Leonardo was taken into his grandfather’s
household sometime before his fifth year (which is the first year of which
there is a written record) but almost certainly not before he was three. He
presumed that this household consisted of Leonardo’s grandparents and
parents, and pictured Leonardo being brought up by grandmother and a
248 ART AS THERAPY

childless and loving stepmother. Today it seems certain that Leonardo’s

father and his young wife lived in Florence from the time of Leonardo’s birth
and seldom visited Vinci. Thus Leonardo’s childhood appears more somber
in Eissler’s view than it does in Freud’s reconstruction.
While such a childhood could have led just as easily to latent or overt
homosexuality, the quality of the resulting disturbance would be different.
Freud supposes a fixation on the image of a loving and seductive mother
whom the child possessed exclusively until he lost her sometime between the
age of three and five and to whom he remained faithful from then on.
Although such an image would naturally contain ambivalences, there would
be at the core of the fixation an unusually gratifying relationship that lasted
throughout the crucial years.
In the light of our new findings, the balance between gratification and
frustration is altered so that we surmise a more profound ambivalence
pervading the relationship to mother. The image of a frustrating and
deserting mother may have originated in early infancy.
Here I cannot resist the temptation to raise the question of whether
Freud’s positive relationship to his own mother, whose favorite he remained
all his life, may have colored his reconstruction. If we compare the fate of the
two geniuses, it is tempting to link Freud’s ultimate success in developing the
science of psychoanalysis and making his discoveries an enormously
powerful force in the thinking of his time, and the comparative failure of
Leonardo’s many ventures, to the difference in the fate of their earliest love.
Eissler concludes that the altered reconstruction of Leonardo’s childhood
would not affect the validity of Freud’s interpretation of the unconscious
meaning of the Mona Lisa’s smile. Freud proposed that the actual smile of the
woman, Mona Lisa, so resembled Mother Catharina’s smile that the
encounter with her made available to Leonardo some deeply repressed
material from his early infancy, not as conscious memory, but as unconscious
content, available for sublimation. Through this partial lifting of repression,
creative energy was freed so that Leonardo was able to express in the portrait
the emotionality of man’s first relationship to woman, which contains the
seed of future relationships, bliss and despair, hope and fear, and the
insoluble emotional ambivalence that is man’s fate. If Leonardo indeed lost
Catharina in his first or second year, the memory of this smile must have
reached back to this period. Eissler points out that such a hypothesis would
account even better than Freud’s construction for the unique, haunting
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 249

quality of the smile, because of the overwhelming importance of the first year
of man’s future emotional life.
When it comes to the psychoanalytic interpretation of the Anna Metterza,
Eissler is inclined to see in this image of harmonious sequences of genera-
tions the symbolic expression of Leonardo’s longings for such a situation
rather than the restitution of childhood experience which it seemed to Freud.
Since Schapiro’s criticisms of Freud concern mainly his interpretation of
Leonardo’s childhood recollections, the Mona Lisa and Anna Metterza, we
can now state the essence of the controversy between Schapiro and Eissler.
Briefly, having found historical errors in Freud’s Leonardo, Schapiro
contends that Freud ought to have informed himself better of Leonardo’s life
and art and the culture of his time. He should not have ventured to apply his
science to the psychological study of that life without considering the
influence of tradition on Leonardo’s childhood recollection.
Eissler accepts this criticism, but takes exception to Schapiro’s inclination
to consider a problem solved when its historical and iconographic connec-
tions have been established, and to his lack of understanding of Freud’s
methods of inquiry. The story of the vulture-kite is a good example of the
strength and weakness of Schapiro’s argument.
Schapiro rightly points out that Leonardo’s fantasy was no novel inv-
ention. The portent of a visit from a great bird is part of the traditional legend
of the childhood of the hero. When Freud (1910) writes that only Leonardo
could have painted the Anne Metterza, just as only he could have invented the
vulture fantasy, Freud was disregarding influence of historical precedents.
Schapiro, on the other hand, fails to explain the personal reasons which
moved Leonardo to adopt the legend as his memory, or rather, Schapiro’s
explanation that ambition prompted Leonardo seems too shallow. Most of
Schapiro’s criticism suffers from the same weakness; while Schapiro points
out historical precedents for certain aspects of Leonardo’s work and life, he
does not ask what prompted him to make his choices, nor does he ask how or
why Leonardo modified the traditional patterns which he adopted.
Eissler fully acknowledges the importance of historical research, but finds
it insufficient. He links the vast knowledge that is obtained from icono-
graphic and historical research to the day residue in dreams. Just as day
residues are a reliable compass in leading us through the ambiguous and
deceptive contents of the unconscious which are always characterized by
manifold meanings, Eissler maintains that the historical constellation at the
time a work of art was created is important for the understanding of its
250 ART AS THERAPY

esthetic, philosophical and religious meaning. But those do not tell us the
secrets of its creator, so that every work of art requires psychological insight.
Common sense psychology can not give such understanding.
At the close of his polemic, Eissler presents a new and promising
definition of the psychoanalyst’s function in the study of the history of art.
‘Cultural change,’ he says, ‘is correlated to ego change… in the course of
imperceptible historical changes the group member’s ego must acquire new
adaptations’ (pp.71–2). The great artist is one in whom personal conflicts,
esthetic antecedents, and historical forces converge to bring forth works of
art that contain the new ego differentiations. Eissler maintains that it is the
function of all great artistic achievement to stimulate new ego differentia-
tions in the personality of the beholder. Psychoanalysis can substantially
contribute to the study of differentiations both in the artist and in his public.
Eissler’s concepts, I believe, will prove extremely valuable in helping us to
organize hitherto vaguely conceived ideas about the relationship between
artist and society, and particularly about problems of the influence of social
change upon styles in art. It is also interesting to see how closely related
Eissler’s ideas are to Susanne Langer’s (1962) thinking on the function of art
in denoting and conveying changing modes of feeling.
At the close of his polemic, Eissler looks forward to a time when historians
and psychoanalysts will work together toward the understanding of the
history of art.
We will now turn to those aspects of Eissler’s book which are more or less
direct continuations of Freud’s ideas.
Central to any psychoanalytic inquiry is the study of the subject’s
sexuality and his object relationships. Here Eissler’s conclusions tally in the
main with Freud’s; but just as Eissler’s reconstruction of Leonardo’s child-
hood reveals greater tragedy, Leonardo’s adult conflicts appear more severe
and more tragic in Eissler’s detailed study than in Freud’s essay.
In Eissler’s inquiry, Leonardo emerges as a man whose unconscious
envisaged the sexual union of man and woman leading to mutual destruction,
and who also fought off temptations to overt homosexuality. Eissler believes
that Leonardo felt any union with another person as a menace. According to
his notebook: ‘While you are alone you are entirely on your own and if you
have but one companion you are but half your own’ (p.119 citing Richter
1883).
Both Freud and Eissler see in Leonardo a man whose capacity for direct
instinctual gratification was so severely curtailed that the defensive measures
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 251

necessary to ward off repressed impulses must have dominated his life. Such
extreme conditions would have been mainly destructive to an ordinary man.
Even though there is much evidence of destructive forces in Leonardo’s life,
the chief result of his instinctive repressions was not illness but unparalleled
accomplishment in art and science. Both in Freud’s and Eissler’s opinion
Leonardo’s creative accomplishment is bound up with his sexual depriva-
tions, so that creative activity serves both as a substitute for direct gratifi-
cation and as a defense against impulses toward it. Freud suggested that two
idiosyncrasies remain inexplicable by psychoanalytic efforts: his exceptional
inclination to instinctive repression and his extraordinary capacities for subli-
mation of primitive impulses.
Freud sees two kinds of sublimation active in Leonardo’s life: sublimation
through art and through scientific work. Freud presumes that the young
Leonardo attained a precarious maturity which permitted sublimation
through artistic creation at the beginning of his career. Since total abstinence
is not easily compatible with art, Leonardo was eventually forced to turn to
science as a better defense against the demands of his dammed-up sexuality.
Freud sees in Leonardo’s increasing preoccupation with science a regression
from a higher form of sublimation to earlier, less complete forms marked by
an insatiability, a rigidity and an incapacity for adjustment to reality which
characterize repressed instinctive drives.
Eissler does not see such a clear-cut conflict between art and science, nor
does he consider Leonardo a scientist in the full sense. Leonardo was,
according to Eissler, primarily an empiricist, addicted to sense data. Seeing
and depicting meant knowledge to him. He was not compelled to go beyond
the visible to form the abstractions indispensable for scientific work. His
observations and deductions remain, therefore, inconclusive even when he
comes upon the right answers. Even though Leonardo’s preoccupation with
science appears superficially a distraction from art, it remained subordinate to
his need to see and depict and so ultimately served art. For instance
Leonardo’s grandiose drawings of The Deluge could not have been created
without his life-long study of the properties of water.
Leonardo’s anatomical work is another example of the fusion of the
empirical observer and the creative artist. Devoting a whole chapter to it,
Eissler makes the modern reader acutely aware of the courage, even heroism,
which anatomical dissection must have demanded in Leonardo’s time, when
no methods existed for slowing down decomposition, when dissection had
to be performed secretly and in solitude, and when moral conviction about
252 ART AS THERAPY

the necessity of dissection for medicine and science, which lends courage to
the modern student, was not yet established.
Eissler believes that Leonardo’s capacity to endure the terrible aspects of
anatomical dissection was bound up with his ability immediately to
transform bloody and fragmented objects into exquisite drawings that show
the elegance and beauty of anatomical structure freed from the revolting cir-
cumstances in which they were observed.
This brings us to the main theme of Eissler’s book, the psychology and
psychopathology of Leonardo’s genius and of genius in general. Leonardo,
Eissler maintains, was addicted to certain aspects of creative work. He had to
observe, to draw, to imagine, to reason incessantly. See his advice to painters:
‘Study in the dark when you wake or are in bed before you go to sleep. I have
proved it to be of no small use, when in bed in the dark, to recall the outlines
of forms previously studied, or other noteworthy things conceived by subtle
speculation…’ (Eissler p.117, citing Richter 1883).
Eissler links Leonardo’s need for incessant exercise of his visual faculties
to a deficiency in the structure of Leonardo’s ego, which made seeing and
drawing his sole means of defense indispensable for his very survival, so
leading to the hypertrophy of this faculty. It seems conceivable to Eissler that
exceptional natural endowment contributed to Leonardo’s failure to develop
solid mechanisms of defense in childhood. From the beginning, great
quantities of energy may have been absorbed in creative activities, leaving
insufficient energy available for building defenses. Also there may have been
less motivation for erecting defenses because sublimation was always
possible.
Eissler supposes that such conditions are frequent among highly gifted
children. From my own observations, I am inclined to agree with Eissler. We
will return to this question later on.
Eissler documents Leonardo’s ego defects mainly in the imagery of his
‘Profetis,’ where archaic material is expressed with nearly psychotic open-
ness, mitigated only by the device of undoing the enormities which are
suggested by offering trivial solutions for his riddles. Example: ‘The masters
of the estate will eat their own laborers.’ Answer: ‘Of oxen which are eaten.’;
‘Many there will be who will flay their own mother and fold over her skin.’
Answer: ‘Tillers of the ground’ (Eissler p.257 and p.264, citing MacCurdy
1956).
The same kind of cannibalistic imagery appears in Leonardo’s famous
harangue: ‘King of all Animals – I should rather say King of the Beasts –
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 253

because thou dost only help them in order that they may give thee their
children for the benefit of the gullet of which thou hast attempted to make a
sepulchre for all animals’ (Eissler p.60 citing Richter 1883).
Haunted by such imagery, Leonardo renounced direct living. Only in his
creative work could he face that which he avoided. He could not eat meat, but
he dissected bodies. He investigated the anatomy of the sexual organs even
though he could not love and he evoked in his paintings feelings which he
could not endure in life.
Eissler postulates that the incomparable excellence of Leonardo’s work
was bound up so insolubly with his ego defects and the resulting extreme
instinctual renunciation that any lessening of his disturbance might have
prevented the occurrence of Leonardo’s genius. This necessarily remains
hypothesis. The existence of destructive forces in Leonardo’s creativity on the
other hand is evident, and Eissler investigates them psychoanalytically.
Leonardo’s most extensive symptom was his general inability to bring
anything to conclusion, be it the editing and publishing of his anatomy, his
scientific treatises, or the completion of his paintings. Since this inability
detracted rather than contributed to the excellence of his work, it constitutes
an indisputably destructive element in his creative life. Eissler links
Leonardo’s inability to complete his work to a fear of separation, ultimately
of death. In this connection, he documents Leonardo’s murderous hostility
against his father by quoting Leonardo’s letter to his brother who has written
him about the birth of a son, where Leonardo tells the brother that he is
foolish to rejoice, for he has created ‘a watchful enemy who will strive with
all his energies after liberty which can only come into being at your death’
(Eissler p.222 citing MacCurdy 1956).
From here on, Eissler’s reasoning is not entirely clear to me. I therefore
venture to present constructions which I have pieced together from various
clues which may or may not express his ideas correctly, but seem logical to
me.
Since the artist’s creations unconsciously represent (among other things)
his children, Leonardo’s murderous hate of his father must also somehow
have been part of his relationship to his own work. Freud presumed that
Leonardo’s neglect of his creations was the projection of the ill-treatment he
suffered from his father. If we follow this through to its conclusion, we see
that Leonardo must consequently have harbored an unconscious fear of retal-
iation from his spiritual children. The moment of parting, when the artist’s
254 ART AS THERAPY

creation acquires a certain autonomy, when its impact upon society can no
longer be controlled by its maker, is particularly apt to arouse such fear.
Basically, the artist fears the return of the repressed, for instance, his
incestuous drives beneath their insufficient sublimation. The work may also
devastate the artist more directly. Encountering his work in a new impersonal
setting, he fears that he himself may be confronted with the revelation of the
unconscious meaning hidden in his work.
In my own experience, I have encountered this neurotic fear frequently
among artists. On the conscious level, it is usually experienced as doubt
about whether the work is good enough, or as a feeling that adverse criticism
would be intolerable, or that the work is too precious or too private for the
public and so on. It is quite logical that artists whose work actually shows a
high degree of emotional restraint are as a rule more prone to this kind of
neurotic reaction than artists whose work displays much raw emotion.
Beyond this general inability to complete work, Leonardo suffered diffi-
culties that were confined to the act of painting. According to his contempo-
raries, Leonardo ‘trembled when he set himself to painting’ (Eissler p.221
citing Freud 1910). It seems that he could endure painting only for short
periods separated by flights into other activities.
Eissler begins the analysis of this disturbance by investigating Leonardo’s
own writing on the art of painting. He finds that Leonardo invests the painter
with god-like powers. Leonardo writes: ‘If the painter wants behold beautiful
things that he can fall in love with, if he wants to see monstrous things that
terrify, or comical or laughable or even piteous things, then he is lord and
God over them’ (Eissler p.246 citing Ludwig 1882).
The assumption of such prerogatives must inevitably have been fraught
with unconscious guilt. Eissler supposes that on the conscious level,
Leonardo’s fantasies of omnipotence may have led him to make inordinate
demands on his faculties. Before analyzing the unconscious implications,
Eissler attempts to fathom what exactly Leonardo might have demanded of
himself consciously or preconsciously.
Leonardo’s ‘Trattato della Pittura’ is mainly a craftsman’s handbook
offering no clues to that which is unusual in Leonardo’s work, with one
exception: Leonardo’s warning against the inclination of painters to paint
‘what they themselves are’ (Eissler p.237 citing Ludwig 1882). In other
words Leonardo demands of the painter the renunciation of primitive
narcissism so that he may become an unclouded mirror for the perception of
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 255

truth. This tallies with Leonardo’s abhorrence of artists like Michalangelo or

Botticelli who express their personal conflicts in their art without shame.
Because of the lack of additional information from Leonardo’s writing,
Eissler casts about for contemporary ideas that have affinity with the essence
of Leonardo’s art, and tries to infer Leonardo’s aims from those sources. The
passage is one of the most obscurely worded and (perhaps for that reason)
least convincing propositions in Eissler’s book.
Eissler believes that Leonardo was influenced by the philosophy of
Nicholas of Cusa (1401–1464), and that he tried to go beyond that which
Nicholas deemed possible. While Nicholas maintains that the individual can
obtain only a partial vision of God, Leonardo attempts to arrive in his
painting at universal vision.
Eissler believes that in his drawing, Leonardo aimed at a full compre-
hension of the property of things, while in his paintings Leonardo tried to go
beyond this. He tried to visualize the transcendent which contains opposites,
to paint the ‘countenance of all countenances,’ (Eissler p.247 citing Cassirer
1927) and to do this without distorting the visual appearance of things. In
Eissler’s words, ‘Leonardo successfully used immanent qualities of the
appearance of things in order to reveal a transcendent truth by means that
went beyond exaggeration, rearrangement or patterns of emphasis’ (Eissler
1961, p.249).
Whether or not Leonardo consciously or preconsciously aspired to such a
feat remains of course forever uncertain. In addition, Eissler’s own words are
so opaque that their meaning can only be guessed – and it is quite possible
that I have misunderstood him. Examples may bring more clarity. Eissler
finds Leonardo’s aspirations best realized in the Mona Lisa and in St. John,
both of which contain the fusion of opposites and convey a feeling of great
finality. Mona Lisa expresses emotional ambivalence, St. John sexual
ambiguity.
Here I depart from Eissler’s reasoning and turn to personal observations.
Ambiguity, both of sex and of emotional meaning, appears frequently in the
art of primitive peoples. Today we see the same thing in the work of
psychotics. Such ambiguities are manifestations of the coexistence of
opposites in the unconscious, and are natural for the developmental stage of
the primitive or the regression of the mental patient. The formal language of
such work is never realistic but is always primitive. (I make a distinction
between primitive and naïve. Folk art, children’s art, the art of amateurs is
naïve, but not primitive.)
256 ART AS THERAPY

We can say that the native formal language of a pre-rational image of the
world is characterized by the inclination to break the organic unity of the
human face and body and to use the various elements as symbols that can be
distorted, exaggerated and rearranged according to unconscious needs.
Unlike the primitive, Leonardo is able to convey the coexistence of
opposites without relinquishing his realistic style, or, to put it into psychoan-
alytic terms, to convey unconscious content without regression. According to
Freud’s interpretation, the unconscious content of the two paintings has its
roots in the earliest phase of infancy, before the union of mother and infant
was broken and before the fact of the difference of the sexes was known.
We can conclude that Leonardo’s difficulty was caused by the labor of rec-
onciling this archaic emotionality with the demands of a realistic style of
painting.
The problem itself is not confined to Leonardo. Every artist in a society
that is no longer primitive must at once maintain access to repressed, archaic
material and resist regression. The difficulty increases as the distance which
has to be bridged becomes wider. This distance can increase in two
directions. The material reached may be more primitive, or the maturity
which is maintained may be higher. This explains, in part, why good art is
more abundant among children and in primitive societies, while the highest
level of great art can only be reached in societies of a high culture.
All this is not new. I mention it because it seems to me that Eissler, in his
single-minded concentration on the enigma of Leonardo’s genius, tends to
forget that much of what he finds in Leonardo pertains to the psychology of
the artist in general and not only to genius.
We now return to Eissler’s psychoanalytic investigation of Leonardo’s
painting inhibition. Leonardo, according to Eissler, tried to outdo Nicholas
of Cusa and prove that the impenetrable world of ideas can be rendered
visible in painting. The unconscious equivalent for the ‘impossible’ is the
‘forbidden.’ Painting then may have had for Leonardo the connotation of
doing the forbidden, possibly of witnessing parental intercourse. Since
curiosity has its roots in the incestuous and destructive drives, Leonardo
trembled when he painted for unconscious fear of the incestuous and
destructive drives activated by painting. This again links Leonardo’s
inhibition to conflicts which all visual artists have to struggle with, for every
painter is a voyeur, and only the severity of the conflict and the excellence of
the work distinguish Leonardo from the ordinary artist.
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 257

Here I am puzzled by one omission in Eissler’s analysis of Leonardo’s

painting inhibition. Eissler ascribes the difference in Leonardo’s untroubled
relationship to drawing and his conflict in painting to the greater demands
which Leonardo made on his paintings. He does not consider that the use of
color may also have contributed to the difficulty.
A cleavage between drawing and painting is not unusual; I have observed
it particularly in persons whose defenses depend on intellectualization or on
mechanisms of isolation and people with latent depression. These people
often draw beautifully and expressively, but the emotional stimulation of
color constitutes a threat that is either avoided or reduced to mere pedestrian
illumination of their drawing. If children of this type are persuaded to use
paint, they usually regress rapidly into infantile smearing.
If we recall that Leonardo’s drawings (all except the Deluge series, and of
this I will speak later) do not evoke emotions to the extent to which his
paintings evoke subdued but profound feelings of reverence, awe, love and
fear, we can imagine that it was color which stimulated expression of feelings.
To control the upsurge of repressed libidinal and aggressive impulses and
transform them into painting may have been an exhausting and painful task
that could be endured only for short periods at a time.
This hypothesis could be much better tested if more were known about
the history of Leonardo’s Deluge drawings. The series is unique in
Leonardo’s work and unique in his time – the drawings are independent
works of art filled with the emotionality and evocative power which Renais-
sance tradition reserved for paintings. If we knew that Leonardo had less
difficulty executing those drawings, we could conclude that the absence of
color made the creative process less dangerous and less painful.
With the Deluge, we have arrived at the end of Leonardo’s life and work.
On the way, we have omitted Eissler’s analysis of Leonardo’s Leda, The Last
Supper, The Battle of Anghiari, his preoccupation with flying and many
minor themes. I can only recommend all this as well worth the reader’s
attention.
I have touched here and there upon the major theme connecting the
various aspects of the book, the ‘psychopathology of genius.’ It is Eissler’s
opinion that the quality of genius is an entity different from even great talent,
and that the psychological processes of genius differ essentially from those
not only of ordinary men but also of the ordinary artist. (Eissler gives no
definition of genius; we do not know, for instance, whether Goya, whom he
mentions frequently, would be a genius or merely a great artist. The
258 ART AS THERAPY

evaluation of degrees of greatness necessarily remains forever debatable.)

The difference does not lie in the nature of the conflicts. Eissler agrees with
Freud who maintains that the genius wrestles with the same contents that all
of mankind must cope with, therefore he can be understood and admired.
The difference lies in the balance of forces in the psychic economy, particu-
larly in the structure of the defenses.
As I mentioned earlier, Eissler postulates that in a genius such as
Leonardo, the ego has either failed to develop adequate mechanisms of
defense such as repressions and identifications in childhood, or that the
defenses were subject to a ‘melting down’ process in adolescence or young
adulthood in which the psychic structure of genius is established. Thereafter,
the ego depends for its very survival on the activation of creative functions, in
Leonardo’s case the capacity to observe, to draw, and to reason.
Eissler feels that it may be a potent stimulus to creativity for a genius when
his wishes are not as profoundly satisfied as one feels inclined to want them
to be for the ordinary man. We do not know what degree of frustration and
what degree of gratification are optimal to creativity. ‘It is conceivable that we
shall one day recognize that a normal vita sexualis is incompatible with
certain types of artistic geniushood’ (Eissler p.287).
In Leonardo’s case, Eissler concedes that a comparative study of the sex
life of geniuses may well confirm one day Freud’s view that Leonardo’s
libidinal economy, though geared to the demands of highest apparatus, came
to be a strain that went beyond his capacity to endure.
Nevertheless, Eissler feels that genius is so rare that it is conceivable that in
the psychic structure of each genius every ingredient, even that which
appears to have been harmful, may have been indispensable for the
phenomenon to take place at all. Therefore, Eissler arrives at the conclusion
that he would ‘with a grain of salt say that in the genius all psychic processes
that support sublimatory processes are ego syntonic and belong to a special
category of psychopathology, which is essentially different from all other
forms of psychopathology as set forth in textbooks of psychiatry. It is the
psychopathology of genius, which is not amenable to criteria derived from
the non-genius’ (Eissler p.287).
Except for ‘purely descriptive purposes,’ Eissler would therefore not
admit psychoanalytic terms denoting neurotic, psychotic, or otherwise
harmful processes in the psychology of genius, or rather he would admit
them only in those instances where it can be proven that the symptom
impairs the quality of the creative output.
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 259

The distinction between ‘descriptive’ and some other use of psychoana-

lytic terminology is startling. Are not scientific terms always descriptive?
Does recognition of pathology imply moral judgment? If Eissler simply
means that symptoms which ordinarily occur only in severe illness may not
indicate the same degree of illness in genius, would it be necessary to make
out a special case for genius? Confusions of this kind occur also in the
evaluation of creative people who are not geniuses. Certain actions and
modes of life sometimes appear alarmingly bizarre or disturbed to the super-
ficial observer, while closer analysis reveals that they are either manifesta-
tions of unusual forms of sublimation, or so interwoven with processes of
sublimation that their dangerous aspects are thereby eliminated or at least
diminished.
I believe that Eissler’s proposition that the psychology of genius differs in
kind from the psychology even of the great artist may very well be true, but
the evidence which Eissler has assembled needs further analysis. In many
instances, it seems to me that Eissler describes extreme manifestations of
processes that are typical of creative artists in general, and are part of a
character structure which probably predisposes to genius but does not
belong to genius exclusively.
For instance, sexual disturbances, perversions, bisexuality and protracted
periods of sexual abstinence occur in the life of many artists. Distortions and
disturbances which ordinarily may lead to severe illness often leave the artist
fairly healthy and productive. We assume that the artist’s capacity for subli-
mation and the gratification he derives from it so balance deprivation and
frustration that they remain tolerable and even beneficial to the artist’s
creative life.
Now it may be that only genius is capable of almost total sublimation of
genital sexuality and that the abstinent non-genius only converts a fraction of
his sexuality into creative work while a great deal of energy is wasted in
unproductive illness. But then the difference between genius and creative
non-genius is one of degree, not of kind.
However, if Eissler’s hypothesis is right, there may still be one essential
difference between the two. While it is at least theoretically possible that the
productivity of the non-genius could be heightened if some of his sexual dis-
turbances were cured or alleviated, the productivity of the genius would
invariably be impaired by such change.
The prevalence of oral sadistic impulses which Eissler notes in Leonardo
is probably also typical for the visual artist in general. Artists are voyeurs,
260 ART AS THERAPY

devouring the world with their eyes. The compulsive need to complement
perception with creation, so characteristic of the artist’s personality, is born
of the need to counteract and redeem the aggressive violence of the drives
which are activated in the incorporation and assimilation of the visible world,
by giving back the incorporated object in the shape of the work of art.
Again, the weakness or absence of ordinary mechanisms of defense, and
the great dependency on the creative act for maintaining emotional health
which Eissler postulates for Leonardo, appear to be an extreme manifestation
of tendencies that appear in more moderate form among many creative
people.
Finally, I want to cite Emmanuel Hammer’s (1961) psychological study of
creativity. Hammer lists several characteristics that distinguish the truly
creative from merely facile individuals. Creative persons have greater access
to their feelings and more tolerance for inner conflict. The disruptive forces
within their inner life are not denied or repressed. However such feelings are
not readily expressed towards others. Rather the individual is inclined to
assume the role of the observer. Self-directedness, independence and a
critical stance are characteristic of the truly creative individual.
Reversal of figure and ground are higher among creative individuals than
among facile personalities, indicating rebelliousness, ambition and striving
for power. These masculine characteristics are balanced by tolerance for the
feminine components of the personality among men or for the masculine
components among creative women.
This description arrived at by non-psychoanalytic methods tallies with
Eissler’s findings on Leonardo in many respects. It is unlikely that the group
of art students studied by Hammer included a genius, but it is probably
typical of the group of persons among whom genius might on rare occasions
emerge.
There is one surprising omission in Eissler’s image of the man Leonardo.
As he contemplates the extraordinary labors of genius, Eissler is deeply
moved by the great courage necessary to create something new, and the
renunciations which dedication to creative work imposes. He writes:
The demand upon the artistic genius is incomparable; he has to achieve
the creation of a new universe that shall be as real as that which he
observes with his senses and still be essentially different from the world
into which he was born and in which he grew up. It is not surprising that
he manages his store of libidinal energy differently from those who are
spared the task that myth reserves to the creative deity (p.151).
 ‘A CRITIQUE OF KURT EISSLER’S LEONARDO DA VINCI’ 261

Somehow this passage, as well as the general tone of the book, makes me feel
that Eissler looks at Leonardo with compassion, almost pity, as one who
suffered beyond measure for the good of mankind.
He does not seem to weigh sufficiently the enormous gratifications which
creative work contains. If we see the artist as one whose ego is vulnerable
because of a lack of ordinary defense mechanisms, we should also consider
that his is an ego which has found a way of maintaining control and equi-
librium without exhausting its energies on a complex system of defenses.
Sublimation, according to psychoanalytic theory, is the most economic
method of dealing with conflict. When it is successful, equilibrium is attained
between id, ego and superego under the ego’s supremacy. The resulting
increase in energy explains the extraordinary capacity for work, the
self-sufficiency, courage, and resilience which belong to genius. Great
achievement demands great renunciation. The artist who tells of the agonies
of creative work is not lying; yet there hardly exists an artist who would
seriously contemplate exchanging his lot for that of ordinary contented
citizens, and for good reason. I believe that if it were possible to measure the
sum of narcissistic gratification versus pain and frustration in the life of
genius, the sum of narcissistic gratification would exceed suffering. This
likelihood should be considered in any attempt at understanding the
psychology of creativity in general and of genius in particular.
References
Cassirer, E. (1927) Individuum and Kosmos in der Philosophie der Renaissance. [The individual and the
cosmos in the philosophy of the Renaissance.] Leipzig and Berlin: Teubner.
Eissler, K. (1961) Leonardo da Vinci: Psychoanalytic Notes on the Enigma. New York: International
Universities Press.
Freud, S. (1910) ‘Leonardo da Vinci and a memory of his childhood.’ The Standard Edition of the
Complete Psychological Works of Sigmund Freud. London: Hogarth Press. 11: 59–137.
Hammer, E. F. (1961) Creativity. New York: Random House.
Langer, S. (1962) Philosophical Sketches. Baltimore, MA: Johns Hopkins University Press.
Ludwig, H. (1882) (ed) Lionardo da Vinci. Das Buch von der Malerei. [Leonardo da Vinci: the book of
the sources for his paintings.] [Quellenschriften für Kunstgeschichte und Kunsttechnik des
Mittelalters und der Renaissance, Vols. XV, XVI, XVII]. Vienna: Braumüller.
MacCurdy, E. (1956) (ed) The Notebooks of Leonardo da Vinci. New York: George Braziller.
Richter, J.P. (1883) The Literary Works of Leonardo da Vinci. London, New York, Toronto: Oxford
University Press.
Schapiro, M. (1956) ‘Leonardo and Freud: An art historical study.’ Journal of the History of Ideas 17,
147–178.

Note
1 This chapter originally appeared in the Bulletin of Art Therapy (now called the American
Journal of Art Therapy) 4, 20, 1964 and was a critique of Eissler’s (1961) Leonardo da
Vinci: Psychoanalytic Notes on the Enigma.
 CHAPTER 20

Survival Under Extreme Conditions

Reflections on The Book of Alfred Kantor:
An Artist’s Journal of the Holocaust1

Eighteen-year-old Alfred Kantor had just begun to study art in his native
Czechoslovakia when he was arrested by the Nazis in 1939. He was interned
at the concentration camp Terezin until 1941, survived two years at
Auschwitz and a year of forced labor at Schwarzenheide, and, in 1945,
returned to Terezin, by then a Red Cross reception center for concentration
camp survivors. From Terezin he traveled to Prague and then to a displaced
person’s camp in Deggendorf, Germany, to await immigration to the US.
It was at Deggendorf that Kantor produced a pictorial record of his expe-
riences – a hand-sewn little book with 127 pages of drawings and water-
colors – writing the captions in English so that he would have a better chance
of getting the work published in America. Finding a publisher would take 26
years.
Survival under extreme conditions depends on many imponderables.
Youth, health, a sound constitution, having a sister who could send an
occasional food package because she was married to a gentile, and above all,
luck – these made Kantor’s survival possible. But as he writes in the intro-
duction to his book:
My commitment to drawing came out of a deep instinct of self-
preservation and undoubtedly helped me to deny the unimaginable
horrors of life at the time. By taking on the role of an ‘observer’ I could at
least for a few moments detach myself from what was going on in
Auschwitz and was therefore better able to hold together the threads of
sanity. (Kantor 1971, unpaged)

262
 SURVIVAL UNDER EXTREME CONDITIONS 263

Although his studies were interrupted, Kantor was able to keep practicing his
art in the ghetto at Terezin, where Jewish culture flourished even in the face
of hunger, epidemics and the ever-present threat of the extermination camps.
At Terezin he first assumed the role of observer, and was able to preserve his
drawings without much danger. Because he gave them to a friend before he
was sent to Auschwitz, these early drawings survived and were available to
him when he composed this book. At Auschwitz and Schwarzenheide,
however, drawing was far more risky, and although Kantor made sketches
documenting the horrors of these camps, he did not dare keep them and
destroyed each one as soon as it was completed.
Even so, sketching helped Kantor stay alive. The act of drawing enabled
him to retain accurate memory images of what he witnessed but, what is more
important, it allowed him to step out of his role as helpless victim to become,
however briefly, the detached observer. This probably kept him from going
insane.
Primo Levi writes in Moments of Reprieve:
It has been observed by psychologists that survivors of traumatic events
are divided into two well-defined groups: those who repress their past en
bloc, and those whose memory of the offense persists as though carved in
stone… It seems to me obvious today that this attention of mine at that
time turned to the world and to the human beings around me was not
only a symptom but also an important factor of spiritual and physical
salvation. (Levi 1986, pp.10–11)
A similarly passionate recall seems to have possessed the newly-liberated
Alfred Kantor, who in a frenzy of creative fervor, produced 127 pictures in
only two months. He was not a naïve artist; equipped with the skills of a
gifted beginner, he commanded considerable draftsmanship in the
description of space, or architectural structures and detail. A skilled
watercolorist, he was able to evoke mood and atmosphere through the use of
color. He was less adept in drawing the figure in action.
These three features of Kantor’s style, however, cannot be attributed
entirely to his technical skills. To the art therapist, these discrete stylistic
elements speak of particular experiences and psychic processes.
The very precision and factualness of Kantor’s drawings of the campsite,
of the barracks, the latrines, the electrified wire fences, the crematorium – all
the complex machinery of extermination, complete with innumerable signs
and warnings – communicates the German obsession with order and
method. We see a highly industrialized, highly literate society using its
264 ART AS THERAPY

technical resources to obliterate a people. Kantor’s drawing style fits his

subject matter superbly.
Kantor’s people, both victims and guards, appear rather puppet-like.
They move stiffly and their faces lack expression, even when extreme
suffering and acts of cruelty are depicted. In this respect, Kantor’s style also
expresses another characteristic of the German extermination machine – its
ability to strip people of their essential humanity. However, we cannot
assume he chose his style deliberately. In addition to his evident inexperience
with figure drawing, a powerful need to disengage from the camp’s horrors
must have been at work, making it impossible for him to depict in the human
countenance or body posture either the sadistic pleasure the guards felt while
inflicting pain or the intense suffering of their victims. In one drawing, a
portrait of the ‘Unterscharführer’ jumping on a man’s belly, tormentor and
victim wear similar facial expressions.
Kantor does not entirely avoid expressing feelings in his work; he creates
a mood of violence and dread through color and the gestures of inanimate
objects. For example, his many detailed drawings of outdoor scenes at
Auschwitz are dominated by the huge columns of ink-black smoke spewing
ominously from the crematorium. Floodlights atop the curved posts holding
up the deadly electrified wire fence stare menacingly down on people
dwarfed by the sheer size of all these implements of oppression. A vividly
brick-red wall contrasts with the gaping black door of the gas chamber.
Scenes of Auschwitz at night, black watercolor skies broken by floodlight sil-
houettes of people and machines at work, convey a sense of restlessness and
doom. The Allied bombing of Schwarzenheide is recorded in powerful
paintings of explosion and fire. In the last desperate trek to Terezin, Kantor
contrasts the peace and beauty of a summer landscape with the grisly
carloads of dead bodies being pushed across the road. He is equally evocative
when he draws the dead being unloaded from the trains at night: they lean
awkwardly against the cars and dangle in the arms of their fellow prisoners. It
is worth noting that Kantor draws the dead more boldly and with more
emotion than he draws the living; but then, the dead can no longer feel or
suffer.
That Kantor was able to convey mood and feeling through color while
insulating himself from the full impact of his experiences testifies to his fun-
damental emotional health. Maintaining his role as impersonal witness and
recorder of events – probably the only role possible in the monstrous
 SURVIVAL UNDER EXTREME CONDITIONS 265

presence of the Holocaust – he could tell his story soberly, without over-
whelming us or being himself overwhelmed.
That it took Kantor 26 years to get his book published indicates just how
unwilling the world has been to face the plight of Holocaust victims, to
apprehend the truth of what millions endured. Now, we are at sufficient
distance to contemplate the Holocaust’s full horror, and so, Kantor’s book
finds an audience two generations after the events it records. Its story remains
timely, however. The evil unleashed in Nazi Germany still pervades our
world in the form of torture and genocide.
Art such as Kantor’s holds a special poignancy for art therapists. Rarely in
our work do we encounter individuals with such inner strength. Kantor’s art,
along with most of the art done within the orbit of the Holocaust, impresses
us as the work of fundamentally sound individuals creating under the impact
of unimaginable hardship. Kantor’s trauma occurred after he had attained
manhood; by contrast, most of the individuals we work with have been
deprived and damaged in early childhood, are handicapped by organic
impairments, or suffer from a combination of both. Growing up in urban
slums, divorced from nature, surrounded by violence and crime, their
humanity has been stunted, and more often than not, their art appears impov-
erished, fragmented, grossly immature. We must give them much support
before symbolic living through art becomes for them a source of healing.
Even as it horrifies and frightens us, Alfred Kantor’s book confirms our
faith in art therapy. It testifies to art’s enormous power as an integrative,
sustaining force in man’s existence.

References
Kantor, A. (1971) The Book of Alfred Kantor: An Artist’s Journal of the Holocaust. London:
Judy Piatkus Publishers.
Levi, P. (1986) Moments of Reprieve. New York: Simon and Schuster.

Note
1 This chapter was first published as a book review in the American Journal of Art Therapy
27, November 1988.
 List of Contributors

Lani Gerity is an art therapist in private practice in Ontario, Canada. She is a

visiting professor at the New York University Art Therapy program and the
author of Creativity and the Dissociative Patient, also published by Jessica Kingsley.
She enjoys conducting art and puppet making workshops within wilderness
settings.
Martha P. Haeseler has worked with groups in Yale-Newhaven Hospital and
the VA Hospital of Newhaven since 1976. She is a visiting professor at the New
York University Art Therapy Program, serves on the Board of the American Art
Therapy Association and has maintained a private practice since 1982.
David Henley is Director and Associate Professor of Art Therapy Programs at
Long Island University’s CW Post Campus in Brookville, New York. His clinical
speciality is children.
Kerstin Kupfermann is an assistant clinical professor in the Department of
Psychiatry and Behavioural Science at the State University at Stony Brook, New
York. She is on the Board and Faculty of the New York School for Psychoana-
lytic Psychotherapy and Psychoanalysis and in private practice. She is the
co-author of The Power of Fantasy.
Jill Schehr has worked in various settings with children and adolescents who
were hospitalised because of psychiatric problems. For several years she was an
art therapist at Albert Einstein College of Medicine in New York city. She is
currently a school psychologist at Sonomon Schechter School of Westchester.
Elinor Ulman served as Adjunct Professor in the master’s degree program at
the George Washington University in Washington DC. She founded the
American Journal of Art Therapy under the title Bulletin of Art Therapy in 1961, and
she edited and published it until 1984. She was awarded the field’s first
honorary doctorate in 1981.
Katherine Williams is Director of the Graduate Art Therapy Program at
George Washington University. She has a private practice in psychotherapy and
art therapy.

266

Subject Index
Adam (schizophrenic, 20s) 53–5
‘adaptive and maladaptive
behaviors’ 24
addiction 205
Adirondack mountains 216
adult potency 116–17
advertising 232–4, 236–7
Africa 94–5, 97
African-Americans 94–7, 138
African kings 96, 97–100
African masks 16
Age of Missing Information, The
215, 216
aggression, etiology of 218–22
Albers, Joseph 183
alienation and art therapy
57–63
Allen, Woody 211
Amazons 221
‘American Dream’ 224
Ancient Egypt 40
art 183, 184
Ancient Greece
art 16
mythology 120, 245
reliefs 221
sculpture 40
vases 182
Andersen, Hans Christian 106
Angel (disturbed gifted child,
aged 6) 112–34
art sessions 119–29
Angel and his father (drawing) Bernard 103–4
122
Angel as Superman (drawing)
123
Angel’s ‘art teacher’, Edith
Kramer (drawing) 125
Clark Kent transforming into
Superman (drawing) 127
cover of ‘self-biography’
(drawing) 121
Dr. Fossum (drawing) 124
‘Nothing but the light’(poem)
130–1
overcoming fear (drawing) 125
reflections 129–31
‘self-biography’ 120–8
song 126
Superman picking up a house
(drawing) 126
angels 10
of St. Wolfgang church
241–5
animals, perception of 170
Anna Metterza (Leonardo) 249
Aphrodite 242
Art as Therapy with Children
(Kramer) 17
art and art therapy 239–65
art materials for evaluation
session 75–7
‘art psychotherapy’ 34
Art Therapy in a Children’s
Community (Kramer) 23
Art Therapy: The Journal of the
American Art Therapy
Association 27
art therapy program (Kramer),
Wiltwyck School for Boys
10, 20
Asian immigrants 225
Attention Deficit Disorder
(ADD) 210
Auschwitz concentration camp
11, 21, 262, 263, 264
Austria 22, 26, 241
Bacon, Francis 59
Barbie 234
Baroque art 182–4, 195, 241–5
baseball 187–9
Battle of Anghiari, The (Leonardo)
257
Bauhaus 16, 21
Bible stories 213
birds, seduction among 206,
208
blind children, art and 132–7
case history (Christopher)
138–45
developmental pattern 133–4
examples 135–7
hands 133
materials 133
size 133
space 133
teaching method 134–5
Bob (Christopher’s friend) 143
267
Book of Alfred Kantor (The): An
Artist’s Journal of the
Holocaust 262–5
Botticelli 255
bridge, the 64–5
Buddhism 232
cancer cells 162
Carl (African-American child)
97–9
painting of king 98
Carl (middle-aged paranoid
schizophrenic) 185, 190
‘Two suns with human faces’
(drawing) 185
categories, perception of and
territorial perception 171–4
Catharina (Leonardo da Vinci’s
mother) 247, 248
Catholic children’s home, Angel
at 119–29
Catholicism 182, 243, 245
Chartres Cathedral 200
Chechnya 218
cherubs, Schwanthaler’s 241–5
children
abuse of 157
see also sexual abuse of
children
and advertising 233–4
art therapy evaluation session
for 73–93
chimpanzees 219
Chinese art 182, 200
chivalry 220
Christ, Jesus 16, 28, 43, 120,
221, 242, 243
Christian iconography 120
Christmas 66
Christopher (blind, aged 14)
135, 136, 137
beginning of the head of Eve
(clay sculpture) 136
case history 138–45
early stages of sculpture of
human head 140, 141
the prophetess (sculpture) 144
sculpture of self at seven years
of age 142
Chris’s Passion 221
Clark Kent 114, 118, 127, 129
268
clay modeling 76, 80, 81,
82–3, 86, 87, 88, 89, 92,
133, 235
clinical work 71–165
Clyde 105–6, 194
painting of monster 105
comic books 113
computers and video games,
effect on children of 203,
204–5, 206, 207–8
conference program 63, 65
contemporary art, plight of
183–4
counting as a protection againstego and superego 42
pain 158
craft and art 40
Coronation of the Virgin 200
corporate advertising 208
Creative and Mental Growth
(Lowenfeld) 21
creativity 260
credo
as artist 15–17
as art therapist 17–18
Cro-magnon cave paintings 180
crutches 162
cultural symbols and innate
signals 181
cultural tradition and leadership
94–111
Czechoslovakia 21, 262
definitions 31–3
Deggendorf, Germany 262
Deluge series of drawings
(Leonardo) 257
Department of Child Psychiatry,
Albert Einstein Medical
College 73, 77
depression 55
developmental pattern of art by
blind children 133–4
Devil 120
devils 104
diaries 23
Dick Tracy 124
Die Fackel (The Torch) 26
disorganization and rigidity,
extremes of 184–6
disturbed gifted child, art
therapy and 112–31
dolls 186, 190
Donald (aged 12) 184–5, 190
ART AS THERAPY
Down’s Syndrome 186
dragons 104
drawing 73–9, 82, 83, 85, 87,
91, 113–27, 129, 131,
152–6, 184, 229–30
Kantor’s pictorial record of
the concentration camps
262–5
Leonardo’s Deluge series 257
dreams and day-dreams 39
Dubuffet, Jean 183
‘Educanto’ 27
Einstein, Albert 28
Elements of Style, The (Strunk) 27
El Greco 245
Empire State Building 65
England 20
Erick (Eva’s biological father)
149
Eros 242, 245
Estrin, Lucy 186
Ethiopia 94–7
‘ethnic space’ (Langer) 183
ethology, society and art therapy
167–238
etiology of human aggression
218–22
Etruscan art 16
Europe 16, 22, 223, 224
Eva 146–4
background 148–52
‘The Dala Horses’ (drawing)
154–5, 162, 163
‘Counting’ (drawing) 158
‘The crib and the building
blocks’ 159, 160–1
discussion 157–63
drawing to survive 152–6
‘Lost in space’ 158, 159, 161
sail boats (painting) 156
‘Scene in hell’ (cover of
booklet) 161
scratchboard images (drawing)
155
evaluation session for children
(art therapy) 73–93
character of the artworks 92
child’s attitudes during session
92–3
observing and recording 76–7
outline of observational
considerations 91–3
summary of findings 89–90
three illustrative cases 78–89
three media 91–2
typical and unusual
experiences 77–8
usefulness of evaluation
procedure 90–1
evolution of human perception,
reflection on 169–98
external success and inner
satisfaction 223–38
face, human 177–8
failures in intervention 56–7
fairy tales 209, 213
‘false fatigue’ 225
Flagellation of Christ (Pacher) 221
flawed empathy 56
Fletcher 102, 103, 104
Florence, Italy 248
folk art, demise of 58, 60
Fossum, Dr. 123, 124
Frank (aged 10) 50–2
Frank (Eva’s father) 148,
149–51
Freddie Kreuger 210
Freudian psychoanalysis 17, 22,
33
frustration 248
games (computer and video),
effect on children of 203,
204–5, 206, 207–8
genius, psychology and
psychopathology of
252–61
Germany 21, 262
see also Nazi Germany
gestures 191
ghosts 104
Giacometti, Alberto 59, 60
God and Devil 120
Good Angel and Lucifer 120
Gothic art and architecture 182,
241, 243
Goya, Francisco 257
graffiti 60
gratification 42, 101, 248, 261
Great Depression 223
greeting card 66, 67

group art therapy, benefits of
228–9
Guernica (Picasso) 221
Guild School, New York 138–9
hands, importance of for blind
children in art therapy 133 Internet 234
Hansel and Gretel 209, 211
Harlem, New York 139
Harry (aged 11) 106–7,
109–111, 194, 196
last monster painting 107
Hercules 114, 115, 117, 120
heroes 96, 113–15, 128
history and lineage of art
therapy (Kramer) 20–4
Hitler, Adolf 17, 26
Holocaust, Nazi 11, 186,
262–5
survival of (reflections on The
Book of Alfred Kantor: An
Artist’s Journal of the
Holocaust) 262–5
horror films 210
human aggression, etiology of
218–22
human face 177–8
human perception, reflection on
evolution of 169–98
Hungry Ghosts 232, 236
hyperactivity 85–7
id commands 200
image of the patient 64, 67, 68
imagery and imagination, effect Karin (blind) 135, 136
of television on children’s
212–16
immigrants 224, 225
Impressionism 16, 176
individual and schematic in
visual arts 180
infants
fascination with schema of
face 177–8
power of signals for 191
innate reaction mechanisms
173–4
innate signals and cultural
symbols 181
inner satisfaction
and external success 223–38 Kokoschka, Oscar 16
and psychosis 227–30
SUBJECT INDEX
benefits of group art
therapy 228–9
quality of artistic satisfaction
230–2
Institute for International
Research 234
intervention, successful 186–90
IQ tests 120
Jack (agoraphobic, aged 38)
212–13
Jacky (aged 9) 49–50, 52
Jacobi Hospital, Child
Psychiatric Ward 22, 113,
114, 123, 127
Jaime (aged 8½) 78–81, 89, 90
first pencil drawing 79
Jason (fictitious psychopathic
killer) 210
Jerry 100–4
painting of prisoner 100
Jewish culture 263
Jewish Guild for the Blind, New
York 22, 139
John (young man with Down’s
Syndrome) 186–90
baseball (drawing/weaving)
187
new art (drawing/weaving)
188
Johns, Jasper 60, 183
‘Journey Course’ (Oldfield) 202
elephant (clay sculpture) 136
Katherine (Eva’s grandmother)
149
Kennedy, John F. 118
Kennedy Home, Bronx, New
York 123, 124
Kenny (aged 8) 82–6, 89–90
drawing of the student 83
painting of the student with
the ‘stop’ sign 85
Kids’ Market: The Myths and
Realities (McNeal) 233–4
kings, African 96, 97–100
kite, Leonardo’s 247
Klee, Paul 16, 183, 216
Kunsthistorische Museum,
Vienna 221
269
Kyle (aged 3½) 230–1
language and art therapy 26–9
Lascaux Caves, France 221
Last Judgment 200
Last Supper, The (Leonardo) 257
leadership and cultural tradition
94–111
Leda (Leonardo) 257
‘Leonardo and Freud: An art
historical study’ (Schapiro)
246
Leonardo da Vinci 10, 117,
246–61
Leonardo da Vinci and a Memory of
His Childhood (Freud) 246
Leonardo da Vinci: Psychoanalytic
Notes on the Enigma (Eissler)
246–61
Lewis, C.S. 9, 11
Lincoln Day Hospital, the
Bronx, New York 52
line drawing see drawing
lines, importance of 146–65
Little Red School House 223
Lobo 218
Lucifer and Good Angel 120
Lucy 190
McCartney, Paul 114, 115, 117
Madonna 16, 241–5
magic and art 40, 116
mandala 178, 190
Maria (aged 7) 77
Martin, the Ethiopian (aged 10)
94–8
painting of Indian 95
masks 16, 191–2, 194
materials used by blind children
in art therapy 133
Matisse, Henri 16
Matthew (aged 10½) 108–10,
194, 196
painting of monster 108
Matthew (aged 12) 77–8
memory and recognition 171–3
Messerschmidt, Franz Xaver
194–5
Metropolitan Art Museum 120
Michelangelo 255
Midway Center for Creative
Imagination, Washington,
D.C. 202
270
Miller, Mr 139
Miller, Mrs. 138, 139
Moments of Reprieve (Levi) 263
Mona Lisa (Leonardo) 248, 249,
255
Mondrian, Piet 183
monocle 98–9
monsters 18, 103, 104–11, 194
faces 192–4
Morton, Mrs. 124
Moses 28
mother’s face 178
Mu Ch’I 200
narcissism 44, 101, 261
Nature 216
Nazi Germany 17, 26, 28, 223,
262–5
concentration camps 11, 21,
22
needle 161, 162
Newspeak 23, 24, 26–9
New York 65, 94, 112, 138,
143, 212, 223, 235
Nicholas of Cusa 255, 256
1984 (Orwell) 23, 26
observing and recording
evaluation session 76–7
Odysseus 120
Oedipal conflict/situation 116,
118, 242, 245
Old Testament 200
On Aggression (Lorenz) 218–19
Oriental art 16
Orwell, George 11, 23, 26, 219
Pacher, Michael 221, 241–3
‘Pacher Altar’, St. Wolfgang
church 241
painting 74, 75–81, 83–8, 90,
92, 94, 95, 97–105,
107–11, 249
inhibition (of Leonardo)
256–7
parasitism 205–6
Pentecostalism 140
perception, reflection on
evolution of human 169–98 Pollack, Jackson 183
art and transitional objects Popeye the Sailor 113
178–84
innate signals and cultural portraits 45, 114, 115
symbols 181
ART AS THERAPY
plight of contemporary art
183–4
schematic and individual in
visual arts 180
illustrative examples 182–3
implications for art therapy
184–96
applying concepts of two
modes of perception to
art therapy 190–2
discussion 195–6
examples: extremes of
disorganization and
rigidity 184–6
Franz Xaver Messerschmidt
194–5
successful intervention
186–90
Wiltwyck School for Boys:
monster faces 192–4
questions and concluding
remarks 196–8
supernormal objects 174–8
signal, symbol and recall
176–7
social smile 177–8
territorial perception and
perception of categories
171–4
innate reaction mechanisms
173–4
recognition of territory:
memory and
recognition 171–3
personal history as artist and art
therapist 13–28
‘Phoenix in flight’ 53–4
Picasso, Pablo 16, 221
pictorial communication and
self-betrayal 63–7
‘Play-Time, Snack-Time,
Tot-Time: Targeting
Preschoolers and Their
Parents’ 234
pleasure 43
‘Politics and the English
language’ (Orwell) 26–9
‘Popperville’ 201, 213
‘potential space’ 235
pottery 235–6
Power Rangers 212
Prague 21, 22, 262
‘primary therapist’ 34
‘Principles of Newspeak, The’
(Orwell) 26
prisoners 100–4
process and product, unity of
36–8
profession of art therapy 31–70
propaganda 208–9
Protestantism 176
psychoanalysis 17, 21, 33–4,
60, 147, 244
Psychoanalytic Explorations in Art
(Kris) 21
psychotherapy 147, 152–7
psychosexual development
116–17
psychosis 227–8
and inner satisfaction 227–30
Public Broadcasting Service
(PBS) 234
Puerto Rico 112, 122
puppetry 213
quality of artistic satisfaction
230–2
Raymond 56–7
Raymond (aged 11) 192–4, 195
new sun (painting) 193
sun with smiling face
(painting) 192–4, 195
rebirth 54, 97
recall, signal and symbol 176–7
recognition of territory 171–3
Red Cross 218, 220, 262
regression 57
Reign of Christ 200
religion 16, 221
Rembrandt 43, 245
Renaissance art and architecture
241–3. 257
‘repetition compulsion’ 146
reports 23
rigidity and disorganization,
extremes of 184–6
Rockwell, Norman 183
Roman Empire 96
art 16
portraiture 40
sculpture 184
statuary 183
 SUBJECT INDEX
Romanesque art 243 Socrates 28, 43
Rorschach Tests 63, 113 Soviet Union 17
Rothko, Mark 183 space, as perceived by blind
children in art therapy 133
St. John (Leonardo) 255 Spiral Jetty, Utah (Simpson) 60
St. Wolfgang church, Stalin, Josef 17
Wolfgangsee, Austria 10 Star (Eva’s mother’s lover) 148,
angels of 241–5 149, 153, 157, 161, 163
Sam (blind) 135 storytellers 213
Samson 117 sublimation
Santa Claus 106 in art 42–6
schematic and individual in art therapy and 39–46
visual arts 180 concept of 41–6
schizophrenics 53, 54, 184, in Leonardo 251
185 sun with human face 192–3,
Schwanthaler, Thomas 241–2, 195–6
244 Superman 112–14, 116, 117,
Schwarzdenheide concentration 118, 123, 126, 127, 129
camp 262, 263, 264 supernormal objects 174–8,
science and art, in Leonardo 205
251–2 Sweden 163
‘scientificalist’ terminology 27 swimming and diving 125,
sculpture, blind children’s 134, 128–9
135–7, 139–45 Sylvia (Eva’s mother) 147–53,
seductive environment and art 157, 163
therapy 201–17
symbolization 180
rebelling against the future
symbol(s) 99, 101, 181, 183,
208–12
197–8
Selassie, Haile 96
innate signals and cultural
self-betrayal and pictorial symbols 181
communication 63–7 signal and recall 176–7
self-destructive behavior 147
sexual abuse of children Tarzan 114, 115
149–52, 154, 157–64, 235 ‘Technobabble’ 29
sexuality of Leonardo da Vinci Teenage Mutant Ninja Turtles
250–1, 258, 259 212
‘Shoddy Lands, The’ (Lewis) 9, television
11 and commerce 233, 234
signal, symbol and recall 176–7 as ersatz parent 202–3
innate signals and cultural influence on mind 213–14
symbols 181 tempera paint 79, 83
‘Six Persimmons’ (Zen painting) Terezin concentration camp 11,
182, 189, 200 21, 262–5
size, considerations of, for blind territorial conflicts 219
children in art therapy 133 territorial perception and
‘skill’ 26–7 perception of categories
Sleeper (Woody Allen) 211 171–4
smile, social 177–8 territory, recognition of 171–3
Smith, Mrs (severely depressed) Thematic Apperception Tests
55–6 113
socially productive acts 43 ‘Therapese’ 27, 29
social smile 177–8 therapeutic alliance 33, 153
society and art 40–1 Theseus 120
271
Thinking in Pictures (Grandin) 24
‘Third Ear’ 48
‘Third Eye’ 48, 67
‘Third Hand’ of art therapist 10,
47–69
Tom (aged 6) 87–9, 90
Tommy Hilfiger 234
tradition 99–100
transference 33
transitional objects and art
178–84
‘Trattato della Pittura’
(Leonardo) 254
‘Traveling Companion, The’
(Andersen) 106
tree, the 65–7
typical and unusual experiences
77–8
United States 16, 20, 22, 94,
186, 216, 220, 223, 224,
225, 262
unity of process and product
36–8
Vienna 20, 21, 26, 221, 223
Virgin Mary 16, 241–3
visual perception 169–98
volcanoes 101
Walter 101–2, 104
warfare 220
Warhol, Andy 59
Western art 16, 40
Wiltwyck School for Boys 10,
20, 23, 51, 94–5, 100, 103
monster faces 192–4
World War I 16
World War II 17
YMCA camp 213
Yugoslavia, former 219
Zen painting 182, 200
Author Index Jamison, K.R. 228
Jung, C. 190, 197
Sachs, O. 29, 172
Sale, K. 212
Schapiro, M. 246, 247, 249
Kanner, A.D. 232 Schaverien, J. 229
Agell, G. 8 Kantor, A. 10, 262–5 Schehr, J. 8, 73–93, 266
American Art Therapy Kiefer, A. 16 Shalek, N. 234
Association (AATA) 66, 73, Killick, K. 229 Smaldino, C. 154
222 Koehler, W. 199 Smithson, R. 60
Angus, I. 26 Kohut, H. 91, 227, 236 Spitz, R. 177
Kostelny, K. 203 Strunk, W. 27
Bernard, V. 23 Kramer, E. 9–11, 19, 46, 58, Sullivan, H.S. 228
Bettleheim, B. 209 73, 93, 111, 199, 232
Bolander, K. 66 Kraus, K. 25 Thompson, E.S. 218
Buck, J.N. 66 Kris, E. 21, 190, 194, 195
Kupfermann, K. 8¸146–65, 266 Ulman, E. 11, 20, 22, 23, 27,
Campbell, J. 211 33–5, 38, 93, 266
Cassirer, E. 255 Lachman-Chapin, M. 227
Langer, S. 18, 183, 250 White, E.B. 27
Dicker, F. 11, 21, 22 Williams, K. 8, 201–3, 207,
LaValle, J. 165
Dissanayake, E. 208 216, 266
Levi, P. 263
Dubrow, N. 203 Wilson, L. 199, 217
Levy, C.A. 8, 38
Leyhausen, P. 173, 174, 177, Winnicott, D.W. 29, 77, 170,
Eibesfeldt, E. 177, 200 178, 179, 227, 236
Eichmann, A. 28 179
Eissler, K. 10, 246–61 Lichtenberg, J.D. 177
Zilzer, V. 8, 52–6, 69, 70
Epstein, M. 232 Lincke, H. 200
Zipes, J. 235
Erikson, E. 21 Lorenz, K. 170, 172, 173, 174,
175, 176, 177, 179, 191,
Federn, E. 164 199, 206, 218, 219, 244
Fields, J. 73 Lowenfeld, V. 21, 209
Frese, F. 228 Ludwig, H. 254
Freeman, L. 165
Freud, A. 21, 29 MacCurdy, E. 247, 252, 253
Freud, S. 28, 29, 146, 246–51, McKibben, B. 215, 216
254, 256, 258 McNeal, J.U. 233
Mander, J. 233
Gabarino, J. 203 Montessori, M. 225–6
Gerity, L. 8, 911, 212–16, Morris, D. 208
232–7, 266
Gombrich, E.H. 231 Naumburg, M. 20, 21, 33
Gomes, M.E, 232
Ogden, T. 235
Goodall, J. 219
Oldfield, D. 202, 210
Grandin, T. 24
Orwell, S. 26
Gutkin, T.B. 93
Owens, M. 234
Haeseler, M.P. 8, 227–30, 266
Patterson, F. 199
Haftmann, W. 216
Pearce, J.C. 213
Hammer, E. 66, 260
Piaget, J. 179, 200, 215
Harris, R. 234
Purpura, P. 165
Henley, D. 8, 186, 187, 189,
200, 208–12, 230–2, 266 Reich, A. 22
Hill, A. 20, 21 Reik, T. 48
Holzapfel, M.M. 171 Reynolds, C.R. 93
Richter, J.P. 250, 252, 253
Itten, J. 21

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