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Arts therapy training in Italy: Toward a pedagogical model
The errs in Pryckrhcrapy. Vol. 19. pp. 1 I l-l 16, 1992 Pruned in the USA. All rights reserved.
Copyright 0
01974556/92 $5.00 + .OO 1992 Pergamon Press Ltd.
ARTS THERAPY TRAINING IN ITALY: TOWARD A PEDAGOGICAL
MARIA
BELFIORE,
dott.. MPS. and MIMMA
The idea of an Italian Arts Therapy Association saw its beginning in New Hampshire, USA, during a conversation with Arthur Robbins. At that time, it was like talking about a dream. but Dr. Robbins’ seriousness and determination in listening to our project made us believe that it might become a reality. About four years later, a training program in art and dance/movement therapy began to develop out of the new-born association. It occurred to us that the training model we were offering to Italian students was the same as the one that our teachers at Pratt Institute, in Brooklyn, NY, had used in our own training. Therefore, we invited them to come to Italy to participate in the first Summer Intensive Training Institute in art, dance and movement therapy that we offered. During the past six years the training has developed its own characteristics, becoming a truly Italian program. This is not only because it is now entirely taught in Italian by a majority of Italian teachers, but also because of its specific structure, which responds to the needs of the students who come from every part of the country and cannot meet with their teachers and supervisors weekly. Part-time programs, monthly meetings, and intensive institutes have therefore been provided. This formal structure has influenced the pedagogy of the training program, as will be seen later in this paper. Our philosophy is centered on the active participation in the creative process by the art and dance therapist who shares the journey of the patient through images and forms. From the beginning of its forma-
lMimma
DELLA
CAGNOLETTA,
MODEL
dott., MPS*
tion the training program has had a clear psychotherapeutic matrix and has utilized psychoanalytic theories to build a frame of reference for the students. This feature arises from the founders’ personal training as well as from a belief in the importance of the interpersonal and intrapsychic dimension of the creative process. From the teachings of Arthur Robbins, we have learned that the understanding of the relationship between patient and therapist helps to determine which particular modality will be appropriate for working through the patient’s problems. We do not emphasize the psychoanalytic dimension over art, but we believe that the two are always interacting in arts therapy. At times they may be given separate space, or one given predominance over the other, but this is only to develop a dialogue between them. We encourage such an exchange as we believe that maintaining rigidity does not make for fluid development of a discipline.’ Pedagogical Considerations When training a student in art and dance therapy, we are faced with the necessity of presenting he? with different ingredients from the two fields of art and psychoanalysis. Each teacher will offer her or his form of integration of these elements, so that students can have different models to follow. Nevertheless, each student is ultimately responsible for a personal integration that will result from the internalization of such models, and the elaboration of different stimuli
Della Cagnoletta is co-founder of the Italian A~I Therapy Association and head of the training program in art and dance/movement
therapy. Maria Belfiorc is co-founder of the Italian Art Therapy Association, of which she is presently Presidem. ‘As the training program offers courses in ark and dance therapy. when using the term ark we will be referring IO both. ‘At present, all the students we are training arc women. WC believe this can be a very interesting topic for discussion.
112
BELFIORB AND DELLA CAGNOLE-I-I-A
provided in the course of the years. Long before this phase begins, students are confronted by a very demanding request-that they keep an open attitude because simultaneously they are in a situation of “not knowing,” which implies a receptive passivity, and, because of the nature of their training, they are asked to participate in a creative process that makes them enter the state of intuitive activity. Receptive passivity and intuitive activity go hand in hand and constitute a fundamental “dis~sition” required from the students. Accepting this con~dicto~ situation implies also that the students agree to make themselves the ground on which they will discover what art and dance therapy is about. The students will discover this through the exploration of their own artwork and their own movements. If we consider receptive passivity and intuitive activity as skills requested from a student (Johnson, 1989). how can a training program contribute to their development? In order to master their “intuitive activity,” students should ultimately feel that they “possess and develop (their) responsiveness to art” (Langer, 1953). It is undcrst~ that in responsiveness there is a great deal of intuition and that intuition cannot be taught in a dogmatic way. However, it can be encouraged and incremented through the exercise and exploration of one’s own personal artistic expression. By becoming responsive toward their own need for expression, students will learn how to approach another’s artwork with empathy. The students’ capacity to form an empathic resonance (Robbins, 1988) with another has its roots in entering their own internal personal artistic expressions. With respect to “receptive passivity,” this is very much connected to a “not knowing disposition” (Bollas, 1989). This in turn is very similar to the attitude of artists toward their work. When artists start their creative effort, they may or may not have an idea of what will unfold. The acceptance of such a knowing-not-knowing state of mind plays a central role in the creative process. It is the acceptance of uncertainty, formless chaos, that will ultimately produce a new form. N. Coltart (1986) stated of the work of psychoanalysts, “We do not know what we are doing . . . in spite of our training, our literature, our experience however much we gain contidence or refine our technique, each hour we spend with a patient is an act of faith” . . . (it consists in) “the unconditional truth that we analysts need to have in order to believe that
whatever else happens in the analysis it will continue working . . .” The acceptance of the not-knowing component is linked here with faith in the work itself. The students will, therefore, come to know that whatever the patient produces, in spite of their capacity at that moment to understand it, to put it in a frame of reference, it will continue to exist and will be another piece of reality that finks together two persons, two experiences, two sessions. The not-knowing disposition also determines the creation of a potential space (Bollas. 1989; Winnicott, 1953) where the communication between patient and therapist takes place. The student is caught between the “urge to know and the essentials of not knowing” (Bollas. 1989). but this is nonetheless “an essential dialectic, one that is at the heart of creativity in living, a dialectic between knowing (organizing, seeing, cohering) and unknowing (loosening, not perceiving)” (Bollas, 1989, pp. 62.63). Students will be helped through their artistic expericnce to meet the extremities of such a process. This will imply the act of fusing with the other, to become one with it and to separate from it. If there may be plcasure in losing consciousness, on the other hand there may be fear and panic about entering the chaos and incoherence of the absence of boundaries. The training program itself will, therefore, act as a “holding environment” in order to provide a safe space for the students during their participation in the aesthetic experience. The dialectic of fusing and separating is one of the sources of the creative process according to Rose (1980). It brings with it the primary and the secondary processes, which in his view are not antithetic, but interconnected with each other so that “one leads to another, in a succession of events” (Rose, 1987 p. 203). The capacity to pass from one process to another has always been seen as one of the most important skills of creative arts therapy students (Robbins, 198 I). Everyone agrees that “interaction involving the creative art therapy student is multilevelled” (Lusebrink, 1989). Khan (1986) wrote that there are two types of experience involved in psychoanalytic pedagogy: apprenticeship and instruction. The first is “the process of experientially facilitating the talent and capacities of a person for a certain skill. in terms of the tradition of that skill. Instruction, by contrast, is the intellectual transmission of certain established and accepted
ARTS THERAPY TRAINWG IN ITALY data of conceptual knowledge in a given field of research and enquiry” (p. 112). Regarding app~nticeship, we are reminded of the past when education of the artist-to-be was given in the atelier of a famous artist, or even at the service of a “maestro.” The practical instruction given by the older successful artist often contained some sort of philosophical reasoning about art and life in general. In this way there was no split between apprenticeship and inst~ction. Questioning psychoanalytic pedagogy, Khan asked “How can one be absorbed with and surrender to the analytic process and be observing and learning from it at the same time?” (1986, p. 116). This capacity involves ego-splitting. It is a kind of benign ego-split, wrote Khan. that the students must tolerate and master in order to achieve the capacity to pass from one state to another. This is the same kind of split that arts therapy students have to face when they are required to move from an intuitive level to a more thoughtful one or vice versa. Will we eventually propose a reunification of the split? How‘? As far as psychoanalysis is concerned, Khan wrote that “neither rational knowledge nor wisdom . . . are sufficient vehicles for the integration of the individuai in depth” (1986, p. 127) and he called on the development of insight (Winnicott, 1959). It goes without saying that the emotional dimension plays a major role in any learning experience. from childhood to adulthood. With respect to creative arts therapy, art itself provides a place where the split can be worked through. The split becomes perceived less as a fracture in a process and more as a succession of different phases. The art experience condenses opposites and reunifies dichotomies; therefore, it is the place where contradictory attitudes--be they feeling/thought, activity/ passivity, “to surrender and to observe” (Khan, 1986)--tan be accepted as fundamental components of the experience itself. In order to perceive and to utilize this function of art, students undergo different experiences that wifi permit them to explore their particular empathic resonance with a variety of affects and ego states. As art is an attempt to find a form that is symbolic of human feelings &anger, 1953). the students will connect their emotions with that specific art form and with a provided concept. Connecting a psychoanalytic concept with an art experience is one of the ways Robbins structures his seminars: in teaching about pathology he will ask the
II3
students to explore different “primitive mental states” (Giovacchini, 1979) so that they will feel that “their life experiences am aI too similar to those of their patients . . . (that) psychopathology is a continuum rather than an absolute defined entity” (Robbins. 1988 p. 98). The students will realize how the art form will vary according to the experiences that are called for. This (which seems obvious) is nevertheless the focus of the students’ work. What the students will be deaiing with is the connection between emotional states and art forms that will change or remain the same depending on the relationship between the patient and his or her primary objects, one of which the students will be taught to recognize as themselves. In other words, the relationship between the studenttherapist and the patient will affect emotional states that will in turn be explored or masked in the art forms. In summary, the emotiona experience that the making of art implies helps the students in two ways: 1. to go through the merging with the object and subsequent separation from it and, from these extremes, through all the phases of this endless process (Rose, 1980). which is the basis for object ~~ationship; 2. to master their knowledge of a theory and link it with their emotional experience so that the evocation of the theory will bring along the affect and/or vice versa. “By facilitating the integration of emotion with thought and perception, art iIiuminates reality in a particular way from within. This is related to the Rower of imaginative insight or empathy-the capacity to enter minds and situations and intuit them from within” (Rose, 1987. p. 207). As has already been noted, art making through structured exercise or studio time helps the students to develop their capacity of “imaginative insight or empathy.” We nevertheless wish to stress once more the importance of enhancing the empathic response by integrating intuition and thought. Sometimes it is easy for arts therapy students to be intuitive, but, in spite of the importance of such intuition, a situation will eventually require a conceptualization of the intuitive response, for instance, in the form of a case presentation. The belief that a theory can be a rescuer in all the difficulties of work produces a split between theory and emotional response -the theory. instead of promoting an understanding of the situation, transforms itself into a rigid,
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BELFIORE AND DELLA CAGNOLE’ITA
fixed schema and prevents the emotional aspect from finding a safe and solid frame of reference. A training program must provide the ingredients; the product will come out slightly differently for each student. Emerging from the fields of art and psychoanalysis, ingredients are those primary sources that motivate the human being to relate to the external world in order to give form to some “dead material” (Milner, 1987). The act of forming has its roots in the relationship with the mother, the first object promoting a change in the form of the baby’s reality and, therefore, allowing an aesthetic experience, perhaps the first human aesthetic. wrote Bollas (1987). Once the capacity of transforming the reality of the self becomes the patrimony of the child, there will be a constant search for some external object capable of promoting a transfo~at~on. The aesthetic experience, Bollas reminded us, whether an artwork enjoyed as author or as audience, or a precious moment of co-participation with nature, contains a transformational quality for human beings. In arts therapy, forming is a continuous process that puts the therapist and the patient in a specific relationship, permeated by a potential aesthetic experience. Such an experience is “par excellence” the ground of exploration of our students. Their inner world will be there to be formed and transformed through the artistic process. The teachers and the supervisors will act as agents who provide the place and the structure when: such expcricnce can occur. From Philosophy to Practice: The St~cture of the Training Program In order to focus on training objectives and methodology, it is necessary to briefly describe the structure of the program, which consists mainly of monthly meetings. Each month a small group from the same academic year meets with a supervisor for about six hours to participate in the following activities: 1. an art or dance therapy group-a fully experiential group where students can express themselves through art or movement and be involved directly in a group process; 2. a “write-up” discussion group-before the meeting each participant prepares and sends to her supervisor a write-up, which is a sort of schema or outline focusing on a major dynamic of a session chosen by the student from her
internship practice. All write-ups, together with the supervisor’s comments, are read and discussed in the group; 3. a group supervision-each month students take turns in presenting a full case study. Therefore we can describe these meetings as a magic box made of three separate containers, each fulfilling a specific and delicate function in the student’s training. The concept of setting, where time and space once defined allows meanings to take form. and vice versa, is here applied both to specific moments and to the meeting as a whole. The same images, themes, movements or issues seem often to run through the case presentations, the experiential and the discussion group. These appear to be the symbolic content of students’ developmental stages in their training experience. Within their peer group and through supervisors’ guidance, students are involved in their own creative processes, learning to know each other and to connect with the group through personal imagery or movement. This understanding will enable them to get in touch with each other’s styles and defense mechanisms and to become more aware of their own as well as each other’s issues, especially because of an increasing trust and cohesion within the same group. Each moment within the monthly meeting is separated and differentiated. Each represents a peculiar level of attention, participation and observation that students need to deveIop in their clinical work. The overall structure promotes a sort of integration of what we think is vital in the learning experience. Starting from the personal experience, the other different levels of understanding will coexist in one’s clinical work. In order to clarify this concept, we will give some examples of how students worked through main issues in their personal as well as their clinical work at a certain stage of their training and how this process was facilitated by the different levels of work involved within each meeting. The quality of the ongoing relationship between a student and a very inhibited child appeared very vividly to the group once they recognized that the child’s and the student’s own imagery had many similarities. The group supported the student’s ego, which seemed quite trapped in the dynamics. In fact, the student described her ~lationship with the child by saying that she was with him in “his castle,” and whales and volcanoes were threatening that place, thus making it
ARTS ‘I’HEbWY unsafe. The student was very upset because the child did not want to come to therapy and yet seemed unable to leave; he was feeling the therapist in a kind of competition with his symbiotic mother, his fear and wish for merging seemed to be his major problem at this point. This helped the student to create a “castle” for herself, where the child could go and “visit.” In this way, the student worked through her own need for a personal territory and boundaries to feel separated and related at the same time, in order to allow a therapeutic process to occur. The image of the castle as a metaphor of personal space was transformed in both child and student; the child built a city inside the walls and the student used the metaphor of the castle to represent personal territory in a workshop she led during the annual EXPO. The fortified castle was no longer needed in either the student’s or the child’s perception. This work was at such a profound level that it could not be developed without a personal involvement with the peer group. During this student’s first year, her issue was to soften her defenses in order to establish contact and get in touch with her client’s world; during the second year, and through the image of “two separate castles” or connected territories, she learned that both involvement and the right distance can be the particular quality of a therapeutic relationship. Another student produced in her group what she called “a meaningless picture.” This happened to be almost at the end of a year when her main worry was being judged by others and feeling uncomfo~able about not finding sophisticated meanings in her own as well as in other people’s artwork. The group responded very well to this picture because of a new brightness and lightness in the lines and in the colors; the title of the picture and its aesthetic value seemed to represent a big change in the student’s attitude toward herself, other group members, and her own clinical work. it was understood by her and the group how important it could be to lower expectations in order to get more deeply involved in the process and in the pleasure or pain that underlie any interpersonal experience. Once she faced this issue within the group, the group supponed her in being more receptive without compulsively searching for “meaning.” She began to accept the unknown side of the creative as well as of the therapeutic process as something to be experienced before being trapped in a readymade mewing. At this point, it appeared easier to understand that a good picture, like a good session, could
TRAINING
IN ITALY
115
happen without her controlling part or ego ideal being in the way. As is shown in these examples, interpretations and interventions are made in order to enlarge a psychological undying of the process as well as of the ongoing dynamics. To learn from each other, and to become more sensitive to countextransference issues that arise in clinical work, is one of the main objectives. Students also need peer support and constructive criticism. The experiential group is a space where difficulties and problems are shared and considered as parts of the training process and not only personal impasses to be aware of. Learning about oneself is part of personal as well as professional growth. From personal p~icipation and involvement in the art/dance therapy group, students are asked to describe and present a specific session during the writeup discussion. In order to clarify the significance of this training tool, we will describe what happens in a compilation of a write-up. We have already noted that the write-up is a sort of scheme, a “closeup” on a particular interaction of a chosen situation. This helps to focus on major dynamics and on the client’s as well as the student’s style in responding to each other through the artwork, art material or movement. The writing up of this interaction is. from a different perspective, a sort of tridimensional view of what is going on. What students gain during compilation is a sense that nothing is casual; they learn to observe and capture the complex interplay of parts that occurs in any given session. The selection of an interaction heips them to focus their attention; this will be partly descriptive (how the interaction takes piace, how the process develops, the choice of art material, a description of the picture in formal terms as well as in the content, how the client appears before this moment, etc.) and partly speculative (What is the symbolic content of the picture? What is the emotional response? What are the associations both in the client’s and the therapist’s verbal and nonverbal responses? What are the motivations of the therapist’s interventions? etc.) At the end of the write-up, the student gives a summary of the session and what it represents in the ongoing relationship and the therapeutic process. Synthesis is both at a verbal and at an image level in order to develop a “hearing attitude” toward conscious and unconscious dynamics. What strikes students most is that they begin to interpret and understand, a posteriori, that what they did s~n~eously and “without thinking,” has its logic and its deep
116
BELFIORE AND DELLA CAGNOLETTA
motivations. They begin to see: (a) in what relationship they are with clients, (b) what they are responding to. and (c) what they activate in the other person through a small gesture or a question or just a word. The roles they adopt, consciously or not, with their clients appear more clear, with a specific order and form. After this “close up” view, we all enlarge our perspective during the case presentation, which occurs during the actual supervision time. Here a student presents a case, its history and the ongoing sessions, the connecting images, and the quality of the relationship as it evolves. The discussion is at a distance where it is possible to plan and reflect on therapeutic goals, diagnostic or clinical issues, psychodynamics, creative and therapeutic interventions, additional tools to keep the process going, and so forth. During this time a theoretical background is provided by the supervisor in order to fully understand the specific clinical issues of the case and to gain from the individual case a common learning experience. In summary. meetings provide a structure and an ongoing connecting space for the entire training experience. Its effects are strictly monitored and verified through periodic self-evaluation and feedback, which each student undergoes individually. This individual time is used to deal with personal training development and to focus on personal strengths or weaknesses. As a matter of fact, the meetings and the peer groups, in their differentiated functions, are tools for training, but the “material” is each student’s personal outcome in her clinical and psych~ynamic understanding. The Link With the Italian Reality In the process of promoting art and dance therapy in Italy following international standards, the first step was the founding of Art Therapy Italiana, whose main objective was to train qualified art and dance therapists. Thereafter the association and its training program developed together. When we started the program, art and dance therapy was almost unknown in Italy or confused with occupational and recreational activities. The word “therapy” gave rise to issues about control; public mental institutions were resistant to the new and needed references to offer placements to our students. In order to provide a supportive network and to respond to the need of our students to be rooted in the italian institutional reality as well as to develop a clear professional identity. we
created the regional “reference groups.” Each reference group represented a link between training and professional issues, also ful~lling the role of establishing a sense of a common profession among students and representing a structure that will also promote public initiatives. Each regional group, guided now by our first graduates, organizes public seminars and conferences where students present workshops and theoretical material to other professionals. By presenting projects, creating internships, and, eventually, job opportunities, the groups come to represent a particular space where the new art and dance therapist’s identity can be reinforced and supported. The purpose of this paper has been to introduce the model of training we at Art Therapy Italiana have been using for the past ten years. Creating a training program and developing its methodology, as well as promoting a new p~fession, is very inspiring work that needs to be continuously developed and constantly “confronted” with other similar programs. Rcfcrcnces
of
Bollas. C. (1987). The shudw the objccr. London: Free Association Books. Bollas. C. (1989). Forces of Jesrirt.v. London: Free Association Books. Coltart. N. f 19X6). Slouching towards Bcthlehcm . Or thinking the unthinkable in psychoanalysis. In G. Kohon (Ed.). The Brirish schaol tf psychwnulysis. The independenttrudirion. London: Free Association Books. Ciovacchini. P. (1979). The treurment o/primitive menfal sfufes. New York: Jason Aronson. Johnson, D. R. f 1989). Introduction to the special issue on cducalion and training in the creative arts therapies. The Arfs in Psyc~af~rupy, Ibl I ). I. Khan, M. R. f 1986). The privucy of rhe se& Lundon: Hogarth Press. Langcr. S. (1953). Feeling andjorm. New York: Scribner’s. Lusebrink. V. B. (1989). Education in creative arts therapies: Accomplishments and challenges. The Arts in Psychorherapy. 16(l). 5. Milncr. M. (1987). The suppressed madness ofsune men. London: Tavistock. Robbins, A. (1981). Expressive fhcrapy: A creutive urts approach to depth-oriented rrcLt~menr. New York: Human Sciences Press. Robbins. A. (1988). A psychoaesthetic penpectivc in creative arts therapy and training. The Arfs in Psychotherapy, /S(Z). 95100. Rose, G. (1980). The power o/form. New York: International Universities Press. Rose, G. f 1987). Trauma und masrery in fife and urr. New Haven & London: Yale University Press. Winnicott. D. W. (1953). Transitional object and transitional phenomena. intemationul JOWM~ of Psychoanalysis. 48. 36& 372. Winnicott. C. (1959). The devclopmenr of insight in child care and sociul work. London: Bookstall Publications.
Copyright 0
01974556/92 $5.00 + .OO 1992 Pergamon Press Ltd.
ARTS THERAPY TRAINING IN ITALY: TOWARD A PEDAGOGICAL
MARIA
BELFIORE,
dott.. MPS. and MIMMA
The idea of an Italian Arts Therapy Association saw its beginning in New Hampshire, USA, during a conversation with Arthur Robbins. At that time, it was like talking about a dream. but Dr. Robbins’ seriousness and determination in listening to our project made us believe that it might become a reality. About four years later, a training program in art and dance/movement therapy began to develop out of the new-born association. It occurred to us that the training model we were offering to Italian students was the same as the one that our teachers at Pratt Institute, in Brooklyn, NY, had used in our own training. Therefore, we invited them to come to Italy to participate in the first Summer Intensive Training Institute in art, dance and movement therapy that we offered. During the past six years the training has developed its own characteristics, becoming a truly Italian program. This is not only because it is now entirely taught in Italian by a majority of Italian teachers, but also because of its specific structure, which responds to the needs of the students who come from every part of the country and cannot meet with their teachers and supervisors weekly. Part-time programs, monthly meetings, and intensive institutes have therefore been provided. This formal structure has influenced the pedagogy of the training program, as will be seen later in this paper. Our philosophy is centered on the active participation in the creative process by the art and dance therapist who shares the journey of the patient through images and forms. From the beginning of its forma-
lMimma
DELLA
CAGNOLETTA,
MODEL
dott., MPS*
tion the training program has had a clear psychotherapeutic matrix and has utilized psychoanalytic theories to build a frame of reference for the students. This feature arises from the founders’ personal training as well as from a belief in the importance of the interpersonal and intrapsychic dimension of the creative process. From the teachings of Arthur Robbins, we have learned that the understanding of the relationship between patient and therapist helps to determine which particular modality will be appropriate for working through the patient’s problems. We do not emphasize the psychoanalytic dimension over art, but we believe that the two are always interacting in arts therapy. At times they may be given separate space, or one given predominance over the other, but this is only to develop a dialogue between them. We encourage such an exchange as we believe that maintaining rigidity does not make for fluid development of a discipline.’ Pedagogical Considerations When training a student in art and dance therapy, we are faced with the necessity of presenting he? with different ingredients from the two fields of art and psychoanalysis. Each teacher will offer her or his form of integration of these elements, so that students can have different models to follow. Nevertheless, each student is ultimately responsible for a personal integration that will result from the internalization of such models, and the elaboration of different stimuli
Della Cagnoletta is co-founder of the Italian A~I Therapy Association and head of the training program in art and dance/movement
therapy. Maria Belfiorc is co-founder of the Italian Art Therapy Association, of which she is presently Presidem. ‘As the training program offers courses in ark and dance therapy. when using the term ark we will be referring IO both. ‘At present, all the students we are training arc women. WC believe this can be a very interesting topic for discussion.
112
BELFIORB AND DELLA CAGNOLE-I-I-A
provided in the course of the years. Long before this phase begins, students are confronted by a very demanding request-that they keep an open attitude because simultaneously they are in a situation of “not knowing,” which implies a receptive passivity, and, because of the nature of their training, they are asked to participate in a creative process that makes them enter the state of intuitive activity. Receptive passivity and intuitive activity go hand in hand and constitute a fundamental “dis~sition” required from the students. Accepting this con~dicto~ situation implies also that the students agree to make themselves the ground on which they will discover what art and dance therapy is about. The students will discover this through the exploration of their own artwork and their own movements. If we consider receptive passivity and intuitive activity as skills requested from a student (Johnson, 1989). how can a training program contribute to their development? In order to master their “intuitive activity,” students should ultimately feel that they “possess and develop (their) responsiveness to art” (Langer, 1953). It is undcrst~ that in responsiveness there is a great deal of intuition and that intuition cannot be taught in a dogmatic way. However, it can be encouraged and incremented through the exercise and exploration of one’s own personal artistic expression. By becoming responsive toward their own need for expression, students will learn how to approach another’s artwork with empathy. The students’ capacity to form an empathic resonance (Robbins, 1988) with another has its roots in entering their own internal personal artistic expressions. With respect to “receptive passivity,” this is very much connected to a “not knowing disposition” (Bollas, 1989). This in turn is very similar to the attitude of artists toward their work. When artists start their creative effort, they may or may not have an idea of what will unfold. The acceptance of such a knowing-not-knowing state of mind plays a central role in the creative process. It is the acceptance of uncertainty, formless chaos, that will ultimately produce a new form. N. Coltart (1986) stated of the work of psychoanalysts, “We do not know what we are doing . . . in spite of our training, our literature, our experience however much we gain contidence or refine our technique, each hour we spend with a patient is an act of faith” . . . (it consists in) “the unconditional truth that we analysts need to have in order to believe that
whatever else happens in the analysis it will continue working . . .” The acceptance of the not-knowing component is linked here with faith in the work itself. The students will, therefore, come to know that whatever the patient produces, in spite of their capacity at that moment to understand it, to put it in a frame of reference, it will continue to exist and will be another piece of reality that finks together two persons, two experiences, two sessions. The not-knowing disposition also determines the creation of a potential space (Bollas. 1989; Winnicott, 1953) where the communication between patient and therapist takes place. The student is caught between the “urge to know and the essentials of not knowing” (Bollas. 1989). but this is nonetheless “an essential dialectic, one that is at the heart of creativity in living, a dialectic between knowing (organizing, seeing, cohering) and unknowing (loosening, not perceiving)” (Bollas, 1989, pp. 62.63). Students will be helped through their artistic expericnce to meet the extremities of such a process. This will imply the act of fusing with the other, to become one with it and to separate from it. If there may be plcasure in losing consciousness, on the other hand there may be fear and panic about entering the chaos and incoherence of the absence of boundaries. The training program itself will, therefore, act as a “holding environment” in order to provide a safe space for the students during their participation in the aesthetic experience. The dialectic of fusing and separating is one of the sources of the creative process according to Rose (1980). It brings with it the primary and the secondary processes, which in his view are not antithetic, but interconnected with each other so that “one leads to another, in a succession of events” (Rose, 1987 p. 203). The capacity to pass from one process to another has always been seen as one of the most important skills of creative arts therapy students (Robbins, 198 I). Everyone agrees that “interaction involving the creative art therapy student is multilevelled” (Lusebrink, 1989). Khan (1986) wrote that there are two types of experience involved in psychoanalytic pedagogy: apprenticeship and instruction. The first is “the process of experientially facilitating the talent and capacities of a person for a certain skill. in terms of the tradition of that skill. Instruction, by contrast, is the intellectual transmission of certain established and accepted
ARTS THERAPY TRAINWG IN ITALY data of conceptual knowledge in a given field of research and enquiry” (p. 112). Regarding app~nticeship, we are reminded of the past when education of the artist-to-be was given in the atelier of a famous artist, or even at the service of a “maestro.” The practical instruction given by the older successful artist often contained some sort of philosophical reasoning about art and life in general. In this way there was no split between apprenticeship and inst~ction. Questioning psychoanalytic pedagogy, Khan asked “How can one be absorbed with and surrender to the analytic process and be observing and learning from it at the same time?” (1986, p. 116). This capacity involves ego-splitting. It is a kind of benign ego-split, wrote Khan. that the students must tolerate and master in order to achieve the capacity to pass from one state to another. This is the same kind of split that arts therapy students have to face when they are required to move from an intuitive level to a more thoughtful one or vice versa. Will we eventually propose a reunification of the split? How‘? As far as psychoanalysis is concerned, Khan wrote that “neither rational knowledge nor wisdom . . . are sufficient vehicles for the integration of the individuai in depth” (1986, p. 127) and he called on the development of insight (Winnicott, 1959). It goes without saying that the emotional dimension plays a major role in any learning experience. from childhood to adulthood. With respect to creative arts therapy, art itself provides a place where the split can be worked through. The split becomes perceived less as a fracture in a process and more as a succession of different phases. The art experience condenses opposites and reunifies dichotomies; therefore, it is the place where contradictory attitudes--be they feeling/thought, activity/ passivity, “to surrender and to observe” (Khan, 1986)--tan be accepted as fundamental components of the experience itself. In order to perceive and to utilize this function of art, students undergo different experiences that wifi permit them to explore their particular empathic resonance with a variety of affects and ego states. As art is an attempt to find a form that is symbolic of human feelings &anger, 1953). the students will connect their emotions with that specific art form and with a provided concept. Connecting a psychoanalytic concept with an art experience is one of the ways Robbins structures his seminars: in teaching about pathology he will ask the
II3
students to explore different “primitive mental states” (Giovacchini, 1979) so that they will feel that “their life experiences am aI too similar to those of their patients . . . (that) psychopathology is a continuum rather than an absolute defined entity” (Robbins. 1988 p. 98). The students will realize how the art form will vary according to the experiences that are called for. This (which seems obvious) is nevertheless the focus of the students’ work. What the students will be deaiing with is the connection between emotional states and art forms that will change or remain the same depending on the relationship between the patient and his or her primary objects, one of which the students will be taught to recognize as themselves. In other words, the relationship between the studenttherapist and the patient will affect emotional states that will in turn be explored or masked in the art forms. In summary, the emotiona experience that the making of art implies helps the students in two ways: 1. to go through the merging with the object and subsequent separation from it and, from these extremes, through all the phases of this endless process (Rose, 1980). which is the basis for object ~~ationship; 2. to master their knowledge of a theory and link it with their emotional experience so that the evocation of the theory will bring along the affect and/or vice versa. “By facilitating the integration of emotion with thought and perception, art iIiuminates reality in a particular way from within. This is related to the Rower of imaginative insight or empathy-the capacity to enter minds and situations and intuit them from within” (Rose, 1987. p. 207). As has already been noted, art making through structured exercise or studio time helps the students to develop their capacity of “imaginative insight or empathy.” We nevertheless wish to stress once more the importance of enhancing the empathic response by integrating intuition and thought. Sometimes it is easy for arts therapy students to be intuitive, but, in spite of the importance of such intuition, a situation will eventually require a conceptualization of the intuitive response, for instance, in the form of a case presentation. The belief that a theory can be a rescuer in all the difficulties of work produces a split between theory and emotional response -the theory. instead of promoting an understanding of the situation, transforms itself into a rigid,
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fixed schema and prevents the emotional aspect from finding a safe and solid frame of reference. A training program must provide the ingredients; the product will come out slightly differently for each student. Emerging from the fields of art and psychoanalysis, ingredients are those primary sources that motivate the human being to relate to the external world in order to give form to some “dead material” (Milner, 1987). The act of forming has its roots in the relationship with the mother, the first object promoting a change in the form of the baby’s reality and, therefore, allowing an aesthetic experience, perhaps the first human aesthetic. wrote Bollas (1987). Once the capacity of transforming the reality of the self becomes the patrimony of the child, there will be a constant search for some external object capable of promoting a transfo~at~on. The aesthetic experience, Bollas reminded us, whether an artwork enjoyed as author or as audience, or a precious moment of co-participation with nature, contains a transformational quality for human beings. In arts therapy, forming is a continuous process that puts the therapist and the patient in a specific relationship, permeated by a potential aesthetic experience. Such an experience is “par excellence” the ground of exploration of our students. Their inner world will be there to be formed and transformed through the artistic process. The teachers and the supervisors will act as agents who provide the place and the structure when: such expcricnce can occur. From Philosophy to Practice: The St~cture of the Training Program In order to focus on training objectives and methodology, it is necessary to briefly describe the structure of the program, which consists mainly of monthly meetings. Each month a small group from the same academic year meets with a supervisor for about six hours to participate in the following activities: 1. an art or dance therapy group-a fully experiential group where students can express themselves through art or movement and be involved directly in a group process; 2. a “write-up” discussion group-before the meeting each participant prepares and sends to her supervisor a write-up, which is a sort of schema or outline focusing on a major dynamic of a session chosen by the student from her
internship practice. All write-ups, together with the supervisor’s comments, are read and discussed in the group; 3. a group supervision-each month students take turns in presenting a full case study. Therefore we can describe these meetings as a magic box made of three separate containers, each fulfilling a specific and delicate function in the student’s training. The concept of setting, where time and space once defined allows meanings to take form. and vice versa, is here applied both to specific moments and to the meeting as a whole. The same images, themes, movements or issues seem often to run through the case presentations, the experiential and the discussion group. These appear to be the symbolic content of students’ developmental stages in their training experience. Within their peer group and through supervisors’ guidance, students are involved in their own creative processes, learning to know each other and to connect with the group through personal imagery or movement. This understanding will enable them to get in touch with each other’s styles and defense mechanisms and to become more aware of their own as well as each other’s issues, especially because of an increasing trust and cohesion within the same group. Each moment within the monthly meeting is separated and differentiated. Each represents a peculiar level of attention, participation and observation that students need to deveIop in their clinical work. The overall structure promotes a sort of integration of what we think is vital in the learning experience. Starting from the personal experience, the other different levels of understanding will coexist in one’s clinical work. In order to clarify this concept, we will give some examples of how students worked through main issues in their personal as well as their clinical work at a certain stage of their training and how this process was facilitated by the different levels of work involved within each meeting. The quality of the ongoing relationship between a student and a very inhibited child appeared very vividly to the group once they recognized that the child’s and the student’s own imagery had many similarities. The group supported the student’s ego, which seemed quite trapped in the dynamics. In fact, the student described her ~lationship with the child by saying that she was with him in “his castle,” and whales and volcanoes were threatening that place, thus making it
ARTS ‘I’HEbWY unsafe. The student was very upset because the child did not want to come to therapy and yet seemed unable to leave; he was feeling the therapist in a kind of competition with his symbiotic mother, his fear and wish for merging seemed to be his major problem at this point. This helped the student to create a “castle” for herself, where the child could go and “visit.” In this way, the student worked through her own need for a personal territory and boundaries to feel separated and related at the same time, in order to allow a therapeutic process to occur. The image of the castle as a metaphor of personal space was transformed in both child and student; the child built a city inside the walls and the student used the metaphor of the castle to represent personal territory in a workshop she led during the annual EXPO. The fortified castle was no longer needed in either the student’s or the child’s perception. This work was at such a profound level that it could not be developed without a personal involvement with the peer group. During this student’s first year, her issue was to soften her defenses in order to establish contact and get in touch with her client’s world; during the second year, and through the image of “two separate castles” or connected territories, she learned that both involvement and the right distance can be the particular quality of a therapeutic relationship. Another student produced in her group what she called “a meaningless picture.” This happened to be almost at the end of a year when her main worry was being judged by others and feeling uncomfo~able about not finding sophisticated meanings in her own as well as in other people’s artwork. The group responded very well to this picture because of a new brightness and lightness in the lines and in the colors; the title of the picture and its aesthetic value seemed to represent a big change in the student’s attitude toward herself, other group members, and her own clinical work. it was understood by her and the group how important it could be to lower expectations in order to get more deeply involved in the process and in the pleasure or pain that underlie any interpersonal experience. Once she faced this issue within the group, the group supponed her in being more receptive without compulsively searching for “meaning.” She began to accept the unknown side of the creative as well as of the therapeutic process as something to be experienced before being trapped in a readymade mewing. At this point, it appeared easier to understand that a good picture, like a good session, could
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IN ITALY
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happen without her controlling part or ego ideal being in the way. As is shown in these examples, interpretations and interventions are made in order to enlarge a psychological undying of the process as well as of the ongoing dynamics. To learn from each other, and to become more sensitive to countextransference issues that arise in clinical work, is one of the main objectives. Students also need peer support and constructive criticism. The experiential group is a space where difficulties and problems are shared and considered as parts of the training process and not only personal impasses to be aware of. Learning about oneself is part of personal as well as professional growth. From personal p~icipation and involvement in the art/dance therapy group, students are asked to describe and present a specific session during the writeup discussion. In order to clarify the significance of this training tool, we will describe what happens in a compilation of a write-up. We have already noted that the write-up is a sort of scheme, a “closeup” on a particular interaction of a chosen situation. This helps to focus on major dynamics and on the client’s as well as the student’s style in responding to each other through the artwork, art material or movement. The writing up of this interaction is. from a different perspective, a sort of tridimensional view of what is going on. What students gain during compilation is a sense that nothing is casual; they learn to observe and capture the complex interplay of parts that occurs in any given session. The selection of an interaction heips them to focus their attention; this will be partly descriptive (how the interaction takes piace, how the process develops, the choice of art material, a description of the picture in formal terms as well as in the content, how the client appears before this moment, etc.) and partly speculative (What is the symbolic content of the picture? What is the emotional response? What are the associations both in the client’s and the therapist’s verbal and nonverbal responses? What are the motivations of the therapist’s interventions? etc.) At the end of the write-up, the student gives a summary of the session and what it represents in the ongoing relationship and the therapeutic process. Synthesis is both at a verbal and at an image level in order to develop a “hearing attitude” toward conscious and unconscious dynamics. What strikes students most is that they begin to interpret and understand, a posteriori, that what they did s~n~eously and “without thinking,” has its logic and its deep
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motivations. They begin to see: (a) in what relationship they are with clients, (b) what they are responding to. and (c) what they activate in the other person through a small gesture or a question or just a word. The roles they adopt, consciously or not, with their clients appear more clear, with a specific order and form. After this “close up” view, we all enlarge our perspective during the case presentation, which occurs during the actual supervision time. Here a student presents a case, its history and the ongoing sessions, the connecting images, and the quality of the relationship as it evolves. The discussion is at a distance where it is possible to plan and reflect on therapeutic goals, diagnostic or clinical issues, psychodynamics, creative and therapeutic interventions, additional tools to keep the process going, and so forth. During this time a theoretical background is provided by the supervisor in order to fully understand the specific clinical issues of the case and to gain from the individual case a common learning experience. In summary. meetings provide a structure and an ongoing connecting space for the entire training experience. Its effects are strictly monitored and verified through periodic self-evaluation and feedback, which each student undergoes individually. This individual time is used to deal with personal training development and to focus on personal strengths or weaknesses. As a matter of fact, the meetings and the peer groups, in their differentiated functions, are tools for training, but the “material” is each student’s personal outcome in her clinical and psych~ynamic understanding. The Link With the Italian Reality In the process of promoting art and dance therapy in Italy following international standards, the first step was the founding of Art Therapy Italiana, whose main objective was to train qualified art and dance therapists. Thereafter the association and its training program developed together. When we started the program, art and dance therapy was almost unknown in Italy or confused with occupational and recreational activities. The word “therapy” gave rise to issues about control; public mental institutions were resistant to the new and needed references to offer placements to our students. In order to provide a supportive network and to respond to the need of our students to be rooted in the italian institutional reality as well as to develop a clear professional identity. we
created the regional “reference groups.” Each reference group represented a link between training and professional issues, also ful~lling the role of establishing a sense of a common profession among students and representing a structure that will also promote public initiatives. Each regional group, guided now by our first graduates, organizes public seminars and conferences where students present workshops and theoretical material to other professionals. By presenting projects, creating internships, and, eventually, job opportunities, the groups come to represent a particular space where the new art and dance therapist’s identity can be reinforced and supported. The purpose of this paper has been to introduce the model of training we at Art Therapy Italiana have been using for the past ten years. Creating a training program and developing its methodology, as well as promoting a new p~fession, is very inspiring work that needs to be continuously developed and constantly “confronted” with other similar programs. Rcfcrcnces
of
Bollas. C. (1987). The shudw the objccr. London: Free Association Books. Bollas. C. (1989). Forces of Jesrirt.v. London: Free Association Books. Coltart. N. f 19X6). Slouching towards Bcthlehcm . Or thinking the unthinkable in psychoanalysis. In G. Kohon (Ed.). The Brirish schaol tf psychwnulysis. The independenttrudirion. London: Free Association Books. Ciovacchini. P. (1979). The treurment o/primitive menfal sfufes. New York: Jason Aronson. Johnson, D. R. f 1989). Introduction to the special issue on cducalion and training in the creative arts therapies. The Arfs in Psyc~af~rupy, Ibl I ). I. Khan, M. R. f 1986). The privucy of rhe se& Lundon: Hogarth Press. Langcr. S. (1953). Feeling andjorm. New York: Scribner’s. Lusebrink. V. B. (1989). Education in creative arts therapies: Accomplishments and challenges. The Arts in Psychorherapy. 16(l). 5. Milncr. M. (1987). The suppressed madness ofsune men. London: Tavistock. Robbins, A. (1981). Expressive fhcrapy: A creutive urts approach to depth-oriented rrcLt~menr. New York: Human Sciences Press. Robbins. A. (1988). A psychoaesthetic penpectivc in creative arts therapy and training. The Arfs in Psychotherapy, /S(Z). 95100. Rose, G. (1980). The power o/form. New York: International Universities Press. Rose, G. f 1987). Trauma und masrery in fife and urr. New Haven & London: Yale University Press. Winnicott. D. W. (1953). Transitional object and transitional phenomena. intemationul JOWM~ of Psychoanalysis. 48. 36& 372. Winnicott. C. (1959). The devclopmenr of insight in child care and sociul work. London: Bookstall Publications.