Couples’ joint drawing patterns: Associations with self-report measures of interpersonal patterns and attachment styles

The Arts in Psychotherapy 48 (2016) 28–37

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The Arts in Psychotherapy

Couples’ joint drawing patterns: Associations with self-report measures of interpersonal patterns and attachment styles Sharon Snir (PhD) a,b,∗ , Hadas Wiseman (Prof) b a b

Tel Hai Academic College, Kiryat Shmona 12210, Upper Galilee, Israel University of Haifa, Haifa, Israel

a r t i c l e

i n f o

Article history: Received 21 January 2015 Received in revised form 5 October 2015 Accepted 27 December 2015 Available online 7 January 2016 Keywords: Attachment style Central Relationship Questionnaire Joint drawings Couples

a b s t r a c t The development of a typology of joint-drawing patterns in couples proposed that three types exist: balanced, complicated, and disconnected (Snir and Wiseman, 2013). The current study explores the links between the three drawing patterns that were derived from the pictorial phenomena expressed in joint drawings and the couples’ interpersonal patterns and attachment styles assessed by self- report measures. Sixty romantically involved couples that completed the joint drawing task. Their drawings were classified into the three types. Couples completed the Central Relationship Questionnaire, and the Experiences in Close Relationship Scale, along with the Couple’s Relationship Perceptions Questionnaire. The results supported in part the hypothesized association. Couples whose drawings were classified in the balanced drawing group reported higher love and care scores and were securely attached. They reported that their partner provided a secure base, and they enjoyed greater personal growth and development than couples in the other drawing groups. These findings provide partial support to the assumption that joint drawing styles distinguish between interpersonal patterns in the couple relationship. Applying the joint-drawing technique with couples can shed light on the relational characteristics of the partners. This finding is relevant for evaluation processes and clinical practice in the art therapy field. © 2016 Elsevier Ltd. All rights reserved.

Introduction Joint drawings In the joint drawing technique two individuals paint or draw together on one sheet of paper (Snir & Wiseman, 2010; Snir & Hazut, 2012). This art-based technique is designed to be used for diagnosis, interpreting, advancing and enhancing interpersonal relationships in systemic art therapy for couples, dyads (parent-child), families and groups (Gavron, 2010; Markman-Zinemanas & Gvuli-Margalit, 2003; Proulx, 2003). It is also used as a tool in dynamic, individual art therapy to reflect and process client–therapist relationships (Robbins, 1994; Lachman-Chapin, 1987). When the joint drawing technique is used as an evaluative tool, observable phenomena are discernible in the drawing itself and during the drawing process. For example, these are manifested

in the choice of materials, colors, the images created, the way in which the couple relates to each other and handles the task, and their verbal reactions to the drawing. The therapist can thus glean information about the couple’s relationship, needs, and difficulties (Wadson, 1973; Snir & Hazut, 2012). Although art therapists’ commonly use joint drawings to enter into an evaluative process and to intervene based on the joint creations, little research has been devoted to examine the key theoretical assumption that the pictorial phenomena manifested in the joint creations express meaningful aspects of the drawing partners’ relationship. The present study was thus designed to explore this assumption by examining the associations between pictorial phenomena expressed in free and undirected joint drawings and the partners’ interpersonal patterns as assessed by self-report questionnaires. Joint drawing patterns

∗ Corresponding author at: Tel Hai Academic College, 12210 Upper Galilee, Israel. Tel.: +972 77 4110060; fax: +972 77 4110060. E-mail address: [email protected] (S. Snir). http://dx.doi.org/10.1016/j.aip.2015.12.006 0197-4556/© 2016 Elsevier Ltd. All rights reserved.

The predominant pictorial phenomena expressed in joint drawings by couples have been documented in a larger study (Snir & Hazut, 2012) in which a phenomenological qualitative analysis led

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Picture 1. The balanced pattern.

to the development of a typology consisting of three joint drawing patterns defined as Balanced, Complicated, and Disconnected (Snir & Wiseman, 2013). The “Balanced pattern” (see Picture 1) is characterized by a coherent product resulting from the couple’s ability to implicitly agree on the subject matter and to work cooperatively on it. The couple’s drawing process is characterized by the fact that each of them creates and adds images and details to the other’s drawing, exhibits sensitivity to the colors and images the other created, but retains the ability for self-expression. As a result of this process of cooperative drawing, the visual

elements used by each member of the couple can be contiguous on the page in a way that does not detract from the other’s work. The “Complicated pattern” (see Picture 2) is characterized by unconnected images lacking a common denominator. The couple’s drawing alternates between a strong connection accompanied by many contacts between the drawn elements, sometimes to the point of defacing the work of the other, and what therapists perceive as estrangement, expressed by the creation of separate, sometimes even disconnected images, and attempts to define separate areas for autonomous drawing.

Picture 2. The complicated pattern.

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Picture 3. The disconnected pattern.

The “Disconnected pattern” (see Picture 3) is characterized first and foremost by an absence of contact between the partner’s drawings on the sheet and a lack of interest of at least one of the partners in producing the joint drawing or joint images. Each partner creates his/her own drawing on the sheet and although sometimes the product may seem coherent, attempts to graphically associate the two drawings do not lead to cooperation. The present study The current study is part of a broader project designed to contribute to the ongoing, complex process of enhancing our understanding of the use of the joint drawing as an evaluative tool. In light of the notion that understanding an artistic product is better done while considering multiple sources of information derived from the art process (Betts, 2012), the larger research program includes multiple sources and aspects of the joint drawing process. Specifically, these include: the artistic product, couples’ behavior while drawing as expressed in the drawing and in the couples’ behavior (Snir & Hazut, 2012), and the couples’ verbal reactions to the drawing process as documented in interpersonal post drawing recall after completing the drawing (Snir & Wiseman, 2015). In the present study, we evaluated the associations between the three joint drawing modes that were identified in the previous stage of the research program and the couples’ interpersonal patterns in their relationship assessed by psychometrically sound (reliable and valid) self-report questionnaires. Definition of terms Given the complexity of “interpersonal characteristics” these characteristics and the association between them were assessed through a number of measures reflecting a variety of theories of close relationships (i.e., psychodynamic, attachment and systems theory). Within the psychodynamic tradition, the central relationship patterns (Luborsky & Crits-Christoph, 1998) of each of the partners was examined. Central relationship patterns refer to

characteristic ways of relating to others that are the product of ingrained schemas of relationships with important others (Barber, Foltz, & Weinryb, 1998). These relational schemas are carried forward into subsequent relationships (Bowlby, 1988; Wiseman et al., 2002) including couples’ relationships. To test these central relationship patterns, the Central Relationship Questionnaire (CRQ, Barber et al., 1998) was employed, which is based on the clinician-rated Core Conflictual Relationship Theme (CCRT) method (Luborsky & Crits-Christoph, 1998). The CCRT method has been used widely in a large number of studies and several studies have shown that it is a reliable method for assessing central relationship patterns (e.g., Luborsky, 2000; McCarthy, Gibbons, & Barber, 2008). Like the CCRT method, the CRQ assesses three components of interpersonal patterns: a person’s wish (Wish), an anticipated or actual Response from Other (RO), and an anticipated or consequential Response of the Self (RS). In this study, the CRQ was used to examine interpersonal patterns of self and other (partner). Within attachment theory, interpersonal patterns were examined regarding the attachment style of each partner by the commonly used attachment in romantic relationships self-report scale (Experience in Close Relationships Scale, Brennan, Clark, & Shaver, 1998). Bowlby’s attachment theory (Bowlby, 1969, 1980, 1988) has been crucial to understanding and empirically investigating close relationships throughout life, including couple relations (e.g., Birnbaum, Mikulincer, & Gillath, 2011; Birnbaum, Reis, Mikulincer, Gillath, & Orpaz, 2006; Mikulincer and Shaver, 2010). Finally, interpersonal patterns relating to each partner’s perception of the overall quality of the couple relationship were assessed using the Couple Relationship Perceptions Questionnaire (CharuviWertzberger, 1996; Sorozin-Bar Or, 1996). The scoring methods for these assessment tools are detailed in the measures section. Research questions and hypotheses The major research question is whether couples defined by the three joint drawing patterns would differ in their perceptions of their interpersonal patterns? Since there is a disparity between

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creative processes that are connected to primary processes and processing of a secondary nature (Noy, 2013; Kris, 1952) as in self-report assessments (Wheeldon, 2010) it was expected that differences between the three joint drawing patters on these measures will be moderate. In addition, gender differences were examined, given the theoretical and empirical literature suggesting differences in interpersonal relation themes. Researchers generally characterize men as more autonomous, separate, achievement oriented, and independent, and women as having better capacities for intimacy, listening, openness, and togetherness (Carothers & Reis, 2013). The specific hypotheses are presented below. Central relational patterns Couples characterized by the three drawing patterns will differ on the three components of the CRQ. Wish (W). The balanced group will score higher on the wish to be supportive, whereas the disconnected pattern group will be lower on the wish to be in conflict. Response from Other (RO). The balanced group will score higher on the responses from other loves me, and lower on hurts me, controls me, is out of control is anxious, and is sexual, in comparison to disconnected and complicated pattern couples. Complicated joint drawing pattern couples will score higher than the other two patterns on the responses from other hurts me, controls me, is out of control and is anxious. Couples in the disconnected pattern group will score higher on the Response from Other is independent, in comparison to the other joint drawing patterns. Response of Self (RS). Balanced joint drawing pattern couples will describe the responses of self as high on feel valued, care for other, and am sexual, in comparison to the other joint drawing patterns. Complicated pattern couples will describe themselves as feeling more anxious and disliked in comparison to the other drawing patterns, whereas the balanced joint drawing pattern couples will score lowest on these subscales. Disconnected pattern couples will describe themselves as higher on avoiding conflict, domineering, and am independent. Attachment styles Given that attachment combinations in couples have been found to have a major impact on couples’ relations (Feeney, 2002), it was hypothesized that balanced joint drawing pattern couples will show a higher percentage of secure attachment style, whereas there will be a higher percentage of insecure attachment among couples in the non-balanced groups (complicated and disconnected). Couple relationship perceptions The three drawing patterns will differ in their perceptions of the couple relationship. Couples with the balanced drawing patterns will have highest scores on the Couple Relationship Perceptions Questionnaire on attachment, autonomy, sex, growth and personal development, familiarity, as well as on concession and compromise, and a secure base than other two groups. Couples with a complicated drawing pattern will have the lowest score on autonomy and the highest scores on emotional intensity than the averages of the other two groups, and couples with a disconnected drawing pattern will score the lowest on emotional intensity. Method This study is the fifth part of a large mixed-method research program which deals with the evaluative nature of the joint drawing

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technique. The qualitative analysis of the drawings that lead to the definition of the three drawing patterns that classified couples into the three groups is reported in detail in Snir and Wiseman (2013). The present study is a quantitative comparison between the three joint drawing patterns of the couples’ interpersonal characteristics. Participants Sixty heterosexual, non-clinical married or romantically involved couples, living together for six months or more, volunteered to participate in the larger study. Their ages ranged from 19 to 36 years (M = 26.61, SD = 3.19) and the duration of their relationships ranged from 10 months to 12.5 years (M = 45.01, SD = 30.42, in months). At least one partner in most couples was a university undergraduate or graduate student. Years of education ranged from 10 to 20 (M = 14.8, SD = 2.28). Findings from the earlier stage of the research program (Snir & Wiseman, 2013) were used as the basis for categorizing the participants into three groups: 26 couples were assigned to the balanced pattern group, 10 couples to the complicated pattern group, and 10 couples to the disconnected pattern group. Of the 60 couples, 14 couples could not be classified as clearly belonging to any group and were excluded, thus reducing the total number of participants to 48. Measures Central Relationship Questionnaire (CRQ) The Central Relationship Questionnaire (Barber et al., 1998) is a self-report measure of central relationship patterns derived from the clinician-rated Core Conflictual Relationship Theme method (CCRT, Luborsky & Crits-Christoph, 1998). The CRQ consists of 7 Wish subscales (71-items), 7 RO (56-items), and 8 RS (68-items). In the current study we used two of the seven W subscales because they could be theoretically assumed to differentiate the drawing patterns (Be Supportive and Be in Conflict), all 7 RO subscales (Hurts Me, Loves Me, Is Independent Controls Me, Is Out of Control, Is Anxious, Is Sexual) and all 8 RS subscales (Feel Valued, Care for Other, Feel Anxious, Feel Disliked, Avoid Conflict, Am Independent, Am Sexual, Am Domineering). Each item is rated on a 7-point scale from “never true or typical of me” (1) to “always true or typical of me” (7), so that higher scores reflect a greater presence of a particular Wish, RO, or RS. Examples of items for the Wish component are: “wish to support” and “wish to help”; for the RO component: “other loves me,” and “other hurts me”; and for the RS component: “I feel accepted” and “I feel vulnerable.” In the present study participants were asked to complete the CRQ regarding their relationship with their partners as they experienced it during “difficult times,” since it has been shown that CRQ ratings of the relationship “at its worst” possess greater variability (Foltz, Barber, Weinryb, Morse, & Chittams, 1999. The Cronbach alpha coefficients for the Hebrewversion of the CRQ range from .65 to .95 for the Wish subscales, .78 to .93 for the RO subscales, and .62 to .93 for the RS subscales (Wiseman et al., 2002). In the current study the Cronbach alpha coefficients ranged from .66 to .97 for the Wish subscales, .72 to .95 for the RO, subscales, and .70 to .95 for the RS subscales. Experiences in Close Relationships Scale (ECRS) The ECRS (Brennan et al., 1998) was used to assess the adult romantic attachment dimensions. This is a self-report multi-item measure of attachment based on a factor analysis of 14 different self-report attachment measures. The 36-item scale consists of two 18-item scales measuring two attachment dimensions: Anxiety and Avoidance. The Anxiety scale assesses fear of being abandoned or rejected by one’s partner (e.g., “I need a lot of reassurance that I am loved by my partner”). The Avoidance scale

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assesses discomfort with intimacy and emotional closeness (e.g., “I get uncomfortable when a romantic partner wants to be very close”). The ECRS employs a 7-point Likert-type response format (1 = disagree strongly, 4 = neutral/mixed, 7 = agree strongly). High reliabilities have been reported for Anxiety and Avoidance scales, .91 and .94, respectively (Brennan et al., 1998). The anxiety scale has been shown to be highly correlated with scales measuring anxiety and a preoccupation with attachment, jealousy, and fear of rejection; and the avoidance scale has been found to be highly correlated with scales assessing avoidance and discomfort with closeness. Evidence for validity has been widely established (Shaver & Mikulincer, 2002; Mikulincer & Shaver, 2007). In the current study, internal reliability coefficients (Cronbach alphas) for the Anxiety and Avoidance scales were .86 and .83, respectively. In addition to yielding the two dimensions of attachment-related anxiety and attachment-related avoidance, the ECRS facilitates classification into four attachment groups: Secure (low anxiety-low avoidance), Fearful (high anxiety-high avoidance), Preoccupied (high anxietylow avoidance), and Dismissive (low anxiety-high avoidance). In this study, participants were classified into the four attachment groups (according to Brennan et al., 1998) and these in turn formed the basis for classifying the couples according to the combination of the partners’ attachment classification: both secure, male securefemale insecure, male insecure–female secure, both insecure (see Snir & Wiseman, 2010). Couple’s relationship perceptions An abridged version of the Couple’s Relationship Perceptions Questionnaire (Charuvi-Wertzberger, 1996; Sorozin-Bar Or, 1996) based on the questionnaire developed by Katz-Shuster (1998) was used. The respondent is asked to indicate the extent to which each statement expresses the experience and meaning for him/her of various aspects in his/her couple relationship on a scale from 1 (does not express at all) to 9 (very much expresses). The uniqueness of this questionnaire lies in its view of the relationship as a whole and not from a perspective of each partner as they see themselves (CRQ and ECR) and their partner (CRQ). This overall view may be expressed in drawing where the therapist can actually witness the interactions of the two drawers. In this study of the 13 original subscales seven subscales which theoretically could be assumed to differentiate the drawing patterns were used. These included: Attachment (items relating to a relationship being warm, secure, with a loving, faithful, and interested partner), Autonomy (a relationship that has privacy and independence), Sex (a relationship with sexual suitability and attraction), Personal growth and development (a relationship that facilitates personal development), Familiarity (a relationship with the only person that knows me well), Emotional intensity (a relationship that influences and radiates onto the individual), Concessions and compromise (a relationship that has concessions), and a Secure base (a relationship that provides a sense of security). The subscale reliability coefficients for the current sample were acceptable for all subscales, and ranged between .52 and .95. Procedure The 60 couples were recruited through notices inviting couples to participate in a study on interpersonal relationships. Sessions took place at the couples’ homes. After a short explanation about the procedure, the participants signed an informed consent form that included the option to withdraw their participation in the procedure at any given time point. None of the individuals that participated in the study asked to stop before completion of the entire procedure. In addition to signing the consent form, they had the choice to indicate separately whether they agree to provide written authorization for their artwork to be presented

and published. Following this, each partner was given box of 24 oil pastels and the couple was given the following instructions for the joint-drawing task: “You have one sheet of paper for both of you. You can draw whatever you like, but no talking.” The participants used the oil pastels to draw on a blank, white, 100 × 70 cm sheet of paper that was pinned to the wall. The task was limited to 5 min and done twice. After the second joint drawing the participants sat separately to complete the self-report questionnaires. The entire joint drawing research project received approval by the Research Ethics Committee of the University of Haifa. Results Central relationship patterns The hypotheses regarding differences in the three CCRT components (Wishes, Responses from Other, Responses of Self) between the drawing patterns was examined using a multivariate variance test (MANOVA). Drawing pattern was the independent variable and the wishes for the couple relationship as measured by the CRQ were the dependent variables. Women’s and men’s CRQ scores were examined separately. Wishes The MANOVA results showed no significant effect of drawing pattern on the wish component; thus the hypothesis was not supported. Responses from Other (RO) Response from Other (RO) among men The MANOVA results showed a significant effect of drawing patterns on the perception of the other’s response as measured by the CRQ [F(14,72 = 2.77, p < .002]. Significant differences were found between drawing patterns and three subscales at the ANOVA level. A significant effect was found for drawing pattern and perception of Response from Other on the loves me scale [F(2,43) = 3.82, p < .030]. A Tukey range analysis showed that as hypothesized, the effect originated in the average scores of men in the complicated drawing pattern group on the loves me scale (M = 4.55, SD = 87), which was significantly lower than the averages of men in the balanced drawing pattern group (M = 5.4, SD = .86) on that subscale. There was also a significant effect of drawing pattern on the perceived Response from Other when the other loses control [F(2,43) = 4.901, p < .012]. As hypothesized, the Tukey range analysis showed that the average score of men in the complicated drawing pattern group for the out of control subscale (M = 3.45, SD = 1.61) was significantly higher than the average score of men in the balanced pattern group (M = 2.30, SD = 1.1), and men with a disconnected drawing pattern (M = 1.95, SD = .59) for the same subscale. Thus, men from the complicated drawing pattern group described their partners as more likely to lose control in comparison to the men in the other two groups. A significant effect was also found for drawing pattern and perceived Response from Other with regards to the is anxious scale [F(2,43) = 5.605, p < .007]. The Tukey range analysis found that the average of men from the complicated drawing pattern on other is anxious scale (M = 4.23, SD = 1.42) was significantly higher, as hypothesized, than the scores of men in the disconnected pattern group (M = 2.4, SD = .60) and men with a balanced drawing pattern (M = 3.11, SD = 1.30). Table 1 presents the averages of the men in each group, which shows that men with a complicated drawing pattern described their partner as tending to be more anxious than the men in the other groups.

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Table 1 Averages and standard deviations (SD) of men’s response from Other (RO, CRQ) according to drawing pattern group. Men’s response on Other subscales

Drawing pattern group Balanced Complicated Disconnected

M SD M SD M SD

Hurts me

Loves me

Independent

Controls me

Out of control

Anxious

Sexual

2.82 1.22 3.48 1.36 2.68 1.01

5.4 .86 4.55 .87 5.36 .90

5.06 1.00 4.96 .64 5.11 .98

2.29 .96 2.56 .71 2.42 .56

2.30 1.10 3.45 1.61 1.95 .59

3.11 1.30 4.23 1.43 2.43 .60

5.00 1.75 4.90 1.75 4.80 2.01

Table 2 Averages and standard deviations (SD) of women’s response from other (RO, CRQ) according to drawing pattern group. Women’s response on other subscales

Drawing pattern group Balanced Complicated Disconnected

M SD M SD M SD

Hurts me

Loves me

Independent

Controls me

Out of control

Anxious

Sexual

2.51 .99 3.31 1.06 3.19 1.19

5.53 1.22 4.89 1.18 5.40 1.35

5.30 .84 5.26 .94 5.15 .66

1.61 .51 2.28 1.19 2.74 1.77

1.82 .94 1.91 .65 1.63 .70

2.61 1.26 2.98 1.23 2.55 .78

5.35 1.78 4.13 4.13 5.70 1.58

Response from Other (RO) among women The MANOVA results showed that there was no significant effect of drawing pattern on perceptions of the other’s response (RO) as assessed by the CRQ. Nevertheless, differences between the three groups of couples were examined in an explorative manner at the ANOVA level. The results of the univariate test showed a significant effect for drawing patterns on perceiving the Response from Other as controlling [F(2,43 = 4.575, p < .016]. A Tukey range analysis showed that the effect could be ascribed to the average score of women with balanced drawing patterns on the other controls me scale (M = 1.61, SD = .51), which, as hypothesized, was significantly lower than women on this scale from the disconnected drawing pattern group (M = 2.74, SD = 1.77). In other words, women in the disconnected drawing pattern group perceived their partner as more controlling than women in the balanced drawing pattern group. The averages and standard deviations are listed in Table 2. Response of Self (RS) Response of Self (RS) among men The results of the MANOVA showed no general effect of drawing pattern on the Response of Self component, as assessed by the CRQ within men. The ANOVA level was examined in an explorative manner and a significant difference was found between the groups on two RS subscales. Specifically, a significant effect was found with regards to drawing patterns and self-perceptions as caring for the other [F(2,43 = 4.649, p < .015]. Consistent with the hypothesis, the Tukey range analysis showed that the effect could be attributed to

men’s average score in the complicated drawing pattern group of care for the other (M = 4.78, SD = 1.15) which was significantly lower than the average score of men in the balanced pattern group on this scale (M = 5.88, SD = .80). Furthermore, a significant effect was found for drawing patterns and the subscale am domineering [F(2,43) = 3.949, p < .27]. The Tukey range analysis showed that as hypothesized, the effect stemmed from men’s average score in the disconnected drawing pattern group on the subscale am domineering (M = 3.85, SD = 1.31), which had a significantly higher average score than men belonging to the balanced drawing pattern group on this subscale (M = 2.67, SD = 1.20). These findings are presented in Table 3.

Response of Self (RS) among women The MANOVA results indicated no effects of drawing patterns on the Response of Self component as measured by the CRQ in women. However, at the ANOVA level a significant difference was found between groups with regards to perceiving the self as anxious [F(2,43 = 4.540, p < .016]. The Tukey range analysis showed that the effect stemmed from the average score of women in the complicated drawing pattern group on the subscale am anxious (M = 3.49, SD = 1.43), which was significantly different from the average score of women belonging to the balanced drawing pattern group on this scale (M = 2.29, SD = 1.01). Women in the balanced drawing group described themselves as less anxious than women in the complicated drawing pattern group. These findings partially support the hypothesis. The averages and standard deviations for women’s selfperceptions appear in Table 4.

Table 3 Averages and standard deviations (SD) of men’s response of self (RS, CRQ) according to drawing pattern group. Men’s response on the self subscales

Drawing pattern group M Balanced SD M Complicated SD M Disconnected SD

Feels valued

Care for other

Feel anxious

Feel disliked

Avoid conflict

Am independent

Am sexual

Am domineering

5.53 1.04 4.76 .79 5.47 .88

5.88 .80 4.78 1.15 5.38 1.25

2.27 .92 3.10 1.11 2.29 .78

2.18 .86 2.92 1.27 2.20 .83

4.04 1.24 3.65 1.07 3.85 .92

5.43 1.04 5.16 .69 5.26 .78

5.43 1.23 4.76 1.37 5.22 1.53

2.67 1.20 3.10 .56 3.85 1.31

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Table 4 Averages and standard deviation (SD) of women’s response of self (RS, CRQ) according to drawing pattern groups. Women’s response of self sub scales

Drawing pattern group M Balanced SD M Complicated SD M Disconnected SD

Feels valued

Care for other

Feel anxious

Feel disliked

Avoid conflict

Am independent

Am sexual

Am domineering

5.66 1.25 4.72 1.53 5.14 1.27

5.70 1.25 4.89 1.27 5.32 1.38

2.29 1.01 3.49 1.43 3.21 1.40

2.12 .83 2.88 .87 2.48 .77

5.59 .74 4.81 1.15 5.23 .83

3.33 .93 3.63 1.56 4.17 1.38

5.96 .73 5.25 1.03 5.50 .93

5.32 1.45 4.60 1.11 5.00 1.03

Attachment styles In order to examine the associations between drawing patterns and attachment patterns, the couples were divided into three groups: couples with both partners classified as having secure attachments, couples with both partners classified as having insecure attachment, and mixed couples where one of the partners had a secure attachment and the other partner had an insecure attachment. The hypothesis was examined using a 2 test. Due to the size of the sample the complicated and disconnected groups were combined into one unbalanced group. Table 5 presents the percentage of couples with secure, insecure and mixed attachment patterns in the two drawing groups: balanced drawing patterns and the unbalanced drawing patterns. The results of the 2 test showed that there was a significant association between couples’ attachment style (secure, insecure, mixed) and assignment to a balanced or unbalanced drawing pattern group. As hypothesized, there were no couples in the group with balanced drawing patterns in which both partners had insecure attachments, as seen in Table 5, whereas in the unbalanced group 35% presented this form of attachment. Moreover, 52% of the balanced group was composed of couples in which both partners had secure attachments, whereas the unbalanced group had only 25% (see Table 5). The validity of these findings, however, is subject to caution since there were two cells (33%) with an expected count of less than 5, whereas the required minimum is 3.11 (20%).

as hypothesized, the average score of the secure base scale for the balanced pattern group (M = 8.39, S.E. = .15) was higher than average score for the complicated pattern group (M = 7.1, S.E. = .25) and the disconnected pattern group average (M = 7.98, S.E. = .25). A significant effect was also found as hypothesized on the familiarity scale [F(2,43 = 5.21, p < .009] where the average for the balanced pattern group (M = 7.6, S.E. = .27) on the range test (Tukey) was found to be significantly higher than the average scores for the complicated pattern group (M = 5.76, S.E. = .43) and the disconnected pattern group (M = 7.15, S.E. = .43). In addition, a significant effect was found for drawing pattern on the personal growth and development subscale [F(2,43 = 5.782, p < .006]. As hypothesized, the balanced drawing pattern’s group average score (M = 8.02, S.E. = .16) was found to be higher than the complicated drawing pattern (M = 7.11, S.E. = .25) on this scale. Finally, as hypothesized, a significant effect of drawing group on the attachment scale was found [F(2,43 = 6.879, p < .003]. The range test revealed significant differences between the complicated pattern group and the other two drawing pattern groups, where the average of the complicated group (M = 7.98, S.E. = .16) was significantly lower than the averages of the balanced drawing pattern group (M = 8.59, S.E. = .1) and the disconnected pattern group (M = 8.09, S.E. = .16). No significant multivariate effects were found for interactions or gender factors, suggesting that women and men do not differ in their perception of the couple relationship.

Couple relationship perceptions

Discussion

A repeated measures, mixed two-way MANOVA was used to test the hypothesis. The between-subject factor was the three drawing pattern groups: balanced, complicated, and disconnected. The within-subject factors were the scores of men and women within couples on each one of eleven subscales of the couple relationship perception questionnaire. A significant multivariate effect was found for drawing pattern [F(22,68) = 2.3, p < .005]. The univariate test showed a significant effect for drawing patterns on four of the seven scales that were included in the study. A significant difference was found between the three drawing patterns on the secure base scale [F(2,43 = 9.8, p < .000]. The Tukey range test showed that

The purpose of this study was to examine the associations between couples’ joint drawing patterns and couples’ perceptions of their relationship as assessed using various self-report measures of interpersonal patterns and attachment style. In so doing, it addressed the strength of the theoretical assumption that therapists can use artwork to orient relational therapy. It thus constitutes the first empirical study to examine the associations between free and undirected couples’ joint drawings, as typically produced during therapy sessions, and reliable and validated self-report questionnaires. The results showed differences between the three drawing patterns in the expected directions, providing empirical

Table 5 Frequency and percentage of couples with secure, insecure and mixed attachment patterns in the two research groups and the significant differences in the distribution between groups. Groups according to couple attachment pattern

**

Both partners insecure

Both partners secure

One secure and the other is not

2 (df = 2)

Drawing pattern Balanced Unbalanced

0 (0%) 7 (35%)

13 (52%) 5 (25%)

12 (48%) 8 (40%)

13.636**

Total

7 (15%)

18 (40%)

20 (44%)

p < .001

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evidence for the idea that the three drawing patterns express three different couple relationship styles (Snir & Wiseman, 2013). It should be noted that not all the hypotheses were confirmed. This was not surprising in light of the expected gap between information obtained from subjective self-reports and non-verbal observed information which, among other things, is related to unconscious aspects expressed during creative activity. In fact, it was quite surprising to find the significant differences that were found between the couples, who were classified based on pictorial assessments derived from the joint drawings and the self-report questionnaires pertaining to the couples’ interpersonal patterns and attachment style. Associations between the three drawing patterns and the couples’ interpersonal characteristics were found in the three defined areas that were examined: (1) Central relationship patterns with regard to the Responses from Other and Responses of Self; (2) Couples’ attachment style with regards to romantic relationships; and (3) Partners’ perceived experiences and meaning in the couple relationship. The first hypothesis dealt with differences between the three drawing patterns with respect to the participants’ perceptions of their wishes from their partner, perceived responses of the other, and perceptions of their own responses during difficult times in the relationship, using the CRQ. The results partially supported the hypothesis, and showed that men from the balanced pattern drawing group described the responses of their partner (RO) during difficult times as more loving than men from the complicated drawing pattern group. These men also described themselves as more caring toward the other than those men with a complicated drawing pattern. Furthermore, the men in the complicated drawing pattern group perceived the response of their partners as characterized by a larger degree of anxiety and a greater tendency to lose control than men in both the balanced and disconnected drawing patterns groups. The women in the complicated drawing pattern group reported being anxious to a greater extent than the women from the balanced drawing group. The perception of their partners and their own relational responses in the couples from the disconnected drawing pattern group differed from couples with a balanced drawing pattern mainly in the area of dominance and control. Both men (RS domineering) and women (RO controls me) in the disconnected pattern group perceived the men as relatively more domineering or controlling. Like the men in the balanced pattern group, men with disconnected drawing patterns described their partners’ responses as less anxious and less tending to lose control than men in the complicated drawing pattern group. Weinryb and his colleagues (Weinryb, Barber, Foltz, Goransson, & Gustavsson, 2000; Barber et al., 1998) also found a correlation between perception of the other as the controller, a trait characterizing women’s perception of their partner disconnected group, and traits of social avoidance and coldness in interpersonal relations, which were present to a certain extent in disconnected drawing patterns. Perceiving the self as responding with anxiety, which characterized women in the complicated drawing pattern, was found by Weinryb et al. to correlate with interpersonal problems in the area of over-nurturing and lack of assertiveness. These traits may be part of the foundation of the problematic combination of over-involvement and the disconnections that may characterize the complicated drawing pattern. Perceiving the other’s responses as more loving and perceiving one’s own responses as more caring for the other, which characterized men in the group with balanced joint drawing patterns, were found to be negatively correlated with cold interpersonal relationships and social avoidance (Weinryb et al., 2000). The second hypothesis posited a significant association between the drawing patterns and attachment styles characterizing the couples. The findings showed greater levels of secure attachment in

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couples with balanced drawing patterns, whereas in the unbalanced groups more couples both reported insecure attachment. Finally, as posited in the third hypothesis dealing with the participants’ perception of the couple relationship, couples with a balanced joint drawing pattern based on cooperation and production of a coherent drawing described their experiences in the couple relationship on the self-report questionnaire as one with a secure base that imparts security and prevents loneliness to a greater extent than couples in the other two groups with unbalanced drawing patterns (complicated and disconnected). Moreover, participants with a balanced drawing pattern reported a greater degree of familiarity in their relationship, and tended to respond that their partner “is the only person who knows all sides of them,” in contrast to those with unbalanced patterns. Couples in the balanced drawing pattern group also differed from those with complicated drawing patterns, by scoring higher on measures of personal growth and development possibilities in the couple relationship and greater levels of communication including support, attention, and sensitivity from their partner. These findings actually describe the association between the couples’ ability for positive, nonverbal interactions, and the participants’ perception of the couple relationship as characterized by mutual caring, and the ability of each to be a source of security for the other in a way that enables each partner to personally grow and develop. In general, these findings support earlier reports indicating a correlation between positive communication and positive interactions in couples and their greater satisfaction and positive perception of the couple relationship (Henery, Berg, Smith, & Florsheim, 2007). Overall, the findings point to the associations between the balanced drawing pattern and secure attachment, partners’ familiarity, and qualities such as love, caring, sensitivity, support, listening, and familiarity. In contrast, the unbalanced drawing patterns appear to be related to a greater presence of insecure attachment and a lesser likelihood that the relationship can serve as a secure base for the partners. Specifically, the complicated drawing pattern was highly correlated with women’s anxiety and tendency to lose control and with men’s relative feeling that the partner does not love them. The disconnected drawing pattern was associated in men with a relatively high level of control and dominance. Attachment theory may help account for the associations between drawing behavior and the couple relationship qualities. Research has reported correlations between secure attachment style, which are characterized by the qualities of perceiving the other as supportive and responsive, perceiving the self as loveable and worthy of response, and having the relationship serve as a secure base (similar qualities reported by participants in the balanced drawing pattern). In addition, participants’ self-reports of characteristic behavior in the relationship such as sensitivity, acceptance, closeness, availability for the other and cooperation, as observed in some of the balanced drawing pattern behaviors as well (Feeney & Hohaus, 2001; Kunce & Shaver, 1994). The anxious attachment style was typified by difficulty in serving as a secure base and having a great deal of anxiety, anger, and frustration. It was found to characterize individuals with less sensitivity and cooperation and compulsive and controlling treatment of the other, similar to the behavioral qualities in the complicated drawing pattern group (Kunce & Shaver, 1994). Similarly, Feeney and Hohaus (2001) found that women with anxious attachment reported more negative feelings about the treatment and caring they gave to their partner, which these researchers associated with a difficulty in meeting the needs or the compulsive treatment of the other. These behaviors may explain the ambivalent functioning affecting cooperation in couples’ in joint drawing complicated pattern.

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The avoidant attachment style, which is characterized by the absence of a secure enough foundation for the couple, but is not typified by high levels of anxiety and loss of control, was found by Kunce and Shaver (1994) to be associated with behaviors such as less caring and nurturing, less availability, and less physical closeness, which also characterized the couples’ interactions during the disconnected joint drawing. Studies have indicated that women with an avoidant attachment style find it difficult to help their partners, ask for help, know the needs of their partner or cope with problem solving (Feeney & Hohaus, 2001), which were characteristic of the disconnection between partners while creating in the disconnected drawing pattern. The findings here failed to confirm the hypothesized difference between the three joint drawing patterns regarding the kinds of wishes characterizing the participants. This deserves attention, given the preponderant weight ascribed to the Wish component as part of the therapeutic power of creative action that sometimes allows unexpressed factors in reality to take on painterly expression (Berger & Lahad, 2010). Early studies examining the connection between wishes and attachment working models on the Adult Attachment Interview (AAI) have also failed to find difference between attachment classifications regarding the wish for closeness (e.g., Waldinger et al., 2003). Bowlby claimed that the wish for closeness with the attachment figure is an integral part of relations from infancy that aid in survival, and that this wish is universal and common to all humans. While the wish for closeness and support in relationships is characteristic of everyone, differences between groups characterized by different attachment representations suggest that there are diverse strategies in which individuals try to achieve this wish. Similarly, the different drawing patterns may express the way various couples handle wishing for relational togetherness, while not reporting different wishes in the couple relationship. While the balanced and complicated joint drawing patterns were clearly different from one another, the disconnected drawing pattern only differed from the balanced drawing pattern regarding the RO of control and dominance attributed to the male by both partners. Since both partners concurred with regards to the man’s dominance in these couples, it is possible that a dominant masculine work style with its attributes of autonomy, separation, and dominance (Carothers & Reis, 2013) contributed to the separation during the joint drawing in the disconnected drawing pattern. The relatively low differentiation in the disconnected drawing pattern may capture the difficulty of some of the participants to report less positive features, elicited by the self-report questionnaires. This difficulty is related to the difficulty of avoidant individuals to report less positive aspects of their relationships and their tendency to idealize relationships, as seen in the AAI (George, Kaplan, & Main, 1984; Crowell & Owens, 1996). The need to describe the relationship, especially relating to its more difficult times, may have elicited a defensive reaction in some of the participants such that they tended to answer the self-report questionnaire in a way that described the relationship as more positive than it was. This is turn could have blurred the differences between participants in the disconnected drawing pattern group and the balanced drawing pattern group. Although couples in the disconnected drawing pattern group were differentiated from the balanced group in terms of the themes of control and dominance, these themes may also have positive connotations implying strength, and thus could be reported by the participants. Finally, it is possible that the low differentiation in the disconnected drawing pattern may have stemmed from the initial definition of the three drawing patterns. Whereas the balanced drawing pattern expresses a positive relationship pattern and the complex pattern expresses an especially problematic relationship pattern, the disconnected drawing pattern could have been in an

intermediate position. Since this was not a relatively large group, the statistical analysis may not have been sensitive enough to detect differences between this group and the other two. In any case, an additional examination of the definitions of the three drawing patterns and additional samples would be important to fine-tune the definitions and interpretation of the three drawing patterns. It is important to emphasize that this study was carefully planned with respect to the assumption that the meaning of a pictorial phenomenon cannot be understood simply through a dictionary definition in which image “x” means feeling “y” (Betts, 2006), and that the context in which it exists (such as other pictorial phenomena around it) is essential to raising questions regarding its meaning (Snir & Hazut, 2012). For this reason the pictorial phenomena were examined in clusters of phenomena which were found to coexist in earlier stages of the research. Thus, the association between the drawings and the validated self-report questionnaires is only statistical, and cannot provide a definitive response to the question of what a specific pictorial phenomenon, or even a specific drawing pattern, expresses. For the same reason we also tried to avoid expressions such as diagnostics or validation of the technique. Despite this limitation, the present findings do offer a broader understanding of couples’ free and undirected joint drawings. Thus, the findings can contribute to the body of knowledge being developed by experienced clinicians, who accumulate insights regarding the possible meaning of pictorial phenomena during their clinical work. These insights may accompany and even direct evaluation processes in the future. Another limitation of the study has to do with the use of self-report questionnaires to evaluate attachment styles, and interpersonal patterns in the couple relationship. Information from interviews, which would also target unconscious areas, could increase the study’s validity since a connection might be found between two independent observation assessment tools, and the limitation of self-reports could be overcome. Thus, the results could have greater relevance for therapeutic practice, in which discussions after the creative act include free (Snir & Regev, 2014), rather than structured expressions of the participants’ experience. References Barber, J. P., Foltz, C., & Weinryb, R. M. (1998). The central relationship questionnaire: Initial report. Journal of Counseling Psychology, 45(2), 131–142. Berger, R., & Lahad, M. (2010). A safe place: Ways in which nature, play and creativity can help children cope with stress and crisis-establishing the kindergarten as a safe haven where children can develop resiliency. Early Child Development and Care, 180(7), 889–900. Betts, D. J. (2006). Art therapy assessments and rating instruments: Do they measure up? The Arts in Psychotherapy, 33(5), 422–434. Betts, D. (2012). Positive art therapy assessment: Looking towards positive psychology for new directions in the art therapy evaluation process. In A. Gilroy, R. Tipple, & C. Brown (Eds.), Assessment in art therapy (pp. 203–218). London and New York: Routledge. Birnbaum, G. E., Mikulincer, M., & Gillath, O. (2011). In and out of a daydream attachment orientations, daily couple interactions, and sexual fantasies. Personality and Social Psychology Bulletin, 37(10), 1398–1410. Birnbaum, G. E., Reis, H. T., Mikulincer, M., Gillath, O., & Orpaz, A. (2006). When sex is more than just sex: Attachment orientations, sexual experience, and relationship quality. Journal of Personality and Social Psychology, 91(5), 929. Bowlby, J. (1969). Attachment and loss: Attachment. New York: Basic Books. Bowlby, J. (1980). Attachment and loss: Sadness and depression. New York: Basic Books. Bowlby, J. (1988). A secure base. New York: Basic Books. Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult attachment: An integrative overview. In J. A. Simpson, & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York, NY: Guilford Press. Carothers, B. J., & Reis, H. T. (2013). Men and women are from Earth: Examining the latent structure of gender. Journal of Personality and Social Psychology, 104(2), 385–407. Charuvi-Wertzberger, T. (1996). Investigating the experience and meaning of the concept of love in couple relations. Department of Psychology, Bar Ilan University (Unpublished master’s thesis, in Hebrew).

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