Fragments of art at work: art therapy in the former Yugoslavia

The Arts in Psychotherapy, Vol. 26, No. 1, pp. 15–25, 1999 Copyright © 1999 Elsevier Science Ltd Printed in the USA. All rights reserved 0197-4556/99/$–see front matter

PII S0197-4556(98)00027-6

FRAGMENTS OF ART AT WORK: ART THERAPY IN THE FORMER YUGOSLAVIA DEBRA KALMANOWITZ, MA, RA, Th., and BOBBY LLOYD, Dip. AT, RA, Th.*

Glenny’s words describe a complex and multifaceted conflict and provide a clue as to why there has been a general confusion in people’s minds as to what was actually happening in this European country. Understanding this war as either a civil conflict characterized by chronic strife, high personal involvement, poor definition of the threat and political, social and economic oppression or as conventional warfare where the enemy (threat) is clearly defined (conflict between nations carried out by force) is important in attempting to decipher the external elements that have psychologically influenced the individuals (both children and adults) with whom we worked. The overlapping of the collective and the individual where the political becomes the personal is pertinent from whichever angle this war is considered. Derek Summerfield (1995) has attempted to understand trauma in the context of political conflict generally. His thoughts are relevant to this particular context: that it is the social fabric itself which is the central target “and in its damaged state remains the context in which large numbers of people must manage their distress and cope with their fractured lives” (Summerfield, 1995, p. 356). The process of arrest, torture, release, flight and exile involves trauma at many levels. In so far as humans are social beings, this trauma can be understood, not only as an assault on the individual person, but as an assault on the links and communications between people and the patterns

Introduction That which is not expressed Will be forgotten That which has been forgotten Will happen again —Russian poet Yevgeny Yevtushenko (1978) The words of this poem resonate with our work in the former Yugoslavia where war spanned 4 years, and are particularly pertinent in a war described by Ed Vulliamy (1994) as “dominated by history,” where the past eclipses the present struggle and history dominates every interview. In presenting fragments of art at work, it has become essential to consider this backdrop. The years 1992 to 1995 saw the destruction of Yugoslavia as a European country. The war arose out of the process of change in modern Europe: a change in the balance of power and a move from communism to democratization. The central conflict which destabilized Yugoslavia was between, on the one hand, the desire to create and consolidate (in the case of Serbia) a state in which one national group was dominant, and on the other, the perceived or demonstrable vulnerability of minority populations in these projected states. (Glenny, 1993, p. 235)

*Debra Kalmanowitz is a freelance art therapist in London. She works with refugees and is presently working at the Medical Foundation for the Care of Victims of Torture in London. Bobby Lloyd is the art therapist in the Children and Families Department of a Community NHS Clinic in Central London. Together they have established “the art therapy initiative” which focuses on art therapy in the context of political conflict. They have co-written a book on their research and co-run a weekly art therapy group for parents in a Central London Refugee/ Homeless Families Centre. 15

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of relationships through which people define themselves and give meaning to their lives. Psychologists have tried to understand the psychological effects of the war on children in Bosnia. Those working for UNICEF (United Nations Children’s Fund), for example, collected the following data by sampling 1,505 school-aged children in Sarajevo in June and July 1993 as part of UNICEF’s War Trauma Screening programme:

Mostar had moved into an apartment formerly owned by their Servian friends), living with a large influx of refugees who changed the character of the town bringing a change of life, not necessarily chosen. As art therapists and care professionals, we needed to consider our position within an overall context of care. It seems that care specialists in this field have not yet developed a structure for defining the plight of the individual who lives through war.

Y 23% of children have been forced to leave their own town or village during the war Y 7% of children reported that family members have been wounded or killed during the war Y 46% have seen dead bodies Y 79% have been in a situation during the war in which they thought they would be killed Y 97% have experienced shelling very near by Y 96% have had their homes attacked or shelled Y 55% have been shot at by snipers Y 11% have experienced serious food and water shortage.

In other words, as yet we have not developed a model comparable to that of divorce, which would enable us to normalise the suffering due to war (which includes the refugee experience) without diminishing its disruptive effects as well as its abhorrent nature. Thus, it appears as an unavoidable consequence that the stories that are told about refugees by themselves and by professionals tend to be formulated within the context of a pathology and deficit paradigm. (Papadopoulos & Hilderbrand, 1997, p. 209)

Out of the same sample taken in Sarajevo, “trauma reactions” showed that “23% of children thought that life was not worth living; 29% felt unbearable sorrow; 21% felt alone; 20% had terrifying dreams and 34% had stomach aches; this may be evidence of extreme hunger, or may be psycho-somatically conditioned” (UNICEF, 1994). Whether such methods of categorization are useful in testing children’s “psychological trauma” is a subject on its own, although the categories do provide shocking detail of these children’s lives in war. Little could have contributed more to our understanding of the situation than actually working in the former Yugoslavia, listening to individuals’ stories and witnessing a reality of their lives. During three visits, the impressions we gained were of Yugoslavia as a country in which Serbs, Croats and Muslims once shared their lives: lived side by side as neighbors and friends and inter-married. These same people had now become enemies with families and cities divided (such as Mostar) and whole communities displaced. The 4 years of the war forced individuals to define themselves as Serb, Croat or Muslim—thus forging identities often never considered on a personal level as of foremost importance before the war. The lives of the people we met and stayed with in Sarajevo and East Mostar were characterized by loss of home, loss of family, at times living without electricity and running water, shortage of food, living in the home of friends who fled the area as they were the “wrong” ethnic group (our hosts in East

Terms such as Post-traumatic Stress Disorder (PTSD) and trauma are frequently used to pathologize individuals’ experience. Can they be useful when explanations which imply external events have little to do with the way the individual perceives these events, digests them and makes meaning out them? In a context in which there is an ongoing debate as to how to make sense of this, specialists have proposed other concepts, such as “cultural bereavement” (Eisenbruch, 1990, 1991), “nostalgic disorientation” (Papadopoulos & Hilderbrand, 1997, p. 213) in which nostalgia is taken from the classical Greek, meaning “the pain experienced in the yearning to return home” and Post Traumatic Stress Syndrome (PTSS) in which there is an effort to create a general description taking the emphasis away from the “disorder” (Marsella, 1994, p. 215). In this context, war and political conflict will have different meanings for different individuals and remembering the centrality of the individual becomes of vital importance. In consideration of the above, what remains is to listen to individual stories and the ways in which each person consequently imagines the world around them. The Origins of Our Work In response to the scope of personal suffering witnessed, a British charity called War Child, working in the former Yugoslavia, began investigations into es-

ART THERAPY IN THE FORMER YUGOSLAVIA tablishing an “arts-based trauma centre” in Bosnia with arts therapies as central to its programme. War Child contacted the Art Psychotherapy Unit at Goldsmiths College, London University, seeking professional advice as to how to begin exploring the viability and implementation of such a project. In late 1994, we established the Art Therapy Initiative (ATI) with a small working party to head and research the art therapy component of War Child’s proposal. In this capacity, ATI carried out two pilot art therapy projects in Slovenia and Croatia, and research in London, Croatia and Bosnia (Sarajevo and East Mostar) in collaboration with War Child and the Art Psychotherapy Unit. Work on this project extended over 2 years, 1994 –1996. On-site work in the former Yugoslavia itself took place in 1994 and included two pilot art therapy projects—the first in Slovenia and the second in Croatia. These were funded by private sponsors, War Child and the Bosnian Support Group. The latter was keen to add a therapeutic component to the aid it already provided to the refugee centre in Slovenia, believed art therapy would be an appropriate form of therapy for this centre and therefore supported the pilot project with a view to long term implementation. We received a small Research Grant in 1995 from Goldsmiths College, London University, to document our research (Kalmanowitz & Lloyd, 1997). The pilot art therapy projects were primarily exploratory with the variables largely unknown. The overall aim was to assess whether art therapy could be used in these contexts and to provide a time-limited art making experience. The art making took place in an art studio (portable studio) environment which we termed art sessions and explore in greater depth later in the paper. In addition to this, it was essential to observe, informally, the life and the environment of the refugee centres so as to gain some small understanding of the experience of the people who found themselves refugees. In both situations, we lived and worked in the refugee centres. The initial premise was that the work would have to be tentative with a desire not to impose a model of art therapy, which may not be applicable or welcome. The intention was to begin with a period of observation and listening before introducing art. Fragments of Art at Work Originally healers were also artists; the healing process was a ritual event, and the shaman or

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medicine man functioned as a ritual master of ceremonies. These healing ceremonies can be seen to recur in different forms as social life differentiated. For example, Greek tragic drama was not experienced primarily as entertainment but as a collective ritual with a cathartic and purifying effect. Similarly, religious ritual, example, the catholic mass, or the Passover seder, is designed to have healing action on the soul. It is only in the modern world-view that the healer is conceived as a detached observer working within a desymbolized reality. (Levine, 1992, p. 3) When we were in Sarajevo, we met art students who had daily risked crossing “snipers’ alley” in order to get to their studio at the art school on the other side of the river. We were invited by one mother to see the room of her daughter, also a student, who had covered all four walls with her diary of her experience throughout a year of the war—poems, words, posters and drawings. The use of the arts in the context of war is not new. In writing about drama in the concentration camps Zivya Seligman, a drama therapist, describes the spontaneous emergence of theatre activities as common. She writes I perceive the theatre activity that characterized most of the concentration camps as part of the (same) struggle for life. If we could explain what sustained the drive to live in a setting that offered little realistic hope for survival, we might be able to explain what sustained this extraordinary drive to create, to perform, or to be a spectator in this very same setting. (Seligman, 1995, p. 125) In our meetings in Bosnia, Croatia and Slovenia, the recognition of the value of art was no less poignant. Indeed, it was striking to note that in almost all situations where support was being offered to both children and adults, art was already being made. Following is a description of fragments of art at work in the two refugee centres—Hrastnik in Slovenia and Prvic in Croatia. For the purposes of this article, all names have been changed. Slovenia On-site work in Slovenia took place at Hrastnik refugee camp. The camp is set above the largest coalmining town in Slovenia, surrounded by beautiful

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Figure 1. Children make a house in the town dump, Hrastnik refugee centre.

hillside and allotments belonging to local Slovenians and consists of six huts grouped on a dirt patch. In 1994, each hut housed about 35 people and each had one shower. The refugees numbered 200 and were mostly Bosnian Muslims. They arrived in April 1992 and most were still there at the time of our visit, 1994. Most were women and children. The few men were either over 60 years of age or were migrant workers in the local mines before the war, the latter having no official refugee status. The art sessions took place over two visits, which were intended to be the first in a series of regular visits and an extended relationship. Local politics, however, were to prevent this from taking place. The art sessions tried to encompass everybody. Art took many forms as it was necessary to approach different age groups in different ways. The mothers would not come to an art session but were able to accept an embroidery session in the evenings (after their communal work was completed). Within this they were open to explore personal themes. In working with the grandparents, art participation took the form of portrait drawing in which couples spent the time looking at and drawing each other. Adolescents seemed to prefer groups in which themes such as drawing ob-

jects in their environment and portraiture were used as a starting point. The art sessions, however, focused on the children as they were the largest group in the camp. We set up morning and afternoon art groups in our room. Each morning we took a regular art group of up to 15 children. Houses soon emerged as the main theme, with the art work often resulting in an attempted drawing— by girls and boys— of a house. Sometimes the surfaces were marred or unidentifiable flying objects would appear as if in spite of themselves: pieces would be gouged out of rooves, or the entire picture would be defaced or scribbled over—at times by another child. Due to this apparent preoccupation with the house, the theme of the house was carried outside into a disused town dump so that a house could be physically built. A group of eight of the older children (aged 10 –13) unearthed an old stove, a basin, a bicycle, three windows, several pots and bottles, a washing basin, a bed, a shelf . . .. By creating a human chain, enough stones were collected from a quarry to build the foundations of the building (Figures 1 and 2). The children took pride and delight in their house. When the house was knocked down by local children, the group rebuilt it—adding branches for a roof.

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Figure 2. Children pose for the camera inside their house, Hrastnik refugee centre.

Knocked down a second time, the children sat in the remains and made drawings of the surrounding landscape. While the house was being built, several of the younger children (aged 6 –9), unfacilitated, appeared to spontaneously make houses of their own in the woods behind the camp. These began as little furnished rooms with tables and chairs made from found objects. Then rugs were fetched from their rooms in the barracks, and the children climbed into their houses—twigs used to demark each space. When these were also knocked down, they calmly reconstructed them, and when they were destroyed a second and a third time, they patiently rebuilt their symbolic homes. This process continued over the subsequent 2 or 3 weeks. Some of these children had spent long nights hiding in woods, before their safe arrival in Slovenia. All of these houses appeared vulnerable, yet all had a marked out skeleton of a boundary. Using our camera, the children were anxious to record the houses (standing and destroyed), placing themselves inside. It was powerful to observe both this act of destroying, and the patient and insistent recreating of what had been destroyed. In addition to the group process, each individual child appeared to infuse the activity with his/her own

preoccupation. The process of Lara, an 11-year-old girl, who participated in the art sessions throughout the 5-week period, was particularly visible. On the day we arrived, we witnessed a telephone call from Bosnia, which gave news of the death of Lara’s father from a grenade. The following day, she attended the first art session and began to draw and paint houses, engaging in the art making with an intensity, which was to continue over this period. From then Lara seldom missed an art session: even when other children were called away, Lara always seemed to be present. Following the building of the house in the dump, Lara was one of the children instrumental in constructing a totemic gateway for the house. Lara’s contribution was a tree trunk splattered with red and black paint. When this gateway was also knocked down, Lara was the one amongst the group who carefully laid flowers on the remains. The building of the houses created a structure in which the children could play, create and imagine. The group, as a whole, did, in fact, continue to make other houses in other woods in the area throughout the time we were there. Issues such as ownership and authorship, finding one’s own space and placing oneself inside it, became crucial and were usually resolved through the activity. After one long dispute,

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we were invited into a shared home to pretend-drink Bosnian coffee on the living room floor (the floor of the forest). Croatia On-site work in Croatia took place in a refugee centre, situated on a small verdant island called Prvic on the Dalmatian Coast. The island was covered with fig and pomegranate trees and olive groves. The majority of the remaining local inhabitants were elderly and appeared to spend most of their days talking on the two small harbour fronts or out in small boats fishing. The centre is accommodated in a three-story building previously used as a summer scout camp with five to six people sharing a dormitory with two showers on the ground floor. By October 1994, (the centre opened in June 1994) at the time of our visit, there were 24 refugees in total, including 9 children between the ages of 2 and 11, a baby of 4 months, 11 adolescents and 3 mothers. The refugees all came from different parts of Bosnia and were mainly children who had lost their parents in this war, or were sent out of the “war zone.” The centre was a place of transition for those who had come without papers. Our work was clearly defined in a 3-week time frame with no future visits intended. The centre was still running in 1996 with between 38 and 40 children, adolescents and mothers in attendance. The criteria for the camp remained for “traumatized children and single mothers.” It is believed the same level of psychological support was still being offered. Initially, it was difficult to get a sense of a functioning structure or routine. However, within 24 hours, we were already aware of the consuming sense of endless waiting, of lethargy and aimlessness. We soon came to realize that the structure was not yet “functioning,” that the daily routine was school, mealtimes and sleep, and that anything beyond this was met with resistance. We became afraid that we would be drawn into the apathy and were in danger of imposing yet another unwanted structure. Yet, within a day, requests were made for us to begin, surprising us by the overall openness to engage in the art-making. Because the United Nations High Commission for Refugees (UNHCR) had earmarked this as a centre for “traumatized children,” the psychologist and social worker had already begun to provide talking groups, but without success. They had also established a drama

and dance group which proved more successful, although intermittent. The pilot art therapy project intended to involve all members of the centre in the art-making process. A regular structure was attempted but was difficult to maintain. It was, however, possible to offer art each day. Usually, individuals were encouraged to explore their own themes. However, at times we did offer a particular material, for example, paint, postcard-size paper, circular paper, clay and scrap wood, which aimed to introduce a variety of options, to serve as a container for whatever themes arose, being acutely aware that this work was short-term and needed focus due to its transitional nature. We devised a structure as a guideline in which to work, offering groups according to age and the opportunity for four art sessions each day during the week. On weekends the sessions were open to anyone who wanted to join. Most of the sessions took place in the dining room, the only indoor communal space. Three years later, it is still difficult to write on the work that took place on this island. The work was filled with so many contradictions that it is almost impossible to express coherently. On the one hand, the response to the art sessions was overwhelming and yet on the other, the pervading sense of barrenness remains. Physically, the dining room was filled with images with the art sessions creating what appeared a hive of activity, and often individual images were both rich and personal. The overriding sense, however, is that of fragmented, unowned, undigested images and experiences. The road and the island soon emerged as the two main themes (Figures 3 and 4). These arose in different individuals’ paintings either simultaneously or in subsequent sessions. Emir, a 16-year-old boy who joined most of the groups, regardless of age, was the first to paint an image depicting roads. Most of the roads appearing in the art work crossed the page and led off it; there was usually a house or series of houses lining the road, and often a crossroad or tributary path leading from it. Although the artists did not appear to attach any importance to these, the roads visibly resembled their other images depicting the villages and cities they had fled. In the same way that many of the roads themselves were often the only part of the image left unpainted, and seemed to have no clear destination, so too the images seemed to have no connection to the artist once created. The island was first drawn by one of the mothers and emerged as a silhouetted piece of land in the

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Figure 3. Roads or paths drawn by different individuals, Prvic refugee centre.

middle of the sea, with a palm tree and orange sunset. This theme was taken up by many of the children and then adopted by the adolescents later. Some of the children painted the island repeatedly over a period of days. The two hills that dominated the landscape of Prvic began to appear as did other details that sug-

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gested a relationship to the immediate environment. However we seldom saw a movement from a stylized depiction of the island to a more personal interpretation. Eventually there were collections of roads and islands covering the walls of the dining room. The allusiveness of the shared imagery was in contrast to the palpable thirst for stimulus and excitement at even the most basic art materials. In the early sessions it was not unusual for one child to produce one dozen paintings in the space of an hour. What emerged, however, was that these children responded to the provision of more structure: the postcard-size paper and paper cut in the shape of a circle were two “themes” which seemed to provide the children with a sense of containment with many choosing to cut their own for the remaining 3 weeks. Four children from one family specifically seemed to respond to structure: For Mari, the eldest (10 years old), the introduction of postcard-size paper led to more detailed paintings and her need to abandon her image half way through in preference for more paper subsided. For Mario (8 years old), paintings and drawings he did on the circular shaped and postcard-size paper were the few he did not cut into shreds or otherwise destroy, and indeed held a softness that was otherwise not expressed. Blazenka (4 years old) had lived half of her life during the war and as a result had spent much of her time indoors with very little opportunity for drawing or indeed access to art materials. She appeared to thrive on any input and made it her own. Over the 3 weeks she seemed to discover for herself, and with tremendous excitement, how to mix green and that the image she had been drawing could be called a house. The youngest child, Mirela (2 years old), born during the war, was on the edge of most of the sessions, occasionally scribbling on paper on the floor. Although these children had arrived on Prvic with their mother, she was often absent for days at a time. Adults and adolescents began in organized sessions, but these became a structure in which individuals painted or drew whenever they had the inclination. They would drift in and out of the dining room at the time of sessions, sometimes arriving with the explicit intention of making art. These sessions often served as a socializing forum— chatting as they painted, but at other times art making took place in complete silence with each individual working on his or her own work. On the last evening there was a party to mark the ending of the art sessions as facilitated by us, and the

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Figure 4. Islands painted by an individual child, Prvic refugee centre.

end of our stay. We handed everyone a folder of their artwork. Beyond a general surprise that the folders had been carefully kept, nobody took their folders back to their room or expressed an interest in them. The following day on the boat to the mainland a few of the older children accompanied us to say a final goodbye; in addition to regret and sadness that we were leaving, they outwardly expressed anger and aggression. We noted that day in our diary: Throughout the three weeks there had been a sense of a bottomless pit in the lives of this group of people and an expectation that we could and should fill it. A tangible expression of this was the constant demand for more art materials, coffee, cigarettes, claiming of our personal possessions. (Kalmanowitz & Lloyd, 1997) This work was built upon and informed by the experience gained at Hrastnik. We were able to introduce the art with less reservation and set about trying to understand the routine of this centre to which we could adapt the art sessions. Unlike Hrastnik, where there appeared to be some acceptance of the situation with the women spending most of their time cleaning and maintaining their immediate environment, at Prvic the communal spaces were mostly uncared for. At

Hrastnik there was a sense of a “community,” in which the roles the women adopted presented not only clean barracks but represented an attempt to create a functioning home. Prvic, by contrast, had a sense of a “dysfunctional home” with no one taking on the role of responsible parent. It seemed that a general response to anything that threatened permanence (i.e., anything outside the essential routine), was one of ambivalence. Thoughts Arising Witness That the individual is made to feel less than human as a result of his/her war experience, whether it be having to flee, having to fight or being tortured—as participants or recipients—and that through the art the individual can be helped to regain his/her humanity is an idea that runs through the art therapy literature in this context. Recent research has emerged from conditions of political conflict around the world (Israel, Northern Ireland, the former Yugoslavia, South American States, World War II Germany and the Vietnam War) and a handful of related articles explore the role of art therapy in a range of diverse situations. Most of the articles discuss long-term art therapy work and talk about the role it plays in inte-

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Figure 5. Pyramid of Intervention: Dr. Tanja Franciskovic. By definition, the higher up the pyramid, the fewer people are effected.

grating the war experience into the lives of the individuals with whom the authors work. Various authors (Golub, 1985; Johnson, 1987; Klingman, Koenigsfeld, & Markman, 1987; Sanderson, 1995; Seligman, 1995) point to different elements in the art therapeutic process: familiarization with the art materials in a non-judgmental environment; beginning to portray the unspeakable; gaining access in a safe and controlled way to memories or experiences which are shared and witnessed through the images; the working through process of acknowledging, conceptualizing and finally, rejoining the world. Certainly the above informed our thinking and motivation in offering the art sessions. Months later, however, we found ourselves still trying to make sense of what we had heard and seen and what we had attempted to offer. We were invited to talk about the work and chose to present it through exhibitions of photographs and drawings. The images that emerged in our own dreams and paintings, although not exhibited, contributed to our making meaning. What we came to understand was our responsibility to bear witness to the individuals we had met and their experiences we had glimpsed, and to present this to a wider audience. In being asked to present art therapy in the context of the war in the former Yugoslavia, we were being asked to provide facts and answers as specialists. We struggled with the fact that we were considered experts in a context in which the work is one of knowing and yet not knowing. At the outset of war, the most pressing form of aid is the provision of basic needs for physical survival (food, blankets, plastic for windows, shelter and clothing). As the war continues, family groups, friends and communities, stretched beyond their limits are no longer able to provide adequate support, and

external intervention of emotional and psychological support can begin to play a part. Dr. Tanja Franciskovic, a Croatian Psychiatrist, Group Psychotherapist and Manager of the PTSD Department of Rijeka Psychiatric Clinic in Croatia, spoke at a conference held at the Tavistock Clinic, London, in March 1996, called War in Croatia and Bosnia-Hercegovina: Psychological Aftermath. She described how the needs of each individual change as war progresses. It is during the “post-war phase” that these “psychological interventions,” along with the economic input and the creation of new and re-establishment of old structures begin to be of greater importance in adapting to the new reality (Figure 5). The art sessions offered in the pilot art therapy projects could be described in terms of this pyramid as providing “emotional, social and psychologicallyoriented group intervention.” This was pertinent at Hrastnik and Prvic refugee centres where individuals could find a “socializing” structure (“socializing” was rated by refugees and displaced people, in Dr. Franciskovic’s research, as the most useful intervention). In both contexts we observed that at times the sessions were indeed acting as little social groups in which the individuals offered each other attention and inspiration. With the individuals in a state of flux, it was clear that the art sessions we presented needed to serve as a vessel strong enough to hold whatever arose. In this circumstance, the act of witnessing became an active intervention. Not only were we witness to the fragmented lives, loss of home and tremendous resilience, but to the details and complexities held in the images. Learmonth (1994) speaks of the potency of “simple” witnessing as frequently the only intervention available in extreme situations. In this context, the art

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serves an essential part as it “neither denies and represses the traumatic material, nor is possessed by it.” The image and the image-making enables the experience to be present and seen, “to be authentic, without being overwhelming” (Learmonth, 1994, p. 20). Portable Studio At first, we struggled to define our work as either “art” or “art therapy.” Now, after reflection, the need to label the work in such a polarity no longer seems relevant: As an art teacher in a prison I was aware of my inability to deal adequately with the content of the images and communications of the students; as an art therapist I may not be working any differently, but the difference lies in the confidence and ability to deal with whatever comes and to use the experience in a reflective way. (Schaverien in Liebmann, 1994, p. 133) Perhaps our attempt to classify the work was in order to contain it for ourselves and for those in our profession. In order to respond responsibly to the needs of those with whom we worked, a balance had to be struck between the cultural and the universal, between the internal and the external, and between the art and the therapy. What we aimed to create was what we called a portable studio. This is based on the premise that the internal structure we carried with us as art therapists could allow for work to physically take place inside and outside: in the bedroom, in the dining room, on the hill, in the town dump. This internal structure involved a conscious awareness and sensitivity to the art, the art making and its ability to provide a form which can contain the individual’s experience; a trust in the individual as possessing resources rather than as a helpless victim in which the therapist alone holds the solutions; an understanding that images potentially hold multiple meanings and that the therapist, in her “active alertness” (Learmonth, 1994), holds this potentiality. This structure could provide an environment which facilitated expression, and allowed for “sustained immersion” (McNiff, 1992) in the art making. It was up to us as art therapists to support each individual in negotiating a way through a complex web, and in realizing that through their own experience, strengths and culture, they have some power.

Although this internal structure is clearly rooted in art therapy, the way in which the art sessions actually took form could be perceived as unorthodox, evolving in this context as the most valuable way of working. Not only was it not possible to work within understood therapeutic boundaries, it was often not applicable here. Practically, the portable studio included the arrangement of the tables, length of the session, tidying and preserving art materials, hanging the art work that individuals’ chose (in the dining rooms of the two centres), and looking after and valuing all the art work. We found that by developing a flexible working method and modifying our model, we had something to offer. In both refugee centres, the traditional therapeutic boundaries were impossible to maintain, such as the lack of a room, the fact that we lived in the centres, the difficulties of adapting art to the routine of camp life. A main objective was to be responsible to ourselves as professionals and to the individuals with whom we were working. These responsibilities were acute awareness of the context, of the time frame, of the level of vulnerability of the individuals, of the healthy elements and an in-depth understanding and respect for the art process. Following on from this, by developing the portable studio it is possible to consider creating a space in diverse situations within which individuals can foster their collective capacities for endurance and survival. Conclusions The therapist is not there to provide reassurance or to give hope. There is nothing to hope for, nothing to hold onto; the therapist must be able to descend into that nothingness without holding on even to ‘therapy’ or ‘art’. It is a matter of survival: when all illusions are gone what is there to live for? The therapist is the one who is willing to ask that question with the client, to be there while the other struggles to answer it, to witness the struggle, and to receive the words and the images which express it. (Levine, 1992, p. 113) We found at both Hrastnik and Prvic an extreme situation in which art played a role as a subtle intervention. The pervading sense of emptiness which existed particularly at Prvic was extremely difficult to work and live with and yet it became increasingly clear to us that the art sessions could not and should

ART THERAPY IN THE FORMER YUGOSLAVIA not attempt to fill this, despite the constant discomfort we experienced at not being good enough or offering enough. In both places, the art sessions, nevertheless, attempted to provide a space in which a seed could be planted which would have a life after we left, and upon which each individual could build. References Eisenbruch, M. (1990). Cultural bereavement and homesickness. In S. Fisher & C. Cooper (Eds.), On the move: The psychology of change and transition. Chichester: John Wiley & Sons. Eisenbruch, M. (1991). From post-traumatic stress disorder to cultural bereavement: Diagnosis of Southern Asian refugees. Social Sciences and Medicine, 33, 673– 678. Glenny, M. (1993). The fall of Yugoslavia: The third Balkan War. London: Penguin Books. Golub, D. (1985). Symbolic expression in post-traumatic stress disorder: Vietnam combat veterans in art therapy. The Arts in Psychotherapy, 12, 285–296. Johnson, D. R. (1987). The role of the creative arts therapies in the diagnosis and treatment of psychological trauma. The Arts in Psychotherapy, 14, 7–13. Kalmanowitz, D., & Lloyd, B. (1997). Portable studio: Art therapy and political conflict. Initiatives in former Yugoslavia and South Africa. London: Health Education Authority. Klingman, A., Koenigsfeld, E., & Markman, D. (1987). Art activity with children following disaster: A preventive-oriented crisis intervention modality. The Arts in Psychotherapy, 14, 153–166.

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