It's Unethical

Being a therapist and counselor puts me in a field with some amazing people and with some people who know how to get through school and take tests. I have known people who will do anything for their patients/clients and have known people who have no idea what they're doing. I seem to have a never ending "a therapist did that!?" list.
One of those moments came a few days ago. I saw video of Dr. Drew talking about Charlie Sheen. Dr. Drew said that he had not spoken to Charlie Sheen. Dr. Drew made it a point to mention his 20 years of experience, he has seen this many times so he is able to talk about the symptoms and his diagnosis of Mr. Sheen.
Although I've been in this field for a short time, I find it offensive that Dr. Drew is being his usual entitled and intrusive way. Dr. Drew not only felt it necessary to give an opinion about someone who he has not talked to but felt that he needed to justify it with his expertise.
As a part of my education, I had to take an ethics class. This usually meant having more questions than answers. There were some absolute guidelines. Most of those were surrounding the client/patient. However, we discussed at length about boundaries. There are lots of boundaries in this world. And one of them is to not to make assessments or diagnoses on people who has not met with a particular therapist. Another is that even if you have an opinion about someone, keep it to yourself.
One thing that stood out to me is being aware of myopia. When a therapist becomes myopic, they only see what they know. I had a supervisor who only worked with people diagnosed with schizophrenia or schizoaffective disorder. Eventually, she only saw art work in terms of psychosis. She once had a patient who drew a fountain the day before he tried to commit suicide. So, every colorful fountain seem to be a symbol, in her mind, of suicidal thoughts. While I respect any therapists' years of experiences, it may mean that they might only see what they want to see and are used to seeing.
In my experience, people are different when they are a celebrity, in the public eye all the time, and expect cameras to be around than when they have privacy and are in their own home. Everyone has a public persona have a private persona-- i.e. differences between being at home, at a doctor's office, and being at work. To judge only what one person does in public is not getting the full picture of the person.
I saw another doctor on Access Hollywood on a clip from the show "The Soup" (seen here ). The Soup's host said that the doctor was not dressed like a doctor and sarcastically said "Access Hollywood did the responsible thing and had a doctor diagnose Charlie in a completely unprofessional setting off a poorly made video, edited together with scary music." I think even Joel McHale can sense the unethical nature of these doctors who are willing to go on TV to diagnose a celebrity or someone who they have not met.
There's two issues I want to talk about briefly here:
One is that often the TV media outlets have a list of professions in various fields. For example, one of my professors had been on a TV show talking about robbery. When Winona Ryder was caught shoplifting, someone from the media contacted my professor, who had to explain she could not give her opinion about shoplifting since her expertise was in robbery (and the difference between the two). Anytime a TV show needs a professional, they go to this list. I have seen some crazy things on shows that use these lists.

The second item I want to bring up, which I have written about before, is when a person asked an art therapist to judge someone's artwork without watching the artwork being made. A woman approached me and asked me to do this regarding colors. I don't think that one color means the same thing to everyone so I didn't say anything about color. I did talk briefly about the patient's focus and what she said about the artwork that was made. In The Secret World of Drawings, author Gregg Furth does just this. He goes through various children's pictures as well as some pictures by famous artists. He writes a "how to look at pictures and analyze them" type of book. While there are some insights he makes about artwork, there are others that are very much up to interpretation. Basically, I wouldn't feel comfortable using his insights in practice. I would want to talk to the person, observe them making the artwork and if I couldn't do that, I'd at least want the person to tell me about the artwork.

Bottom line here is that these TV doctors have to keep up with boundaries and understand that diagnosing someone without talking to them is unethical. It seems that there are many doctors and therapists who have boundary issues and who feel entitled to diagnose or make assumptions based on whatever they find important or intriguing. I hope that these are just a few bad examples and that most people can see that this is all wrong.

Art Therapy and PTSD

PTSD and Art Therapy

With Veteran's day passed, some people have been raising awareness about post-traumatic stress disorder (PTSD). This happens when a person goes through something like war, persistant abuse, rape, and other traumatic events. Sometimes it can be a singular event (a person gets robs at gunpoint) or it could be a series of events (childhood abuse).
There are many symptoms to PTSD such as flashbacks, hypervigilance, anxiety, and depression. If you want to know more about PTSD symptoms, check out: http://www.webmd.com

Doing and Undoing
Freud talked about this as a defense mechanism. Say you thought something badly against someone and to undo that thought, you were extremely nice to them.
There are two ways that this comes out in art therapy:

1. Repetitive drawings.
There was a kid who was in the behavioral health hospital who went through a fire on Christmas. He drew Christmas trees over and over again. Sometimes he cross them out. Other times the firefighters came and put it out; then, the Christmas tree would turn to a scribble of blue. Sometimes the fire engulfed the tree and it turned to all yellow and orange scribbles.

2. Piecing back together
There was a Veteran who saw someone's hand blown off. He made a hand out of clay. The clay messed up. He was in tears, trying to get the hand back together. Eventually, he did put it back together and then was able to move onto peaceful pictures of jungles.

In both cases, the people in therapy were trying to control the things that had happened to them. The construction paper and the art materials themselves were a way for the trauma to be contained. They could regain themselves.

Revealing
The point of therapy is to get out what is on a person's mind. Trauma tends to stick with a person and they can't always talk about it to everyone. Sometimes these events and the issues surrounding the event come out anyway.
Talking isn't always a container. Sometimes when a person talks about events, they tend to feel raw and unsteady emotionally as well as have difficulty calming down. The advantage of art therapy is that people can talk about their art. Sometimes they don't even have to talk about their art or about their issues. They get to keep their secrets. The pictures will reveal what has been on their mind. Art gives a person a chance to reveal something without having to talk about it. This could be important for a person who has difficulty sharing. It may even lead to a person disclosing about traumatic events.

Regaining Control
When a trauma is happening, a person doesn't have control over the event. Some people with PTSD assign a great amount of blame to themselves, more than they actually had, as one way to gain control.
Another way to gain control is to gain mastery over art materials. This could be as simple as making a collage or as learning a new art technique. It also can be that on their paper/canvas, they can do what they want. As was seen with the kid with repetitive drawings, he could try out new endings for the event.


Art can help to manage symptoms of PTSD in several ways, including doing and undoing, revealing and regaining control. In using art, people with PTSD can start to process events and symptoms.

Rec. Therapy and Training

My internship supervisor gave me a little discussion to read about the difference between recreation therapists (which is my current title at my job at the hospital, before I get my masters, then I will be called an art therapist) and art therapists. The discussion was basically that if rec. therapists think they are the same as art therapists, they will ask to be art therapists without the proper training. This got me thinking about two things: one, how much I love the title of rec. therapist; and two, the idea of training and schooling.

First, I love being a rec. therapist. I have a lot of fun. Although art can be anything and therapy can be just about anything, I enjoy that I don't have to bring up art materials all the time. I can bring up the materials to make no-sew pillows or other little projects. While this is a craft, I can see that these are transitional objects and that they can really give the client a sense of achievement. I can also bring up a white board and play "Wheel of Fortune" or Pictionary. In the past, these have been very beneficial to clients in challenging their mind and getting their thoughts off of whatever is going on in their life or the hospital. With the children, I have also gotten little tubs of water that are good for getting kids to get their hands wet and play a little bit. I also have books about drama techniques. Most of my seasoned coworkers come to me for tips and ideas because they know I'm full of them. I like feeling unrestrained by materials.

Second, the idea of schooling and training. Although I agree that some training and oversight is necessary, there are lots of people who just know things and are good at what they do. The beginnings of therapy started with Freud being interested in what was on the mind of middle and upper class women from Vienna. After that, to be a psychoanalyst, people had to be in analysis for 6 years and then they'd be able to take the techniques and apply them to their clients. However, now that there are standards, which can be a good and bad thing, people often learn about only certain types of theories or they learn things for a test and then cannot apply it to their clients, etc. This has happened to me and others. I am encouraged to take a test to get my LPC (Licensed Practicing Counselor) so that insurance can bill me. The LPC test is a lot of money, the book to study in a lot of money, and I won't be tested on much that I learned in school. Also, after taken some practice questions recently, the test just seems to want to trick people into answers. Basically, the people who made it want people to think with their ninja mind. And after this test, whose to say that any of it applies to what I'm doing at the hospital or where ever I am. Sometimes I'm glad that there are standards, however, that still doesn't mean that a therapist is good, that they know what they're doing, or anything like that. It means that they can jump through hoops and take some tests. Yet, there are people with natural gifts that Iwish I could hone in on and they don't have degrees due to whatever circumstances.

I'm glad I was sparked to think about these things by a woman being passive aggressive. I do enjoy my job and I enjoy school. I don't think those things are going to make me a professional. I think job experience and having morals and ethics will help me become a good therapist.

Art Therapy is not a Mystical, Magical Thing. It's not Mind Reading.

I was thinking today about an incident that happened to me. This woman came up to me after my group and after she had had a visit with a patient and asked me what the patient's drawing meant. She wanted to know what it would all mean. I told her the only thing I could tell her was that the patient was quiet when she was coloring it in. The woman had taken a class in art therapy and she had a dictionary about color so she was going to go home and look it up. I didn't say anymore about it. My thoughts went to the reasons why looking up colors that she used is not a good idea.

Some people think that art therapy, or that therapy in general, is really mind reading. We'll tell people things that they're thinking or going through or just know things that they don't want other to know.Some people think that therapist will know things that the client doesn't know about themselves. And if we get mad at a client, we'll use our powers for bad things. People might think that art therapy is more like mind reading than talk therapy because some people have symbols in their artwork and a client might think that a symbol can be interpreted as something else instead of what it means to them.

It doesn't help that there are dictionaries about color or books that basically say, "If you draw this, it means this other thing." But my point is that therapy is not like this. An art therapist should not start telling a client that using red and black most definitely means the person is depressed. It matters about behaviors. It matters about what the person says about the artwork. If a person is using a lot of black and red because that was the colors of their high school football team or because they really like tomatoes with pepper, and on top of that, client doesn't act depressed, then that theory doesn't apply to them.

Art therapy is about what the client says about the artwork. And each therapist has their own theory. For example: I'm a Feminist Jungian type of therapist. I think that people have patterns of behavior that repeat in their life until they notice them and choose to stop them. Societal expectations and gender roles hold people back from pursuing what they want or being the type of people they would like to be. If something's on a person's mind, it will come out whether I ask questions about it or not. For artwork, I like to ask people questions like "If your artwork were a type of music, what type of music would it be?" or "If your artwork was a type of food, what type of food would it be?" I don't ask "why," or "what inspired you to make that?" because the answer most likely is going to be "because I felt like it" (that would most likely be my answer). People don't have to be realistic in their artwork for it to be expressive. And they're not coming to me for me to be an art teacher to them. For my personal self, I like there to be a question or a memory I have in mind while doing the artwork or a "directive" to the art because I get to know more about myself that way. But in practice, I mostly let people choose what art materials they would like to use. I do this because it's probably been a while since people have done art and they just have to experiment with the art materials.

Freudian, humanistic, and behavioral art therapists would most likely practice a lot differently. Some might use more directives. Also, art therapist can choose the medium or style they'd like to use, such as comic books style, clay, photography, graffiti, and others. Some art therapists are more about what symbols a person used and not what the person said about the artwork. But they are trained so that they are not impeding a person's personal growth, assuming that's why they're coming to therapy.

So, therapy is not mind reading. Therapists don't tell you things about yourself that you wouldn't know about yourself. And they don't tell you things that you don't know about yourself. Also, art therapists have different styles, however, it's supposed to help in your art and growth.

I'm Not An Art Teacher

I'm not an art teacher. I'm studying to be an art therapist. I know that traditionally, people take art classes and want to learn techniques to make their drawings look more realistic. When's the last time anyone took a painting course in how to make things look surreal? I'm sure they're out there but I don't know much interest in them, other than people already in the art community.

I'm studying to be an art therapist. There are some art therapists who were artists first and they are trained traditionally. My internship supervisor is one of these art therapists. There is much conflict already between art therapists and their titles. Art therapists fight to not be called the arts and crafts lady or the art lady. We try to not be just artists or just therapists.
My internship supervisor suggested, as she has before, that I take an art class. In the past, this has really pissed me off. I did a piece I wasn't happy about and then she told me that I needed to take a human figure drawing class to improve. I didn't do it. So, now, here she is again. She's waiting to see my human figures and the way I draw.

Since joining the art therapy program, I have become more expressive. At first, this caused a lot of anxiety. I had been taught traditionally. And anything outside of picture perfect was "weird" or "outsider" art. But as I've learned to express myself and enjoy using art materials, I have been less strict with myself about making anything traditional.
In the past year, I've worked as a recreation therapist assistant (it's just a title, I actually run art activities in a therapeutic session and without my license, at this point, it's NOT art therapy). In the past year, I've maybe been around one or two people who liked their artwork to be perfect and traditional. If they are, though, they usually are in a class. But a majority of people I've seen don't mind a little doodle here or a word or two here. They even like coloring pages. I also bring a lot of collage materials. I think collage is good for people who are too anxious to draw and have it be like a picture.

I resent my supervisor, though, for suggesting an art class. The first time, I wanted to pull out past art projects and show to her that I could do it. But I didn't. I just festered and sat with my anger. Now that I have an awesome professor who I can talk to about the issues in internship, I feel that I can change the angry energy into something else and not let it get to me so much.

Yes, she believes that an art therapists should demonstrate to her that they have art skills. This is a lot of pressure that I don't want to deal with. Yes, I do have these skills. And no, I'm not going to share them with her because it's better if I just do my thing and not worry about how she (or others) might judge me.

Only one or two people who I've worked with in the art activities wanted to have something perfect. I think they wanted me to draw a star. I wouldn't and said I didn't know how. And they've said, "How are you going to be an art therapist if you can't even draw a star?" While it's a low blow, I don't think my art therapy license will ever depend on me knowing how to draw a star. I often encourage the clients to do their own artwork, no matter if they like it or not, because eventually, they do like it. They do get a sense of achievement. I don't want to take that away (and I'm not going to draw stars either!).

Vanessa

Art Teacher Vs. Art Therapists

Many art therapists have relayed that we, as students and going into the field, have to make it clear we're not arts and craft teachers. I also resent being called this, on the few occassions it's happened, but I can understand how people might see art therapists like that. We are, after all doing art. I have had to take art classes and I do know how to do use (and teach) some techniques. The difference is that an art teacher teaches techniques and has a direction to get a student there. They try to get a student to be an artist or at least understand how the technique will help them in their realism. There might even be critiques with other students where people look at a student's work and offer suggestions on how to make it better or what they like about it. An art therapist may help a client with a technique if the person asks.

Most of the time, the art therapist wants a client to express themselves, not labor over the technique or materials. There are often not critiques in a group art therapy session. Mostly, an art therapist attempts to get a person to say something about their work and what it might say to others about them, if that's the art therapist's theory. Sometimes it's just that the person is able to express themselves (and often want to talk about it). There is an importance on titles and dates of pieces. A title to give an indication what the subject is or what the person thought. And a date so that there can either be a review or the client can go back to that artwork and remember what they were going through and if it's reflected in the art. This also marks progress, which is a benefit of doing art therapy compared to talk therapy. In the groups that I run that involve art therapy, I ask clients about what they liked about their work or the activitiy and what they might change about the work or activity or how they generally feel that day or at that time. I'd venture to guess that whether a student liked the activity or materials is inconsequential to an art class. I see this as a major difference between an art class and art therapy-- the art therapist cares about what the person liked and didn't like and how they are feeling.

I hope that more people in general are able to either participate or observe groups that art therapists run because it might give some clarity about the difference between art classes and art therapy.