Art therapy: a break in patients’ hospital life
Art therapy is viewed both as a means of expression and of communication. Psychiatric hospitals are more and more numerous to propose art therapy workshops to their in-patients, whether to draw, paint, sculpt. or play music… These workshops raise a number of questions in the medical, legal or artistic fields. How do patients feel about these activities and about their therapeutic benefits? What are their expectations and what should become of these artistic products?
The study has been conducted as part of the Pluriart project (Multidisciplinary Art Therapy), concerning the status and future of art therapy production in psychiatric hospitals. We have interviewed in-patients and the hospital staff in charge of these workshops in different hospitals.
In general, in-patients do not spontaneously apply to participate in a therapeutic workshop, it is part of a medical approach in patient care. It is therefore initiated by a prescription, which is precisely what makes art therapy workshops different from mere cultural workshops. But in-patients’ direct application may also be considered. It is quite frequent that they do not consent to so-called classical care prescriptions, but agree to participate in a therapeutic workshop where painting, drawing or clay sculpture are the means of expression most often proposed.
Hospital professionals see art therapy as an additional care alternative. Each patient’s participation is discussed by the hospital team and is only accepted if she/he is « stabilised », in other words, not in a state of crisis. Patients from all departments are likely to participate, there is no specific profile. When a patient starts attending, she/he may continue but only as long as she/he remains at the hospital. If they wish to continue after they have left, they may be offered other workshops in a day care centre.
Although art therapy workshops are part of patient care, they definitely have a cultural and artistic dimension. Health professionals operate there, in-between the therapeutic and the cultural, whose porous boundaries are regularly questioned. Workshops are mostly run by occupational therapists or nursing professionals who systematically report back to the rest of the medical team. Outside contributors and artists are occasionally invited to conduct the workshop, but always under the supervision of a member of the care team.
A break in hospital life…
Most of the patients interviewed express similar representations: a special moment within the time of their hospitalization. The workshop is described as « a break »: « you just do what you feel like doing, nobody is making fun of you, here I feel like being in my own little world, away from everything » (patient’s interview, Marchant).
This feeling and the way patients perceive this occupational activity is also due to the fact that the workshop takes place within the institution but not in care services. The time spent at the workshop is felt like a break in the hospital pace: « at the workshop, I forget about my illness, my pathology, all that and it keeps me busy and I like that » (patient’s interview, Marchant).
And yet, they are well aware that their participation to the workshop is part of a therapeutic process: « it helps us, our morale, when you feel low; you can talk about your malaise and get rid of your ill feelings » (patient’s interview, Montfavet). Nevertheless, they mostly insist on the fact that it keeps their minds busy, which makes them feel good and brings them some peace.
Among the reasons given, it seems that what is essential is the very atmosphere of the workshop as well as the kindness and receptiveness of the hospital staff in charge, together with the help they can provide along the lines of the pre-established care framework. The staff is aware of their contribution and the patients’ self-esteem is enhanced: « they behave with us more like we were trainees rather than patients, it boosts us » (patient’s interview, Marchant).
The relationship they establish is different from the one they have during their daily treatment. Patients particularly enjoy the nursing staff’s lack of uniform as it is usually the case in most workshops.
A feeling of freedom
The word of freedom was a recurring term in the interviews whether it referred to the freedom they had to come or not, the freedom in the choice of their productions or in the training: « you take a sheet and you draw whatever you like, it’s quite free » (patient’s interview, Marchant).
The freedom they have to create whatever they want relieves their fear of being judged and helps them feel better during the workshop periods: « you struggle a bit finding your way, but that’s good. You try this or that, you make do with what or who you really are » (patient’s, Montfavet).
The workshop is actually the junction where care and artistic creation meet. Production there is free which really helps patients discover or pursue some artistic experience. They do not have to attend the whole session; they may only participate as long as they want to or as they can.
At the beginning of a workshop, participants do not really have any idea of what they are going to produce. They usually get their inspiration from the material available at the workshop (art books, photographs) or with the help of the person in charge. They do not have to absolutely produce something and each patient may spend as many sessions as she/he wishes on the same piece. To define what they make, they tend to use the word « artwork ».
Practising an art activity during hospital time does not necessarily make them want to develop some artistic practice on their own later on. What patients ultimately favour is the proposed scheme which offers a warm, peaceful context rather than the artistic activity in itself. The workshop setup represents the opportunity to experience a new context which can help develop different interactions with both the nursing staff and other patients.
The ongoing artworks remain at the workshop and there are several possibilities concerning conservation once they are achieved.
Conservation: a blind spot
Because there is no current legal framework, situations are quite heterogeneous. The most common ones fall under two main trends: either patients take their works or the latter are kept by the hospital. There are as many people who wish to keep them as there are who wish not to. On the one hand, some express a feeling of pride and their hope for some kind of recognition: « I’ve kept two drawings in my room and I want to keep them. It shows that I’m feeling better and better, that it’s in progress » (patient’s interview, Marchant). On the contrary, others express the desire to forget about everything that could remind them of the difficult time of hospitalization.
The second case obviously raises artistic, ethical or practical conservation questions … There is no consensus about the future of these artistic productions, each hospital sets its own criteria of conservation. They take into account a number of elements: the facility’s storing capacities, the patient’s history, sometimes the aesthetic quality of the work as valued by the care team: « these are testimonies, works that I can’t part with, not so much for the sake of art, but because of the memories I have of the person, I cannot throw them away » (staff member’s interview, Montfavet).
Hospitals do not really give much thought to the question and it is up to the staff to find some solutions. It is clear that the conservation of the artistic productions from art therapy workshops remains a blind spot and that it should become a real concern so as to harmonize overall practices at hospital level.
How should artistic productions be exhibited?
Each hospital has its own dynamic and the issue is also an object of tensions between care professionals. Not everybody agrees that exhibitions are necessarily part of art therapy projects. According to some, the creative phase is sufficient whereas exhibiting may prove counter-productive for some patients.
Exhibitions are most of the time organised within the hospital facility or in the workshop area, in a friendly place like a cafeteria or less often within care services. Some exhibitions may be held outside the hospital, during cultural events such as the Avignon off-festival for instance or also with cultural partnership structures such as MJCs (cultural youth centres).
Previous agreement from each patient is of course required. There is no real consensus concerning patients’ behaviour, their reaction to exhibiting their artwork is a personal matter which often depends on the extent of their involvement in their artistic production and/or whether they are looking for recognition.
Reactions are clearer when dealing with the question of sale, which, anyway, is rarely the case. Artistic productions from art therapy workshops are not meant to be sold, and yet it does happen in some facilities and is seen as the pursuit of the therapeutic project. Although the practice is not common, it is worth being questioned as patients express extremely mixed feelings about it. They rather fear other people’s judgment and mention their lack of artistic competence which, to them, makes it impossible to display/sell their artworks. Those who have been less involved sound more open while those who keep their works are less so; in both cases, it has to do with something deeply personal.
An important inventory of these artistic productions should be carried out and art therapy practices harmonized so that these works can be recognised and preserved.
Illustration by Adèle Huguet for Mondes Sociaux: all rights reserved Adèle Huguet.
To discover more drawings, https://adelehuguet.wordpress.com/
Image credits in CC: Flaticon Freepik
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