“Art Psychotherapy: illuminating Latin American identity.”

 
By Ana Laura Treviño Santos

Translated by María Ritter Miravete
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Ana Laura Treviño Santos has a degree in psychology from the Universidad Iberoamericana in Mexico City, where she also specialized in child psychotherapy. 

She has a master's degree in psychoanalytic psychotherapy in adolescents and adults from the Instituto de Investigaciones en Psicología Clínica y Social (IIPCS) and another in Family Therapy from the Instituto de la Familia A.C. (IFAC). 

She specialized in art psychotherapy at Loyola Marymount University in Los Angeles, CA, where she was also a guest teacher.

At the Centro de Estudios Superiores en Investigación en Antropología Social (CIESAS) she studied the Diploma in Anthropology of Art. She completed the Diploma in Open Dialogue (DialogiC-ComuniRED) and is currently studying the Diploma in Systemic Clinical Supervision at the Instituto Latinoaméricano de Estudios de la Familia (ILEF) as well as the doctorate in psychology at the Universidad de las Américas (UDLA-CDMX).

She is the founder and director of the Mexican Institute of Art Psychotherapy and Co-founder of Alfaga: Therapeutic Intersections for Adoption. 

She has participated as a speaker in various forums both in Mexico and abroad. Also, in several workshops as a lecturer on topics related to art psychotherapy, mental health, human development, crisis and trauma intervention, grief, transitions, among others.

She has 28 years of clinical psychotherapeutic experience with children, adolescents, adults, and families, dealing with numerous issues.

She has published two articles in the journal Temas Selectos en Orientación Psicológica (2009) Manual Moderno Volumen IV. Universidad Iberoamericana:

- Intercultural Supervision of Art Therapy with a Pregnant Mexican Teenager.

- Vicissitudes of Migration: Art Therapy with Families Left Behind.

She co-authored, along with Tucker, Naomi: Art Therapy Domestic Violence Preventing Group in Mexico. Journal of Clinical Art Therapy (2011) Loyola Marymount University. Vol. I 

Collaborated on a chapter in the book The Wiley Handbook of Art Therapy (2016): Chapter: Art Therapy in Mexico. Edited by David Gussak and Marcia L. Rossal. Publisher Jhon Wileys and Sons. 

Co-authored with Metzl, Einat: Working around the border: shared experiences of an art therapist working with families impacted by immigration and political realities in Mexico and the United States (April 2021). Journal of Community Psychology.

"Knowledge so conceived is not a series of self-consistent theories that converges towards an ideal view; it is not a gradual approach to truth. 

It is rather an ever-increasing ocean of mutually incompatible alternatives”

(Feyerabend, P., 2017).

Psychotherapy, creative process, and liminality are concepts shared between different fields of art, science, and creativity [1]. Conceived by different fields, applied to different areas, but when interweaved and applied together, they create Art Psychotherapy. This article reflects on the use of art throughout history, of the way in which it is made accessible as a therapeutic agent, the dominant history of its emergence, as well as its alternative history in Latin America.

 

Art and its meaning in history

One of the main characteristics of all societies is the use of art. The universality of making, and enjoying making art, immediately suggests the importance and need it has had to the human being (Dissanayake, E., 1995), providing a sense of meaning and signifier (Riveros Aedo, E., 2013), or of intensity to human life that cannot be obtained in any other way. Making art has been a response to man's first experiences of existentialism for more than 500,000 years (Haslam, 2011).

 

The paleolithic human experience allowed a greater temporal, emotional, and cognitive awareness that probably cemented a path for early humans to develop the idea of spirit or soul. It functioned as a biopsychosocial feedback system that allowed to conceptualize themselves as independent of their bodies and begin to question different conditions of life and death, nature processes, creativity, and art as a tool for survival, since then to the present day (Elkins, 2002).

From Ellen Dissanayake's (1995) conceptualization, we understand the arts as a cultural phenomenon: we expect that their manifestations vary from one culture to another and that certain individual art forms, as well as attitudes towards art, are found in some societies and not in others. 

 

The understanding of the arts has varied over time, with the fine arts playing a significant role for a long period, excluding artistic representations that the Anglo-Saxon Western world did not comprise. In recent years, a revealing and growing movement has criticized the traditional Western interpretation of art and culture as having a Eurocentric bias, which implies neglect and outright oppression of non-Western cultures (Dissanayake, E., 1995).

Seeking discrepant views of history allows us to appreciate excluded and unseen, yet significant, narratives that speak of the lives, thoughts, ideas, ways and how’s of countless societies. History in general, and the history of revolutions in particular, is always richer in content, more varied, more multilateral, livelier, and more ingenious than what even the best historian and the best methodologist could imagine (Lenin, 1967 in Ferbayand, 1975).

 

In psychotherapy, theories and practices are cultural products subject to the prevailing discourses at each moment of its history. Botella and Figueras (1995) point out that the traditional way of presenting and evaluating the different psychotherapeutic approaches has basically focused on their formal and theoretical aspects (basic concepts, personality structure, vision of psychopathology or conception of therapeutic change), which leads to the idea that this type of constructs promotes the vision of psychotherapeutic models, as if they were objective discoveries about the human being, although isolated from their cultural, socio-political, geographical contexts, etc. It is from the influence of postmodern consciousness that the so-called hard sciences, such as the philosophy of science, recognize the influence of the social context on theories. 

 

The literature on psychotherapy that has permeated many countries has not been spared from this Eurocentric view with Saxon theoretical and cultural foundations. This article intends to initiate a dialogue on how the perspective of Latin American and Mexican culture, as well as their histories, politics, geographies, and artistic creations influence the definition and application of art psychotherapy in these contexts.

 

Art Therapy

The origins of art therapy extend back to prehistoric times. Humans have continually created artistic configurations as an attempt to express and manage both the world around them and inside them. Throughout the centuries, art and its expressions in all cultures have shown us the way people lived, thought, related to each other, their ideals, their gods, their governments, as well as their values and rituals.

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Fig. 1 Frescoes of Altamira.

The convergences with the discoveries of the prehistoric caves of Altamira in 1897, the Black Art exhibition in 1914, and the African and Oceanic Arts exhibition in 1919, in sum with the interest in psychotic art, awakened the curiosity for "primitive art" (Marxen, E., 2011). Art Brut, another manifestation that escaped the established canons, generated new ideas for both artists and psychoanalysts about artistic expression as an agent of emotional communication (J.P. Klein, 2009).

Towards the end of the 19th century, the health sciences began to manifest an interest in the artistic activities of the mentally ill. Prinzhorn, marked a turning point in the field between art and psychosis; he stated that people used artistic expression to address their experience with illness, given that the artworks often represent a regression and manifest the "imperious need" of the psychotic "to impose order on chaos", trying to restore symbolic order (Marxen, E., 2011).

Around the same time, the French neurologist Jean Martin Charcot (1825-1893) analyzed the physical and behavioral forms of the mentally ill with the objective to compare them with the works of the great masters of painting (Goya, Rembrandt, Rubens, El Bosco, among others), whose themes included madness, demonic possessions, etc. Charcot suggested extending medical science to the spiritual field as therapy of the soul, based on the psychophysiological treatment of mental illnesses, justifying his method with examples of artists consecrated by the history of art; he studied the similarities between artworks by these artists and the clinical pictures of the patients in order to determine, classify and categorize the type of pathology they presented (Charcot and Richer, 2002). 

Sigmund Freud, who was Charcot's student, used throughout his work the processes of mythology, comedy, art products, and dreams as the axis of the manifestation of the unconscious. Undoubtedly, his theoretical positions cemented the artistic creation of countless artists.

Formally, according to Western history (Jung, M & Asawa, P.,1994), art therapy arose until the 20th century, when in psychiatric hospitals, psychoanalysts, psychiatrists, and doctors observed the way in which patients communicated through art with the artists who imparted "occupational therapy"[2] sessions. This led to the recognition of art as an agent of access to the inner world of patients. Each creative product was understood as an illustration of mental health or disturbance. 

However, the term art therapy was first coined in England in 1942 by the London artist Adrian Hill (1895-1977) who, while working with soldiers with tuberculosis during World War II, recognized the potential in their recovery by employing art appreciation and using it as a mean of expression, which generated fundamental skills to increase confidence and security in various areas of their lives (Hill, 1945).

The development of the theory and practice of art psychotherapy has been greatly influenced by psychoanalysis, systemic-oriented psychotherapy, group theory, the use of projective tests and the Rorschach test, as well as critical theories, artistic elements, and cultural, artistic, and social contexts of the time.

One of the most important representatives of art therapy in the United States is Margaret Naumberg, who began to include the practice of art and its interventions as a central modality of psychotherapeutic treatment; people's art productions were seen as symbolic communications of unconscious material in a direct, concrete, and uncensored way. 

Additionally, in the late 1950s in the United States, Edith Kramer used art as a therapeutic agent. She witnessed the work of Friedl Dicker-Brandeis with children from the Terezin concentration camp, and following in his footsteps, she began working as an art therapist in New York. Her contributions in this field have been fundamental.

In 1963 the first professional art therapy associations were founded: in France, the French Society for the Psychopathology of Expression; in the United Kingdom, the British Art Therapy Association (BAAT) and, in 1969, the American Art Therapy Association (AATA). In countries such as France, Spain and Germany art therapy began to spread naturally, opening therapeutic spaces with art; gradually more organizations began to emerge in places such as Australia, New Zealand, and Singapore.

 

Most articles and books on the history of art therapy are focused on what is described above (Jung, M & Asawa, P., 1994; Haslam, M., 2011). Consideration of the histories of this therapy in other parts of the world have been sparsely named, leaving a significant historical and cultural gap for its development and application.

 

Art therapy in Latin America.

Searching for the origins of art therapy in Latin America, we consider that in Mexico and Latin America art is manifested everywhere and in very diverse forms: pyramids, frescoes, ceramics, metals, textiles, etc. These objects when created by individuals, groups, cultures, and regions show us their expressions regarding ancestral and present daily life. Likewise, pre-Hispanic mural painting in Mexico encompasses different geographical areas, from the central highlands, the Gulf Coast to the Mayan zone. Spaces in which our ancestors left traces of their gods, symbols, sacrifices and their concepts of life and death (Arias, S., 2018).

 

According to Dissanayake (1988), indigenous cultures have used art as a way of expressing their understanding of the world and events happening both internally and externally. Art, through the ages, has been used as a way of "making special" and finding physical, psychological, and cultural meanings. Thus, ceramics, textiles, woodwork, music, instruments, and jewelry, among other artistic media, have functioned as symbols of the emotional histories and experiences of each civilization.

 

Regarding Mexico’s conquest, the art of the original cultures was transformed; theological ideas and the way in which the Spaniards understood the world permeated the artistic expression of Mesoamerica, to the point of reaching a syncretism in art (painting, sculpture, music, ceramics and others), as well as in traditions and religion. It was not until the beginning of the 20th century that the muralists, and the whole artistic and cultural movement around them, offered new ways of generating dialogues related to culture, identity, nationalism, and society among Mexicans. José Vasconcelos was one of the main promoters of this movement in which Diego Rivera, José Clemente Orozco and David Alfaro Siqueiros were its principal representatives.

 

However, among the most significant representatives of art therapy in Latin America we find the Brazilian Nise de Silveira, "the psychiatrist of creativity" (López, A. self, 2020), who was one of the pioneers in the 1950s. She began to include art as a medium of emotional expression in the psychiatric hospitals of her country.

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Fig. 2 Nise de Silveira.

In turn, Mimi Marinovic, a pioneer of art therapy in Chile, has a vast experience working as an academic at the Catholic University of Chile, dedicated to research and publication, and has worked in psychiatric hospitals combining psychodrama with different plastic activities.

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Fig. 3 Mimi Marinovic.

In Mexico, Frida Kahlo began to use artistic expression as a therapeutic agent for herself. Incorporating in her paintings: symbols, metaphors, and emotional meanings to her personal experiences of pain, love, and loss, as a way to resolve, accommodate and resignify them. "I don't paint my dreams, I paint my own reality" (Cerro, 2007). Along with Remedios Varo and Leonora Carrington, influenced by psychoanalysis, as well as artists such as Luis Buñuel, Octavio Paz, Carlos Fuentes Carlos Monsiváis and Edward James, opened the doors to the surrealist world in Mexico, capturing their experiences, feelings, and psychic processes, taking a relevant place in the cultural, artistic, political, and emotional world of Mexicans, which extended its borders towards Latin America.

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Fig. 4 The two Fridas.  Frida Kahlo.

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Fig. 5 Untitled. Leonora Carrington.

Fig. 6 Mujer saliendo del Psicoanalista. Remedios Varo..png

Fig. 6 Woman leaving the Psychoanalyst. Remedios Varo.

Art Psychotherapy in Latin America.

The field of art psychotherapy in Mexico and Latin America has been a mixture of Eurocentric ideas regarding culture, geography, politics, history, art, and the artistic and emotional experiences of the people who practice it nowadays. The influence of these, as well as the integration of the different histories and all the vicissitudes that compose it, display a way of practicing art psychotherapy in these latitudes.

The importance of including regional histories, the broadening of influences in the creation of art psychotherapy and the possibility of opening to new perspectives show possibilities of expansion of a wider history, which allows to extend the clinical, cultural, social, personal, and family spectrum in which a person or a group of people is immersed, offering a wider field, both for therapists and consultants.

Art psychotherapy is a therapeutic process that is configured at the intersection of three components: the person of the therapist, the person of the consultant and the artistic expression. When these three elements are interwoven, they generate what Turner (1996) calls the 'liminal' space; that is, a place between what is and what is not, what Martin del Campo (2019) calls the 'place where you are represented in the ever-present gaze of the other', that is the therapeutic space.

The conjunction of the three components allows people to name, process, express and re-signify events of their lives, transitions, crises and traumas, or any experience lived regardless of age.  

 

From this perspective, art psychotherapy is not only a tool that produces well-being and improves the quality of life of the human being (Malchiodi, C., 2003). Nor is it exclusively a process of making art and, definitely, it is not only a space to verbally name the experiences, problems, and challenges of daily life. Art psychotherapy is the liminal contained space that is constructed between the therapist, the patient, the creation of art, and the interrelationships that emerge between them. 

 

Each component provides different aspects that contribute to create what Didier Anzieu (1987:39) names "a maternal continent", that is, a protective, elaborated, and guaranteed envelope that allows the free expression of the consultant's self, the therapist's self, and the flow (Csikszentmihalyi, M., 2008) of the artistic expression, generating "therapeutic adherence" (Higashi et al., 2013), therapeutic bond and process to the art psychotherapy experience.

The art psychotherapist has clinical training in psychology, psychotherapy or any area related to mental health; numerous hours of clinically supervised practice, personal therapy, knowledge of various aspects of individual, family, social development, illness and mental health, classical and current psychotherapeutic theories, geopolitical, ethnic, and cultural contexts, as well as significant training in the artistic process. 

On the other hand, the person of the consultant enters this "liminal space" (Turner1969), in which his or her belief systems, values, culture (in the broadest sense), history, context, family, situations, experiences, difficulties and resources, resilience, desire for change and hope are directly embodied. Coupled with the right conditions, it allows the therapist's person, the therapy process, the artistic materials, their creative representations, and dilemmas to be diluted in order to find new forms and solutions to their life challenges, promoting the development of the self and its cohesion, fostering identity, and eliciting maturation in general (Kramer, E., 1993).  

Artistic expression is the "third hand" of the therapist (Kramer, E., 1986), which allows the client to find meanings and signifiers (Riveros Aedo, E., 2013) through metaphors in colors, shapes, names, which allow externalizing problems, feelings, thoughts, bodily experiences and give emotional solutions to situations someone is experiencing at that moment or has done so previously.

The creation of the therapeutic "liminal space" (Turner, 1969), the adherence to it and its shelter is the meeting place where the flow (Csikszentmihalyi, M., 2008) manages to condense the three components of the process (therapist, consultant and artistic expression) which allows it to "dilute", to entangle and give a new form to the experience through the process of making art, accommodating it, processing it and resignifying it, through art psychotherapy.

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Fig. 7 Intersections in Art Psychotherapy. Outline of the author.

Stories define us, they give us meaning and identity, allow us to know ourselves as human beings in a more complete and meaningful way, especially when the official story is not the dominant one, when we are able to investigate, question, go beyond to find meaning and significance to what we do, to what we dedicate ourselves to, to accompany the other to dilute in the therapeutic process from its territory, from its origin, from its history and from its culture. Honoring the past, Eurocentric and Latin American, thanking the present and looking towards the future will help us find an epistemological identity of Latin American Art Psychotherapy more real and meaningful for the profession.

[1] Liminality: the application of transitory processes, the widespread existence of a type of rituals that socially mark the passage from one stage to another. In a broader sense they can encompass the passage of social position, such as status or age, and it can happen in the individual or plural (Del Valle, T., 1987).

[2] The American Occupational Therapy Association, (OATA) 2012 defines as the application of core values, knowledge and skills to help clients (individuals, organizations and populations), engage in daily activities or occupations that they want and need to do in ways that support health and participation (Jimenez-Echenique, J.2018).

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