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By Noah Hass-Cohen, M.A., A.T.R.-B.C., L.M.F.T. (Los Angeles, 2006)
Art therapy is a visual-expressive approach to relational therapies in which
non-verbal expressions are made easier by creating simple forms, colors or cut-outs.
Three decades of clinical experience have shown me how the approach can provide clients
with sensory integrated experiences that facilitate change and safely counterbalance
traumatic environmental influences. The art therapy processes involved in these experiences
help regulate and recruit stress and fear-based subcortical right hemisphere quick stress-survival
responses necessary for therapeutic outcomes (Bigsiach & Berti, 1990; Leusbrink, 2004; Langhinrichsen &
Tucker, 1990; Ledoux, 1996, 2002; Springer & Deutsch, 1989; Martindale, 1990, Schore 2003). Verbal
discussion of clients’ art products can further help enlist explicit memory and consolidate verbal
autobiographies by bringing the left hemisphere, and the hippocampus online (Cozolino, 2002; Siegel,
1999). Unique to these art-therapy conversations is that they capitulate on right hemispheric language (Kane, 2004).
Art therapists encourage clients to take action by putting the image forward in a
tangible, sensory and visible art expression. This is a concrete, sensory-oriented
activity (Ogden & Minton, 2000) within a therapeutic relationship that results in an
art product (Achterberg, 1999; Camic, 1999; Naparstek, 1994). The art can uniquely assist
necessary therapist-client interpersonal alliance and attachment processes (Main, 2002) as
art-making and art products act as a regulatory mechanism that mimics the reiterative dynamics
of approach and avoidance observed in mother-child play (Mead, 2001). Art therapists can use this
modified therapeutic alliance to safely mediate vivid imagery that is congruent with internalized
change imagery that the person already has working for his/herself (Anderson,, 1997; Naprastek, 1994).
Then the art therapist can provide specific feedback in the form of art therapy directives and
interpretation (Hass-Cohen, 2003; Riley, 1994).
The art therapist facilitates simple but novel art activities that are
easily experienced by the amygdala as interpersonally safer, as well as
help generate more active coping responses (Phelps, Delgado, Nearing & Ledoux,
2004). This benign sub-cortical perception of the art product can stimulate an
inwardly attuned, alert state that supports hippocampal processing of new information.
Safe symbolic sensory experiences within a therapeutic relationship can bring online a
heightened sense of perceived control and well being (Malchiodi, 1999). The sensory-laden
vivid artwork created in session can be experienced as real affective experiences accessible
to the relational brain. When attention is sufficiently focused, it is as if the mind does
not seem to qualitatively distinguish between a real image and an imagined image (Cappas,
Andres-Hyman, & Davidson,, 2005; Tart, 1990). This makes sense, as the processing of internal
and external imagery processing share mostly equivalent neurological processes (Faw, 1997;
Martindale 1990). It is during these states that art-imagery symbolism also seems to have
the unexplained ability to provide symbolic clues about immune system function (Ferencik, Novak,
Rovensky, 1998; Ferencik, & Stvrtinova,, 1997). These clues can assist in medical arts therapies
practices (Achterberg et al., 1994; Brigham, 1994; Dantzer, 1997; Hiramoto et al., 1999; Glaser
& Kiecolt–Glaser, 1998; 1999; Malchiodi, 1993, 1999; Naparstek 1994; Spiegel, et al., 1989;
Vick & Sexton-Radek, 2005).
To summarize, it is likely that art therapy can help provide distraction and relief from stress
(Sapolski 1998, Cozolino, 2002), update memory systems (Ledoux 1998; Dadds, Cutmore, Bovbjerg,
Redd, 1997), mediate a compromised immune system (Pennebaker, 1997) and facilitate coherent
autobiographical narratives. Foundational to future discussions is the consideration of visual,
perceptual, and attentional processes with a tie-in to survival-based responses (Buck, 1992),
meaning-making (Siegel,1999) and forward-functioning executive systems (Faw, 2003). Through
relational verbal experiences and concretized art making memory, emotion and cognition are called into bodily action.
Noah Hass-Cohen, M.A. is the founder and director of the art therapy program at
Phillips Graduate Institute, a 60 units masters degree in psychology.
The program focus is on the integration of art therapy with clinical neuroscience
and marriage family therapy theories. Noah is in the process of completing a clinical
doctorate degree in psychology where she is pursuing her interest in neuropsychological
and psychodiagnostic assessment. In her article, she outlines in an isomorphic nutshell
the clinical neuroscience areas pertinent to art therapy. She wishes to emphasize that she
is looking forward to a time where neuroimaging and other clinical advances will be able to
provide empirical support for the ideas and hypotheses presented in her brief article. In her
private practice in Encino Noah provides psychotherapy and consultation. She can be reached at
noah@pgi.edu or 818.386.5611.
Achterberg, J. (1999). Imagery, ceremony, and healing rituals: Interview by Bonnie Horrigan. Alternative Therapies Journal, 5(5), 77- 82
Achterberg, J., Dossy, L., Gordon, J. S., Hegedus, C., Herrmann, M.W., & Nelson, R. (1994). Mind-body interventions: Panel report to the National Institutes of Health on Alternative Medical Systems and practices in the United States. U.S. Government Printing Office, Washington, D.C.
Anderson, H. (1997). Conversation, language and possibilities. New York: Basic Books.
Bigsiach, E., & Berti, A. (1990). Chapter 3: Waking images and neural activity. In Kunzendorf, R.G. & Sheikh A.A. (Eds.) The psychophysiology of mental imagery: Theory, research and application. New York: Baywoood Publishing Company, Inc.
Brigham D.D. (1994). Imagery for getting well. New York, London: W.W. Norton & Company.
Buck, R. (1999). The biological affects: A typology. Psychological Review, 106(2), 301-336
Cappas, N. M., Andres-Hyman, R., & Davidson, L. (2005). What psychotherapists can begin to learn from neuroscience: Seven principles of a brain based psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 42(3), 374-383.
Camic, P. M. (1999). Chapter 2: Expanding treatment possibilities for chronic pain
through the expressive arts. In C. Malchiodi (ed) Medical arts therapy with adults. London & Philadelphia: Jessica Kingsley Publishers.
Cozolino, L. (2002). The neuroscience of psychotherapy. New York, London: Norton.
Dadds, M.R., Cutmore, T.R.H, Bovbjerg, D.H., & Redd, W.H. (1997). Imagery in human classical conditioning. Psychological Bulletin, 122(1), 89 –103
Faw, B. (2003). Pre-frontal executive committee for perception, working memory, attention, long-term memory, motor control, and thinking: A tutorial review. Consciousness and Cognition, 12(2003), 83-139.
Faw, B. (1997). Outlining a brain model of mental imaging abilities. Neuroscience and Biobehavorial Reviews, 21(3), 283-288.
Ferencik, M., Novak, M., & Rovensky, J. (1998). Relations and interactions between the immune and neuroendocrine systems. Bratislavske Lekaraske Listy (Bratislava Medical Journal), 99(8-9), 454-64.
Ferencik, M., & Stvrtinova, V. (1997). Is the immune system our sixth sense? Relation between the immune and neuroendocrine systems. Bratislavske Lekarske Listy (Bratislava Medical Journal), 98(4), 187.
Glaser, R., & Kiecolt –Glaser, J. K. (1998). Stress-associated immune modulation: Relevance to viral infection and chronic fatigue syndrome. The American Journal of Medicine, 105(3A:35S-42S)
Hass-Cohen, N. (2003). Art therapy mind body approaches. Progress: Family Systems Research and Therapy, 12, 24-38.
Hiramoto, R. N., Solvason, H. B., Hsuch, C.M., Rogers, C.F., Pemissie, S., Hiramoto, N.S., Gauthier, D.K., Lorden, J.F., & Ghanta, V. K. (1999). Psychoneuroendocrine immunology perception of stress can alter body temperature and natural killer cell activity. International Journal of Neuroscience, 98(1-2), 950-1.
Kane, J. (2004). Poetry as right-hemispheric language. Journal of Consciousness Studies, 11(5-6), 21-59.
Klorer, G., (2005). Expressive therapy with severely maltreated children: neuroscience contributions. Art Therapy: Journal of the American Art Therapy Association, 22(4), 213-220
Kiecolt–Glaser, J.K., & Glaser, R. (1999). Psychonueroimmunology and cancer: Fact or fiction? The European Journal of Cancer. 35(11), 1603-7.
Langhinrichsen, J. & Tucker, D.M. (1990). Chapter 8: Neuropsychological concepts of mood, imagery and performance. In Kunzendorf, R.G., & Sheikh, A.A. (ed.) The psychophysiology of mental imagery : Theory, research and application. New York: Baywoood Publishing Company, Inc.
LeDoux, J. (2002). The synaptic self. New York, NY: Viking Penguin
LeDoux, J. (1996). The emotional brain. New York, NY: Simon & Schuster.
Lusebrink, V.B. (1990). Imagery and visual expression in therapy. New York & London: Plenum Press.
Lusebrink, V. B. (2004). Art therapy and the brain: An attempt to understand the underlying processes of art expression in therapy. Art Therapy: Journal of the American Art Therapy Association, 21(3): 125-135.
Malchiodi, C.A. (ed.1999). Medical art therapy with adults. London & Philadelphia: Jessica Kingsley Publishers.
Malchiodi, C.A. (1993). Editorial: Introduction to special issue: Art and medicine. Journal of the American Art Therapy Association. 10(2), 66-69
Main, M. (2002). Coherence vs. incoherence in behavior and discourse: Overview and new directions. In Attachment: From early childhood through the lifespan. Los Angeles: UCLA Conference, March 2002.
Martindale, C. (1990). Chapter 4: Creative imagination and neural activity. In Kunzendorf, R.G. & Sheikh, A.A. (Eds.). The psychophysiology of mental imagery: Theory, research and application. New York: Baywood Publishing Company, Inc.
Mead, M. (2001). Growing up in New Guinea: A comparative study of primitive education (1st Perennial Classics ed.) New York: Harper Perennial.
Naparstek, B. (1994). Staying well with guided imagery. USA: Warner Books.
Ogden, P., & Minton K., (2000). Sensorimotor psychotherapy: One method for processing traumatic memory. Traumatology, VI (3)
Pennebaker, J.W. (1997). Opening up: The healing power of expressing emotions. New York: Guilford Press.
Phelps, E. A., Delgado, M. R., Nearing, K. I. & LeDoux, J. E. (2004). Extinction learning in humans: Role of the amygdale and vmPFC. Neuron, 43, 897-905.
Riley, S. (1999). Chapter 9: External stress: The impact of illness on the family structure: In Malchiodi, C. (Ed). Medical arts therapy with adults. London & Philadelphia: Jessica Kingsley Publishers.
Riley, S., & Malchiodi, C.A. (1994). Integrative approaches to family art therapy. Chicago, IL: Magnolia Street Publishers.
Sapolsky, R. (1998). Why zebras don’t get ulcers. New York: W.H. Freeman and Company.
Schore, A.N. (2003). The right hemisphere is dominant in clinical work: Implications of recent neuroscience for psychotherapists. In New developments in attachment theory: Applications to clinical practice. Los Angeles: UCLA Conference, March 2003.
Siegel, D.J. (1999). The developing mind: Towards a neurobiology of interpersonal experience. New York, London: The Guilford Press.
Spiegel, D., Bloom, J.R., Kraemer, H.C., & Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastic breast cancer. Lancet, 2(8668): 888-891.
Springer, S., & Deutsch, G. (1989). Left brain, right brain (3rd ed.). New York: W.H. Freeman & Company
Tart, C.T. (1990). Chapter 2: PSI mediated emergent interactionism and the nature of consciousness. In Kunzendorf, R.G., & Sheikh, A.A. (eds.). The psychophysiology of mental imagery: Theory, research and application. New York: Baywoood Publishing Company, Inc.
Vick M. R., & Sexton-Radek K. (2005). Art and migraine: Researching the relationship between artmaking and pain experience. Art Therapy: Journal of the American Art Therapy Association, 22(4),193-204. |