For whom: examples

Difficulties, indications and therapeutic goals:

There is a wide range of indications, or issues that call for systemic art therapy, including :

self-confidence issues, difficulty in “taking one’s place”
immigration and all losses that come with it, including several generations
couple issues, difficulty communicating, a painful separation or divorce, sometimes accompanied by sadness, behavioural or anxiety issues with the children
splitting with family members or friends, painful fights or “cut-offs” with siblings
transition periods, linked to expatriation or moving house, but also after illness, job changes, or during life phase changes, such as becoming a parent, children leaving the home or retirement…
alarming behaviour of children and adolescents, because of a traumatic event, but also when no obvious cause is found
an exhausted parent, children that don’t listen, need of parent support
repetitions of relational problems, of conflicts
a difficult adoption for a child or parent, attachment problems, identity issues
substance or relational dependency, addictions
frustration, anxiety, anger, feelings of hate that are not attuned
loss or mourning: of a family member, a close friend, a job
insomnia, nightmares
feelings of guilt or shame, of loneliness or depression
difficulty addressing certain subjects, hidden facts, family secrets and their devastation
the desire to understand one’s family (dys)functioning, wanting to better comprehend oneself, wanting to feel “legitimate“, to improve one’s situation, wanting to become the principle actor in one’s own life.

Sometimes it is not at all obvious why one isn’t feeling well, or what the precise reason is for seeking therapeutic help. Finding the “therapeutic goals” can be the core challenge of the therapy. The goals can be approached indirectly through creative art therapy, together with either circular or direct questions. Ideas and hypotheses can emerge as a result of observation, the creation process and verbal elaboration. The hypotheses are not final goals in themselves, but levers to help open up and move forward in the therapeutic process.

Examples of therapy:

A child and his parents

Michael chooses several black pencils and markers. At home, the child isolates himself and he has fits of anger. He has lost his dearest friend: his dog. During our third session, I offer him charcoal, which he crushes, and he then draws crosses on the paper. With his parents, I discuss how they can reserve quality time for Michael at home, while at the same time still maintaining the important rituals and rules of daily life. After several studios, Michael shows interest in water-soluble coloured pencils, and discovers how to make coloured water. He starts playing with the liquid and makes it run and leak. With a straw, he blows into red droplets, creating “explosions” on the aquarelle paper. A few sessions later, I propose coloured modelling clay, and he makes several animals. A mean wolf wants to eat a little one, which dies. Michael has now given form to the painful event and starts to integrate his loss. He makes other animals that become friends with each other. At this point, he can now say that he misses his dog. We light a little candle for the animal, and Michael blows it out. He takes a small knife, and carves a fine and smooth wax stick out of it, which he caresses. Towards the end of the therapy, he makes a print of his hand in fibre clay. It dries as solid material. In our next session, he paints it and finishes it with shiny varnish. With great care, he has made a trace, a witness to his existence. His parents confirm that his fits of anger are less intense, and that he is beginning to play more.

A parent – child therapy

Stephen, the father of Jonathan, age seven, calls me after a discussion with the teacher who indicates that Jonathan is afraid of making mistakes in class. Even when he has good results, he shows fear of failure. Stephen tells me that he is something of a perfectionist himself, and quite demanding of those around him, as his ex-wife regularly reminds him. I explain to him that I need him, the parent, to take part in the therapy to help Jonathan recover his self-confidence. I propose receiving father and son together for an observational studio session. During that session, they decide to make a model of a house. Dad builds the walls in cardboard, and the son wants to make a table and some chairs with paper. Quite rapidly, Stephen is helping his son, and even wants to cut out the backrest of the chair for him, even though Jonathan had already begun making a chair that would stand alone. When I later share my observations with the father, he becomes aware that his son didn’t really need his help at all. He personally has trouble letting his son discover and build things on his own. I propose simple and clear solutions for the next session, which Stephen thinks are good ideas. During the following joint session, Stephen compliments his son on his manual skills, and on his choice of solid paper for the furniture. He explains that he would like to take care of the windows, and that he thinks that Jonathan’s furniture will be perfect for their house. The positive feedback and the recognition of Jonathan’s qualities by his father turn out to work. Jonathan relaxes and gains self-confidence, in school as well.

A pre-adolescent

Hugo’s parents have announced that the family will have to move again, to a new country. For 11-year old Hugo, this is hard to digest and accept. As the child of an expatriate family, he has already been through culture shock in the past. He shows his anger with brown packaging paper, which he crumples, then tears into pieces. Anger is a secondary emotion that covers his frustration and apprehension. We build a tent with different pieces of cloth, light rope and clothespins, and the packaging paper becomes the rug on the floor. He imagines a new friend (the therapist) in the unknown country and proposes that we invite him over. In the tent, he offers his visitor a drink of water with orange ink, and biscuits with red cherries, which he has made with modelling clay.

An adolescent of 16

Rose follows several months of therapy. Her mother suffers from episodes of depression, and is hospitalized after having taken too many tranquilizers. Compared to other depressions, this seems more serious. Rose’s father succeeds rather well in organizing the household, despite long working hours, and Rose knows that her father is there for her. But despite her father’s support, she feels tense, anxious, and has trouble concentrating at school. During our sessions, she plays with flour, and its ultra-soft touch. She transforms it into a paste by adding purple paint. Then she says that she is worried about her mother. A few sessions later, she feels like hitting something, and I propose a piece of marble and a hammer. She breaks the stone into pieces, with force, and then realizes how angry she is with her mother. It is an emotion she feels guilty about. In our next session, she makes a sculpture with the marble pieces, and we talk about her family. Does she know what the lives of her parents were like when they were her age? Her favourite aunt, her mother’s sister, gives her a clue, a key, in the form of information that had never before been discussed with Rose. This allows her to understand the anxiety of her mother, who went through a traumatic experience when she was the same age Rose is now. It is known that anxiety is “contagious”, transmitted from parents to children without words. Knowing the context of her mother’s trauma helps Rose to understand, to give her own anxiety a place outside herself.

An adult

Kerstin, 55 years old, has trouble sleeping. After a life as a housewife and mother, married to a well-to-do man, her divorce has hit her hard, and she feels depressed. She tears thick paper into strips, which she uses in a collage with intense colours. When I propose that she make a drawing with all the systems of which she feels a part, she says: “Ah, it’s much easier to talk with a pencil in my hand”. Drawing and talking at the same time do her good. She doesn’t need to worry about money, but the empty hours every day weigh heavily on her. She has several friends in Denmark, but she says she would also like to become part of social activities in her neighbourhood in Paris. She travels to her native country to “recharge her batteries”, but she realizes that her home is here in Paris, that she needs to feel useful. She decides to offer her time as a volunteer in one of the many associations in the area. After a few months, she realizes that she is sleeping well again.

A professional

Frank is a specialized educator who enjoys his work, but he can’t stop boasting whenever he sees his colleagues. He is well aware of his behaviour, because he explains that he is in fact trying to hide his lack of self-confidence. In our studio sessions, his three-dimensional creations reveal wonderful interest and curiosity. He has a wide knowledge of materials, and I observe that he has excellent manual abilities. When he talks about his childhood, he explains that he’s the youngest of six, and has always been the “little one”. I bring him back to “today”, and mirror his qualities back to him: I remind him of his positive energy, his manual aptitude, his curiosity and his work with the children, which he seems really good at. He realizes that his self-image is antiquated: it no longer corresponds to today’s reality. He begins to change his perception of himself. He is now able to consider himself “good enough“.

A senior

Albert Johnson feels isolated. With his 74 years, he feels bitter about the loss of his younger brother, as well as several friends. In one session, he selects a magazine with images of Asia and fine scissors. He makes a collage with images from Nepal, and then he announces that he would like to travel again, and meet new people. I ask him if he feels ready to work in a group, and I propose that the next time he bring along a catalogue with travel opportunities for retired people.

A family with a young child

Lionel and Clare come with their son, Noah, who is nine and has been suffering from nocturnal enuresis (bedwetting) since his maternal grandfather passed away. Lionel travels frequently for his work. Clare had a burnout before Noah was born. Since her father died, she feels fragile, and the problems with Noah are too much for her. Noah provokes her more and more whenever his father is away. Feeling exhausted, Clare often just gives in to his various demands. For their second family observation session, I propose they make a collage of a garden with flowers. Lionel decides to make the surface of the ground from stiff cardboard, and that Clare and Noah make the flowers. In addition to the tension that I observe between mother and son, Noah also tries to help his mother. The following meeting is with the parents, and I share my observations with them. Together we plan the next joint creation. We decide that the parents will make an aquarium together, using a cardboard box and coloured paper. Their son will make the fish. Whenever Noah attempts to provoke his mother, Lionel will ask him in a calm but firm manner to talk to his mother in a respectful way, and both parents will be careful to prevent Noah from helping his parents. Instead, they will guide him in hanging the fish that he will make with paper and markers. We agree that Lionel will be a stronger support to his wife when Noah provokes her. We also agree that he will telephone his son every day whenever he is travelling. Successive studio sessions with specific propositions for this family help the couple to consolidate their position as parents, leaving Noah to take his place as a child. During my intermittent meetings with the parents, I remind them of the importance of clear rules that every child needs: offering limits gives the child a sense of security. And providing simple tasks, such as preparing the dinner table, can give a child his appropriate place in the family. Receiving compliments for his contributions will make the child calmer, because he feels appreciated. These exchanges with the parents contain useful moments of psychological education and positive parent support. Noah seems to feel more at peace at home. During the final evaluation meeting with the parents, Clare says that she plans to contact her psychotherapist. She realizes that she personally needs help coping with the bereavement she feels because of the loss of her father.

A family with grown children

The Polak family seeks therapy because the parents are worried about their 18-year old son. Samuel smokes soft drugs daily and no longer wants to pursue his studies. His older sister Miriam is 20, and is a brilliant student, although she has no close friends. I propose an observation session with a simple proposition for a creation with different materials, which they will discuss and build together. Samuel arrives late, but participates in making the collective model of “beach life“. The mother immediately sets herself to work, and decides who does what. The daughter, sitting at her mother’s side, will make a sand beach with semolina glued onto a cardboard surface; the son will create a square of sea with turquoise paper covered with cling film, and dad will make a blue sky with clouds of cotton. Mom herself makes four little figures in modelling clay, seated side by side on the sand. The result corresponds to the proposal, but the creation process leaves me with the feeling that the children seem much younger than their actual ages. When I share this impression with the family, the parents admit that they have been rather strict with Miriam and Samuel, that it is difficult for them to “let go“. I ask Samuel if he has an idea why his mother immediately put herself to work in the way she did, and he replies that he thinks that she is often nervous, maybe because of old family stories and the war. This subject proves difficult to address for the moment, but the family members all agree that the children have both achieved majority and are old enough to be more autonomous. During the ensuing sessions, I propose other creations, now more “guided”: the family starts with a common drawing, which then leads to individual creations. During these sessions, both the parents and their children discover each other in a different way. They all have lots of ideas: they are a creative family. The atmosphere becomes more relaxed, and this allows them to work together on creating their family genogramme, using colours and materials. Their family tree turns out to have “holes” in it, and Miriam and Samuel discover the extent to which the Holocaust had left deep traumas in both of their parents’ families. Two sessions of individual expression follow for the grown up children. The parents alternate between individual and joint creations. Towards the end of the therapy, everyone creates his or her own systemic family shield, where the past is now expressed with new images, where the present shows openings, and where future projects are given positive shape.

A couple

Denise and Paul come for couple therapy. Paul spends a lot of time at his computer after work, and Denise complains about “a void” she feels, compared to their first years together when they were still in love, often went out, and spent quality time together. She finds it difficult to talk about it with Paul. As for their intimate life, it became surprisingly calm after they moved in together. It is not uncommon to feel “deceived” during this new phase in a relationship. Falling in love is a marvellous thing, but also incredibly complex. In a new relationship, we feel accepted and understood, valued, loved. Our desires, our expectations, and our bodies can create confusion. Our pheromones stimulate physical attraction for up to two years. Later on, when a crisis arises, it can be helpful to revisit this period, to rediscover the forgotten qualities of both participants, because sharing a household, the practical aspects of living together can be a challenge for both partners. One discovers that habits, convictions, and the things that seem “normal” to one, are not necessarily the same for the other. Our initial projections about being two almost perfectly matched individuals are not always what we discover after that “honeymoon period” is over. Denise and Paul are each irritated with their partner. Hurtful things have been said, and this has created a gap. They express their respective frustrations in their drawings, and they also explore their hurt. We retrace unpleasant or traumatizing events of their childhoods. Through analysing a conflict during the session, in an experiential way, they start to separate those old wounds from the past from their relationship today. Paul and Denise are starting to better understand their moments of irritation or anger. Now, like an alarm, this helps to remind them that it is time to communicate! I propose that they draw and write down key words about their own qualities, as well as the qualities of their partner. Joint creations become moments of learning about how they can manage their differences in opinions or tastes, and they receive tasks to do at home in between sessions. They learn to communicate more, and to start asking questions first, before getting unnerved or angry. They each put expressing their own needs into practice, listening to the other, and finding consensus or solutions that can be accepted by both.

Two adult siblings

Michelle calls me because she’s very upset with her brother Kevin. She takes care of everything, while her brother lets her know that he’s fed up with her habit of controlling. Their fight has reached the point of not wanting to speak to each other any more, but their ageing mother depends on them. Michelle does most things alone, feels exhausted, and is afraid she’ll have a breakdown soon if nothing changes. I propose that she come together with her brother. She can tell him that she needs him, and that she has reached her limit. During the first session, the tension is palpable. I ask if there had been a time of strong tension in the family when they were children. Yes, there had, when their mother had a miscarriage, something the family didn’t talk about for years. Despite that silence, they both remember their mother’s depression when Michelle was ten and Kevin seven. Siblings are the best witnesses one can have: with no one else have we shared so much. I propose they draw their nuclear family of that moment, and to indicate, in colours and shapes, the intra-familial relationships, adding some key words if they wish. They remember how Michelle had to do the household chores, like cleaning, and how Kevin, feeling jealous of his sister’s importance, got into fights at school during that difficult period. I express my understanding that they both suffered at that time. The mutual recognition of brother and sister led to another proposal: that each make a drawing of the qualities of the other sibling. During the next session we start from there. Kevin is good at earning money and seeing the bigger picture. Michelle is a real organizer, and completes what she starts. Together, we elaborate on how they can use their respective strengths to improve their response to the needs of their mother. Kevin is willing to pay someone for a couple of hours of cleaning and care each week, and he asks his sister if she would organize that for him. Michelle would like to bring meals to her mother during the week, while Kevin will visit her on Sundays, organizing occasional outings with his mother in his car.

A new family

Mary and Linda ask for family therapy and come with their only son, Martin, who is nine. This married lesbian couple seeks help for Martin, who has nightmares in which he dreams of being all alone, lost in an immense forest. During our first session, I observe that Martin seems remarkably independent for his age. Whenever he encounters a technical problem, he tries to resolve it by himself, without asking for help from his parents. Both Linda and Mary work on creations of their own, whereas I had asked them to make a joint collage, an image of their nuclear family. When I receive the parents without Martin, I share this observation with them, and both parents describe their demanding professional lives. They conclude that they indeed take very little time to do things together with their son outside school holidays. They decide to each set aside an evening reserved for their son, instead of systematically leaving him with a neighbour or babysitter, and to plan family trips together on Sundays, to movies, museums, or walks in nature. For their second family session, I propose a more guided joint creation: the parents will construct a rugby field and Martin will make the players. I had established details in advance together with Mary and Linda, such as which materials they’d be most comfortable with. During this creation, Martin asks me a technical question, and I reply that this is something he can ask his parents. This reinforces their intra-familial relationships. During the third and forth sessions, the mothers draw their respective families over four generations, and Martin integrates his donor father, a subject his parents had tended to avoid. Although his identity is unknown, he seems important to Martin, who invents a name for him, which he writes down on the genogramme creation. Martin also discovers that he has a “lost” uncle, excluded from the family. Mary realizes that this separation from her brother still touches her today. She wonders if she should go and look for him, but this idea also creates apprehension. I suggest she choose a chair, symbolizing her brother, and to add that chair to our circle. I ask her what she’d like to say to him if they met again. She’s touched, and finds words through a poem. Martin has been drawing. He’s been very calm, and says that perhaps his uncle is lost too, and alone. For our final two sessions, the parents invent propositions for joint creations. They express real joy, while symbolizing a stronger parent-child relationship in their creations.