A woman paints during an art therapy workshop at the Montreal Museum of Fine Arts offered in partnership with the Jewish General Hospital. (photo © Mikaël Theimer, MKL)
I’m sitting in my Victoria home with a sketchbook and some coloured pencils trying to visualize myself as a rosebush – one snagged in a thorny pandemic. First, I scribble in some reds and oranges, then some greens. It’s a hot mess, but that’s OK. This is therapy.
Rebecca McGlinchey, an Ontario social worker training to become an art therapist, watches my progress from her computer screen, and then asks a few questions. "What do I notice most about the rosebush? What does it need? What does it give?"
Keenly aware that we’re entering the powerful realm of metaphor, I study the rosebush with new eyes. It's in a bubble of sorts, along with a patch of earth and a bit of sky, floating alone amidst a much larger empty page.
- Related: ART & HEALING: Part 1 and ART & HEALING: Part 3
While the sketch captures the joy of a sunny day outside, it also evokes what’s been gnawing at me during the pandemic – isolation, anxiety and sadness – things many of us are facing amidst the second wave of COVID-19.
I'm in this 50-minute online session offered by the Canadian International Institute of Art Therapy, a Victoria-based school that trains students from around the world, to better understand the growing popularity of art therapy.
It costs me just $10 – a special pandemic rate that's a fraction of what therapy usually costs. It counts as a practicum hour for McGlinchey, who needs 700 hours of practical experience to become a full-fledged art therapist.
Working with an art therapist may help you access early life experiences. (courtesy Canadian International Institute of Art Therapy)
The last two decades have seen considerable growth in art therapy. The Canadian Art Therapy Association, the collective voice of some 620 members, recognizes nine training programs, mostly in major cities like Vancouver, Edmonton, Winnipeg, Toronto and Montreal. Their graduates have been setting up in private practice and picking up contracts with health care and social services providers.
One fascinating development is art therapy's move into art galleries. In this realm, Stephen Legari has a unique claim to fame – he's the first full-time art therapist to work at an art museum anywhere in the world.
He joined the Montreal Museum of Fine Arts in 2017 and, through various programs and partnerships with community organizations, is helping people cope with cancer, heart disease, eating disorders and more.
Stephen Legari, educational programs officer – art therapy, at the Montreal Museum of Fine Arts. (courtesy MMFA)
“At its most basic level, art therapy simply means using visual art in combination with the tools of counselling to help with exploring a person’s needs, a particular problem they are living with, perhaps a diagnosis, things they want to build for themselves,” says Legari. “We work through the image, we work through creation, as a way of constructing that narrative.”
Legari, who has post-secondary degrees in fine arts, creative arts therapies and mental health counselling, and couple and family therapy, recognizes his good fortune.
“I’m in a very privileged position,” he says. “And I work for a very prestigious museum. We've been able to share a lot of what we do, both through scientific articles and publications, and also through some other articles that have been published locally, nationally, internationally.”
There's solid scientific evidence, he says, that art therapy can offset anxiety and depression, boost self-esteem and give people a sense of social connection.
Research underway at the museum addresses other fascinating questions: How does art therapy affect breast cancer survivors? What are the neurophysiological impacts of creativity for people on the autism spectrum? Can creative workshops help teenagers with psychiatric problems?
The museum, which closed temporarily this fall due to spiking COVID-19 infections in Montreal, has a dedicated art therapy workshop, a consultation room and an art hive, a space equipped with tables and art supplies so people can drop in and make art in a casual environment.
The art hive at the Montreal Museum of Fine Arts. (photo by Sébastien Roy)
Therapists, wherever they work, talk enthusiastically about the advantages of engaging with non-verbal creative processes. For instance, they say it can be useful for clients who have stalled with various forms of talk therapy. They describe how tactile sensations, as well as the elements of art's formal language – colour, shape, line, pattern and the like, things we often gravitate to instinctively – seem to help people dig more deeply into their psyches.
Sometimes clients unearth traumas that were stored in the body as youngsters, perhaps before they could talk. Such traumas can be linked to addictions, attachment disorders and dysfunctional coping mechanisms. Making art, therapists say, can also help externalize complex inner struggles that may be hard to articulate.
One woman, for instance, told the Montreal museum that art therapy had helped her let go of the past.
“I was able to express in words things I could not before,” she said. “It gave me access to my own inner world and to some lovely discoveries ... And I came away from it with a strong sense of inner calm.”
A group art therapy exercise. (courtesy Canadian International Institute of Art Therapy)
Victoria art therapist Lucille Proulx recalls working early in her career at the Montreal Children’s Hospital, where she would give mothers crayons and ask them to draw with their toddlers on a single sheet of paper. Mothers were to follow the child’s lead, whether they drew squiggles or smudgy lines, essentially mirroring the youngsters.
“The parents would come in looking very solemn and very rigid,” Proulx says. “And they would leave smiling with their child. They’d had pleasure out of their encounter.”
When Proulx talked to the mothers later, she was surprised to learn the exercise had brought back memories of their own childhoods.
“There were a lot of traumatic experiences that came to the surface that they really had repressed, that they had never bothered dealing with,” she says.
“It was more healing for the parent. They didn’t have to talk about their artwork, they just had to do it with their child. And yet doing the art with infantile materials at that primitive level seemed to touch their own attachment difficulties growing up.”
Art therapist Lucille Proulx (left) works with a client in Thailand. (photo used with client's permission, courtesy Canadian International Institute of Art Therapy)
Proulx is a big believer in the power of creativity.
“Once you’re in touch with your creativity, then you can do anything you want in life,” she says. “The only reason people cannot accomplish what they would like is they are blocked, their creativity is blocked.”
Her views about the link between creativity and well-being are supported by much research over the last two decades. One of the most comprehensive assessments, a 2019 World Health Organization review of more than 3,000 international studies, found arts interventions have “a clinically meaningful impact.”
A collaborative whiteboard drawing shares some feelings that may come up during art therapy. (courtesy Canadian International Institute of Art Therapy)
Proulx, along with fellow art therapist Michelle Winkel, founded the Canadian International Institute of Art Therapy in 2016, in part to spread awareness of art therapy globally, particularly in countries where it is not well known. The institute, with its digital model of distance education, was well ahead of the curve when the coronavirus pandemic pushed the art therapy community – like so many others in health care – to explore online delivery.
“Recently, the schools that were only face-to-face are trying to shift their model so they can continue supporting their students,” says Winkel, the institute's clinical and academic director. “I do believe we’re still quite unique.”
The institute has about 60 students from Canada as well as places as far away as India and Malaysia. The diverse student body allows the clinic to offer online therapy in languages ranging from Russian and Arabic to Mandarin and Hindi. Many of the students have previous training in counselling or psychology and want to transition into art therapy as a second career.
Mapping your inner self is one of many art therapy exercises. (courtesy Canadian International Institute of Art Therapy)
Telemedicine has surged during the pandemic, particularly for routine procedures like renewing prescriptions, but it remains controversial. Critics caution that it can undermine the trust that develops during in-person visits to a primary-care physician. And as we've learned from Zoom calls, it can be challenging to read non-verbal cues online, meaning doctors might miss symptoms they would notice in person.
But does that hold true for therapy? Winkel says recent research suggests that therapeutic alliance – the rapport between client and therapist – can be just as strong over the Internet as in face-to-face encounters. Even so, she acknowledges that online therapy is not for everyone.
Michelle Winkel
“Someone who is doing fairly well and has only mild or moderate stressors in their life and may be struggling with some emotional-regulation issues or emotional concerns can often benefit tremendously from virtual art therapy,” she says.
However, people with severe symptoms, such as hallucinations or suicidal ideation, are best referred elsewhere.
“What is so important when we take anything into the virtual platform is proper intake and assessment,” she says. “We really shouldn’t be doing art therapy with folks who are outside our scope.”
Michelle Winkel demonstrates a drawing technique at a workshop about COVID-19 anxiety in the workplace at a Victoria company. (courtesy Canadian International Institute of Art Therapy)
The institute has been conducting research about the impact of online art therapy on anxiety – the most common problem people are bringing to its clinic during the pandemic.
Preliminary results from 500 virtual sessions over the last six months suggest that clients report, on average, a 23-per-cent decline in anxiety symptoms over the course of a single treatment.
The final results will be included in a book Winkel is editing, The Reality of Virtual Art Therapy, which includes chapters by international experts. It will be published by Routledge, a leading academic publisher.
“I think the fact that Routledge was so excited about our proposal must mean that it’s fairly cutting edge,” says Winkel.
Still, online therapy creates a range of issues that might not arise in face-to-face meetings.
Therapists must check – as McGlinchey did with me – that clients are in a safe and private space. And access to reliable high-speed technology is also required.
But there are advantages too, including easier access for people who are housebound, live in remote communities or would have difficulty getting to a therapist’s office. Online therapy may also work for people who face stigma from friends or family if they are spotted going to a therapist.
Similarly, there are benefits and challenges when offering art therapy in an art museum.
Galleries are often beautiful architectural spaces and offer magnificent art and other resources that can help lift spirits. But therapeutic relationships require confidentiality. Touring the collection to get ideas for making art, for instance, might leave some clients feeling vulnerable or even trigger emotional reactions. And while galleries have a pleasant vibe compared to clinical settings, people from some cultural groups may feel uncomfortable because of the colonial legacies the institutions embody.
You don’t need fancy art supplies to express yourself. (courtesy Canadian International Institute of Art Therapy)
Practitioners often find themselves confronting common misconceptions about art therapy.
One is that it’s only for artsy people who can draw. Therapists emphasize it’s not about facility with materials or creating a pretty picture. Art therapy is a process and the key is self-expression – whether through paint, crayons, clay or other media.
Nor do therapists interpret the work – they are trained instead to ask clients what an image, or a mark within the image, means to them. And, they add, art therapy is helpful for people at any age – it’s not just for children or seniors.
Creating a personal mandala may help ease stress. (courtesy Canadian International Institute of Art Therapy)
For those unwilling or unable to try formal art therapy, simply making art may ease stress levels.
Keeping a gratitude journal, for instance, and writing, drawing and collaging images of things you feel grateful for – even small moments like a child's smile or sitting in the sunshine – may pay emotional dividends, says Haley Toll, past-president of the Canadian Art Therapy Association.
Other ideas are setting up an art night with friends – even virtually – or focusing on simple mindfulness activities like creating a mandala that expresses how you feel.
“Focusing on strengths and resiliency can be really helpful right now,” says Toll.
“There are just so many challenges that we’re all going through … focusing on what we can do, focusing on gratitude, focusing on coping, can be extremely helpful."
Or, you could take a lesson from Quebec, where doctors have started prescribing free visits to the Montreal Museum of Fine Arts. Checking out some art, wherever you find it, can’t hurt, and it may help lift your mood. ■
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