and Art therapy
All children draw. There is some doubt
whether they feel any especial impulse to create and set to paint
by themselves. At school and at pre-school everyone is stimulated
to take a pencil or a brush and so is encouraged to draw. Traditionally
teachers correct childs chosen colour: the sun is yellow,
the sky is blue, and trees are green. Unfortunately, later on
just a very few children become artists. One patient of mine,
a graphic artist, coming from countryside and with no artists
in his family, and so having no possibilities to learn painting,
has told he has, as far as he remembers, drawn everywhere: in
small stick on sand, in coal on walls, and on various pieces of
It is obvious genius must be born, but
it seems to me, that every grown up person might be taught to
paint well, and even to create original art-works. Meanwhile music
needs innate abilities (ear, voice, sense of rhythm, etc.), which
are not possible to learn. Usually grown-ups are shy to draw insisting
they are incompetent, though somehow they do not avoid singing.
It is much more easily to persuade to
draw a person suffering from mental disease. What happens? Probably
the public censorship stops functioning: one
cannot draw one should not draw? The opinion, that
artists and other people having non-verbal contacts with their
environment are kind of mad, is now dominating. And when one falls
ill, one thinks why cant I become an artist if I am
It is such a common myth in the society
that all the artists and creative persons are oddities, or said
even stricter, abnormal, i.e. mentally ill. I am not
going to analyse in this article an especially complicated problem
concerning psychology, psychiatry, and philosophy, what it means
to be normal and pathologic. As far back as Plato distinguished
clinical and creative madness.
In the work of Siegmund Freud, published in 1910, it was psychoanalytically
examined a biography of the famous Leonardo da Vinci. S. Freud,
referring to quite meagre facts of L.da Vincis biography
(an imagination about a hawk from his childhood, and a funeral
list made by Katherine, who probably was his mother or his nurse),
made a conclusion that the artist was homosexual. This work laid
the foundations for a new genre pathography. Pathography
is a determination of pathology, referring to personal biography,
letters, creative works, and so on.
It is known surely, that such artists
as Vincent van Gogh, Michail Vrubel, Eduard Munch, Mikalojus Konstantinas
Èiurlionis had been hospitalised in the mental clinics
due to mental disturbances. It may be interesting to psychiatrists
but in no case should be important to those fond of their works.
I am very displeased when patients having red books start naming
famous people with mental disorders. Not every mental user might
be Èiurlionis, and the disease certainly does not make
equal different personalities. I do not agree that disease helps
a person to become a genius. Disease, especially a mental one,
is medically negative factor. A person is more likely to be talented
before the disease; just he most probably has been censored by
society as well as by himself. The disease has enabled to get
free. Sometimes I see that most of us are too much sound and limit
our abilities too long. Otherwise, as my other patient says: I
would prefer being an unknown worker to mad genius.
Does it exist the
art of mental patients?
More than 100 years it has been interested
in the art of mental patients in the world. In 1870 in Paris there
was organized the first world exhibition of works of mental users.
The art works exposed in the exhibition shocked the society. Such
creativity held people in contempt and fear (by the way, the first
exhibition of impressionism was held in 1874 in Paris as well).
In 1921 Walter Morgenthaler, a Swiss psychiatrist, published a
monograph titled A Mentally Ill Person as Artist about his patient
Adolf Wölfli, where his creative personality was held in
respect. One of the most famous book on the art of mental users
until now is Artistry of the Mentally Ill (1922) by German Hans
Prinzhorn. The other book, Artistry of the Prisoners is less known.
Hans Prinzhorn was an opera artist, later he studied medicine,
become a psychiatrist and collected a rich collection of mental
There is a question mark about the correctness
to discern a concept of mental patients drawings.
Very often it is very hard to describe creative abilities of a
person with mental disorders; and to distinguish them from criteria
of contemporary arts. Not all famous psychiatrists recognized
modern arts. In 1922 famous German psychiatrist Ernst Kretschmer
equated the arts of those suffering form schizophrenia to crude
drawings and expressionism. In 1932, Karl Gustav Jung published
an article about Pablo Picasso where he had declared that painters
reaction to a deep brainstorm was a complex of schizoid symptoms.
Art could hardly be divided into the
art of mental patients and non-patients. It would be the same
to discern the art according to gender or initial profession of
the artist. It is known that Vasily Kandinski was a lawyer, Henry
Rousseau was a customs officer, Andre Breton was a doctor, and
Henry de Toulouse-Lautrecks leg was paralysed. Thus their
works could be divided into the categories of lawyers
art, doctors art, art of paralytics
and so on. But nevertheless it is stressed that only a part of
creative works of patients could be considered an art.
What features of drawings
are characteristic for a person suffering from schizophrenia or
There are a lot of creative differences
between patients and true artists described in the literature.
Drawings of patients with schizophrenia are primitive and childish.
Such patients draw like pre-schoolers, their drawings are transparent
(roentgen paintings). There is no perspective; various
elements of paintings are ignored. It is hard to understand whether
a thing is here or there. Sometimes drawings seem to be drawn
looking down from upstairs or look like maps. It is painted up
to the very border. Authors seem to fear of emptiness and try
to fill their drawing with ornaments and colours; various written
elements (explanations, numbers, separate letters, foreign words,
etc.) are inserted into the pictures. People with schizophrenia
due to the way of thinking often use symbols in their drawings,
but the symbols are neither usual nor understandable to everyone.
Most often they might be explained only by the authors themselves.
The drawings of mental patients link to be comic and grotesque.
Figures in their drawings are disproportional (abnormal limbs,
too small head, too big body, it may be many heads, breasts, hands,
or legs). Separate body parts, ugly faces and disgusting grimaces
are depicted in their drawings. People or separate human body
parts are combined with things, i.e. stones have eyes, plants
are drawn with ears, or human faces are painted to various things.
Sexual and sadistic scenes are often repeated in the pictures.
It is stressed that people suffering from schizophrenia usually
link to draw portraits, but during my practice I have met many
patients never painting human beings. One of my patients is fond
of drawing busses, trains, and planes. He often goes to an airport
to look at the newest models of foreign planes in order to depict
them later on the sheet of paper. It is interesting I have seen
a very similar work of planes in one patients exhibition
People with epilepsy due to changed personality
features tenacity and pettiness usually paint very pedantic
and business-like pictures. Movements of a hand while painting
are impulsive. Hand is often strained as much as to pin a paper.
Contrary movements, as up and down, are very characteristic. This
is the way in which space like and bas-relief
like pictures are created. The lines usually do not have
any connection, are interrupted and dynamic. The subject of the
painting is never static, but the principles of perspective are
maintained. Every days life, daily routine and nature are
most commonly depicted in their pictures. It has been noticed
that during acute condition of the disease the paintings become
much nicer; and they lose their richness when patient gets better.
People suffering from epilepsy like bright and contrasting colours.
There are a few very interesting drawings of house with all the
things of daily routine and of forest full of snakes, lizards,
moles, and birds in our collection.
All those mentioned details are portrayed
in paintings of contemporary artists as well. So what is the difference
between mental patients and non-patients art? The
most important distinctive feature is the ability of real artist
to manage his creativity or talent; and to choose various means
of self-expression. Meanwhile patients are managed by strange
experiences and emotions, which cause personal and archetypal
symbols understood only by him. The artist creates as he wishes,
and the patient draws, as he is not able to do this different
I think human creativity may be either
artistic or not. The main distinctive feature is a fact of place
and condition due to which the work has been created. The common
characteristic for some creators spent some time in a mental hospital.
Thus it may be works of patients of mental hospital as well as
works of Vilnius painters.
Is it art for everyone
but therapy for patients?
The term of art therapy was
first used by Adrian Hill in 1938 describing his work with patients
suffering from tuberculosis. These days art therapy means all
kinds of occupation held in hospitals and mental health centres,
although lots of professionals consider such a description incorrect
and too wide. The question if art therapy (or treatment in art)
could be considered a kind of psychotherapy or psychosocial rehabilitation
causes lots of discussions between psychiatrists and psychoanalysts.
Followers of S.Freud consider any art occupation a therapy. They
refer to an idea of S.Freud stating primary thoughts and experiences
raised in subconsciousness are rather expressed in symbols and
images than in words.
There are opposite opinions as well. A
creative action is a way of self-expression and existence. Creative
activity is not treatment to an artist. Creative self-expression
is characteristic both to patients and non-patients. Polish psychiatrist
Naomi Madejska in her book Painting and Schizophrenia
(1975) says striving to create fairly good existential conditions
for mental patients by compulsory long term hospitalisation must
be based not only on the necessity for treatment but also on the
human point of view. Why should an entertainment be just a pleasure
to a sound person, and a therapy to a patient? If it is an effort
to excuse oneself not to apply suitable treatment? It is not news
that assurance of entertainment, work and possibilities to create
obviously improves patients health. It would be expected
to be the same if non-patients were deprived all those possibilities.
Patients think similar way. A member of the US NARPA (National
Association for Rights Protection and Advocacy) organisation Rae
Unzicker in her sarcastic essay (1984) on the feelings how it
is to be a mental patient among other statements says also this:
to be a mental patient is to participate in stupid groups
that call themselves therapy. Music is not music, its therapy;
volleyball is not sport, it is therapy; sewing is therapy; washing
dishes is therapy. Even the air you breathe is therapy and that
is called the milieu.
may be useful in the treatment of mental disorders for those reasons:
- Gives a possibility to express aggressive
feelings in a social acceptable form. Drawing, painting or modelling
are not dangerous ways of aggressive expressions (abroad art
therapy is widely applied in the treatment of compulsory hospitalised
mental patients having committed crimes).
- Fastens a process of therapy. Subconscious
conflicts and inward feelings are easier expressed in images
than during an interview. Improves interrelations inside the
- Creative output may be used for diagnostics
- Enables the feelings of internal control
and order to arise and to realise forms and colours.
- Improves self-confidence and creative
In Lithuania still there are not
professional art therapists; no high school qualifies them. In
some institutions this work is performed by self-educated pedagogues,
and by social workers in others. All that related to art and performed
in mental hospitals should be called an occupation therapy. The
most it is done working with mentally retarded children. But in
my work with grown up mental patients I see an obvious advantage
of art therapy as well. Sometimes drawings reveal patients
odd and secret emotions. They become more sincere and communicate
among themselves easier. Sometimes they need a smaller doze of
medicine to get quiet. But above all it is the fact that creation
improves a self-evaluation, and an image of a mental patient in
the society at the same time. Creative work often is a counterweight
to a mental disease, which is not unfortunately tolerated by society.
As patient S. says: Earlier I had five professions and I
was unknown. But after I have got ill and started drawing, my
drawings are displayed in art exhibitions in Lithuania and abroad,
I am interviewed by journalists. And lots of people are
sincerely jealous to him
It was an idea to found a separate
art gallery for mental patients, but the latest point of view
to mental patients have made to refuse it. The foundation of separate
gallery it would be a precondition to stigmatise (gr. Stigma mark,
sign, it means a distinction of patients, marking in diagnosis)
patients, a step behind. These days it sounds like a chorus
of blinds. Creative works of mental patients must be exposed
together with works of other artists. It is important what the
creation says, not mental status of an author.