Art Therapy Case Study - Tom, age 9

In order to protect the family’s right to confidentiality pseudonyms are used throughout the course of the study.

Tom was referred to Art Therapy by the adult outreach team who worked for a period of time with his mother Laura. Laura had 3 other children including Tom who at 9 years of age is the second eldest sibling.

Laura had experienced both physical and emotional domestic Abuse from Tom’s father John for 13 years and so Tom had been witness to abuse all his life. Tom had also experienced both forms of abuse from his controlling father who did not allow Laura to bond freely or build a nurturing relationship with her children. Laura reported that the physical abuse increased in severity during her pregnancy when John would ‘try to punch the children out (of her)’ When I began work with Tom, he had been living away from his father with no contact for approximately seven months after his parents had separated. Tom’s contact with his mother was also reduced for the first two months of my working with him due to Laura’s mental ill health and assessed incapacity to provide adequate care for the children. The Children stayed with family friends until Laura was considered well enough to take full responsibility for the children once more.

Tom was referred to Art Therapy because of Laura’s concerns regarding Tom’s behaviour. He appeared to swing from aggressive and angry outbursts, directed towards his brothers and sisters to periods where he seemed to psychologically ‘shutdown’, withdrawn and confused. As Laura was not able to bring Tom to the Advice Centre for Art Therapy I offered appointments at his school that were able to provide an appropriately private setting. Tom attended the weekly Art therapy sessions for 10 months.

On meeting Tom for his first session he appeared quiet, calm and keen to begin Art Therapy once he had an understanding of the nature of the space provided. The tone soon changed as he began his first images, he quickly began drawing aggressive images of violent fantasies played out towards his father. In these images his sister and himself would be shooting and bludgeoning his father to death or torturing him in some way. In figure 1 he is holding a gun whilst wearing stilts that were higher than the pair his father was given, perhaps symbolising his desire for power over his controlling father. While making the image he spoke about how his father had often threatened to kill his mother, and his fantasies of revenge appeared to help him feel empowered whist at the same time communicating how disempowered and frightened he had felt in the presence of his father. His mood seemed frantic and excited as he entered a state of hyper-arousal not unusual in someone who has experienced the psychic and psychical trauma of domestic abuse. It was important that he was able to have time to calm down and relax before going back into class and so we created helpful techniques to enable emotional descent.

The framework, boundaries and acceptance that the Art Therapy offered were able to safely contain the difficult and powerful feelings Tom was experiencing. After feelings had been expressed and explored the images were put away by Tom, this can also be seen as a metaphor for handling the feelings. The Violent projections onto paper continued for many weeks until it seemed he had purged himself of every violent image he possessed at that time. In analytical Art Psychotherapy this process is termed ‘scapegoat transference’ (Schaverein, P 61) Intolerable parts of the self are split of and projected towards the image. The scapegoater feels relieved of the burden yet at the same time owns the split off elements of the psyche through their disposal in the picture. In the act of accepting the picture the therapist acknowledges the fantasied attack towards parent/therapist giving therapist an opportunity to witness and survive the attack, ‘The child could feel relieved that he was not rejected despite his awe-ful fantasy or wish; he was lighter for having owned the feelings and for the therapist’s acceptance of them’, (Schaverein, P 36). This ritual of disposal of images can result in a reintegration of previously split-off emotional elements.

Figure 1

‘Bombing Dad’

Tom began to intersperse the murderous projections with more affable images of happy recent memories and hopes for a brighter future. These were of bikes rides, day trips to Skegness and people who cared about him. He surprised himself by his ability to visualise so many close friends and family. One week he painted a sun which gradually spread light across the page; he was able to see the metaphor for himself in the creation of this picture and freely reflected on its meaning in relation to his progression. Art making appeared to have become a vehicle for coping for Tom, one week he spontaneously told me that if he had a bag of weapons it would include art materials as these help him to protect him self.

His Anger and rage were still being expressed towards brothers and sisters, this seemed to be reciprocal. He described his anger as ‘bigger than this room…red….could throw it miles…you wouldn’t want to see it’. However, together We devised a safe way of ‘seeing it’ by creating a large paper plane on which he drew pictures of his father with a limp which seemed to represent a way of humiliating his Dad in the way he had been humiliated previously, there were also drawings of a happy face, this he said was a kind of mask ‘to cover up’ the sadness he felt that his Dad hadn’t been the sort of Dad he felt he should have had. This was the first time he had expressed disappointment and sadness about the broken relationship with his father. He admitted that he often hides his true feelings whilst folding up the paper plane. We went outside to throw it as a symbolic gesture, simultaneously encompassing possible ideas of disposal, ‘flight and fright’ responses and freedom. After throwing it across the school field he decided to pick it up and keep it with him, perhaps representing his desire to deal with these complex feelings rather than avoid or repress them. As Cathy Malchiodi observes ‘art making may channel chaotic, aggressive energy into more constructive and acceptable actions’ (Malchiodi, P 10)

The last two months of Tom’s time in Therapy took a very different turn. His work began to become a more explicit personal reflection. As the crisis dissipated and the defensiveness subsided, a variety of other emotions manifested themselves. He began with a life size self portrait on black paper. He asked me to draw round him so that he could fill in his body shape with paint. He became absorbed in his efforts to paint black paint onto the black background.

The finished result is one which I would refer to as an ‘embodied image’ which seems to reveal previously unconscious aspects of a clients internal world, ‘unlike the diagram, which needs the elaboration of the spoken or written word, the embodied image is not immediately amenable to discourse’ (Schaverien, p79). This piece and the following self portrait appeared not to need words for explanation, the shadowy, almost invisible figure spoke for itself and followed a period of quiet reflection for both Tom and myself as we held the meaning of this painful self discovery in respectful reverence. Children from violent homes can often feel invisible as their emotional needs are often inadequately met by either care giver due to the dichotomy of misused power and intense fear.

The subsequent figure was on a white background and filled with colour inside and out. Many colours were used to represent different feelings; Red on the head, hands and feet to symbolise anger, black on the stomach area for disappointment and lots of glitter around much of the body symbolising his wish for a happier future. Surrounding the figure was orange paint and more glitter, which he described as all good things around him. It encapsulated a multitude of bodily feeling states as well as a connection to a positive environment and felt like a great amount of internal development and change had occurred for him since the previous portrait. The cross near the mouth of this figure was not elaborated on verbally, however he communicated his frustration and sadness that his mother did not provide him with the interaction he needed, it may be that the cross suggests dissatisfaction with not being heard on many levels at home. This was something that we were able to discuss in review with Laura who was also concerned that she was not giving enough quality attention to Tom and aimed to practise strategies to attend to this deficit.

Tom ended therapy by adding post it note reminders to the final image; One had both our names on it, another was a reminder to ‘draw, paint, cut and stick’ in the future. He decided to take all his work home with him and Laura reassured him that they would remain in a safe place away from the other children.

In summary Tom’s time in therapy began by using defensive mechanisms of projection, usually involving superhuman power and control, this gradually changed into an acknowledgement of his thoughts, feelings and wishes at which time he made many surprising discoveries of self revelation and personal understanding. He found many coping mechanisms which he could take with him through to adult life; these may enable him to continue to regulate his emotions in a safe and healthy way, encouraging an increased self esteem, more fulfilling relationships to others and simultaneously within him self.

Bibliography

Malchiodi, C. ‘Breaking the Silence. Art Therapy with children from violent homes’ Brunner/Mazel Publishers 1990.

Schaverien, J. ‘The Revealing Image’ Jessica Kinglsey1992.