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INTRODUCTION
Gaining an evidence-base for why art therapeutic practices are of benefit for
people experiencing mental illness has been a challenging process (Howells
19
20 T. Van Lith
& Zelnik, 2009; Stickley, 2010). This is partly due to that the concepts of art
making and mental health recovery involve thinking in both a convergent
and divergent fashion, so that questions about human nature are incorpo-
rated holistically (McNiff, 2008). As both art making and mental illness both
enthrall and mystify us, its meanings cannot be easily reduced to concrete
definitions of reasoning (Dissanayake, 2000; Green, 2009).
a mental illness. Anthony (1993) claimed that developing new meaning that
goes beyond the devastating effects of a mental illness involves moments that
“click,” or revelations. As Ridgway (2001) highlighted, recovery is a journey
of finding oneself and subsequently transforming through this process, with
pivotal moments that are quite subjective. A key finding from Ridgway’s
(2001) analysis of lived experience accounts was that through experiencing
transpersonal events, participants discovered humility and conscientiousness,
which led to a more robust and holistic sense of understanding of their
life.
However, the recovery research tends to overlook the extent of the
process of finding a purpose and the crises that may in fact result from
facing this dilemma. The kind of deep questioning that the participants were
expressing relates to Szasz’s (1983) view that the search for meaning in life is
“the expression of man’s struggle with the problem of how we should live”
(p. 21). Roberts (2007) suggested that Szasz’s (1983) “problems in living”
(p. 20) related to the rise of modernity where we as humans have begun
to increase our understanding of self within the world, which has led to
an increasing burdening awareness of ourselves. According to Szasz (1983)
illness was the consequence of this confrontation.
METHOD
Study Design
Maximum variation sampling was used to recruit participants, as it aimed
to capture and describe the central themes of a wide range of partici-
pants’ differences (Morse & Field, 1995; Patton, 1990). This also allowed
for the greatest gain from a small sample (Sandelowski, 1995). I sought to
explore the entire continuum of art-based practices in these organizations
by recruiting participants from four different art-based programs. These pro-
grams encompassed a range of art-based practices along a continuum from
individual art making, studio art making, art making with emphasis on skill
development and mastery, program-facilitated and structured art groups, and
individual art making with a healing purpose to art psychotherapy (Van Lith
& Fenner, 2011).
Once I received ethics approval from the two collaborating organiza-
tions and La Trobe University Human Ethics Committee, I began recruiting
participants. In order to participate, consumer participants needed to be
regarded by the program manager and respective key worker as actively
engaged in their art-based program and satisfactorily managing their mental
illness. These criteria were important to recruit participants most relevant to
this study, as well as to ensure participants were well enough to make their
own decisions about engaging in the study.
The study used a longitudinal multiple case study approach. Three inter-
views were conducted with each participant (N = 12) at 6-month intervals
over a 1-year period, to explore the changes and development in their expe-
riences of art making and mental health recovery. Each interview loosely
followed the order: Filling out the Recovery Environment Enhancing mea-
sure (REE; Ridgway, 2005) then participating in an open-ended conversation
on the experience of art making (Finlay, 2008; Finlay, & Evans, 2009; Finlay
& Gough, 2003); and finally engaging in symbolic meaning making by
reflecting on artworks completed in the previous six months (Barry, 1996;
Betensky, 1995, 2001).
Once the interviews were completed and transcribed, I sought to cre-
ate collaborative accounts of the open-ended conversations and symbolic
meaning making reflections for each participant. The key aim was to stay
true to the participant’s words and create an accessible account for review
(Sandelowski, 2000).
For verification purposes, each collaborative account was sent back
to the participant for verification. The first two accounts were sent prior
to the third interview, and all 12 participants acknowledged that this was
true to their experiences, albeit with a few minor grammatical changes. The
third account was sent along with the researcher’s intersubjective response
of their responses, and two participants wrote back that theirs was a true
account. As I only asked for a response if changes needed to be made,
it was assumed that these accounts were in keeping with the participants’
Painting to Find My Spirit 23
Thematic Analysis
The interpretative phenomenological analysis (IPA) approach was adopted
for the thematic analysis stage. This involved several sequential stages to
draw out themes from the lived experience inquiry and art-based inquiry
accounts (Smith & Dunworth, 2003; Smith, Jarman, & Osborn, 1999). IPA
is particularly appropriate for understanding the participant’s point of view
by identifying and empathizing with his or her lived experience (Smith &
Osborn, 2008). Therefore it is not just about analyzing the words as they
are written in the transcript; the feelings, physical responses and the silences
behind these words are also taken into account. Consequently, this analytical
process can be seen as an iterative and inductive course involving a cycli-
cal moving between the descriptive and the interpretative processes (Smith,
2007; Smith & Osborn, 2008).
FINDINGS
Participants’ Demographic Details
The study involved 12 participants: five males and seven females. Their ages
ranged from early 20s to late 50s. The length of time engaged with mental
health services ranged from 5 years to more than 10 years. At the time of
the first interview the length of participation in the current psychosocial
rehabilitation program ranged from 3 months to 7 years. The majority of
participants were not currently looking for work or study. A pseudonym was
chosen by each participant in order to protect his or her identity.
DISCUSSION
In keeping with previous studies, the participants referred to the art mak-
ing process as enabling them to experiment with a renewed perspective of
themselves, their relationships with others, as well as with the external world
24 T. Van Lith
TABLE 1 (Continued)
(Howells & Zelnik, 2009; Stacey & Stickley, 2010; Stickley, 2010; Stickley, Hui,
Morgan, & Bertram, 2007; Van Lith, Fenner, & Schofield, 2011). The process
of art making also assisted the participants’ re-formation as they authenti-
cally committed to investing in the rebuilding and enhancing of themselves
(Sullivan & McCarthy, 2007, 2009). The catalyst for exploring their senses of
self through an art form was their own desire to excel at art making and
become more self-assured as a result (Thompson, 2009).
In line with the critical review of relevant literature (Van Lith et al.,
2012) the findings from the participants’ accounts indicated that art making
was found to benefit the psychological and social aspects of their recovery.
Like the artists whose experiences were described by Sullivan and McCarthy
(2007), these participants tried and tested a number of possible ways of
being, and established various different relationships with their own art mak-
ing. For example, Neg created her botanicals to please others (the socially
appreciated artist), but also created for herself using forms of expression that
were pertinent to her in that moment (the authentic self). She consciously
moved between the two, knowing that both provided different purposes.
On the other hand, Sarah would create to escape her symptoms (the healing
self), but also used art to bond with her children (the mother). Sarah, like
Neg, was conscious of the differing ways of being that she inhabited, but
knew that by connecting with herself on a psychological level she would
build resilience and enhance her abilities as a mother. Therefore, enhancing
one component of the self was seen as helping develop other parts.
The participants’ perceptions ranged from seeing their artwork as: an
expression of the unconscious self (Neg, Sean, Mia, Clare), the result of
tapping into the fantastical self (Louise, Richard), a combination of both
26 T. Van Lith
It was clear from the participants’ accounts that their self-knowing could
not have occurred if they had to rely on written or verbal forms of com-
munication. Instead, it was the symbolic and metaphorical meanings formed
during the art making process that assisted in providing a sense of harmony,
inner peace, social inclusiveness, and mental balance (Erdner, Andersson,
Magnusson, & Lutzen, 2009). Swinton (2012) referred to this type of knowl-
edge as “ideographic” (p. 100) and differentiated this from nomothetic
knowledge which, although tangible, does not give us the depth we need to
understand experience to its fullest.
Recovery as the attainment of knowledge was highlighted in Deegan’s
(1996) lived experience account. She came to understand that as a conse-
quence of her illness she had become a question in search of answers, and
spoke about this learning process as involving a state of becomingness to
embrace questions of self-determination (Deegan, 1996). It is an important
idea that the recovery process is about acknowledging that one is looking
Painting to Find My Spirit 29
for ways to seek freedom from oneself and others in order to feel a sense of
autonomy.
Viewing the recovery process as intertwined with life-long learning was
also suggested by Griffiths and Ryan (2008), who emphasized a need to
look at how we acquire knowledge and to introduce this into recovery ser-
vice models. The authors referred to Delors’ (1996) four pillars of lifelong
learning to illustrate the many forms by which we acquire knowledge. These
included:
These four pillars also coincide with the prominent theory that art mak-
ing helps us to come to know or see ourselves differently (Allen, 1995;
Higgs, 2008; Levine, 2000; McNiff, 2008). Engaging in art helps us to use an
innovative lens without pre-conceived expectations of a need for definitive
structures or conclusions (Liamputtong & Rumbold, 2008; McNiff, 2008).
The participants knew that many insights about their artworks were
revealed in emotive and bodily sensations, never to be decoded through a
linguistic form (Polanyi, 1966). As opposed to long coherent narratives, they
often spoke about these insights as snapshots or brief glimpses of an insight.
Sometimes the participants knew exactly what had been revealed and other
times they were vague, almost as if the meaning had not yet been fully
disentangled. Either way, no insight was regarded as absolute, as frequently
another thought would be revealed at a subsequent interview. This would
often take the form of “I have been thinking about this artwork again and I
realized this . . . about myself” (Kathryn, Neg, Sean, Mia, Alex).
Ultimately, it was the participants’ attitudes of openness and freeness
that enabled meanings to be easily refined, changed, or completely morphed
into something else. This revealed that knowledge was never in a fixed
state as new learnings were constantly being revealed. Interestingly, this
mobile and flexible attitude to their artworks also applied to their outlook on
life. As the interviews progressed, problems or issues seemed to dissolve or
slowly fade away and new issues would gradually emerge. Although during
the study important decisions were made and several crises occurred, there
was an overarching sense that the participants were managing changes by
30 T. Van Lith
living life at a steady pace. This suggested that art making had strengthened
their ability to live with adversity and the varying disruptions that come
throughout life.
Culture is the land, the land and spirituality of Aboriginal people, our
cultural beliefs or reason for existence is the land. You take that away
and you take away our reason for existence. We have grown the land up.
We are dancing, singing and painting for the land. We are celebrating the
land. Removed from our lands, we are literally removed from ourselves.
(Dodson, 1997, p. 41)
described the artworks’ meanings in layers and saw that uncovering occurred
through description, reflection and being in a serene state. Kathryn was not
so much interested in solutions but connection and attunement with her life
purpose, thereby allowing more allegorical insights to emerge.
A few of the participants (Paul, Sean, James, Clare, Mia) were unafraid or
unashamed of discussing their perceived limitations and need for ongoing
support in certain areas of their life. Peck (1988) expressed the increasing
push for individualism in our society and the problem it creates by stating;
“ it denies entirely the other part of the human story: that we can never
fully get there and that we are, of necessity in our uniqueness, weak and
imperfect creatures who need each other” (p.56).
These participants had tried to recover on their own but, as Peck (1988)
suggested, they found it resulted in an even greater sense of loneliness.
Assisting individuals to be self-governing in their self-development was fur-
ther critiqued by Kushner (2002) who queried why mental health services do
not instead emphasize judiciousness and solidarity to determine one’s state
of recovery.
Kushner (2002) also warned that detaching ourselves from society and
relationships to solve life problems can end up increasing our feelings of
abandonment and despair. However, working within a group structure might
enhance more well-rounded ways of understanding issues that were creating
distress as well as a sense of collective experience. For example, most of us
would have experienced the positive feeling when someone explains to us:
“I missed you when you didn’t come to such and such.” We feel elated that
someone had cared to think about our absence and the difference we make
through our participation with that particular group.
Through the art making process many of the participants came to real-
ize that they were interconnected with others as well as their surroundings,
and not just spectators. Believing in a greater purpose beyond ourselves
has been regarded as one of the key aspects of connecting and enhanc-
ing of community (Kushner, 2002; Peck, 1988). Ideally, this relates to being
able to set aside one’s individual desires to focus on attaining a more uni-
versal goal. At the same time, participants also saw themselves as being
able to resolve dilemmas as well as act on decisions about their life, whilst
retaining an awareness of some of the wider community’s aspirations. For
example, a few of the participants spoke about wanting to be more help-
ful in the day-to-day running of the open studio, by helping to teach
an art class or assisting in the induction of new members. In this way,
the participants’ experiences highlighted the need for a more diverse art
offering by encouraging a range of individual and communally oriented
qualities.
32 T. Van Lith
CONCLUSION
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