Considerations and Reflections by Hatto Fischer

Art therapy took on a meaning for me when I met Mari Pizanis (www.arttherapistmari.com) who was teaching at that time art at La Verne University in Athens, in particular abstract art. I joined the faculty in 1992. We gave a joint course before she left for the United States to take up further studies of art therapy at Pratt in New York. By now, she is a well known art therapist.

What was indicative of special interest in art therapy is what can be linked to identity. Mari Pizanis accounted to me the following experience when we met. She had been involved in a motorcycle accident and had been in coma for two weeks. When she woke up again, she vaguely remembered who she was. However, she did recall that once, when involved a bit in art therapy, that this had helped her a lot in gaining consciousness of ‘self’. Consequently she used methods of art therapy to regain her identity.

Mari Pizanis’ identity was complicated by the cultural fact that she grew up in the United States but was born to a Greek father and a Greek mother. She had been only twice in Greece, once when a small child and then for a summer vacation which extended to a 5 year stay, encouraged by the accident. Mari’s stay in Greece led her to work at La Verne University.

Children with cross cultural identity formations remark often that their memory work can be linked to stories told by parents, grandparents and relatives about the land back home. This gives in to a reign of projections about that what was left behind so that any child growing up under such circumstances always wonder what is different in Greece compared to what can be experienced in the United States, more concretely in California where she grew up. That makes the experience of differences as part of the identity building process into a complicated acculturation process (see a definition of this term in the paper presented by Kostas Theologou in Athens, Oct. 18 – 19, 2007 – www.productivityofculture.org) .

But that is not the main essence of her story. Important is that she relied on art therapy to regain her identity. Mari Pizanis convinced me in a way no other person had done before since she was always ‘mentally’ present when talking with her. She had humor but also such a disposition which encouraged honest expressions. It can be easily linked to what Simone Weil had defined as honesty, namely the rooting of self identity in the words we use to say something to the other. This suggests that identity must have an ethical base linked to honesty in a way that a lawfulness cannot be circumvented, but must be heeded if recognition is to be given to the individual and not to a normed personality according to the wishes and desires of society.

Consequently the criticism I received then by Kris Rogiers and Prof. Bekemans for having included art therapy was not justified. More so, art therapy does handle more specific questions of identity building processes than overt or general references to cultures as being unique but then forgotting that one single cultural stamp for an entire region entails as much destruction of unique identities (see the writings by Nikos Stavrolakis about Thessaloniki being ruined as a city based on cultural diversity once a single Greek stamp was put on it after the Asia Minor crisis in 1921) as if a single Europe would wipe out cultural differences. This play on fear transformed into a threat of ones identity has been discussed as well in workshop 8 with literature a vehicle of expanding the scope of possible identification possibilities, but more crucial is here what Brendan Kennelly said about mistaking challenges as being threats and therefore counter productive measures are adopted rather than be challenged in one’s identity by others.

To remind, Adorno and Horkheimer predicted in analysing the failure of the Enlightenment in “Dialectic of Enlightenment” that even when Fascism shall be defeated (they wrote it in 1944), there will still be the force of xenophobia to be dealt with as this force may be just as terrible as Fascism (as was seen in the form of ‘ethnic cleansing’ in former Yugoslavia and many other forms of genocides, including the great human tragedy of the Armenians and about which the Polish journalist R. Kapuscinski wrote so convincingly when depicting the break-down of the Soviet Union as having left people exposed to such changes but without the ‘cultural tools’ to cope with these changes).

Once it is clear that ‘art therapy’ has a value, then insights gained into identity building processes should be made more explicit. Moreover, the problem of objectivity to which Karin Danneker referred to in her initial paper reminds of Adorno’s attempt to prove that the very concept of the ‘unconsciousness’ used by Freud has its own scientific validity.

Also as a follow-up it would be important to distinguish and highlight the progress made in art therapy since 1994. Following aspects should be emphasized:

- whenever reference is made to Prinzenhorn’s collection and to the schizophrenic patient of Freud who painted magnificently, then it should not be left out that while these other artistic expressions were treated by artists like Klee or Kandinsky as new inspirational sources, the movement leading up to Fascism framed already these efforts as ‘undermining’ the creativity of the ‘Volk’, the people and thereby used the term ‘healthy’ to fight against those responding to the outcome of First World War with ‘abstractions’ since ‘beauty could now only be recalled as having been experienced in the past, making thereby any expression thereof by necessity abstract’ (Paul Klee). If anything, the linkage between what is considered to be healthy and what was imposed as a new ruling as to what art should do or not (as if behavioural expressions made explicit by people throwing stones through the shop window behind which Otto Dix was exhibiting his portrait of his parents with the stone throwers saying that is no way to show respect to your parents), should underline the importance of reflecting possible links between culture and identity.

- Interestingly enough Karin Danneker and the others did not discuss the difference between diagnosis and therapy, but that is very important in establishing the value of art in any therapeutic process. As this reflects as well an understanding of art, and how diagnosis can be linked to what Adorno would say is the importance of ‘Deutung’ – an interpretation with a certain risk of not showing understanding to the person why in a certain state – any person interacting with another person should heed what Habermas said about psychoanalysis allowing as the only science a self-understanding as basis of any ‘rationality’ or ‘rationale thought’. The dispute about being scientific or not has had always ideological under tones while not heeding the need of art itself requiring not merely aesthetical reflections but the art of interpretation which goes with a special way of understanding how the art work was brought about i.e. what decisions flowed into it while not reducing the art work to the biography of the painter or artist. There have been links between Picasso’s blue period and the death of his friend, yet such links are not causal in the way science would understand any cause-effect relationship. It would be crucial for art therapy to distinguish between these two approaches if to do justice to the need for a healthy life of any individual when in distress, pain or ‘mentally ill’ to warrant medical and professional treatment. A diagnosis must be in the outcome open to what will be a therapy i.e. the person responds to the treatment given in a way that allows a recovery of a healthy status, including self esteem and confidence to be able to link the inner and outer world on the basis of own abilities to mediate. This means a dignosis using art to figure out what is happening inside a person cannot preclude that art therapy is the best treatment. Only once that difference is acknowledged, then also the specific nature of art therapy will be acknowledged and used as a method according to both need and appropriateness.

- There is one crucial point made by Karin Danneker in her point about possible conflicts with other medical practices insofar as art therapy may perceive a patient very differently. I recall when working in the University Clinic for Psychiatry in Heidelberg and offering ‘English classes’ to patients the conflict with one doctor who had diagnosed a patient as schizophrenic with symptoms to justify the diagnosis as being extremely egocentric and asocial while in the English class that patient was most helpful to others. Two aspects play here a role: in a classical doctor-patient structure only certain things become visible while in another opportunity e.g. participant in an English class, some other aspects of the personality can suddenly become dominant traits and therefore leading to quite another behaviour; and by being not ‘patients’ but ‘students’ the self esteem of those called otherwise only patients with limited rights especially if imprisoned on a closed station of the hospital and merely preoccupied whether or not they have taken their daily rations of pills and medicine, can lead to a healthy confrontation with the authorities limiting their Rights on the basis of declaring them as being unhealthy and even as in the past as being dangerous to others in society e.g. schizophrenia linked to very aggressive behaviour.

- An extension of this point linked to the kind of diagnosis possible is that art helps to see the invisibile in a much more humane way than perhaps any other form of diagnostic method. Again the example of a truck driver kept as a patient in Heidelberg bemoaned the fact that everyone thought he was playing tricks, theatre. Manfred Schlick would say, “everyone thinks I am healthy because I look physically strong and able to work, hence they conclude I am just lazy and don’t want to work when in fact no one sees my depression”. After having worked through his memories for three years therafter, it was easily explainable why Manfred Schlick never could perform well at the height of an examination. He simply paniked. The reasons for his depression well hidden and leading to that negative repetition Freud had diagnosed already as ‘death drive’ were multiple but he had revealed over time how it happened that he became completely ashamed of himself and this at the risk of abandoning everything. This includes tearing the libido or what connects a person not to one other concrete person, mother or father, but to human beings in general and which is needed for having a love life since the libido is the general connectivity of the self to other people. Obviously once that libido is torn, it is very difficult to restore as these people tend to exaggerate on negative developments both in politics and society at large with countless examples given to prove them to be correct in their assumptions. It should be said, generally speaking, most medical practices tend to omit the political projections made especially by highly sensitive and intelligent persons who experience break-downs or nervous disorders because of exaggerating certain points while proving only to themselves as not being capable of coping unless they become themselves super-heros i.e. with extra strengths or powers. Even Dali as painter was considered to be using the method of paranoia by singling out one item in reality and after exaggerating on it driving it back into reality as a way to depict in a Surrealist way the juxtaposition between one mind set and another complexity of feelings and associations once confronted by such a reality. Indeed, a lot can be learned from art by developing intuitive models of guessing as to what is affecting a person when confronted by a certain reality. That there are local specificities and given times should also be included in the diagnosis. When working at a Psychiatric Hospital in Munich in 1971 several patients had a strong political past e.g. a Socialist who had fought in the civil war in Spain and hid in the underground in France throughout Second World War and who ended up in hospital after having a nervous breakdown simply because he could not stand the pain his wife must be going through when having an eye operation. As such this kind of over empathy – over identification with the other not really a proper term – leading to an excess of human experience (of pain) with which the own mental apparatus cannot cope with, can be a key to others who use ‘empathy’ as a weapon if so desired by leaving others in pain especially when withdrawing the original empathy shown. The term ‘perversion’ can be applied in such cases with no answer found as of yet to such conversions from love to hate, from friendly to aggressive behaviour. In any case, as the arts and literature but also paintings in particular lend to various insights (one needs only to think about Dostovesky’s Gambler to understand the nature of someone inclined to gamble or about Thomas Mann’s way of understanding the drug addict in ‘Magic Mountains’), it would be good to group all these under ‘artistic insights’ with intuitive guesses the best way to describe the way forward when making a diagnosis.

- The term ‘cartharsis’ is an old Greek term and means a solution when the mind figures out a way to become optimistic and allows the person to look forward to leading a healthy life. Most crucial in understanding both the arts and the therapeutic effect which can eminate from the arts is when a patient becoming an artist by means of the therapy itself discovers that both the arts and the way his mind works is not arbitrary. Discovering a lawfulness is an art itself. More crucial is that since each identity is unique, the freedom of artistic expression will facilitate the finding of a true, that is unique identity suited only for that person and not another. Most of the health problems originate from a coercion to fit into just one or the other category, and interestingly enough it was already Hegel who said to find a recognized identity within the state, the very concept of identity says that the own identity will be destroyed once conceived in its linkage to the state. The problems of self destruction have never been thematised so clearly at philosophical level in difference to political reality, but again the over simplification as typical representation of ideologies is not to give people a chance to appraise political conditions in realistic terms but to demand a normed identity a priori, that is without looking and appreciating any identity building process as unique, complex and open ended. If to become a German citizen a person will have to negate all differences and otherness, then indeed the very poverty of such national identity linked to the state as prerequisite for becoming a law abiding citizen will hardly give such a citizen the freedom of expression, never mind the ability to question what politicians do with such a manipulative concept as state loyalty and allegiance. ‘Cartharsis’ comes only once the person can link up with all human beings in terms of human self consciousness and therefore does not exclude others who do not fit the scheme of a pre-defined identity as citizen of just one state or allegiance. We know from children playing in two teams football how quickly identification with the own side can polarize the original group into two hostile fractions trying to win at all costs while forgetting all were from the same class. “Krieg der Knoepfe” or the lovely film “War of Bottons” showed the same polarization only overcome when the two leading heads end up in the same dorminatory of a private school to which they were send in order to correct their bad behaviour.

All in all, it would be good to take up the dialogue with art therapists to see how things have developed since 1994 and what lessons have to learned from art being applied in both cases, the diagnostic process and the therapeutic course towards recovering or finding of a healthy identity.

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Considerations and Reflections by Hatto Fischer