Health, illness, well-being: the vital integration process through  Art therapy experience.

“True is that in the Atelier there is a poetics for ugliness , which changes into  a complete new beauty”. ( Gli Irraggiunti, a Gunter Ammon portrait, by Ezio Benelli) 1.

This painting expresses a complexity; the person who made it was going through a difficult time. She had been thrown out from her best psycho-physical functioning condition into a sudden inability of operating in an indipendent life. She was not happy about her life, she was suffering, and she was not able to accept her condition. Therefore we might say that this painting reveals the story of the attempt of  establishing a relationship between the person, the pictorical work, and the therapist. By observing it we might pick some traces; beautiful ones? ugly ones?

What makes them be considered one way rather than another?

What is really the concept of beauty about?   Talking about  beauty and ugliness is no simple matter. We need a contact, which does not simply mean feeling an emotion, but  rather getting into a process and living it from inside. The first contact is established through the sight. What expressive, relational  Art therapy  suggests, by  its method, is a journey that is meant to be made together. A person who approaches the painting experience often feels lost. It also happens to famous painters; it is the experience of emptiness before a white paper, which is appalling  and yet fertile. It requires silence. It requires slow thoughts.

Which kind of  aesthetical parameters can be used to decribe a painting in an Art therapy setting? Why beautiful? Why ugly? Where do we start from? As an  Art therapist I can state that it is a matter of creativity, since it is spontaneous, that it is art, since it is experienced as a process. The artwork emerges from a dialogue between the artwork itself , the artist, and the therapist.

Getting back to the title of the painting  “Scribble”,  Bettina Egger in her book Uhrformen des Mahlens states that:

“The scribble is usually the first form drawn by the child when he starts  drawing. Even though it does not seem to be like it,  it is a gestaltic form of the body. It arises in a period of life of this little human being, where he/she still does not know any borders yet,  being still unable to get oriented in time or space.  The very first scribbles are totally motorial. There is no direction. Pure impulse. As in any other archetype-form, they often come back during the life of human being to highlight movement in the painting. Adults seldom get in touch with this archetype-form and, when it happens, they get scared.”2

I have been partecipating many times  to the birth of these archetypical forms in the Atelier, which are indeed basic structures belonging to every human being, since they are  indipendent of cultural and personality features. People who enter an Art therapy Atelier for the first time rarely have experience in painting, and they very often arrive because they are going through a destabilised period of their life. This is  why the proposal concerning painting is not always welcomed, at least at the beginning.

But let us come back to the “Scribble”; it is a Gestalt, a form. As a therapist I am able to get into the painting and share the feelings of anguish without taking on the burden of it. I just get in and out while observing   what is  happening both in me and in the other person.

Whilst witnessing the birth of the first traces on the white paper, which means painting on the spot, I get aware of a certain need of movement which involves profound  processes experienced by the person.  I usually  find myself partecipating in a process by which the disclosure of the own interior world is possible, as well as a contact with reality, with all  its unknown aspects.

I work as an Art therapist in a hospital where I deal with heavy traumatised people affected by serious psychological and physical consequences.

The daily contact with the desease inspires me to an incessant search for the meaning of Beauty and Ugliness. More trivially , we could simply say that it is a matter of personal experience. Nevertheless the complexity of the matter urges me to search, and draw from the ancient knowledge to better understand. Plato, for instance,  in his work Diotima’s Discourse, leads us by his logical thinking deep into the meaning of beauty and ugliness starting from the idea of their mutual relationship.

Diotima, while talking to Socrates, points out that not being beautiful does not mean being necessarely ugly. In logical terms beauty and ugliness are more likely opposed one another than not in a contradictory relationship.  If, on the one  hand, we cannot be beautiful and ugly at the same time without infringing the  principle of non-contradiction, on the other hand  we can be not beautiful and not ugly simultaneuosly. There is a gradation between the two extremes of beauty and ugliness. Therefore we can state that the person who is ugly is not beautiful and that the beautiful person is not ugly, while not being  beautiful does not in any way mean being ugly: it might be in fact possible to be placed in an intermediate grade of the  aesthetical pleasure scale, quite different from the extreme grade of absolute ugliness.

I do not consider myself an expert of Plato, but I recognise in this passage what I think  and what I want to say.

In my work the experience of beauty and ugliness can find a correspondence in the two extremes of health and illness.

In its ordinary meaning health means harmony, balance, health is beautiful. Illness instead, means imbalance, disharmony, screeching. Illness is ugly. Taking things a stage further, we can say that illness takes us back to what is essencial revealing an evil root: which is despairing , unbalancing , ugly. It evokes and makes us reconsider all what we have lived, and we still live for. Illness makes us be real, naked, vulnerable, makes us take off the mask.

Is it possible to feel well despite  illness? My reflection concerns the emotional experience and the feelings. I think that, regardless of whether they are pleasant or unpleasant , they play an extremely important role in order to keep our system well working. I am deeply convinced that all sentiments , both the joyful and the painful ones have to be considered as a gift; they just demonstrate that I am alive and this means to me that it is beautiful and true. Being connected to life that flows in me is always a gift.

Working daily in contact with sick people made me understand that there are no bad sentiments, because they simply belong to life. What I feel pushes me to ask myself; what is alive in me? This is a basic question which I very often discuss with my patients. In other words, we will say that beauty is not an obvious matter. It is rather a discovery.

The encounter with the patients and their condition begins when they enter the Atelier. This is because they never come alone taking instead all their ralationships, such as their families, relatives, friends, and collegues, with them. They come along with all this bundle which will need to be slowly examined and clarified, by giving value to active listening and direct observation. Entering the Atelier is not obvious and it is not an obligation. Therefore my first important step is to understand how much the patient is willing to attend it  and whether he/she is ready to face the therapeutical experience which is being proposed.  My afford is to let a choice arise, even if conflicting. An ambivalence usually   emerges from their answers;  they are happy for being here because the place and its function are welcoming enough, and expecially because they realize to have a chance but, in the meantime, exactly because of that, they often feel deeply angry and desperate.

Reality seems to be unfair, dramatic; its ugliness  makes them feel upset , its disharmony is breaking. They feel alienated which sometimes leads to depression, as if they had lost everything because of the traumatic experience. “ I’m ill and nothing will be the same again”. They feel so much anger  because they feel having been thown, in the middle of their life, into an unknown place and condition. Being unable to find any plausible reason they pose a desperate question: “ Why me?”.

In addition many patients feel a sense of inferiority and discouragement. Very often they have to face the idea of spending the rest of their life on a wheelchair,  rising serious concern about their capacity to handle such large difficulties. Considering this personal tragedy, it may be wandered whether it makes sense to attend an Art therapy Atelier. Illness belongs to the world of ugliness, of the limit, why should it be useful to be in a place of colour and art which voices the idea of freedom?

An answer may be that when beauty affects you directly, it awakes a sense of belonging to life. It might be argued: what does this sense of belonging have to do with the aesthetical dimension? Colours, gestures, words ,and Art have the strength to fulfill unsatisfied desires. Resorting to the vital strength of art in the dramatic circumstances of illness, is extremly important because beauty has the power to be influent.

A person forced to stay in hospital very often feels a general perseption of being imprisoned. Hospitals might express compultion both beecause of their internal structure such as long corridors, rows of closed doors, smell of several disinfectants, people locked inside and because of their function.

It might become very difficult for people  who experience the hospital stay  to conceive the idea of time, as well as managing it because it appears to be totally distorted.  All this generates a strong impulse to run  away.

In some moments life requires to be resilient. Crisis is what allows us to build a bridge between the illness and our well being, between beauty and ugliness. It is impossible to leave the the ship while a thunderstorm  is unleashing, so the condition of pain and suffering asks to be fully experienced and lived.

What space does hope have in the despairing reality of illness and loss of autonomy suffered by these people? As A. Ricci writes in his article “Cambiamento e speranza – Change and hope”:

“ Searching for change, acceptance of the problem and suffering are closely linked, it is a genuine starting point although not sufficient. Every day while getting out of bed we silently invoke hope: some of us reconfirm this hope, some others search for it even if invisible, and certain others no longer succeed in doing it.  Without hope there would not be any change. Yet we all know that hope is what makes us really human.”3

The hope for change accompanies the patients in the Atelier. Here it is very often possible to witness very intense emotional moments: paralysis, mistrust and despair sometimes are overwhelming, just as if life were suspended, blocked, prevented in its flowing by something which seems to lie much deeper under the accidental condition of illness.

In the Atelier time and space become containers able to welcome, tell and give voice to suffering and interior experiences. So it might be that one day we could have a glimpse of something entirely different, never noticed before: a different colour, light and shadow, a shape, a line, a rhythm, a symmetry, a motion, a sign, something which reaches a meaning talking directly to the person, something which is guided and urges from deep psychological processes. Something which leads the person to get in touch with some aspects of his/her inerior world, and inspire him/her to work on the gap with the real world. There is no interpretation, in a certain way we can say that the patient is seduced by art. It represents the biginning of a dialogue, made of expressiveness and active listening.   This is what I think Art is in its specific therapeutical  significance. According to my experience Art may become a tool to get aware of grief. At the same time it makes you feel less alone because it teaches that illness, grief, death are part of life health. There is no medicine to be taken rather the patient must take the responsability for himself.  So several aspects of reality may emerge: what am I no longer able to do? What can I still do? What is possible? Becoming gradually aware of tangible resources is beautiful. The track we try to follow is the one which leads us to live consciously feeling every motion.

I must say that the process I witness  my patients undergo through the work in the Atelier is such a  complex one, that I can only mention a few of its multifaceted aspects. I would like to present only  some elements which in my opinion are relevant and distinctive in Art therapy: the searching  of a harmony  with the other within separation and diversity, making the experience of being truly myself.    

What is empathy? According to my experience it means getting in touch with the feelings of a person, the patient, without confusing these feelings with mine. It becomes to me increasingly clear  that if I am too distracted by my mood, I won’t be able to be in touch with the other, loosing therefore  contact with the here and now of the relationship.  A  deep breath helps me to get back to the present.

Developing an attitude to empathy is a complex task, which urges me to detect the differences between feeling and being empathetic.

When I am within my setting, and I realise to be in trouble about distinguishing my experience from the patient’s one , I begin to listen and try, with all my strength, to concentrate on the other person’s needs and feelings. It is not easy because it requires my full participation  and awareness, but most of all, it requires to operate feeling a clear interior differentiation. I can only start by myself to welcome life and to include all the sentiments, good or bad they might be, If I really want to help my patients  do the same. Beautiful and real together.

I very often refer to Caravaggio’s work as a metaphor. I love showing my patients the painting called Basket of fruit, where  we can see next to the fresh fruit also a withered leaf. That leaf is the evidence that Caravaggio preferred reality instead of any idealization. The dramatic light brings lively contrasts to life. Caravaggio used to bring out light from the dark, light from caves. According to his painting style, the subjects are only partly illuminated leaving the rest in the dark. Lights and shadows. The artist  used to let  the colour contrasts inspect and shape everything such as  gestures, motions and behaviours. In so doing he used to highlight the tragedy of the real.

We can see the use of the contrast between lights and shadows which gives or deprives the subjects of importance. Neither beautiful nor ugly, just real.

In the Atelier we usually work with colours using the contrasts  of life as well as  the opposition between beauty and ugliness . Contrast in painting might be considered to be a synonym  for Beauty. Our eyes really love contrasts; thanks to them we manage to give a sense to what we see. The three primary colours are in close opposition , so that they seem not to have any relation between them. Each colour stands for itself as he was able to express everything. That is what we call contrast in hue. Caravaggio used this approach to painting hundreds of years ago.

Why is contrast in painting important?

Because it implies the need to see beauty and ugliness; that is including ugliness as well as beauty. It suggests the making of  an integration process, a contact with reality.   What is interesting in a contrast is that it leads you inevitably to another perspective, to a new vision . It allows to get in touch with another kind of reality, which is unespected, hopeful, a signal that something different is possible.  We talk about a hope which is not an illusion, which paves the way to a real change. Internally we build a place where a new code for beauty  and ugliness can be welcomed.

The difficulty of accomplishing the pictorical gesture sometimes  derives from noticing how harmony and disharmony might coexist in the same shape. In some other cases instead, the idea of shaping something harmonic is originated by an instinctual force which leads instead, to the opposite direction. This force leads to the destruction of harmony, it wants to create confusion, disharmony, ugliness. Here we need to suspend any judgement. There is nothing wrong; following the pictorical gesture might help to perceive its transformative power, the emotional need  that leads the change.

It is no longer a matter of beauty or ugliness , it is something different, something new which must come to light. This gives hope.

Empathy means feeling responsable both for our own life quality and for that of the others. It means answering actively to the other’s needs being attentive, prompt, and measured.    I am daily involved in illness and ugliness, I have learned from experience that even grief may promote growth, managing to become a path to knowledge and rebirth. Most of all I really believe that although life may be sometimes painful and ugly, it never can be considered without bearing a meaning: appreciating life is right and proper.

In his seminar entitled “La volontà di star bene”( The will to be well), Paolo Menghi states:

“ Wishing to be well and wondering how truly to achieve it  is a birthright, not a privilege for a few. (…) We achieve the first stage of well being when we realise that  we have the right to it, and when we try to understand what really wellbeing means for us trying to find the proper way to get to it. (…) There is a tremendous beauty in the eyes of those who are seeking, and we can’t avoid this magnificence because these eyes demand your soul (…)”.4

1. Ezio Benelli, Gli Irraggiunti, un ritratto di Gunter Ammon.
2. Bettina Egger, Urformen des Malens, Hogrefe Verlag, Bern, 2015.
3. Antonio Ricci, Cambiamento e speranza, blog, Manuale Inapplicabile.
4. PaoloMenghi, Trasformare la Mente, seminario la volontà di star bene.