77;~" Arts in P.sychotherapy. Vol. 12 pp. 233-238. ~ Ankho International Inc., 1985. Printed in the U.S.A. 0197-4556/85 $3.00 + .00

PERSPECTIVE

E N V I S I O N I N G T H E L I N K A M O N G T H E C R E A T I V E A R T S T H E R A P I E S

DAVID READ JO H N S O N , PhD, RDT*

The official at the government agency was on the phone and she was confused. " W h o is this? A drama therapist? The National what? Are you an arts therapis t?" I replied, ~No, we are drama therapis ts ." Her irritation was evident. '~You people are entirely fragmented. Do you realize that I have talked to nine or ten of you in the last week. Some art. Some dance. Music. Now drama. Presidents have called. Committee chairs have called. Everyone asking the same ques- tions. 1 don ' t get i t ." I explained, "'You see, we are all creative arts therapis ts ." She sounded re- lieved. "Ohh! Good! So tell me about your posi- tion on the bill ." " I can only represent drama therapis ts ," 1 muttered. She moaned. ~'You mean you don ' t have an organization? . . . . Organ- ization? . . . . That ' s right. You don ' t have any chance of being included in the legislation until you ' re organized. Surely you know that!"

Economic, legal, and professional necessities are making it extremely clear that only through organized collaboration will art, dance, drama, music, and poetry therapies survive and grow. Licensure, third party payments , inclusion in JCAH standards and federal legislation are the stuff of myth and dreams for an individual asso- ciation. Our growing awareness of this reality has led to a series of joint conferences such as the L o o k i n g to t h e 90's symposium at Hahnemann University in Philadelphia (June 1984), Legisla- tive Affairs conference in Washington (July 1984), creative arts therapy conference at Con- cordia University in Montreal (April 1985), and

*David Johnson is Assis tant Clinical Professor , Depar tment National Associat ion for Drama Therapy.

the National Coalition conference in New York (November 1985). A number of articles have also begun to address the need for consolidation of the creative arts therapies (Cashell & Miner, 1983; Dulicai, 1985; Johnson, 1984a: Robbins, 1982, 1985: Stark & Warres, 1984).

These political and economic realities alone are sufficient to bring us together, and I believe we will do so within this decade through the further development of the National Coalition of Arts Therapy Associations. The question is, on what basis will we join together? Solely for polit- ical and economic reasons, motivated by survi- val? Or for more central philosophical reasons, authentically felt, that enrich our professional identity? I believe that now is the time, when our collaboration is being conceived, to articulate the reasons why the creative arts therapies form a coherent profession.

For years there have been calls for combining the arts therapies and legitimizing the notion of the expressive arts therapist, who is capable of facilitating clients' expressions in all media (McNiff, 1981; Naitove, 1980). What is now being sought, however, is a consolidation of the professional groups, not a fusion of the therapies themselves. Each modality has had time to de- fine itself, reassure itself that it exists, and de- velop reasonable standards. Now we are ready to create a larger unity while preserving the indi- viduality of each medium.

Recently I wrote in this column that we need to diversify our professional roles in order to

of Psychiatry . Yale Universi ty School of Medicine and President,

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234 DAVID READ J O H N S O N

survive in the health care field (Johnson, 1984a). We need researchers , scholars, managers , and publicists as well as clinicians. We need a strong and sophist icated understanding of the contribu- tion of each medium. Yet diversification without an integrated core identity will lead to fragmen- tation of the field. Thus, we are under pressure to consolidate in order to establish that identity, to acquire a jointly held vision of who we are.

We need to articulate the common ground of the creative arts therapies and not rely on their assumed natural affinity. We then need to understand how that com m on ground is related to the society within which we find ourselves, and anticipate in the future. If what links us is irrelevant to or even conflicts with the values of the larger society then we will be further chal- lenged.

We are faced with a difficult task because we have been both defined and divided by our alle- giance to our particular art medium. Unlike the fields of psychology or medicine whose students study a common body of knowledge for several years before specializing, the arts are differ- entiated f rom the start. Artists do not begin with a core curriculum and then specialize in an art form. Thus, creative arts therapists are more apt to have had similar courses in psychology and therapy than in aesthet ics or artistic develop- ment. Our media are so engrossing, and require so much training in the craft that specialization precedes an understanding of general aesthetic principles and the ar t is t ' s creative vision. Though medicine also identifies its specialty areas according to various criteria, such as body organ (cardiology), state of the body (pathology), or technical procedure (radiology), the presence of the physical human body gives the field a de- finable cohesion. What is the " b o d y " of which art, dance, drama, music, poetry are a part'? What would a core curriculum be'? The list of courses we often propose includes psychology, liberal arts, fine arts, research methods , anat- omy, neurology, a little bit of this, and a little bit of that. Are the creative arts therapies really a tossed salad of the major intellectual fields of the 20th century? If we arise from the same source, and our similarities are not merely apparent on the su r face - - i f we are indeed s ibl ings-- then who are our parents?

The creat ive arts therapies are certainly not

united by an agreed upon set of techniques (as psychodrama or bioenergetics are). While there are similarities in types of technique (e.g., im- provisational, s tructured, performance) , they are used in many different ways by each practit ioner and in each medium. Nor are the creative arts therapies united by a theory of therapy. Cur- rently, theories are borrowed from established fields, such as behavioral , psychoanalyt ic , ges- talt, and Jungian. Many therapists may have a greater allegiance to other therapists of the same theoretical school than to other arts therapists. There is not even agreement among creative arts therapists about what is the pr imary therapeutic agent in our work: is it participation in the art media itself, the insight derived from reflecting on the ar twork, or the therapeutic relationship with the therapist'?

If neither our techniques nor our theories link us, perhaps our media of expression do. Are the creative arts therapies those therapies in which the client utilizes the creative arts, as the verbal therapies are those in which the client uses words'? Unfortunately, this is too often the posi- tion we fall back on when we cannot articulate a more fundamental link. We then constrain the definition of ourselves to what we do, rather than representing an attitude concerning healing and human interaction. This is the equivalent of call- ing psychoanalysis siletu'e therapy. The problem with this utilitarian definition is that we then worry about merely talking with the patient. We ask ourselves , " ' If a creative arts therapist spends a whole session talking with the client, is he doing creative arts therapy?" The answer is No if creative arts therapies are defined by our activity, and Yes if they are defined by a more basic principle.

The common source of the creative arts therapies is therefore more likely to be found at a different level than that of technique or theory or media, at the level of basic perspect ive on the human condition, such as creativity, play, or aes- thetic knowing. A number of authors have struggled to describe this unifying perspect ive and, not surprisingly, several different perspec- tives have emerged. Let me review them.

77te Brain

Imagine how reassuring it would be for our

PERS P ECTIV E 235

colleagues, and perhaps for some of us, to be able to locate the creative arts in a portion of the brain! If it is in the brain, then it is real. Recent neuropsychological research has indeed indi- cated that the skills required for artistic expres- sion, such as spatial awareness, analogical rea- soning, and identification of musical forms, are more often performed by the right or nondomin- ant hemisphere, while verbal, logical, and se- quential learning is performed by the left hemi- sphere (Gardner, 1980). According to this per- spective, the creative arts therapies are linked because they all utilize processes mediated by the right hemisphere and thus are valuable as nonverbal, nondiscursive innovations in treat- ment, providing access to the thoughts and feel- ings unavailable through verbal means alone. The discovery that aphasics with damage to the left hemisphere from a stroke can speak with less impairment if they sing the words (since singing is processed by the undamaged right hemi- sphere), or the observed importance of music and song with Alzheimer 's patients, are two examples of therapeutic applications of a neuro- logical understanding of the arts.

The research on hemispheric differentiation is often extended to imply that the arts, creativity, spirituality, etc. are located in the right hemi- sphere of the brain. From a metaphorical per- spective, this is major progress, since in most other theories, the arts are located in lower re- gions, e.g., lower developmental levels, down in the id or unconscious, in contrast to verbal proc- esses that are in higher areas. Now at least we are alongside verbalization (even though we re- main nondominant)! Unfortunately, the research is more uncertain and the distinctions between hemispheres less clear than originally thought. Though specific artistic skills and cognitive proc- esses might be localized, there is no evidence that something as abstract and complex as creativity or artistic vision is contained in a spe- cific location in the brain.

I have included a biological perspective be- cause in the present environment we will be in- creasingly tempted to justify our profession with a biological basis, despite the fact that our roots are clearly elsewhere. Nevertheless , we should not retreat from using these biological incanta- tions of "r ight hemisphere" to appease the gods who now hold sway.

Religion

It has now become a cliche for descriptions of the creative arts therapies to begin with, "S ince the earliest of times, man has used art (or dance, drama, music, poetry) to express his deepest fears and greatest wishes . . . . " The hope is, of course, to establish that artistic expression is fundamental to humankind. Instead, this often romanticized at tempt to articulate our roots from so far back may communicate our alienation from the current culture and recent historical times. If our '~parents" were tribal shamans, then we truly are orphans, for they have long been gone.

It is not clear to what extent early art was characterized by aesthetic principles. At that time, religion, the arts, and healing were not dif- ferentiated, as they are today. Shaun McNiff (1981) and others have carefully explored the similarities in role and function between the creative arts therapist and the shaman, and our techniques with those of ritual. He states the religious perspective most clearly: " I believe that our work in the arts is more closely allied with the larger continuities of religious belief and faith. The arts can, in this sense, be viewed as sacramental actions that symbolically represent the mysteries and intensities of inner experience. They are 'sensible signs' of the psyche 's efforts to become transcendent and this kinship with religious ritual explains much of their po t ency" (McNiff, 1981, p. xxiii). The basic concepts of this view of the creative arts therapies include faith, devotion, communion, acceptance, and the sacred. Ritual and ceremony become the central f rameworks for action.

In contrast, Susanne Langer (1953, p. 402) supports a purely aesthetic view: that the arts were linked to religion only temporarily. " T h e arts were never bound to ritual or morals or sa- cred myth, but flourished freely in sacred realms as long as the human spirit was concentrated there. As soon as religion becomes prosaic or perfunctory, art appears somewhere e lse ." It is a natural impulse to look back to find our roots in an early, original attribute of mankind. However , we must assess in what ways our heritage lives on in us now. The challenge for McNiff and others is to envisage a role for the creative arts therapies that integrates our roots in the past

236 DAVID READ JOHNSON

with the current developments of our society. If we are to be shamans, then we must discover how we are shamans of our time, and for the future.

Aesthet ics

Arthur Robbins (1985, p. 68) in his reply to my article (Johnson, 1984a) describes the unique identity of the creative arts therapies as aesthetic understanding. "As we understand science in a different context , beauty becomes a means of discovering scientific truth. It is also a means of understanding meaning and truth as communi- cated from one individual to another. As creative artists, we indeed provide a frame for the explo- ration of truth, truth that is framed within a theory of aesthetics and presented either in artis- tic, dramatic, or poetic fo rm." Certainly many authors have seen aesthetics as underlying and unifying the perspective of the creative arts therapies, though I am not aware of many crea- tive arts therapy programs that actually have courses in aesthetic understanding and its rela- tionship to therapy (Levick, 1980). If an aesthetic theory of therapy is to develop (and Dr. Robbins is one who is approaching such an achieve- men t - - s ee Robbins, 1980), then the concepts of beauty, harmony, rhythm, resonance, brilliance, dynamic tension, and balance will have to be applied to psychological states of persons. The goals of therapy will be described in terms of increasing beauty, balance, or harmony in the person.

Each therapy envisions the client through a guiding metaphor. For psychoanalysis , the client is the dreamer; for behaviorism, a hungry animal; for primal scream, a crying infant. The creative arts therapies envision the client as an artist who creates his own self and life. Susanne Langer (1953) describes art as the "crea t ion of forms symbolic of human feeling." Each art form creates an "essent ial illusion" through which the ar twork symbolizes an aspect of human life. In the creative arts therapies, the ~'essential illu- s ion" is the self. The a r twork - -be it a painting, song, or dance- -symbol izes the essential cre- ation: that of the self-in-the-world. In an aes- thetic theory of therapy, the self is Conscious- ness' artwork-in-progress. Instead of id, ego, and superego, perhaps its central concepts will be the

three modes of artistic reality: the creator, the performer, and the audience. Since the artist is producing something both expressive of himself and for the world, he must constantly shift back and forth from his internal source of creative vision to the viewpoint of the audience, and at the same time translate these perceptions into his use of the actual artistic materials in the perform- ance. The actor must both be his character and remember to keep his face to the audience. This state of aesthetic distance has important implica- tions for health and healing that are only recently being explored (Landy, 1983; Scheff, 1979). For the arts are not direct expressions of feelings; they are the artist 's ideas about feelings (Langer, 1953). Aesthetic distance is therefore one possi- ble artistic metaphor for well-being.

Thus, while the goals of psychoanalysis be- come to dream as freely as possible, of behav- ioral therapy to achieve success in coping, for creative arts therapies they are to create a mean- ingful symbol of oneself that captures the beauty in one 's soul.

Play

Despite the clear intimacy of the creative arts therapies with artistic principles, the aesthetic perspective does not explain well the centrality of improvisation in creative arts therapy work. We tend not to treat our patients as we train art- ists. Artistic training involves a step by step, disciplined process of modeling basic forms, which are repeated many times. Whether the pli6 in dance, the still life in art, or the scales in music, the artist-to-be is trained in the rigorous refinement of basic forms. A creative arts therapy session takes another shape, reflecting another influence. Something more than the aes- thetic ufiderlies the creative arts therapies, some- thing involving play. We engage in play with our clients, and value flexibility, humor, and spon- taneity in our relationships. The play perspective images the client as the child, exploring, grow- ing, having fun (how different an image from that of the shaman or the artist!). Creative arts thera- pists who view their work within a play perspec- tive are inclined to emphasize developmental notions, even in their descriptions of " adu l t " forms of improvisation (Irwin, 1977: Jernberg, 1979; Johnson, 1982).

PERSPECTIVE 237

Improvisation is a relatively late development in the arts, and has been a forceful presence in many art forms of the 20th cen tury- - in jazz, ex- pressionist painting, modern dance, and im- provisational theatre. The stretching and altering of the rigid artistic forms seem a characteristic of this century ' s art, and clearly created the conditions under which the creative arts therapies could develop. Yet we know very little about the similarities and differences in im- provisation across the arts media.

In religion, the artist hopes to be possessed by the inspiration of the God, the Creator. The creativity is attributed to a t ranscendent source. In art, the artist owns his creativity, but seeks to create within high artistic standards, for a public and for a culture. The artist is very much aware of this reference group and hopes to speak to it. In play, the artist seeks to please himself and, instead of accommodat ing to a God or a culture, assimilates them into his own world (Piaget, 1951). The products of ar twork within a religious context are seen as sacred and preserved at all costs. Within the artistic context , they are highly esteemed and placed in special places. Within the context of play, the artworks simply pass on, turning into something else. Because the Self is neither a ritual nor a script, but a living, changing entity, the element of play will always be rele- vant to the process of therapy. Since at most of our symposiums we attempt to define ourselves vis-h-vis psychiatry, we tend to emphasize our artistic values. With " p u r e " artists, on the other hand, who view us often as taking the art less seriously, I believe we find ourselves defending the values of play.

C O N C L U S I O N

The unifying link among the creative arts therapies surely lies in one of these areas or in some combination. Or is it possible that all of these--biological , religious, aesthetic, and playful- -are the specific expressions of some- thing even more basic? I believe so, and I suggest that it is a transformational perspective.

To the extent that life involves the continuous transformation of self and world, then religion, art, and play are means by which we at tempt to structure these transformations to answer in new ways the basic question, " H o w and why did we

come abou t?" The creative moment begins with the representat ion of the void: the empty stage, the blank page, the moment of silence. The artist poises before creating the world again. And in creating the world, the self is again recast. For what fills the stage or page or silence is neither a design nor a prearranged model; it is the spon- taneous expression of one 's insides. As it comes out it is altered, and then, as it is understood and taken in, one's internal world is changed. In filling the canvas, the artist deals with the void, with death, and seeks another answer to "What is the point?" Langer said that the pleasure of beauty is the perception of a life wholly significant. The creative arts therapies offer a way toward a life of significance, one entwined in feeling. A suc- cessful artwork is so powerful because it reas- sures us that significance and meaning can emerge from nothing.

The specific medium and skills of expression are secondary to this basic transformational, creative urge. Why then do we hold so much allegiance to our specific medium? Why, in our efforts to establish our profession, have we so emphasized training in the specific art medium, when such emphasis keeps us apart? Because while there are many paths to authentic expres- sion, each of us must take one path at a time, and to be helpful our guide must know the way.

The creative arts therapies have not developed in the mid-20th century by accident. They are the result of historical processes, and serve some function for our culture now and in the future. We must understand that function and find a way to articulate it meaningfully. I believe that we have emerged as a healing force that serves the urge for transformation and meaning in a society aware of its capacity for self-destruction and seeking more and more desperately for a reason to exist. While other humanistic approaches seek the sacred, the spiritual, or the transcendent, the creative arts therapies seek the beautiful and the playful in us. True, it appears that the values of the creative arts therapies conflict with those of the wider culture, whose major interest seems to be weapons. There is more consumer interest in handguns than in artistic works; more govern- ment funding in missiles than health care. Perhaps sports, which are also a form of play, receive more support due to their imagery of ag- gression, success, and defeat. Yet does not this

238 DAVID R E A D JOHNSON

highlight even more strongly the role of the crea- tive arts therapies? From an intergenerational program linking a nursing home with an elemen- tary school, to the Live Aid concert, the arts have a healing role to play within our com- munities (Johnson, 1984b).

The creative arts therapies must move into the future together. We cannot do so by locating our links in the romance of the past, in pristine artis- tic standards, in the innocence of child's play, or in impassive neurons of the right hemisphere. We must acknowledge our mutual interest and our mutual vision of human relationships, so that the next time I am on the phone with a government official I will be able to say, "Yes, we are crea- tive arts therapists" with assurance, clarity, and a sense of community, deeply felt.

We have a powerful vision, and we have emerged for a reason, a reason and a vision that can unite us all.

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DULICAI, D. (1984) The challenge we face. The Art,s in Psychotherapy 11: 247-248.

GARDNER, H. (1982)Art, Mind, aml Brain. New York: Basic Books.

IRWIN, E. (1977) Play, fantasy, and symbol: Drama with emotionally disturbed children. American Journal ql' Psychotherapy 31: 426-436.

J E R N B E R G , A. (1979) l 'heraplay . San Francisco: Jossey- Bass.

J O H N S O N . D. (1982) Developmental approaches in drama therapy. The Arts in Psychotherapy 9: 183-190.

J O H N S O N , D. (1984a) Establishing the creative arts therapies as an independent profession. The Art~ itt Psychotherapy 11: 209-212.

J O H N S O N , D. (1984b) The arts and communitas, l)e,~ign 86: 36-39.

L A N D Y , R. (1983) The use of distancing in drama therapy. The Arts in Psychotherapy 10: 175-185.

L A N G E R , S. (1953) Feeling and Form. New York: Scribner's.

L E V I C K , M. (1980) Response to Connie Naitove. The Arts in Psychotherapy 7: 261-264.

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N A I T O V E , C. (1980) Creative arts therapist: Jack of all trades or master of one? The Art,~ in P.~ychotherapy 7: 253-260.

PIAGET, J. (1951) Play, Dreams, and Imitation ill ('hihl- hood. New York: Norton.

ROBBINS, A. (1980) Expressive, "lTwrapy: A freat ivc Arts Approach to Depth-Oriented l)'eatnt(,nt. New York: Human Sciences Press.

ROBBINS, A, (1982) Integrating the personal and theoretical splits in the struggle towards an identity as art therapists. ~l?le Arts ill Psychotherapy 9: 1-10.

ROBB1NS, A. (1985) Working towards the establishment of creative arts therapies as an independent profession. The Arts in Psychotherapy 12: 67-70.

S C H E F F , T. (1979) Catharsis in ttealin~,. Ri tual and Drama. Berkeley: University of California Press.

S T A R K , A. & W A R R E S , J. (1984) A working model for a conference on the creative/expressive arts therapies. ]Jt~, Art.s in P.vychottlerapy 11: 279-282.