“A Rock & A Hard Place”

“A Case Study Summary from a Forensic Mental Health Setting,Looking At the Potency of the First Image Made In Art Therapy

& the Centrality of the Therapeutic Relationship”

Emma Allen, Art Psychotherapist, Rampton Hospital

“Joe” accessed Art Therapy through attending an Open Art Therapy Group on a mental health admission ward in a high secure hospital. After becoming violent and mentally unwell in prison, Joe was admitted for psychiatric treatment where he experienced delusions and acute paranoia. Joe was witness to domestic violence and victim of violent abuse from an early age and eventually became so unwell that he kept his partner hostage where she died from significant injuries.

Joe’s first image made in Art Therapy was particularly powerful. “A Rock and A Hard Place” (it’s given title by Joe on the back of his work) was a combined drawing of two infamous paintings – Edvard Munch’s ‘The Scream’ and Gustav Klimt’s ‘The Kiss’. The couple ‘locked’ in intimacy seemed to not only remind both therapist and patient of his index offence and the domestic violence he witnessed, but also seemed to illustrate the therapeutic relationship and how intoxicating and frightening this could feel. Joe would often make attempts at trying to control and domineer in the group, and on once occasion pinned the therapist to the spot whilst talking of the offence. It became crucial for Joe to see how possessive he could be and to think about why.

Joe’s early attachment experiences of separation, violence and loss are made visible in the first image, and help explain his emotional distress and personality disturbances whilst also providing a valuable way of accessing traumatic memories and experiences. Both patient and therapist could find a way for the unspeakable to be shared and to gain insight into his impact upon others and ways of relating.

Joe was able to talk about what happened, whilst also becoming aware of his possessive nature. More importantly, he was able to express his deepest fears; the fear of loving and losing and his subsequent ambivalence over relationships – an expression of feeling caught between “A Rock and A Hard Place”. The image helped Joe to not only tell his story, but to learn from it too.