Clay Work and Body Image in Art Therapy

“Clay Work and Body Image in Art Therapy is an insightful synthesis of women’s authentic expressions of body image experience and representation, with extensive theoretical integration and analysis. Trisha Crocker and Susan Carr present, through the art-based vignettes and the authors’ reflective writing, a lyrical and clinical account of new knowledge in this field, emerging through the clay work sculptures. The book works on a number of levels – providing insight into the body image issues women face that echo and enrich our understanding, and how these issues can be passed down through the motherdaughter relationship. Offering new knowledge and a transparent process of analysis, this book is important reading for practicing therapists and students alike and sows the seed for further research in this important field.” Michal Bat-Or, Art therapist, lecturer and researcher at University of Haifa, Israel “This well-researched book draws on the most helpful and influential theories which have become integral to UK art therapy practice: embodiment of emotions, attachment theory and the impact of the socio-cultural context on mental health and in this case, body-image. It elegantly demonstrates how clay has specific attributes which support the exploration of these issues within art therapy. Above all, it is anchored in the authors’ extensive clinical experience and the stunning visual imagery makes it a much welcome publication which will be of interest to arts therapists, service users and artists in health.” Val Huet, PhD, Director of Research & Development, British Association of Art Therapists 9 Taylor & Francis Taylor & Francis Group http://taylorandfra ncis.com Clay Work and Body Image in Art Therapy Clay Work and Body Image in Art Therapy provides an important addition to resources available in the field of clay work and art therapy, highlighting the unique sensory aspects of the medium and its ability to provide a therapeutic resource for women who experience body image issues. Chapters offer a comprehensive distillation of current knowledge in the field of body image, clay work, neuroscience, and art therapy, building a theoretical framework around personal narratives. Case studies examine the benefits of exploring body image through clay work within art therapy practice, providing a positive and contained way to find personal acceptance and featuring photographs of clay body image sculptures created by research participants that highlight their individual stories and experiences. As well as offering both clinical and practical implications, the text provides a full protocol for the research and evaluation methods carried out, enabling further replication of the intervention and research methods by other therapists. This book highlights clay work as a significant resource for art therapists, arts in health practitioners, and counsellors, providing an emotive yet contained approach to the development of personal body image acceptance and self-compassion. Trisha Crocker, PhD, is an art therapist working with at-risk children and women in private practice. She runs workshops in clay-making and body image from her pottery in Oxfordshire, England. Susan M.D. Carr, PhD, is an artist, author, and art therapist in private practice, and currently co-Editor-in-Chief of the International Journal of Art Therapy. She has also developed and researched Portrait Therapy. 9 Taylor & Francis Taylor & Francis Group http://taylorandfra ncis.com Clay Work and Body Image in Art Therapy Using Metaphor and Symbolism to Heal Trisha Crocker Susan M.D. Carr First published 2021 by Routledge 605 Third Avenue, New York, NY 10158 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2021 Trisha Crocker and Susan M.D. Carr The right of Trisha Crocker and Susan M.D. Carr to be identified as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Crocker, Trisha, author. | Carr, Susan M. D., author. Title: Clay work and body image in art therapy : using metaphor and symbolism to heal / Trisha Crocker, Susan Carr. Description: New York : Routledge, 2021. | Includes bibliographical references and index. Identifiers: LCCN 2020048563 (print) | LCCN 2020048564 (ebook) | ISBN 9780367564667 (hardback) | ISBN 9780367564650 (paperback) | ISBN 9781003097884 (ebook) Subjects: LCSH: Body image. | Imagery (Psychology) | Self-perception. | Art therapy. Classification: LCC BF697.5.B63 C77 2021 (print) | LCC BF697.5.B63 (ebook) | DDC 306.4/613—dc23 LC record available at https://lccn.loc.gov/2020048563 LC ebook record available at https://lccn.loc.gov/2020048564 ISBN: 978-0-367-56466-7 (hbk) ISBN: 978-0-367-56465-0 (pbk) ISBN: 978-1-003-09788-4 (ebk) Typeset in Times New Roman by Apex CoVantage, LLC This book is dedicated to the 16 women who generously shared their body image stories and their sculptures during the PhD project, and for making this book possible, we thank you . . . 9 Taylor & Francis Taylor & Francis Group http://taylorandfra ncis.com Contents List of Figures Acknowledgements xi xiv SeCTIOn 1 Preparing the Ground – Digging for Clay 1 1 Introduction and Context: Body Image, Art Therapy, and Clay Work 2 The Distorted Mirror: Body Image, the Critical Mother, and Shame 20 Making Connections: Metaphor, Evolution, and Neuroscience 36 3 3 SeCTIOn 2 Vignettes and Case Studies – Shaping the Self 4 5 49 Case Vignettes, Study One: Sessions One, Two, Three, and Four 51 Case Studies, Study Two: Metaphor, Symbolism, and Body Image 91 6 Case Studies, Study Two: Mothers’ and Others’ Influence on Body Image 108 7 Case Studies, Study Two: Clay Work as Meaningful Play 123 x Contents SeCTIOn 3 Protocol, evaluation Methods, and Conclusions – Opening the Kiln 135 8 Intervention Protocol 137 9 Methods of Analysis 151 10 Adding the Glaze: Finding Meaning and Healing through Metaphor and Symbolism Bibliography Index 160 179 196 Figures Chapter 1 1 2 “An Army of Women No. 1” by Trisha Crocker, 2008. “Large and Lovely” by Trisha Crocker, 2008. 5 6 Chapter 2 3 “The Beautiful Women Project” by Cheryl-Ann Webster, 2006. 21 Chapter 4 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Sculpture No. 1 by Helena. “I’m Ready Just to Cover That Over.” Sculpture No. 1 by Sarah. “Me, My Mummy Head, and My Work Head.” Sculpture No. 2 by Sarah. “Smile on a Stick.” Sculpture No. 1 by Victoria. “Victoria’s Concern About Her Large Breasts.” Sculpture No. 1 (from above) by Victoria. “A Large Hollow.” Sculpture No. 1 by Linda. “It’s the Spine.” Sculpture No. 2 by Linda. “All Women.” Sculpture No. 3 by Linda. “Gosh, I Don’t Even Think I’ve Got a Body!” Sculpture No. 1 by Veronica. “I Couldn’t Do Anything Until I’d Made a Wall.” Sculpture No. 1 by Nancy. “For Me, It Was About Being Really Honest.” Sculpture No. 1 by Jenny. “I’ve Got a Comfort Layer. . . .” Sculpture No. 1 by Edina. “I Think I Feel Quite Defensive About My Size at the Moment.” Sculpture No. 1 by Willow. “The Face Was Most Important.” Sculpture No. 1 (Front) by Priscilla. “How Embarrassing.” Sculpture No. 1 (R. Side) by Priscilla. “I Hate You.” Sculpture No. 1 (L. Side) by Priscilla. “It’s Not for Me.” 52 53 54 55 56 57 58 59 60 62 63 65 67 69 70 70 xii Figures 20 Sculpture No. 1 by Jane. “Remembering What It Felt Like to Do the Splits.” Sculpture No. 1 by Eleanor. “Three Distinct but Connected Parts”, or “Broken Pieces.” Sculpture No. 1 (Front) by Paula. “The Image Is As I See the Outside World Seeing Me.” Sculpture No. 1 (Back) by Paula. “Like a Piercing.” Sculpture No. 1 (Front) by Justine. “The Pearl Is My Husband.” Sculpture No. 1 (Side) by Justine. “The Spine Represents a Strong Backbone.” Sculpture No. 1 by Sunny. “I Think the Image Represents Me as a Mother.” Sculpture No. 1 (Front) by Cynthia. “As I Made the Skin/Jowls They Became Part of an Owl’s Face.” Sculpture No. 1 (Side) by Cynthia. “My Wings Are My Hands Too, Reaching Out.” Sculpture No. 2 by Sunny. “I Think the Positive About the Image Is It’s Quite a Proud One.” Sculpture No. 2 (Front) by Justine. “The Odd Lumps and Bumps Represent My Some-way Shapely Aging Body.” Sculpture No. 2 (Back) by Justine. “I Spent a Lot of Time Trying to Get My Buttocks Right and My Legs in Some Way Shapely.” Sculpture No. 2 by Cynthia. “I Felt Sadness and Almost Tearful when I was Scraping Out a Hollow Within Myself . . . My Womb?” or “The Mushroom Shape.” 21 22 23 24 25 26 27 28 29 30 31 32 71 73 75 75 77 77 78 80 80 82 83 84 85 Chapter 5 33 34 35 36 37 38 39 Sculpture No. 3 by Cynthia. “The Container Outside.” Sculpture No. 3 by Cynthia. “The Container Inside.” Sculpture No. 2 by Priscilla. “Torso with Large Hips and Angry Words.” Sculpture No. 1 by Priscilla. “How Embarrassing.” Sculpture No. 1 by Priscilla. “I Hate You.” Sculpture No. 1 by Cynthia. “The Owl in Baggy Trousers.” Sculpture No. 2 by Priscilla. “Cutting Away.” 92 92 99 100 100 103 105 Chapter 6 40 41 42 Sculptures Nos. 1, 2 & 3 by Nancy. “For Me, It Was About Being Really Honest”, or “The Three Nancys.” Sculpture No. 2 by Priscilla. “Sticking It Back On.” Sculpture No. 2 by Priscilla. “That’s Just How It Is.” 113 118 120 Figures xiii Chapter 7 43 44 Sculpture No. 2 by Priscilla. “There You Go . . . I’ve Lost an Inch!” Sculptures Nos. 1, 2 & 3 by Nancy. “The Three Nancys.” 125 126 Chapter 8 45 “The Pottery.” 138 Chapter 10 46 “An Army of Women No. 2” by Trisha Crocker. 178 Acknowledgements Trisha: I would like to thank my mother, who taught me that I could always do anything I wanted as long as I perservered and didn’t give up. To Professor Mitchell J. Rycus, who encouraged me to begin the PhD and was always there for me with moral support to the very end and after. Lastly, I would like to thank my daughter Charlie MacGregor for her support and constant love throughout the long process of the PhD and the creation of the book. Charlie’s photography of the women’s images has enhanced the pages of the book. I would also like to dedicate Chapters 2 and 6, on Body Image and Mothers and Daughters, to my sister Ellen, who knows better than anyone the impact of a mother on a daughter’s self-esteem. You were a driving force from day one of the PhD and were forever in my thoughts throughout the process. Susan: It has been a great experience collaborating with Trisha on this book, and exciting to see it through to publication. As always, with any project there are people working quietly in the background that make it all possible and for whom thanks are in order. I would like to thank my partner Terry for all his support and endless good humour, despite me locking myself away in a garret room for months on end, especially as this coincided with a national lockdown due to the pandemic! I would also like to thank my Mum and Dad, and sons James and Matthew, for their on-going support for ‘yet another project!’ Section 1 Preparing the Ground – Digging for Clay 9 Taylor & Francis Taylor & Francis Group http://taylorandfra ncis.com 1 Introduction and Context Body Image, Art Therapy, and Clay Work A Very Personal Journey, by Trisha Crocker I was born in Hollywood, California and brought up in Beverly Hills during the 1950s, an area of the world known for its obsession with the ‘perfect’ body. Becoming a professional dancer in the 1960s, I attended many auditions where the choreographer was less interested in the perfect kick than in the perfect bottom! One can point the finger at social media, air-brushed models, even painfully thin Disney characters; whatever the reasons the results are the same – women feel pressurised to conform to an unrealistic female body image, and to feel flawed and ugly if they do not, resulting in a lack of self-esteem, and poor body image. My personal interest in the effect of poor body image on women developed when, later in life, I became a dance and fitness instructor. I remember how astounded I was to find that so many of the beautiful women I taught had negative thoughts about their bodies. I was particularly concerned as these women seemed outwardly confident and comfortable in their bodies, and yet they all expressed stress and anxiety around their body image. I wondered why so many women seemed dissatisfied with their bodies, and where this selfjudgement emanated from. Later, from my experience as an art therapist working with women with a negative body image, I began to see how this could lead to the women experiencing feelings of utter despair and self-loathing, resulting in anxiety, depression, and a lack of self-confidence. I began thinking about the potential value of creating images using the tactile and three-dimensional properties of clay as a safe tactile material for women to explore their body image, and turn their negative experiences into positive ones. I was also inspired to develop a suitable intervention for women with body image issues after reading a book called A Waist Is a Terrible Thing to Mind (Philips et al. 2000), a collection of poems and stories written by women across America, describing the ways in which they battled with a negative body image. I discovered the book quite unintentionally whilst exploring body image through working on my own series of clay sculptures of women. My attention was immediately seized by the urgency and despair in the writings, 4 Preparing the Ground a despair I recognised in my own art therapy clients, underlining for me just how important this subject is. I was also struck by the link between mothers and daughters and body image. Here ‘Maggie’ writes about her anxiety for her unborn daughter: Most of all, this is for my daughter, a daughter who is not even born. A daughter I would comfort, tasting the tears off her cheek when one day she, too, learns that she is not pretty enough, she is not perfect enough [. . .] simply not enough. (Maggie, quoted in Philips et al. 2000, p.166) Maggie goes on to say: This is for the tears I will cry with her because I have no words to feed the empty place in her that will never understand that she absolutely IS just enough. (ibid.) Ideas for the intervention were sparked when, during a clay teaching session, I intuitively sculpted a small shape and gave it breasts and a belly. In between the weekly sessions I felt drawn back to the studio to make another, larger sculpture of a round-bellied women with full breasts and buttocks. When women from a ceramics class I was running at the time walked into my pottery the following week and saw the sculpture, one pointed at one of my sculptures and exclaimed “That is definitely me!” The following week another lady from the class walked in and saw my latest sculpture and exclaimed “This one is me!” I therefore became aware that women identified strongly with my sculptures, and I felt compelled to sculpt the female form in all its multitudes of shapes and sizes and at different ages. This resulted in a series of over 200 sculptures I called An Army of Women (see Figures 1 on p.5 & 2 on p.6), which were exhibited in 2008 at Norden Farm, in Maidenhead, The Mirror Gallery, South Hill Park, Bracknell, and the Henley Festival. An Army of Women spoke to me about feelings of ‘solidarity’ with all women and the idea of there being ‘strength in numbers’. It seemed to me that each of my sculpted ‘women’ possessed a soul and a reason for existence, and the key message I wanted the Army of Women to portray, was for women to recognise that each of them, in their own unique way, is beautiful, and is ‘enough’, no matter what shape or size they are. In a review written about the exhibition, Dr Outi Remes (2010) wrote that the work portrayed ‘bodies of difference’ and a ‘celebration of the female form’ with ‘multiple body shapes and colours’ without any hierarchy of race or class. At the exhibition, I witnessed strong emotions from many female visitors, who often remained near the sculpture they most identified with, seemingly searching for the ‘soul’ within the piece. Through this ‘soul searching’ they were able to find their own personal connections and interpretations within the ‘army’. Therefore, the Army of Women is testimony to my personal exploration of the female form in clay, something that has been explored as far back as Introduction and Context 5 Figure 1 “An Army of Women No. 1” by Trisha Crocker, 2008. 28,000 years ago (Henley 2002), since humans first took a fist of clay or stone and fashioned it into the shape of a woman. Small figures, often referred to as ‘Venuses’ with overly large breasts and bellies, were fashioned out of clay, then placed on hot coals until they exploded, signifying their magical significance and power as objects of fertility (ibid., p.83). Clearly, despite the span of centuries, the female form remains a subject of curiosity and awe, and these ancient creations resonate and share a kinship with my own early clay work and those of the women who share their own personal stories and creations around body image within this book. In my own art therapy practice I use a person-centred approach to clay work, with the focus often being on that of play. I currently work at a school with excluded children aged between 5 and 11 years, and play works because it comes naturally to children, and my role is about ‘being with’ the child, allowing them to interpret their creations, and develop personal understanding so that opportunities for change can become a natural outcome. This same paradigm of clay work as ‘play’ was used in the PhD research case studies (Crocker 2017), discussed in this book. Play speaks of letting go, of being given permission to ‘make a mess’, allowing a sense of freedom and learning to develop, within the ‘held’ therapeutic space. My PhD thesis explored clay as a tool to help women heal their body image issues, and the evidence provided by this is outlined within this book, offering a new intervention for art therapists to use in their practice, providing the full protocol and analysis techniques used within the study to aid replication. The evidence provided within this book 6 Preparing the Ground Figure 2 “Large and Lovely” by Trisha Crocker, 2008. Introduction and Context 7 shows that women who create their body image in clay are (perhaps for the first time) able to take ownership of that image and to heal the psychological trauma of never feeling ‘good enough’. A Creative Collaboration: embodiment and Self-Portrayal, by Susan Carr It was a natural development for Trisha and I to collaborate on this book. When we were art therapy students together, we both aspired to continue our MA research by individually undertaking a PhD, and although the subject matter of our PhDs differ, they are linked by a fundamental interest in self-portrayal and disturbances in body image, whether it be through the impact of illness, or the impossibility of living up to idealistic female social stereotypes. My own interest in body image was sparked by my work as an art therapist in the field of palliative care. My PhD – developing Portrait Therapy (2015, 2018) – was therefore inspired by working with clients, and involved developing an art therapy intervention for patients living with life threatening or chronic illnesses. Portrait Therapy reverses the traditional terms of engagement within art therapy and uses the art therapist’s artistic practice or ‘third hand’ (Kramer 1971, 1977, 2000; Carr 2014, 2015, 2017, 2018) to create portraits for patients; however, in a series of ‘negotiations’, the patients co-design their own portraits – directing how they wish to be portrayed. This builds on an understanding that severe illness is not just an attack on the body, it is an attack on a person’s sense of self-identity and body image, shattering the means by which a person experiences the world, and by which they also are experienced. This profound sense of loss and disruption to selfidentity and body image contributes to a person’s sense of distress and powerlessness and is made manifest in statements such as “I don’t know who I am anymore” and “I look in the mirror and say ‘who’s that?’” As body image is an integral part of self-identity, it is important to explore this in relation to the creation of an ‘embodiment’ of the self in clay. Concepts such as ‘self’ and ‘identity’ have been historically, and to this day, a complex and contested phenomenon (Bauman 2004 p.77; Lawler 2008), with meanings that are both ambivalent and elusive (Vecchi 2004, p.2). However, they remain key topics of interest across the social sciences (e.g. Oyserman et al. 2012; Leary & Tangney 2012). For the purposes of this book, we describe a ‘cohesive sense of self-identity’ as comprising: ‘a realistic body image, subjective self-sameness, consistent attitudes, temporality, gender, authenticity, and ethnicity’ (Akhtar & Samuel 1996). However, Palmer’s (2007 [1998]) description of identity is also important as it brings together all the diverse cultural and nurturing elements that may make up a person’s sense of self-identity. He describes identity as [. . .] an evolving nexus where all the forces that constitute my life converge in the mystery of self: my genetic makeup, the nature of the man and 8 Preparing the Ground woman who gave me life, the culture in which I was raised, people who have sustained me and people who have done me harm, the good and ill I have done to others and to myself, the experience of love and suffering [. . .] identity is a moving intersection of the inner and outer forces that make me who I am, converging in the irreducible mystery of being human. (Palmer 2007 [1998], p.14) Self-identities can therefore be viewed as relational and also culturally constructed (Evans 2005a, p.40) or at least culturally influenced, and as such characterised by change and fluidity, sometimes referred to as a ‘reflexive project’ (Giddens 1991, p. 32). Embodiment For renowned phenomenological philosopher Merleau-Ponty (1908–1961), the body is central to how we experience and interpret the world, and is the whole reason we have a world to experience (Merleau-Ponty 2002). Certainly, our embodiment is central to our experience as human beings and it is through our bodies that we are able to understand other people (ibid. p.186). This is something that Finlay (2009) describes as our ‘embodied intersubjectivity’, or our ‘corporeal commonality’ (p.8). As therapists and researchers, it is therefore important to be able to put ‘oneself into the experience of the patient as much as possible, feeling it as if in one’s own body – without losing a separate sense of self’ (Yontef 2002, p.24). With an understanding that the body or embodiment is central to all aspects of perception, consciousness, and human experience (Merleau-Ponty 2002), the concept of the body as home can be recognised, with body image sculptures therefore becoming a depiction of a person’s sense of homelike or unhomelikebeing-in-the-world (Svenaeus 2011). The idea of ‘home’ brings to mind a protective material environment, combining a sense of permanence, security and continuity, with a space that is full of emotional significance and meaning (Dupuis & Thorns 1998, p.30). With our bodies so significant to our understanding of the world, it follows that as human beings we are intensely conscious of our own bodies and those of other people. A large part of the way we communicate with others is through body language or facial expressions, instantly recognising behavioural or emotional clues that tell us something about the thoughts, feelings and intended actions of the other person (Freeland 2010, p.154). When creating our own body image out of clay, the sculptural form becomes imbued with personal significance that can be perceived by others, it exists in space in a way that bodies do and has an intentionality that is recognisably human. This subject/object that is both ‘me’ and ‘not me’, ‘home-like’ and ‘unhome-like’, is a significant therapeutic vessel for exploring the intra-personal relationship one has with one’s own body, and how that body relates to others and the world. The process of creating one’s body image in clay enables people to depict themselves as Introduction and Context 9 they see themselves, through the lens of the distorted mirror that encapsulates all the damaging things others have said about their bodies over time, and then gradually rectify these distortions through the malleability of clay, coming to a more balanced and personally healing view of the self. Clay as a Therapeutic Medium For most of the women who attended the body image sessions featured in this book, clay work was new to them, or at the very least a distant memory from art classes at school, or from making ‘mud pies’ in the garden as a child. As such it was still a familiar material, something that was unlikely to provoke anxiety as a medium. Derived from the very building blocks of mother nature and the universe, the therapeutic and cathartic nature of clay is clearly evident, and the sensory playful qualities it exudes are plain to see. In its natural form clay is: tactile, wet, malleable and messy, it can be shaped, scraped, cut, rolled, squashed, squeezed and even poured and ‘clay has the capacity to be done and undone multiple times, providing the opportunity to smash down or remake a clay-sculpture’ (Rubin 1984, p.58). Once fired, clay becomes solid, immovable, durable, and yet retains a fragility that reflects the human condition. The firing process, like that of life, is dangerous and unpredictable, with clay sculpture prone to breaking, cracking, or exploding within the kiln. Clay is a sensory, tactile, three-dimensional material for creating one’s own body image; it allows for play and reflection in ways that other two-dimensional materials do not. It can be cut, pulled apart and then repaired and put back together, becoming a metaphor for injury, trauma, and making whole again. These processes of change are the practical benefits of clay work. Within this context we understand the term ‘clay work’ (which other authors may write as ‘clay-work’ or ‘claywork’) to mean ‘the process of handling, manipulating, and sculpting clay, and the products of these activities’ (Sholt & Gavron 2006, p.66), highlighting that an ‘art expression is not merely the final product but is also the process by which the product has been developed, and that process and product foster significant psychological processes, revealing meaningful information about the creators’ inner world’ (ibid.). In her therapeutic clay work with children, Rhodes (2008) suggests that pinching, poking, squeezing, constructing, and cutting away are what create the clay work. A useful theory for therapeutic clay work was identified by SouterAnderson (2010) as a theory of contact: physical, emotional, and metaphorical; she describes this as follows: [. . .] playing with the medium is a physical contact, a sensate experience, with the substance that appears to stir feelings and make contact with emotions whilst simultaneously engaging with the world, the imagination, thus incorporating a metaphorical contact. (Souter-Anderson 2010, p.51) 10 Preparing the Ground For the purposes of this book, and the research it refers to, we use Sholt and Gavron’s (2006) description of the characteristics of ‘clay work’ as including ‘procedural expression through touch, movement, and the three-dimensional aspect, the reflection of construction and deconstruction processes, and the regression process’ (p.66). Sholt & Gavron also suggest that clay is ‘a familiar material in art therapy and in psychotherapy’ which many promote for its capacity to provide a therapeutic tool ‘in individual and group therapies’ (Sholt & Gavron 2006, p.66). Working with clay stimulates all the senses and involves ‘very primary forms of expression and communication’ (Snir & Regev 2013, p.95). Henley (2002, p.75) believes that re-creating the body image in clay ‘naturally invites projective identification into the art process’ and suggests that the processes of creation and destruction inherent within clay work can be beneficial to clients. The clay sculpture can also be revisited over time, and held by the maker both figuratively and literally, as a reminder of change. Rabinor and Bilich (2002) suggest that clay work in art therapy, can be used to help clients change or adapt their body image (p.474). Cash and Pruzinsky (2002a) believe that nonclinical populations of women who experience negative body image could be helped with an experiential approach. The beauty of working with clay is the direct, physical, and therefore sensory, contact the clients have with the art material. For Ogden (1989) human experience often relates to primitive experience, which may be dominated by the sensory experiences of touch and rhythm. The physical presence and materiality of clay sculptures mean that they can also be used as significant objects within rites and rituals. Cohen and Mills (1999) suggest that ‘drawings, paintings and sculpture made in art therapy can reveal distorted body-image and introduce it into therapeutic conversation in a way that clients can tolerate’ (p.204). Art Therapy and Clay Work: Reviewing the Literature The British Association of Art Therapists (BAAT) describes art therapy as: [. . .] a form of psychotherapy that uses art media as its primary mode of expression and communication. Within this context, art is not used as a diagnostic tool but as a medium to address emotional issues, which may be confusing and distressing. (BAAT 2004) Art therapy is an accessible therapy, in that no skills in art are required, with the focus being mainly on what the art product represents or reveals about emotional or psychological issues. Art therapy helps clients to bring to the surface and externalise issues which may have been internalised over many years, within a safe and contained Introduction and Context 11 environment. The therapeutic ‘triangular relationship’ (Schaverien 2000, p.55) between the art therapist, the client, and the art object, is an important aspect of art therapy theory, and it is therefore the presence of the art object, created by the client, that makes art therapy unique. Maintaining client/therapist boundaries is essential within art therapy in order to provide a safe space for clients to work freely with the art materials, explore their thoughts and feelings, and promote healing. Research into art therapy as a therapeutic discipline has been ongoing since art therapy was developed during the 1940s in the UK by British artists and early art therapy pioneers – Edward Adamson (1911–1996) and Adrian Hill (1895–1977). Adamson and Hill were founder members of the British Association of Art Therapists (BAAT), established in 1964, with Hill becoming its first president (Ostrowska 2013; Hogan 2001). It is not generally known that the use of clay and ceramics has its roots in the very inception of art therapy in the United Kingdom (SLaM 2018). One of the first documented instances of clay or ceramics being used is the presence of 500 ceramics, some dated 1948 (SLaM 2018), stored at the South London and Maudsley NHS Trust as part of the Edward Adamson collection. The collection as a whole consists of 5500 objects, including paintings, drawings, ceramics, sculptures and works in stone, flint and bone, that were created between 1946 and 1981, by in-patients at the long-stay mental health hospital, Netherne, where Adamson worked (ibid.). Adamson’s style was ‘non-interventionalist’, meaning he was against the psychological interpretation of patients’ artwork, which he dismissed as ‘the therapist’s own projections’, maintaining that only the creator of the work could explain their own image (O’Flynn 2011, pp.46–53). Adamson saw himself less as a ‘therapist’ but more as an ‘artist’ facilitator, with a broadly humanistic theoretical base (Ostrowska 2013), and an intermediary between the patients and the medical staff. The space within which Adamson worked was always called the art studio rather than a therapeutic space (Adamson 1970). Adamson is reported as saying [t]he actual ‘therapy’ is purely incidental. The important thing is the art [. . .] that’s the thing that is getting them better. The mere fact that they put their brush to paper and try and paint. (Adamson, cited in Seftel 1987, p.50) Adamson is also quoted as saying: ‘The strength of the art therapist is in being an artist’ (Seftel 1987, p.48). However, both Hill and Adamson became increasingly unhappy as the profession developed toward a psychodynamic and psychoanalytical orientation of art therapy (Hogan 2001), feeling that it was losing its focus on the creation of art as a fundamental aspect of healing in art therapy, with Adamson deciding to focus much more on Outsider Art (Ostrowska 2013). Adamson exhibited the collection in various galleries during his lifetime, including major international exhibitions of Outsider Art, with 12 Preparing the Ground a view to reducing the stigma associated with mental health problems, by educating the public and highlighting through the art, the humanity and creativity of his patients (ibid.). Art therapists use many different theoretical approaches when working with clients, e.g. humanistic and client-centred (Rogers 2003 [1951]) and existential (Yalom 1980) at one end of the theoretical continuum, and psychodynamic (Freud 1913 [1899]) and psychoanalytic (Jung 1933; Klein 1952) at the other. Many therapists use a variety of different approaches depending upon the client group and/or issues clients present. Similarly, the art materials used may be influenced by the client group or issues being addressed, with clay work being particularly recommended for art therapy work with children who have experienced abusive relationships. The research discussed within this book also indicates that clay is a useful medium for art therapy with women to explore body image issues. Art therapy as a profession continues to develop theoretically and practically, with ongoing research in all areas of the discipline (e.g. research published within: The International Journal of Art Therapy; Art Therapy: The Journal of the American Art Therapy Association; The Arts in Psychotherapy; and the Canadian Art Therapy Association Journal. Clay work in art therapy practice is currently an under-researched area of practice, and therefore this book, and the PhD thesis from which the case studies are drawn, seek to address this balance, particularly addressing the area of clay work, women, and body image. Clay Work in Art Therapy As an art therapy intervention, working with clay typically involves the shaping and manipulating of the material with the goal of producing a product where both the process of creating and the product are considered to hold significance for the interior world of the creator. (Henley 2002 p.23) Whilst there is a general paucity of published research on the use of clay in art therapy, significant books have been written on the subject. Australian psychotherapist and educator Dr Patricia Sherwood developed a specific therapeutic discipline called ‘Clay Therapy’ (2004), from which she has written a book by the same name. Whilst this is not the same as using clay within the specific discipline of art therapy, Sherwood’s work offers considerable insight into the use of clay to help clients with anger, grief, and related issues. Sherwood talks of the undiscovered potential of clay used in therapy, saying ‘clay work is like the Cinderella of the art therapies’ still waiting for her ‘magic, her beauty and her ability to transform the wells of human suffering into places of insight and celebration’ (Sherwood 2004, p.5). Art therapist and educator Dr David Henley has written extensively on art therapy, and in 2002 wrote his book Clayworks in Art Therapy. As a ceramicist Henley speaks from experience when he talks about clay’s potential for Introduction and Context 13 therapeutic application. In his book Henley uses case studies and vignettes to explore the theories, techniques and history of clay work and its power to enable positive therapeutic outcomes. By promoting both aesthetics and artistic integrity, Henley offers a holistic approach to working therapeutically with clay. In Lynn Souter-Anderson’s (2010) book Touching Clay, Touching What? The Use of Clay in Therapy, she takes an existential theoretical stance, focusing on what it means to be human, and how clay work can enable the release of emotions, memories and sensations, that can be explored within a safe therapeutic space. Souter-Anderson outlines a sound theoretical basis for the use of clay in therapy, based on her own original research, and her deep understanding of the processes involved. Writing of the lack of research into clay work, Souter-Anderson says, ‘The value and particularly the therapeutic significance of using clay in therapy has essentially not been recognised or understood’ (2010, pp.11–13). Art therapist Cornelia Elbrecht (2013) writes about a technique she has developed for using clay with clients, something she has defined as the ‘Clay Field’®; Elbrecht describes this as ‘a rectangular box filled with non-gritty clay’ (2013, p.19), and as a ‘psycho-physiological art therapy process that engages the hands with the material of clay within the safe setting of a containing box’, and includes ‘an intricate interaction between human neurobiology and expressions of lived experiences’ (ibid.). In a later article on the ‘Clay Field’® Elbrecht and Antcliff (2014) suggest that ‘haptic perception allows non-verbal access to psychological and sensorimotor processes thwarted by trauma’ and that trauma can be resolved via touch (p.19). Creating a three-dimensional object out of clay within a safe therapeutic space has many advantages; for Jung (1916, p.82), giving personal disturbances or issues a ‘visible shape’ produces a ‘vitalising influence’, something that enables the issues/disturbances to be reproduced in either a concrete or symbolic form. The three-dimensional process of forming the female figure in clay enables clients to turn the image around 360 degrees and view it from different directions and angles (Buchalter 2004; Henley 2002). This allows one to look at the figure as a whole and from different perspectives, unlike the two-dimensionality of drawing or painting, which allows viewing from just one direction. In her book Women Who Run with the Wolves (1992) American poet, psychoanalyst and post-trauma specialist, Clarissa Pinkola Estes states: ‘It is clear that the instinctive nature of women values body and spirit far more for their ability to be vital, responsive, and enduring than by any measure of appearance’ (p.199). She goes on to say that [d]estroying a woman’s instinctive affiliation with her natural body cheats her of confidence. It causes her to perseverate about whether she is a good person or not and bases her self-worth on how she looks instead of who she is. (p.201) 14 Preparing the Ground Cohen and Mills (1999) suggest that ‘when clients believe there is something deeply wrong with their body, they might also need to defend against this belief by dissociating (the mind is me, the body is not-me)’ (p.203). The sensory nature of clay and its capacity to be ‘body-like’ (Foster 1997, p.68) means that it can ‘stimulate life-like perception’ (Waldman 1997, p.12), serving as a ‘bridge between the sensory experiences imprinted in the body and conscious awareness of these events’ (ibid.). Ellis (1989) also suggests that the use of clay in therapeutic encounters encourages client reflection, through its tactile qualities, and can enable the reflection of unconscious bodily experiences, through embodied actions such as stroking, stabbing, smoothing, and squashing (p.267). In her art therapy case study using clay to help a female client (‘Susan’) diagnosed with depression, Waldman (1999) considers how the social construction of gender, and the demands put on women, is linked to the prevalence of depression in women (p.10). The case study describes how using clay was significant in enabling ‘Susan’ to ‘access memories of childhood trauma and to develop a more authentic subjectivity’ (ibid.). Waldman also suggests that working with clay in therapy can be a ‘powerful medium to engage clients physically by stimulating primary sensory experience, directing them to expel rage and experiment with being in control’ (ibid.). In their review of clay work in art therapy and psychotherapy Sholt and Gavron (2006) suggest that, [. . .] ‘the development of the ability for threedimensional representation in clay has not received enough attention’ and that further research in this important area is required (p.67). The therapeutic research within this book is therefore, in part, a response to the calls for further research in the use of clay within art therapy (Sholt & Gavron 2006; Henley 2002; Golomb and McCormick 1995; and Woltmann 1993, p.66). Clearly a wider understanding of the process and product of clay work in art therapy is necessary to develop an understanding of its potential therapeutic use and the nature of any risks or ethical considerations posed by this medium. In a review of 35 clinical reports Sholt & Gavron (2006) identified six main therapeutic factors of clay work in art therapy and psychotherapy; these include facilitating: ‘expression of emotions’; ‘catharsis’; ‘rich and deep expressions’; ‘verbal communication’; ‘revealing unconscious material’; and ‘concretisation and symbolisation: The embodiment of inner representations in visual images’ (ibid. p.70). The benefits for clients offered by clay work include ‘a significant exploration of self by clients and therapists that enable the detection and integration of primal experiences of the self, and its multifaceted nature. It is by which clients widen their access to their inner selves and thus continue their journey of becoming’ (Sholt & Gavron 2006, p.71). The therapeutic nature of clay and clay work within therapy is inherent within the three-dimensional nature of clay and the opportunity for clients to create a concrete three-dimensional object, which can become a symbol and metaphor for their own inner world and experiences (Sholt & Gavron 2006, Introduction and Context 15 p.68). The three-dimensionality of clay means that it can closely resemble, recreate, and represent objects from real life (Sholt & Gavron 2006, p.68). It can also be used to create figures that represent powerful emotions that were previously inaccessible to clients (Henley 2002; Mciver 2001; Brock 1991; Keyes 1984; Mitchell 1984). There is evidence within the literature of a connection between loss and clay work. Henley (2002) investigates clay and ‘object loss’ in his art therapy work with a young teenage girl whose mother had died, saying the girl felt unable to talk about her grief. However, after a few months of therapy, the girl created a large clay cup on which she scratched the word ‘Mother’; the girl loved to hold this cup and through this she was able to begin to talk about how much she missed her mother’s touch (Henley 2002). This demonstrates the potential for clay to be used to help clients who are experiencing loss and mourning, using created objects, or the created image of a lost loved one as a way to cope with emotional pain. For Henley (1991), the malleability of clay and the manipulation it can withstand in a therapeutic setting are important aspects of its therapeutic value, as he says: ‘Clay taps into the depths of human consciousness. [. . .]. Clay’s plastic, malleable nature gave birth to the metaphor that it possesses a life and body of its own’ (p.67). Research has shown that clay work can empower the creators (Snir & Regev 2013). Snir & Regev (2013) write of the findings from their research, claiming that working with clay enabled clients to report a sense of ‘relief’, ‘release’, and a ‘sense of calm’ (p.98). With reference to their clients’ use of clay they maintain that ‘childhood memories evoked by working with clay were particularly prominent’ and that the sensual property of clay brought forth ‘memories of smells, touch and baking bread’ (pp.98–99). It is important to keep in mind the interaction that can happen between the art materials offered and the particular characteristics of the client/artist (Snir & Regev 2013; Moon 2010; Sholt & Gavron 2006). This holds particular relevance for clinicians who offer art therapy to clients with specific physical and emotional needs (Snir & Regev 2013, p.100). The versatility of clay as a therapeutic material is beneficial as it can either be worked upon and left unfinished, or it can be painted/glazed and fired (Yaretzky & Levinson 1996, quoted in Abramowitz 2013, p.2). Glazing a finished piece such as a cup or bowl can make it waterproof. Also, if a client decides to glaze and fire a piece, they can then choose to display it in their home, which can create further opportunities for self-reflection. Art therapists including Elbrecht 2013; Elbrecht & Antcliff 2014; Sholt and Gavron 2006; O’Brien 2004; Fabre-Lewin 1997; McNiff 1992; and Ellis 1989, have written about the haptic qualities of specific three-dimensional art materials used by clients in therapeutic sessions, e.g. making a ‘mess’ by rubbing hands into paint, scrunching and ripping paper, rubbing wool into felt, and specifically clay work. Henley (2002) and Sholt and Gavron (2006), believe that the use of clay in art therapy can be a sensory, whole-body experience for the client, an experience that can lead to moments of ‘illumination’ (Malchiodi 16 Preparing the Ground 1998, pp.66–68) or ‘breakthrough’ experiences, where one achieves a discovery or ‘is satisfied with what one has created’ (ibid.). Sensory three-dimensional art materials such as clay involve the haptic processes of touch, sight, smell, and sound. Because of clay’s ‘body-likeness’ some clients may find it stimulates a perception of being life-like (Foster 1997) containing uncomfortable feelings, and therefore can act as ‘a bridge between sensory experiences imprinted in the body and conscious awareness of these events’ (Waldman 1999, p.12). However, clay work in particular also involves what is often called a ‘sixth sense’, that of proprioception (also known as kinaesthesis), which is a sense of body position or movement that ‘combines with other senses to locate external objects relative to the body and contributes to body image’ (Taylor 2009, p.1143–1149). Art therapist Arthur Robbins (1999) talks about how working in clay helped him to discover his ‘soul in the mess’, and that it ‘[. . .] seemed to touch such a deep part of me, creating such a sense of excitement and aliveness that I could hardly wait from one class to another’ (p.121). In a qualitative study on the use of clay in a psychiatric day hospital in Brazil, A.H. de Morais et al. (2014) conclude that ‘the use of clay as a therapeutic method by psychiatric patients promoted creativity, self-consciousness, and benefited those who sought anxiety relief’ (p.128). The properties of clay mean it has a unique capacity to reflect bodily experiences that are unconscious, through the tactile and versatile nature of the medium (Ellis 1989). Clay can be a powerful medium for clients, in that it engages them physically, stimulating often primary sensory experience, meaning they can safely expel anger, and experiment with being in ‘control’ (Waldman 1999, p.12). As such clay modelling can help clients to tell stories about attachment, and also self-harm and destruction (Gampel 1993, p.289), as well as ‘bypass intellectual defences, invite playfulness’ and ‘confront distorted body imagery’ (Waldman, 1999, p.12). Art therapist Judith Waldman (ibid.) discusses a case study where changing the art materials offered to a client to clay, changed the course of therapy, with her client ‘Susan’ explaining that, with clay, “I express more of my basic feelings with it. It’s not just cosmetic and pretty. I’m more involved.” This book, and the thesis from which the case studies are drawn, fills a gap in the available research and literature on the specific subject of clay as an art therapy intervention for women exploring issues related to body image. Art therapy sourcebooks/handbooks (e.g. Malchiodi 1998; Case & Dalley 2000) have been remiss in referencing clay as an art therapy material in the subject indexing. It is difficult to understand why such a versatile, sensory, and healing art material should be side-lined in this way. There are reasons that make clay a more difficult material to work with, e.g. these are: a lack of knowledge around using clay; the cost of the materials and access to a kiln; health and safety issues; the storage of 3D sculptures; and the need for an art studio where the ‘mess’ created by clay can be contained and accommodated. Whilst these Introduction and Context 17 are significant issues, the benefits of overcoming them, to enable clients with specific issues to work in this way, are clear. The Power of Clay Work: ethical Considerations Rubin (in Snir and Regev, 2013, p.100) writes of how important it is for art therapists to have an in-depth knowledge of the art materials they offer to clients within therapy sessions. As Malchiodi (quoted in Snir and Regev, 2013 p.94) says: Our understanding of the therapeutic potential of each [art] material and its unique “personality” is significant to the ability to design suitable interventions for clients. This is specifically important when offering clay, as it has sensual as well as tactile qualities, which can be enjoyable for clients, however, its messiness and wetness may bring up unconscious material (Kagin & Lusebrink, 1978, quoted in Sholt & Gavron 2006, p.71), as well as unwelcome memories or feelings of disturbance for the client. Kramer and Schehr (1983) suggest that ‘clay invites regression’ and can result in ‘playful behaviour that easily takes on an oral, anal, phallic or genital character’, which can lead to the integration of fragmented parts of the self into sculptural works that contain the whole (p.77). Enabling abused children to work in clay can help children to open up about their abuse, either during, or after, the clay work took place (Kramer 2000). Strong emotional responses to clay work are therefore important to consider when working with clients (Henley 2002), in particular clay’s ‘propensity to loosen controls given its faecal, smearing qualities and its dirtiness, which can rekindle early psychosexual conflicts’ (Schlossberg 1983, p.103). Regressive work can be anxiety provoking for clients, therefore extreme care should be taken by therapists to ensure that a client is ready for this kind of work and able to withstand the emotional impact. The intensity of clay work and its propensity to bring up unconscious material means caution should be used when working with art therapy clients who have experienced abuse or trauma (Sholt & Gavron 2006, p.71). Rhodes (2008) states that ‘the clay therapist must always be ready to step in to shore up weak psychic structure and collapsing pieces’ (p.27). Creating images in clay can be challenging, perhaps also due to the fragility of clay when dry (Sholt & Gavron 2006). The fragility of clay can be a negative aspect of the process, but it can also be turned into a positive, as Yalom (2003, p.36) advises: ‘Recall the fundamental therapy principle that all that happens is grist for the mill.’ Therefore, if when firing, a piece cracks, or breaks off, or if the entire piece explodes in the kiln, this can be used by the therapist to help the client explore important metaphors around loss, damage, breaking, fragility, impermanence, incompleteness, 18 Preparing the Ground imperfection, and death, as well as repair, renewal and recovery, particularly if a process of visible mending (Jones 2008; Carr 2015) is utilised. Clay work as Meaningful Play Play lies at the core of creativity and innovation. (Brown & Vaughan 2009, pp.4–5) Play is an important, pleasurable activity that enlivens, energises and eases depressed mood, promoting a sense of optimism and creativity (Brown & Vaughan 2009, pp.4–5). Infants begin to play very early on, as a way to make sense of their bodies and surroundings (ibid. p.83). Neuroscientists, biologists, social scientists, psychologists, and researchers recognise that play is a ‘profound biological process’ that has evolved over millennia to promote survival in many animal species (ibid. p.4). In higher animals, play fosters empathy, and enables complex social groups to be formed, and of all the animal species it is humans that play the most (ibid. p.5). Human beings are ‘built to play and built through play’, it is the ‘purest expression of our humanity, the truest expression of our individuality’ (ibid.). According to Winnicott, play is vitally important in the development of selfidentity; he describes it as a place where a person is able to find one’s self. He says that ‘it is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self (Winnicott 1971a, p.54). Unfortunately, at some point as children grow into adulthood, they are made to feel guilty about playing, and told that it is childish or a waste of time (Brown & Vaughan 2009), and they are therefore shamed into giving it up (ibid. p.145). Creating a play space through building sculptures in clay can therefore help clients to reconnect to their ‘inner child’ (Carr 2017), where memories of making mud pies, modelling animals and figures in Plasticine®, Play-Doh® or pastry, come to the fore, and they are once again given permission to play. Play, and art therapy as a ‘play space’, are therefore key theoretical constructs used within clay work, which happen within the ‘transitional space’ between the therapist and client. When clients are unable to ‘play’ or use the art materials, then the therapist will help the client relearn this skill (Winnicott 1968, pp.711–716). Winnicott (1896–1971) described ‘transitional space’ as: [. . .] a space between inner and outer worlds, which is also the space between people – the transitional space – [within which] intimate relationships and creativity occur. (Winnicott 1953, p.89) In art therapy this ‘held space’ has also been described as a ‘framework for freedom’ that is both a ‘physical and psychological space in which it is safe to be freely creative’ (Rubin 2001 p.25) and to play. Introduction and Context 19 Betensky (1995) claims that when using clay in therapy, the initial ‘pre-art play’ is a time for experimenting with the materials, and can last for anything from a few minutes to a few sessions, depending on the needs of the client (p.15). This initial phase ends when the client begins to invest meaning in the object they are creating, and they are able to describe it to the therapist (ibid.). Play can therefore be seen as a crucial stage of therapy, a time for the client to connect with the material and feel a sense of held freedom to create within the physical and psychological space created by the therapist (Crocker 2017, p.58). The play space is also a space for the body, where physical activity can be safely explored and enacted. Therefore, clay work provides this physical space for the body, to move and to experiment and – as discussed in Chapter 3 – through the mirror neuron process clients are also able to physically experience or copy in their minds the movements and actions of others as they also work on their body image sculptures. Play that uses movement, such as clay work, ‘lights up the brain and fosters learning, innovation, flexibility, adaptability, and resilience’ (Brown & Vaughan 2009, p.84). Play also seems to be important for health, as REM sleep and play ‘share similar brain stem evolutionary biological patterns’ (Brown & Vaughan 2009, p.204). This indicates that the need for play may be linked to the vital human requirement for rest and renewal (Medic et al. 2017). What’s shocking is the similarity between the biological need for play and our body’s need for rest, a topic that also emerged as a major theme in Wholehearted living. It seems that living and loving with our whole hearts requires us to respect our bodies’ need for renewal. When I first researched the ideas of rest, sleep, and sleep debt—the term for not getting enough—I couldn’t believe some of the consequences of not getting proper rest. (Brown, 2010, pp.227–228). A biological and psychological need for play means that ‘the opposite of play is not work – the opposite of play is depression’ (Brown, quoted in Brown 2010, p.101). 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