Rehab 4 Addiction

Nowadays, there are lots of alternative or complementary therapies to go alongside the more traditional ‘talking therapies’.

These include acupuncture, yoga, meditation, biofeedback, and art therapy, among others.

Addiction is a complex disease, which affects the mind and body. The range of complementary therapies now offered by most rehab centres is designed to mirror this complexity. Addicts are a diverse set of people with very different circumstances, and different treatments work better for different people.

In this article, we will be focussing on art therapy, which is one of the most common forms of complementary therapy offered by rehabs and drug treatment programmes.

Complementary therapies like art therapy can be very effective when used in combination with CBT, group counselling and a full detox. These sorts of therapies bring something slightly different to the table, and studies have shown that they can be very effective in aiding recovery.

What is art therapy?

Art therapy, according to the British Association of Art Therapists (BAAT) is ‘a form of psychotherapy that uses art media as its primary mode of expression and communication.’ [1] Rather than verbalising difficult emotions or feelings, art therapy allows those in recovery to express their feelings via art.

This can be incredibly valuable for those who struggle to find the words to describe experiences that may still be very raw and traumatic. Addiction can take people to places they may not be proud of, and, especially in a group setting, it can be hard to get over that feeling of shame or embarrassment that may be attached to those experiences.

Art therapy is a blanket term that incorporates many different branches and schools of thought. According to BAAT, these include ‘psycho-educational, mindfulness and mentalisation-based treatments, compassion-focussed and cognitive analytic therapies, and socially engaged practice.’ [2]

Therefore, when talking about art therapy, we’re really talking about a very broad set of techniques based around the production of art as a means of overcoming problems.

Types of Art Therapy

In this section, we discuss some of the main types of art therapy.

Art therapy doesn’t have to be limited to just drawing or painting: sculpting is another common form of artistic expression used in art therapy. Other forms of art, such as poetry and dance, can also be classed as ‘art therapy’.

However, the main kinds of art used in art therapy are drawing and painting, since these are the simplest and most accessible types of art. Accessibility is an important quality in art therapy since not all of those in recovery will have artistic skill or experience.

The three main approaches to art therapy are as follows:

  • Gestalt – In this method, the person in recovery attempts to produce a piece of art that reflects their current mood and emotional state. The therapist can then use this as a springboard for discussion
  • Active Imagination – This method differs from the Gestalt method in that the patient does not try to express their current feelings in their artwork. Instead, they simply paint whatever they like or whatever comes into their mind, while the therapist watches and asks questions. The questions are intended to link the work of art with feelings or experiences that the recovering addict may have had
  • Third Hand – In this method, the therapist draws or paints while the patient directs them. This method is best for recovering addicts who don’t feel confident in their artistic ability, or who haven’t yet reached the stage where they can express their feelings in an artwork without significant assistance

Other forms of art therapy include ‘incident drawings’, which are drawings or paintings of a specific incident that occurred during the period of addiction. There is also ‘stress painting’, which is painting to relieve stress; creating art journals, and sculpting. [3]

What happens in a typical art therapy session?

As stated above, art therapy sessions can take many different paths. However, it may be helpful to give a summary of a ‘typical’ art therapy session.

To begin with, every art therapy session requires a qualified art therapist. This will usually be someone with a university qualification (such as a Master’s) in a field related to the subject, like psychology, paired with experience or training in an artistic setting. Due to the involved nature of art therapy, it is essential that the therapist is sufficiently qualified in these areas.

An art therapy session can last anything from an hour to a few hours. Most art therapy sessions are group sessions, and these tend to be on the longer side.

An art therapy session will usually begin with some discussion. In a group setting, the therapist may start the discussion by outlining the purpose of the session, or what techniques are being used (e.g. Gestalt, Active Imagination or Third Hand).

Once the work of art is completed, the therapist will normally ask the recovering addict some questions. These might include:

  • What feelings were you trying to convey in this artwork?
  • What name would you like to give this artwork?
  • Has this artwork led you to have any new thoughts about your addiction and recovery?
  • Did drawing or painting this artwork cause you to feel any new emotions? If so, what were they?
  • Were you thinking of any particular memories as you made this artwork?

In a group setting, there may also be some discussion between different members of the group. These conversations provide another dimension to the therapeutic side of art therapy.

At the end of the session, the therapist will likely hold on to any artworks created during the session for safekeeping. These can then be collected at the end of the course of treatment if the recovering addict wishes to keep them, as is often the case.

What scientific evidence is there for art therapy?

There have been lots of scientific studies on the effect of art therapy on addiction. Generally speaking, the scientific consensus is that art therapy can have a variety of positive impacts on recovery.

To give just a few examples, this study by Cox and Price concluded that art therapy can be effective in breaking through denial, especially in adolescent substance abusers. [4]

Another study by Elizabeth Holt and Donna H. Kaiser found that art therapy encouraged patients to begin making a positive change in their lives. [5]

The fact that the scientific community broadly supports art therapy as a form of addiction treatment suggests that of all the complementary and alternative treatments available, art therapy worth considering. It is certainly one of the most common. 36.8% of programmes offer art therapy, compared to 8.8% that offer acupuncture, and 3.3% that offer hypnotherapy. [6]

What are the benefits of art therapy?

There are many benefits to art therapy, some of which have already been covered in this article. However, for the sake of completeness, here is a list of the main ones:

  • It allows complex feelings to be articulated
  • It allows the recovering addict to rediscover (or even discover for the first time) their creative side
  • It can be useful not only for the recovering addict but also for the therapist, who may be able to get a better understanding of the addict’s emotional state from their artwork than from what they say in traditional talking therapy
  • It can foster feelings of pride and a sense of having achieved something among those who embrace this technique
  • It gives recovering addicts a mode of expression which some find easier than speech
  • It promotes freedom of expression via a therapy which allows people to express themselves creatively without fear of judgement
  • It teaches a skill that can be practised outside of treatment, promoting continued recovery and providing an added layer of protection against relapse
  • Many recovering addicts report that art therapy has a calming effect. It can be used in times of stress or anxiety to get rid of these negative emotions

Art therapy as a form of group therapy

Generally speaking, art therapy happens in groups. This forges connections between recovering addicts who are going through the therapy together.

As Alison Hawtin puts it, group art therapy ‘offers you a different experience from one-to-one work because the group creates and offers its own unique dynamic.’

While some may be less inclined to share their feelings in a group setting, a group can also be an incredibly supportive environment which encourages people to speak up.

The key to this supportive environment is the idea that everyone is going through the same thing together. Although people’s individual circumstances obviously differ, everyone is suffering from the same disease, and that creates a sense of solidarity which the therapist should foster. This all adds to the ‘unique dynamic’ offered by group art therapy.

How is art therapy incorporated into addiction treatment?

Art therapy should be just one component in a wider treatment programme. It can be very beneficial, but in order for the recovering addict to really feel those benefits, they need to have gone through a detox, be receiving some sort of talking therapy, and probably be in group counselling as well.

The role of art therapy alongside these other forms of treatment should be to deal with some of the more repressed and difficult to discuss feelings or memories that go hand-in-hand with addiction.

That is why the art therapist needs to really focus on the recovering addict as they go through art therapy, in order to ascertain what feelings their art is expressing.

Often addiction is paired with other disorders, such as depression, anxiety, or post-traumatic stress disorder (PTSD). It may be that the recovering addict is unaware of these other disorders, if they are suffering from them.

One part of the art therapist’s job is to see whether they can use the artwork produced by the patient to uncover any underlying mental health problems such as these.

Art Therapy and the 12 Steps

It is sometimes said that art therapy can be especially useful for those who are following The 12 Steps. In particular, art therapy can be effective in achieving the first step, which is this: ‘1. We admitted we were powerless over alcohol – that our lives had become unmanageable.’ [7]

Though not everyone uses the 12 Steps, and there are many other substances that people abuse besides alcohol, the comparison with The 12 Steps is still useful. It shows that art therapy can be very good at helping people to come to terms with their addiction. It, therefore, occupies an important role in the treatment process.