Contemporary Art Therapy with Adolescents. Shirley Riley

to blatantly contradict the words that I heard. However, when I allowed myself to get beyond my own ‘visual knowing’ and move into the drawing as the client described it, I often was rewarded with valuable information.

      Drawing as communication

      As I describe the encounters with clients of this age, I have used the term ‘drawing’ repeatedly. This is not accidental. In my experience in an outpatient clinic, adolescents prefer to draw. They favor black markers, red is second choice. The drawings may be stereotypic; gang symbols and teenage logos may take the place of spontaneous images. Again, this is the need to conform to the peer standards, to keep the adult at a distance, and make their mark of identity. Collage is also acceptable to this age group since they are often perfectionists and highly critical. It is seen as a way to make art that does not reveal their low opinion of their artistic capabilities. Adolescents can be very inventive in their use of magazine pictures. They often cut away parts of several pictures and reassemble them to make some startling images. If teens are aware of the second level meanings present in these collage pictures they do not necessarily share their insight, but hope the message gets across to the therapist. As the therapeutic relationship grows the adolescent will expect the therapist to ‘get’ their revelation and understand the meaning. When these expectations have become clear between the child and the therapist there is a great deal more latitude for speculations and cautious interpretation. As the system of communication is strengthened, the therapy becomes less mysterious.

      Missing the message in the art

      A girl was in treatment with me for a rather long period of time. We started when she was twelve and our contact continued inconsistently until she was in her late teens. ‘Annie’ was a troubled girl who ran away from home and acted out with drugs, but made most of her appointments faithfully even if she was on the streets. She repeatedly drew walls with ladders leaning against them. Annie identified the wall as her problem that she had to scale, and the ladder as the therapy. I inquired about the hidden side of the wall, what time frame was needed to scale the wall, and every other supportive and interested speculation I could imagine. The walls kept appearing and I was fairly sure I had a notion of what they meant, but I was reluctant to make an interpretation before her decision to disclose. In due time she identified the wall as her struggle with her gender identity. She was very forthcoming in her complaint to me that she thought I would never ‘get it’. In her mind she felt I should have known that wall equaled ‘coming out’ and have addressed it openly. Perhaps I should have. I was concerned that I would be ahead of her with an interpretation, she was hoping I had the ability to read her mind and say the words she wanted to say.

      A major area of treatment that must concern therapists, is supporting the gay and lesbian adolescents as they make very serious decisions concerning ‘coming out’. Depending on the family context this choice is a major turning point in a young person’s life which is already more or less painful. If the family is punitive it is a traumatic event. In all cases there are identity issues, both personal and societal that must be examined. The support systems for the gay community have recently expanded, but prejudice and religious pressures are still dominant. It is essential that art therapists become informed of the literature recently published, and inform themselves of the community services which can aid the youth find a supportive environment. The strength of using art therapy is that the image can serve as a first step toward telling the story non-verbally; the story of gender identification. The case mentioned above is an example of a girl working out her decisions in the art and conveying the message without words. When she felt more secure she could tie words to representation.

      Talking in numbers

      During adolescence the ascent from year to year marks significant changes. There are differences between being twelve and thirteen, there are changed expectations of a fifteen-year-old versus a sixteen-year-old. How the child defines these changes and their expectations that surround the transitions differ radically in every case and are influenced by many factors, such as, family, economic, and cultural conditions. By taking advantage of the concept that each year of adolescence is a metaphor for behaviors, sexuality, and individuation, I have learned to talk numbers. Numbers are neutral, they are non-perjorative.

      By ‘talking numbers’, I allow teenagers to make their own interpretation of the question of growth and change. The content of the response to a ‘numbers’ question, fits the youth’s interpretation of the question. For example, I will ask a girl of thirteen; ‘What expectations will the guys have of you when you become fourteen? How did that differ from twelve?’ This question implies an examination of the growth of sexuality and social pressures. It could also lead to a personalized interpretation that has to do more with physical maturation, responsibilities, etc. To another child I could ask; ‘Show me what age your parents see you as? How old do you see yourself ?’ ‘How will this image change when you are __ years older?’ ‘If they treat you like ten, how can you convince them that you are thirteen?’ None of these questions ask specific questions, but all of them open the door to a variety of responses that are shaped by the needs of the client. I also emphasize change by inventing reality. ‘How old are you?’ ‘Sixteen.’ ‘Did you know that sixteen is the perfect age to accomplish the changes that you want?’ (Whatever age is proposed is the ‘perfect’ age.) This invented reality invites the youth to supply an alternate outcome to a negative script (Watzlawick, 1984). I have offered the concept of a turning point, which I believe is a critical tool for anyone in therapy. Talking numbers moves the dialogue to a different plane, and by its neutral, non-judgemental language, allows the adolescent to communicate easily. If I have added a little magic to the therapeutic prescription, I am guilty.

      Figure 1.11 Middle school girl looks to the future: over the bridge to graduation. A behavior change

      Many teenagers have a clear understanding of the dilemmas of their lives, they lack the vocabulary to project their ideas. A parentified child doesn’t know that expression, but they do know how to draw an old lady of fifty, a self-image that represents their inappropriate responsibilities. Often this image is followed by a drawing of a child of five, which depicts how their parent treats them. Imagery makes it all clear; to the child, to the therapist.

      I had a thirteen-year-old parentified boy in group, where his main goal (which was conceptualized and supported by the group) was to be thirteen! Every time he began to justify why he had to be responsible for his mother, the group got on his case and yelled ‘thirteen!’ He understood that goal perfectly and was able to report how ‘old’ he had been during the week between group meetings.

      Language

      Language can be a barrier to understanding. We all hear a word in the context in which we were taught its meaning, as time passes the word cumulates further significance. There is no pure meaning to any word, since it not only has a unique intellectual significance, it also has a singular visual image activated by the vocalization. The advantage of the shared image in art therapy is one of the greatest values that can be credited to this modality. The tangible communication of the problem allows both client and therapist to focus on an art product that is before them. The mystery and miscommunication embedded in languaging is greatly reduced. I offer one example. If I were to say ‘father’, would anyone of us visualize the same person with all the emotional significance attached to that person/word? Would it not be more clear if I created a picture of my father, through collage or simple drawing, that embodied the essence of that man? I could then point out his character and his role in my life. My concept of father would become not only visible to another person, but where, when, and how, that word ‘father’ came to mean a certain set of values to me.

      The challenge of communication is described by the social constructionist theorists as ideas, concepts, and memories arising from social interchange and mediated through language. The therapeutic process is a system where the dialogue leads to a creation of a new narrative. The alternative story allows for change and hope to become a turning point for the client (Gergen, 1991; Hoffman, 1990). For adolescent treatment this approach allows the therapist to enter into a dialogue with the client in a manner that is positive and instills hope. Changing the outcome of a story does not seem daunting to a teen,