L1 - Surviving closeness, narcissism and shame in art therapy with severely damaged clients

Abstract for TAoAT 2002 by Val Huet and Neil Springham

Over the last 2-3 years of running a course on this topic, we have had a strong positive response from Art Therapists who mostly work with very damaged clients, difficult to engage with other verbal forms of therapy.

We have been aware as educators and practitioners of an apologetic stance to our own practice: art therapists have adapted their approach in order to work well with severely damaged patients.  Although the reality is that when unpacked, practice is very efficient and meets the needs of the patients, Art Therapists often feel ashamed of owning the way they adapt their practice, sometimes fearing they are providing ‘second rate’ psychotherapy.

We suggest that this feeling may have some of its roots in the dynamic of the work with clients itself. We find that narcissism and shame play a significant part in the psychopathology of these clients. Their combined effect means that the closeness implied in the therapeutic relationship is the very feeling which patients fear and wish to escape from.

We are not suggesting that these are the only aspects to consider in working with very damaged clients but that these issues, particularly shame, have been generally avoided.

Using the work of Mollon (1984), Pines (1987) and Block-Lewis (1982) we will define the key concepts of closeness, narcissism and shame.  We will think about the gaze, an important factor in the dynamic of shame and its impact on the Art Therapy process.  We will show how when unacknowledged, shame may have a detrimental effect on the therapeutic process and on the art therapist.  We will describe how the dynamics of shame are also echoed within institutions and play a big part in the clients’ reluctance to engage successfully in therapy.  We will then reflect on our own perspective in owning our differences in Art Therapy practice, rather than hiding them shamefully.

Key words: Closeness, Narcissism, Shame, Adapting Art Therapy Practice

Client group: severely damaged clients from all ages (children, adolescents, adults) and clients with Borderline Personality Disorders. 

Biographies of Val Huet & Neil Springham

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