A Brief History of Art Therapy

If one could name a grandfather of art therapy, then that name would be Sigmund Freud. Freud's theory of psychoanalysis influenced art therapy pioneers, Margaret Naumburg and Edith Kramer, to employ artmaking to enhance its therapeutic processes. While Naumburg focused on enhancing verbalization and transference through symbolic communication, Kramer focused on enhancing sublimation through creative work. This distinction is important because Naumburg retained a traditional psychoanalytic focus on revealing unconscious conflict in relationship, while Kramer shifted the focus to strengthening a mature ego defense to better cope with unconscious conflict autonomously. This put at stake the notion of therapy as founded in verbalization and transference in favor of sublimation.

Freud's theory is built on the assumption that within the human psyche there exist conscious and unconscious thoughts. According to Freud (1962), the psychic structures containing these thoughts are the id and the ego. The id encompasses basic pleasure-seeking instincts, while the ego acts as the moderator of those instincts. Id impulses are not always appropriate to society or fulfilled in life, so there is a constant pressure to modify them to better suit reality. This conflict between the drive to fulfill id impulses and the pressure to modify them becomes internalized within the ego, which enacts defenses to cope with the frustration, ranging from pathological to mature. A neurosis is the result of unconscious conflict between the id and the ego, when the anxiety resulting from pathological ego defenses becomes severe enough to bring a patient into treatment.

With psychoanalysis, Freud established a method by which patients could free themselves from their neuroses by making their unconscious conflict conscious. This was accomplished through the complementary processes of verbalization and transference, with the ultimate goal of developing insight and using a mature ego defense, such as sublimation, to cope with the inevitability of psychic frustration.

Verbalization is the process of giving conscious form to unconscious thoughts. Freud (1960) distinguished between two types of unconscious thoughts: preconscious ideas, which are latent yet fully capable of becoming conscious; and unconscious ideas, which are repressed and cannot become fully conscious without the help of psychoanalysis. The unconscious ideas are "worked out upon some sort of material that remains unrecognized," while the preconscious ideas are linked to perceptions, particularly "verbal images" (p. 21). The difference between these two types is a connection to language. Within psychoanalysis, patients are encouraged to notice and communicate to the analyst every notion that passes through their mind without suppressing an idea because it is unimportant, inappropriate, or nonsensical (Freud, 2010b). This free association allows hidden material to reveal itself, transforming unconscious ideas into conscious words.

Verbalization allows patients undergoing psychoanalysis to express and gain awareness of transference. Freud (2010c) defined transference as strong emotions, whether hostile or affectionate, generated towards the person of the therapist that are not justified by the situation. Rather, these emotions originate from earlier experiences and are re-experienced under the conditions of treatment. Patients develop insight when they realize their feelings do not originate in the present situation and are not intended for the person of the analyst but merely repeat what happened to them at some former point in time. Repetition transforms into recollection, and the locked compartments of psychic life are opened up.

According to Freud (2010d), this new edition of an old conflict creates a transformed neurosis in place of the former with the therapist at center as its object. Under this new situation, the patient would like to behave as they had originally, but the therapist compels them to make a different decision. Therefore, the decisive part of the cure is accomplished by means of a relationship, with transference as "the battlefield on which all the contending forces are to meet" (para. 10).

Once psychoanalysis is complete, the patient's newly revealed conflict can now arrive at more useful applications, primary of such is sublimation. According to Freud (2010a), sublimation is the mature ego defense by which instinctual energy is redirected towards socially valuable goals, including that of artistic expression. Freud believed that, to sublimation, humanity owes its highest cultural achievements. However, he warned against completely abandoning the original animal part of our natural impulses in favor of greater and greater assimilation, as this would have "all the evil effects of a robbery" (para. 8). In other words, the persistence of compromise may also lead to neurosis.

Naumburg (1987) was a follower of Freud's and used his theory as the base for her dynamically oriented art therapy. While Freud never asked his patients to depict their unconscious lives, Naumburg encouraged her patients to create spontaneous imagery as a form of "symbolic communication" (p. 1). She believed symbolic communication could more easily circumvent the difficulties of speech and bypass conscious ego censorship. To her, symbolic communication within art therapy enhanced the psychoanalytic processes of verbalization and transference, as unconscious conflict was "frequently expressed more directly in pictures than in word" (p. 1).

Verbalization