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Enhancing Your Therapy with Gestalt Approaches
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Section 22
Interpreting Clients' Choice of Materials in Gestalt Art Therapy

CEU Question 22 | CEU Test | Table of Contents | Gestalt
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Betensky (1987), a phenomenological art therapist, regarded art materials as active partners that challenge the patients' senses, and stimulate both their emotional arousal and their awareness. She saw the art material painting Therapy with Gestalt Approaches social work continuing educationas becoming a part of the patients' phenomenological field. Materials can enable the patient to maintain, through them, a dynamic, interactive relationship with processes that are otherwise mostly elusive.

Rhyne (1984), a Gestalt art therapist, advocated a permissive approach in the prescription of materials in art therapy. She believed that if provided a wide enough choice of materials and ample time for experimentation, patients would spontaneously choose those materials that suited them best. She believed that art materials should be viewed as sensory stimulants that are most efficient in uncovering non-verbal sensory memories.

The developmental approach to art therapy regarded materials primarily as assessment tools. Kagin (1969) suggested that the sensory properties of the material can evoke age-specific reactions, and, therefore, could aid in evaluating the patient's developmental level.

Psychoanalytic schools of art therapy emphasized that the different media activate different levels of psychological functioning. Some support the ego-organizing capacities of the mind, some tap libidinal levels, and still others have an exploratory quality. Some media challenge a sense of mastery, whereas others provide an opportunity for fun and play. Robbins (1994) pointed out that art media could be used to explore and work through psychological polarities. For example, patients who are naturally attracted to working with hard and resistant materials that require aggressive movements could benefit from a gradual exposure to softer, more pliable media requiring milder manipulations. Robbins (1994) provided another example involving armature wire. This material can be used both to create soft-looking rounded shapes, or spiky, aggressive projections.

Therapists are encouraged to give careful consideration to the specific materials they offer their patients for art therapy. Clinicians should familiarize themselves with the various working techniques and possibilities relevant to the suggested art material so as to minimize unnecessary frustrations and enhance the therapeutic use of the material. Rubin (1978) suggested that materials should be synchronized, in terms of their properties, with the patients' needs and skills. She likened the process of familiarization with the material to being introduced to a new acquaintance. This can be done cautiously or impulsively, by applying familiar exploratory styles or by venturing with daring innovation. The material is regarded as a partner in a dialogue, a partner possessing clear traits and characteristics that require negotiation. It is incorporated into the artist's phenomenological field of the self, and becomes a link between the artist's mind and his or her sensorium.

There are several dimensions on which art material can be classified. Kagin (1969) saw materials as possessing varying degrees of pliability, ranging from fluidity (e.g., liquids) to resistance (e.g., stone). The harder it is to process and manipulate the art material, the more energy is required to produce the desired expressive end. Working with resistant materials can promote awareness concerning the limits of the material, as well as the limits of one's own capacities.

Rubin (1984) differentiated between structured and unstructured materials. She suggested that the less structured the art material is in terms of the expected outcome, the greater the likelihood for projection of intrapsychic processes. Conversely, the clearer the qualities and boundaries of the art material, the greater the likelihood of accomplishing the intended result. Materials that possess clear boundaries can, with proper structured guidance, lead to ego strengthening accomplishments. More fluid materials, such as chalk, clay, or watercolors, can facilitate work that is not dictated by physical boundaries, or confined by them. This category of materials promotes an experientially expanding experience, and can trigger a sense of loss of control. This is a potentially regressive experience that can be enhanced if the material is wet, and if it is manipulated manually, without intermediary tools (Kagin and Lusebrink, 1978).

Lusebrink (1990) classified creative art materials along the fluidity-hardness continuum. When considering two-dimensional work materials, she anchored finger paints at one end of the spectrum, followed by water colors, pastel colors, chalks, markers, and felt pen colors. She placed pencils at the opposite end. When three-dimensional artwork was considered, she classified the materials in ascending order of resistance: water-based clay; oil-based clay; wood; and stone.

Robbins (1994) classified art media as soft, brittle, breakable, hard, or sticky. He also tried to understand the rhythm and movement that the material dictates to the working artist. Not only was he interested in the degree of control that had to be exercised to effectively work with the material, but he also saw importance in synchronizing what he termed "the patient's inner and outer flow." Investment of forceful energies in the art process, such as in stonecutting and chiseling (outer flow), may trigger powerful pre-existing emotions, such as anger or crying (inner flow), that could, in turn, impede the patient's capacity to work with the material and it's structural dictates. If a resistant material, such as stone, triggered rage, it would more likely be attacked than artistically sculpted. Although engraving and carving in wood may require similar rhythm and movement as working with stone, wood's characteristics can better "guide" the patient to the correct method of working with it.

To facilitate the encounter between the patient and the material he or she is working with, the art therapist should be conscious of predictable changes in the state of the material's matter, and of the patient's possible reactions to such changes. Robbins (1994) drew attention to plaster, which emits heat as it hardens. This is a surprising physical change to many novice artists, and can even be startling to some. Plaster hardens quickly, often in the patient's presence. This can be a disheartening experience to unprepared patients, as they discover that the material does not respond any longer to shaping attempts. The consistency of clay can also change over time, and may not be as plastic and malleable as it was during previous sessions.

The patient's ability to take risks and tolerate mistakes related to mishandling of the material's properties is also worth considering in the selection of materials for art therapy. Patients who face the stubbornness and unforgiving nature of their art material may benefit from processing flexibility in decision making and attribution of responsibility in less controllable situations.
- Somer, Liora; Somer, Eli; Perspectives on the Use of Glass in Therapy; American Journal of Art Therapy, Feb2000, Vol. 38 Issue 3
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #8
The preceding section contained information about interpreting clients' choice of materials in Gestalt art therapy.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 22
Why does Rhyne advocate a permissive approach in the prescription of materials in Gestalt art therapy? Record the letter of the correct answer the CEU Test.

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Table of Contents

Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory. - March 21, 2019
Interpersonal, social, and structural stressors have been identified as key elements that explain health disparities between transgender and cisgender individuals. However, most of this research has focused on binary transgender individuals or has not differentiated between binary and nonbinary individuals; little research has examined the experiences of minority stress or health of those identifying outside the gender binary. Guided by intersectionality and drawing on a sample of 3,568 college students from the Center for Collegiate Mental Health’s 2012−2016 database—of whom 892 identified outside the gender binary—we conducted analyses of demographic and outcome measures administered in participants’ 1st counseling appointment, examining differences between cisgender, transgender, and genderqueer individuals. We found that genderqueer individuals were harassed, sexually abused, and subjected to traumatic events at higher rates than were either cisgender or binary transgender individuals, with approximately 50% of genderqueer individuals reporting one of these experiences. We found that genderqueer individuals experienced more anxiety, depression, psychological distress, and eating concerns than did binary transgender and cisgender individuals and more social anxiety than did cisgender individuals. Genderqueer individuals more frequently reported self-harm and suicidality than did any other group, with approximately 2/3 of participants’ having contemplated and nearly 50% making a suicide attempt. We extend current theorizing about minority stress (Hendricks & Testa, 2012; Meyer, 2003) to include genderqueer individuals and delineate several structural aspects of genderqueer experiences that may be responsible for these trends, including others’ lack of knowledge about genderqueer experiences and pronouns, poor access to legal and medical resources, and systemic discrimination. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
A caballo regalao no se le mira el colmillo: Colonial mentality and Puerto Rican depression. - April 18, 2019
Dignifying the colonizer and depreciating the colonized is a reflection of internalized colonial oppression (i.e., colonial mentality). The current study examined the effect of colonial mentality on depression symptoms in a sample of mainland Puerto Ricans (N = 352). A structural equation model was examined, in which colonial mentality was hypothesized to be directly and positively associated with depression symptoms. The proposed model also tested the indirect effect of colonial mentality on depression symptoms via acculturative stress. Results indicated that a full mediation structural equation model (SEM) had a better fit to the data than our hypothesized partial mediation model. Bias-corrected bootstrapping indicated that the effect of colonial mentality on depressive symptoms was mediated by acculturative stress. That is, colonial mentality increased the risk of experiencing depression symptoms in Puerto Ricans when they felt pressured to maintaining a connection with Puerto Rican culture and society and when they experienced rejection by the society they want to emulate (acculturative stress). The current results underscore the need for researchers and clinicians to consider and assess colonial mentality when conceptualizing depression symptoms among mainland Puerto Ricans. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
The development and validation of the Emotional Cultivation Scale: An East Asian cultural perspective. - April 15, 2019
Research on emotion regulation in East Asian children and adolescents is limited. One obstacle hindering the development of emotion regulation for East Asian children and adolescents is the lack of a culturally sensitive measure. To fill this gap, we have developed and validated the Emotional Cultivation Scale using samples of Taiwanese children and adolescents. In Study 1, an exploratory factor analysis (n = 341) identified two factors: Cultivating Emotion Strategies and Understanding Emotion Connotations. A confirmatory factor analysis (n = 358) confirmed this two-factor structure. Coefficient αs were .69 to .88 for Emotional Cultivation. Convergent validity was evidenced by positive associations with cognitive reappraisal and cognitive flexibility. Discriminant validity was supported by a nonsignificant association with suppression. Concurrent validity was revealed by positive associations with positive affect, basic psychological need satisfaction, gratitude, responsiveness from teachers, responsiveness from parents, and academic self-efficacy. Incremental validity was evidenced by the finding that emotional cultivation significantly accounted for an additional 2 to 20% of the variance in predicting cognitive flexibility, positive affect, basic psychological need satisfaction, gratitude, responsiveness from teachers, responsiveness from parents, and academic self-efficacy above and beyond cognitive reappraisal and suppression. Results from the multigroup analysis further indicated factor loading invariance and validity invariance between boys and girls and between elementary and middle schools. The factor structure was cross-validated by a clinical sample of Taiwanese children and adolescents (N = 161) and their parents in Study 2 (N = 159). The counseling implications were discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Cognitive and affective expectation of stigma, coping efficacy, and psychological distress among sexual minority people of color. - May 30, 2019
There is a paucity of research on the potentially distinctive functions of cognitive and affective expectation of stigma. Moreover, expectation of stigma has received limited research attention with sexual minority people of color who may anticipate interlocking heterosexist and racist stigmatization. In this study, data from 209 sexual minority people of color were analyzed using path analysis and bootstrap procedures to test direct and indirect relations among perceived discrimination, expectation of stigma, coping self-efficacy, and psychological distress. Analyses disaggregated expectation of stigma into its cognitive (i.e., perceived likelihood of stigma) and affective (i.e., worry and anxiety about stigma) components. Results revealed that perceived discrimination had a unique direct link with psychological distress. In addition, perceived discrimination was linked indirectly with greater distress through affective expectation of stigma and problem-focused and emotion-focused coping self-efficacy. These findings suggest the importance of social justice interventions to reduce discrimination. Additionally, the findings suggest that interventions should attend to affective worry and anxiety about stigma and foster problem-focused and emotion-focused coping self-efficacy. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Surviving and thriving: Voices of Latina/o engineering students at a Hispanic serving institution. - April 15, 2019
This study examined factors that played a role in Latina/o undergraduate students’ persistence in engineering at a Hispanic serving institution (HSI; N = 10) using the consensual qualitative research method (CQR; Hill, Thompson, & Williams, 1997). Data analyses resulted in five domains: institutional conditions, additive intersectional burdens, personal and cultural wealth, coping skills, and engineering identity. Participants described how they persisted in the face of stressors, citing specific coping skills they developed over time as well as general personal and cultural strengths they carried with them into their pursuit of engineering. Although the structures of the students’ institution were generally described as supportive, Latina participants reported experiences with gendered racism that created added barriers to their persistence in engineering. Supportive institutional conditions, personal and cultural assets, and adaptive coping strategies appeared to facilitate the development of a strong engineering identity, which helped to solidify students’ sense of belonging, pride, and commitment to complete their degree. Results highlight the need to address intersecting experiences of privilege and oppression to promote access and equity for Latinas/os in engineering. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

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