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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 Answer Booklet | Table of Contents | Gestalt
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

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.

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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 Answer Booklet.

 
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Latina/o adolescents’ family undocumented-status disclosures directed at school counselors: A latent transition analysis. - April 19, 2018
For adolescents from undocumented families, school counselors may serve as a resource to draw upon for support should the adolescents decide to disclose their family status. In this study, we identified psychological factors that were associated with adolescents’ decisions to disclose (or not) their own or a family member’s undocumented status to a counselor and examined corresponding mental health implications. Utilizing latent transition analyses with a sample of 410 Latina/o immigrant high school students, four profiles emerged in Wave 1: (1) indifferent nondisclosers, (2) concerned revealers, (3) anxious revealers, and (4) secure revealers. By Wave 2, we identified the same profiles, except anxious revealers were no longer present, and anxious nondisclosers emerged as a new profile. At Wave 3, we only identified three profiles: (1) indifferent nondisclosers (2), concerned revealers, and (3) anxious revealers. As Latina/o immigrant students experienced greater fear of deportation in the middle and end of the year, they were more likely to be concerned revealers (i.e., reporting moderate perceived risk of disclosing, low communication efficacy, and moderate levels of disclosure) compared with most profiles. Anxious revealers reported higher levels of depressive symptoms than several other profiles in the beginning of the year, and concerned revealers reported higher levels of depressive symptoms than several other profiles in the middle and end of the year. This study emphasizes the importance of considering the diverse experiences of family undocumented adolescents, and it sheds light on the extent to which family undocumented adolescents confide in a counselor. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
An examination of the Psychology of Working Theory with racially and ethnically diverse employed adults. - April 19, 2018
The present study tested key tenets of the Psychology of Working Theory (PWT) in a sample of 526 racially and ethnically diverse employed adults. The authors investigated how economic resources and marginalization predicted decent work through experiences of work volition and career adaptability. Support for the hypotheses was mixed. There was a direct, negative relation between marginalization and decent work; a direct, positive relation between economic resources and work volition; and a direct, negative relation between marginalization and work volition. There was a positive relation between work volition and career adaptability as well as with decent work. Work volition was also found to significantly mediate the relations between marginalization and economic resources to decent work. These results suggest that the primary reason why greater economic resources and lower experiences of marginalization predict engaging in decent work is attributable to an increased sense of choice in one’s career decision making. Results suggest the need for further investigation using the PWT to understand how racially and ethnically diverse employed adults secure decent work. Practical implications are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Testing the predictions of the existential constructivist theory of suicide in a college student sample. - April 19, 2018
There is a lack of empirically supported theories explaining suicidal ideation and few theories describe how suicidal ideation can be prevented in the context of normative human development. Rogers (2001) proposed an existential constructivist theory of suicide (ECTS) wherein existential distress and the inability to reconstruct meaning from adverse life events contribute to suicidal ideation. The ECTS includes a distinct focus on meaning reconstruction from adverse life events, which is congruent with existing research on college students and developmental frameworks used by counseling psychologists. Thus, in the present study, we tested the predictions of the ECTS in a college student sample. We collected data online from 195 college students (i.e., ages 18–25) attending a large, Midwestern university and analyzed the data using structural equation modeling. Findings provided partial support for the original ECTS. Post hoc analyses of an alternate ECTS model indicated that existential distress mediated the negative association between meaning reconstruction and suicidal ideation. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Transgender people of color’s experiences of sexual objectification: Locating sexual objectification within a matrix of domination. - April 19, 2018
The purpose of this grounded theory study was to investigate transgender people of color’s (TPOC’s) sexual objectification experiences (SOEs). Fifteen TPOC were interviewed about their experiences with sexual objectification. Using intersectionality and objectification theories as our research paradigms, results suggested that participants’ SOEs were shaped by the intersections of cissexism, sexism, and racism, and that participants experienced various levels of privilege and oppression based on their specific identities. Results revealed similarities with previous sexual objectification research as well as unique sexual objectification experiences for TPOC, including racialized sexual objectification, fetishization, genital- and gender transition-based comments, and body policing. Results also suggested that self-objectification may manifest as a desire to affirm one’s gender identity and result in physical safety anxiety. TPOC may engage in body surveillance to achieve transgender congruence and reduce potential victimization experiences. Mental health practitioners are encouraged to attend to how intersections of cissexism, sexism, and racism may encourage SOEs, and the ways in which such experiences may impact TPOC. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Predicting PTSD severity from experiences of trauma and heterosexism in lesbian and bisexual women: A longitudinal study of cognitive mediators. - April 19, 2018
Sexual minority women (SMW) are at high risk of trauma exposure and, subsequently, the development of posttraumatic stress disorder (PTSD). The authors extended a theoretical model explaining the higher risk of mental disorders in minority populations to the maintenance and exacerbation of PTSD symptoms among young adult SMW specifically. This study used observational longitudinal data from a sample of 348 trauma-exposed 18- to 25-year-old individuals assigned female sex at birth who identified as either bisexual (60.1%) or lesbian (39.9%) and met screening criteria for PTSD. Participants identified as White (82.8%), Hispanic/Latina (12.4%), American Indian/Alaska Native (13.5%), Black/African American (13.8%), and/or Asian/Asian American (4.9%). The authors investigated whether distal stressors (i.e., criterion A traumatic events, daily experiences of heterosexism) produced proximal stressors (i.e., trauma-related cognitions, internalized heterosexism) that maintained or exacerbated PTSD symptoms. Findings indicated that daily heterosexism longitudinally predicted trauma-related cognitions (i.e., cognitions related to the self, world, and self-blame). Internalized heterosexism and cognitions about the self longitudinally predicted PTSD symptom severity. In addition, a significant indirect effect was identified between daily heterosexism and PTSD symptoms via self-related posttraumatic cognitions. These findings suggest that exposure to minority-specific distal stressors appears to promote nonminority-specific cognitive processes that, in turn, may maintain or exacerbate PTSD among young adult SMW exposed to trauma. Clinicians should consider addressing daily heterosexism in young adult SMW presenting with PTSD and evaluate how these experiences might promote clients’ global, negative views regarding themselves. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

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