Breakthrough Moments in Arts-Based Psychotherapy, by Aileen Webber 

How images and symbols can create profound and illuminating insights

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“I’ve been to see lots of therapists in the past and none of them have ever helped me.”  This was the opening statement of my new client Melissa, a successful accountant in her late forties who came to visit my practice one afternoon.

“What is it that you need help with?” I asked her.

“I can’t speak about it,” she said, “I’ve never told anyone before and it’s just too terrible to speak about”.

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painted stones used by clients for sand tray work

What could I do to help this distressed woman, particularly when she couldn’t communicate the problem?  I am an arts-based psychotherapist so this gave me several options. I work with clients through arts media that include: visual and mental imagery, puppets and drama, music and sound, painting and drawing, sand trays and miniatures, rituals and enactments, poetry and sculpting. After Melissa had been coming for a few sessions but still felt unable to tell me what it was she needed help with, I wondered if one of the many items in my practice-room might help her communicate the problem. “Perhaps something in this room could help you find a way to show me what it is you need to tell me without having to use words?” I suggested to Melissa.

“That feels a bit scary,” she replied, and she glanced nervously at the crowded shelves, packed with myriad objects and art materials.

She spent a long time surveying the dozens of puppets and figurines, animals and monsters, dolls and dragons, orbs and painted stones but none seemed to resonate with her. I felt a stab of disappointment. As a self-examining psychotherapist I found myself wondering if I was disappointed with myself or with what was going on for Melissa here in the room. Was it a projection of what was happening in her life or a surfacing of my own sense of wanting to help her but not being able to?

Seeing as Melissa was unable to pick an object to represent her hidden desperation, an alternative idea flashed into my mind. “How about you choose a few objects that you feel represent what it is you can’t tell me?” I found myself asking her. “You can then cover them up with one of the scarves over there and maybe that way you will feel able to show me what you don’t feel ready to tell me about yet”.

Melissa seemed reluctant even at this suggestion, but gradually she began to choose items from the shelves. She carefully selected a snake, a furry spider, a large wooden cheetah, and a few painted stones. Next she selected, just as carefully, a large black silk scarf and covered her chosen objects with it completely.

When she had finished we sat together staring at the scarf on the floor between us, now bulked up by the objects beneath. For some reason we were both spellbound. Melissa had grown pale and alert. She seemed to have slipped into a trance-like state as she focused on her creation. She was also clearly shocked, and after what felt like a very long time she began to speak, in a voice choked with emotion.

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opening the door to transformation

That’s it!” she said, trembling, her eyes staring fixedly at the scarf. “That is what I can’t tell you”.

I saw clearly from her face that she had experienced a sudden, powerful flash of insight. In fact, it felt as though we both experienced this astonishing insight at the same instant. It seemed to come prior to all intellectual understanding.

Melissa began to cry, softly at first, and then a dam broke and she sobbed. She had had an emotional breakthrough – all the more extraordinary for seeming to arrive out of nowhere. She told me later that it had felt as if the issue she could not talk about was right there with us in the room, concealed by the metaphor of the objects she had chosen (I did not yet know what they signified) and literally covered up by the scarf. Seeing her issues presented this way allowed her an entirely new emotional understanding and whilst it did not yet communicate the substance of the problem to me, it appeared to show her the weight that she had been carrying around, and the existential burden it had placed upon her.

"I determined it was necessary to coin my own term: breakthrough moments"

“I determined it was necessary to coin my own term: breakthrough moments”

Melissa had been strongly defensive when I asked what it was she found too terrible to speak about. She had been reluctant to select an object that represented the problem directly. But once she had created this image that symbolised the problem she could not discuss, almost instantaneously, everything about her understanding of herself seemed to shift.  The creation and subsequent observation of her seemingly random art-object had facilitated a crossroads, a tipping point and a breakthrough that brought about the potential for real change in her.

What arrested me most about Melissa’s revelatory work is the same thing that frequently astounds me when working with clients in arts-based psychotherapy; namely, the mystifying arrival of sudden and unexpected moments—moments in which the ground beneath us seems to shift and the client and I are transported to another realm of experience.  These profound moments, which occur time after time, have the power to bring about new realisations that change everything a client thought they knew about themselves and of their way of being in the world.

I have always intuitively believed that therapy could help a person, but once I started to encounter pivotal moments like Melissa’s, I began to believe it could have a profound, mysterious power to heal beyond anything I had previously imagined. I became very excited. If I could enable my clients to experience such profound moments, I felt sure I could make a difference to their lives in deeply significant ways and improve my efficacy as a therapist. But here was the problem. How could I ever hope to enable my clients to experience resonant and mysterious breakthrough moments when in truth I had no idea how they occurred or what they really were?

Martin's claw paintings: featured in the book

Martin’s claw paintings: featured in the book

Diane's saboteur sand tray: featured in the book

Diane’s saboteur sand tray: featured in the book

I scoured the existing literature for accounts of these profound moments in a psychotherapeutic setting. I discovered various specific terms for moments that were somewhat similar to the ones I was investigating – I-Thou” moments, tipping points, moments of meeting, sparkling moments, “A-ha” moments… But none of these quite captured the range of moments that I wished to study. I determined it was necessary to coin my own term: breakthrough moments.

I began to document these breakthrough moments that took place with my clients and certain key features about them began to emerge.  A breakthrough moment, for example, always seems to arrive suddenly. The atmosphere in the room appears to change in an instant and the accompanying feeling can be described as astonishing, profound, deep or mysterious for the client who experiences it (and often also for the therapist); it can also feel transformational—beyond the usual experience of a therapy session.

Stephen's bird drawing: featured in the book

Stephen’s bird drawing: featured in the book

Breakthrough moments are frequently accompanied by a sudden and powerful moment of clarity. They feel like an overturning of one’s previous thoughts, feelings, and ways of behaving.  But they don’t seem to be the result of any sort of intellectual reasoning or understanding.

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Simon’s snake candle drawing: featured in the book

I was able to determine some shared characteristics of these moments.  It feels as though time is standing still or that it is stretched out to become almost timeless – when in reality the breakthrough moment may be over in seconds—perhaps because the flow of internal thoughts and mindless chatter has been halted.  There is also a real intensification of the connection between therapist and client in a breakthrough moment – one that can deeply increase the mutual trust and connection. In the wake of these magical, abstruse moments the whole therapeutic relationship seems to change and become more intense.

There may be a sudden rush of emotion or a flash of new understanding. A spotlight is shone on something not previously recognised and the client understands for the first time something she did not know she knew, something that can never then be forgotten. How a client understands their own self can also change or reorganise itself at this time in new and deeply emotional ways: a breakthrough moment seems to hold the potential for change and the possibility for a new way of looking at situations or problems. From that moment onwards everything seems to shift and the way a client views the world seems to change and be transformed.

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the inclusion of arts media creates a triangular relationship

I first trained and practised as a gestalt psychotherapist and only later began to include the use of arts media in my practice.  Once I began to introduce art and art materials, I noticed a marked increase in the number of breakthrough moments that arose with my clients. The inclusion of arts media in a therapy session expands the regular nature of the therapeutic relationship (client-therapist) to a triangular relationship, in which client and therapist don’t just have a direct connection to one another, but they each also have a separate connection to the art-object (or image) that has been created. I discovered that the possibilities for a client’s radical growth and breakthrough seemed greatly increased when this triangular relationship was present.

When I first began training as an integrative arts psychotherapist, it seemed strange to be introducing a box filled with sand to my clients, or asking them to choose an object from the shelves. Why should that be helpful? But once I had gained firsthand experience of working this way as a therapist and as a client (during my training), I very clearly saw the transformative potential of this approach.

Having spent many years cataloging and documenting the myriad breakthrough moments that occurred with my clients, I started to feel ready to try and write the book that I had always wished existed – a book documenting breakthrough moments in an arts-based therapy setting; a field guide to these pivotal and transformational events that might finally answer the many dizzying questions that haunted me: What is happening in a breakthrough moment? How significant are these moments? Can the therapist do anything in particular to encourage their arrival? Do these moments always lead to change for a client, and is this a lasting change?

However much I scoured the literature, attended lectures and asked colleagues and psychologists, I couldn’t seem to find satisfactory answers to any of these questions.  There was nothing left to do. I would have to write a book and attempt to uncover the answers for myself.

As research for the book progressed, I found myself discovering that many of the new sciences (neurobiology, quantum theory, dynamical systems theory, and chaos and complexity theory) are filled with their own facts of mysterious imponderabilia that cannot be ignored, and equally cannot be rationally understood. It struck me that this holds a striking analogy with breakthrough moments. It is undeniable that such moments occur in therapeutic work and yet it is near impossible to logically understand them; art similarly addresses unspeakable and unknowable aspects of existence that make emotional sense to a spectator. The combination of art and therapeutic work together seems to spark something extraordinary.

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“I found myself discovering that many of the new sciences are filled with their own facts of mysterious imponderabilia that cannot be ignored, and equally cannot be rationally understood”

The resulting book, Breakthrough Moments in Arts-Based Psychotherapy, is my attempt at providing the answers to what is happening during these pivotal moments of therapy. As is often the case with thorough (and honest) attempts to answer difficult questions, rather than obtaining neat and clear conclusions, I found that more and more strange questions seemed to emerge. I thus chose to take a heuristic approach to the material, allowing me to also include my own personal experiences and the various diversions I took along the way.

The night before starting to write these words I had a vivid dream. I dreamed that I was having a therapy session with a girl who seemed to be about eight years old.  As this young client got up to leave the room at the end of her session, I became aware for the first time that there were many people sitting around the edges of the room, (some of whom were supervisees I recognised from waking life). It seems these onlookers had all been watching the session very closely as it took place. I turned to one of them as she was leaving and said, “I must apologise if it wasn’t a very interesting therapy session today.”  To my surprise this woman replied, “oh no, it was really fascinating!”

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“The combination of art and therapeutic work together seems to spark something extraordinary”

On reflection I can see that this dream illustrates some of the many layers of feeling involved in being a psychotherapist, and now an author. It shows both the faith and doubt I still feel (after many years) about whether I even know what I am doing as a therapist. And now that my book is about to be published, I have similar fears about whether it will be interesting or understood. Maybe my reader will find it dull, maybe they will be critical of how I work; or just maybe, like the strange but compassionate figure in my dream, they will find it interesting enough to want to step inside the therapy room and take a peek at the extraordinary work that takes place.

Aileen Webber is a Gestalt and Integrative Arts Psychotherapist who works with children and adults as a therapist and supervisor. She has a private arts-based psychotherapy practice in Cambridge. Her work has been inspired by four years of Gestalt Psychotherapy training with Helen McLean in Cambridge and four years training at the Institute for Arts in Therapy and Education in London. Prior to working as a psychotherapist she worked as a teacher of children with physical, emotional and learning difficulties and as an adviser and consultant to others working with children.

Her new book, Breakthrough Moments in Arts-Based Psychotherapy, has just been published by Karnac.

Reviews and Endorsements

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The cover of this book was inspired by the author’s vibrant dream

‘Aileen Webber has written a wonderful book, which explains the power of using the arts in psychotherapy and personal development. It is a treasure trove of practical techniques, inspiring stories, and incisive illustrations. The book convincingly links the arts and the sciences – showing how the human brain is supported, nourished, and developed by the use of symbol and story. I thoroughly recommend this book.’
– Jenny Mackewn, creative catalyst, consultant, and trainer in organisational, community and environmental development

‘This is a must-read book for those interested in the impact of creative and arts-based interventions in individual psychotherapy. Aileen Webber writes in an accessible way with a voice of personal and theoretical integration and in a spirit of curiosity, respect and wonder.’
– Anna Chesner, UKCP registered psychodrama and group analytic psychotherapist and supervisor; co-director of the London Centre for Psychodrama Group andIndividual Psychotherapy

‘The purpose of Aileen Webber’s book is to reflect deeply on important breakthrough moments in arts-based psychotherapy. In this she draws on a wide pool of knowledge in the neurological and physical sciences, as well as her extensive practical experience. As a theoretical physicist, I am extremely impressed with how accurately and appropriately she uses illuminating mechanisms and analogies to understand these pivotal moments. Her many stories are truly touching, and her success impressive.’
– Volker Heine, FRS, theoretical physicist, fellow of Clare College and Emeritus Professor at Cavendish Laboratories (Physics Department), University of Cambridge

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