Case Study: Using Art Therapy for a Client with Identity Issues

NOTE: THE INFORMATION BELOW IS TAKEN FROM OUR ART THERAPY GUIDEBOOK – DEVELOPING THE SELF

This guidebook can be found in the Art Therapy Resources store here: Art Therapy Guidebook – Developing the Self

Each of us is influenced by society and social relationships along with our individual experiences. We respond to situations differently from anyone else. This response is a reflection of the experiences perceived through our own personal beliefs and identity. Our personal identity is what defines our experience of an event in a unique way compared to someone else.

To understand self requires an exploration of social influences, personal experience and the effect of interpersonal relationships, particularly from an early age when an individual’s personality is being developed.

Having an understanding of the self can provide insight into why some clients struggle to overcome adversity, while others are able to use adversity as a challenge for positive outcomes. This perspective provides insight into how a client may interact with their therapist and if they will view the therapeutic process as helpful or threatening.

As we move through the lifespan, our experiences become increasingly complex through marriage, divorce, employment, death, and other positive and negative events. The ability of someone to navigate through these experiences depends on the foundations of personal identity and self-worth that has developed from earlier years.

If these foundations are built from an experience of stability and safety, this will increase the chances of a person responding to events with resilience. If the foundations of personal identity are formed from an experience of instability, chaos, and trauma, this results in the person dealing with events on a reactionary basis that is constructed to protect the person. This protection can present as defense mechanisms which can be harmful to resolving conflict.

An individual’s identity is usually defined by various social roles that the individual is labeled with. A few examples of identity are listed below:

• Work – dentist, lawyer, nurse, driver, teacher, leader, colleague
• Interests – musician, artist, runner
• Inner self – religion, meditation, cultural leader, personal development, ideologies
• Relationships – mother, father, daughter, son, spouse, sibling, friend

You may have experienced or heard a friend or client make a statement such as “I’m not sure who I am anymore”. This statement is usually made at a time of crisis when the individual is feeling separated from aspects of their identity. This can occur if you have been made redundant from your 20 year teaching career, or when your children leave home as adults, or when you go through a divorce. All of these critical life events test the connection you have with this aspect of your life and question how your identity is defined.

This separation from your identity can happen unexpectedly to you or be a deliberate choice by you. The dissociation can occur through significant life events, emotional maturing or existential predicaments. Regardless of how the separation occurs, it will force you to reconsider your beliefs and attachments to your identity.

The most common outcomes from an ‘identity crisis’ are depression and anxiety. These feelings can be exacerbated if the person has a low self-esteem. While an individual is progressing through the stages of identity loss, they may exhibit behaviours similar to those with depression and anxiety which can negatively impact interpersonal relationships.

If an individual views a third party as responsible for their current crisis, they may express emotions of anger, blame, and resentment. This is common when individuals lose their job or go through a divorce. The workplace or spouse becomes an outlet for anger and blame.

Everyone reacts differently to these life events. You may have a client who expresses their emotions outwardly. Alternatively you may have a client who suppresses their emotion, yet still feels intense emotions of anger inside.

HOW ART THERAPY CAN HELP WITH IDENTITY:

• understanding previous identity connections
• defining future identity connections
• processing emotions regarding third party blame
• processing emotions regarding anger towards a third party
• reframing blame for the ‘identity crisis’
• assisting with conflict and avoidance issues
• assisting with depression outcomes
• assisting with anxiety outcomes

To learn more about the self, identity, and how art therapy can help develop these aspects of an individual, you may like to purchase our Art Therapy Guidebook – Developing the Self

This guidebook provides therapists with a foundational understanding of self and how the self may influence your client’s response to art therapy.

As a therapist, you can help your client explore the primary influences behind their identity and how to deal with a crisis in identity.

Understanding how an individual experiences events can help broaden your understanding of your client’s perspective. To gain this understanding it is useful to explore how your client perceives “self” in situations of conflict.

You can help your client gain perspective on the development of past self and current self, as well as initiate goals for influencing the construct of a positive future self.

This guidebook explores the impact of interpersonal relationships, including the influence of parenting styles of the development of self-esteem.

Using this guidebook, you will be able to work with your client to combat negative self-beliefs and self-criticism.

After learning the process of discovering the self with your client, you can use this guidebook to help your client construct a positive outlook for the future self by exploring self-awareness, self-acceptance, self-worth and self-esteem.

A significant portion of the guidebook is dedicated to self-esteem with an analysis of the types of self-esteem that exist, along with how life experiences influence levels of self-esteem.

Having a solid understanding of the development of self and self-esteem is essential when dealing with clients who are experiencing:

• Anxiety
• Depression
• Eating disorders
• Personality disorders such as Borderline Personality Disorder
• Difficulty with family relationships

Included in the guidebook is a Self-Esteem Scale based on the Rosenberg self-esteem scale. The scale will provide an indication of the types of statements you may want to explore with your client in discussion with art therapy activities.

This guidebook will help you explore short term and long term goals with your client with a view to developing a healthy level of self-esteem.

You will find a list of 20 art therapy exercises that you can use with your client to explore the many facets of self and self-esteem.

Also included in the guidebook is a list of 50 general art therapy interventions across 9 themes relating to the self.

This guidebook is direct and easy to understand. The materials presented in the guidebook are written based on current scientific literature available.

Included in the guidebook is a comprehensive reference list of publications that were used to form the content of this workbook.

The contents of this guidebook includes:

INTRODUCTION TO SELF

• Early development of self
• Personality theory
• Past, present, future self

PAST SELF

• Identity
• Core Self
• Interpersonal relationships

PRESENT SELF

• Autobiographical self
• Self-beliefs
• Self-criticism

FUTURE SELF

• Self-awareness
• Self-acceptance
• Self-worth
• Self-esteem
• What is self-esteem
• Experiences that influence self-esteem
• Gender differences and self-esteem
• Benefits of high self-esteem
• Maintaining self-esteem
• Self-esteem and lifespan

TREATMENT

• Main phases of therapy
• How to assess self-worth
• How to assess self-esteem
• Types of treatment
• Treatment goals

ART THERAPY EXERCISES

• 20 Art Therapy Exercises

GENERAL ART THERAPY INTERVENTIONS

• (9 themes and 50 interventions)
• How art therapy can help with identity
• How art therapy can help with core self
• How art therapy can help with interpersonal relationships
• How art therapy can help with autobiographical self
• How art therapy can help with self-belief
• How art therapy can help with self-criticism
• How art therapy can help with self-awareness
• How art therapy can help with self-acceptance
• How art therapy can help with self-worth

WORKBOOK REFERENCES

To learn more about the self, identity, and how art therapy can help develop these aspects of an individual, you may like to purchase our Art Therapy Guidebook – Developing the Self

• Name: Emily
• Age: 15
• Summary of sessions to date: Emily had recently moved to a new town and was having trouble integrating into her new school and establishing a new circle of friends. She had begun to withdraw from participating in activities and hobbies that she usually liked. She had started attending art therapy sessions on a recommendation from her GP to help deal with the changes in her life including her recent move as well as changes in her development as a teenager.

Emily recently discussed how she had stopped engaging in some of her previous hobbies and interests such as drawing, skating, and collecting her favourite doll. She thought all of these hobbies were too young for her now and she had nothing interesting left to do. She felt this made her uninteresting and was the reason why she couldn’t make any new friends.

This exercise is designed to help clients understand the nature of human development and transformation. This client had expressed an interested in drawing, skating, and collecting dolls but felt these hobbies no longer applied to her because they were too young for her as a teenager. This exercise can help the client understand how parts of us can change as we age and develop more mature perspectives in our life.

INSTRUCTIONS:

• Discuss with your client the type of art supplies they may like to work with in this session. This exercise would suit drawing, painting or collage to help illustrate the concept of transformation and development through images.
• Ask your client to reflect on an activity, hobby, or interest that has formed a significant part in their life. Ask them to reflect on the activity itself and the benefits they have derived from the hobby/interest including the impact on the client’s identity. For example as an artist, skater, and collector.
• Ask the client to create an artwork that reflects the benefits the client has gained from that hobby/interest.
• Discuss with the client the potential ways the hobby/interest could be transformed or changed into another hobby/interest that would suit them at their current stage in life. How might these changes be made?
• Ask your client to represent their new view of their hobby/interest in a second artwork.
• Discuss with your client the potential benefits of modifying their hobby/interest and how this might impact their enjoyment of the hobby/interest. This can also open a discussion about changing interests over the lifespan of an individual and how the benefits of these activities affect our identity.

SUPPLIES USED INCLUDE:

• Angora Watercolour Pan Set http://amzn.to/2hLxtf1
• White Sharpie Paint Pen X-Fine http://amzn.to/2hCZcSZ
• White Sharpie Paint Pen Medium http://amzn.to/2j36ChW
• 18 Brush Pens Set For Drawing Watercolor Pen http://amzn.to/2BmbXrD
• Simply Simmons Brushes http://amzn.to/2hramK7
• XL Watercolour Pad (trimmed to 12×12 inch) http://amzn.to/2gGdja2
• Water Bottle

Emily could see from the artwork she created that there were benefits that her hobbies gave her including the formation of her identity as someone who likes to learn and undertake interesting activities. Emily was able to see that her hobbies and interests are continuously evolving and changing as she matures and discovers new things. Emily mentioned that finding new hobbies could help her find new friends.

This case study represents a snapshot of the client’s progress in treatment. The exercise in this article could be used as written or as a guide for new and original tasks developed by the Art Therapist. Responsibility for treatment resides with the individual therapist who understands their clients specific needs. The art therapy exercise should not be viewed as a pre-defined directive on how to treat a client that presents with a specific range of problems.This art therapy exercise will help build a database of knowledge to draw upon when helping your client. Art Therapy is associated with psychotherapy techniques, however each therapist often approaches therapy with their own foundation of psychological interventions, whether it be psychotherapy, CBT, DBT or other methods.