Case Study: Using Art Therapy for a Client with Guilt

There has been much discussion recently about the impact of carrying shame and guilt. It’s important to define the difference between shame and guilt. Shame is how we think about ourselves personally whereas guilt is more associated with our specific behaviours. We may feel guilty about yelling at someone but feel shame for feeling that we are a perpetually angry person.

Both shame and guilt are linked strongly with judgment specifically about ourselves and also experiencing judgment from others. To combat our own feelings of judgment connected with shame and guilt, we need to develop the ability to extend compassion to ourselves.

This implies that guilt isn’t necessarily a bad thing for people as it can often motivate us to change behaviour or make amends with another person. This is usually most helpful when the experience, insight, and behavioural change occur within a short time frame after an event.

If guilt continues over a longer period it can eventually lead to shame and decreased self-esteem. This decrease in self-esteem can then impact the desire of the individual to see help, accept support, and change behaviour.

Guilt is considered a relational emotion as we usually feel guilt in relation to another person. Life events and experiences may affect our overall emotions of sadness and loss, however, we feel guilt when we feel a disconnect or inconsistency between our behaviour and our morals or expectations of ourselves and how we interact with others.

Guilt is almost always a result of ingrained beliefs based on messages we were given as children about how we should interact in specific relationships. This is especially relevant between parents and children where high expectations are placed on specific behaviours in that relationship.

REASONS FOR GUILT

Some of the most common situations where feelings of guilt can be dysfunctional:

• Addiction
• Abuse – by the abuser and the victim
• Relationship issues – infidelity and divorce
• Parenting – non supportive or absent parenting
• Crime – by the perpetrator and the victim
• Trauma – survivor guilt
• Cultural expectations – family or religious demands on our behaviour

HOW ART THERAPY CAN HELP WITH GUILT

The therapy process can help individuals who are overwhelmed by guilt and find it difficult to move from the past immobilized by guilt to the future where change can be made.

Through art therapy, an individual can:

• Acknowledge the guilt
• Gain insight into the origins of guilt
• Give voice through art to the personal feelings of guilt
• Give voice through art to the memories associated with an event
• Reframe emotional guilt about an event that occurred

• Name: Joe
• Age: 68
• Summary of sessions to date: Joe had been attending art therapy sessions as part of his recovery of a medical issue. He had been experiencing significant emotional distress over his illness and loss of mobility. His medical issue had changed his ability to participate in life and he had been working with his art therapist about how he would miss out on milestones in the future due to his illness.

As a result of Joe’s recent discussion with this art therapist about future events he would miss out on, this caused him to reflect on past experiences he had also missed out on. This included spending time with his children when they were younger. Joe had spent the majority of his time at work including hours in excess of what he was required to do.

As Joe’s illness has caused him to reflect on many personal things in his life, it also caused him to reflect on the relationship he has with his children. He finds it difficult to share his worries and concerns about his illness with his children.

This art therapy exercise is designed to help the client connect their emotions and any physical manifestations to their experience of guilt. Before the client can work on changing their beliefs or behaviour, it’s useful to gain insight into the emotional experience of the client and how this can manifest itself in physical feelings.

INSTRUCTIONS:

• Discuss with your client the type of art supplies they may like to work with in this session. Your client may wish to use collage techniques and collect images from magazines or free clip art from online sources (eg. http://www.freepik.com/). Alternatively your client can use drawing or painting materials.
• Ask your client to reflect on a current situation that they find generates conflict or difficult emotions between themselves and another person
• Ask your client to identify the primary emotions and physical feelings that arise as they recall a recent incident or difficult situation
• Ask your client to create an art work that reflects these physical feelings and emotions that arise in this situation
• After the client has created their art work, discuss with your client the impact of the situation on their emotions and physical feelings. Are these emotions preventing the client from moving forward in resolving any conflict with the other individual or internal negative beliefs.

SUPPLIES USED INCLUDE:

• Liquitex Acrylic Paint Set http://amzn.to/2gFVRRD
• Permapaque Fine Point Black Pen http://amzn.to/2lLOZEX
• Simply Simmons Brushes http://amzn.to/2hramK7
• XL Watercolour Pad (trimmed to 12×12 inch) http://amzn.to/2gGdja2
• Water Bottle
• Art Therapy Resources Collage Sheet

Joe was able to identify from this art work that the overall emotion he felt was guilt and it was eating away at him. Joe felt the guilt was consuming him and his inability to deal with his emotions was paralyzing him. Joe felt that he was unable to discuss his current concerns about his illness was due to the guilt he felt over his parenting when his children were younger.

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.