in the education of children and suggested the alternation of study and play in working with children (Flake, 1988). In the 1600s, “writers such as Robert Burton, author of The Anatomy of Melancholy (1621), talked about the role of the imagination in both psychological illness and health” (Coughlin, 1990, p. A9). One of his premises was that individuals who were imaginative and creative were more likely to be healthy. They could respond to both comedies and tragedies and thereby keep a better balanced and realistic perspective on life.
The integration of health and the arts was exemplified in the work of 17th-century physicians such as Tommaso del Garbo, who advised his patients that one way to avoid the plague was to keep a positive mind-set and to listen to music (Peters, 2001). His belief in the healing power of music was apparently part of the culture of the day, as plays such as those written by William Shakespeare demonstrate. Likewise, the poetry of meditation in 17th-century England arose at this time with an emphasis on health and wholeness. Poets such as Robert Southwell, John Donne, and George Herbert practiced meditation to become more sensitive to the images within themselves, which they then expressed in verse (Martz, 1962). Thus, concentration led to art, which led in turn to further exploration and discovery of the self.
By the time of the Industrial Revolution in England (the 18th century), the use of the arts in the service of healing had expanded. Reformers such as Philippe Pinel in France, Benjamin Rush in the United States, and William Tuke in England stressed the humane treatment of mental patients. A form of counseling known as moral therapy was begun. In this approach to treatment, individuals with mental disorders were sent to country retreats to commune with nature, where they received individual attention, including occupational training and special involvement in arts such as reading, music, and painting. It was in this type of an environment that Vincent van Gogh, the famous Impressionist painter, spent part of his life as an adult. Overall, this approach proved to be beneficial but was quite time consuming and expensive. Thus, it was relatively short lived in Europe and the United States. Yet despite the brief lives of some forms of art treatment, the power and impact of the arts continued. Music, for instance, was seen as an adjunct to the practice of medicine in many cultures throughout the world (G. N. Heller, 1985). It is still valued in many medical settings: Soft, soothing music is often played in the background of physicians’ offices, and surgeons may play music that calms and inspires them when they are operating.
The Arts in the 20th and 21st Centuries
In the 20th century, the use of the arts in counseling increased significantly. One of the reasons for this was the work of Sigmund Freud. It was Freud who first probed the influence of the unconscious through the exploration of dreams and humor. His systematic treatment made it possible for others to emulate many of his methods, such as the inducement of catharsis. More important, Freud set the standard for incorporating artistic concepts into his therapeutic work.
Creative Reflection
Why do you think moral therapy has not been reinstated as a major treatment for those who suffer mental distress? How would you go about bringing this approach back? What changes would you make?
Freud found the fiction of Dostoyevsky, Sophocles, and Shakespeare, the sculpture of Michelangelo and Leonardo to be the inspiration for his theories. It was not his formal medical training, as much as his readings of King Lear, Hamlet, Oedipus Rex, and The Brothers Karamazov, that formed the cornerstone of his theories. (Kottler, 2017, p. 73)
The work of Carl Jung (1964)—in particular, his examination and use of universal archetypes, such as mandalas—also made the arts more attractive to researchers and innovators in counseling. Mandalas are symbols of completeness and wholeness, most often circular (see Chapter 4 for further explanation). As Jung (1933) stated, “The psychological work of art always takes its materials from the vast realm of conscious human experience—from the vivid foreground of life” (p. 157). Throughout his life, Jung continued to draw and paint, portraying his dreams in writings and through illustrations that he sometimes carved in wood and stone. He felt that psychological health was a delicate balance between the demands of the outer world and the needs of the inner world. To him, the expressive arts represented an important avenue to the inner world of feelings and images. He came to see the unconscious mind as a source of health and transformation (Allan, 2008). Thus, through the influence of Jung, art and creativity became more valued as ways of understanding human nature in our culture.
In addition, the creative genesis of Jacob L. Moreno (1923/1947), the founder of psychodrama, fostered the use of enactment to work through pain and achieve balance. Moreno originated numerous psychodrama techniques to help clients become more self-aware and make insightful breakthroughs. All of his innovations have an artistic dimension, but among the most notable are the following:
Creative imagery, in which participants imagine pleasant or neutral scenes to help them become more spontaneous
Sculpting, during which participants nonverbally arrange the body posture of group members to reflect important experiences in their lives with significant others
Monodrama, during which participants play all the different parts of themselves
Role reversal, during which participants literally switch roles with others
Overall, a major factor in the growth of the arts in counseling during the 20th century was the power of the personalities who ad vocated for them. In addition to the writings of the theorists already mentioned, those of Abraham Maslow, Rollo May, Arnold Lazarus, Virginia Satir, Bunny Duhl, Peggy Papp, and Cloé Madanes emphasized the importance of counseling as an artistic endeavor and as a profession that can make a difference through the use of the arts. Research emphasizing the results of specific arts-related strategies and interventions also resulted in increased acceptance of artistic components in helping relationships.
Another important reason why the use of the arts and artistic methods achieved prominence in counseling in the 20th century has to do with the events following World War II. For example, veterans of the war were often in need of extended care for the traumas of combat. In addition to the traditional talk therapies, mental health practitioners began developing new approaches to working with those who were impaired. These included the use of some arts, such as drawing or painting, music, and literature. In this creative atmosphere, clients were helped to identify and work through pent-up emotions. Interest in the arts as an adjunct to traditional mental health practices thereby gained new recognition and acceptance. Furthermore, professional arts therapy associations were formed. Some of these, such as the American Dance Therapy Association, advocated using the arts in the service of counseling in a professional way.
Thus, out of the development of theories and the treatment of clients following World War II, arts therapies attracted more interest and gained more acceptance as unique and valuable disciplines. In the 1960s, universities began designing degrees in the arts therapies, such as dance and the visual arts. From the graduates of these programs came new enthusiasm and energy to develop standards and guidelines for practice. By the beginning of the 21st century, most art therapy associations either registered or certified their members as qualified practitioners and were attempting to license or had succeeded in licensing their members as mental health practitioners in many states. Uniting many professionals in the field was the International Expressive Arts Therapy Association (www.ieata.org/), which held conferences in many countries, including the United States.
Creative Reflection
Reflect on how your interest in creativity and the creative arts has grown over the years. What art forms
