Visual & Verbal Mismatches
A mismatch between a client’s art products and her/his response to them could signify a thought disorder, a processing disorder, or an organic condition. Or it could signify denial…or deceit. Responding to a client’s mismatched visual products and verbal statements takes some training, as it’s important to address this delicate issue in a manner that’s appropriate to the particular situation. “What you permit, you promote” is the adage, so it’s crucial to understand what it is that you’re permitting and promoting—and why. Sometimes addressing the discrepancy between an individual’s images and words is actually contraindicated, particularly within the context of a group. On the other hand, being overly accepting of a client’s images in a group setting may be counterproductive and result in the perpetuation of the client’s issues as well as in the endorsement of these issues among other group members.
When I worked at an adolescent residential treatment center, my group sessions occasionally resulted in the creation of facility-forbidden things like a marijuana leaf, a bong, or a shroom. Because of their illicit status, these art products were respectively referred to by their creators as the Canadian flag, a birdfeeder, and a bonsai tree. The makers of these things did not appear to have a thought disorder, a processing disorder, or an organic condition. However, there were definite elements of denial and deceit present.
Unconditional positive regard dictates that the therapist separates undesirable behaviors from the person engaging in them. But that doesn’t mean the therapist has a duty to downplay such behaviors. Respect dictates that the therapist takes a person seriously and holds her or him accountable for her or his actions, both positive and negative. Thus confrontation has its therapeutic applications.
So I called out the marijuana leaf, the bong, and the shroom. No one was ever happy to have her or his art compared to drug paraphernalia, but these were easier confrontations than would have been the case if the art hadn’t been involved. Art allows for an externalization of internal material, including fantasies, wishes, impulses, and drives. Because these confrontations were about art products rather than about personal choices and actions, they were indirect, less threatening, and allowed for shame control. “Are you aware that your birdfeeder appears to resemble a bong?” comes across much differently than “Why did you make a bong?” Externalizing urges through these illicit images also made it safer for group members to reveal thoughts of relapse prior to a weekend pass—something they censored in their verbal therapy groups. And once the thoughts were put out there in an art form, they could be responded to and dealt with.
Interestingly, the birdfeeder-bong was called out by other group members, as they perceived its creator to be lying not only to me, but to them. Other illicit images were tolerated in the groups in which they arose, suggesting that those particular groups had not reached a level of safety where unsafe content could be addressed by peers; it was up to me as the group facilitator to offer protection by making sure that such things were brought out into the light.
When dealing with psychological safety in a group setting, it’s possible that inconsistencies between a client’s art products and her/his responses to them might have to be addressed. But like I said, responding to a client’s mismatched visual products and verbal statements takes some training; not all mismatch scenarios call for pointing out the discrepancies, and even when such a pointing out is called for, there are preferred ways to do this—and not-so-preferred ways. All situations have their own context and must be dealt with on a case-by-case basis to ensure the likelihood of a therapeutic outcome. While this article is not intended cover all those case-by-case possibilities, hopefully it provides you with a starting place for thinking about how you manage your encounters with clients whose images and words don’t sync. Remember: what you permit, you promote. When in doubt about what it is that you’re permitting and promoting and why, seek professional consultation with an art therapist.
With appreciation for the important work you do,
Megan August 2014