Person-Centred Creative Art Therapy

Person-Centred Creative Arts (PCCA) is the creation of art using any creative medium. Both the creative process and the finished artwork are approached without judgement, assessment, or external interpretation.

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Creating art in this way allows authentic expression of some aspects of the person creating the piece which can be therapeutic and healing. It is not about creating a beautiful picture. It's about the meaning and process of the art created.

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Using images can help us to get in touch with parts of ourselves that may be difficult to access or express through words. It can help us to get to know ourselves more fully. Images can be like dreams in that they can tap into a form of spontaneous knowing and can provide access to experiences, feelings and meanings that may not yet be fully expressed or understood consciously.

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Using art (in therapy) promotes emotional, mental, and physical wellbeing.

PCCA consists of 5 stages

1. An image emerges – something comes into the person's awareness.

2. The image is expressed – the client is externalizing the image in artform through an art or creative medium.

3. The meaning is verbalised – edge of awareness. Body language might change as the client goes a bit more internal. There might be signs of anxiety, change in behaviour i.e., laughter.

4. Dialogue with the facilitator to allow deeper meaning to emerge and enter the client's awareness. Less conscious material may emerge, but the facilitator does not decide or interpret what this means.

5. Work on the revealed meaning using the gained insight.

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Reflecting is an important part of the facilitation – to hold up a mirror and reflect back what the client is expressing. This allows the client to hear themselves and helps to keep the facilitation non-interpretative and non-directive.

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The therapist also observes the client and notices changes in body language. This is also reflected back to the client, so they become aware of that too. Body language often changes when the client is working on something significant. Body language might provide an opportunity to explore something that the client has not yet consciously noticed.

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Process is to be reflected back to the client too. For Example, if the client expresses ‘I didn’t know where to start’ or ‘I was unsure of what materials to use’ – This can also be linked to their life: ‘Is that something you recognise?’

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When something is expressed by the client, for example I used ‘green’ this is reflected back and then bridged. Bridging is connecting the image to the person. So, a bridging question could be: ‘what is green to you?’. The client might say ‘nature’ ‘being natural’ and a following question could be ‘nature’ ‘being natural’ – ‘can you connect with that? Or ‘nature’ ‘being natural’ Is that around for you at the moment’. This could connect the image to the client.

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Images can sometimes say more than words can. The client may manifest an image by, for example, a guided visualisation exercise. (1) For example, the guided imagery of ‘If you were an animal today, what animal would you be?’

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The client might create this image. (2)

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It can help the client to express how they feel and by creating an image and verbalising meaning they are acknowledging what is going on (instead of avoiding) They then can make sense of the image and verbalise this (3)

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For example, the facilitator might say ‘what can you tell me about your image’ – The client might answer: "it’s a Giraffe". The therapist would reflect and bridge: "Giraffe, what is Giraffe to you?" The client might say. It’s an animal with a long neck. This would be reflected back so the client can hear themselves and process this.

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The therapist might ask: ‘what else do you notice?’ The client might say, ‘it has a wonky neck, and the colours are the wrong way round’ – The therapist would reflect and bridge and ask: ‘Can you connect with that?’ The client might say ‘I often have neck issues and things are the wrong way round at the moment’. Again, this would be reflected back.

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The client might also notice that this Giraffe doesn’t have a mouth. What is missing can sometimes provide an important opportunity for exploration, so the therapist would reflect and bridge this rather than deciding what the missing mouth means. The client might link it to them needing quiet time.

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Towards the end the therapist might ask: ‘if this image were to have a message for you, what would that message be?’ – The client might come up with ‘I really need to look after myself’

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There is a lot of awareness and insight gained in this session (4). The last stage is working on the revealed meaning (5).

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Metaphor

The Giraffe is a Metaphor. A metaphor is when we use something to represent something else in a non-literal sense. In this case the Giraffe represents something about the client's experience.

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A metaphor can also be a word, a phrase, a character, a story, or an object. In this case the metaphor was an image.

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A metaphor can also be described verbally, for example: ‘I feel like my head is about to burst’. Using metaphors can help communicate experiences of a situation in more depth. It allows the client safe access to experiences that may feel buried, guarded or difficult to approach directly. It might be a lot easier for the client to talk about the Giraffe than to talk about themselves.

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When working with a metaphor you work with the meaning and the qualities.

It can deepen empathic understanding.

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It is important for the therapist to not interpret or make assumptions. Even though this image looks like a Giraffe, it might be something completely different to the client.

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The image/metaphor may occur spontaneously and can provide valuable information for exploration. It may hold information about how the person experiences themselves, how they think, how they act and how they are likely to act in the future. Working this way might bring something new to the client. It can help the client to connect with their inner world. The metaphor is a hook to provide an opportunity to explore experiences that may not yet be fully conscious and bring them into conscious awareness.

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The client might not have known that everything is the wrong way round at the moment until they looked at their Giraffe. It might have helped them to understand what is going on for them and to identify their needs.

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Working with metaphors is working at greater depth and therefore needs to be done safely. If the client were to ‘just talk’ about how they were feeling today they might not have gained this awareness. They may have had their defences up and they might have been really guarded.

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It is important for the therapist to stay open to hearing and exploring the meaning. There needs to be a level of sensitivity and to invite the client to explore and if they don’t want to, to stay with the client and not direct or push. The client might not be ready. They will allow and explore when they feel emotionally safe and ready.

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Defences are there for a reason so if the client says ‘A Giraffe is a Giraffe, there is nothing I notice’ then its important for the therapist to stay with that and accept that.

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Images may contain both conscious and less conscious material, so staying with the client is vital as the client may not yet be aware of what is emerging and might not be ready to explore it. Plus, we never know what a picture means to the client and therefore if we keep it non-directive and non-interpretive, we keep it safe.

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Space is important too. Allowing silences for the client’s process.

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Working with a metaphor engages creative and associative ways of thinking. Details matter. The details of an image may provide useful opportunities for exploration. What is missing is important (the missing mouth). Whatever is unusual is important too (the colours are the wrong way around). When things are disproportionate, this may also be relevant. However, the therapist does not decide what these details mean. Only the client can determine the personal meaning of their image.

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Carl Rogers’ (Person-Centred) core conditions offer psychological safety: Empathy, Acceptance (UPR) and Congruence, these need to be present in the facilitation of working with image.

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Empathy means being fully present and available and to listen empathically.

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Acceptance means Unconditional Positive Regard; to accept the client’s humanness and connect to that without judgement.

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Congruence means genuineness. For the therapist to be open and authentic about what is going on for them externally and internally. The inner and out experience match, there is no façade.

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PCCA is also non-directive and non-interpretative. When the therapist interprets or judges an image this means that their own projection and assumptions can stand in the way of the client's meaning-making. It is important that the therapist is trained in working with art and continues to work on their own ‘blind spots’ and continue to gain self-awareness so they remain aware of their own assumptions and projections and are able to work with the client without imposing their own meaning onto the image.

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The image belongs to the client, and the meaning belongs to the client. The role of the therapist is to notice, reflect, invite and explore, while allowing the client to determine what the image means to them and how, or whether, it connects to their life.

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