Navigating Therapeutic Diversity

Thompson provides an insightful and valuable discussion of how memoir writing can end up perpetuating traumatic experiences rather than working them through. However, I would suggest going slow before generalizing from Thompson’s experience. The complexities that emerge whenever we compare therapeutic modalities are legion. These complexities exist on several registries: philosophical, empirical, cultural, and ethical just to name a few. I touch briefly on each of these, but before doing so let me back up and explain why I see Thompson’s article as a form of comparative therapeutic analysis. That takes a little explaining, because “memoir writing” is not on first glance a form of therapy.

To locate memoir writing as a therapeutic option it helps to see memoir writing, and other artistic expression, as a form of creative or expressive therapies. The key similarity between expressive therapies and other forms of therapy is that both the artist and the person in therapy have in common the need to explore their internal psychic life and their relations to the surrounding world. Both the artist and the person in therapy use this awareness to transform their experiences through self expression. Building on this similarity, expressive therapists focus their attention along a continuum that places more or less emphasis on the art side or on the therapy side. One side of the continuum may be called “art in therapy” and the other side of the continuum may be called “art as therapy” (Edwards 2004, 1).

The expressive therapist working from the art in therapy side of the continuum uses artistic expression to help the person access psychic materials, which can then be processed through a therapeutic relationship. Art in therapy, therefore, functions similar to the way Freud used free association and dream analysis. Artistic expression helps the person and the therapist to tune into aspects of the person’s thoughts, feelings, and perceptions, which are difficult for the person to reach through direct conversation alone. Once this material becomes available through art, expressive therapists help the person to process the material and work it through in ways similar to other therapists.

At the other end of the continuum, when the focus is on art as therapy, the expressive therapist focuses less on standard therapeutic goals and more on helping people to achieve creative expression. This side of the continuum makes sense because art alone, independent of traditionally defined therapeutic goals, can be tremendously healing for several reasons. First, many people find art to be deeply engaging. When a person is absorbed in the process of art, other aspects of life, even painful aspects, may drift into the background. Plus, art allows people to take hard-to-reach experiences and share them with an audience. These experiences, which might otherwise be toxic or alienating, find a voice through creative expression so that the artist is no longer isolated and alone with them. In addition, art rewards people for their sensitivity. To be an artist one must be able to pick up on aspects of inner life and the world that often escapes other people. This sensitivity, which is often coded negatively in the context of most therapies (most therapeutic approaches suggest that people “stop being so sensitive”), is coded positively in the context of creative expression. A highly sensitive “patient” may be a bad thing, but a highly sensitive “artist” is nearly always a good thing. Finally, art takes experience which may otherwise be seen as ugly or inappropriate and turns it into something aesthetically beautiful and/or politically moving. Art, therefore, brings the artist outside of their own preoccupations and into the community. It gives people an invaluable and meaningful role in making the world a better place.

Expressive therapists vary in how much they emphasize art in therapy compared with art as therapy. Some primarily focus on the former, some on the latter. Most focus on a combination. It is important to note, however, that the farther we move toward the art as therapy side, the more the therapeutic language recedes and the creative language emerges. If one goes...