Importance of art therapy

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Lucy is the daughter of Betty, a parent with the potential for a disorganized attachment due to her own parental upbringing. We are told Lucy was born when her mother was only sixteen, and so still emotionally immature herself. Her mother also reported having being 'pressured into the pregnancy'. We are not told by whom she was pressured, but we do know her father Frank was in or about to join the armed forces, and so possibly would not have been a constant in their lives.

I think is important to look a little at Betty first, as her parental care of Lucy could be affected by the way she herself was parented. As O'Brien (2008, in Case & Dalley 2008, p.37) explains, 'As this caregiver has probably not experienced attachment to her own mother, she does not know how to play with her infant and cannot 'read' or understand his expression of stress'

Betty was raised within a marriage that 'consisted of extreme levels of physical violence' directed at her mother. These factors must be taken into account when looking at the parents to be, as Case & Dalley (2008, p.2) explain that 'Internally, their own experiences of being parented will influence and affect their capacity to parent their new baby', and that 'This can be particularly damaging if there has been trauma such as physical, sexual or emotional abuse in either of the parents past'.

We are told Betty went to live with her own father following the divorce, but we are not told why, and do not know if she was subject to the same abuse as her mother. Even if she were not abused herself, the trauma of witnessing such abuse would have affected Betty and her relationship with her mother. Balbernie (2001 cited in Case & Dalley (2008, p.106) explains that, 'A baby's developing brain is damaged when exposed to neglect, trauma and abuse, and prolonged maternal depression'

If this were so and Betty never formed a secure attachment to her own mother then it is possible through transgenerational transmission as described by O'Brien (2008), the attachment formed between Lucy and her mother could suffer the same pattern, and if unchecked it could lead to Lucy struggling to form an attachment with her own children. O'Brien (2008 in Case & Dalley, 2008, p.48) explains that 'Disorganized attachment, like all attachment patterns, continues through the generations, leading to each new mother finding it hard to attach to her baby'. This being so Betty may not have learnt any 'good enough' maternal skills from her own mother that would help prepare her for motherhood.

We can so far surmise that Lucy was born to a mother that was emotionally unprepared and possibly did not want a child. This being the case we have to imagine what it was like for her mentally and physically. Being only sixteen at the time she may not have had the emotional maturity to know what was happening to her body, she would essentially be still developing herself. As Winnicott (1971, p.200-201) explains:

'It is sometimes taken for granted that boys and girls who 'hop in and out of bed', as the saying goes, and achieve intercourse (and perhaps a pregnancy or two), have reached sexual maturity. But they themselves know that this is not true, and they begin to despise sex as such.'

Betty possibly knew that she was not ready for the responsibility of a child, but was not given the choice; she may have felt guilty and ashamed of her pregnancy.

We are told that Lucy and her mother had to stay in hospital for three months after the birth. Although no details have been given as to why this occurred, it would have provided a difficult environment for mother and child to start to form an attachment.

We do not know what kind of physical or emotional contact Lucy had with her mother or father at this time. It is possible that her first primary care givers were the hospital staff, or that she may have been in an incubator in which case handling or contact may have been restricted.

Winnicott (1971, p.19) suggests the importance of the 'breast' or 'mothering' in the developmental processes of the baby and obtaining a sense of self and reality. He explains the importance of 'transitional objects' and transitional phenomena' as the 'basis of initiation of experience' and that:

'This early stage of development is made possible by the mothers special capacity for making adaptation to the needs of her infant, thus allowing the infant the illusion that what the infant creates really exists' Winnicott (1971, p.19)

For the first three months of Lucy's life at the hospital this crucial stage of development and quality of contact with her mother may not have been available to her.

After leaving the hospital we are told the young family moved down to a southern military base. So Betty lost any family or social support she may have had before, and she had to learn how to care for and respond to her new baby without a socially secure environment.

We do not know if Betty suffered any post-natal depression at this time but such a possible lack of knowledge, support and security would not have been easy.

We know from Holmes (2001, p.6) that 'Attachment security is dependent on sensitive and responsive care-giving.' And that for a child to use the mother as a 'secure base' she must provide the appropriate responses such as Holmes (2001, p.9) describes:

'responsiveness, sensitivity, consistency, reliability, attunement, the capacity to absorb protest and 'mind-mindedness', the ability to see the distressed child as an autonomous and sentient being with feelings and projects of his or her own.'

We also know from Winnicott (1971, p. 150-159) the importance of the 'Mirror-role of the mother', he suggests that what the baby sees when it looks at the mother is a reflection of itself, and its own emotions. And so if the mother cannot empathise with the baby and can only reflect back her own emotions the baby cannot begin to recognise herself in the mother. This may lead to a confused sense of self. Gergely and Watson (1996 cited in Holmes 2001, p.69) agree that 'an attuned mother helps her infant identify feelings by mirroring behaviour'.

However if Betty was suffering from post-natal depression, or did not have the capacity to respond appropriately to her child these natural developments may not have happened, and an insecure attachment may have formed. Hall (2008, in Case & Dalley 2008, p.27-28) explains that:

The overriding effect of post-natal depression is an inability to cope with the huge life change which results from pregnancy and giving birth.'

She goes onto say that:

To enter this uncharted territory already burdened with unresolved issues can be quite devastating for the woman, and her family, and serious for the development of her baby.'

With these factors taken into account a 'normal' secure attachment may have been difficult. Holmes (2001, p.30) suggests that:

'If she is depressed or troubled by her own uncontained feelings, she may impose these feelings, or be unresponsive, so that what the child 'sees' in the mirror is either blankness or his mothers sadness, which in turn, may set up insecure models of attachment'

If Lucy was not able to form a secure attachment to Betty this could effect her development, and how she deals with strange situations, events and relationships throughout her life. She may find that a pattern of attachment is formed, that may be unconsciously carried on in other areas of her life Holmes (2001, p.15) explains that:

Implicit or procedural memories are those that are laid down in the early years of life and consist of the 'ways in which things are done' (i.e. patterns of relationship), including, for example, parental responses to infant distress, which are stored within the child's mind and which will influence subsequent relationships even if there is no explicit awareness of their role.'

Lucy may find she over reacts to certain events, or that she struggles to cope with loss. She may have problems decision-making or she may not find that she has the capacity to cope with stressful situations. As an adolescent still searching for a secure base she may look to find it in other places such as self-harm or an eating disorder.

Betty did not have the experience of a secure attachment to her own mother, she was not ready to have a child yet, and was not secure in her own identity or life. There is no information on if there was any support system in place for the young family, or if Betty and Frank had to cope on their own.

We know that by Lucy's second birthday they had had to move again due to her fathers work. So along with the stresses of moving house, Betty most likely will have lost her social network again. Betty would have been eighteen at this point, a time when a lot of eighteen year olds would be out socializing, and embarking on the next stage of life, but Betty is raising Lucy. It is possible she resented this and inadvertently Lucy, for being the cause.

We do not have any information about Lucy's relationship with her father and how much involvement he had in her development. But if he were fairly constant in her life, then his sudden loss when the parents separated would have created anxiety for Lucy. She may not have understood the situation between her parents, and may have blamed herself for the separation.

We are told that the relationship became 'strained' and that there were incidents of verbal and physical violence, but we are not told if it was by or too the mother, or if Lucy was witness to any of the abuse.

When Lucy's parents separated, Betty moved up near to her own mother and took Lucy with her. This would have taken Lucy even further away from her father and away from any constants she had such as school, or friends.

Such an upheaval could be quite traumatic especially if she did not have a secure attachment to her mother.

I find it interesting that she is crying at night before she sleeps, and not it would seem finding comfort with her mother. This again makes me wonder about their relationship and whether Lucy does not feel she can go to her mother if she feels insecure. It is possible she has formed as described by Case and Dalley (2006, p.100) an 'Anxious avoidant attachment' with her mother were 'an individual has no confidence that, when they seek care, they will be responded to helpfully but, on the contrary, expect to be rebuffed'.

Lucy has been seeing snakes moving across her floor prior to sleeping and has been suffering nightmares comprising of themes of being chased by monsters and witches. Dreams are the minds way of processing thoughts and events that are current in our lives. Daws (1989, cited by Case 2005, p.83-84) explains the importance of dreaming when discussing Palombo's (1978) work on dreams:

'He convincingly suggests that dreaming plays a central function in assimilating memories of the day into settled long term memory. Thus if dreaming is insufficient or interrupted, the consequences are very serious for child and adult alike - they are left with a jumble of unassimilated memories.'

Lucy currently has a vast amount of unsettlement in her life, and she needs time to process these events. At the moment it is possible that this can only be done in Dreamtime, as she does not have the support or the skills to achieve this otherwise.

As explained by Mallon (2002, p.31) as to children around the ages of 5 - 7 sometimes, 'still have difficulty in distinguishing between dreaming and waking reality' and so the snakes moving across Lucy's floor maybe part of her anxiety induced nightmares. She may also have been used to her fathers presence at bedtime, and now feels insecure about her 'safety' with only her mother there.

Nightmares about monsters, witches and being chased are a common theme in children in the latency period. Lucy's nightmares could be her attempt to process her anger at her mother for the loss of her father. Mallon (2002, p.30-31) suggests that 'It is much 'safer' to project all our angry feelings on to a mad dream-bull for instance, than to acknowledge just how destructive we feel'. Witch type creatures have been an archetypal symbol used throughout history to portray evil, matriarchal women. Case (2005, p.83) goes on to describe the links between the witch and the 'bad' mother as so:

'Witches usually represent the destructive negative side of a mother image, which needs to be integrated and accepted. For the child they are frequently to do with aspects of the 'bad' mother, all those times where she has not been available to the child, mixed with projected hostility; so a condensed image of the sum of hatred, rather than idealised mother, and the child's own aggression.'

Winnicott (1971, p.167) also supports the theory of the witch as a representation of the mother, in his therapeutic consultations with Sarah, and relating her dream of being chased by a witch to her feeling around her mother. Lucy has many factors that could be taken into account for her possible hatred of her mother and her possible symbolization as a Witch in her dreams. Freud explains (cited in Sayers 1998, p.64) 'that his women patients' childhood hatred of their mothers drove them to look to their fathers for love. This, he said, often added another factor to his patients' hatred of their mothers - hatred of them as rivals for their fathers love.' Her mother may have been perceived as to have 'driven' away Lucy's father, and Lucy may feel anger at her mother for this, for taking away her safety and love. Lucy's mother made the decision to move to the midlands, which would have also taken Lucy further away from her father and anything familiar and secure she knew. Lucy may not know how to deal with these feelings of anger and betrayal, and so she is trying to process them through her dreams.

We are told that Lucy is performing well at school and although this appears to be a positive sign, it could be a sign she is being compliant and giving the illusion she is 'coping'.

I feel the security and containment that Art Therapy has to offer would be of benefit to Lucy. It would allow her to work through her loss of her father, and her anger at her mother, in a safe environment. And give her the must needed time to process her thoughts and feelings. Perry & Malchiodi (2008, p.17) explain how insecure attachments maybe changed to form healthy attachments through therapeutic intervention:

'While early childhood trauma affects relationship patterns later in life, it maybe corrected, at least in part, with appropriate intervention. Research in neuroscience is demonstrating that infancy is not the only chance a person has to develop healthy attachment; there seem to be ways to reshape and repair some early experiences. Recapitulating the normal, attachment-building sensory experiences of childhood through therapeutic intervention and through strengthening the parent-child relationship may help re-establish healthy attachments.'

I feel that it is important for Lucy to try and break away from the 'transgenerational' pattern of abuse and insecure attachments that seem to have formed in her family, so that she can be herself and not bring the 'ghosts' of her past with her into adulthood. And now that the family has moved to be near the maternal grandmother we do not know the effect this will have on the family due to her own experiences of abuse.

Through the creativeness of Art Therapy Lucy will have the potential to build up her self-esteem, by proving a secure base from which she can explore her own identity, making her more confident and able to cope with the new events in her life. This can be supported by Perry & Malchiodi (2008, p.17) explanation on the benefits the creative therapies can have for children:

'For children in general, creative activities in therapy offer many benefits: pleasure in making, doing, and inventing; play and imagination; and the enhancement of self-worth through self-expression.'

Lucy is at a stage in her life where she can change and adapt more easily than when she is an adult. I think it is important for her to have the support she needs now before she enters into the stresses and strains of puberty, and before there is a break down in the family. We can hope that her mother will also enter into therapy and so a stronger relationship between mother and daughter can be formed.


  • Case, C. (2005). Imagining Animals: Art, Psychotherapy and Primitive States of Mind. London & New York: Routledge. p.83-84.
  • Case, C. & Dalley, T. (2006). The Handbook of Art Therapy. 2nd ed. London & New York: Routledge. p.100.
  • Case, C. & Dalley, T. (eds) (2008). Art Therapy with Children: From Infancy to Adolescence. London & New York: Routledge. p.37, p.2, p.106, p.48, p.27-28.
  • Holmes, J. (2001). The Search for the Secure Base: Attachment Theory and Psychotherapy. London & New York: Routledge. p.6, p.9, p.69, p.30, p.15.
  • Mallon, B. (2002). Dream Time with Children: Learning to Dream, Dreaming to Learn. London: Jessica Kingsley Publishers. p.30-31.
  • Perry, B. & Malchiodi, C.A. (2008). Creative Interventions with Traumatized Children. New York: Guilford Press.
  • Sayers, J. (1998). Boy Crazy: Remembering Adolescence, Memories and Dreams. London & New York: Routledge. p.64
  • Winnicott, D.W. (2005). Playing and Reality. 2nd ed. London & New York: Routledge. P.200-201, p.19, p.167, p.150-159.