Irina Katz-Mazilu
A Case of Music and Choral Painting in Online Arts Therapies
Abstract
This chapter presents an art and music online art therapy process with a 19 years old young woman during the lockdown period of the COVID-19 pandemic in 2021. The EFAT-European Federation of Art Therapy implemented social actions offering free online art therapy by some of its members to anyone experiencing difficulties at this time. The author volunteered to offer eight free art therapy sessions in individual settings in 2021 to 10 clients. The chapter describes the therapeutic process that successfully helped the client solve issues resulting from social isolation and other personal and familial aspects. The art therapy process combined art and music in each session with writing, recording, and finally, sharing. The therapeutic methodology, relationship and creativity are presented in their specific and original context. The chapter discusses the advantages and limits of the online methodology and some clinical and ethical questions and refers to other research in the field. While more research is needed on the synergy between different media, this case proves the efficiency of online arts therapies. The originality of this case is to cross music and art – as asked by a very gifted client. The healing power of the therapy is reinforced by crossing the two media and the two partners’ creativity: client’s and therapist’s.
1. Introduction
Early 2021, Margherita is a 19 years young woman studying contemporary literature at the university of the city, where she lives with her parents.
The year before, she had a difficult time: “her father left the home to join a new partner, her mother, already fragile, was unhappy, destabilised and clinging on her (daughter…) Margherita has still a good relationship with her father but this event was a shock as she didn’t expect it, nobody knew about the parallel life of the father. Moreover, she has had a hard time to be a teenager, to become a woman, she was searching….”
Margherita lives in Italy, the first European country to be strongly impacted by the COVID-19 pandemic. With the first – and strict – lockdown, she finds herself brutally isolated. She keeps living with her mother, studying online, separated from her friends. She gets anxious, depressed, lost.
In these siderating times, between 2020 and 2021, the EFAT-European Federation of Art Therapy – offers support to its members personally and professionally. Working groups, seminars and meetings help keep in touch, belong to a community and maintain professional development. First social action will be implemented between early January and the end of March 2021, offering eight free online art therapy sessions to anyone experiencing psychological difficulties with the pandemic. Each art therapist is free to organise the process (duration and frequency of the eight offered sessions, methods and materials, individual or group workshops, etc.) but has to sign a specific contract established by the EFAT. The characteristics of online art therapy have to be thoroughly explained to clients, and their consentment asked if any further use of their art therapy work is previewed. At the end of the social action, the participating art therapists are asked to deliver a short report. Group supervision is offered by experienced colleagues [1].
I am a volunteer for this action, able to work in French, English and Romanian. Starting from early 2021, I have had the opportunity to offer individual online art therapy to up to 10 clients from several European countries: France, Italy, Slovakia, and Ukraine. But, at this time, online art therapy is a challenge for me as I never practised it before. I feel insecure… Moreover, the lockdown echoes my own locked-in experience in my native country, Ceausescu’s Romania, where I lived my young years in an open-sky prison… Through EFAT, I can benefit from four supervision sessions which are very helpful.
2. The arts therapy setting and process
Margherita gets in touch with me in this frame, and we have eight art therapy sessions online in English. She has to find some place in the small apartment where she lives with her mother offering confidentiality and intimacy – sometimes the kitchen, or a glory hole where I can see the vacuum cleaner, etc.
I require Margherita’s consentment to take pictures of her work and record the sessions to allow her to view herself in action. She agrees with this method often used in drama therapy and dance therapy. Mirroring oneself is a plus offered in online work.
Margherita is a brilliant and very gifted young woman. Before COVID, she already had experienced painting, music, theatre and dance, and she is writing poems…her wish is to be a multimedia artist exploring the synergy of crossed arts’ possibilities. But for now, she feels locked and blocked: is her creativity lost? Behind this anxious self-questioning, I can feel the importance of the family background, her emotional and sexual difficulties, and the struggle to evolve to maturity and adult identity.
Building our therapeutic relationship and acknowledging how to collaborate in online art therapy are the objectives of the first two sessions. They are dense, rich and inspiring. Margherita likes painting with music and asks me if I agree. Yes, of course…she chooses either classical or jazz music, according to her feelings of the day. Soon I suggest painting with her hands, on the floor on big sheets of paper, with liquid materials, gouaches and ink. Her body dances while painting in music.
The third session carried by one of Beethoven’s symphonies, Margherita paints with her hands, immersed in painting, her long hair diving into the paper, and finally, she kisses her painting. In fusion with materials, soul and body in a sensual movement, she feels, she is living, she exists… (Figures 1–4).
Early 2021, Margherita is a 19 years young woman studying contemporary literature at the university of the city, where she lives with her parents.
The year before, she had a difficult time: “her father left the home to join a new partner, her mother, already fragile, was unhappy, destabilised and clinging on her (daughter…) Margherita has still a good relationship with her father but this event was a shock as she didn’t expect it, nobody knew about the parallel life of the father. Moreover, she has had a hard time to be a teenager, to become a woman, she was searching….”
Margherita lives in Italy, the first European country to be strongly impacted by the COVID-19 pandemic. With the first – and strict – lockdown, she finds herself brutally isolated. She keeps living with her mother, studying online, separated from her friends. She gets anxious, depressed, lost.
In these siderating times, between 2020 and 2021, the EFAT-European Federation of Art Therapy – offers support to its members personally and professionally. Working groups, seminars and meetings help keep in touch, belong to a community and maintain professional development. First social action will be implemented between early January and the end of March 2021, offering eight free online art therapy sessions to anyone experiencing psychological difficulties with the pandemic. Each art therapist is free to organise the process (duration and frequency of the eight offered sessions, methods and materials, individual or group workshops, etc.) but has to sign a specific contract established by the EFAT. The characteristics of online art therapy have to be thoroughly explained to clients, and their consentment asked if any further use of their art therapy work is previewed. At the end of the social action, the participating art therapists are asked to deliver a short report. Group supervision is offered by experienced colleagues [1].
I am a volunteer for this action, able to work in French, English and Romanian. Starting from early 2021, I have had the opportunity to offer individual online art therapy to up to 10 clients from several European countries: France, Italy, Slovakia, and Ukraine. But, at this time, online art therapy is a challenge for me as I never practised it before. I feel insecure… Moreover, the lockdown echoes my own locked-in experience in my native country, Ceausescu’s Romania, where I lived my young years in an open-sky prison… Through EFAT, I can benefit from four supervision sessions which are very helpful.
2. The arts therapy setting and process
Margherita gets in touch with me in this frame, and we have eight art therapy sessions online in English. She has to find some place in the small apartment where she lives with her mother offering confidentiality and intimacy – sometimes the kitchen, or a glory hole where I can see the vacuum cleaner, etc.
I require Margherita’s consentment to take pictures of her work and record the sessions to allow her to view herself in action. She agrees with this method often used in drama therapy and dance therapy. Mirroring oneself is a plus offered in online work.
Margherita is a brilliant and very gifted young woman. Before COVID, she already had experienced painting, music, theatre and dance, and she is writing poems…her wish is to be a multimedia artist exploring the synergy of crossed arts’ possibilities. But for now, she feels locked and blocked: is her creativity lost? Behind this anxious self-questioning, I can feel the importance of the family background, her emotional and sexual difficulties, and the struggle to evolve to maturity and adult identity.
Building our therapeutic relationship and acknowledging how to collaborate in online art therapy are the objectives of the first two sessions. They are dense, rich and inspiring. Margherita likes painting with music and asks me if I agree. Yes, of course…she chooses either classical or jazz music, according to her feelings of the day. Soon I suggest painting with her hands, on the floor on big sheets of paper, with liquid materials, gouaches and ink. Her body dances while painting in music.
The third session carried by one of Beethoven’s symphonies, Margherita paints with her hands, immersed in painting, her long hair diving into the paper, and finally, she kisses her painting. In fusion with materials, soul and body in a sensual movement, she feels, she is living, she exists… (Figures 1–4).
Figure 1.
Painting hands.
Painting hands.
Figure 2.
Hand and brush.
Hand and brush.
Figure 3.
Painting movement.
Painting movement.
Figure 4.
Margherita with blue lips.
Margherita with blue lips.
After this third session, she sends me paintings and poems. Her creativity is released (Figure 5)
Figure 5.
Dancing figure.
Dancing figure.
“and these tired shadows
for you today cradle
your hands scratch high on the ground
and shake my lonely steps
there’s a world for you
where it’s always spring
you living in colours without asking anything in return
these days are sharpened by men,
but I have a place for you in my pockets.
tomorrow morning I’ll dress up my twenties
but tonight I am eternal
I don’t dwell
because I don’t ressemble”
Margherita Fabbri, January 29, 2021, translated from Italian/French by herself.
In the fourth session, Margherita chooses the Heroical Symphony by Beethoven. In her glory room, the vacuum cleaner is like a big musical instrument, and she is her own orchestra director… (Figures 6–8).
for you today cradle
your hands scratch high on the ground
and shake my lonely steps
there’s a world for you
where it’s always spring
you living in colours without asking anything in return
these days are sharpened by men,
but I have a place for you in my pockets.
tomorrow morning I’ll dress up my twenties
but tonight I am eternal
I don’t dwell
because I don’t ressemble”
Margherita Fabbri, January 29, 2021, translated from Italian/French by herself.
In the fourth session, Margherita chooses the Heroical Symphony by Beethoven. In her glory room, the vacuum cleaner is like a big musical instrument, and she is her own orchestra director… (Figures 6–8).
Figure 6.
Finger painting.
Finger painting.
Figure 7.
Painting with the back of the hands.
Painting with the back of the hands.
Figure 8.
Margherita like an orchestra director.
Margherita like an orchestra director.
The fifth session is dedicated to layers painting. Colours and writing follow, recover and transform each other… (Figures 9 and 10).
Figure 9.
Margherita showing her painting.
Margherita showing her painting.
Figure 10.
The red finger paint.
The red finger paint.
For the sixth session, I propose painting with “real life” raw material: coffee grounds, egg yolk, beetle juice…and mixing the techniques: painting, writing, collage, splitting, holes, etc. This brings her even closer to her body-mind subjective reality. She experiences jubilation with these warming familiar materials, with the freedom to transform them, with the vivacity of her body, with the sensual synergy of the visual, phonic and tactile elements (Figures 11 and 12).
Figure 11.
Painting with coffee.
Painting with coffee.
Figure 12.
Painting with eggs.
Painting with eggs.
She is diving into this original magma. Her defences are lowering; she escapes the omnipresence of intellectual interpretations, esthetically regressing to the age of the free handling of visual and sound stimulations by a toddler1. She feels secure in my presence. At the end of each session, we share our impressions and thoughts, coming back to the here and now. The regression is contained by the art therapist. Finally, from the original magma, a new structure is coming to life…
She also shows me some of her artwork before the start of art therapy. We discuss the evolutive trends and perspectives. She keeps working on it between our sessions, sending images and poems. A kind of new-born artistic complicity is happening… (Figures 13–15).
She also shows me some of her artwork before the start of art therapy. We discuss the evolutive trends and perspectives. She keeps working on it between our sessions, sending images and poems. A kind of new-born artistic complicity is happening… (Figures 13–15).
Figure 13.
A silhouette.
A silhouette.
Figure 14.
Painting with a square piece of paper.
Painting with a square piece of paper.
Figure 15.
Yellow painting with black spots.
Yellow painting with black spots.
Her paintings are now fluid and light. She figures the frame is a protective and mild container.
The seventh session is caressing and tender… (Figures 16 and 17).
The seventh session is caressing and tender… (Figures 16 and 17).
Figure 16.
Tracing with fingers.
Tracing with fingers.
Figure 17.
Smiling Margherita with her painting.
Smiling Margherita with her painting.
The eighth and last session is a crowning choral moment of our collaboration. I propose to create simultaneously, each one behind her computer, on the theme of togetherness in spite of the physical distance. We are listening to the same music and painting simultaneously, and the sound is carrying us and bringing us physically and emotionally closer. We feel connected. We show our art and share our feelings. The synergy of image and sound creates a powerful and nourishing stance for both of us. Beyond our therapeutic relationship, we feel belonging to the human community, and we are two human beings, two women, and two artists (Figure 18/Irina, Figure 19/Margherita).
Figure 18.
Simultaneous painting - Irina.
Simultaneous painting - Irina.
Figure 19.
Simultaneous painting - Margherita.
Simultaneous painting - Margherita.
At the very end of our sessions, Margherita showed me a self-portrait she had drawn before her art therapy process. Compared to her actual creative outburst, the change is obvious. This transformation spreads to her relationships with her parents, friends and colleagues. Soon the lockdown will end, and even if the pandemic is not yet over, she feels much stronger to face the challenges to come (Figures 20 and 21).
Figure 20.
Self-portrait before the art therapy process.
Self-portrait before the art therapy process.
Figure 21.
Fluid painting in brown and white at the end of the art therapy process.
Fluid painting in brown and white at the end of the art therapy process.
3. Second time
Two years later, Margherita lives in Paris, studying theatre at the Sorbonne University. She starts a new series of art therapy workshops, in my studio, in real life. We were both surprised when we first met: she is much taller than I imagined her online, and my studio is much smaller than she imagined it… This makes us laugh and comment, at which point the virtual reality is biaised…but maybe not more than our subjective perception of the reality? We explore new issues about her evolution, research, travel, expatriation and broadening her life horizon. Each time again, she chooses a musical piece to combine with visual traces. She feels a powerful echoing between the two media in her body and mind. The whole of her being is diving into action and creation (Figure 22).
Figure 22.
White and yellow painting with writing.
White and yellow painting with writing.
Meanwhile, in 2022, Margherita also published a collection of poems titled “Anime Fradicie” (“Soaking Souls”) in Italian.
With respect to the reglementation on the patient’s protection, when I decided to write this article, I asked Margherita’s informed consent for publishing images of her art therapy work and portraits of herself, as well as for giving some information about her personal and familial difficulties. I also asked her if she wanted to be published anonymously or with her full name. After some reflection, Margherita decided to testify openly and wrote these lines:
“Since when I met Irina and we begun our therapeutical path, I’ve been feeling the unveiling of something, someone in me, who’s not left me since then. A Me in me who’s the truest answer to my being. The reason of my consent to using every material without censorship is deeply radicated in this: if there’s someone I would want as an expression of me, it is that Me.” Margherita Fabbri, January 2023.
4. Discussion
Online art therapy at 2000 km distance: did this context facilitate or limit the efficiency of the art therapy? We discussed it without deciding definitively if yes or no, or none of the two…Working with Margherita in this way – and in English – did not damage the quality of our collaboration. It was the only possible strategy at that time of isolation and social distancing – and it proved to be helpful.
One of the advantages of online art therapy is that it lets us free of masks – which obviously is a precious aspect. Also, it allows recording and taking photos/screenshots during the process without disturbing or interfering with the patient’s concentration, making it possible to restitute these recorded traces to the patient and discuss each step of the art therapeutic and creative process in detail. Also, for some clients, the physical distance might facilitate contact and relationship.
It would be interesting to check and develop the existing research for a better understanding of the synergy of image and sound in the art therapeutic context by the use of recent possibilities of neuropsychiatry and other medical sciences. The concept of synaesthesia helps to understand how the complementarity and the crossed use of our senses can enhance our creativity as well as the healing power of art and art therapy [3].
Nevertheless, if digital technology offers many possibilities, the therapeutic relationship is prevalent in any technical context. Much research has been realised since the COVID-19 pandemic on the pertinence of online tools and methodologies in arts therapies [4].
Several articles have been published between 2020 and 2022 by Emmanuelle Césari and others in The Canadian Art Therapy Association Online, Magazine [5, 6, 7, 8]. Most interesting is the concept of the “présence modifiée du corps”/“modified body presence” (trad.IKM). The discussion corroborates my own perceptions and analysis of the specific link to the body in virtual settings. We must learn to take advantage of digital techniques and understand their limits.
The specific ethical issues of the confidentiality, privacy, realisation, and the conservation of art therapy products, the sharing with pairs and medical partners, etc., have been the object of a careful elaboration by the EFAT’s Ethics Committee and resulted in a Guide for online art therapy destinated to the members of the Federation [1].
5. Conclusion
The use of digital methods in art and music therapy proved to be efficient in the case presented and might be extended to other clinical situations such as loneliness, isolation at home, hospitalisation in a sterile environment, social or school phobia, addiction to virtual games, geographical or social distancing… – when the patients are in a transitory or long-lasting impossibility to join a care centre or a private arts therapist’s studio. Music and art are easy to use in a digital context, with simple materials and just a mobile, an Ipad or a computer, in most circumstances. Some existing creative apps might also be helpful for clients who manage digital techniques. Of course, as soon – and if – possible, meeting in real professional life is important because it allows connecting the other’s presence by subtle phenomena that virtual techniques and reality cannot offer.
References
With respect to the reglementation on the patient’s protection, when I decided to write this article, I asked Margherita’s informed consent for publishing images of her art therapy work and portraits of herself, as well as for giving some information about her personal and familial difficulties. I also asked her if she wanted to be published anonymously or with her full name. After some reflection, Margherita decided to testify openly and wrote these lines:
“Since when I met Irina and we begun our therapeutical path, I’ve been feeling the unveiling of something, someone in me, who’s not left me since then. A Me in me who’s the truest answer to my being. The reason of my consent to using every material without censorship is deeply radicated in this: if there’s someone I would want as an expression of me, it is that Me.” Margherita Fabbri, January 2023.
4. Discussion
Online art therapy at 2000 km distance: did this context facilitate or limit the efficiency of the art therapy? We discussed it without deciding definitively if yes or no, or none of the two…Working with Margherita in this way – and in English – did not damage the quality of our collaboration. It was the only possible strategy at that time of isolation and social distancing – and it proved to be helpful.
One of the advantages of online art therapy is that it lets us free of masks – which obviously is a precious aspect. Also, it allows recording and taking photos/screenshots during the process without disturbing or interfering with the patient’s concentration, making it possible to restitute these recorded traces to the patient and discuss each step of the art therapeutic and creative process in detail. Also, for some clients, the physical distance might facilitate contact and relationship.
It would be interesting to check and develop the existing research for a better understanding of the synergy of image and sound in the art therapeutic context by the use of recent possibilities of neuropsychiatry and other medical sciences. The concept of synaesthesia helps to understand how the complementarity and the crossed use of our senses can enhance our creativity as well as the healing power of art and art therapy [3].
Nevertheless, if digital technology offers many possibilities, the therapeutic relationship is prevalent in any technical context. Much research has been realised since the COVID-19 pandemic on the pertinence of online tools and methodologies in arts therapies [4].
Several articles have been published between 2020 and 2022 by Emmanuelle Césari and others in The Canadian Art Therapy Association Online, Magazine [5, 6, 7, 8]. Most interesting is the concept of the “présence modifiée du corps”/“modified body presence” (trad.IKM). The discussion corroborates my own perceptions and analysis of the specific link to the body in virtual settings. We must learn to take advantage of digital techniques and understand their limits.
The specific ethical issues of the confidentiality, privacy, realisation, and the conservation of art therapy products, the sharing with pairs and medical partners, etc., have been the object of a careful elaboration by the EFAT’s Ethics Committee and resulted in a Guide for online art therapy destinated to the members of the Federation [1].
5. Conclusion
The use of digital methods in art and music therapy proved to be efficient in the case presented and might be extended to other clinical situations such as loneliness, isolation at home, hospitalisation in a sterile environment, social or school phobia, addiction to virtual games, geographical or social distancing… – when the patients are in a transitory or long-lasting impossibility to join a care centre or a private arts therapist’s studio. Music and art are easy to use in a digital context, with simple materials and just a mobile, an Ipad or a computer, in most circumstances. Some existing creative apps might also be helpful for clients who manage digital techniques. Of course, as soon – and if – possible, meeting in real professional life is important because it allows connecting the other’s presence by subtle phenomena that virtual techniques and reality cannot offer.
References
- 1.EFAT–European Federation of Art Therapy. Available from: www.arttherapyfederation.eu
- 2.Simon R. Symbolic Images in Art as Therapy. New York: Taylor & Francis Ltd.; 1997
- 3.Synaesthesia. 2022. Available from: https://www.bbc.com/culture/article/20221102-synaesthesia-the-superpower-behind-great-art
- 4.Zubala A, Kenell L, Hackett S. Art therapy in the digital world: An integrative review of current practice and future directions. Frontiers in Psychology. 2021. Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.600070/full
- 5.Cesari E, Barberi C. Visio-consultation: art-thérapie en miroir. In: The Canadian Art Therapy Association Online, Magazine. Vol. 5, Issue 2. Envisage, Spring 2022; 2022 [Online]
- 6.Cesari E, Clain M. D’écran à écran: un nouveau cadre art-thérapeutique. In: The Canadian Art Therapy Association Online, Magazine. Vol. 5, Issue 1. Envisage, Winter 2022; 2022. [Online]. Available from: https://www.canadianarttherapy.org/envisage/envisage-winter-2022-cesari-clain
- 7.Cesari E, Gerard S. Un atelier e-art-thérapeutique avec un processus de faire créatif contre l’anxiété due à la COVID-19. In: The Canadian Art Therapy Association Online, Magazine. Vol. 3, Issue 3. Envisage 3.3 Fall 2020; 2022 [Online]
- 8.Cesari E, Gerard S. Un atelier e-art-thérapeutique avec un processus de faire créatif contre l’anxiété due à la COVID-19. In: The Canadian Art Therapy Association Online, Magazine. Vol. 3, Issue 3. Envisage 3.3 Fall 2020; 2020. [Online]. Avaialble from: https://www.canadianarttherapy.org/envisage/envisage-fall2020-cesari-grard
- The aesthetic regression is a concept introduced by Rita Simon as a symetrical concept of regression in psychotherapy [2].