Art therapy for patients diagnosed with personality disorders cluster B/C: A thematic analysis of emotion regulation from patient and art therapist perspectives

Figures & data

Figure 1. The Expressive Therapies Continuum (Hinz, 2009).

Table 1. Example of AT session content and objectives.

Overview of content (Session 4)	General change objectives PDs	Performance objectives in AT
Warming up: exploring clay; sensory, motoric and affective (mindfulness skills) Art assignment: Making of two clay figures – ‘Big self & little self’ – as symbolisation of when feeling competent and strong, and when feeling small and vulnerable. Place these two figures in relation to each other. Add some other material to soothe the little self-figure. This assignment is focused on the exploring of different self-images, schema modes, and polarities in the person, e.g. adult mode versus child mode, and on the active search for the relation between these two modes in order to integrate polarities. Evaluation: Description of the two figures and the characteristics of each. Making up a dialogue between the clay figures to explore the relation between the modes, to explore the internal dialogue between different parts of oneself and to reflect on this.	Experiences a (more) stable and positive sense of self Is able to express and regulate emotions Understands own emotions, thoughts, and behaviours Uses improved problem-solving skills	Develops observation skills and positive thinking about own and other’s actions and art products Experiments with self-expression and spontaneous and structuring art processes Becomes aware, reveals identity in a situation of first reduced and then felt control

Figure 2. Thematic map example.

Table 2. Data extract, with codes applied.

Data extract	Coded for	Themed coding
Making those dark surfaces my emotions came out and I was also really upset. That is really my emotion that does that. Not me, but my emotion that takes over. I had a strong cognitive side, also a light. But a picture doesn’t lie. What my picture shows gives me a lot of information about what currently plays in me and what I am not always aware of. Then I worked quite rationally, and I would now rather express myself more spontaneously.	Using image aspects (e.g. use of colour, light/dark) to express and regulate emotions Emotion awareness Cognitive approach versus affective, spontaneous approach	Preferred approach in the art process and emotion regulation

Figure 3. Art assignment: ‘The tormentor’. Pastels on paper (female, 32 yrs).

Figure 4. Assignment ‘Group painting and role play’.

Figure 5. Assignment ‘Image of pain and soothing’.

Figure 6. Assignment ‘Warming up’ based on the emotion anger.

Figure 7. Assignment ‘Emerging’ (female, 21 yrs).

Figure 8. Assignment ‘Monster’ (female, 21 yrs).

Figure 9. Assignment ‘The tormentor’ (female, 21 yrs).

Figure 10. Assignment ‘Big self and little self’.

Hinz, L. D. (2009). Expressive therapies continuum: A framework for using art in therapy. New York, NY: Routledge.

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