Art therapy and COVID-19: supporting ourselves to support others

It was thought initially that COVID-19, a virus to which none of us had immunity, would be a great leveller across the world, however, as with all international disasters, in reality, it has served to highlight the inequalities in society, with – people living in poverty, the elderly, ethnic minorities, and those with underlying health conditions – most at risk. Yet it can also kill the young, the fit and the healthy, and we have watched in horror as health care professionals and key workers have lost their lives as they support others. We as art therapists are no more immune to this horror than we are to the virus, and we need to ensure we first support ourselves to enable us to support others.

As caring individuals with a drive to help others, we can sometimes feel an overwhelming urge to rush our response to the needs we see unfolding before us, but if we want to be at our most effective, and in for the long haul, we must first take time to stabilise, reflect and prepare, to ensure we are ready, and can offer our service users the most helpful interventions. It is important to read and follow the guidance distributed to art therapists by our professional associations e.g. the British Association of Art Therapists (BAAT) shared the UK COVID-19 Trauma Response Working Group (www.traumagroup.org) guidance, available here: https://232fe0d6-f8f4-43eb-bc5d-6aa50ee47dc5.filesusr.com/ugd/6b474f_5626bd1321da4138b1b43b78b8de2b20.pdf.

A number of papers have been published on the subject of art therapy and bereavement (e.g. Arnold, 2020; Garti & Bat Or, 2019; Hardy, 2013; Kohut, 2011) during the past decade which may be of use to art therapists working with clients who have lost relatives during the pandemic. However, one of the important challenges we as art therapists may have to face, is to help service users who are experiencing complicated grief (Lobb et al., 2010). As a direct consequence of social distancing and visitor restrictions at health care facilities and care homes (Wallace et al., 2020, p. 1), people have been unable to communicate with or see their loved ones before they died (Otani et al., 2017). The COVID-19 pandemic has also disrupted the usual rituals that surround death, such as funerals and wakes, and the availability of wider family support and comfort. Complicated grief can present as symptoms more akin to Post Traumatic Stress Disorder (PTSD) such as ‘recurrent intrusive thoughts of the person who died, preoccupation with sorrow including ruminative thoughts, excessive bitterness, alienation from previous social relationships, difficulty accepting the death, and perceived purposelessness of life’ (Wallace, Wladknowski, Giibson, & White, 2020, p. 2).

Papers published on the subject of art therapy and trauma, and post-traumatic stress (e.g. Carr & Hancock, 2017; Chong, 2015; Elbrecht, Liz, & Antcliff, 2014; Gibson, 2018; Greenwood, 2011; Hass-Cohen, Findlay, Carr, & Vanderlan, 2014; Homer, 2015; Jones, Walker, Drass, & Kaimal, 2018; Learmonth & Gibson, 2010; Lobban, 2016; Lobban & Murphy, 2018; Naff, 2014; O'Brien, 2004; Skeffington & Browne, 2014; Smith, 2016; Stace, 2014; Testa & McCarthy, 2004; Tripp, 2007), provide important insight into the issues faced and examples of innovative interventions developed. However, modified approaches to support trauma and complicated grief caused by COVID-19 are required, and research is much needed in this area.

It is also important for art therapists to understand the symptoms of ‘secondary traumatic stress’ (stress which can result from knowing or helping someone experiencing trauma), which can include ‘excessive worry and fear, feeling ‘on guard’ all the time, recurring thoughts and physical signs of stress (Wallace et al., 2020, p. 4). As art therapists, we may be trained to focus on our clients’ care and wellbeing first, however, taking time to process our own emotional response during a time of crisis is important if we are to provide ongoing helpful support for service users, as is receiving ongoing supervision and peer support (Gibson, 2017). Work-related stress (Huet, 2017, 2015) and burn out (Ashby, 2020; Tjasink & Soosaipillai, 2019) may also be issues to look out for during this time.

It is of course natural to feel anxious, fragile and disoriented in these unprecedented times, after all, anxiety can be seen as the mind’s effort to achieve control over the unknown when everything is in doubt. Scientist Richard Feynman once said that one of the most valuable things that science can teach us is to value doubt and uncertainty … as it is full of possibilities  … and nearly always precedes new knowledge (Feynman, 1955, p. 14) and in this case, we need new ways of working to meet the needs of our service users. Art on the other hand can teach us things that science and maths cannot, it can teach us that problems can have more than one answer, that small changes can have large effects, and that through art we can say things that are inexpressible in words. The challenge of how to document this extraordinary time through art is reflected in the many social media posts created on this subject, as we all discover new meanings and new ways of being, in order to look after our social, emotional and mental health throughout these difficult times. If you would like to share your artwork too you can do so through the #BAATOpenGallery – find out how to submit here: www.baat.org/About-BAAT/Blog/246/BAAT-Open-Gallery

In this issue

In the light of this pandemic, supporting our health workers and caregivers has never been more important, and this is highlighted within Kaimal, Mensinger, and Carroll-Haskins (2020) paper examining the outcomes of the use of collage and narrative self-expression with home hospice caregivers. Art therapy in the form of the Clay Slip Game is discussed within Klein, Regev, and Snir’s (2020) paper, highlighting the sensory nature of playing with clay slip as a meditative process with the potential to enhance emotional control. In their paper Yoon, Betts, and Holttum (2020) highlight the importance of attachment security as the source of many art therapy service users’ presenting issues and report the findings of their research into the Bird’s Nest Drawings (BND) and accompanying stories as an attachment security measure. One of the overriding concerns expressed during the COVID-19 pandemic has been the effect of school closures on vulnerable children, with huge increases in calls from distressed children being reported by charities like Childline (https://www.independent.co.uk/life-style/health-and-families/coronavirus-childline-mental-health-anxiety-young-people-schools-closed-a9429486.html). Therefore, Moula’s paper presenting a systematic review of the effectiveness of school-based art therapy is very timely (Moula, 2020).

Conclusion

If there have been any positives from this pandemic, it has been the international scientific research collaborations and sharing of data, in order to find effective tests, treatments and a vaccine. A very important step for art therapists in the UK and USA, has also been the decision to share journal access for the American Art Therapy Association (ATTA) and BAAT members, with both Art Therapy: The Journal of the American Art Therapy Association and the International Journal of Art Therapy, available in the BAAT and ATTA website ‘members areas.’ This may also be an opportunity for global art therapy research projects, as disseminating our research and practice with and to others has never been so important.

Clearly the wide-reaching effects of this virus will be felt by all of us for many years to come, particularly as we seek to support those most affected. Many of us may be feeling fragile and disoriented and in need of reassurance and comfort in this time of uncertainty and change. However, along with the current changes comes an urgent need for creativity, reimagining and innovation, something that art therapists have in abundance, all of which will help us develop our art therapy practices in ways that focus on the new therapeutic landscape before us and enable us to shape the decade to come.

We extend our sincere condolences to anyone who has lost friends, colleagues and loved ones due to COVID-19.