art therapy writing
Christy Bergland ATR-BC, LCPC
Don Ross, MD
From the great white oak to a sapling planted by nature or human intention, the tree represents strength, patience, survival and hope through time. Trees endure. For that reason the tree has become a symbol of endurance. Trees are the cleansing lungs which help make our atmosphere breathable. They give us cooling shade and refresh our bodies and minds from the heat of a summer's day. The tree also figures prominently in stories involving the major religions. Didn't Buddha attain enlightenment while sitting under the bod-hi tree?
The tree is the cross of redemption in Christianity's Crucifixion. This followed Adam and Eve's interaction with the serpent in the Tree of Knowledge in the Garden of Eden in Judaism's Old Testament. In the written law of the Jewish tradition "man is as a tree in the field,"(Dvarim 20, 19-20). From this oral law the tree is a model for human behavior, "whoever has more deeds than wisdom is like a tree with more roots than branches, and no hurricane will uproot him from the spot" (Mishnah, Tractate Avot, Ch.3, Mishnah 17). The tree with its upward thrust and its rootedness in the earth is a cosmic tree in diverse mythologies such as Hinduism and in Nordic lore. In ancient Egypt the most popular deity associated with rituals of life and death was the god Osiris, a tree spirit. Carl Jung(1964 ) saw the tree as a universal symbol of individuation of the self in all its complex physical, emotional and spiritual facets. Out of the primal ooze of mother earth emerges a struggling and upward striving entity. Jean Paul Sartre, the French Existentialist, beginning with his struggle over his being rooted in his work Nausea (1997) experienced a mature Chestnut tree as symbolic of his existence.
The tree is also metaphoric for the human body and for intergenerational relationships. Our torsos we call trunks - our arms and legs limbs. The crown is another name for our head. When we are feeling stable we can say we are grounded or rooted. Family systems can be diagramed with many branches which flow from the trunk, the seat of primary ancestors in the multigenerational family tree.
The tree is embedded in our language. We are "up a tree" when we don't know what the issue is. We go "out on a limb" when we take a chance. We are "stumped" when we are perplexed. "The apple doesn't fall far from the tree" we say when we are talking about similarities intergenerationally. "Big oaks from little acorns grow" speaks to our life span from childhood to adulthood.
The tree has been used as a formal psychological assessment motif since 1948 when J.N. Buck published the House-Tree- Person (H-T-P) test. The tree according to Buck seems to describe deep aspects of personality. Koch (1952) published The Tree Drawing Test. In 1988 Cohen et al incorporated the drawing of a tree into the Diagnostic Drawing Series (DDS) - a drawing series adapted for use on The Retreat at Sheppard Pratt. Also Morris (1995) while using The Diagnostic Drawing Series (Cohen et al, 1988) and the Tree rating Scale (Creekmore, 1989) found differing emerging patterns of formal artistic characteristics in various diagnostic categories.
The tree, an early schematic image children make, is much less anxiety provoking than the directive 'draw a human figure.' In addition it can yield a richness of personal and interpersonal information about which advocates of tree drawings will attest. Many adults perhaps tapping into their early tree drawings will move into the drawing with spontaneity. Sometimes the artwork becomes a memory of an early childhood tree; a favorite tree in present time; a surviving tree from storms; a tree imbued with emotion in its name such as the weeping willow; or a tree concocted from fragments of imagination. In all cases at The Retreat, the trees the patients make are unique in their look and intuitive feel.
Visual art is the art form that directly precedes the ability to speak in children. It is fundamental to the development of language structure as well as beginning metaphoric symbology for a child's location in time and space. Often patients, who are heavily intellectualized, come to The Retreat without words for their real internal experiences, but even before that some have no idea what these thoughts and feelings are. Art therapy is a way to help locate more authentic thoughts and feelings within a playful context- play being an essential ingredient in mastery.
There are general characteristics of the tree drawings that call my attention. What is the orientation of the paper- is it horizontal or vertical? How does the tree fit within that format? How many colors are used and with what pressure? What kind of environment exists for the tree? What kind of tree is it? Is the tree grounded or floating? Does the tree rest on the bottom edge of the paper? - An indicator this art therapist believes is suggestive of primary dependency issues with the present environment. Are there roots and if so, how are they drawn? How large is the trunk? Is there bark? Are there holes in the trunk/branches? If so, is there a story associated with that? How is the branching? Is it connected to the trunk and the branching system? Is there a crown? If so what is the color? Does the tree break through the boundaries of the paper? If so what is the tenor of the break through? Are other objects included such as trees and flowers around the tree? Are there swings or other creatures living in the tree?
An interpretation of the tree's symbology is both deeply personal and culturally determined. For instance, an evergreen tree is "ever green," often associated with wintertime rituals and holidays. These meanings may be far from a patient's conscious understanding who might only at first remember a good climbing tree when he was a child. It is most important when musing with a patient over the tree's meaning to start with the patient's associations.
The patient is asked to make a drawing of a tree using oil pastels in the beginning art therapy sessions at The Retreat. These beginning pictures are described in the comprehensive diagnostic session, which the patient is given at the end of his first 2 weeks. The presentation of the artwork with the patient's and art therapist's descriptions usually happens at the end of the session and is seen as a visual summation of the other clinicians' clinical impressions.
There are a myriad of questions about the tree to ask the patient. What the patient says and how he says it becomes the beginning of the unfolding of the patient's story as told through the metaphor of this ancient and stable motif. I ask the reader to experience the artwork and the patient's description as metaphor for the patient's experience. The artwork as D.W. Winnicott (1971) discusses, is a transitional object formed within a transitional play space between subjective and objective realities. It is the "me- not me" experience; the origin of metaphor and symbol making, so vital in living an engaged, fully present life.
As medical Director of The Retreat, I( Dr. Don Ross) have had the privilege of participating in many Diagnostic Conferences, close to 800, since The Retreat opened 10 years ago. During that time, I have developed a growing appreciation, respect, and even reverence for the tree drawings that the patients have made and shared with the staff. I have developed the conviction that they have drawn their trees in an effort to help us understand them on a deeper level. I doubt whether any of our patients have drawn their tree with the conscious intent of baring their soul to their treatment team. And yet, with a remarkable degree of openness and courage, many patients have done just that. Week after week, I have seen the tree picture pull together the major threads of the patient's innermost story. Often, those threads were beginning to take shape out of the narratives being woven together the psychiatrist, nurse, social worker, recreational therapist, movement therapist, family therapist, and various consultants, but it's the art therapist and the tree picture at the end of the Diagnostic Conference that pulls it all together. We save the art therapist for last. We didn't plan it this way; it simply evolved into that sequence over the first year or so. The artwork proved to be so powerful as an organizing tool that it naturally gravitated to the end of the Conference.
Another advantage of the tree picture is that it is also a projective screen for the Medical Director. I get an opportunity to hear from the rest of the treatment team and the patient, to see the tree, and then see what I see in the picture. It's a creative process for the patient to draw the tree. But it is also a creative process for the Medical Director to take in the tree, "interpret" it, and make use of it for the patient's benefit. All art has this quality. The artist creates and the appreciator of the art must create as well when he or she engages with the artwork. It is a process similar to interpreting a dream in psychotherapy. In dream interpretation, the patient dreams the dream by creating it from her unconscious mind. She then presents it to the therapist as something for appreciation and discussion. Together, patient and therapist talk about the dream. The therapist brings to the dream her creative mind, along with knowledge of dream formation and knowledge of the patient. Finally, the therapist offers some interpretation about what the dream might mean. I have used patients' tree drawings in many Diagnostic Conferences in a similar fashion. For the first two weeks I have gotten to know the patient on The Retreat. Then for a full hour, I have immersed myself with the patient and the treatment team. And now I have a tree in front of me that the patient has made. I use this tree picture to help me summarize what I have learned. I will use the tree picture to pull together a lot of words into a powerful visual metaphor, one that the patient has helped create.
We have included briefly 2 cases with their tree illustrations;
Janet is a 65-year-old woman whose goal for treatment was "to get my life back and get rid of anxiety." The tree picture called "Winter Tree" feels "lonely and bare," she said sadly. 'I have a tremendous fear of abandonment. I'm afraid my husband will leave me." This major depression brought on by aging issues and her father's death at the patient's current age is classically seen in artwork by emptiness, insufficient grounding, monochromatic color usually somber, and light hesitant strokes. A horizontal format of the paper conflicts with the verticality of the tree. Disconnection and lack of substantial branching poignantly describe her malaise.
Peter is an 18-year-old man whose initial reason for treatment was "because I was having a difficult adjustment period into college life." Entitled "The Thing," the title seems to describe his low sense of self worth. The tree itself, remarkably descriptive of the patient's bipolar highs and lows, is drawn in a deliberate perspective to show a great distance from the bottom to the top of the paper. The patient described the top of the tree as "the lighter, logical side which is far away and hard to reach. . . The bottom of the tree, ominous, dark, and goofy is my evil side of animal instincts and out of control impulses… I like to be in control." This anthropomorphized tree has "lines like veins and internal organs (inside the tree's hole) which like a vortex draws the viewer in. . . The ivy is like a fragile ladder connecting the bottom and top."
Diagnostic categories and artistic characteristics are for the most part inadequate to fully understand and know both artwork and patient. There is so much more contained within these drawings that diagnostic categories can only touch upon. This is why we have given the drawings such prominence as well as the patient's words about their work.
Carl Jung (1961), speaking on the influence of nature on his world view when he was a child said, "Trees in particular were mysterious and seemed to me direct embodiments of the incomprehensible meaning of life."
Buck, J.N. (1948). The H-T-P test. Journal of Clinical Psychology, 4, 151-159.
Cohen, B., Hammer, J.S., & Singer, S. (1988). The Diagnostic drawing series: a Systematic approach to art therapy evaluation and research. The Arts in Psychotherapy, 15, 11-21.
Creekmore, J. The Diagnostic drawing series tree rating scale. (as cited in Morris, 1995).
Jung, C.G. (1963). Memories, dreams, reflections, New York, NY: Random House.
Jung, C.G., & Von Franz, M.L. (Eds.). (1964). Man and his symbols. Garden City, NY: Doubleday and Co.
Morris, M.B. (1995). The Diagnostic drawing series and the tree rating scale: An Isomorphic representation of multiple personality disorder, major depression, and schizophrenic populations. Art Therapy: Journal of the American Art Therapy Association, 12(2), 118-128.
Sartre, J.P. (1997). Nausea. Mattituck, NY: Amereon Limited.
Winnicott, D.W. (1999). Playing and reality. London, England: Routledge.