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Empowering patients with art

Author: Leila Hawkins
12 October 2017

Artist Susan Carr has developed a new form of therapy for patients with life-limiting conditions by reversing traditional art therapy. Instead of creating self-portraits, the patients tell Susan about their lives and how they wish to appear while she paints them. Here she tells ehospice how portrait therapy is empowering those who feel they have lost their identities through illness.

How did you become interested in palliative care?

I worked with local school children in Swindon for two years, mainly with challenging young people in the exclusion unit.  Over the two years I noticed how therapeutic creating art was for these youngsters, who began to take ownership of the school, as the work we created together was displayed in prominent positions.  As I came to the end of the two years I typed “art” and “therapy” into a search engine and up came MA courses in art therapy.  I thought “yes” this is what I am meant to do next!  

I was given a hospice as my placement. Initially I was not keen on the idea of working in palliative care, so asked for my placement to be changed, but I was told in no uncertain terms that if I could not face “death” I could not be an art therapist!  I therefore went to my first session at the hospice full of fear and trepidation about what I might find.  However, my fears soon disappeared as I was given a wonderfully warm welcome by the day-hospice team, and what I found at the hospice was “life” not “death”.  Although there were sad moments, it was joy and laughter that I remember most about that time.  When I came to the end of my placement at the hospice I was offered a position as an art therapist working in day-therapy, which I gladly accepted.  It has been a profound privilege to work with many patients there over the past 12 years.

How did the idea of portrait therapy come about? 

During my time working at the hospice I noticed that patients talked on a daily basis about a disruption to their sense of self-identity, caused by illness and invasive treatments.  Patients would say to me, “I not the person I used to be before I became ill”, and “I look in the mirror and I say, “who is that?’”  This disruption causes patients to feel disoriented, depressed and anxious.

I wanted to develop an intervention that would help patients rebuild and strengthen their sense of identity.  I have always had an interest in portraiture and the portrayal of self-identity, and my first idea was for patients to create their own self-portraits.  I set up a focus group with patients, and asked them if they would take part in an intervention where they had to paint their own self-portraits.  At first they all laughed, saying “No! I would not take part!”  One lady said, “can you imagine what it would look like with these shaking hands?”  Then another lady said, “but if you painted the portrait I would take part!”  Soon they were all saying, “Oh yes, paint me, paint me!” 

Do the patients watch as you paint them and give you suggestions? 

By reversing traditional art therapy and painting the portraits for the patients I am able to become their “third hand” (Edith Kramer 1971).  This means that the intervention is totally inclusive, so patients who are too ill or disabled, or unwilling to create art, can still take part.  Portrait therapy is a collaborative process, patients direct how they wish to appear in the portraits. Over a number of weeks I work with the patients to identify significant moments in their lives, uncovering stories of self-identity patients often claim they have never told anyone before.  I then create collages and prose-poems that reflect these stories back to patients, and these stories are developed further within the portraits. 

What are the benefits of portrait therapy to the patients?

Portrait therapy enables people to develop a stronger, more coherent sense of identity, effecting closure to difficult life experiences, and improving their overall quality of life.  One of the most important findings was the overriding need of patients to know themselves and “be known” at end of life, and that portrait therapy facilitates this in a gentle, supportive and inclusive way.

You have published a book, what does it cover? 

Firstly, may I say that this book is not just for art therapists, it is for anyone who works closely with patients in palliative care, as it offers important insights from patients themselves about the impact of severe illness on a person’s self-identity, and also highlights the power that practitioners have to either affirm or demean a patient’s self-identity.  

The book is divided into three parts.  Part one is a description of the background to the project, a review of the literature and a discussion of the theories that underpin portrait therapy.  Part two focuses on the findings from my PhD research study, highlighting the important benefits identified by the seven patients who I worked with collaboratively to develop this intervention.  These benefits include helping patients to develop their creative capacity to adapt to illness, illustrated by their extraordinary stories of self-identity. 

Part three is a complete protocol of portrait therapy described in detail for other therapists to follow and learn from.   

Do you have any other projects in the pipeline? 

For three months this summer all the portraits completed during the development of portrait therapy (39 in total) were displayed in an exhibition called “Paint me this way!”, held at Swindon Museum and Art Gallery.  This exhibition was sponsored by the Arts Council England, and was received very positively by visitors. One comment left by a lady very succinctly described the exhibition, she said “You see the beauty in people, then translate that into the portraits, so that we can see it too!”  

My plan now is to make another application to the Arts Council, this time for a touring exhibition of the portraits around the UK.  I would also like to develop portrait therapy in another direction, perhaps by working with different client groups.  I could see portrait therapy being very effective for people living with combat stress or dementia. 

Where do you see yourself in the next ten years?

A lot can happen in ten years!  I hope that I will have written a few more books by then, and developed portrait therapy further.  I would also like to spend more time painting outside and I have always wanted to learn to play the piano!  In the short term however, I will be running art therapy courses in Swindon and the surrounding area, as well as working in private practice as a portrait therapist.  I will also be working as a visiting lecturer for university art therapy courses, and continuing my role as an inspirational speaker, delivering key note speeches at conferences.  

Susan’s book Portrait Therapy: Resolving Self-identity Disruption in Clients with Life-threatening and Chronic Illnesses was published last month.

To see more of her work visit Portrait Therapy

See more articles in People and places

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