Keywords

Art therapy; Psychotherapy; Mental health; Psychiatry

Introduction

Defined as a tool for the integral and holistic rescue of the patient, aiding self-knowledge and the development of psychic abilities and individual potential, art therapy was strongly influenced by Freud's Psychoanalysis and the idea of art as a non-verbal manifestation of the unconscious. The introduction of art therapy workshops had its space expanded and is currently part of the practical activities of care services and treatment of patients in mental health, including as an additional and essential alternative in the monitoring of psychiatric patients, as well as a strong ally in health promotion in psychiatry.

The creation of a space with the presence of various mental health professionals, who integrated will contribute in a rich and welcoming way to the evolution and the realization of art therapy workshops, decentralizing the idea of treating patients with mental disorders with a focus on hospitalization and overvaluation of psychopharmacological treatment, thus introducing a differentiated environment that will help to rescue creativity, organization and artistic expression skills. [1,2]

The use of different types of materials such as paints, clay, paper, glue and fabrics help to create and reinvent a new look at reality transformed by the artist with a different notion of the aesthetic, in a creative and reflective way. Art in its individualized form enables connections and internal and external communications, dialoguing and acting on self-knowledge, resignification and reproduction of realities and ideas, uniting communications from the patient's internal and external environment. The introduction of art in the therapeutic process as a health promoter and an additional step in the process of treatment, rescue and reinsertion of the individual in the field of mental health narrows ties and spaces between clinical and pharmacological treatment and the development of artistic and cultural skills. [2,3]

Objectives

General objective: Debate concepts and themes related to the introduction and relevance of using art therapy as an ally in the treatment of patients in mental health.

Specific objective: Expose and review the literature for the realization of reflections on the impact of art as a therapeutic methodology associated with psychopharmacological treatment.

Methodology

This is a literature review, with consultation in the Virtual Health Library. The descriptors “art therapy” and “mental health” were used, resulting in a final balance of 17 scientific articles. 10 articles were selected for the present work, being within the inclusion criteria, articles in Portuguese and English, published in the period from 2005 to 2014.

Results

During bibliographical research, it was identified that the vast majority of articles emphasized the expansion of art therapy not only in the context of mental health, but also in the context of cancer patients, terminal patients, pediatrics and the elderly population. Most of the works analyzed also report experiences that took place in CAPS and in hospital services as a psychology initiative, with publications in specific journals of psychology and nursing. The participation of physicians or publication in specific journals of psychiatry or other areas of medicine was scarce, but all studies pointed to the need for an integrated and multidisciplinary team to plan and develop art therapy workshops. There were no studies and projects that included academic leagues and the work of academics and students in the environment of construction, reinsertion and development of the creativity of the mental health patient who performs art therapy.

Discussion

Art as an expression of the patient's subjectivity was discussed a lot, from works on art in psychotherapy, fruits of Jung's studies, to art in a psychoanalytic approach by Freud. The use of art in workshops as a therapeutic resource was based on the idea that non-verbal expression in images and the use of materials that awaken the development of senses and creativity would be the reproduction of the individual's internal world, encompassing thoughts, feelings and derivations of the unconscious [4].

The expansion and independence of the use of art therapy as a health promoter and treatment tool allowed the creation of a therapeutic branch with different and unique characteristics that encompass intrinsic and individualized techniques and concepts of art therapy, helping the affirmation of this therapeutic modality, with focuses that they vary between the artistic process and its healing properties and the expansion of creativity and individual potentials along with emotional development and the expansion of dialogue between patient and psychotherapist [4,5].

The pioneering introduction and development of art therapy in mental health in Brazil occurred with figures such as Nise da Silveira and Osório César, who greatly contributed to the idea of using art as an effective therapeutic tool and proof of the relevance and importance of this new methodology in the approach and treatment of psychiatric patients, as it breaks traditional forms of treatment and includes a modality capable of valuing individual aspects of creative production that stimulates sense organs, language, intelligence, emotions and the most diverse ramifications of psychic functions, as well as enables greater contact and interaction of the individual with the internal and external environment in an active, participatory and transformative way [5,6].

Art therapy is not an exclusive modality of mental health, being also used to promote the general health of the population, having as target populations patients with cancer, the elderly, children, and various social groups, regardless of whether they are associated with mental disorders or the work of the psychic suffering. However, the essence of the performance and role of art therapy is preserved in the most diverse action groups, generating psychic transformations through experiences of art construction with the use of creativity and individual imagination, helping in the elaboration and knowledge of problems and conflicts little discussed or denied, acting mainly in reproduction, resignification and work of feelings of pain and anguish. The work and understanding of unconscious processes can be elaborated in art therapy sessions for patients with somatic pathologies, but the interaction component of these diseases and the condition of each patient with psychological distress and possible mental health problems that can be be associated with somatic pathologies [7,8].

The factor that led to the introduction of art therapy in the hospital context, both in the work with hospitalized children and in palliative care patients, was the need and concern for the hospitalized patient's state and mental health. The focus of the implementation of art therapy in hospitals is present in the need for alternative and complementary practices to pharmacological treatment as a form of psychological development and break from the routine and the hospital environment, enabling, in addition to self-knowledge, the realization of pleasurable activities that at the same time time inspire and encourage the continued dedication to art and act as reproduction and work of discovery and research of individual feelings that were hidden or not questioned and developed by the patient [9,10].

The therapeutic approach using art is widely used by psychopedagogy, being also inserted in the school environment, with the presence of a multidisciplinary team for the development of workshops. Within pedagogy, art is used to confront anxieties and enhance individual skills and creativity of students, having great strength among children with behavioral disorders, but it can be used in general for all children, resulting in identification and the work of psychic sufferings present in each reality, personal and family history of the child, regardless of having a diagnosed mental disorder or not. Such vision and use reinforces the idea of the effectiveness and expansion of art therapy as a health promoter, focusing not only on lines of treatment, but a general expansion of the use of art in dialogue, self-knowledge and mainly as an auxiliary tool for the quality of individual's life, being a means of integration, social insertion, reproduction, participation and interaction.

Conclusion

The process of breaking the stigmas that permeate madness and psychiatric patients, as well as deinstitutionalization, will not be achieved only with the creation of less exclusive tools and the expansion of debate and communication about rights and new approaches for patients with mental disorders. Breaking existing barriers to the expansion of new methodologies for approaching and treating patients in psychological distress is associated with the growth and structuring of new art therapy workshops, as well as the construction of schedules and an increasingly expanded and integrated team, disseminating the benefits and importance of this type of treatment for the patient in mental health. The inclusion of academics and high school students in the planning and carrying out of activities in art therapy workshops is important to change the popular imagination of madness and breaking misconceptions, even among those most familiar with mental health policies. The inclusion of students, adolescents and academics in the health area in practical activities and in the planning of workshops helps to create bonds with the patient, perception and learning of the effectiveness of art therapy in mental health treatment. Such insertion also contributes to change traditional ideas related to the overvaluation of pharmacological treatment to the detriment of the association of new care practices and treatment of psychiatric patients.

It is necessary to break concepts and prejudices that link the work of art therapy only to professionals in psychology, nursing and pedagogy, emphasizing the importance of the participation of the psychiatrist with the mental health team in the construction of the alternative treatment process of approaching the patient with use of art, stimulating creative work and creating bonds in the doctor-patient relationship.

References

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