The Feeling of Unity
The Feeling of Unity explores the benefit of a weekly emotion-regulation-themed art therapy group. The study was conducted in an OASAS-approved outpatient clinic for adults with substance use and co-occurring mental health disorders.
From an attachment perspective, individuals with insecure attachment history and limited regulatory capacities are at risk of developing substance use disorders.
The art therapy group has shown advantages for individuals who experience frequent dysregulation by creating a holding environment, managing emotions through creative materials, improving client engagement, fostering social connections, and building frustration tolerance skills.
Seven art therapy directives were designed to meet essential treatment goals for those clients with substance use and other psychiatric diagnoses at the clinic. Five emerging themes are found in this study, including:
● Self-regulation through artmaking
● Building emotional safety
● Fostering peer and family connections
● Working through frustration and ambivalence in recovery
● Improving program engagement
Directive 1: Acrylic Print Book
This project is an intro-level directive that combines printmaking and book-making methods. The project is adopted from an emotion regulation directive designed by Edell (2016). The participants were encouraged to identify recent emotions and assign colors to them. They later used the colors to visualize the emotions in a painting and create prints using the painting. When finished, the participants bound the pages together into a print book as the final product. The group members were also invited to share their artwork and how the process felt for them as the closing discussion.
The clients created artwork in response to a variety of emotions, such as excitement, calmness, confusion, anxiety, and sadness. For example, one client requested black, white, and brown paints for her artwork and shared that she chose the colors because they connected to her “sad and ugly feelings”. She specifically created grey color using black and white because it was “a mixed feeling of sad and calm”. Reflecting on her final product at the end of the group, the client commented that she found the marks she made in the prints interesting, and she no longer felt the colors were ugly as they created fascinating combinations through textures and color mixtures.
The directive was found beneficial for improving client engagement, building confidence, and understanding the ebb and flow of intense emotions.
Directive 2: Pompom Doll
This project was designed as a family-oriented art project, as many clients had children in their families. After being introduced to basic pompom-making techniques, the participants utilized various materials to decorate their dolls to create their own characters. They were also encouraged to take extra materials and make dolls with their family members at home.
The group took place on the Monday after Thanksgiving weekend. During check-in, group members shared their holiday experiences, and the topic of family conflicts came up. Many clients at the program reported having traumatic interpersonal experiences with their families and struggling with the lack of healthy support systems. During the group, the clients were able to share and process bitter-sweet feelings about their families.
The directive appeared helpful for clients to destress through textile materials, process family conflicts, and strengthen social relationships. One client, after sharing her feeling of disconnection from her daughter during her recover, said that she named her doll after her youngest son and wanted to send it to her oldest daughter as a gift.
Directive 3: Paper Beading
This project aimed to help clients build self-regulatory skills through the repetitive process of beading. The participants were encouraged to create paper beads and combine them with premade beads to create bracelets.
Beading was especially challenging for clients with limited fine motor skills and eye-sights. For those clients, the art therapy intern utilized the third-hand technique and offered customized support to them during the process.
Beading appeared effective in reducing stress, regulating emotions and exploring identities. For instance, one client expressed that beading connected to her background in art history, and the repetitive process of rolling paper felt soothing. Another participant also stated “(beading) is relaxing and helped me with my anxiety and stress.”
The directive was found successful in destressing, building self-competence, improving engagement, and enhancing social connections. Many clients also shared that they enjoyed the directive as the final products were aesthetically pleasing.
Directive 4: Body at Peace & Body in Tension
This project was designed to promote physical awareness for emotion regulation. The participants were encouraged to reflect on how emotions and physical states could interact and affect each other.
Transitioning into artmaking, they later created two self-portraits to represent the self at peace and the self with tension using materials of choice. At the end of the group, clients reflected on their experience of the directive and talked about what helped to bring them back to peace when they felt dysregulated. One client shared, “painting peace actually brought me peace, and painting tension made me feel tense.”
Meditation, exercise, dancing, and connecting with nature were discussed as coping strategies for distress.
The themes that emerged from the group included mindfulness techniques, emotional containment, and self-care.
Directive 5: Squeegee Painting
Squeegee Painting was a directive designed to promote spontaneous artmaking and reflective writing.
The squeegee painting directive was the first group project that required using acrylic paints. While some clients had previous experience with painting, others appeared hesitant to start. One client stated, “I haven't drawn since elementary school. I didn’t like it.” The art therapy intern then informed the group that the directive was a simple one that required minimal skills and that “the most important thing is not to make a perfect painting but be in the moment and feel the flow of the paint.”
The participants used cardboard and acrylic paints to create paintings and later added written reflections to their images. The directive was effective in engaging non-verbal clients, practicing healthy risk-taking, and building self-reflective skills.
Directive 6: Journaling Notebook
This project focused on the benefit of journaling for emotion regulation. The participants used various texture paper to create their own notebooks.
While some clients had previous experience with journaling and seemed interested in the directive, one client stated, “I tried it before, but it’s just not my thing.” The art therapy intern
acknowledged his experience and told the group, “I am aware that journaling might not work for everyone, which is totally ok. You can also dedicate your notebook for other purposes. Notebooks are versatile.”
The clients came up with various purposes for their notebooks besides time management. For example, one client created a notebook using patterned paper and stickers and stated, “I’m going to use this to record my readings for diabetes.” Another client, who said, “I was not feeling well last week, and I was going through some ups and downs” during the open check-in, created a notebook dedicated to tracking her emotions and recording “ups and downs".
Directive 7: Mindfulness Weaving
This project utilized cardboard weaving techniques to explore the benefit of textile materials for emotion regulation. The clients were encouraged to create yarn tapestries while discussing personal matters in the groups.
All four participants of the project had no previous experience with weaving. While most of them appeared confused and hesitant when they first heard about weaving tapestries, they were all able to learn the flat stitch and start their artwork independently.
Although all clients experienced some level of difficulties during the process, they were also able to solve the problems they encountered with some help from the art therapy intern. No client appeared distressed due to the difficulties.
Discussions were held on mindfulness, stress relief, interpersonal conflicts, and time management.
The directive was found beneficial for building frustration tolerance skills, processing gender identities, strengthening therapeutic alliances, and improving self-competence.