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Photography and art therapy: An easy partnership

Alexander Kopytin
Published online: 02 Jan 2008.

To cite this article: Alexander Kopytin (2004) Photography and art therapy: An easy partnership, Inscape: Formerly
Inscape, 9:2, 49-58, DOI: 10.1080/02647140408405677
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PHOTOGRAPHY AND ART THERAPY

An easy partnership
by Alexander Kopytin
Abstract

Photography is a visual medium. It would seem natural for art

therapists to consider its therapeutic use and potential.
Paradoxically, however, there are only rare instances where art
therapists have explored the use of photography. The aim of
this article, therefore, is to stimulate thinking about photography
from an art therapeutic stance that involves its use in clinical
practice.

of creative activities based on photography are described.

Case illustrations demonstrate different forms of thematic group
activities and contexts where photographic pictures may be
used.

K~~ words: art therapy, groups, photography, phototherapy

A wide range of therapeutic factors implied in the taking and

perceiving of photographs are presented. Additionally, a variety

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In tro duc tion

Due to our own personal experience and from the
pracbce of phototherapy (Cook, 1997; Krauss and
Fryrear, 1983; Spence, 1986) we all know that healing
and self-discovery often takes place when people are
involved in either taking pictures or just looking at
and discussing them with others. We could not
imagne our life nowadays without photography,
whch accompanies us from birth. For most people,
photographic pictures serve as a valuable
documentary of their personal histories. Photographs
can biing people together and speak much more
eloquently and convincingly than words. They can
also serve as vivid and concentrated fragments of
external reality as well as the objectified
repre5entation of our inner worlds. This can lead to
personal discoveries by providing a cohesion and
contiriuity to experience.
Taking:photos and later arranging and rearranging
them in albums can be playful as well as develop a
sense of order. Through photographs we can pose
and ( ontrol objects and even create a new reality.
We can also try to stop the flow of time and make
various instances of our life last forever. Through
photography we can also pose ourselves - our
fantasies, sensations and feelings as well as our body
and relationships, because we can create the context
and take what we need for ourselves. And sometimes
with the help of photography, we can restore the
forgotten or thngs that we have lost.
ALl thrl possible health-promoting effects of
photopphy are fairly obvious within the therapeutic
context. It IS surprising, therefore, that it remains a
somewhat exotic medium for most therapists and still
poorl!. represented in contemporary literature. Since
photography implies making and perceiving visual
images it would be natural for art therapists to take
the lead in the exploration of its therapeutic potential,

lnscape iolume Nine No. 2 2004

using the ideas and principles that characterise their

profession.
There are some examples where art therapists have
used photography with individuals and groups and
applied different theoretical approaches to support
their practice. Judy Weiser (1993) encourages the use
of phototherapy techniques alongside other skills, in
particular for family therapy. She started as an art
therapist and extended the scope of phototherapy
through the use of other visual media. She indicates
that certain qualities of photography such as the
mechanical production of images make it easier for
some clients than most other visual arts techniques.
Looking at photos is less intrusive, in her opinion,
than looking at a painting.
Fryrear and Corbit (1992)attempt to integrate Jungian
psychology and photographic techniques within an
art therapeutic context. Central to their work with
active imagination is the process of graphic
elaboration, where the subject of the photo is cut out
from the background and glued to a piece of drawing
paper. The client is then encouraged to elaborate on
the image in various ways.
These authors demonstrate how photo art therapy
can be used in dealing with specific short-term
treatment challenges such as relieving fears and
depression and resolving intrapsychic conflicts. They
have also applied photography in group therapy
situations and give suggestions of how to work with
the stuck group by integrating aspects of
psychodrama, photography, meditation and
videotaping.
Michael Barbee (2002)presents a visual-narrative
approach, which he used with a small group of
transgender clients in San Francisco. Partiupants
were asked to photograph their gender story.
Photographs later became the basis for open-ended
interviews, leading to a narrative portrayal of

49

PHOTOGRAPHY AND ART THERAPY

participants experiences. In Barbees study,
photographs proved a valuable stimulus for eliciting
individual meanings of transsexual experience.

of producing visual images when a client has no

ability or is too anxious to draw may be two of its
advantages in the art therapy process.

Wadeson (2002) refers to the art therapy work of

Bettina Thorn (1998),who combined writing with
photography and art in a phototherapy group she
established at a psychosocial rehabilitation facility.
The group visited locations around the city and took
photographs. Through photography, art and writing,
members of the group learned new skills that
improved their self-esteem and confidence.

The physical density of a camera and photographs

can evoke a feeling of safety, which can be especially
important with regard to anxious clients or those who
are fearful of strong or difficult emotions. Through
this quality, and by the fact that it enables
representation of the external world, photography
provides grounding in reality and helps a client to
cope with internal chaos. When a client makes
pictures, a sense of power and possession of objects
or feelings may be important, especially if the client
feels powerless.

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Phillips (1986)found photography useful as a

metaphor for self in her clinical work with people
with schizophrenia.It helped her to enter the visual
field of her clients and experience their sense of
reality, as well as allowing her clients to come to a
more realistic view of themselves.
A similar approach to the use of photography is
developed by Mark Boorno (1989),in his therapy
through creative self-expression.He claims that
photography enables a client to achieve a sense of
individuality and thus understand his/her specific
creative way of life.

In her pioneering work with photographic images,

Landgarten (1993,1994) used photo collage as a quick
and economical way to evoke descriptive accounts
and explore cross-cultural themes.

All these studies indicate that photography has vast

possibilities for art therapy practice and some have
indeed been successfully realised by our colleagues. It
seems, however, that many such possibilities are not
sufficiently used. The specific qualities of
photography as a visual medium and the effects it
can have on clients, depending on the different
formats and procedures of its use, remain subjects for
further investigation in our profession.

Photography as a visual a r t medium

The art of photography is multifaceted, but it cannot
exist without making and perceiving photographic
images. Unlike painting, drawing or clay-work, it
needs special technical equipment. This provides
additional possibilities for creative self-expression, in
particular the possibility of copying pictures,
exploring different formats and colours, using special
visual effects, etc.
The conscious control needed to use the camera can,
however, lead people away from spontaneity and
thus inhibit emotional expression. It seems more
natural for photography to provide a more structured
way of expressing ideas and emotions and to be a
means of projective-symbolic communication rather
than a means of their direct expression. The
mechanical nature of photography and the possibility

50

Due to the social nature of photography, that is its

ability to link people together and stimulate
communication, it can be used to structure
relationships and provide a sense of order and
cohesion in individual or group situations, especially
when the situation is perceived as not safe enough.
Photography is environmental,in the sense that it
reflects relationships between objects. Searching for
objects and arranging them in some or another way
in order to make a photographic picture of them, or
choosing a certain position and posture while making
photographs, helps to include oneself in the space
and develop a sense of physical presence in the
environment.
Photography stimulates visual thinkmg. Through
photography, clients can think through images and
compensate for a deficiency of verbal ability.
The art of photography is akin to play, because it
gives vast possibilities to play with reality and its
representations. Conscious and unconscious, fantasy
and reality can come together through picturemaking. We can consider photography as a means of
active dialoguing with the world and ourselves. Due
to its play quality, picture-making may bring a
feeling of joy and freedom.
Making and showing pictures often involves selfrepresentation, by demonstrating oneself in one or
another appearance or role to a real or imapned
audience. Photography often implies fixing ones own
or other peoples appearance, activities or
interactions. We can see various postures and mimic
expressions that reflect different emotions and
reactions to persons and objects as well as how we
feel in certain environments. This enables us to use
photography as a means of exploring our body image
and our ability to express feelings.
Showing photographs to others is often accompanied
by stories. Telling stories helps render our attitude to
what is represented in photos and clarify what is
hidden behind them. This also helps to explore the
meaning of events by connecting them together.

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PHOTOGRAPHY AND ART THERAPY

Stories accompanying pictures are often complex and

vivid, which makes them even more powerful, by
being ible to express thoughts and feelings more
fully. Ths makes the narrative element of
photography significant in its therapeutic effect.
Thus photography can be regarded as a complex
visual medium with many unique qualities absent in
most art materials. It also integrates various creative
activities and art forms such as play, drama,
movement, story-telling, etc. that can be used in
different combinations throughout the therapeutic
process.

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Some therapeutic functions of

photography t h a t m a y be relevant in
art therapy
Specific qualities of photography as a visual art
medium provide therapeutic functions, which are
outlined in this section. As far as the art therapy
process is concerned, these functions can be
sufficiently realised and understood in the context of
therapeutic relationships. This draws on fundamental
principles of art therapy.

These are: that visual image (or object-)making is an

important aspect of the human learning process; that the
image.making . . . in the presence of a therapist may enable
a client to get in touch with early, repressed feelings as well
as with feelrngs related to the here-and-now;that the
ensuiirg art object may act as a containerfor powerful
emuticins that cannot be easily expressed; and that fhe
object provides a means of communication between
therapist and patient. It can also serve to illuminate the
transkrence (that is,feelingsfiom the past which are
brought into the here-and-now and influence the way we
experience others) between the therapist and patient.
(Waller, 1993, p. 3 )
Photographs provoke memories and feelings, both
positive and negative. Though memories may be
traumatic and negative, feelings are sometimes
overwheIming; when psychological safety is
established and containment of feelings is provided
h s c m lead to catharsis and resolution. This
focusinglactualisingfunction is also connected with
expression of latent, previously hidden characteristics
of a client. Perceiving a photo, a client may discover,
for instance, that she or he is presented in a new and
unusual way or does something she or he never
imagined they would do.
Photography stimulates diferent sensory systems
inchding vision, tactile and kinaesthetic sensations.
When a person is taking photographs or showing
them to others she or he takes an active stance in the
world. In this way, photography promotes initiative
and zntentzonality. It stimulates fantasy and thinking,

lnscapt Volurnt Nine No. 2 2004

evokes different emotions and often physical activity.

By creating an image, a person taps into her or his
creativity. Photography is inseparable from ones
ability to choose and include a perceived object or
feeling into a system of personal meanings and relate
them to ones experience and needs. This can be an
important factor of bringing the unconscious into
consciousness.
Another therapeutic function of photography is
reflecting the dynamics of external and intonal changes.
Photography enables us to see and recognise changes
in our appearance and environment and often
understand changes and our identity and way of life
as well. Photography can help a client to observe
changes as a result of certain events or influences and
to see a meaning in the clients own and other
peoples actions and feelings. Combining certain
photographic images taken from different sources
may lead to a discovery of new, meaningful
connections between them. There is therefore the
possibility for self-reflectionand reframing.
Keeping pictures in an album may be an additional
factor of containing. It is interesting to speculate about
associations to the camera and its containing function.
It may also represent a kind of hermetic vessel. When
the film is inserted into the camera it is as if it goes
through stages of an alchemical process. Our actions
and feelings can be safely kept on the film inside the
camera and later assume a new quality, when the
film is taken out of the camera and processed.
Photography has a cathartic and communicativefunction
in helping the expression of feelings and ideas. There
is also a protective function by enabling some distance
from traumatic experiences.

Different forms o# using photography with

art therapy groups
Various photographic techniques may be used
periodically during the art therapy process
depending on clients needs. There may be a wish to
capture some moments of their artworks or to create
a new experience. Sometimes photography helps to
establish a more direct contact with reality and a
distance from powerful feelings. In certain cases,
clients may want to use photography in order to
objecw changes that take place within them or
around them.
Though clients and groups can spontaneously come
to using photography, in some cases a therapist may
stimulate them to use it by introducing certain
themes, games or exercises. Client or group activity
may be structured differently depending on the
situation. Sometimes, for instance when a group lacks
self-organisationor anxiety is high, a therapist can

51

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~~

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use such a thematic approach. I choose from a

number of different themes, games and exercises that
can be separated into several categories such as
Thinkmg, dexterity, memory, General themes,
Self-perceptions(Liebmann, 1986).To give an
example: the Polarities theme may represent the
Leneral themes category. Working on this theme,
group members are asked to make a series of pictures
representing objects with opposite or complementary
characteristics, or those that evoke opposite feelings.
Some of the particular polarities may be The big and
the small, Beautiful and ugly, Pleasant and
unpleasant and so on. It is possible for group
members to formulate or choose a theme themselves.
Photographs can be made either during or between
sessions.
When the photographs are ready, group members are
invited to arrange them in certain ways making a
composition, installation, album or poster. Texts,
including those created by members themselves or
borrowed, can accompany the visual material. Later,
presentation and discussion takes place.
The polarities theme may allow symbolic expression
of different feelings, including difficult or negative
ones and their recognition and conscious integration.
It can also improve self-control and facilitate safe selfdisclosure, in particular with regard to clients latent
needs.
An example of the Self-perceptionscategory might
be the theme Life-line, when a client or group
members are asked to bring photos from their homes,
in which they are represented in different periods of
their life. Some pictures may reflect important
biographic events, such as weddings or graduating
from college or university. People choose any pictures
they find significant. Sometimes, if a group is mature
enough, members can concentrate on most difficult or
dramatic events.

During the session, group members show their

photos to one another, accompanwg them with their
commentary. Sometimes I might invite people to
concentrate on particular periods of their life or
relationships. In some cases, the role dynamics,
professional career, hobbies, family relationships, etc.
can become a subject of discussion.
The first case example presented below illustrates
clients responses while they work on this theme.
Sometimes my approach is less directive and open
projects can be introduced to the group, giving
participants more space to choose from a number of
perspectives (Waller, 1993).
Group members may also be asked to arrange
pictures in certain ways, making a composition, an
album or a poster. A long sheet of paper, such as
wallpaper, can provide a suitable format for this task.

52

~~

They may use texts and different art materials to

draw between pictures to provide additional visual
and narrative material.
Beside personal photos, which clients bring in by
invitation or on their own initiative, they may also be
asked to make photos either during or between
sessions and later use them in different ways (to
produce a thematic album, a book or a poster, or
include them in a collage or an installation).
Combinations of visual media with different art
forms may satisfy the changing needs of clients at
different stages of the art therapy process and
provide additional avenues for self-expression.
Using the exercise Expressive gestures and postures,
group members form pairs. One person expresses
different feelings and emotional states, particularly
those that are most typical of or signhcant to her or
him,through a series of movements or postures. In
doing so, the group member should not say what
concrete states or feelings are being expressed.
Meanwhile the second member of the pair observes
the others movements and postures and periodically
takes snapshots. She or he should also pay attention
to what feelings and fantasies of their own are being
evoked by the partners movements. Later, partners
share their impressions. One describes what states or
feelings she or he expressed, while the other describes
what states or feehgs she or he observed. They then
exchange roles.
When the photos are developed, the partners discuss
the movements and gestures shown in the pictures.
They might pay special attention to the degree to
which their experience of particular states or feelings
is expressed in movement and postures. Sometimes,
they might be asked to make a composition of several
photos reflecting the dynamics of their movements
and gestures. Their personal meanings may also be
conveyed by arranging photos and inserting
drawings and/ or texts.

This exercise helps to express different feelings and

develop interpersonal skills and the ability to be
engaged in collaborative activities. It also helps to
improve self-regulation and ones ability to
experiment with new roles and experiences, to reveal
and make conscious ones latent needs, to develop
empathy and give emotional support to others. When
mutual trust between group members is established,
using this exercise may provide safe self-disclosure
and facilitate closeness.
I realise, however, that the effects of clients activities,
and the particular photographic technique or theme
they may use, depend on the context and such factors
as the stage of the individual or group art therapy
process, the quality of therapeutic and group
relationships, the time limits, individual

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PHOTOGRAPHY A N D ART THERAPY

characteristicsof a client or group, overall goals of

therapy, etc. I also understand that some techniques
may be used to achieve certain immediate goals
(better understanding of the clients situation,
establishing rapport, emotional release, stimulating
interaction between group members, etc.) in one case
and serve as an instrumental basis to achieve longterm goals in other cases.

Examples of using photography in the

context of interactive art therapy groups

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In h s section some examples of using photography

in an interactive art therapy group are presented.
Examples 1,2 and 3 reflect my work with short-term
training groups. Participants were asked to bring in
personal photographs and later include them in their
artwork. Example 4 reflects work with a long-term
therapeutic group of psychiatric patients resident in a
specialised unit.

Example 1: finding meaning and cohesion in life

stories through individual art-making with
photographs
During a session, members of a thematic group were
asked to make a two- or three-dimensional
composition reflecting their life story and various
past and present roles. Compositions could be made
using personal photographs and any art materials.
Group members had different cultural and
professional backgrounds. Most of them were
Latvians, a few members had a Russian background
and one member came from the Czech Republic.
One member of the group, Mara, made three paper
cones and placed her personal pictures onto them.
These also symbolised her past, present and future.
Presenting her composition to the group, she said
that her family had experienced deportation and been
sent to Siberia when Stalin occupied Latvia. She had
been born in Magadan, in the far east of the USSR,
and lived there for some years. Though she had later
returned to Latvia many years ago, personal pictures
from her childhood stirred up strong feelings as she
recalled her past.

first time in my life. At school I was ashamed to show them

to anyone. When we came back to Latvia I was
uncomfortable,because children in my school were very
suspicious of me. . .
Here is my present. 1like to be alive, tofeel, to meet
diferent people, to create, to be a woman. There are my
children here as well . . . I dont like to be in the Fumes.
Im lucky to be an artist, because it gives me an
opportunity to go out of the 'frames'. I put the two photos
which represenf me together with my brother on this cone
as well. He now lives in America. He also doesnt like to be
in Fumes. Our relationship is very important to me. I
placed the cone which sign$es thefuture on the paper with
diferent colours and glued a blue paper onto the top of it,
because I perceive myfuture in this colour. This colour
signifies something that is very dificult to render in words,
but which can be perceived intuitively. 1want to see the
world and travel in the future and keep my connection
with arts - my art and that of others.
The commentary presented indicates that arranging
personal photos and creating three-dimensional
images that incorporated the photos enabled
distancing from difficult feelings; it helped Mara to
feel in control of her memories and to find a meaning
in her past, present and future. This also facilitated
verbal expression of feelings and provided structure
and cohesion to her life story. She found the group
space safe enough to present those photos and
memories, which she had never presented outside
her family before.

Example 2: art-making with photographs and

creating stories in pairs
The group was instructed to form pairs and then
make an art object together (a collage, a drawing, a
painting, a composition in plasticine, etc.) that would
contain personal photographs of the group members,
and then create a story. It was suggested that the
stories be imaginary and not necessarily reflecting
biographic events of the participants.
There were six pairs in the group. The first pair cut
two windows in the form of hearts in the centre of a
sheet of pink paper and placed their childhood
pictures in the windows. After that they put five
pieces of dark blue paper around the windows and
placed pictures that they had cut from magazines on
the blue pieces.

Mara 1 made the three cones. I understand that my inner

lfe must be represented in such a form. Thefirst cone is
my past - my family, my childhood. The second cone is my
present and the third one is myfuture. I placed pictures
represtwting the life of my family in Siberia on thefirst
cone. 1 dont remember who took these photographs, but the
past eiiokes strong feelings in me . . . M y parents were in
hell. We lived in Magadan, but 1 didnt sufir. Our home
was vt7y small. 1 saw the sea and its presence was v e y
positive. I remember how I tried to imagine what Latvia
looks iike while 1was a child. . .

The second pair started their work together with a

discussion, that lasted for about fifteen minutes.
During this time they approached the piano, but then
placed their photos, portraying themselves in
different periods of their lives, in several rows on the
floor and began to carefully select pictures. Later they
asked the leader to let them leave the room for a
whde in order to prepare their performance.

1 am iiow showing these pictures to other people for the

The third pair took a big sheet of paper; one started to

lnscape Volumv Nine No. 2 2004

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PHOTOGRAPHY AND ART THERAPY

Figure 1. The Sea and the Maiden: artwork incorporating personal photographs.

draw, while the other person was writing. They drew

a stormy sea on the left and a figure of a maiden
standing on the rock in front of the sea on the right.
Below the maidens figure there was a tree with
leaves and blossom (Figure 1).
The fourth pair also started their work silently
drawing together. They later began to select and cut
pictures from magazines and exchange ideas from
time to time. The fifth pair took wax crayons and
started to draw on a sheet of paper. Then they placed
two photos in the centre of their drawing, one
portraying a man, woman and child and another
portraying a child. The sixth pair took longer to
decide what to do. At last, they glued two sheets of
paper together and started to draw what looked like a
film.
When the art objects and stories were created and the
discussion had begun, the first pair read their story to
the group. Their composition consisted of their two
centrally placed childhood photos and ten pictures
taken from magazines placed around them numbered
one to ten.
The second pair titled their performance Talking in
between and throughout. They put on their coats
and approached the piano. Both had their latest
personal photos attached to their backs. They started
to improvise. After a minute, they took off their coats
and there was another selection of pictures on their
backs, this time portraying them when they were

54

students. Finally, after a couple of minutes they took

their shirts off to reveal their childhood pictures fixed
to their bare backs with sellotape. One of them said
that the pictures on his and his partners backs
signhed something in the past. While performing he
felt a warmth in his back. He explained that his and
his partners childhood pictures were shown only for
a few seconds, because they could only make contact
with their early memories for a short while and these
photos were very intimate. He also said that it was
important to feel mutual trust while he and his
partner worked together. They selected pictures to be
placed on their backs without being able to see how
the pictures looked. This meant seeing oneself
through the eyes of another person, because each
had selected photos that reflected the most
characteristicpersonal features of the partner.
Presenting their artwork and story, the third pair
switched off the light and lit a candle. One person put
the drawing of the sea and woman on the chair, sat
down by it on her knees and started to read the story
while her partner played the piano. The story was as
follows:

The sea was stormy and presaged changes. The maiden

wanted to make a new beginning, but was afraid of this.
She looked at the sea and held an old mirror.The stars were
bright and the moon was shining. Everything was
mysterious. The sea and the sky were herfiiends and she
shared her feelings with them. She wanted to get to the core

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PHOTOGRAPHY AND ART THERAPY

of hrr being. She believed that the mirror must help her and
1ookt.d at the sea and in the mirror. And soon she
discovered her new face. The storm changcd meything and
it changed her as well.
Then the maiden asked the mirror, Tell me, who am I?
Show me my future! I want to know what to expect. And
the mirror answered, You are a queen, you are everything
in the world, the tree, the storm, the strength, the sand, the
sea and all the elements, if YOU want to be. All these things
are imde you and around you.

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The maiden looked in the mirror and understood that she

already knew this, but she needed strength to believe in it.
Soon her anxiety disappeared and there was no mirror in
her hand anymore. There were no waves on the sea. The
sky was calm and the world was at peace. She looked below
and iioticed that spring had already come and the tree was
blossi>ming.
The fourth pair just showed their drawing to the
group. As they were very engaged in the drawing
they chose not to create a story. The fifth pair
expldined that they had drawn spontaneously.Only
when they had stopped did they start to think about
what their drawing might represent and how their
photographs might be included in the drawing. One
of the partners said that the blue line she had drawn
was <issociatedwith a river. She understood that it
might signify a family. The blue line ran down to the
lower part of the paper, where the partners had
placed current pictures of themselves. The other
partner associated the colour blue with trust. A blue
element in the lower part of the composition signified
joy.
After the sixth pair presented their drawing they said
that their work together was significant because it
had helped them to understand each other. They
found their experience of working together more
important than the mere drawing and story that they
had made
What emerged from the discussion was that
perceptlons of the photographs changed several times
throughout the sessions. For example, an adolescent
photo changed from being rebellious to soft and
tender and then to very romantic and sincere.
In hs example the same personal photographs, that
the members had been asked to bring in and had
already been presented and discussed during
previous sessions, now revealed new meanings
through reframing. This became possible by
arranging group members activities in such a way
that they created new imaginary contexts, played
with images on their photos and felt free to project
new roles a d qualities onto them.

Example 3: creating and inhabiting the shared space

The group decided to make a group painting on the
theme The city. Their intention was to use a variety
of art materials and include photographs representing
each of the participants. The day before, they had
been asked to bring in photographs from home.
Group members were invited to settle in the city by
finding or creating a personal space (in the form of a
house, a public building, a park, etc.) to put the
photographs of themselves.
The group consisted of sixteen members. It was a
mixed training group including individuals from
different professional and cultural backgrounds and
of varying ages (from twenty-three to forty-eight
years). All but one member of the group were female.
Because the session took place after a summer break,
it was important to stimulate interaction and reestablish group cohesion. A big sheet of paper was
placed in the centre of the room. Some participants
immediately started to draw or search for a space
where they could place their photos. Several
members of the group, however, just watched what
others were doing, or sat at a distance drawing or
looking at their photographs. Some participants
established pairs or small groups and started working
on art objects together. There was only one initial
territorial quarrel, between two women. Although a
few members had some difficulty in joining the
group, overall an atmosphere of openness, mutual
support and emotional warmth prevailed. There was
laughter heard from time to time during the group
work.

A three-dimensional house made of paper was put in

the centre of the composition; it looked like a private
house and did not integrate various parts of the
composition. The collective composition looked more
like a small town or a village than a city. There were
no cars in it; on the contrary, public parks and private
gardens with green trees and ponds were abundant.
There were also several public buildings representing
a fitness club, sauna and restaurant as well as a
cathedral in the composition. It was full of threedimensional images (trees, houses, boats) and
contained several personal objects (see Figure 2).
Though three of the participants settled near the
centre, most of the group preferred to inhabit
territories located more or less at a distance from the
centre. Ths could possibly be indicative of their
unwillingness to be responsible for the city as a whole
(in fact, for the group) and feeling uncomfortable
about taking on leadership roles. A tendency to be in
the shadows or to hide prevailed.
Most group members found one or other place to put
their photographic self-images; in most cases they
settled in the houses, and only three women decided

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PHOTOGRAPHY AND ART THERAPY

Figure 2. The Ciw. a group painting incorporating personal photographs.

not to include their photos in the group painting at

all.

I observed that most group members were very

emotionally involved in their work, searching for
wavs to settle their photographic selves in the
houses they had created or to find another place
(such as a park). This contributed to a feeling of
safety and containment in the group. The discussion
helped to reveal members roles and express feelings
with regard to the group as a whole. Inclusion of
members photographic self-images in the group
painting stimulated identification with its space and
intensified projections. On the other hand, vast
possibihties for exploring hidden meanings and
experimenting with roles existed due to creating and
inhabiting the imaginary environment.

Example 4: working w i t h psychiatric patients in a

s p e d unit
This example describes my work with patients who
have committed severe offences due to psychiatric
illnesses such as schizophrenia or personality
disorder. As well as medication, verbal
psychotherapy and art therapy are offered to some
patients. Throughout the course of art therapy,
patients sometimes took photographs and later used

56

them to produce thematic artwork. Sometimes photos

were given to patients as stimuli. The group that I
worked with met once a week. The sessions lasted
one-and-a-half hours; and sometimes in summer
patients took photos in an enclosed yard.
The group consisted of six men. Their ages ranged
from twenty-two to thirty-eight years. All of them
had a diagnosis of schizophrenia. None of them had
previously attended individual or group psychotherapy.
Before beginning to use photographic techniques, the
patients had worked for about three months, mostly
with paints, crayons and pencils. Sometimes I took
photos of them and their artwork and noticed that
they were always pleased to be photographed and
even asked me to give them some of the pictures.
This led me to introduce some special themes and
exercises using photography. I describe below some
of these themes and exercises and present my
observations on patients responses.

Self-portraits: The session started with a discussion,

about the word self-portrait and what this might
mean to them. The group members were then invited
to paint a background for their own self-portraits on a
big sheet of paper. When the backgroundswere

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PHOTOGRAPHY AND ART THERAPY

completed, the patients were asked to stick them to
the wall. Then they 'tried on' their 'backgrounds' by
standing in front of them and loolung in a mirror. The
therapist photographed each of them. The session
finished with patients sharing their feelings about this
process.

Making stories with photographs: In the following

session, I brought in photos that I had previously
taken (landscapes, objects, street scenes, etc.) and
asked each group member to select one photo. Then I
invited them to create a story around the selected
photo, whch were then read out and responses
sharcd.

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During one session, a patient selected a photo of the

psychiatric hospital. The hospital had solid brick
walls and bars on the windows. His story was as
follows:
The world is a crude thing and due to a relentless law you
can lose everything . . . Cells, walls, bars, all this takes
everything that was beautifulfrom a woman. Only when
she sometimes looks at the sky she comes back to the world
of sun and pleasurefor a moment . . .
He related that his girlfriend was being treated in the
same hospital. He said that he felt sad and wanted to
select another photo in order to create a different
stoq . This time he chose a photo with a window
through which the sun was shining, and said:
The window. Sometimes the v i m that opensfiom it is very
eloquenf as lfyou are lookingfor a moment into another
world, into something beautiful, which you ignore most of
the time being in the ordinary world. But you can see and
feel anofher world through your soul and your fantasy . . .
At the end of the session the patient was more
relaxed and satisfied with what he had done.
Another patient in the same session selected a photo
featuring a cesspit and created the following story:
Life I S overburdened with old and useless things. W e are
surrounded hy them and cannot escape from them. W e
spend our life among garbage.
As if he were continuing this story, the third patient
wrote a poem as a response to a photo portraying a
toy bear that had been put in a dustbin.

Hello' My name is Bear.

M y llfe is a garbage bin.
I am/orgotten forever,
But there's a taste herein.
Then are new friends in garbage
And ;'m not alone.
People call me 'son of a bitch',
But I don't care at all.

This patient asked me to give him the photo and later

lnscape Volume Nine No. 2 2004

he wrote another poem and a song. Several patients

asked me whether they could keep the photos as
powerful feelings were invoked.

Making photos in the hospital yard: One of the

following sessions was spent in the hospital yard. It
was spring and I explained that participants could try
taking photos of different objects. I said that though
the yard was well known to the patients they could
hopefully see it with fresh eyes. I invited them to find
an object or scene that evoked positive or negative
feelings or seemed meaningful for them.
Since there was only one camera in the group, the
patients walked around the yard in search of an
object. When an object was found, I gave the camera
to the patient so he could take a snapshot. When the
pictures were printed they were shown to the group
and discussed. Sometimes strong emotions were
expressed, both positive and negative.
As a positive object, one of the patients (twenty-two
years old) had chosen the black cat that lived in the
hospital. An object that evoked very negative feelings
in him was a concrete slab that resembled a
tombstone. He took two sticks and made a cross and
then put it at the 'head of 'the tomb'. Doing this he
looked agitated. When his 'installation' was
photographed he was able to explore some intense
ambivalent feelings: he felt pity and sadness, on the
one hand, and satisfaction, on the other hand, since
he had made his own creation.
Enacting stories evoked by photographs: The
patients were asked to select a whole series from a
pile of photos (previously taken by me) and create a
scenario of a drama, a farce or a comedy that could
later be enacted.
One of the patients made a sequence of the following
pictures: (1)an exterior view of the psychiatric unit;
(2) a view of the Finnish Gulf shore; (3) a mop; (4)
vegetables (potato, onions) on the floor; and (5) an
open oven. During the discussion he imagined his
release from the hospital. He went to the Finnish Gulf
shore to relax, then he came back home and cleaned it
to get ready for his guests. He then peeled vegetables
and prepared a meal for his guests, who had come to
celebrate his release from the hospital. He added that
he would like to invite the group to such party when
he eventually left the hospital. He then enacted the
story by moving furniture as if it were on a stage.
Patients showed increased activity and interest in
various objects around them, as though they were
discovering them anew. They also became more
attentive to their own and other people's appearance.
Some of them expressed an interest in learning more
about 'body language' and how others perceive them.
When photography was used, the interaction

57

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-

between the patients stimulated their emotional

support of each other. Photographic techniques
together with other art therapeutic activities helped to
restore many functions that were damaged or lost as
a result of illness and social isolation in such patients,

Waller, D. (1993) Group Interactive Art Therapy: Its Use in

Training and Treatment. London: Routledge.
Weiser, J. (1993) Phototherapeutic Techniques: Exploring the
Secrets of Personal Snapshots and Family Albums. San Francisco:
Jossey-Bass.

BiograpkicaZ details

c012 c I usi0 n

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Mv intention in this article has been to consider

photography used within the art therapy context as
distinct from other applications of photography that
may be characteristicfor occupational therapy or
verbal therapies. A wide range of therapeutic factors
implied in taking and perceiving photographic
pictures as well as various possibilities of including
photographic techniques in the art therapy process
ha\re been presented with illustrated case examples.
I bt3lievr that photography has very much to offer to
art therapists. They can be leaders in the therapeutic
use of photography, because their practice is rooted
in 1-isualarts. This does not exclude, however,
conibinations of various therapeutic approaches and
art forms with the vast range of photographic
practices, because photography is universal and
integrative by its nature.

Alexander Kopytin graduated from Kemerovsky State

Medical Institute (Russia)in 1982 and then trained as a
psyduatrist. From 1984 to 1999, he worked primarily
as a psychiatrist with outpatients in St Petersburg. In the
latter half of the 1990s he also trained in psychotherapy and
for several years ran therapeutic groups introducing art
therapy in lus work with outpatients. Though his interest in
art therapy began as early as 1984, he has no qualification in
art therapy. It is not recognised as a profession in the Russian
Federation. Currently, he works as assistant professor at the
Faculty of Psychology, St Petersburg State Academy of
Postgraduate Pedagogical Training and also at the
Department of Psychotherapy, State Medical Academy in the
name of I. Mechnicov. He has published several books
(mostly on art therapy) in Russia.

Refuences
Barhee, M. (2002) A Visual-Narrative Approach to
Understanding Transsexual Identity, Art Therapy: Journal of
the American Art Therapy Association 19(2):53-62.
Boorno, M.E. (1989) Therapy through Creative Self-Expression.
Moscow: Nauka (in Russian).
Coo&.,J.A. (1997) The Disposable Camera Technique, in
Kaduson, 3. and Schaefer, C. (eds) 101 Favorite Play Therapy
Techniques, pp. 388-390. Northvale, NJ: Jason Aronson.
Fryrc<ar,J.L. and Corbit, I.E. (1992) Photo Art Tkerapy: A
Junginn Perspective. Springfield, IL: Charles C. Thomas.
Krauss, D.A. and Fryrear, J.L. (1983) Phototherapy in Mental
Health. Springfield, IL: Charles C. Thomas.
Landgarten, H. (1993)Magazine Photo Collage: A Multicultural
Assessmcnf and Treatment Technique. New York
Brunner / Mazel.
Landgarten, H. (1994) Magazine Photo Collage as a
Multicultural Treatment and Assessment Technique, Art
Therapy:Journal of the American Art Therapy Association ll(3):
218-219.
Liebniann, M. (1986)Art Therapy for Groups: A Handbook of
Them s, Games und Exercises. London: Croom Helm.
Phillips, D. (1986) Photographys Use as a Metaphor of Self
with 5tabilized SchizophrenicPatients, The Arts in
Psychrlthrrapy 13: 9-16.
Spence, J. (1986) Putting Myselfin the Picture. London:
Camden Press.
Thorn,8. (1998) Picture This: Phototherapy with Chronic
Mentally Ill Adults, unpublished masters thesis, University
of Illinois at Chicago.
Wadeson, H. (2002) Confronting Polarization in Art
Therapy, Art Therapy:Journal of the American Art Therapy
Associution 19(2):77-84.

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Inscape Volume Nine No. 2 2004