Содержание материала

E. Kjellberg


This article will present a way of being together with families when the ordinary talks with words seem too blunt or even dangerous to engage in. Or simply when there are no words to express chaotic experiences, as is often the case when the family members are caught in strong feelings as anger, fear, sadness or shame. The work combines two main fields of clinical practice: Talking in reflective processes in a systemic-constructionis tic framework and painting and meeting with ’’inner pictures” in art-therapy. Before going into the world of expressions-principally painting and talking, I will shortly present the daily, clinical work which constitutes the ground and frame for this telling.

Everyday practice

BUP Gallivare - Kiruna is a psychiatric outpatient clinic for children and adolescents situated in the very north of Sweden above the arctic circle. The area is very large, mostly wilderness with subarctic heaths, swamps and alpine mountains. Altogether 60.000 inhabitants live mostly in the four communities built up around large iron ores which have provided much of the economic welfare of the whole country. Other branches of industry are forestry and production of electrical energy from large waterfalls that have been tamed. The lappish people herd semi-wild reindeers since ancient times. So, earning a living is still much dependent on hard manual labour and closely dependent on prerequisites given by and changing with inherent forces in nature. In recent years technology has rendered much labour superfluous, unemployment rates are high and the area holds relatively high figures for psycho-social maladjustment. Three languages, Swedish, Lappish and Finnish are spoken in the area and in the south, Laplanders are thought to be silent, reliable and direct. Another description of a common way of interaction is: ”In the whereabouts of Gallivare stories are told in a very special way; the stories are often of a large vocabulary, undulating and unpredictable with long digressions wrapped up in a magnitude of details. The telling itself has a value in it’s own right, just as highly valued as the point of the story”.
Our team consists at present of three psychologists, four socialworkers and one psychiatrist and is responsible for all psychiatric work in the defined region. That means that we handle all ordinary child and adolescent psychiatric problems, such as anorectic behaviour, depressive and suicidal states, conduct disorders, autistic disturbances , child abuse and so on. We are the only professional team in the area and have to be of help both to the children, adolescents and support their parents. Other obligations are to support social authorities and courts in the region as well as colleagues in the health care and medical systems with evaluations and collaboration. The very large and scarcely inhabited area has made it very natural to try out systemic theory and practice, in order to be of help. Since the beginning of the nineties we are part of a large professional network in the Barent’s Region centered in Troms, Norway and led by Tom Andersen, professor of social psychiatry. He is famous for having ’’invented” and developed the practice and theory of ’’reflecting processes ” (Andersen, 1991). In the team we have successively integrated the practice of talking in reflecting processes as a basic attitude in our different meetings and talkings with families and their networks. This means that much emphasis is put on the relational aspects of our psychiatric assignment. (Kjellberg et al 2001).
No matter what the problematic behaviour and needed intervention, medical, psychological or social; it is always performed in a context constituted by the assembled knowledge and wishes of all those concerned round the problematic situation, the so called problem-created system (Anderson, 1996). We are responsible for creating a format that makes it possible for everyone in that ’’system” to express themselves and to listen to each others. This opens for a possibility to understand oneself and the others in another way. This in turn makes it possible to ”be and act” in new ways. Of course, reflective talks depend on the spoken words, but in the way they are performed they are also very sensitive to the feelings and inherent rhythm of the participants.
During the same period, the nineties, I have been interested in, trained and started to integrate art therapy in the everyday practice in the clinic. Janet Svensson is one of the leading Swedish art therapists whose work originates from the theory and practice of the Swiss psychoanalyst C G Jung. She has opened up the world of ’’inner pictures” to me and guided me in a more general understanding of the meaning of pictures, painted as well as seen.
There are many similarities between the reflecting talks formed by Tom Andersen and the painting therapy formed by Janet Svensson. This is especially true for the attitude to what is expressed; said or painted. In both these clinical traditions the person who talks or paints has an absolute right to the interpretation of their own said or painted expression and is thus markedly respected as the prime expert on their own life. No outsider can know what the picture contains, what it expresses, means or symbolizes as no outsider can define in words what different experiences or expressions mean to a storyteller. The only possible to say is what the picture or told story contains or means to the viewer or the listener himself. Sharing those impressions with the narrator or painter makes meeting and dialogue possible.

Reflecting processes

Talks with reflecting processes means in short that you organize the talk so that it will be possible for all participants to shift between ’’inner” and ’’outer” talks. That is to get the opportunity both to talk freely, uninterrupted and also to listen to the others and to yourself. It is in these talks of great importance that the therapeut makes room for everyone present and follows and supports, one at a time, the different participant’s unique ways to express themselves- and not disturbs those processes. The others listen.
Often some teammembers form a listening and reflecting team in order to bring more perspectives into the dialogue. The team is sitting in the room, listening to the conversations, and when asked give their reflections to what they have heard, how they were affected by that and which associations came up.
This marked attention to listening to what is really said , and the listeners comments to what is heard generates a strong concentration on the ongoing present life- which is the actual dialogue. This contributes to the speakers ability to find his own way to a new understanding anchored in his own experience. It is not only the intellectual understanding- the result of the development of thinking - that gives possibility for problemsolving. It is just as much the talking in itself that brings forth development of the thinking. Systemic work with reflective processes gives all the participants in the conversation access to their own thoughts and the perspectives of the other’s.
The reflective contributions give a more nuanced picture of the whole situation and thus a deepening and development of experience and thinking for all present participants. Basic principles and theoretical background to working with reflecting processes is best captured in ’’Dialogues and dialogues about the dialogues” by Tom Andersen (1991) . Many different applications in clinical practice is written about in : The reflecting team in action, ed. Steven Friedmann (1995).
In art therapy or painting therapy the ongoing life is expressed not in spoken words, but in painted pictures. It is just another way of expressing the same.
Painting therapy
In the United States art-therapy is practised with strong emphasis on the artistic side of painting pictures. Not only the painting expression, the process, is important, but also the resulting painting or sculpture in itself as a product to be proud of having achieved. One of the pioneers in this field, still giving lectures at more than 80 years of age is Edith Kramer (Kramer, 1971). In Scandinavia most ’’art-therapists” put more emphasis on the process of painting and concomitant talking and therefore in our countries the practice is named picturetherapy, or painting therapy instead of the perhaps a little more pretentious arttherapy.


Janet Svensson has developed her own way for expression of and meeting with the so called ’’inner pictures”. Her format includes methodology for a stable frame in which there are possibilities for free expression in painted pictures and analysis of that process, the Alma-method (Svensson, 2002). In fact the stable frame is an absolute prerequisite for the free expression. From the Austrian art therapist Bettina Egger she brought to Scandinavia the practice of letting the patients paint their pictures standing with paper pinned to the wall. This practice she developed further and let the clients use large papers and by themselves decide the format and size of the paper. This to ensure free bodily movements when painting. Bodily movements which take part in forming the pictures, and the painting of pictures giving movements that are felt in the body. The room for painting is limited with respect to outer stimulants. Fibreboards designed to pin paper cover the walls. In the middle of the room there is a table where a palette consisting of bottles with fluid temperacolours of all nuances of the colourspectrum is situated. The colours are watersoluble, easily blended with each other and dry quickly. On the table there are also paintbrushes of different forms and sizes, swabs and crayons of oil pastel. That is all. These limited palettes, the colours given, constitute the joint possibility for the participants to express their individual processes-inner pictures. Sometimes the structure is strengthened by giving themes for painting. Most often the participants are led more freely into the painting, invited and inticed to follow their impulses in relationship to choice of material, colours or following a movement felt in the body. Be in the movement and transfer it through your hands onto the paper! Choose colours that capture your eyes and that feel good or somehow important!
When painting is finished the pictures are talked about. This also in a structured way. A so called process analysis.
The format of talking about or meeting the pictures with the clients has many resemblances with the practice of reflective talks. When the painting takes place in a group setting the painter is asked whether he/she wishes to hear comments from the others who have been painting their own pictures at the same time. If the painter so wishes, the other participants in the group are encouraged to go into the pictures and ’’make them their own.” They are then asked to give their reflections: How does it feel to be there? What do I actually see? Do I get any associations I want to share? None of these thoughts or feelings are to be ascribed as belonging to the painter, they are strictly contributions for the painter to consider if he so wishes, or not. To follow these guidelines is to ensure that the painter can keep his or hers picture intact...
The pictures are there to be met, received and responded to. They are not to be interpreted by anyone else but the painter.
In her work, Janet Svensson constantly remind the participants: ’’The pictures are our holy grounds! They are subtle and contain so much more than what we are seeing and are able to denominate. Sometimes it is enough that a picture is painted and that it is seen. It may be too difficult to talk about it. So: Be sensitive ...don’t analyze... don’t valuate... Through being in the pictures we are where the patient (painter) is. It is there, and only there we can meet, and go on”.

How it all started

In the beginning of the nineties I had my first personal encounter with painting therapy. It was to me a quite new, almost shocking experience to meet with my own and other’s worlds of pictures and take part in structured painting of these inner pictures. Many may be conscious of the fact that performances of theatre and film movies all the time, throughout life are shown to the inner eye. This happens when the ordinary life is going on as usual. I did not know that this was happening until I had this experience of my own. I also experienced what happens when you see these pictures, get the possibility to express them concretely by painting and afterwards share the impressions with others who have been occupied in similar processes at the same time in the same room. I got very fascinated by the strength and the joy in this mode of expression and the possibilities to in a safe and lenient way discover, see, meet and be in relation to the different private themes of life it turned out to contain. The initial experience has been strengthened by the richness in variations of pictures and processes of all those I subsequently have met during the years. And of course the continuous meetings with my own pictures. Many of the thoughts and ideas in this text are also inspired by the efforts made by deeply comitted artists trying to describe their work. Wassili Kandinsky, Henri Matisse, Pablo Picasso, Helene Sherfbeck and Alberto Giacometti have all beautifully tried to put in words what is at the heart in their nonverbal practices of communication.
As long as I can remember I have loved to paint, draw and watch pictures and always been fascinated by colours and forms. I have also always felt more trust in what my eyes have told me than in what I have heard through my ears, but this was a whole new experience. I was drawn into the world of inner pictures and was captured by one for me earlier quite unknown way of meeting myself and others.
I found myself creating earlier unknown and yet in some parts wellknown landscapes. In the process of materializing and exploring those landscapes, new landscapes came forth. And everywhere there were treasures, some of them long forgotten while others were brand new, previously unknown, and there were also obstacles to deal with.
This can happen in a spontaneous painting of pictures that is without other aim than expressing what just now, at this moment, in the ongoing context is occupying the painter.
What happened to me and the others was that the different themes, often complicated lifesituations that we were occupied by, showed spontaneously in the pictures. They always showed in a form that somehow was surprising to the painter. And new pictures always followed, neverending, the first painted and reflected about giving birth to the next, and so on...
Spontaneous creation of picturesexpression- colours can sometimes bring you in contact with different feelings that also are ’’stored as memories in the body”. That means that when certain episodes remind you of similar experiences earlier in life which were followed by bodily reactions to the felt fear or distress, these reactions can recur, often as muscular tensions or pain. All this without one really noticing how it came about. It just happens. Through associations that connect those memories with the concomitant feelings that are relived, expressed in painting and met, tensions that earlier were concomitants to those feelings can be made ’’out of labour” and thus loosened. Painting of spontaneous pictures is thereby a vigorous practice that ’’bypasses” our traditional fears of talking. The pictures that emerge are often surprising and can contain themes, previously unknown to the painter himself. The painter does at that time not know what he has done and can be taken by surprise by contents of the picture that awaken strong feelings as shame, sorrow, fear or anger. The picture may also contain elements which feels fragile and sensitive to deal with. It is therefore of utmost importance that the painted pictures are met in a way that is concrete, careful and respecting.

Painting as movement and creative power

What now follows is a description of my first experience of meeting with inner pictures. I took part in a seminar held by Janet Svensson together with other professionals interested in experiencing painting therapy. After a short easing of tension through concentration on bodily sensations including breathing and listening to music, we, the participants in the group were instructed to stay within that experience until a picture became clear enough to the inner eye to elicit the wish to concretisize it in a painting. When that impulse came it was time to begin painting. I closed my eyes and saw very clearly a beautiful landscape in dark midnightlight. The sky was vast and bluish-black, lit up by moonshine and numerous of brilliant stars. The ground: A green meadow filled with high, lush grass. Far away at the horizon appeared a white shimmering fairy castle with towers and pinnacles. Suddenly, fast moving greyish- black clouds emerged in the sky and turned into flying wolves on their way to the castle.
It was very beautiful and exiting and I quickly decided to paint the whole scene before it disappeared. When I had painted what I had seen there in the grass emerged a sphinxlike woman in grey veils, which made me somewhat confused. After a while I continued with placing a large red flower in the middle of the meadow, and then after a while at it’s side a small budding growth leaning towards the large one. After having done that I felt glad and full of expectations, The picture was complete - what was next to happen?
When afterwards we all met with the pictures of ourselves and the others, someone commented that she felt relieved to see the little flower, since the landscape otherwise gave such a ferocious and lonely impression onto her. I remember finding that reflection surprising, it was a view rather far from my own immediate experience.
The next time we were to paint, large threatening faces turned up in my imagination. They changed their facial features with one another, and reminded me of different persons I knew well. I painted them and felt sad, afraid and unsure. When I was asked a simple question by Janet about whom the faces represented, I told her that and in that moment it was as if 1 was immediately moved back into my childhood. In my mind I felt to really be there and in an emotion of agony I painted some pictures containing traumatic experiences. After this followed pictures that gradually shaped fear, sorrow, death and wrath in the guise of a dragon being killed by a young child. All this in first greyish and thin, later in clear and bright colours, after which there was a feeling of relief.
The final scene that appeared to the inner eye was once again a midnight image with a large starry sky that turned into broad daylight. On the ground this time was a big open tent where grownups and children were resting upon furs lying on the ground. Warm red fire in the middle. One of the furs, clearly a wolf, looked only apparently dead. One eye open. Outside the tent then appeared two women, this time in white veils, offering large vessels of fresh water to the inhabitants.
At the same time the others were painting their own pictures. All of this took place during some days in a relaxed atmosphere, actual happenings and memories were rarely denominated. If at all, only just as much as the painter, in this case myself, thought necessary in order to elucidate, be heard and seen and to be able to go on. Afterwards? Relief, calmness and self-confidence. So, what I and the others were doing was to materialize in pictures experiences and feelings which regardless of their origin still were alive in our present lives.
In painting we shaped what was occupying our minds and yet not fully seen and understood. These were elements which caused trouble, thereby seeking attention in order to be dealt with. When painted and expressed in pictures they were made possible to meet and deal with. Thus they become understandable and by and by meaningful as integrated parts of life. There are clear signposts and compasses in the inner pictures. Just give them room and possibilities to show themselves! Then you can put down your feet safely. And trust not to go astray.

Family painting

During the time I trained and learned to work with pictures, I wrestled with how this knowledge should be integrated into my daily work with families in different critical circumstances. I felt it increasingly necessary to try to introduce the experiences from the ’’paintwork” into the daily work. What I had learnt and practised was however a pronounced individual work even if it took place in a group context. My eve- rydaylife consisted of meeting children and adolescents together with their closely related, accordingly, always meeting and talking with the children and adolescents in their natural context. I did not want to change that! So how find a possible way? All the time however, I felt that the common elements in the two ways of practice was the key for doing both-and. The common parts are two as I see it.
First: The creation of a stable frame for talking or painting that makes it possible for the different participants to safely, freely and in their own way, express what is important to themselves. Expressing and meeting with, seeing or hearing the concrete own picture, whether told in words or painted, increases the understanding of the own situation.
Next: The reflective stance in relation to what is expressed by the other. Meeting with the other’s description of himself in words or pictures where the own expression is central and eventual explanations or interpretations explicitly belong to the person who has talked or painted. Others can, even if they don’t understand the content, perceive emotions and feelings and also see the variations in the other’s expression and give that back as a reflection of their own experience in the meeting.
I just had to try to bring in painting of pictures as a part of the ordinary meetings and talkings that I took part in daily.

"Today I want you to paint instead of talk!”

In clinical practice I sometimes meet with families who for different reasons are caught in difficult situations- crises when strong feelings as fear, anger or sorrow has diminished the possibility to talk in a nuanced way to each other. This relative, temporary inability often gives rise to deadlocks and escalating crises and misunderstandings.
When this happens everybody tends to uphold one-sided pictures and simplified models of understanding . They get occupied with their own understanding, so there is very little room for listening to the others, or to see each other. It can also be that the actual experiences are so severe that there really are no words available to describe them. It may also be that the spoken language is perceived too dangerous or potentially harmful so that silence is judged to be the best way to survive. Words can sometimes be more destroying than helpful. All these circumstances contain in different ways fear of talking and being in dialogue with each other. This fear can always be felt in the room as an atmosphere of high tension and a somehow common waiting for something to happen to avoid an expected explosion. Anything is welcome to protect from talking.
This was the case the first time I dared suggest to a family to paint together. The daughter in her younger teens came with her parents to see if we in any way could help them to find a way back to each other again. The girl had very forcefully decided to move from home, where she felt unloved and misunderstood to the extent that she in protest had been silent and not taken any part in the families life for many months. She had also emptied her room and demanded from the social authorities to give her a foster-home. All efforts to talk were fruitless, they very soon turned into bitter mutual accusations accompanied by many tears and angry outbursts. I really felt frustrated, not knowing what to do, and to my surprise I heard myself saying something like : Please, this is not leading anywhere, I do not know what to say anymore, couldn't we try to paint instead? That might not work either but I think it holds at least some possibility to come somewhere. If not anything else I am sure it is a more comfortable way than this to be together. And they all said yes! The girl immediately started to paint a beautiful large picture, where she shaped her lifesituation with many symbolic expressions including a thunderstorm with lightnings striking a furious fire. Very, very carefully she painted a large delicate fruit wrapped up in and surrounded by a black cloud. Then she put much effort in painting two dancing lions. The mother and the father painted at the same time, both three pictures after the other, which they were intrigued by.
Meanwhile they were smalltalking to each other. Suddenly, the father looked up at the daughters painting an d exclaimed.: Oh, now I see that she is not leaving us! The girl turned to him, shook her head and mumbled something inaudible, then went back into the picture again. She painted for more than an hour. Afterwards we all sat down together and talked about the pictures. The girl had many observant comments to all the pictures of the parents which started lively discussions containing many questions and also smallteasing and even some smiles. So, ice was broken and they were able to start talking again. I think that perhaps I was the most surprised.
So when I get this feeling of locked up uneasiness which is hard to get around I have begun to say: ” It seems as if it is very difficult to talk. Sometimes it is I know that Couldn't we try to be together in another way instead? Do something together  We could try to paint! it might be easier to express something that way...try to meet in another way than talking perhaps it is a way to feel a little better. I have some rather nice colours here which feels good to use. Just look!”
So in this way I bring in an often unexpected moment, an offer to in a way get out of a painful, strenuous situation. If the crisis is bad enough almost everybody that I have invited in this way say ”Yes, why not?” Bad enough means that there is much pain and frustration and at the same time the attempts to talk don't seem to make the participants feel any better.
What almost invariably happens then, is that some family-member, most often the father says "-But I cannot paint! I haven't held a paintbrush in my hand the last twenty years!” Many teenagers say: ” I cannot draw, it becomes so ugly and bad. It never looks the way it should!”
So then I very quickly say some things like: ''Such things don't matter at all!
This kind of painting is not about achieving something. It is all and only about painting with colours on paper just as it happens. -Finding a colour you feel like using, taking a paintbrush in your hand. It is the painting in itself it is all about, not what it incidentally will lead to -1 will show you!.”
Then I take material out of the cupboard if it is not already put in the room.
Paper in large rolls, white or brownish, liquid tempera- colours in many nuances. Brilliant hues, easily mixed with each other, water-soluble, thereby easy to paint with and also to decide the degree of "floating” on the paper with. They also dry quickly, so they allow for painting new layers upon the first within a short time.
Paintbrushes of different sizes and shapes, swabs. On the walls wood fibreboards from floor to ceiling to pin the paper onto. I help the familymembers, one at a time to cut a piece of paper in the size they wish for their painting, and everybody knows, when asked, exactly the size and format of the painting to be. They choose where in the room they want to stand and I help them to pin the paper to the board at the height they choose. Everybody gets a bucket with lukewarm water and a swab to wet the paper before painting. This to initiate a comforting sense in the hands and it also brings the painter in a direct bodily contact with the paper .All get empty cups to fill with the colours and blendings they choose. Then, all is on its way.
Within a couple of minutes all present usually are completely concentrated in their own creation of pictures. Sometimes they look at each other's pictures and say something briefly. Some start to small-talk with each other about their chosen colours, comment something about the brushes and similar ordinary, concrete items. Gradually all get absorbed in their own activities till the painting "feels complete”. This will mostly take about three quarters of an hour.
I remain during the painting "passively attentive.” I stay in the background, often sitting and drawing a little with crayons , walking around and seeing to that enough colours are available all the time. I ask the young ones if I can help them to change the water in the buckets so that it gets all fresh. I talk a little commonplace if someone wants that during their painting, without disturbing the others. During the painting the participants almost invariably begin to talk to each other and connect in a gentle good-humoured way as tension lessens and different associations and memories emerge.
The atmosphere is rapidly changing concurrently with this coming into ’’motion”.
I am attentive to if someone seems to get ’’stuck”, and can in such a case for example support a continuation by carefully asking what is happening in the empty field of the painting. I also observe when a picture seems to be finished and ask the painter if he also feels ’’ready”. If there is a hesitation I ask if he will make another picture. If so we together cut and pin a new paper to the board. Sometimes even another picture will be necessary to paint before the painter feels that he is all ’’finished”.
When all have made their paintings we sit down together to look at the paintings, one at a time. This is done in the structured reflecting way described above with emphasis on being caring of the painters integrity when meeting with his pictures.
Many times the young children talk about the pictures as if they are real- ”Look! There is our summerhouse, and I see mother going with our noisy dog, and they are fighting as always!” Which of course is quite ОК. They can also get bored and want to go out and play when they think they have had enough. Which of course also is quite ОК. Most important with the younger kids seems to be that they go into a free painting and then that the grownups can say something about the picture that shows they have tried to take seriously what they see in and feel about the picture. For example: I see a real sad boy in that big,'dark wood. It feels so lonely being there. It looks like he is looking at something far away, what is there? A house? He is holding something bright in his hand, is it a flashlight? It looks like there is a small path, a dog jumping, is he hunting a frog? That green in the corner looks like a real old frog to me.
With the elder ones and the grownups it is of real benefit if you persist in their taking a reflecting stance to the pictures of the other’s. They most often very fast grasp the idea and go into playful and amused comments to each others expressions. But also often really look intently and contemplating at the perceived content.  When I comment, I am careful to comment upon all that I see, and share the feelings they elicit. I do this both to show the painter that he or she is seen and accepted in their complex many different expressions and also to help myself from the temptation only to focus on what I myself think is most important to hold forward in the painted picture. It is also important to identify parts that lead forward, containing the possibilities for a new picture. This can be parts that ’’look” unfinished or make you wonder what is happening outside of the paper. Or symbols of new life like tender vegetation or an infant. During the painting together and afterwards when talking about the painting totally new topics suddenly can come up and cause long discussions. And the problematic themes often are dealt with in a much more easy and matter-of-fact way together with other themes in the families life. So it seems that being in the process of spontaneous painting, freely standing so that also all bodily movements can take part in the painting , ’’loosens the ties of the tongue ”. Often when leaving the clinic the members go together, smalltalking in a good- humoured way, very different from the tension and silence in the beginning of the meeting.. Sometimes it is quite enough to paint once, sometimes they want to paint more, some have come back many times during a year till they have felt ’’ready”. The painting is used as a way of being together when temporarily the usual talking with words is not possible. Therefore meetings with a family can contain times to paint and times to talk. That depends entirely on the actual situation and the wishes from the family- members. It is not planned or structured on before-hand. The children like to be together with the parents , doing the same things , sharing the same kind of experiences. They are often more confident and master this way of being better than their parents and so the ordinary roles are for a while turned upside-down. The parents often in the beginning turn to the youngsters for support and help. This contributes strongly to another kind of respect for each other than before. It seems like the grown-ups when experiencing the complexity and also the vulnerability in their own expressions turn into a more understanding and careful attitude towards the expressions of their children, and the kids get more interested in their parent’s thoughts. So, mutual interest and respect of integrity is enhanced. The whole process seems to give the participants relief of pain and confusion, and a more nuanced understanding of both themselves and the others. It also seems to respond to deep lying, strongly felt needs to meet with others in a way that makes you understand more about yourself. You become less lonely and less afraid.

Inner pictures-images and talked language

Nature is not only all that is visible to the eye- it is also the inner pictures of the soul- the images on the back of the eye.
This was stated by the great Norwegian artist Edward Munch , whose forceful and very emotional paintings rendered him a position among the godfathers to the 20th century expressionist painters (Tojner 2000).
From where do the pictures emanate? How are they connected to emotional experiences and movements in the body? Why is there such a strong feeling of ’’wholeness”?
Inner pictures or images are constantly newly born and they contain courses of events, memories, and expressions of emotions and feelings linked to different events and life- experiences now and earlier in life. They also contain conceptions of the future with hopes, longing and shifting possibilities of development. They exist inside us, live their own life and change concurrently with new experiences modifying our attitudes to life. New aspects are constantly brought in which may nuance and broaden our understanding. Through painting these pictures they are brought outside ourselves and get materialized. Thus they are possible to meet, talk to and relate to. Often in this process you are able to see parts of life that earlier were hidden. Suddenly, the painter will see new aspects and nuances. The complexity of events and experiences becomes evident and thus possible to understand, (”Aha! So this is what was going on - and is”), in a way that if obtained by words could have taken a long long time, if ever. These spontaneous pictures contain ’’the whole”, they mirror dark experiences but also joy, longing, strength and hope.
Colour in itself carries an emotional aspect beyond the words. The picture and the colours materialize the experience of reality and emotions are liberated when colours are brought in.
So all of which we all the time experience and take part in; all the impressions we receive, from outside and inside, all the life we live constantly forms complex inner pictures ready to be brought out into the open whenever we so wish. In those pictures there is a totality that reflects where we are in the world, what occupies us, what is important and meaningful to us. We can see it and experience it. Perhaps we are also using the spoken language to build pictures with words in order to search for an understanding of what is going on.
It is not always so easy to find such words. Especially not when you are caught in strong emotions or when you have to position yourself in relation to shifting realities which are unfamiliar and difficult to understand.
If one is trying to understand courses of events or experiences solely by talking in words it can easily happen that you go into tracks and sidetracks that lead astray. Especially if you meet and talk with someone who thinks he knows what is your problem, and brings into the conversation his own words and fantasies about it as matter of facts. Then you easily can loose your own vague and still unstable train of thought.
The ’’inner pictures” are given a chance to appear when there is a concentration on the bodily language, movements and feelings- and when attention is paid to impulses that emerge and these are followed. This happens automatically when you drop concentration on logical thinking, planning and analyzing and also ’’outer seeing”. You can not feel and analyze logically at the same time. Thinking has a tendency to occupy and take space from feeling, that is why it often has to actively be suppressed in order to make room for feeling, being and moving. This of course is a problem for most grown-ups. The more grown-up and rational you become the more you have to consciously shift attention in order to notice feelings and bodily expressions. Mostly children are closer to that way of being and all kinds of nonverbal communication comes more natural to them than the spoken language in words.

Painting of pictures as play in a structured form.

When playing takes place in a structured form there is a guarantee that nothing gets out of hand. That is taken care of by the format and the boundaries. The participants can safely relax and give themselves over to the moment. They do something together that directs the concentration to the ongoing moment. In doing that, body and emotions go together into one being, which opens up a feeling of wholeness. This in turn generates feelings of joy, lust and often curiosity which counteracts feelings of shame, wrath and fear. In so doing it undermines the hindrances for communication- relating brought about by those stressful feelings.
It is hard to resist being in a context that is so relieving.
In order to make this happen we must create, structure a context that is safe and confident.
Our attitude must be respectful to all the participants, calm and convey security for all. Minimize fantasies and conceptions. No secrets. Go into a common rhythm. Find what is most important for everyone. If there is a critical situation in the familylife: See and respect the sensitive parts of all as the intertwining background, thereafter it is possible to be in the present and look ahead.

Clinical examples

These are constructions of some ’’usual ” encounters with painting in family crisis. This way of describing the process is chosen out of respect of the real boys and girls I meet who are too young to be able to give an informed consent to make public their private strivings.
Case 1
When I first met with Mary she was twelve years old. She was referred to the clinic from social sevices after having revealed sexual abuse in the family. She did not want to talk to us and her mother also thought they cold handle things best themselves now that they had been helped to a sheltered home. So we just parted and we said they were welcome back if they sometime should want that. Two years later there was a new referral, this time from the pediatric ward where she was on heavy treatment on account of intestinal bleeding that recently had debutated. She was very weak and anemic from the bleeding that did not seem to stop. She refused to follow the instructions for eating an medication necessary for cure. All were worried and an additional worry was that she said very little, as did the mother.
The first week we communicated by plastic coloured clay, which I gave her and we just rolled small pearls together to form necklaces and other ’’jewellery”. Only some fifteen minutes every day. Just to do something little fun that was not at all demanding and at the same time got her hands into movements making them a little warm. We talked a little about her being tired and in stomach pains. She made very clear, as did the mother that the earlier traumatic events were no theme for talking. The mother was there all the time, quiet, but the few words she uttered were all in the direction that Mary would be well. I was surprised she could be so sure. I was not and I really felt very uncertain about what was going on in this tiny, silent, very weak girl who looked almost transparent. I invited them to come to my clinic and paint, using the words: It's a nice place, I have some very nice colours there and you can come out of this hospital-room for a change.
So, they came. Mary , to weak to walk, came in her bed fully equipped with bottles and tubes for her continuing intravenous treatment. Now in ordinary clothes for the first time. We sat down in the painting room at a table where Mary chose what colours she wanted to paint with. I helped her to pour them in cups, as did the mother. She wanted a big paper, and started to paint immediately. Mother did not want to paint herself, but sat beside Mary and started to Smalltalk with Mary and me for the first time. Very soon she came to talk about the times when Mary and her brothers all had been small children. She remembered having pinned papers to the wall for the children to paint upon! And that they had had great fun. Mary and her mother then continued to remind eachother of funny episodes from that time. Mother also told me that Mary was very talented and had plans to be an artist. Whilst talking Mary completed a picture that astounded me in being such a contradiction to her almost non-existing apparition. A summerlandscape had been created with partly sandy desertland and partly fresh green grass with some beautiful, red flowers and a large tree that was bending in a strong wind. In the blue sky: Sun and moon.
She seemed content and smiled at our admiring comments of the strong and healthy though windblown vegetation. After having seen this expression of Mary and witnessed the strong connectedness between Mary and her mother I was as sure as her mother that she would be fine in due time and I also could transfer this conviction to the medical department. We did some more painting, talking about ordinary girl things, dreams and longings. When she was well enough to leave the hospital we could even talk a little about some things in connection with the abusive events that she needed to get clarified.
Case 2
When Peter was five years old he suffered from an acute astma attack, more severe than ever before. The longlasting breathing difficulties made him quite convinced that he was going to die, and nothing that parents or doctor said or made could take him out of this terrifying experience, even though his breathing was normalized. I was called in when many hours had passed and his panic wouldn’t subside.
Fortunately I had some clay in my pockets and after having put the scared Peter in mothers lap and told him very clearly that he was absolutely not going to die, we started to build a little house together and then a big dragon. This succeeded to distract him and even laugh and talk a bit between the fearful all the time reoccuring questioning: Am I going to die now? After some hours the panic had diminished to a level that seemed possible to endure, and the family could return home instructed to answer Peter every time he asked if he should die that he should not. And not to leave him alone. We then met quite often the first weeks. Playing disaster with dolls and buses and trains, always ending in ambulances coming to the hospital in the last second for all the wounded to have their lives saved. Peter was the head director of these plays which I and successively the parents took part in with increasing engagement. We also painted. Peters first picture was completed on a large paper where he painted in many bright colours detailed forms that filled every inch of the paper. He was very proud of this and said: Look! I have painted the whole Earth. And Cosmos also! Mother was more careful but soon she found herself painting some peculiar figures with bright eyes and big ears. Peter was amused and painted his name on mothers paper. For some months Peter continued to paint explosions of Earth into outer Space. Mother became more and more interested in the painting and talking about the pictures and soon her tiny figures changed into colourful whole pictures. Peter was very anxious to come to our meetings and he ran into the painting room every time. Once he made a marvellous picture of a little child with a large divingmask under water telling us not to be afraid since the child got his air through many tubes that he showed us. After that he painted children every time. One day mother said: Now I understand what you mean by playing together! Father, a silent truck driver, also painted when I told him it would do his son good. He enjoyed it and so did Peter who admired his big, strong father a lot.  During the painting all kinds of topics for talking came up. The parents discussed many aspects of their family life, reflecting on how different attitudes might influence their very sensitive little son.
Peters fear of losing breath and of dying slowly subsided over one year. The parents also rearranged some parts of their life in order to have some more time together.

Some datas

During the last years I have been engaged in painting with about 25 families in different kinds of crises. The presented problems of the children/adoles- cents have varied from anorectic disturbances, depressive-aggressive state in youngsters with and without autistic difficulties, chronic gastric pain, posttraumatic stress disorder, severe migraine, different emotional and somatic reactions after sexual abuse, school-phobia, extreme long-lasting anxiety state, suicide attempt and other conditions with high tension and frustration also held by the parents.
The ages of the children have varied from 6-18 years. The number of painting sessions have varied from one to ten. Mostly combined with ordinary talking meetings. Some families have preferred to paint as main way of communication at every meeting. Sometimes all family members were present. Sometimes the child with the mother, sometimes with the father. They choose themselves. Sometimes I suggest that someone more could come. Never that someone should not come.
There has been no follow-up of the families or children's welfare, that is they have not been asked about their present life situation after having finished their contact with us. However, all left the clinic in a better state than before coming. Almost all said that the original problems were dissolved in a way that they now felt able to go on in life by themselves. Two have come back after some years for additional help. About the others all that is known by us is that they have not come back to the clinic for more help, nor have they been actualized to us by social authorities or colleagues in the medical system.

Can all this be understood?

Feelings and bodily expressions
Those feelings, or rather affects, that make the most lasting impressions in us are suffering, sorrow, pain and especially shame since they make us alienated from others- we withdraw. (Nathanson, 1992).
Those stressful feelings can also lead to protective reactions in the body which give muscle tensions. The tensions protect you from feeling the feelings. Those tensions may persist and they can readily be reactivated when the same feelings reoccur. ’’The body remembers everything”. We can therefore get caught in some old memory - feeling when it is activated by some present experience.
Delight and satisfaction is often of short duration and it often gives a relief in the body that does not make marks like that of the stressful feelings. The body does not have to be protective against joy Craative eppressinn transmits feelings which can be recognized and reeeperiencvd. It gets possible to approach and investigate when it is no longer connected to the real threat that was there when it originally got hold of us. In that process the feeling- memory changes quality. There is a positive eeperience added to the original which makes it more possible to meet and integrate.
The meaning of inner pictures
The painted picture comes together with the feeling-emotion that is awakened by the colours and the material and the movements involved in the painting in itself. After that, the picture that was created with help of the movements, the colours and the feelings makes the emotions obvious. Probably this gives room for new feelings-emotions and thoughts which are awakened by the picture and the movements. Which in turn can give rise to eeplorations of emotional eeperiences in a talked dialogue and new pictural expressions. The relationships between bodily movements, emotions and words is in the center of attention in the norwegian tradition of psychomotor physiotherapy formed by Aadel- Bulow-Hansen. (Ianssen (red.) 1997).
In addition the picture-painting in itself also gives a satisfaction to have strained one-self and made something fine and valuable. It also brings forth a sense of pride that opens up for movement towards, thereby increasing the closeness to other people. Pride always counteracts feelings of shame. Shame is coherent with everything that is hurtful to the self-respect. When ashamed we react with different rapid movements away from others and break communication.
So everything that counteracts shame is of benefit for being able to open up and thus be closer to others. This in turn increases the possibilities to be in motion with others.
More about emotions and painting
Which emotions are usually dominating our patients’ eeperience of their life situation?
Often feelings of worthlessness, emptiness and shame of varying degrees. These feelings often colour their selfappreciation and diminishes their ability to be in life. So it is with children and adolescents and often their parents when the kids are not feeling well and you don’t seem to manage the difficulties. At the same time there are all the good feelings as joy, pride, trust and hopefulness. When times are difficult those feelings and concomitant memories are depressed, almost forgotten and not directly available.
But they are there, in the body and in the inner pictures. They can be taken out and be further strengthened by a concrete expression which sharpens senses as sight and perception of touch and couples-integrates this with thoughtchains.
The colour in itself strengthens, gives joy of living that changes the painter and helps him transform the unpleasentness into valuable parts of life.

Some thoughts about the preverbal

Once, after having presented this work in a seminar someone commented that my description of the painting was a clear illustration of the preverbal expression of children before eighteen months of age. That remark caught my attention.
What if, when in crisis, we return to the state of being of the one-and a half year old child we once were? Not in the spoken language but all in bodily expressions? And then we are trying in vane to use words? Preverbal language has to do with feelings-sens- es and is bodily bound. It is more whole than the verbal language- takes in more aspects.
What if we, in crisis, go into the bodily expressions of the small child which are nothing but movements and scream, fence and fight for a while and that way get out of the affective state we were in? Is that what brings us into another emotional state which eventually opens up for the talking again?
Is painting one way of opening up frozen movements? Through those expressions, movements and being in the colours- then we can go back to our ordinary age, and begin to talk again.
We are in all our ages. We carry them inside us with all the different reactions and ways of expression. When in crisis we temporarily loose some of our more ’’grown-up” ways to react, understand and be. That gives space for our more childish parts to be in charge for a while. For better and worse.
The ’’bad” is that we loose some control and orientation, and are apt to react in an unreflecting way... The ’’good” is that we get more access to our emotions which can be good sign-posts.
When we have been very grownup, sensible and clever for long times it happens that we get stuck and don’t seem to understand what is going on any more. Life becomes grey and meaningless. The saying ’’finding the child within ”, holds an attempt to recapture the play and the movements, the curiosity and hopes for the life still to come, in order to be able to be alive, attentive and participating in what is going on.
Painting inner pictures can be one way to get there.
The power of creative expression in the form of painting.
Matisse was one of the greatest artists of our times in the so called impressionistic tradition and he had many thoughts about artistic expression (Matisse, 1972). The following to me comprise the essence of what is the heart and soul of the paintingprocess and thus makes understandable its inherent power to promote personal growth.
’’Colour carries in itself an emotional power and inherent beauty. It is not possible to separate colour from drawing. The drawing is the expression of the painter having taken possession of the objects. An old Chinese saying goes:
‘When you draw a tree, you shall feel that you get higher and higher.’
The colour contributes to express the light, not as a physical phenomenon though, but the only light that really exists, the light that is in the heart of the artist.
The colour can interpret the essence of every thing and at the same time come up to the intensity of the emotional shock. Especially the colour is a liberation.
The liberation is the expansion of conventions. Is not exactly this the priv- ilegue of the artist: To ennable and make the meanest motive precious?”
And this also becomes the privilegue of everyone expressing themselves in painting: Even the most frightening, sad or mean parts of the private mixture of memories, conceptions and imaginations can be expressed in a way that transforms them to valuable, strong, often even beautiful, parts of the whole lifepicture.


When we, the group of Scandinavian colleagues, were visiting Archangelsk in September 2000, we were invited to the department of adolescent psychiatry.
There, as part of the program, the child psychiatrists Vera Yakovleva and Irina Mitchkaiovleva showed us all a film they had made . The film showed their work with some children painting their spontaneous inner pictures. These were children with heavy traumatic experiences which clearly were expressed in the pictures and developed into new stories and pictures which were talked about with their doctors. The adolescents were watching very carefully and afterwards they were asked if anyone would like to say what he or she had been thinking of.
After a while one of the boys said, at the same time eager and surprised: ”I was thinking of my whole life!”. He was then asked if he would like to paint himself and he said with emphasis: ”Yes, I would like to do that very much!”
This is an illustration of the impression on the viewer that is transgressed through the expressive quality of personal pictures.
This may also be the unique quality that many understand constitutes art and which is not to be fully understood. Many great artists have, when asked, tried to express their understanding of what is going on when a viewer looks at a picture painted with the purpose to express something of importance to the artist. The Finnish artist Helene Scherfbeck said: The painter is the labourer of emotions.
So, perhaps that is what our families are doing? Expressing and handling emotions together with the close ones in a way that they are at the same time made clear to themselves and transmitted in such a gentle way that they are possible to meet and understand for the others. This gives a strong common emotional experience.
At the same time all naked and protected, as is also the quality of the being together when painting and talking about the paintings. Showing the most private- in disguise.
As a real good play.