A case example of art therapy in relation to Dialectical Behaviour Therapy

Abstract

Theoretical and practical aspects of Dialectical Behaviour Therapy (DBT) as developed by Marsha Linehan are related to the development of a pragmatic art therapy approach to working with severe distress and disturbance, including ‘borderline personality disorder’, through a case example. The dialectical approach of DBT to acceptance and change, emotional regulation and the development of ‘wise mind’ are found to resonate with art-making processes, both inside and outside the formal art therapeutic space, and the art therapist's interventions become central to a team approach. Innovative art therapy interventions (for example the structured use of ‘homework’) and theory (for example ‘the Learning Circle’) contribute to a therapeutic journey from dangerous and extreme patterns of self harm and in patient admissions to a stabilised and community-based level of support. The approach challenges the helpfulness of a formal psychodynamic psychotherapeutic model of art therapy in all circumstances. It opens up the possibilities of developing art therapy not only as an integrated aspect of a DBT-based approach, but also of developing art-making and therapeutic relationships in terms of a psychosocial education model. Psychotherapy understandings underpin, contain and amplify pragmatic, arts-based interventions which are shown to catalyse profound psychological change.