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Art Therapy as a Liminal, Playful Space: Patient Experiences during a Cancer Rehabilitation Program

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Experience on the Edge: Theorizing Liminality

Abstract

Many patients with cancer face existential challenges struggling to find mental respite from their illness and a space for processing and transforming difficult thoughts and concerns. Research has shown that providing a room for cancer patients’ own creative expression can foster healing processes and mental well-being. Using theories of Donald W. Winnicott and liminality as a theoretical lens, we aim to show how a group of 40 cancer patients participating in a rehabilitation program have experiences of transition through art therapy. 33 women and seven men (within the age span of 31–76 years), across all disease stages and types of cancer, participated in a five-day rehabilitative program, addressing different existential themes (e.g., death, hope, love). On the last day of the course, we performed focus group interviews to explore the participants’ perceived significance of the art therapy among other course elements. The analysis led to three main processes of transition: a) engaging in a new creative realization or refusing to do so, b) therapeutic change, and c) reintegration: contemplation and peace. We show how the participants’ experiences can be understood as a space of reflection on new patterns of life. The use of art therapy as an extended part of a rehabilitation care contributes to positive processes of “corrective emotional experiences” and to transformation of crisis by fostering patient expression, especially in combination with encounter groups.

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Notes

  1. 1.

    Ethical considerations: The study was approved by the Research and Innovation Organization (RIO) of the University of Southern Denmark (Journal no. 18/27303). All patients were provided with written and verbal information about the research project before attending the course and gave their written informed consent.

References

  • Abdulah, D. M., & Abdulla, B. M. O. (2018). Effectiveness of group art therapy on quality of life in paediatric patients with cancer: A randomized controlled trial. Complementary Therapies in Medicine, 41, 180–185.

    Article  Google Scholar 

  • Alexander, F., & French, T. M. (1946). Psychoanalytic therapy: Principles and application. Ronald Press.

    Google Scholar 

  • Assing Hvidt, E., Hvidt, N. C., Graven, V., LaCour, K., Rottmann, N., Thomsen, K. F., Lindqvist, O., Rasmussen, A., Skaarup, H., & Roessler, K. K. (2020). An existential support program for people with cancer: Development and qualitative evaluation. European Journal of Oncology Nursing, 46, 101768.

    Article  Google Scholar 

  • Boehm, K., Cramer, H., Staroszynski, T., & Ostermann, T. (2014). Arts therapies for anxiety, depression, and quality of life in breast cancer patients: A systematic review and meta-analysis. Evidence-based Complementary and Alternative Medicine, 103297.

    Google Scholar 

  • Blows, E., Bird, L., Seymour, J., & Cox, K. (2012). Liminality as a framework for understanding the experience of cancer survivorship: A literature review. Journal of Advanced Nursing, 68(10), 2155–2164.

    Article  Google Scholar 

  • Bruce, A., Sheilds, L., Molzahn, A., Beuthin, R., Schick-Makaroff, K., & Shermak, S. (2014). Stories of liminality: Living with life-threatening illness. Journal of Holistic Nursing, 32(1), 35–43.

    Article  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

    Article  Google Scholar 

  • la Cour, K., Josephsson, S., Tishelman, C., & Nygaard, L. (2007). Experiences of engagement in creative activity at a palliative care facility. Palliative and Supportive Care, 5(3), 241–250.

    Article  Google Scholar 

  • Fancourt, D. (2017). Arts in health, designing and researching interventions. Oxford Press.

    Google Scholar 

  • Fancourt, D. & Finn, S. (2019). What is evidence on the role of art in improving health and wellbeing? A scoping review. Health Evidence Network synthesis report, No. 67. Copenhagen: WHO Regional Office for Europe.

    Google Scholar 

  • Freud, S. (1959). The relation of the poet to day-dreaming. In Collected papers by Sigmund Freud (Vol. 4, pp. 173–183). Basic.

    Google Scholar 

  • Froggatt, K. (1997). Rites of passage and the hospice culture. Mortality, 2(2), 123–136.

    Article  Google Scholar 

  • Gabriel, B., Bromberg, E., Vandenbovenkamp, J., Walka, P., Kornblith, A. B., & Luzzati, P. (2001). Art therapy with adult bone marrow transplant patients in isolation: A pilot study. Psycho-Oncology, 10, 114–123.

    Article  Google Scholar 

  • Gibbons, S. W., Ross, A., & Bevans, M. (2014). Liminality as a conceptual frame for understanding the family caregiving rite of passage: An integrative review. Research in Nursing & Health, 37(5), 423–436.

    Article  Google Scholar 

  • Graven, V., Assing Hvidt, E., Roessler, K. K., Thomsen, K. F., Lindqvist, O., Rasmussen, A., Skaarup, H., Rottmann, N., & Hvidt, N. C. (2019). Energi til livet—et eksistentielt patientforløb for mennesker med kræft. Rehpa Notat 16, May 2019.

    Google Scholar 

  • Guay, M. (2018). Impact of group art therapy on the quality of life for acquired brain injury survivors. Art Therapy, 35(3), 156–164.

    Article  Google Scholar 

  • Huizinga, J. (1955./org.1938). Homo ludens. A study of the play-element in culture. Routledge.

    Google Scholar 

  • Kim, K. S., Loring, S., & Kwekkeboom, K. (2018). Use of art-making intervention for pain and quality of life among cancer patients: A systematic review. Journal of Holistic Nursing, 36(4), 341–353.

    Article  Google Scholar 

  • Lee, J., Choi, M. Y., Kim, Y. B., Sun, J., Park, E. J., Kim, J. H., Kang, M. H., & Koom, W. S. (2017). Art therapy based on appreciation of famous paintings and its effect on distress among cancer patients. Quality of Life Research, 26(3), 707–715.

    Article  Google Scholar 

  • Lenormand, M. (2018). Winnicott’s theory of paying: A reconsideration. International Journal of Psychoanalysis, 99(1), 82–102.

    Article  Google Scholar 

  • MacDonald, R. A. R. (2013). Music, health, and Well-being: A review. International Journal of Qualitative Studies on Health and Well-Being, 8(1), 1–13.

    Article  Google Scholar 

  • Nielsen, S. L., Fich, L. B., Roessler, K. K., & Mullins, M. F. (2017a). How do patients actually experience and use art in hospitals? The significance of interaction: A user oriented experimental case study. International Journal of Qualitative Studies on Health and Well-Being, 12(1), 1267343.

    Article  Google Scholar 

  • Nielsen, S. L., Mullins, M., Brorson, F. L., & Roessler, K. K. (2017b). The significance of certain elements in art for patients’ experience and use. Visual Anthropology, 30(4), 310–327.

    Article  Google Scholar 

  • Pratt, M., & Wood, M. J. M. (1998). Art therapy in palliative care: The creative response. Routledge.

    Google Scholar 

  • Roessler, K. K. (2011). A corrective emotional experience—Or just a bit of exercise? The relevance of interpersonal learning in exercise on prescription. Scandinavian Journal of Psychology, 52, 354–360.

    Article  Google Scholar 

  • Roessler, K. K., Graven, la Cour, Hvidt, N.C., Rottmann, N., & Assing Hvidt, E. (2020). “The quietness of the place calmed my troubled mind”—The restorative potential of environments in an existential rehabilitation programme for patients with cancer. Expository Times, May.

    Google Scholar 

  • Rowe, S. (2008). Modern sports: Liminal ritual or liminoid leisure. In G. S. John (Ed.), Victor Turner and contemporary cultural performance (pp. 127–148). Berghahn Books.

    Google Scholar 

  • Stenner, P. (2013). Affectivity, liminality and psychology without foundations. In J. Straub, E. Sørensen, P. Chakkarath, & G. Rebane (Eds.), Cultural psychology, aesthetics and postmodernity. Psychosozial Verlag.

    Google Scholar 

  • Stenner, P. (2017). Liminality and experience: A transdisciplinary approach to the psychosocial. Palgrave.

    Google Scholar 

  • Stiles, W. B. (1993). Quality control in qualitative research. Clinical Psychology Review, 13(6), 593–618.

    Article  Google Scholar 

  • Turner, V. W. (1969). The ritual process: Structure and anti-structure. Aldine De Gruyter.

    Google Scholar 

  • Turner, V. (1974). Liminal to liminoid in flow, play and ritual: An essay in comparative symbology. Rice Institute Pamphlet—Rice University Studies, 60, no. 3.

    Google Scholar 

  • Turner, V. W. (1986). Dewey, Dilthey, and drama: An essay in the anthropology of experience. In V. W. Turner & E. M. Bruner (Eds.), The anthropology of experience (pp. 33–44). University of Illinois Press.

    Google Scholar 

  • Van Lith, T., & Spooner, H. (2018). Art therapy and arts in health: Identifying shared values but different goals using a framework analysis. Art Therapy, 35(2), 88–93.

    Article  Google Scholar 

  • Van Gennep, A. (1909/1960). The rites of passage. University of Chicago Press.

    Google Scholar 

  • Winnicott, D. W. (1964). The importance of the setting in meeting regression in psychoanalysis. In Psychoanalytic explorations. Karnac.

    Google Scholar 

  • Winnicott, D. W. (1971). Playing and reality. Routledge.

    Google Scholar 

  • Yalom, I. D. (1980). Existential psychotherapy. Basic Books.

    Google Scholar 

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Acknowledgements

The authors wish to thank all the patients who participated in this study for their time and interest and for sharing their illness and live stories.

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Correspondence to K. K. Roessler .

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Roessler, K.K., Hvidt, N.C., la Cour, K., Mau, M., Graven, V.P., Assing Hvidt, E. (2021). Art Therapy as a Liminal, Playful Space: Patient Experiences during a Cancer Rehabilitation Program. In: Wagoner, B., Zittoun, T. (eds) Experience on the Edge: Theorizing Liminality. Theory and History in the Human and Social Sciences. Springer, Cham. https://doi.org/10.1007/978-3-030-83171-4_8

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