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International Journal of Art Therapy

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Image: Reflections on the treatment of images and dreams in art psychotherapy groups
Francesca La Nave

Online publication date: 26 May 2010

To cite this Article La Nave, Francesca(2010) 'Image: Reflections on the treatment of images and dreams in art

psychotherapy groups', International Journal of Art Therapy, 15: 1, 13 24 To link to this Article: DOI: 10.1080/17454831003752378 URL: http://dx.doi.org/10.1080/17454831003752378

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International Journal of Art Therapy, June 2010; 15(1): 1324

ORIGINAL ARTICLE

Image: Reflections on the treatment of images and dreams in art psychotherapy groups

FRANCESCA LA NAVE

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Abstract Social Dreaming sees dreams as differentiated particles of the undifferentiated unconscious, here understood as infinite and containers for unconscious wisdom. Through sharing dreams and their free associations in a particularly structured meeting called the Matrix, Social-Dreaming promotes access to unattended knowledge and transformation of thinking. Analytic Art-Psychotherapy groups promote therapeutic change through image making and interpersonal contacts. Neurological phenomena associated with both dreaming and creativity suggest that art and dreams can act as conduits to unattended knowledge, bridging conscious and unconscious thinking. The author suggests that in Art Psychotherapy this dimension could be enhanced by viewing image ownership as collective rather than individual and by routinely using free association in preference to more common, explanatory practices and describes some structural modifications to the context of Art Psychotherapy group work with clinical evidence. The conclusion is that creative thinking promotes homeostasis, a state of internal equilibrium, necessary to well being and a function of internal coherence. The ideas in this work derive from the authors personal experiences in Social-Dreaming and as an Art Psychotherapist. Relevant here are Gordon Lawrences works on Social Dreaming; David Maclagans on Imagination and Lois Oppenheims on Neuro-psychoanalysis.

Keywords: Social Dreaming, Matrix, meta-verbal, meta-visual, free association, homeostasis

Introduction

This paper concerns the treatment of visual and narrative material in Art-Psychotherapy analytical groups in adult psychiatric services and asserts the centrality of collective and interactive modalities to group work. Art-Psychotherapys technical and clinical coherence could be enhanced by viewing image ownership as collective rather than individual and by using free association routinely, in preference to more common, explanatory practices. I propose that a more robust application of the principles of collective ownership and free association could strengthen the ties between art and psychoanalysis, bearing in mind that innovations in the clinical use of images interact with the work structure and may flounder if unsupported by a suitable container. I start by considering how Art-psychotherapy could benefit from a study of the Social Dreaming system where similar currencies to those of Art-Psychotherapy, such as dreams, imagination and language, are treated differently. These variations open the way to a new phenomenology

with possibilities for the transformation of thinking, also relevant to Art-Psychotherapys therapeutic aims, such as the dissolution of fixed assumptions and crystallised mental constructs, favouring reflective thinking over symptom-led preoccupations. This study is based on the evidence provided by participation in SocialDreaming programmes and direct clinical work. Arts transitory subversion of the familiar relies on image ambiguity which, in Art-psychotherapy, is instrumental to patients capacity to articulate beyond language. It is also central to visualize the unexpected, a helpful activity for patients wanting to destabilize unhelpful constructs and entice new ones. The use of dreams in clinical and non clinical groups led me to believe that there is scope for improving the basis from which patients are routinely invited to view the images made during sessions. In particular, I refer to a change in the perception of the ownership of images from individual to collective. Oppenheims (2005) suggestion that dreaming and creative activities share comparable neuro-psychological phenomena supports

Correspondence: Francesca La Nave, SWLSTG NHS Trust, Sutton Hospital, Cumbrian House, Cotswold Rd., Sutton, Surrey. Email: franlanave@hotmail.com 1745-4832 (print)/1745-4840 (online) # 2010 British Association of Art Therapists DOI: 10.1080/17454831003752378

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concepts and methodologies relevant to both Social-Dreaming and Art Psychotherapy. The latters group analytical mode aims at enhancing wellbeing through activities which promote transformational processes while requiring a kind of attention associated with both interactive and meditative positions. The groups capacity to alternate action with reflection (Yalom, 1995) and the application to affective changes and emotional development of the catalyst of art do not describe definitively cognitive, emotional or behavioural operations, but composite ones and are implicated in the development of new mental attitudes. Conceptually grounded in the domain of unconscious phenomena with its basic form the Matrix, Social-Dreaming is a non-clinical application suitable to a wide range of social and relational areas. Whether used as a research tool, or as part of larger organizational consultancy programmes, its consistent purpose is the transformation of thinking, through free association and amplification to dream narratives. Like Social-Dreaming also, Art-Psychotherapy groups take different forms according to the use made of its psychoanalytic- and art-centred paradigms, modulating the approach to dreams, images and other creative mental activities. The clinical work described is from an NHS analytic Art-Psychotherapy group, attended by outpatient adults with mental health problems and personality disorders. The atypically sophisticated emotional handling of the visual material, for a public sector group, may be partly due to the narrative style and partly to the dynamic effect of the method. I am indebted to Gordon Lawrences discovery and development of Social-Dreaming, the writings of Maclagan (2005), Mann (2006) and Skaife (2008) and to Lois Oppenheims (2005) Neuro-psychoanalytic perspective on the connection between neurobiology, psychoanalysis and creativity. Accounts include personal experiences in the Social-Dreaming Matrix and anonymous, clinical material. I obtained my patients permission to reproduce their images.
A theatre for dreams

Social-Dreaming was developed in the early 1980s in the Department of Human Relations at the Tavistock under the direction of W.G. Lawrence and has since attracted a growing number of contributors. It is a method to access and manage new knowledge in various contexts through sharing dreams and their free associations in a social setting.

Lawrence (2003, 1998) speaks of SocialDreaming as a social aggregate method to reveal and process the unattended of the unconscious connections between individuals and society. The Social-Dreaming Matrix1 (SDM) is an assembly between 10 and 70, who sit in configurations shaped like stars, or snowflakes, to narrate and free associate to dreams. The focus is on the dream, not the dreamer; the attention is on collective elaboration, not on interpersonal dynamics; the aim is to stimulate the transformation of thinking and the emergence of new thoughts. A Matrix sitting position facilitates dream recollection by reducing the distracting personalization of eye to eye contact; a paradoxical innovation this, gesturing both towards and away from the conventional psychoanalytic position. Both Social-Dreaming and Art-Psychotherapy involve participants in states of temporary, psycho-physical isolation, like the one of social dreamers recalling dream images and that of patients engaged in making images. Despite their differences the two configurations perform activities bridging different symbolic orders. The former summons the primary experience of dreams while the latter produces images through physical engagement with materials. They are both intensely sensual, mining the undifferentiated unconscious (Eherenzweig, 1997) to make the unknown perceivable and therefore knowable. Common prerogative to dreams and art and, by extension to Social-Dreaming and Art-Psychotherapy, is the capacity to lead us to a dimension, called by Lawrence (2005) the Infinite, which by transcending the restrictions of logic and sensibility disengages us from the ordinary laws of space and time governing the physical world. Art and dreams usher in the domain of visionary phenomena, bypassing the censorship of rationality, to proffer the unthought of, with its chance for new wisdom. One of the guiding principles of Social-Dreaming is a view of dreaming as a form of elaborative thinking. According to this, dreams manifest the digestion and transformation of the lived experience particularly in respect of psychic elements, sensually perceived, but not cognitively available (Bion, 1989, 1991). Ogden elaborates Bions (1961) concept of the psycho-analytic function of the personality, seen as a constitutional faculty capable of examining experience through the simultaneous lenses of conscious and unconscious thinking. This faculty operates through dreams as a diffused form of mental activity for the transformation of emotional material, comparable to reverie and involving:

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Reflections on the treatment of images and dreams a form of psychological work in which there takes place a generative conversation between preconscious aspects of the mind and disturbing thoughts, feelings and fantasies that are precluded from, yet pressing towards conscious awareness . . . For Bion, dreaming occurs both during sleep and waking life . . . Dream-thought is an unconscious thought generated in response to lived emotional experience and constitutes the impetus for the work of dreaming. (Ogden, 2004, p. 1355)

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Embryonic ideas are not definitively individual, but start in their proto-form within society, to be developed through the creative activities of individual intermediaries (Lawrence, 2005). This is the sense in which Social-Dreaming and Art-Psychotherapy share common aims. By interposing a collective apparatus at the point where dream material is exposed, the Matrix gives expression to the consciousunconscious relationship just described and carries out collectively, rather than individually, the thinking that dreams had already started. Thus, dream thoughts are extracted from the isolation of the individual mind and are extended to the entire assembly. One could say that the job gets shared out. Dreams are pictographic issues of a spacetime continuum, alien to discourse, always incompletely remembered and reported (Puget, 2002). Differently from pictorial images dreams cannot be known directly because the filters of memory and language distance us from the primary experience. The paradox between this and the cognitive structure of their narrative translates into a tension between inclusiveness and alienation in the experience of both dreamers and audience (2002, p. 99). Although opening dreams in Matrices are considered to have a special authority in setting the course for all subsequent dreams (Lawrence, 2007), these remain no more predictable than any image made in a group. Free association, however, can draw lines of coherence by building recognisable themes through the narratives of dreams and of images. While the actual dream is elusive and cannot be known directly (Lawrence, 2007, p. 12), linking distinct dream narratives through free association and amplification generates, for each person, cumulative experiences of meeting other peoples dreams as if they were ones own. This phenomenon bridges the gap between putatively separate individual experiences, imaginatively embracing ideas, otherwise deselected by ordinary logic. This thinking combines the as if of transitional phenomena with the what if of fables.

A notable difference between dreams and art is that dreams are involuntary, primary phenomena, while art-images are visible products of processes involving intention and determination. Despite these differences, both dreams and creative activities emerge in a state of relative regression (Oppenheim, 2005) with comparable neurological changes and freer connections made between disparate mental material during dreaming and during acts of creative imagination. Through reflective elaboration the products of these connections can be made available to consciousness and to ego scrutiny. Oppenheim (2005), referring to Kris (1952) and Brenner (2004), states that regression, as a function of creativity, is also at the service of sanity. The more elastic and fluid the connection between ego and id, the less rigid the persons defensive system, assigning to creativity a role in the achievement of internal coherence. Accordingly, creativity is not the province of artists but rather a function of human existence, residing as much within the recipients as within the creators (Maclagan, 2005, p. 1314). The psychodynamics of creativity, including problem solving and aesthetic experience, have observable (Oppenheim, 2005; Hass-Cohen and Carr, 2008) connections with increased dorsolateralprefrontal cortex activity, alterations in the presence of certain neurotransmitters and associated biochemical changes, found to affect mood, affect, memory and personal motivation. These conditions are associated to a spectrum of creative experiences, ranging from the active processes of creativity to the appreciation of its products (Oppenheimer referring to Holland [2003]). Physiology, therefore, is the common base for the psychodynamic exchanges of creativity, whose different affective states are communicated through the body. This communication also constitutes a bridge through which we can move the discussion on the connection between Social Dreaming and Art Psychotherapy.
Art psychotherapy as a meta construct

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Describing Art Psychotherapy as non-verbal succinctly answers the professions need to promote its versatility in offering psychodynamic treatment to client groups normally excluded from classic forms of analytic psychotherapy. This definition, however, neglects the fundamental verbalvisual continuum integrating the paradigms of Art, Psychoanalysis and, in the case of groups, Group Analysis. Art-Psychotherapy groups deal with variably tangible phenomena

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such as art and collective relationships and hold transactions between the unconscious and the knowable by cyclically distancing and bringing together their members activities. As patients disperse to engage in image making, they also remain a group thanks to the shared physical boundaries of the room and by being held in mind. Art-Psychotherapy groups address the tension between the diverging drives to closeness and self sufficiency (Storr, 1997) by being functionally structured to mediate between privacy and interaction. They work non-linearly, connecting co-existing personal and interpersonal narratives through the making and viewing images, in the presence of others. What we obtain is a system of parallel narratives interplaying with the shared reflection of the group in ways which are not definitively verbal, non-verbal, or visual, but rather meta-verbal and meta-visual. The purpose of the composite meta-verbal and meta-visual discourse of Art-Psychotherapy groups is to help patients to review their mental and psychosocial positions, by taking them through broader, collective experiences. According to Winship and Repper (2007) the most productive conversational styles are not linear but complex cacophonic ones, entailing degrees of competition and dissonance. Through concurrent presentations of images and voices ArtPsychotherapy groups generate conversations which, while inclusive, have a non-linear, dialogic order and leave material traces of variable permanence. The clinical session is the temporary structure through which these multimedia utterances become organized. The transmutation between language and image is seen as crucial in the symbolic representation of trauma (Seth-Smith, 1997), when preverbal traces of negatively cathected events, imprinted in the childs ego as un-metabolised elements, emerge in later life as symptoms and disorganizing forces. Processing these elements to digestible forms, that is, assisting the development of a capacity for attributing meaning to inchoate, or evacuated material, is one of therapys objectives. The therapeutic situation replicates the mothers alpha-function of developing a capacity for reverie. This faculty grows dynamically through processing all emergent associations, to all images, in the entire meta-visual experience of the group to allow something previously unattended to be seen. Reverie, the emotionally ruminative process transforming chaotic material into something tolerable and meaningful, is essentially a transitional activity, between signified and signifiers (Lacan, 1991), that is between the shadow presence of what cannot be known and

the utterances striving to make it knowable. In language this transition is problematic because it aspires to bridge two separate orders. Conversely, visual imagery, whether governed by sight, or by the tactile experience of the shape of things (Isserow, 2008), by emerging developmentally earlier, is a natural mediator between pre-verbal and verbal states and avoids the inarticulate being colonized and reduced by language, while adding force to its poetic forms. Therapys endeavour is to improve unsatisfactory conditions, resistant to change through ordinary resources being unavailable, unconscious, or unknown. In the NHS this task is particularly challenged by patients levels of ego fragility and distress, which lend additional defensive rigidity to the general tendency to view images through the lens of what we know. Yet recovery demands that patients go beyond responses which just reiterate the known and I find that, given sufficient time and space, they benefit from becoming receptive to images as conveyers of new information as well as conduits for personal narratives. Art Psychotherapy is methodologically creative because it relies on being receptive to the revelation offered by the image. However, this calls for a contemplative approach and an open mind-set, antithetic to systematic defences. Schaverien (1992) talks of some images being descriptive, like diagrams, inhibiting rather than embodying poetic possibilities and manifesting creative blocks, even within an inherently creative system. Conversely, patients complaints of feeling blank, of not having a clue as to what to make, may be openings to spontaneity in absence of premeditated material. While giving no assurance of creativity, this condition may be fruitful in generating the unexpected, just as dreams are. In other words, patients may benefit from forgetting, temporarily, what they know about their troubles and start looking for what they do not. This finds obstacles in patients tendency to refer to their own images as a point of departure, with their familiar constructs blocking the way to more elusive connections. Decreasing the emphasis on individuals explanation of their own work and promoting a collective, less linear take on the images involves distancing them from their individual makers. Considering images as a collective body of others in group situations is problematic because it challenges patients reluctance to be spontaneous with their comments for fear of causing conflict and, technically, benefits from the systematic adoption of free association. Establishing such a culture in respect to images may flounder without a

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Reflections on the treatment of images and dreams

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structure to support it, such as Social Dreaming has for dreams. I have therefore developed a distinct method which demands a degree of direction from the therapist.
The amphitheatre

Art-Psychotherapy groups not uncommon experience that insufficient explorative time is dedicated to the images can be exacerbated when initial, verbal phases are allowed to extend into the session. Psychodynamically this can be viewed as a defensive manoeuvre, delaying progress and disconnecting visual links, but a routine absence of visible imagery at the opening stage may play into expectations that whole sessions could continue in purely verbal mode, contradicting efforts to deliver an image-based treatment and calling for an intervention to address the issue of continuity. Discontinuity in the substance of the Art Psychotherapy method, as well as discontinuity between sessions, can be addressed by routinely having all images made the previous week present at the very beginning of each session. This move is integrative in a number of ways: it reinforces the consistency of the method through integration of verbal and visual modes, leaving no part of the session without image presence; it also promotes deeper exploration of existing work, over the obligation of creating new images each time. A word about the ethics of including absentees images and the management of confidentiality: it is the timeless agency of the image which remains available for consideration, not the image maker. A culture of collective entitlement to the entire body of work reduces the likelihood of absence being used to undermine progress. In fact this method fosters a particularly interactive culture, sensitising patients to the relevance of past images to the current discourse, where they can be confidently and concretely brought back, resulting in the odd session with over 15 images simultaneously in view. Managing the viewing of larger bodies of work from a topographic and a conceptual point developed into the idea that images could be assembled separately from the group of their authors. While the latter are engaged in image making I rearrange the chairs, changing the initial circle into a semicircle. This mid-session transformation, while ritualising ordinary activities, marks a change of pace in the sessions environment. The act of organizing the images in a zone separate from the semicircle of patients focuses the groups attention to the images

details and interplay because it draws temporarily away from the image makers. This departure from the analytic circle towards the amphitheatre of Greek drama places people in a position similar to that of the public in a theatre, moving away from a face to face, to a side by side position. While not contradicting the analytic principles specific to this type of treatment, this changes the emphasis of the interaction by accentuating the significance of the images as central manifestations of group reality. Once grouped together the images begin to describe a distinct drama, separate and simultaneously interactive with its public, the patients, now become viewers of something distinct from and yet referring to them as integral to the play. The visual and emotional experience of viewing art in galleries, without the artists presence, resonates with the dynamics of distance and interaction described, drawing a political frame around the separation between images and their makers and introducing images identity as res publica.
Voices

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Assuming that the most authoritative voice about an image is that of its author is problematic because of its investment in definitive exegeses, rather than in concomitant readings, attributing finality to patients accounts of their own work. In the amphitheatre patients report a sense of freedom growing from free associating to all images and all sessions events. Finding themselves at a distance from their images they are liberated from seeking factual explanations about others images and from the obligation of explaining their own. Engaged in collective free associations patients often show surprise at previously unnoticed and unattended aspects of the works. Particularly fruitful, from a therapeutic point, is patients inquisitiveness towards the ideas emerging from the comprehensive effect of all images positioned together, such as common or contrasting themes, interlinking the images and their significance to the current reality of the group. This effectively trains patients in tolerating the temporary disorientation and the lack of control connected with viewing images in terms not absolutely linked to their authors intentions and more socially situated. This method seeks to create the conditions for patients attention to roam in ways less encumbered by performance anxiety, like being judged, or defined through their images individual appraisal. Growing able to make out what had not been intentionally included in the images sponsors

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a kind of thinking defining knowledge differently from one attributed exclusively to consciousness. This kind of attention has, as Bion (1993) suggests, no memory, or desire, but opens to the experience of surprise and revelation. As unseen elements become progressively seen, the unimagined becomes imaginable and new relationships become knowable. This reorganization therefore is not directed at disconnecting patients from authorship and personal expression, but at setting opportunities for collective imagination to be exercised as springboard for a culture of open enquiry. Effectively this is a phenomenon of image autonomy potentially opening the way to one of personal autonomy and described by Skaife (2008) as patients opportunity to view themselves imaginatively and from different perspectives.
Clinical examples

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The synergic use of art, dreams and collective free association assists thinking by maintaining contact with the ambivalence of the images, while making the connection between images into the basis for all interactive and interpretative processes. The following clinical examples show how the discourse of the images as a linked group is being made more evident by these technical changes. My narrative abandons individual pathologies to concentrate on relationships through the images lens. Stadium (Figure 1) derived from Samuels dream:
While doing my DJ work at the hospital2 a man tells me to do it in an auditorium for a large audience. I am very anxious and try to refuse, but he says that all I need to do is exactly the same as I always do, only on a larger scale. I try 3 times to do the programme in front of the auditoriums microphones, but anxiety stops me each time. I wake up.

The group was discussing this in terms of themes of personal courage and the already acknowledged problems of exporting into ordinary life the internal accomplishments of the group, when Gina, a very short-sighted woman, surprised everyone by saying that what she could see was a house with a thatched roof and dark windows, like The Witchs House in the woods (Figure 2)3 in the story of Hansel and Gretel.4 Congruent with the dynamics between neglect and the seduction of the marzipan house, the fable became the metaphor for the groups own narrative of anxiety about the transitions between therapy and external life and their fear of being abandoned. Having to move from intransigent dependency to reliance on new resources for survival, the group had to take stock of their ambivalence towards me. This image, and what they collectively made of it, told the tale of the groups primary fear of abandonment and rage against dependency, and made me into something of a witch. Insight into this process revealed danger, not as prerogative of a demonised external world from which the group provided idealised shelter, but as the shadow of internal objects brought to the theatre of the group, where anxieties and resources were both to be found, a fact which had eluded explicit understanding until then. Samuel also painted The Cave and the Storm (Figure 3), again from a dream:
I am in a cave where water is rushing. I feel afraid and on the horizon I see twin tornadoes approaching.

This image straddled commentary and prophecy as interpersonal tensions had been building for some time, eventually finding discharge in a polarised confrontation between Gina and Joseph, a man who was considering leaving and whose presence she ambivalently experienced as threatening and desired. For weeks the group referred to this image. As a harbour they could

Figure 1. The Stadium (paint on paper).

Figure 2. The Witchs House (association).

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Figure 3. The Cave (paint on paper).

Figure 4. Mother Makes Tea.

shelter in from whirlwinds, so as to remain able to think despite the climate of raised voices, anger and tears. Eventually the storm subsided, but the regulatory function of the image remained active. A large phallus on the right was eventually seen and sexual tensions could be finally acknowledged, giving way to a period of reparation during which relationships were deeply reviewed. During that time I had a dream I experienced as part of my thinking about the events described:
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I sit with the group wondering how to improve things; there is a large brown, jute bag from which I extract surprise presents for the group. I pull out a bulldog puppy, sitting on four sturdy legs and looking like the Churchill Insurance advertisement one. It also looks like one of the group members. I pull out an old fashion iron, of the kind people used to heat on a fire range, but it is also an old Singer sewing machine. When I put it down it settles on its base and it is stable.

mountaintop involves swapping ascent for descent, which now aptly described how the pair had swapped roles. Joseph began to consider his recovery as connected with the exercise of his own authority, while Gina recognised how her victim role had been abandoned in favour of an angry protest against being abandoned. Thoughts of guarding, ironing, sewing and internal housekeeping were followed by new ideas about hiding, desire, separation, de-fragmentation, truth and boundaries, leading eventually to questions of whether the gendered polarization had been the groups way of dumping conflicts onto the pair subgroup, while protecting the rest. All the interplay between dreams and images potential value was harnessed by sustaining rather than resolving the ambivalence they generated. Several months later, in a different group formation a young, new member, Mario, brought two recurring dreams:
I am walking between the two walls of a tower climbing over filing cabinets. At a window at the top a zombie appears, then a second one, and I am walking in a red desert.

Following the gift association, I resolved to tell the dream to the group, reasoning that ironing things out and sewing them back together might require a bit of daring. The bulldog and the sewing machine reminded me of the quarrelling pair. Joseph said he had felt unprotected by me from her fury, his transference from childhood sexual abuse experience, expressed in a recurring dream/images where he had to sit with his abuser/ step-father while mother stood by making tea (Figure 4). Temporarily I was the loved/hated parent, ignoring his plight; however, someone pointed out that here, instead of becoming aggressive, Joseph had kept calm while Gina, habitually casting herself as the victim, had expressed anger directly, loudly and had stormed out of the room twice. Someone brought up an older image of Josephs, The Purple Mountain (Figure 5), at one time associated to the task of therapy itself: the difficulty of the route, the effort of climbing and the anxiety of not knowing what waited on the other side. Reaching a

The group responded by producing a shoal of images and dreams during the following weeks. I made a suggestion that the group may try and play around with the images as if they were a

Figure 5. Purple Mountain (paint on paper).

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story-board. Following Figures 6 to Figure 11 the story goes:

The Traveller walks through the Red Desert and finds himself in a Winter Wood. A Tower of Bleeding Stones appears and entry is somehow gained through a Staircase made of Filing Cabinets. Various Exits prove blocked but a place is found where the Traveller is composed in a Cocoon, like an insects chrysalis.

Privately I felt my views, style and ethics wanting to colonize this chronicle of a journey through adversities, where opportunities for 1radical but slow change occur through indirect means. I thought of Dante showing in The Divine Comedy how from a state of confusion salvation is achieved through relinquishing the allure of an obvious path in exchange for the terrifying journey through the underworld. In analytic terms, this is the way of the depressive position, marking the sentient acceptance of our existential solitude. However, the group suggested a different text with the sequence inverted (116):
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Figure 7. The Forest.

From a Cocoon a Being emerges, breaking through Barred Exits. After climbing a Staircase of Filing Cabinets, a way out is gained and the Traveller leaves the Bleeding Tower behind, to cross a Wood to an Open Space.

While this text remains equally open to speculation, it bears the mark of separation from the authority of the therapist, asserting a new, evolutionary authority shifting the power from therapist to patient and inherently unburdening the latter of dependency. Although the content of the second meta-narrative may appear more simplistic, the process involved was progressive.
Imagination

whose potential for revelation and innovative thinking hinges on their open interactions. By considering images in sequences open to deconstruction (Skaife, 2008), their composite metaphors register wider signals than taken individually. Given the physiological similarities between dreaming and creative activities (Hass-Cohen & Carr, 2008) and that images, like dreams, are containers for meaning as well as of meaning (Armstrong, 1998) the best structure for their exploration must be one that maximises an open exegesis. In therapy the transformation of troublesome internal objects occurs through mastering the troublesome processes of therapy itself and in groups it means managing a kind of compromise between the conflating attractions of dyadic dependence, autonomy and cooperation. Art-Psychotherapy groups do this through their members collective and personal relation to their images. However, unless interaction is directly indicated (Waller, 1996), pairing up of image and

I now want to focus on how visual images, like dreams, are conduits for composite narratives,

Figure 6. The Traveller.

Figure 8. Tower.

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Figure 9. Exit.

Figure 11. Cocoon.

personal authorship highlights an assumption of individual ownership, not usually challenged by either group or therapist. Art Psychotherapy traditionally recognises that images, like dreams, have no definitive meaning (Waller, 1991; Skaife & Huet, 1998; Maclagan, 2005), setting the conditions to get away from preoccupations with ultimate meaning. Despite this we often collude with patients preoccupations with descriptions, foreclosing imaginative possibilities and stressing content over process, thus reinforcing expectations that an images mystery should be resolved by its makers explanation.5 I see the act of talking about the image, as opposed to talking from the image, as symptomatic of a defence against the dread of being overwhelmed by the instability of meaning. This dread can be reduced provided we promote a reliable platform. Maclagan (2005, p. 23) writes:
I shall argue that art therapy is not just a therapy with imagination, but a therapy of the imagination: in other words, that before we can depend upon it, imagination itself has to be restored and renewed, not only in the patients we work with, but in ourselves as artist therapists.

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When trying to make our services comprehensible to financially squeezed, bureaucratically anxious organizations, we compound the problem by simultaneously recommending and denigrating Art Psychotherapy with phrases such as It uses art making to help expression of feelings and communication and it is not necessary to be good at Art. We are not told to tell our dreams with the caveat they neednt be good ones. Perhaps if in Art psychotherapy we spoke of images, rather than art, we could free ourselves from the need to make allowances for their quality while retaining the connection with their visionary nature. Maclagan (2005, p. 23) sees imagination in both patient and therapist as essential for therapeutic progress:
Imagination is not something which has to be associated with the making of art, or even with our responses to the resulting art-works. It is something much more pervasive and fundamental. In fact it enters into every aspect of our psychological life: it colours our perceptions, it recreates our memories, it contributes to shaping and solving problems, not to mention its more familiar outcrops in fantasy, dreaming and creative incubation.

And Oppenheim (2005, p. 14):

Every mental act, being a compromise formation, is inherently creative. Creativity is therefore neither uncommon nor in any way exceptional dynamically speaking.

Figure 10. Climbing Filing Cabinets.

The exercise of imagination inherently mobilises emotional, intuitive and perceptive faculties in therapists and patients, at the service of engaging with narratives, particularly through images. Through these activities, which are non-linearly combined and essentially creative, the therapist models the possibility of grasping something beyond the factual data of referrals. Therapists

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and patients need to establish and maintain positions of creative mutuality. Oppenheim (2005, p. 17) talks of homeostasis and creativity being linked with the enhancement of brain functions and self-definition:
The key to this homeostatic activity lies in the representational processes of the mind, and the neurophysiological systems upon which they rely, precisely because subliminal awareness is requisite to the mediation between inner needs and external environs. I refer here to not only the mental imaging that is representation, but the dynamic inner representational world, the self and objects representations comprised of memories of experiences and the feeling states associated with them. Creative expression reorders these representations; it offers alternative perspectives on experience and does so through the meaning the creative communication of affect-laden representations suggests.

Homeostasis, our internal balance, relies on the successful deployment of new neurological configurations in response to new situations. Neurobiology understands the creation and transmission of new ideas as the minds capacity to set aside old categories to test the possibilities offered by new ones through the brains temporarily abandoning of known neurological configurations in favour of new ones. The neurobiological process maintaining homeostasis also requires fluidity of meaning. To comprehend and maintain stability in new situations, meaning must be continually recreated. Anything from distinguishing hostile from friendly environments, to intellectual problem solving, calls for absorption, evaluation and integration of new sensory data into knowledge already stored (Oppenheim, 2005, p.17). The management of knowledge is a series of continuous intellectual and emotional operations dedicated to the creation of meaning between the familiar and the unfamiliar. Agility in rearranging neurological patterns leads to more plastic mental representations and more adaptive conditions. This impacts on our psychosocial wellbeing because to each unprecedented neural configuration corresponds an innovative mental version of reality. This cycle of information juxtaposes layers of expected and unexpected experiences with objective and subjective ideas about the way we fit into reality. This fit produces a sense of external and internal coherence which we achieve by producing renewed versions of internal self-representations. Emotional and creative registers combine in interactive cycles, extending the capacity of an

autobiographical-self (Damasio, 1999 in Oppenheim, 2005, p. 22) to build coherent innerouter self-representations and to thrive. The drive towards homeostasis is essentially a creative effort because it seeks to assign meaning through our assessments of internal and external events (Oppenheim, 2005, p. 1723). Art and psychoanalysis share a role in the homeostatic function by sharing interests in the emergence of meaning, especially when serving this goal by generating art, a system of innovative metaphors, externalising internal representations of reality. Modell (2002; in Oppenheim, 2005) distinguishes truly creative metaphors, capable of generating new meaning, from representations whose role is one of repetition of what is known and lacking the capacity to promote change. Schaverien (1992) and Mann (2006) concur that some images are not the product of creativity, but rather the effect of a postponement of creativity at the service of defensive strategies. Tracing imagination back to the metaphor implies that creativity may be the product of imaginative activities, rather than their origin. This position would support the suggestion that creativity may be found in the inventive handling of the visual products of experience before it is found in the images themselves. Imagination is a free associative faculty deploying the capacity to create chains of images, physical and mental; keeping the links open and moving from one point to the next indefinitely. Free association is central to fantasy and imaginative processes in psychoanalysis (Mann, 2006) and in relation to transference this reveals the measure in which imagination is developed, or inhibited (p. 35). Imagination enables us to remain reflective when projective identification challenges our sense of reality. Imagination is what keeps us within the symbolic as if position against collapse into symbolic equation (Segal, 1988). Because of this, it can assist patients to move from a position of sterile bondage to symptoms, to one of emotional intelligence.
Conclusion

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Social-Dreaming is relevant for Art-Psychotherapy groups because it predicates the use of free association with a focus on dreams as social constructs. Both systems share neurological activities and comparable phenomenological manifestations and propose collective handling of the products of unconscious thinking. The synergic use of art, dreams and free association enhances the therapeutic use of image ambivalence and in

Reflections on the treatment of images and dreams

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my group practice I have introduced techniques harnessing the imaginative states implicit to the processes of image making and viewing. I have aimed at developing patients mental plasticity through supporting collective authority and through encouraging groups to operate in the dialectic space between images and image-makers. The technique of having previous images already available at the start of each session in the interest of enhancing continuity is also proving helpful in supporting the delivery of a coherent meta-visual treatment. This treatment invests in images potential to deliver insight, taking patients through a meta-visual journey to their unknown, yet knowable reality where work is not defined by productivity but by the exercise of imagination searching for meaning. At a neurological level, this translates in the formation of new patterns. This is understood to promote homeostasis, achieved through generating new neurological configurations, during acts of innovative thinking. This contributes to patients capacity to thrive by promoting flexible self-representations. These processes involve complex operations, not definitively physical, spiritual, emotional, or intellectual, but functioning simultaneously across different symbolic orders, through chains of signifiers. In ways comparable to those of dreams, art operates meta-physically and concretely through the senses, remaining simultaneously unchanged and open to change. This transformative process creates a synthesis of roles by making us into agents and recipients for new knowledge. By accepting to be such vessels we can transform our world through it.
Notes
1

2 3 4

A different apparatus from the Group Analytic matrix of Foulkes (1986), which is a network of exchanges focussed on transference and personal interactions. Voluntary activity, at a local hospital. Digital approximation of her description. A tale of two siblings abandoned in the woods by their destitute parents. Hungry and desperate they nd a hut made of marzipan which they start eating, only to become entrapped by a witch who plans to eat them. In the literature i.e. McNeilly (2006), Frank & Whitaker (2007), also personal communications.

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F. La Nave around the use of dreams and images in Art psychotherapy and the practice of Social Dreaming. She is a visiting lecturer on a number of Art psychotherapy courses and has a private supervisory practice.

Biographical details Francesca La Nave is an Art psychotherapist and Group Analytic psychotherapist working in the NHS as well as in Special Education. Her MA in Group and Intercultural Therapy focussed her interest

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