New Contexts: what art psychotherapy theory can bring to an understanding of using images to communicate the experience of pain in medical pain consultations

Abstract

This paper looks at whether we can bring art psychotherapy theory to understanding the role of art in a new context; the medical pain consultation, as part of an experimental arts in health research project. The project studied the introduction of a set of art images into chronic pain consultations, to help patients and doctors communicate complex experiences of pain. The paper draws on different theoretical approaches from art psychotherapy, to provide ways to understand the meanings of an art object introduced between two people. Triangular relating, symbolisation and transactional uses of the image are explored (Isserow 2008, 2013, Schaverien 1991,1995, 2000). The image is also considered within a social frame and from an intersubjective viewpoint (Tipple 2003, 2011, Skaife 2008).

The images were artistic depictions of pain, previously co-created by other pain patients with an artist as a communication resource. Videos of consultations where doctors and patients used these images were studied. The paper takes case examples of features observed in a thematic analysis and uses art psychotherapy theories to explore them further.  Suggested implications are that using images in this setting may allow negotiation of unconscious dynamics between clinician and patient and have potential to aid communication and empower patients, suggesting avenues for future research. The potentials and limitations of bringing theory to this context are considered. The research took place within a multidisciplinary team.

Keywords: chronic pain; triangular relationship; transactional objects; multidisciplinary research; art psychotherapy theory; arts in health.