Introductions

These introductions offer different focal perspectives across wide range of events, people, and cultural works in the art therapy timeline.

class, race, and mental illness

Sanya Jaffer, Lucia Lopez, & Zemaye Okediji
April 22, 2019

The direct impact of Western imperialism and intervention in foreign affairs is substantial and affects a lot more than just the broad economic dynamics within the country under colonization–it affects the social dynamics of class, race, and mental illness. The concept of having a class system was implemented in many countries by the colonizers themselves as a means of exerting control, influence, and exploitation over the population and resources. The creation of this division amongst the population into categories of the working, middle, and upper classes, defines who has access to what resources, who can participate in what work fields, and also shapes personal experiences. Even though this concept is a part of globalization, the concepts of class, race, mental illness, and who has access to what, can be found throughout U.S. history, and in its current events. These control structures are tied to U.S. legislature at the federal, state and local level and form the socio-economic systems that govern our healthcare, housing, education and labor.

Before the economic devastation of the 1930s, the U.S. in the 1920s saw African American advancements in employment and policies edging toward equality in the New Deal inciting a backlash in racialized federal housing policy. When the Great Depression and various catastrophes occurred, all races and classes across the nation were hard-hit, yet, a color-coded Federal Housing Act manual that benefited only the white labor class was formed. The FHA dictated which “race” and “class” had access to housing loans citing the need to preserve neighborhood “stability” (1939 FHA manual). In 1944, the GI Bill further limited access of returning veterans of color to housing loans and quality elementary education. This lowered the chances of admittance to quality colleges, ultimately making starker the class system and intergenerational wealth gap. After the Housing Act of 1967, it was not until another economic crisis in 1974, that Section 8 housing was introduced to serve at-risk people and the homeless in urban areas. These policies created the context that gave rise to a predominantly white upper-class membership in the American Art Therapy Association (AATA) since its growth in the 1970s, and people of color as the predominant clientele, which can still be seen today. It was against this national backdrop of inequality that Cliff Joseph advocated for alternate forms of entry to the field, other than a costly masters degree, which would broaden the limited access to an ethnocentric art therapy field.

Joseph, the first black member of AATA, using themes of war, racial segregation and common experience in his art, recognized the unique opportunity art presented for social change as well as in his art therapy work in prisons and education. His social interventions were through his artistic practice, advocacy in the AATA, and through direct protest and negotiation with art institutions that birthed the formation of the Black Emergency Cultural Coalition (BEEC). Advocacy by the BEEC drew public attention to the need for more equitable labor standards and reformed access to combat the entrenched history of marginalization that is still upheld today.

gender, disability, and criminalized behavior

Katherine Lamb, Danielle Swan, Chloe Beltran, & Caroline Casey
April 23, 2019

Gender, disability, and criminalized behavior are overlapping themes that affect how people are viewed, treated, cared for, and punished within the US mental health care and penal systems. The Americans with Disabilities Act (1990) defines disability, “as a physical or mental impairment that substantially limits one or more major life activities” (para. 2), with mental impairment including developmental disabilities, organic brain damage and mental illness or “psychiatric disability.” Proponents of a social model of disability critique the medical model for its failure to examine the role of social structures and attitudes in creating the experience of disability, (Berghs et al, 2016), but disability discourse continues to evolve, as exemplified by the more recent emergence of critical disabilities studies.

Because disabled people are often labeled by societal norms as deviant or “abnormal,” they are at increased risk of criminalization. Deviant behavior often results in the criminalization of a person, “the action of turning someone into a criminal by making their activities illegal” (English Oxford Online Dictionary, 2019). Power is apparent when considering who determines which behaviors, and therefore which people, are abnormal or illegal. When disabilities are presented onto people, it is easier to have power over those individuals. Once someone is disabled, pathologized, and/or criminalized by society, they lose power and autonomy. The incarceration system, mental health care system, and art therapy as a byproduct of these systems, manage people when their behaviors and/or identities do not fit the norm, or what is expected in a society. This is done by criminalizing a person to take away their rights, often controlling them through institutions. Criminalizing does not solely happen in the form of incarceration, but in a broader sense, happens anytime someone is pathologized, deemed as abnormal, and punished for their identities and/or behaviors which are influenced by the social, cultural, and interpersonal forces around them.  

Issues of disability and criminalization also intersect with considerations of gender identity, which is also formed within the context of social norms. Gender identification and affirmation references an interpersonal and interactive process. The recognition and support for nonconforming gender identity and expression is threatened once introduced to an institution where gender norms are strictly maintained. This is seen in the extreme and violent ways European colonizers treated Indigenous genders that fall outside western gender binaries and how Native Americans continue to encounter having Two-Spirit gender identities treated as criminalized behavior within education and penal systems (Deerinwater, 2018). Penal systems set in place to reform criminalized and deviant behaviors support and maintain the social order of gender roles as it relates to criminalized behavior. Socio-cultural influence maintains that gender is deeply internalized by both males and females starting at a young age. Observing the history of formal institutionalization, the early adoption of “gender behaviors play a fundamental part in constructing prisoners’ identities in circumstances that led to their incarceration, their management and response to the control exercised over them in corrections facilities” (Butler, 1999). Comprehending gender, disability and criminalization acknowledges the prevailing questions as to: What are the criminal effects of pathologized disabilities that arise out of gender dysphoria? What are the steps being taken to regulate the treatment of gendered disabilities within the criminal justice system? How might these steps offer a decolonized approach to addressing gendered disability and pathologization? Safety considerations must be considered when approaching such a topic in thus understanding the effectiveness of treating gender dysphoria. Hormone therapy, psychotherapy, and art therapy are tools used to address comorbidity of mental health diagnoses.

People experience criminalization on the basis of both disability and gender, and these aspects of identity interact in many complex ways to shape people’s experiences of criminalization and pathologization. Ultimately, an analysis of disability, gender and criminalization cannot be separated from an analysis of race and other issues of identity and power, as made evident by the historical attribution of disability to BIPOC as a form of and justification for control and the historical attribution of physical and cognitive disability to immigrants.

References

Butler, A. (1999). Gendered justice in the American West. Urbana: University of Illinois Press.

Bergs, M., Atkin, K., Graham, H., Hatton, C. & Thomas, C. (2016). Implications for public health research of models and theories of disability: a scoping study and evidence synthesis. Public Health Research, No. 4.8. Accessed at: https://www.ncbi.nlm.nih.gov/books/NBK378951/ (Links to an external site.)Links to an external site..

criminalization. 2019. In Oxforddictionaries.com. Retrieved April 22, 2019, from   https://en.oxforddictionaries.com/definition/criminalization (Links to an external site.)Links to an external site.

Deerinwater, J. (2018, June 05). Our Pride: Honoring and Recognizing Our Two Spirit Past and Present. Retrieved from https://rewire.news/article/2018/06/05/pride-honoring-recognizing-two-spirit-past-present/ (Links to an external site.)Links to an external site.

Introduction to the Americans with disabilities act. Accessed at https://www.ada.gov/ada_intro.htm (Links to an external site.)Links to an external site.

age, class, and physical illness

Sarj, Tabitha Kunkes, & Poppy Liu
April 23, 2019

Art therapy, in the United States, is a faceted profession that is regulated by the American Art Therapy Credentials Board under three different board credentials (ATCB, 2019). Art therapy plays a role in the mental health field and healthcare as a whole. Art therapists are employed in settings such as hospitals, schools, mental health clinics, and residential and rehabilitation centers. Our group explored the themes of physical illness, socioeconomic class and age in regards to the role these play in the profession of art therapy. We explored these topics by examining who can practice art therapy, who receives care, how those who get care can afford to get care and how they feel about that care.

Age plays a role in healthcare through laws that define the level of services and self-advocacy available for people – both depending on their age and through including age in the requirements needed to become licensed to provide healthcare. The American Medical Association created standards that require a medical degree to practice medicine and standards for what is needed to obtain said medical degree (AMA, 2019). These standards were created in 1847 and were revised in 1852 to include the need to be over the age of 21. Licensed professionals who hold a degree are then the ones who are legally eligible to diagnose and provide care, therefore determining physical illness and the needed treatment. Similarly, art therapists are required to have both a higher education degree and board-certified licensure: this puts them in the position of power to treat a person’s diagnosed physical illness (ATCB, 2019). Thus, art therapists in the United States are typically at least 24 years old when they start practicing as a licensed professional.

Requiring a degree and licensure to practice medicine reinforces the divide of socioeconomic classes. Who is ill and who benefits from someone else’s ailment? Paying for healthcare is a key part of getting care. Socioeconomic class is divided into a set of hierarchical social categories, the most recognized being the upper, middle, and lower classes. Government healthcare funding plays an essential role in many people’s lives in the United States, specifically the people in the lower socioeconomic class. In 1965, the Social Security Act Amendment was signed into law (“Social Security Act Amendments”, 1965). The act is known for its inclusion of Medicare and Medicaid. It has established a health insurance program for the elderly and people in the lower socioeconomic class. Also, from an international lens, in Chengdu, China, a government-aided health insurance program called Mutual Funds for Children was established for children and adolescents from rural to urban communities in Chengdu. A new version of the policy came out recently that revised to increase the price and an enlarged range in protection in population ( “Mutual Funds for Children”, n.d.).

Our timeline entries address these topics through situating events, people, and laws that have a direct impact on our understanding of art therapy as a multi-dimensional profession. Art therapists provide services to individuals who have specific historical, social, and cultural contexts. Among many factors, art therapists should consider their clients’ age, socioeconomic class, and physical health. This analysis only begins to do this task.

References

AMA. (2019). American Medical Association. Retrieved from https://www.ama-assn.org/

ATCB. (2019). Art Therapy Credentials Board. Retrieved from https://www.atcb.org/

sexuality, disability, and mental illness

Erica Wang, Laura Young, Susannah Ward, & Denise Majka
April 24, 2019

In order to understand the intersectionality of sexuality, disability, and mental illness, we have presented some key medical, sociocultural, and policy milestones in history that have formed and evolved that context in the United States. As future art therapists, it is vital to work through and understand intersectionality and all its facets in order to best serve our clients.

Medical: The AIDS Crisis seemed a clear choice to be included under the umbrella of our group’s collective topic – due to the numerous connections to various cultural components. In terms of who was being affected by the virus various groups were involved, especially marginalized ones. In the specific case brought to the timeline regarding Robert R. these identities included being a homosexual male, and a man of color living in the midwestern United States during the 1960’s. Moving forward in time, the addition of the entry examining eating disorders through an LGBTQ+ lens served to connect the group’s topic to modern times through a cultural context. Eating disorders have long been associated with a very specific client type, but the findings introduced in the collaborative survey conducted by NEDA and the Trevor Project challenged and altered this belief in a very public sphere.

Sociocultural: Paul B. Preciado, author of Testo-Junkie, outlines the era we live in today (that began in the 1970’s) that commodifies and capitalizes sex. Through the production of products such as Viagra, the Pill, testosterone, estrogen, etc., corporations have become “managers” of human bodies. In socializing the ideas that certain bodies fail to have sex “normally”, society capitalizes upon the formation of a “disability”. Mental illness easily fits into this conversation as products such as birth control and Viagra can, “fuel violent and aggressive behavior in men” (Milman & Arnold 2002), while different birth controls can, “affect the user’s mood and increase the risk of depression or other emotional changes” (Smith, 2018). A more current event, the foundation of the Tyler Clementi Foundation, also highlights each topic thoroughly. This foundation was organized after 18 year old Tyler Clementi died by suicide following abuse from his roommate. Clementi’s roommate recorded an intimate sexual encounter between Clementi and another man without permission which was then shared across their school’s campus. Easily encompassing sexuality and mental illness, the topic of disability is a bit harder to suss out in this example. However, disability can be defined as a “a disadvantage or handicap”. In identifying as LGBTQ+, many workplaces and religions can legally discriminate against such individuals, therefore creating a disadvantage – or disability.

Throughout history, disability has served as a marker of difference and, like any other marker of difference, a site of speculation. Starting in the 1840s, travelling exhibits called “Freak Shows” toured America showcasing exotified and sensationalized bodies for the masses, further marking their difference in their notoriety. Cognitively and physically disabled black men (“What Is It?”), Sartje Baartman (“The Hottentot Venus”), and Julia Pastrana (“The Ugliest Woman in the World”) were just some of the many marketed as “missing links” between modern humanity and its primitive ancestry. The popularity of freak shows dwindled in the 1940s with the rise of a more medical model of disability, where the public’s gaze went from carnivals and state fairs to operating rooms and doctor offices. And with the rise of a medical model came the pressure for a “cure” -a solution to the problem of disability, and of difference. With cure as the ultimate aspirational goal, a television advertisement that aired during the 2000 Super Bowl featuring the famously super and disabled Christopher Reeve walking through CGI shocked the nation. With some disabled viewers calling their doctors to request whatever treatment Reeve was getting, to others criticizing Reeve’s involvement as ableist and ultimately harmful to disabled folks, to others being moved to tears upon seeing Reeve’s triumphant first few digitally edited steps, the commercial was polarizing.

Policy: It is imperative to consider the legal structures that defined the lives of those living under such categories of identity and citizenship; or, in other words, the institutionalization of social inequality in the US. The Eugenics Movement dominated the early 20th century, from the US Public Health Service inspecting arriving immigrants for infectious and hereditary diseases to the legal segregation and/or forced sterilization of those deemed “unfit” or “feebleminded,” which the Supreme Court upheld in Buck vs Bell (1927). The legitimization of heredity and race as indicators of human superiority by state and federal laws perpetuated the White, middle-class concepts of illness and disease as well as justified social inequalities. The federal ACE (Adverse Childhood Experiences) Study established that the more ACEs reported, the more likely and more prevalent the negative health outcomes as well as fall victim to crime. Only when the Violent Crime Control and Law Enforcement Act of 1994 was established did the Hate Crime Statistics Act (HCSA) of 1990 get amended to include violence and crimes with bias against persons with disabilities. In 2009, Rosa’s Law was passed to replace all language using “mental retardation” with the “intellectual disability in federal health, education and labor laws. Also in 2009, gender and gender orientation would be added to the HCSA.

race, religion, and criminalized behavior

Julienne Gerner, Johanna Tesfaye, Amanda Sanabria, Annalise Castro
April 24, 2019

Our entries span from 1692 to 2016 and highlight some of the ways in which race, religion, and criminalized behavior have, as interwoven themes, impacted social movements, political rhetoric, legislation, diagnoses, and acts of violence and terrorism. In addition, these entries may be used as points of reference for understanding current practices within the field of art therapy. For instance, the Salem Witch Trials of 1692, raise questions regarding diagnosis, piousness, and criminal behavior with regard to race, religion, and social status. Throughout the era of slavery in the US, the enslavement and abuse of black people was condoned through medical diagnosis, a legacy that continues well into practice today. In 1851, Dr. Samuel Cartwright coined the terms Drapetomania and Dysesthesia Aethiopica to pathologize enslaved black people mental and physical being to justify their enslavement. Similarly, the criminalization of people of color has continued to be reinforced through scientific and medical research. Dr. Mary Benheim’s 1928 discovery of the genetic enzyme monoamine oxidase (MAO),  linked to the regulation of neurotransmitters such as dopamine and serotonin, led to the discovery MAO-A. MAO-A, nicknamed the Warrior Gene, has been associated with aggression, depression, and other mental disorders. Studies have attempted to correlate race, class, and genetics for behavioral prediction with this research, such as Charles Murray’s The Bell Curve (1994). The Harrison Narcotics Tax Act of 1914 contributed to the pathologization and criminalization of drug use within the United States’ legal system and in many treatment methodologies. The Radiant Church Roundtable with Mike Pence can be viewed as resulting in part from the previous two entries, as Pence informally pardons police brutality as part of an effort to gain support for Donald Trump’s presidential campaign. In addition, since Donald Trump’s 2016 presidential campaign, he has proposed building a wall along the United States and Mexico border. The border wall efforts have [been] promoting the belief that the southern border has been a gateway for criminals and terrorists to enter the country, perpetuating racism and acts of hate amongst people of color and immigrant communities. The intersections of race, religion, and criminalization within the United States is not unheard of outside of this country, but the US has managed to back and promote those intersections within other countries. Looking to the year of 1968 the United States experienced liberatory movements for workers’ rights, protests against the Vietnam War, women’s liberation movements, and African independence struggles. In the same year the Radical Psychiatry Movement , specifically in Gorizia, Italy, lead by example for its improvement of conditions for patients and opening up asylum wards intended to confine and control people deviant from society. Ideas of anti-institutionalism, social analysis, and critique of the medical establishment were key tenets in the struggle for deinstitutionalisation and human rights for those criminalized and incarcerated in asylums in the 60’s and 70’s, as well as in the United States. A recent example can be seen in the 2013 documentary God Loves Uganda, by filmmaker Roger Williams, that highlights how the America’s Christian right participated in Uganda’s attempt to pass a bill that would make homosexuality a crime punishable by death; the Uganda Anti-Homosexuality Act was ultimately passed in 2014. Our timeline focuses on the interrelatedness of pathology and trauma, specifically race, religion, and criminalized behavior, throughout the history of the United States.

gender, sexuality, and physical illness

Amethyst Strivelli, Courtney Bennett, Jessica Walters, Emily Holmes

When considering physical illness, gender, sexuality, within art therapy, we cannot disentangle these topics from the historical context that gave rise to the field. Art therapy in the United States is a product of multiple histories, many of which affect those who lie at the intersection of gender, sexuality, and physical illness. In The Art Therapy Sourcebook, Cathy Malchiodi argues that art therapy is an effective treatment for physical illnesses. She posits that participating in art therapy may lower stress, give patients an alternative focus other than their ailment, and enhance pain medication relief through dissociating pain from psychological distress (Malchiodi, 1998). This argument has been used to justify art therapy as a treatment for a variety of physical illnesses including HIV/AIDS and diseases specific to women’s health. Our group decided to construct our timeline around these illnesses as they have a rich histories related to gender and sexuality.  

Art therapy has always been a field comprised mostly of women. Whether or not “female” is a marker of the profession, it is worth examining the aspect of gender from other perspectives in medicine in order to understand implications for art therapy. Reflecting the 19th century hysteria debate, medical fields have generated a problematic history regarding women and illnesses related to reproductive health such as PMS, dysmenorrhea, and menorrhagia. These issues, along with doctors’ unsettling history of not taking women’s pain seriously, lead to important questions regarding the “gendering” of a field embedded within health systems in the US. Specifically, what does it mean for art therapy—a female-dominated profession—to exist in a society that has never prioritized female health?

When it comes to scientific research and development, most research does not include women as subjects because men (and the male body) are considered to be the default. This concept is referred to as the “default male” and we see it throughout all aspects of society, language, history, and medicine. Sciencedaily.com reported on a study done by Plataforma SINC that showed that the majority of images in medical textbooks are portrayals of white, male bodies. Women’s bodies were mostly only referenced if the pictures were specifically of female sex-organs. Most images or diagrams of body parts shared by the sexes (e.g. limbs, the nervous system) depict these body parts on male-assigned bodies. This “default male” medical model only familiarizes students studying to be physicians (which is a male-dominated field already) with a male body. This “standard” is also how dosages for medications are determined. Giving someone medication and treatment that was not considered for their body can cause immense damage.

Art therapy can also be understood through other illnesses specifically tied to gender and sexuality. For example, in the United States HIV/AIDS was initially perceived as a gay men’s illness. Although HIV/AIDS can affect individuals of any gender, the disease is still heavily stigmatized. Today, art therapists work with a range of people living with HIV/AIDS. Further, art therapy is also being used in multiple palliative care settings, which “aims to preserve a person’s dignity and quality of life in the face of incurable illness” (Pratt M. 1998 p.12). This includes end of life hospice-care, various terminal illnesses, cancer patients, and grief in some instances, among many others. Art therapy in these specific setting are more focused on well-being and holistic approaches as opposed to diagnosis and long term treatment goals.

It is crucial within this context to recognize therapist bias regarding pain, medical discrepancies in relation to gender and race, perceptions of “quality life”, as well as historical and current political agendas such as travel bans, private health insurance, LGBTQ+ rights, and women’s rights, to inform therapeutic approaches for physical illnesses.