Draft:Three Modalities of the Creative Process in Art Therapy

The Three Creative Process Modalities (3MPC) is a model used in art therapy to help the art therapist understand a person’s lived experience. The 3MPC were proposed by Mimma Della Cagnoletta, co-founder in 1982 together with Marilyn La Monica and Maria Belfiore of the first art therapy school in Italy (Art Therapy Italiana). As she began teaching art therapy to groups of students, she noticed distinctive models of working emerging in their creative process that fascinated her and led her to investigate them further, publishing the theoretical framework that emerged in her handbook in 2010. They emphasize the importance of the process over the product within art therapy, a core factor recognized early on by Arthur Robbins and developed in Art Process Therapy (Rhinehart & Engelhorn, 1982), Sensorimotor Art Therapy and Somatic Art Therapy (Hamel, 2021) .

The 3MPC has some similarities but also some important differences from the Expressive therapies continuum, the model of creative functioning proposed by Lusebrink and Kagrin . Each model is valid and useful in different ways within different contexts. While the ECT correlates the creative process with levels of functioning in terms of the development of our nervous system and human information processing, the Three Creative Process Modalities finds its origins in psychoanalysis and psychodynamics, specifically in Thomas Ogden’s three modes of experiences. As such the modalities explain the way in which the person is relating with their environment, the fears and defense mechanisms that are operating, and the resources that may be activated. Comprising of 3 levels that mirror Ogden’s 3 modes of experience, it offers the art therapist an immediate and operational guide in the here and now of the service user’s relationship with the art materials during the creative process.

Ogden’s Modes of Experience

Drawing from the theories of object-relation psychoanalysts, Ogden’s three modes of generating experience follow the child’s three developmental stages. But they remain in a dialectic relationship with each other throughout the person’s lifetime, so that “each creates, preserves and negates the other” . Ogden’s starting point was based on the Kleinian theory of the Paranoid-Schizoid and Depressive positions, two psychological states of being that Klein attributed to the infant’s development from a biological to a psychological entity . Even if Ogden maintained their original names, the two positions became two different modes of experience, no longer limited to the child’s development but used by adults to process life’s events. He also added a third mode, called Autistic-Contiguous, which precedes the Paranoid-Schizoid one and constitutes the primary form of experience. It is important to note that the names of each level of experience are not meant to be interpreted in terms of pathology but denote the kind of mechanism and fears which every person is susceptible to at some level regardless of their mental health.

Autistic-Contiguous Level In the Autistic-Contiguous mode of experience, the need is to restore bodily boundaries, when we are afraid for our psycho-physical integrity. A person does so in many ways, often using sensations to heal a ruptured boundary. This can be through the reassuring rhythm of whatever generates a feeling of being held for that person, from having a shower, to listening to a favorite song, to wrapping oneself in a blanket.

Schizo-Paranoid Level This mode protects a person from a feeling of chaos, when our life seems to fall apart. We can restore order by organizing and classifying, distinguishing things that work from things that don't. The Schizo-Paranoid mode is based on splitting. Dividing and separating is a defense mechanism but also an organizing principle without which everything would be confused in our mind. Many of the mechanisms that dominate this state of experience are used every day to deal with ordinary situations, avoiding unpleasant or painful things by distancing or denying their emotional impact. Someone might say, “no, I didn't feel anything when she left”, or the momentary dissociation between body and mind, “when I run, I don't think about anything, as if it hadn't happened”.

Depressive Level Finally, in the Depressive mode, a person becomes aware of the complexity of life with all its gains and losses. What is "me" is separated from the "not-me". We can feel alone and suffer from missing the other. We may realize how our actions have harmed someone we love and feel guilty. We might be jealous if the attention we would like to receive goes to another person. The entire emotional range and meaning of interactions between people are the subject of thoughts and analysis.

The Three Creative Processes

All 3 modalities are of equal importance for a balanced well-being and all three remain operational throughout a person’s life-time and within every creative process. The dominance of one over another, or the complete absence of a certain modality, guides the art therapist in understanding which developmental need is calling for attention.

Bodily Concentration As its name implies, this is first and foremost about the body and it is about relating at a sensorimotor level. It is pre-symbolic and pre-verbal and is about the body’s lived experience and not the mind’s interpretation of that experience. The sense of self may be built around the sensorial input in terms of contiguity or about the motor output in terms of rhythm and movement. In psychodynamic terms, it evokes and responds to fears around disintegration, disconession and destruction of the self as a whole object, of the loss of a cohesive boundary. It responds to the fear of falling into an infinte void. In order to protect the self from this, it is important to re-establish the continuity of the body’s boundary, the skin.

Formal Resolution This level is above all about protecting the self from overwhelm, especially from over-powering emotions and so when it emerges the art therapist knows that the person feels unsafe in some way. It can be easy to recognize as it is often very schematic. It is about separating and organizing, hence it’s name. It is about creating an artwork that is resolved in formal terms. It responds to the need to turn chaos into order. In psyhcodynamic terms, it responds to the need too separate the good from the bad and as such it is about categorizing and relating to partial objects. In this sense, it is pre-subjective and non-reflexive because there isn’t a genuine intersubjective field yet, as the other is partial and not whole. It’s good or bad parts have been split off to make it “all bad” or “all good”. It is the level that coincides with Segal’s Symbolic Equation.

Symbolic Narration At this level, the aspect of communication with the other becomes central. Objects within the artwork become symbols that represent things, the cognitive meaning becomes important and the art therapist’s presence becomes important as receiver of the communication. Here, the capacity to symbolize is active. The element of time also because important as a story often develops, implicitly denoting a past, present and a future. In psychodynamic terms, in this modality, the person may protect themselves from the fear of losing love by repressing aspects of the story and by rationalizing events so that their emotional implications are reduced.

The 3 Modalities together

The art therapist looks not just at the presence of the three modalities within a single artwork but also at their presence and/or absence over the course of the art therapy intervention. The presence of all three modalities in more or less equal proportions would indicate a balanced ideal rarely occurs as every person has an individual personality and temperament that creates preferences. The absence of a specific modality within a specific session may indicate the response to the matter that emerged in the here and now, whereas the absence of a specific modality over an entire intervention may indicate a developmental need that was not met.

There are also differences within types of interventions in art therapy, depending on the problem that needs to be addressed. For instance, within sensorimotor art therapy the primary creative process is the Bodily Concentrated modality, focused on accessing implicit memory patterns within the sensorimotor base.

Uses within Research

The Three Creative Process Modalities provide a theoretical framework that can be useful for art therapists to convey the specificity of this profession to other colleagues, how it works, structure case studies and compare research across the field. As you can see in the article "Not female-to-male but shadow-to-human: an exploration of body tracing in terms of embodiment and identity definition during gender transitioning" it becomes a way of understanding the different function of each body tracing, the relationship between the person and the artwork and the way in which the artwork is serving as an expression and/or a vehicle for transformation.