"Come to Treatment!"

Every Monday at 9am, I lead a group therapy session called "Arts and Sciences." The rationale for the group topic and title is twofold. First, scholars have demonstrated the benefit for artistic therapeutic modalities in substance use treatment settings for numerous reasons. Dingle et al. (2009) have shown how music therapy in this setting compels clients to pair their efforts in recovery with the parts of themselves that derive motivation from music. Heiderscheit (2009) explains how music therapy engages the individual and the group at the same time, thereby making it ideal for substance use treatment centers where most of the day is dedicated to group therapy. Anggawijayanto et al. (2024) and Breslin et al. (2003), though in different ways, identify the process of "finding one's voice" as crucial for increased self-esteem, which, in turn, can fuel long-term recovery. As such, narrative-based art therapies (e.g., poetry or manifesto writing) can provide useful containers into which clients can place strong values and beliefs. Wadeson (1980) explained “that what is more desirable than isolated descriptions of [arts therapy] techniques is a theoretical framework from which to select appropriate materials and methods” (cit. in Hinz 2009, 20).

​Whichever artistic medium one may choose, the process of thinking artistically gives clients access to parts of themselves that have likely been turned off by drug addiction and alcoholism, parts that were active during childhood but deemed "useless" or tangential to the "true" purpose of life (ostensibly, getting work, contributing to the world, making a difference). And while scholarship is important, my own personal experience leading art therapy groups in the treatment setting has validated my long-held belief that art is transformative and that the therapeutic journey requires more art and less science, especially in treatment settings. 

My second rationale for leading an "Arts and Sciences" group is that, while the evidence is compelling, clients often have a bias against art, claiming that it is unserious or superfluous in a setting where each group emphasizes the life and death stakes of treatment. Equally as common is the belief in clients that "I'm not a good artist," which is often a narrative they acquired from authority figures who judged or invalidated their artistic expressions against certain ideals or norms. As such, given these biases, I've found it necessary to explain the brain science and cultural studies-like social science behind artistic expression. I'll point, for example, to the work advertising is able to do upon the brain to persuade people of needs they didn't know they had, or to the culture jamming (a la Situationist International) projects that have been capable of challenging and shifting epistemic frameworks that shape how one sees anything at all. Taken together, then, "Arts and Sciences" is a group topic that enables clinicians to play creatively with interventions not typically taught in textbooks of addictions treatment and that enables clients to tap into parts of themselves that store strong emotions that haven't been validated in years or sometimes decades. 

One of these Arts and Sciences groups asks clients to make three types of flyers that I promise to hang in public spaces. 1 flyer must be a serious or genuine ad for going to treatment. 1 flyer must use irreverence to solicit authentic interest in substance use treatment by utilizing "dark" humor or direct speech to compel attention. 1 flyer must be for "meaning in life," and I leave it open-ended so as to see what clients make of that invitation. The role of irreverence in this activity is important for many reasons. One, the ability to laugh at oneself and at others like you is, generally, an ability to truly see yourself in the world. As Simon Critchley writes in On Humor (2002), “The object of laughter is the subject who laughs” (14). He goes on to say, “A true joke, a comedian’s joke, suddenly and explosively lets us see the familiar defamiliarized, the ordinary made extraordinary and the real rendered surreal, and we laugh in a physiological squeal of transient delight, like an infant playing peek-a-boo....Thus, jokes are a play upon form, where what is played with are the accepted practices of a given society” (10). One may not immediately think of a client in treatment as a "comedian," but there is no doubt that clients in treatment are in the best position to help society challenge the accepted stigma against addicts and shine light on the ostrich-head-in-the-sand behavior that leaves substance use treatment in the category of "Things we just don't talk about." As such,  by using humor capable of breaking through the wall of silence around addiction in society, clients become powerful change agents. If clients are comedians, per se, then they certainly ought to be empowered to engage in comedy during a time in their life beset by mirthlessness and feelings of failure. 

Here's an example of one of the flyers made by a client at Nova Transformations where I work. 

If we take a moment to analyze this, we see the arts and sciences at work. First, note the handmade appearance of the flyer. Compared to the AI-generated group of people engaged in serious conversation in a group setting that one is likely to see on treatment websites, this flyer feels quite human. More than that, it feels childlike. In a public forum like the public library or a grocery store bulletin board, a handmade aesthetic like this will catch people's eyes. Second, the childlike, handmade aesthetic clashes with the large "Free Drugs" that pops into our vision first. Third, the clash produces an incongruence that compels further inspection. If, fourth, the inspector is a person who uses drugs, then the words "Free Drugs" will entice them even more, but, fifth, the "sale" of free drugs is undercut by the smaller print that reveals the entire pitch: "be free from drugs." The spectator is then forced to act: stay and think or recoil.

Talking about this particular flyer in the group, each client recognized the habitual, anti-authoritarian response to such appeals that still lives in them even as they sit in treatment. "Don't tell me I need help!" That adolescent defiance is a hallmark of in-built defense mechanisms that, far from actually protecting people, often lead them into commerce with "the devil they know." All the clients in this group know this defiance because I always chip away at it, ask them to perform it, and ask them to over-emphasize it thereby drawing it out into the light where it withers upon inspection. The clients know that spectators of this sign will elicit strong responses, and that's precisely why this client chose to design the flyer in this way. It's a provocation. It is irreverent. It effectively winks at those who know and then gets real to say, no, really, come join us. Come to treatment. 

Anggawijayanto, Erydani; Putrikita, Katrim Alifa; Widanarti, Mulianti. (2024) Improving the Generation Z's Self-Esteem and Decreasing their Mental Issues by Creative Expression Art Therapy. Journal of Educational, Health & Community Psychology (JEHCP), Vol 13, Issue 3, p849. https://doi.org/10.12928/jehcp.v13i3.28667

Breslin, K. T., Reed, M. R., & Malone, S. B. (2003). An Holistic Approach to Substance Abuse Treatment. Journal of Psychoactive Drugs, 35(2), 247–251. https://doi.org/10.1080/02791072.2003.10400006

Critchley, Simon. On Humour. New York: Routledge, 2002.

]DINGLE, GENEVIEVE A.; LIBBY GLEADHILL, FELICITY A. BAKER. (2009) Can music therapy engage patients in group cognitive behaviour therapy for substance abuse treatment?
Drug and Alcohol Review. https://doi.org/10.1080/09595230701829371

Heiderscheit, A. (2009). Songs, music and sobriety: An overview of music therapy in substance abuse. In S. L. Brooke (Ed.), The use of creative therapies with chemical dependency issues (pp. 136–161). Charles C Thomas Publisher, Ltd.

Hinz, L. (2009). Expressive Therapies Continuum: A Framework for Using Art in Therapy. New York: Routledge.

Wadeson, H. (1980). Art psychotherapy. New York: John Wiley & Sons.