As I wrote this book I gained pleasure from the memories that came flooding back through the many years of working with this group of youngsters. I have always been drawn to the adolescent youths, and find getting to know them fascinating. If some of this pleasure and excitement has surfaced in my writing I will be satisfied. There are many paths to success in all forms of therapy, this has been my path; I hope the reader will find our walk together profitable.
CHAPTER 1
Integrating Developmental Theories
with Art Expressions
I ain’t Mental.
(Spoken by countless teenagers as they came to the mental health clinic)
There would be therapists dancing in the street if there was one sure theoretical approach that would lead to successful treatment with adolescents. The reality is; there is no one ‘right’ way to help adolescents with their problems. No single theory can be the complete answer since each adolescent presents a unique combination of difficulties, each adolescent group is different, and concepts that seemed valid last year are invalid this year. It is time to re-evaluate the myth of ‘adolescent treatment’ and create a workable mix of theory and experience to serve the youthful clients we treat. Giving up formulae does not mean giving up an educated base which informs adolescent treatment; it does mean that uncertainty and exploration are necessarily components of an exciting challenge (Anderson and Goolishian, 1988). How to integrate classic and post-modern adolescent treatment is a subject that I intend to explore with the reader.
This chapter will set forth the concepts of adolescent development and the manner in which I believe art therapy treatment can successfully serve the needs of this age group. Helping adolescent boys and girls through the ‘rite of passage’ of the teen years is challenging and exciting. Much depends on a personal empathy and interest in teenagers, a segment of our population that constitutes a large percentage of clinical services and the attention of society in general. Given a positive outlook on this age group, a sense of humor, and some creative therapeutic tools, the therapist can find pleasure and satisfaction in working with the adolescent client.
The adolescent of the millennium
Adolescence still exists, but the ‘adolescent’ youth, as he or she has been described in developmental texts, has become invisible. Instead, we have young people propelled into unsuitable, semi-adult behavior before they have reached appropriate maturation; unprepared youths who choose to escape the pain and stress of entering into the adult world by drug use or other destructive behaviors. The myth of adolescence implies that this age group is irresponsible. The dominant story is that adolescent youths will not contribute to family or society. However, we should not forget that between these extremes of behaviors are some adolescent boys and girls who are defying the stereotype which society has created around the ages of eleven to twenty. These healthy ‘misfits’ are progressing through their teen years with relative ease and without seeking alienation from family or society. Paradoxically, often their lack of rebellion results in making them social outsiders with their peer group, a rejection which can lead to depression. At the opposite end of the scale, youths who seek a life style of high conflict often turn to acting out, alienation from family, and/or suicidal behaviors. The radical adolescent image that is projected by society and confirmed by the teen peer group and the media, becomes a self-fulfilling prophesy. A created reality has made adolescence a period of life that is often feared and ridiculed by adults. Therapists contribute to this negative image since the adolescents they see in treatment are drawn from the group of teens that are troubled, and they study clinical literature which focuses on these problem situations.
A therapist cannot treat an adolescent successfully unless the influences of social norms and economic pressures are seriously examined. Adolescent treatment must be seen through multiple lenses; regional, urban and suburban, poverty and wealth, culture and ethnicity. External stressors in the child’s environment translates into internal belief systems. Furthermore, each adolescent brings their own difficulties to treatment. No two youths develop at the same rate, either physically, intellectually or emotionally. The current thought about adolescent development supports the notion that the guidelines to development can no longer be applied rigidly, as they have been in the past (Leveton, 1984; Fishman, 1988; Rutter and Rutter, 1993; Bloch, 1995; Blau and Gullotta, 1996).
Wylie (1998) offers a description of the teen years:
The common miracle that defines childhood and adolescent development is its constant change; there is no period of life when human beings are so malleable, so protean in their own unfolding possibilities. There is also no time in life when human beings are so utterly in thrall to their own emotions, so completely in need of guidance, nurture, the steadying hand of someone who knows better what the world can offer, for good or ill. Children who are denied the deep embrace of loving and lovingly demanding adults – real grown-ups, not over-age wanna-be teens – during their young lives do not necessarily turn into human monsters (in fact, miraculously, most of them do not), but the worse the circumstances, the greater the danger. (p.37)
Developmental process: traditional and post-modern
In spite of my hesitation to present the notion of a predictable progression of adolescent tasks, as suggested by some of the earlier observers of adolescent evolution (Blos, 1962; Erikson, 1968; Malmquist, 1978), there are some basic changes which must be achieved before adulthood. It is helpful when working with adolescents to keep these constructs in mind, and to add some of the more modern theories which broaden the scope of developmental evolution (Bloch, 1995; Fishman, 1988; Mirkin and Koman, 1985).
There are two processes of growth during adolescence; puberty (physical maturation), and adolescence (psychological maturation). The rapidity of physical growth varies with each child and depends on genetic inheritance, dietary nourishment, and general health of the individual. Ethnic groups also show some recognizable growth patterns, and sexual development appears to be more or less rapid depending on genetic factors. The refined research regarding these factors are beyond my expertise, however working with teens for two decades has given me some guidelines which I incorporate when planning a treatment plan.
Figure 1.1a First expression of anger at adults
Figure 1.1b Second expression, anger with explanation. ‘When I get angry – I feel torn inside, I feel guilty for feeling this way. I get headaches, I feel very strong forces, as though they’re exploding in my head. I cannot express anger openly’ (16-year-old)
In spite of subsequent work on adolescent developmental patterns, it is helpful to list the stages of development that Blos recorded in his germinal book, On Adolescence (1962). Many of his criteria still hold true, some of the psycho/sexual concepts are outdated, but the search for identity as the key issue remains constant. When using these concepts as a reference, it is helpful to bear in mind that the form, shape, meaning of the adolescent identity has recently gone through a major shift. The identity sought for in the 1960s is not the identity favored in today’s adolescent world.
Blos (1962, pp.12–14) believed that adolescence maturation occurs ideally in seven major areas; not necessarily in sequential order or chronological progression.
1The adolescent moves from concrete to abstract thinking.
2Judgement and logical thinking are developed.
3Social skills, empathy, altruistic and sexualized feelings become