Artistic Language for the Impact of Therapist Turnover on Therapy Participants

How might we consider potential trauma from repeated service interruption? As I explored this question about the impacts of service disruption on therapy participants I found myself attempting to create a metaphor for the experience. As a therapy participant and therapy practitioner I recognize that none of my own experiences are necessarily applicable to others. So I sought to imagine ways that I can conceptually recreate the experience of revolving care practitioners. I thought deeply about what it is that is asked of participants in therapy. Often participants are asked to explore their own identities and experiences and construct meaning and awareness of these experiences and identities. There is a great vulnerability in constructing and deconstructing ourselves while being witnessed. And I began to ponder ways in which we explore and layer experiences and identities in the creation of self.

As a queer, non-binary person I think of cultural identity markers and communal identity largely through the lens of personal expression and personal freedom. LBGTQ Americans have been medicalized and criminalized throughout history. Often our process as queer Americans is deeply connected to personal expression often through mannerisms and fashion choices. Our history has, at times, been a visual construct in defiance of enculturated norms. We construct our presentation of ourselves to the world often at our own risk. Often we do not know where it is dangerous to show ourselves, to be ourselves, until we have made the attempt at authenticity only to be harmed. The garments and presentation that we adopt to be physically or financially safe often comes at a psychological and moral cost; yet when we arm ourselves in the visible elements associated with authentic self-expression we are still at risk.

I began to think of the environments in which we construct and prepare ourselves for interactions in the world. I thought about bathrooms, and the quintessential ‘look in the mirror before you leave’ trope. I thought about the way we groom and present ourselves to the world and how we require a reflection to see ourselves as we perform this construction of presentation. For this reason I employ the vanity experience. Exhibit goers are asked to do their makeup or hair in a public space.

Yet, even with this history, members of the LBGTQ communities continue to embrace the opportunities that therapy offers in processing familial rejection, exploring and affirming identity, accessing physical health treatment crucial to gendered services, certification for adoption processes, and processing systemic oppression. I thought about asking exhibit goers to build something on a moving surface. In the literature the impact of turnover is often referred to as a revolving door of employment. If the environment of art therapy and counseling is shifting constantly how can a participant build. This seemed like a natural approach. Upon further examination I found reducing the art therapist and counselor to environment was insufficient and a short cut. An art therapist and counselor is not the environment.

I imagined art therapists as potential opportunities for reflection and awareness building at various stages and states of care. Art therapist and counselor as a mirror became a beautiful mirror. No two mirrors in the display are the same. Each mirror has its own reflective quality, color, lens, and position. Some mirrors are smaller; some are larger. In this way the diversity of therapeutic modality and therapeutic skill is represented in an artistic language. Conceptually using objects to represent an occupation, and specifically workers, can be a tricky and ethically precarious. For instance, women make up the vast majority of art therapists, therefore representing women and their work as objects has the potential to lean on harmful tropes that dehumanize women. However, as I debated this I began to consider whether or not therapy participants do see the full breadth and depth of art therapists and counselors as humans.

Because the therapeutic relationship is constructed within a power dynamic and focused around the well-being of the therapy participant, there is a level at which the art therapist and counselor is reduced to their functional use in relationship to the participant. When institutions do not value workers, and instead of making efforts to retain employees and employ the ample research into the costs and impacts of employee turnover, there is a message sent that art therapists and counselors are interchangeable. The systemic churn of mental health care practitioners does objectify practitioners as replaceable, interchangeable parts. So it seems appropriately to present that system as it exists. If therapy participants view us as a function of our work, rather than as workers within a larger system, than we do become objects, flattened and reduced to our ability to aid therapy participants in their self-awareness building.

I ultimately concluded that if I want exhibit experiencers to ask questions of the effects of systemic high turnover, I must present them with the implications of the system at work. I’m hopeful that people interacting with the art works will ask questions about the nature of the representation of the art therapist. While the metaphor is an unflattering image that does not actually reflect the human nature of our work as art therapists and counselors, people experiencing the exhibit must have the opportunity to interact with the systematic implication. Will exhibit experiencers question whom the mirrors represent or will they simply accept the mirrors as rotational objects?

 

 

 

I began to sketch out this rotating display piece and explored how to invite people to engage with it. By establishing a constant, slow rotation I could be sure that someone approaching the exhibit is well aware that the installation is moving, so as not to startle or surprise the participant. I believe the constant motion acts as a metaphor for informed consent. There may be some awareness that change occurs in programs and that staff leaves, however the degree of awareness participants have in the likelihood of provider change is unclear in the research I found.

I wanted to entice people to spend time attempting to work with this rotational vanity. I took care to ensure that ball lighting was present to invoke the feeling of a vanity layout in a water closet or powder room. The lighting is far superior for self-construction than the lighting present in any of the bathrooms at SAIC- which is typically made up of spaced, florescent light fixtures or wall mounted units that don’t allow participants to closely and clearly examine their faces without shadowing their own reflection. By adding layers of gel over the mirrors, I created bursts of color that quickly draw the eye of perspective participants in an otherwise statically designed environment. Moving lights and colors are often employed to get people’s attention and are effective in doing so. Furthermore clear signage indicating “Werk With It” applied to the table invites people to “werk” with the display. Ample table space around the rotating unit allows people to lay out their makeup, or set up their down their personal items before checking themselves or attempting to construct their presentation in the rotating mirrors.

 

To clarify that the mirrors are a representation of the art therapist/counselor, I backed the mirror display in specially constructed ‘documentation’. This documentation IS NOT made up of actual documentation or participant information. Instead the documentation focuses solely around the actions of the art therapist/counselor and where primary health information or participant information appears to be present, long redaction bars cover the page. Behind every art therapy/counseling session there is documentation and notation, often dictated by institutions and broken down into forms or data entry points. While participants may be told this and may understand what is documented, documentation being present in the foundation of the mirror display reminds participants that there is a a type of recording present. It is near impossible to read the ‘documentation’ while the display is moving with the mirrors over it when engaged in self creation. It is equally difficult for therapy participants to gain access to their medical information and files while participating in therapeutic programs.

Asking people to perform ablutions in public is a request for vulnerability in a public space. In this way I hope to represent the nature of Mandatory services. When we know we are being observed and potentially judged by people outside of the therapeutic process, how do we effectively deconstruct and reconstruct our experiences and ourselves? The possible pressure is a present element necessary to the exhibit and to the research upon which this exhibit is based. While there is somatic and possibly necessary incentive to partake of the exhibit, there is also pressure to perform while being observed.

 

This art piece asks several simultaneous questions. Will people engage knowing that the mirrors are rotating in a constant slow motion? Will people question whether or not the mirrors represent people? Will exhibit experiencers question the objectification that occurs in institutions with endemic, high turnover? Will those interacting with the work, make it werk? Or will those interacting with the work, abandon the process for more stable environments elsewhere? How do people interacting with the artwork navigate being potentially witnessed or observed by others in the space?