ISSN 2500-3585 peer-reviewed open access journal
N 2 (27) 2021
Publication Date: 30.08.2021
N 3 (28) 2021
Publication date: 31.10.2021
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Psychological sciences
How art therapy supports development of self-consciousness

Azevedo Ge. ., Filippovich Yu. Se.

DOI: 10.21626/j-chr/2020-3(24)/3
UDK: 159.923.2
Article received: 04.06.2020
Article accepted for print: 24.09.2020
trans.date_of_release: 24.09.2020
Annotation Full text Reference About authors

As a therapeutic tool, art is a way to develop reflexive self-awareness. We suggest that to establish a link between art-therapy and the advancement of self-consciousness is a necessity taking into account that consciousness compounds of awareness of one’s body and one’s environment. Then we can regard self-awareness as recognition of consciousness. We suggest that a human body plays a key role in the process of conscious experience and that art can refine this process, increasing the awareness of self and others. 


self-awareness, self-consciousness, art-therapy.

Technological development and fine and performing arts have become highly refined and linked to the social and mental processes. The basic psychological needs have become more reachable in terms of the agro-industrial development. It let the food production leave a total dependence on climatic conditions and discover the new energy resources, from fossil fuel to wind power, which gave us the industrial and domestic facilities, like keep food refrigerated during a month. The facilities improved in conjunction with the progress of society allow the body devotes less energy for the basic physiological needs satisfaction – food, shelter and clothing. In other words, the human body devotes energy to the activities related to cognition and decision-making process. Human was able to spend energy for the mental process, including artistic expressions, without a fear of being eaten by a bear and crying from sadness.

According to American Art Therapy Association, art therapy is used to improve the cognitive and sensory motor activity, fostering self-esteem and self-awareness and cultivating emotional resilience. It also promotes insight and enhances social skills, reduces and resolves conflicts and distress, and advances societal-ecological change. 

Art as a therapeutic tool has been using since the end of 19th century and the term ‘art therapy’ was coined in 1942 by British artist Adrian Hill. In the next year it considered as an occupational therapy and it was introduced to the sanatorium where Hill started teaching to draw and paint patients. It was the beginning of what culminated into Hill’s book “Art Versus Illness” (1945), that documents the birth of the field. He defined his work using painting in psychological rehabilitation as an “instrument for the treatment of disease and the prevention of unhappiness” [1]. In 1964 Adrian Hill founded and became president of the British Association of Art Therapists.

Over years the methods of art therapy have spread all over the world and the term has undergone refinement. Nowadays, art therapy means “(…) the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma, or challenges in living, and by people who seek personal development” [2]. Through the integrative methods, art therapy engages mind and body in a way that is understood as distinct from verbal articulation. Kinesthetic, sensory, and symbolic opportunities provide the alternative modes of expression, communication and assimilation.

The Halmstad University conducted a study in collaboration with the art therapists [6] based on what these professionals consider to be a patient’s inner change and how it may appear during art therapy. There were included 38 trained art therapists, members of the National Association for art therapists in Sweden. The mean length of time working with art therapy was 17 years (median value 16 years). The art therapists had to answer two opened-ended questions in their own words: “Can you describe how you perceive inner change in your patients?” and “Can you describe one or more situations where you perceived an inner change in your patients?”

The professionals relate the increased self-awareness and awareness of others widening perspective and understanding of the internal processes and the self-image improvement. The improved self-image includes the changes such as a soften self-criticism, a reasonable self-acceptance, a rightful sense of self-irony, and the ability to not take oneself very serious. 

In the researches Blomdahl with the colleagues [3, 4] suggested that art therapy is a part of treatment with patients with depression and works for improving the perception of self-image that makes it congruent more with the reality. The result of studies is based on the certain indicators: reduction of self-criticism, acceptance of one’s limitation and strengths, ability to engage in self-irony, taking oneself less seriously, and enhancement of self-awareness.

To be self-aware is to realize that you are a thinking being and are able to think about your thoughts. It means to be conscious. Self-awareness is an integrative process of all conscious experiences. It binds together all conscious experience from different natures. Let’s look at this example. You are in a store and try a pair of trousers that you think don’t fit you well. To be aware of this ‘unlike’ felling, you tell yourself: “It doesn’t fit me well”. Then, you start wondering around asking yourself: “Maybe it is because I’ve gained weight”, “Should I try a large one?”, “I think I’m too short to use this model of trousers” and so on. What is happening in this moment is that you’re thinking, judging and evaluating your own thoughts. It means that you had identified one idea and started thinking about it. This means to be self-aware. 

A number of authors have stressed the need of divide self-consciousness in two categories “embodied”, also called “minimum”, and “narrative.” Gallagher defines the minimal self as “a consciousness of oneself as an immediate subject of experience, unextended in time” [5], on the contrary with the temporal thickness of the narrative self-consciousness by autobiographical memories and self-projection to the future. In other words, narrative aspects linked to autobiographical memory, self-related thoughts and mental time travel, and embodied aspects rooted in multi-sensory processes. 

While the distinction between high-level/narrative and minimal/embodied selfhood is helpful as a first pass to clarify the umbrella notion of self-consciousness, it remains somewhat ambiguous and potentially simplistic it. It leads to distinction in the self-consciousness’ dimension.

The dimensions of self-consciousness are a well-established measure [7] that divides into three related, yet independent, spheres: private and public self-consciousness, and social anxiety.

Private self-consciousness is a tendency to introspect and examine one’s inner self, including inner unshared part of the self, thoughts, feelings, motivation, beliefs and values. Individuals high in private self-consciousness were more likely to reject false information about the self; and had a greater need to obtain information about them than a need to protect their self-esteem.

Public self-consciousness is an awareness of the self as it is viewed by others, describe how public aspects of the self may be perceived by others, and the tendency of an individual to think about what others think about him/her. In general, individuals with a significant trace of public self-consciousness in their personality, engage in self-presentational tactics designed to maximize social approval and reduce negative evaluations by others. For example, were more likely to exhibit compliance with group pressure to give incorrect answers on a perceptual rating task; were more concerned about their physical appearance to others; were more likely to adapt their behavior in order to conform to the expectations of a partner, and were more anxious concerning being evaluated negatively by a peer [9].

Finally, social anxiety, describes the extent to which people react to perceptions of their public self and evaluations from others. Social anxiety is linked to an attention bias concerned with external attention, potentially to the reaction of other people to the public self [8].

The mechanism of all natures and dimension is given by metacognition. Metacognition is often considered to have two dimensions: metacognitive knowledge and metacognitive regulation. Metacognitive knowledge refers to what learners know about learning. This includes knowledge of their own cognitive abilities (e.g. “I have trouble remembering shop list”), particular tasks (e.g. “The ideas of this theory are complex”), and different strategies available to be applied in useful moment (e.g. “If I the easer exercises first, it can help me to understand the more difficult ones”). 

Metacognitive regulation refers to what learners do about learning. It describes how learners monitor and control their cognitive processes. For example, a learner might realize his unhappiness in a relationship, then starts looking for a solution, breaks up or has a talk. Art therapy can be a way to develop both of them, metacognition knowledge and regulation. The metacognition knowledge is developed because it is conducted with therapeutic bases, and the metacognition regulation is due to engagement of motor and cognitive process in order to make the art.

The therapists relate that patients were often surprised by the insights about themselves or their relationships [6]. An interesting case is about a patient that identifies himself with a painted tree. “One patient felt relieved after painting a tree that featured something that the person could not express in the verbal therapy. The patient became more emotionally alive”, said the therapist.

The Institute of Care and Health Science of University of Gothenburg, Sweden, realized interviews with ten patients diagnosed with moderate to severe depression. All of them were participants of manual-based Phenomenological Art Therapy for patients with depression (PATd), a program developed for patients with depression. The goal of PATd is to facilitate the processes of art-making and to improve the comprehension of the inner dialogue in patients suffering with depression. One patient said: “I drew all the feelings. And so when I chose two of them, I chose loneliness and sadness. In a second, I felt my heart started to beat. This is how it is. I knew now why I was feeling bad, and I didn’t know this before”.

Art-making increases awareness of emotions and thoughts. Art therapy is concerned with expressing inner images through art-making process. The research affirms that meeting oneself through art-making raises awareness and provides an opportunity for making choices that are more consciousness in life.

The notion that self-awareness and awareness about others can increase through creating and reflecting on an image is a settled knowledge in all forms of art therapy, according American Art Therapy Association.

When scientific researches prove that art therapy improves self-awareness, it is equal to say that art therapy as a technique may contact with all processes related to self-conscious. Therefore, art therapy articulates the one’s judgments about their thought and helps to do a trustworthy evaluation of any situation according to individual cognitive stimulus. It adjusts the narrative that “I ‘tell’ myself” related with a situation, and the personal evaluation of the history that I “told” to me, equalizing my judgment about the situation with the reality of it. Moreover, helps to regulate my evaluation of one’s judgment about me, it means, what I think that someone thinks about me, giving to the patient who practice art therapy a more realistic view of the relation “my thinking/another ones thinks about me”, and practical relevance of its external view. All this process is summarized by what “I” know and what “I” do with what “I” know. 

It is possible to realize that self-consciousness is a process that gives a conscious experience of being someone. Through creating art and reflecting on the art product and process, people can refine this process increasing the awareness of self and others cope with symptoms, stress, and traumatic experiences, enhance cognitive abilities, and enjoy the life-affirming pleasures of making art.

1. Hill, Adrian. Art versus illness - The story of Art Therapy. George Allen and Unwin Ltd; Edição: First Edition (1945) 

2. American Art Therapy Association. (2004). Art therapy: Definition of the profession. AATA newsletter, 35 (2), 4.

3. Blomdahl, C., Gunnarsson, A. B., Guregård, S., & Björklund, A. (2013). “A realist review of art therapy for clients with depression.” The Arts in Psychotherapy, 40(3), 322–330.

4. Blomdahl, C., Wijk, H., Guregård, S., & Rusner, M. (2018). “Meeting oneself in inner dialogue: a manual-based Phenomenological Art Therapy as experienced by patients diagnosed with moderate to severe depression.”  Arts In Psychotherapy, 59, 17-24.

5. Gallagher, Shaun. (2000). Gallagher, S. 2000. Philosophical conceptions of the self: implications for cognitive science. Trends in Cognitive Sciences. 4. 14-21. 

6. Holmqvist, Gärd, et al. “What Art Therapists Consider to Be Patients´ Inner Change and How It May Appear during Art Therapy.” The Arts in Psychotherapy, vol. 56, 2017, pp. 45–52, doi:10.1016/j.aip.2017.07.005.

7. Millière, Raphaël et al. “Psychedelics, Meditation, and Self-Consciousness.” Frontiers in psychology vol. 9 1475. 4 Sep. 2018, doi:10.3389/fpsyg.2018.01475

8. de Caso, Irene et al. “That’s me in the spotlight: neural basis of individual differences in self-consciousness.” Social cognitive and affective neuroscience vol. 12,9 (2017): 1384-1393. doi:10.1093/scan/nsx076

9. Scandell, D. J. & Scandell, D. (1998) “The personality correlates of public and private self-consciousness from a five-factor perspective”. Journal of Social Behavior & Personality, 13(4), 579-593.

Azevedo Ge. .

Kursk State Medical University (KSMU) student 305041 Kursk, st.K. Marx, 3, Russian Federation

Filippovich Yu. Se.

Kursk State Medical University (KSMU) M.A. in linguistics, laboratory assistant at the Department of Social Work and Belarusian Railways 305041 Kursk, st.K. Marx, 3, Russian Federation