International Journal of Art Therapy: Inscape

ISSN: 0264-7141 (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/rart19

Art therapy with two sibling groups using an

attachment framework

Teresa Boronska

To cite this article: Teresa Boronska (2000) Art therapy with two sibling groups using
an attachment framework, International Journal of Art Therapy: Inscape, 5:1, 2-10, DOI:
10.1080/17454830008413083

To link to this article: https://doi.org/10.1080/17454830008413083

Published online: 02 Jan 2008.

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 ART THERAPY WITH TWO SIBLING GROUPS
USING AN ATTACHMENT FRAMEWORK
~
by Teresa Boronska
ABSTRACT
The two case studies presented in this article concern two
separate sibling groups of children, who were in care to a local
authority. The reason for the children being in care was the
failure of parents to keep them safe. In both cases the children
were referred to look at their attachment relationship to each
other, with a view to future long-term placement. What
prompted the author to write up her findings was her keen
interest in early attachment with regard to children in care, and
the therapeutic benefits to be gained in considering this within
an art therapy group context.
Mario Marrone (1998) writes that secure attachment within the
first two years of a baby’s life will encourage sociability and
healthy emotional development. Those children are more able
Introduction
Both groups described in this paper were set up with
colleagues acting as co-therapists. The aim of therapy
was therefore to support the children’s capacity for
more enriching relationships, which in turn would
encourage higher self-esteem, empathy and feelings
of self-worth. Through the use of image-making, play
and story-telling, all processes relating to creativity in
childhood,we hoped to encourage cognitive and
emotional development, a natural step towards
determining the children’s ability to conceptualise,
grow out of egocentricity and narcissism, and tolerate
and utilise their feelings.
I was aware of the trauma these children had suffered
at so young an age, and wanted to use the tool of
mirroring to encourage self-reflection, so that
behaviour presented in the group could be seen to
have an effect, not just on themselvesbut for another,
thereby encouraging the capacity for empathy
towards each other. Malcom Pines (1998, p. 42)
expands,
Following the suggestions of Emde (1983) and other
authors, I propose that mirra’ng is an importantfunction
in the developmental line of the process of organisation and
coherence that will lead to self-awareness and to the
awareness of the relationship between selfand objects.
In using an attachment framework we familiarised
ourselves with the type of parenting styles the
children had experienced. Looking at the categories
of attachment as defined by Ahworth et al. (1978)
and Main and Solomon (1986,1990),it can be seen
that infants use a variety of strategies to manage
affective arousal and stress created by separation and
reunion with their caregivers.Four patterns have
been identified securt?, avoidant, dependent and
disorganised/fearful.The children came under the
fourth and most worrying category of
disorganized/fearful,as violence had been part of the
children’s early life experience within the home,
2 Inscape Volume Five No. 1 2000
to play symbolically and cooperate with others. Insecurely
attached babies will show poor sociability, greater expression of
anger and less emotional control. Keeping siblings together
within an art therapy group context came about because of the
demand to see several children from one family. Bowlby
observed that siblings kept together, even when there is a
negligible degree of substitute mothering, is found to be a
factor of some significance and alleviates distress. This
premise suggests therefore that if there was to be any
significant improvement in the children’s relationshipto each
other, then it would be advantageous to keep these siblings
together in therapy.
which was subsequently enacted amongst
themselves. It follows that children will derive much
of their ego and super-ego structures from adults
around them, so that if the primary carer is unable to
control feelings of extreme anger, and expresses their
violence through acts of abuse on the child, then
these children may well go on to enact similar acts of
violence.
In these two groups, the children lacked a sense of
self-regulation,by which I mean the monitoring of
pleasurable and unpleasurable experiences. Both co-
workers and I had to persist in our attempts at clear
communication relating to boundaries. Similar to the
role of the parent, the therapist needs to demonstrate
care through their capacity to be strong and powerful,
so that the children can begin to trust that abuse will
not take place. Children initially attempt to be self-
sufficient in order to avoid rebuff, as their early
experience has been one of self-preservation,when
their parents have been unable to keep them safe.
With this in mind, a framework for working with the
siblings evolved which considered the use of art
therapy in the context of the attachment needs of the
children.
The aims of the art therapy using an attachment
framework were:
w To encourage the child’s relationship with the
artwork
w To make a space in which to be reflective starting
with a creative act.
w To support autonomy via the confidence of
having created an image: this new creation instils
hope as each achievement is a new start.
w To build on this new start through repetition of
creation.
To encourage a reflective stance whereby the
therapist, and children themselves, feed back
what is made.
Language development through reflective
functioning. This can encourage the capacity to
 ART THERAPY WITH TWO SIBLING GROUPS USING AN ATTACHMENT FRAMEWORK
be validated by something or someone other
which stimulates excitement in interaction.
To encourage symbolic communication.
The initial phase of the group was one of chaos, as
the children would move from one task to another.
This meant there was little follow-through; every
kind of art material they could find was used. We
were mindful of the need to make links with what
was made, and encouraged the children’s thoughts
on their artwork by leaving space for this at the end
of the session.
Differentcoping strategies were enacted, each having
a function as a defence against experiencing feelings.
We saw the helper/parent, the male/female
aggressor, the peacemaker / avoidant, the
psychosomatic, the quiet one. The eldest boys would
take it upon themselves to be responsible for their
siblings in a way that was frightening and aggressive
for the younger siblings. Schwartz (1960, p. 184)
writes: ‘If youngsters could talk and understand what
they felt inside, there would be no need to act these
feelings out and this could also help them control
their lives.’
The children had little understanding of what they
felt inside. They would act out their fear of attack by
attacking each other, which in turn inhibited intimacy
as their trust of each other was continuously being
challenged. Tolerance of frustration was low and this
was compounded by narcissistic hurt, as their self-
esteem had been damaged very early in their lives.
The children’s need for self-protection was evident
and this was a high priority.
When working in therapy groups, the transference
relationship brings to light the group members’
original family relationships. In working with groups
of siblings where brother and sister are biologically
related, we have a direct family enactment. Family
norms are already established. The siblings, in the
two groups, experienced themselves as a unit with a
particular function, which related to keeping the
status quo. They were fearful of change, as change
had meant loss and rejection by the parents. These
fears brought an added challenge to the therapists, as
the transference relationship could be said to be that
much more intense because of the multiple defences
used in the avoidance of a relationship with adults. It
is important therefore to create a setting where the
therapist can be seen to have a contribution to make.
Establishing trust takes longer as there is denial of
dependency needs. The adults are peripheral and
inconsequential, which in the countertransferenceis
very powerfully evoked.
This thinking helped us in our understanding of the
children’s needs, as trust in adults had been broken.
In The Sibling Bond (1941) Bank and Khan write:
Inscape Vdume Five No. I 2000
When children‘s parents abandon fhem or no longer
nurture fhem, the children will displace onto each feelings
of rage, helplessness and sexual desire, and 11s a resulf there
is a mixture of aggression and sexuality in cerfain
relationships. (Bank and Khan, 1941, p. 158)
Sibling group B
The first siblings I shall consider will be called the B
group. This was a group of three siblings. Although
there were six children in their family with four
different fathers, only three siblings joined the
therapy group. I had already conducted twenty
months of individual art therapy with the eldest
brother, and was seeing another brother for
individual art therapy, neither of whom were
involved in the group; the sixth brother was still a
baby.
The three siblings who were chosen for the group
were the middle three, aged between six and eleven.
They all had the same father. I shall call them David,
eleven years, Ann, ten years, and Tom, six years.
They had initially beer.referred to art therapy for
individual work, to consider their attachment to each
other, with a view to their future placement in long-
term fostering and adoption. However, I offered to
work with them as a group with a colleague. Hilary,
my co-therapist for the B group, was a senior social
worker and family therapist. Her contribution was
invaluable to the runningof the group in that she
introduced systemic ideas. A particularly useful
concept was binocular theory of change (de Shazer,
1982, in Simonet al., 1985) where two people can
hypothesise about essential aspects of the group from
different perspectives and think about
countertransference reactions, both to each other and
the group members. This was especially helpful
where destructive forces were in play. We also used
circulatory questioning as a means of exploring
metaphorically the child’s thoughts on what other
people in their lives might think.This helped the
children notice themselves as observed by someone
other. Karl T o m (1985) develops this idea with
regard to the observer perspective question. This
allows for the development of a capacity to consider
other possibilities.
The B group of siblings had moved over tkurty times
with their mother, the pattern being that she would
involve herself with partners who were violent, and
when the situation became unbearable, would end up
in bed and breakfast, and the cycle would begin
again. The children had been both witness to abuse,
as well as having been physically abused themselves.
With regard to the sexual abuse of her children, their
mother had actively encouraged the children’s
relationship with male friends who were Schedule 1
offenders.When taken into care the children had
subsequently disclosed sexual abuse.
3
ART THERAPY WITH TWO SIBLING GROUPS USING AN ATTACHMENT FRAMEWORK
Figure 1.
When the children had been placed in foster care, the
neglect they had suffered was more than apparent.
Parenting was a difficult task for the foster carers as
the children had been accustomed to caring for
themselves and each other. It took many months
before the children could experience care as genuine
and consistent. Meeting with the foster carers over a
three-month period helped me consider the impact
that caring for such needy children had on them as
carers, as these Same issues would arise in the group.
Art therapy sessions
We conducted a series of six assessment sessions,
then after reviewing the work with the children and
foster carers, it was decided to continue with the
group. This resulted in a sense of relief from the
children. Issues that had arisen in the assessment
related to difficulties in interaction. David had been
unsure of his role and how thismight conflict with
the p i t i o n of the group conductors. Ann had
persistently intruded on Tom’s artwork, which in
turn gave her little satisfactionwith her own attempts
at what she made. Tom brought ideas to the group,
which he would then let go of once David and Ann
were engaged in some activity of their own, thus
leaving him at a loss for what to do. Throughout the
initial six weeks we had been actively reflecting back
our observations, which did have the effect of making
the children less intrusive with regard to each other‘s
work.
On return to the group
after the assessment, the
children began to feel less
inhibited and more able to
concentrate on what they
were doing for themselves.
In the first session back
David made a volcano with
lava spilling out (Fig. 1).
He explained that the lava
related to his angry
feelings, which he kept
hidden. He said he was
4 lnscape Volume Five No.I ZOO0
Figure 2.
particularly angry with Ann, who ignored him.This
became evident in subsequent sessions when
mother / father issues developed. The social worker
had traced the children’s birth certificates and it was
discovered that Ann, the only girl, was the only child
to hold their mother‘s surname legally. The boys had
their father‘s surname on their birth certificate, which
meant a change of surname to what was on the birth
certificate. This allowed for rivalrous feelings to be
worked through - David saying he had ‘alwaysbeen
his father‘s favourite’ and that ‘Ann was special to no
one’.
In the group the notion of being special became
important for each of them and was further explored
when Tom, who had moved a few weeks previously,
discovered that his new foster carer was to have a
baby. In a later session he became tearful and anxious
on telling us that a little baby girl had been born. His
position as the new child in the family had been
taken away within just weeks of moving. He dressed
up as a little girl calling himself Tomasina, stating it
was his birthday. Tom was able to symbolise the
extent of his upset, and his need to feel special. This
showed his resilience, as he was able to communicate
what he needed through play. David and Ann
responded by giving him more attention in their play,
which sigrufied that empathy was developing,
something that had not been evident in previous
sessions.
David’s artwork suggested
fear of his own violence
and anger, which his
exploding volcano had
predicted (Fig. 2). He
would return to this image
regularly, filling the
volcano with ever more
red, oozing paint. The
theme of violence also
developed through play
with the use of m y
vehicles which he covered
Figure 3. in play dough, nails and
 ART THERAPY WITH TWO SIBLING GROUPS USING A N ATTACHMENT FRAMEWORK
other objects which were then used to attack each
other (Fig. 3). He would engage us in watching these
fights. Towards the end of the group’s life he was to
pry offthe dried out play dough and the nails,
leaving the vehicles in their original state, without the
need for cover.
Hilary and I reflected on his anger in the group
sessions. This eventually helped him talk about his
fear, saying, ’if we saw his anger everyone would be
blown away. It was only after several attempts at
joining his siblings in play that he was allowed in, but
this was on two conditions. These conditions were in
metaphor: he was not allowed to eat them, and that
their magic potions, which they were concocting,
could work on him.In this way Ann and Tom gained
some ground in their struggle for equality and safety.
Hilary and I wondered what control and power he
had yielded at home as the older brother. He had
witnessed violence of his mother’s male partners, yet
we also knew that David had been the carer in the
family, bottle feeding his younger siblings when they
had cried at night. They were beginning to feel it was
safe enough to play together in the group. If the
situation got out of hand they could trust the
therapists to step in, as if acting as the group’s super-
ego /parental voice.
By the hrty-fifth session David was again included
in their play to a fuller degree. This time the game
enacted went a little further. Towards the end of the
session David refused to tidy up and cajoled Tom to
destroy a piece of Ann’s work. Some pushing and
shoving occurred surreptitiouslyby David. We saw
this and commented on their wish to play together,
and also their fear of where this might lead. It was the
end of the session and David stormed out saying ‘I
hate you‘ to us all. It was only at this point, when
David had shown a glimpse of his anger, that both
Ann and Tom could openly express the extent of their
pain. Tom exclaimed, ’no one loves me‘. Ann replied,
’I know, our foster carers care for us but it‘s not the
same, you just have to get on with life’. David’s
outburst brought to the fore the reality of their
situation - the realisation of coming into care and the
loss of their mother. This was something they rarely
discussed. What followed was a shift in their
communication. After the session both Hilary and I
experienced an overwhelming sense of sadness. This
strong countertransference reaction gave us insight
into the level of repression which was being held in
regard to loss of a parent. In allowing these emotions
to be vented, I also became aware of the extent of the
familial bonds which they held for each other and
which they could now express more openly.
In session 37 the loss of mother was symbolically
explored. David introduced the theme of ‘back to the
future’ as a means of remembering the past. He
stated that he did not want to go back to his mum,
Inscape Volume Five No.I 2000
Figure 4.
but wanted to be a baby. Tom was tearful, wanting to
make her a card. He said, ’I think of her often and
pray she is in heaven’. For Tom, although mother still
visited at the foster home, it appeared he experienced
her as having died, as she was unavailable for him.
David expressed the depth of his need, and asked for
individual sessions, saying he wanted more from us.
We acknowledged his need, connecting this to his
wish to be the baby and return to a state of
dependency.
During the next stage of the group’s life the children’s
artwork became ever more involved in play, paint
being used as a medium with special powers to
transform themselves to become invisible, to kill and
bring back to life. This allowed Ann and Tom a
means of asserting themselves with David, which
equalised their relationship with him to a further
degree. David in turn was able to enter their play and
allow their powers to work on him through a touch
or a magic word. This helped Ann and Tom build on
their ever growing confidence in their relationship
with David, moving from omnipotence to reality
testing.
Ann’s move into permanent foster care proved
successful, and she was able to achieve a sense of
belonging very quickly, gaining in self-confidence as
her happiness grew. It was after a break in therapy
and on return to the group that Ann was able to say
how much she had missed her brothers, surprising
even herself in her ability to openly express her warm
feelings to them. This prompted David to continue in
his attempts at drawing closer to Ann and Tom,
although this was still difficult for him and he would
yet again become too intrusive in their play, and
again be pushed out. At one point, towards the end
of the group’s life, he stormed out of the session,
saying he ‘wished them dead for a million years’ (a
powerful curse). Ann and Tom were very upset but
we encouraged them to talk about it with David the
following week. As they told David of their feelings,
David began creating an ‘alien family’, which he used
as a medium through which to talk His continued
attempts to risk intimacy were beginning to give him
5
ART THERAPY WITH TWO SIBLING GROUPS USING AN ATTACHMENT FRAMEWORK
a greater sensitivity and resources in reaching out to
Ann and Tom (Fig. 4). I reflected on David’s attempts
at closeness, by saying that as a family, closeness
might have seemed dangerous for them, that maybe
in the past it might have been safer for them to show
distance and anger than it was to show affection and
care, and this may be the reality even now. It was this
reflection which proved to be a breakthrough for the
siblings. In the finishing weeks the children found
ways of initiating games in which they could be
intimate, sitting close together in comfort. In
achieving a degree of closeness, David, Ann and Tom
were able to express sadness at the group’s ending,
and work with this through to the end.
Sibling group S
The second set of siblings I consider will be called the
S group. Their mother had had several relationships,
which meant that the group comprised four half-
sisters and a brother. In this group I also co-worked
with a male senior social worker called Chris, for the
initial seventeen sessions.
The five children were: Rob, the eldest, aged fourteen,
(he was developmentally delayed both physically and
emotionally), Sue and Jo, who were twins aged
thirteen,Mo, ten and Mary, nine. The children had
been taken into care after being placed on the child
protection register, under all categories of abuse.
Their stepfather, who was father of the twins,had
been convicted of violence and physical abuse and
had been sent to prison. A court proceeding, where
the children might have had to give evidence had not
been necessary as there was enough evidence to
prosecute him.At the time of disclosure their mother
refused to see those of her children who had
disclosed, until after her partner had been convicted.
Rob and Sue had been the initial children to disclose.
This resulted in a split between those children who
had said nothing as being favoured and those who
had disclosed. They had been in residential care for
over two years and were soon to be fostered as a
sibling group. The aim of therapy was to prepare the
children for moving on to permanent care and to
work with the children’s relationships to each other.
They related in an abusive way, resulting in a limited
capacity to understand the impact this had on
themselves on a conscious level. Residential staff
were persistent in their struggle to find new ways for
them to relate, but this was an ongoing battle,
especially with Rob, who would often physically
attack his younger sisters.
Art therapy sessions
An initial planning meeting had been set up with the
children‘s social worker, key workers, the children
and ourselves. The referral €or art therapy signalled to
the children that they would won be moving on, as
6 lnscape Volume Five No.1 2000
the group was seen
as a preparation for
this transition. Issues
which the children
wanted to address
were not clearly
articulated, other
than wanting to
participate. Rob
alone had voiced that
he had wanted to
think about his
relationship with his
mother.
During the initial
phase of the group
the children Figure 5.
concentrated on
making houses in Leg0 and in picture form. Rob had
led this initiative and stated that his structure was
‘Buckingham Palace’ which was where he wanted to
live. This led to fantasies about Chris and myself, that
we loved each other and would get married and be
their parents. The need to attach to us so early in the
group life gave us a sense of the children‘s desperate
need for a family.
The emphasis of the children’s artwork led to
discussions of love and what people did when they
loved each other. They imagined that Chris and I
kissed and had sex. The preoccupation with sex was
evident in each session, giving Chris and myself a
sense of the distortions the children held in regard to
loving relationships between children and parents,
parent to parent, and child to child. Jo expressed her
thoughts regarding boyfriends - they only wanted
you for your body. This gave the group an
opportunity to think about relationships, and hear
that there may be different ways of relating and being
close. Her twin Sue was prone to bouts of
disassociation, and was in special school because of
her poor capacity to learn. Sue had said nothing up to
this point but she was suddenly able to think about
her father and express hate for him,describing him as
a homble and ugly man (Fig. 5).
The children’s play was also sexually focused, hiding
in corners, touching each other, working over each
other‘s work with no awareness of physical or
personal boundaries. We reflected on this behaviour,
although it was impossible to pick up on each
interaction, we discussed the importance of giving
themselves their own personal space, or asking
permission when working on each other’s art.
All the while the children continued to be prolific in
their creativity, Sue setting the pace by making pots
in clay, which the other children would then copy
(Figs 6,7 and 8). Robs behaviour however was
 ART THERAPY WITH TWO SIBLING GROUPS USING AN ATTACHMENT FRAMEWORK
Figure 6.
becoming ever more violent in the group. A ‘Robin
Hood’monster was made adding sword and a shield,
which suggested Rob’s need to defend himself with a
positive, heroic figure which could also change into a
scary adversary. This spoke to Rob’s position in the
group, which was dual in nature. He wished to be
part of the group, yet would continue to sabotage its
safety, through his violent outbursts attacking his
siblings with flying objects such as scissors. He had
also questioned whether the group was working
for him.
We took this up, and discussed the situation with all
the professionals involved. It transpired that Rob’s
behaviour was also a major concern within the home.
His aggression was becoming ever more dangerous
with regard to his twin sisters since renewed contact
with his mother. She had a partiality for buying pfb
for his sisters but not for him.Rob was furious with
his mother, but could not express this to her. Taking
the safety of the group seriously we felt Rob would
benefit from individual therapy from a male, who
could begin to work with his aggression and role
model a benign male stance which could address his
outbursts of aggression. We were aware of the
implications of taking Rob out of the group, but felt it
was important to demonstrate the need for safety
first, and also Robs need for more individual work.
No other male therapist was available so it was
decided that Chris, my co-worker, would see Rob for
individual work and I
would take the girls on my
own. We thought about
Rob reaching puberty and
his need to separate from
his sisters; this was very
difficult for him as his
mother had relied on him
to play the male / father
figure. He was confused
about his role as elder
brother and protector of
his sisters, yet his
behaviour often led to
Inrcape Volume Five No.1 2000
Figure 7.
abusive interaction. Boundaries had been
transgressed in the S family, by both mother and
father. We discussed Rob’s leaving openly in the
group, explaining that Chris would see Rob
separately. There was sadness but also relief
expressed by the sisters
On Rob’s exit the girls became aggressive towards
each other. I made the observation that his departure
did not mean violence was no longer present in the
group, or that he had taken it away with him;
violence was unacceptable as it hindered safety for
everyone. Jo clapped and said ’exactly’. The taboo of
their aggressive behaviour towards each other, not
just Rob’s violence, was acknowledged.
At the point of Rob’s exit the artwork became
extremely productive. There were concerns regarding
whether I would also want to finish with them, and
they voiced this openly. The images produced in the
group were now illustrating a positive transference
amongst the group members and myself. Mo drew
the room, including a portrait of me, adding the
names of her sisters and my name (Fig. 9). She drew a
heart and wrote ’I love Teresa’. Mary,then Jo also,
made a portrait, making me sit very still and
observing me intently (Figs 10 and 11).I felt the gaze
akin to the first awareness the baby has when it
realises mother is present, and separate. I was struck
with a feeling of calm. Jolater made a container for
all the clay work that had been done by the group,
and this was put away
safely in a cupboard,
writing their names on the
container. Sue made a
picture of the church of
‘Sacre-Coed in Paris,a
place she had remembered
visiting some time ago and
had really enjoyed seeing
(Fig. 12).
The girls began to
experiment with hierarchy
issues. In session 19, Mary,
Figure 8. the youngest, came in
7
ART THERAPY WITH TWO SIBLING GROUPS USING AN ATTACHMENT FRAMEWORK
Figure 9.
dressed as Queen Ehzabeth and Mo as Queen
Victoria, calling themselves their ’Queenliness’, and
asserting themselves over Jo, who they said was
disturbing the peace. Jo responded to their request
and quietened down. Mary and Mo enjoyed the role
of being regal and calm, and being heard. This had
been an important session for them, as in the past
Mary would often resort to hysteria when she was
not heard, and Mo would feign illness and withdraw
into herself. This would cause frustration and anger
in the other children.Finding a new way of relating
became fun.Their hysteria and withdrawal gradually
subsided.
In the following week the children had been told that
a new family had been found for them; they rejoiced
by singing songs. Jo hid herself in the doll’s house,
stuffing pillows and blankets inside until there was
no room left, symbolically going back to the womb,
waiting to be born again. Sue, her twin,made her a
birthday cake with candles and sang happy birthday.
The session became fun,and a long period ensued
with the children playing families. The focus of play
for Jo and Mo concerned power struggles of the
children over parents. What would the birth into a
new family be like?
During the final stages of the group life the children
became demanding once again, each wanting my sole
attention. In the countertransference I experienced
feelings of being useless, tom between each of them,
unable to respond adequately to their demands.
Other times I experienced great warmth and joy at
being with them. This behaviour helped me in my
understanding of the anxiety the girls were
experiencing as they became aware of the initial loss
of their family, the loss of the residential home they
had lived in for three years since entering care, and
the loss also of the group. They had also gained some
stability with people who cared for them, and would
write down the names of all the staff they would
miss. Overriding all these feelings was their main
preoccupation, which was to move on and have a
family where normal life could begin.
8 Inscape Volume Five No.1 2000
Figure 10.
Similarities and differences
There were many similarities between the two groups
of siblings, especially in that both had experienced
inadequate parenting through neglect and both
physical and violent abuse. I am reminded of
Bowlby’s theory on patterns of attachment, which
helps me think about a child’s need for protection,
comfort, pleasure and care in order to thrive. If this
fails then a child will experience disillusionment, hurt
and shame, which will threaten their expectations of
their needs being met by carers. The consequences of
this demonstrate that fear and anger are acted out as
a means of defending against the pain of failed
attachment, as Felicity De Zulueta writes:
What has become increasingly apparent is that this
primary relationship has very important and long term
effects on how an individual relates to others throughout
his or her life. Links have also been shown between an
infant‘s attachment patterns, the development of internal
’workingmodels’ or ’object relations’ and the development
of the self: As a result, it has become clear that, whilst
depnvation and loss can affect the more psychological
substrate of human attachment behaviour, at the same time
internal object-relations also affect the way individuals
permbe the environment: this leads to the reaction of
familiar self affirming patterns of experience in their
attachment relationships. Such a tendency, ifnot
disconfinned by experience or therapy, can lead to repeated
self destructive relationships as well as to child and spouse
abuse. @e Zulueta, 1998, p. 276)
It had been our intention to make a therapeutic space
available so that the children could express their fear,
 ART THERAPY WITH TWO SIBLING GROUPS USING A N ATTACHMENT FRAMEWORK
Figure 11.
anger and destructive impulses safely, using their
innate ability for magical and egocentric thinking and
creativity. The aim was to bring about some relief
from the internal frustrations which the children were
experiencing. Once they were able to concentrate on a
task for more than brief moments of time, the artwork
began to show symbolic images of violence as well as
images that were vessels for holding chaos and mess.
These images would be returned to time and again
and were highly valued. The capacity to talk about
their art helped them develop a reflective function,
where an inner dialogue was able to take place
because outer reality had been adequately
maintained.
We were struck with the power the older brothers
yielded. This was an area which both groups
struggled with, as the younger siblings were
frightened of them. The consequences of this were
different in the two groups. In the B group violence
never occurred, it was only in the air. In the S group
Rob had resorted to violence, which he was unable to
give up. We articulated our own struggle with
understanding the groups’ actions through verbal
communication,demonstrating to the children our
own ability to negotiate difference and to speak to the
womes we had about their abusive behaviour. A
positive factor of both groups was that the children
were together as siblings. This helped them to make
positive shifts, as they had familial support in the
presence of each other. Bowlby (1973, p. 35) writes:
’that when a young child is in a residential nursery
with a sibling his distress is alleviated. Thus the
presence of familiar companion, even when that
INUIP( Volumt Fiuc No.1 2000
Figure 12
companion provides a negligible degree of substitute
mothering, is found to be a mitigating factor of some
sigruficance.’
I consider art therapy to have an important role to
play here, as it can go hand in hand with the care
given on a daily basis. Weekly sessions, over time,
offers a separate forum from school or family in
which imagemaking and play is witnessed by the
therapists, demonstrating to the children the
importance placed on creativity. Through play and
their artwork the children found deeper levels of
extemalising powerful emotions, which would not
‘blow people away‘.
Conclusion
Both groups have now ended. The experience of
sibling therapy groups was made possible by co-
workers and staff who were totally committed to the
group, and gave support and encouragement
throughout. Hope and trust in the art therapy group
process was always alive even in the most difficult
moment, as Malcom Pines, writes:
But hope is the strongest antidote that we have to the state
of demoralisation which is part of every depressive
situation. All states of hopelessness. That the hope should
not be facile and over-optimistic, that it should be based
upon a well-grounded foundation of learning and
experience, is essential to the planned therapeutic
endeavour that psychotherapy represents. (Pines, 1998, p.
80)
Using the concept of mirroring, our aim had been to
turn the negative into positive reflections. For
9
ART THERAPY WITH TWO SIBLING GROUPS USING AN ATTACHMENT FRAMEWORK
instance,when one of the children did not want to
share we would condone this need, explaining to the
group that maybe it was important to feel they could
have things for themselves, before they were able to
share. This nearly always allowed for sharing to take
place soon after. As Pines explains, it is:
The chdd’s emergencefrom narcissism through the greater
awareness ofthe selfmked by refzectim comingfrom the
outside, helps him [sic] to difienfiate between what he is
and what he is not ... Note t k g o r e that the mirror
reactions rejk both to tkapeutic processes and to early
darelopmental processes. (Pines, 1998,p. 18)
As the p u p progressed the children became more
aware of each other. I would observe at different
times a child intently watching another, especially
when in role play. The capaaty to hear, see and
engage with each other was now in operation. At the
finalreview of the B group both Ann and David were
able to say that they could now play together and
enjoy each other‘s company.
Rigid family structures, which were once adhered to,
shifted to make room for risk-taking. They were able
to challenge each other and the therapists alike.
Comments about making new friends or a remark
made in a caring way was something that became a
more common occurrence. The S group finally moved
on to a family which they wanted to be with, and the
ending of the group was negotiated with this in
mind. Rob, however, was not to move on with his
sisters. The B group had moved to permanent foster
carers before the group ended, leaving several
months for the children to settle.
I am in the process of working with a new sibling art
therapy group. The use of an attachment framework
which supports improved levels of interaction
through creative means has given me hope based
upon experience, that change can occur.
10
Ac knwledgement
I would like to thankboth Hilary Manicom, senior social
worker and family therapist, and Chns Shields, senior soaal
worker, for their contribution in co-running S and B groups.
Note
This paper was presented at the Conference for Theoretical
Advances in Art Therapy in Birmingham 1998, and was
adapted and presented to the Attachment Conference in
October 1999 at the Phoenix NHS Trust, Bristol.
References
Ainsworth, M. D. S., Blehar, M.C., Waters, E. and Wall, S.
(1969) Putterns of Attachment: A Psychological Study of the
Strange Solution. Hillsdale, NJ:Erlbaum.
Bank, Stephen P. and Kahn, Michael D. (1941) The SzHing
B a d . New York Basic Books.
Bowlby, John(1973) Attachment and Loss: Volume 2, Separation.
New York Basic Books.
De Zulueta, Feliaty (1998) The Traumatic Roots of
Destructivenessfrom Pain to Violence.London: W. Whurr.
Main, M. and Solomon, J. (1986) ‘Discovery of a New,
Insecure-Disorganized-DisorientatedAttachment Pattern’, in
Brazelton, T. B. and Yogman, M. (eds) Afictive Development
in Infancy. Norwood: Ablex.
Main, M. and Solomon, J. (1990) ’Procedures for Identdymg
Infants as Disorganized/Disorientedduring the h w o r t h
Strange Situation’, in Greenberg, M., Cicchetti, D. and
Cummings, F. M . (eds) Attachment in Pre-School Years: Theory,
Research and I n t m t i o n . Chicago: University Press of
Qucago.
Marrone, Mario (1998) Attachment and Interaction. London:
Jessica Kingsley.
Pines,Malcom (1998), Circular Reflections: Selected Papers on
Group Analysis and Psycho-Analysis. London: Jessica Kingsley.
Schwartz, M. (1960) ‘AnalyticGroup Psychotherapy’,
International Journal of Group Psychotherapy 19.5212.
Steele, Howard and Steele, Miriam (1994)Intergenerational
Pattern of Attachment. Advances in Personal Relationships., Vol.
5, pp. 93-120. London: Jessica Kingsley.
Simon, Fritz B., Steirlin, Helm and Wynne, Lynn C. (1985)
The Language of Family Therapy. A Systemic Vocdbulay and
Source Book. New York Family Process Press.
T o m , Karl (1985) ‘Circular Interviewing: A Multifaceted
Clinical Tool’, in Campbell, D. and Draper, R. (eds)
Applications of Systemic Therapy. The Milan Approach. London:
Grunne and Stratton.
Biographical details
Teresa Boronska graduated from Birmingham Polytechrucin
1978 with a h e art degree. She went on to do a post-
graduate certificate in art and design education at Middlesex
Polytechnic in 1981, and worked as a teacher and
environmental artist in both primary and secondary
education in inner-city London schools.Since quahfymg as
an art therapist from Goldsmiths’ College in 1989, she has
worked with chddren and adolescents with emotional and
behavioural disturbance in special schools. She qualified as a
group psychotherapist from Goldsmiths’ College in 1996 and
currently works as a senior art therapist in social seMces
with childrenand adolescents in the area of child protection.
Teresa is also employed as a visiting tutor on the Art
Psychotherapy Training Foundation and Diploma courses at
Goldsmiths’ College.
Imcape Volume Five No. I 2000