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Art Therapy With Orphaned Children: Dynamics ofEarly Relational Trauma and Repetition CompulsionKsenia Meshcheryakova aa NY, New YorkPublished online: 13 Jun 2012.

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articlesArt Therapy With Orphaned Children: Dynamics of EarlyRelational Trauma and Repetition Compulsion

Ksenia Meshcheryakova, New York, NY

Abstract

This article explores the dynamics of orphaned children’sengagement with art therapy in a group of preadolescent chil-dren living in a Russian orphanage. The phenomenon of rep-etition compulsion (i.e., origins in past traumatic experiences,destructive consequences, and protective psychic function) is dis-cussed with respect to the children’s artwork and its impact onengagement, countertransference, and termination. The thera-peutic relationship and the art-making process are two vehiclesthat help restore a child’s capacity to feel and to engage in newrelationships without the interference of repetitive defenses oftraumatic origin.

Introduction

This article is informed by materials from an art ther-apy program that took place in the late 1990s with a groupof children living in a Russian orphanage. The collapse ofthe Soviet Union gave rise to economic and social insta-bility, which directly impacted the well-being of familiesacross the country and tripled the number of children instate care. Unfortunately, even with recent improvementsin domestic adoption laws, the number of children livingin Russian orphanages remains persistently high (RussianFederation Ministry of Education and Science, 2008). Theproblem of reintegrating children raised within the state in-stitutional care system continues to exist, making the di-alogue surrounding the impact of early relational traumaexperiences a topic of contemporary importance.

Art therapy in Russia ceased being a prerogative of psy-chiatric institutions and entered the social sector realm in themid-1990s; however, access to other practitioners as well asto literature on art therapy continued to be extremely limited

Editor’s Note: Ksenia Meshcheryakova, ATR, LMSW, for-merly a practicing psychologist in Russia, currently works withthe Jewish Board of Family and Children’s Services in Brooklyn,NY. She is a human rights activist and the founder of severalRussian nonprofit organizations servicing underprivileged popu-lations. Correspondence concerning this article may be addressedto the author at kss99@mail.ru

(Kopytin, 2002). A dearth of resources required inventive-ness on the part of practitioners in finding venues that wouldsupport learning about and experimentation with art ther-apy practices. In my case an interest in the healing propertiesof art was incorporated into the work of a multidisciplinaryresearch team that sought to address problems of psycholog-ical support for orphaned children. I viewed art therapy as acatalyst for facilitating a child’s greater autonomy and copingskills in the absence of formative interpersonal relationshipsand other deficits of institutionalized care (Zhedunova &Meshcheryakova, 1999).

Ten years later, I returned to my collection of the chil-dren’s artworks with the task of reexamining them. Some ofthe difficulties I had in building relationships with childrenin the orphanage had a great deal to do with what I rec-ognize today as the phenomenon of repetition compulsion.I assert that understanding this phenomenon is crucial forprofessionals working with people who experienced disrup-tion of their important early relationships. This article is anattempt to share my insights into how repetition compul-sion presents itself in the therapeutic relationship and in theart-making process itself.

Repetition Compulsion and EarlyTraumatic Relationships

Freud (1920/1954) believed that people tend to “revive”past unwanted and painful experiences in their transferencerelationship with a therapist and may repeat these unpleas-ant experiences “under the pressure of a compulsion” (p. 20).He further theorized that the emergence of repetition com-pulsion represents an individual’s shift from having been apassive recipient of a traumatizing event to currently beingin active relationship with the event through its repetition.Therefore, the purpose of the compulsion to repeat painfulpast experiences can be seen as an attempt to master them.This idea was further conceptualized by a number of authors(Cohen, 1980; Horowitz, 1976; Loewald, 1971). However,repetition compulsion rarely leads to mastery and integra-tion of a traumatic past on its own (Chu, 1991; van der Kolk& Greenberg, 1987).

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Levi (2000) proposed that repetition compulsion couldbe conceptualized as a response to posttraumatic stress. Hesuggested that it consists of two primary components, thereappearance of which does not diminish with time: (a) thereexperiencing in the present of feelings, beliefs, and sensa-tions that originated in a past stressful event; and (b) thecompulsive repetition of defenses that are designed to avoidthe reencountering of the traumatic stressor. Levi furtherargued: “As the compulsion to repeat is a repetitive, self-defeating, and rigid way of being in the world that causesthe individual distress, this process needs to be understoodas a maladaptive attempt of mastery” (Levi, 2000, p. 47).Compulsive repetition aims to maintain a person’s psycho-logical sense of safety; however, its fixation on the past of-ten puts the individual at the risk of revictimization, self-destructive behaviors, and victimization of others (van derKolk, 1989). Compulsive repetition and reexperiencing of-ten lead to a reenactment of the traumatic past. The reenact-ment of traumatic themes within a person’s family system orcommunity is linked to the phenomenon of the intergenera-tional transmission of victimization and violence (Krugman,1987; Shabad, 1993).

Russell (2006a) emphasized the interpersonal aspect ofrepetition compulsion and its connection to early trauma.He noted that the interruption of a significant nurturingrelationship could cause arrested development in an arrayof a child’s competencies—in particular, the child’s affec-tive competence. Attached to the loss in the past, repetitioncompulsion is based on a dysfunctional feeling system thatoperates at the expense of a person’s capacity to feel and ex-perience connectedness that is necessary for growth. Russell(2006b) observed two conditions where affective connected-ness can be interrupted: (a) when one has lost an affectivelynurturing relationship in the past and (b) when one experi-ences a relationship in the present that cannot afford suchnurturance. In the former condition the loss is experiencedas a traumatic event; in the latter, the relationship and en-vironment itself are traumatizing, which is a more pervasiveand costly experience for the individual and falls under thecategory of complex trauma.

Van der Kolk (2005) defined complex trauma as “the ex-perience of multiple, chronic, and prolonged developmen-tally adverse traumatic events, most often of an interpersonalnature (e.g., sexual or physical abuse, war, community vio-lence) and early-life onset” (p. 402). Along with other au-thors (Green, 1983; Terr, 1981), he posited that childrentend to incorporate their experiences of trauma into theirworldview and personality structure, and may organize theirrelationships and life choices around the possibility of thetrauma’s recurrence.

Institutional Care and RepetitionCompulsion

Unfortunately, orphanages historically have had verylimited resources available to compensate for the loss ofaffective connectedness that a child may have experiencedprior to or during orphanage placement. The structure and

content of a child’s relationships with orphanage caregiversare determined by the conditions of group living, the dailyroutine, and any deficit of individualized attention. Such re-lationships tend to be limited in terms of time and emotionaldepth; impacted by staff turnover or burnout; and mediatedby various styles of relatedness to children, including beingoverly disciplined, overprotective, or emotionally withdrawn(Dubrovina & Ruzskaya, 1990).

The deficit of intimate nurturing relationships withcaregivers and a strictly disciplinary, group-oriented systemof care often results in overcompensation on the part ofthe children, which is manifested in disobedience, runningaway, psychosomatization, self-injurious behavior, rebellion,and so on. In the absence of the child’s own capacity to ne-gotiate his or her needs the child is forced to comply byneurotically merging with the orphanage environment. Inthe long run this merger leads to the development of a de-pendent life scenario and complicates the child’s future inte-gration into society (Baiborodova, Zhedunova, Posysoev, &Rozhkov, 1997; Zhedunova, 1997).

Thus, children living in the orphanage environment arecoping not only with the disruption of relationships withtheir families but also with an ongoing deficit of nurturingrelationships that an orphanage cannot afford to offer. Realrelationships are substituted with the compulsive repetitionof defenses, hindering the child’s capacity to be in touch withthe self and to negotiate connectedness with others.

In her analysis of the attachment behavior of chil-dren ages 3 to 5 years who were living in Russian orphan-ages, Bardyshevskaya (1995) hypothesized that the earlierthe disruption took place, the costlier the event was tothe child’s development. She proposed the following hier-archy of coping styles based on a child’s ability to estab-lish a personal relationship with a caregiver: (a) avoidingtype in children who perceive the world as a threat and,when attempting to establish contact with others, experiencetension that is usually reduced by avoidance and aggressiveattacks on others; (b) clinging type in children who crave ex-clusive bodily contact with any adult, even those least knownto them, because such physical contact provides feelings ofcontainment, stability, and warmth, despite the fact thatit also complicates the completion of contact; (c) undiffer-entiated attachment type in which emotional relationshipswith adults are superficial, disorganized, easily substituted,defined by positive moments while negative moments areignored, and where the presence of a caregiver stimulateslearned helplessness in the child; (d) ambivalent attachmenttype in children who have contradictory, conflicted relation-ships with adults that are defined not so much by pleasantinteractions but by the traumatic experience of frustrated oraborted contact; (e) socially anxious attachment type in chil-dren who form a strong attachment to one particular care-giver that results in heightened fear and anxiety around allother adult strangers; and (f ) harmonious type in childrenwho develop normal, hierarchically organized systems of at-tachments that are relatively open and flexible. Similar cat-egories of attachment behavior in children are found in theresearch literature of various disciplines (Kaiser & Deaver,2009).

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52 ART THERAPY WITH ORPHANED CHILDREN

For a child who experienced the traumatic loss of a care-giver and subsequent placement in an orphanage, the ap-pearance of a potential new caregiver such as an art therapistbrings up anxiety and compulsive repetition of protective,defensive measures that the child used when the early re-lationship failed. The repertoire of such behavior commu-nicates the child’s unique coping style and particular needfor the restoration of relatedness. For example, children withan avoiding attachment style can be expected to experiencecontact with the art therapist as extremely uncomfortable;engagement in creative activities will be jeopardized until asense of safety in the therapeutic relationship is established.For children with a clinging type of attachment, the needfor physical contact with an adult is so urgent that it com-pletely undermines any possibility of interpersonal involve-ment. Children with an undifferentiated attachment oftenproduce stereotyped drawings because their art activity isguided by the need to please the art therapist, and they likelywill meet creative challenges with learned helplessness. Chil-dren with ambivalent and socially anxious attachment styleswill rigorously test the relational space before engaging in thecreative process. Children who are capable of harmonious at-tachment may engage in the art therapy process without re-liance on maladaptive interpersonal defenses; their presencein the group art therapy space can be very beneficial for otherchildren and serve as a model of a healthy relational negoti-ation and the potential use of art for nurturance. It shouldbe noted that in actual practice these various coping stylesmay overlap (Mechtcheriakova, 2004).

In working with repetition compulsion the therapeu-tic advantages come from two sources: (a) the transference,which communicates the experience of a failed relationship,and (b) the reality that the therapist is a different objectfrom whom the transference derives. According to Russell(2006c) “the therapist must negotiate to be both the per-son with whom the initial negotiation failed and the personwith whom it might be different” (p. 64). Russell (2006a)also insightfully noted that the paradox of repetition com-pulsion within the context of therapy is that it is both “aninvitation to a relationship and an invitation to repeat the in-terruption of some important earlier relationship. It is bothadaptive and suicidal because, in this context, relatedness iswhat the person most needs and cannot yet feel” (p. 611).The reparation of an early relational injury can be possiblewhen “some present relationship survives the recreation ofeverything that made inevitable the earlier loss of connect-edness” (p. 612).

Phillips (2003) proposed that art and art materialsrepresent a “more durable attachment” in circumstanceswhere there is a high turnover of caregivers (p. 145). Inher work with children in foster care she emphasized theinnate nurturing aspect of art, stating that “fostering theclient into the art, responding mostly to the art, and soon all help the child relate to and deal with issues with-out the dependence on the ‘person’ of the therapist” (p.145). The internalized nurturing capacity of art can becomea lifelong resource of self-sufficiency and self-reliance for achild.

Art Therapy Program

The art therapy program site was arranged by the Rus-sian Department of Education, which allowed me to or-ganize my work with the children with minimum bureau-cratic interference from the orphanage administration. I waspresent at the orphanage for two fall semesters (4 monthseach) in 2 consecutive years. Because I had no prior experi-ence working in the Russian orphanage system, I spent thefirst semester orienting myself to the new environment, itsspecific opportunities, and its limitations. As my clinical ex-perience and theoretical knowledge grew, I moved towarda more structured art therapy program that focused specifi-cally on the developmental needs of the children.

In each of the 2 years I arranged to work with a newgroup of about 20 children, aged 7 to 12 years old, whowere living together as a group while attending the first andsecond grades. The office space was well equipped for indi-vidual and small group sessions. I made an effort to establishfriendly relationships with the two teachers who supervisedthe group’s living quarters and the children’s daily activities.The group home schedule permitted me to use the 3-hourearly evening recreation break for my art therapy sessions.I received weekly supervision from an experienced clinicalpsychologist. I made a conscious decision to refrain fromaccessing the children’s case files and from making inquiriesinto their life histories. This was an attempt to avoid a biasthat I believed would interfere with my ability to build agenuine relationship with the children. In congruence withcommon art therapy methods, I chose to learn about thechildren as they presented themselves through their art andin contact with the art therapist. This decision also was inagreement with the conceptual framework of research thatencourages focusing on psychological resources available tothe child rather than psychopathology (Zhedunova, 1997).

Pictorial Reenactment of Relational Trauma

The phenomenon of repetition compulsion—its originsin past traumatic experiences, its destructive consequences,and its protective psychic function—was manifested in theart therapy program and in children’s artwork. In one in-stance I found two 8-year-old boys sitting on the floor nearthe bathroom, giggling over their drawings. With some hes-itation and embarrassment they agreed to showme their im-agery and became engaged in discussing it with me. Figure1 depicts a massive figure of a woman hanging by hooks onlong chains with open wounds to her chest and lower body.A fire is burning underneath her. Little balls are coming outof her mouth and rolling down to the right. As they rolldownward the balls grow in size and turn into unidentifiedcreatures. One of the boys explained that he had drawn a pic-ture of a mother and that she was being punished becauseshe was a bad mother.

In the second drawing (Figure 2) two adult men (pre-sumably father figures) with disfigured bodies are depicted.The boy said that he had drawn two criminals beingpunished for their bad deeds. He described in detail the

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Figure 1 Mother Figure Hanging by Hooks (Color figureavailable online)

suffering each man had been subjected to; for example, oneman has a distorted mouth, some bones scattered inside hisbody, a mutilated right leg and left hand, a body cavity open-ing up on his side, and an outline of his torso that seems pur-posefully misshaped. The other man is hanging on a hookconnected to a chain (like the mother in Figure 1) and histhroat is being attacked and wounded by some sort of mech-anism. He also is shown with an open wound to the sideof the torso. Both men are not wearing any protective gearand they appear to be castrated. Finally, the children pointedout with excitement and shame that they were the two malesportrayed in the drawing.

The pictorial expression in Figure 1 suggests a degreeof dissociation from the mother, who is not a nurturingfigure: Her face is unemotional, her chest is wounded, andher breasts are displaced. Her oral aggression is depictedwith the objects/creatures coming out of her mouth androlling down and out into the world. It seems that theboys gained control over her powers by assuming the roleof an aggressor and by victimizing her—she is chained,hanged, burned, and mutilated. In contrast the male orfather figures in Figure 2 retain their powers by defyingthe social order. Their harmful aggression is pictoriallyneutralized by physical punishment and bodily mutilation.Identification with the aggressor is literal—the boys claimedtheir association with their abusive, self-destructive, andsocially ostracized male role models.

Figure 2 Disfigured Father Figures (Color figure available online)

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54 ART THERAPY WITH ORPHANED CHILDREN

This encounter with the children took place during myfirst months at the orphanage. The meeting occurred spon-taneously in their living quarters. The content of their draw-ings indicates the presence of a highly conflicted, early rela-tional history in the lives of these children and is suggestiveof the ambivalent attachment style as a means of coping withpast trauma. Identification with a hostile and aggressive care-giver is a compulsive defense mechanism that aims to bindthe rage against a traumatizing relational environment andto avoid self-fragmentation (Kramer, 1971). When such acaregiver is the only relational model in the child’s reper-toire, a future cycle of reenacted abusive relationships, self-destructiveness, and violence against others may result.

Encounter With an Art Therapist: Working WithRepetition Compulsion

New encounters with prospective caregivers (such as theart therapist in this case) can be potentially uncomfortableand anxiety provoking. The new relational territory will betested by repetition compulsion. If a new relationship sur-vives the child’s guarded deployment of repetitious defenses,it opens an opportunity to restore the capacity to feel and toconnect genuinely to others and to the self. The relationshipalso will elicit a need for grieving and reintegration of earlylosses.

To reduce anxiety and to ensure some sense of safety inthe presence of a new adult, my first encounters with chil-dren in the orphanage took place in small peer groups. Inmy first meeting I asked the children to draw themselves on

a shared paper that was drawn to resemble the room whereour sessions took place. I repeated the assessment in our fi-nal meeting. The objective of the projective assessment wasto understand the relational and coping resources availableto each child, as well as to observe their defenses as they en-countered a new adult and engaged in a spontaneous art-making process.

Misha (pseudonym), a 7-year-old boy who presentedwith a harmonious attachment style, drew himself as a ma-gician with a magic wand, hat, rollerblades, and tape player(Figure 3). He depicted his friends as a ninja turtle, a cat,and a biker. (The biker character was in reference to anotherchild who had been adopted by a French couple, an eventthat impacted many drawings of children who wished to beadopted.) Misha’s characters are all resourceful in that theyare depicted as possessing special powers, friends, and be-longings that make them self-sufficient and happy. In con-trast Serega (pseudonym), an 8-year-old boy with an am-bivalent attachment style, drew himself with a bottle ofvodka and a cigarette in his mouth (Figure 4). Within thecontext of his first encounter with an art therapist, his draw-ing was a statement of disobedience and rebellion. It illus-trates another example of identification with the aggressor,in this case with a dysfunctional caregiver. Reference to al-cohol and nicotine use is a culturally conditioned claim ofmasculinity in Russia and can be interpreted as a metaphorfor failed affective nurturance being substituted by the self-destructive consumption of illicit substances.

Dima (pseudonym) was a 7-year-old boy with an at-tachment style that tended toward clinginess and a high levelof anxiety in the presence of a new adult. In drawing his

Figure 3 Misha’s Self-Portrait (Example of Harmonious Attachment) (Color figure available online)

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Figure 4 Serega’s Self-Portrait (Example of AmbivalentAttachment) (Color figure available online)

self-portrait he declared that he was a “robot-transformer.”His agitation noticeably grew as he started demonstratingthe protective and offensive powers of his ammunition.These included firearms and the burning head and handsof his character. Less than one minute later Dima destroyedhis drawing (Figure 5). He withdrew from the activity withsadness and shame while other children continued to workon their drawings. It may be inferred that first contact witha new adult was emotionally overwhelming for Dima. Re-sponding with anxiety, his search for pictorial protectionsled to the destruction of his self-portrait and to emotionalwithdrawal.

Dima created his next drawing approximately 1 monthlater. He had had a difficult day and his teacher decided thatit would be useful for him to spend some time away from thegroup. Dima drew himself with a bloody nose while shar-ing his feelings about a fight earlier in the day with otherboys in the class (Figure 6). In contrast with the example de-scribed above Dima was able to relate to me in the presentmoment and to process his emotional distress caused by hispeer relationships. His affect was contained with a degree ofintrospection that suggested developmental movement to-ward affective competence and the ability to self-regulate.

Later in the program I asked Dima to draw a characterthat he knew intimately. He depicted a truck that was deliv-ering gifts to other children and he named the truck “Dima.”

Figure 5 Dima’s Self-Portrait (“Robot-Transformer”)(Color figure available online)

On that day he had to draw the character independentlywithout my presence. After the drawing was completed, I in-quired about the character’s self-sufficiency, supporting thedevelopment of his narrative. The boy said that the truck’sfood source was at the gas station, and that he slept at thegarage and had friends who were the children he deliveredgifts to. Dima had created a personally meaningful imagethat could be used for further ego-supportive explorations.

Petya (pseudonym) was 7-year-old boy with anambivalent attachment style. He began his self-portrait,a small figure of a boy, with a light green pencil. As heworked his agitation grew and was reflected in a seriesof ever more provocative self-portraits. He started bydrawing a “strong, naked, pissing Petya” and continuedwith “defecating Petya” followed by “scared, fat, ugly Petya,”and “Petya ninja-turtle.” He finished with the portrait ofan alien-looking character (Figure 7) that had a differentlast name from Petya’s (a reference to the classmate who hadbeen adopted by a French couple). Significantly, Petya’s firstself-portrait is realistic and colored with lighter pressure,and is both smaller and less defined than the rest of his

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56 ART THERAPY WITH ORPHANED CHILDREN

Figure 6 Dima’s Self-Portrait (With “Bloody Nose”)(Color figure available online)

self-representations. Such defensive “acting out” imageryreflects his testing of the art therapist’s ability to providea space for containment. The child’s sense of safety andintimacy may be restored if his relationship with the arttherapist and art materials is able to withstand the work ofthe repetitive trials on behavioral, verbal, and pictorial levels.

During individual sessions Petya told me that he wasa 4-year-old when he arrived at the orphanage. He remem-bered his older siblings but his family had not visited himsince his placement. Petya shared his sadness and hope thatone day they would come to visit him. Later in the course ofthe program, when I asked him to draw a character that heknew intimately, Petya drew the ego-supportive “DinosaurSisinov and his son.” He said that the dinosaurs slept inthe forest where they fed on the leaves from the trees andthat they carried a supply of these leaves on their backs.Petya created what appeared to be an intimate and nurturingfather–son relationship with a capacity for self-care (food)and survival (shelter).

Figure 8 illustrates Petya’s coping with termination fromart therapy. I announced the impending termination of theprogram in advance to allow time for processing. In the fi-nal session I asked the children once again to draw picturesof themselves. Petya’s coping can be described in three dis-

tinct steps that were pictorially represented in his processof creating his self-portrait. In the first step he returnedto compulsive defenses, as seen in the left section of Fig-ure 8. Petya depicted himself with a distorted body thathe called “ugly and unattractive.” He was emotionally over-whelmed with anger and disappointment in his therapist’sdeparture and he protested verbally and pictorially. In hissecond step he attempted to cope with the loss of connect-edness to his self, seen in the middle section of Figure 8.Petya could not accomplish this attempt to create a self-portrait; it was left unfinished after several trials and era-sures, suggesting a symbolic loss of affective connectednessand speaking to the cost of return to compulsive defenses.Petya’s third step was reintegration, which can be seen in theright section of Figure 8. He finished the art therapy ses-sion with a realistic self-portrait and left the session calm andcomposed.

Termination is an especially complex and potent mo-ment in therapy for a person with a history of early attach-ment disruption. The termination period brings up anxietyand defenses against the risk of reencountering the feelingsof early loss of the caring object. The formative gain of liv-ing through the stress of termination is in the opportunity toachieve closure with a subsequent relationship that was notdisruptive to the individual’s well-being. In the long run thechild internalizes the capacity to manage the ability to enterand leave relationships without the interference of repetitivedefenses of traumatic origin.

Discussion

Work with early relational injury requires a well-thought-out therapeutic position that is focused on thepresent moment, offers the child emotional attune-ment/containment during the contact, and facilitates the de-velopment of interpersonal mutuality and partnership. Theworking through of repetition compulsion will vigorouslytest the boundaries of the therapeutic relationship and itscapacity to carry out a protective and reparative function. Inthis respect I have found that two major sources of counter-transference may interfere with the therapist’s ability to re-spond to the child’s reparative needs. First, the reenactmentsof a child’s early relational trauma may trigger the therapist’sown experiences of abandonment, rejection, and loss. There-fore, work with one’s own past interpersonal traumas canbe a potent resource for a therapist’s expanding ability toprovide clients with restorative relational space. In my caseentering the orphanage environment brought back memo-ries of my own childhood fears of being lost or separatedfrom my caregivers. Addressing these issues in supervisionand personal psychotherapy gave me the opportunity to re-connect with the complexities of my personal attachmenthistory and helped me to better adjust to the institutionalstructure of the orphanage. Second, working with a childwho is deprived of parental love and care may evoke a desireto act as a substitute for the missing parental figures. Thisaspiration may arise in the form of a fantasy or a real urgeto take the child home, and/or the temptation to providefood, clothes, toys, and art supplies. The realization of one’s

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Figure 7 Petya’s First Self-Portrait (Color figure available online)

personal inability to save a child from orphanhood usuallyis accompanied by feelings of sadness and guilt.

In many cases children come up with sophisticated waysto engage the therapist in a pseudo-nurturing type of re-lationship. For example, Dima, whose clinging attachmentstyle was described earlier, insisted on taking an object at theend of each session—whether a pencil, an eraser, my watch,or even buttons from my shirt. He had difficulty complet-ing and exiting our sessions and engaged in elaborate, repet-itive begging for possessions that he associated with me. Ashard as it was to say no to such a desperately needy child,

these ritualistic and repetitive behaviors fed his dependencyand defensive merging with the environment. Blocking thismaladaptive way of relating soon led Dima to give up thehabitual begging and turn to the intrinsic aspects of our re-lationship, such as art and self-exploration.

As much as the omnipotent desire to rescue is normal,it can be counterproductive when the therapist is working inan environment that fosters protectiveness and dependencyover self-reliance and self-initiative. As art therapists, we canoffer an orphaned child encounters of a radically differentnature that include the formative and healing experiences

Figure 8 Petya’s Final Self-Portrait (Color figure available online)

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58 ART THERAPY WITH ORPHANED CHILDREN

of engaging in real relationships (co-being) and personal artmaking (self-being).

Conclusion

Children living in an orphanage environment are cop-ing not only with the disruption of relationships with sig-nificant caregivers but also with a continuing deficit of nur-turing relationships that many orphanages cannot afford tooffer. As both a protective measure and a response to chronictraumatizing stress, a child may develop and maintain a sys-tem of rigid maladaptive defenses. The compulsive repeti-tion of these defenses does not lead to the mastery of trauma;instead it has a pervasive effect on the child’s capacity to bein touch with the self and to negotiate connectedness withothers.

The initial encounter with orphaned children may bedifficult to manage. Children present an array of reenact-ment behaviors (behavioral, emotional, and pictorial) thatinform the art therapist about the child’s past failed signif-icant relationships. The art therapy space, which is under-stood as the child’s process of relating to the art therapistand art materials, can offer a safe and reliable territory forthe reenactment of traumatic themes. Survival of this rela-tionship is an important milestone in a child’s restorationof the capacity to feel and to genuinely connect to others.Compulsive relational defenses become substituted with thecentrality of the art-making process. The art therapist as-sumes the role of a supporter of the child’s creative pro-cess and growing ability to utilize art in relating and sup-porting the self. The experience of engaging with art as aself-nurturing process is an important psychic gain and po-tential source of self-support within the often unpredictableand inconsistent relational environment of institutionalizedcare.

Termination is an important relational task that may in-clude reenactment of original interpersonal defenses, loss ofconnectedness to self, and the reintegration of a survived re-lational experience. On a pictorial level, this process may in-clude the return of regressive and stereotyped imagery, theloss of the ability to produce formed expression, and thereintegration of self-sufficiency and nurturance of the art-making process. The formative potential of termination isin the opportunity to actively negotiate these tasks with acaring person and to internalize the experience of a manage-able and therefore nondisruptive closure.

Finally, practitioners who are working with this pop-ulation should be aware of two common sources of coun-tertransference, that is, one’s own personal experiences ofdisrupted significant relationships in the past and an om-nipotent desire to compensate missing parental figures atthe expense of the child’s self-determination. Working withthis material under supervision and in personal therapywill help ensure that the therapist is optimally positionedto respond effectively to the child’s reparative relationalneeds.

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