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Already have an account? Log in. Event Saved. Your message has been sent! Your email will only be seen by the event organizer. Your Name. Email Address. Enter the code as shown below:. Send message Please wait Copy Event URL. In this section we present the themes, define and describe each theme, present exemplars to amplify the meaning, and provide a summary synthesis of the thematic results as related to our research questions. As we present these results we re-emphasize the limitations of this analysis.

The limitations became more apparent as we embarked on this project and realized that the scope, depth and breadth of our data might extend beyond the time and space constraints for this article. Our assessment of the data at this point in our analysis is that they are extremely rich and meaningful holding multiple implications for further research, theory building, and practice therefore requiring additional analysis. Within those limitations, we identified several preliminary thematic patterns of evidence that were distributed throughout and across five of the original a prior i parent categories of arts-making processes and arts-based research, relationship, ruptures, intersubjectivity, and transformation.

These new integrated categories and their meanings were re-organized, collapsed, and rearranged to become the three primary themes and the related modifying and defining themes. Through our analysis we identified the following primary thematic phenomena along with their modifying and defining thematic constructs. Relationship and Intersubjectivity: Relational Attunement, Dialectical tensions, Intersubjective transcendence.

Transformation is a major category and central focus for this study. The definition for transformation was the arousal of memories, re-activation of emotions, and levels of consciousness that mediate the new learning and insight through dialectical rupture and resolution Hayes et al. This theme includes the most frequently cited category of dialectical rupture and resolution along with inter-related defining constructs of relational and imaginational ruptures.

Dialectical rupture and resolution was the most frequently coded defining theme describing key transformative actions and moments. Dialectical rupture and resolution is inter-connected to multiple dynamic processes including relational attunement, imaginational flow and transcendence, and intersubjective transcendence and their dialectical counterparts of imaginational and relational ruptures.

The dialectic between these relational and imaginational attunements, flow, and ruptures represents contradictions and tensions between the drive for progressive innovation and discovery and the longing for familiar recalcitrance—the known and the unknown. These tensions create the conditions for a system of dynamic change through destabilization and de-construction, reflection, re-construction, and re-stabilization resulting in insight, illumination, psychic growth, and new personal and intersubjective narratives Israelstam, ; Zittoun, ; Forster et al.

Nothing stays the same — there is a constant flux. In our studio class we became aware of such dichotomies as death and life, distance and closeness, divorce and intimacy, facing a threat and running away from it. In an attempt to understand my inherent tensions between consonance and dissonance, my ritual of staying in my learned comfort zone and the spontaneity of newness, and my holding onto of the familiar while letting go and growing, I wrote the following musical lyric:.

It was through this lyrical writing where I helped myself reflect on my tension, embrace the different emotions I was feeling, and come to terms with this tension. I found that through the course, even though this dialectic existed and challenged me, I was more accepting of it as time passed.

I understood that this dialectic would become present and the task would simply be adapting around or within it. However, when we arrive at communal art making, we can face terrors, loss, and trauma and not be broken. We can experience sadness and anger and not fall down. Creating art together allows us to cope with the darkness, make meaning of our experiences, transform our existence, and find hope and peace. Through art we find resilience. Relational ruptures are inextricably connected to the dynamic between relational attunement and dialectical tensions.

This process is iterative, hopefully progressive and transformative, but exists along a precarious dialectical edge the navigation of which can lead to either creativity and illumination or destruction and devastation Israelstam, , p. About half way into the class, we were both on the floor, one of my classmates began to tear up and appear visibly upset. At that time I was tending to myself and my own needs, calmly breathing, humming a little melody, and overall in a peaceful state.

Her condition aroused an immediate response from me, first one of surprise and helplessness, followed by one to breathe and attune to her. I recognized her stooped position and the passive weight in her body. Suddenly, seemingly out of nowhere, a lightness overcame me and my hand approached hers with a playful, non-threatening movement.

She responded and we were engaged in a time of short play…. It was inevitable that it would affect me but the way it did, superficially at first possibly defending myself by setting boundaries? We are always positioning ourselves in relation to each other and always sensing where we are and how we are.

The triangle formation appeared while writing a song and moving in response to the lyrics, as a song and dance gave the participants a creative vehicle for representing the conflict that had appeared between the student-participants and their instructors. An understanding and empathy for what others in the class were feeling existed, even if their feelings were in opposition of my own. This made it clear that our feelings were on a dialectic continuum within an intersubjective context.

Imaginational ruptures are dialectically related to imaginational flow and transcendence. Ruptures in imagination include sensory, embodied, emotional psychic processes that evoke memory and fantasy, cause disruption in states of consciousness, and flow, and collisions between fantasy and reality. Imaginational ruptures are transitions in levels of consciousness requiring relinquishment of control, suspension of familiarity, renouncement of mundanity, and interruptions of rigid modes of thought Bollas, ; Knill, ; Czamanski-Cohen and Weihs, Transitioning into the world of imagination is a dialectical and dynamic process creating tension between the real and imagined, the present and absent, and the known and unknown resulting in a conflict and resistance to the process Knill, ; Israelstam, and negotiation of a creative resolution.

Imaginational ruptures and resolutions are considered to be central to achieving states of flow, transcendence, progressive and creative transformation necessary for insight and growth. The artwork that I created in the initial classes represented the unknown, the muck. The ideas that formed were abstract and unclear. The images from these first classes were of the free flowing ink, and the muck, and the discussion that followed the classes reflected that other group members had a similar experience.

It was an important stage because by allowing to freely explore the artistic media, clear symbols started to emerge. It was from the muck, if you wish, that the symbols of the tree and the bird grew. As the heaviness lifted in the room, a Blues rhythm picked up and we all…engaged in a time of rhythmic movement and music making. I thoroughly enjoyed this and thought I could go on enjoying it when, unexpectedly, I no longer did.

An image of an incoming storm mirrored that experience for [Participant 1]. The air is thick with anticipation of a storm. I feel like something is going to happen, resolve, open up, come together. What it is?

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But I can sense a certain tension and an anticipation of something. Relationship and intersubjectivity includes the modifying and defining themes of relational attunement and dialectical tensions and intersubjective transcendence cross referenced in the arts based expressive process theme. This theme refers to the attunement to others at the most fundamental emotional and unconscious level and joining in the co-creating, re-imagining, and transforming our personal and intersubjective narratives.

Relational attunement and dialectical tensions emerge and co-exist in the intersubjective arts-based expressive experience and in combination are akin to relational ruptures.

The combination of attunement and dialectical tension occurring within the potential space appears to be essential to the construction of authentic relational knowing and attachment. When we create art, all differences melt and become irrelevant. We come together and connect through art. I followed, I lead, I existed, interconnected to sounds and feels and raw emotion. It was exhilarating and so calmingly beautiful in the same space.

In short, the interrelatedness of movement and emotion was present throughout, no matter what initiated what. In the same artistic experience, one of us could feel comfort and another could feel discomfort, and we somehow transitioned within and around this space as individuals as well as a group within the experience. Alternately, dissonance is defined in opposition to these terms, being disorganized, different, and disconnected.

What happened with me when I was moving, that I was reminded of two different types of responses to other people, also informed me of proxemics. It is now clear to me that distances between people differ according to relation close-distant, personal-professional, or first time-know.

The arts-based expression requires the immersion in creative process that makes thoughts visible using the media, modes, and methods of artistic expression Levine, ; Zittoun, ; Caddy et al. Immersion in the expressive arts process requires engagement in the dialectic between resistance, rupture, and resolution, surrendering to the imagination, and ultimately entering a transcendent state of consciousness and imaginative flow, acute relational attunement, and empathic intersubjective transcendence.

Initially the ocean drum and the swaying around me took me to a peaceful place, but over time the feeling shifted in the room. The movements slowed down, all DMTs were on the floor. Harmonies sung in a minor key, combined with the restricted movement and contracted body language around me evoked a state of deep, penetrating sadness.

I found myself rocking, crying, remembering. This emotional state was hard to shake, even when I made physical changes standing up, increasing energy. With my eyes closed there was little coping, however, as I opened them and began to create with my hands, first in a miniscule manner, but over time more and more elaborately, I was able to gain a new perspective and move outside of myself.

When I was dancing I noticed that my body takes different positions and shapes in space. I noticed that my movements varied. Once I was moving slowly, and other times quickly with more expression. Once I was using just parts of my body, in separation, and other times my whole body was moving. There were times that I was in a low position, and there were times that my body took shapes when I was standing or jumping. I decided to move naturally for a while, warming up my body, as in preparation for deeper exploration.

Surrendering to the imaginational flow through free association and attunement to sensory embodied ways of knowing results in restoration of play, loss of time consciousness, transcendence beyond physical and mental strife, and expansion of the perception of possibility Knill, ; Van Lith, I lay down on a floor stretching my mind to the limit of its extension to find answers. I felt stuck. How I am supposed to find it? I closed my eyes and my mind went somewhere far, far away. In my mind I was levitating over the mountains, rivers, seas, oceans and dessert. I felt relaxed and calm. My breath was stable and my heart beat pretty calm.

I stayed there for a while, however, I lost control of time. I think I might have fallen asleep as at one point I felt cold, so cold that I curled up in the embryonic positions shaking and tensing my muscles. I slowly began to twist, bend, writhe with a extremely bound muscle tension and without any direction.

Just shaping my body through space and to adapt to the cold. It was so unexpected as a quick unexpected frog coming out of a dark sleepy pool. Dark sleepy pool? Unexpected frog? I stopped myself for a while and wondered if I feel ok. Frog, pool, splash, unexpected… Yes! I have an idea. Through my movement inquiry I noticed that true togetherness, a connecting of the hands, wiped away all the differences. This results in an increased degree of somatic and emotional understanding as well as empathy. At the beginning there was a sense of slowness, careful attention and intimate contact among the participants, and deeper exploration of individual problems, however, expressive movement was limited.

Later during the session, expressive movement emerged and There was a sense of meditative and trance dance, in relation to expressive and meditative music. In addition to analysis of the data thematically, we also wanted to explore how these thematic results emerged, sustained, developed, or diminished over time in the laboratory course. The progression of the themes over time was tracked by the frequency with which these thematic categories were coded in the study records from the introductory course to the advanced course Interestingly, all of these coded categories except for two, increased in the coded frequency over the progression of the course.

Of particular note is the dramatic increase in the frequency that dialectical rupture and resolution was coded along with imaginational flow, relational attunement, relational and imaginational ruptures and tension and dialectics generally doubled in frequency. Medium mode and method in the arts-based expression category and sensory, kinesthetic and embodied knowledge remained the same over time with the latter dipping by just a few instances.

In summary, the primary thematic categories of ruptures, resolution, and transformation, relationship and intersubjectivity, and arts-based expression together with their modifying and defining themes, represent what may be transformative phenomena equivalents to mechanisms of change in the creative arts therapies. Due to the pluralistic intersubjective nature of reality and aesthetic knowledge in the creative arts therapies, these transformative phenomena are conceptualized as interactive dynamic systems of change in contrast to singular, linear, causal mechanisms of change.

In this preliminary phase of our research study, we have explored formative phenomena that, taken together, may be descriptive of the ways in which change occurs in the creative arts therapies. In this section we explore the dynamic interactive relationships between the primary and modifying themes and propose how these interactive phenomena might form a system of change. We also address the limitations of the study and how those limitations both elucidate the results and illuminate directions for future research. Finally, we recommend methods of evaluating these formative dynamic constructs of change in research, clinical practice, and the development of an evidence base for the creative arts therapies.

Therefore, considering the interpretation and transferability of these constructs to theory building and clinical practice resides within and is limited by that context.

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With that said, we also may have to re-consider the hegemonic criteria, implicit in that statement, by which we typically evaluate research results. For instance, in this study a method for evaluating the results of this study have to more mindfully include a paradigm shift. In this paradigm shift it may be more useful and relevant to select arts-based or qualitative research evaluative criteria that are more aligned with the aesthetic intersubjective mental model Greene, or worldview of the creative arts therapies in contrast to a quantitative research reductive mindset more aligned with physical sciences.

Within an aesthetic intersubjective mental model, the themes we identified represent phenomena that are dynamically and spatially inter-related presuming change as related to interaction as opposed to singularly static linear and causal constructs. Consequently, we are exploring the construction of meaning and change through kinetics, dynamics, inter-relatedness, and dialectics reflective of the ontological and epistemic nature of our fields and these thematic phenomena. Contextualized within these paradigmatic and methodological shifts we explore the dynamic systems of change created from these thematic phenomena, their implications for clinical and research theory and practice.

The primary, modifying and defining themes identified in this study represent dynamic phenomena that dialectically adjoin and collide in the arts-based relational context descriptive of qualities of perceptual, emotional, relational, and behavioral experience contributing to change in the creative arts therapies.

The primary interactive thematic constructs from our analysis are: 1 ruptures, resolutions, and transformation; 2 relationship and intersubjectivity; and, 3 arts-based expression. The dynamic interaction between these phenomena occurs in an arts-based expressive and intersubjective holding environment that can tolerate, emotionally regulate, and accommodate the creative and relational dialectical processes of contradiction, tension, and resolution necessary to promote change. We explore these dynamic constructs in more depth, examine different interactive configurations, and consider their relevance as a system of arts-based relational mechanisms of change.

Central to our discussion of mechanisms of change is the operational definition we used for transformation which was the arousal of memories, re-activation of emotions, and levels of consciousness that mediate new learning and insight through dialectical rupture and resolution Hayes et al. Within the literature and our data dialectical rupture and resolution was identified as one of our most predominant and overarching themes instrumental to transformation. Dialectical ruptures and resolutions are the pervasive ongoing and driving forces central to change, fueling creative, relational, and psychological growth from the friction between seeming contradictions in thought, belief, and experience.

Arts-Based Research Approaches to Studying Mechanisms of Change in the Creative Arts Therapies

Typical dialectical tensions emerge from the existential anxieties and conflicts between the drive for progressive innovation and the gravitational longing for familiar recalcitrance—seeking the known from the unknown, creating something from nothing. In our study, the dialectical rupture and resolution process was mediated primarily by the dynamic interaction between relational attunement, imaginational flow, and intersubjective transcendence and their correlates of relational and imaginational ruptures.

These tensions create the conditions for a system of dynamic change through iterative phases of destabilization and de-construction of pre-existing beliefs and narratives, re-construction of new narratives, and relationship re-stabilization resulting in new insight and illumination Israelstam, ; Zittoun, ; Forster et al.

Essential to the resolution and reparation of these dialectic tensions and ruptures are the interrelated thematic constructs of relationship and intersubjectivity and arts-based expression. In our study and, in the creative arts therapies and psychotherapy literature, the construction of a relationally attuned, emotionally held and responsive intersubjective culture is deemed essential for facilitation of surrender to and engagement in the arts-based expressive processes. Surrendering to the imagination, necessarily includes engagement in dialectic between resistance, rupture, and resolution ultimately allowing for the attainment of the transcendent state of imaginative flow, acute relational attunement, and intersubjective transcendence.

Consequently, the intersubjective arts based expressive process juxtaposes imaginational flow and relational attunements and their correlate dialectic ruptures creating an ongoing transformative dialog necessary for resolution and change —jarring fixed and rigid beliefs that impede progressive expression, conceiving, re- imagining and birthing new systems of thought and perception, contributing to reparation, synthesis and transformation within a strong relational attuned emotionally holding environment.

This state of flow facilitates levels of consciousness that transcend the limitations of physical, temporal, and spatial boundaries enhancing interpersonal awareness and empathy and the basis for the construction of authentic emotional relationships that could both withstand and facilitate ongoing ruptures and resolutions. We propose, therefore, that the dynamic interaction between these thematic phenomena in varying combinations and at varying strategic times, within the therapy and the therapeutic relationship, generates transformative responses.

This is a preliminary study with formative qualitative evidence about these transformative phenomena. That evidence combined with the progressive frequency by which our categories were coded across time in the study posits some intriguing ideas and questions. Of particular interest is dramatic increase in the frequency of coding for the theme of dialectical rupture and resolution, within the overall theme of ruptures, resolutions and transformation, along with modifying themes of relational and imaginal ruptures.

This increase along with the concomitant increases in relational attunement, intersubjective transcendence, and imaginational flow suggests that there is perhaps a dynamic interaction between these experiences that create the progressive conditions necessary for facile engagement in the dialectical rupture and resolution process essential for change.

In other words, the interactive mechanisms or phenomena from the study progressively contribute to the creation of a relationally attuned intersubjective culture in which imagination, dialectical tensions, and arts-based expressive process develop over time and indeed might be contribute to change and transformation.

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In considering the nature, meaning, relationship, and progression of these preliminary and formative interactive dynamic phenomena we revisit the concept of mechanisms of change. With regard to mechanisms of change and how change occurs in the creative arts therapies, we think that our findings necessitate a paradigm shift from a singular causal action to a dynamic interactive system between multiple human phenomena.


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In this paradigmatic shift and proposed model, in contrast to more traditional definitions and evaluation of mechanisms of change, the relationship of the mechanism and the outcome is not linear and measureable but rather dynamic, multi-dimensional, and descriptive. A review of the nature and relationship of our thematic findings relative to the extant concepts of mechanisms of change suggests paradigmatic and methodological reconsiderations.

Mechanistic research resides predominantly within a post-positivist paradigm in which a statistical and singular causal relationship is created between the mechanism, intervention, and the outcome as the explanation of how change occurs Kazdin and Nock, ; Kazdin, There are particular bodies of knowledge and domains of scientific research in which this approach is warranted resulting in valuable answers to specific questions. However, due to the nature of reality and forms of knowledge in the creative arts therapies, mechanisms of change may require reconsideration, redefinition, and reconfiguration.