Art Psychotherapy, Vol, 1 pp- 31-43, Pergamon Press, 1973, Printed in the U .S .A .

A DIAGNOSTIC ART INTERVIEW' t t

JUDITH A . RUBIN

Art Therapist, Pittsburgh Child Guidance Center, Pittsburgh, Pennsylvania

BEFORE describing in detail the background andcharacteristics of the diagnostic art interview used atthe Pittsburgh Child Guidance Center, it might begood to look briefly at what happens with a typicalclient . Jamie, a fearful boy of six, is taken to theplayroom by the art therapist . whom he has justmet. As he enters, he sees an easel and a table,drawing papers in. a range of sizes and colors, a sinkon which are many kinds of fluid media : fingerpaint, powdered tempera, liquid tempera, watercolors, and brushes of all shapes and sizes . Onanother table, he sees both familiar and new draw-ing tools: chalk, crayons, markers, "paintsticks,"and "tempra markers." He also sees possibilities forwork in three dimensions : wood scraps and glue,clay, cardboard, tape, scissors, and clay tools . He istold that he may use any materials he wishes, workwherever he likes, and make whatever he decides .

After carefully inspecting this wide array of mate-rials, Jamie decided to use "paintsticks" ; and stand-ing at the table he drew with care a triangular shape(in three colors) on the largest size of paper(18'"x24") . (Fig. Ia) He then brought small shakersof powder paint and some water to the table .Sprinkling and pounding the colors, he talked abouthis little sister who is "bad--she kicks me!" (Fig . Ib)He then used creamy fingerpaint, and whilerhythmically smearing, told a "make-believe story"about how "the police got me one time . I cutsomeone's nose off." He added reassuringly that hismother has a rule about cutting noses off, presum-ably a rule against it . (Fig. le) After washing hishands and joking about things going down thedrain, he worked on the floor with wood scraps andglue, carefully constructing a tall rocket . (Fig. Id)Again choosing the largest size of white paper, he

proceeded to draw, with markers, a picture of aspaceman who went all the way up to the moon ;but who would starve, because the people on earthhad not supplied him with enough food . (Fig, le)After meticulously rearranging the markers to matchthe colors on the box, he used thick chalk to drawa picture of Hansel and Gretel and "a dirty oldwitch," working quickly so he would have time topaint. (Fig . If) Bringing every color of tempera tothe table, he painted a picture with a flat shortbrush, excitedly narrating the story as he worked .(Fig. lg) First came the house, then the fire, thenhe yelled "Help! Help! Fire!" He explained that the"little kid" in the house is yelling for help andwants to get out . But the parents--all the otherpeople in fact-are dead, and the child is the onlyone left, although this same "little kid" had startedthe fire himself . Jamie then proceeded to rescue theboy, by adding to his picture a fire engine with ahose and two firemen who have come to save thechild. He was deeply and passionately involved inboth the telling of the story and in the painting ofthe picture, the product barely reflecting the intensedynamism of the process .

Jamie did not want to leave, but reluctantlyaccepted the termination of the one hour session .What may be one of the most important features ofsuch interviews is that they are perceived as fun andas nonthreatening, unlike most testing situations . Infact, the majority of children have spontaneouslyrequested another such interview, and for the mostit is indeed a pleasurable experience .

As an introduction to outpatient treatment in amental health clinic, there is much to be said for anactivity which is a pleasant kind of cathartic orexpressive projective technique, serving both thera-

`Requests for reprints should be sent to Judith Rubin, Ed . M . . A. T . R., Pittsburgh Child Guidance Center, 201 De Soto Street,Pittsburgh, Pennsylvania 15213 .,This paper was originally delivered as a slide-presentation at a Roundtable Meeting of the American Society of Psychopathologyof Expression in April of 1971 .tThe Photographs accompanying this article were taken by Norman and Sheila Rabinovitz .

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peutic as well as diagnostic purposes . (Dewdney,Dewdney & Metcalfe, 1967 ; Frank, 1948) .

The unstructured art interview, developed andused for the past several years at the PittsburghChild Guidance Center, has its roots in the work ofmany disciplines. It represents part of an ongoingintegration of my own experiences in art, education,child development, and art therapy with those ofmy colleagues in child psychiatry, clinical psychol-ogy, and social work .* While related to other pro-jective approaches to personality through art, it issubstantially different in the range of possibilitiesavailable to the client .

Although art work produced spontaneously inschool or treatment settings has been sensitivelystudied by such workers as Alschuler & Hattwick(1947). Elkisch (1945), Hartley, Frank & Goldenson(1952), Schmidl-Waehner (1942), and Bender(1952); it is virtually impossible under "naturalistic"conditions to either standardize what is available orcontrol extraneous influences . These studies have,

JUDITH A. RUBIN

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f

FIG. I . A series of art products created in one interview by a boy of 6 .g

however, provided a rich source of diagnostic dataand hypotheses on relationships between child artand personality ; as has the work on the normativedevelopmental aspects of children's drawings andpaintings by such educators and psychologists as DiLeo (1970), Goodenough (1926), Griffiths (1935),Harris (1963), Kellogg (1969), Lantz (1955), andLowenfeld (1952, 1957) .

In the more controlled setting of the testingroom, most procedures follow what Hammer (1958 .p. 54) has called "psychology's demand for stan-dardization" ; and control rather stringently medium,topic, or both . In copying (Bender, 1938 ; Di Leo,1970) and in completion tasks (Ames, 1943 ; Hel-lersberg, 1945 ; Kinget, 1952), a small piece of paperand a pencil are the rule . Assigned topics,such as human figure (Machover . 1949), family(Reznikoff & Reznikoff, 1956 : Burns & Kaufman,1970), animal (Levy & Levy . 1958), house (Kerr,1936) ; or broader themes like "The Most ImportantEvent in Your Life" (England, 1943 ; 1946) limit

*1 wish to express my deepest gratitude to Marvin L Shapiro, M.D . . whose advice, support, and encouragement were essential tothe work reported herein .

what may be depicted, and also limit the materialto be used .

While planning this format, assigned topics suchas human figure or family drawings had been con-sidered; the dynamic way in which the children,from the first, structured the hour themselves madesuch procedures appear unnecessarily constricting .Of course, human figures, houses, animals, or fami-lies do appear spontaneously at times . Even thewell-known combination of house, tree . and person(Buck, 1948) is often drawn by clients .

Needless to say, different goals require differentmethods. For example, a clinical psychologist and Ihave developed a "family art evaluation" which isused in our clinic with ever-increasing frequency .(Rubin, Magnussen . & Shapiro, 1971) . Since themajor purpose is to understand individuals in rela-tion to the family unit ; the sequence of tasksincludes family portraits, a jointly-executed mural,and a discussion of these by the family . Structuredinto the format, therefore, are requirements to worktogether as a unit, to project individual images ofthe family, and to react to each others' familydrawings as well as the joint task. Although freeproducts are encouraged while any family memberwaits for the others to finish their family portraits ;these unplanned items merely supplement, but arenot the focus of the diagnostic data-gathering . Inother words, assigned topics or media are notcategorically rejected, but are used when appropri-ate .

Free choice of subject matter is sometimes com-bined with assigned topics in procedures requiring aseries of drawings, as in those reported by Burbury(1957), Kwiatkowska (1967), Schmidl-Waehner(1946), and Ulman (1965) . It is also common ininterviews using media other than pencil or crayon,as in Napoli's (1951) work with fingerpaint orWoltmann's (1964) with clay . Rarely, however, area range of media offered along with a free choice ofsubject matter with the possible exception of theart interviews reported by Pasto & Runkle (1955)and Schmidl-Waehner (1942, 1946) .

Perhaps the closest example of an analogousinvitation to freely structure time and space, given avariety of materials, would be a play interview for ayoung child . One major difference between a playsession and the art interview reported here is thelatter's applicability to a broad range of ages . Justas a child at a prerepresentational level of graphicdevelopment could not draw a "person" or a "fam-

A DIAGNOSTIC ART INTERVIEW

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ily" ; so an adult is not likely to play freely withdolls or sand . Both, however, can respond appropri-ately to the range of materials offered in the artevaluation ; which has already been used successfullywith children and adolescents from 5 to 17, as wellas with adults-Although the choice of a topic is sometimes

difficult, it has never been necessary to give eventhe most dependent child a specific suggestion .Rarely (once with an adult and twice with adoles-cents), has it been felt necessary to suggest that theclient begin with a scribble upon which to project,and then draw an image . This procedure of creatingand then responding to one's own ambiguous stimu-lus has been used by many (Cane, 1951 ; Naumburg,1947, 1966 ; Elkisch, 1948; Winnicott, 1971) ; andmay be one exception to Harris' conclusion that"free drawings are more meaningful psychologicallythan assigned topics," even for "global personalityassessment" (1963, p . 53). Like the "doodles" pro-duced on the pad which Hammer (1958, p . 562 ff .)places near his clients for use during therapy, picto-rial projections on such self-made Rorschachs mayindeed represent a "shortcut" to unconscious mate-rial . (Elkisch, 1948, p . 254) .

Eleanor, age 15, had been reluctant to draw, butsoon projected and developed an image of a bird inher scribble (Fig . 2) . In regarding it, she finally decid-ed that it was an eagle, but then said, "1 think it's ahawk or something ." She continued, saying that shewould either like to be the bird or take care of it,finding the latter idea a more comfortable one topursue. She went on to explain that eagles were indanger of becoming extinct through people's ne-glect, and that she would like to work for thepreservation of the species . These comments sherelated to her own strong and largely unmet depen-dency needs (she was living with her brother, butwas far from happy or accepted in his home) . Lessconsciously, the eagle expresses both her hunger andher oral aggression, evident in her explosive, sullen,angry speech . Tim, a boy of 16, was acutelyuncomfortable about drawing due to his feelings ofinadequacy as an artist . He agreeably drew anddeveloped a scribble, however, and described it asthe head of a person who was crying : "Maybe helost something, like a friend . . . the friend might havedied, might have been the same age . . .Hey! I justthought of something! I'm talking about myself!"

When a product is nonrepresentational, it is stillpossible to utilize it as a stimulus for projected

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FIG . 2 . Scribble : Eagle

verbal and thematic associations (as with a Ror-schach). Jim's painting, for example, was first des-cribed as "just a picture, a design" (Fig . 3) . How-ever, when asked what the design reminded him of,Jim soon saw it as "an old-fashioned boat they usedto have in the olden days ." Upon further ques-tioning, he clarified his image as "a war ship," onwhich he would be the captain who would win thebattle . The orange dot above the "boat" is "wherethe cannon ball was fired up, and accidentally itblew up in the air ."

Similarly, the multicolored finger-painting, 9-year-old Max, produced with powdered temperaand water, reminded him of "something you havefor lunch ." (Fig . 4) At one point, while engaged inthe process of making the picture, he made a mockaggressive gesture toward me with paint on hishands. The picture itself had no title until helooked at it again at the end of the hour and called*On a sample of 50 Ss ages 5-17, the various media were

JUDITH A. RUBIN

it "Something pretty, like a rainbow" ; then, "erup-tions, something erupting, like a volcano ." Whenasked what might be erupting, he said, "Differentcolors of gems . . .Jet is the black one, the blue one islapislazuli, the red one is ruby, the white spots arediamonds, the green ones are emeralds, and theyellow is topaz ." He elaborated further, explainingthat the volcano was spurting out beautiful jewelsand fire and lava . He then shifted in his associationsfrom this anal image to an oral one, saying that themulticolored picture now reminded him of a fruitbowl. Pointing to the colors, he explained . "Thepurple could be grapes, the green could be grapes,the black could be . . . a rotten bunch of bananas, thered could be apples, and the orange could beoranges ." When asked what he might want to eat,Max replied, "Apples" ; and when asked who wasgoing to get the fruit in the bowl, he said that noone would, because his grandmother would throwthe bowl in the fireplace unless he stopped her byplugging it up .

Woltmann (1964, p . 325) has said that "the lessstructured a nonverbal activity is, the greater are thepotentials for projective communication" ; and sinceone must agree with him that "not all children doequally well on all nonverbal projective activities,"it would seem appropriate to extend the range ofchoices offered in media as well as content . Certain-ly individuals differ in their preferences* as well asabilities, perhaps in accord with innate or learnedpreferred modalities . Perhaps even more significantfor diagnostic purposes are the differential responsesand associations--tactile, kinesthetic, and visual--stimulated by different art media. Equally impor-tant are the inherent capacities and limitations ofeach medium, and how the individual reacts tothem .

For example, think of the many possible re-sponses one can have to the frustration of drippingpaints at the easel . How the child handles this kindof problem is one index of his ability to deal withfrustration in general, his "flexibility" if you like .While creating his "old-fashioned boat," for exam-ple, 10-year-old Jim was rigidly compulsive in hischoice of paint colors for successive parallel lines .(Fig. 3) Having unsuccessfully asked me severaltimes to select the next color for him, he resolvedthe problem by settling on a magical ritual. Hewould repeat the rhyme, "Ocka-bocka soda-crocka,

used in the following proportions : Clay (24 .1%), Paint (22.4%),Crayons, Chalk and Pencil (20.5%), Water Color Markers (16.1%), Finger Paint (8 .9%), Wood Scraps and Glue (8.0%),

A DIAGNOSTIC ART INTERVIEW

3$

FIG. 3 . Painting: "Boat"

FIG. 4 . Finger Painting

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JUDITH A. RUBIN

ocka-bocka-boo--ocka-bocka soda-crocka, I chooseyou!" ; each time bouncing his brush in the air overeach paint jar in the easel, using the color he landedon at the end of the rhyme . After painting eachhorizontal stripe, he would carefully remove thecolor just used front the easel tray . When only onejar was left in the tray, he still compulsively re-peated the magical rhyme . His potential for moreflexible behavior, however, was demonstrated in hishandling of the "accidents" occurring in the courseof the process . When the purple paint dripped, forexample, he said "Whoo," grinned, paused ; and thenproceeded, rhythmically pressing the brush againstthe paper to create more purple spots at patternedintervals .

Both finger paint and clay have the capacity tobe done and undone multiple times ; providing theopportunity to smash down or remake a clay struc-ture, or to make a series of images in finger paint,smearing over between each . One 6-year-old girlestablished a dramatic repetitive rhythm, workingbimanually, while fingerpainting at the easel. She

aFIG . 5 . Finger Paintings . (a) Angry Cat ; fb) Taco the Horse

would rapidly draw or scratch a picture into thepaint ; then, just as quickly, cover it over, smearing .scratching, and clawing the medium. Her final imagewas called "An angry cat, with his Big Teeth ." (Fig .5a) She had been in therapy for a year with a childpsychiatrist, and her use of denial had been impene-trable . When he saw her picture and read theprotocol, he expressed surprise at how quickly shehad relaxed her usual defenses .

A picture of "Taco . the horse" is also the lastword in a long sentence of images and associationsby the 5-year-old girl who drew him . (Fig. 5b) Shehad begun by using powder paint and water, angrilybanging the paint container, saying "I'll show thisbottle who's the boss!" Stating that she hatedgetting her fingers messy and really hated fingerpaint ; she looked longingly at the finger paint jarswhile she used powder paint and water and a verylarge brush . While she brushed on the paint, shecontinued to express her concern about cleanliness,saying "I'll clean up every mess I make : after eachlittle mess, not one big mess . No wonder 1 never get

stuff cleaned tip at school . All the other kids messaround and piss!" She then secured the creamyfinger paint and glossy paper, vigorously smearinghuge gobs of paint on the surface, expressing herambivalence with grins and verbal ejaculations like' -Yuck!" or "Ick!" Her series of done and undonepictures began with a scribble, then a bell, then aheart reworked several times, then squiggly linescalled "Snakes tangling up," then two squiggles withfaces meeting in the center, called "Two SnakesKissing . Every day they're tangling up!" This wasfollowed by an attempt to draw a boy into thepaint, with much reworking and verbal expressionof dissatisfaction : "I'm not an expert on this . Ooh!That's a bad boy!" He was quickly erased, followedby her attempt to "just make a snake," duringwhich she became concerned that "I gotta find theend. He can't got a tail! It looks more like a horse ."This animal was finally developed into "Taco," whowas later described in an interview about the pictureas "a boy horse who is goin' to eat grass . His momis callin' him for supper right now, but he's notcomin' to eat . If he's hungry, why doesn't he cometo eat? His father is gonna spank him if he doesn'tcome. His mother will spank him too . He's notallowed to eat any more grass . lie didn't hold histemper, 'cause he hit the baby horsie! He told hismom and his mom spanked him. The others aretelling his mom too, 'cause he hit his baby!"

Sam, age 12, worked long and hard on a clay"statue" of a person to go on the flat slab "pedes-tal" he made . He first worked on the body, thenadded the legs, carefully building in armature-likesupports for all the limbs . As he added the headand neck, he began to describe the figure as nolonger a boy as first indicated, but rather a "girl" of34 whom you could tell was "nice" because "shewouldn't holler much ." At this point, he began todiscuss grownups who holler, male and female, andsqueezed the body . making it taller and thinner . Hethen began to press it downward, then grinned andsmashed it with his fist . He proceeded to secure abowl of water, and spent the remainder of the hourexperimenting with clay and water, saying it re-minded him of "mud pies ." He shook some powderpaint on the clay, rubbed it in, and admired hiscurved form, saying it reminded him of "somebodybeing born," explaining that next week he would"make it a man this time," He liked the shape sowell, however, that he decided to save it, his finalstatement in a regressive hour . (Fig. 6)

A DIAGNOSTIC ART INTERVIEW 37

FIG. 6 . Clay: Someone being Born .

In the art interview, the client has other optionsin addition to selecting media and topic, includinghow he will position himself in space . A longrectangular table, an easel, and the floor provide achoice of working surfaces and locations . Whilesome remain at the same spot for the duration ofthe session, most children have chosen differentlocations for different activities . One such wasDaniel, who made a conical paper "fire starter"containing feces-like balls of clay and wads ofpaper, standing with his back to me the whole time .He then chose to paint at the table, adjacent to me ;but he soon became so self-conscious and evenparanoid about the observers (whom he knew to beon the other side of the two-way mirror) that hequickly taped his painting on the mirror because, ashe explained, "They could spy ." When asked whohe thought "they" were going to tell, he whispered"Mothers!" Although he was reassured to the con-trary; he spent his remaining time in the roomcovering the entire observation window with paper,drawing "bars" of steel with chalk so that "themlittle sneakies" couldn't see or hear what was hap-pening .

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Since there are different places to work, the childmay in consequence choose to stand or to sit, to beclose to or far from the examiner_ to look at or towork with his back facing the clinician . Manychildren try out some of each, and often seemsignificantly more relaxed and more freely verbalwhen not facing the adult . Bill sat at the table as hedrew his first neat, careful, somewhat stereotypedcrayon scene of a farmhouse and pumpkins . (Fig.7a) He then moved to the easel, back to me, andbegan to experiment with thick poster chalk, re-laxing and swinging rhythmically as he explored thenew medium- (Fig. 7b) His projected title for hisline-swinging abstraction was "A Colorful Cloud ."When asked how the cloud felt, this rather meek,polite boy said ; "Well, the way the eyes are, she'spretty mad . . . at the sun, for drawing all the waterout ." When he next returned to the table, heanimatedly created and wore an openly angry mon-ster mask .

The client may choose to speak or not to speakspontaneously ; though if there is little or no sponta-neous verbalization after perhaps one third of thehour, he is encouraged to talk about his ideas andfeelings while using the art media . lie can alsodecide whether he wishes to be interviewed abouthis product directly after it is finished, or at theend of the session. Even the most silent child canspeak eloquently through art, as in the case ofTommy, a timid boy of eight who worked on awood scrap and glue "Hobby Horse" with his backto me, sitting on the floor, at the opposite end of

JUDITH A. RUBIN

FIG . 7 . (a) Farm Scene ; (b) Cloud .

the room. While waiting for part of it to dry, hecame back to the table, quietly squeezing andmanipulating a small piece of clay, avoiding eyecontact. lie first called the clay a "Rowboat," thena "Snake" with which he hissed in a meek butplayful manner ; and also a "Ball," which hedropped on the table, gradually throwing it downwith force, ostensibly to flatten it in order to makea pancake . Tommy finally developed the clay into atiny round "Monster Face" ; which lie was encour-aged to use as a puppet, and through which he wasable to express the boy monster's anger at both hismother and his sister,

Lynn, too, was shy and relatively nonverbal, butgradually relaxed and opened up in the course ofthe one hour session. As if to demonstrate thestimulating and soothing effect of fluid media, thisgirl (who had been described by a psychiatrist notnl as constricted, but as barren and unimagina-

proceeded to produce a charming and ratherfree tempera painting . (Fig- 8) While she worked,she began to talk, first tentatively and then morefreely, about the fears which apparently underlayher school phobia . She told of a "good girl" who"'hates to go outside the school when it's crowded. . .[because] they tramp on her . . . Bad boysfrighten her. They punch her." Perhaps related tothe omission of legs on her Figure was her commentthat when the bad boys punch, the girl kicks themand they then kick back, hurting her so she cries .Lynn then described a teacher who is there, butdoesn't help, and who even yells at the girl in the

picture when she cries . The bunnies in the paintingwere described as twin sisters who "mostly kickeach other and punch each other ." She followedthis product and story by hungrily accepting adozen gobs of clay, manipulating and digging vigor-ously with tools, and finally making spherical"blocks" with which she built a "Castle ." Whenasked who would live there, Lynn grinned shyly andexplained that the occupant would be herself as"Queen Sarah" (of a children's television program) ;and that she would be having a baby soon, but hewould definitely not be like her own baby brotherwho always gets into her toys and whom she indeedkicks in retaliation when he pinches her .

FIG . 8. Girl and 2 Bunnies .

Others, like 16-year-old Marilyn, speak freelyfrom the moment they enter . It often seems as iftongues are further loosened by the relaxing . regres-sive aspects of the art media ; and indeed Marilyncommented several times on the sheer pleasure of"playing" with the clay . While she worked . Marilynspoke in depth and detail of the realities of hercurrent confused state . (Fig. 9) She identified herhead of a man as an idealized father-lover-savioursort of figure ; yet, on another level, the gaping eyes,mouth . and ears seem to scream out her inner panic,her feelings of emptiness, and the intensity of her

A DIAGNOSTIC ART INTERVIEW

FIG . 9 . Clay ; Head of Man .

anxiety (another kind of articulation through art) .In accord with the recommendation of many

workers that a sample of several art products isdiagnostically more reliable (Elkisch, 1948, p . 253 ;Hammer, 1958, p . 389; Harris, 1963, p . 52 ; Napoli,1951, p. 400); the one hour art interview typicallybrings forth more than one creation (average 2-63 ina sample of 50 cases*), at times as many as seven .Thus, from the majority of these interviews, muchdata on each child is available, to counter theproblem of insufficient evidence and of intraindivid-ual variability (Kellogg, 1969, p . 191) .

In addition to all of the overt behavioral re-sponses, there is the full range of symbolic state-ments in and around the process of making theproduct, as well as any verbal or nonverbal associa-tions thereto . The product itself can be consideredfrom the point of view of both form and content,

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*There is a tendency for younger children to produce more products than older ones . In a sample of 50 Ss ages 5-17 the meannumber of products created by the youngest group (ages 5-8, 19Ss) was 3 .42 . by the 9-12 year olds (14 Ss) 2.71, and by the13-17 year olds 1 .76-a clear decline in number of separate creations with increasing age .

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further enlarging the data pool on which an impres-sion is based . Recall that the client has multipleoptions in his use of space, time, materials, and theclinician. The manner in which he structures thehour, plus what he produces and how he does it,add up to a rich storehouse of data which may thenbe fitted together like the pieces of a puzzle tomake diagnostic sense . Wolff (1946, p . 113) hasstated well the fundamental task facing the clinicianfollowing such art interview : "If we have a sequenceof (products] and a sequence of associations, ouranalysis starts in searching for a common denomi-nator to which each element can be related ; then,by combining and interrelating all the elements witheach other, we may reconstruct the sentence whichwas spoken by the child's inner personality in thelanguage of pictured associations ."The organization and reporting of the data de-

pends in part on the purpose of the report . Mostreferrals are made during the diagnostic workup,

FIG. 10 . (a) Tree ; (b) "Fred"_

and the products and report are presented at adiagnostic conference . The chairman and other par-ticipants then attempt to integrate the evidencefrom the art interview with other clinicians' evalua-tions .

In a paradoxical way, it seems that the unstruc-tured art interview is peculiarly sensitive to bothstrengths and weakness ; for often it will elicitbehaviors revealing unknown capacities in a child or,conversely, it will pick up trouble signals beforethey are apparent elsewhere . So far, the diagnosticformulations and interpretations based upon the artinterview have correlated surprisingly well withthose of colleagues involved in understanding thesame individual . In those few cases where there hasbeen a significant divergence, it often seemed as ifthe child's art spoke more truly than other indices .For example, a stark, split, barren purple tree (Fig .10a) was painted by an adolescent girl ; who fol-

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lowed it with a drawing she called "Fred," de-scribed as "an 18-year-old girl ." (Fig. lob) Bisexual"Fred" was described as being called "crazy" byother kids, and as talking to herself because it wasbetter than talking to others . Although the psychiatristremarked that the girl's art looked "sicker" thananything else, it was her subsequent suicide attemptwhich unfortunately validated the disorganizationand withdrawal evident in her drawings and associa-tions, It is no surprise that, while hospitalized, sheresponded well to adjunctive art therapy . a t a pointwhere she was withholding verbal communication.

It was necessary, of course, to modify the artinterview procedure when a totally blind boy was

A DIAGNOSTIC ART INTERVIEW

referred to the clinic . For him and for 21 blindchildren seen in a pilot program at a local school ; agreater range of sensory stimuli were utilized, suchas foods (taste, smell), musical instruments(hearing), and objects of different sizes, textures,and consistencies (touch) . In addition, it was neces-sary, for those with no useful vision, to explicitlyverbalize the choices of art media, such as clay,wood scraps and glue, fingerpaint, drawing tools,etc .

Another sort of evaluative interview was held foreach of 50 children following a summer program inwhich every child had six weekly one-hour sessionsof group art therapy . The format of these individual

FIG. I t . (a) Painting - ]St . week ; (b) Sculpture -4th, week ; (c) Later Painting .

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review sessions was to lay out before the child all ofthe products he had made over the six week period .He was then asked to react to his creations, at firstin an open-ended fashion, then with more directedquestions concerning most and least-liked products,experiences, etc . In a sense this provided not onlyan opportunity for the child to assess himself, butalso for the worker to judge what was recalled .repressed, valued, etc . from the short but intensiveprogram . In reviewing a sequence of his art work,from its first compulsive beginnings (as in a designdone twice (Fig. I la) because it was not perfectenough the first time); one 10-year-old boy chose, ashis favorite product, a clay sculpture of somebodydead in a pool of blood . As fie looked, he said,"Well, I'd like to mess somebody up, but he'syounger than me and I'm not allowed to ." Hisproduction of this sculpture (Fig . Ilb)during thefourth session had represented a breakthrough . andmade possible insight into his intense rivalry withhis younger brother (the symbolic victim) ; enablingthis previously tense and constricted child who hadspoken in a whisper to begin to move freely, tospeak firmly, and even to smear and mess withoutfear of loss of control or overwhelming guilt . Al-though some rather smeary paintings were his lastproducts of the summer, his choice of a balanced,yet free painting as a gift for his therapist monthslater reflects the integration he was, by then, ableto achieve (Fig . 11c) .

In all of these modifications of the art interview,the basic principle has been to allow the individualto structure as much as possible of the situation forhimself, compatible with his characteristics and thegoals of the interview. The assumption implicit inthis methodology is in agreement with a statementby Harms (1948), that "we do best for any diag-nostic purpose if we give the patient `completefreedom' to reveal his own unique reaction" (p .243) . So far, the richness of the data yielded in oneintensive hour spent in the unstructured format firstdescribed, seems to make this a useful addition toother projective expressive methods .

REFERENCES

ALSCHULER, R. and HATTWICK, I . . W. (1947) Paintingand Personality : A Study of Young Children (2 Vols .),Univ. Chicago Press, Chicago .

AMES, L . B . (1943) The Gesell incomplete man test as adifferential indicator of average and superior behavior inpreschool children, J. Genet. P.sychol. 62, 217-274 .

BENDER, L. (1938) A visual motor Gestalt test and itsclinical, use, Res, Morrogr Amer. Orthopsychtat . Ass, No .3,

BENDER, L. (1952) Child Psychiatric Techniques, CharlesC. Thomas, Springfield, HI .

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