Drawing on the end of life : art therapy, spirituality and palliative care

Art therapy practice in palliative care offers a creative way of responding to the emotional, psychological and spiritual needs of the dying individual within the principles of integrated whole person care. In this research spirituality is identified and defined through a retrospective 'critical and imaginative ethnography of the everyday'. The methodology described in chapter two focuses on the ethnographic imagination and incorporates a reflexive approach to define the meaning-making that takes place in art therapy with people who are living with a life-threatening illness. The case studies focus on the artefacts created by the terminally ill and dying person within a typical art therapy intervention. The analysis reveals a variety of meanings attributed to the artefact with a particular emphasis on the spiritual significance of the art-making process and the drawings and paintings created. In order to achieve this reference is made to developments in practical theology as a way of throwing light on how art therapy can facilitate the expression and exploration of spiritual and religious areas of need. This is important for art therapy practice as spirituality in hospice and palliative care is considered to be an important concern and an essential dimension of support. The modem hospice movement has always valued this aspect of the experience of the terminally ill patient and continues to pay attention to the meaning of dying and death and its spiritual significance. The analysis of the art-making process and the artefacts in art therapy demonstrates the profound importance of meaning-making at the end of life. This also provides evidence of the contribution that art therapy can make to palliative care. This adds to the support of the continued relevance and preservation of a psychosocial model of care that integrates the emotional, spiritual, psychological, physical and social aspects of patient care. It also raises the profile of the pastoral dimension to care of the dying by placing art therapy as an allied profession to the role of chaplaincy within health care contexts. The argument in this study is that the integrated approach cannot be assumed to be a secular stronghold that ultimately marginalises the religious and spiritual significance of cultural and social relations. Spiritual and religious meaning continually refuses to disappear and occupies a significant place within the economy of health care practice. Throughout the modem hospice movement it has been argued that the bio-medical model has to be continually challenged and critiqued in order to prevent the erosion of psychosocial aspects of care. Equally, the organisations that provide the environment of care for the terminally ill and dying person need to foster a culture of open, reflective debate and dialogue to avoid institutionalised attitudes and behaviours becoming established that can ultimately crush the human spirit. Art therapy contributes to the community of hospice and palliative care as an integral part of the complex cultural and religious dimensions of human experience at the end of life.