The Vitality of Fragmentation: Desublimation and the Symbolic Order

This chapter will focus on theoretical, clinical and personal challenges surrounding my work as an art therapist in an adult outpatient service of a psychiatric hospital. The evolution of my thinking pervades my clinical work with the client discussed in the vignette, as I sought to integrate desublimation from art theory and philosophy with psychoanalytic theory. (Thompson, 2007). When I first met Evelyn, who is diagnosed with Schizoaffective Disorder, she was hospitalized, constantly agitated and psychotic with auditory hallucinations, severe labile mood, disorganization in cognition and behavior and paranoid delusions, linked to her experience of the polarizing states of grandiosity and inferiority. She constantly sought to expel the experience of being belittled and hurt by projections and hostile attacks on other patients and clinicians. As a result, she was frequently expelled from verbal group psychotherapy after vicious angry attacks on peers and therapists. She could frequently be seen pacing the hospital corridors while engaged in an angry verbal monologue of diatribes. Evelyn’s physical appearance was also notable for her reliance on trailing scarves, jewelry, and numerous bags and necklaces, strung impossibly around her body. Staff and fellow patients at the center would consciously avoid her when she approached, anticipating the inevitable hostile barrage of affect, fueled by paranoid ideation. In this chapter I will describe the process, challenges and outcome in our work together over a four-year period. I hoped that the seemingly impossible task of developing a meaningful relationship with Evelyn, one, that might support therapeutic growth through the intermediary container of art, could be accomplished. Ironically, some of the later breakthroughs of our time together were the direct result of a Derridean deconstructive approach to initial models of art therapy. (Derrida, 1997). Evelyn had become part of the complex narrative of the institution, the psychiatric hospital, which co-creates shared meanings. In the case of Evelyn the hopelessness surrounding her pervaded the milieu and was mirrored leading to a shared sense of marginalization and failure. This was a familiar narrative when I met her and it extended to her tentative and abortive relationship with art and art therapy. (Fig. 1) Traditional models of art therapy that are quintessentially modernist employ some basic assumptions regarding pivotal aspects of art and creativity. These will be explored in the chapter and include the Symbolic Order, sublimation, desublimation, and embedded in these areas are the roles of regression, repression, selfidentity, rationality and the irrational.


Introduction
This chapter will focus on theoretical, clinical and personal challenges surrounding my work as an art therapist in an adult outpatient service of a psychiatric hospital.The evolution of my thinking pervades my clinical work with the client discussed in the vignette, as I sought to integrate desublimation from art theory and philosophy with psychoanalytic theory.(Thompson, 2007).When I first met Evelyn, who is diagnosed with Schizoaffective Disorder, she was hospitalized, constantly agitated and psychotic with auditory hallucinations, severe labile mood, disorganization in cognition and behavior and paranoid delusions, linked to her experience of the polarizing states of grandiosity and inferiority.She constantly sought to expel the experience of being belittled and hurt by projections and hostile attacks on other patients and clinicians.As a result, she was frequently expelled from verbal group psychotherapy after vicious angry attacks on peers and therapists.She could frequently be seen pacing the hospital corridors while engaged in an angry verbal monologue of diatribes.Evelyn's physical appearance was also notable for her reliance on trailing scarves, jewelry, and numerous bags and necklaces, strung impossibly around her body.Staff and fellow patients at the center would consciously avoid her when she approached, anticipating the inevitable hostile barrage of affect, fueled by paranoid ideation.In this chapter I will describe the process, challenges and outcome in our work together over a four-year period.I hoped that the seemingly impossible task of developing a meaningful relationship with Evelyn, one, that might support therapeutic growth through the intermediary container of art, could be accomplished.Ironically, some of the later breakthroughs of our time together were the direct result of a Derridean deconstructive approach to initial models of art therapy.(Derrida, 1997).Evelyn had become part of the complex narrative of the institution, the psychiatric hospital, which co-creates shared meanings.In the case of Evelyn the hopelessness surrounding her pervaded the milieu and was mirrored leading to a shared sense of marginalization and failure.This was a familiar narrative when I met her and it extended to her tentative and abortive relationship with art and art therapy.(Fig. 1) Traditional models of art therapy that are quintessentially modernist employ some basic assumptions regarding pivotal aspects of art and creativity.These will be explored in the chapter and include the Symbolic Order, sublimation, desublimation, and embedded in these areas are the roles of regression, repression, selfidentity, rationality and the irrational.

The Symbolic Order
The Symbolic Order pertains to the conception of art and language within cultural parameters and is relevant in this case because it can either assist or hinder an understanding of what constitutes art.Art therapy has historically adopted the symbolic order of modernism without questioning its validity, and especially its relevance or efficacy with challenging populations such those individuals seen within the psychotic spectrum disorders.This approach has contributed to the sense of impasse and failure of art, thus joining the psychoanalytic understanding that psychotic patients are unable to participate in the shared discourse of symbolic meanings prominent in language.(Wrye, 1993).During the course of modernism art has developed along a continuum of new, avant-garde movements each progressing in a temporal rhythm.Art history has tended towards reading ontological development of a system codifying visual form.This type of codification is the substance of the modernist epoch that stressed logical and organic growth so that, at least officially, it appeared the multiple "isms" flow naturally from one to another.The end game of modern art became entrenched in what the art historian Greenberg (1965Greenberg ( , 2003) ) described

www.intechopen.com
The Vitality of Fragmentation: Desublimation and the Symbolic Order 93 as formalism.Formalism, briefly, postulated that modern art was driven to advance only those characteristics deemed integral to a specific medium.The metaphor of art originating and developing as an organism bears similarities to developmental theories and especially psychoanalytic drive theory that stresses mastery and maturation of biologically derived stages of growth and development.Both fields harnessed movement towards rationalism and integration but there are exceptions.The site and the specifics of these exceptions are important because they point towards alternative means of generating meaning.Exceptions can be seen as ruptures that provide opportunities to reconfigure the generation of meaning and in this particular case offer a reparative window through which Evelyn could find beauty and success.As if anticipating these difficulties and minimizing potential ruptures and impurities, cubism's radical departure was interpreted smoothly within this continuum.Differences are swept aside in the overarching historical reading that stresses the continuum of visual form.One of these sites is the historical period of Impressionism, where modernism supported the development in both art and early psychoanalysis of the symbolic order.The graphic supremacy of the line disappeared in the impressionist's small individual dabs of color as the form is designed to appear magically in our own eyes as a direct result of optically mixing the separate colors.Nineteenth century color theories were influential in lending a measure of scientific respectability to the avant-garde.The final reading and cognitive grasp of the painting in the (optical) unconscious took place through the cohering of all the separate interacting colors.Voila!The haystack, bridge or landscape is there to behold in Technicolor, magically solidified as the visual proof of the artist's authentic vision.Clark (1999) reiterates the connection between the optical mix integral to the impressionists and both Helmholtz and Freud.Freud (as cited in Clark, 1999) states, "The intention of this project is to furnish us with a psychology which shall be a natural science: its aim, is to represent psychical processes as quantitatively determined states of specifiable material particles and so to make them plain and void of contradictions."(p.139) Clark (1999) explains more on this connection that a young Freud (writing in 1895) is "still struggling to think the unconscious in a language borrowed from Helmholtz and Fechner."(p.142).The coherence of visual images configured as an aspect of unconscious processing informed Freud's psychology of the unconscious and these in turn would then be reapplied throughout modernism by providing the ready model that Ehrenzweig (1971) used to advocate a hidden order.Sense can always be made of seemingly irrational images or forms because all will conform to this biological drive to cohere incoming perceptions.Even analytic cubism and the drip paintings of Jackson Pollack could then be made conform to the cultural expectation of the symbolic order, as the significance of the seeming irrational and sheer incomprehensibility of this radical form of painting suddenly conforms after all.The connections between "high art" and psychological theory colluded spawning alliances such as Winnicott's (1971) squiggle technique and the use of such spontaneous images in art therapy.(Cane,1989;Naumburg, 1987).This model has repercussions in contemporary art and in art therapy practices, where non-conforming art is marginalized, unless it can be retrieved within the dubious frame of "Outsider" art.In Evelyn's case her fragmented paintings (see Fig. 1) embody the frustration that taps the parallel process of her own psyche and the apparent failure to enter true symbolic communication.

Sublimation and art therapy
Evelyn's sense of failure emanates partly from the therapeutic frame that can pathologize intrapsychic fragmentation and from the pivotal model of art therapy that relies heavily on the psychoanalytic concept of sublimation.Freud (1989) on sublimation explains, "the transformation of object-libido into narcissistic libido which thus takes place obviously implies an abandonment of the sexual aims, a desexualization-a kind of sublimation, therefore.Indeed the question arises, and deserves careful consideration, whether this is not the universal road to sublimation, whether all sublimation does not take place through the mediation of the ego, which begins changing sexual object-libido into narcissistic libido and then, perhaps, goes on to give it another aim."(pp.24-25) An early pioneer of art therapy, Edith Kramer (2001) echoes this, "whereby primitive urges, emanating from the id, are transformed by the ego into complex acts that do not serve direct instinctual gratification."(p.28).Sublimation completes a temporal sequence that takes place from the innate and primitive drives culminating in a final form, transformed by the dynamic mechanism of psychic process that can then communicate within the accepted norms of cultural speech, the symbolic order.This takes the shape of interpersonal communication in language or in art the product and its imagery, may be referred to as Naumburg (1987) did as symbolic speech.Green (1999) charts the original course of sublimation from Freud's early work where it was conceived in direct relationship to the drives acting as a kind of bridge between sexual energy and aims, becoming diverted or displaced within the matrix of society (p.217).As regression loosens the ego's control on primary process some of the newly tapped energy must escape repression; "sublimation has indeed to be considered in relation to repression: namely, as the outcome of a certain drive quota which has partially escaped its action."(p.218).Green explains that the duality of repression and sublimation is a continual process, with repression occurring, "each time there is a return of the repressed liable to 'let through' repressed material."(p.218).Sublimation, according to Green (1999) is a "vicissitude of the drive but also as a deviation of this same vicissitude."(p.218).This deviation particularly interests Green because it focuses on the negative or anti-sexual aspect of sublimation.Green describes this negative as reinforcing the narcissistic self from "a retreat into the ego, corresponding to a desexualisation, [that] results in a unification, a kind of total unity [and] the ego, thus invested (through identification) with the finery of the object, has desexualized its relations with the latter and, ceasing to love it, sets itself up as its rival."(p.226).Kramer (1971) proposed five distinct ways of using art materials, precursory activities, chaotic discharge, art in the service of defense, pictographs and finally formed expression (p.54) The five stages echo developmental theory and constitute a hierarchy with formed expression as the most advanced and desirable.As such it is also where sublimation has been most successful; it attains "the production of symbolic configurations that successfully serve both self-expression and communication." (p. 55).With all systems of hierarchies inferiority lurks and so it is with these stages that privilege a certain pedigree of aesthetic form.The form that is favored by Kramer is usually representational and aspects from the earlier stages are described using the focus on what is lacking or deficient, for example "scribbling, smearing; exploration of physical properties that does not lead to creation of symbolic configurations, [or] banal conventional production… pictographs are, as a rule, crudely executed" (p.54).Kramer linked the five stages to the relationship between the sublimated images to how successful the therapeutic encounter as a measure.When difficulties arise with sublimated art, Kramer sometimes used the term pseudo-art, a term that resembles Green's (1986) characterization of pseudo-sublimation.Henley (1992) weighs in on Kramer's linkage of sublimation of formed expression with how successful a given therapeutic intervention is, coming down with some reservations, in support.Henley believes that "a model of aesthetics and even art criticism can be constructed that is commensurate with the aims of therapy without diluting the intent of either discipline."(p.153).Henley questions Kramer's criticism of the primitivism associated with Art Brut that "an intelligible communication is either obscured or so alien that it invites speculation regarding the problems of its maker."(p.154).Primitive art is irreconcilable in Kramer's paradigm because it fails to meet certain judgments regarding its ability to communicate inviting Kramer to speculate about the health of the artist/client.Severe psychopathology characteristic of extreme regression of psychosis can compromise artistic integrity and at such times "aesthetic expectation should be all but suspended."(Henley 1992. p. 161).Knafo (2002) describes the way that regression in the service of creativity can produce mental states that have similarities to psychosis, stating: "These processes resemble childlike states or characteristics generally associated with madness…[except]…they are under the artist's control in the sense that he or she has the capacity to make the transition from these states to others requiring observation, discipline, and criticism."(p.46) The ability to step back and forth in this regressed state is the hallmark of creativity and the specialization of the artist.This phenomenon relates to the function of the observing ego and the way the art object occupies transitional space (Winnicott, 1971) providing psychic distance between self and other.Through the use of art the ability to navigate between these different realms of the psyche could be accomplished.Given this particular scenario does it really make sense to abandon aesthetic criteria since this is the substance of the regressive/creative state of mind?This is the intertwined relation between madness and art and the aesthetic imperative perhaps is to focus on their meeting rather than abandoning the task.Foucault's (1973) observation that madness is incompatible with art persistently shadows this discussion; Foucault stated, "Artaud's madness does not slip through the fissures of the work of art; his madness is precisely the absence of the work of art, the reiterated presence of that absence, its central void experienced and measured in all its endless dimensions."(p.287).Nietzsche's demise, Foucault explains comes at the point when the philosopher's art disappears from the "very annihilation of the work of art, the point where it becomes impossible and where it becomes silent …[and]… Van Gogh, who did not want to ask 'permission from his doctors to paint pictures,' knew quite well that his work and his madness were incompatible."(p.287).

Fragmentation, regression and creativity
A psychoanalytic concept developed by Kris (1952) called regression in the service of the ego illustrates how creativity is intertwined with regression.Kris was interested in delineating the role of regression in both pathological and non-pathological states, acknowledging that with important differences this phenomenon taken to its logical conclusion on the one hand can lead to the type of psychosis found in schizophrenia and on the other the highest cultural products in art.Kris (1975) explains the difference between a creative individual and a "psychotic artist" is the concrete nature of the depictions, "…words are not signs but acts, pictures tend to become verdicts, and creation may mean 'making' in a literal and magical sense."(p.488).The ability of the ego to loosen control as a result what Freud (1989) called a flexibility of repression while not becoming engulfed was seen by Kris (1975) to be an essential element of the creative process.This permits primary process to be used in the service of the ego, which retains control of the psychic processes, and art is communicative rather than in psychotic experience, concrete and magical.The healthier characterization of creativity that Kris (1975) formulated were taken up by the psychoanalytic theorists that comprise of the group referred to as ego psychology; this movement was oriented towards an understanding of the adaptive functions and structure of the ego and its relative defenses.More recently, Knafo (2002) summarized Kris' theories regarding creativity and his assertion of two main phases, "During the first inspirational phase, the artist is passively receptive to id impulses [that are] otherwise hidden and unavailable, emerge to communicate with the ego." (p.26).The second phase of elaboration "calls for the artist's active use of such ego functions as reality testing, formulation, and communication."(p.27).This resembles Freud's (1966) concept of secondary revision, and Ehrenzweig's (1971) application of secondary process to locate rationality in art.The artist displays a flexibility regarding relative control in the dynamic relationship between the ego and the id and the ability to move back and forth in these levels of consciousness.Freud (1989) describes the substance of primary process relating to instinctual drives that seek satisfaction through discharge and, that an instinct deriving from one particular erotogenic source can make over its intensity to reinforce another component instinct originating from another source, that the satisfaction of one instinct can take the place of the satisfaction of another.(p.43) The source of energies emanates from the vast store of id characterized by sexual, aggressive and narcissistic instincts or drives and Freud (1989) theorized that as these energies are cathected to objects, the satisfaction of instinctual impulses can be displaced.Freud explained, "it was in dream-work that we first came upon this kind of looseness in the displacements brought about by primary process."(p.44).Freud continues, if this displaceable energy is desexualized libido, it may also be described as sublimated energy; for it would still retain the main purpose of Eros-that of uniting and binding-in so far as it helps towards establishing the unity, or tendency toward unity, which is particularly a characteristic of the ego." (p.44) Freud (1989) writes concerning obsessional neurosis that "through a regression to a pregenital organization, for the love impulses to transform themselves into impulses of aggression against the object."(p.55).When the tendency towards unity fails due to severe pathological states fragmentation can result.The aggression unleashed upon objects can fragment and potentially destroy the object.While Knafo (2002) and Kris (1952) before her sought to depathologize regression, the dual processes that lead to either art or psychosis are linked and share the same foundational psychological processes.Therefore, "if regression predominates the symbols used in the artwork are egocentric and take on private meaning" (Knafo, 2002, p. 27) which pushes the work towards the continuum of psychosis.Egocentric might mean personal and inscrutable because in psychosis the images are often characterized as private, falling short of partaking in the community of either visual or verbal forms of symbolic speech.The psychology of the self and the generation of meaning that is dependent on growth within the symbolic order could perceive this as precipitating a crisis of faith.This is the prevalent frame that Wrye (1993) discusses, when "very disturbed patients often begin treatment unable to enter into the therapist's verbal-symbolic framework.Without the capacity to communicate with and understand symbolic language, experience remains concrete.Such individuals cannot enter into the world of consensual meaning."(p.115).The incomprehensible images, words and behavior reinforce Evelyn's and the institution's sense of the symbolic void.Desublimation will illustrate an alternative means of generating meaning where comprehension reigns.The regression to magical procedure might contribute to confusion with reality but the navigable path out of this could be the same creative process.The fragmentation involved in the creative process can find itself at odds within the frame of art therapy when the broken, fragment, piece, or unintegrated meshes with psychological conception of splits, schizoid, schizophrenic and psychotic process.An integral part of creativity is then linked to pathology and may be seen as interesting but unformed and essentially lacking the integration that is necessary for wholeness.

Desublimation in art and art therapy
The transcendent function of art that has been the hallowed ground of the modern era has been challenged by the philosophy of structuralism and post-structuralism.Krauss (1987) explains the depth of these ramifications: "On the one hand, structuralism rejected the historicist model as the means to understand the generation of meaning.On the other, within the work of poststructuralism, those timeless, transhistorical forms, which had been seen as indestructible categories wherein aesthetic development took place, were themselves opened to historical analysis and placement."(p. 2) Thinking about a work of art as a structure challenges the dominant ontological model and permitted radically new discussions of how meaning in art can be generated.One gap or rupture in the symbolic order is the conception of a revitalized gestalt operating in analytical cubism (roughly the period between [1908][1909][1910][1911][1912].The desperate attempt to rationalize the fragmentary and split planes of cubism was required to maintain the historical evolution of progressive modern art.Form can be reconfigured, as it was in cubism, so that it will not cohere into a logical and hence progressive order that makes sense.As the cubist forms lurch, fragment and unravel there may in fact be the flavor of irrationality, but of a qualitatively different character to the primary process more characteristic of regression.Desublimation in my text is not the reverse of sublimation, not pseudo-sublimation or unsublimation, or the type of overt sexual images that Jones (2003) describes as desublimation occurring in surrealism.(p.122).Rather, it originates from the insight that gestalt could be seen as resembling a state of flux as it offers a multiplicity of possible configurations rather than a correct one that compels the order of the good gestalt.Einstein (2004) wrote "…by means of art, one attempts to contest deadly generalizations and the rationalistic impoverishment of the world, to sever the chains of causality, to unravel the web of significations."(p.174).The separate planes that Einstein refers to in cubism are deliberately fragmentary to subvert the nature of vision by preventing and interrupting the tendency to order form.Desublimation works in cubism by undermining the concept of the mnemonic in art, radically altering the cognitive sense of seeing a work of art as a totality with a fixed structure.The fragments of planes do not make sense in the usual way of building an image in the mind from scanning the temporal sequences and utilizing memory and causality to connect this piece with the next.Zeidler (2004) describes the challenge that was evoked in the critical texts of Einstein who began to question the idea of a work of art that exists as "a sublimated version of everyday experience."(p.5).The idea of the art object in modernism representing an epistemological regime was one of the main challenges of the work of Einstein.He identified the work produced during Analytic cubism as a testament to a rupture in the episteme.Perhaps Ehrenzweig (1971) was right after all when he envisioned cubism as an attack on conscious sensibilities.However the source of this affront was not the characteristic of schizoid fragmentation awash in primary process resulting from the alienating destruction of humanism, that he feared, but rather the optical challenge to the notion of form as a fixed and hence predictable and logical organism.The desublimated form challenges the idea of the connection to the work of art transformed into "a reconfiguration of the world into a 'world seen.'"(Zeidler, 2004. p. 30).In this methodology of embodied vision the artist presents for the viewer, the potential to construct a subjective identity construction: "…a world made over into a set of stimuli to be synthesized by a subject's vision: a world in which appearance takes precedence over object and where pictorial means no longer served to clarify the objective order of things."(p.30).The preceding discussion helps to illustrate that art history, theory and even criticism brings an urgency as well as agency to the pivotal role of art in art therapy.The opening that desublimation affords changes the context for meaning making and challenges the prevailing theories outlined.The foundational theory involving sublimation, regression and repression bends the art to conform to this paradigm, This has resulted in pathologizing work that reflects incompleteness.Kramer (1971) wrote, "we know in particular that disturbances in feelings of identity and personal intactness invariably reveal themselves by distortions and fragmentations of the visual images" (p.29).The relationship of the unsublimated and fragmented work of art to satisfying the demands of the pleasure principle will be at best an incomplete wish fulfillment "limited by his pathology, the state of his ego, his manual skill, his 'talent,' and many other factors."(p.29).Green (1986) also examined pseudo-sublimation that might also be named a defensive sublimation or a failed sublimation and states "undeniably, there do exist sublimations which are the offspring of certain pathological forms.These can be viewed as emergency exits from conflict" (p.132).Green (1986) links pseudo-sublimation to personality types who demonstrate a moral narcissism and the partial pleasure afforded by incomplete sublimation to the potential of "the essential part of this observation of the ego is the completion of the constitution of what Winnicott calls a false self."(p.133).The identification with the false self blocks the connection to the generative inner core where true creativity resides.The false self "also functions to limit and to block the symbol-making capacities of mental life, because of the important role that unconscious processes play in the image-making processes of the mind."(Dragstedt, 1998. p. 498).This state of "living is superficial, and it often contributes to states of claustrophobia, preoccupation with self-image, and acting-out archaic relationships with the body."(p.498).Deconstructing the relationship between sublimation, regression, and art helps to reveal how subjective identification emerges within culture to circumscribe belief systems.Dualism informs this or that, high/low, true/false logic whereas desublimation leads to another kind of mental space free of these stifling parameters.Embedded in these structures are power relations in which Foucault (1984) sought to understand the "…modes of objectification which transform human beings into subjects."(p.417).This is primarily achieved through dividing practices, "The subject is either divided inside himself or divided from others.This process objectivizes him.Examples are the mad and the sane, the sick and the healthy, the criminals and the 'good boys.'"(p.417) Fragmentation in the art in art therapy is enormously difficult to separate from this kind of dividing practice, where it easily can be linked or interpreted as evidence of pathology or a kind of "not good-enough" sublimation.The undoing of form, honoring fragmentation as a gestalt ever changing, permits a dialogue with these archaic relationships to the body, accessing the regenerative healthy core, giving it form and substance as it pulls apart conventions.

Vignette
Evelyn is a sixty eight year old woman who currently attends a Community Mental Health partial hospitalization service for severely mentally ill adults.She was first diagnosed with mental illness at age twenty-four after an aborted suicide attempt.She earned a college degree and worked as a Kindergarten teacher for twenty-seven years before retiring on a medical disability related to her current psychiatric diagnosis of Schizoaffective Disorder Bipolar type.She participates in psychotherapy and other therapeutic regimes including art therapy producing many paintings like the example in Figure 1 and Figure 2 that lend clarity to the stages described by Kramer (1971).These paintings are crudely executed and seem to accentuate the fragmented split between Evelyn and the reality of the world around her.They fit with the following description and as such they seem to fall short of Kramer's coveted status of formed expression, (p.54) belonging instead to the level characterized as pictographs and "art in the service of defence" (p.121) reflecting, "bland stereotypes that are dull, repetitious, and conventional; work that is rigid and stereotyped but presents unusual or bizarre configurations; work that is filled with false sentiment, such as saccharine sweetness, hollow heroism, or false piety."(p.122) Evelyn had produced many of these bland paintings with daubed text describing sentimental messages and depictions of flowers incongruent with her frequent paranoid raging attacks.Empathic support and various interventions all appeared inconsequential to this repetitive cycle that provided the artistic equivalent of acute fragmentation with the resulting negativity and frustration.With traditional materials such as paint and pencils Evelyn stubbornly derailed any attempts to continue in an engaged, prolonged manner with the images.Green's (1999) conception of the negative relates to Evelyn's wall of incomprehension.Green cites Bion's work on the positive (+K) and the negative (-K) attributes of knowledge when "-K is not content with qualifying the negative in terms of an insufficiency or deficit; it gives it status.Not-understanding is brought into play by the patient's psyche when it is in his interest to stop understanding.This is a widely encountered phenomenon.It is with psychotic patients, or in Bion's terminology, with the psychotic part of the personality, that the specific nature of this mechanism can be pinpointed."(p. 8-9) The concept of attack on linking (Bion, 1967) meshes with the process by which Evelyn at times appears incapable of knowing or understanding.The splitting of parts of the self and others into bizarre objects that are then perceived "out there" as inhabiting the dangerous and destructive world infects the milieu.The theories outlined earlier now appear to make sense with this dynamic, when the art experience follows a format that would require linking, integration and sublimation, working images towards a sense of completion and wholeness the psychic level of fragmentation intrusively impinges upon the process.The smoothness of paint and the insubstantiality of pencils were quickly sabotaged and aborted as a result of the fragmented nature of Evelyn's cognitive and affective chaos, leading to further disconnection and fragmentation.Derrida (1997) calls the absolute break by introducing a radical newness without discarding the existing framework, instead finding a phenomenological openness to art, materials and intersubjective space.Part of this orientation involves a slow temporal discovery of the sense of self as an artist, initially through a sustained focus on the constituents of artistic sensibility.(Thompson, 2009).After introducing collage to Evelyn many significant changes took place.Collage confronts fragmentation directly with the potential to hold disparate ideas and affects while honoring fragmentation and differences.(Figure 3) I thought of the desire of Close (2004) to use multiple fragments in his paintings to subvert and prevent the image from cohering into a whole.What would happen if Evelyn began making images that do not cohere from an aesthetic perspective as opposed to the incomplete sublimation resulting from regression?The sculpture that Evelyn titled appropriately "A Portrait of Beauty" (Figures 4 & 5) resulted from her increased investment, going-on-being (Winnicott, 1986) over the period of one year, realizing her vision of beauty, standing as a testament to the strong therapeutic alliance that developed between us.The apparent contradictions in the work are a mark of its complexity and result in part from the slow temporal unfolding.In this way the individual history that informs the way the materials are joined has now become a palpable presence.The sculpture has the embodied affect contained in the visible fragments that are tied together and the invisibility of the negative three-dimensional space that almost magically supports the structure.The sculpture reiterates Lyotard's (1984)  Stepping in and out and back and forth was necessary to complete this work and required careful negotiation and increased self-and body-awareness heightening the physical presence that in turn strengthened Evelyn's spatial-kinesthetic sense -previously she had a history of falls (not explained medically) that now had stopped.
The slow incremental use of the disparate fragments of wood, paper, tissue, wire, beads, and styrofoam derailed the derailing from the internal attacks on linking.Aesthetic action (Thompson, 2010) guided Evelyn as she found herself freed from the confines of the symbolic order.Evelyn discovered that desublimation leads to a new and exciting configuration where a lack is not a hindrance; the negative becomes knowledge since it is operating beyond the reach of the dualistic parameters of whole/broken or integration/disintegration.Thus, it relates to the stage of being or becoming that is related to unintegration; a value-neutral process of being that Winnicott (1986) describes as necessary for the development of ego integration.Abandoning convention does not mean spiraling through a regression where primary process abounds; rather it permits possibility by embracing all the separate pieces, fragments, thoughts, affects embodied and worked on through the safe, meditative action of tying and binding.The abstraction of form also released the cultural and self-imposed constraints that influence how representational art should appear as the sculpture now reads as a self-portrait.Evelyn revealed during the course of this work that she had been estranged from her twin sister for many years, a disclosure that throws new light on the twin roles that The Portrait of Beauty may hold for her.Her jealousy of her healthy, successful sister with a loving family had been intolerable for Evelyn, since she is acutely self conscious of failure, the stigma of severe mental illness and the debilitating physical effects of Hailey-Hailey's disease (hereditary skin eczema).This sculpture had been made during an art therapy group with non-English speaking patients, an unusual paradoxical example of the positive attributes of the language barrier -Evelyn felt safe enabling her paranoid ideation to subside and the group-as-a-whole were blissfully unaware of her anger and sadistic attacks which also rapidly discontinued.The tilt of the final piece captures Evelyn's gait and posture and strikingly she shed her bizarre manner of dress with multiple scarves, necklaces and handbags, as the symbolic equivalents were bound together in aesthetic form.A Portrait of Beauty exceeds the stage of formed expression achieved with the fragmentary now sublimated in the desublimated form that permits this new conception; the fragments remain distinct.The sculpture surprises and overpowers clinicians and peers alike as testament to the generative power of creativity allowed to develop and unfold on Evelyn's own terms.This phenomenon desublimates the viewer's sensory experience forcing a radical new appreciation of the artist and her oeuvre.(Marcuse, 1978).Seasoned clinicians marveled at her work leading to a positive reappraisal of Evelyn, unimaginable prior to this undertaking!It was selected from over several hundred submissions to an Outsider art Exhibition in New York City and later exhibited and subsequently sold, in the gallery at the hospital she attends, completing the cycle from studio to gallery within the institution that is confronted with Evelyn, now visible as a unique, skilled and beautiful person, rather than a patient with severe mental illness (Thompson, 2009).Desublimated art can alter form, freeing it from the stifling repressive symbolic order, to permit coherence within an alternative paradigm while remaining fragmentary.Desublimation is the aesthetic dismantling of form, supporting the multiplicity of self.The sculpture shows the process of Evelyn's attempt to construct recognizable and knowable patterns and arrangements that contain new patterns.Amidst these new patterns the poetic containment of trauma, ruptures, attacks and nihilistic yearnings can be empathetically perceived, as perhaps the sculptural form of desublimation accesses both the return of the repressed and the dissociated experiences caused by trauma.(Van der Kolk and Van der Hart, 1995).The holistic totality of this experience had several parallel effects on the therapist, the client, and the institution itself leading to openings based in the real and tangible feeling and experience of success and hope.Evelyn now at times co-leads groups with therapist and has returned to more conventional painting that is now invested with tremendous care, love and she has progressed closer to the goal she shares with the notable artist Agnes Martin, (1992) to find inspiration and beauty in oneself and in the world.
Evelyn has after all integrated self, accepting imperfections while tolerating many stressful situations that previously may have triggered severe decompensation and possible hospitalization. 92

Fig. 3 .
Fig. 3. Collage.Tempera & Paper on Paper.I wanted to introduce whatDerrida (1997) calls the absolute break by introducing a radical newness without discarding the existing framework, instead finding a phenomenological openness to art, materials and intersubjective space.Part of this orientation involves a slow temporal discovery of the sense of self as an artist, initially through a sustained focus on the constituents of artistic sensibility.(Thompson, 2009).After introducing collage to Evelyn many significant changes took place.Collage confronts fragmentation directly with the potential to hold disparate ideas and affects while honoring fragmentation and differences.(Figure3) I thought of the desire ofClose (2004) to use multiple fragments in his paintings to subvert and prevent the image from cohering into a whole.What would happen if Evelyn began making images that do not cohere from an aesthetic perspective as opposed to the incomplete sublimation resulting from regression?The sculpture that Evelyn titled appropriately "A Portrait of Beauty" (Figures4 & 5) resulted from her increased investment, going-on-being(Winnicott, 1986) over the period of one year, realizing her vision of beauty, standing as a testament to the strong therapeutic alliance that developed between us.The apparent contradictions in the work are a mark of its complexity and result in part from the slow temporal unfolding.In this way the individual history that informs the way the materials are joined has now become a palpable presence.The sculpture has the embodied affect contained in the visible fragments that are tied together and the invisibility of the negative three-dimensional space that almost magically supports the structure.The sculpture reiteratesLyotard's (1984) description, "What is important in a text is not what it means, but what it does and incites to do.What it does: the charge of affect it contains and transmits."(pp, 9-10) The desublimated form can harness this affective charge in a powerful way.Since this sculpture was so large (eight feet tall) the phenomenon of Fig. 4. A Portrait of Beauty.Syrofoam, Fig. 5.A Portrait of Beauty.Detail.beinginside heightened the sense of play thatWinnicott (1986) describes as transitional space, the intermediate zone between what is me and not me (p.45).Stepping in and out and back and forth was necessary to complete this work and required careful negotiation and increased self-and body-awareness heightening the physical presence that in turn strengthened Evelyn's spatial-kinesthetic sense -previously she had a history of falls (not explained medically) that now had stopped.The slow incremental use of the disparate fragments of wood, paper, tissue, wire, beads, and styrofoam derailed the derailing from the internal attacks on linking.Aesthetic action(Thompson, 2010) guided Evelyn as she found herself freed from the confines of the symbolic order.Evelyn discovered that desublimation leads to a new and exciting configuration where a lack is not a hindrance; the negative becomes knowledge since it is operating beyond the reach of the dualistic parameters of whole/broken or integration/disintegration.Thus, it relates to the stage of being or becoming that is related to unintegration; a value-neutral process of being thatWinnicott (1986) describes as necessary for the development of ego integration.Abandoning convention does not mean spiraling through a regression where primary process abounds; rather it permits possibility by