THE ART OF HEALING- A JOURNEY THROUGH CANCER- IMPLICATIONS FOR ART THERAPY
A THESIS FOR THE AWARD OF MASTER OF ARTS
CARMEN ZAMMIT

Abstract

This thesis is designed to investigate how art assisted in the healing process of a person suffering from a life-threatening illness. The research method used is a clinical case study. This study is a form of evaluative research, a systematic data-based inquiry concerning the participant's engagement with art in her healing process, a process which unfolds as being both life affirming and spiritually enriching. This case study takes a qualitative approach, with its emphasis on the participant's own account of her behaviour. The participant is a fifty-three year old woman, a psychiatrist and psychotherapist, who was diagnosed with multiple myeloma seven years ago. Multiple myeloma is cancer of the bone marrow and blood, a medically incurable form of cancer (Mayo Clinic, 1996; Australian Institute of Health & Welfare, n.d.).

The principles of Holistic Medicine and Arts Medicine provide the theoretical framework. Data was accumulated from multiple sources: in-depth, open-ended interviews; direct observation; video-tapes; audio-tapes; written documentation and artwork. Art therapy literature reveals a scarcity of formal evaluative research in the area of how art assists people in their healing of a life-threatening illness (Malchiodi, 1993a, 1993b). This research project follows the tradition of existing studies and formally documents one person's journey. The aim is to assist in efforts to develop art interventions that will promote healing for people suffering from serious illnesses, and in many cases, those facing imminent death.
Introduction

All knowledge about reality begins with experience
and terminates in it.

- Albert Einstein (cited in Dossey, 1982, p.43)

The theory and practice of the scientific model of Western medicine has been documented in a vast body of literature that addresses virtually every kind of physical illness and its treatment. As a society we are predominantly informed by the rationales and successful applications of Western medical knowledge. This knowledge permeates our thinking; our personal responses to illness is inevitably and profoundly affected by its influence.

Despite enormous progress in the treatment of various diseases and an ever increasing understanding of medical conditions, a study of the literature related to the medical treatment of cancer reveals that medical knowledge is nevertheless limited (Borysenko, 1987; Dossey, 1982; Gawler, 1984; Meares, 1977, 1978; Pert, 1997). There are many people suffering from cancers for which there are still no medically effective treatments, no medical cures. In such cases perhaps our traditional, almost exclusive focus on a physically-oriented, primarily curative approach to illness has inhibited our ability to respond effectively and appropriately. A more comprehensive approach to critical illness appears necessary: a primarily preventative approach to illness, one which will encompass the totality of human experience, concerned not only with responding to people's physical symptoms, but also to their emotional, psychological and spiritual pain.

Alternative and complementary approaches have been developed to address the limitations perceived in traditional Western medicine. These approaches are sometimes referred to as holistic (Brennan, 1993; Drury, 1983; Hay, 1984; Norman, 1998; Pearce, 1989). Holistic health care is defined in this study as an eclectic approach to the care of oneself, an approach which sees disease as the physical manifestation of a deeper disturbance, and aims to engage the whole personality - the body, mind and spirit - in the healing process.

Although not yet generally investigated by the scientific community, holistic approaches are nevertheless becoming increasingly explored by cancer sufferers (Baron, 1985; Gawler, 1984, 1995; Meares, 1978; Siegel, 1986, 1990; Simonton, Matthews-Simonton & Creighton, 1978). There is an increasing body of evidence which suggests that holistic principles, in parallel with and in addition to the Western medical approach to healing, are proving effective in practice, that is, in treating and curing diseases previously diagnosed as medically untreatable and incurable (Chopra, 1989; Cilento, 1993; Gawler, 1995; Hirshberg & Barasch, 1995; LeShan, 1984; Simonton, Matthews-Simonton & Creighton, 1978).

This research documented one person's self-healing of a life-threatening illness: multiple myeloma, cancer of the bone marrow and blood. Multiple myeloma is a comparatively rare form of cancer which is usually fatal (Macpherson, 1995). Though rare, multiple myeloma shares the three properties found in all other cancers: uncontrolled cell growth, tissue invasion, and metastesis, that is, the tendency of the disease to spread throughout the body (Hellman & Everett, 1996). Statistics show that of an average of 60,000 people in Australia diagnosed with cancer in 1990, 706 (1.2%) people were diagnosed with multiple myeloma, (Australian Institute of Health & Welfare, n.d.). In 1990, an average of 30,000 (50%) deaths occurred due to cancer in Australia. Of these, 530 (0.6%) people were recorded to have died from multiple myeloma. In Western Australia alone, 49 people were diagnosed with multiple myeloma in 1990 and 39 (80%) people died from the disease.

The research participant's response to her diagnosis was initially to engage in traditional medical treatments. Her response at that time was congruent with her professional training. She was a medical practitioner - a qualified and experienced psychiatrist and psychotherapist. While still suffering from cancer, she discontinued her medical treatment to embark on a personal journey in which artwork became an essential tool in her healing process. Through her art she gained a deeper understanding of her illness, herself and her healing process; these insights ultimately contributing to her present state of well-being.

As of this date, art therapy literature reveals a scarcity of formal evaluative research on the therapeutic effects of art during life-threatening illness. Art therapist Cathy Malchiodi, editor of Art Therapy: Journal of the American Art Therapy Association, stated in her articles published in 1993 that no reliable data was available at that time to support the hypotheses made and the questions raised by art therapists and other clinicians about the role of art in the healing of people with critical illnesses (Malchiodi, 1993a, 1993b). In summary, the questions Malchiodi identified include: Are there clues in artwork that suggest the development or regression of disease? If so, could art be used as a diagnostic tool? Does art have predictive qualities that might indicate the likely outcome of an individual's illness? What interventions might be used at the different stages of the disease process? Does group support, in the case of those suffering from life-threatening illness, lengthen life or add to the quality of life, as Spiegel and McNiff's work might suggest (Spiegel, 1991; McNiff, 1992)? How is art healing? Malchiodi concluded that "long-term outcome studies ... may be necessary to begin to identify if there are properties of art expression which contribute to the health and well-being of a specific patient population or to physically ill individuals in general" (1993a, p.8).

The literature reviewed for this research project provides a number of studies which document personal testimonies and observations of the therapeutic value of art during critical illness. Diana Halliday, for example, found that art brought to her awareness psychological issues that she needed to process in order to heal (Halliday, 1988). She concluded that "creativity is life-giving and restoring" (1988, p.22). Christina Mango's work with a client diagnosed with Alzheimer's disease, showed that her client was producing work similar to work produced by cancer patients. Her client was later diagnosed with cancer. This case study showed evidence of the diagnostic and predictive qualities of art. Similarly, Tracy Councill looked at recurring themes in the artwork created by paediatric cancer patients in a hospital setting (Councill, 1993). She subsequently developed art interventions appropriate to specific, identifiable stages of the disease process. Associate Professor Elizabeth Predeger, using a "holistic nursing paradigm", discovered that a group of women survivors of breast cancer reported an overwhelming need for expression and for "actualising the need to express" their illness experience through art (Predeger, 1996). Ultimately, the study illustrated that "Chronic illness became an expansive, growth-producing event that allowed women permission to express and transcend through art and the group process" (1996, p.57).

This research project followed the tradition of these studies and formally documented one person's journey. The significance of this case study to the field of art therapy was that it addressed some of the questions identified by Cathy Malchiodi and others, primarily, how art assists healing in the case of a person with a life-threatening illness. This proved to be an information-rich case, one that was both instructive and inspirational in content. The results of this research may add to existing knowledge, and may provide the inspiration for further research. In broad terms, this study is anticipated to assist in the efforts to design, develop and implement art interventions that will promote healing for the many people with serious illnesses, those possibly facing imminent death.

 

Definition of Terms

I shall live a year, barely longer.
During that year let as much as possible be done.

- Joan of Arc (cited in Penson & Fisher, 1991, p.119)

 

Healing, Curing and Therapy

A review of the literature reveals that words such as "healing", "curing" and "therapy" are often used interchangeably, and so their meanings may become obscure. In order to clarify the meanings of the words, definitions from a dictionary source will be presented. These will be followed by excerpts from selected authors noted in the literature reviewed. These authors provide their own definitions of the words, in terms of their understanding of the experiences or concepts they intend to convey.

The word "cure" has its origins in the Latin word "cura", which means care, treatment, concern; also from the Medieval Latin (700-1500) root which conveyed the meaning "ecclesiastical [ie. churchly, spiritual] cure" (Macquarie University NSW, 1981, p.451). The definition, according to the Macquarie (Australian) Dictionary, is "(1) a method or course of remedial treatment, as for disease (2) successful remedial treatment; restoration to health (3) a means of healing or curing; a remedy (4) spiritual charge of the people in a certain district..."

"Heal" comes from a Middle English (1100-1500) word "hele(n)" and the Old English (before 1100) word "haelan" from the root word "hal" meaning whole (Macquarie University NSW, 1981, p.808). The dictionary definition is "(1) to make whole or sound; restore to health; to free from ailment (2) to free from anything evil or distressing; amend..."

The word "therapy" is derived from the Greek root "therapia" which means healing, and is defined in the Macquarie (Australian) Dictionary as "(1) the treatment of disease, disorder, defect, etc., as by some remedial or curative process (2) a curative power or quality" (Macquarie University NSW, 1981, p.1760).

Playwright and writer Barbara Graham suggests that: "being healed isn't the same as being cured. Healing is a process of becoming whole - physically and psychologically ... healing takes place even when the body weakens" (cited in Malchiodi, 1993, p.8).

Similarly, surgeon and author Bernie Siegal, M.D., writes:

To me 'healed' represents a condition of one's life; 'cured' relates strictly to one's physical condition. In other words, there may be healed quadriplegics and AIDS patients, and cured cancer patients who are leading unhealthy lives. What this means to me is that neither my patients nor I need ever face the inevitability of failure, for no matter how life-threatening their disease or how unlikely a cure, healing is always possible. (Siegel, 1990, p.136)

A number of writers associate illness with the loss of soul, and suggest that healing must necessarily include the spiritual level (Groff, 1993; Levine, 1987; McNiff, 1992). Healing in this sense consists in allowing or facilitating those forces for recovery that already exist in the person. In summary of this approach to illness are excerpts from the work of author and poet Stephen Levine, former director of the Hanuman Dying Project (U.S.A.), and teacher of meditation. He, together with his wife Ondrea, a former cancer sufferer, offer these insights:

If healing was as it seemed, the harmonising of the disquieted, a balancing of energies to bring about peace where there had been war, then healing clearly was not limited to the body, or even the visible. It includes the possibility of quieting even the deepest, unseen wounds - the discomforts which make death seem a respite ...

Healing is the growth that each person seeks. (Levine, 1987, p.3&4)

Seen from this perspective, physical survival is not the goal. From their experience of the thousands of people with whom they sat deathwatch, the Levines observed:

Though each seemed to experience a greater wellness, a sense of quiet completion, not all who opened to life survived in the body ... Some experienced their body returning to wholeness. Others experienced the wholeness of death. (1987, p.5)

... healing affects the heart at least as much as the body ... We saw again and again in those who seemed to heal their bodies a willingness to investigate with gentle clarity not just the pains of the moment but of a lifetime. We noticed yet a deeper healing in their hearts and minds, a deepening capacity to touch with mercy that which had been excluded during a lifetime ... Illness investigated had led to a melting of the ancient prison of one's own making. (1987, p.14)

In this research paper, the words "healing" and "curing" will be used in the same way as Stephen and Ondrea Levine, Bernie Siegal and Barbara Graham suggest. That is, the term "curing" will primarily relate to ameliorating the suffering of physical illness. The term "healing" will encompass the totality of experience, and will relate to ameliorating the person's physical, psychological, emotional and spiritual pain. As these authors point out, this means that though physical survival is possible, it is not necessarily the goal in the healing process. It is possible to succeed in improving one's living and one's dying.

Literature Review

Medical Literature on Cancer

Ultimately, the entire universe (with all its "particles",
including those constituting human beings,
their laboratories, observing instruments, etc.)
has to be understood as a single undivided whole,
in which analysis into separately and
independently existent parts has no fundamental status.

- David Bohm (1980, p.174-175)

Recent findings show that cancer, tragically, touches many lives. Globally, the World Health Organisation estimates that six million people die from cancer annually (Rennie & Rusting, 1996). In Australia alone, an average of 60,000 people are currently diagnosed with cancer each year, and annually 30,000 people die of cancer (Australian Institute of Health & Welfare, n.d.).

Medicine's response to cancer has not changed significantly in recent years. It is a uniform approach to a disease which takes more than a hundred forms (Weinberg, 1996). Treatment traditionally entails surgery, radiation and chemotherapy (Hellman & Everett, 1996). These treatments aim to combat the three key characteristics of cancer: uncontrolled cell growth, tissue invasion, and metastesis, that is, the tendency of the disease to spread throughout the body (Hellman & Everett, 1996).

While the traditional types of medical therapies have not as yet significantly changed, they have been refined to varying degrees, resulting in more effective treatments and cures for some forms of cancer (Fanning, 1997). Improvements have been made in two major areas: in improved diagnostic procedures and in improved administration of treatment. For example, chemotherapy may be given in smaller doses over a longer period of time, resulting in fewer side-effects such as nausea, vomiting and hair loss. Radiotherapy is becoming more sophisticated in that the amounts given are more accurate and treatment is becoming less generalised: the focus of treatment is more specific, more targeted, and consequently less harmful. Improvements in diagnostic procedures mean that some forms of cancer are detected earlier and are therefore treated earlier. The early diagnosis of cancer may prevent rigorous, painful treatment procedures, and may greatly improve the person's chances of survival.

The traditional, uniform approach to cancer has not proven to be highly effective. Scientists acknowledge the need for less rigorous and more effective treatments for specific cancers, with fewer negative side-effects. In their article Advancing Current Treatments for Cancer, Samuel Hellman and Everett Vokes, Professors at the University of Chicargo, suggest that:

Anticancer treatments should be safe, effective and discriminating. Their actions should be limited to cancer cells and should result in few, if any, side effects. Most important, treatment should consistently return the patient to his or her former state of health. (Hellman & Vokes, 1996, p.84)

Considerable scientific efforts are at present being focused on research into gene therapy and immunotherapy (Fanning, 1997; Old, 1996). One form of gene therapy involves introducing a gene into the body that will override the function of the mutant, potentially cancerous gene. This approach, considered by the medical profession to be a potentially preventative approach to cancer, is an attempt to detect tumour cells before they develop, thereby decreasing or completely eliminating the need for the rigours of traditional treatments. It aims to help those with a predisposition to cancer by correcting the disease at its source.

A second approach is to augment the body's immune response to the cancer by using a vaccine. The cancer vaccine differs from traditional vaccines in that it aims to cure rather than prevent cancer. This approach was developed in response to the observation that the immune system does not see tumour cells as being abnormal, and therefore does not attempt to eliminate them. To produce the vaccine, cancer cells are taken from the patient's tumour and a gene is added that will stimulate an immune system response. Melanoma, a malignant tumour derived from pigment-containing cells especially in skin cancer, is one form of cancer that already appears amenable to the vaccine approach.

T-cell immunotherapy trials are at present being conducted on children treated for tumours of bone marrow origin. In this procedure, the children are given bone marrow from another individual, with the donor's T-lymphocytes (the "killer" T-cells) being given along with the bone marrow transplant. This procedure has been found to prevent tumours in these children, who were previously immune suppressed and susceptible to developing cancer. It is hoped that this approach will be extended to other forms of lymphoma, which are not viral based and therefore do not respond to the vaccine approach.

Another approach involves introducing a gene into a cancer cell to render that cell more sensitive to chemotherapy. This form of gene therapy involves changing the DNA (deoxyribonucleic acid) so that a patient's cancer is much more susceptible to chemotherapy or to radiation, thereby facilitating the effectiveness of treatment. This approach is also in its trial phase of development.

In summary, conventional medicine's claims to success is well-founded for some forms of cancer. The diagnosis of cancer is no longer necessarily a death sentence; tens of thousands of lives are saved in Australia alone by the current technologies. Given the incubation period of two to five years for the development of the more malignant types of cancers (eg. lymphoma), and perhaps ten to thirty years for the development of the more common types of cancers (eg. breast cancer and bowel cancer), the treatments presently used are effective ("Topic of cancer", 1997).

Western medicine's claims to success and the focus on the technical efficiency of the treatment strategies may, however, disguise the limitations of the medical approach to cancer. One consideration is that the death rate from cancer in Australia is at present approximately 50 percent. Many people do not survive cancer or the treatments. An additional consideration is that the psychological, emotional and spiritual devastation, the despair that results from the medical treatment of certain cancers can make death or defective health appear to be far preferable options. For example, the reality of surviving some treatments such as the "heroic" commando or forequarter procedures (which are generally technically successful) is often horrific. The commando procedure involves the removal of malignancies from the head, often resulting in the removal of facial features. The forequarter procedure involves the loss of a limb, usually the arm and shoulder. In general terms, should cancer treatment not succeed, death is at times precipitated, often prolonged, painful and desolate (see Rudloff, 1985).

It also appears important to note that there is evidence in scientific and medical literature of a mind set that is militaristic in its treatment approaches. Together with medical terminology there is language drawn from military concepts and jargon. In a recent television documentary, a leading cancer researcher likened the present treatment of cancer to "throwing a handgrenade at it and hope it kills more bad cells than good" ("Topic of cancer", 1997). To pose a question: how different could medical treatment be if instead of "blasting" the cancer, or only using "slash and burn" techniques and "fighting" and "killing off" cancer cells, a very different conceptual model was used?

The promise of gene therapy as a possible preventative measure also has limitations. Though it has the potential of helping thousands, only approximately 10% of all cancer sufferers actually inherit a defective gene (Sidransky, 1996). Furthermore, it has been found that the fact of inheriting a defective gene is not enough to ensure that the person will in fact develop cancer. Further damage needs to occur to cause the development of cancer - from the toxic effects of smoking, diet, and exposure to viruses and/or chemicals (Fanning, 1997; Trichopoulos, Li & Hunter, 1996).

A defective gene may be acquired, and the approach then is curative rather than preventative. The curative approach is predominant in medicine's response to cancer. Many cancers are not evident till their later stages of development, and so their early detection and treatment are imperative. There are difficulties, however, when dealing with cancer in its later stages of development, as James Wilson, the Director of the Institute for Gene Therapy at the University of Pennsylvania points out, "To a certain extent, when a tumour develops, it's a battle lost - a battle lost between our body trying to fight it off and the tumour growing" ("Topic of cancer", 1997). This statement highlights the problems of working with cancer in its later stages of development; at a time when the person is emotionally and physically stressed, at a time when the body's immune response is "losing the battle" and the body is dying.

The efforts to develop a vaccine are also made in the hope that a cure is possible once a cancer has developed and is detected. Again, this technology is limited, as the vaccine approach is as yet predominantly possible for those cancers that are viral based (Fanning 1997). Furthermore, it relies on augmenting the body's immune response - at a time when it is depleted by a life-threatening illness.

Should the more recent medical treatments under study succeed in precluding the need for the rigours of traditional therapies, the treatments will be costly. The application of molecular biology will be very expensive. Glenn Begley, Principal Research Fellow at the Walter and Eliza Hall Institute of Medical Research in Melbourne, also the Director of the Rotary Bone Marrow Laboratories at Royal Melbourne Hospital, expressed this hope: "Certainly, we have to make sure that our health system is able to deliver world class care in the face of rising costs and increased demand" ("Topic of cancer", 1997). Unfortunately, this assurance can only be given by those we entrust with the economic management of our country - the political party in office at a given time - who may or may not give priority to the health status and social welfare of the general community.

In conclusion, the medical approach to cancer has proven to be somewhat successful. At the same time, there clearly are limitations to the medical model's approach to cancer. The deficiencies of the traditional medical approach are readily apparent; the principal error is not one of focus but one of exclusion. Cancer, the disease, with all its dreadfulness is explored and studied as a physical phenomenon. The less apparent manifestations and effects of the illness tend to be denied: the feeling, thinking, knowing, spiritual parts of the human being. The amount of suffering endured and the quality of its nature is not so readily apparent in the medical literature, perhaps not so easily quantifiable. The suffering is, nonetheless, a reality.

Scientific research has established links between cancer and environmental and lifestyle factors (Fanning, 1997; Trichopoulos, Li & Hunter, 1996). These factors are considered important predisposing factors, deemed more so than a purely inherited genetic predisposition. The minimisation of the importance of these factors perhaps reflects the limitations of an approach principally informed by scientific method, which is regarded as the only valid systematic acquisition of knowledge. A review of the relevant literature and of the topic of cancer points to the need for a more reflective, self-critical appraisal of the current paradigm. There appears a need for a far greater emphasis on self-responsibility and preventative approaches towards illness; and for treatments which will include and address both the physical and non-physical needs of people presently experiencing life-threatening illnesses, people who, in many cases, are facing death.

Body/Mind Literature

Healing.

I am not a mechanism, an assembly of various sections,
it is not because the mechanism is working wrongly
that I am ill
I am ill because of wounds to the soul,
to the deep emotional self,
the wounds to the soul take a long, long time
only time can help, and patience,
and a certain difficult repentance, long, difficult repentance,
realisation of life's mistake
and the freeing oneself of the mistake
which mankind at large has chosen to sanctify.

- D.H. Lawrence ("On Wholeness and Healing", 1995)

 

 

There is a growing field of literature that explores the link between body and mind in the development of illness (Borysenko, 1984; Dossey, 1982; Harrison, 1984; Hirshberg and Barasch 1995; Hislop, 1991; Pert, 1997; Ruff, 1997; Simonton, Matthews-Simonton and Creighton 1978; Chopra, 1989). Within the literature there appears a small but growing trend among medical practitioners and researchers towards formal evaluative research into mind/body links.

The experimental psychologist and author Dr. Lawrence LeShan in his research on the link between the emotions and cancer, found that (1) the loss of the person's reason for living (usually related to the loss of a central relationship), (2) an inability to express hostility such as anger and resentment, and (3) emotional tension concerning the death of a parent, were three factors that were common amongst a statistically significant number of the 152 cancer sufferers in his study (LeShan, 1984). After further research he added that:
Both the self-alienation and the inability to become aggressive in their own defence were factors strongly related to an even more important - in fact fundamental - feeling about life that characterised the cancer patients. This basic element in the emotional life of the cancer patient I call 'despair.' It was observed in 68 out of the 71 therapy patients studied - yet it was found in only three of the control group of 88. (1984, p.34)

LeShan was in fact able to predict with 86% accuracy the incidence of cancer amongst a mixed group of 28 patients (made up of 15 people with cancer and a control group of 13) solely on the basis of the three psychological factors he identified (p.25).

Similar factors were found in research undertaken by biochemist Carlyle Hirshberg and award-winning national editor and journalist and former cancer sufferer, Marc Ian Barasch, who document a number of cases of "remarkable recoveries" and "spontaneous remissions" from normally fatal cancers (Hirshberg & Barasch, 1995). Among their findings were several published studies that have linked psychosocial factors with the incidence, mortality, and survival rates of cancer. They state that: "A 'Type C' coping style - described as people who suppress anger (and other negative emotions) and put the needs of others before their own - has been postulated" (1995, p.381). Alternatively, they found that personal qualities such as quiet determination, group affiliation, fighting spirit, "creative" denial (ie. the refusal to accept the "medically incurable" status of their disease), the expression of needs, and the expression of both positive and negative emotions have been associated with survival.

The work of psychologist Jeanne Achterberg further reinforces these findings, particularly in the relationship between suppressed negative emotions and the incidence of cancer. In a study of women with metastatic breast disease (breast cancer), it was found that those who exhibited the lowest levels of hostility and the most upbeat mood, survived for the shortest time. Such patients, she notes, "seem bewildered when the same virtues that succeeded for them in the past - kindness, graciousness, a giving constitution, a cheerful outlook - don't work for them in the struggle against disease" (cited in Barasch, 1993, p.55). Furthermore, she observed that people who were criminally insane, many of whom had committed heinous crimes, had been "unusually protected from cancer, despite poor health habits, such as heavy smoking" (cited in Barasch 1993, p.55). People with a mental handicap, she found, were similarly protected from cancer; in fact, she observed that as individuals approached normal intelligence, their cancer rates also increased. Achterberg asks:

Is it because the retarded have less frictive inner wheelspinning, more uncomplicated emotional responses, than the 'normal' citizen? Does the violent acting-out of the criminally insane mitigate the physiologically corrosive harbouring of anger? Does the expression of powerful emotions, even dangerous ones, create a state of autonomic arousal that boosts the immune function? (cited in Barasch, 1993)

She concludes from her research that "there is clearly more than one route for the mind to influence the immune system, and not all the pathways are pretty" (cited in Barasch, 1993, p.55).

One of the growing numbers of medical practitioners who advocate an alternative/complementary approach to traditional medical treatments of cancer is radiation onclogist Dr. Carl Simonton. He and his wife, psychologist Stephanie Matthews-Simonton, developed a "mind/body model" of cancer development, "to show how psychological and physical states work together in the onset of cancer" (Simonton, Matthews-Simonton & Creighton, 1978, p.85). They were convinced from the findings of their clinical research that psychological intervention could in fact reverse the cycle of cancerous growth, ie. positively affect cancer outcome. They applied "behavioural medicine" strategies to cancer, using visualisation techniques and biofeedback methods to stimulate the mind/body mechanisms for recovery. These formed the basis of a self-help program they developed for cancer patients. The Simontons noted the necessity of patients to participate in their own recovery:

From the process of facing a life-threatening illness, confronting basic life issues, and learning their power to influence their health, they emerge not just restored to health, but restored with a sense of potency and control over their lives that they may never have felt before the illness. (1978, p.91)

Another notable contributor to the mind/body field of literature is Dr. Candace Pert, a neuroscientist and a foremost authority in her field. She currently holds a Research Professorship in the Department of Physiology and Biophysics, Georgetown University School of Medicine in Washington, D.C. and is a scientific consultant to the sponsors of Peptide T, a nontoxic AIDS therapy now in Phase II trials. Her earliest work involved the discovery of opiate (narcotic) receptors and the actions of the endorphins, the pain suppressants released by the brain.

In her study of consciousness, which originally began with a study of the brain 25 years ago, Dr. Pert discovered - to her astonishment - that consciousness is in fact in the body; that the mind and body are one, the "bodymind", which she states must be viewed in its holistic entirety (Pert, 1997). Based on recently established scientific facts, she and her colleague Dr. Michael Ruff (1997) defined the "psychoimmunoendocrine network", an information network within the body, composed of neuropeptides and their receptors, which they propose are the biochemical basis of our emotions.

Dr. Pert writes an eloquent summary of her findings in her recently published article "Molecules of Emotion: The Mind-Body Connection" (Pert, 1997). She states that:

The mind has potential access to every molecule and cell of the body through the psychosomatic network. Behaviour takes place at the level of the whole organism, the sum of all decisions, conscious and unconscious, which are constantly being made from moment to moment. Because of the network rather than [a] hierarchical organisation of our bodyminds, old unconscious traumas lodged deep in the body (the intestines, for example which are a very rich source of neuropeptides) can 'take command' and lead us to irrational or destructive behaviours. The ideal state for perfect health is one of free-flowing communication, integration, wholeness.

Mind-body techniques such as meditation, yogic breathing, conscious movement and massage are powerful tools for enhancing consciousness and enlightening 'dark', 'blocked-off' areas of the psychosomatic network where pain- and disease-causing trauma can persist in the form of 'somatoemotional cysts' (as John Upledger has called them). Stanley Krippner has documented how virtually all healing rituals in the world have concomitants of strong emotional release. (1997, p.120)

Dr. Pert believes it may now be possible to scientifically study how mind-body techniques can intervene in the psychosomatic network to exert their healing effects, in order to optimise their effectiveness. As one example of how neuropeptides affect the body, Dr. Pert goes on to describe how various neuropeptides applied to the floor of the fourth ventricle in the hindbrain which contains the "breathing centre", altered the depth, frequency and other breathing variables.

In summary, these authors are finding evidence that suggest a link between non-physical factors and cancer. This means that if the cause of cancer was proven to be wholly or in part non-physical, then the approach to cancer would involve developing strategies that would initially identify and subsequently heal the non-physical aspects of the disease. As Dr. Pert points out, the link between cancer and non-physical factors has not as yet been scientifically established, but such a link may explain the "spontaneous remissions" and the unexplained recoveries from medically incurable cancers and other diseases (Chopra, 1989; Hirshberg & Barasch, 1995).

In general terms, the merits of a holistic paradigm have not as yet been scientifically explored in depth nor its principles disproved. Nevertheless, the emerging field of bodymind (w/holistic) medicine has been subject to criticism from sources within and outside the field. The criticisms challenge holistic medicine both in its practices and theory. Ronald Frankenberg, Professor Emeritus of Sociology and Social Anthropology and Director of the Centre for Medical Social Anthropology at Keele University in England, for example, observes that those suffering with illness present themselves to alternative healers in their already learned role of "patients" - with an attitude of learned helplessness - thus substituting one external authority for another (Frankenberg, 1993). Mark Ian Barasch, an award-winning national editor and journalist, and former cancer sufferer responds to some of the criticisms. He states that in a society where:

...the mainstream of technology views the art of healing as an archaic, uninformed troublemaker, alternative practitioners often receive the marginal cases on whom modern medicine has given up; they are the helpers of the last rather than the first resort. (Barasch, 1993, p.236)

In a succinct critique, scientist and author Dr. Fritjof Capra writes:

Some individuals and organisations among these 'New Age' movements have shown clear signs of exploitation, fraud, sexism, and excessive economic expansion, quite similar to those observed in the corporate world, but these aberrations are transitory manifestations of our cultural transformation and should not prevent us from appreciating the genuine nature of the current shift of values. As Roszak has pointed out, one must distinguish between the authenticity of people's needs and the inadequacy of the approaches that may be offered to meet those needs. (1982, pp.461-462)

In their writing these authors acknowledge the need for a new paradigm, also the general tendency towards approaching the new and unknown with what biologist and psychologist Dr. Joan Borysenko calls "old age" thinking and methods (Borysenko, 1995). Co-founder and former Director of the Mind/Body Clinic at the Harvard Medical School, Dr. Borysenko is critical of certain elements of the "new age" movement. She specifically notes the rise of a phenomenon she calls "new age guilt". These feelings of guilt, she believes, arise from one's perceived failure to attain an ideal in which self-responsibility is taken to an extreme, one which implies ultimate control over one's body, life and destiny. Dr. Borysenko strongly advocates greater self-responsibility towards health, and the development of preventative approaches towards illness. At the same time, she states that our experiences clearly show that there is simply not a one-to-one correlation between our state of mind and our state of body, more specifically, between length and quality of life. Dr. Borysenko asserts that although there is much we can do to heal ourselves, ultimately human beings are limited. She believes that we are subject to forces beyond our control, that we live in the presence of "sacred mystery", of forces beyond our comprehension and power.

Finally, Dr Candace Pert responds to the criticism that the effectiveness of bodymind medicine is as yet not scientifically proven and therefore unworthy of support. She proposes that there is a need for:

... more research on how, not whether, mind-body interventions improve health, being already convinced from my own personal experience that they do. An astonishingly large percentage of mainstream medical practices have not been scientifically proven, and I am not proposing - as some have - that complementary mind-body medicine be held to a higher standard of proof before it may be utilised by the many who can benefit. (Pert 1997, p.121)

 

Art Therapy Literature

If you bring forth what is within you,
what you bring forth will save you.

If you do not bring forth what is within you,
what you do not bring forth will destroy you.

- Jesus (The Gospel of Thomas, Gnostic Gospels)

Healing Art

As outlined under the Body/Mind section above, the findings of bodymind research assert that both psychological and physical trauma are liable to cause the physical manifestation of disease. Researchers in the field consequently promote mind-body techniques as being "powerful tools for enhancing consciousness and enlightening 'dark', 'blocked-off' areas" and further point out that "virtually all healing rituals in the world have concomitants of strong emotional release" (Pert, 1997, p.120).

Art therapy is one such technique. Psychoanalyst and author Dr. Gregg Furth, who trained at the C.G. Jung Institute, Zurich, and worked with Elizabeth Kubler-Ross in the area of death and dying, describes art therapy as a method of bringing into consciousness what is submerged in the unconscious. He states that "Our unconscious thoughts come through to us in the symbolic language of dreams, paintings and drawings" (Furth, 1988, p.15). Dr. Furth believes that healing occurs at the unconscious level (Furth, 1997). His writing builds on the work of eminent psychoanalyst Dr. Carl Jung who, he points out, recognised the healing potential in drawings containing symbols from the unconscious, but did not provide the means to analyse drawings for their subconscious content. This task was subsequently undertaken by Jungian therapists Susan Bach and Jolande Jacobi. Their work was further developed by Dr. Furth, who endeavoured to provide practical guidelines for deciphering drawings "to better understand certain psychological and somatic events within the individual" (1988, p.3).

In his powerful and poetic book "Art as Medicine", art therapist Dr. Shaun McNiff, writes:

I view the making of art as a medicine that proceeds through different phases of creation and reflection. Although therapists and other people involved in this process make their contributions as guides and witnesses, the medicinal agent is art itself, which releases and contains psyche's therapeutic forces. (McNiff, 1992, p.3)

Another art therapist, Vija Bergs Lusebrink, draws on the work of Jeanne Achterberg and G. Frank Lawlis to look specifically at the role of imagery and emotion in the healing process. She concludes:

Images in a relaxed state provide a bridge between the body and mind. Thus, imagery becomes a healing agent that supplements conventional medical procedures. Imagery also is the intermediary between the physiological experience of emotion and its symbolic processing. Impairment in the ability to express emotions, or alexithymia, is characterised by an impairment in the symbolic function. Alexithymia contributes to the formation of psychosomatic illnesses in that the emotional stress is dealt with on a physiological instead of a psychological level. (Lusebrink, 1990, p.239)

Lusebrink suggests that the cognitive, supportive approach of using imagery in healing is appropriate for those clients who are inhibited in their emotional expression, while a symbolic and insight-oriented approach benefits clients who are aware of their symbolic processes.

A number of authors not directly associated with psychotherapy have also observed and utilised the therapeutic properties of art (Siegel, 1986; Predeger, 1996; Breslow, 1993). Among them are medical practitioners, such as surgeon and author Dr. Bernie Siegel, who uses drawing as a way of revealing the unconscious beliefs of cancer patients (Siegel, 1986). He states, "I've found that analysis of these drawings is one of a doctor's most accurate aids to prognosis. When combined with other psychological tests, mental imagery often is more useful than laboratory tests in assessing the patient's prospects" (1986, p.116).

Medical Art Therapy

In her paper "Medical Art: Defining a Field", art therapist Cathy Malchiodi refers to medical art therapy as the application of art therapy within a medical context (Malchiodi, 1993a). According to Malchiodi, medical art is "the use of art expression and imagery with individuals who are physically ill, experiencing trauma to the body, or who are undergoing aggressive medical treatment such as surgery or chemotherapy" (1993a, p.3). In this way, medical art therapy differs from art therapy conducted within a psychiatric setting where the physical care of patients is not of primary and immediate concern. Nevertheless, Malchiodi states that her understanding of healing "extends beyond blood chemistry or the eradication of tumours; healing involves becoming whole both physically and psychologically" (1993a, p.1).

Art therapy interventions within a medical context are designed with the overall medical treatment of the patient in mind, and with the knowledge of the person's particular illness, medication, and the possible medical procedures involved. Malchiodi believes that the greatest value of medical art therapy lies in art's ability to synthesise and integrate issues that clients within a medical context commonly struggle with: issues such as pain, loss, and death.

Personal testimonies

While not extensive in this formative stage of the art therapy field's development, the literature within and outside of the art therapy profession reveals a number of personal accounts which attest to the experience of art as a healing agent for those suffering with serious physical illnesses.

Elsje King is an artist and teacher who has a serious physical illness. Using textile as metaphor, she makes visible her affinity with the fragile objects of her creation. Her work is described as "a homage to process" (O'Brien, 1997, p.4). She uses natural dyes and textures inspired by the natural environment to create at times exquisitely sheer flowing fabrics in warm, earthy tones. Her work is beautiful in effect and poignant in content. Of one piece entitled "Dark Night" she remarks that "This 'Dark Night' is also the dark night of the soul" (cited in O'Brien 1997, p. 24).

In "Healing through Art", Darcy Lynn recounts her personal experience of art as healing from the point of view of an artist with lymphoma, an aggressive form of cancer (1995). Lynn creates striking images of her experiences during hospitalisation through to her recovery: images, sometimes of hope and symbolic of survival, as in her work entitled "Rebirth". At other times she graphically expresses her intense physical and emotional pain, as in "Hospital Nightmare".

The art therapist Suzanne Lovell shares her experiences of the art she created in response to the diagnosis of uterine cancer (1993). She draws on the Wounded Healer archetype in processing her inner journey, referring to art as a powerful healing tool. "Trusting the imagery evoked through Art Therapy Process and Authentic Movement, my illness became not an obstacle or impediment to living but an initiation into profound spiritual awareness" (1993, p.111).

Mary Lynne Ricci's article "Portrait of an Illness" (1993), describes the author's experiences during her rehabilitation from the paralysing, "devastating" effects of treatment for the potentially fatal rheumatic disease, lupus. She states unequivocally, that while she was ill the art process was her therapy. The article includes a retrospective interpretation of the symbolic content of her artwork during her hospitalisation. The author, now an art therapist, asserts that the artwork she presents in the article "evolved long before I understood the art therapy process or appreciated the therapeutic impact that process had on my life" (1993, p.96).

In her article "My Art Healed Me" (1988), the art therapist Diana Halliday, relates her experiences as a cancer patient in a London hospital. She also outlines a parallel process as an artist using spontaneous painting in her "self-healing". She describes in graphic detail her shock and terror at the initial discovery of her tumour, her sense of powerlessness on encountering the impersonal and at times fallible medical approach to her illness, her subsequent depression, recovery, and finally her sense of relief and renewed hope. Reflected in her drawing and writing is her preparedness and ability to meet the horror, the chaos, the frightening truth of her precarious life situation.

Through the reading of the above literature, common themes emerge in these personal stories. The authors express an urgent need to personally engage in their own healing processes. Although not all these authors were artists at the time of their illness, they each felt compelled to find a creative outlet for that need. There is a reflective quality in their writing, where in hindsight they each explored the process they used in overcoming the seemingly insurmountable obstacles to recovery presented to them, and where they created meaning out of their traumatic experiences. The final products of their creation, and the art materials they used, appeared to be of lesser importance than the art process itself.

The authors each expressed or alluded to a period described as "blackness" at a specific time in their individual journeys. Taken within the contexts described, the blackness appears to represent desolation, an experience of great suffering; as Elsje King, for example, suggests in her words "the dark night of the soul" (cited in O'Brien 1997, p.24).

This experience of despair appeared to be ultimately transformed, and led to expressions finally of transformation: "... it is simultaneously nebulous, fragile and illusory. It dissolves before our eyes. What has been made by the hand can be unmade by the mind" (King, cited in O'Brien 1997, p.24). Each author gives expression to the need to overcome her predicament, her need to heal - a process described by Dr. Rosemary Gordon in her paper entitled "Reflections on Curing and Healing" as being "an evolution toward a greater wholeness" (cited in Halliday, 1988, p.22). Once this goal is attained, the healing process appeared to give rise to feelings of completion, restoration, transcendence; for example, as Darcy Lynn's subsequent book title suggests: "Myself resolved..." (Lynn, 1995, p.71).

It is significant that the authors of these writings give far greater importance to the emotional, psychological and spiritual aspects of the illness than to the purely physical. So much so, that while most of the authors acknowledge the medical interventions they receive, they generally attribute their healing specifically to their art. This is in marked contrast to the medical approach to healing, where the opposite is asserted; where the literature and approach relate primarily to the physical manifestation of disease. From that perspective, life-threatening illnesses such as cancer are a physical phenomenon, requiring a purely physical response.

Art therapists' accounts of art as healing

Art therapist Christina Mango (1992) describes her work with Emma, a geriatric client who was admitted to a psychiatric ward diagnosed with Alzheimer's disease. Interestingly, Emma's artwork showed similarities to art created by cancer patients. She was in fact diagnosed with cancer of the liver three months later, and died shortly afterwards. The author concludes that Emma unconsciously knew she was dying, and independently worked on issues related to her own death through art work. This article highlights the diagnostic, predictive properties of art, as well as its therapeutic effects. "Through art work, Emma prepared for, accepted, and perhaps transcended death" (Mango, 1992, p. 267).

An art therapist intern, Louise Rudloff (1985), writes a disturbing account of her work with a reticent young man she calls Michael, who died in an army medical hospital 10 months after his initial diagnosis of cancer (osteogenic sarcoma). During this short time he appears to have endured relentless assaults to his body and sensibilities, including: the news of his life-threatening illness with a poor prognosis, three operations including the amputation of his leg, two bouts of chemotherapy, and the grim reality of dying in emotional isolation. Art therapy began just five months before his death. In her article, the author notes that "the discrepancy between Michael's calmness on the outside and the disturbing, agitated quality of the drawings seems a particularly graphic illustration of how the visual language of art can reveal inner states that might not otherwise be evident" (Rudloff, 1985, p.53). Michael "intensely and consistently drew on art therapy to vent very deeply felt emotions he could not express in words" (1985, p.49). She examines her role as an art therapist, a changing role from being active in the therapeutic relationship, to one of "a steady and caring presence" when Michael was dying and no longer physically able to engage in art therapy (p.58).

These two articles share some similarities. Both art therapy clients used animal images in their artwork. For example, one of Emma's drawings entitled "Vanishing Species", shows a tree stump devoid of any green growth (ie. dead or dying), surrounded by an owl, a turtle, a pig and monkeys. The author notes that they represent species of animals that are in fact vanishing; and that there appeared to be a parallel between these living creatures that may soon be extinct and Emma's own inevitable demise. Michael created a drawing which in reflection was predictive and revealing of the nature of his death. The drawing shows a man shooting a bear (with blood dripping from its mouth) which is about to devour a seal. Rudloff suggests that the vulnerable (legless) seal represents Michael, while the bear could be seen as the cancer that had already partially devoured him. She suggests that the man in the drawing appears to represent the doctor trying to save Michael's life by killing the cancer. Interestingly, though Michael states that the man was drawn to protect the seal from the bear, the seal is placed between the man and the bear. The gun points towards the bear but is also aimed directly at the seal's head. This may suggest Michael's unconscious knowing of his death, though efforts were being made to save his life.

Emma and Michael received medical treatment and art therapy, which in both cases were offered at the later stages of the disease process. Neither of them physically survived their cancer, though both showed evidence of unconsciously acknowledging, expressing and exploring their dying process through art.

Art therapy programmes in medical settings

In her article "Womanspirit: A Journey into Healing through Art in Breast Cancer", Dr Elizabeth Predeger (1996), Associate Professor of the School of Nursing and Health Sciences in Alaska, described research she undertook with a collective of women survivors of breast cancer, who used art therapeutically to facilitate healing. The group met on a biweekly basis over a six month period. In the study, the author used a holistic nursing paradigm which incorporates multiple ways of knowing. The focus was the "healing-art connection". Each woman who participated "referred to her art as being created as part of a necessary healing process" (1996, p.49). The author concluded that "Art, created out of illness by artists with breast cancer, was found to be healing personally as well as collectively..." (p.49).

Art therapist Gill Thomas (1995), employed by Marie Curie Cancer Care at Edenhall Hospice in the UK, describes art therapy as being complementary to the medical services provided. She believes that art therapy plays an important role in a holistic approach to health care. Working in a non-directive way, the author enables hospice residents to work towards psychological rehabilitation and a greater sense of well-being. She considers art therapy to be a psychotherapeutic process which allows emotional conflicts to be externalised through the making of images, pictures or three-dimensional works, and provides a case study as an illustration. "It is extraordinary how a piece of paper can act as a symbolic battleground, where issues can come to a resolution without having to be voiced" (1995, p.121).

In the same article, Jacqueline Kennedy writes about her experiences as the resident artist at the Trinity Hospice in London. Having failed in her efforts to coax hospice residents into taking the initiative in their art making, she painted for them instead. She found that setting themes proved very successful; themes such as the person's "happiest memory", "most meaningful memory", "most exciting memory" or "funniest memory". The author concludes that: "For those facing death and their bereaved relatives, the painting gives form to the intangibility of loss and creates a positive space and a safe passage with which to negotiate the future" (Thomas & Kennedy, 1995, p.123).

"Art that Heals" (ATH) represented a collaborative, patient-oriented approach to healing in hospitals, developed at the Jonsson Comprehensive Cancer Center UCLA, Los Angeles (Breslow, 1993). The programme "grew from an instinct that the arts have therapeutic properties" (1993, p.101), at the same time consciously addressing the perceived need for a more humanistic approach to health care. Five programmes evolved after the success of the fourteen-month ATH pilot project: Art-as-Therapy, Strolling Musicians, the UCLA Art Cart, Changing Exhibitions by Artists with Cancer and Confronting Cancer Through Art 1987. The ATH approach proved demonstrably successful for cancer sufferers, and was supported by hospital staff including one psychiatrist who stated that "It works beautifully" (p.106). However, in spite of its success, the ongoing lack of financial support forced the programmes to eventually fold after being in operation for seven years. Devra Breslow, Director of Art That Heals (1982-1989), commented that "Without funding by the UCLA Medical Center, whose patients and staff benefited from the interventions, the potential of Art That Heals was not fully realised" (p.102).

Tracy Councill (1993), an art therapist and a member of a Paediatric Oncology team at a cancer treatment and research centre, outlines the findings of her research with paediatric cancer patients. She describes her work as addressing themes presented to her by critically ill children; themes of separation and anxiety, alienation, anger, aggression and fear, body image and self-concept, beliefs about treatment and disease (eg. punishment for a misdeed), and themes around their concepts of death. Using a number of case study illustrations, the author identifies the art therapy interventions she found most appropriate at the different stages of the disease/treatment process, from the early phases (diagnosis and initial treatments) through to the middle phase (maintenance) and following relapse or in the advanced, final stages of the disease process when death is imminent.

Similarly, artist Stan Hyslop (1993) acknowledges the therapeutic effects of clay in a palliative care hospice setting. He observes that "Working with patients with advanced disease means helping someone to approach death" (1993, p.71). It was found that the benefits accrued from this type of intervention also flowed on to the residents' families, for example in facilitating communication, as in one case: "I occasionally met the family and realised how important and precious those few weeks together had been as they shared their feelings of love, sadness and grief" (p.72). His article includes a number of case illustrations and personal accounts which attest to the healing quality of the art making.

The article "Art therapy - a meaningful part of cancer care" is written by Astri Aakrann Ziesler (1993), an occupational therapist with art therapy training from the Northwest Institute for the Creative Arts Therapies, Oregon, USA. The author defines art therapy as "based upon the belief that every human being - whether trained or untrained in art - has a latent capacity to give thoughts and feelings a visual form" (1993, p.107). The article briefly reviews different psychological approaches to art therapy with cancer patients; and describes, with case study illustrations, the goals and methods of a weekly art therapy group. The group is led by two occupational therapists from the Department of Psychosocial Oncology at the Norwegian Radium Hospital, both having additional background in art therapy and group work. The author concludes that "through art therapy, cancer patients may have an outlet for inner emotional pressure; an increased insight into their own situation; and a better mental balance that may lead to an improved quality of life" (p.107).

In her article "Group work with cancer patients" art therapist Penny Baron (1985) also advocates the importance of providing a support system for cancer sufferers, those who face "disfigurement from surgery, fear of pain, of becoming a vegetable and of the actual act of dying" (Yalom in Baron, 1985, p.22). She argues that a group can provide an empowering connection with others, a stable force for individuals whose family members are often drained by the long-term illness; a group can also provide a means of positive change in an individual's self-destructive attitudes and behaviour. In addition, the safe, supportive environment challenges the isolation and stigma often associated with cancer, an illness described as the "leper of the twentieth century" by McCloy and Lansher (cited in Baron 1985, p.27) eg. "People stopped hugging...neighbours stayed away...children stopped playing at my house" (Baron, 1985, p.27). The author speculates that the reason for such displays of aversion may lie in people's perception of cancer as being contagious, or that cancer may be seen as being synonymous with death. Using Simonton and Creighton's self-help guide (1978) as a basis for twelve sessions, the author describes the process of two cancer support groups she facilitates, which "evolved as a synthesis of modalities from the fields of holistic health, art therapy, and psychotherapy" (p.29).

Many of these articles report observations that are descriptive of the events and based on sound psychological and holistic (body/mind) principles. Breslow correctly points out that a systematic study of the interpretations of the art productions and their healing effects is clearly needed, so as to legitimise and substantiate the claims made of the therapeutic effects of the art itself. Councill's approach establishes a precedent in her efforts to identify the art therapy interventions most needed at the different stages of the diseases process, from illness through to recovery or death.

Each author attests to the role of art as a healing agent, and many see it as an adjunct to medical treatments. There is a danger, however, in presenting these approaches as separate, complementary, and mutually exclusive. There appears to be a growing movement which expresses the need for collaboration - for a mutually supportive approach to illness - in the effort to acknowledge the reality of the inseparable quality of the body/mind connection.

Theoretical Framework

The ultimate measure of a man is not where he stands
in moments of comfort and convenience but where he stands
at times of challenge and controversy.

- Martin Luther King (cited in Penson & Fisher, 1991, p.255)

There are two main influences on the theoretical approach I am taking in this research. The first influence is that of the Holistic Health Care movement (Holistic Medicine). The word "holistic" comes from the Greek root "holos" (whole), and is used to express the concept that the whole is greater than the sum of its parts. The terms "holistic health care" and "holistic medicine" refer to the application of this concept to healing (Borysenko, 1987; Brennan, 1987, 1993; Capra, 1982; Chopra, 1989; Dossey, 1982; Pearce, 1989). The Holistic Health care movement has as a central concern the unity of the body, mind and spirit. This approach is in opposition to current medical theory and practice which is firmly rooted in the mechanistic world view of Cartesian-Newtonian science. In biomedical science, the Cartesian view of living organisms as mechanisms constructed from separate parts, still provides the dominant conceptual framework. The Holistic Health movement, with its emphasis on both mind and body, the physical and non-physical aspects of the personality, represents a departure from the mechanistic world view. The holistic model requires a much greater responsibility for health care from the individual, as a greater emphasis is placed on "inner" healing. Ultimately the distinction between self and other, life and non-life, is transcended. As Dr. Larry Dossey, practitioner of internal medicine and former Chief of Staff at the Medical City Dallas Hospital, eloquently writes:

It is clear that we all have our roots in the universe, that interpenetration of all matter is the rule, and that the dividing line between life and nonlife is illusory and arbitrary. There is only one valid way, thus, to partake of the universe - whether the partaking is of food, water, the love of another, or, indeed, a pill. That way is characterised by reverence - a reverence born of a felt sense of participation in the universe, of a kinship with all others and with all matter. (Dossey, 1982, pp. 214-215)

The spacetime view of health and disease tells us that a vital part of the goal of every therapist is to help the sick person towards a reordering of his [sic] world view. We must help him realise that he is a process in spacetime, not an isolated entity who is fragmented from the world of the healthy and who is adrift in flowing time, moving slowly towards extermination. To the extent that we accomplish this task we are healers. (1982, p.xi)

Holistic medicine, in this sense, represents an important step in the reordering of the current predominant world view.

The second influence on the theoretical approach I am taking in this research project is the emerging field of Arts Medicine (Achterberg, 1978; Achterberg & Lawlis, 1984; Malchiodi, 1993a, 1993b; McNiff, 1992). In summary of this approach, art therapist Dr. Shaun McNiff writes:

Whenever illness is associated with loss of soul, the arts emerge spontaneously as remedies, soul medicine. Pairing art and medicine stimulates the creation of a discipline through which imagination treats itself and recycles its vitality back to daily living.

My perspective on medicine is artistic. Rather than attempting to explain the artistic emanations of soul, our psychology desires to activate and move soul by striving to speak its own language. (McNiff, 1992, p.1)

The medicinal agent in this approach is art itself. The emphasis is on increased awareness rather than on specific images.

It is important that research generates new meanings and interpretations of a phenomena. This inquiry will therefore also take a hermeneutic approach. The term "hermeneutics" refers to a Greek technique for interpreting legends, stories, and other texts (Patton, 1990). Hermeneutics asks "What are the conditions under which a human act took place or a product was produced that makes it possible to interpret its meanings?" (Patton, 1990, p.84). This form of inquiry uses qualitative research methods to establish context and meaning for what people do. It is a shared inquiry, a collaborative research effort, requiring the active participation of both the researcher and the person/s researched. Transpersonal theorist and author Ken Wilber defines hermeneutics as:

the science of interpretation, or the determination of the meaning of mental productions (eg. what is the meaning of Macbeth? of last night's dream? of your life?). As such it is a transempirical discipline, for no amount of analytic-empirical-scientific data, no matter how complete, can totally establish the meaning. Rather, meaning is established, not by sensory data, but by unrestrained communicative inquiry and interpretation (cited in Reason & Hawkins, 1988, p.82).

 

Case Study Methodology

Everything can be taken from a man but one thing:
the last of the human freedoms - to choose one's attitude
in any given set of circumstances, to choose one's own way.

- Viktor Frankl (1959, p.86)

Participant

The participant in this research project is a fifty three year old woman, a psychiatrist and psychotherapist, who was diagnosed with multiple myeloma (cancer of the bone marrow and blood) seven years ago. She resides in Perth with her family.

The participant was selected on the basis of a purposeful sample (Patton, 1990, p.169). Purposeful sampling allows for the selection of an information-rich case for an in-depth study, one from which much can be learned about issues of central importance to the purpose of the research. The selection of this participant was based on the criteria of an "extreme or deviant" case sample, being an example of an individual who responded to her circumstances in an unusual way (Patton, 1990, p.169 & 182). In this case, the participant has succeeded in living many years longer than expected, and has achieved a quality of life which is uncommonly high for a person diagnosed with cancer of the bone marrow and blood (multiple myeloma), a normally fatal illness (Mayo Clinic, 1996). The participant's background as a physician, her decision to seek firstly medical, and then non-medical forms of treatment when she had cancer, and the creative, personally meaningful and life enhancing way she responded to her diagnosis, are qualities that make this an information-rich case, one from which the researcher and other interested parties could learn a great deal.

Design

A case study design was chosen for this study, as this is an in-depth study of an individual's behaviour (Patton, 1990; Stakes, 1994; Yin, 1984). The case study design seemed the most suitable method given the rare opportunity to study a "deviant" case, an individual who is also representative of the population for whom this study is targeted. An in-depth study was considered the ideal way of eliciting the information needed to address the purpose of this research, which is to explore the interrelatedness of art and healing during critical illness. Another reason for using a case study design is that it is the preferred strategy when "how" or "why" questions apply to a contemporary phenomenon (Yin, 1984, p.13,17). This case study is designed to examine "how" art assists healing in the case of a person suffering from a life-threatening illness. A further reason for using a case study design is that by using a variety of data collection, the case study design allows research to be holistic in explaining a wide range of meaningful characteristics of real life events, which include idiosyncratic complexity (Hakim, 1987, p.61).

As this is a relatively underdeveloped area in Art Therapy research, this research project is an exploratory study. A qualitative approach to this study is used because of its emphasis on people's lived experience and its concern with individuals' own accounts of their attitudes, motivations and behaviours (Hakim, 1987; Miles & Huberman 1984; Patton, 1990). A qualitative approach to this study also allows the researcher to expand the focus to include unexpected data, and provides a depth of understanding that is not usually possible with a quantitative approach. Furthermore, a qualitative approach allows for a greater exploration of the relationships among variables which may not be clearly formulated at the outset of the study.

The information elicited from the interview and other sources is derived primarily from the participant's personal experience. A personal experience perspective makes possible the description and in-depth understanding of both externally observable behaviours and internal states eg. world view, opinions, values, attitudes, symbolic constructs, etc. (Clandinin & Connelly, 1994; Patton, 1990).

The interview is semi-structured and open-ended. The semi-structured interview protocol allows for spontaneity, and the participant's unrestrained account of her journey. At the same time, a semi-structured interview enables the researcher to maintain focus so that the purpose of the interview is achieved (McCracken, 1988; Yin 1984).

The questions largely relate to the purpose of this study, that is, how art assists the participant in her healing process. The data also includes the salient points made in the Literature Review: the importance of telling the story (Baron, 1985; Clandinin & Connelly, 1994), the themes in the participant's artwork that present the different stages of the disease/recovery process (Councill, 1993; Malchiodi, 1993a, 1993b); the participant's world view represented by her decision to seek out alternative forms of treatment to the traditional medical treatment for cancer (Dossey, 1982; Reason & Hawkins 1988), group support and affiliation (Baron, 1985; Praedeger, 1996; Simonton, Matthews-Simonton & Creighton, 1978); the participant's own account of her art and healing (Clandinin & Connelly, 1994; Malchiodi, 1993a, 1993b; Siegel 1986, 1990); and changes in attitudes, lifestyle, relationships (Dossey, 1982; Levine, 1987).

Procedure

I had encountered the participant on previous occasions before asking her to participate in the case study, once at a workshop and again at an exhibition of her artwork. When I finally approached her, she expressed interest in participating in the research project.

Step 1: An initial meeting took place in which the proposed research project was explained and a consent form to participate in the research proposal was left with the participant to peruse and sign.

Step 2: Upon receiving her consent (Appendix A), the date for the first of a series of three reflexive interviews was negotiated. The interviews were designed to progressively elicit insights and information which were omitted previously. They were audiotaped, with the participant's knowledge and permission.

At the interviews the participant was encouraged to relate her story from the time of the initial diagnosis of cancer till the present time. Demographic data and background information was also gathered. The length of each of the interviews was negotiated. They were approximately an hour and half each.

Step 3: The third and final interview was videotaped with the participant's permission (Appendix A). This was a semi-structured interview, using a questionnaire designed to gain information specifically about her art and healing process (Appendix B; "The art of healing", 1998).

Step 4: Data was collected from a number of sources, from the information gathered from: (1) the interviews - the most important source of information in a case study design; (2) non-participant observation - this form of observing may be casual and ad hoc observations made during a visit when other evidence is being obtained, eg. impressions and perceptions that add to the understanding of the context of which the area under study is a part of; (3) documentation - of literature already available on the participant's art and healing process, ie. through existing articles, newspaper clippings and videos; (4) archival records, ie. personal journals; and (5) from the participant's own works of art (Yin, 1984). Multiple sources of information allowed for triangulation, ie. the use of three or more methods of data collection as a means of cross-checking the information thus improving the validity of the case study (Miles & Huberman, 1984; Patton, 1990).

Step 5: The raw data was condensed into a manageable size by organising and coding the material both chronologically and thematically. The sequence of events was identified, together with the corresponding artwork.

Step 6: In order to ensure the validity of the information collected, the participant was invited to check the accuracy of the material. The material was reproduced in a concise form and in a way that addresses the aims of the research. The participant was encouraged to edit the material; that is, to make changes related to the accuracy of the write-up, and to elaborate on information that may have been omitted or that needed clarification.

Data Analysis

Both descriptive and explanatory analyses are used to analyse the data. A descriptive analysis is used to describe the contents of the artwork; and an explanatory analysis is used to interpret the findings. The overall results are then compared and contrasted to the findings in other research.

Limitations

Because of a lack of empirical data in art therapy literature related to those suffering from life-threatening illnesses, one limitation of this study is that the findings cannot be compared to the results of previous evaluated studies. This means that the reliability of the findings cannot be tested. However, other researchers should be able to replicate the findings of this case study.

The interview is approached with the assumption that the perspective of others is meaningful, knowable and able to be made explicit (Patton, 1990). The strength of the qualitative approach to this study is the validity of the data obtained: the individual is interviewed in sufficient detail for the results to be taken as true, correct, complete and believable reports of her views and experiences (Hakim, 1987; Patton, 1990). This study provides systematic documented research with an evaluated outcome. This may represent a step towards legitimising the effectiveness of art therapy with people experiencing life-threatening illnesses.

Art therapist Pamela Diamond points out that the primary problem with a case study as an evaluative tool is that it does not rule out the possibility of conflicting explanations and interpretations of the observed results (Diamond, 1988). Researcher bias is yet another consideration. The strength of a case study methodology is that it will be effective in developing an understanding of the process involved in therapy - the main focus in this study - and for developing hypotheses about what might be the therapeutic factors in the participant's use of art in her healing process.

In a qualitative study, there is a need to consider the voice that is heard and the voice that is not heard. The proposed use of an interview protocol in this research project that is not highly structured allows for the participant to express matters of importance to her which may not specifically relate to the topic, but which may nevertheless be relevant.

Because this is a qualitative study, the participant's personal experiences will be elicited during the interviews. In this respect, the case study design may be seen to be limited in terms of its non-representativeness and therefore limited in its generalisability to the larger population. However, the pathway of inquiry from experience through explanation to general theory appears as valid as the use of theory as the starting point of inquiry (Clandinin & Connelly, 1994, p.414).

This approach questions the validity of utilising distance and objectivity to reduce bias. Rather, this perspective assumes that without empathy and sympathetic introspection derived from personal encounters, the observer cannot fully understand human behaviour (Patton, 1990, p.47).

Ethical considerations

Issues related to confidentiality and ethical concerns were raised with the participant at the initial meeting. As the participant agreed to participate in the research, she was asked to sign a form of consent (Appendix A). The content, length and spacing of interviews were negotiated between the par¬ticipant and the researcher. With the par¬ticipant's permis¬sion, one interview was videotaped, all the interviews were audiotaped, and photos were taken of the par¬ticipant's artwork for inclusion in the final thesis.

The participant's consent to our initial meeting indicated her willingness and ability to undertake the project. Never¬theless, the conditions specified in the consent form included the participant's right to withdraw from the study at any time she felt it necessary, without prejudice.

Profile of the case study participant

The most beautiful thing we can experience is the mystical.
It is the source of all true art and science.

- Albert Einstein (cited in Gordon, 1978, p.144)

Introduction

Selecting the thesis topic

The topic for this thesis emerged as a response to my life experiences at the time of writing. I was feeling disturbed by the recent and untimely deaths of two of my older sisters. I watched them die unnecessarily cruel deaths, within six months of each other, both with different forms of cancer. It was not so much their deaths as the way they died that was most distressing to me. The memory of the people they once had been, my hopes for what they might have become, and their senseless demise, weighed heavily on me. I could only imagine how different it could have been. Until I met Maria.

Meeting the participant

I first met Maria when I attended a weekend workshop conducted by the Australian Transpersonal Institute in Fremantle. She was one of three facilitators. I found her to be a vibrant, beautiful, mature woman, with a gracious and open manner. It was a creative weekend full of writing, poetry, movement, and art. Maria and I chose each other as partners for an exercise on the final afternoon of the workshop. We were asked to talk about our life's wounding. Maria talked about her cancer, her life and her passions. I shall never forget how moved I felt by her story, and how inspired I was by her response to her illness.

Some time later, I attended an exhibition of her artwork. Again, I was deeply moved. Her artwork depicted her journey, a journey with which I had become to some degree familiar. At that point, I decided to ask her if she would consider being the participant in this case study. Maria readily agreed.

Background of the participant

Family of origin and cultural influences

Maria, the second of three children, was born in the city of Brisbane in Queensland, Australia, on 22nd March 1945. She has an older sister and a younger brother. She came from a mix of mainly Irish-Roman Catholic and Celtic ancestry, with some Chinese ancestry (on her mother's side). Her mother was a teacher and her father, a businessman.

Maria had a difficult childhood. She now believes that her mother was ambivalent about giving birth to her. Her mother's doctors had recommended that she have no more children after her older brain-damaged sister was born three years previously. Maria's birth was in fact not problematic. However, her mother believed that she would die in the process of giving birth. And consequently, Maria feels that there was "a cloud of fear" permeating her intrauterine experience, and that she was unwelcomed by her mother. After her birth, Maria felt that her mother's ill health and the demands of her brain-damaged sister, took priority over her own needs. Her feelings of neglect were made worse by her family's isolation - there were no friends or relatives to help or support her.

After the birth of her younger brother four years later, Maria was placed in institutional care for some time as her mother was having difficulty coping. When she was returned to the household, Maria was locked away on her own as she was ill and infectious with measles. She interpreted her enforced isolation as yet more rejection, and as her mother favouring her younger brother. During this time, Maria remembers that a great deal of hostility and sexual tension had accumulated between her parents. Consequently, her parents lived separate lives, at opposite ends of the house. The family dynamics were such that her father favoured Maria's older sister, and her mother favoured her younger brother. Her parents fought often and violently, and Maria felt caught in the middle, and unwanted by them both.

Maria's mother returned to work as a teacher when her younger brother was four years old, until he was about eleven. She collapsed at that point and was bedridden for much of the time afterwards. Maria became her mother's caretaker and confidante. She describes her relationship with her mother as intensely symbiotic and clearly inappropriate. Her mother discussed her problems with her, including the sexual problems she experienced with her father. Maria describes her mother as having been very ambitious and dominant, incapable of showing tenderness, and unable to touch her children with love, or cope with their expressions of emotion. She deeply hated and was very suspicious of vulnerability. Maria feels that her mother experienced deep shame about her body and sexuality. Her father was a strict Roman Catholic, and although her mother rebelled against the Church, she was still unhappy. She was unable to free herself from what Maria describes as the Patriarchy - she honoured and idealised her own father who was a distinguished public figure in Queensland politics.

Maria believes that her mother was ruled by her intellect. She had believed in the education of women, and Maria now feels grateful to her for encouraging her to study. She feels, however, that her mother's drive for her to succeed was extreme and displaced. Maria did not feel respected other than for her ability to perform well academically. Her mother seemed to want her to be the most brilliant student, "hyper-achieving for her own (reflected) glory".

Maria observes that her mother is still very disturbed and is still very alone. She lives in Queensland with her daughter, Maria's older sister. Maria remembers her sister mimicking their mother and being very cruel towards her. She never married and has worked as a domestic in hospitals, a remarkable achievement considering her low I.Q. level. Maria acknowledges that her parents educated their three children to their fullest potential. Maria's brother is now a psychiatrist, and is married with three children. She has always felt close to her brother, and feels a bond of love exists between them still.

On reflection, Maria believes that while her intellect was recognised and developed, her body was seen as "sin before I was born." Maria observed that pain and suffering were very dense around her as a child, particularly among the women in her family. Her mother suffered from a physical and psychiatric illness, her older sister was born brain-damaged, an aunt was institutionalised, and her great aunt died with a depressive illness. She now believes that much of her own suffering was related to issues around her femininity. She recalled:

I was aware that being a woman in my culture meant incredible suffering, that something sent these women mad. I set out on a journey to really understand what happened.

Professional training

Stifled by her mother's enmeshment with her, Maria asked to go to a Catholic boarding school for her last year in high school. Breaking away from home proved very difficult as her mother was heavily dependent on her. Nevertheless, she attended the boarding school and excelled in her studies, as always. She found that students received harsh treatment from their teachers, who were brutal and severe in their punishments. Undeterred, Maria persevered and completed her studies. After high school she went on to Brisbane University and then to medical school. Eventually she trained in psychiatry. She was determined, she said, "to end up on the right side of the desk!"

At most times during her training in psychiatry she was the only female registrar. This proved difficult. The medical model, from her point of view, seemed to reflect teachings that were "from men about men's ways and men's healing, the patriarchal way of healing". Nevertheless, she internalised the patriarchal approach she was exposed to. She was goal-oriented and wanted to succeed in her quest. Looking back on those times, Maria now believes herself to have been:

Masculine-identified, a very patriarchal woman, very competitive, very out there for external power, one of the boys.

Though vulnerability in doctors was frowned upon by the medical profession, Maria eventually went into therapy for support and to begin the task of healing her childhood wounds. She turned her attention to child psychiatry as a way of further understanding the effects of her own upbringing. She eventually went into private practice and became a psychotherapist. She no longer prescribed drugs, though she acknowledged they had a legitimate place in psychiatry. She became increasingly interested in dreams and the psyche.

At the time of her diagnosis, Maria was running a busy practice in Perth and was happily married with two children.

Diagnosis of cancer

Apart from what she thought were minor longterm health problems, Maria believed herself to be "pretty healthy". She remembered always suffering from tension, energy depletion and anaemia around the time of her menses. Some months before her diagnosis of cancer, she had a hysterectomy as a result of her concerns about her worsening anaemia. She was convinced the hysterectomy was the cure. She found, instead, that her anaemia became even worse. Maria said she will never forget that phone call: "It was 11 o'clock on Friday, 30th of August, 1991." Her doctor told her on the phone: "Maria, you've got cancer. It's one of two types. Let's hope it's the one that is curable." She recalled her reaction: "The whole world just spun." The first thought that went through her mind was how precious and magnificent life really is. She then realised the seriousness of having a life-threatening illness:

And then it really hit me, the horror of course, and the terror.

Prognosis

After the news from her doctor, Maria had a bone marrow test to confirm the diagnosis. She discovered she had multiple myeloma, cancer of the bone marrow and blood. The prognosis for her condition was poor. The latest statistics provided by the Mayo Clinic indicated that multiple myeloma was incurable. She also knew from her experience as a doctor and from witnessing the death of two close friends from the disease, that it would be a painful death which would involve the bones collapsing.

I really thought I was going to live forever you know, if I was really honest about it. Even though I had seen lots of death as a doctor, I thought I'll worry about that when I get to my nineties. And there I was at forty-six, with a death sentence. I was just devastated. I can't tell you in words. It was just ... just devastating.

Medical treatment

Maria agreed to chemotherapy and began treatment as soon as possible. Chemotherapy had the potential to abate some of her symptoms and to perhaps extend her life a year or so; it also held the promise of an easier death. As her husband was an intensive care specialist, she arranged to have the treatment at home. The powerful effects of chemotherapy were quickly felt. On the first night she took the chemotherapy tablets she felt so ill she thought she was going to die. She was almost completely drained of energy and unable to move.

Near death

During the first night on chemotherapy Maria remembers having a near-death experience. This was a critical moment, one that was to have a transforming effect on her life. She recalled:

A light appeared in front of me and there was this tunnel. But I wasn't frightened strangely enough, because when the light came it was beautiful - it was just pure love.

Maria went on to report that as part of this vision, she saw an image of Sai Baba. (Sai Baba is considered a holy man who currently lives of India. He teaches spirituality in a universal language: "There is only one caste" he says, "the caste of humanity; there is only one language - the language of the heart; there is only one religion - the religion of love; there is only one God - He is omnipresent" (Sandweiss, 1975). Sai Baba is renowned for his ability to perform miracles and for producing "vibhutti", a sacred healing ash.) Maria continued to describe her experience and her vision of Sai Baba:

This white light came closer and closer to me and in the middle of the light came this beautiful face. It was Sai Baba. His face came out of the middle of this love, and he said to me 'You are not going to die now, you are going to be OK.'

Maria described this as a most ecstatic spiritual experience, an awakening. She felt comforted by the experience, and deeply connected to something much larger than herself. She felt "overwhelmed by how much love there was in the universe". Her near-death experience dramatically changed her perspective on death and dying. She lost some of her fear of death. (Her acceptance of death was to take many years.) She realised that the body, with which she had identified before, was not her at all:

I had a body and it was going to die. There was something beyond death. It's ineffable sweetness and something much bigger than me.

Alternative healing methods

Shortly after Maria discovered she had cancer, her brother, also a psychiatrist, came to visit her from Brisbane. He had been working with cancer patients and had seen some marked changes and healing among those who had been to an alternative cancer treatment centre in Victoria. This centre is run by Ian Gawler. Ian is a veterinary scientist who had cured himself of osteosarcoma (bone cancer), a cancer so virulent that at one point he was expected to live for only two weeks. Impressed by what she had heard, Maria and her husband went to Victoria to attend one of Ian's workshops. Ian introduced her to meditation and to the spiritual aspects of healing. He also introduced her to Dr. Bernie Siegal's book Peace, Love and Healing. In the book Dr Siegal suggests that it is helpful for cancer patients to use art to explore their experience of cancer and its meaning in their lives. Maria followed the author's recommendations when she returned to Perth. She began to draw images of her cancer and to use art in her healing process.

Maria had attended Ian's workshop about two months after she started chemotherapy, and she continued her monthly chemotherapy treatments afterwards. Contrasting the ecstacy of her near-death experience, she describes her physical experience of her chemotherapy treatments as "torturous", the "crucifixion phase" of her life:

It was a real shamanic death and rebirth each time. You actually, literally, see your body die in front of you. All my mucous membranes came off. I would be full of ulcers right through my body, my hair would fall out, and my skin would break out in ulcers and I would just feel so sick. I really thought I was dying.

The positive physical effects, in retrospect, were that she could not think and she could not get out of bed; both her mind and body were stilled. She was unable to use her intellect psychotherapeutically, and had come to the limit of what could be done medically for her at a physical level. She believed she had to find another way. Her meeting with Ian Gawler had opened her to a whole different orientation to healing: spirituality. Using meditation at this stage of her illness, she was learning to:

Stop judging, not criticise, and not add suffering to pain. I was sinking into another part of me that I really hadn't spent time with. Words are hard here. This culture doesn't have a lot of words for this type of experience. It took me straight into the unconscious without words, the non-verbal, out of left brain into right brain. I think it's something much bigger than that - into the transpersonal, past the everyday personality, past the thinking, into this quiet space where everything is and nothing is. It's paradoxical.

Her near-death experience was followed by other spiritual experiences when she began to meditate. On one occasion, while lying in bed unable to think or move, she heard Gregorian chanting. She had a vision, while fully awake, of people she describes as being "from all cultures and all time" file past her. Maria found this to be a beautiful and very mystical experience, and she felt a connection to all eternity. On other occasions she had visions, sometimes through dreams, of mystics visiting and teaching her. Maria believes that her mystical experiences, her creativity, her dreams and visions came from this quiet space.

During the fourteen months Maria received chemotherapy, the cancer cell count was reducing. However, at the conclusion of her treatment, the cancer cell count increased. She decided to discontinue chemotherapy, while she still had cancer and against her doctor's advice:

It was very, very hard. My cancer cells, after all this chemo, actually started going up again. That was incredibly devastating.

Her response was to retreat. A friend from the Cancer Support Association gave her a place to stay where she could be alone. She felt very angry "I was blaming my husband, blaming everybody." Eventually she found herself wanting to relinquish the struggle. She surrendered to her fate, she wept and mourned her own death.

I prayed that I could love the cancer instead of fight it, just embrace it and love it.

To assist herself in this, Maria practised Buddhist loving-kindness meditation called "metta", and was visited by two Reiki masters who interpreted her dreams and gave her Reiki - a form of hands-on spiritual healing.

And she painted prolifically during this time. Her art focused on Goddesses, the "feminine face of God". Maria eventually decided to have an art exhibition to honour her journey and to tell her story. She presented 150 pieces of her artwork at the Cancer Support Association on 6th July 1996, five years after she was first diagnosed with cancer.

I had come to terms with the fact that I was going to die. I was going to show my paintings and tell the story of my journey with love. And strangely enough when I did this, the cancer went! After I had accepted and honoured my journey. I believe this is a metaphor for life. When we love the thing we are most frightened of, the shadow becomes our greatest strength.

Artwork

Discovering art

It was just after Christmas in 1991, about four months after her diagnosis of cancer, that art became an integral part of Maria's healing process. At this stage she was very sick in hospital, bedridden after her third monthly chemotherapy treatment. She finished reading Dr Bernie Siegal's book entitled Peace, Love and Healing: The Path to Self-Healing. According to Dr Siegal, a paediatrician and general surgeon, each person's experience of an illness had a unique meaning; illness was symbolic of the individual's life dilemma. He recommended that cancer patients draw a picture of their cancer and develop a dialogue with it so as to understand the meaning of the illness in their lives. Maria experienced her cancer as "energy loss". With pencils and crayons at hand, she drew her first piece of healing art. She recalled that:

It was very child-like, a five-year old's drawing of myself as a young girl kneeling down in a purple dress and praying. The cancer was a big magnet drawing out all my energy. My doctor's there on one side, and the divine child is next to me. God is above me, and it's a woman. There's a little male God there too. The female God above me is virtually holding me, pouring down light on me. It was the first time I'd realised that the female God, the feminine face of God, was very important to me.

In an effort to gain a deeper understanding of her cancer, she drew the magnet again.

A face came out of it and I wrote down what the face said. The face said to me 'I draw all your energy to me to save you from facing a very important fact you refuse to accept, that you are God, psychic, divine, powerful, loving, all at one. (I wasn't in touch with that, though I knew it intellectually.) You have to use this for mankind. Once you accept it, there is no turning back. And stop blaming your mother as an excuse for not reaching your full potential' - which was so true. That was a bit mind-blowing actually. Here in front of me was the reason I got cancer, I felt. And of course that's where my art and my whole journey started.

Maria found that her art revealed her inner world, truths which were previously unconscious and inaccessible to her. Her first piece of art, she said, "... was so incredibly revealing. It was even better than my dreams." Through her involvement with art, she had discovered another dimension by which she could understand and heal herself.

Art Media

Maria had virtually no experience of art before her illness. She remembers only one piece of art she created many years earlier in medical school after a particularly gruelling year. When she became ill she did hundreds of drawings of her inner world. Using pencils and crayons she drew her cancer, dreams, feelings and intuitions in the diaries and journals she kept. Her first mandala and subsequent artworks were painted in acrylics. "They're water-based. I just didn't want turps around me because I was frightened of the chemicals." Looking back, Maria considered herself very naive about art. "I didn't even know you had to prime the canvas."

Gold fabric paint and other reflective media feature in most of her artworks. She said of her use of gold and reflective media:

Metallic paint was so beautiful. I think it was about the light in myself waking up. The gold reflected what was happening to me, a kind of spirituality that started to come through. I love it. When you put a candle in front of this art it takes on another dimension. The gold stands out and the acrylics recess. It's magical. The paintings are all meant to have the light shining on them. We don't see the magnificence of our life till we actually shine the light on it.

Art as healing

Maria reflected on how she experienced art as healing: "Art was how I got in touch with the depths of my soul."

She recalls that "agony" often led her to paint, she would be in great physical and psychic pain. On one such occasion, after believing that her cancer had gone, the cancer returned and she again thought she was going to die. Maria felt a need to paint her cancer, the Black Goddess, the Goddess of Death:

She was going to pull me to bits, I felt. And out of that agony came the most beautiful transformation. I transcended something. I found in myself a power I didn't know I had.

This feeling of power, of having power to influence her healing, was significant. Maria said that she previously had a pervading feeling of powerlessness. She believes it stemmed from the abuse she was subjected to as a child, when she felt herself very much the victim of her life circumstances.

Maria did not often like her paintings when she was working on them. However, when she viewed them again on the following day, she was transfixed, she would just stare at the art she had created:

It was like God talking to me, my soul mirroring back to me who I am. Actually the more horrifically painful it was for me, often the more release and the more beauty I saw in my art. I don't know if other people liked it or not, it didn't matter. It wasn't for anybody but me.

Feelings of release and wonder accompanied her creative process. Maria compares these feelings to giving birth:

It was like my body pushing out a baby; this incredible creation would come through me.

She said she felt very connected to God, "It's like we co-created something much bigger than me." And she felt humbled by the experience, that "this wonderful expression of life could come through me."

Maria found that art gave her feedback about herself and her life. Answers to insoluble questions would come to her when she was able to stop thinking and to just watch what transpired on the canvas.

To me, art was life. In fact, the deepest kind of life being mirrored back to me. I just feel ... Wow! This is real life, real answers are coming out of this.

Maria feels that her life has been changed through art. She describes the process as the art of living and dying, "not just art on paper." She believes that art has helped her understand her life, "and beyond this little life and into the transpersonal, into the eternal." Through art, she believes that she has come to know the feminine face of God and the Tao, the eternal truth. Overall, she said:

I felt good. And I'm sure my immune system loved it. I'm sure my endorphins went up, and I'm sure that's been a big part of the healing.

The participant's selection of significant art

Artworks: content and themes

Maria approached her art "usually in a meditation trance", without planning and without reference to the external world. Images and symbols would appear spontaneously and intuitively from her inner world, all having symbolic meaning in the unconscious.

The following are descriptions of the themes and content of a small selection of artworks created by Maria. She chose these paintings and drawings on the basis of the artwork she most experienced as healing.

FIGURE 1. Drawing her cancer (1991)

While bedridden during the first year of chemotherapy, Maria worked on hundreds of pencil and crayon drawings which she kept in journals and diaries. She wanted to develop a dialogue with her cancer which she had symbolically depicted in her art as a magnet drawing out her energy. The most significant of these drawings were her first pieces of art. Maria believed the drawings showed her the cause of her cancer and, by implication, the remedy. The cause of her cancer was her refusal to accept that she was a spiritual being, divine and psychic. Her healing would come from accepting her true nature, her divinity.

FIGURE 2. Stations of the Cross (1991-1992)

The first 14 pieces of her artwork represent the trials Maria endured during 14 pulses (monthly chemotherapy). She said she experienced being the Christ myth. She describes this "crucifixion phase" of her journey as the death of her ego and body consciousness, and her ascension into a level of cosmic consciousness.

The Seven Days of Creation (1994)

Maria was convinced from the feedback she received in her first drawings and subsequent dreams that her healing related to a spiritual journey, specifically the journey into feminine divinity. She approached this task by rewriting the Bible "according to woman", beginning with Genesis. A series of seven mandalas represented the seven days of creation. The art, Maria said, was about "love, change, cycles, joy and weeping: the feminine". "Mandala" is a Sanskrit word meaning "sacred circle". The word was adopted by Swiss psychiatrist Carl Jung to mean "formation, transformation, eternal mind's recreation", "the monad", and "symbol of the self" (Jung, 1964). This series of mandalas marked Maria's first use of acrylic and metallic paints on paper.

Maria painted her first mandala, entitled "The Goddess Dances" (Figure 3 below) on her 49th birthday in 1994, which for her meant "the end of seven (seven-year) cycles" in numerological terms. The mandala , a flower motif, shows a snake coiled at the centre of the picture, surrounded by seven crosses. Maria sees the coiled snake as representing "kundalini" energy. Kundalini refers to the Tantric Hindu Goddess who is believed to dwell coiled at the base of the spine as a snake but can rise up through the chakras as one's psychic energy moves towards enlightenment (Graham, 1997). She embodies the energy of wisdom. Her symbolic form, the double serpent, is at least as old as the Bronze Age and may date back to the Stone Age. Kundalini symbolises primal being.

The remaining six paintings in her first series were painted over six days. Each was a mandala, a flower motif painted in different colours, one also incorporating the Kuan-Yin colours of pink and green. Kuan-Yin refers to a Far Eastern goddess, originally the Taoist Mother Goddess, and later the Buddhist deity of infinite love and boundless compassion (Graham, 1997). Also in the paintings are butterflies which, according to Maria, are symbolic of her soul's journey, and sequins which represent divine love and light.

Nearing the completion of the sixth mandala, entitled "Goddess Speaks" Maria remembers having a mystical experience when she left blank the centre of the mandala. She heard what she interprets as the voice of the Goddess in her room pronouncing "I am". This coincided with an intuitive sense of being "at one with the Goddess". On the following day, medical tests showed that her cancer had gone for the first time, almost three years after her initial diagnosis.

Figure 4. Goddess Speaks

The last piece of the series painted in gold and pink on the seventh day was entitled, appropriately, "Goddess Rests" This mandala contained the image of 12 snakes leaving the centre and passing out through 12 petals of a flower motif. The crosses fade into the background. A very round symmetrical mandala, it was experienced by Maria as "completion".

Figure 5. Goddess Rests

 

 

FIGURE 6. Resurrection of Goddess (1994-1995)

With news that the cancer had gone, Maria felt renewed and in celebration of life. This painting followed the Christian myth she was pursuing at the time "from the crucifixion of the chemotherapy to the resurrection of the feminine face of God". Painted in acrylic and metallic paints on paper, the painting was started in 1994 after "The seven days of creation" and took Maria nine months to complete.

The image is of the head and torso of a woman with large cat's eyes ("the Goddess symbol of seeing in the dark"), short hair ("regrowth"), an owl ("intuition"), the rainbow serpent ("the Aboriginal symbol of the creative Holy Spirit"), and menstrual blood. Her arms are held up sky-wards. The image stops at the eyebrows and mid-thighs. Her "womb of creation" is bright gold radiating light; its placement above the pubic hair, also depicted in gold, suggests to Maria a chalice. The right side of the painting, depicting the moon, stars and planets, suggests the dark and unconscious as well as the transpersonal. The left side depicts a flowering plant and butterfly, and suggests to Maria the light of consciousness.

FIGURE 7. The Ascension of Goddess (1995)

The first of a series of paintings inspired by the "Black Goddess", Maria considers this one of her most significant paintings. She explained that:

The Gods and Goddesses are energies within ourselves, archetypes we resonate with, that help us through and understand the deeper meaning of life and death. The Black Goddess is a very important part of the feminine that is rising in our culture. She is the energy about endings and beginnings, the part of our spiritual tradition that has been denied and burnt at the stake. Also known as the Goddess of Death and Destruction, she is that energy in us that we are terrified of. The Black Goddess in reality takes us through a death, but also brings us back to life.

Maria understands the all-destroying aspect of the Great Goddess as co-existing with, not as separate from, the all-loving aspect. She believes that there is an unconscious and conscious terror of death in Western Culture, which inevitably gives rise to an imbalance, manifested as the denial of death. Maria suggests that in indigenous cultures "where the feminine is still alive", the two aspects of life - creation and dissolution - are perceived as an undivided unity of opposites and continuous. While Western Cultures tend to think of life and time as linear and limited, indigenous cultures consciously accept and experience the cyclical nature of life as eternal.

For Maria, the process of confronting her own mortality involved "befriending" the Black Goddess. It meant accepting her cancer and her imminent death. For her cancer was the Black Goddess. Maria explained her first visionary experience of this Goddess of Death:

I thought she was going to be a horrible woman who was going to pull me to bits, but she wasn't. She turned out to be an ecstatic woman full of life. So she is the wonderful part of myself that I found, that understands death. Even though we die, we are reborn, the spiritual part of us lives on.

The artwork, painted in acrylics on a large six-foot canvas, took Maria nine months to complete. The painting shows a life-size image of a dark woman standing with arms and legs open wide. Her head is tilted back and upward. Her smile is open and wide, her hair wild and flowing. She holds a skull in her left hand and an apple in her right. Behind the figure is the sun setting over the ocean, its warm tones reflected in the clouds above. Her feet are immersed in the water. Two dolphins are shown poised in and above the ocean, water splashing. They are placed in the water with the blood, at the base of the painting between the open legs. The figure is naked, her nipples are gold, and menstrual blood is flowing down freely between her legs.

Maria says that this is the image of her own body which she painted while posing in front of her mirror. In painting her image she felt she was honouring her body. This honouring was a celebration of her physical self as menstruating, given her "horrific and violent" initiation into menarchy. She received a severe belting by her father. The experience left her feeling shamed and dishonoured. Maria said of this:

In my family, menstruation was seen as dirty. Women's sexuality was seen as ugly. The Catholic Church really put women's bodies down. We were told it was sinful to even think about our bodies. Some of the nuns were cruel women, cruel also to themselves. I was brought up with crazy, sinful injunctions about my body. So it was important that I re-owned my body with love. And so I painted my body, and my menstruation too.

Maria associates the image on the canvas with Lilith, Kali and Baubo. Lilith, who first emerges in Sumerian culture as a handmaiden to the great goddess Inanna, and first wife of Adam before Eve. She represents sacred sexuality (George, 1992). Her image and her cult were eventually banished and demonised by the Christian patriarchy (Walker, 1983). Kali is the Hindu Goddess of Death and Destruction, she is represented by the figure grasping the skulls and the "apple of immortality"

(Willis, 1993). Baubo, or Iambe in ancient sources, is the Goddess of obscenity and of women's belly laugh in Greek legend (Warner, 1994; Estes, 1992). In Maria's painting she stands in defiance of social and sexual taboos, with her legs astride, openly menstruating and in orgasmic pleasure. Her pupils are dilated, she celebrates her body and sexuality as hers; she is a woman unto herself. Maria says of Baubo "She knows how to enjoy her body and laugh". The dolphins represent love and healing to Maria. The sunset represents an ending, and the ascension a beginning. The figure's upward tilt of her head, her upward gaze, and the upward flow of her hair suggests to Maria her connection to the universe and higher states of consciousness through Tantric sex. She commented:

I was understanding my immortal self and grasped who I was: a woman unto herself, an immortal soul - proud to be a real, whole and holy sexual woman.

 

 

FIGURE 8. Croning of Maria Gaea of the Tao (1995)

This was painted in celebration of Maria's 50th birthday and in commemoration of her "Croning Ceremony". During the croning ceremony Maria honoured the symbolic death of her menstrual times and mothering, and underwent an initiation into the Crone, which is the priestess status of the wise woman in ancient Goddess cultures (George, 1992). The ceremony took place at sunset, symbolising an ending. Maria, wearing a crone cape, was taken across the Swan river by a woman friend, a shaman, who had lived with Aborigines and had a better understanding of "women's business" than most Westerners Maria knew. She was taken to the Waggal Cave at Fremantle. This was symbolic of the soul's journey across the river Styx to Hades in the underworld. According to the Greek legend, the underworld was where the souls of dead mortals were judged and, if necessary, punished in the dark infernal regions of Erebos or Tartaros. The underworld also encompassed the lands of the divine dead, the Elysian Fields or Islands of the Blessed. It was ruled by the god Hades, a name also given to the underworld itself. Charon, the boatman of the underworld, ferried the souls of the dead across the river Styx to Hades (Willis, 1993).

On the night of the ceremony, three dolphins spontaneously appeared and led her canoe across the river. Twenty of Maria's women friends witnessed her initiation and celebrated the occasion with her. Maria recalls feeling "reborn", "very dignified", and describes the event as "the most sacred and magical experience".

The painting shows Maria and the shaman in the canoe led by the three dolphins. Maria describes the dolphin as one of her animal totems. Also illustrated is "the spirit of the owl" in flight across the night sky, which Maria interprets as the wise woman. The spiral symbolises to her the journey towards the centre to the divine self, the Goddess. The wise woman or the crone, is an aspect of the Black Goddess who Maria describes as having negative connotations in our culture. Maria includes in her painting the drum which featured throughout the ritual, the "power stick" carried by the shaman, and a depiction of the circle of women dancing around a fire.

"Maria Gaea of the Tao" is the initiation crone name she -gave herself. Maria says that she was previously very much Dr Maria Weekes, the psychiatrist, who identified very strongly with her particular body and a particular mindset. After the ceremony, she noted:

I gave myself another name. I didn't feel like the same woman. I am Gaea because I feel one with everything, the earth, the desert, the birds; not separate, no boundaries. And I am the Tao, which is everything, the Great Spirit, God, the eternal. So is everybody else, we are all one. We just think we are separate, which is an illusion, a delusion.

FIGURE 9. Dark Night of the Soul (1995)

This image was conceived in the months following her croning. This was Maria's first use of black paper for the background of her artwork. Maria experienced a very deep "dark night of the soul", a term originally coined by St. John of the Cross in the Christian tradition. Maria understands the experience as witnessing a death of a part of the self, and refers to these dark times as "a descent into the underworld". She believes that this experience is very often diagnosed in psychiatry as depression, a mental illness. While she acknowledges the legitimate use of antidepressant drugs for people in need, Maria suspects that in many cases self-healing is possible. She suggests that the diagnosis of a psychiatric illness is shaming of the individuals involved, and the drugs subsequently prescribed arrest the process of spiritual emergence. In contrast to this, the process of self-healing has an empowering effect. Maria found that when she fully experienced her dark night of the soul, which included the many descents over the years, the experience was healing on a spiritual level, and personally meaningful. She said

I don't see physical illness or mental illness as a bad thing. I see it now as something wonderful trying to get out, your greatest dream trying to break through. The death of the body is not a failure nor a great horror.

FIGURE 10. The Akashic Records: Into the mind of God: The Crone Magic (1995)

This mandala was conceptualised when Maria "went into a deep dark place" inside herself after her initiation ceremony, and began remembering many past lives. Recalling the events after her croning, Maria commented:

After my initiation into the wise woman it took three months in the darkness of pain and no energy before I re-birthed and remembered many of my past lives. I remembered I had often been burnt as a witch for knowing too much and for defying Patriarchy. I had many tortured deaths. I was raped, burned and executed for being a wise woman. The memories and the screaming went on for months. The terror of this recurring in the present time was with me as I started being public about my life and knowledge. I realised just how much fear I was still carrying about speaking up like this. I was breaking taboos and being a wise crone who spoke her truth.

These experiences, referred to by Jung as "tribal memories of the collective unconscious" are depicted in her painting entitled "Tribal Memory of Witches' Persecutions" (1995). In the painting the featured wide open mouths give expression to the screams and horror of the women being burnt alive. A related subsequent painting entitled "The Rage" (1996) gives expression to the intense anger she felt as a result of the brutality and oppression she endured at the hands of her parents, religion and culture.

Maria says that the multiple eyes in her painting symbolise her ability to see beyond this life into other lives, also her ability to perceive the collective unconscious, and her perception of halos. She said:

I love the purple and gold in the painting, and my ever expanding vision of who I really am.

 

The Rage

This paiting represents Maria's response to her memories of being burnt as a witch. She felt rage at all the repression she suffered at that time, also at the opporession she has suffered durung this lifetime (1996).

 

FIGURE 11. Transcendence (1995)

This was painted when Maria felt that she was emerging from the pain of her dark night of the soul. She and her husband went to Rottnest Island for a recuperative holiday. Maria feels that the painting's bright colours and glitter indicate a new spiritual emergence. The balance and symmetry of the art, together with the use of four fish placed within a circular motif express to her a sense of wholeness.

FIGURE 12. Birthing My Spiritual Self (1995-1996)

Her second six-foot canvas, this painting was also significant to Maria. Maria originally felt dread at the prospect of expressing and depicting the darkness she was feeling after her croning. She eventually found that her feelings of dread and terror were finally transformed. Maria said of the experience:

I thought I was going to die with cancer at that stage. Again, I thought the Black Goddess was going to be this big ugly horrible witch, but she is so beautiful and soft. The artwork around her was beautiful, and very helpful.

I have had many dark nights of the soul. I now know the experience as another shedding of a skin, another piece of my ego or belief system that I need to let go of and mourn. There's no despair, and the rewards are fantastic! I realise that if I go with death in my life, let things happen, there's this beautiful energy that re-births me always.

In her painting, Maria celebrates the birthing of what she refers to as her Highest Self. She believes she was able to do this by understanding who she really is, that is, the divine immortal, and by confronting her own physical death from cancer in the form of the Goddess of Death, crone, wise woman. She interprets the snake as the playful Goddess, the cat as its feminine symbol, the crow as the bird of wisdom, often seen with Hecate, the Greek crone Goddess, and as a representation of the Death-Goddess. On the left side of the painting is a depiction of an Australian shrub, the red bottle brush. Maria experienced this painting as "grief and pain resolved".

 

FIGURE 13. Poppa (1995)

Maria produced this painting in honour of her relationship with her father, who had died nine years previously and with whom she had both warm and painful associations. She said that what started out as "sucking" tentacles in the painting, became the image of a snake. Maria interprets the prominent "eye" at the centre of the painting as the eye that "judged and shamed" her; it is shedding tears of blood. Superimposed on the image is the gold outline of a large fish and "yoni", the female sexual organ in Sanskrit, she noted. Maria sees the fish as a symbol of Christ consciousness, and the yoni as a symbol of the Goddess. She said that her father was a strict Roman Catholic and she believes he worshipped Mary as well as Jesus, in the Christian tradition. Maria remembers her father as being much warmer than her mother. She believes he coped as well as possible with a sick and disturbed wife. He seemed to feel deep shame about his own sexuality and about sex in general.

FIGURE 14. The Scream (1995)

This was painted when Maria's daughter was critically ill, and expresses the grief Maria felt at the time. In this painting, Maria has a six fingered hand, the symbol of a witch. Her daughter, who is gradually recovering from her illness, is seen cradled in her mother's arms, and appears as a skeleton. Maria believes this painting also depicts facing her own physical death, and finding her Goddess/Witch wisdom holding and transcending the death of her body. She considers this one of her most significant works, a cherished piece of art.

 

FIGURE 15. Please Love and Approve of Me (1996)

This painting depicts Maria's inner child who she felt was "in an orphanage, unloved and unwanted". As a small child, Maria was in fact placed in an orphanage for some time when her younger brother was born. She distinctly remembers the pain, her feelings of abandonment and rejection as she watched her mother walk away through the iron bars of the building's gate. One consequence of this event was that she had always felt that her brother was a preferred child. Maria became her mother's helper when she returned home, her "mother's mother". So much so, that when as an adult Maria wanted to leave her family home, she got the distinct impression that her mother "wanted her dead rather than to leave". Her mother was unable to show love. Remembering how desperate she was for her mother's affection and care, Maria said with remarkable clarity and insight:

I felt deep in my bones 'what have I got to do to get my mother to love me, kill myself?'

FIGURE 15. Kunapippi Births the Universe: Cancer Gone Softly Home: Eternal Orgasm (1996)

Kunapippi is Maria's Aboriginal initiation name which means the Earth Mother who creates the universe. She was given this name by an Aboriginal woman at another initiation ceremony after her croning. Maria said that she had started to paint the seven stages of death two years beforehand when she was again convinced she was going to die from her cancer as her cancer cell count increased. She found that she could not continue with it. After some time of inertia, she felt an urge to paint the image of Kunapippi, an image of creation. Of the painting she said:

It was going to be a death experience. I was going to do the seven stages of death according to the Tibetan Book of the Dead, but I couldn't. I only got to the first stage.

This is my self birthing universe within universe all from the heart chakra, which is the Tao. The universe I am creating out of myself now is out of love. I felt free of cancer and more importantly, free of my fear of death, for no matter what happened I would be spiritually reborn. Lust had been converted into love and creativity in my body and life.

The painting shows a birthing, with breasts that are "forever milking". "Eternal Orgasm" refers to a state of bliss Maria said that she experiences most of the time. She says that compared to how it used to be, her life is very peaceful and joyful. She discovered at the completion of this painting that the cancer had in fact gone. She has since refused to have any more blood tests, as she trusts in her own intuitive knowing.

FIGURE 16. When women's menstrual blood falls on the earth again, men's blood will no longer be shed in war (1996)

This title is a direct quote from a poem that resonated strongly with Maria. This painting became one of a series entitled "The Blood Mysteries of Women". Reflecting on the images, she said

I just felt that so many women don't connect with the earth and get back to who they are, particularly around menstruation, birthing and menopause. It's about honouring the earth, the planet, and our bodies which are sacred; reclaiming that deep spirituality of the shamanic female. All the religions with a Transcendent God look down on matter, women, the body, nature, earth, and see Spirit as superior.

Maria recalls meeting Lightning Bear, an American Indian Shaman and gynaecologist, who taught her the meaning of the blood mysteries of women. He said that in his culture menstruation was a most sacred time of the month. Women's menstrual cycles were attuned to the dark phase of the lunar cycles or mid-full moon. During their menses, women go into an altered state of consciousness, they can go deep inside themselves and be quiet, as they are at their most psychic and at their most spiritual. They went to the Moon Lodge to meditate, dream and do their crafts with other women. The wisdoms and insights they gained were then brought back to heal the tribe. Women were in fact revered for their powers to heal. Maria discovered that "rape" was unheard of in Indian culture before the "white man" came. Such was the level of respect accorded to women.
Similarly, she found that in pre-patriarchal times, the Goddess cultures considered menstrual blood to be healing. A young woman's first blood was the most sacred of all blood, and menarchy was a most sacred time. The word "eucharist" originally related to the menses of the Goddess (Walker, 1983).

Maria described these revelations as music to her ears. She further found that there is evidence that the abeyance of the feminine, the state of temporary inactivity, happened simultaneously at the universal, astrological level. Historically, 3000 years of patriarchy has brought about left brain, logical, "masculine" consciousness from which technological advances have developed. Meanwhile, the right brain, intuitive, "feminine" aspects receded. Maria explained:

Everything is in cycles. If you look at nature, there is always a time of 'endarkenment'. The universe has been going through a dark phase, a Kali cleansing time. Things die and are reborn. The Goddess energy is coming out again, and this time she is more powerful than before. Before there was an unconsciousness about it, whereas now it is in the process of being a conscious relationship. She can be one with the masculine.

 

FIGURE 17. Dancing in the Flames: Deva Kali Ma (1997)

This voluptuous figure of Kali is yet another representation of the Black Goddess for whom Maria feels a "fascination". In this depiction, she is dancing in the flames of transformation with a sickle with which she has cut off the head of her consort, Shiva. Maria sees Kali as the "energy of the universe that destroys in order to rebirth". She associates the head with the intellect which is full of concepts, ideas and attitudes that she says "get in the way of my enlightenment". The severed head represents to Maria a shift from her "masculine" intellect to her "feminine" body and intuition, thus symbolically redressing the balance between the masculine and feminine aspects within herself.

 

FIGURE 18. Death of the Patriarchal Prostitute (1997)

 

This was the second of a series of four paintings about the polarised aspects of feminine sexuality in Maria's psyche. In the series, one extreme is represented by the virgin, nun, and the other is the prostitute. Maria believes this polarisation is the result of cultural conditioning during her formative years, particularly in terms of her religious indoctrination. In Christian doctrine, the split occurs between the idealised feminine, epitomised by the Virgin Mary, mother of God, and the sexually potent and sexually active female, Mary Magdalen. One has a child without sex, the other sex without a child. Reproduction is on one side of the split, and sexual drive is on the other. Maria believes that these two aspects of feminine sexuality have become separate, two clearly differentiated feminine principles. She also mentions that they are related to the menstrual cycle: receptive and motherly around the time of ovualtion, and assertive around the time of the menses.

In this painting, the Black Goddess holds the dead prostitute, symbolising for Maria the shedding of a role, the "prostitute", who wanted to fit in with the "too Yang" patriarchal values of power, money and prestige. Maria describes this as "a difficult letting go". Sexuality in this Patriarchal context, she noted, is about power, not love. This painting also represents Maria's grief for that part of her that was sacrificed in order to fit in: the spiritual, intuitive, wise, loving, relational feminine aspect of herself. The "matter" and "spirit" split is eventually redeemed.

The series of four paintings ends with a depiction of the "gipsy free bodysoul", Maria redeems "Lilith's, Eve's and Santa Maria's bodysoul".

Bodysoul

The two aspects of the feminine are no longer separate, polarised and mutually exclusive. Maria ultimately rejoices in her own body (the carnal, instinctual feminine) which is not separate from soul (the divine feminine spirit). A new model of masculinity also emerges within herself, an inner male who she described as:

A holy man, not patriarchal power over, but power to enable others and myself.

 

 

FIGURE 20. The Shaman's Graduation (1997)

This is Maria's depiction of a dream in which a phallic woman (androgyn) comes out of a burning bush. A voice declares "You are now a shaman", and a thunderbolt sounds in the heavens as the voice speaks. The huge belly suggests to Maria that the woman is "pregnant with everything, she has the whole world inside her". Maria interprets the two snakes as a symbol that suggests healing, the star of David as the integration of the masculine and feminine principles within herself, and the "purple hair reaching out to the universe" suggests to her a connection with other states of consciousness. The phallic woman's feet rooted in the ground, suggests to Maria that she is connected to and one with the earth. She is all.

FIGURE 21. Honouring Mad Women (1997)

When the cancer returned at that time, Maria again went into a state of depression and despair. She said that it took two weeks of sitting in front of the canvas before she "could just paint it black". Then slowly a cauldron emerged and then a skull. She said

I realised I would die and there was nothing more I could do. Inside me was a negative death mother that wanted me dead. I didn't want to eat. Slowly I faced and accepted my physical death. I surrendered.

Maria drew the "Shaman of Death" with her medusa snake hair, dancing around the cauldron beating her drum. Maria slowly, reluctantly, reconciled with her. She felt devastated, that she had "gone to hell and back". Eventually she felt the golden snake rise up in her spine. The golden snake for Maria represents the voice of the Goddess inside herself. Maria said that she has been in touch with this sacred voice since then. Hakomi therapy and meditation has helped her deepen this connection. The golden snake image, associated also with the Kundalini energy in her first mandala, appears in many of Maria's paintings, and has slowly uncoiled over time. Her first image of the snake was the tightly coiled snake in her first painting, the mandala of the First Day of Creation, entitled "The Goddess Dances". By contrast, in this painting the snake appears uncoiled, rising up to the length of the Shaman's spine and out through the third eye.

FIGURE 22. The Seer (1998)

This was painted for a friend's initiation as crone. Maria interprets the Seer as the wise woman in whom the polarities of life have come together. Maria said:

The Seer sees both worlds, life and death, man and woman, dark and light, good and evil, God and humanity, as one.

The oneness is symbolised by one eye. She considers this image as a reflection of the self as a holy woman, a white light healer. Maria interprets the wand with two snakes twined around it as the caduceus, representing healing. The rational and historical explanation of the caduceus, according to Juan Eduardo Cirlot in his book A Dictionary of Symbols (1962), is the supposed intervention of the Roman god Mercury in a fight between two serpents who thereupon curled themselves round his wand. Cirlot states that what defines the essence of the caduceus is the nature and meaning not so much of its individual elements as of the composite whole. The precisely symmetrical and bilateral arrangement, as in the balance of Libra (the seventh sign of the Zodiac), or in the tri-unity of heraldry (a shield between two supporters), is always expressive of the same idea of active equilibrium, of opposing forces balancing one another in such a way as to create a higher static form. In the caduceus, this balanced duality is twice stated: in the serpents and in the wings, thereby emphasising that supreme state of strength and self-control (and consequently of health) which can be achieved both on a lower plane of the instincts (symbolised by the serpents) and on the higher level of the spirit (represented by the wings usually depicted on the serpents).

Maria sees the star of David, made up of two triangles, one pointing upwards, and the other downwards, as representing wholeness: "as above, so below". Commenting on this painting, Maria quoted a passage from the Bible:

When we see the world through one eye, the body is full of joy.

 

FIGURE 23. The Source (1998)

This is one of a series of paintings entitled "The Source" which represent Maria's increasing identification with her divine self. After discussions and meditations on Death with a Tibetan Buddhist monk, she felt that this painting appears to represent the stages in the process of dying, the dissolution of the four Elements. According to Maria, the flames represent fire, the depiction of space is the air element, the flowers suggest the earth, and the inverted triangle represents water. This painting also represents to Maria the realisation of her goal. "The Source" is the end point of her journey towards her centre, the divine Self, and is experienced by Maria as completion. She said:

I have been trying to paint God, which has really been my journey: into God, to understand me, and our oneness.

Reflections on healing

Reflecting on the nature of her healing, Maria says "I am full of awe, and feel deeply privileged to be in touch with such a profound process." She considers herself "extraordinarily grateful" to have had the money, time and training to have been able to undertake such a journey. She has ultimately survived, and finds herself and her lifestyle changed in many ways. She says she lives very differently now than before her awakening.

Though she is still interested in working as a healer, Maria has stopped practising medicine. She has found "letting go" of her profession very difficult because it has meant relinquishing the power, status and income associated with it. Relationships have become the priority in her life, with a focus on her family, friends and her spiritual life.

All that really mattered when I thought I was going to die was that I left love behind and that our relationships were all healed.

She believes that her primary relationships have changed, that there has been deep healing in her family. She describes her husband's loyalty and unconditional support of her throughout her ordeal as a deepening experience for them both. "There's so much love between us. He is incredible, he has just blossomed." She sees evidence that her two children have reclaimed their feminine power. Her older daughter has changed careers, from pursuing a career in law she is now "following her soul journey; she's going to be a vet. She's got that lovely Artemis energy, the Goddess energy to heal animals." Her younger daughter is at present studying the blood mysteries of women "and is doing some wonderful work." Maria has found that her healing also changed her relationship with her mother with whom she previously had a very painful association. She now feels deep gratitude, love and compassion for her.

Her most significant challenge "by far" was facing the fact that she was going to die. At one point in her struggle to heal herself, she accepted her fate and prepared to die. She made her will, planned her funeral, made videos for her children, and urged her husband to let her go, to move on with his life.

John stayed with me and we worked through the agony together. I really wanted him, if he wished, to feel free and to find another woman if I died. I was able to say ‘move on, just let go - whatever is best for you, I free you, I am not holding on to you’.

She found that in the process of letting go of her life (her body, her husband and children), she became "liberated". She now experiences a newly found freedom; she regularly retreats alone into bushland seclusion to paint and meditate.

I think I've got my values right at last, a very deep connection to life and what's beyond. Life is all about love and compassion with all aspects of existence.

She has come to believe that:

There is always hope. The philosophy here is to heal your life not to cure your cancer - because you can't always cure your cancer. Some people do, I've been fortunate so far. But even that's not important. It's important how you live in the now, living in the moment, full of love, peace and joy. It's not about dying, it's about living. That's what cancer is all about for me, just letting go and being full of love, compassion, joy and equanimity.

Maria believes that the journey she has undertaken is primarily about learning to love herself.

It's to love very, very deeply every part of me, even the darkness. To love and know myself is to know and love and understand life, God, all.

She feels that she had introjected the abuse and neglect in her upbringing, that what had been done to her as a child she was perpetrating on herself as an adult. She found she had a great deal of self-hatred to overcome. She now sees that her own and other's inadequacies come from exactly the same place: from the deprivation of love. This understanding enables her to see past negative behaviours and emotions to the hurt person inside herself and in others.

If I don't love me deeply, I can't love other people deeply. So loving is what it's all about, opening my heart to every bit of life, every bit, and to every person and nature too.

One of the hardest things Maria has had to confront is her predisposition to "worshipping" the intellect.

I was very proud of my intellect, very attached. And it's been a very painful struggle watching that wall come down, brick by brick.

Looking back over her journey she sees that many of her "dark nights of the soul" have been about dropping rationality as much as possible:

Getting out of my head and getting into this body, this woman's body, listening to it, trusting it, trusting the emotions and the intuition that comes out of that.

To achieve this, Maria engaged in bodywork, Hakomi body centred therapies, yoga, meditation, dancing as well as art. One of the outcomes is that her sexuality has changed from being orgasm-oriented sex, to a heartfelt loving connection, "Tantric type of sex".

I've changed from a masculine, patriarchal way of being a woman into a much more spiritual, transpersonal, body-oriented person. I've got out of knowing with my intellect into trusting intuitive knowing. I'm trusting nature, my body, and life.

Maria says that she now "implicitly" trusts her own knowing, so much so that she no longer goes to doctors for tests. During the healing of her cancer she became so attuned to her inner knowing that her dreams would reveal to her exactly what her test results would be two months beforehand. She is now convinced that "energy comes before matter." Maria believes that it may therefore be possible to observe people's energy fields and use this information to prevent illness before it becomes manifest in physical form. In this respect, she believes the journey is not hers alone. It is her hope that from the wisdom and insights she has gained, others will also benefit "as we are all one anyway".

A major obstacle Maria has confronted and overcome is her fear of speaking her truth about the feminine. It was essential to her healing that she elevate what religions desecrate, affirm what cultures refuse to recognise, nurture what her family neglected and abused, reclaim what she had disowned in herself: the feminine. Maria believes that women today share an unconscious memory of the Inquisition. Millions of women were tortured and burned alive. She believes this memory alone silences women, especially older women, collectively. Having confronted her own fears, she finds when telling her story she is, in fact, well received by men as well as women.

Some of the most beautiful receptions have been from men who understand. They are reclaiming their feminine and their true masculinity.

Maria believes, in retrospect, that her soul chose an illness that was not treatable by the medical profession. "It had to be something I had to heal from within." She feels that had it been otherwise, she would not have had the opportunity to embark on a journey of self-exploration that has brought wholeness and healing to her life. She believes that she carried a great deal of unresolved anger, shame, hate and rage. She noted that once she cleared herself of the self-hate she now perceives as toxic, there was room for healing.

In retrospect, Maria has come to believe her anger and hatred towards others have been resolved. She now understand that her persecutors were necessary for her healing. In this sense, she feels deeply grateful for their part in their efforts to awaken her to the truth of who she really is. She in fact sees them as part of herself at a deep level, like characters in dreams. As the first drawings of her cancer had suggested to her: she must wake up and accept that she is God, the Divine Immortal.

Maria views her healing as ultimately coming from "a deep spiritual connection". "I really would go through every bit of that again just to find what I have found." Reflected in her art is the agony and the ecstacy, the light and darkness, the richly woven tapestry of her life's journey. "A wonder-filled journey into Divine Love" she observes.

Overall analysis of the artwork

The following is an analysis of 77 artworks Maria created over the last seven years, from 1991 to 1998. These pieces are not a complete representation of her work. Maria created literally hundreds of line drawings and paintings. This was a convenient sample, a selection made on the basis of its availability at the time of recording them photographically. A limit on the number of artworks represented was also made so as to keep this project to a manageable size. While only six of a total of several hundreds of her earliest line drawings are represented, they include the first two of those Maria considers to be her most significant works. Other artworks Maria referred to as most healing are all included in this selection.

A study of the art's content revealed eight major categories: (1) people, (2) animals, (3) symbols, (4) colours, (5) numbers, (6) archetypes, (7) thematic motifs, (8) spiritual references. The numbers that are associated to the items listed under each category, correspond to the number of artworks in which the items are found. For example, the item "Butterflies", listed under the category "Animals" appeared in 10 paintings, though in each painting several butterflies are depicted.

(1) People

Women: Out of the 77 drawings and paintings studied, 43 included images of people. Of these, a significant number (40) were images of women. They were depicted in a variety of roles and age groups, as: mothers, daughters, children, infants, old women, black women and nature women. Of these, images of black women (18) and mothers were mostly represented (11). The "black" women included women whose images were outlined on black paper (11), and women depicted with dark skin pigmentation (7).

Men: It is interesting that out of the total of 77 paintings there were only six paintings and drawings with depictions of men. They included images of a holy man, lover, angel, God, doctor, boy ("monkey face male child"), and a symbolic rendition of a negative father. The holy man, lover and the negative father are relatively large and prominent drawings and paintings. The male images on the three remaining artworks are small and relatively insignificant.

Actions: The images of women were depicted in a variety of actions: in pregnancy, squatting, birthing, cradling, sitting, standing, menstruating, communing, coupling, dancing, suffering, threatening, killing, praying and dying. Most included among these actions were life phases, and actions which create bonding and community. The most common and unusual body posture, depicted in 12 paintings, was a standing posture with fully extended arms held upward and outward and legs astride.

Body parts: Of the 49 artworks in which the human form or body parts were depicted, a significant number feature eyes (26), hands (22) often with painted fingernails, hair usually rising (21), mouths (18), and breasts sometimes milking (16). Among depictions of the eyes were fully open eyes, third eyes, multiple eyes upturned eyes and closed eyes. Hearts feature to a lesser extent, along with images of disembodied heads. Interestingly, the torso (24) was more commonly depicted than the full body image (19).

(2) Animals

A variety of animals were represented in the artwork. Snakes were featured in 16 artworks, birds in 11, butterflies in 10, dolphins in 4, fish in 3 and cats in 3. Snake images included: the double/intertwined snakes as in the caduceus, the Aboriginal Rainbow Serpent, the Ouroboros (snake/serpent biting its own tail), the golden snake, and snakes representing hair in Medusa-like images. Bird images included the dove of peace, birds representing spirit, the pelican, owl, crow and garuda.

(3) Symbols

(a) Representational: A large variety of representational symbols were depicted in the art. Most commonly depicted were images of flowers (36), stars (26), the moon (15), leaves (15), night sky (12), tears (12), fire (10) and hearts (9).

(b) Graphic: Among the graphic lines and shapes represented, the symbol of the mandala was mostly featured (44), radiating lines (33), spiral (28), waves (20) and dots (16). The designs incorporated within the mandalas included: concentric circles, spirals, flower formations, flower petals in wheel formations, squares within the circle, centres with star or cross symbols radiating four, six, seven, eight, eleven and twelve rays, a snake coiled in the centre in a spiral or ring shaped around the circumference, and designs representing eyes (pupil and iris).

(4) Colours

The colours most frequently applied in Maria's artwork were: blue (65), followed by glitter (54), then green (50), red (49), white (47), yellow (39) metallic gold (39), pink (38), silver (34) and copper (32). Black was prominent as the background colour in 23 of the 32 paintings in which it was found.

(5) Numbers

The most commonly represented numbers were: the number 8, which was represented in 10 artworks, the number 7 which featured in 8 artworks, the number 3 in 6 artworks and the number 4 was represented in 4 artworks. In terms of people, of the 43 artworks with images of people, 27 were single figures, two figures were depicted in 10 paintings, 3 figures were featured in 2 drawings, and there were multiple figures in 4 artworks.
(6) Archetypes

In his book Man and his Symbols, psychoanalyst Dr. Carl Gustav Jung describes archetypes as:

"'archaic remnants' - the mental forms whose presence cannot be explained by anything in the individual's own life and which seem aboriginal, innate, and inherited. These manifestations which I call archetypes are without known origin, and they reproduce themselves in any time or in any part of the world - even where transmission by direct descent or "cross fertilisation" through migration must be ruled out. They are an instinctive trend, as marked as the impulse of the birds to build nests, or ants to form organised colonies". (Jung, 1964)

According to Jung, the presence of an archetype is felt as "numinous"; that is, as profoundly spiritual in significance (Jung, 1983). He states that the most powerful ideas in history go back to archetypes. This is particularly true of religious ideas, but the central concepts of science, philosophy and ethics are no exceptions to this rule.

In Maria's work, four major archetypes are represented in both their positive and negative aspects: the queen/tyrant, heroine/ruthless warrior, priestess/dark trickster, and lover/tramp. The archetypes represent human qualities which are inter-related, not mutually exclusive. Each represents the tendencies that are most pronounced. The relatively few men (7) in Maria's art are represented in the archetypes of the King (God, tyrant), Warrior (the victim, disembodied head), Magician (holy man, healer) and Lover (sexual partner). Interestingly, the Warrior archetype is not represented in its positive aspect, and the Magician and Lover are not represented in their negative forms. As the large majority of the people represented in Maria's art are women (40), in addition to mandalas as symbols of the self (17) and the symbolic renditions of the Goddess (9), the following will relate to the feminine aspects of each archetype.

The archetypes of Wounded Healer and the Great Mother are powerfully represented throughout Maria's work. The Great Mother, the Magna Mater, is associated with the Queen and Lover, the maternal woman and the process of creation and nurturance. This archetype is symbolic of Maria's creative process, and is depicted in her art in the form of goddess, mother, Kunapippi, Kali and Demeter (the Creator) on the positive side, and the death mother, Kali (the warrior/destroyer) and prostitute (tramp) in its shadow aspect. The Lover is also revealed as symbolic not only of the goal and destination of Maria's journey but also of the way, in the process of healing. In her earliest works and throughout her art are a number of paintings with depictions of the heart.

Less apparent than the Great Mother archetype but equally significant is the Wounded Healer. This archetype is apparent in Maria's process of self-healing, a process in which art was an integral part. The Wounded Healer is symbolised in Maria's art by images of the serpent, the caduceus and the intertwined snakes. One of the archetypes associated with the Wounded Healer is the Priestess archetype symbolising spirituality, reflection and intuition, representing some of the outcomes of Maria's journey. This archetype is depicted in images of the Crone and the Seer in its positive aspect, and in depictions of the Witch and Black Goddess (sorceress as agent of transformation) in its shadow aspect. The Heroine archetype is also symbolic of the heroic journey of self-healing. The Heroine is represented in the artwork which encompasses both the pain Maria encountered and the victories she claimed, also in the images of Maria's struggle with her "hindrances" and in the images of Kali the destroyer and creator. Other qualities associated with the Heroine are personal authority and power to influence. These qualities are evident in the art process, in Maria's ability to speak in her own voice and to express her own wisdom through her art.

(7) Thematic Motifs

The subject matter in Maria's art did not have its source in the external world. All of the images in Maria's art depict her inner world, they represent an exploration of her being. The themes prevalent in her drawings and paintings were:

An exploration of her cancer (4), the cause and its meaning in her life. These represent only four of several hundred of her earliest drawings, and include Maria's first two pieces of healing art, which were among her most significant works;

Expressions of inner change (18), as in artworks depicting initiations, menopause, integration, transformation, merging, emerging, regeneration, death, evolution and transcendence;

Expressions of painful emotions and physical suffering (16), such as physical and psychic pain, agony, feelings of anger, depression, grief, blackness, sorrow, abandonment, aversion, restlessness, compassion and loss;

Expressions of resolution and celebration (17), including love, joy, triumph, respect, honouring, dancing, communion, redemption, connection and nurturing;

Expressions of spirituality (22), for example, images of near death experiences, meditation, prayer, the chakras, the tunnel of light, images of inner divinity, the source, the seer, the shaman, interconnectedness and the voice of the goddess.

The sequence the themes are placed in above correspond to the sequence they appear in the art process. That is, after the initial stage of exploring her cancer, expressions of change appear most frequently, followed by expressions of suffering, then celebration, and finally, expressions of spirituality in her most recent work.

(8) Spiritual References

The spiritual references which predominated were those related to a personal and experiential form of spirituality (31), for example, images of the Goddess, the Black Goddess, the tunnel of light representing Maria's near death experience, images of multiple eyes representing her memory of past lives, and images of her divinity, the "Source" within. Other spiritual references include: Christian and Biblical references e.g. Genesis, 14 Stations of the Cross, the Virgin Mary (11); Buddhist references e.g. Kuan-Yin, the Hindrances, the meditation technique called Tonglean (8); Hindu e.g. Kundalini, Kali (7); pre-Christian theological references e.g. the Lilith, Demeter (7); Aboriginal spirituality e.g. Kunapippi, Illawongu (3); animistic references e.g. tree/woman, garuda woman (3); and Taoism (2).

Interpretations of the artwork

Turning-Point.

For there is a boundary to looking,
And the world that is looked at so deeply
wants to flourish in love.

Work of the eyes is done,
Now go and do heart-work
on all the images imprisoned within you;
for you overpowered them;
but even now you don't know them.

Learn, inner man, to look on your inner woman,
the one attained from a thousand natures,
the merely attained
but not yet beloved form.

- Rainer Maria Rilke (cited in Hamburger, 1977)

 

People

Women
Maria's artwork is clearly female-dominated in the sense that the greatest number of the people she paints are women. They are depicted at different life stages (baby, girl, woman, crone) and in different roles (mothers, daughters, nuns, prostitutes, victims, warriors, slayers, nature women, seers). The focus on women in Maria's art emphasises the importance of the feminine.

Her depictions of black women and her black art suggest that the dark shadow aspects of her psyche are coming to light. She is confronting and integrating the shadow aspects of the anima: the black, primitive, disowned feminine, which was cast in the shadow of consciousness. "Anima" is the word for soul in Latin, and is in the feminine gender. The anima, according to Jung, represents the "inner woman", the "soul figure". The dark shadow aspects of the anima are indicated by images in Maria's work such as those of the Goddess Kali and the Shaman of Death, which appear to represent the Terrible Mother, the dark forces of destruction embodied in the negative death mother (Figures 16 and 19).

Equally apparent and significant in Maria's work are images which suggest that she is embracing and integrating the positive shadow aspects of her anima, that is, the nurturing, the beautiful, ethereal power of the feminine. It would appear that because Maria's psyche was initially shaped by the patriarchal values of her society, the (feminine) anima-soul was essentially hidden, and consequently stood in opposition to the ego, the (masculine) centre of consciousness. To attain wholeness and healing in her life, her task in psychological terms was to embrace the feminine, in order to create a balance with the over-represented masculine aspect within her psyche. Hence the importance of the feminine in her artwork and in her healing process. Maria's images such as those of the Goddess appear essentially to be expressions of soul retrieval.

Men

One of the outcomes of Maria's confronting and integrating the feminine, was that a new masculine emerged within her psyche. This new masculine was redefined within the context of the feminine. Maria described the image she had created of the new masculine as "A holy man, not patriarchal power over, but
power to enable others and myself" (Figure 17.4). A masculine who could relate to the soul.

Maria's inner work led to the integration of the masculine and feminine within her psyche and ultimately to the transcendence of opposites. Jung refers to the state of integration as inner conjunction, in alchemical terms (Jung, 1983). This describes the joining of opposites, identified by Jung with the close union of the male principle of consciousness with the female principle of the unconscious. As Jungian psychologist, psychoanalyst Dr. June Singer writes:

We are both desirous and frightened of these mighty figures, yet the anima or animus, as the case may be, must become a part of our conscious experience if we are ever to approximate the ultimate goal of wholeness. (Singer, 1972, p.230)

This state of integration, also known as the "inner" or "sacred" marriage, is best observed in Maria's artwork entitled "The Beloved of the Soul" (1996) (Figure 22.6 b.). In this painting, the man and woman, the dark and light, and the sun and moon, accentuate the sense of polarity, the pairs of opposites to be united. Maria said of the artwork:

Here the man and woman embrace in Tantric sex. Wholeness of the inner world is reached with the dark (moon) and light (sun), male and female. The opposites come together in deep love.

I was feeling a deep coming together of my opposites at this stage. It was Easter, a time of death and resurrection and wholeness.

Maria's reference to Tantra is significant and is discussed further under the heading of Spiritual References on page 158. The transcendence of opposites, the supreme state of non-duality, is best illustrated in Maria's painting "The Shaman's Graduation" (1997) (Figure 18). It is the image of the Androgyne, whose symbolism and its meaning follow.

Androgyne

The image in Maria's art of a serpent coiling round an androgynous figure which merges into a tree-like form is reminiscent of the Divine Androgyne, the Tree of Life and the Caduceus. In Maria's art, as in popular mythology, the Great Goddess as the Divine Androgyne generates all; she is all matter that exists in space and time (Lanier, 1997, p.44). The Divine Androgyne symbolises the supreme unity that transcends all opposites; she is the universal synthesis of all particulars. The central teaching of this symbol is that the ultimate goal of the spiritual quest is androgyny, a state of mind in which the finite consciousness of the individual and the realm of the infinite cosmos are realised to be one. In this sense, the consciousness of the Divine Androgyne is identical with that of Buddha consciousness or Christ consciousness. The Divine Androgyne, a visual metaphor for non-duality, does not
refer to bisexuality; the reference is to the ultimate goal of realising the psychological integration of the Goddess and God within oneself.

Cirlot suggests that the image of tree and serpent are, in mythology, prefigurations of Adam and Eve (Cirlot, 1962, p.275). He suggests that, by analogy, the snake curled round the tree (or staff of Iris, Hermes, or Asklepios) represents symbolic Entanglement and moral dualism. Paul Diel suggests that the snake coiled round the staff of the god/dess of medicine recalls the Biblical symbol of the Tree of Life encircled by the snake signifying the principle of evil; the pattern points to the close relationship between life and corruption as the source of all evil (Cirlot, 1962, p.275). He further suggests that it is the subversion of the spirit that brings about the death of soul, and that this is what medicine must, in the first place, set out to combat.

Body parts

Hand: Maria associates the hand in her art with being able to handle life and to express herself. She sees hands as symbolising the ability to give and to take away. In her black art, the upright hand is a "stop!" signal, suggesting to her "that's enough", it is a symbol of protection. She also associates the hand with being held, cradled; with touching and being touched with love, especially by women healers (as her mother withheld touch, considering it sinful). The hands of healing, as in Reiki, Maria refers to as "hands of light", sacred touching and spiritual healing. When hands are held up in the air in her paintings, they suggests to her a gesture of triumph. Six-fingered (left) hands she associates with witches. Maria associates the long nails in some of her work with claws.

In traditional symbolism the meaning of the hand varies. The Egyptians associated the hand with support, strength, manifestation and action (Cirlot, 1962, p.130). In Jung's opinion, the hand is endowed with a generative significance (cited in Cirlot, 1962). In Maria's art this might indicate her creativity, both in her art and life. The prominence of the hand may also suggest being able to handle her life situation, being able to cope. Fincher suggests that when hands appear in mandalas, one may be experiencing a sense of vitality, a desire for action, and justified confidence with one's ability; one should also consider the meanings of the numbers five and ten suggested by the number of fingers (Fincher, 1991, p.127). In Maria's case, the number six also appears relevant. Maria associates the six fingers on the left hand with the sorceress (witch). This is consistent with the split-brain tradition in which the masculine right is the hand of the doer and the feminine left hand is the hand of wisdom (Johnson, 1990, p.194). The painted fingernails suggest femininity: doing things with a feminine approach.

Hair: The hair is very important to Maria. At the secular level, Maria associates long hair with beauty and the feminine; at a deeper level, hair flowing upwards represents the connection of the body to the Divine through the seventh chakra, like the halo. Hair is the connection out to the aura and to the universe. Long flowing hair also suggests to Maria the presence of energy, like the wind blowing through it.

According to Cirlot, hair represents energy; on the head it stands for the higher forces, and abundant, beautiful hair signifies spiritual development (1962, p.129-130). He suggests that hair is also linked with fertility and success. In Maria's art, women are mostly depicted with hair which is abundant and usually rising. Her interpretation is consistent with Cirlot's in that she associates hair with a connection to the universe and to other states of consciousness.

Mouth: Maria considers the large fanged open mouth to be expressive.

Cirlot states that in Egyptian hieroglyphs, the mouth stands for the power of speech and hence for the creative word (1962, p.211). One of Maria's paintings shows a large open mouth containing an image of witches burning. Cirlot makes the observation that the mouth and fire are often linked. In the Old Testament they are linked with adjectives such as “devouring” or “consuming”. Consequently, mouth-symbolism like fire-symbolism has two aspects: creative (as in speech) and destructive (devouring). Maria makes a similar connection when she expressed her initial fears around "being burnt as a witch" when she started being public about her life and knowledge. Cirlot points out that the mouth is the point of convergence between the external and inner worlds (1962, p.211). In this sense, images of the mouth might also suggest nourishment, the thirst or hunger for wholeness.

Breasts: Also a very important symbol to Maria, her images of breasts represent the need for maternal love, the nurturing of oneself, and the nurturing received from other women. Maria felt the need for the gentleness associated with feminine (yin) energy. Maria associates breasts with finding the Great Mother spiritually, thereby transcending her personal sense of maternal deprivation and abuse. The breasts in Maria's art are usually large and dripping, symbolising to her "the milk of life". In some of her paintings, the nipples are metallic and give the appearance of eyes.

Breasts suggest the ability to give nourishment, to nurture and comfort. The breast symbolised by a circle with a dot in the middle as an ancient representation of the Great Goddess, associates the breast with the Mother, the creatrix and sustainer of life. In the negative sense, as in images of the negative death mother, breasts might suggest the withholding of nourishment or the inability to nourish.

Eyes: Maria interprets the images of eyes in her artwork as the ability to see both inwardly and outwardly. She associates eyes with the ability to see past the veils of illusion, past the mind/consciousness, into the soul. The single eye in profile are rendered in the image of animal eyes, which to Maria suggests the ability to see the whole picture, eyes which have the full scope. She also associates eyes with the ability to see beyond this life. She considers the eyes as being very expressive: when tears fall, they suggest the need for compassion, tears of blood suggest a wounding.

Eyes are generally associated with the ability to see both physically and metaphorically, in the sense of understanding (Fincher, 1991, p.123). "What [others] need daylight to understand, the High Priestess knows in the dark" writes healer, artist and author Vicki Noble (1983, p.35). Eyes also suggest the awakened state of the visionary, the one who is able to see clearly, to anticipate possibilities and to see beyond appearances (Drury, 1991, p.1). Maria's art and healing process appears to have been a journey of vision, of deep spiritual insight which has led to profound self-transformation. Her journey has also been about re-visioning, reframing her experiences, about seeing herself and the world differently.

Animal imagery

Snakes and serpents were mostly featured, followed by bird imagery and butterflies. In terms of snake symbolism, artist and theoretician Juan Eduardo Cirlot states in his book A Dictionary of Symbols that if all symbols are really functions and signs of things imbued with energy, then the serpent or snake is, by analogy, symbolic of energy itself (Cirlot, 1962, p.272). Given this description, it is interesting to note that Maria conceptualised the image of the snake, a symbol of energy, during her illness, at a time when she was experiencing profound energy depletion.
The symbolic significance of the snake is determined by its basic characteristics (Cirlot, 1962). For example, because it sheds its skin it symbolises renewal and resurrection. Its capacity to coil itself around its victim and strangle it signifies strength. Its sinuous movement is similar to that of waves and may be a symbol of the wisdom of the deep and of the great mysteries. The snake is a creature that can survive in a variety of habitats, a quality that suggests adaptability: there are snakes which inhabit woods, others which thrive in deserts, there are aquatic serpents and those that lurk in lakes and ponds, wells and springs. In the Near East the serpent's ability to move rapidly without arms and legs is regarded as magical, and the serpent's lightning strike relates it to cosmic phenomena.

According to Maria, snake imagery in her art was intrinsically linked with the Goddess. Historically, Goddess-centred cultures were common during the Neolithic or "New Stone Age", from about 6500 to 3500 BCE; twenty times more female than male figurines of deities have been excavated (Dexter, 1990, p.4). These Neolithic European Goddesses were represented in mortal form, in animal form, and in animal/human combinations. Two prevalent hybrids were those of snake-woman and bird-woman. Nearly 40% of the figurines excavated were combinations of female figures with serpentine or avian attributes (Dexter, 1990, p.5). Evidence that the serpent was intimately linked with the Goddess dates back to the earliest period of cave art between 40,000 and 26,000 B.C.E. (Johnson, 1990). The serpent and Goddess shared common attributes. They were linked with birth, death, and resurrection: the serpent through its ability to shed its skin, the Goddess through lunar associations with rebirth. Both shared the realms of earth, water, and the underworld. The female deity, as She was known in Babylon, Egypt, Crete, Greece, and elsewhere, was identified as a serpent or with serpents, and was closely associated with wisdom and prophecy (Stone, 1976, p.204). One explanation for the connection between serpents and oracular revelation lies in the chemical makeup of the venom of certain types of snakes which, like mescaline (a product of the peyote cactus) or psilocybin (found in certain types of mushrooms), causes the person to feel in touch with the forces of existence and to experience a sensation of perceiving the events and meaning of the past, present and future with great clarity and comprehension (Stone, 1976, p.213; George, 1992, p.13). Because the serpent could kill and cure, characteristics also associated with the Goddess, it was both feared and revered; the serpent/Goddess symbolised the aggressive powers, positive and negative, which rule the world (Dexter, 1990; Cirlot, 1962).

Intertwined serpents appear frequently in Maria's art, often in the form of the caduceus, which is the symbol of the medical profession. As Maria is a doctor, perhaps she is journeying back to the archetypal significance of what it means to be a doctor; reconnecting to its metaphysical roots that she was not in touch with before, and that most physicians are disconnected from. Symbolically, the symmetrical placing of two serpents as in the image of the caduceus, indicates an equilibrium of forces, of the counterbalancing of the cowed serpent (or sublimated power) by the untamed serpent, so representing good balanced by evil, health by sickness (Cirlot, 1962, p.276). Jung suggested that individuals can reconcile the conflicting elements of their personalities: they can strike a balance that makes them truly human, and truly the master of themselves (Jung, 1964,p.157). Jung considered two intertwined serpents as a motif symbolising chthonic (underworld) transcendence. The intertwined serpents on the end of a staff is a therapeutic symbol, usually associated with the Greek deity Hermes (or the Roman God Mercury, the divine messenger) who taught healing to Asklepios (or the Roman God of medicine, Aesculapius). In earlier times the caduceus belonged to the Greek Goddess Iris who transported the healing power of the Mother Goddess to earth on the rainbow (Graham, 1997, p.101). The serpent coiled around the staff of the healing God/dess was originally a non-poisonous tree snake, it seemed to Jung to embody a kind of mediation between earth and heaven. Jung observed that the much used image of the double serpent is like homoeopathy in that it suggests a cure effected by that which caused the ailment (Cirlot, 1962, p.276). In this sense, the serpent becomes the source of healing of the wound caused by the serpent.

The double serpent in Maria's art is a symbol she also identifies as Kundalini, the Tantric Hindu Goddess who embodies the energy of inner strength and wisdom (Campbell, 1990; Cirlot, 1962; George, 1992; Douglas & Slinger, 1979). The double serpent of Kundalini is an ancient symbol which is at least as old as the Bronze Age (2500-1000 B.C.E.) and may date back to the Stone Age (2,000,000-7000 B.C.E.) (Graham, 1997). Kundalini comes from the Sanskrit word "kundalin" which means "coiled up". Kundalini energy, referred to as an inner fire or serpent power, is represented symbolically as a white female snake coiled three and a half times around a "lingam", a symbolic male sexual organ, in the subtle part of the organism corresponding to the lower extremity of the spinal column, at the base of the body. When kundalini is activated as a result of exercises directed towards spiritualisation, the snake uncoils and stretches up through the spinal column, activating each of six energy wheels (chakras) corresponding to the various plexuses of the body (located at the sexual region, spleen, navel, heart, throat and head), until it reaches the area of the forehead, corresponding to the third eye of Shiva (representing awakened consciousness). In other words, the Kundalini energy, which is the active principle in sexual union, travels through the psychic centres and finds fulfilment in ecstatic union with the passive Shiva-principle in the Head Centre. It is then, according to Hindu belief, that humans recover their sense of the eternal. There is in fact a seventh chakra but it is unnamed and, like the central point of certain mandala-like patterns, is not represented visually. Cirlot suggests that the symbolism here relates to an ascending force, rising from the area governed by the sexual organs up to the realm of thought - an interpretation he believes is justifiable by simple reference to the symbolism of level, taking the heart as central (1962, p.275).

The ouroboros, or serpent biting its own tail, is a recurring image in Maria's art. The Gnostic symbol of the Ouroboros expresses in graphic form the connection of the snake to the wheel. In the broadest sense, the ouroboros is symbolic of the eternal cycle of birth, death, and rebirth. In mandalas, bliss can be symbolised by the ouroboros, or the archetypal parents in "The Dragon Fight" suggesting inner tensions and conflict (Fincher 1991). The ouroboros is sometimes symbolised half dark and the other half light, as in the Chinese Yin-Yang symbol, which clearly illustrates the essential ambivalence of the snake in that it pertains to both aspects of the cycle (the active and the passive, the affirmative and the negative, the constructive and destructive). In the Yin-Yang symbol each half includes an "eye" or circle of the colour of the opposing half to symbolise that every mode must contain within it the germ of its antithesis. Cirlot quotes Rene Gernon who sees the Yin-Yang symbol as a helicoidal symbol, that is, as a section of the universal whirlwind which brings opposites together and engenders perpetual motion, metamorphosis, and continuity in situations characterised by contradiction (Cirlot, 1962, p.360).

When snakes replace hair, as in Maria's painting entitled "Honouring Mad Women", they represent the higher forces of creation (Johnson, 1990, p.150). The concept of a force that erupts from the head seems to have been indigenous to the ancient Goddess religions, related perhaps to Kundalini and may be why serpents rear from the deity's head in many cultures. In Greek legend the Gorgon Medusa, an ancient Goddess and an archaic denizen of the netherworld, has hissing snakes for hair and boar tusks for incisors. Her tongue is thrust out to catch moisture, her glance turns people to stone. One of the three Gorgon sisters, Medusa is known as the Mistress of the West Gate, or death, because her home lies at the entrance to the underworld on the side of the Western Ocean. She represents the disturbing power of the abyss (Johnson, 1990, p.152). In his book The Greek Myths author Robert Graves sees the Gorgons as priestesses of the Triple Moon Goddess, the masked guardians of women's mysteries (1955, p.129). Similarly, in her book Mysteries of the Dark Moon teacher and counsellor Demetra George suggests that in the pure form, Medusa symbolises the source of our instinctual body wisdom and power (1992, p.169). She suggests that when Medusa's hair is transformed into snakes, this symbolises the rising of the Kundalini energy and the ability to utilise this force for regenerative healing, mental creativity, oracular wisdom, and spiritual power. Artist and researcher Buffie Johnson suggests that the Gorgon Medusa may well personify Athena's shadow, her destroyer aspect, since Medusa represents the chthonic power of the Great Goddess in the underworld (1990, p.152). Athena, to whom the snake is sacred, is the Mother-Goddess of Athens. It is interesting to note that in Maria's painting entitled "Honouring Mad Women", her depiction of "the Shaman of Death" closely resembles the Gorgon Medusa, not only in appearance but also in her role as the Mistress of Death. Maria noted that the image emerged just before her own experience of the Kundalini energy rising, resulting in a deepened connection with her divine nature, the "God voice" within.

The bird is symbolic of the release of the spirit from bondage to the earth (Campbell, 1988). Birds represent the Element of air and denote height and loftiness of spirit (Cirlot, 1962). In Maria's art, the birds represented included the dove of peace, the owl, pelican, crow and garuda. In Greek mythology, the dove was Aphrodite's totem. As bringer of death or "peace", Aphrodite, known as the goddess of love, sometimes bore the name of Irene, Dove of Peace (Walker, 1983). Her catacombs, mausoleums, and necropoli were known as "columbaria", dovecotes. Thus the soul returning to the Goddess after death was envisioned as a dove. Christianity, inspired by the Scriptures, depicts the third person of the Trinity, the Holy Ghost, as a dove.

In Maria's artwork the owl was associated with the wisdom of the Goddess. Early symbolism related to the owl stressed the owl's sagacity (Rowland, 1978). The bird was highly esteemed in Athens where the owl was held as sacred by Pallas Athene, goddess of wisdom. The owl's luminous eyes, its ability to remain awake at night and to see in the dark were indications of its supernatural powers. According to Christian legend, the owl was one of "three disobedient sisters" who defied God and was transformed into a bird which never looked at the sun (Walker, 1983). The owl in the Egyption system of hieroglyphs symbolised death, night, cold and passivity (Cirlot, 1962). It related to realm of the "dead" sun, that is, the sun which has set below the horizon and which is crossing the lake or sea of darkness. Interestingly, this is how the owl is depicted in Maria's painting of her Croning, that is, in flight over dark waters.

The pelican was associated with Christ, as indicated in Psalm ci.7: "I am like a pelican who dwells in solitude" (Rowland, 1978). It was (mistakenly) believed that the mother pelican fed its young with her blood. Also, like Christ the Redeemer or God who sacrificed His son and then revived him after three days, the mother pelican was thought to pierce her side to revive her dead young.

Maria identified the crow with wisdom and the dark. Its black colour associates the crow with beginning as expressed in symbols such as the maternal night, primigenial darkness, the fertilising earth (Cirlot, 1962). It is a symbol for creative, demiurgic power and spiritual strength in its association with the atmosphere. These interpretations appear appropriate and relevant in the painting depicting Maria birthing her Higher Self.

Maria considered her image of the garuda to be a metaphor for the release of her true self, "the core", when all falseness is pecked through. She understands the garuda to be a mythical bird which emerges from its egg whole, fully grown. In religious symbolism, the garuda, originally an eagle in India, is the golden-winged bird of the sun, an emblem of Hindu god Vishnu (Rowland, 1978).

Maria's image of Garuda Woman bears resemblance to the winged depiction of Isis, the Egyptian goddess of wisdom, also entitled the Giver of Life (Johnson, 1990, p.134).

Butterflies, usually associated with metamorphosis, appear to be an apt metaphor in Maria's artwork for personal transformation. Maria sees butterflies in her art as a symbol of the soul and of transforming energy. Similarly, butterflies were considered in ancient times to be an emblem of the soul and of unconscious attraction towards the light (Cirlot, 1962). And in myth, the human spirit often assumed the form of the butterfly fluttering and shimmering in the sun (Johnson, 1990, p.194). The concept of the butterfly soul in fact extends around the world and appears as a manifestation of the breath of life (Johnson, 1990, p.194). These interpretations appear descriptive of Maria's journey. Butterflies may symbolise Maria's transformative journey towards life in her efforts to heal herself physically, and towards light representing her efforts to heal herself spiritually.

Mandala symbolism

Mandala symbolism constituted a significantly large proportion of the artwork, that is, 44 (57%) of a total of 77 artworks. According to Jung, mandalas emerge in a time of crisis and transformation (Jung, 1973). Mandalas serve two purposes, namely, the conservative purpose of restoring a previously existing order, and the creative purpose of giving expression and form to some new and useful pattern that does not yet exist (von Franz cited in Jung, 1964, p.225). In these ways, mandalas function to heal and transcend crises. In Maria's art, the mandala served both purposes. The mandala symbolism (her first full-colour artworks) emerged during a time of personal crisis in the form of a life-threatening illness, and her art process revealed the emergence of spirituality, a new spirituality, her connection with the divine feminine.

The introduction of paint as a medium coincided with the emergence of the mandala in Maria's work. Colour in mandalas expresses one's innermost thoughts, feelings, intuitions, and physical sensations (Fincher, 1991). Maria's earliest work which preceded her mandalas was rendered largely in pencil, feint crayon and marker. These mediums may be associated with control, consciousness and the intellect (Kramer, 1983). In her reflections on healing, Maria expressed her awareness of an overdeveloped intellect. Her early drawings were followed by paintings expressing the need for a deeper connection with her body, instincts and intuition. For example, Maria interpreted her painting of Kali severing her consort's head with a sickle, as her own need to cut off her intellect, which she saw as being a hindrance to further spiritual development.

As mentioned above, Jung noted that mandalas emerged spontaneously in art during a time of crisis. He identified patterns that appeared to correlate to the process of individuation, which Jungian analyst Dr. Marie-Louise von Franz describes as "the conscious coming-to-terms with one's own inner centre, psychic centre, or Self" (cited in Jung, 1964, p.166). Theorists who came after Jung developed his observations further, and identified the order in which mandala motifs and patterns evolved. Artist Joan Kellogg proposed an order of typical mandala patterns she named the Archetypal Stages of the Great Round (Fincher, 1991). Consisting of twelve stages, each represents a significant stage along a continuous path of personal growth. The twelve stages encapsulate the unfolding of a cycle that is lived not once but many times in a lifetime. Dr. von Franz described the mandalization process as "that of an ascending spiral, which grows upward while simultaneously returning again and again to the same point" (Jung, 1964, p.225).

Maria's mandalas appear to corresponded to the following categories, as described by art therapist Suzanne Fincher in her book Creating Mandalas: for insight, healing, and self-expression, and based on Kellogg and DiLeo's research (Fincher, 1991):

Stage One: Among Maria's mandalas there are those that fit into the category of The Void, for example, paintings of the tunnel of light in Maria's near-death experiences, including one containing an image of a spider's web.

Maria associates the experience with feelings of ecstasy. The lustrous white area at the centre of the mandalas identifies Maria's paintings as the "white void", which is described as a peak experience known for a fleeting moment when we move from the end of a cycle to stage one on the Great Round. The white void represents the attainment of God-consciousness. The experiences associated with stage one are in fact feelings of salvation, redemption, joy, freedom, reconciliation, love and ecstasy. Entry into stage one is sometimes experienced as a fall into darkness. Metaphorically speaking, this is the point at which consciousness enters matter, one comparable with the prima materia with which alchemists began their work. This stage is the "dark void" characterised by feelings of ignorance, darkness, confusion, alienation, pain, agony, oppression and constriction. The task for this stage is to wait, keep faith, trust in the process, and to be patient with our poor performance. Stage one activates memories of one's intrauterine experience. The spider's web recalls the foetal connection to walls of the womb. Spider web images may indicate that our early life in the womb was uncertain, either because we failed to thrive or because the uterine environment was not supportive. Creating a spider's web might suggest that we are reaching back to heal some of our earliest experiences, and to recreate our view of reality as we begin our passage around the Great Round.

Stage Two: Some other mandalas in Maria's paintings fall into the category of Bliss, for example the mandala entitled "Agony of Spiritual Emergence" showing a number of white flowers in blossom like starbursts within the circular formation.

Maria described this image as a "beautiful pure white blossoming" after an emotionally painful retreat. This stage corresponds to the intrauterine experience described as a state of blissful union and containment of all things. Consciousness is diffuse and lacking a clear sense of ego boundaries. Infinite possibilities exist at this stage, but it is a time of suspended action. It is a time when we identify with the nourishing, cosmic rhythms of the universe, and experience ourselves as loving and infinitely loved.

Stage Three: Also represented among Maria's mandalas are examples of the Labyrinth or Spiral, for example "The Demon of Restlessness" in which a fish at the centre of the mandala is superimposed upon a colourful spiral. Describing the image as a "whirlwind", Maria was emerging from the depression she experienced after her croning.

The experience at this stage corresponds with the intrauterine connection with the womb through the umbilical cord. It also recalls the severing of the umbilical connection during childbirth. This stage represents the commencement of a journey whose final goal is a mystery. It is seeking without a clear idea of what is sought after. During this stage we experience increasing energy and the desire to move, create and become.

Stage Four: There are mandalas that suggest the stage of Beginning, for example the mandala entitled "Grief" which shows a flower motif with a smaller flower emerging from the centre.

Maria considered this to represent "new growth from the pain of letting go". This stage signifies the choice of just one of the myriad possibilities at stage three. It represents the infant dependent on its mother for nourishment. The child is separate, but contained within the mother's world. When in stage four we can take pleasure in something new, young, and tender in ourselves. The task is to honour the growth of the new, and to be a good parent to ourselves. The circle with a dot in the centre, an ancient symbol for God/dess, resembles a breast. In Maria's art, it may represent the God/dess within.

Stage Five: Maria's mandalas also include The Target, for example "Poppa", showing an eye at the centre of the mandala with an outline around it radiating out like concentric circles. The lines are superimposed upon an image of tentacles or a snake. The target recalls the toddler's antagonism towards its parent. The separation from paradise is an unpleasant experience but a necessary one that establishes our identity. Consciousness here reflects an awareness of self as the one who is suffering and does not know why. From the perspective of the target, the world is a dangerous place. We feel vulnerable, angry, indignant, paranoid, anxious and in need of protection. The challenge is to transcend these limitations. Stage five might be compared to an alchemist vessel in which ingredients are tightly sealed and pressure is increased until a transformation is brought about. Maria described a psychological shift related to this mandala, from "much pain to opening to enlightenment".

Stage Six: The mandala motif of The Dragon Fight also emerges, for example, the painting entitled "Croning of Maria Gaea of the Tao" shows Maria crossing a river in a canoe to her initiation ceremony at sunset with a landscape behind her; the colours are contrasting, almost black and white. Another example is the mandala entitled "Beloved of the Soul". In this painting, opposites are highlighted, the man/woman, the dark/light, the sun/moon. Symbolically, the dragon (the adversary, monster) is the ouroboros (Gnostic dragon biting its tail) which represents the archetypal parents. The struggle here is the separation of the ego, as the carrier of individual consciousness, from the matrix of the parent's world of ideas. In Maria's case, this stage may represent her departure from society's ideals. It is experienced as a time of inner conflict, a time to give birth to a new sense of self. It is considered to be a time full of energy, passion, and change.

Stage Seven: Maria's artwork includes The Squaring of the Circle, for example the mandala entitled "Dark Night of Soul" created during the depression she felt after her initiation into the crone.
Squaring of the Circle

This stage marks the full-fledged establishment of ego. There is a strong sense of autonomy at this time. The Squaring of the Circle is the place where we take a stand on what we know within ourselves to be right. It is the beginning of life lived according to our own values. Behind the development of our individuality is the Self, the dynamism that compels us to become who we were meant to be. When at stage seven, our conscious attitudes are most strongly influenced by the archetype of the Self. Powered by the Self we have the courage to become truly heroic, putting our best efforts in the service of high ideals.

Stage Eight: There are images that correspond to Functioning Ego, for example the mandala entitled "Being Lived by the Tao". Maria describes this as experiencing the joy of her life as she surrenders to the Tao. To Maria, the nudity of the figure means being free from all covering defences, and the rainbow symbolises fullness of life and joy. Stage eight is the culmination of the process begun at stage three: the attainment of individual consciousness. This stage is an important indicator of the mobilisation of will and with it a sense of responsibility for directing one's own destiny. One commences an active role in the world, and accepts the burden of choice. The number five (as in the five-pointed star) is associated with Functioning Ego, and in fact symbolises the human figure, feet firmly planted and arms extended reaching out to contact the world. A number of Maria's artworks depict this posture.

Stage Nine: Crystallisation is represented in several mandalas, for example in the painting of the Genesis series entitled "Day Seven: Goddess Rests" which Maria describes as expressing a sense of completion. Stage nine is in fact described as reflecting the completion of important creative endeavours. In Maria's work, the accomplishment appears in the form of some inner work. This stage often brings a feeling of satisfaction, harmony, and fulfilment. Our self-esteem is enhanced by the pride of accomplishment.

Crystallisation is reminiscent of middle age. The inspiration that energises consciousness begins to slow somewhat here because our creative activity is nearing completion. The task for Crystallisation is to enjoy our success to the fullest, without becoming attached to it, so that we can gracefully relinquish our position when the time comes.

Stage Ten: Gates of Death is evident, for example in the mandala "Vipassina Death Rebirth". This artwork was created after a painful meditation retreat, when Maria confronted more of her inner shame and pain which she represented in the form of the black goddess of death and rebirth dancing in the flames.

Maria describes her as "happy in her job of death and regeneration". Stage ten marks the end of a cycle, the onset of entropy. Feelings of loss, depression, and helplessness are not uncommon. The midlife crisis typifies stage ten. Mandalas at this stage often suggest the cross of crucifixion; the wheel motif suggests martyrdom and the relentless turning of the wheel of life. We become increasingly aware of our inner world, of the relentless cycles of nature, especially decay and the inevitable approach of death. The task here in the words of Meister Eckart is to "Let go and let God".

Stage Eleven: The motif of Fragmentation is not represented in this selection of Maria's mandalas. Mandalas at this stage do not have centres. Fragmentation is a time of fear, confusion, loss of meaning and disorientation; one's world has fallen apart. Fragmentation is truly the dark night of the soul. Dreams and fantasies of mutilation, death, contortion, decapitation, humiliation, disintegration and castration abound at this stage.

The task is to surrender, to face the shadows, to listen to the trickster, and in short to let the former order disintegrate. Mythologically, this passage is mediated by dark, profound monsters who devour and tear apart that which has form in order to reduce it once again to formlessness. Our faith in a deeper order may blossom to sustain us through this time of transition.

Stage Twelve: There are many of Maria's mandalas that fit into the category of Transcendental Ecstasy, for example "Garuda Woman", a painting Maria created when she finished hakomi therapy. For Maria, the image was a metaphor for the release of her true Self, who was "free to fly as a 'holy' spirit". She describes the garuda as a mythical bird which emerges from its shell fully grown. Transcendental ecstasy marks the blissful return home, the coming together of a fragmented ego in a new alignment. We are aware, and sense the importance of a higher power, the Self. Powerful energy channelled by the ego in Transcendental Ecstasy often results in a peak experience. We are blessed with feelings of joy, harmony, and reverence. We may experience ourselves as suffused with light. Paradoxes that were once disturbing are resolved through nonrational means, by grace. The task of Transcendental ecstasy is to accept the gift of grace gratefully, humbly, as the fruit of a life fully lived.

Suzanne Fincher writes that these stages are not usually experienced in a sequential order. One stage more often represented than others might suggest being comfortable with that particular stage. Conversely, an especially difficult stage may not be represented at all. She notes that while there are variations in the experiences of individuals and in their mandalas, a universal pattern reflecting the individuation process underlies the infinite variety of forms.

Colours

The following discussion focuses on the colours that Maria most used in her art. They are listed in order of frequency, beginning with the colour which most appeared. There are a great many considerations bearing upon the meaning of colour. The interpretations used in this paper are derived from perspectives seen by the author as perhaps most relevant to this study, including: (1) Jungian psychology, (2) Chinese (w/holistic) healing and (3) alchemy, as symbolic of the process of personal transformation.

(1) These interpretations describe the relationship between colour and the four functions, based on Jolande Jacobi's study of Jungian psychology (Fincher, 1991; Cirlot, 1962). The four functions are thinking, feeling, sensation and intuition, which represent the four ways information is universally perceived and processed. (2) Chinese healing, linked historically with ancient Goddess cultures and probably to the matriarchies, is based on the prevention of imbalances, and on righting them before they cause serious illness (Stein, 1990). Yin and yang, according to Chinese / Asian healing traditions, is a concept of balance and harmony with the universe, the balance of opposite complementary energies. Yang describes the outgoing, hot, active, firm, assertive, bright qualities, and yin the retreating, cold, receptive, yielding and passive. While yang is associated with masculine (male) attributes in the Western mind, and yin with the feminine (female), the concept of yang-yin or yin-yang points to non-duality, it is essentially a concept of wholeness. That is, to maintain a state of well-being is to maintain a harmonic balance of both yin and yang energies within the body. (3) Alchemy describes the chemical process involved in the endeavour to transmute base metal into gold; although it is usually associated with medieval times, historically alchemy had its roots in the first century B.C. (Cirlot, 1962). The four stages of the alchemical process are signified by different colours. The process refers symbolically to personal transformation. As G.C. Evola writes: "Our Work is the conversion and change of one being into another being, one thing into another thing, weakness into strength, bodily into spiritual nature" (cited in Cirlot, 1962, p.8).

Blue

Maria considers blue a favourite colour. She associates a mid/purple blue with the garments of the Virgin Mary, and so it has feminine and spiritual associations to her. A dark, rich "electric" blue also suggests the mystical to her, and the ability to see in the dark. She associates the colour blue with water and sky, spirituality, the higher chakras, the third eye, and with wisdom as in the ability to see inwardly and outwardly. Maria also associates the colour blue with the Zodiac sign of Aquarius, the astrological sign governing our present times.

According to Jung, blue stands for the vertical and means height and depth (the blue sky above, the blue sea below) (Cirlot, 1962). Chinese medicine describes blue as a cool, yin (feminine) colour, the symbol for the element of water which rules the kidney (yin) and bladder (yang) meridians, the energy channels in the body (Stein, 1990). It is interesting to note, in terms of Maria's art and healing, that blue, a feminine colour, was most frequently used, again indicating that she predominantly explored and utilised the power of the feminine in her work. Also, that among the healing issues for the kidney and bladder meridians are hearing, sexuality and the bones, the latter of clearly significant concern to Maria. In terms of esoteric healing, blue is the colour of the throat chakra, and is associated with communication, it also relates to the emotion of fear, and suggests calmness, serenity and peace or a strong need for peace (Gunstone & Osanz, 1994). Blue appears to be associated with mystery and religious imagery. It is darkness made visible. According to Jungian psychology, blue is the colour of the rarefied atmosphere, of clear sky, and stands for the function of thinking (Jacobi in Cirlot, 1962).

Silver

Maria's use of silver can be observed in the silver of radiating lines, in the outline of tears and breast milk, in the silver thread of hair, and in lines accentuating birds, stars and the moon. Silver is predominantly seen in Maria's use of glitter, glistening and shimmering throughout her work. Maria attributes spiritual significance to her use of glitter and metallic colours, she said "It's about the light in myself waking up".

According to Cirlot, silver corresponds to the mystic aspects of the moon, as gold corresponds to the mystic aspects of the sun (Cirlot, 1962). Fincher also relates silver to the moon. She further states that:

[Silver] recalls the image of armor-clad knights, gleaming jewellery, and the mirror's capacity to reflect. Because the lunar connection of silver places it within the feminine realm, the use of silver in mandalas suggests a heroic undertaking that is decidedly feminine in nature. Initiatives in the area of healing, relatedness, or creativity might be indicated. (Fincher, 1991, p.44).

Green

Maria associates green with the earth, growth, life, and the green and pink that suggest to her the colours of the Kwan Yin, the Buddhist Goddess of Compassion. She notes that at times of turmoil, her greens are muddy, khaki colour.

In Jungian psychology, green is the colour of "the earthly, tangible, immediately perceptible growing things, green represents the function of sensation" (Jacobi cited in Cirlot, 1962, p.51). Associated with Venus the goddess of beauty, and with Nature, the colour green indicates the fertility of the fields, sympathy and adaptability (Cirlot, 1962). Cirlot suggests that green is the colour of antithetical tendencies: it is the colour of vegetation (or life) and of corpses (of death), hence, the Egyptians painted Osiris (the god of vegetation and of the dead) green. Similarly, green is the mid-point of the spectrum. In Chinese medicine, green, a yin (feminine) colour, represents the element of wood, which rules the gall bladder (yang) and liver (yin) meridians and the emotion of anger (Stein, 1990). The liver is a blood purifier and assimilator of food, and the gall bladder aids digestion and distributes energy. Green is the colour of the heart chakra in esoteric healing. Fincher observes that green is often seen in the mandalas of those in the helping profession (Fincher, 1991). She quotes Kellogg who finds that green in mandalas suggests "the ability to nurture, to parent and protect" (cited in Fincher, 1991, p. 58). In Maria's art, this might reflect her ability to nurture, parent and protect her new, emerging spirituality, her higher Self.

Red

While it was not the most frequently used colour, the way it was used (e.g. to represent menstrual blood, blood tears, fire, broken heart) indicates that red was a significant colour in Maria's art. She considers it in fact a very important colour to her, as it symbolised blood, where she had cancer. She associates it with the belting she received by her father when she first began menstruating. Blood, for Maria, is the life force; the blood red tears in her paintings signify woundedness, overwhelming pain and sorrow.

According to Jolande Jacobi, red is the colour of the pulsing blood and of fire, and stands for the surging and tearing emotions; (cited in Cirlot, 1962). In terms of esoteric healing, red relates to the base/sacral chakra located at the base of the spine, and is associated with energy and vitality (Gunstone & Osanz, 1994). Red is the colour representing the third phase in the alchemical process and relates to the state of suffering, sublimation and love (Cirlot, 1962). In Chinese medicine, red, a yang (masculine) colour, is associated with the fire element which is life force creativity. The heart and pericardium (or circulation-sex meridian) are yin, and the small intestines and 'triple warmer' (solar plexus) meridians are yang. The heart meridian is the ruler of the entire meridian system and it regulates blood circulation. The interpretations of the colour red as it relates to the heart (love) as central, blood flow, fire, passion, suffering and life force creativity appear to reflect Maria's use of red.

Black

The colour black relates to the state of fermentation, putrefaction, occultation and penitence (Cirlot, 1962). Black, in general terms, represents the initial, germinal stage of all processes, as in alchemy. To quote Cirlot:

Jung points to the relevance of the 'dark night' of St. John of the Cross, and the 'germination in darkness' of the alchemists' nigredo. Darkness for both Victor Hugo and Richard Wagner signifies the maternal, and that the light appearing out of the gloom represents a kind of crystallisation. In connection to this, Jung points out that carbon - the predominant chemical component in the human organism - is black in so far as it is charcoal or graphite, but that, in so far as it is a diamond (that is, crystallised carbon) it is "crystal-clear water', thus underlining the fact that the profoundest meaning of black is occultation and germination in darkness. (Cirlot, 1962, p.55)

Similarly, Susanne Fincher states that when the sad, mournful or nihilistic feelings described by St John of the Cross as the 'dark night of the soul' are lived through with awareness, black suggests the psychological death that precedes the grace of new understanding (Fincher, 1991). Fincher suggests that black in mandalas may reveal the process of integrating our dark, shadowy aspects into our sense of who we are. These interpretations of black appear to correspond to Maria's use of black in her work, particularly when considering the recurring theme in Maria's art of the dark Goddess, which may represent a shadow aspect of the negative death mother. Also, Maria's first use of black paper as the starting point of her paintings coincided with a mandala she entitled "Dark Night of Soul", a painting she said expressed her "agony after [her] descent into the underworld".

White

Maria associates white with spiritual light. Symbolically, white in fact signifies light; and is an element in the creation stories of many cultures and a metaphor for human consciousness; white also suggests purity, virginity, and spirituality (Fincher, 1991). Cirlot suggests the function of white is derived from the sun: from mystic illumination, symbolically of the East; when it is regarded as purified yellow it signifies intuition and, in its affirmative and spiritual aspect, intuition of the Beyond (Cirlot, 1962). White also relates to the state of illumination, ascension, revelation and pardon, timelessness and ecstasy; white corresponds to mercury and the second stage in the alchemical process of transmutation (Cirlot, 1962). According to Fincher, the alchemical process of calcinatio (transformation through fire) is reputed to produce white ash. This signifies the albedo or whitening phase and has paradoxical associations. She quotes Edward Edinger who states "On the one hand ashes signify despair, mourning or repentance. On the other hand they contain supreme value, the goal of the work" (Edinger in Fincher, 1991, p. 44). In this sense, Fincher suggests that white can represent surviving a psychological baptism of fire which forges a connection between ego and the archetypal psyche. By this experience the ego becomes aware of its transpersonal, eternal or immortal aspect. In Chinese healing, white is similarly associated with the emotion of grief, and the metal element which rules the large intestines (yang) and lung (yin) meridians. The large intestine moves wastes from the body, this also referring to emotional wastes; and the function of lungs is breathing. Eastern traditions place the control of breathing high among their values for well-being, as the speed of breathing reflects metabolism and emotion (Stein, 1990). These interpretations are consistent with Maria's use of white in her work. White predominantly appears at the centre of her depictions of the void, in images of stars, the moon, and flowers depicting the blossoming of her spirituality. Her "baptism of fire" is apparent in the images of pain and suffering evident throughout her journey.

Gold

Gold is significant to Maria. She considers gold to represent spirituality. Being a metallic colour, she associates gold with its reflective qualities; with its ability to stand out when a light shines on it, while the acrylic colours recede.

In Hindu doctrine gold is the 'mineral light' (Cirlot, 1962). Similarly, in alchemy, gold is regarded as the symbol of illumination and salvation; it is the glorified fourth and final stage in the alchemical process of transformation and is symbolic of all that is superior. Gold corresponds to the mystic aspects of the sun, it is the image of solar light and hence of divine intelligence. Gold is also the essential element in the symbolism of the hidden or elusive treasure, which is an illustration of the fruits of the spirit and of supreme illumination (Cirlot, 1962). These interpretations of gold correspond to Maria's own understanding of her use of gold in that it relates to illumination and spirituality which was also her goal, the culmination of all her endeavours in her process of personal transformation.

Yellow

Yellow is "the colour of the far-seeing sun which appears bringing light out of an inscrutable darkness only to disappear again into the darkness, [stands] for intuition, the function which grasps as in a flash of illumination the origins and tendencies of happenings" (Jacobi cited in Cirlot, 1962, p.50). Yellow indicates magnanimity, intuition and intellect (Cirlot, 1962). Similarly in esoteric healing, yellow relates to the solar plexus chakra, stimulating the intellect, and is associated with logic and reason as well as joy and enthusiasm (Gunstone & Osanz, 1994). In Chinese healing yellow, a yang (masculine) colour, relates to the element earth, which is grounding and centring, suggesting emotional and physical balance, and relates to living in the material world (Stein, 1990). Its meridians/organs include the spleen (yin) and stomach (yang), and merging with water, earth meridians are sexuality and fertility. The spleen builds blood and the stomach digests nourishment; together they rule menstruation, digestion and emotional balance. In Maria's art, yellow is used: in fire depictions, in rainbows, floral motifs, and in radiating lines. Sometimes an earthy tone, an ochre, the colour yellow is more often bright, and appears to have a radiant and luminous quality, at times similar to gold.

Numbers

In order of frequency, the number eight appeared mostly, followed by the numbers seven, three and four. In terms of the artworks with images of people, the majority of Maria's paintings featured a single figure, and so the number one appears significant, followed by paintings featuring two figures. The following interpretations are those which appear most relevant and are taken from Cirlot's book "A Dictionary of Symbols" (Cirlot, 1962, pp.220-223), unless otherwise indicated.

The number 1

One is the number from which all other numbers are derived. The number one is symbolic of being, and of revelation to humans of the spiritual essence. One is the active principle which, when broken into fragments, gives rise to multiplicity, and is equated with the mystic Centre, the Irradiating Point and the Supreme Power. One also stands for spiritual unity, the symbol of divinity, and is equated with light. In Maria's art, Cirlot's interpretations appear to correspond with the personal and divine experienced as one. Maria's mandala entitled "Goddess Speaks " - with "I am" painted in the centre - comes immediately to mind; also the numerous paintings and references to the Goddess as symbol of the divine feminine, her higher self. Maria's statement that to love others one must first learn to love oneself also seems relevant.

The number 2

Two "divides, repeats, and engenders symmetries" (von Franz cited in Fincher, 1991, p.94). Fincher suggests that two has come to be a symbol for differentiation, out of unity and into the duality of opposites (1991, p.94-95). It is in this sense that the number two appears most relevant in Maria's art, where the images of the pairs of opposites (sun and moon, light and dark) appear frequently; perhaps more significantly in her process of confronting and integrating the feminine with the masculine principle, creation with the creator/creatrix, the finite with the infinite.

The number 8

Maria associates the number eight with the symbol of infinity. Symbolically, eight, the octonary, is related to two squares or the octagon, it is the intermediate form between the square (or the terrestrial order) and the circle (the eternal order) and is, consequently, a symbol of regeneration. By virtue of its shape, the numeral 8 is associated with the two interlacing serpents of the caduceus, signifying the balancing of opposing forces or the equivalence of the spiritual power to the natural. It symbolises - again because of its shape - the eternally spiralling movement of the heavens (shown also by the double sigmoid line - the sign of the infinite). In Maria's art the connection between the number eight and the caduceus is readily apparent. Her representation of eight is very often in the form of an eight petalled flower in her mandalas, an image which suggests an eight-spoked wheel. According to Cirlot, the eight-spoked wheel is a venerable symbol of the sun as the divine instigator of endless change (Cirlot cited in Fincher, p.105).

The number 7

Seven is symbolic of perfect order, a complete period or cycle. This interpretation is reminiscent of Maria's final painting in a series of seven paintings entitled the "Seven Days of Creation". In her comments about the seventh painting, entitled "Goddess Rests", she describes attaining a sense of completion. The number seven also comprises the union of the ternary (involving three) and the quaternary (involving four), and hence it is endowed with exceptional value. Similarly, in Maria's art, seven as a symbol of sacred wholeness is represented in the union of masculine and feminine (in ancient Goddess cultures, three was related to the three-sided triangle representing the primordial divine mother, and number four was thought to be masculine) (Fincher, 1991, p.104).

The number 3

Three, according to Jung, "denotes insight, the rise of consciousness, and the rediscovery of unity on a higher level" (Jung in Fincher, 1991, p.97). Similarly, Cirlot suggests that three symbolises spiritual synthesis; it proposes the solution of the conflict posed by dualism; and it forms a half circle comprising: birth, zenith and descent. In this respect three is reminiscent of the ancient goddesses who manifested in three forms: the virgin, the mother, and the crone (Fincher, 1991, p.97). The number three is imbued with sacred meaning: it is associated with the Trinity in the Christian tradition; similarly, the three-sided triangle appeared as a symbol of the Goddess in ancient times, and was considered a feminine number (Fincher 1991, p.97). The image of the Maria's Divine Androgyne in her painting "The Shaman's Graduation" comes to mind representing the solution of the conflict posed by dualism. Also, her painting entitled "The Goddess is Alive and Dancing" which is a representation of the ancient Triple Goddess found at Grange in Ireland. The symbol is made up of three spirals and conveys the sense, as many of Maria's artwork suggest, that her highest ideals, all that Maria has aspires to, is within. As she states: "The Goddess is immanent not only transcendent".

The number 4

Maria associates the number four with wholeness. Similarly, Fincher suggests that the number four symbolises balance, wholeness and completion (Fincher 1991, p.98). Cirlot suggests that four is symbolic of the earth, of terrestrial space, of the human situation, of the external, natural limits of the 'minimum' awareness of totality, and of rational organisation (1962, p.222). He states that four is equated with the square and the cube, and the cross representing the four seasons and the points of the compass. Also, that a great many material and spiritual forms are modelled by the quaternary; it is the number associated with tangible achievement and with the Elements (earth, water, air and fire). Jung viewed mandalas characterised by the number four as a natural attempt on the part of the psyche to establish a symbolic structure through which an understanding of ultimate reality could be achieved (Jung cited in Fincher, 1991, p.99). This interpretation appears to correspond to Maria's mandala entitled "Dark Night of Soul". Fincher states:

Fourness emerges in our mandalas when our identity is closely aligned with the patterns of the archetype and Self. This may occur when we are feeling strong, heroic, and bursting with energy. Oddly enough, the influence of the Self may be most apparent during times of transition when we feel deflated because our customary ego functioning is disturbed or challenged. At times like this, the fourfold patterning of the Self shines through our mandalas, revealing its function as matrix and guarantor for the ego. The Self acts as a bridge to new ways of being, sometimes rewarding us with lovely mandalas when we need encouragement to go on. (Fincher, 1991, p.99)

Archetypes

The two predominant archetypes, the Wounded Healer and the Great Mother, appear to have had significant and complementary roles in Maria's art process during her illness and healing. At the beginning of her journey, Maria discovered through her artwork that her illness was caused by her refusal to accept her divinity. In her first drawing depicting her experience of cancer, Maria's spontaneous drawing of a female God was proportionally much larger than her drawing of a male God. This suggested to her that there was an imbalance, that she particularly needed to acknowledge the presence of the feminine, specifically the divine feminine. Her process of self-healing (represented by the Wounded Healer archetype and the images of the double serpent and caduceus) consequently involved accepting the divine feminine within herself (represented by the archetype of the Great Mother and images of the Goddess). Maria ultimately found that her initial experience of an inner void in fact mirrored an outer void. She found that the absence of the divine feminine within herself mirrored an absence of the divine feminine in the wider culture.

Themes

The analysis of Maria's art indicated that the thematic motifs predominantly expressed were: an exploration of her illness, inner states of change, expressions of emotion and finally, of spirituality. Of an overall total of 77 artworks, 33 (43%) were explicitly focused on the depiction of emotional states. It is interesting to note that expressions of painful emotions, for example anger, grief and abandonment, tended to follow expressions of inner change, and preceded expressions of joy and resolution. This sequence is reflected in Maria's own description of how she experienced art as healing. After explorations of the meaning of cancer in her life in journals filled with drawings and writing, the insights she gained appear to have initiated a process of inner change which was indicated in artworks related to renewal and initiation. Change appears to have then triggered strong emotion. Maria finally described a process in which painful feelings such as grief and anger were transformed into feelings of resolution, joy and celebration - their opposite - during her art making.

Also revealed by the analysis of thematic motifs was that 22 (29%) artworks contained explicit expressions of spirituality. These artworks were predominantly amongst her latest works which were accompanied by expressions of completion, of achieving her goal. Maria's verbal reports indicated that she believed that her healing essentially came from a "a deep spiritual connection", a connection with her divine nature, the eternal.

Spiritual References

The content of Maria's artwork reveals that she embraced a personal, experiential form of spirituality. Her references are mainly related to the Goddess, representing the divine feminine. The redemption of the sacred feminine and her experience of both immanent and transcendent divinity, appear to have been essential to her attainment of a sense of spiritual fulfilment. Maria also makes a number of references to the "Establishment", to the various churches and religious groups whose opinions and values have a strong influence on the existing power structures of the community. She clearly has an understanding of a range of religious doctrines, both Eastern and Western. Her knowledge appears broad based and eclectic, in the sense that she relates to and uses what is best for herself from the various traditions. In this respect, Maria demonstrates experientially based knowledge of the various doctrines, not merely theoretical understanding. For example, the Buddhist concept of the Hindrances, the Hindu concept of Kundalini, and the Christian concept of the Fourteen Stations of the Cross, were worked with from her experience of the psycho-physical manifestations of each.

One advantage of her eclectic, non-denominational approach to religion is that it includes all that is valuable to her from every perspective. Another advantage is that she is able to challenge the weakness of a religion without negating its strengths and dismissing it altogether. For example, while she is scathing about some of the Christian Church's doctrines and practices, she embraces others.

Maria mentions the (past) murderous intentions and practices of Church clergy, for example, the witch trials and burnings. Events which were clearly enacted with prejudice - doctrines which pre-judged women to be inferior and evil, essentially served to justify the cruel and unjust treatment of them. The perpetrators of the tortures and murders during the witch trials were not brought to trial - their victims were not vindicated. Notwithstanding her knowledge of such events, events which point to the weakness of the Church, Maria has nevertheless been able to continue to relate to the strengths of Catholic doctrine. As mentioned earlier, among her artworks based on Christian themes she created a series of drawings based on the Fourteen Stations of the Cross and a series of paintings based on Genesis. She counts them among the artworks she experienced as most healing.

Maria's journey through her illness represents a psycho-spiritual achievement. Her journey is about confronting and integrating the feminine, essentially about redeeming the feminine, in order to create within herself psychological wholeness and spiritual fulfilment. Maria's images of women depict the active, dynamic feminine. This would have been in sharp contrast to the feminine that was previously oppressed within a patriarchal context: the feminine that was disregarded, frozen, paralysed, not exercised to fulfilment. Through honouring and reflecting upon her journey, Maria was able to redeem the inner feminine as well as the outer feminine, in the form of owning her female body and mind. We see in her art the moving, active feminine, in contrast to the restrained and passive feminine. We see the female body giving her joy, as the vehicle for life and love, in contrast to the body with cancer, the potential vehicle of death.

In terms of the method she used, her process appears very Tantric, which is a most powerful force for spiritualising life. "Tantra" is a Sanskrit word which literally means thread or continuity (Yeshe, 1987, p.166; Allen, 1981, p.14; Douglas & Slinger, 1979, p.375). This meaning implies the continuous present moment, and continuity beyond physicality. There is in fact a strong focus on the present. Tantra is not an intellectual endeavour, the divine is in our here-and-now experience. The skilful practitioners of Tantra learn to think, speak and act now as if they are already fully enlightened. Tantra emphasises process and experience over theory and dogma. In this sense, Tantra is a form of spirituality that is radical in relationship to established religious practices. Tantra acknowledges the sacredness of sexuality as a way of reaching an experience of unity, that is, non-duality. One of the basic beliefs in Tantra, is that our basic essence is pure and that bliss and ecstacy underlies every physical manifestation. In alchemical terms, the gold is within

us and in everything. Unlike other forms of religions which
suggest the suppression or denial of our earthly desires and passions, Tantra directs one to allow them, to include them in our experiences so that they in fact become the means for their own transmutation, they can change and be transformed. The emotion of anger can become compassion, pleasure can become awareness, and so on. Every emotion or experience is widened and involves a deep penetrative awareness. In this way there is a "letting be"; an opening up to, rather than the denial of, experience. The body in Tantra is seen as the vehicle for an embodied spirituality. These factors seem very relevant to Maria's process of transformation. Maria's process is consistent with the ways of Tantra: through the sensual and physical, she experiences the spiritual.

Conclusion

Authentic spirituality is revolutionary.
It does not console the world, it shatters it.

- Ken Wilber (1997, p.26)

The following includes the strengths and limitations of this study, a summary of findings and their possible therapeutic applications, also some recommendations for future research.

The strength of the case study methodology is the validity of the data obtained: Maria was interviewed in sufficient detail for the results to be taken as a true and accurate account of her views and experiences. In addition, Maria had the opportunity to check the relevant thesis sections for their accuracy in interpreting her life events and artwork. The main limitation in general terms, however, is that while case studies allow for depth, the results cannot necessarily be generalised, because one person cannot be taken as representative of the wider community without further research to confirm this.

Nevertheless, while Maria's story is unique, some important aspects of her journey have the potential for wider application. As researcher and author Michael Patton points out, the selection of an "extreme or deviant" case represents the study of an individual who responded to her circumstances in an unusual way (Patton, 1990, pp.169 & 182). In this case, Maria's background as a physician, her decision to seek non-medical forms of treatment when she had cancer, and the creative, personally meaningful and life enhancing way she responded to her diagnosis, were qualities that promised and proved to make this an instructive, information-rich case, one from which much could be learned. Ultimately, the exception may disprove the rule, as social scientist, researcher and author Dr. Catherine Hakim suggests, or at least the exception may prove that the general rule needs to be re-defined as applying only in certain circumstances (Hakim, 1987, p.62).

Primarily, this investigation revealed the ways in which Maria experienced art as healing. In summary, Maria's art process was:

(1) creative: of an awareness of those realities that would have otherwise remained inaccessible to her, for example, her unconscious, inner world;
(2) diagnostic: of the cause and nature of her illness, that is, her prior exclusion of the feminine and authentic spirituality; (3) prescriptive: of the nature of her healing, that is, through her acceptance of her divine nature;
(4) expressive: of emotions, insights, imagination, and particularly of those realities which were socially taboo in Western culture, such as menstruation, the sacred feminine, and immanent/transcendent divinity;
(5) predictive: of her recovery, for example, death images became creation images and preceded Maria's discovery through medical tests that she was cancer free;
(6) compensatory: of the lack of balance she perceived in her life, for example, her focus on the feminine counterbalanced her previous (unconscious) disregard for the feminine;
(7) transformative: of emotional states and her understanding of herself, for example, the insights she gained through her art process allowed her to reframe her understanding, to re-create herself. Maria transformed former conceptions of herself that damaged her self-esteem, and used art to heal her self-concept by identifying with the archetypal, spiritual, divine essence within.

The link between the expression of emotions and healing is interesting; it appears to support the link made by LeShan, Achterberg, Pert, Hirschberg and Barasch in the Literature

Review between unexpressed emotions and illness. The diagnostic and predictive functions of art also support Bernie Siegel's claims. And art's ability to create an awareness of unconscious content, an awareness that has a transformative effect, confirms the observations made by Gregg Furth, Vija Lusebrink and Rosemary Gordon. A pattern of themes also emerged in Maria's art process. One theme appears to have led to the next, in the following sequence:

(1) an exploration into the nature of her illness
(2) expressions of inner change
(3) expressions of painful emotions and physical suffering
(4) expressions of resolution and celebration, and
(5) expressions of a new found spirituality.

Applied to clinical practice, this might represent a guideline by which art may be used therapeutically: to explore illness, to gain insight, to express emotion, the attainment of therapeutic goals, and to explore spirituality. Alternatively, this sequence may be used as a tool by which to interpret art. That is, the images in artwork may be identified with a stage in a process of change. Change in this context relates to personal transformation, with the ultimate goal of the recovery of soul, the soulful life, a personally meaningful spirituality which relies on the importance of one’s own inner guidance.

In terms of the literature reviewed, the personal testimonies express these various themes, although not in a specific order. Art therapist Tracy Councill proposes art

therapy interventions at different stages of the disease/healing process, but they differ from these. The difference may be in the context or target population; her patients were hospitalised children with cancer. Further research is necessary to account for the differences.

Balance appears to have been essential to Maria's healing, so much so, that the concept of balance appears to be interchangeable with the concept of healing, in the following ways:

(1) in the counterbalancing of the opposing forces within (for example, the feminine with the masculine principles, dark with light, body with spirit),
(2) in the integration of opposite forces, and ultimately
(3) in the transcendence of opposites.

Healing appears to have applied to a number of aspects of her personality, as Bernie Siegel, Barbara Graham, and Steven and Ondrea Levine have suggested. That is, healing applied to her physical health, emotional well-being, psychological wholeness, and primarily to spiritual fulfilment. This might indicate the need for better, more accurate definitions of concepts such as "healing" and "curing".

Perhaps the most important contribution of this study is that Maria's art and healing process demonstrated the inseparable nature of the body/mind/spirit, as Joan Borysenko, Candace Pert, Bernie Siegel, Ainslie Meares and Ian Gawler assert in the literature. That her dreams were able to predict her medical test results with 100% accuracy, that her art was able to diagnose her illness and to predict her healing when she was preparing to die, indicated the intrinsic link between her mind and body. She was convinced by these events that "energy comes before matter". Also, her insight that the "Goddess is immanent not only transcendent" suggests the intrinsic link between spirit and matter, that is, body and soul.

Applied to clinical practice, these insights confirm that images in artwork may diagnose illness and predict therapeutic outcomes, as Dr Bernie Siegel has already demonstrated. Another implication is that physical illness may be seen as a manifestation of psycho-spiritual disturbance or imbalance, as the w/holistic healers and the mystic traditions of the East suggest. A purely physical approach to health and healing appears, therefore, to be reductionist and limited.

This research endeavoured to answer some of the questions raised by art therapist Cathy Malchiodi regarding the role of art in the healing of people with critical illness. Further study is needed to confirm, deny or expand upon the findings. In terms of Western medical practice, these findings indicate that our basic premisses about illness may only be partly valid, and subsequently, new or more comprehensive models of investigating illness are needed, along with new and different treatments.

Already, advancements in science such as in quantum mechanics and chaos theory are rendering obsolete the materialistic, monistic, Cartesian-Newtonian paradigm that has largely informed our present thinking (Capra, 1975). Such developments in what has been referred to as the new paradigm in science are becoming increasingly compatible with the mystic traditions of the East, and with the insights of Transpersonal Psychology in the West (Grof, 1998; Wilber, 1996). Ultimately, a synthesis of the spiritual and scientific dimensions appears possible, resulting in a world view, inclusive of both.