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

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