Last Word: Seeing the Big Picture

Art therapy helps people with life changing illnesses muster inner strength.

By Hope Heffner ’08

Resilience. I can remember vividly how my Bucknell psychology professors explored this concept in their classrooms. But it wasn’t until I was a junior, and far from Lewisburg, that I truly began to understand what it meant for a person to suffer through trauma and attempt to heal.

As a double major in psychology and studio art studying abroad in Uganda, I asked two groups of high-school seniors to paint a mural about their futures. The first group, in southeastern Uganda, had persevered despite living in crushing poverty. They literally lifted each other up to reach the top of a colorful mural titled "Think Big". They worked collaboratively to depict themes of hard work and hope.

A month later, in war-torn northern Uganda, I met the second group, which had survived traumatic abduction by the Lord’s Resistance Army. The teens worked separately to paint what they hoped to become: a soldier holding a bloody knife, a nurse holding a blanket. I realized as I bicycled along a red-dirt road to my hostel that resilience and trauma were no longer classroom concepts; they were reflected in how and what people create as art.

Nine years after that realization in Uganda, I push a cart laden with art materials through the sterilized hallways at The Children’s Hospital of Philadelphia. I do not bring medications or needles into the room, but as an art therapist and licensed professional counselor, offer a chance for overwhelmed parents to take a break and for patients, ages 3 to 30, to create. There is learning, sharing and oftentimes a rather colorful mess, but there is something much deeper happening, too.

Art therapy combines psychological theory and the artistic process. By creating and verbally describing artwork within the context of a therapeutic relationship, patients can express, organize, create meaning and achieve insight. Individuals enduring the trauma of a life-threatening illness and extended hospitalization find their lives disrupted and independence taken away. Endless medical information and a lack of privacy can leave a patient feeling more like a diagnostic puzzle than a person. The goal of art therapy is not simply to “have fun” but to empower patients to engage in life as whole and capable human beings again — to help them face mortality and then face the day.

During a typical workday, I’m in the oncology unit meeting with a teenager who is struggling with heightened anxiety, fear and a painful course of treatment. I suggest that she draw a boat journey to represent how it feels to be in the hospital. I emphasize there is no grade; this is not art class, and the artwork does not need to be happy or perfect, just honest. As she works with colored pencils, I ask her how the water around her feels, where she is going and what the weather is like. Her answers reflect how she sees herself in this moment. Is she alone in a rowboat without oars, helpless against the winds? Is a storm raging, or is the sun peeking out from beyond the clouds?

I validate and normalize her emotional experience by encouraging her to consider the support available to her as she journeys and to imagine the destination of her voyage. In art therapy, we do not find perfect answers, but we recognize the difficulty patients face and reflect on their innate capacity to withstand storms. Drawings become tangible reflections of patients’ inner resilience, a resilience that will carry them through.


Hope Heffner '08 earned the Class of 1905 Art Prize at Bucknell. She is a board-certified art therapist and licensed professional counselor at The Children’s Hospital of Philadelphia. She earned an M.A. in art therapy from Drexel University.