The princess of polka dots: Using art as a medium to cope with hallucinations.

Sir,

Thoughts are usually expressed in the form of language, music, and art. For individuals with mental disorders, it can be challenging to express their ideas and emotions. In patients who are otherwise unable or unwilling to vocalize or explain the inner workings of their minds, art therapy can be a novel way to break the communication barrier. Art therapy can take a variety of forms and can be used as a form of interaction with their therapist, to potentially help in elucidating conflicts, defenses, and thoughts that may not be verbalized by the patient.

There are many examples of artists who used art as coping mechanisms to ease symptoms of mental disorders. The iconic work “The Scream” by Edvard Munch was in fact inspired by one of his hallucinations. However, the most prominent instance of this phenomenon in recent times is that of Yayoi Kusama, an 88-year-old Japanese contemporary artist, aptly called the princess of polka dots. Most of her art is in the form of sculpture and installations, but she is also well known for her paintings, poetry, fiction literature, film, performance art, and fashion. Countless artworks created by her are displayed in museums across the world, and according to her, she is inspired by hallucinations which comprised of “flashes of lights, auras, dense fields of dots”.[1] Yayoi Kusama's Walking Piece is a performance art, and “Kusama's Self-Obliteration” is a film she both produced and acted in.

Kusama was born in 1929, and around the age of 10, she began to experience hallucinations; she perceived patterns moving, multiplying, engulfing everything around her and finally consuming her, a process she termed “Self Obliteration.” She began to paint out her visions, which she felt helped her gain control of anxiety and provide an outlet for her intense psychological turmoil. The origin of her obsession with polka dots started with looking at pebbles in a riverbed near her childhood home. She has called herself an “obsessional artist,” with polka dots permeating all aspects and forming a central theme of her various works [Figure 1]. The Infinity Room is an illusion of never ending space, created by light and mirrors [Figure 2]. The famed yellow pumpkins with black polka dots have been exhibited in various forms around the world [Figure 3]. Her Self-Obliteration piece depicts the polka dots surrounding and engulfing her [Figure 4].

Figure 1

The polka dots………………

Figure 2

The infinity room

Figure 3

The pumpkin installations

Figure 4

Kusama's self-obliteration piece

She had a disturbing childhood, with her mother being physically and emotionally abusive, forcing her daughter to spy on her husband's extramarital affairs because of which she developed a strong aversion to the male body and an obsession with sexuality. She said, “the sexual obsession and the fear of sex sit side by side in me.”[2] Her artworks contain sexual themes, especially her soft sculptures, which have protruding phallic structures attached all over them.

When she was 13, she was sent to work at a military factory during World War II. Listening to the sirens while sitting in the dark workroom had a lasting impression on her future artworks.

She was later permitted to study art at a university in Kyoto but was only allowed to practice “Nihonga,” a traditional form of Japanese art, which robbed her of her creative freedom. Eventually, the imposed conformity stifled her and she moved to New York in 1958.

While in New York, she quickly gained popularity and became an integral part of the avant-garde art circles. She organized various “Happenings” across the city, which often involved her painting dots on participants’ naked bodies, with the intention of breaking down barriers associated with gender identity, sexuality, and oppression in society, which also included antiwar themes.

She moved back to Japan due to her failing health, after which she started living in a hospital for the mentally ill on her own accord, where she continues to live. She uses her art studio near the hospital to produce art and surreal poetry and fiction. She often says, “If it were not for art, I would have killed myself a long time ago.”

Art therapy is defined as using art as a form of therapy in itself. It is important to differentiate between art in therapy and art therapy. “Art in therapy” typically uses art as a component of a talk-based modality, while “art as therapy” suggests that the artistic endeavor is, in and of itself, therapeutic. Change occurs through sublimation of feelings into the images and through communication with the therapist through the art object.

According to Richardson et al., art therapy produced a significant positive impact on the negative symptoms of schizophrenia (assessed by scale for the assessment of negative symptoms) but had little effect on other symptoms of the disease.[3] Green et al. in their randomized controlled trial allocated patients into two groups, with one being given intervention in the form of group art therapy + standard care and the second group being administered standard care alone. The patients allocated to the first group reported better self-esteem after completion of the group therapy.[4] Meng et al. showed improved health and social functioning after 15 weeks of twice weekly group art therapy.[5] According to a review of studies conducted on use of art therapy in schizophrenia and schizophrenia-like illnesses, the art therapy groups showed significant improvement in negative symptoms.[6] Qiu et al. showed that the intervention group reported decrease in anxiety, depression, anger and negative symptoms, better compliance with rules, better socialization, better compliance with medication, and regular sleeping pattern after weekly sessions of art therapy for 16 weeks.[7] The 2014 guidelines of the National Institute for Health and Clinical Excellence on Treatment of Psychosis and Schizophrenia in Adults recommend including art therapy in conjunction with pharmacotherapy to “enhance an individual's creativity, emotional expression, communication, insight, and ability to relate to themselves and others.”[8]

Art therapy can be a very good modality for improving the symptoms of psychosis, and the best argument in support of this statement is Yayoi Kusama, who is a living example of the success of art therapy.

“I do not consider myself an artist, I am pursuing art in order to correct the disability which began in my childhood. My art originates from hallucinations only I can see. I translate the hallucinations and obsessional images that plague me into sculptures and paintings. All my works in pastel are the products of obsessional neurosis and are therefore inextricably connected to my disease. The only method I have found that relieves my illness is to keep creating art.”[910]

-Yayoi Kusama

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.