Introduction

Art has been one of the most effective methods of communication since humans began to perceive their environment. Artworks enable information about social experiences, religious beliefs, cultural values, or political events to be transferred between generations, while visually based, embodied communication can effectively convey emotions and thoughts as well as information.

Art history therapy, which brings together the disciplines of art history and psychology, aims to accelerate client self-disclosure to the therapist by bringing their unconscious to consciousness through artworks, thereby establishing the therapeutic alliance. It also aims to increase psychological well-being through aesthetic experience. Recent neuroscientific researches have shown that aesthetic experience improves psychological well-being by triggering reward mechanisms in the brain of individuals (Mastandrea etc., 2019).

Psychology and Art

It is known that repressed childhood experiences, emotions and desires cause behavioral problems. In psychoanalysis, the client can get rid of pathogenic emotions and neurotic symptoms through the release of unconscious emotions; in other words, catharsis is achieved. Through this method, Freud aimed to help his clients know themselves better. Besides, the integration of psychoanalysis with art provides catharsis, which allows the unconscious analysis of the artwork, the artist, and the audience (Celikkan, 2017). Freud also supported that while an artwork may have a clear subject at first glance, further interpretation can reveal an implicit meaning that may vary between individuals (Freud, 1983).

It is clear that function of art is to bring repressed emotions and thoughts to consciousness by reflecting unconscious associations, thereby providing catharsis and, as a result, facilitating self-knowledge. Artwork can also provide a safe space to experience negative emotions because we know it is art, not reality (Winner, 2019). Moreover, individuals use defense mechanisms, such as repression, to protect themselves from anxiety-producing thoughts and feelings related to internal conflicts and outer stressors (Di Giuseppe et al., 2020). Art also functions as a defense mechanism, namely sublimation, by making the artist’s primitive negative impulses socially acceptable in the form of artwork. Hence, artworks can be used as therapeutic tools (Thomson et al., 2018).

Aesthetic Experience

An individual’s first impression of an artwork is called “aesthetic perception, aesthetic value, aesthetic sensation, aesthetic experience or aesthetic attitude” (Gorodeisky & Marcus, 2022). According to Cupchik and Winston (1996), this aesthetic experience involves a psychological process in which the viewer focuses on the art object while suppressing consideration of all other objects, events, and everyday concerns. An individual’s aesthetic experience of the artwork is related to their subjective aesthetic judgments based on a combination of the object’s physical characteristics and the viewer’s emotions. Thus, while the formation of aesthetic judgments is primarily subjective, the existence of the object- and subject-based common aesthetic judgments adds another dimension to the process.

Recent studies also suggest that the self-rewarding nature of aesthetic experience can promote health and psychological well-being. Mastandrea et al. (2019) supported that viewing visual artworks is a form of hedonic experience that affects mood and improves the viewer’s psychological well-being. Harrison and Clark (2016) argue that aesthetic experience is related to mindfulness meditation in that it enhances a person’s ability to establish a perceptual relationship with an object.

Different individuals may experience a stimulus, such as an artwork, in both similar and different ways to each other. This can be explained in terms of selective perception, defined as directing attention to one or more of the available stimuli, events, or objects in the environment, which insignificantly affects human perception processes (Huber, 2019). Selective perception is affected by both external and internal factors. The former includes stimulus intensity, extreme contrast, mobility, continuity, repetition, and non/familiarity. The latter include expectations, interests, needs, and beliefs. However, the individual does not consciously choose any of these orientations (Verhaeghen, 2018).

Hence, differences in the attitudes of individuals towards the same artwork depends on selective perception. The elements in an artwork that address the individual’s expectations and needs are perceived as being more attractive and having more effect on the viewer’s recall of particular memories. That is, different people pay attention to different stimuli in the same painting, while the meanings they attribute to the same stimuli may differ.

Art History Therapy

As the study of aesthetic objects and visual expression in their historical context, art history examines the historical development of visual art forms, such as painting and sculpture, as well as their aesthetic and cultural significance. New archaeological excavations and research have pushed our knowledge of art history ever further back into prehistory. Given the evidence that humans have always used their creativity for various purposes, the beginning of art can be considered as contemporaneous with the history of humanity.

Given the many functions of art, such as directing human life, making life meaningful, and arousing positive emotions, it is of great importance in the psychotherapy process. Here, the common ground between art and psychological disciplines is psychological well-being. In particular, art history therapy has been developed as a new psychotherapeutic method that can help facilitate clients’ self-disclosure, raise their self-awareness, and increase psychological well-being.

Art history therapy aims to increase psychological well-being through the aesthetic pleasure that people experience from viewing art works. Hence, they can benefit from the healing power of art in psychotherapy. Regarding the selection of the artworks, after a preliminary interview with the client, the clinical psychologist works with an art historian to choose therapeutic materials from art works that are generally appreciated within art history and reflect the characteristics of different periods and artists, although the final selection also depends on each client’s psychological state and symptoms.

This therapy method consists of two phases. In the first phase, the client views and interprets an artwork while the therapist makes connections between these interpretations and the client’s childhood experiences. In the second phase, the therapist informs the client about the same artwork in terms of art history. The main aim is to help the clients recall their experiences and increase their psychological well-being by providing an aesthetic experience.

First Therapeutic Phase

As outlined above, in this phase, the client is shown an artwork and asked to interpret it on the basis that their interpretation will reflect their own experiences and emotional state. This enables the client to express their feelings and the associations evoked by the artwork. The process assumes that the elements in each artwork that attract the client’s attention, and the impressions and meanings of the artworks depend on the client’s particular experiences, emotions, cultural values, etc. Hence, different clients viewing the same artwork will likely have different perceptions due to the uniqueness of their personal experiences. By triggering the client’s negative childhood experiences, the artwork can make it easier for the client to explain themselves to the therapist. The faster the cause of the problems is learned, the sooner the problems are solved.

The psychotherapist then makes connections between the client’s interpretations of the artwork and their previous experiences. Through appropriate questions, the therapist can facilitate the client’s self-disclosure. That is, anamnesis (disease history taking) can be done more quickly and elaborated through dialogues about various visual elements in the artwork. Here, the therapist aims to facilitate the recall of the client’s repressed negative life events.

Another aim of this phase is to use the artworks to establish the therapeutic alliance between client and therapist more quickly. For a fragile personality, such as that of the client, it can be challenging to form a direct relationship with another person. However, establishing therapeutic alliances can be made easier with an object. The therapeutic alliance can be described as a coalition based on the patient’s motivation and the therapist’s provision of appropriate therapy techniques (Kazantzis et al., 2017).

Regardless of the technique, method, or theoretical approach, this alliance and the associated development of interpersonal relations can help heal the client (Soulsby et al., 2021). Agreement through a working alliance is associated with greater symptom improvement and more reduction in clients’ global psychological distress. Many studies have shown that the therapeutic alliance, through key features like cooperation in the tasks and goals of therapy and establishing the affective client-therapist bond, is the strongest predictor of psychotherapeutic outcomes (Karver et al., 2018). A stronger alliance is associated with better mental health outcomes, improved psychological well-being (Alessi et al., 2019), decreased depression (Cameron et al., 2018) and social anxiety symptoms (Kivity et al., 2021).

Art can bring the unconscious to consciousness and, through its healing power, facilitate the establishment of the therapeutic alliance. Visual artworks can thus be considered therapeutic tools that can reveal an individual’s unconscious thoughts. By triggering associations, artworks can reveal the client’s unconscious emotions.

For example; Belgian artist Egidius Linnig (1821–1860) deals with the life of a 19th century Dutch family in his work called “Dutch Interior”, which he made for the Town Hall collection. In the enclosed space, which seems to be a country house, the light coming from the window on the right focuses on the figures. When looking at the figures, there is a baby sitting on a table, and in front of him, there are boy figures, who are understood to be mother, father and his brother, in a closer position. On the left of the picture, the door left open draws attention.

Looking at the facial and body expressions of the figures, all attention is directed to the baby sitting on the table. The light from the window was also used to strengthen this effect. In this way, he succeeded in directing the audience to the figures. Despite the poor appearance of the interior in the work, the happiness of the family is conveyed very successfully and the baby is placed as the source of this happiness. With this work, the artist conveyed the positive effect of the new person joining the family, regardless of rich or poor, on other family members through the 19th century Dutch family (https://artuk.org/discover/artworks/dutch-interior-137605 Date of access 12.09.2023).

In the therapy session, the Dutch Interior artwork was shown to a 50-years-old, mother of 2 children, retired nurse, female client with OCD symptoms and was asked what she saw in the picture. Client stated that the mother in the picture is quite irresponsible because she sits her child on the table, that the child in the back is neglected, and that the messy house is also the mother’s irresponsibility. When the client was asked about her relationship with her children, she mentioned that she was a very protective and devoted person. Considering the role of women in the family, it is seen that the obsession with cleanliness is quite high and she attaches great importance to house works. Based on the client’s family relationship with their parents, therapist asked that “Which child are you in this picture? and she stated that it was the boy in the back. From this point of view, when talking about her childhood, she said that her mother was very obsessive about house works. She always said her to clean house; but his brother is always privileged. Her mother always took care to meet his needs. It was seen that she gave importance to house works in order to be appreciated by her mother and she models her mother to herself.

However, regarding the same picture, another 35 years old, academician man stated that both children are happy and the parents treat both children equally. When therapist asked about his childhood, he explained that he had a brother who was 5 years younger than himself, his parents treated both of them equally, the birth of his brother made him happy, that he did not experience sibling jealousy, he was happy because he had a friend. Their parents showed similar care for their two children. For this reason, he explained that he had a happy childhood. The therapist then asked the client which color in the picture he remembered and what it meant to him. Finally, the client was asked what color he could name his childhood with and what it meant to him.

Besides, another art work that is “The Potato Eaters (1885)” is another art work used in the therapy sessions. Van Gogh mostly included peasants and village life in his early works. His work “The Potato Eaters”, which he completed in 1885 in a realistic style, is now exhibited in the Van Gogh Museum. In the picture, five figures, consisting of two men, two women and a girl, are seen indoors eating potatoes and drinking coffee, gathered around a table illuminated by a lamp. Two figures are presented to the audience, one in profile as face and body, the other in profile as three quarters, and one figure from behind.

The main subject of the work is the depiction of the villagers in their daily clothes, sharing and eating the potatoes they planted. The stage has a dim atmosphere. Since the style is not linear, the contours cannot be followed exactly and therefore creates uncertainty on the surface. In the picture, there is an oil lamp hanging from the ceiling as the only light source. The light is on the figures and most importantly the potatoes on the table. On other surfaces, dark tones dominate. Especially brown and dark green tones dominate the composition. Van Gogh tried to give the color of unpeeled dusty potatoes in this painting, where the expression is strengthened by color. It is likely that the painter chose dark colors and tones to emphasize the difficulty of these people’s lives. Thus, an ordinary moment of daily life has acquired a somewhat melancholic appearance. The crooked, rough hands and expressions on the faces of the figures also reveal the difficulty of their lives. Volumes are strong. The bodies are firmly on the chair. Although the dark tones and faces of the people have a somewhat sad effect, it is not a pessimistic and hopeless picture. Despite all the difficult living conditions, the fact that family members have provided meal together around the table emphasizes their family integrity. The peace and serenity brought by sharing manifests itself in the work (https://www.vangoghmuseum.nl/en/collection/s0005V1962 Date of access 12.09.2023).

This art work was shown to 28 years old, student woman saw in the picture that women service to men as usual. She was angry about gender roles because of her family. She said that women always serviced to men; but men did not help them and patriarchal culture was dominant in her family. That’s why, the first thing that attracted women’s attention was women’s service.

However, another client who grew up in a family with strong family tie, see a happy family that they have a dinner. said that this family looks like his own family that all his family ate dinner as together and the whole family would chat. Then therapist asked that “What kinds of topics did you talked?” He replied that all family members were important in his family and no, he tries to eat dinners as together with his children and wife. Therapist interpreted that the client modeled his own parents to himself and his childhood was happy. So, it can be said that visual artworks were used as a tool to accelerate clients’ self-disclosure to the therapist by bringing their unconscious to consciousness through artworks, thereby establishing the therapeutic alliance in the case examples.

Second Therapeutic Phase

In this phase, the therapist analyzes the artworks with the client in terms of art history by providing technical and iconographic information to the client. In doing so, the therapist aims to shift the client’s focus from themselves, and their feelings triggered by the artwork to knowledge about the artwork while also grounding the client’s impressions about the artwork from the perspective of art history.

Kabashi (2019) supported that pictures are more effective than words in showing complex ideas and providing information. It is known that art works stimulate our senses and awaken emotions we have never felt before. Some people wonder what the symbols, events, people and abstract ideas in pictures mean and how they relate to each other and to the real world. At that point, iconography that is the branch of art history that deals with the subject or meaning of artworks rather than their form helps people to understand deeper meaning of visual artworks (Panofsky, 1955). In addition, iconography and iconology give detailed information about the artist and the period of the artwork. That the client’s aesthetic experience can be deepened by sharing iconographical information about the artwork. In other words, the aesthetic experience depends on both the object’s physical characteristics and the viewer’s emotions regarding the artwork. According to Leder et al. (2006), for example, the provision of background information about an aesthetic stimulus influences aesthetic appreciation.

While some clients may perceive an artwork used in therapy as peaceful because it evokes positive previous experiences, other clients may perceive it as disturbing because it evokes negative previous experiences. Nevertheless, in both cases, there is an aesthetic experience. For example, painful or frightening events experienced by the heroes of a tragedy can trigger an aesthetic experience in the viewer. The particular aesthetic experience triggered by the artwork also changes the client’s focus, for example, by taking them away from the sorrows, anxieties, and hopelessness of everyday life through the experience of different emotions.

The client’s perceptions of an artwork may also be changed by information about the artist and the period they lived in. Gaining a new perspective in this way can increase the client’s aesthetic pleasure, which in turn can increase their psychological well-being. In addition, information about the artist’s emotional state and life can trigger further associations with the clients and serve as an example. This can make the client feel that they are not alone and experience identification with another person through that artwork. This, in turn, can strengthen the therapeutic alliance.

Aesthetic experience is defined as the emotional result of art appreciation. In this regard, each artwork can elicit a specific emotional quality related to childhood memories (Moeskjær Hansen & Roald, 2022). Linguistic vocabulary is limited for describing certain emotions, whereas artworks can trigger and thereby reveal those that are related to an individual’s experiences (Funch, 2022). Furthermore, aesthetic experience is related to the appreciation of aesthetic objects (Mastandrea et al., 2019) in that it activates the viewer’s reward system thereby creating feelings of pleasure (Christensen & Gomila, 2018). Such pleasure is not derived from the utilitarian properties of the object but is linked to its intrinsic qualities as an aesthetic object. This self-rewarding nature of aesthetic experience increases psychological well-being (Mastandrea et al., 2019).

Discussion

Throughout human history, art has been one of the most effective tools for expressing emotions and thoughts, whether in written, phonetic, or visual form. In particular, because visual art reflects the artist’s unconscious processes, visual artworks are considered as the most effective art form; hence, such art is mostly used in psychotherapy.

It is known that art therapy depends on creative art processes and it is effective on increasing peoples’ well-being and and quality of life (Oh &Chung, 2021). Besides, researchers supported that art therapy can also foster self-esteem and self-awareness, cultivate emotional resilience, promote insight, enhance social skills, and reduce conflicts and distress (Richards et al., 2019; Abbing et al., 2019). An important distinction is needed here. In art therapy, the artworks used are those made by the clients, whereas in art history therapy, the psychotherapeutic process uses plastic and/or visual artworks made by artists rather than the client.

Another form of psychotherapy that has similar functions to art therapy is phototherapy. Photographs are used as metaphorical elements on the assumption that two viewers of the same photograph will not derive the same meaning from it (Weiser, 2018). Hence, in therapy, photographs can reveal the values that individuals believe in, their way of perceiving life, and their attitudes and expectations. Şahin (2023) also argues that individuals can express otherwise non-verbalizable feelings, beliefs, and behaviors through photographs. Similarly, artworks provide other metaphors that make it easier for clients to express themselves to the therapist.

As objects of art history, artworks can trigger associations with childhood experiences in clients. Because they are discussing an artwork, this can enable clients to express their repressed feelings, thoughts, and memories more easily without fear of being judged by the therapist. Furthermore, self-disclosure provides catharsis to enable clients to discharge the effects connected to traumatic events. Viewing art can thus facilitate self-disclosure, increase awareness of the unconscious, and discharge emotions, thereby strengthening the therapeutic bond.

Unconscious processes lead to maladaptive behaviors, while people use various defense mechanisms to cope with stressful and traumatic memories. Bringing the unconscious to consciousness is essential for treating such inner conflicts. Psychoanalysis provides various methods, such as free association, to access these unconscious processes. Likewise, art history therapy can offer a new method to reveal unconscious processes, make it easier for client and therapist to establish the therapeutic alliance, and increase the client’s psychological well-being via aesthetic experience. Accordingly, art history therapy can be proposed as a new psychotherapeutic method for facilitating client self-disclosure, providing catharsis, strengthening the therapeutic alliance, and increasing the client’s psychological well-being via aesthetic experience.

In the present paper, we offer a theoretical framework for this method. Further research applying the method to clients with various psychological problems can investigate the effect on self-disclosure, the therapeutic alliance, and psychological well-being. Studies using a pretest-posttest research design can also measure the potential effects on clients with validated scales like the Emotional Self-Disclosure Scale (Oral, 1994), the Therapeutic Alliance Scale-Short Form (Gülüm etc., 2018), and the Psychological Well-Being Scale (Telef, 2013).