Attunement in Art Psychotherapy

Abstract

Background: British art psychotherapy in 2020 is influenced by an integrative psychodynamic and ‘affective neuroscience’ approach, which measures emotions or feelings (‘affects’) embodied in brain processes – such as the firing of ‘mirror neurons’ – and relates them to intersubjective inner processes of the unconscious such as ‘attunement’. Attunement is frequently confused with related concepts such as empathy; these concepts have been correlated with successful therapeutic outcomes, so it is important to break them down into essential, operational components in order to apply them to theory, research and practice. In art psychotherapy these interpersonal processes take place within the multidimensional ‘triangular’ relationship between client, therapist and image. Research Question: What are the essential components of the concept of ‘attunement’, and how has this been operationalised in the art psychotherapy literature? Method: From a subjective/constructivist/‘metaphorist’ paradigm and using a qualitative approach, Walker and Avant’s eight-step concept analysis method is applied to 25 primary literature sources with ‘attunement’ in their titles. Additionally, 16 snowballing reference sources and 43+ articles published in BAAT’s Inscape/International Journal of Art Therapy (IJAT) are examined for their uses and operationalisation of attunement. Findings: Attunement is a mutual, automatic/unconscious, ongoing process which ‘recasts’ the outward expression of the same shared affect into a different form or modality matching in ‘activation contour’ (intensity, shape, rhythm, etc.), e.g. a sound into a movement, or the creation of an image into words. This ‘recasting’ is what distinguishes attunement from emotional ‘contagion’ and mirroring; empathy is more conscious/intentional. There are differing levels of attunement, and ‘moderate’, with ruptures and repairs, appears to be the most developmentally and therapeutically effective. Key conclusions/recommendations: Articles in IJAT refer to attunement with increasing frequency and scholarly citation/definition over time, although there appears to be ongoing misunderstanding of the concept. Several authors describe attunement with the image, and it has been suggested that this can generalise over time to attunement with the therapist, the self, and others. Future research could use video analysis and physiological measures to investigate ‘moderate’ attunement with the image and therapist, and how the rupture/repair cycle applies to art psychotherapy.