Book review for Del Loewenthal’s (ed.) ‘Phototherapy and Therapeutic Photography in a Digital Age’

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Berkeley Kaite, McGill University, Montréal, Canada


What is therapy? That is an embedded question coursing through the 14 essays in Del Loewenthal’s Phototherapy and Therapeutic Photography in a Digital Age and a vexed question it is. “Therapy” is of course a broadly-applied term and covers the many possible schools of thought and practice. The psychoanalyst, trained to adhere to the modus vivendi of “say what comes to mind,” will not bring material into the session that the patient has not first introduced him/herself. It is, strictly speaking, client-driven and it is focused on unresolved material – neuroses – whose transmutation can be found in an understanding of the patient’s past, much of it during the pre-verbal period. Many of the essays in this book, while indebted to “depth” models of psychotherapy, are committed to existential psychotherapy with its concentration on tools for addressing the present and hence future behaviours. Still, all therapies rely on versions of the “talking cure” with language and words are at their centre. And yet, as Ulla Halkola suggests in her essay, “A photograph as a therapeutic experience” a word is a mental image and thus the use of photographs in the therapeutic process may be considered in tandem with verbal expression. For Halkola, photos are “connected to client’s mental images, beliefs and memories of self. The event of viewing or taking photos evokes sensations, emotions and memories, which can be of a very early, painful or surprising nature” (p. 21). 

And so, what is a photograph for? This is the second question lurking in these chapters. Some of the authors in the book refer outright to theorist Roland Barthes, most others implicitly, with special emphasis on his idea of the punctum, that which pierces the viewer and evokes “an immediate, personal and emotional connection” between him/her and the photograph (Julia Winckler, p. 130). Going further, I will note that the punctum, for Barthes, is also what the picture cannot do without, by its own aesthetic logic, but cannot communicate in words. By that reason, photographs can easily assume a place within the therapeutic discourse and aid in the discovery and expression of suppressed and repressed emotions and memories. Most of the authors are therapists practicing in Europe and they advocate the use of photographs in a few ways. One is “phototherapy” in which, in the words of Rosy Martin, “clients are invited to tell a story using their chosen photograph as a starting point, by entering the space of the image …’ (p. 70). The photo can be from the client’s own collection or one chosen from a stock selection provided by the therapist.  Another use of the photograph is through “therapeutic photography” and here the goal is similar to that of phototherapy, i.e., to gain self-knowledge through the exploration of emotions and personal narratives via images. But the photos used for this exercise are not from the existing family album or therapist’s repertoire; rather they are taken by the client and used to tell or retell a story, or to tell a story differently.

Both of these methods, phototherapy and therapeutic photography, rely on assumptions about an archive and all that the term can imply. And here is where therapy and photography converge in suggestive and often fruitful ways. In therapy, any client brings an archive of stored material to each session, much of it dusty and filed randomly with no apparent coherence. Each client is also from an established familial archive of relationships, patterns of interaction, repression and prohibition, sometimes trauma, and always replete with stories. Julia Winckler defines the archive as “processes of exclusion, omission, discarding and forgetting … intrinsically linked with practices of acquisition and accumulation” (p. 128). Inclusivity, exclusivity, hoarding and letting go, remembering and purposely forgetting: these can also be called the “family album” (and of course, simply the family). The family/archive has its omnipresent “editor,” as Rosy Martin notes in her chapter on re-enactment in phototherapy, and it is usually the mother/archivist “whose preferences are shaped by an unconscious desire to provide evidence of her own good mothering” (p. 71). Add to this the helpful and cautionary note that photographs “do not tell truths” (Halkola, p. 29), are in fact “fictions” (Martin, p. 70), and we can ask, then, what does the photograph perform? What can it perform?    

The many case studies discussed in these chapters foreground the utility of photography and the photograph in the telling and re-telling of personal narratives. The client, through the photograph, begins to build a modified, sometimes rather different, family album and archive of stories and “future memories”. For example, Del Loewenthal tells of a girl who took pictures of her despised hand warts so that she could confide in the camera and look at and talk about her fears. Rosy Martin photographed clients acting out anxious memories. The goal was to re-perform those memories as a new “series of fictions”  (p. 72). Christina Nunez believes that in photographing one’s self one can feel “greatness,” even “become a hero” (p. 101). Julia Winckler writes of a seminar with photography students in which she asked them to use a photographic archive (a private family album or a public collection) to establish its genealogy in relation to the student/ researcher, “its original value … its conditions of production … its orgins or its relationship to other objects” (p. 131).  Winckler discusses the work of those who used family photo albums (and in one case an album of photos found in an antique store) to work through relationships with, and memories of, family members, some living and some dead. The strategies employed here, which include photo-shopping one’s self into old family photos, are a play on presence and absence, a binary at the heart of the therapeutic enterprise and central to the conceit of photography.  As Winckler notes, “… the past is now part of one’s present and the present now has a past” (p. 141). Therapeutic discourse is thus both material and immaterial (like language itself). Alexander Kopytin urges the inclusion of photography into art therapy, for example through the use of a photograph in multi-media collage whose purpose is to create a therapeutic virtual reality. Rodolfo de Bernart writes of the deployment of the “photographic genogram”, the collection of “pictures, slides, 8mm films and video recordings of events” within the family (p. 121). The idea is to use this genogram within family therapy to provide a structure for and then decode the multiple relationships and ways of knowing among family members.

The “digital” in the title is taken up in an essay on the making, use, sharing and viewing of images and how these alter contextual information in “Fotos, Fones & Fantasies,” by Mark Wheeler. The issue of digital capabilities also foregrounds the matter of time and differing engagements with the making, viewing and use of photographs. Mike Simmons notes that digital photography challenges photography’s “core values” (p. 53). Rosy Martin observes that with the digital camera “what one loses is the deferral” (p. 79); that is, the very stuff of memories – the archive – is now fleeting and ephemeral.

All the essays in Phototherapy and Therapeutic Photography in a Digital Age are written with great compassion and commitment to exploring new avenues of research and therapeutic interaction, including interest in the nascent fields of “mirror neuron system” (Halkolla, p. 23), “neuro-psychoanalysis” (Wheeler, p. 47), and “neuroimaging” (Karlsson, p. 161). The writing in the book is uneven and some of the prose is awkward and clunky (perhaps because English is not the first language of many of the authors). There are a few scientific acronyms to do with the evaluation of behavioural outcomes peppered throughout some chapters, which are meaningless to the lay reader (e.g., PHQ-9 score, GAD-7, 5-HT1A receptors, carbonyl-11C). However, the chapters make clear that the photograph can aid in therapeutic analysis in provocative, creative and unexpected ways. Editor Del Loewenthal quotes Wilfred Bion who describes therapy as “two frightened people in a room” (p. 174). The introduction of the photograph should alter that dynamic in subtle but potentially powerful ways. 


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