Bilateral Artmaking

(Draft Version)

Bilateral artmaking is a self-regulatory and brain-based practice experienced through gesture, gross and fine motoric expression whether in the air, on paper, canvass, or nontraditional surfaces. The psychological and physiological benefits vary from grounding or stabilizing effect (Malchiodi, 2015), to lower cortisol levels (Lorance & Warson, 2012), engagement of neural networks (Konopka, 2014), and improved functional brain connectivity (Bolwerk et al., 2014).

As a formally trained art therapist, my first introduction to bilateral drawing was a warm-up activity to promote expansive vs. constrictive movement.  This bilateral approach was due in part to Florence Cane, a formative art educator from the 1950s; she was the sister of pioneer psychoanalytic art therapist Margaret Naumberg.  Florence Cane’s (1951) seminal book The Artist in Each of Us resonated with me both as an artist and art therapist, because of her foresight into the physiological benefits of interventions such as bilateral “air drawing” and corresponding paper-based/movement- oriented drawings.  Florence Cane astutely noted that these “liberating” exercises allowed for controlled breathing, focus on joint movement, and the flow of neural messages between brain and hand. Cane utilized this approach primarily with children to move them past constricted movement in artmaking.

Combining artmaking with Gestalt concepts, psychologist Janie Rhyne transcended warm-up bilateral exercises into whole-body experiences.  Janie Rhyne was not only a mentor during my graduate art therapy studies at Vermont College, she was my research professor and guided the way to operationalizing artistic concepts into measurable variables. I discovered her work serendipitously through my undergraduate training at the Cleveland Institute of Art where my undergraduate art therapy instruction Sarah Dickman handed me her book and informed me it would be “transformational.”  Janie Rhynie’s (1996) Gestalt Art Therapy continues to define my work as an art therapist and even as a somatically based Eye Movement Desensitization and Reprocessing (EMDR) practitioner. Her training with the founders of Gestalt Therapy Fritz and Laura Perls enabled Janie Rhyne to integrate theoretical concepts from Gestalt therapy with basic tenets of artmaking. Her approach came to life for me while watching videos tapes of her group sessions from her years in San Francisco’s “Haight.” Clay work provided an excellent medium for in vivo work incorporating Gestalt emergent somatic experiences and externalization of present moment sounds, movement, feelings, and cognitions: In essence, a whole-body experience.

Bilateral artmaking is an integral part of my practice as an art therapist–because of the influences of Florence Cane and Janie Rhyne. However, it was through training as an Eye Movement Desensitization and Reprocessing (EMDR) practitioner that it became clear how bilateral movement and artmaking activated somatic responses and enhanced neural connectivity. Since 2002, I have used an arts-informed approach to EMDR incorporates bilateral artmaking reminiscent of Florence Cane’s (1951) gestural air drawings and corresponding paper-based mark making as well as nonobjective mapping concepts from Jane Rhyne’s (1996) emphasis on present-moment emotions. The result was bilateral chalk drawings on large-scale horizontal and vertical “removable” surfaces.  After years of experimentation with various forms of bilateral artmaking including drawing, painting, clay work, and felting, it became apparent that the art process could serve as a form of bilateral stimulation comparable to EMDR. Although the midline crossing emphasis of EMDR has now been “debunked,” the brain connectivity across the midline when engaging in bilateral movement and gestural artmaking contributes to hemispheric integration (cite).

Bilateral artmaking as an integrated approach to reprocessing somatic or “felt” experiences, evolved from my ongoing work with “Madeline,” a 13-year-old Latina/Caucasian female with a history of impulsivity and parasuicidal behaviors. Eye Movement Desensitization and Reprocessing (EMDR) was our primary treatment incorporating an arts-informed approach. Madeline complied with the art tasks associated with the 8 phases of EMDR and was able to reduce her level of distress consistently (cognitions); however, Madeline continued to struggle with self-regulation physically and emotionally. As an athlete, Madeline demonstrated excellent proprioception in her artmaking movement and as a result, we started to incorporate “air drawing” and bilateral gestural drawings on a vertical and horizontal bulletin board. (insert figure 1)

When it became apparent that Madeline was more receptive to bilateral drawing using sidewalk chalk on my wall/table chalkboard than directed arts-informed EMDR tasks, Madeline and I decided to “test” the effectiveness of specific bilateral movements and corresponding gestural drawings. Using the Positive and Negative Affect Scale (PANAS; Watson et al.,1988), Madeline self-reported her affect before and after each session (3 total), comprising 1. simultaneous (occurring at the same time) bilateral drawing on a horizontal and vertical chalkboard surface (chalk), 2. simultaneous and continuous (unbroken lines) bilateral spiral drawing series (chalk pastel), and 3. simultaneous, continuous, overlapping (lines crossing) bilateral breath drawings (chalk pastel, 4 total) that were assembled into a meandering accordion breath journal. All three bilateral movements and gestural exercises incorporated midline crossing  becoming more intentional as we progressed. (insert figure 2, 3, and 4)

The bilateral drawing protocol for session 1 re: simultaneous bilateral drawing on a horizontal and vertical chalkboard surface (chalks), consisted of bilateral circle and line “air” drawings, which were repeated on two black chalkboard surfaces using yellow chalk for contrast (one per hand). Madeline was instructed to make marks using both hands simultaneously, switching back and forth between the horizontal and vertical surfaces, when prompted. Madeline incorporated additional colors while maintaining her simultaneous bilateral movement and mark making. Reflecting on her gestural marks, Madeline circled and embellished areas that she felt connected to while maintaining her simultaenous bilateral movement.

The second session, Madeline completed a sequential spiral drawing series on 18” x 24” white drawing paper, alternating again between a horizontal and vertical surface. Madeline engaged in spiral and mountain “air” drawings to connect with the bilateral movement. Using chalk pastels as her medium of choice, Madeline created simultaneous and continuous bilateral spirals (both hands changing the direction of the spiral) in response to emotions experienced that day (identified 6 total from the pre PANAS). Madeline was instructed to shift negative or neutral emotions using the stimultaneous and continuous bilateral spiral movement and gestural drawing.

The bilateral intervention for the third session consisted of combining breathing exercises with simultaneous, continuous, and overlapping bilateral movement and gestural drawing reinforcing her own rhythm. Our “air” drawings considered her experience of her breath in the present moment (before each gestural drawing), reinforcing her discovery of her own rhythm. On two 18” x 24” sheets of white drawing paper, Madeline was instructed to create four bilateral drawings (front and back side of paper), with an emphasis on crossing the midline (overlapping) while maintaining a simultaneous and continuous approach. I read a breath script from an EMDR containment visualization focusing on what I renamed as shallow breathing, distracting breathing, focused breathing with distraction, and long/slow exhale. As a visual representation of her breath and bilateral work, Madelyn created a meandering accordian journal from her 4 bilateral gestural breath drawings representing the flow of her breath from shallow to deep.

The results of the pre and post PANAS, from our three dedicated sessions, indicated bilateral movement and gestural drawing, specifically, the combination of “air” drawings and simultaneous bilateral drawing (session 1) demonstrated an increase in positive affect (6-point increase) and a decrease in negative affect (9-point decrease). Overall, the bilateral movement and intuitive chalk drawings that emerged from my sessions with Madelyn were the most efficacious, reinforcing the importance of what Florence Cane (1951) espoused: rhythmic movements as a form of “liberation.” Today, this is what it means to self-regulate through embodied practices re: bilateral movement and artmaking.

Our co-collaboration on this endeavor contributed to a sense of safety and personal agency in co-creating a protocol specific to bilateral movement and artmaking. From this process, Madeline discovered her own rhythm: goalie glove painting or “punching” the paper bilaterally (overlapping, crossing the mid line) to “release emotions.” As we shifted from the standard 8 phase EMDR approach to a more bilateral movement and artmaking emphasis, she was able to ameliorate her body’s experience of emotional distress, observed through changes in positive and negative affect (PANAS): Madeline internalized this approach as her self-regulatory practice.

Bolwerk, A., Mack-Andrick, J., Lang, F. R., Dörfler, A., Maihöfner, C. (2014). How art

changes your brain: Differential effects of visual art production and cognitive art evaluation on functional brain connectivity. PLoS ONE 9(7): e101035.

Cane, F. (1951). The artist in each of us. London, England: Thames and Hudson.

Konopka, L. M. (2014). Where art meets neuroscience: A new horizon of art

therapy. Croatian medical journal55(1), 73–74.

Malchiodi, C. (2015, September 29). Bilateral artmaking: Self-regulation for trauma

reparation, Psychology Today.

Rhyne, R. (1973/1996). Gestalt art experience, Chicago, IL: Magnolia Street


Warson, E. & Lorance, J. (2012). Physiological measures in art therapy evidence-

based  research. In C. Malchiodi, (Ed.), Art Therapy and Health Care. New York, NY: Guilford Press. 

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of

brief measures of positive and negative affect: The PANAS scales. Journal of personality and social psychology, 54(6), 1063.

Copyright 2021 Elizabeth Warson

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