Using Aesthetic Response - A Poetic Inquiry to Expand Knowing, Part II: Theoretical Perspectives on Arts-based Research

Theoretical Constructs Underpinning the Rx6 Method

Contemporary affective neuroscience and attachment research (Cozolino, 2002/2010; Schore, 2012, 2014a, 2014b; Siegel, 1999) give important insight in understanding what might be the bearing agents of image formation (Horowitz, 1983, 2012, 2014). The value of the aesthetic response, as a source of knowledge, cannot be underestimated. Ammaniti and Gallese (2014) noted, “Before and below mind-reading is intercorporeality as the main source of knowledge we directly gather about others” (p.16). They also see this embodiment as a prerequisite for sharing and understanding symbolic representations. Our activated mirror neurons impact our ability to empathize with unconscious states of others. Intercorporeity, rather than the symbolic representation, therefore is placed at the core of emotional resonance. Intercorporeity means the experience of being embodied and it is never a private affair, but is always mediated by our continual interactions with other human and nonhuman bodies (Weiss, 1999, p. 5).

Csordas (2008) and Allegranti (2013) pointed out that our existence in relation to others – our inter-subjectivity – is something tangible and bodily. Intersubjectivity is not only declarative or explicit but an analogical map of the other within us, and needs to be read on implicit levels from inside ourselves (Lyons-Ruth et al., 1998). Gerge (2016) exemplified this in her analyses of clinicians’ drawings of a worrying or reassuring clinical meeting. The arts-based inquiry offers each and every one of us possibilities to read, by experiencing those maps and work with the embodied aesthetic response (Panhofer et al., 2011), thus allowing a deepened sharing over time and space.

The Aesthetic Response

The function of an aesthetic response (Robbins, 1971, 1987) is, according to Conrad (2010), to stabilize the brain’s semi-randomly generated neural circuits. The neuronal circuits are selectively steadied if they succeed in making sense out of raw sensory input. Under the brain’s developmental process, the aesthetic response of humans serves the function of calming the circuits or networks that successfully mediate perception and interpretation. These will become more agile, in the process of making something special. According to Conrad (2010), this is triggered by structures in art and nature, which provoke the sense-making, a deliberate human action.

When discussing the theoretical underpinnings of how self-identity is revised through portraiture in palliative care, Carr (2014) stated:

Carr’s (2014) clinical standpoint is based in the tradition focused on the ‘art’ within art therapy (Allen, 1992, 2001; Malchiodi, 1999; McNiff, 1986), thus a therapeutic endeavour closely connected with ABR.

This endeavour can be as valuable in research as in clinical work. The aesthetic sensibility needed in arts-based inquiry (Viega, 2016a) can be considered especially well-suited for professionals trained in the creative arts therapies, for examples see (Gerge, 2016; Gerge, Wärja, & Pedersen, 2017).

In Phenomenology of Perception Merleau-Ponty (1963) described the body's encounter with the phenomenon, as it is through the body we understand the world (Bullington, 1999). Damasio (1995, 1999) stated that a thought always is a description of an embodied state. By using our theory of mind (Frith & Frith, 1999) and our embodied empathy (Rothschild, 2000) we can imagine ourselves as the other and authentically meet the other; an important prerequisite for change-inducing meetings in psychotherapy (Gerge, 2011, 2015) and research (Gerge, 2016). This capacity rests on an embodied felt-sense experience (Gendlin 1964, 1978), which is the core of the aesthetic response, empathy, image formation, and at its end-point, an acknowledged perception. We think such a standpoint is valuable also in research.

The Experience of the Felt Sense

Gendlin (1978) developed Merleau-Ponty's (1963, 1973) ideas to show how interactions are more fundamental than perception. The bodily experience was essential to the work of Merleau-Ponty, who referred to the internal total awareness as body schema (1963, p. 113–114); see definition at the end of the article. This embodied felt sense is supposed to ground our conscious awareness, in line with Damasio’s (1995, 1999) notion – a thought is an ongoing description of a state in the body. In everyday language, we lack words to name these crucial processes, however in the therapeutic practice of Focusing (Gendlin, 1978), it is described as an embodied tacit knowledge. This is a special kind of internal bodily awareness, a body-sense focused on meaning making, which offers a potential research tool for collecting and describing data from non-verbal sources. What is described can further on be analysed.

Attachment Theory and Contemporary Neuroscience in ABR

The capacity of being together is mediated over our mirror-neurons (Rizzolatti, Fadiga, Fogassi, & Gallese, 1999). Our brains are in Gallese’s words “we-centric” (Gallese, 2009). Our capacity to resonate – a necessary prerequisite for reasoning - can be used as a vehicle for deepening our understanding of the topics of interest we want to study. These processes will always be partly preverbal.

Recently, McCaffrey & Edwards (2015) discussed ABR as non-narrative, “as many processes and products in arts creation transcend literal meanings” (p. 516). We fully agree with their reflection, though we think that the concept non-narrative has to be problematized, as narrate, apart from referring to speech and writing can be to tell by means of images. Our conscious awareness resides in larger orders of affective and cognitive narratives, which are based in experiential implicit bodily processes referred to as the “neuronal architecture which supports consciousness” by Damasio (1999, p. 15). In 1992, Daniel Stern introduced the term "proto-narrative envelope” ( pp. 291–295). This envelope he stated, contains experiences organized within the structure of a narrative and are built from the child’s experiences of happened or imagined events, as these are unfolding. However, it refers to a story without words or symbols, a plot visible only through the perceptual, affective, and motoric strategies to which it gives rise. Stern (1995) stressed how early experiences of mother-child interactions “have a beginning, a middle, and an end and a line of dramatic tension; they are tiny narratives … 'proto-narrative envelopes'” (Stern, 2002, p. 6). In 2004, Stern changed the concept proto-narrative envelope to “lived story” (Stern, 2004, p. xiii). This concept is related to an emotional narrative that is felt rather than told as a cognitively constructed story for both infants and adults (Stern, 2004) and is a prerequisite for a moment of meeting, (see further definitions at the end of the article). The concept lived story and our contemporary neuro-affective understanding of human recognition processes (Gallese, 2009; Hass-Cohen & Findlay, 2015), make statements such as the arts-based inquiry is nonverbal or non-narrative highly questionable. On the other hand, they point to possible ways in which music, experienced on preverbal levels can give us images and evoke stories (Stern, 2000, 2004, 2010). From this perspective arts/artifacts can be seen as frozen moments in time, even if the person who has produced the artifact is not present.

As shown in the method description of part 1, (Gerge et al., 2017), we want to highlight the short time frame of a half of a minute, to be used when becoming touched and initiating an aesthetic response (even though conducting an artwork or performance might take somewhat or much longer time). An extended moment of meeting will not be longer than 30 seconds according to Stern (2004). We propose that this limited time frame is an essential building block of the felt-sense experience. It is a prerequisite for the aesthetic response, even at times when the final arts-based inquiry involves composing a musical symphony or creating a mural painting (taking months to prepare).

We hypothesize that the similar processes as in attachment modulation are active also when we relate to an artifact, for examples see part 1 (Gerge et al., 2017), where poetic responses were achieved. In poetic transcription (Faulkner, 2009; Furman, 2006; Leavy, 2015) the inquiry is derived from a grounded theory perspective, where selected words and phrases from the informants become building blocks of the poems conducted. In poetic transcription, according to Faulkner (2009), notes of written statements of the informants are directly cited, and then put into a structure chosen by the researcher. In our work, poetic statements were created as aesthetic responses in line with the primary signification of the word poetry (poiesis) meaning “to create”. When working with the aesthetic response in an arts-based inquiry, we consider it possible that the implicit information, the proto-narrative in the art piece, can be listened to in a similar way as when one is present with another human being. In this way, ABR has the potential to resemble the regulatory processes of the early dyad where the concept moment of meeting (MoM) is crucial (Sander, 2002; Stern, 2004). These time-framed important building blocks of early development and attachment continues to be active in human perception all through our lives. As adults we also form lived stories in our on-going endeavour to understand the world and ourselves. Organisation of meaning is implicit as Lyons-Ruth (1999) stated. She highlighted that we do “not require reflective thought or verbalization to be known” (p. 578).

The process of being known, or feeling felt, is well described in attachment research (Schore, 1994, 2003a, 2003b, 2003c, 2003d; Sander, 2002; Stern, 2004). We consider these communicative aspects of attachment research also relevant in the experiential being with in relating to an art piece in art/creative arts therapy or ABR. The processes that build the experience of being known are scientifically validated in recent neuro-affective research on mirroring (Ammaniti & Gallese, 2014; Gallese, 2009) and inter-subjectivity (Siegel, 2010).

Sander (2002) highlighted the communicative aspects of affects and affect regulation. In line with Schore (1994), he described affects as observable states and thus highly communicative. Such perspective is emphasized in contemporary social psychological research (Wetherell, 2015). Daniel Stern (1985) developed Silvan T. Tomkins’ affect theory (1962, 1963) and added the concept vitality affects, where the musicality and dynamic quality of being together (and being with emotions and affects) and relate on preverbal levels as building blocks of perception were highlighted (Ammaniti & Ferrari, 2013; Stern, 1985, 1994, 2000). Building on nonlinear systems theory, Sander (2002) and Stern (1985, 2010) developed our understanding on how human beings can fit together. By accurate preparatory attunement (recognition processes) special moments of shared experience (MoM) can generate strong feelings of connection between people. These processes are well described in psychotherapy research (Hughes, 2007), including music therapy (Blom, 2014; Coomans, 2016) and art therapy (Hass-Cohen & Findlay, 2015). Also, when moving into a relationship with an artifact, we can open up to a transformative meeting. By using the timeframe of an extended MoM in profound meetings with other human beings and/or their artifacts, we consider that a certain rigor can be brought into the multi-layered themes of implicit processing, which will be activated every time our attachment system is activated (Trevarthen & Aiken, 2001). This processing will also be activated every time we allow ourselves to be touched, which is an essential part of the arts-based inquiry.

Research on attachment points to the role of shared interconnectivity described by (Gallese & Ferri, 2014; Bowlby, 1968; Gaensbauer, 2016; Schore, 2003d, 2009; Siegel, 1999) as a prerequisite for development, empathy, and mentalization (Fonagy & Luyten, 2015). Kenny (1989, 2006) described an intuitive level of togetherness that encompasses therapist and client in clinical work. Kenny’s (2006) meta-theory on what might happen in the encounter between client and therapist is highly relevant for ABR. She highlighted the need for an existential phenomenology; immersion, tacit knowing, and intentional verification of the felt sense experience (Douglass & Moustakas, 1985) to make sense of what one experiences. This neatly fits into contemporary attachment research (Gallese 2009; Narvaez et al., 2013). Kenny (2006, 2015) labelled the process of making sense as an act of creativity, empathy, and letting oneself be touched by the other/the other’s expression, and what might be called existential beauty. She also stated “Perhaps my words will never be able to describe the beauty of these moment” (Kenny, 2006, p. 192), thus addressing the implicit nature of togetherness. This is in line with Stern’s reflection “one can not get to the lived experience and stay there while talking about it” (2004, p.xiii). But of course we ought to try, and we are genetically hard-wired to make sense of, and share implicit information, both for our survival as individuals and as species.

Art as “Making Special” and Implicit Processing

Dissanayake (1988, 2000, 2003) argued that art serves as the key social role of “making special” when experiencing phenomena and thus can help us both invest and research certain phenomena with special significance. In Jungian psychology this process is described as crystallization (Henderson, 1964). Knill, Barba, and Fuchs (1995) spoke of crystallization as “the basic human need to crystallize psychic material; that is, to move toward optimal clarity and precision of feeling and thought” (p. 30). This is a key function of art-making and art experiencing and can be considered an important principle when making sense of information in the aesthetic domain. In this way the artistic process has great similarities with the pragmatic and eclectic approach to qualitative research (Gordon, 1999; Leavy, 2015).

According to Faulkner (2005), cited in Leavy (2015), The poetic criteria related to qualitative and artistic criteria are; “artistic concentration, embodied experience, discovery/surprise, conditional, narrative truth, and transformation” (p. 97). In line with this, Leavy (2015, citing Richardson, 1997 and Pelias, 2011) put forward what we might speak of crystallization instead of triangulation. She continued, “poetry is both a style of representation as well as a vehicle through which the research community can engage in larger questions about the nature of social research, truth and knowledge” (p. 97). In this way the arts-based research or inquiry can help us grasp the essence of the studied phenomena and experiences. It can add resonance to reason. The ABR potential experience of resonance and touching “essence” supposedly adds to the experience of deepened sharing. This encompasses also to lower the guard, to make oneself vulnerable, and open to a potential experience of awe (Gerge, 2016).

Concluding Words

Our aim in this paper was to describe a vital procedure including a timeframe in line with contemporary theory of the phenomenon of the moment of meeting (MoM) (Sander, 2002; Stern, 2004). The use of the method and its six steps; relate, resonate, respond, reflect, react, and results was exemplified in “Using Aesthetic Response, a Poetic Inquiry to Expand Knowing. Part I: The Rx6-Method” (Gerge et al., 2017). The Rx6 method is grounded on a theoretical framework of inter-subjectivity and implicit processing, in line with relational psychodynamics. Engaging in ABR can offer clinicians and researchers of all orientations a deepened, expanded, and embodied understanding of the studied phenomena. This can be considered a prerequisite for heightened empathy. We consider the ABR-approach especially important when working with the indwelling procedures of implicit processing, eg., when using tacit knowledge (Polanyi, 1958), in research and psychotherapy.

We hope that the MoM can be considered a perceptual tool to make sense of what we encounter in the experience of being with another human being, and/or with her/his artifacts, or - when being in an I-Thou relation (Buber, 1962/1993). The MoM theory helped us conceptualize the perceptual building blocks of coming close to another human being. This understanding is necessary in attachment work (Schore, 1994; 2003a, 2003b, 2003c; Trevarthen, 1993), which is well documented and implemented in psychotherapy with psychodynamic orientation (Schore, 2003d; Terr, 2003), music therapy (Blom, 2014; Coomans, 2016), and art therapy (Carr, 2014). Though we propose that this approach can be of value for clinicians and researchers of other orientations as well.

The theory of MoM, (Sander, 2002; Stern, 2004) and consciously working with intermodal transfer can build loops of ABR over an extended time (days, weeks and months) (Gerge, 2016). We regard the MoM as a grounding basic beat – a pulse of perception – a building block of the flow of human experience in processes where the medium is the message (Lyons-Ruth, 1999); as in experiential psychotherapy (Gerge, 2015) or ABR (Gerge, 2016; Gerge et al., 2017). Although Ledger and McCaffrey (2015) argued that it is too early to create definitions as these might limit the possibilities for innovations that ABR might bring to music therapy (p. 453), we consider the structure, including the time frame suggested here, as an important reflective tool, both as a method, and for methodologies “steeped in aesthetics” (Viega, 2016b, p. 5). In putting focus on perception, as described in attachment research (Sander, 2002, Stern, 2004; Narvaez et al., 2013), contemporary affective neuroscience (Ammaniti & Gallese, 2014) and clinical work, (Hass-Cohen & Carr, 2008; Hughes, 2007), we can begin to structure ABR. From a solid hub of theoretical frameworks (with spokes in all directions), various modalities and art disciplines can radiate. From such a hub, seen as an “orienting lens” for understanding a phenomenon (Creswell, 2009; Shannon-Baker, 2015), a variety of sound research and innovative applications might rise. In this way ancient roots of creativity can meet and be nourished from heuristic research perspectives (Moustakas, 1990, 1994), expressive arts therapy (Estrella, 2005; Levine & Levine, 1998, 2005; Richardson, 2016) and attachment theory, including the theories of the lived story (Stern, 2004), and the theory of MoM (Sander, 2002; Stern, 2004). This will further enrich qualitative research, the discursive practice (Wetherell, 2015), and psychotherapy research including the arts-based therapies.

To conclude, first we propose that clinicians, conducting clinical research, scholars in psychology and health care research, including rehabilitation medicine, consider using ABR as a means to expand their understanding. Second, these processes will deepen their compassion for and understanding of their research participants and their processes of change. With Chenail (2008) we answered the question concerning ABR “But is it research?” with a firm YES.

Glossary of Terms

Body schema: Merleau-Ponty (1963, p. 113–114) referred to the internal total awareness as body schema. This embodied awareness is conceptualised as an on going bodily interaction that opens us to a sense of the world beyond what we conventionally call perception. The body-sense can encompass perceptions and emotions but also memories of past situations and options of what to do next.

Present moment or now moment: Daniel Stern (2004) defined the “present moment” as a lived story with a beginning and an end, intentional characters, together with a “temporal contour along which the experience forms during its unfolding” (p. 219). The present moment is defined as lived through as it unfolds and is not distanced by language or abstract explanation from those experiencing it. The now moment consists of an emerging interpersonal process that is unpredictable—hence “sloppy,” consisting of the present moment in life-as-lived, which Stern generalizes from attachment research to psychotherapy. The concept is elaborated from The Interpersonal World of the Infant (Stern, 1985).

Moment of meeting: The now moment is often followed by a moment of meeting (Stern, 2004). When this occurs, new ways of being-with-the-other unfolds through the offered time-framed togetherness, where we can “read in the behavior of the other a reflection of their own experience” (p. 220-221). This leads to the possibility of events becoming intersubjectively conscious, and further on verbalized and narrated experiences.