The process is conducted in the form of spontaneous or structured expressive work, depending on the patient’s ego strength and
level of regression, working on his/her own or from time to time
with the participation of the therapist.
Working with drawing/painting was used in every session with
all of the patients during the first two years of the psychotherapy process. As verbal communication improved, the interviews
have been conducted mostly face to face. The criteria for the
transition from artwork to verbal therapy are: polarized self and
that integration and interpretation of object projections is sufficiently conducted on artwork, that primitive defenses reached
a certain level of maturity and observation that acting-out reactions decreased, the patient can focus on verbal interactions and
his/her ability to express oneself verbally has developed. After
those criteria are reached, at the end of the second year, during
which time the form of communication was mostly verbal, the
artistic symbols created during the psychotherapy process during the first two years were interpreted as recalled memories of
the patient’s personal process and the relational past with the
therapist. Working with art continued at some sessions after two
years.