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Clinical Meeting: 12 Creative Steps

This month we had a fascinating talk on using art therapy in a residential, 12-step treatment programme for people who struggle with addiction. Yafit Nahari, an art therapist who worked in two different addiction clinics for several years, started the presentation by challenging us to visualise the feeling of “falling in love” and depicting it using the art materials. The images – mostly showing explosions, intense colours with a dark core and strong contrasts – were striking and powerful. We talked about the sense of being “pulled in” and losing control when we fall in love; about the obsessive nature of yearning with the object of our affections and losing the ability to think about anything else. Yafit explained what neuroscience tells us about being in love (DiSalvio, 2014) –

Love is addictive: Thinking about one’s beloved – particularly in new relationships – releases a flood of the neurotransmitter dopamine (the so-called “pleasure chemical”) into the brain’s reward (or pleasure) system. This gives the lover a ‘high’ not unlike the effect of narcotics.

Love is obsessive: At the same time, the brain in love experiences an increase in the stress hormone, which increases heart rate and blood pressure. These effects are similar to those experienced by people using potent addictive stimulants like methamphetamine.

Image by Amanda Lebus

The brain of an addict has been found to differ from the brain of non-addicts, although it remains unclear if differences in brain chemistry and architecture are caused by, or are the cause of, addictive behaviour. However, we know that only 10% of those of us who enjoy drinking socially will become alcoholics, and a growing body of evidence shows that many addicted people have brain chemistry imbalances that make it difficult for them to manage stress. Discussing both the biological and psychological theories for the causes of addiction, Yafit explained the typical addictive beliefs which serve to reinforce addiction and isolate the person from those who might challenge their behaviour:

  1. Using my drug of choice is good for me and will magically fix me and solve my problems (biological reinforcement)
  2. Not using my drug of choice is bad for me.
  3. People who support my alcohol and drug use are my friends.
  4. People who don’t support my alcohol and drug use are my enemies.

This is followed by social factors, e.g. addictive lifestyle choices and losing contact with sober friends, and it is reinforced by denial and blaming others for difficulties. Because of these patterns of avoidance and difficulty facing up to the damage caused by the addiction, group therapy is often used when working with addicts. In fact, Yafit pointed out, alcoholics and other chemically dependent people seem to recover best in group therapy settings, since groups effectively break down the denial process through a combination of identification, confrontation, feedback and support. Art therapy groups have the role of facilitating expression, protecting defences, providing containment, allowing for letting go of control, and addressing low self-esteem and interpersonal isolation.

Yafit talked us through the 12-steps introduced by AA alongside the Convergence Model suggested by Yalom (2005), with any references to a higher power re-framed as finding strength within external sources (such as nature) the self, or within meaningful and honest relationships with others. Participants in the group are encouraged to discover and develop self-compassion, understand the reasons for their addiction and forgive themselves. Quoting Giblert’s writing on compassion, she ended the talk with the concept of “The Perfect Nurturer”:

The Perfect Nurturer is ever present, kind, compassionate and wise and guides without overindulgence (as what we want is not always what we need and what is good for us). Some people have an angel; a bright shining light, nature… Others have found it helpful to imagine an ‘inner perfect nurturer’ or ‘compassionate mind’, that part of you that has your best interests at heart i.e. the part of you that knows what you need rather than what you want and guides you with compassion. Some people have referred to this part as a ‘higher consciousness’ within themselves. 

Showing images made by clients who have been through the art therapy group process, Yafit shared expressive and authentic images of inner turmoil, pain, and – finally – healing.


  • DiSalvo, D. (2014). What neuroscience Tells Us About Being in Love. Psychology Today
  • Gilbert P. (2010). The Compassionate Mind. Constable.
  • Gorski, T.T. (2007). Biopsychosocial Symptoms of Addiction: A Science-based Description of the Brain Disease in (book) Straight Talk About Addiction: Herald Publishing House
  • Yalom, D. I. (2005). Theory and Practice of Group Psychotherapy. NY: Basic Books; 5th Revised edition.


I would like to thank Yafit for such a touching and informative talk. This will be my final article; I am leaving the London Art Therapy Centre after being involved with the team and the clinical meetings since it opened. I have thoroughly enjoyed coordinating the meetings and writing the blog, and hope some of you have found it useful or informative. I will continue to practice and develop art therapy in Devon, and I’m sure the Centre will continue to remain a vibrant and exciting hub at the forefront of art therapy practice, research, training and innovation!

Posted by Nili Sigal, art therapist

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