‘You might be sick’: the abject and abjection in medical art therapy

Abstract

This paper draws upon Kristeva’s (Citation1982) theory of the abject and abjection. Abjection is connected to the formation of identity and the feelings of disgust and fascination that emerge when our sense of identity is threatened. Bodily fluids, childbirth and death are considered abject as they break the boundary between me/not me. For Kristeva, abjection first occurs during separation from our mothers at birth, rendering the maternal space abject through a connection to mess, waste and death. I also apply later reworkings which consider the abject and abjection as states of social and political exclusion as well as potential sites of resistance and disruption, specifically through artmaking. I examine my work as an art therapist alongside previous experiences as a nurse to explore the abject and abjection in an NHS hospital where physical and therapeutic boundaries are often threatened. This paper suggests that both art therapist and patient can be subject to powerful unconscious defences within these settings, often manifesting in the depersonalisation of patients and an ambivalence around the art therapist’s status where ‘messy’ caregiving roles are considered maternal and therefore at risk of abjection.This paper offers a conceptualisation of the abject and abjection as organisational and societal defences against existential fears of vulnerability, illness and death, which can render both patient and art therapist abject within clinical settings. I conclude with a call for the abject within art therapy to be harnessed as a potentially disruptive force that enables the hidden to become visible, thus resisting abjection.Plain-language summary.This paper draws upon Bulgarian-French philosopher and psychotherapist Julia Kristeva’s theory of the abject and abjection (Citation1982). Abjection refers to the feelings of horror, disgust and fascination experienced on both physical and psychological levels when something threatens a breakdown between the self and other. Bodily fluids, childbirth and death are considered abject as they break the boundary between me/not me. Kristeva suggests that we first experience abjection when we are separated from our mothers at birth, which then leaves the maternal space forever linked to mess, waste and death. Later reworkings argue that certain groups in society can be seen as abject and therefore at risk of exclusion, or abjection. The paper also explores the idea of the abject and abjection as being tools of resistance and disruption, specifically through artmaking.Within the paper, I examine my experience as an art therapist alongside previous experiences as a nurse to explore the abject and abjection within an NHS hospital where physical and therapeutic boundaries are often threatened. I suggest that both the art therapist and the patient within these settings can be subject to powerful unconscious defences. These can appear as a lack of personalised care for patients and an uncertainty around the status of the art therapist within organisations, where ‘messy’ caregiving roles are linked to the maternal and therefore at risk of abjection.This paper offers a theory of the abject and abjection as organisational and societal defences against fears around vulnerability, illness and death. I argue that due to these defences both patient and art therapist are at risk of being made abject. The paper concludes with a call for the abject within art therapy to be used as a potentially disruptive force that allows the hidden to become visible, therefore resisting abjection.

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