Alessandra Colfi, Ph.D.(c)





"If we knew what it was we were doing, it would not be called research, would it?"                                         ~ Albert Einstein
Title Content Introduction Why a web-based Dissertation
Review of  Literature on Empathy
Ch. 3: Mirror Neuron - Empathy occurs in the Brain Story Telling Cancer Patients Developmentally Disabled     Bibliography


June 1, 2009 - revised March 1, 2011

From Empathy to Resilience:

a Journey with Cancer Patients through the Expressive Arts



This dissertation is intended as a phenomenological approach which focuses on what people

experience during and after being engaged in expressive arts processes and how they interpret

those experiences. I start with the assumption that empathy and resilience are essential qualities

in human psychology.

I intend to explore what cancer patients experience when engaged in expressive arts processes

and how they develop empathy and increase their resilience. I will present empirical and

qualitative evidence that cancer patients experience the benefits by increasing their resilience or

ability to face and cope with the trauma of diagnosis and the emotional and physical challenges

and changes through the treatment process and beyond.

The therapeutic relationship between facilitator and client(s) and the empathy aroused in the

client/artist(s) through their manifested expressions in all the arts, using the ‘intermodal

approach’ (Knill, 2004) are key elements throughout the process. The creative process that takes

place during the engagement with the expressive arts is the vehicle for accessing emotional

content and raw memories from both the conscious and the unconscious mind.


Emotional expression can occur with or without self-awareness, even when an individual’s desire is to

control such expression and may have deliberate intent in not displaying it.

In addition, I intend to offer a narrative account of and reflect upon my own process as I learn

about a client and prepare for each session and interaction, and why I choose the kind of

approach and tools that are most appropriate for the client to open up to a chosen approach or

prospective. This is motivated by a very common occurrence: what I plan to do with a client in

preparation of a given session often changes based on the perception of where the client is in that

particular moment and what I intuitively realize is a suitable prompt or activity to best and most

comfortably move him/her towards the desired therapeutic goals. In other words, this dissertation

includes a testimonial and an inquiry about my own experience of empathy.

My Expressive Arts practice is an integrated multi-arts experience using Expressive Arts

Therapy’s fulfilling and rewarding intermodal approach, its dynamic and transformative

processes in a gentle, playful and yet profoundly meaningful experience.


Empathy is defined as the understanding of another’s feelings, or the ability to identify with and

understand somebody else's feelings or difficulties; this process generates a caring attitude and

moves to compassionate thoughts and hopefully, to compassionate actions and choices.

Moreover, empathy is identified with the transfer of somebody's own feelings and emotions to an

object such as a painting, a piece of music, a dance. This is revealed in the clients’ self-expression

and in the aroused emotional experience.


The empathic relationship between the artist and his/her creative expression is assumed

encouraging and fostering the ability to raise awareness of their own emotional state, their own

resilience or inner resources, unconscious wisdom and beliefs, as well as intuitive knowledge.

The premise for this assumption is that self-exploration and introspection in a focused manner

allow for greater knowing of oneself, better understanding, and increased confidence in one’s

ability to cope with life’s challenges, all which lead to becoming more empathic towards others.

‘If I am aware of my feelings and the unconscious attitudes through which I view the world, I am

more likely to be sensitive to others.’ (McNiff, 1992). Shaun McNiff calls it ‘sympathy’;

sympathy is defined as the ability to enter into, understand, or share somebody else's feelings;

while empathy shares the same meaning, it adds the attribution of feelings to an object: the

transfer of somebody's own feelings and emotions to an object such as a painting – this is the

instance when art ‘moves’ a person emotionally. In the Greek empatheia "affection, passion".

To express is a transitive verb to state thoughts or feelings in words, to convey meaning by

gesture, behavior, representation in art, music or drama, or in some other symbolic way.

It is easy to observe that the word express ‘always carried the connotation of something definite

and explicit’ (Betensky, 1973); it also alludes to ‘rapid delivery’, fast and direct.

I submit that the expressive arts process is a direct and often fast way to go from point A to point

B, being A the unconscious mind/psyche/soul of the artist/client and B the

artwork/music/poetry/enactment, or the manifestation of having accessed the information,

resulting in authentic self-expression. It’s important to note that ‘every work of art … expresses

and means something’. It does ‘something to the observer.’ (Betensky, 1973); the

 artwork/music/poetry/enactment communicates back to the artist and elicits an emotional

experience in him/her.

Resilience is the positive capacity of people to cope with stress and adversity. This coping may

result in the individual “bouncing back” to a previous state of normal functioning, or using the

experience of exposure to adversity to produce a strengthening effect and function better than

expected (much like a vaccine gives one the capacity to cope well with future exposure to

disease) (Masten, 2009). Resilience is most commonly understood as a process, and not a trait of

an individual (Rutter, 2008).

I also disclose the assumption that the dynamic of ‘tuning in’ and being present with the client’s

needs in the moment and acting on it is a manifestation of empathy, it is generated by empathy.

This is a key factor for the therapeutic relationship to be successful, in such a way that generates

trust in the client towards the therapist, which then opens up to the possibility of change,

transformation and growth.


I intend to create this dissertation as a web-based teaching vehicle offering resources available to

the academic community, foremost IUPS students and practitioners - a step into creating

teaching tools to serve the University-Without-Wall concept. Why?

A website is a great platform for an art-based dissertation also for these very important reasons:

Collage is my preferred art medium – designing a website is very much like a collage –

which I regard as a metaphor for life itself; images, elements, colors, symbols and content

show up and interact among one another and with the artist, who shapes his/her own

experience and his/her life.

Multi-layers and links/inquiries are a metaphor for EXT processes. Researching and writing a

dissertation on a web-based platform allows me to be more intuitive, to be in a natural

process of researching, creating and collecting content, and organizing all the parts like

multiple, interconnected sets of Russian dolls (a hollow painted wooden doll in which the top

and bottom come apart to reveal a smaller, similar doll inside, which similarly comes apart to

reveal a smaller doll inside, and so on). All the features of the dissertation are at my

fingertips, as well as at the fingertips of any reader/user. Navigation of such website is

facilitated by links, and exemplified by meaningful, pertinent images, videos, references,

quotes, etc.

The expressive arts process reveals information in layers as it surfaces from the unconscious,

its interconnections with emotional content, memory, desires and intent to control both the

expression and the emotional experience.

The interconnectedness is very important, as it is in my spiritual approach to understanding

the Self, human suffering and empathy as the way to increase resilience and foster peace.

It provides a visual/functional framework that is conducive to a visual artist like me, who

also thrives in and incorporates all the arts - dance/movement, music, story telling, etc. ;

Flexibility of combining text, images, PPT presentations, video, links to reference materials

and links to sources for future expansion of the material and of the field of EXT;

Flexibility in the development and evolution of the dissertation itself, which is a dynamic

living organism, as opposed to a static book;

Live contributions and interviews will be incorporated;

Easy sharing within the academic community and with the public;

Low-cost production;

It spares trees and chemical inks to print it;

It can easily be edited and printed in book form if desired – the content will be intact.

WEB-BASED dissertations is referenced in ‘The Authentic Dissertation – Alternative ways

of knowing, research, and presentation’, by Four Arrows, aka, Don Trent Jacobs, 2008,

where Simon Pockley, Ph.D from Australia contributes to this collection of essays with his

pioneer dissertation and mention the Electronic Thesis & Dissertation Movement or ETD;

universities have incorporated his protocol, such as Virginia Tech, and the University of

Vermont among others.


The focus will be on the experience of empathy during my work with clients and groups, the

experience of empathy and resilience as pertaining to the perceived quality of life in cancer



The materials and references providing the substratum for this dissertation are authentic and

verified as belonging to scholars and students of the academic world, their research, writings and

activities. In addition, I will deliberately refer to and include authentic and meaningful content

generated from actual Expressive Arts Therapy processes either from my personal experience,

from my interaction with clients and from accounts of other respected practitioners.




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