The Art of Communication Through Drawing: The Case of "Mr. R," a Young Man Professing Misanthropy While Longing for Connection With Others


  • Kayoko Murase



drawing, integrative therapy, Japanese client, therapeutic communication, therapeutic relationship, personality disorder, case studies, clinical case studies


This case study reports the psychotherapy process of "Mr. R," who was 18 years old at the time when the therapy started. A total of 10 sessions were held in a period of six months. As the therapist, I was still at an early stage in my career, in the process of forming an integrative approach, which values an authentic and genuine therapeutic relationship with the client on the one hand, and the client’s adjustment to his living environment, on the other. Mr. R initially presented intense aggression and violence toward his family. He had been given a diagnosis of  personality disorder, possible schizoaffective disorder, and atypical mental illness by different psychiatrists who had seen him. Because a past attempt with conventional talking therapy and pharmacological treatment did not produce positive results, I attempted to create a therapeutic relationship characterized by genuineness and authenticity, and I used Mr. R's drawings to help him express his emotions. The series of drawings that he created are presented in the article. These depict historical figures who parallel the therapeutic changes that occurred. Over the course of therapy, Mr. R's aggression was alleviated and he started relating to me not through hostility, but through his need for contact and respect. After termination, Mr. R's family members informed me that he had found peace with himself since therapy. I explain the reasoning behind my rather unconventional treatment decisions in terms of (a) contexts surrounding the practice of psychotherapy in Japan at that time; (b) the particular needs at that time of Mr. R, who had dropped out of all his previous treatment; and (c) other factors associated with Mr. R and his family. 






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