Collage in Art Therapy

Presentation

Collage holds a special place in the arsenal of visual arts therapy techniques. Its uniqueness lies in its radical accessibility: unlike painting or drawing that may intimidate patients who judge themselves "unable to create," collage requires no technical skill. Choosing an image from a magazine, cutting it out, and gluing it onto a surface — these elementary gestures are within everyone's reach, including people with motor or cognitive limitations, or major resistances to creation.

But this apparent simplicity masks considerable therapeutic depth. Collage engages a complex psychic process: choosing an image among hundreds means exercising an act of selection that reveals the patient's unconscious preoccupations. Cutting is separating, fragmenting, extracting. Composing is organizing, prioritizing, making meaning. Gluing is fixing, committing, making permanent. Each step mobilizes fundamental psychic mechanisms — identification, projection, relating, integration — at the heart of therapeutic work.

Collage is also a privileged medium for identity work. By assembling fragments of pre-existing images, the patient composes a composite portrait of themselves, their aspirations, fears, and history. This visual mosaic makes tangible the multiplicity of identity facets and opens dialogue about the relationship between different parts of the self.

Materials and Technique

• Image sources: magazines, newspapers, catalogs, personal photographs, postcards, printed papers, stamps, tickets. The choice of sources is itself meaningful
• Supports: cardboard, canvas, box, three-dimensional object. The support format influences creation
• Cutting tools: scissors and cutters for precise controlled cutting, hand tearing for a more instinctive and emotional approach. The choice between cutting and tearing is therapeutically significant
• Glues: white glue, glue stick, adhesive tape. Glue makes the choice permanent, confronting the patient with commitment and irreversibility
• Complementary materials: fabrics, threads, buttons, beads, natural elements, tissue paper, glitter

The Creative Process in Four Stages

1. Browsing and selection: the patient browses magazines and selects attracting images, often without knowing why. This intuitive choice phase operates through unconscious resonance — an image "calls" the patient because it corresponds with psychic content.

2. Cutting: the patient extracts selected images from their original context. This separation gesture is symbolically charged. The cutting mode is revealing — meticulous scissor cutting (need for control), spontaneous tearing (expressivity, emotional urgency), approximate cutting (letting go).

3. Composition: the patient arranges cut images on the support without gluing. This spatial arrangement engages the question of inner world organization. Which images are central? Which are peripheral? Are there overlaps, gaps, thematic groupings?

4. Gluing: the patient permanently fixes the images. This commitment gesture makes the composition permanent and confronts the patient with choice irreversibility.

Therapeutic Applications

• Identity reconstruction: after trauma, grief, or major life rupture, collage allows visually recomposing a fragmented identity. The patient assembles pieces of who they were, who they are, and who they wish to become
• Trauma work: for patients unable to verbalize their traumatic experience, collage offers an indirect expression path. Selecting existing images rather than creating own images creates protective distance from traumatic material
• Struggling adolescents: collage is the preferred medium with adolescents as it uses images from their visual culture. Building a "portrait in images" explores forming identity without aesthetic judgment threat
• Therapeutic vision board: a collage variant projecting the patient into the future by assembling images representing desires, goals, and values
• Elderly patients: browsing and selecting stimulates memory and language. Collage of old photos promotes reminiscence and life review

Session Structure

1. Material preparation (5 min before session): the therapist arranges diverse magazines and materials on an accessible central table
2. Welcome and introduction (5-10 min): verbal exchange about emotional state. The therapist may propose an open prompt
3. Browsing and selection phase (10-15 min): the patient browses magazines and selects images
4. Cutting phase (5-10 min): extraction of selected images
5. Composition phase (10-15 min): arranging images on the support without gluing
6. Gluing phase (5-10 min): permanent fixing of images. Possibility of adding drawn or written elements
7. Discussion time (10-20 min): the patient presents their collage. Open questions about what spoke to them, what they see now that they did not during creation

Contraindications

• Patients with severe obsessive disorder: the selection process among hundreds of images may trigger decisional paralysis. Limit the number of proposed magazines
• Patients with dissociative disorders: the fragmentation process (cutting) then recomposition may reactivate experiences of psychic splitting. Favor whole images rather than fragments
• Caution with potentially retraumatizing images: ensure magazines do not contain violent or sexually explicit images
• Patients in manic phase: the multiplicity of images and choices may fuel manic dispersion. Propose a restrictive framework
• Caution with scissors and cutters in contexts where patients present suicidal or self-harm risks: adapt tools or favor tearing