What is art brut, and why did psychiatric patients' works enter art history? The Prinzhorn collection, the ethics debate and how it differs from art therapy.
Imagine standing in a museum gallery in front of hundreds of small figures drawn in pencil on scraps of cardboard by someone nobody has ever heard of. The label gives only an initial, a year and a note saying "made in a psychiatric clinic". You feel both admiration and a certain unease: is this a work of art, a record of an illness, or a piece of someone's privacy put on display without anyone asking them? The question of what art brut is sits right in the middle of these mixed feelings. In this article we calmly look at the concept of art brut, at the Prinzhorn collection that is said to have been one of its sources, at the ethical debates surrounding the concept, and at why this movement should be kept separate from art therapy.
What Is Art Brut? A Short Definition
"Art brut" is a French expression meaning roughly "raw art" or "unrefined art". In art history it is used to describe works produced outside academic art training, the gallery world and established aesthetic rules. In English the term "outsider art", that is, art from the outside or from the margins, is also frequently used to describe a similar field.
The makers of works in this category are very diverse: people who spent long periods in psychiatric institutions, villagers who taught themselves to paint, retired workers, people living alone who never showed anyone what they made. What they have in common is that they mostly produced their work out of an inner necessity, without thinking of an audience or a market.
The first important distinction needs to be made here: art brut is an art category, not a diagnostic or treatment concept. A work being classed as art brut does not mean that the person who made it had a mental health condition. Many works of art brut were made by people with no psychiatric diagnosis at all.
Are art brut and naive art the same thing?
Another frequently confused concept is "naive art". Naive art also usually refers to the work of people without academic training; however, these artists generally address an audience and hope to be exhibited and appreciated. With art brut, the emphasis is on the work being made in the language of the person's own inner world, independently of the outside world's expectations. The boundaries are of course not clear-cut, and art historians hold differing views on this.
The Prinzhorn Collection: One of the Known Sources of Art from the Margins
One of the sources often cited in discussions of art brut is the body of works known as the Prinzhorn collection, which is said to have been assembled in the 1920s at the psychiatric clinic in Heidelberg, Germany. According to art history sources, the collection consists of drawings, paintings, writings and handmade objects by psychiatric patients.
We would like to add a note while passing on this information: we have not been able to verify independently from primary sources, for this article, matters such as the collection's detailed history, how many works it contains or how it was gathered. For this reason we give here only the framework commonly told in general art history; we recommend that readers interested in the details consult art history sources.
Why the collection made such an impact is easier to understand. According to accounts in art history, at the beginning of the 20th century many artists were looking for a "pure" or "direct" form of expression outside academic rules, and it is reported that works produced in psychiatric clinics inspired some of the artists engaged in this search. In this way, what had been made by people pushed to the margins of society began to be discussed at the centre of the art world.
Art from the margins makes us question not so much the works themselves as whose voice we consider worth hearing.
The Ethical Side of the Question "What Is Art Brut?"
When answering the question of what art brut is, it is impossible to skip over the ethical dimension. Collecting, exhibiting and trading works made by psychiatric patients raises serious questions when seen from today's perspective.
Consent and ownership
Who owns a drawing a person made in a clinic, perhaps during the hardest period of their life? According to the ethical understanding accepted in mental health today, a picture or object made in a therapeutic setting belongs to the person who made it. It may be kept, photographed or exhibited only with that person's explicit permission; with children, the child's own consent is respected alongside the parent's permission. For many works collected in the past, it is not known whether any such consent was obtained.
Privacy
Works produced within mental health care fall under confidentiality, just like what is said in sessions. Writing a person's diagnosis, length of admission or personal history beneath a picture can mean making that person's most sensitive information public without asking them. Nor is this only a problem of the past. Even today, at a well-intentioned exhibition organised by a hospital or an association, participants' names, photographs and stories can be exposed more than necessary. So however lovely the idea of an exhibition may be, participants should be asked again at every step what they want to share and what they want to keep private.
Romanticisation and stigma
One of the deepest debates around art brut is the romanticisation of mental illness. Clichés such as "all geniuses are a little mad" can turn the experience of people who are suffering into an object of aesthetic curiosity. Yet for people living with psychosis, severe depression or other psychological difficulties, these experiences are usually exhausting, frightening and isolating. Drawing a simple cause-and-effect link between creativity and mental illness is both scientifically indefensible and stigmatising.
On the other hand, there is another side to the coin. Exhibiting these works can make visible the fact that people pushed to the margins of society also have rich inner worlds, aesthetic sensitivity and something to say. The ethical question is less about exhibiting itself than about how it is done: is the maker treated with respect, are their name and wishes taken into account, is the work presented as a "case" or as one human being's expression?
What Is the Difference Between Art Brut and Art Therapy?
Art brut and art therapy are often confused, because both sit where mental health and art meet. Yet their aims, settings and ethical frameworks are very different.
Let us summarise the difference point by point:
- Aim: art brut is a category of art history and collecting; the work is looked at from an aesthetic and cultural angle. In art therapy the aim is psychological: the picture or material helps the person to express their feelings, notice them and build a new relationship with them.
- Product or process: in the art brut debate, interest lies largely in the finished work. Edith Kramer, one of the pioneers of art therapy, by contrast emphasised the process of creating itself rather than the interpretation of the work. In other words, a therapeutic session does not need to produce "a beautiful picture".
- Interpretation: in art therapy the person does the interpreting themselves; the professional does not impose readings such as "this tree is your mother", and meaning is discovered together.
- Confidentiality: works made in therapy are made not for display but for the person themselves, and they fall under confidentiality.
If you would like to know in more detail how art therapy works, take a look at our article what is art therapy. We have covered the ethical principles in this field separately in our article on ethics in art therapy.
Where did the concept of art therapy come from?
The development of art therapy as a professional field falls in roughly the same century as the art brut debates, but it followed a different path. It is reported that the painter Adrian Hill in the United Kingdom was the first to use the term "art therapy", drawing on his experiences in a tuberculosis sanatorium; Hill's book Art Versus Illness was published in 1945. In the United States in the 1940s, Margaret Naumburg framed art therapy as a form of dynamic psychotherapy based on spontaneous drawing and free association. What interested these pioneers was not collecting works but how making pictures could help people get in touch with their inner world.
What Does Art Brut Tell Us About Mental Health?
Works of art brut cannot be used to diagnose a person's mental state. This is a very important point, because the idea of "reading a person from their pictures" is still widespread in popular culture. Research shows that human figure drawings are among the projective tests with the most limited evidence of validity. Heavy lines, dark colours or strange figures in a picture are influenced by the person's state that day, the materials to hand, their habits, their culture and many other factors.
Art brut tells us something else: even in the hardest circumstances, human beings tend to create meaning, to express themselves and to give shape to their world. Someone who spends months drawing on scraps of paper in a clinic room may be trying to make bearable an experience for which words are not enough. This also makes us think about why space should be made for creative expression in mental health services.
The idea is not at all foreign to us. We all know women in Anatolia who never studied at any art school but who weave their own stories into their needle lace, kilims and printed headscarves; and grandfathers who, after retiring, carve small wooden figures on the balcony. Most of these creations never enter a museum or a catalogue; but for those who make them they are a way of resting, of telling and of being. The concept of art brut reminds us that such quiet creations are valuable too. At the same time it also gives us a warning: valuing what someone has made does not mean deciding on their behalf. It is the maker who decides who sees it, when, where and how.
Imagine that a retired teacher, after losing his wife, starts drawing patterns on small pieces of paper at the kitchen table in the evenings. He shows his drawings to no one and keeps them in a drawer. One day his grandchild finds them and says, "Grandad, these should be in an exhibition!" The first question to ask here is not how "valuable" the drawings are, but whether the grandfather wants them to be seen. Perhaps drawing is his way of coping with grief, and that process does not have to be opened up to other people's eyes.
Suggestions for Your Relationship with Your Own Creative Work
The art brut debate can also inspire the way we look at our own creative work. The suggestions below are not therapy; they are meant as a creative self-care habit:
- Make things for no one: not every drawing or piece of writing needs to be shared. Keeping a notebook just for yourself can be liberating.
- Put the "is it good?" question on hold: try setting judgement aside while you create. What matters is how the process makes you feel.
- Play with materials: you do not need expensive paints; newspaper, coffee grounds and fabric scraps are enough.
- Respect other people's work: always ask permission before sharing something a loved one has made on social media. When sharing your child's picture, ask for their view too.
- Do not read meanings into pictures: rather than looking at a loved one's or your child's picture and concluding "you're depressed", it is far more helpful to ask, "Will you tell me about this?"
When Should You Seek Professional Support?
Creative work does many people good; but in some situations it is important to speak to a mental health professional:
- If intense and long-lasting low mood, anxiety or restlessness is disrupting your daily life
- If you are experiencing changes in your sense of reality, such as hearing voices others do not hear or intense suspiciousness
- If the effect of a loss or trauma you have experienced is not easing even after months
- If you are finding it so hard to express yourself that it has become isolating
Pictures, a sand tray or other creative tools may be used during psychological support; but the process is always shaped around the person's needs. In individual therapy, research-supported methods such as cognitive behavioural therapy form the basis, and an assessment by a psychiatrist is recommended where necessary. If you are having thoughts of harming yourself or ending your life, call 112 (emergency services) in an emergency.
Frequently Asked Questions
Does art brut cover only works by psychiatric patients?
No. Art brut covers works produced outside academic art training and the art market, mostly out of an inner necessity. Some of these works were made in psychiatric institutions, but many belong to people with no diagnosis at all.
Can a person's mental state be understood by looking at a picture?
No. Drawings are influenced by many factors and cannot be used as a diagnostic tool on their own. A picture can be a valuable way of opening a conversation with someone; but a psychological assessment is carried out in a rounded way, through observation, interviews and, where needed, standardised tests.
Is it ethical to exhibit works by psychiatric patients?
This depends largely on how it is done. According to today's ethical understanding, the work belongs to the person who made it; exhibiting it requires explicit permission, protection of privacy and respect for the person. Exhibitions that go ahead without consent or that present the person as a "case" raise serious ethical problems.
Do you have to suffer to be creative?
No. The image of the "suffering artist" is a cultural stereotype. Many people have their most productive periods when they are feeling well. Psychological difficulties are far more often a burden that drains creativity than one that feeds it, and they deserve support.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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