The process of developing a painting, and other forms of artistic practice, involves undertaking research (Sullivan 2010). Competent artists will critically consider what message their work is to convey, how this relates to their experience and understanding of reality, and how the formal elements of their work (e.g. composition, imagery, line, space, shape, texture) can be arranged and exploited to best convey their intention. The output can be seen as a means of disseminating this research process to others. The term ‘visual essay’ has been employed to refer to one or a series of images incorporating social messages informed by research or reflection (e.g. Rose 2007; Thomson 2011), and in this article it is posited that a socially engaged painting can be understood as a visual essay on a topic. 

There are several ways of thinking about what art has to offer (Carey 2005; Fischer 2010) that other outputs of research may not. None of these claim to do a better job, but rather one that is different to natural science (Vattimo 2010). Midgley (2002, 2004) poses a philosophical challenge to the authority claimed by science over the arts. She reminds us that science, including its most positivistic branch, has relied on experiences acquired through the senses to understand the world, and has often represented this visually to convey meaning. She also emphasizes the importance of meaning, critiquing science’s attempt to monopolize meaning through its exertion of stringent quality criteria pertaining to what counts as valid knowledge and epistemology. Yet, she argues that when it comes to matters more regularly concerning social scientists such as relationships, emotions and ethics, art, literature and poetry and even spirituality are far better servants of meaning and have a great deal of validity on such topics. Art therefore represents an appropriate choice for researching the impact of certain discourses on identity.

There is also Wittgenstein’s point (2001) that language is an elaborate indexing system of the physical world, represented through nouns, verbs and their relationships. Or Postman’s point (1995) that language is a technology. Words are tools indexing an element of experience, and although the written word can have a more fixed nature, its meaning is frequently affected by context and can be contested. Science’s use of language has been an attempt to fix the meaning of a word, something that art has both endorsed and challenged in the past. Art, particularly pre-modern art when general literacy levels were low, has often used its formal elements to serve a similar purpose: crucifixes, halos, the division of the picture plain into thirds, etc. have intended meanings and serve as common reference points for viewers. Even postmodern art attempts to do this in a sophisticated sense, as modern art ‘quotes’ from its own heritage and develops its own ‘in-jokes’. Much of Damian Hirst’s work (Kent 1994) can be seen in terms of reference to the Dada movement for example. Nonetheless, the meaning in such works is frequently more fluid and dialectical, allowing for subjective responses and engagement with the work.

The use of a visual metaphorical approach to ‘language’ is perhaps key to the power arts have in saying something about human experiences (Midgley 2004; Parsons 2010). People in fact struggle to convey the nature and depth of their experience in factual language. One only has to recall Wystan Hugh Auden’s poem about the death of a close friend or lover, ‘Stop All the Clocks’ (1995), and compare the meaning this would convey over the information provided by a coroner’s report or death certificate to illustrate this point. The arts use visual metaphor in a way that science would not endorse, yet the conveyance of meaning, whilst referring to the same fact in actuality (e.g. a death), is arguably much deeper and more meaningful, and therefore useful for communicating the experience of the fact (e.g. mourning), when expressed via metaphor.

Sontag (1979) and Rose (2007) draw our attention to the poignancy of the still image as another powerful vehicle for visual communication of meaning. An image can raise the viewer’s awareness of a moment in time and why this particular moment may be significant. In cases where the still image has been selected and/or composed, the viewer also has to contend with why such decisions have been made in a particular way, what they are trying to communicate and why this might be important. Given the mega visual culture we live in, and the speed of image presentation, the ‘moment’ can encourage deeper reflection as it demands the viewer to slow down and contemplate (Abbs 1988). Reflection is also needed on how the elements within an image have been juxtaposed: What, if anything, do they symbolize and what are their relationships? This encouragement to look, feel and reflect can establish a relationship and a dialogue between the viewer and the image-maker. Such an output is more consistent with a cultural theoretical standpoint that acknowledges the contextuality and shifting nature of mediated meaning. This relationship is of course possible with any style of writing, but the visual has an immediacy here, allowing complex relationships to be sensed and processed instantaneously, although their meaning may change upon subsequent and deeper reflection. Hence, time with an image such as Figure 1 may lead to a different type of ‘conversation’ than one would have with a text, such as a research report.

The process of producing the image shown in Figure 1 involved (1) consulting two areas of literature: visual methodologies and the impact of educational and medical discourse upon identity; (2) looking at the work of artists treating similar subject matter and the kinds of metaphors they use (Beveridge 2010 provides a good review); and (3) conversations with a mental health nurse and a psychotherapeutic counsellor as well as two young adults identified with a diagnostic ‘disorder’ in the past (ADHD and depression/bipolar disorder in these cases). These strands were then synthesized into a visual exploration of the topic in both preparing and executing the painting, which will be more fully explained in the commentary that follows. 

In developing the image, photographic research (of figures and text) was initially conducted and Adobe Photoshop used as a virtual sketchbook. This software allows an image to be built in layers, and consequently elements of an image can be selected or deselected and moved around. The advantage of this process was that it allowed the composition to be manipulated numerous times before a strong image was achieved. In the early stages, a collage of text, a photograph of a small glass box, circles and a line drawing of figures in a waiting room were moved around (see Figure 2). There was also a blindfolded head screaming in the image, a testament to the work of Edward Munch and Francis Bacon, which was soon edited out as a less promising idea.

The early stages of the process were informed by the kind of research artists do, drawing, and playing with composition and different effects (Sullivan 2010). The sharing of early images with colleagues from mental health professions and service users was informative at this stage. Their feedback led to editing decisions, further compositional play, and the taking of further photographs to enrich the image idea before the painting stage, until it resembled the design shown in Figure 1. This iterative process served at least two functions: (1) it helped strengthen the work visually, but also (2) gives it greater credibility as the image incorporates the perspectives of others with direct experiences of the theme.

When elements of the image are presented in the following commentary, features will be juxtaposed to images of other artists’ work and a discussion of literature relevant to the topic, alongside some of the comments people made when discussing the image as it developed. 

The influence of activity theory (Cole 1996; Engestrom et al. 1999) and influential thinkers such as Foucault and Bourdieu informs the conceptualization of the relationship between the individual, the institution and wider culture shown in Figure 1. An activity theory perspective suggests that there is a weak boundary between psychology and culture, where human behaviour is mediated by culturally produced tools such as language, which in turn play a key role in identify formation. The image is concerned with how language is produced, often by powerful institutions, and the impact this has upon our values, understanding and priorities. Language is used and reproduced by individuals, often unaware of the power it exudes over their psyche (Bruner 1986).

The intellectual contribution of Foucault (1995, 2001) also informs the construction of the image. One of Foucault’s central concerns was to understand how it has come to be that people talk about certain phenomena in certain ways. In educational and medical contexts, this is usually a focus on how people have come to talk about marginalized groups in reference to polarized categories, such as healthy/sick, mad/sane and normal/dysfunctional. Such conceptual frameworks are useful to a researcher wishing to grapple with the figure in relation to context, from both an aesthetic and/or a theoretical standpoint.

The painting’s (or visual essay’s) main thesis is that institutions produce forms of language that exude tremendous power over the ways in which individuals understand their difficulties with social life and the options for support available to them. Hence, the development of the image sought to manipulate the formal elements so that a number of metaphors could be constructed. The following table explicates these metaphors, their intentions and their sources/influences: