Alone within the ALONESS of Covid-19: Developing Contemplative, Artistic Inner Friendship for Turbulent Times
Graduate School of Counseling & Psychology, Naropa University, 2130 Arapahoe Avenue • Boulder CO 80302-9926, USA
Academic Editor: Noah Hass-Cohen
Received: March 27, 2023 | Accepted: October 15, 2023 | Published: October 25, 2023
OBM Integrative and Complementary Medicine 2023, Volume 8, Issue 4, doi:10.21926/obm.icm.2304045
Recommended citation: Franklin MA. Alone within the ALONESS of Covid-19: Developing Contemplative, Artistic Inner Friendship for Turbulent Times. OBM Integrative and Complementary Medicine 2023; 8(4): 045; doi:10.21926/obm.icm.2304045.
© 2023 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.
Families, communities, and entire nations burdened by the unprecedented losses caused by the Covid-19 pandemic needed supportive tools like art and meditation for managing all forms of bereavement exhaustion. My students and professional colleagues from art therapy and art education revealed that the pandemic inspired them to address their fatigue by renewing their vows to their expressive-arts roots. Many of my confreres were also motivated to take up self-enriching, contemplative practices like yoga and meditation while isolated, alone, and grieving; but why? Answers to this question are tied to the guiding points driving this autoethnographic research which describes the benefits of combining art with contemplative practices to cope with existential ambiguity, loss, and the disruptive shifts of moving from an extraverted lifestyle to the introverted existence of social isolation during lockdown. Answers can also be traced to the reliable flexibility of art materials , the freedom of the creative process , and sublimated imagery  to help manage emotionally charged consequences stemming from introverted isolation. After all, an unforgettable quake of bereavement was sent through our global citizenry that will be studied for decades, especially the exponential consequences of social isolation and introverted loneliness, which are two significant determinants of overall health and core themes addressed in this article.
2. The Current Study
The overall objective of this autoethnographic investigation was to explore the experience of combining the spiritual elements of visual art  with introspective practices like yoga , meditation [6,7], and imaginal mindfulness (IM) [8,9] to relieve mind-body distress associated with pandemic-related fear and isolation.
Based on personal and collegial self-reporting, findings described the cultivation of inner friendship (self-compassion), witness awareness (focusing mindful self-observation), and imaginal freedom made available through working with art materials, processes, and contemplative practices. The stories were not formally studied with a review of scientific samples. Instead, in response to the pandemic, innovative forms of social communication spontaneously emerged within my peer group. For example, this information was collected during office hours with students and countless hours of collegial communication by Zoom, phone calls, and email. As a result of these interactions, the material gathered for this article is based on the authenticity of personal, informal samples of shared, observed, interpersonal phenomena. Additionally, the ideas explored herein cast a wide net around several autoethnographic themes that I was actively investigating and applying within the context of my various roles as an art therapist and educator during the pandemic.
As a methodology investigating lived experience, even messy non-linear accounts, autoethnography argues that the privileged, retrospective information gleaned from personal narratives leads to a deeper, sociological understanding of one’s life circumstances, which was the case for this research [10,11]. Berry  noted that we exist “in” ethnography in fluctuating ways that are directed by the “phenomenological life-worlds” that we inhabit (p. 3). This approach is well suited for this study since the efficacy of interpersonal communication during the pandemic revealed meaningful information worthy of investigation . By connecting myself with others and telling our reflexive stories to each other, a cultural view of pandemic survival was expressed in non-linear pieces of communication .
Tracking the intersectional, cultural influences of my peer group and students over the years of the pandemic, supported my convictions about the benefits of contemplative life and practice during turbulent times. Our work as art therapists offers credible authority for nourishing social, cultural, and spiritual survival during chaotic, unpredictable events . Personally, the pandemic supported the idea that art therapy and mind-body practices, like yoga and meditation, were not luxuries, but necessities for surviving the extreme emotional fallout of loss and loneliness during the devastation of the pandemic, especially the need for community [15,16].
3.1 An Epidemic of Loneliness
Suffering related to aloneness and loss of community connections was significant, but not necessarily universal . These authors rigorously summarized relevant evidence for fluctuations in loneliness during the Covid-19 pandemic, noting that an epidemic of loneliness while significant, was seemingly overblown. Yet, there is evidence to refute this perspective . Within my expanded circle of colleagues, many reported increases in anxiety related to social isolation, financial insecurity, and fear of illness and death as the mortality statistics steadily climbed over one million in the United States. Students in our art therapy program were particularly vulnerable since they had acquired significant financial debt burden, served as frontline workers during their part-time jobs, and were quickly moved out of the classroom and onto Zoom calls resulting in understandable disappointment. Their overall malaise matched what Elharake and colleagues found in their review of the literature concerning the effects of Covid on children, adolescents, and college students, particularly increases in anxiety, despondency, weariness, and distraught agitation .
3.2 Extroversion and Introversion: Life Prior and During the Pandemic
Prior to the pandemic, life was mostly unrestricted. People freely went to school, a gym, a concert, or places of worship. However, once quarantine became public policy, isolation tormented many people as their extraverted lifestyles were suddenly thrown into reverse forcing them into a crash course in how to be alone within existential aloneness. This problem was further compounded for those who had little mentoring in how to gracefully manage their plaguing thoughts. Dealing with the cognitive distress of forced introversion became emotionally demanding. As social distractions faded, ruminating thoughts justifiably increased, demanding the use of innovative tools like the Cognitive Behavioral Art Therapy (CBAT) thought record (Table 1) that I created at the end of this article for tracking thoughts, moods, behaviors, and related imagery . Several students reported that the art sketches produced for their thought records helped to materialize personal imagery as isomorphic reflections mirrored back for introspective processing [21,22,23]. In some cases, these thumbnail sketches became miniature studies for larger artworks.
3.3 Isomorphism and Art
Isomorphism is a foundational tenet of art therapy [22,23], emerging from Rudolf Arnheim’s Gestalt theory of expression . The overall premise suggested that there is equal similarity (iso) between inner emotional states and the outer visual elements of an artwork (morphic - line, shape, color). Essentially, what we feel, we potentially show in our creative work, resulting in an art-based X-ray of one’s inner state . Additionally, meditation and yoga provided access to advanced levels of self-observant, mental wellbeing . Pairing art with these contemplative practices, especially meditation, helped guide my colleagues and students to become less judgmental and more self-regulated witness-observers of their stressful circumstances, which is a major theme of this article [9,24].
3.4 Artistic Sublimation
Artistic sublimation is an effective strategy for observing and creatively transforming formidable emotions [3,25]. Rather than act out destructive urges in public, artistic sublimation offers an alternative pathway for moving impetuous behaviors into corresponding, socially productive imagery. Throughout this process, we slow down and keep our focus in two simultaneous directions by remaining connected to the disturbing content while searching for accurate imagery to organize and contain this subject matter. The result is a victory for the maturing ego that learns to delay impulsive gratification by methodically creating accurate, valued, symbolic equivalents . For example, the artwork that I created while homebound helped me to access, feel, and find purpose in all that had piled-up upon me. The clay sculpture below, Figure 1, metaphorically assembles together delicate, representational pieces of accumulated, unwieldy emotions. These piled up delicate clay forms looked beautiful to me, revealing a compassionate view of stacking tribulations made aesthetically tolerable.
Figure 1 Repetitive, piled up emotions represented in clay. Photographed and created by the author.
Similarly, my students insisted that they show their artwork based on their experiences of quarantine. As a community, they were encouraged to seriously pursue various art projects while shut-in their homes. Zoom calls were regularly used to show the progress of their work. Eventually a virtual gallery was set up, culminating in a final art show (Figure 2). While a satisfying outcome for some, as artists, students and faculty craved seeing the artwork in a physical gallery space. We all strongly felt our disappointment, doing our best to mindfully manage frustrations brought on by our less-than-ideal circumstances. Other art therapists observed similar community needs to show artwork in a public space .
Figure 2 Poster for Student Art Show.
3.5 Space Matters: Brief Reflections on the Arts and Covid-19
Anyone who keeps fish as pets quickly learns that they grow in size related to the dimensions of their environment. Essentially, fish with the capacity to grow large will stay small in a small tank. This metaphor begins to describe the phenomena of moving from extraverted living enjoyed by many to the confines of lockdown living. We all had to shrink our world to fit into our new lives. For example, artists previously inhabiting large, public studios now had to create working spaces in their small apartments.
Karen Wilkin, faculty at the New York Studio School, tracked the work of professional artists and MFA students. While digital gallery spaces increased the visibility of artists in 2020-2021, working styles like large format painting that needed to be created in a sizeable studio and seen in a traditional gallery setting were stifled. Being stuck inside smaller spaces while enduring distressing thoughts and emotions associated with the pandemic increased feelings of anxiety . As a result of these new realities, many artists were challenged by the reduction of freedoms to investigate their physical surroundings which had previously been a significant source of inspiration.
3.6 International Arts Relief
Internationally, the arts offered respite from Covid-19 challenges while also revealing significant social problems . In Ghana, murals helped to improve the aesthetics of healthcare environments . Imagery in one public mural advocated for preventative handwashing and wearing face masks while also exposing the regional hypocrisy of water poverty.
In Israel, anonymous images were studied by thematic analysis revealing important subjects of self-regulation, artmaking for containing emotional expression, creativity, imagination, and play . Additionally, museum culture offered virtual visits, creating generous access to their extensive collections. Google Arts & Culture tours featured Street View technology that some found “clumsy” to use, however traffic to their museum sites also increased . People quickly realized that they could view noteworthy artwork from their desk at home.
In a large study sample of over 19,000 adults prior to the pandemic in 2019, Mak and colleagues found support for the importance of the arts for coping with stressful situations . Using the Emotion Regulation Strategies for Artistic Creative Activities Scale, findings from their study showed that the arts supported emotional homeostasis, increased agency, and problem-solving skills, resulting in better overall mental health . Their work offers supportive credence for why the arts were helpful during the pandemic.
4. Meditation and Art
Inner freedom found in meditation and art, including IM, resiliency, the capacity to be alone, and connections between observation and relational intimacy were additional themes that emerged throughout this study.
4.1 Inner Freedom
Prior to pandemic life, my Colorado community was rather gregarious. Between seasonal sports, hiking, frequenting restaurants and music venues, life was freely lived outside. Then Covid arrived, diminishing our freedoms and forcing us inside. During countless Zoom discussions, I heard people say how hard it was to live within the limits of their new homebound restrictions. This reclusive lifestyle meant that social contact was limited beyond the immediate family system. People began using terms like trapped and imprisoned. During the worst days of the pandemic, my community needed to decode extraverted living in order to manage introverted necessity. In addition to the confines of personal architectural space, we were also quarantined within the confines of our thoughts. Without accessibility to our usual distractions, we were quickly discovering how uncomfortable we were with our own company. Those who had contemplative practice experience, specifically focusing awareness inward with caring, observant attention, seemed to fare better due to their years of cultivating positive inner friendship .
My students, who learn and seriously practice mindfulness meditation across the arc of their graduate studies, wholly realized that this training offered a lifeline for navigating their many disappointments with Zoom classes, virtual art shows, relational distance, and being alone. Their practice sitting in silence together in classes, learning to observe the movements of their mind, and applying self-compassion proved to be invaluable skills. However, due to the seismic lifestyle shockwaves of the pandemic, many of us struggled at first to implement our artistic and contemplative skills. Simply, the magnitude of our negativity bias ruminations proved to be too extreme to initially sit with.
Moving from disengagement to engagement with a contemplative routine unfolded over time. Reconnecting to our training of sitting with all states of mind was tested since we were all spending a lot of time with and in our thoughts. There was nowhere to go, all we could do was sit on our meditation cushions and compassionately observe our fears and disappointments. Many conversations during office hours and Zoom classes focused on the differences between feeling our frustrations and witnessing them with empathic detachment. This right understanding did not change our circumstances; however, it did eventually reveal our resilient capacity to be alone and silently present with our existential discontent.
4.2 The Capacity to be Alone
For many, isolation was intolerable. For others, seclusion brought degrees of welcomed solitude . Personally, I liked the quiet seclusion of the Covid lifestyle. Review of Winnicott’s classic article on the capacity to be alone offered guidance as I navigated these points in my personal life and role as an educator . The capacity to be alone emerges out of an interesting paradox. While in the separate yet connected presence of the primary caregiver, young children learn to be comfortably alone . Finding inner delight being alone in proximity to a caring, not too close or distant adult, becomes an introjected, ego syntonic part of the child’s self-structure. These solitary moments are retained into adulthood seemingly supporting the development of Csikszentmihalyi’s notion of the autotelic personality, a quality of character helpful during lockdown . This form of temperament favors intrinsically motivated activities for their own sake. External acknowledgement, which was in short supply during Covid-19, was not necessary for the autotelic personality. Private activities like creating artwork or meditating, was reward enough. It is possible that Winnicott’s  and Csikszentmihalyi’s  insights could explain the emotional buoyancy that supported my students and colleagues.
During Zoom sessions with students, we noticed the same paradox described by Winnicott as well as Csikszentmihalyi’s description of autotelic agency. Within our separate boxes on the screen, we were clearly disconnected while also in community within the confines of our mediating technology. For many students, this was an acceptable situation. For others, this was an agonizing disappointment. Consequently, this was not the graduate-study experience for which they signed up. However, experiencing the group curative factor of shared, universal struggle helped calibrate disappointments related to internship, studio time, and in-person learning .
5. Art as Contemplative, Spiritual Practice
Before Covid, the field of art therapy had been researching art and spirituality, addressing the power of visual imagery to support transformational growth [4,40,41]. Yoga too had been researched before and during the pandemic . Horovitz  investigated connections between yoga therapy and art therapy, while Rappaport  examined intersectional influences between mindfulness and the expressive therapies. Bokoch and Hass-Cohen  conducted a significant study examining the integration of mindfulness meditation with art therapy groups in a school setting. And most recently a single session, art and mindfulness-based doodle intervention revealed statistically significant increases in mindful creativity, positive emotions, and overall improvements to mindful awareness . In addition to the important work of these authors, fundamental questions remain related to how visual art qualifies as a legitimate contemplative practice and antidote to the suffering experienced by many during the confinement of quarantine.
5.1 To Contemplate
Essentially, to contemplate means to focus awareness inwardly and outwardly with reverent attention . The word temple is rooted within the meaning of contemplate and the Latin contemplum (reading omens) relates to observant, devotional engagement with events unfolding before us . In terms of the pandemic, where did people find spiritual solace and how did they access temple-like spaces in their homes and more importantly, their thoughts? Contemplative experiences can emerge anytime, anywhere, especially when aided by combing the arts with meditation. The sanctuary of introspective attention can be honed by slowing down and refining open-minded attention, which summarizes the discoveries realized by many of my colleagues during quarantine. Moments of happiness emerged for them during states of mindful absorption with art materials and processes . Looking ahead to the next inevitable health crisis, how then do we train ourselves to participate in inner life and our outer surroundings with nonjudgmental, focused attention, regardless of whether we are in an architectural temple, nature, or while alone in a small apartment during quarantine? Partial answers to this question can be found in the flexible, receptive quality of art materials. Although the mind might judge our initial creative forays, the materials signal non-judgmental receptivity. In fact, Joan Erikson astutely noticed decades ago that art materials do not get angry, they simply respond, thus becoming an unprejudiced ally during the creative process .
6. The Practice of Imaginal Mindfulness and Artistic Sublimation
Mindfulness advances relaxed, flexible, attention to the “reflective self,” while developing nonjudgmental, “moment-to-moment awareness” of expanding and contracting thoughts and sensations . Additionally, mindfulness addresses attention to inner and outer events by supporting open awareness to these phenomena. Kabat-Zinn’s  mindfulness meditation approach addressed stress reduction by promoting open-minded attention. Remembering to remember to return to the emerging present now with gentle presence develops an expansive mind, full of emerging sensorial, intrapersonal, and interpersonal phenomena.
6.1 Imaginal Mindfulness
Imaginal mindfulness (IM), which is a personally created term and practice, blends imaginal psychology with mindfulness meditation and artistic sublimation. It is a contemplative method of nonjudgmentally observing the moment-to-moment arrival and evolution of autonomous, living narratives within surfacing imagery, and plowing those observations into artworks [8,9]. And since art can be planned or spontaneous, there is plenty of opportunity to become mindfully engaged with the poetics of personal imagery. Furthermore, IM moves from thinking about images to manifesting them through art materials, processes., and products. Specifically, when combined with the creative process including instinctive mark making, spreading color on a canvas, or chiseling stone, the movements of the imagination will summon forth contemplative practice opportunities for awakened experiencer-observer witness awareness.
6.2 The Practice of Imagination
The power of autonomous images can be observed in the popular 2000 film Castaway starring Tom Hanks. Stranded alone on a desert island for years after a plane crash, Hanks’ character, Chuck Noland, finds a volleyball that he names Wilson after the manufacturer of sports equipment. At one point, Noland cuts his hand and then throws the volleyball resulting in a blood painted surface that he manipulates into a face. As time passes, Wilson becomes an emotionally animated friend that is more than a personified companion. Instead, a true relational connection is established, stimulating numerous, emotionally charged conversations. This example can be generalized to the symbolic, archetypal nature of images found in artworks. Within this framework, the living, autonomous authority of symbols creates space for expressively charged, imaginal relationships to unfold.
With Wilson serving as a viable example, James Hillman  and art therapists Abbenante and Wix , offer further explication on the nature of images. For them, an image is not the retinal event of perceiving an object. Seeing a tree or touching ice is different from the image of a tree or tactile image released when feeling a frozen surface. Essentially image is the implicit poetic narrative that lives within the object or event that is perceived or experienced. It consists of “context, mood, and scene” which together constitutes the architecture of imaginal narratives that can be explored through IM [8,49]. Additionally, the freedom to imagine is referred to by Patricia Berry  as the complete democracy found within an image. Engaging freely with the simultaneous context, mood, and scene contained within an image unfurls its expressive sovereignty.
Therefore, the practice of imagination was a primary ally during lockdown as our emotions moved at lightning speed between pre-Covid-19 life, present struggles, and hopeful future outcomes. Like an indispensable appendage, imaginal creativity helped to transcend Covid-19 time-space bound restraints. Artwork created by students and colleagues confirmed the importance of the intrinsic full and free democracy of personal imagery [51,52]. During lockdown, the liberty to cross imagined versus real borders and rewrite traumatic narratives was happening around me and with my students. The limits of conceptual reason could only take us so far when faced with fleeting hopes and deep grief. Artistic sublimation and IM integrated painful narratives by aesthetically unifying oppositional forces into socially productive, resolved artworks. When IM is practiced, inner awareness noticeably expands. Furthermore, observantly tracking thoughts, somatic sensations, and corresponding imagery, according to my students and colleagues, increased degrees of psychological liberation during quarantine. Essentially, imagining and manifesting alternative outcomes and realities, was a source of cognitive and emotional freedom.
6.3 Observation, Intimacy, and Social Distancing
Just before the pandemic, I took my studio class to the Denver Art Museum to see a Claude Monet exhibit. In each gallery, firm boundaries were marked on the floor to restrict touching the work and close viewing. However, with careful observation, intimate encounters were possible. When in an art museum, we are always practicing forms of social distancing with the work. Even if we cannot physically touch the canvases, we can confidently touch them with our eyesight, a skill familiar to art therapists (Figure 3).
Figure 3 Observational distancing when looking at artwork in a museum. Photograph by the author.
Furthermore, when perceiving art or people at a distance we learn that we can still have intimate encounters, including over Zoom. Figure 4 below shows a moment of surprise during Zoom office hours when a student was discussing significant emotional challenges with her final project. Suddenly her room became bathed with sunlight, creating a spontaneous moment of shared, unexpected joy. Her exasperated feelings quickly transformed into sentiments of reframed delight and surprise to help balance out her valid frustrations.
Figure 4 Zoom office hours. Photograph by the author.
After decades as an art therapist, my most valued clinical and artistic skill, particularly during quarantine, was the intimacy created through disciplined observation. Whenever awareness is mindfully focused, even on a Zoom screen, precious information is waiting to be discovered, subverting the boredom and distance of isolation.
6.4 Personal Artwork
During the pandemic I did clay work as a way to keep busy (See Figures 5-7). I found myself forming pots with extremely thin walls, a style of hand-building that I have been doing for a while. The reason for creating narrow walls had to do with taking the clay to its limit where it was on the verge of collapsing. This served as the perfect metaphor for exploring themes of self-support, falling apart, and embracing resiliency found within fragility.
Figure 5 Pot with thin walls that are about to collapse. Photographed and created by the author.
Figure 6 Satisfying clay forms that stimulated tactile and aesthetic joy. Photographed and created by the author.
Figure 7 Satisfying clay forms that stimulated tactile and aesthetic joy. Photographed and created by the author.
7. Imagining a Hopeful Future
As new variants spread, and warnings of new pandemics loom large, we are susceptible to the possibility of future quarantine events. Guides who can therapeutically combine art with reflective methods like meditation, yoga , CBAT , and IM, will be needed for managing trauma and embodied distress . One way to support this endeavor is with the daily thought record below in Table 1 that I created for my clients and my history and theory of art therapy class. I used this tool in preparation for quizzes before and during Covid. In anticipation of taking a test over a “Canvas” learning platform, the goal was to connect mindful awareness with embodied experiences associated with thoughts, moods, behaviors, and corresponding sketches. Students were asked to use the rubric two to three times a day for a week before the quiz. Once on the other side of the test, they reported that the rubric increased caring awareness of their thoughts, moods, and behaviors in positive ways, ultimately helping them to track and begin to accept their associated anxieties. It is my hope that other educators and clinicians will find this tool helpful and perhaps study its efficacy for use in the classroom and with clients.
Using awareness to understand the contours of human sentience is what calls many to explore artistic work. As we produce meaningful imagery under the guidance of a well-developed autotelic, intrinsically motivated personality, we learn that we are not alone when communing with personal artistic imagery. The more we mindfully engage imaginative wisdom, the more we can transcend isolation by being content with our own company and the companionship of our symbolic visual guests. With this understanding the differences between contemplative solitude and the anxieties of loneliness become clarified. There will be another global crisis, extreme weather events, and violent, racist crimes to navigate. In order to prepare for these impending adversities, this article argues for the support of the arts, combined with contemplative practices, and the skills of an art therapist to gracefully manage being alone within pandemic existential Aloneness.
The author did all the research work of this study.
The author has declared that no competing interests exist.
- Knowlton G. The contemplative process of sue hammond-west industrial felt, animal fur and meditative practice. Surf Des J. 2007; 31: 34-37.
- Rothenberg A, Hausman CR. The creativity question. Durham, NC, US: Duke University Press; 1976.
- Franklin M, Siemon T. Toward an understanding of the fundamental healing and therapeutic qualities of art. J Thai Tradit Altern Med. 2008; 6: 269-273.
- Allen PB. Art is a Spiritual Path. Boulder, CO, US: Shambhala Publications; 2005.
- Priyanka S. A cross-sectional study of mental wellbeing with practice of yoga and meditation during COVID-19 pandemic. J Family Med Prim Care. 2021; 10: 1576-1581. [CrossRef]
- Davis DM, Hayes JA. What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy. 2011; 48: 198-208. [CrossRef]
- Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Delacorte; 1990.
- Franklin MA. Imaginal mindfulness-Imaginal intelligence: Musings on the languages of shadow and light in art, meditation, and clinical practice. Colorado Springs, CO, US: University Professors Press; 2016.
- Franklin MA. Art as contemplative practice: Expressive pathways to the Self. Albany, NY, US: SUNY Press; 2018.
- O'Shea SC. Isolation. Gend Work Organ. 2020; 27: 717-722. [CrossRef]
- Wall S. An autoethnography on learning about autoethnography. Int J Qual Methods. 2006; 5: 146-160. [CrossRef]
- Berry K. Implicated audience member seeks understanding: Reexamining the “gift” of autoethnography. Int J Qual Methods. 2006; 5: 94-108. [CrossRef]
- Hamdan A. Autoethnography as a genre of qualitative research: A journey inside out. Int J Qual Methods. 2012; 11: 585-606. [CrossRef]
- Johnson H. Arts and culture in a 'new normal'. Psychologist. 2020; 33: 98-99.
- Mackay S, Klaebe H, Hancox D, Gattenhof S. Understanding the value of the creative arts: Place-based perspectives from regional Australia. Cult Trends. 2021; 30: 391-408. [CrossRef]
- Lancaster M, Arango E. Health and emotional well-being of urban university students in the era of COVID-19. Traumatology. 2021; 27: 107-117. [CrossRef]
- Ernst M, Niederer D, Werner AM, Czaja SJ, Mikton C, Ong AD, et al. Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis. Am Psychol. 2022; 77: 660-677. [CrossRef]
- Lin SL. The “loneliness epidemic”, intersecting risk factors and relations to mental health help-seeking: A population-based study during COVID-19 lockdown in Canada. J Affect Disord. 2023; 320: 7-17. [CrossRef]
- Elharake JA, Akbar F, Malik AA, Gilliam W, Omer SB. Mental health impact of COVID-19 among children and college students: A systematic review. Child Psychiatry Human Dev. 2023; 54: 913-925. [CrossRef]
- Rosal ML. Cognitive-behavioral art therapy: From behaviorism to the third wave. New York: Routledge; 2018. [CrossRef]
- Arnheim R. Toward a Psychology of Art: Collected Essays. Berkeley, CA, US: University of California Press; 1966.
- Agell G, Rhyne J. Special feature: Janie Rhyne's dissertation, drawings as personal constructs: A study in visual dynamics. Am J Art Ther. 1998; 37: 14.
- Rhyne J. Gestalt art therapy. Philadelphia, PA, US: Brunner-Routledge; 2001.
- Sahni PS, Singh K, Sharma N, Garg R. Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID-19 lockdown: A cross-sectional study. PloS One. 2021; 16: e0245214. [CrossRef]
- Kramer E. Art as therapy with children. New York, NY: Schocken Books; 1971.
- Kramer E. Childhood and art therapy. New York, NY: Schocken Books; 1979.
- Devine S. Therapeutic impact of public art exhibits during COVID-19. Art Ther. 2023; 40: 50-54. [CrossRef]
- Wilkin K. Covid chronicle. New Crit. 2020; 39: 41-44. Available from: https://newcriterion.com/issues/2020/9/covid-chronicle.
- Aikins AG, Akoi Jackson B. “Colonial Virus”: COVID-19, creative arts and public health communication in Ghana. Ghana Med J. 2020; 54: 86-96. [CrossRef]
- Lakh E, Shamri Zeevi L, Kalmanowitz D. Art in the time of corona: A thematic analysis. Arts Psychother. 2021; 75: 101824. [CrossRef]
- Haigney S. Dizzying visits to virtual museums. Art Am. 2020; 108: 21-23.
- Mak HW, Fluharty M, Fancourt D. Predictors and impact of arts engagement during the COVID-19 pandemic: Analyses of data from 19,384 adults in the COVID-19 social study. Front Psychol. 2021; 12: 626263. [CrossRef]
- Fancourt D, Garnett C, Spiro N, West R, Müllensiefen D. How do artistic creative activities regulate our emotions? Validation of the emotion regulation strategies for artistic creative activities scale (ERS-ACA). PloS One. 2019; 14: e0211362. [CrossRef]
- Franklin M. Mindful considerations for training art therapists: Inner friendship - outer professionalism. London, UK: Jessica Kingsley Publishers; 2014.
- Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psychol Trauma. 2020; 12: S55-S57. [CrossRef]
- Yadavalli S. Mourning and the capacity to be alone: Cultural and existential rituals in loss. Psychoanal Self Context. 2022; 17: 243-254. [CrossRef]
- Winnicott D. The capacity to be alone. London, UK: Hogarth Press; 1965.
- Csikszentmihalhi M. Finding flow: The psychology of engagement with everyday life. New York, NY: Basic Books; 1997.
- Yalom ID, Leszcz M. The theory and practice of group psychotherapy, 5th ed. New York, US: Basic Books/Hachette Book Group.; 2005.
- Farrelly-Hansen M. Spirituality and art therapy: Living the connection. Philadelphia, PA, US: Jessica Kingsley Publishers; 2001.
- Horovitz EG. Spiritual art therapy: An alternate path. Springfield, IL, US: Charles C Thomas Publisher; 2017.
- Horovitz EG. Head and heart: Yoga therapy and art therapy interventions for mental health. Scotland: Handspring Publishing; 2021.
- Rappaport L. Mindfulness and the arts therapies: Theory and practice. Philadelphia, PA, US: Jessica Kingsley Publishers; 2013.
- Bokoch R, Hass Cohen N. Effectiveness of a school-based mindfulness and art therapy group program. Art Ther. 2021; 38: 117-126. [CrossRef]
- Isis P, Bokoch R, Fowler G, Hass Cohen N. Efficacy of a single mindfulness-based art therapy doodle intervention. Art Therapy. 2023. [CrossRef]
- Mahony WK. The Artful Universe: An Introduction to the Vedic Religious Imagination. Albany, NY, UK: State University of New York Press; 1998.
- Cooper A. The man who found flow. Shambhala Sun. 1998; 9: 5-63.
- Erikson JM. The arts and healing. Am J Art Ther. 1979; 18: 75-80. [CrossRef]
- Hillman J. Further notes on images. Washington, DC, US: Spring; 1978.
- Abbenante J, Wix L. Archetypal Art Therapy. The Wiley Handbook of Art Therapy. Hoboken, NJ, US: Wiley Blackwell; 2015. pp. 37-46. [CrossRef]
- Berry P. Echo’s subtle body: Contributions to an archetypal psychology. Dallas, TX, US: Springer; 1982.
- Marlon S. Archetypal Psychologies: Reflections in Honor of James Hillman. New Orleans, LA, US: Spring Journal Books; 2012.
- Howard J. ‘Creativity is good for you’: Responding to the needs of our communities after COVID-19. J Appl Arts Health. 2022; 13: 393-399. [CrossRef]
- Persons JB. Cognitive Therapy in Practice: A Case Formulation Approach. New York, NY, US: W. W. Norton & Company; 1989.