Pioneer of Response Art: an Interview with Dr. Barbara Fish, a Renowned Art Therapist, Researcher and Educator
By Journalists: Yangminxing Wu, Yangminyan Wu
Dr. Fish is an internationally renowned art therapist and has spent more than forty years helping people use the creative process to explore their emotions. She currently resides in San Diego, California. Dr. Fish had taught for decades in the art therapy program at the School of the Art Institute of Chicago and also worked in hospitals and residential programs. She served as the inaugural chair of the Art Therapy Credentials Board and, in 2019, received the American Art Therapy Association's highest honor — Honorary Life Member. Recently, two rising high school seniors, founders of the Youth Mental Health Art (YMHArt) program, sat down with Dr. Fish over Zoom to discuss her life's work: using images, rather than words alone, to help people heal.
A Photo of the Interview with Dr. Fish
A Childhood Surrounded by Art
Dr. Fish's journey toward art therapy began long before she knew the field. Dr. Fish's mother is a sculptor, and she grew up in an artistic environment. In her childhood, she was surrounded by art materials and sculptures, some of which still sit in the cupboard of her office. She recalled that the moments during her childhood when she felt closest to her mother were when they engaged in art-making together. This experience led her to realize at an early age that art-making possesses the power to heal and to foster resonance with others, even though she could not yet articulate the underlying reasons. It was not until after she graduated from university that she happened to meet an art therapist and realized she could combine her passion for creativity and her curiosity about human nature into a career as an art therapist.
Art-Based Supervision
Dr. Fish's research and clinical practice focus on "Art-Based Supervision" and "Response Art", which hold significant influence in the international art therapy community. Her book, Art-Based Supervision, introduces a novel model of clinical supervision in which the supervisor and supervisee go beyond verbal communication to incorporate art-making, such as drawing, collage, or sculpting, as a means of exploring the client's situation and the therapist's internal reactions. In the supervision groups Dr. Fish leads, therapists bring in artworks that were created in response to challenging moments with clients, which serve as the starting point for the ensuing discussion. She has found that this approach fosters deeper dialogue than mere verbal communication, as it is far more difficult to evade certain issues when confronted with an image.
When asked whether this kind of art that lays bare vulnerability carries any risk, particularly for people growing up in certain cultures who feel that showing vulnerability is unsafe, Dr. Fish described her long-running supervision group with art therapists in Taiwan. The group spends an hour discussing a clinical case and a second hour making art together about it, and she participates in art-making alongside them. She said this practice levels the power difference in the supervisory relationship and helps people feel safe enough to be vulnerable, which matters because unexamined countertransference, the feelings that a therapist has toward a client, needs to be brought out into the open for discussion rather than kept hidden. In Dr. Fish's words, supervision is to provide therapy for the therapist.
Dr. Fish presenting "How Art Therapists Deal with the Dilemma of Countertransference?"
Dr. Fish also recounted an experience from her internship — one she has used for decades to educate her students: while working with a group of twelve-year-olds with behavioral disorders, she set down a sharp knife after cutting mural paper, turned around to tape the paper to the wall, and turned back, she noticed a boy holding the knife and threatening her. Outwardly, she appeared composed, yet inwardly she was gripped by extreme fear. For years, she has used this story to remind her students that there is no need for those who come after to repeat the mistakes she herself once made.
Response Art and the Unconscious
Dr. Fish is the originator and advocate of the concept of Response Art, an approach that allows both therapists and clients to explore and express their experiences through the creation of artwork. Much of her research centers on Response Art. She traces this practice back to the theories of Swiss psychologist Carl Jung, who placed great emphasis on imagery and symbols and introduced the technique of "Active Imagination" — essentially a form of waking dreaming that allows individuals to enter their own imaginative worlds and engage in dialogue with the figures that appear there. For Dr. Fish, when she feels confused or struggles during the course of therapy, expressing herself through art-making helps her move beyond surface-level reactions and tap into something deeper, whether it is her personal unconscious or the collective unconscious described by Carl Jung.
Dr. Fish shared an impressive example. During a training session for hospital staff, she asked two psychiatric residents to draw a patient they felt they had failed to help effectively. One of the residents, without warning, drew a hospital door featuring a window, through which a blood-stained face was visible. Deeply shaken by his own drawing, he told Dr. Fish that he had never intended to bring up this memory: a hospitalized adolescent patient who had been attacked and tragically killed in the ward while under his care. Dr. Fish explained that her task at the time was to help the doctor understand that images could surface without warning, much like dreams; as his supervisor, her role was to provide a safe space where he could confront whatever emerged without feeling a loss of control.
The Creator is the Authority on Their Artworks
A core principle that runs throughout Dr. Fish's career is that a therapist should never position themselves as an expert to interpret another person's artwork. She explained that creators themselves are very clear about the relationship between themselves and their artworks. Dr. Fish is well aware that a certain authenticity gets lost when others attempt to interpret these artworks from the outside. She believes her role is to provide a safe space for clients and to witness what they discover through their creative work, rather than analyzing the work for them. She often sums up her work with a simple phrase: she serves those whose imaginations have been impaired, and her mission is to help them rebuild the bridge to their own creativity. To truly change one's life, one must first be able to imagine what that changed life looks like.
Art for Peace
Dr. Fish also spoke about "Art for Peace", an online community she has been involved with for twenty-five years; the project began with a small gathering following the 9/11 attacks in 2001. Today, people from places such as Taiwan, South Korea, Hong Kong, Japan, Canada, and Singapore participate in it. Anyone can join, provided they are willing to create art together in a spirit of mutual respect. Among them are a three-year-old child who created a piece alongside her mother, as well as Dr. Fish's own mother, who — at the advanced age of ninety-eight — worked with the group to complete a sculpture. Dr. Fish said that in the face of the world's ongoing turmoil and trauma, this community allows members to stay grounded, helping them respond to conflict in ways that are meaningful rather than driven by fear.
About Artificial Intelligence
When asked about the role that artificial intelligence might play in art therapy over the next decade, Dr. Fish frankly admitted to being puzzled by the matter. She mentioned a student who used artificial intelligence to generate an assignment of Response Art instead of creating the artwork themselves. She worries that something vital will be lost when artificial intelligence takes over the aspects of the creative process involving struggle and the unknown. To better cope with this unease, she created a drawing of herself walking toward a wall that symbolizes artificial intelligence — a wall that she is still trying to transform into a door. Nevertheless, she still believes that the true power of therapy stems from the relationship between two people — a realm she considers beyond the reach of artificial intelligence. She believes that people will still need each other's companionship and help as long as they continue to endure suffering.
Dr. Fish presenting her thoughts on the role of artificial intelligence in art therapy
Mental Health Challenges Asian-American Youth is Facing
The two young journalists are focusing their research on the mental health of Asian-American youth. Noting that many second-generation Chinese-American teenagers view "living between two cultural systems" as a significant part of their lives, they asked Dr. Fish about the specific challenges these young people face and the coping strategies they are able to employ.
Dr. Fish frankly acknowledges that schools and the education system often lack an understanding of the pressures faced by Asian-American teenagers, particularly academic pressure. Asian cultures often place immense value on achievement and academic perfection; yet teachers, peers, and even the education system itself frequently fail to recognize the pressure students are under — a situation that is fundamentally a cross-cultural issue closely linked to parental expectations. Furthermore, hate incidents targeting Asians have made the situation even more difficult. Dr. Fish believes it is crucial to break down this stigma.
Beyond the challenges at the social level, Dr. Fish discussed struggles at a more personal level: teenagers want to please their parents and fit in with peers while finding a sense of comfort and belonging in the world. This requires a safe space to express the struggle of navigating between two cultures. Then there is adolescence itself — a period she describes as incredibly difficult. Bodies change, rules shift, and friendships evolve; meanwhile, young people must figure out whether they want to remain in the family nest or strike out on their own — everything is in flux. In addition, there are other pressures, such as translating for their parents, among the various extra responsibilities teenagers must shoulder as second-generation immigrants. Therefore, finding a safe, accepting space and a trusted adult can be immensely helpful. Such support can also help parents understand the pressure their children face, recognizing that certain behaviors stem not from rebellion but from the process of cultural adaptation. Dr. Fish also mentioned that the fear stemming from immigration and enforcement policies is another major source of stress. She lived in Chicago for many years, where, in many Mexican immigrant families, children would go to school and be completely unsure of whether their parents would still be home when they returned. This uncertainty required both children and therapists to work hard at creating a safe haven because therapy, after all, should fundamentally be a safe space where both vulnerability and strength can be revealed.
The two young journalists then mentioned that they had spoken with Kristin Calabria, founder of the BRIDGE Foundation, who identified intergenerational trauma as a key factor underlying the situation, and asked Dr. Fish for her thoughts on the idea of "breaking" intergenerational trauma. Dr. Fish acknowledges that intergenerational trauma is real and serves as a factor behind many of the conflicts in today's world. It manifests continuously through cultural customs, through family conflicts, and through the inability of people to truly see one another. As for how to "break" it, she frankly admits she is unsure; yet she believes that people can understand and respect it, and find ways to carry it and imbue it with meaning. Much like the concept of "Harm's Touch", at the very least, let us not pass it on to the next generation exactly as it is.
She further illustrated this point using Carl Jung's theories: when a person pushes away things they find difficult to face and refuses to process them, those elements do not vanish; instead, they accumulate, eventually becoming a burden that demands immense energy to suppress and conceal. The more one denies or repels these aspects, the more powerful they become; when a person devotes almost all their energy to suppression, very little remains for the true vitality of life. Jung's concept of "individuation" refers to the process of gaining sufficient self-awareness and insight to soften these boundaries, confront one's "shadow" side, and learn acceptance. For example, one might realize that one does not truly hate one's mother; while she certainly had negative traits, there were also aspects worth celebrating and remembering. In this way, a person can gradually resolve inner conflicts and soften the boundary between their "shadow" and the "persona" they present to the world.
Dr. Fish believes that this approach of softening toward one another, showing mutual respect, making space for each other, and listening attentively is equally applicable to parent-child relationships. Trauma is often transmitted through the harshness and severity of interactions between parents and children, creating further rifts between family and culture. Ultimately, truly making space to listen to, respect, and safely hold space for one another is the most vital way to heal these fractures.
Giving Voice to Silent Works
The journalists asked Dr. Fish about a specific challenge they encountered in the YMHArt project: participants often created deeply moving artworks but were reluctant to discuss the meanings or emotions behind them. They wanted to know if Dr. Fish had observed similar phenomena in her own work and how she would encourage individuals to respond to their own creations.
Dr. Fish explained that she always tells clients they are under no obligation to discuss their work; the decision of how to handle their work rests entirely with them, as they are the creators and the voices behind the pieces. She candidly shared that when creating content of a highly sensitive nature, she often tells herself she doesn't have to show the work to anyone. Yet, it is precisely this permission that often gives her the confidence to share it, as the act of sharing suddenly takes on new importance. However, she emphasized that if a person does not feel safe, they should not force themselves to do so.
She also discussed the distinction between private and public art. For instance, if she were to create a piece about her sister that is filled with anger and depicts extreme behaviors, she would not post it on her website. Such a piece belongs to the private realm; it serves as a way for her to process and confront her emotions. While she might discuss it with a supervisor or therapist, she would not publish it publicly. She noted that YMHArt participants might similarly possess private works they wish to keep to themselves, or want to create public pieces that address mental illness and related issues more directly, or simply take time to digest the experience before deciding how to proceed. She advocated for leaving this decision entirely in the hands of the creators themselves.
She also discussed the concept of an artwork's "life story", a notion she developed during her doctoral research, which explores the forces that sparked the work's creation: how it was made, the materials chosen, the physical pressure applied during its making, the location of its creation, who saw it, where it was subsequently stored, whether it still exists, its age (five or ten years old), and its exhibition, sale, destruction, disposal, or gifting history. All these elements constitute the artwork's "life story". In her thesis, the artwork itself becomes the subject of the interview; she engages in direct dialogue with the piece — exchanges that sometimes span as many as twenty-five pages. She offered an analogy: the creator acts as the artwork's "chronicler." It is similar to a parent taking a child to the doctor; while the child is the one being treated, the parent recounts the medical history — recalling details like a bout of flu at age seven, the circumstances of birth, or schooling — yet the child remains the true subject of the treatment. Similarly, while the creator tells the story, the artwork itself is the true "protagonist." The artwork holds all the information and "speaks" for itself, while the therapist bears the weight of the entire narrative.
She noted that recounting the story behind an artwork, or allowing the piece to speak with its own "voice" rather than relying solely on the creator's expression, serves as a way to maintain an appropriate distance from the work. Finally, she added that when dealing with participants reluctant to speak, the best approach is to foster a sense of safety rather than pressuring them to open up. By ceding control and decision-making power entirely to them, they gain a sense of agency over what happens next. It is also crucial to let them know that any level of disclosure, whether speaking at length, saying just a single sentence, or remaining completely silent, is perfectly acceptable.
Advice for the Next Generation
For young people considering a career in art therapy, Dr. Fish recommends starting with literature, attending regional conferences such as those held by the Southern California Art Therapy Association, and thinking carefully about which populations most interest them, whether that is children, older adults, people with disabilities, or psychiatric populations. Above all, she encourages using one's own art making as a tool for self-exploration long before stepping into the therapist's chair.
This interview is being conducted by the two founders of Youth Mental Health Art, a non-profit initiative dedicated to sparking conversations about mental health among young people through art. The team comprises members from various countries, and their work has garnered over one hundred thousand views worldwide.
