Painting Therapy for Fear in Palliative Care

Dagmar Brauer

Last update: 27.08.2018

Painting therapy works through experiencing the painting process, the colors, color transitions and specific motifs. Its use is recommended in multimodal treatment of fear. Aspects specific to the disease and the patient’s inner experience are brought “out into the open” in the paintings, making them visible and thus also more easily processed. After painting therapy patients feel relieved, calmed and can see new perspectives. Sometimes fear is unconscious and only emerges during painting. It is raised into consciousness and becomes accessible for further processing. Physical relaxation is achieved, fear can be reduced in the soul by the artistic-therapeutic process, and on a spiritual level, new pictures for finding meaning, perspective and development can emerge.

Painting therapy for anxiety in palliative care

Art therapy for people in palliative care is initially an offer of relationship. It presupposes that the therapist is aware of what it means to be afraid of losing one’s independence, to fear physical suffering and dying. Fear can paralyze the patient’s soul, or it can make him angry, and it can also cause him to alternate between the two. Therefore, the focus of art therapy is on the goal of developing the greatest possible quality of life for the patient, supporting the patient in dealing with fear and enabling new spiritual perspectives and meaning to arise. In doing so, we must take into account physical, psychological, social and spiritual aspects (1, 2).

Painting therapy is provided as a calming, accompanying, active, or receptive activity, which is steadily adapted to the patient. This can be prepared in a way that enables the patient to remain in bed while painting. We can offer to simply contemplate a picture together, if a palliative care patient asks for a receptive or viewing form of painting therapy (3).

Painting therapy in palliative care is becoming increasingly important, but it is also a challenge. It is important to have very precise perceptions of the patients, the framework and the available possibilities. The artistic options need to be chosen very carefully and purposefully. Anthroposophic therapists accompany the creation of a patient’s “last pictures” responsibly, as such images are especially ingrained in the patient (4).

Therapeutic recommendations

Anxiety with tension, mental strain

  • An inwardly relaxing wet-in-wet technique can be used to effect a sensation of easing.
  • This can be promoted by using plant colors, particularly the enveloping and safety-imparting shades of blue and violet, as well as golden yellow and warm colors.
  • Simple motifs that bring light in all its manifestations into the center of the picture give perspective and awaken inner forces for dealing with the disease.
  • Corresponding color meditations can also be offered.

Fear of “losing one’s center”

Working with images—e.g., with pictures from the wisdom of fairy tales, which patients have often known since childhood—can open up spiritual perspectives and also help with fear of losing their center.

Fear with a depressive mood and despondency

If fear is experienced as an inner darkness, we can provide positive experiences by painting

a series of

  • simple pictures “from darkness to light”
  • simple motifs on the theme “my safe place”
  • simple, dynamic imaginations in warm colors.

Fear with anxiety

In cases of agitated fear, we can use geometric painting and drawing. These painting techniques stimulate structural and formative forces that help counter the agitated fear. Objective drawing supports sensory perception, freeing the patient from his inner imprisonment in his anxious soul and guiding him to observe nature and the environment.

The independent artistic expression of the patient is of course always taken up and included in further therapy (5).


  1. Gruber H, Reichelt S (ed.). Kunsttherapie in der Palliativmedizin. Berlin: EB Verlag Dr. Brandt; 2016.
  2. Kortum R, Koch S, Gruber H. Kunsttherapie in der Palliativversorgung. Ein narratives Review. Teil I: Forschungsstand. Zeitschrift für Komplementärmedizin 2017; 09(06):52-60.[Crossref]
  3. Compare Brauer D. Das “Irische Kreuz” von Margarethe Hauschka—eine Bildmeditation. In: Glöckler, Michaela (ed.). Meditation in der Anthroposophischen Medizin. Berlin: Salumed Verlag; 2016.
  4. Gutknecht K. Das letzte Bild. Der Merkurstab 1997; 50(6):351-354.
  5. Brauer D, Asmussen A, Müller U, Gonsior E: Anthroposophische Maltherapie in der Onkologie. Der Merkurstab 2009;62(4):373-377.

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