The notion of using methods of artistic expression to help heal trauma survivors is hardly a new one. The depictions of battles carved or drawn on ancient weapons or cave walls may have served such a purpose, as did some types of Native American ritual dance. Samurai warriors painted, composed haiku, danced, and acted out scenes of war, partly in order to come to terms with its horrors.
An Edna Ferber story written in 1918 describes the recovery of a "shattered nerve" World War I soldier via weaving and painting plus a pre-trauma memory trigger. Art therapy is certainly no flash in the pan; it holds a time-honored place in the pantheon of effective treatments for a significant percentage of Posttraumatic Stress Disorder (PTSD) patients.
Expressive Visual Art Therapies Alleviate Some PTSD Symptoms in Certain Patients
Visual art therapy is especially useful for children, those whose traumas occurred at a preverbal stage of development, and patients who feel great distress verbalizing their experiences, including war veterans and sexual abuse survivors. Conversely, it may also be helpful to patients who read extensively about PTSD and speak coherently and freely of their trauma, yet their over-intellectualizing blocks emotional release, thereby impeding recovery. Painting, drawing, sculpting, and other forms of visual art creation may tap into repressed memories and emotions and allow catharsis unaccompanied by severe panic or terrifying feelings of loss of control.
PTSD sufferers often experience recurring nightmares of the traumatic events. Depicting the nightmares as visual art has been shown to decrease the nightmares themselves, while writing about them actually caused them to occur more often and with greater severity. Some pain is apparently "beyond words;" art may be able to step in and provide a meaningful expressive substitute for verbal communication.
One of the most intrusive PTSD symptoms is technically termed "dissociation." As with autism or other disorders, there's an entire spectrum of PTSD-related dissociative symptoms. Degrees of dissociation range in severity from complete amnesia for the traumatic events to sudden odd sensations of depersonalization or "otherworldliness" to relatively mild but bothersome reoccurring daydreaming akin to that in which practically everyone indulges at one time or another. Severe dissociative symptoms may lead to withdrawal from family, friends, and spouses; some sufferers become virtual shut-ins, so fearful are they of an outside influence or occurrence triggering an episode of "spacing out."
Art therapy may empower the patient to release their pain, anger, and fear through creativity, thereby lessening their tendency to use dissociation in order to avoid these debilitating yet necessary reactions to the healing process. In a way, all artists, writers, and other imaginative types might be said to "dissociate" while they are laboring at their craft. The intense concentration necessary to the production of any art project could be a positive form of temporarily "going away" from the real world. Thus, art therapy might simply be replacing a detrimental form of dissociation with a much healthier one.
Art Therapists and Types of Visual Art Therapy
All visual art therapy should be conducted under the guidance of a qualified art therapist. Do-it-yourself art therapy is never appropriate, since certain PTSD patients (e.g., those with complex PTSD or those in very early stages of recovery) may experience a worsening of symptoms rather than improvement. In the U.S., if your primary therapist agrees that you are ready to try and may benefit from art therapy, contact the American Art Therapy Association for a referral to a registered art therapist in your area.
Some therapists, including the respected Dr. Wendy Miller of Create Therapy Institute, recommend starting out with play therapy or sand tray therapy. The comments made by the patient during play and the structures he creates using a sand tray will help guide the observing therapist to the types of expressive art therapy best suited to that patient's individual recovery journey. An individual patient's needs may be better served by dance or music therapy than visual art creation, for instance. Therapies that blend several different artistic techniques may be quite effective for some, but overkill for others.
If visual arts are appropriate, the patient may then create drawings or paintings depicting her feelings about herself, her abuser(s), the traumatic events, or the elements of her personality altered by PTSD. A "safe place" may be created as an artistic representation, and later mentally used as a haven during flashbacks or panic attacks. An artistic memorial to fallen wartime comrades or a friend or relative lost to the traumatic events may provide a grieving ritual that mere "talking it out" fails to adequately provide.
Clay modeling of figures and safe places is used in Intensive Trauma Therapy (ITT), a one- or two-week, seven-hour-per-day outpatient treatment program that uses art therapy in conjunction with narrative processing and dissociation reversal techniques (note that hypnosis is also involved, which may make recovered memories inadmissible as court testimony). While the overall ITT treatment is definitely not appropriate for everyone, its art therapy component may allow patients to discover and embrace the differences between their traumatized self-image and their newly healing self.
Remember that none of the above therapies require any genuine artistic talent, just the desire to release traumatic memories and their associated emotions and improve PTSD symptoms in a vivid and perhaps eventually even a little bit “fun" way. If successful, art therapies will not merely treat surface symptoms, though; they go deeper than that. Twentieth century interpretive dancer Isadora Duncan once said, "Art gives form and harmony to what in life is chaos and discord." A better description of the therapeutic value of art cannot be found, for it does indeed allow the survivor to snatch creativity from the jaws of destruction, providing an affirmation of life despite indescribable suffering, a resurgence of hope and healing drawn from the very depths of despair.
Disclaimer: The information contained in this article is for informational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a mental health professional. Any reader who is concerned about his or her health should consult a qualified professional for advice.
Sources
- Blume, Sue E., Secret Survivors, New York: Ballantine Books, 1990.
- Ferber, Edna, One Basket: Thirty-one Short Stories, Chicago, IL: People's Book Club, 1947; story mentioned in article is "Long Distance," 1919, pp. 89-93.
- Schiraldi, Glenn R., Ph.D., The Post-Traumatic Stress Disorder Sourcebook, Second ed., New York, McGraw Hill, 2009.
- Tick, Edward, Ph.D, War and the Soul, Wheaton, IL: Quest Books, 2005.
- Isadora Duncan's quote from facing page to Part One of Seroff, Victor, The Real Isadora, New York: The Dial Press, 1971.
Amy Sillup - I have a B.S. in Chemistry from Delaware Valley College and a Juris Doctorate from the University of Pennsylvania. I have worked as a ...
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