Art Therapy & Trauma Work
Creative expression and the use of art in healing rituals can be traced back tens of thousands of years, and is considered a defining attribute of humanity. Art therapy, as a distinct practice and profession, emerged in the 1940s, developing simultaneously in Europe and the United States. In England, Adrian Hill, a WWI veteran, practiced artmaking to tolerate his own treatment for tuberculosis, and later applied his practice to WWII veterans returning from the war with “shell shock.” In the U.S., Margaret Naumburg, inspired by psychoanalysis and her background in education, developed dynamically oriented art therapy, which focuses on the spontaneous creation of images as a way to connect to the unconscious mind.
As our understanding of how the mind operates has evolved over the past century, evidence supporting art therapy’s roots in trauma treatment, and in expressing content that can be difficult to share verbally, has been developed across a variety of methods of research. We now understand that part of how PTSD develops is an alteration in how memories are encoded in the brain during and after a traumatic event. These memories can be fragmented, non-linear, and can be more somatic in nature, leading to the phenomenon of re-experiencing traumatic experiences as if you were in that moment again.
Art therapy for trauma focuses on processing the aspects of a trauma that are difficult to put into words using visual representations as an alternative to traditional talk therapy. What was once carried internally by the client can be externalized by creating a physical image or form of their experience, emotion, or thought, offering clients the distance they may need to begin exploring their experiences.
Within the practice of using art in therapy, there are two approaches to treatment. “Art as therapy” uses the physical act of making the artwork as its own therapeutic tool. The movement involved in making art can serve as a grounding tool for clients, helping them stay present and embodied to safely explore their experiences. It can also assist clients in exploring the connection between emotions and physical sensations, as they use a range of physical acts, from pounding clay to delicately brushing on paint, to express themselves.
“Art therapy” takes on a more directive approach, where clinicians guide clients through specific projects designed to practice skills or explore themes. Examples of directives include works employing bilateral drawing, where both hands are used simultaneously to create a scribble drawing. These can be used as a tool for practicing grounding while encouraging trans-hemispheric stimulation. That initial scribble can then be interpreted into a representational image, helping clients practice cognitive flexibility while also engaging in mindful or relaxing coloring to complete their piece. Clients explore themes in treatment tied to physical sensations, use metaphors to represent their experiences, and can move toward creating their own cohesive narrative of events through art as part of the process of healing.
Specific protocols, like the trauma-focused art therapy methodology, have been developed in recent years to guide clinicians and clients through stage-based, time-limited treatments. However, exploring art in therapy is not “owned” exclusively by art therapists, and its application in therapy can be as creative and broad in range as the artwork itself. The use of art as a tool in counseling can be integrated into a wide variety of approaches as a supplement to traditional therapy, and as a methodology in its own right.
In sessions, I employ art therapy as a tool that clients of all ages can use to practice grounding and mindfulness, connect with their bodies, and take a creative approach to expressing themselves. Art therapy projects can range from simple scribbles or coloring pages, to using a sketchbook as a form of journaling, to long-form projects that are revisited and adapted across sessions to reflect changes clients experience each week. Artistic “skill” isn’t necessary to benefit from or engage in art therapy, and clients can use a broad range of materials to explore their emotions, memories, and experiences with this expressive approach to therapy.