ArtTherapy and PTSD: Listen to the Artist

Running head: Art Therapy and PTSD

Art Therapy and PTSD:

Listening to the Artist

Tom Hoeg

Excelsior College

Abstract

When a person has survived tremendous trauma is there a

vehicle that would provide some relief while waiting for

help? How can a person learn to control the symptoms of

PTSD and share their feelings and emotions? There are times

in the life of every person where they reach out and utilize

a talent to express their feelings. The very word “talent”

has a reinforcing property of positive energy. The symptoms

of PTSD, the physiological and neurological impact, and

interventions are gaining momentum in research and based on

many traumatic experiences. Those that have chosen to help,

are in a professional capacity to do so, and are “all ears”

should take advantage of art therapy.

Art Therapy and PTSD: Listening to the Artist

Art Therapy is a hybrid discipline based primarily on the fields of art

and psychology, drawing characteristics from each parent to evolve a

unique new entity. But the interweaving of the arts and healing is

hardly a new phenomenon. It seems that this pairing is as old as

human society itself, having occurred repeatedly throughout our

history across place and time. (Malchiodi, 1998)

Diverse populations of people are being diagnosed with

PTSD and the symptoms have been an ongoing issue through

history. Children and adults that are physically and

sexually abused, soldiers that return from combat, and those

that have suffered extreme illness and survived natural

disasters, are some examples of populations that continue to

manifest similar and plaguing symptoms. The Diagnostic and

Statistical Manual of Mental Disorders IV (DSM-IV) lists the

following as symptoms associated with PTSD:

A. RECURRING INTRUSIVE RECOLLECTIONS OF THE TRAUMA:

Intrusive thoughts, dreams, flashbacks, 'dissociative‘events, intense

emotional and physiological distress when re-exposed to trauma

associated stimuli

B. AVOIDANCE OF TRAUMA -ASSOCIATED STIMULI OR 'NUMBING':

Sense of detachment, restricted range of affect, dysphoria, and loss of

recently acquired developmental skill, sense of a foreshortened future

C. PERSISTENT PHYSIOLOGICAL HYPERAROUSAL:

Sleep difficulties, hyervigilance, difficulty concentrating, increased startle

response, Emotional lability, behavioral impulsivity, irritability, profound

anger, increased physiological reactivity (“Posttraumatic stress disorder”, 1994)

The commonalities of symptoms exhibited by those

experiencing natural disaster, physically or sexually abused

children and adults, combat veterans, and those that suffer

illnesses are stunning as is the horrendous exposure to

trauma. The incidents that culminated in PTSD may vary

greatly as are the specifics of the symptoms but there is

emotional duplicity. Research has broadened the

understanding of how the brain, human physiology, and

emotions are intricately intertwined, the importance of early

attachment in neurological functions and the impact of trauma

on memory. These findings are far reaching and affecting how

psychotherapy is being designed and delivered. (Siegel, 1999)

Art therapy should be considered as an intervention, is less

of a stressor in discussing and processing the catastrophic

chain of events, and alleviates some of the symptoms of PTSD.

In the age of Health Care reform, which may result in

increased reporting of PTSD as a result of abuse, traumatized

state side combat veterans of any war, and the numbers of

people diagnosed with extreme medical problems, there needs

to be consideration given to a tool that appears to be

powerful, effective in treatment and cost, and provides an

avenue of expression for those burdening PTSD. The artists

within the PTSD population need to be heard.

Childhood PTSD

In my work with young people that have experienced

traumatic violence and have been diagnosed with PTSD, I have

had countless experiences where youth have demonstrated an

amazing talent in an art form. The rewards of

acknowledgement of any talent, and particularly art, are

manifold. The boosting of self esteem, the ability to

converse about any subject, and appreciating growth are the

foundational benefits to further treatment. I have had

astounding drawers, rappers, poets, singers and songwriters

in my presence that in their chosen talent allowed them the

space and time to “tell it like it is”. Listening is

critical as is demonstrated by the need for feedback at the

end of a “performance” or completion of an artwork both for

recognition and reaction to content. What discussions could

you have with these young artists?

(Deaver, 2009)

Art therapists call upon their knowledge of human

psychological development, psychopathology, and children’s

drawing development; their own in-depth art making

experience; and knowledge of art-based projective assessment

techniques to arrive at an understanding of a child based not

only on the child’s artwork but also upon the therapists’

clinical “sense” of the child. (Deaver, 2009 p. 4)

Encouraging children to utilize art is a non-invasive request

in the right setting and enhances dialogue, sharing, and

accepting praise. In children that have been victimized the

introduction of art followed by therapy delivered by a

professional proves to be a valuable tool and opportunity to

assist in sorting through difficult memories.

Combat Veterans and PTSD

Having a father that had many of the symptoms of PTSD, I

watched a man that was able to do his own art therapy. He

was an avid lover of the arts that would shed tears at

movies, song lyrics, or museums. He was able to restore his

faith in what was beautiful by his love of culture, people,

and enjoying every moment of his life. He was never freed

of his physical and emotional scarring from the Korean War

with episodic displays of the symptoms of PTSD. He was free,

however, when he was singing, whistling, or taking in an

exhibition or a movie. If he were able to share this with

other vets, I can only imagine the recognizable strengths he

had that would be reinforced and how he could appreciate

others in the same situation.

According to Collie, Backos, Malchiodi, and Spiegel

(2006) approximately 30% of people who have been in war zones

develop PTSD. The rates of PTSD for veterans of the wars in

Afghanistan and Iraq are conservatively estimated to be 11%

and 18% respectively, with a higher rate for veterans of the

war in Iraq because of greater combat exposure.

The article further discusses seven primary therapeutic

mechanisms provided by art therapy that respond the DSM-IV

symptoms of PTSD expressed prior:

reconsolidation of memories,

externalization,

progressive exposure,

reduction of arousal,

reactivation of positive emotion,

enhancement of emotional

self-efficacy, and

improved self-esteem.

Military personnel do well with a semi-structured

therapeutic activity which provides enough guidance to

complete an assignment but is not so rigid as to inhibit

creativity. This approach lessens anxiety that often

accompanies uncertain directions, which, of course, tends to

aggravate PTSD and minimize group participation. (Lande,

Tarpley, Francis, Boucher 2010 p. 44) What would a therapist

hear from this artist?

(Crist, 2010)

Cancer Patients and PTSD

Having sat in waiting rooms and having had discussions

with people awaiting treatment for cancer one can feel the

angst, dread, and apprehension that people are experiencing.

As I went through my experience I recall people with all

levels of side effects and I wondered what could help. If I

had the opportunity to be creative with the anticipation of

sharing my talents or offered a quiet space to draw, I may

have been able to deal with what was coming later on. As I

came to the end of treatment I drifted into an extreme bout

of anxiety, an incontrollable fear, and the inability to

envision a future. I believe that art therapy would have

given me a safe outlet, a group process, and the opportunity

to share my tattered emotional state.

The fact is, artistic activities—

whether painting, sculpture,

drawing, writing, music or dance—

can benefit patients facing cancer

in countless ways. Creative work

can offer distraction from the side

effects of treatment, soothe

anxiety and create a way to express

feelings that might otherwise seem

too difficult to share. (“Art

Therapy and,” 2010)

There is a growing body of literature demonstrating that

art therapy can be effective in ameliorating symptoms

associated with cancer both in children and adults. Art

that Heals was one of the earliest and most comprehensive

programs that demonstrated how art therapy could be useful in

an oncology setting by helping patients reinforce positive

coping behavior and increasing their self-esteem and their

sense of control. (Nainis, Paice, Ratner, Wirth, & Lai, 2006

p. 162)

Can you hear what these artists, in the midst of treatment,

would be saying?

(Nainis, 2008 p. 118)

One needs only listen to the artist, feel the emotion,

and appreciate the strength of interpretation within a piece

of artwork done by a person with PTSD symptoms. The

rediscovery of oneself, the recognition and organization of

recurrent thoughts, and the ability to emote are all proven

benefits that art therapy provides. Of the described

populations that are impacted by PTSD, of which there are

many more, art therapy is a beautiful way to start a journey

to coping. The quiet bright spaces, the pen, crayon, paper,

clay, chalk, charcoal, are controlled by the person dealing

with PTSD. The pace, the product, the discussion are owned

by the person that feared all ownership was lost. The

patience of the therapist, the recognition of ability and

externalizing a problem are only a few components of this

milieu of therapy and these facets alone are powerful in and

of themselves

How many times must a man look up,

before he sees the sky?

And how many ears must one man have,

before he can hear people cry?”

(Dylan, 1963)

If anyone could capture words swirling in the wind, (the

answer as suggested by Dylan is “Blowin’ in the Wind)” I

would have the faith in survivors; those coping with PTSD,

whose emotions captured in art forms are vibrant.

Listen to the artist!

References

Art therapy and cancer. (2010, March 26). Cancerconsultants,

Collie, K., Backos, A., Malchiodi, C., & Spiegel, D.

(2006). Art therapy for combat related ptsd: recommendations

for research and practice. Journal of the American Art Therapy

Association, 23(4), 157-164.

Crist, B. (2010, January). Drawings of bill crist. Retrieved

from

http://www.nvvam.org/store/bill_crist_original_drawings.php

Deaver, S. P. (2009). A Normative study of children's

drawings: preliminary research findings. Journal of the American Art

Therapy Association, 26(1), 4-11.

Dylan, Bob (1963) “Blowin’ in the wind”. On “The Freewheelin’ Bob Dylan”

(Record) New York: Columbia Records.

Lande, R.G., Tarpley, V., Francis, J.L., & Boucher, R.

(2010). Combat trauma art therapy scale. The Arts in Psychotherapy,

37, 42-45.

Malchioni, C. (Ed.). (1998). The Art therapy sourcebook. New

York: McGraw-Hill-NTC.

Nainis, N. (2008). Approaches to art therapy for cancer

inpatients: research and practice considerations. Journal of the

American Art Therapy Association, 25(3), 115-121.

Nainis, N., Paice, J.A., Ratner, J., Wirth, J.H., & Lai,

J. (2006). Relieving symptoms in cancer: innovative use of

art therapy. Journal of Pain and Symptom Management, 31(2), 162-169.

Posttraumatic stress disorder. (1994). Diagnostic and statistical

manual of mental disorders. Washington D.C.: American Psychiatric

Association.

Siegel, D.J. (1999). The Developing mind: towards a neurobiology of

interpersonal experience. New York: Guilford Press.