The capacity to bounce back - more commonly known as
resilience - enhances
trauma recovery in children. But what about children who do not have the innate capacity to bounce back? Or those whose lives have been compromised by abuse, neglect, fetal alcohol syndrome, or exposure to multiple traumas? There's good news--sensory activities, along with positive relationships and a positive environment, can make all the difference.
I am writing today from the 2009 National Institute for Trauma and Loss Annual Symposium, a gathering of trauma specialists from around the US who share an interest in sensory and somatic interventions for traumatized children and their families. According to John Micsak, symposium keynote and director of a resiliency outreach program for youth, addressing three regions of the brain can help. These regions are defined as 1) the thinking brain [cortex] responsible for abstract reasoning; 2) the emotional brain [limbic] responsible for affect regulation, empathy, affiliation, and tolerance; and 3) the survival brain [brain stem or reptilian] responsible for fight or flight, heartbeat, and other body regulation functions.
From an expressive therapies perspective, it's promising that mental health is beginning to realize that the arts, play, and imagination address the whole brain and support what Bruce Perry calls "neurosequential therapeutics"--a method of working with severely traumatized children using body reactions [survival brain] as a starting place and eventually addressing other brain functions through progressive interventions that focus on refining neural pathways in other regions. The NT process essentially tries to match specific interventions to the developmental stage and specific parts of the brain that mediate presenting neuropsychiatric problems. Application of sensory interventions are key to helping meet the needs of the child and to the development of resilience.
In brief, using this approach distills down to addressing the traumatized brain from an arts therapies perspective as follows:
1) The survival brain needs modulation through rhythmic and patterned sensory input, such as activities like drumming, singing and music at the resting rate of the human heartbeat, basic movement and rocking, breathing techniques, and massage;
2) The emotional brain needs the self-soothing reinforcement through tactile experiences o
f art making and play as well as the relational aspects of mutual engagement between adult and child using creative arts, imagination, and play as means to establish and reinforce positive
attachment;
3)
The thinking brain needs the opportunity to engage in storytelling through all the creative arts, relating not only the trauma story, but also as a means to express the self and practice cognitive-behavioral skills used in long-term
self-regulation.
As I listen to other professionals share their experiences today, I also quickly realize that the challenges of encouraging resilience in severely traumatized children still seem to be impossible to overcome. After all, the problems most therapists confront in children who have been maltreated, abused, or neglected have had years to take hold. For many children, the intervention needed to redirect behavior may involve a decade of sustained effort; in addition to intervention, the presence of a positive environment and social support are also key. But compared to a few years ago, I can now celebrate that our collective thinking is moving from a traditional medical model to a neurodevelopmental approach that embraces the senses and "how the body remembers" trauma as privotal to reparation and recovery. It is exciting to think about how the simplicity of art, play, and imagination can assist the formation of new neural pathways and re-regulate the survival, emotional, and thinking regions of the brain over time. And most of all, how our growing understanding of sensory interventions is changing young lives.
© 2009 Cathy Malchiodi
www.cathymalchiodi.com
Visit the growing community of art therapists from around the world at the International Art Therapy Organization [IATO], www.internationalarttherapy.org. One world, many visions...working together to create an inclusive and sustainable future for art therapy.
