It's well known that traumatic events have profound effects on cognitive, emotional, and physical functioning in children. Fortunately, many children recover from traumatic events in a matter of weeks, but others have serious reactions that may last months or years. For those children who do not bounce back, there is hope through structured intervention and one simple activity: drawing.
For almost twenty years, the National Institute for Trauma and Loss In Children [see earlier post, Resilience Matters in Traumatized Children's Lives] has been "ground zero" for the study and promotion of sensory-based interventions [art, play, and somatic therapies] in children's recovery from trauma. Dr. William Steele, founder of the Institute, has been a passionate, dedicated advocate and visionary for development and research on methods to support this approach. I first met Bill in 1994 after a decade of working as an art therapist and a mental health counselor with children exposed to violence, abuse, and neglect. I immediately knew that I had encountered a kindred spirit who understood how trauma is experienced by children -- that it is primarily an implicit experience that involves sensory memories involving sight, sound, touch, smell, and taste.
The idea that trauma is encoded in a sensory fashion by mind and body is now widely accepted by professionals who work with individuals with stress reactions, including posttraumatic stress disorder in children and adults. Well-known traumatologist Bessel van der Kolk observes that when terrifying events such as trauma are experienced, but do not fit into a contextual memory, new memories or dissociations inevitably are established. In other words, when a traumatic memory cannot be articulated with words, it remains at a symbolic level. So to retrieve it, it must be externalized in symbolic forms such as images. This iconic symbolization gives experiences a visual identity because the images created contain all the elements of that experience-in other words, what happened, our emotional reactions to what happened, and the horror and terror of the actual event.
What Bill Steele and I concluded more than a decade ago is that one of the best ways to begin to address the needs of children in trauma is to begin with drawing as a form of intervention. What we began to slowly find out over the next ten years was exactly why having children engage in drawing and similar creative activities made a difference. Here's a brief summary:
1) Drawing taps implicit memory. Trauma and drawing are largely sensory experiences; drawing pictures about aspects of "what happened" prompts sensory memories of traumatic events.
2) Drawing actively engages children in the process of repair and recovery. It provides the possibility to move from a passive to an active role in the treatment process.
3) Drawing provides a symbolic representation of the trauma experience in a concrete, external format.
4) Drawing makes us a witness to children's trauma experiences.
5) Drawing increases children's verbal reports about emotionally laden events. Research supports that drawing encourages children to provide more details and to organize their narratives in a more manageable way than children who are asked only to talk about traumatic experiences.
6) Drawing assists in reduction of reactivity (anxiety) to trauma memories through repeated visual re-exposure in a medium that is perceived and felt by the client to be safe.
This list is a very simplistic overview of why drawing helps children in trauma. Fortunately, we now have a growing body of research to support the reduction of posttraumatic stress in children and adolescents who participate in structured intervention using drawing as a core activity. As a researcher and helping professional, I continue to be intrigued by just how drawing "helps" bring about recovery, whether through decrease of worry or fear or reduction of more complex acute trauma and posttraumatic stress reactions. But of equal importance, giving traumatized children the opportunity to express through images what is often impossible to say with words underscores my responsibility to bear witness to their very human suffering, honoring those voices that might otherwise have remained silenced.
© 2009 Cathy Malchiodi
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.