The Brain-Wise Therapist by C. Malchiodi, © 2013

October is Domestic Violence Awareness Month and National Bullying Awareness Month. Both domestic violence and bullying are defined as a form of violent behavior directed toward others and thus forms of interpersonal violence. Bruce Perry summarizes the complex topic of violence as follows: “Physical violence can be impulsive, reactive or defensive; or it can be predatory, remorseless aggression. Violent behaviors can be related to intoxication from alcohol or psychosis or other neuropsychiatric conditions (e.g., dementia, traumatic head injury). Violent acts may be the result of personal (Oklahoma City bombing) or cultural (political terrorism) belief systems. Violence can be sexualized (rape) or directed at a specific victim (domestic violence) or at a specific group (e.g., African-Americans, homosexuals, Jews).” I would add verbal attacks [as in bullying] to this definition because they are forms of violence that may have a similar impact on victims. Exposure to violence, whether directly experienced in the form of assault, abuse or attack or witnessed, may result in traumatic stress, grief, and loss reactions. In its extreme forms, it can manifest as an internalized sense of terror.

Creative arts therapies [art therapy, music therapy, dance/movement therapy, drama therapy and creative writing/poetry therapy] have emerged in mental health and healthcare as an essential part of the spectrum of interventions that mediate the psychosocial and, in particular, the body’s reactions to violent acts. In the past decade there is emerging evidence, based on greater understanding of the trauma, that creative art therapies successfully address both mind-body reactions in the following brain-wise ways:

1) Self-Regulation. Self-regulation is basically the ability to moderate emotions when under stress; in others words, individuals with good self-regulation skills can calm themselves down when upset and respond to adverse experiences with resilience. Exposure to violence, particularly interpersonal violence, often undermines the ability to self-regulate; in trauma-informed intervention, an initial goal of treatment is to provide survivors with opportunities to practice self-regulation. Evidence-based studies indicate that creative arts therapies are key approaches that provide the necessary sensory experiences to support positive self-regulation, including reduction of stress-related reactions and development of self-soothing behaviors.

2) Right Brain Dominance. When a violent experience traumatizes an individual, there is wide agreement that the left side of brain may temporarily go offline; that is, the left brain’s language center may be affected and logical, linear narratives about the trauma may become unavailable. The right brain stores trauma memories in sensory-based forms—sounds, sights, and other fragments of experiences in non-linear, non-verbal forms. Additionally, neurodevelopment research underscores that early relational trauma [such as abuse or neglect] impacts the right hemisphere and interferes with secure attachment to a caregiver or parent during the first several years of life. While art expression in all its forms is a whole brain activity, it is one that involves right brain dominance because it is an experience largely involving tactile, kinesthetic, auditory, proprioceptive and other senses; in brief, it taps trauma memories on a sensory level rather than a verbal level.

3) Integration. Reparation and recovery from trauma is often referred to as “trauma integration.” In essence, successful integration is a state of being able to talk or think about the trauma experience without reliving it, including psychosocial and somatic reactions to traumatic events. Emerging research on the creative arts therapies with individuals who have experienced interpersonal violence or war underscores that art expression is a way to help reconnect sensory memory [the right brain’s experiential memory of events] with a linear, explicit memory [the left brain’s chronological narrative of events].

4) Meaning-Making. Judith Herman’s seminal treatise on trauma highlights the essential reason that violence must be shared and expressed in order for recovery to manifest. In a brain-wise sense, trauma integration also involves an experience of making sense and meaning of what has happened, no matter how violating or horrific. In Telling Without Talking I wrote, “Art as a healing force does not come easy for those whose lives have been controlled, are accustomed to betrayal and punishment, and have learned self-hatred. But inevitably when it does, creativity and imagination restore a sense of possibility, identity, and reconnection with parts of the self that were silenced in order to survive the violence.” To me, this is a fundamental principle in the neurobiology of art expression. It is why humans paint, sing, dance, and dramatize in the first place; it is the drive to make meaning of events when words are not enough.

While creative arts therapies are not a panacea for violence and those violated, they are proving to be effective approaches to help survivors. In the subsequent posts, I will explain in a more detail how creative arts therapies capitalize on these four areas to support reparation, recovery, and trauma integration in children, adults, families, and communities exposed to violence.

Be well,

Cathy Malchiodi, PhD, LPCC, LPAT, ATR-BC

© 2013 Cathy Malchiodi

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Malchiodi, C. A. (1990, 1997). Breaking the silence: Art therapy with children from violent homes. New York: Routledge [look for the new edition in 2014].

Malchiodi, C. A. (2012). Art therapy and the brain. In C. Malchiodi (Ed.), Handbook of Art Therapy. New York: Guilford Press.

Malchiodi, C. A. (2008). Creative interventions with traumatized children. New York: Guilford Press.

Perry, B. (2013). Aggression and violence: The neurobiology of experience. Retrieved at

Waller, D. (2006). Art therapy for children: How it leads to change.Clinical Child Psychology and Psychiatry, 11, 271-282.

Gilroy, A. (2006). Art therapy, research and evidence-based practice. London: SAGE Publications.

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