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Art Therapy and Fear: Acknowledging the Dread

It’s time to creatively address trepidation.

© 2016 "It's not 9/11, it's 11/9" art journal entry, C. Malchiodi, PhD
Source: © 2016 "It's not 9/11, it's 11/9" art journal entry, C. Malchiodi, PhD

I had the unusual experience of being in Australia during the recent Presidential election, encountering not only the shock of colleagues while in another country, but also watching reactions unfold back in the US via social media and communications from family and friends. When I returned to the US through Los Angeles International Airport, I blurted out to the immigration officer who checked me through, “I feel like I am returning to a different country than the one I left.” He said, “you have,” with a chuckle followed by a grimace. What I realized in that moment of dark humor is that I actually was just a little afraid to be back in a place that now seemed dramatically different.

Since my reentry into the US after this extended time abroad, like many mental health professionals, I have noticed a distinct change in many of the individuals I see in treatment, post November 8th, 2016. Some are cycling through a grieving process, many are simply sad and others describe a feeling of “strangeness” in response to the results of the national election, not quite knowing how to describe their feelings. Now that almost a month has passed since the election, fortunately many of these individuals are gradually becoming less anxious as part of the natural process of adjustment to what was perceived as a traumatic event.

But for others, a decrease in unease is not the case; they continue to experience some degree of the reactions we know to be common in people, post-trauma, including hyperactivation [fight or flight] and hypoactivation [depression or dissociation, aka “freeze”]. In almost all cases, this is a sense of fear that is somewhat difficult to shake for various reasons. For one thing, this current sense of fear is not the same experience for each individual and the degree of fear is variable, based on individual history and in particular, previous trauma. It is obvious that survivors of sexual assault, women who have experienced misogyny, and those who have encountered anti-Semitic, anti-Muslim and anti-LGBT actions, among other discriminatory acts, understandably are having a heightened sense of trepidation. This fear is also unfortunately contagious and is easily passed along to those encountered, including mental health professionals themselves, clouding reason, paralyzing at times, debilitating and casting doubt on the future.

As therapists, we know that these feelings will subside over time, but for many clients, this will not necessarily be the case. Here are a few recommendations and practices [but not an exhaustive list] to address these feelings with the individuals we see in treatment as well as ourselves as helping professionals:

Self-Regulation. Possibly the current “gold standard” within the practice of art therapy, self-regulation is always a good place to start when fear is the dominant sensory narrative. There is some preliminary data that indicate that several forms of art making may be a stress-reducing activity and a simple form of relaxation for many individuals. There are also more specific expressive arts therapies practices to support self-regulation, including positive attunement [enhancing a sense of internal safety]; grounding [slowing down stress responses], anchoring [developing specific sensory cues or even self-created objects] that bring one’s focus into the here-and-now; and entrainment [stabilizing, rhythmic synchronization]. [For the basics of self-regulation and expressive arts, please see this post on the topic for more information about these key practices]. Finally, there is also an inherent sense of mastery found in action-oriented, arts-based experiences that are not only self-regulating, but also tangible moments of personal empowerment that enhance an internal locus of control.

Identify the Felt Sense of Fear. Because I am a trauma-informed, somatically-focused practitioner, at some point in working with individuals the felt sense of what they are experiencing, particularly in their bodies, is important. For some, this can take the form of drawing "what the worry looks like;" for others, it may be key for helping professionals to assist them in using colors, shapes, and/or lines “where the worry is felt in your body” on a simple body outline. Mindfulness practices may also help some observe thoughts or sensations related to distress and subsequently release them over time. The felt sense of fear may also be a background feeling that is always there, manifesting as an uncomfortable experience of unease that detracts from pleasure in life or enjoying relationships and daily activities. The main point here is that what is important to address is the body’s sense of unease (fear) rather than to initially invent stories or achieve insights; it is through the somatic experience that many individuals can begin the process of identifying the source of what is causing the fear and distress.

Take a vacation from media. One thing I learned in working with children and adults after the events on September 11th, 2001, is that exposure to media has a significant impact on how traumatic events are encoded as well as the process of reparation. In brief, televised media can rapidly induce unwanted sensory overload and overstimulate an already over-active nervous system. Repetitive stories about the election and subsequent news coverage in the weeks, post-election, are potential sources of “revisiting the trauma” for many, increasing anxiety in those most susceptible. In contrast to 2001, social media is now much more pervasive and it is tempting to try to find relief through taking on causes, engaging in the numerous wars of words on various blogs, or posting opinions as ways to feel less disempowered. Limiting exposure to these platforms and the sensory overload induced by the endless television political pundits alleviates both mind and body of at least some of what is destabilizing, paralyzing and debilitating; this simple practice opens up the necessary space for “islands of calm” to occur.

Focus on resilience. In working with trauma survivors, at some point a focus on resilience is an essential part of reparation, just as much as self-regulation and the felt sense of what is troubling. It is a way to redirect the experience of surviving to one of thriving; in this current situation, simply bearing witness to the courage of the individual in front of us is a good starting point for rekindling personal strengths. We can also encourage individuals caught up in waves of anxiety and fear to try thinking about people in their lives that have lifted them up in the past in order to begin to redirect them to what is hopeful rather than frightening. With regard to art-based approaches, I have always believed that expressive arts provide us with the chance to re-author the dominant narrative of any challenge and to tell one’s story without parameters, restrictions and judgments. In this sense, art’s purpose in psychotherapy is not merely to exemplify internal conflicts, but actually is to provide a way to continuously reinforce the self-empowering, life-affirming capacity for resilience [see “Art is About Resilience, It Always Was” for a more complete discussion.

In these post-election days, we have an opportunity as helping professionals to not only assist individuals with their fears, but also to provide support to those most affected by what has become a traumatic event for many. On a personal note, I am truly surprised at how silent the US art therapy community has been about the current needs of the individuals we serve, particularly those who are most likely to experience fear and increased anxiety as a result of recent events. With so many self-proclaimed social activists within this profession, the silence from these voices is deafening, noticeable and remarkable. This is also a moment in time when all helping professions must reiterate that we hold anti-discrimination principles with the highest regard, if only to reassure the most vulnerable individuals in our care that we support these values within the context of human service. This is by no means a matter of political stance, who won an election, or what the future holds. It is a matter of how we stand as helping professionals in the here-and-now, how we share and promote best practices with our colleagues, and how our core beliefs in compassion and justice openly manifest to those in greatest need.

Be well,

Cathy Malchiodi, PhD

© 2016 Cathy Malchiodi

For more information on Trauma-Informed Expressive Arts Therapy, please visit this site for resources, including downloadable articles at

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