Expressive Arts Therapy and Windows of Tolerance

Expressive arts provide a safe distance for self-expression and reparation.

Posted Feb 29, 2016

© 2014 "Sensory integration" from journal of C. Malchiodi, PhD
Source: © 2014 "Sensory integration" from journal of C. Malchiodi, PhD

Lamott (1995) in her novel Bird by Bird: Some Instructions on Writing and Life, provides a story that I often share with older children, teenagers and adults in expressive art therapy. She tells the story of her brother who at the age of ten years had a report on birds to write and due on the next day. Although he had three months to write it, he left the project until the last minute and understandably became overwhelmed by the magnitude of the report. Lamott’s father put his arm around his son’s shoulder and simply said, “Bird by bird, buddy. Just take it bird by bird” (p. 18-19). This short story explains how overwhelming any large task can be and how we have to take it on “bird by bird.” Similarly, individuals in the process of recovery from any challenge must be carefully guided into taking small steps that can be safely tolerated rather than stretching one’s limits only to feel worse as a result.

In any application of expressive arts therapy, sensitivity to the “window of tolerance” (Siegel, 2010), the area of arousal within which a person can comfortably participate, is key. This window is bounded by two common responses: hyperarousal (overactivation) and hypoarousal (withdrawal or dissociation). When individuals respond in either way, they are experiencing something intolerable and likely something that is sensed as unsafe. While many individuals have the ability to return themselves to their tolerance zone, those who have a limited window may not have the same capacity. In these cases, it is important to understand not only what can be tolerated in terms of creative intervention, but also how to appropriately pace expressive arts in a way that maintains that individual’s zone of comfort to support a sense of safety.

For many people, the expressive arts can be forms of communication that naturally bypass the discomfort of direct disclosure, thus alleviating some of the stress of verbalization. Because individuals can "tell without actually talking" through expressive arts, it can be an effective means of self-expression when words are not possible for reasons of emotional or even physical safety in the case of survivors of interpersonal violence. If necessary, the expressive arts and imaginative play also support opportunities to shift perspectives as needed. Refraction, a form of parallel communication, is one way to encourage a shift without direct confrontation. In play therapy, for example, it is essentially the process of the therapist using a prop or puppet to indirectly communicate a story; similarly, in drama therapy, stories and enactment are strategically introduced to convey parallel experiences. In brief, refraction allows the individual to maintain enough distance to feel safe and infer meaning when ready.

In art therapy, projection, a shift in perspective from a first-person narrative to a third-person one, is another way to support adaptive coping. This form of projection is not the same as the historical definition of the term that defines it as a form of defensive behavior in response to threat. Projection is a human response that allows a child or adult to communicate uncomfortable memories or feelings in a safe manner through either an expressive art form itself or through telling about the art form through a “third person” narrative. For example, if I ask a child to show me a “worry” through a drawing, clay sculpture, or puppet play I then ask them if that worry could talk, what would that worry say?” In this way, I am not specifically requesting a first-person disclosure, but allowing the child to establish a safe distance from the experience being conveyed. Similarly, I may ask an adult to write down five words that come to mind after completing a drawing or a movement experience; the five words can be used to create a story or poem to verbalize an experience or perception from a third person stance. The goal is to provide possibilities for individuals not only to establish a distance between themselves and distressing reactions, but also to authentically express uncomfortable feelings, perceptions and thoughts.

Windows of tolerance are also evident when there is direct disclosure of trauma memories and experiences that activate an alarm response in some individuals and increase arousal to the point of distress or dissociation. This is often labeled as “resistance,” but from a trauma-informed or humanistic perspective it is a natural response indicating a need for distance from distress. As Crenshaw (2008) summarizes, “Any child, any adult for that matter, would prefer to avoid the ‘hard stuff’” (p. 22). While expressive arts and play-based approaches can buffer the “hard stuff” and support a sense of safety, it is also essential that therapists build in expectations that resolving distress is the ultimate goal and thereby expand the window of tolerance.

This is an excerpt from the forthcoming Trauma-Informed Expressive Arts Therapy (Guilford Publications, 2016).

Be well,

Cathy Malchiodi, PhD

©2016 Cathy Malchiodi, PhD

www.cathymalchiodi.com

References

Crenshaw, D. (2008). Therapeutic engagement with children and adolescents. New York: Jason Aronson.

Lamott, A. (1995). Bird by bird: Some instructions on writing and life. New York: Anchor Books.

Siegel, D. (2010). Mindsight: The new science of personal transformation. New York: Bantam.

Visit the Trauma-Informed Practices and Expressive Arts Therapy Institute for more information about expressive arts therapy with children, adults and families and educational offerings on trauma-informed expressive arts therapy for mental health professionals and students around the world.

For more information on expressive arts and traumatized children, see Creative Interventions with Traumatized Children, forward by Bruce Perry, MD, PhD (2015, Guilford Publications) and Creative Arts and Play Therapy with Attachment Problems (2014, Guilford Publications).

For professional applications of art therapy, see Handbook of Art Therapy (2nd edition, Guilford Publications.