by Jayne Holtman, MA, ATR-BC
American Day Treatment Center

Trauma has become very much a part of our current shared cultural experience.  For many, our general awareness now includes a heightened sense of potential threat as a result of both recent natural disasters as well as those that are human-made. 

The trauma spectrum includes both acute trauma and chronic trauma.  Type I Acute Trauma is short and severe, an isolated event in one's otherwise "normal" life.  This could include natural disasters such as hurricanes, floods, fires, tsunamis and earthquakes.  This also includes medical trauma such as motor vehicle accidents, physical assaults, falls, burns and hospitalization.

Type II Chronic Trauma refers to repeated, anticipated trauma with persistent exposure such as repeated physical and sexual abuse, on going neglect, combat, and repeated exposure to violence (both as witness and/or victim).

Chronic trauma is much more likely to generate symptoms of PTSD (Post Traumatic Stress Disorder) than acute trauma.  However, there can be some variation between individual responses, which are influenced by the context/consequences of the disaster as well as a person's prior trauma history. 

Chronic trauma can also occur vicariously for first responders and therapists.  It can also occur developmentally, with poor attachment resulting from neglect or multiple foster-care placements early in life.  PTSD symptoms can interfere with one's ability to grieve, and therefore to heal from loss or death.

The human organism has a natural process of accommodation to manage stress in order to ensure survival. The body reacts to extreme stress by increasing the heart rate, which makes blood flow to the muscles to prepare them for the "flight or fight" response.  Adrenalin and pain levels are elevated (that's how people can "lift cars" to rescue someone).  During this time, parts of the brain that are not required for survival are inhibited.  Memory association circuits are altered making recall unclear.  There is an inability to transfer memory and the trauma experience can become trapped, making it physically impossible to fully access the memory using verbal means.  For example, "I was speechless with terror".

There is much research related to the way our brains handle and heal from trauma.  This research shows that conventional methods may not be the best.  One popular method, desensitization, which encourages the individual to explain their trauma experience repeatedly so as to "desensitize" them, can often increase arousal without resolution.  This may actually be detrimental to the healing process.  

Current studies demonstrate that forms of therapy that access the sensory parts of the brain in non-verbal ways are very useful.  These therapies support the natural progression of the trauma memory that is "stuck".  The expressive therapies,  most notably Art Therapy, are being utilized increasingly to help people heal from traumatic experiences.   EMDR (Eye Movement Desensitization Reprocessing) is another modality currently being used with success. (For more information on EMDR read the book EMDR Basic Principals and Procedures by Francis Shapiro.)

Art therapy assists individuals by connecting the non-verbal to the verbal, which allows for the cognitive therapy process.  Art therapy is essential in allowing the trauma experience to be expressed through non-verbal means. The tactile experience involved in making art activates the brain's sensory areas.  Art Therapy techniques are engaged, connecting the activated abstract (non-verbal) and concrete sensory memories with the organizing areas of the brain, thereby moving the experience into the brain's cognitive structures for resolution of symptoms.

An important component in these expressive therapeutic modalities is the reintroduction of a visceral sense of safety into the individual's perception of the trauma experience.  A mindful awareness and acceptance may be cultivated to assist the individual in present-orientation and help them develop coping skills.  In addition, techniques are engaged which give the individual greater control of their own emotional and physical response.  As well, the act of making art endows the individual with control of both materials and image formation, supporting an intra-psychic sense of regained power.

In summary, art therapy can be an essential way to help individuals heal from trauma experiences. The creation of a non-verbal, pictorial recovery of the traumatic experiences is translated to a coherent verbal narrative.  Through this process cognitive as well as emotional resolution is made possible.

This article draws on information from the following highly informative seminars:

• "The Traumatized Child:  A Neuro-developmental Approach to Treating Acute Trauma in Children and Adolescents"  by Linda Chapman MA, ATR-BC, RPT-S
• "An Unmet Clinical Need:  Effectively Managing Bipolar Depression", by Claudia Bardassona, MD
• "Obsessive Compulsive Disorders:  Challenges and Solutions", by Christian R. Komar, PsyD. CPPA
• "Counseling Victims of Sexual Truma:  The Three Stages of Healing" by Melissa Bradley, MS, NCC, BCETS, FAAETS
• "Breakthroughs in Healing Trauma:  Success Through Guided Imagery and the New Theraies",  by Bellaruth Naperstek, LISW, BCD
• "Mindfulness and Acceptance-Based Approaches to Psychotherapy", Frank L. Gardner

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