What is trauma?
As simply put by Dr Daniel Siegel, trauma refers to an experience that overwhelms one’s ability to cope. Complex trauma refers to multiple exposures to traumatic events.
Developmental trauma occurs when a person undergoes multiple exposures to early relational traumatic events that interrupt the development of healthy attachment patterns such as emotional regulation, cognition and behavioural control. Examples of such events include separation from parents, loss of a parent, sexual, physical and/or emotional abuse.
Developmental trauma affects an individual’s developmental brain and behaviour, resulting in long-term impact, till adulthood. One such key impact is their struggle to form or maintain relationships, both with others and themselves.
Some examples of trauma include:
- Experiencing the loss of a loved one or pet
- Bullying at work or in school
- Toxic family dynamics, relationships or friendships
- Loss of job
- Constant exposure to high-stress environments
- Serious accident or sustaining injuries
- Academic pressures
- Physical, emotional, mental or sexual abuse
- Major illness and surgeries
- Witnessing violence
- Discrimination (gender, race, religion, health, etc)
Trauma and its impacts
The fight or flight system helps us react in times of danger and works towards bringing us back to a stable state whenever it encounters danger. This system is altered in a person who has experienced complex trauma. Such a person will constantly by on a hypervigilant mode, where the slightest stressor can trigger their fight or flight system. In addition, such a person can also ‘freeze’, where they dissociate themselves from things going on around them as a form of protection. Simply put, they may not be able to self-regulate in stressful situations.
Prolonged experience of being in a hypervigilant or dissociative mode can result in one developing mental health conditions such as Post-Traumatic Stress Disorder, substance abuse, and depression. These can be life-long problems when the past traumatic experiences are not addressed.
A person with complex trauma can experience long-term physiological health problems. Such a person is more easily reactive to stressors. As such, even when there are no stressors, their body may continue to release the stress hormones. Persistently high-stress hormones put a person at risk of health conditions such as heart diseases, sleep disruptions, weight gain, diabetes.
Long term trauma and lack of internal resources to cope can result in one seeking negative external coping methods, such as substance abuse, smoking and over-eating, to numb their emotional and physical pain. This then contributes to greater negative impacts on mental and physiological health.
Where is trauma stored?
Trauma leaves an imprint in the mind and the body, mostly in the body. While a person with complex trauma may not be actively thinking about the traumatic event, their body continues to feel like that event is happening right now. This causes both their mind and body to be constantly in a hypervigilant state, leading to disproportionate reactions that do not ‘match’ a situation. This happens because their perceptual system in the brain has been re-wired, due to the traumatic experience, to protect themself. They can also get ‘stuck’ at the time of the trauma and consequently, have a hard time accepting and integrating new experiences.
Traumatic memories are stored in our right brain, which is also the part of the brain that is non-rational and reactive. As a protective mechanism to allow a person to function normally, the right brain tends to ‘block-off’ the traumatic experiences that it stores. This, in turn, impacts a person’s ability to recollect and speak about their traumatic experiences. If and when they are able to recollect, their frontal lobe and speech centre can go ‘offline’, causing them to be struck with speechless terror.
Benefits of art-making on the mind and body
A study in 2014 showed that engaging in self-expressive art-making has both mental and physiological benefits. It facilitates increased brain connectivity, greater introspection, self-awareness and better memory.
Engaging in art-making activates our brain’s reward system and that increases the levels of serotonin (i.e. the ‘feel-good’ hormone). An increase in serotonin levels can positively change a person’s outlook on life, reducing the risk of depression and anxiety. The activation of the brain’s reward system is similar to what occurs when a person engages in addictive behaviours. However, unlike addictive behaviours, art-making is a healthy coping method that has positive impacts in the long-run.
Further, studies have shown that 45 minutes of art-making results in the reduction of cortisol, a stress hormone, and significantly lowers blood pressure. There was no significant difference in the reduction of cortisol between a trained artist and a non-trained artist. Hence a person does not need to be skilled in art-making to reap its benefits.
How does art therapy heal trauma?
Art therapy is a combination of art-making and reflective processes. It aims to increase self-awareness and self-expression through the process of art-making to support a client’s personal and relational goals. Art therapy consists of three components forming a triangular relationship that sets the safe space for clients: the client, the artwork and the therapist.
In art therapy, clients use art materials to express their challenging experiences that they may not be able to put in words. Art making and creativity engage the right brain, which is also part of the brain that stores traumatic memories. Hence, art-making has the potential to access traumatic memories, which might otherwise be suppressed, in a non-intrusive manner. When the challenges or traumatic experiences surface in a client’s artwork, they can process them in a safe distance (between self and artwork), with support from a trauma-informed art therapist.
Processing trauma at a safe distance through art therapy
Art therapy is an optimal platform for people who have experienced trauma to process their challenges in a safe and calming manner. Further, art therapy engages the mind when we are creating, viewing and reflecting on the artwork and it engages the body as we experience bodily movements and sensorial experiences in the art-making. This concurrent engagement allows the healing process to take place in both mind and body and increases the connectivity between these two, allowing clients to feel whole again.
Getting people to reconnect with their traumatic experiences repeatedly and invasively can result in desensitization or re-traumatization. The mind and body must feel safe and calm when a person relieves their trauma. Hence, when working with a person who has experienced trauma, it is important to first focus on bodily regulation, building a safe space and a trusted therapeutic relationship.
When they feel calm and safe, they can then feel in control while processing their challenges. This empowers them to know that they can make changes and are in control of their own bodily reactions.
While building a safe space and a trusted therapeutic relationship will take time, it is integral to achieving the best possible outcome for clients. At the end of the day, art therapy helps the body to learn that the danger has passed and the individual can live and flourish in the reality of the present.
Elbrecht, C., & Antcliff, L. R. (2014). Being touched through touch. Trauma treatment through haptic perception at the clay Field: A sensorimotor art therapy. International Journal of Art Therapy, 19(1), 19-30. https://doi.org/10.1080/17454832.2014.880932
Kaimal, G., Ayaz, H., Herres, J., Dieterich-Hartwell, R., Makwana, B., Kaiser, D. H., & Nasser, J. A. (2017). Functional near-infrared spectroscopy assessment of reward perception based on visual self-expression: Coloring, doodling, and free drawing. The Arts in Psychotherapy, 55, 85-92
Van der Kolk, B. (2014). The body keeps the score: Mind, brain and body in the transformation of trauma. Penguin UK.