There is a reason for the saying: “A picture paints a thousand words.” Especially with trauma and loss, words often fall short. Images are the language of our body, spirit, and emotions. In our development as a species and as infants to adults, we have communicated in images before language. Images and sensory experiences come to us before we form words for experiences, only most of us aren’t aware of these and look to words to make sense of things. Art therapy is the practice of using image making to access, express, and transform one’s experience on a deeper level. It isn’t about being an “artist”, but rather, learning to use image-making and other creative, symbolic expressions for inner-exploration, understanding, and guidance. Once images are accessed, reflection, sharing, and words help integrate and apply the new knowledge.
The use of Art Therapy with families provides a vehicle to activate and shift family dynamics by using art experiences that metaphorically facilitate new perspectives and change. In groups, Art Therapy can encourage both individual expression and a connection among members. When complex emotions are safely felt and expressed, the congruence between thoughts and feelings increases. The incongruence between these is often the culprit of stress. Medical Art Therapy helps patients with pain management, stress, understanding what is happening in their body, and the expression of emotional and spiritual issues that arise from illness or disability.
The American Art Therapy Association’s definition of Art Therapy is as follows: “Art therapy is a mental health profession that uses the creative process of art making to improve and enhance physical, mental and emotional well-being. The creative process involved in artistic self- expression helps people resolve conflicts and problems, develop interpersonal skills, reduce stress, and increase self-esteem and self-awareness. Art therapists are master’s-level professionals who hold degrees in art therapy and/or a related field. The educational requirements art therapists must fulfill include coursework in theories of art therapy, counseling, and psychotherapy; individual, group, and family therapy; human and creative development; assessment and evaluation; multicultural issues; research methods; ethics and standards of practice; and practicum experience in clinical and community settings. Art therapists are also trained in applying a variety of art modalities as part of assessment and treatment, including drawing, painting, sculpture, and other visual media.”
You don’t have to have any art experience for Art Therapy to be effective for you. Nor do you have to be a kid (though it is a natural fit for kids). Using art in a healing way calls upon an innate capacity we all have. It is especially helpful for people who get frustrated trying to “figure” their way through feelings, and who feel like they just aren’t getting anywhere with talking about problems. Art-making puts one in their body—it is a sensory experience, accessing the right hemisphere of the brain. After creating an image or sculpture, an Art Therapist facilitates reflection on the work, which helps integrate new understanding into the left hemisphere of the brain. Although there is an aspect of Art Therapy that is assessment, most often it is used in a way that supports the client’s discovery of their own internal symbolic language. Often, people worry that their images will expose something they aren’t ready to deal with. Although it is true that using art tends to bypass the usual verbal defenses we are accustomed to, a trained Art Therapist supports your process of understanding the image at your pace.
From the American Art Therapy Association: “Art therapists who meet rigorous education and experience requirements are credentialed by the Art Therapy Credentials Board. The “Art Therapy Registration” credential (ATR) is granted to art therapists who have completed graduate education and post-graduate supervised experience requirements and the “Board Certification” credential (ATR-BC) is granted to Registered Art Therapists who pass a written examination. Credentialed art therapists are entitled to use the professional designation of ATR or ATR-BC after their name. The credentials are recognized by all states and D.C. and are maintained by meeting stringent continuing education requirements.”
Children naturally use play for healing. Through play they express feelings, what is troubling them, and their understanding the world around them. Play also allows them a way to try new solutions. Often children’s play remains in metaphor. Art Therapists understand metaphor and can support the child’s movement toward healthy resolution. Play can be in the sand tray as interactive “sand tray”, using puppets, a doll house, dolls, and therapeutic/board games. Games are used in groups and family therapy as they help facilitate sharing, cooperation, structure, patience, and good sportsmanship.
Sand Tray Therapy is an expressive therapy similar to Art Therapy in that it is non-verbal and uses the imagination, subconscious, and metaphor and can be useful to children, teens, adults, families, couples, and groups. Sand Tray Therapy allows a client to create a reflection of their inner and outer worlds by arranging miniature figures in the sand tray. The “world” created can illuminate new understanding and provide opportunities to resolve conflicts, remove blocks, and explore new scenarios in a way that is unthreatening. This form of Sand Tray Therapy is called “World Technique.” Often, especially with children, the sand tray an ongoing inter active story and can involve the therapist role-playing figures as directed by the child’s “story.” This form of sand tray is similar to Play Therapy.
Children who have experienced trauma often aren’t able to talk about their emotional states. Not only are sand, art, and play natural arenas for kids to feel secure and comfortable, they are metaphoric and natural languages for children. The therapist follows the child’s lead in sand and play, interacting upon request. This allows the therapist to normalize and psycho-educate about emotional reactions to trauma. Independent play or interactive play allow the child to express feelings and their understanding of what happened, while also empowering them with a sense of control and movement toward healing resolutions.
EMDR International Association defines EMDR as: “. . . an evidence-based psychotherapy for Posttraumatic Stress Disorder (PTSD). In addition, successful outcomes are well-documented in the literature for EMDR treatment of other psychiatric disorders, mental health problems, and somatic symptoms. The model on which EMDR is based, Adaptive Information Processing (AIP), posits that much of psychopathology is due to the maladaptive encoding of and/or incomplete processing of traumatic or disturbing adverse life experiences. This impairs the client’s ability to integrate these experiences in an adaptive manner. The eight-phase, three-pronged process of EMDR facilitates the resumption of normal information processing and integration. This treatment approach, which targets past experience, current triggers, and future potential challenges, results in the alleviation of presenting symptoms, a decrease or elimination of distress from the disturbing memory, improved view of the self, relief from bodily disturbance, and resolution of present and future anticipated triggers.” (for more information please visit EMDRIA http://www.emdria.org/)
EMDR uses bilateral stimulation (BLS) to stimulate right and left brain hemispheres to integrate memory and internal resources. This can be done by the therapist or client tapping on right/left shoulders or knees in a steady rhythm, the therapist moving her fingers back and forth while the client tracks with eye movement in a right/left rhythm, using a device that has a light for the client to track with the same right/left rhythm, or using a device that has headphones that deliver a tone alternating in the right and left ears, while simultaneously holding small vibrating paddles that are synchronized with the tones. This is done with particular pacing to the client’s internal experience of a memory or emotionally charged situation. Prior to BLS, the client has identified the specific trigger and the negative assumption that often goes with it. EMDR uses “sensing into the body” similar to focusing, as part of its protocol.
The term, Focusing, was originated by Eugene Gendlin, Ph.D in the 60s. The concept is based on bodily knowing; meaning that your body picks up and holds more about situations and feelings than you consciously are aware of. Learning how to sense into your body and hold open attention there, to allow what arises to inform you toward resolution is the practice of focusing. EMDR uses a similar sensing into the body as part its protocol. (For more about focusing visit: http://www.focusing.org)
In my private psychotherapy practice and in my workshops, I integrate focusing with art therapy, as the body’s felt sense often carries an image or metaphor. Drawing from the felt sense and then dialoging with the image or an element of it, usually brings forth surprising results. Both the body and the creative process elicit implicit knowing via felt sense and imagery. This knowing is a deeper wisdom than our conscious mind’s best efforts to figure things out. I refer to this practice as Somatic Art Therapy.
Ideally the whole family comes to an initial session which is often 75 minutes vs. 50 minutes. Depending on the age of the children and the issues the family is struggling with—art experiences, board games, sand tray, and/or communication exercises are chosen by the therapist initially for assessment and then for shifting relationship dynamics toward healthier patterns and restoring balance and connection.
Through the course of treatment, different constellations of the family may attend sessions according to what best serves the health of the whole family. When working with children younger than 11, I meet with the parents periodically or communicate via text or email to support the child’s progress at home. When seeing children over 11, I ask them permission to speak to their parents if doing do would be helpful to their therapy progress. At times, families are best helped by the parents attending therapy for support as parents and as a couple, with the children coming in occasionally as an opportunity to practice new skills with coaching and feedback available to them.