Expressive Arts Therapy for Traumatized Children and Adolescents

A Four-Phase Model

Carmen Richardson

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317814931
• Edition: 1
• Topic: Psychologie
• Subtopic: Psychothérapie

Expressive Arts Therapy for Traumatized Children and Adolescents is the book so many expressive arts and trauma therapists have been waiting for. Not only does it lay out an organized, thorough framework for applying varied expressive arts modalities, it provides clear directions for the application of these modalities at different phases of treatment. Both beginning and experienced clinicians and students will appreciate the thoughtful analyses of ways for introducing expressive arts to clients, engaging clients with their art, being present to the art that is created, and working within a particular session structure that guides the treatment process. Readers will also receive more specific learning regarding the process of using body-focused and sensory-based language and skills in the process of trauma treatment over time. They'll pick up more than 60 priceless expressive-arts assessment and treatment interventions that are sure to serve them well for years to come. The appendices features these interventions as photocopiable handouts that will guide the therapist working with youth through each phase of treatment.

Part 1 The Expressive Arts Therapy Way

DOI: 10.4324/9781315817859-1

1 Expressive Arts Therapy

DOI: 10.4324/9781315817859-2

THE EXPRESSIVE ARTS WAY

Expressive arts therapy… is the practice of using imagery, storytelling, dance, music, drama, poetry, movement, horticulture, dreamwork, and visual arts together, in an integrated way, to foster human growth, development, and healing.

Appalachian Expressive Arts Collective (2003, pp. 3–4)

Six-year-old Kali stepped into the room with art boards, paints, drums, and puppets. She looked around attentively and said, “This is a magical place.” Over time, she found her own way with creative expression, following her senses; she found her unique way of demonstrating all that she needed to express. She loved to dance and knew exactly which song she wanted me to play. One day, Kali sat with the bin of puppets and, one by one, she held them and looked them deep in the eyes and asked if they needed a friend. She would turn her head, then listen to the answer the puppet would whisper in her ear. She then turned to me and shared the suffering and story of each puppet and how each needed a friend. She developed a special connection to Licorice, the stuffed kitty. Licorice helped Kali tell her story of suffering by sitting with her while she told me the details. I wrote out her story in the form of a play that Kali and Licorice later acted out. Kali painted small backdrops to each scene in her four-part play. She was engaged in full creative expression through storytelling, creative writing, visual art, and play.

Imagination was at the heart of Kali’s expression. In this book “art form” and “modality” are used interchangeably. When the various art forms are used sequentially or simultaneously, full life expression and healing occur. Each art form has a unique sensory expression, such as sound, movement, or sight. They are not separate; in fact, they come to life when one art form enhances another through the imagination of the child—in this case, Kali, as actor, storyteller, and artist.

The arts have been, and continue to be, the way of life for many indigenous cultures. Rituals of dance, music, and poetry celebrate and honor traditions of burial, marriages, and other life transitions. These action therapies bring us into active involvement with the “stuff of life,” including the hurts, pains, joys, and celebrations that are part of the therapeutic landscape. We may well be returning to the source of our own ancient roots as the arts are invited into the center of the psychotherapy room.

There are a variety of names to describe this work, including expressive therapies, creative therapies, integrative therapies, and intermodal expressive arts. The expressive therapies are also known as action therapies. Each art form, such as music, dance/movement, or drama, is a profession in its own right, and many forms have their own regulatory bodies, codes of ethics, and standards of practice. Expressive arts therapy is based upon the interrelatedness of the arts— that common ground of imagination, play, and self-expression. These self-expressions through movement, writing, and visual arts are more related than they are different. All art forms are available to the client to express himself for whatever purpose, be it to simply play, to heal, or to maintain health and vibrancy on life’s journey.

The client learns to listen to the creative impulse within that may be wanting to tell her life story through music and images. This impulse asks to be known through a modality that best expresses its intention, such as the woman who grew up in silence and never knew she could speak her mind who finds her voice through spoken poetry and dramatic enactment of her own story. The expressive arts therapist guides and witnesses this process of expression and offers simple frames that may bring this seed of self-expression, this impulse, to life. This seed may blossom and grow into fruit through the use of many art forms. If we were flies on the wall of an expressive arts therapist’s office, we might see some of the following: The making of masks with gypsona, dancing or moving in response to a picture painted, drumming as the client speaks a poem he just created, a group making clay fantasy creatures, family members wearing hats as they act out their family dynamics, writing stories, telling stories with puppets, listening or drawing to music, creating images in a sand tray… and so many more possibilities.

Although we may not produce what some would deem as gallery- or stage-worthy art or acting, we all have within us the capacity to use our voices, to create images with paint, to sound the xylophone, and to string words together to make poems. We have the ability to use language not only for meaning making, but also for creative self-expression. The arts are not available only for the gifted; they belong to all of us as individuals and communities as a means to unite, celebrate, grieve, and express all elements of human existence.

My own training in intermodal expressive arts therapy influences and guides the therapeutic model described in this book. Intermodal expressive arts is the movement from one art form to another in a single session (Knill, Barba, & Fuchs, 2004). A client may begin by painting an image, then move to writing a poem about the image, then finally, he may speak or sing the poem. As he stays in the creative world, moving from art form, to art form, transformation can be experienced. As creator of the art, the client is encouraged to be open to learning from what becomes visible, tangible, or known before him in this process. The client’s art is not simply an extension of his inner world; it can be that and more. From the art expression itself, he may learn new ways of being in the world. For example, if a client has drawn an image of his memory of a traumatic event, his relationship with the memory can begin to change as he works imaginatively with the art. The expressive arts process is active and alive. There is movement and a growing relationship between the creator of the art and the art that is emerging. The client is often surprised by some element of his creation, something new and fresh that he had not recognized before. Herein lies the gift of transformation that the arts offer.

THE PROFESSION OF EXPRESSIVE ARTS THERAPY

Expressive arts therapy is a nascent therapeutic field. The registering body, the International Expressive Arts Therapy Association (IEATA), was formed in 1994. There are many training programs internationally that offer various master’s or doctoral degrees or certificates in expressive arts. IEATA’s website has a list of expressive arts training programs around the world (www.ieata.ca). The IEATA code of ethics can also be found on their website.

There are two streams of expressive arts professionals as outlined by IEATA. IEATA recognizes therapists who, with the proper credentials, may register as registered expressive arts therapists (REATs) or artists/facilitators who may register as registered expressive arts consultants/educators (REACEs). How REATs and REACEs utilize the expressive arts in their work is different. The REAT utilizes the expressive arts therapy process for individual, family, or group healing that is part of the REAT’s overall therapeutic work. The REACE is not necessarily a trained therapist, but may be a teacher, nurse, educator, or coach who uses the expressive arts processes for health and well-being, social action, teaching purposes, and community events or projects. IEATA acknowledges the professionalism of both streams.

THE SHAPERS OF THE FIELD

One of the exciting elements of this profession is the unique approaches that various leaders in the field have developed in expressive arts. While there are too many to acknowledge, some key contributors to the field will be highlighted. Anna and Daria Halprin developed an approach they call the Life/Art Process that emphasizes drawing, movement, and writing (Halprin, 2003). This movement-based approach to expressive arts works with “body stories” through movement metaphors. Halprin (1999) states,

Movement is the body’s mother tongue, a powerful and universal language. Made conscious and creative, movement is a language for the body and soul to speak through, a bridge to the interior world of self and between self and the world; it is a way to build bridges and begin dialogues between the separated parts.

(p. 134)

Natalie Rogers developed a person-centered process she calls the Creative Connection^®, which is moving from one art form to another for healing, self-exploration, and personal growth (Rogers, 1993). The Creative Connection approach specifies that the role of the therapist is one of “being empathic, open, honest, congruent, and caring as she listens in depth and facilitates the growth of an individual or a group. This philosophy incorporates the belief that each individual has worth, dignity, and the capacity for self-direction” (Rogers, 1993, p. 3). Rogers combines her own love of the arts, influenced by her mother, who was a gifted artist, with the person-centered philosophy developed by her father, Carl Rogers. The Creative Connection philosophy is also used in groups for personal healing and social action; she has written about this extensively in her book, The Creative Connection for Groups (2011).

Intermodal expressive arts therapy, developed by Paolo Knill, articulates a theory drawing upon principles of polyaesthetics and crystallization theory (Knill et al., 2004). The theory of poly-aesthetics is a way of understanding how all art forms are interconnected: “Roscher’s theory of polyaesthetics was premised on the observation that all the art disciplines engage, to some extent, in all the sensory and communicative modalities” (Knill et al., 2004, p. 28). Crystallization theory, when applied to an expressive arts process, elucidates the unfolding of meaning and clarity that occurs as one engages in art making through the use of layering of art modalities and/or the moving from one art form to another. Imagination, ritual, and play are key elements in this approach.

Ellen and Stephen Levine have contributed significantly to the teaching and practice of expressive arts therapy and the written documentation of the practice of intermodal expressive arts in their works Foundations of Expressive Arts Therapy (Levine & Levine, 1999) and Principles and Practice of Expressive Arts Therapy (Knill, Levine, & Levine, 2005). Stephen Levine has been a primary contributor to the development of the philosophical underpinnings of expressive arts by grounding the work in the philosophies of Heidegger and Kant. Levine identifies that suffering, while part of the human condition, can be reshaped and transformed through the imagination and creativity (Levine, 1992, 2009).

Shaun McNiff has developed his own therapy of imagination, proposing that art itself is the medicine (McNiff, 1992). In this seminal work, McNiff encourages the active engagement with the imagination through whatever artistic means necessary to express and heal. McNiff advocates using multimodal approaches to engage meaningfully with what has been expressed. He emphasizes developing a relationship with the image, a term that not only refers to visual art images, but that is also inclusive of poems, movement, and enactments. Rather than analyzing and interpreting images, he suggests

we meditate on them, tell stories about how we created them, speak to them, listen to what they have to say, dramatize them through our bodily movement, and dream about them. All of these methods are dedicated to the ongoing release of art’s expressive medicine.

(1992, p. 3)

McNiff further distinguishes between telling stories about the art and creating stories with the art, the latter meaning we enter into dialogues with the art. McNiff suggests that “the painting might have something to say to me, and so I take on the role of listener rather than explainer” (1992, p. 105). We are encouraged to ask the art questions about what it is feeling or needing. When we enter a relationship with art that is personified, a multitude of possibilities open before us, such as soulful connections within ourselves and between self and the art.

Another approach was developed through the collaborative work of a variety of faculty members at Appalachian State University. From this collaboration, two primary pieces of written work have evolved and contributed to the expressive arts world (Appalachian Expressive Arts Collective, 2003; Atkins & Duggins Williams, 2007). The unique perspectives emerging from this approach include an emphasis on the practitioner becoming “a theory maker as well as a toolmaker” (Atkins & Duggins Williams, 2007, p. 4). The idea is to encourage the deepening experience of the practitioner by finding his own voice, perspective, and knowing in this work. Another feature that distinguishes the Appalachian philosophy from other philosophies is the importance of the natural world as it informs and guides the creative process. Learning from the cyclical nature of the natural world teaches us about the interconnectedness of all life forms. Two other features that are specific to this expressive arts philosophy are the resources found by working with the material of dreams and the emphasis on community building.

EXPRESSIVE ARTS THERAPY: THE PRAIRIE APPROACH

At the Prairie Institute of Expressive Arts Therapy, we work therapeutically with clients and we train students and professionals. Expressive arts therapy embraces all modalities of creativity that can be imagin...