As more and more service members come home with President Obama’s withdrawal plans for both Iraq and Afghanistan, the effects of traumatic brain injury, post traumatic stress disorder, and other psychological health problems will undoubtedly be more widespread. According to Doctor Andrew Stone, Director of the PTSD Clinical Team at the Philadelphia VA Medical Center, of the half million veterans of the Iraq and Afghanistan conflicts who have visited the VA since 2002, 92% have possible mental disorders.
These service members, either home between deployments or back permanently, often find it difficult to return to civilian life — families, friends, employment, education. Different types of treatments have been used, from medication to talk therapy, but there are other types of therapies less spoken about that are doing much good for these men and women. One of them is through art.
MALCHIODI There’s a lot of attention to art therapy right now. A lot of people intuitively understand that art is very helpful in ways that other treatments are not.
That’s Cathy Malchiodi, a leading art therapist in the field for 25 years and president of the international organization Art Therapy Without Borders. According to Malchiodi, the use of art therapy for service members, especially those who have been in combat, is increasing nationwide. Art therapists have a degree in art therapy or a related field at a minimum — many are also licensed professional clinical counselors, like Malchiodi. Art therapy traditionally takes two routes: focusing on the art making as a therapeutic activity or using the artwork to build a relationship between the therapist and client, a starting point for talk therapy. Malchiodi explains why art therapy in general is so successful with trauma victims:
MALCHIODI The use of behavioral cognitive therapy is helpful, a form of talk therapy, but I think people are starting to find — and veterans are giving this to us in firsthand accounts — that they need something more sensory and less language-driven to process and communicate what has happened to them. If we go through a traumatic event, we don’t have words for it […] — the brain doesn’t record it that way […] Well if you talk to a military veteran who’s been in an explosion, they might site what they saw but also what they smelled and what they heard but not be able to put it in words.
Art therapy has been around for a while, increasing in use with World War II veterans and more-so with Vietnam veterans, but is now more widely recognized as a helpful and rewarding therapy. Expressing difficult events through a creative outlet can be a powerful healing mechanism for service members, especially those in combat. Malchiodi describes these soldiers:
MALCHIODI The skills they developed in being good warriors helped them stay alive and protect their buddies when they’re out on a mission, but those things when you come back, eating quickly, be hyper alert, sleep lightly, always be ready to respond to danger, now those behaviors are getting in the way, because that’s not how normal life is.
Art therapy aims to ease the effects of these behaviors. Melissa Walker, an art therapist at the National Intrepid Center of Excellence, NICoE — which treats active duty service members mostly for TBI and PTSD — and also the center’s Healing Arts Program Coordinator, further discusses why verbal work with trauma victims is not always the most effective treatment.
WALKER They did some scans while people were doing art and trying to talk about trauma, and in trying to talk about trauma the left side, Broca’s area kind of shuts down, but the right hemisphere lights up — that’s of course the side we use to be creative. So they’ve just found for some of these people experiencing traumas that it’s much easier to express themselves in a nonverbal modality.
Walker agrees with Malchiodi about the power of art therapy. She says it has myriad benefits, from beginning to talk about the trauma, to learning to relax, to increasing self esteem, to being able to live a more normal life.
WALKER They come in here, “I’m so angry, I have the worst outbursts,” so I say, “Great. Art therapy might be godd for relaxation or a great outlet for you to feel like anytime you’re angry you can come and sit down and get that on paper…Or if they say “I’m having a really hard time focusing” — well then something they can be proud of is that they sat there for an hour and a half and worked on a piece of art. […] Once they get it out and they can see the work they’ve created, and feel proud of it because it’s an extension of themselves, they can see what they’ve been through right before their eyes
Art therapy is applied in response to diagnosis and symptoms.
Walker, at NICoE, and Malchiodi, at her private practice, both meet one-on-one with service members to decide how to best conduct the therapy. Both therapists spoke about first trying to help their patients to relax, and, once comfortable, to then introduce the art activity. There are varying techniques employed and levels of engagement with the actual trauma. Art therapy, like many therapies, is practiced on a continuum. Malchiodi does a great deal of work in exposure therapy:
MALCHIODI A lot of people with post traumatic stress have actual terrible memories of things that happened. Then what I do is like exposure therapy, we might be doing actual artwork about what happened. […]
NARRATOR: Malchiodi talks about witnessing what soldiers call “pink mist,” when a person’s body is completely destroyed in an explosion.
MALCHIODI One of the people that I’ve worked with recently […] what this person needed to finally be able to express on paper was what that looked like, what that felt like. And realize that that happened and it was really bad, but it’s now in the past. Art makes it concrete; an image that never was expressed but was held in the body and was disturbing and to be able to put it on paper and then to talk about it is a very powerful thing.
Within art therapy, there is quite the range of media employed and supplies used.
Walker has found one in particular to be rewarding:
WALKER When I started working w service members individually one of the main things i felt w some of them was reconnecting w their identities, “who am i since the injury who was i before why am i not enjoying the things i used to.” […] 809 in realizing that this reconnecting with their identity, I thought mask making would be something they could really connect with […]
NARRATOR Walker says the service members talk about two sides to themselves: one in combat, another one at home with their families.
WALKER So many of the masks are literally divided in half, half of the mask angry and red or this is the injury or half of it serene […] but we’re also seeing some of them dealing with the death and the grief they experienced while they were over there, so there’s been quite a few skulls, bloody tears. We’re seeing some patriotism of course so a lot of red, white, and blue, they really get into it, symbolism down to every last dot, it’s pretty incredible. It’s nice for them to think about “who i am”. One group put it nicely, we’re trying to find the new normal. since i was injured what is the new normal. 1003
Both Malchiodi and Walker have learned a great deal from the service members. Malchiodi expressed a sense of humility when working with them.
MALCHIODI I sit there and say honestly I don’t know if I could do what you do. And these people chuckle and say, no Cathy you haven’t had the training. […] I always commend them, and some of the work we do in art therapy is to make a collage or maybe capitalizes or commemorates their bravery and the skill-set they have […] I can’t even imagine learning how to protect people in the way that our military do everyday.
Walker feels a similar admiration:
What I’ve learned from them it really humbled me, I respect them, I see how passionate they are about this, even if it’s not the mission of the war but in general about their careers, fighting for us. I’ve seen many of them sad because they can’t go back and be a part of it. It’s amazing to know what they’ve been through and they want to go back and continue serving our country. I think it takes a very special person.
To view some of the service members’ artwork, visit out website warnewsradio.org.
For War News Radio, I’m Elliana Bisgaard-Church