Art making to externalize emotions related to COVID 19, reduce internal stress, and promote post-traumatic growth
Clare McCarthy, ATR-BC, LCPC
Art is a way of recognizing oneself. –Louise Bourgeois
What is externalization?
Externalization is the process of transforming our thoughts, memories, feelings, and insights into an external form. This external form can take many different formats including writing, speaking, drawing, painting, sculpture, collage, or other modes of sensory self-expression. By making our internal processes tangible and external we are able to convert our amorphous and rapidly shifting psychological experience into physical environmental stimuli. This provides us the ability to clarify what we are experiencing, to gain support and build solidarity with others, and to reflect on and consciously re-input information into our mental frameworks. Using these processes we are able to use a variety of interconnected cognitive resources to process complex information and come to a deepened and solidified understanding of our own internal processes and experiences.
Why externalize through visual art making?
While speaking and writing are incredibly important tools for externalization and self-understanding, they often are difficult starting places in exploring our internal worlds. Studies have shown that overwhelming, stressful, and traumatic experiences are encoded more readily as images and sensations rather than words. (Clark & Mackay, 2015; Gantt & Tripp, 2016; van der Kolk, 2014). The creation of art images within the safe environment of art therapy helps to allow clients to access memories, thoughts, and feelings in novel and nonthreatening ways (Gantt & Tripp, 2016) through the use of art materials, metaphors, and symbols “which may facilitate consolidation of experiences by converting an artistic form, representative of emotions and reactions to trauma, into verbal communication” (Campbell et al., 2016). Using visual art making processes, clients are able to access their internal states from a safe distance (Johnson, 1987) rather than need to communicate their complex experiences directly through spoken dialog (Talwar, 2007; Tripp, 2007). In this way, creative arts therapies can be used to reduce anxiety, promote healthy creativity, and establish a sense of safety to help process complex or frightening emotions that cognitive treatments alone do not provide (Campbell et al., 2016).
In addition to the effects of externalization, art making in the context of art therapy also provides clients opportunities to grow their emotional creativity (the ability to experience novel and appropriate emotions) and their creative self-efficacy (one’s confidence in their ability to be creative). Researchers Orkibi and Ram-Vlasov (2018), “found that emotional creativity followed by creative self-efficacy (as two sequential mediators) statistically mediated a positive association between exposure [to trauma] and posttraumatic growth as well as a negative association between exposure and mental health symptoms” (p. 9). In short, our ability to be creative and to express ourselves through visual arts helps to reduce mental health symptoms associated with trauma, and to promote psychological growth following traumatic experiences.
How can we use art making to externalize our emotions connected to COVID 19?
For me, and for many of my clients, one of the most difficult things about managing the emotions surrounding COVID 19 is how diffuse they are, and how many environments and behaviors are connected to these emotions. The pervasive nature of the pandemic, combined with the invisibility of the threat and the length that it has spanned in our lives makes it particularly challenging to externalize. Finding time in my own art making to allow myself to explore this concept and my internal state connected to it has been useful in helping me to make sense of what I am experiencing and find a way to conceptualize and validate my own emotive and cognitive processes. I find that starting with an abstract sketch or doodle and then moving intuitively towards a particular concept or form allows me to more quickly see and understand what I am holding, and brings me closer to the words I may need in order to communicate with myself and others in building the strategies and behaviors required to take care of myself and connect with those around me. While this process tends to become easier as we practice it, it is available to all individuals, regardless of their level of artistic experience. Seeing what we create allow us to validate the needs and perspective of the creator, and deepen our authentic relationship with ourselves.
References:
Jacqueline P. Jones, Jessica M. Drass, Girija Kaimal,
Art therapy for military service members with post-traumatic stress and traumatic brain injury: Three case reports highlighting trajectories of treatment and recovery
The Arts in Psychotherapy, 63 (2019), pp. 18-30, https://doi.org/10.1016/j.aip.2019.04.004.
M. Campbell, K.P. Decker, K. Kruk, S. Deaver
Art therapy and cognitive processing for combat-related PTSD: A randomized controlled trial
Art Therapy, 33 (4) (2016), pp. 169-177, 10.1080/07421656.2016.1226643
Clark and Mackay, 2015
Mental imagery and post-traumatic stress disorder: A neuroimaging and experimental psychopathology approach to intrusive memories of trauma
Frontiers in Psychiatry, 6 (2015), p. 104, 10.3389/fpsyt.2015.00104
Gantt and Tripp, 2016
The image comes first: Treating preverbal trauma with art therapy
J.L. King (Ed.), Art therapy, trauma, and neuroscience: Theoretical and practical perspectives, Routledge, New York, NY (2016), pp. 67-99
Johnson, 1987
The role of creative arts therapies in the diagnosis and treatment of psychological trauma
The Arts in Psychotherapy, 14 (1987), pp. 7-13, 10.1016/0197-4556(87)90030-X
Orkibi, H., & Ram-Vlasov, N. (2019).
Linking trauma to posttraumatic growth and mental health through emotional and cognitive creativity.
Psychology of Aesthetics, Creativity, and the Arts, 13(4), 416–430. https://doi.org/10.1037/aca0000193
Talwar, 2007
Accessing traumatic memory through art making: An art therapy trauma protocol (ATTP)
The Arts in Psychotherapy, 34 (2007), pp. 22-35, 10.1016/j.aip.2006.09.001
Tripp, 2007
A short term therapy approach to processing trauma: Art therapy and bilateral stimulation
Art Therapy, 24 (4) (2007), pp. 176-183, 10.1080/07421656.2007.10129476
van der Kolk, 2014
The body keeps the score: Brain, mind, and body in the healing of trauma
Sage, New York, NY (2014)
