It takes a lot of effort for the brain to deal with trauma. Whether because of post-traumatic stress disorder or the many adaptive behaviors that victims use instinctively in threatening situations, the traumatized brain is constantly on high-alert, particularly its lower regions, where survival instincts originate.

Simple artistic activities like drawing or sculpting clay can soothe those lower regions, which is why arts therapists argue that their methods can help trauma victims calm down and release some of that mental tension. These evidence-informed therapies use creativity to raise victims’ awareness of their physical and mental states and build resilience and a sense of safety. Counselor and author Cathy Malchiodi, who has pioneered Trauma-Informed Art Therapy and Trauma-Informed Expressive Arts Therapy, claims that the use of music, art and other creative activities grant victims a means of expressing the effects of trauma even after therapy ends.

When the lower-brain’s instincts are over-activated, they can inhibit people’s ability to perform higher cognitive functions until they have started healing from trauma. “Teens who are stressed may have difficulty answering questions about their drug use, or about making goals and plans for the future,” Malchiodi says. However, as she and other researchers (including child psychiatrist Bruce Perry) have found, these effects can be reversed with therapies that rebuild the brain from the ground up.

Nancy Gerber, Director of the PhD Program in Creative Arts Therapies at Drexel University, explains that expressive arts support trauma recovery, especially for those victims who were traumatized or seek treatment at a young age, because they engage the regions of the brain that develop earlier in life. “A lot of kids in adolescence struggle with language,” she says. “They know how to talk but they don’t always know how to talk with emotional intelligence. The idea [of arts therapy] is that images are a form of cognition, a way of knowing. They develop very early in our lives: little kids point at things before they have a word for them. These images provide a history for the early life, and when we grow up we don’t have a word for that.”

Simply put, arts therapy helps trauma victims reconnect with that image-based part of the brain, a process which calms the parts of the brain that have been overworked by trauma.

Here’s how it works:

Step 1: Getting in touch with the “lower brain”

Traumatic stress manifests differently for different people; victims may be withdrawn and incommunicative, or wild and confrontational. (In therapeutic terms, this is referred to as “internalizing” or “externalizing” one’s feelings.) In her previous work at an inpatient psychiatric hospital, mostly focused on adolescents, Gerber included drawing in every young patient’s intake process. She would then share the drawings with staff when they met to decide on a treatment plan. It was particularly useful for those young people who couldn’t easily express their experiences verbally.

“The art provides a different dimension that most of us don’t know how to say,” Gerber says. “A picture can tell a story about our internal life that isn’t accessible in words.”

 Malchiodi begins her therapy by observing her clients to infer what kind of activities would help them best. Some may benefit from therapies that help them loosen up, such as movement activities with music. Others need to do something that will help calm them down and focus, such as drawing or painting.

In one treatment, she gives individuals a rubber duck and asks them to build a safe place for it using feathers, paper plates, leaves, fabric and other materials.

“This highly sensory experience, where you can actually feel the nest, pond, or whatever you build, engages the lower parts of your brain, whereas simply drawing a safe place or depicting goals require higher cognitive areas,” Malchiodi explains.

Step 2: Becoming more expressive

For young and older people alike, the experience of traumatic events can be difficult to express in words. So Malchiodi uses the first step to get them feeling calmer and more creatively expressive. Then she engages them in storytelling activities that use higher cognitive areas. For example, she might ask, “If you could draw a bridge that starts in the past and goes into the future, show me where you are on the bridge,” or to depict one’s family in any way they choose to depict it.

Gerber says that expressive arts therapy allows victims to deal with trauma in the same deeply emotional way that they experience it, which in turn prepares them to address it more fully. “They no longer had to act out,” she says of her clients. “They could have conversations about how they saw themselves and the world.”  

Malchiodi saw similar results in her young people. “Trauma memories are sensory memories,” she says, “meaning that people feel them in their bodies and react with their bodies.” Creativity can help them make that leap to full understanding and expression.