Healing the Invisible Wounds

“Cautionary Materials in Art Therapy”

Certain materials should be avoided or used carefully in art therapy with human trafficking survivors due to their potential to trigger traumatic memories. For example:

• Sensors: May remind survivors of surveillance or control mechanisms used by traffickers.
• White Glue: Could evoke memories of semen and sexual abuse, causing distress and retraumatization (Kommentiani, 2020).
• Dark or Red Paints: These colours may remind survivors of blood and violence.
• Sharp Objects: Scissors, knives, or other sharp tools could evoke memories of violence or self-harm.
• Tightly Bound Materials: Such as heavy tape or strong adhesives, which might trigger feelings of being restrained.
• Certain Textures: Textures resembling restraints or confinement materials, like rope or heavy fabric, should be used carefully to remind survivors of their captivity.

Therapists can create a more effective and supportive therapeutic environment by carefully selecting materials and techniques that promote safety and comfort.

Case Examples

Art therapist Chris Drosdick case study on brothers who are child trafficked survivors (Kommentiani, 2020).

Background:

The brothers came from a two-parent household. Their mother was a stay-at-home mom, and their father worked in the financial industry. Both parents hailed from upper-middle-class neighbourhoods, and the children attended a highly-ranked public school. The family lived in the same neighbourhood, and to an outsider, life for these two children seemed quite normal.

When the two brothers were 6 and 10 years old, they revealed that they were being sexually abused by a male relative of the family. The statement led to a two-year research, revealing a sex trafficking web coming from the relative. The abuse started to happen three years before the brothers came forward to their parents.

Treatment Stage:

When therapist Chris Driosdick entered the picture nine months after the boys started therapy, he initiated the phase of trauma reintegration. The therapeutic process was planned to last six to eight weeks, with sessions twice a week. After re-evaluating the treatment, each brother would continue seeing the therapist individually, the mother would see the therapist once a week for progress reviews and parenting support, and the entire family would see the therapist once a week for an entire year.

Therapeutic Process

The trauma art therapy approach considers four key points:

1. How the mind, body, and spirit respond to trauma.
2. Awareness of symptoms as coping mechanisms.
3. Cultural sensitivity.
4. Teaching resilience and building a thrive mentality (Malchiodi, 2011).

Boy 1: Boy one experienced anxiety, dissociation, paranoia, somatic preoccupations, compulsions, and obsessive thoughts. During sessions, his legs would become stiff, and he increased his movements, frequently patting his thighs and asking for affirmation of being a good person. This led to a three-phase approach: creating safety, building stabilization, and improving day-to-day life.

Boy 2: Boy two experienced distress and panic and would often go to great lengths to avoid discussing his memories. He would hide behind the couch, wrap his face with a blanket to avoid being seen, and sit with the heels of his feet pressed against his rectum, applying pressure to the area.

Therapist Chris Driosdick focused on trauma-informed art therapy, EMDR, CBT, DBT, and mindfulness. CBT, DBT, and EMDR are integrated easily with art therapy. CBT helped restructure thought patterns, while EMDR helped with distressing memories, decreased psychological arousal, increased attentional flexibility, and provided a distancing effect and decreased worry (Shapiro, 2017). Driosdick balanced sessions between art therapy and talk therapy.

EMDR

The boys sometimes drew their responses to visual, auditory, or tactile stimulations. Bilateral stimulation is one of the core elements of EMDR. Their initial drawings were chaotic, often featuring red and black colours. For both patients, red symbolized blood, which related to many of their traumatic memories. The boys struggled with perfectionism and would become frustrated if their art did not meet their expectations. Boy Two would often throw out his artwork but eventually learned to appreciate and reuse it for future paintings.

“Learning to improve and reclaim their art addressed and enhanced their self-esteem during the initial sessions” (C. Driosdick).

T.P Mindfulness

Mindfulness was used to rebuild the heart/head connections, addressing the common feeling of disconnection that trauma victims often experience. In this case, the boys’ brains were frequently on high alert, stuck in a fight-flight-freeze response.

The therapist introduced yoga nidra, or yoga sleep, as a meditation practice. Both boys found this practice helpful, particularly before bedtime or when panicky.

Additionally, the boys participated in a community-based art therapy class called Mindful Masterpiece, which I teach. In this class, they created acrylic paintings each week inspired by famous artists and learned three types of mindfulness exercises combined with music and slow breathing.

T.P Safety

Both boys and their families faced safety trauma and lived in a constant state of emergency. To address this, the therapist provided the boys with journals to write in before going to bed, which were reviewed during their sessions. This journaling activity aimed to capture their thoughts and leave them on the pages, allowing them to sleep more peacefully. Additionally, the therapist worked with the boys to create positive artwork to hang above their beds, providing a sense of safety.

The boys also experienced dissociation from their bodies at night. To counter this, the therapist taught them grounding techniques that included engaging the five senses to bring them back to the present moment. These techniques involved using citrus-blend essential oils, body scans, and breathing exercises.

T.P Negative thoughts

To address the boys’ negative thoughts, therapist Driosdick focused on cognitive distortions such as all-or-nothing thinking, catastrophizing, perfectionism, and personalization. The therapist also helped the boys create trigger lists, develop positive affirmation cards, and use feeling decks to identify and express their emotions.

Additionally, the therapist worked on preventing the traumatic experiences from defining the boys’ identities. By analyzing that only a small percentage of their lifetime had been spent as abuse victims, the boys were encouraged to understand that this 1 per cent should not dictate the rest of their lives.

T.P Male Gender Role Stress

The parents were worried about the impact the situation would have on their children’s gender identification. The boys also saw themselves as weak and felt shame. To address this stage of trauma, the therapist worked with the boys on building art pieces that used the first letter of their names to help build a sense of personal identity. They used collage and acrylic paint to decorate these letters, reinforcing their individuality and self-worth.

T.P Disclosure

During many sessions, the boys made statements about their abusers, details of the trauma, and their lived memories. Driosdick utilized expressive writing and drawing to capture the details of each reported incident. This approach helped the boys talk about the events, release their fear and shame, and gradually diminish the power of their traumatic memories. This method also facilitated communication between the therapist and authorities, such as the police and Child Protective Services (CPS).

After six months, Therapist Driosdick noticed significant changes in the brothers’ artwork. The symbols they used became softer and more organic, the colours brighter and neater, and the pieces more detailed. They also handled frustration with the materials better. These improvements in their artwork reflected their progress in therapy, showing a shift towards healing and a more positive self-identity.