What does painting have to do with mental health? Lots, actually.
PTSD and other childhood attachment issues like neglect are particularly amenable to art therapy. Many studies analyzing children with PTSD find that the participants in the treatment group often see a reduction in their acute symptoms (Chapman 2011).
Why Art Helps With Trauma
Why does art work so well with trauma? Research has found that traumatic memories are stored in the right hemisphere of the brain. Speech is located in the left. Because art is a right-brain activity, it is often easier for those suffering from PTSD to draw about their trauma rather than talk about it.
Melissa Walker, a well-known art therapist, says that the process of art “bypasses th[is] speech-language issue with the brain.” Through art, children can process their traumas in a “non-threatening,” safe space. “They can then apply words to their physical creations, reintegrating the left and the right hemispheres of the brain.”
Adolescents and Art
Art therapy is also an ideal way to reach treatment-resistant teens. Oftentimes, teens are reluctant to engage in talk therapy or decide not to participate at all. It is often both physically and emotionally difficult to delve deep into the recesses of one’s emotions, and then discuss them with another person. Art therapy is a good way to get the ball rolling.
Los Angeles art therapist Shirley Riley says art is amenable to such teens because “adolescents are [anyway] attracted to making symbols and graphic depictions” more than verbal question-and-answer sessions. Art therapy can involve drawing a picture, making a collage, creating a mask with different materials, or forming a piece of clay. After the adolescent produces the art, something happens…
“When the negative behavior is illustrated, it is then external to the individual…the behavior thus becomes the problem, not the individual.” Now that the art has externalized the problem, it’s easier for the teen to talk to the therapist about their struggles. The creation has allowed clients “to distance themselves from their own dilemma.”
When the Trauma is Abuse
Art therapy can often reveal a pattern of abuse, such as sexual abuse in childhood. When it comes to sexual abuse, many adolescents find it hard to talk. Sometimes this is because the experience was so traumatic, and they were so young, and/or because the perpetrator (or someone else) ingrained in them “not to tell.”
“…But no one told him or her not to draw,” writes Riley. So teens can let the therapist know what has went on – even subconsciously – through visual creations that belie the “forbidden subject.”
Riley, an art therapist in the San Fernando Valley, shares that “mild-mannered” teens can often produce dramatic, angry art. The anger only comes out during their sessions together. For example, one boy who was abused once drew a detailed picture of him holding the gun at a mall shooting.
“Their repressed emotions were too powerful to be expressed in words; the images provided boundaries and structure within which they could vent their anger. Often, teens have no words available to express their deep feelings. In many cases, the image comes first and the understanding of the visualization comes later.”
Art Therapy: Evidence-based?
It’s important to mention, however, that art therapy is usually supplemental to traditional talk therapy (like DBT, CBT, or other modalities.) In fact, not every study finds art therapy an effective intervention for mental diagnoses. Or, even if it’s effective, the effects are not significant enough to be used as a standalone therapy.
The very first randomized, controlled study on group art therapy is the well-known MATISSE trial in 2012. Despite the large sample size, researchers did not find that art therapy provided significant effects for the 400+ patients with schizophrenia. However, just a few years later, another RCT on art therapy found that art therapy did reduce patients’ psychotic episodes. It also improved their emotional awareness. (Montag, 2014).
These conflicting studies simply confirm that art therapy would be best used as a supplemental therapy. In fact, in most adolescent mental health treatment centers (both residential and partial hospitalization/intensive outpatient programs), this is the case. Staff usually incorporate art therapy into the weekly schedule as an experiential therapy. Not only do teens find it easy to express themselves through the creative medium of art, they often find art therapy enjoyable and pleasurable—an important factor in enhancing wellbeing.