Dual perspectives on art therapy and EMDR for the treatment of complex childhood trauma

ABSTRACT

Background

This article explores art therapy and EMDR for the treatment of complex PTSD caused by childhood sexual abuse, from the point of view of both client and therapist. It was co-written with a former client who wishes to remain anonymous.

Context

The therapeutic work took place in an NHS community setting. The idea of writing together – emerged organically as therapy came to an end, with both client and therapist feeling they have learnt from the process and that sharing these ideas could be beneficial for other practitioners.

Approach

While psychodynamically informed, much of the intervention followed the main principles of a trauma-focused approach with an emphasis on embodied processes – both in art therapy and EMDR.

Outcomes

The client made a great deal of progress during therapy and both writers explore the changes and insights that were gained as part of the article, with a particular emphasis on using interoceptive skills to enhance emotional processing.

Conclusions

When working with clients who have complex PTSD it is important to be aware of trauma-informed approaches and the role of grounding, stabilisation, embodied experiences and trauma processing. At times, this might be essential in order to help clients manage high levels of emotional arousal in the room, learn to contain their distress and improve their symptoms.

Implications for Research

More research is required to establish ways in which trauma-informed thinking can be incorporated into art therapy, the link between visual and emotional processing, and whether art therapy can improve interoceptive ability.

Plain-language summary

This article contains the summary of three years of art therapy and Eye Movement Desensitisation and Reprocessing (EMDR). It was co-written with ‘Rob’ (pseudonym), a male client in his mid-thirties who has a history of childhood sexual abuse and who wishes to remain anonymous. In the paper, Rob provides his account of the intervention while I explain my process as a therapist. I had limited experience of complex trauma work before I met him, and in many ways the journey was transformative for both of us.

In my writing, I briefly outline the theoretical basis of my thoughts and choices within our art therapy sessions. I reflect on the way my practice has expanded and changed, in order to incorporate an understanding of the way trauma affects the body and how we can work with the body in art therapy. As an EMDR therapist, I often combine EMDR and art therapy with clients who have complex trauma and believe that these two approaches can complement each other.

Therapy with Rob was often difficult to contain and there were times where his risk – of self-harm, substance misuse and suicidal urges – had to be carefully considered and managed. The principles of trauma-informed interventions were crucial for our work together. This includes explaining the current research about trauma to the client, so that the client understands his/her experiences better. It also involves helping clients to feel as calm and safe in the room and in their own bodies as possible, and maintaining an emphasis on body sensations in the here-and-now.

The article considers the idea of ‘interoceptive imagery’ as a way of working with the body in art therapy with traumatised clients. Some of Rob's images are explored and a link is provided for a video we co-produced, where he discusses more of his journey and his artwork.

Video Abstract

Watch the video on Vimeo

© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

KEYWORDS:

• EMDR
• PTSD
• abuse
• complex trauma
• interoception
• embodied
• CSA

Acknowledgements

With special thanks to Sue Holttum for her help, advice and support.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Nili Sigal

Nili Sigal is an art psychotherapist, supervisor, accredited EMDR therapist and the founder (and previous coordinator) of the Complex Trauma, PTSD and Dissociation BAAT Special Interest Group. Nili has a background in fine art and psychology, and an ongoing fascination in the way creative expression reflects internal processes. Originally from Israel, Nili lived and worked in London for many years with a variety of marginalised communities and hard-to-reach client groups. Her experience includes working in forensic settings, community organisations, acute inpatient wards and crisis services. She ran a blog for the London Art Therapy Centre, wrote several articles for BAAT Newsbriefing, and published book chapters about art therapy in private practice and embodied processes in trauma-focused art therapy. Nili is currently based in Devon, where she works for the NHS in a community setting. She specialises in working with adults who have complex trauma.

Rob

Rob is the co-author of this paper. He has chosen not to share further biographic details beyond what we have written, in order to protect his confidentiality.