Ericha Scott, Ph.D., LPCC917, ATR-BC, REAT, ICRC


It is one of the functions of art that it restores to us the whole of human history in optimum condition. In the face of fragmentation and alienation it restores our identity, reactivates our memory and gives us precisely the reorientation that we sometimes need…
Art has wrought miracles in the past and there is no reason to think that they have come to an end.

~Vaclav Havel, 1990, New York Times

We are living in complicated and difficult times. We are all affected by what is happening on the world stage, regardless of nationality, political affiliation, gender, age, race or religion. Those of us who are privileged are not completely exempt, even if all that touches us is the cacophony of news reports about mass suffering. In fact, while writing this article, another public shooting event is unfolding on social media as it is happening in real time.

The creative arts are able to help people find balance, meaning and purpose.

The Greek root word for trauma means “wound”. Recently, it seems as if more people are able to relate to the term “wound” than “trauma”. We all have wounds, and most people are able to acknowledge that they have experienced a wound in the past, whether it is visible or not, and whether or not we still carry the impact of that wound with us.

I believe that the arts, all of the arts, are well suited to address and ameliorate emotional and physical pain. Science supports this assertion. Broadly speaking, the creative arts therapies include a variety of the visual arts, music, dance, theater, and creative writing. Although the creative arts are not yet considered to be an evidence-based therapy, there is significant research supporting the efficacy and power of creative arts psychotherapies to heal. In fact, the creative arts appear to be especially effective for trauma. As a point of reference, up to 85 percent of the veterans at Walter Reed Hospital participate in art therapy groups.

The creative arts therapies can be tailored to address trauma of all kinds, and people with various symptoms and diagnoses. Clinicians find that art therapy helps people put words to unspeakable or unbearable pain because the arts are better able to engage the pre-verbal, nonverbal, metaphorical, symbolic, imagistic and right-brained processes. These processes which help elicit words and narratives are necessary to reduce symptoms of trauma and abuse, and they appear to be able to do so more effectively than traditional talk therapy alone.

There are few words in our language that adequately express pain. To express emotional or physical pain to another human being we often rely upon metaphor. ~Scott, 1999

For example, you may describe a headache as, “like I have my head in a vise,” “a jack hammer is pounding on my skull,” or “as if I have a ticking time bomb inside my head.” While there are many reasons the art therapies can be useful, one important reason is that by its very symbolic nature, the arts help us translate pain into expression and relief.

Not only are the art therapies well suited to address post-traumatic stress disorders, trauma, grief and loss – they are also well suited to help those who suffer from a variety of substance use and mental health issues. From a PsychLIT database search of 10 outcome studies, “most of the studies found significant symptom improvements using different outcome measures” for the following diagnoses: Substance Abuse, Eating Disorders, Complex Trauma/Dissociative Disorders, Psychosomatic Symptoms, Borderline Personality Disorder, Anxiety Disorders, Suicidal Ideation, Schizophrenia and Mixed Diagnoses. The study suggested that the creative arts therapies offered the greatest positive impact
for trauma and compulsivity. I have also found that the art therapies are able to support with the treatment of developmental delays, attachment disorders, traumatic brain injury, and as described often in the media, dementia.

What I tell my trainees is that you can and may use art therapy with just about any issue or diagnosis. The challenge is to properly adapt and tailor the creative arts interventions for the specific individual needs of each person or clinical population. In an amusing and rather simplistic anecdote thirty years ago, I learned not to use wet paints with a traumatized child- unless I wanted to wear most of the colors home on my clothing.

With regard to trauma, it all begins with trust.

Trust between the client and therapist is an essential and critical aspect of successful counseling. As one might expect, victims of profound early childhood trauma have the most difficulty trusting. Simply put, they have been betrayed and their trust – not just their bodies and minds – was violated.

Victims of childhood trauma experienced untrustworthy adult caretakers which were not necessarily their parents but a trusted adult. Therefore, trust was undermined due to the violation of the sanctuary of childhood innocence, especially, if the betrayal was by a loved one. This break between the caretaker and child when the child is small, vulnerable and just beginning to shape his or her world view, can last a life-time and is able to contaminate all future relationships with others and/or the self.

In today’s world, many people, even those without an overt trauma history are expressing difficulty with trust. Many people feel betrayed or even sabotaged by recent financial and political upheavals. Others are frightened by serious illnesses that suddenly appear as threats from various parts of the world. Many of us in California – and elsewhere – have been concerned about drought conditions, earthquakes, extreme weather and/or natural disasters.

Fortunately, art is a gentle, silent, but powerful voice. Art, in a session, becomes the co-counselor and leaves space and place for me to align in a very proactive and supportive way with a client. ~Ericha Scott- FB PAGE

Often, it is the art that best challenges psychological blocks or denial. A client might look at an art piece and say something to the effect of, “Gosh, this art piece is so chaotic, and… so is my life, I never realized that before now.” I ask my clients to portray their whole life history of emotions, trauma and addiction on a life-sized silhouette (body map on butcher block paper).Body maps often include physical illnesses and surgeries. Sometimes, women and men who were sexually abused paint graphic descriptions of sexual abuse, STD’s, gynecological problems or surgeries and find that the representations of trauma visually overlaps with physical illness.

At this point, clients begin to realize the full impact of trauma on all aspects of their health, not just emotional.

This art exercise helps clients recognize the self-sabotaging mechanisms of denial for both trauma and addiction. While looking at their finished body map the client becomes clear that they are not weak because they have PTSD and/or addiction, but in fact, they have been – in the true context of their life history – quite strong.

While this would appear to be a painful process, it usually provides profound relief by bringing to consciousness a deeper implicitly known truth. Clients who have been historically frustrated by their body’s health problems begin to develop compassion and self-forgiveness for how the body tells the unspoken story. This imagistic narrative of a life story reframes cognitive distortions of failure associated with symptoms of trauma, and energizes, empowers and motivates clients to recover.

In the art piece that has been included in the heading of this article, the initial intent was to portray joy … yet this clients trauma history clearly intruded, just as it does in life. The client has progressed to the point that she is able to acknowledge the concept of holding the paradox of joy and pain, freeing her from polarized, superficial and self-defeating ideas of emotional wellness.

Decades ago, an alcoholic man who was looking at his art piece suddenly realized that he loved his family and said something to the effect of, “Suicide is no longer an option, I want my family back. I have to deal with the trauma because it is dealing with me, and I must stay sober to do it.” Suddenly, the client became assertive and proactive in his own treatment process.

It seems as if the art product in therapy becomes a bridge to trusting the self. Trusting the self and/or the therapeutic process helps the client begin to trust the therapist. Then, what follows is- that as the client trusts the therapist, that trust helps the client trust others.

Art can even work as a therapeutic transitional object. Just as a teddy bear is able to help comfort a young child while his or her parents are out for dinner, clients may refer to an art piece instead of a teddy bear to remind them of the safety of the therapy room.

As patients progress, they can amplify and extend the healing process they experienced in the art therapy room to home and beyond. By taking art home, a patient is able to help maintain a bridge of connection to the therapist and safety in-between sessions. Art also helps clients see in a concrete and somewhat measurable form the psychological work they are doing.

Often, clients understandably question “What have I accomplished in therapy?” even as their lives are improving because the processes of talk therapy can appear to be invisible and nebulous.

Art functions as a memory mnemonic. In other words, art helps remind clients of the work they are doing and have done, even – or maybe especially, if trauma has negatively impacted their ability to focus and remember.

The use of art therapy to address trauma and pain heals and that healing spills over into many areas of a client or patient’s life.

One of the many aspects of art therapy that I cherish is how a therapeutic art process helps the client to become creative in all aspects of life. I am from Texas and we have a corny expression for this type of unexpected bonus, we call it a “two-fer”.

There is much more to be said about the potential benefits of the practice of creative arts therapies when practiced by a certified art therapist. Contrary to common myths, the art therapies are much more than entertainment, arts and crafts, or a diversion and distraction from treatment. In fact, a certified art therapist generally has training above and beyond licensure requirements, not less.

Another myth is that the art therapies are benign and cannot cause harm. In fact, in the hands of an untrained therapist, art can be too provocative and can even trigger excessive flooding of traumatic memories, overwhelming the clients’ defenses and ability to cope. Therefore, it is recommended that only certified art therapists be hired for individual, family or group sessions in substance use treatment programs.

The arts are a different language and the therapist needs to be trained in the language that the arts speak.

Fortunately, the clients who use art as a therapeutic tool often find that using art for healing enhances creativity in all aspects of life.

Article adapted from an interview by Ms. Barbara Burke for The Malibu Chronicle 2017.

References Provided Upon Request

Dr. Ericha Scott – Licensed as E. Hitchcock Scott, Ph.D. has 32 years of professional experience working with those who have co-occurring addictions and complex trauma. She has published on topics of addiction and trauma, research on self-mutilation
by dissociative disordered individuals, and her theory of creative arts therapy. Dr. Scott is an artist, a Board Certified Registered Art Therapist (ATR-BC), a Registered Expressive Arts Therapist (REAT), and an Internationally Certified Advanced Addiction Counselor (ICAADC).