What is Trauma-Informed Expressive Arts Therapy? A Clinical Psychology Podcast Episode.

Whenever my own mental health isn’t doing great, my mind always turns to learning more about trauma and different forms of psychological therapy. In previous podcast episodes, I’ve spoken about the benefits of art therapy, how it works and more and I’ve discussed at length the importance of trauma-informed practice. Now, we need to think about what happens when we combine these two approaches to mental health. Therefore, in this clinical psychology podcast episode, you’ll learn what is Trauma-Informed Expressive Arts Therapy, how can it improve lives and what principles underpin Trauma-Informed Expressive Arts Therapy. If you enjoy learning about trauma psychology, mental health and psychological therapies, then this will be a great episode for you.

Today’s psychology podcast episode has been sponsored by Introduction To Psychotherapies: A Clinical Psychology Introduction To Types of Psychological Therapies. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

A Brief Note On Trauma-Informed Practice in Clinical Psychology

As I mentioned in a previous podcast episode called “What Makes a Trauma-Informed Psychologist”, I explained how trauma-informed practice helps us, aspiring or qualified mental health professionals, to guide an individual through trauma recovery whilst using arts therapy as a basis. Since trauma-informed practice helps clinical psychologists to understand how the body, mind as well as brain interact and what role they play in the trauma responses and the maladaptive coping mechanisms that the client has.  Also, trauma-informed practice is very useful because it helps therapists to de-pathologised whatever the client is going through and by combining with clinical work with arts therapy, it allows the client to express themselves, their emotions and their experiences. This helps the client in turn to fell more empowered, engaged and hopefully they’ll find therapy more fun and pleasurable compared to traditional talk therapy.

Ultimately, trauma-informed practice is all about helping a client to go beyond just surviving and towards thriving so they can live a happy, purposeful and fulfilled life where they control their behaviour. Instead of their trauma controlling their lives. Then this can be achieved through arts therapy by making meaningful use of creativity, play as well as imagination.

Personally, I’ve spoken about this before in my sexual violence-focused books and before I finished my rape counselling, my trauma responses definitely ruled my life. For example, if I went out by myself, if I meet a stranger or once I took some friends home and I drove them, all of these situations resulted in me having a massive mental health crisis and mental breakdown. I was so anxious, so fearful and I hated what my trauma responses were doing to me.

Post-Traumatic Stress Disorder is not fun, not in the slightest.

Even this weekend at the time of writing, a lot of small factors have added up this week but I am rather anxious, on edge and my mental health hasn’t been amazing. Yet because of the trauma-informed counselling I went through last year, I am thankfully fine 99% of the time. I can live my life, I can date and I can work.

I’m happy the vast, vast majority of the time but that’s only possible because of the trauma-informed counselling I underwent.

That’s why it is so important in clinical psychology.

What Is Trauma-Informed Expressive Arts Therapy?

Trauma-Informed Expressive Arts Therapy is a model for arts-based mental health interventions that combines best practices in trauma-informed clinical practice as well as play-assisted and expressive arts therapy. This combined approach helps a client to integrate their trauma into their lives so it is still there, but it’s in the rear-view mirror of the life, and they are able to move forward and heal. This therapy is based on characteristics of expressive arts therapy as well as trauma-informed practice.

Furthermore, according to Malchiodi (2020), Trauma-Informed Expressive Arts Therapy is underpinned by seven key principles.

How Does Trauma-Informed Expressive Arts Therapy Focus on Co-Regulation and Self-Regulation?

As I spoke before on the podcast about the window of tolerance, when you’ve experienced trauma, it is very easy for us to have our senses overactivated, hyperaroused and this leads us to feel really, really anxious. I mentioned earlier how during the most severe periods of my PTSD, even going outside and meeting up with friends would make me so anxious I would have panic attacks. Even though, you don’t need PTSD to experience hyperarousal, hypoarousal or any other trauma responses.

Therefore, expressive art interventions can support people to learn about and learn how to use their internal resources to manage their own mental health. This is an example of self-regulation where you’re able to manage your own mental health, emotions and distress. Yet expressive art interventions can also provide ideas for a wide range of action-oriented and creative approaches to co-regulation if a therapist decides to apply this within group therapy settings.

Personally, this is something I really tried to focus on last night and I will admit, I was a little too distressed for this to work effectively. Also, I was tired, sensory overwhelmed and I had a lot on my mind. I’m telling you this because I want to be honest and I want you to know that we don’t always get it right. We can slip up and that’s okay. That’s normal, understandable and it’s a part of being human.

Self-regulation is flat out critical though in trauma recovery.

How Does Neurobiology Inform Trauma-Informed Expressive Arts Therapy?

I explain this topic a lot more in my sexual violence focused books, but trauma isn’t just a psychological experience. Even after my rape, it took me a while to understand this fact, but trauma is also a mind-body experience. Since a lot of trauma responses are physiological reactions. For instance, the shaking, the heart pounding, the sweat and the physical sensations associated with the trauma. All of them are very, very real physiological sensations to the trauma survivor.

As a result, Trauma-Informed Expressive Arts Therapy uses neurobiology to understand how to use expressive arts to address these trauma reactions as well as it helps clients to reconnect with the sensory (implicit) as well as the declarative (explicit) memories of the trauma.

In my opinion, I just want to jump in here and add that this doesn’t always happen in trauma-informed practice because my rape counselling didn’t involve any talking about the rape itself. We focused on the here and now, my trauma responses and we focused on everything but the rape itself. Which was really nice.

Anyway, neurobiology as well as neurodevelopment provides therapists with a framework for determining how to apply expressive arts therapy to various treatment goals. For example, how a client can help themselves to self-regulate, form positive attachment, build resilience as well as achieve self-efficacy.

How Does Trauma-Informed Expressive Arts Therapy Support Positive Attachment?

Building upon this, Trauma-Informed Expressive Arts Therapy can be used to support a client to reconnect with a sense of safety, prosocial relationships as well as positive attachments. And I always remember this amazing feeling I had during my rape counselling and it was a real game changer moment for me. I was able to feel safe in my own body for the first time in seven months. I was able to relax, untense all my muscles and actually feel safe. It’s such an amazing feeling and it’s so hard to describe but achieving that sense of safety as a trauma survivor feels impossible. Yet when it happens, it is one of the best feelings ever.

In addition, Trauma-Informed Expressive Arts Therapy helps individuals to recover a sense of internal wellbeing and wellbeing in relationships with others. For instance, expressive arts therapy can provide a range of opportunities for people to engage in creative experimentation that integrates experiences of guidance, unconditional appreciation, experiences found in families with secure attachment, support amongst other benefits. As well as when expressive arts interventions are used in group settings, this can help clients to support prosocial interactions and connect themselves with their community.

And that’s something that I am starting to realise as the months and years roll on is that survivors really are a community. Since if we take rape and sexual violence for example, a lot of people have sadly experienced it, but a lot of people haven’t. That means not everyone in your life has experienced it and without lived experience, you only have a limited understanding of what happened to the other person. Therefore, that feeling of community and knowing what you’re experiencing is normal, okay and understandable given your trauma.

That is a very powerful and potentially healing realisation.

How Does Trauma-Informed Expressive Arts Therapy Help A Client With Distress?

As I’ve mentioned in other places, like the podcast and books, when you experience trauma, it has a wide range of different impacts on you. You can have increased threat detection and this means you’re more anxious, distressed and fearful because you don’t want to be attacked or experience your trauma yet again. Yet trauma does have a lot of somatic and physiological impacts too. And this is why expressive arts interventions are very useful because a therapist can use these interventions to help a client identify and repair a client’s bodily responses to different trauma triggers. As well as expressive arts interventions can help a client learn that their bodies are a resource in trauma recovery, and they want to normalise the body’s reaction to trauma as it isn’t a pathology, it is an adaptive coping mechanism.

How Does Trauma-Informed Expressive Arts Therapy Provide Meaning-Making Experiences?

Another benefit of Trauma-Informed Expressive Arts Therapy is that expressive arts interventions allows a trauma survivor to talk or express what is often unspeakable to them. It allows them to reframe, restructure, restory as well as explore the trauma they experienced and loss through non-verbal, self-empowering, participatory and asset-driven ways.

Personally, this is something that I loved about my own rape counselling because whilst it wasn’t expressive arts-based, it was trauma-informed. It was so healing, empowering and validating to make new narratives of my rape after my trauma. It allowed to realise that it wasn’t my fault, I couldn’t have prevented it and despite what a lot of people were telling me, there was nothing wrong with me.

How Does Trauma-Informed Expressive Arts Therapy Respect a Client’s Preferences for Self-Expression?

Another brilliant part of trauma-informed practice that I flat out love is the fact that it focuses on putting the client at the centre of their own trauma recovery. A lot of research says “treatment” but for some reason that made me uncomfortable, because it’s healing and recovery. Treatment is a little too biomedical model for me. Anyway, trauma-informed practice helps a client to determine how much participation they would prefer in their treatment, and this can be determined by values, worldviews, previous experiences, their culture as well as other interpersonal dynamics. This is useful because some clients, like me, would like to be at the centre of their trauma recovery and they would be very comfortable talking about all aspects of their lives. Yet other clients would not.

Whatever the case, expressive arts therapy provides a client with a wide range of methods to express “What happened” depending on their comfort level with the idea of self-expression. Then the therapist can respect the use of symbols and metaphors that allow the client to control how they communicate sensitive experiences.

How Does Trauma-Informed Expressive Arts Therapy Support Resilience and Strengths?

Finally, expressive arts therapy can be very useful in supporting a client’s strengths and building their resilience over time. Since trauma-informed practice helps mental health professionals to see that everyone is capable of growth as well as trauma recovery, with an acknowledgement that resilience is central to the recovery process.

If a client is not resilient then they cannot really recover.

This is why expressive arts therapy is always life-affirming, it honours a person’s capacity to be resilient as well as they encourage mastery of personal strength. With the ultimate goal being to encourage a client to move their self-perceptions from being a victim to a survivor to a thriver.

Something I firmly agree with.

Clinical Psychology Conclusion

Personally, I have really enjoyed researching and writing up this clinical psychology podcast episode because my mental health hasn’t been great this weekend. I started a slightly under-stimulating new job, it’s loud and leaves me sensory overwhelmed, some rape trauma stuff popped up this week, I didn’t sleep well Friday night because of it and I have been really anxious. Mainly, because I know at some point sooner rather than later, I need to have the rape conversation with someone I’m dating.

Since my rape is starting to impact me again as we start to do things. I am getting distressed, my mental health is dipping and I’m scared that he’s going to dump me, leave me or break up with me if he finds out I’m a rape survivor.

Yet after doing this trauma-focused podcast episode, I understand that this is what I need. I need to have the “Rape Conversation” because it is the most empowering and self-compassionate thing I can do for myself. And even in the awful circumstance that he breaks up with me because I’m a rape survivor. I will understand, I’ll be sad and really disappointed because this guy is brilliant, lovely and we get on really well.

But it just means we weren’t the right fit.

It doesn’t make me a bad person, a failure and it doesn’t mean I’ll never get into a relationship.

Whatever the outcome, I will keep surviving, thriving and living one day at a time.

I really hope you enjoyed today’s clinical psychology podcast episode.

If you want to learn more, please check out:

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Have a great day.

Clinical Psychology References and Further Reading

Heiderscheit, A., & Murphy, K. M. (2021). Trauma-informed care in music therapy: Principles, guidelines, and a clinical case illustration. Music Therapy Perspectives, 39(2), 142-151.

https://www.psychologytoday.com/gb/blog/arts-and-health/202005/what-is-trauma-informed-expressive-arts-therapy

Lusebrink, V. B., & Hinz, L. D. (2021). The expressive therapies continuum as a framework in the treatment of trauma. In Art therapy, trauma, and neuroscience (pp. 42-66). Routledge.

Luzzatto, P., Ndagabwene, A., Fugusa, E., Kimathy, G., Lema, I., & Likindikoki, S. (2022). Trauma Treatment through Art Therapy (TT-AT): a ‘women and trauma’group in Tanzania. International Journal of Art Therapy, 27(1), 36-43.

Malchiodi, C. A. (2020). Trauma and expressive arts therapy: Brain, body, and imagination in the healing process. New York: Guilford Publications.

Malchiodi, C. A. (Ed.). (2022). Handbook of expressive arts therapy. Guilford Publications.

Sajnani, N., & Johnson, D. R. (2024). Trauma-informed drama therapy: Transforming clinics, classrooms, and communities. Charles C Thomas Publisher.

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