From Friedl Dicker-Brandeis to Edith Kramer to Cathy Malchiodi
While engaging in my own art work recently I began re-thinking of how self expression through artistic means has the potential to heal, to help us recover material, to deepen our knowledge of self and others, to help us transform or/ and overcome pain, to document even, but also how our art tells the truth about us and often about our circumstances and social context, Edith Kramer (1916-2014) believed that ‘Art tells the truth’. Sadly, Edith Kramer, an early pioneer in the field of art therapy, passed away this year at the age of 98 (her official website address is in the Links part of this site, where you can view her art and read her articles and about her). Edith Kramer escaped to the USA from Austria as a political refugee just before World War II (1938). In Europe Kramer had studied art with Friedl Dicker Brandeis (1898- 1944) and had worked with her in Prague helping children whose parents were refugees and was probably influenced by her philosophy and outlook on life. Friedl Dicker and her husband were deported to a camp called Terezin, known as Theresiendstadt, in 1942. They were instructed to pack only 50 kilos. Dicker chose to pack a few clothes only and fill the rest of her weight quota with art supplies not only for her own artistic needs, but to ensure that she would have the necessary art supplies to teach art to the children she expected to meet at the ghetto. Dicker nurtured and taught hundreds of traumatized children as it turned out and her work reflected a form of art therapy because she helped children use art as a way to express their emotions and to cope with their internment in the concentration camp. In the USA Kramer taught art first at the Little Red School House in New York City and later at the Wiltwyck School for Boys, where she applied psychoanalytic theory to her work and was given the title ‘art therapist’. She supported that there is a connection between making art and the Freudian concept of sublimation, which summarily could be defined as a process in which destructive or self-destructive feelings or urges are transformed through art or work into socially productive and acceptable outcomes. Edith Kramer was also the founder of the graduate program at New York University, has authored seminal papers and books, and is a renowned social realist painter, sculptor, print-maker and mosaicist. Her work Art Therapy in a Children’s Community and Art as Therapy with Children have become material read in art therapy courses and programs. Kramer writes ‘My therapeutic medium is as old as mankind. Since human society has existed the arts have helped man to reconcile the eternal conflict between the individual’s instinctual urges and the demands of society. Thus, all art is therapeutic in the broadest sense of the word. The artist who applies modern psychology in the field of art has to adapt his methods to the medium so that the therapeutic value of art is heightened by the introduction of therapeutic thinking, not destroyed or weakened by the introduction of concepts and methods that might be incompatible with the inner laws of artistic creation’. Edith Kramer also believed and supported the idea that the art process, in itself, as well as, the final art product, are both healing factors and people benefit from both. She is also known for her concept ‘the therapist’s third hand’ (I have discussed this elsewhere on this site). Cathy Malchiodi writes that ‘the third hand can be summed up as the therapist’s ability to facilitate a person’s artistic process’ (for instance, intervening or helping the individual mix colours, choose material, cut out pictures, etc. She continues ‘To me, the “third hand” exemplifies our modern-day interpersonal neurobiology paradigms of attunement and empathy, Daniel Siegel’s over-arching concept of ‘mindsight’ and Daniel Goleman’s ideas about ‘focus’ and ‘emotional intelligence’.
So, reading about Edith Kramer and viewing her work again brought me to Cathy Malchiodi’s site, where I also found a very useful article in which Malchiodi discusses Developmental Trauma and Trauma-Informed Art Therapy (TI-AT) and interventions for children and adolescents, which I’d like to refer to briefly. It is apparent that in order to provide and apply trauma informed intervention understanding the effects of chronic trauma on every aspect of one’s experience is essential, in this case on every aspect of a young person’s life. Malchiodi writes ‘in 2005 Bessel van der Kolk and colleagues proposed developmental trauma disorder (DTD) to more accurately describe children and youth who present a range of difficulties as a result of exposure to early, chronic and severe trauma. These individuals may have experienced developmentally adverse trauma involving abandonment, physical abuse or assault, sexual abuse or assault, emotional abuse, witnessing violence or death, and/or coercion or betrayal. Understandably, these types of repeated events cause feelings of rage, fear, shame, defeat, and withdrawal; they are reactions to years filled with adverse and inhumane treatment by parents, family members, caregivers, or others who impact these children’s lives’. Children, like adults who have suffered complex trauma, have problems with emotional regulation because they have probably never been helped to resolve difficult feelings like anger, grief or fear, but also because their amygdala in the lower parts of the brain (limbic system) have in some sense ‘hijacked’ their frontal cortex, because this is how humans are wired to react when dealing with adversities and traumatic experience. Furthermore, young survivors of trauma will have attachment and trust issues and may have difficulty paying attention and learning, and behaving in an appropriate or adaptive manner. Allan Schore has written that negative early attachments with care givers impacts infants’ brain development, especially, the right hemisphere, which as a result, influences one’s attachments and relationships and capacity to regulate emotions. Alan Schore has written that negative early attachments with care givers impact the developing brain, especially, in the right hemisphere, which subsequently influences one’s capacity to regulate emotions and one’s future attachmentsAlan Schore has written that negative early attachments with care givers impact the developing brain, especially, in the right hemisphere, which subsequently influences one’s capacity to regulate emotions and one’s future attachmentsHelping children understand this through psychoeducation, providing therapy and a safe environment can facilitate healing and restoration.
Malchiodi provides a list of recommendations based on her work with children from violent homes, abused children, and youth who witness homicides. Summarily, (you can read more on her website) she suggests a) establishing safety (internal sense and support systems); b) teaching children how to regulate and moderate arousal; c) helping them rebuilt trust and re-establish attachment with positive adult role models and learn how to empathize and interact with peers in a healthier way; d) enhancing brain’s functioning because prolonged trauma has a negative impact on both cortical and cognitive functioning, which of course impacts children’s capacity for learning and problem solving, which in turn impacts their sense of self and e) enhance children’s adaptive and coping skills, and ultimately help children and adolescents transform and construct meaningful lives.
Cathy Malchiodi also explains that Trauma-Informed Practice addresses the neurological, biological, psychological and social effects of trauma in the individual and recognizes the interrelation between trauma and its symptomatology and the possibility that traditional service delivery may exacerbate symptoms, trigger and re-traumatize survivors of trauma. One can read more on this and what Trauma-Informed programs & services represent at http://mentalhealth.samhsa.gov/nctic/trauma.asp. Finally, Malchiodi’s article refers to the role of trauma informed art therapy and expressive arts therapy in working with trauma survivors and PTSD. She writes ‘most children I have worked with over the years have been chronically abused and neglected. As a result, these children generally have a variety of severe trauma reactions (hyperarousal, avoidance, dissociation, and intrusive memories), learning and psychosocial challenges, and attachment difficulties. In many cases, psychodynamic and cognitive behavioural strategies alone cannot address the reactions of children whose cognitive, developmental, and interpersonal skills are compromised by multiple traumatic experiences’. She defines Trauma-Informed Art Therapy and Trauma-Informed Expressive Arts Therapy as ‘the integration of neuroscience and neurodevelopment, somatic approaches, mindfulness practices, and resilience enhancement, using art making as the core approach’.
Since young children may not yet have the means or the words to express their experience art creation can help them (and adult survivors) integrate implicit (sensory) fragmented traumatic memories and explicit (declarative) memories, as discussed more extensively elsewhere. Art is also something that most or at least a lot of children, if they have not been shamed or criticised for their efforts, enjoy doing in any case. Most children like to use art material and they are still at an age when they worry less about the end result and can benefit more from the process. And art is not only a useful approach in therapy but I think in educational settings, as well, where I believe it is underutilized. Being a language teacher for many years I repeatedly found that when writing tasks were linked to art activities or when writing projects required illustrating the number of children to do their homework or engage more enthusiastically with the writing tasks was always higher. In some sense artistic expression facilitated the language learning process. Over the years I found that not only did I get more students involved in writing tasks and elicited more enthusiasm on their part, but their performance in the particular language skill improved. Furthermore, displaying their colourful work around the school boosted their confidence and made writing tasks, even for students who were reluctant or less interested or who found writing more difficult, a more appealing activity.
Tonya Kyriazis-Alexandri, October 30th, 2014
References
Edith Kramer (2002) Art as Therapy: Collected Papers by Edith Kramer, Edited by Lani Alaine Gerity, Jessica Kingsley Publishers
Friedl Dicker Brandeis, Life in Art and Teaching, Retrieved on 29 October, 2014 from http://makarovainit.com/friedl/home.html
Goldman Rubin, S. (2000), Fireflies in the Dark: The Story of Friedl Dicker Brandeis and the Children of Terezin
Malchiodi, C. (1998) Understanding Children’s Drawings, The Guilford Press
Malchiodi, C. Trauma-Informed Art Therapy (TI-AT) and Trauma-Informed Expressive Arts Therapy. Retrieved on 28 October, 2014 from http://www.cathymalchiodi.com/Trauma Informed Art Therapy.html
Malchiodi, C.(March 6, 2012) Trauma-Informed Expressive Arts Therapy. New York: Sussex Publications/ Psychology Today
‘The process of drawing, painting or constructing is a complex experience in which the child brings together diverse elements of his environment to make a meaningful whole. In the process of selecting, interpreting and reforming these elements, he has given us more than a picture; he has given us a part of himself’ (Lowenfeld, 1947, cited in Malchiodi, 1998)
A collage of some of my students’ Christmas cards-artwork offered to me