A case analysis of service-member trauma processing related to art therapy within a military-intensive outpatient program

Exploring the evocative qualities of masks' visual imagery and their associations with adversity and trauma

Introduction

Studies suggest a relationship between the emotional evocativeness of visual imagery and viewer responses, however, there is limited understanding of these associations, especially as they relate to viewers' personal experiences of adversities.

Methods

In this exploratory study, we examined the relationship between the visual content of mask images and viewers' responses. In an online survey 699 participants (of n = 1,010 total initial participants) rated 98 masks based on valence, arousal, and personal relevance and completed the Life Events Checklist. The masks included those created by service members (SMs) with traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD), depicting physical, psychological, and moral injuries and matched neutral masks created by creative arts therapists and arts in health scholars.

Findings

The findings indicated that responses to mask image content (traumatic versus neutral) were associated with viewers' personal history of adversity and trauma. Specifically, images representing injury/trauma provoked stronger reactions on valence and arousal than neutral images. Moreover, participants with personal histories of trauma had heightened emotional responses to distressing imagery.

Discussion

These findings have implications for art therapists as well as for clinical and general populations in that these results highlight the potential impact of distressing imagery particularly for individuals with personal histories of experiencing or witnessing traumatic events.

A case analysis of service-member trauma processing related to art therapy within a military-intensive outpatient program

Objectives

Art therapy has been widely used in clinical settings and has shown preliminary success in military trauma. This case study describes a mask‐making art therapy directive facilitated by a board‐certified art therapist as an adjunct to group posttraumatic stress disorder (PTSD) treatment in a military‐intensive outpatient program.

Methods

Described are clinical outcome measures, linguistic analysis of a personal journal, evaluation of this service‐member's artwork, and experiences in the program.

Results

Mask‐making, as a trauma‐focused group‐art therapy directive, expanded the understanding of treatment progress reflected in journal notes, mask imagery, and by a change in linguistic indices of trauma processing, despite an overall increase in PTSD symptoms as he confronted his traumatic experiences. He reported improvement in coping and successfully returned to full military duty following treatment.

Conclusions

This case study suggests that art therapy and written narrative, combined with standardized self‐report assessments, may more accurately indicate improvement in overall PTSD treatment.