Creative Connections:
Meeting the Mental Health
Needs of Adolescents with
Trauma
Charles E. Myers, Ph.D., LCPC, NCC, NCSC, ACS, RPT-S
Adolescence Development
Cognitive (Piaget)
• Concrete to Formal
• Combinatorial and
Abstract
• Moral Autonomy and
Social Justice
Psychosocial (Erikson)
• Physiological
Revolution
• Emerging Identity
• Role Confusion
• Intimacy
Adolescence Challenges
• Friendships
• Conflict Resolution
• Social Skills
• Scholastic and Career
Goals
• Sex and Abstinence
• Substance Abuse/Use
• Caught in Between
Trauma
•Physiological vs. Psychological
•Psychological Trauma
• Response to unexpected event experienced
intimately and forcefully (Everstine & Everstine)
• Overwhelming one’s internal resources (Briere &
Scott)
• Resulting feelings of anxiety, danger, and
instinctual arousal (Eth & Pynoos)
Trauma
•Interpersonal Trauma
• Rupturing of a significant caregiver
relationship (Dayton)
• Break in trust through abandonment, abuse,
or neglect (Findling et al.)
Trauma
•Singular or Accumulative
•Personal
•Negatively Impacts Development
• Affects all development (Gil; James; Terr)
• Effects are more pervasive and long lasting (van der Kolk)
• Disrupts regulation of emotions, behaviors, and
attention (Ford)
Trauma
•Loss of Safety, Trust, and Worth (Perry & Szalavitz)
•Posttraumatic Responses (Terr)
• Intense and repetitive thoughts of trauma
• Reenactment of trauma
• Fear highly correlated to traumatic event
• Sense of featurelessness
Trauma and Neuroscience
Brain Stem (Reptilian Brain)
• Regulates bodily functions
• Coordinates motor, emotional, and cognitive
functions
• State memory
(Malchiodi; McHenry, Sikorski, & McHenry)
Trauma and Neuroscience
Limbic System (Emotional Brain)
• Affective memory
• Affects attachment and motivation
• Self-preservation
• Very vulnerable to traumatic stress
• Source of urges, needs, and feelings
(Malchiodi; McHenry, Sikorski, & McHenry)
Trauma and Neuroscience
Neocortex (Thinking Brain)
• Reasoning, communication, and planning
• Language and abstract thinking
• Cognitive memory
• Oversees executive functioning
(Malchiodi; McHenry, Sikorski, & McHenry)
Trauma and Neuroscience
• Trauma affects the limbic system
• Trauma reactions are non-productive limbic system
responses to external threats (i.e., survival mode)
• Survival Mode (energy expended)
• Fight, flight, or freeze
• Traumatic Stress (energy held)
• Disruption or impairment of normal functioning
• Habitual response development
(Malchiodi)
Mind-Body Connection
• Body Mirrors Emotions
• Difference parts of the brain activate with
different emotions
• Emotions are connected to hormonal,
cardiovascular, and neurological effects
• Trauma physiology so complex - conscious mind is
largely unaware
(Malchiodi)
Memory Storage
Explicit Memory
• Conscious memory
• Facts, concepts, ideas
• Assess to language
• Conesus processing of
information, reasoning,
and meaning
• Defines and makes sense
of experiences
Implicit Memory
• Sensory and emotional
memory
• Body learned memories
• No language
• Senses are memory
(Malchiodi)
Trauma and Memory Access
• Posttraumatic stress reactions exclude explicit
memories (Rothchild)
• Prevents access to context of the emotions and
sensations
• Broca’s area (language center) shuts down (van Dalen)
• Difficult to relate to trauma narrative
• Difficult to identify and verbalize experiences
• Language is often inaccessible
Trauma and Memory Access
• Brain protects itself from extremely painful
memories
• Trauma is stored through somatic images and
senses and is not readily available to verbal
communication (Malchiodi)
• Creative interventions allow the expression of
somatic and sensory memories through concrete
representations and experiential activities
Trauma and Creative Connections
•Creative arts therapies (Malchiodi)
• Use of creative art modalities in treatment
• Utilize creativity, imagination, and selfexpression
• Include: Art, Dance/Movement, Drama, Music,
Play, Poetry, Sandtray, and so forth
• Often integrate mindfulness, relaxation,
visualization
Unique Creative Characteristics
• Brainwise Interventions
(Badenoch)
• Externalization
• Sensory processing
• Right hemisphere
dominance
• Arousal reduction and
Affect regulation
• Relational aspects
• Therapeutic Distancing
• Grounding
• Speech and Language
• Metaphors
References
Briere, J., & Scott, C. (2006). Principles of trauma therapy: A guide to symptoms, evaluation,
and treatment. Thousand Oaks, CA: Sage.
Dayton, T. (2000). Trauma and addiction: Ending the cycle of pain through emotional
literacy. Deerfield Beach, FL: Health Communication.
Erikson, E. H. (1963). Childhood and society. New York, NY: Norton.
Everstine, D. S., & Everstine, L. (1993). The trauma response: Treatment for emotional
injury. New York, NY: Norton.
Findling, J. H., Bratton, C. B., & Henson, R. K. (2006). Development of the trauma play scale:
An observation-based assessment of the impact of trauma on play therapy behaviors of
young children. International Journal of Play Therapy, 15(1), 7-36.
References
Gil, E. (1991). The healing power of play. New York, NY: Guilford.
James, B. (1998). Treating traumatized children. New York, NY: Free Press.
Malchiodi, C. A. (Ed.). (2015). Creative interventions with traumatized children (2nd ed.).
New York, NY: Guilford.
McHenry, B., Sikorski, A. M., & McHenry, J. (2014). A counselor's introduction to
neuroscience. New York, NY: Routledge.
Perry, B. D., & Szalavitz, M. (2006). The boy who was raised as a dog: And other stories from
a child psychiatrist’s notebook: What traumatized children can teach us about loss, love,
and healing. New York, NY: Basic Books .
References
Piaget J., & Inhelder, B. (1969). The psychology the child (H. Weaver, Trans.). New York, NY:
Basic Books.
Terr, L. C. (1983). Play therapy and psychic trauma: A preliminary report. In C. E.
Schaefer, & K. J. O'Connor (Eds.), Handbook of play therapy (pp. 308-319). New York, NY:
Wiley.
Zieglar, D. (2002). Traumatic experiences and the brain: A handbook for understanding and
treating those traumatized as children. Jasper, OR: SCAR/Jasper Mountain.