Active-duty military service members’ visual representations of PTSD and TBI in masks

Abstract

Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery.

Assessing the potential use of art therapy in the United Kingdom Ministry of Defence Department of Community Mental Health

“…Combat Stress art therapy department in consultation with Kings College London has produced research that evidences the benefits of art therapy with veterans who have PTSD (Lobban, 2017). There are a number of published research papers studying military personnel who enrolled in art therapy programmes in the US and Russia supporting the hypothesis that art therapy improves the health and wellbeing of those who are currently serving or, have served in the military (Alexander, 2015;Campbell et al, 2016;Collie et al, 2006;Jones et al, 2017;Kopytin & Lebedev, 2015;Malchiodi, 2016;Salmon & Gerber, 1999;Walker et al, 2016Walker et al, , 2017. A study in Israel hypothesised that stressors for women in the IDF were not the same as their male counterparts (Harel-Shalev et al, 2017).…”

Art therapy interventions for active duty military service members with post-traumatic stress disorder and traumatic brain injury

“…Treating PTSD, TBI, and co-occurring mood disorders in active duty SMs poses challenges. The programmes presented here point to the value of art therapy as a component of an integrative treatment model that aids in non-verbal discoveries for SMs along the themes of physical and psychological injuries, relational support and losses, military identity, community identity, existential reflections, questions, transitions, and resolving a conflicted sense of self (Walker et al, 2017).…”

“…In this safe space, SMs can explore difficult emotions in relation to their combat trauma. Simultaneously, the mask may serve as a visual representation of positive and negative aspects of self as SMs relate to individual personhood, relationships, community, society, and changes over time (Walker, Kaimal, Gonzaga, Myers-Coffman, & DeGraba, 2017). The mask becomes an externalised functional object that helps SMs talk about their inner experiences with peers, caregivers, and family members.…”

Art therapy and underlying fMRI brain patterns in military TBI: A case series

“…The ability to express specific experiences, emotions or memories and the associated granularity/richness of those subjective psychological elements cannot fully be expressed with standard clinical testing. Cognitive and physical tasks involved in art-making can offer assessment opportunities, outcome improvement, and therapeutic, artistic, and verbal processing of the injury experience (David, 1999;Walker et al, 2017). The 'open canvas' concept of art therapy, therefore, offers a more robust and holistic option for describing trauma and disability in a respectful and dignified manner.…”

“…Art therapy treatment provides an opportunity for an individual's response or outcome from injury to be assessed using external depiction of internal symbolic and metaphorical content. Recent reports indicate thematic patterns of expression in mask making that may represent common types of injury or responses to trauma in SMs (Walker, Kaimal, Gonzaga, Myers-Coffman, & DeGraba, 2017). These studies demonstrate that art therapy, in this case a clinical mask-making directive, provided a platform in which patients were able to express emotions and feelings related to their experiences, often traumatic, and offered visual representations of the self ).…”