Creative Forces: Healing Arts for the Military

On Memorial Day, we honor members of the military who made the ultimate sacrifice to preserve our country’s liberty. We also pay homage to those who returned home bearing the scars of their heroism. Since May is Mental Health Awareness Month, it’s a fitting time to acknowledge that more than 500,000 service members are living with conditions that compromise their mental wellbeing and relationships: post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI).

Service members bearing these invisible wounds have a valuable ally on the home front in Creative Forces , a partnership of the National Endowment for the Arts (NEA), the Department of Defense and the Department of Veterans Affairs. Creative Forces helps overcome the ravages of PTSD and TBI by providing creative arts therapies that span a wide spectrum of human expression, including painting, drawing, music, dance and creative writing. These therapies are embedded into a broader, integrative treatment model at 11 clinical sites around the country. Creative Forces also offers a telehealth program that provides “virtual therapy” via telecommunications to those out of range of the clinical sites.

Around 25 creative arts therapists coordinate to learn what works best in a clinical setting and set goals for future research. Each participant receives daily doses of art therapy that may involve anything from mask making and writing personal essays to producing musical recordings.

Bringing Repressed Memories and Emotions Out into the Open

While the arts can improve wellbeing in most anyone, they are an especially logical choice for someone grappling with PTSD or TBI. Bill O’Brien, Director of Creative Forces and Senior Advisor for Innovation to the Chairman at the NEA explained, “When you deal with these psychological health issues and existential types of problems, spiritual wounds, and moral injury, the role that the arts can and should play to help unpack and confront these issues is almost obvious.”

Artistic activities allow service members to utilize metaphors and symbolism for self-expression. This helps them access repressed memories and communicate feelings that are difficult to express verbally in cases where combat trauma has shut down the language pathways of the brain.

O’Brien tells us that arts-based therapy can also be a source of pride that turns a position of weakness into one of strength. “I think that when you are able to confront something really traumatic or dark, give expression to it and share it with other people, it becomes craft,” he said. “It becomes a demonstration of skill rather than a revealing of weakness or disease.” By becoming a source of pride, therapeutic creative activities may turn into lifelong habits that continue to support wellbeing long after treatment is over.

Backed by Rigorous Science

Creative Forces utilizes therapies based on clinical studies that confirm the positive benefits of artistic expression on brain function, mood and overall wellness. Among the areas under investigation in its five-year research plan for 2018 through 2022 are how to determine optimal dosing and duration for specific therapies, as well as how to compare the performance of social versus solo therapies, and telehealth versus onsite interventions.

Important insights have been gained by Creative Forces on the neuroscience associated with the creative arts. We now know, for example, that creative arts therapy in those with physical or psychological injury can help shift one’s internal focus dramatically—from a part of the brain that focuses on survival to the learning brain, which is calmer and more likely to accept new information. Art therapy involving the senses may facilitate access to non-verbal aspects of traumatic memories that are often repressed. This enhanced recollection allows memories to be processed and organized in a meaningful way, which may then lead to a reduction of anxiety and depression. More studies, especially long-term ones, are warranted to confirm these therapeutic outcomes.

A lot of fascinating work has been done in therapies that involve making masks. Studies show that participants who make masks with images associated with despair and anger are in more urgent need of therapy than those whose masks have themes related to nature, military unit identification, sociocultural metaphors, and cultural and historical characters. These findings may help therapists determine the level of dysfunction and the right therapeutic approach for a specific service member with PTSD or TBI.

Results published in more than a dozen research papers associated with Creative Forces show that creative arts therapies enable service members to:

• Have fewer flashbacks and nightmares.
• Improve frustration tolerance.
• Cope with grief, loss, avoidance, survivor’s guilt and shame related to wartime.
• Feel a stronger connection with society after returning home.
• Improve self-regulation of anger and anxiety.
• Experience more hope, gratification and confidence.
• Reduce feelings of isolation and stigma.

Forging Connections with the Community

Creative Forces also has a Community Connections program that builds bridges between service members, veterans, and local arts organizations.  In forging these relationships, the program aims to provide an arts-based support network to military personnel transitioning from clinical treatment back to daily life.

In 2019, 10 Community Connections projects are being hosted throughout the country. In Anchorage, Alaska, participants will perform and present exhibits to the public following a series of two-day creative workshops. A program in Bethesda, Maryland, includes workshops on storytelling, improvisation, theater crafts, playwriting and theatrical design. In Killeen, Texas, participants will create their own broadcast-quality audio documentaries and share them at an open community event. Other programs are building connections in cities in California, Colorado, Florida, North Carolina, Virginia and Washington.

Exploring the Possibilities for Civilians

The therapeutic benefits generated by Creative Forces are echoing outside the military realm. “We are beginning to explore other trauma-exposed populations and I think creative arts therapies would be beneficial for them too,” acknowledges O’Brien. Music therapy, for example, can benefit people affected by Parkinson’s disease or stroke. There also may be applications for victims of substance abuse, sexual abuse and other types of trauma where standard therapies alone don’t get to the root of the problem.

An overview of creative arts therapies for the military in International Journal of Art Therapy offers a fitting appraisal of what these treatments can achieve: “The art therapy journey serves as an agent of change, during which [service members] establish a new sense of self as creator rather than destroyer, as productive and efficacious instead of broken, as connected to others as opposed to isolated, and in control of their future, not controlled by their past.”

Written and reported by IAM Lab Contributor Ed Decker.  Ed Decker is a freelance neuroscience writer and former Science/Health Editor at Rewire Me, a wellness website.

Art Therapy Medicine Mental Health Military Research