I am privileged to work with new moms in my private practice. It is tremendously gratifying to help women and their families move through what can be one of the most challenging life transitions—that of parenthood. In my work with mothers, I see many women who experience perinatal mood/anxiety issues (PMADs), perinatal loss (miscarriage), fertility challenges, and traumatic birth situations (see prior articles on these subjects on my GoodTherapy.org profile page). Most often, interventions with moms are a combination of evidence-based cognitive behavioral work and interpersonal approach to assist the client in full recovery. I have also found great benefit in the use of expressive arts to assist this population in healing.
Expressive arts therapies are defined as the use of creative arts (art, dance, music, writing, drama) as a form of psychotherapy. The process of art making is emphasized versus the final product. In my practice, I employ the use of visual arts and crafts as a powerful intervention with clients of all ages. Although I am not an art therapist, I believe the use of art intervention is incredibly meaningful and assists in recovery from PMADs.
The American Art Therapy Association defines art therapy as a practice as “the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma, or challenges in living, and by people who seek personal development.” Art therapy itself is considered a specific subspecialty in the field of psychology/counseling and requires an intensive registration and education process. With either expressive arts intervention or art therapy, the client does not need to have prior art training and need not feel pressured to produce a masterpiece. Again, the focus of the intervention is the process, not necessarily the product outcome.
I was initially exposed to the power of art to heal trauma in the drawings of child survivors of domestic violence in a San Diego shelter when I first began my career in clinical social work 20 years ago. In graduate school, I worked with a registered art therapist in a hospice setting, counseling children and families who experienced the loss of a loved one due to terminal illness. Art intervention was the primary modality in individual, group, and family work.
Moving forward through my career, most every setting I have been employed in involved the use of art as an intervention and source of healing. School and clinic-based settings provided ample opportunity to continue to bring art and creativity to the therapy process for children and adults managing depression, anxiety, trauma recovery, loss, life transitions, divorce, social skills issues, and medical traumas.
Art intervention is incredibly helpful for trauma survivors and those recovering from life challenges (including for clients feeling a sense of PTSD from perinatal depression). Art allows the right brain to be balanced and integrated with the rational, logical left brain. The bilateral movement of the hand moving across the page (mimicking the back-and-forth motion of EMDR) in turn assists in releasing trauma and integrating the experience in the brain.
Typically I will invite my client to participate in an art intervention at a point in her healing process in which she is beginning to feel the first glimpses of recovery. Sleep is beginning to be restored, mood is lifting, and anxiety is starting containment. Prior to art intervention, I will have helped to stabilize any crisis, link my client with other helping professionals and extended support networks (psychiatrists, lactation consultants, doulas, support groups, family support), and work with her to attain a level of recovery in which her focus and concentration are improving, along with her mood health. She may begin an exercise regimen; she may have hired a doula (caregiver) or enlisted the assistance of her extended family with baby care. She is beginning to feel biochemical relief, perhaps with the assistance of an SSRI, improving her nutrition with omega-3 fish oils, and she is sleeping for at least five consecutive hours (a full sleep cycle which restores serotonin).
Art interventions which I find particularly helpful for new moms contending with PMADs (which can also be adapted to other populations) can be created in individual or group modalities. Significant others of new moms may also participate in a couple/family session. The following are suggestions for use with new moms recovering from PMADs:
Materials needed: colored pencils/markers, large poster paper.
Have client draw images of symbols which represent the wishes she hopes to manifest (for example, “good health/vitality” may be a sunshine image); encourage client to add powerful affirmation to the page (“I am reclaiming the best of my health and vitality”) and label each image. Invite client to post “treasure map” in a prominent location in her house to be reminded of the goals she is setting for herself in active manifestation.
Purpose: a visual guide to affirm client’s goals and provide reassurance.
Materials needed: magazines with a variety of images, large butcher/poster paper.
Have client select images from magazines which represent her new identity transformation as a mother, or use theme in intervention above to guide client in goal attainment for self-care and balance as a new mom. Discuss images and invite client to verbalize how the images are important and meaningful to her.
Purpose: validation and support with role transition to new motherhood.
Materials needed: preformed paper/cardboard face masks (available in craft supply stores), feathers, colored markers, beads, yarn.
Ask client to create one mask which demonstrates how she presents to the “outside world.” The second mask will reflect how she feels “inside” as a new mom. Discuss how masks are similar and different and why. What is the purpose of each emotional mask?
Purpose: identifying how feelings inside often do not match what we show to the outside world.
Materials needed: sculpy clay, paint, paintbrushes.
Invite client to create image out of sculpy clay (that which can be baked and hardened at a later time, then painted). The image can be a symbol of new motherhood, an image of mother/baby, or an object representing courage and healing (perhaps a bead for a charm bracelet or necklace). Once completed, client gets to keep the object in a special place as a reminder of her strength and courage in her healing process.
Purpose: a transitional object/symbol of the work the client is doing in psychotherapy and a tangible representation of her inner strength and courage.
Materials needed: art journal, colored pencils/markers/paint/paintbrushes.
Many clients prefer to draw feelings in lieu of writing about feelings. Invite client to create image of her birth experience using vibrant color of her choice, and to narrate her story of the experience. This exercise is especially helpful in working with survivors of birth trauma. It is also helpful to add second exercise of an image in which client creates a symbol on paper representing healing and recovery.
Purpose: Recording emotions (written or drawn/painted) allows a container for the client to “place” her feelings so she is less overwhelmed. She is able to “master” any traumas by telling her story and her experience.
Materials needed: array of bead supplies (beads, bracelet/necklace wires, etc.).
Invite client to create jewelry representing her new identity as a mother, her connection with her child.
Purpose: affirmation of new role and connection/attachment to new baby.
Materials needed: shoebox, construction paper, markers/pens/paints, any supply to decorate a box or album.
Assist client with decorating a special box to hold keepsakes (photos, poems, cards, etc.) as she becomes a new mother. A scrapbook can be a similar project. Discuss her identity transformation and the joys/positives of this new life role.
Purpose: recording the most transformational journey a woman can ever go through and celebrating it.
Materials needed: paper, pastels, paints, pencils/pens.
Mandalas are circular images from ancient cultures and religions which represent the power of one’s healing process (see Mandala book). Invite client to create a mandala with the materials of her choice.
Purpose: for client to enjoy process (versus product) of art making and generating an image which represents healing and recovery; practicing self-care through creativity flow.
Materials needed: paper plate, yarn, beads, feather, single-hole punch, scotch tape.
Assist client in constructing a native American dreamcatcher, which can symbolically protect her from nightmares and scary, intrusive thoughts at night. Discuss the dreamcatcher as symbol of nighttime inner peace and tranquility.
Purpose: Most moms with PMADs have horrible sleep initially and need comfort at night. This craft is a great visual to calm the nerves and assuage the soul. Add some lavender- and vanilla-scented oil to the dreamcatcher, and invite client to place above her bed.
Materials needed: clothespin, yarn, tongue depressors, colored pens, fabric scraps.
Invite client to create a Guatemalan worry doll which can hold her worries before she goes to sleep at night or when she begins her day (see The Kid’s Multicultural Art Book).
Purpose: Women with PMADs are anxious. They need a “container” in which to place their worries and fears; worry doll may represent transitional object of the therapist in between sessions.
“The aim of art is not to represent the outward appearance of things, but their inner significance.” —Aristotle, 384-322 B.C.
The following are books and websites which have been, and continue to be, a source of inspiration and enlightenment:
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org.