An Introduction to "Projective Drawing and Traumatised Children"
Nowadays, traumatic experiences have been bringing distress to not only adults but also
countless children and adolescents (Allen & Tussey, 2012; Levine, 2005; O’Flynn,
2011; Robinson, 2011; Sander, 2006). Both nonviolent and violent incidents
cause trauma to human beings.
Earthquake, war, floods,
hurricanes, workplace violence, neighborhood
violence, physical/sexual abuse, house fire, murder, kidnapping, hostage
taking, separation from a parent, divorce, adoption, car crash, terminal
illness, sudden death, and so on
are all situations that may trigger traumatic
responses in people of different cultural
backgrounds (Kuban &
Steele, 2008; Perry & Szalavitz, 2006; Calhoun &
Tedeschi, 1999; McCann & Pearlman, 1990;
Weaver & Clum, 1995; Tennen & Affleck, 1990).
It is now accepted and validated by
research
findings that not only adults but also children
can and do experience all the reactions of post-traumatic stress disorder (PTSD) (APA, 2000; Levine, 2005; Malchiodi, 1998;
Sander, 2006; Silva, 2004; Steele & Raider, 2009).
No matter if one is exposed
to a traumatic incident as a surviving victim or witness, or as a loved one, friend, or peer
of the victim, such as a school mate and a
neighbor of the victim, or has
viewed on television situations like the Columbine shootings and the Philippine travel coach hostage taking, human beings, especially
children, are vulnerable to PTSD and grief-related reactions (Steele,
2009).
PTSD is defined, in simple terms, as a
diagnosis predicated on the experience of a traumatic event (APA, 2000). The
DSM-V further describes PTSD as a psychiatric disorder that emerges from the
direct or indirect exposure to a traumatic event
such as actual or threatened death, serious injury, or sexual violence, with
the presence of recurrent, involuntary and intrusive distressing memories and
dissociative reactions to the event(s) (APA, 2013, p. 271). Specifically, PTSD is a
psychiatric disorder that can occur following the experience or witnessing of a
violent event, serious accident, or natural or man-made disaster. In children,
PTSD symptoms include re-experiencing the event, avoidance behaviors, and hyperarousal (National
Child Traumatic Stress Network, 2007). PTSD has become a significant mental
health issue in children, particularly those who have experienced natural
disaster, family transition, violence, physical or sexual abuse, illness or
injury (Malchiodi, 2008; Silva, 2004). Catastrophic disasters such as the 2001
terrorist attacks in the United States and the 512 earthquake in Sichuan,
mainland China, 2008, and the experiences in a counseling project with a
children home have prompted my interest in studying children’s experiences of
trauma and how to help them heal from its effects.
Children use drawings, among many
other ways, to express themselves (Gil, 2006; Kaplan, 2003). Many psychologists,
counselors, and other helping professionals use children’s drawings in clinical interviews and assessment. Drawings
have been used in psychological assessment and therapy for over 100 years
(Koppitz, 1968). For decades, projective drawings have continued to be used in
diagnostic and therapeutic settings to gain insight into the unconscious world
of human beings (Hammer, 1958; Lack, 1996; Wadeson, 1980). Over recent decades, projective
testing has been playing an important role of diagnostic and therapeutic
information gathering in the field of psychology and art therapy (Brown &
McGuire, 1976; Di Leo, 1973; Lack, 1996; Lubin, Larsen, & Matarazzo, 1984;
Oster & Crone, 2004; Piotrowski, 1984; Piotrowski, Sherry, & Keller,
1985; Rubin, 1984; Sundberg, 1961; Wadeson, 1980). Yet, there is a general lack
of data to support if drawings reflect trauma symptoms (Cox and Catte, 2000).
Also, little is known about how drawings are used therapeutically with children
who have experienced trauma.
The problems and significance of my study
then, is multi-faceted. First, there is a lack of both quantitative and
qualitative studies on children’s drawings in general (Cox and Catte, 2000;
Deaver, 2009; Gardner, 1980; Golumb, 1990). In Hong Kong and mainland China,
there is hardly any research on the topic. Second, few quantitative and
qualitative studies have been performed on children’s drawings and traumatic
events (Kaplan, 2003; Peterson & Hardin, 1997), let alone qualitative and
studies examining children’s drawings and PTSD. Third, there have been very few
qualitative studies on the use of projective drawings therapeutically with children
in trauma. Hence, I have been interest in exploring the use of projective drawings
therapeutically with children who have experienced trauma, and will make my
attempts with a view to establishing a new clinical model for clinicians to help heal the children who have
experienced trauma by using projective drawings therapeutically. My blog will start with a literature review of research about trauma and
children, followed by a review of relevant studies on how project drawings help
with children from 19th century to date.
References
Allen, B.
& Tussey, C. (2012). Can Projective Drawings Detect if a Child Experienced
Sexual or Physical Abuse? A Systematic Review of the Controlled Research. Trauma, Violence, & Abuse, 13(2),
93-111.
American
Psychiatric Association. (2000). Diagnostic
and statistical manual of mental disorders: DSM IV-TR. (4th ed.). Text
Revision. Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association.
Blos, P. (1962). On adolescence. New York, NY: The Free
Press.
Brown, W. R., & McGuire, J.
M. (1976). Current psychological assessment practices. Professional Psychology, Nov, 475-484.
Buck, J. N. (1948). The H-T-P
Test. Journal of Clinical Psychology, 4, 151-159.
Calhoun, L. G., & Tedeschi,
R. G. (1999). Facilitation posttraumatic
growth: A clinician’s guide. New Jersey: Lawrence Erlbaum Associates Publishers.
Cassidy, J., & Shaver, P.
(Eds.). (1999). Handbook of attachment
theory. New York, NY: Guilford.
Cox, M., & Catte, M. (2000).
Severely disturbed children’s human figure drawings: Are they unusual or just
poor drawings? European Child and
Adolescent Psychiatry, 9, 301-306.
Deaver, S. (2009). Normative
study of children’s drawings: Preliminary research findings. Art Therapy: Journal of the American Art
Therapy Association, 26, 4-11.
Di Leo, J. H. (1974). Children’s drawings as diagnostic aids.
New York, NY: Brunner/Mazel.
Di Leo, J. H. (1983). Interpreting children’s drawings. New
York, NY: Brunner/Mazel.
Drachnik, C. (1995). Interpreting metaphors in children’s
drawings: A manual. Burlingame, CA: Abbeygate Press.
Elbrecht, C. (2006). The transformation journey: The process of guided
drawing-An initiatic art therapy. Germany: Johanna Nordlander Verlag.
Erikson, E. H. (1950). Childhood and society. New York, NY: W.
W. Norton.
Erikson, E. H. (1959). Growth
and crises of the healthy personality. Identity
and the Life Cycle, Psychological Issues, 1, 50-100.
Fraiberg, S.
M. (1955). The magic years: Understanding
and handling the problems of early childhood. New York, NY: Scribner’s.
Freud, A.
(1936). The ego and the mechanisms of
defense. New York, NY: International Universities Press.
Freud, A.
(1946). The psychoanalytical treatment of
children. New York, NY: Schocken.
Freud, A.
(1965). Normality and pathology in
childhood: Assessments of development. New York, NY: International
Universities Press.
Gardner, H.
(1980). Artful scribbles: The
significance of children’s drawings. New York, NY: Basic Books.
Gil, E.
(2006). Helping abused and traumatized
children. New York, NY: Guilford.
Golumb, C.
(1990). The child’s creation of a
pictorial world. Berkeley, CA: University of California Press.
Hammer, E. F.
(Ed.). (1958). The clinical application
of projective drawings. Springfield, IL: Charles C. Thomas.
Harris, D. B.
(1963). Children’s drawings as measures
of intellectual maturity. New York, NY: Harcourt, Brace, and World.
Kaplan, F. E.
(2003). Art-based assessments. In C. Malchiodi (Ed.), Handbook of art therapy (p. 25-35). New York, NY: Guilford.
Klepsch, M.,
& Logie, L. (1982). Children draw and
tell: An introduction to the projective uses of children’s human figure
drawings. New York, NY: Brunner/Mazel.
Koppitz, E. M.
(1968). Psychological evaluation of
children’s human figure drawings. New York, NY: Grune and Stratton.
Koppitz, E. M.
(1984). Psychological evaluation of HFD’s
by middle-school pupils. New York, NY: Grune and Stratton.
Kramer, E.
(1971). Art as therapy with children.
New York, NY: Schocken Books.
Kramer, E.
(1979). Childhood and art therapy.
New York, NY: Schocken Books.
Kramer, E.
(2000). In L. A. Gerity (Ed.), Art as
therapy: Collected papers. London: Jessica Kingsley.
Kramer, E.
(2001). Sublimation and art therapy. In J. A. Rubin (Ed.), Approaches to art therapy (2nd ed., pp. 28-39) . New York, NY: Brunner-Routledge.
Kuban, C.,
& Steele, W. (2008). One-minute interventions for traumatized children and adolescents.
Clinton Township: The National Institute for Trauma and Loss in Children.
Lack, H. S. (1996). The person-in-the-rain projective drawing as
a measure of children’s coping capacity: A concurrent validity study using Rorschach,
psychiatric, and life history variables (Doctoral dissertation). Available
from ProQuest Dissertations and Theses database. (UMI No. 9715576)
Levine, P. A. (2005). Healing trauma: A pioneering program for
restoring the wisdom of your body. Boulder: Sounds True.
Lubin, B., Larsen, R. M., &
Matarazzo, J. D. (1984). Patterns of psychological test usage in the United
States: 1935-1982. American Psychologist,
39(1), 451-454.
Machover, K. (1949). Personality projection in the drawing of the
human figure. Springfield, IL: Charles C. Thomas.
Malchiodi, C. (1998). Understanding children’s drawings. New
York, NY: Guildford.
Malchiodi, C., Steele, W., &
Kuban, C. (2008). Resilience and posttraumatic growth in children and
adolescents. In C. Malchiodi (Ed.), Creative
interventions with traumatized children (p.285-301). New York, NY:
Guilford.
McCann, I. L., & Pearlman, L.
A. (1990). Psychological trauma and the
adult survivor: Theory, therapy, and transformation. New York, NY:
Brunnel/Mazel.
National
Child Traumatic Stress Network. (2007). Child
traumatic stress introduction. Retrieved from
http://www.nctsnet.org/nccts/nav.do?pid=faq_main
Naumburg,
M. (1950). Schizophrenic art: Its meaning
in psychotherapy. New York, NY: Grune and Stratton.
Naumburg,
M. (1953). Psychoneurotic art: Its function
in psychotherapy. New York, NY: Grune and Stratton.
Naumburg,
M. (1966). Dynamically oriented art
therapy: Its principles and practices. New York, NY: Grune and Stratton.
O’Flynn,
C. D. (2011). The effect of traumatic and
non-traumatic grief on children’s human figure. USA: ProQuest, UMI:
3472261.
Oster, G. D.
& Crone, P. G. (2004). Using drawings
in assessment and therapy: A guide for mental health professionals (2nd
ed.). New York, NY: Brunner-Routledge.
Perry, B., & Szalavitz, M. (2006). The boy who was raised as a dog and other stories from a child psychiatrist's notebook. New York, NY: Basic Books.
Peterson, L. W., & Hardin, M.
(1997). Children in distress: A guide to
screening children’s drawings. New York, NY: Norton.
Piotrowski, C. (1984). The status
of projective techniques: or “Wishing won’t make it go away”. Journal of Clinical Psychology, 40(6),
1495-1501.
Piotrowski, C., Sherry, D., &
Keller, J. W. (1985). Psychodiagnostic test usage: A survey of the society for
personality assessment. Journal of
Personality Assessment, 49, 115-119.
Robinson, C. J. (2011). A validity study of projective drawings
(Doctoral dissertation). Available
from ProQuest Dissertations and Theses database. (UMI No. 3481825)
Rubin, J. A. (1984). The art of art therapy. New York, NY:
Brunner/Mazel.
Rubin, J. A. (2005). Child art therapy. Hoboken, NJ: John
Wiley & Sons.
Sander, C. (2006). Using the House-Tree-Person test to assess
sexually abused adolescents. USA: ProQuest, UMI 3255223.
Schildkrout, M. S.,
Shenker, I. R., & Sonnenblick, M. (1972). Human figure drawings in adolescence. New York, NY: Brunner/Mazel.
Silva, R. (Ed.). (2004). Posttraumatic stress disorders in children and adolescents. New York, NY: Norton.
Steele, W. (2009). Trauma intervention
program, structured sensory interventions for traumatized children, adolescents and parents. Clinton Township: The National Institute for Trauma and
Loss in Children.
Steele, W., & Raider, M.
(2009). Structured sensory intervention
for traumatized children, adolescents and parents (SITCAP): Evidence based
interventions to alleviate trauma. NY: Edwin Mellen Press.
Sundberg, N. (1961). The practice
of psychological testing in clinical services throughout the United States. American Psychologist, 16, 79-83.
Tyson, P., & Tyson, R. L.
(1990). Psychoanalytic theories of
development: An integration. New Haven, CT: Yale University Press.
Tennen, H., & Affleck, G.
(1990). Blaming others for threatening events. Psychological Bulletin, 108, 209-232.
doi:10.1037/0033-2909.108.2.209
The
National Institute for Trauma and Loss in Children. (2010). From
trauma to resilience: Short-term help long-term gains. Clinton
Township: Starr Commonwealth.
van der Kolk, B., McFarlane, A., &
Weisaeth, L. (1996). (Eds.) Traumatic
stress disorder: The effects of overwhelming experience on mind, body and society. New York: Guilford Press.
Wadeson, H. (1980). Art psychotherapy. New York, NY: Wiley.
Weaver, T. L.,
& Clum, G. A. (1995). Psychological distress associated with interpersonal
violence: A meta-analysis. Clinical
Psychology Review, 15, 115-140. doi:10.1016/0272-7358(95)00004-9
