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 19^th 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.

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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.

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Gil, E. (2006). Helping abused and traumatized children. New York, NY: Guilford.

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Hammer, E. F. (Ed.). (1958). The clinical application of projective drawings. Springfield, IL: Charles C. Thomas.

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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.

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Koppitz, E. M. (1984). Psychological evaluation of HFD’s by middle-school pupils. New York, NY: Grune and Stratton.

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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)

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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.

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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.

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