Art can heal PTSD's invisible wounds | Melissa Walker

120,831 views ・ 2016-11-02

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You are a high-ranking military service member
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deployed to Afghanistan.
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You are responsible for the lives
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of hundreds of men and women,
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and your base is under attack.
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Incoming mortar rounds are exploding all around you.
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Struggling to see through the dust and the smoke,
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you do your best to assist the wounded
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and then crawl to a nearby bunker.
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Conscious but dazed by the blasts,
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you lay on your side and attempt to process what has just happened.
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As you regain your vision,
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you see a bloody face
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staring back at you.
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The image is terrifying,
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but you quickly come to understand
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it's not real.
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This vision continues to visit you multiple times a day and in your sleep.
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You choose not to tell anyone for fear of losing your job
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or being seen as weak.
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You give the vision a name,
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Bloody Face in Bunker,
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and call it BFIB for short.
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You keep BFIB locked away in your mind,
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secretly haunting you,
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for the next seven years.
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Now close your eyes.
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Can you see BFIB?
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If you can, you're beginning to see the face
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of the invisible wounds of war,
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commonly known as post-traumatic stress disorder
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and traumatic brain injury.
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While I can't say I have post-traumatic stress disorder,
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I've never been a stranger to it.
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When I was a little girl, I would visit my grandparents every summer.
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It was my grandfather
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who introduced me to the effects of combat on the psyche.
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While my grandfather was serving as a Marine in the Korean War,
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a bullet pierced his neck and rendered him unable to cry out.
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He watched as a corpsman passed him over,
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declaring him a goner,
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and then leaving him to die.
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Years later, after his physical wounds had healed
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and he'd returned home,
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he rarely spoke of his experiences in waking life.
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But at night I would hear him shouting obscenities
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from his room down the hall.
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And during the day I would announce myself as I entered the room,
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careful not to startle or agitate him.
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He lived out the remainder of his days
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isolated and tight-lipped,
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never finding a way to express himself,
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and I didn't yet have the tools to guide him.
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I wouldn't have a name for my grandfather's condition
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until I was in my 20s.
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Seeking a graduate degree in art therapy,
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I naturally gravitated towards the study of trauma.
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And while sitting in class learning about post-traumatic stress disorder,
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or PTSD for short,
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my mission to help service members who suffered like my grandfather
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began to take form.
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We've had various names for post-traumatic stress
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throughout the history of war:
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homesickness,
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soldier's heart,
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shell shock,
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thousand-yard stare, for instance.
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And while I was pursuing my degree, a new war was raging,
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and thanks to modern body armor and military vehicles,
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service members were surviving blast injuries they wouldn't have before.
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But the invisible wounds were reaching new levels,
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and this pushed military doctors and researchers
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to try and truly understand the effects that traumatic brain injury, or TBI,
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and PTSD have on the brain.
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Due to advances in technology and neuroimaging,
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we now know there's an actual shutdown in the Broca's,
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or the speech-language area of the brain, after an individual experiences trauma.
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This physiological change,
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or speechless terror as it's often called,
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coupled with mental health stigma,
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the fear of being judged
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or misunderstood,
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possibly even removed from their current duties,
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has led to the invisible struggles of our servicemen and women.
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Generation after generation of veterans
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have chosen not to talk about their experiences,
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and suffer in solitude.
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I had my work cut out for me when I got my first job
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as an art therapist at the nation's largest military medical center,
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Walter Reed.
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After working for a few years on a locked-in patient psychiatric unit,
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I eventually transferred to the National Intrepid Center of Excellence, NICoE,
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which leads TBI care for active duty service members.
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Now, I believed in art therapy,
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but I was going to have to convince service members,
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big, tough, strong, manly military men,
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and some women too,
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to give art-making as a psychotherapeutic intervention a try.
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The results have been nothing short of spectacular.
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Vivid, symbolic artwork
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is being created by our servicemen and women,
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and every work of art tells a story.
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We've observed that the process of art therapy bypasses
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the speech-language issue with the brain.
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Art-making accesses the same sensory areas of the brain that encode trauma.
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Service members can use the art-making to work through their experiences
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in a nonthreatening way.
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They can then apply words to their physical creations,
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reintegrating the left and the right hemispheres of the brain.
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Now, we've seen this can work with all forms of art --
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drawing, painting, collage --
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but what seems to have the most impact
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is mask-making.
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Finally, these invisible wounds don't just have a name,
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they have a face.
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And when service members create these masks,
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it allows them to come to grips, literally, with their trauma.
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And it's amazing how often that enables them
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to break through the trauma and start to heal.
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Remember BFIB?
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That was a real experience for one of my patients,
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and when he created his mask,
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he was able to let go of that haunting image.
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Initially, it was a daunting process for the service member,
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but eventually he began to think of BFIB as the mask,
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not his internal wound,
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and he would go to leave each session,
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he would hand me the mask, and say, "Melissa, take care of him."
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Eventually, we placed BFIB in a box to further contain him,
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and when the service member went to leave the NICoE,
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he chose to leave BFIB behind.
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A year later, he had only seen BFIB twice,
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and both times BFIB was smiling
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and the service member didn't feel anxious.
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Now, whenever that service member is haunted by some traumatic memory,
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he continues to paint.
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Every time he paints these disturbing images,
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he sees them less or not at all.
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Philosophers have told us for thousands of years
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that the power to create
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is very closely linked to the power to destroy.
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Now science is showing us that the part of the brain
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that registers a traumatic wound
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can be the part of the brain where healing happens too.
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And art therapy is showing us how to make that connection.
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We asked one of our service members
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to describe how mask-making impacted his treatment,
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and this is what he had to say.
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(Video) Service Member: You sort of just zone out into the mask.
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You zone out into the drawing,
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and for me, it just released the block,
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so I was able to do it.
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And then when I looked at it after two days, I was like,
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"Holy crap, here's the picture, here's the key, here's the puzzle,"
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and then from there it just soared.
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I mean, from there my treatment just when out of sight,
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because they were like, Kurt, explain this, explain this.
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And for the first time in 23 years,
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I could actually talk about stuff openly to, like, anybody.
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I could talk to you about it right now if I wanted to,
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because it unlocked it.
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It's just amazing.
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And it allowed me to put 23 years of PTSD
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and TBI stuff together in one place
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that has never happened before.
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Sorry.
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Melissa Walker: Over the past five years,
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we've had over 1,000 masks made.
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It's pretty amazing, isn't it?
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Thank you.
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(Applause)
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I wish I could have shared this process with my grandfather,
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but I know that he would be thrilled
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that we are finding ways
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to help today's and tomorrow's service members heal,
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and finding the resources within them
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that they can call upon
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to heal themselves.
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Thank you.
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(Applause)
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