Do traumatic life experiences impact how we engage with distressing imagery? How does that affect the way that we approach and consume art? Could this alter the effectiveness of art therapy? Drexel University, PA, USA, psychologists paint a clearer picture in a new research study published in Frontiers in Psychology this month. The trauma therapy researchers report that imagery that reflected anguish evoked stronger feelings in PTSD patients than people who did not have a history of trauma. 1
Masks as a Medium
In this study, the Philly researchers sketched our relationship between personal trauma history and our emotional response to art. This study is the first of its kind to examine how a personal history of adversity can impact our reactions to traumatic vs neutral art.
In art therapy, mask-making is a common practice found to ‘externalize internal conflicts’.2 Drawing comparisons between life and art, the study used masks as their visual medium. Here, the team repurposed images of masks created by military service members diagnosed with traumatic brain injury or PTSD. These masks illustrated physical, psychological, and moral injuries. In contrast, art therapists created neutral versions of these masks to serve as the control.
In an online survey, 699 participants rated 98 masks on whether the image evoked a positive or negative reaction, the intensity of that reaction, and how relevant the mask felt to them. The participants then completed a life events checklist (LEC) to record their history of trauma. The most common traumatic events included physical and sexual assault, natural disasters and transportation accidents.
Facing Trauma
The study used F values to describe how reactions to mask type differed based on the subject’s experience of trauma. An F value of 0.1 reflects a small effect, F= 0.25 denotes a medium effect and 0.4 or greater represents a large effect. 3
The masks created by service members elicited a stronger emotional reaction in those with a history of accident/injury compared to participants who did not. The F value here was 4.74. Similarly, this reaction was more intense in the traumatized cohort. Here, the study reported an F value of 0.43.1
Diverse Lives Lived
The researchers also saw these results replicated across different trauma types. This included people who experienced natural disaster, sexual violence, criminal assault and substance abuse. Considering the more graphic and gory themes of the service member masks, these findings, although validating, came of no surprise to the scientists.
Interestingly, the study also reported that those with personal experience of adversity felt an equal connection to the traumatic and neutral masks. In simple terms, this means that these participants found the traumatic imagery depicted in the masks relatable and could apply the visuals to their own lives. The study hypothesized this is likely due to PTSD-related brain changes that both the service members and participants would have experienced.
Additional research is needed to pin down and confirm these brain alterations. As expected, those with no personal history of trauma found more relevance in the neutral masks.
Real-World Implications
As interesting as these findings are, you may be asking how they apply to real-life people experiencing trauma. Great question! This data highlights to caregivers the importance of sensitivity when exposing patients to visual imagery. Initially, 1,010 people took part in this study. However, this number was whittled down by a third as the survey progressed. This could point to the emotionally demanding nature of the imagery on those with a history of trauma.
Although content with their findings, the scientists emphasized the need for further research. In particular, the team suggested that future studies should include demographic information. It is unknown how factors such as age, gender, ethnicity and cultural background could impact responses to the mask imagery.
In the era of personalized medicine, could individualized art therapy be the key to better outcomes?
References
Arslanbek A, Malhotra B, Stickley KS, et al. Exploring the evocative qualities of masks’ visual imagery and their associations with adversity and trauma. Frontiers in Psychology. 2024;15. doi:10.3389/fpsyg.2024.1337927
Walker MS, Kaimal G, Gonzaga AM, Myers-Coffman KA, DeGraba TJ. Active-duty military service members’ visual representations of PTSD and TBI in masks. International Journal of Qualitative Studies on Health and Well-being. 2017;12(1):1267317. doi:10.1080/17482631.2016.1267317
Cohen J. Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Journal of the American Statistical Association. 1988;84 (408). doi: https://doi.org/10.2307/2290095
Hendler T, Rotshtein P, Yeshurun Y, et al. Sensing the invisible: Differential sensitivity of visual cortex and amygdala to traumatic context. NeuroImage. 2003;19(3):587–600. doi:10.1016/s1053-8119 (03) 00141-1
Hyatt L. From Compassion Fatigue to vitality: Memoir with art response for self-care. Art Therapy. 2019;37(1):46–50. doi:10.1080/07421656.2019.1677423
