Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Artemis: Free-spirited Greek goddess of hunting. Protector of youth. Source of strength and health.
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veterans from all branches of the service. I co-created the group together with Kim Layne L.Ac, AOBTA ® -CP, AOMA graduate and Director of Integrative Medicine at the Samaritan Center here, and Annie McMillin, a decorated army veteran and accomplished artist. The result was the Artemis art and peer group. We staged our first collective exhibit at the end of 2014. Three more shows are scheduled for 2015, including a fall exhibit at Austin's Washington Carver museum.
Empowerment Via Informal Peer Groups
Some members of the Artemis group are clients of Kim's and mine. Some have experienced various layers of trauma including sexual abuse by military colleagues while on deployment. Other veterans and those still on active service joined us later.
Initially, we thought the group might be a useful, informal way of offering a safe space for women veterans to create art projects while airing and sharing experiences – not just about a complex range of PTSD symptoms. We did not aim at a self conscious "therapy group." Perhaps that's the secret. We were not hampered by bureaucracy. No one felt under a spotlight. No one felt pressured to "talk." Stories spilled out spontaneously. We met a couple of Saturdays per month in a comfortable, well lit classroom setting offered to us by the First Unitarian Universalist church of Austin.
We all chipped in to provide coffee, fruit and muffins. As the stories grew, I scribbled down some of the comments we later pinned up between the artworks at our first exhibit in the church's gallery.
- I was afraid my nightmares would come true.
- I was told women should not be in the military. My stress level shot up.
- I was there for Them. Not for Myself.
- I had to become gender neutral. Our male colleagues would often label us as sluts, ballbusters, or dykes.
- No sane person would jump out of a plane. So you just shut down your emotions.
- We experience "Stress Inoculation."
- Why can't I do normal things like other people? I bolted out of church.
- I lost the normal range of emotions.
- Civilians Don't Understand.
The latter comment became something of a refrain. Any mild or acute post-traumatic stress symptom grew when these servicewomen returned to civilian life or to non-military families, partners and spouses, who just did not get it. Or couldn't understand why noisy crowds were intolerable. Or asked dumb questions like, "what's it like to kill someone?" We began to see the art exhibit as a way of communicating some tough but poignant facts to the general public.
Artemis members reflect all ethnic backgrounds. Ages range from early 30s to over 90. They represent all branches of the service from WW2 to current deployment in Iraq and Afghanistan. Experienced artists with portfolios of works in oils, pen and ink and water colors, mixed media and sculpture, sit alongside participants toting large drawing pads for impromptu sketches.
Those with technical or e-skills generously share their expertise with those who haven't touched a sketch pad since childhood. New artists are born.
Our first group show included an eclectic mix. Painted skulls of animals – (from roadkill to a bobcat randomly killed by kids) were exhibited next to nature scenes in oils, and a jazz work showing BB King's hands on a piano. Aprons made of recycled materials hung alongside pen-and-ink Zentangle sketches, and water colors of Asian women. A collage of photographs and verse displayed next to the only directly military theme – a personal exploration of a heroine – a paratrooper juxtaposed with a picture of herself as a little girl. Experienced artists exhibited alongside those who were just discovering their inner creativity. The result surprised us all. Guests at the opening spent as much time studying the exhibits as they did while contemplating and discussing the quotes.
As the Artemis organizers, Kim, Annie and I avoid labels. We enjoy the way the group dynamic enables participants to share whatever is in their minds. No topic is off limits. "This has deepened my appreciation for peer support in a recovery process. I feel so much gets lost in the use of the single acronym PTSD. Very few people take the time to think critically about the complexity of it," said Kim Layne L.Ac. Annie McMillin adds, "There's no medicine like a quick pill to build trust in yourself. Only talk groups like this helped me regain trust in myself and others. Very empowering. I feel I belong. We have all walked the same path. We have the warrior spirit and now we're here for one another. Using beauty and art to heal."
We all feel it's helpful to balance "protocols" or "prescriptions" with direct experiences and observations of what works for some but not others. As some Artemis group members are clients at the Samaritan Center, they have the additional advantage of an integrative approach. This can include individual and family counseling, peer support linked to the Military Veteran Peer Network, acupuncture, herbs, Tuina, massage, biofeedback and neurofeedback, Tai Chi and Yoga, group therapy and EMDR, where appropriate.
Kim Layne's lead article in the August 2014 issue of Acupuncture Today details the Samaritan Center's comprehensive treatments and Hope for Heroes program, offering relief for military veterans seeking alternative integrative care. Grants enable the center to offer treatments on a reduced-fee sliding scale for veterans – men and women. In a logical progression, we have moved our Artemis group meetings into the Samaritan Center to prepare for our next group exhibit – May 16, Armed Forces Day.
Treatments And Controversies
The need for an individual and creative approach to PTSD symptoms was certainly highlighted by David J. Morris, former Marine infantry officer, in a New York Times article published on January 17th of this year and titled, "After PTSD, More Trauma." Outlining his strong objections to repeated sessions of Prolonged Exposure Therapy as being counterproductive – though helpful to some – he dubbed it "emotional chemotherapy" compared with the "emotional Tai Chi" he experienced in Cognitive Processing Therapy. The article prompted a flurry of letters to the Times opinion page, mainly in support of Mr. Morris. Charles R. Marmar, chair of psychiatry at NYU Langone Medical Center and director of the Steven and Alexandra Cohen Veterans Center there, wrote about the need for more studies to help clinicians move away from a one-size-fits all approach.
On a final note, my own zeal for such progressive work honors three generations of my family in the military. Specifically, my army veteran niece Dyan Ferguson, who helps direct Honoring the Path of the Warrior veterans programs out of the San Francisco Zen Center involving group meditation, hikes and kayaking to help ease PTSD. I also honor the memory of my mother's brother Cecil Coombe, who, sadly, and according to the treatment-of-the-day, was institutionalized for years following a lobotomy to quell stress symptoms after serving on a Royal Navy minesweeper in WWII.
For more details about the Artemis Project, email Pam at Pamelacudot@gmail.com or Kim Layne L.Ac at firstname.lastname@example.org.