How Creative Expression Can Change your Experience of Pain and Trauma

I am not sick. I am broken. But I’m happy to be alive as long as I can paint. - Frida Kahlo

When it comes to pain, everybody seems to have an understanding of it, and knows what it feels like. Whether we talk about physical or emotional pain - the experience of pain is something we all have. Yet getting a profound diagnosis of pain and treating it can be extremely difficult for physicians. Why is that so and how can art help with that? To gain a better understanding of how art can change your experience of pain and trauma let’s go back in history a bit.

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It’s September 1925 and eighteen year old Frida Kahlo and her boyfriend at that time Alejandro Gomez Arias embark on a bus returning home from National Preparatory School in Mexico City, where Frida is studying to fulfill her dream to become a medical doctor. But that day her faith should forever change, when an electric trolley car collides with that bus, killing several of the passengers. Frida survives the accident but her dreams are crushed. A pelvic bone fracture, a broken spine and collarbone, dislocated shoulder and punctured uterus and abdomen force her to undergo many surgeries and bind her to bed for several months. We can only imagine how much pain she was, not only from her physical damage but also from having to drop out of school and giving up on her medical career. It is her father, an artist himself, who arranges an easel for his daughter so she can paint from bed. First Frida simply tries to fill the seemingly endless hours confined in her room. Later she discovers her internal experience through a series of self-portraits. This is the moment when the artist Frida Kahlo, we know today, is born.

It probably comes as no surprise that Arias, who luckily only suffered minor injuries from the accident, eventually leaves Frida, which makes her feel even more agony and loneliness. Seeing others in pain can be terribly difficult, make us feel helpless and bury us in feelings of fear and guilt. And sometimes it can be so hard to bare, that we have to turn away, leaving the hurt left all alone. This inability to stay put, when confronted with pain and trauma is very much connected to stigmatization of the ill. It is a form of fear of feeling too much.

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When we talk about pain, we have to talk about nociception. Nociception is the neurological pathway of pain, starting in free nerve endings, that are receptive to tissue damage, going all the way up our spine and ending in our brain, where the experience of pain is created. Many factors modulate our pain experience, for example whether we have a memory of that pain, our stress-levels, self-esteem and our expectation of pain. Pain is, after all, highly dependent on factors that lie outside of nociception and the physiological process of pain perception, making the experience of pain a highly subjective one.

If pain occurs for more than three to six months it can become chronic pain, forming a vicious cycle of increasing pain due to alterations of our nervous system, leading to severe pain caused even by soft touch or the slightest movement. But why are physiological and emotional pain so related?

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Let’s take a look at emotional trauma, caused by an event that felt highly threatening. Whatever may have happened to you in that situation is not necessarily defining your trauma. About 80% of people experience a potentially traumatizing situation at one point in their lives, yet only 1,5 - 2 % develop a trauma-related disease. The reason for that is that psychological pain is - just as physiological pain - a subjective reaction to a situation. That reaction can include feelings of fear, helplessness, shame, numbness and the inability to act. To put it into trauma expert Dr. Gabor Maté’s words:

[…] [T]rauma is not the bad things that happen to you, but what happens inside you, as a result of what happens to you.

Because of its subjectivity, pain is one of the most difficult symptoms to diagnose and treat. People in pain often have difficulties describing their pain and pinpointing a certain localization. But also physiological changes in our brain can cause an inability to speak about pain and trauma. Studies revealed that trauma related stress can alter the gray substance around Broca’s area, which is our speech center in the brain. These alterations can make speaking about trauma especially difficult, adding on to the mistrust and shame that comes along with trauma. With no language and no one to turn to, we tend to reenact the isolation experienced in the traumatic event or in times of excruciating pain.

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How can art help? Creative expression can help us articulate pain, when words seem to fail us. This goes for the emotions that come along with pain, the localization of pain and its intensity. Symbols and metaphors can make it easier for someone else to understand our situation. Photographer and visual activist Zanele Muholi said:

I use art as my own means of articulation. And it heals me. When I really needed therapy and I wasn’t willing to sit with a shrink, I started to take photographs.

Zanele Muholi discovered their own artistic outlet when they were suffering from depression and suicidal thoughts, not having the means to see a therapist.

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But art can also serve as a direct pain release. Hunter Hoffman and David Patterson co-originated the new technique of using immersive VR „SnowWorld'' for pain control for burn-unit-patients, who have to undergo regular painful bandage exchanges in order to prevent infections of the wounds. Normally these procedures happen under the influence of high doses of opioids - highly effective but also highly addictive pain medication. By creating an immersive virtual winter world colored in different shades of ice blue and white, full of glaciers, penguins and snowmen, the patients didn’t only experience less pain, lower blood pressure and breath frequency, but also for brief moments were able to break the cycle of pain, forgetting about it completely. Patients reported that their pain was reduced by 30-50% due to the VR World. There is a direct effect of colors to our well-being and depending on how they are administered they can compete with strong medication. Colors shape our lives a lot more than we probably think. They play such a huge but subtle role. Most of the time we don’t notice the colors around us, yet they influence us on a deeper level, altering our nervous system, our stress-response, the way we perceive the world.

Simply coloring for twenty minutes can have the same psychological effect on our brain as meditation does. Tibetan monks work with mandalas as a spiritual practice. The sacred geometrical form can help us focus, turning our attention towards the coloring process and away from pain, helping us to find a moment of stillness and peace. C.G. Jung let his patients color mandalas and additionally let them fill in the blank spots with spontaneous symbols that gave insight to their unconsciousness. Those symbols help to gain a better understanding of thought patterns and unconscious emotions.

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Creation is our nature. We are born to create. We draw and paint way before we learn to speak. Our creative nature is our first way of communication. It is how we tell our stories. So when we turn to the arts, we are also able to change our narrative, leaving behind the passive role of a victim and taking over the active role of the producer. Learning new skills and trying out new things can leave us with satisfying gratification and acknowledgement. We can see our Self as something besides the pain, independent from it. Art can not only give us deep insights to our personality but it can also help that personality to grow, by processing inner conflicts.

By painting, drawing, dancing, acting, by singing and all other forms of expression we make ourselves understood. Our experience becomes digestible. Art touches us, when it combines the beautiful with the horrible. It connects with us on a deeper level, creating empathy in the beholder. This process plays a terrific role in the reduction of stigma. When other people’s pain can be seen,  can be appreciated for it’s beauty, understood and felt, our fear of the sick or the ill can reduce and our ability for compassion grows.