Trauma and the Arts

a review of Trauma, Tragedy, Therapy: The Arts and Human Suffering by Stephen K. Levine
London, England: Jessica Kingsley, 2009. ISBN 978-1-84310-512-1. $29.95, paperback
Reviewed by Ilene Serlin, Ph.D.
Published in PsycCRITIQUES -- Contemporary Psychology: APA Review of Books - May 26, 2010, Vol. 55, No. 21, Article 8


Trauma, Tragedy, Therapy: The Arts and Human Suffering is a beautifully poetic title for a book that looks at the role of the arts in working with trauma and human suffering. I believe that this book, and this approach, should be required in all trauma curricula. In my own experience working with trauma as a psychologist and dance therapist, I see over and over the power of the arts to reach, express, and transform human suffering (Serlin, 2009a). With troops returning from Iraq and new deployments in Afghanistan, it is imperative to find new and creative ways to work with trauma. The expressive arts therapies are a cost-effective, noninvasive, hopeful new possibility (Serlin, 2007).

Levine introduces his book with an artful challenge to the dominant scientific paradigm on which trauma studies are based. This dominant paradigm is scientistic and produces psychotherapy outcome measures that are based on quantity rather than quality. Its outcome measures are reductionistic and extract "treatments" out of the context of real-life experience. These treatments are based on the old Cartesian mind/body dichotomy, are expressed in a mechanistic discourse, and do not address the speechless, frozen quality of trauma. In this model, trauma is pathologized, adding to shame and guilt, and blocking exploration of feelings and meaning.

Levine looks for an alternative to this paradigm in the area of the arts, which represent an embodied, playful, creative approach to express and transform human suffering into creative action.

Understanding Trauma Is Key to How We Work With It
Levine describes the phenomenology of trauma as a shattering event that marks a life. Trauma is not a concept or an event; it is an experience that cannot be grasped with a purely cognitive approach. Most trauma diagnoses and therapies are too rational and cannot convey the experience of fragmentation, meaninglessness, absurdity, or horror.

In the old paradigm, human beings are understood as information-processing machines that can be understood in terms of their mastery of existence. In the new paradigm, human beings can also create themselves in the future by means of the traumatic imagination. This imagination can see and express images of fragmentation while also seeing the underlying unity of connections and patterns.

The traumatic imagination helps us see that all human experience is shaped by joys and suffering, celebration and mourning. Creating art out of the whole range of human experience is an act of courage, a leap into the void (May, 1975; Serlin, 2009b). Through it, we can transform terror into beauty and imagine new possibilities for the future.

What Therapy Helps Us Give Voice to These Joys and Sufferings, and Create New Lives?
We heal by facing our mortality. Many people who suffer or have suffered awful trauma report that facing death has taught them how to live (Kubler-Ross, 1997; Serlin, 2004, 2007; Serlin & Cannon, 2004; Yalom, 1980). Sometimes death comes in the form of chaos, threatening dissolution of the self. In this case, one heals by embracing the chaos of existence, the Greek god Dionysus, who passes between life and death.

We heal by facing the fragmentation of postmodernity and finding a creative way to live with the reality of constant change. We gather the disparate pieces of our existence and find new connections; these connections live in the truths of our lives and in our embodied relation to the earth (Stolorow, 2007). Art powerfully takes us to the very center of our experience. Sometimes this confrontation with the truth of our experience brings us terror; Rilke, for example, has observed that terror and beauty are often comingled.

We inoculate ourselves against terror by immersing ourselves in tragedy. Through an immersion in the performative mode of Greek tragedy, we achieve catharsis, or purification. The healing power of tragedy comes, according to Aristotle, when pity and terror are transformed into compassion and awe. As Levine says, "This is the effect of poiesis, the mimesis that works through aesthesis to bring about catharsis, the purification and sanctification of human life" (p. 50).

When it lives in our bodies, trauma calls for an embodied therapeutic approach that is based on tacit, not cognitive, ways of knowing. Levine quotes Merleau-Ponty's idea of the lived body and gesture as the links between perception and language (p. 34). In my own work with dance therapy, I have called the integration of body and imagination kinaesthetic imagining (Serlin, 1996). I have seen that it can be cultivated as a way of knowing in therapists and students.

Sharpening our embodied response to others heightens the use of our own bodies to understand the other. As therapists, art therapists are not blank slates but resonate with others. We know through sensing as aesthesis.

Finally, unlike most discursive therapies, the arts can convey a sense of the sacredness of life.

Summary
On the whole, Levine makes an important contribution to the field of trauma study by identifying philosophical problems within the current field of trauma study. He then shows how a new discourse, a new imagination of the problem and of new possibilities, can be created through the expressive arts therapies. He introduces trauma therapists to Aristotle and Plato, Merleau-Ponty and Jacques Derrida, Rudolf Arneim and James Hillman. Strangely enough, Levine overlooks Rollo May (1975), whose views are close to his own. These writers, artists, and therapists offer trauma therapists a new language to understand and work with trauma. For this introduction, Stephen Levine is to be greatly commended, and his contribution will continue to influence generations of trauma therapists.

My only reservations come through my own direct clinical experience and observations. For example, despite Levine's disclaimers in the chapter "Is Order Enough? Is Chaos Too Much?," I found that there is still a slight note of romanticizing chaos. I find this to be true in some Jungian and archetypal writings (Hillman, 1964); sometimes it seems clinically na´ve. I also am personally more inclined to a more Zen and orderly approach to healing and thus found Levine's style sometimes repetitive and baroque.

It almost seems that Levine recycled previous work as a retrospective of his oeuvre. Instead of deepening the focus and understanding of the phenomenology of trauma, he stays theoretical and repeats endorsements for the expressive arts therapies in general. I thought it odd that he did not review other approaches to using the creative arts therapies to work with trauma (Carey, 2006; Haen, 2009).

Finally, although Levine begins his book with a story about his discovery of his family's Holocaust history and his own confrontation with trauma, unfortunately he does not return to this theme at the end of the book, which ends on a very theoretical note. It would bring emotional closure to this significant book if he could tell the reader how his work with trauma has transformed his own relationship to it. Connecting his own search back to specific cultural roots would support his method's cultural diversity and applicability (Carey, 2006; Haen, 2009; Serlin & Speiser, 2007).

However, his students and other arts therapists can follow this book with more concrete case studies and narratives. What Levine has done with Trauma, Tragedy, Therapy is an enormous gift to the literature on the psychology of trauma, and it lays the foundation for careful and productive new studies.

References
  • Carey, L. (Ed.). (2006). Expressive and creative arts methods for trauma survivors. London, England: Jessica Kingsley.
  • Haen, C. (Ed.). (2009). The creative arts therapies in the treatment of trauma [Special issue]. The Arts in Psychotherapy, 36.
  • Hillman, J. (1964). Suicide and the soul. New York, NY: Harper & Row.
  • Kubler-Ross, E. (1997). The wheel of life: A memoir of living and dying. New York, NY: Scribner's.
  • May, R. (1975). The courage to create. New York, NY: Norton.
  • Serlin, I. A. (1996). Kinaesthetic imagining. Journal of Humanistic Psychology, 36, 25-33. doi:10.1177/00221678960362005
  • Serlin, I. A. (2004). Spiritual diversity in clinical practice. In J. L. Chin (Ed.), The psychology of prejudice and discrimination (Vol. 4, pp. 27-49). Westport, CT: Greenwood.
  • Serlin, I. A. (2007). Expressive therapies. In M. Micozzi (Ed.), Complementary and integrative medicine in cancer care and prevention: Foundations and evidence-based interventions (pp. 81-94). New York, NY: Springer Publishing Company.
  • Serlin, I. A. (2009a). Posttraumatic growth: Whole person approaches to working with trauma. The California Psychologist, 42.
  • Serlin, I. A. (2009b, October). A tribute to Rollo May and the arts. Journal of Humanistic Psychology, 49, 486-489. doi:10.1177/0022167809341747
  • Serlin, I. A., & Cannon, J. (2004). A humanistic approach to the psychology of trauma. In D. Knafo (Ed.), Living with terror, working with trauma: A clinician's handbook (pp. 313-331). Northvale, NJ: Jason Aronson.
  • Serlin, I. A., & Speiser, V. (2007). Introduction: Imagine: Expression in the service of humanity [Introduction to special issue]. Journal of Humanistic Psychology, 47, 280-287. doi:10.1177/0022167807302184
  • Stolorow, R. (2007). Trauma and human existence: Autobiographical, psychoanalytic, and philosophical reflections. New York, NY: Analytic Press.
  • Yalom, I. D. (1980). Existential psychotherapy. New York, NY: Basic Books.

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