Why creative expression supports trauma processing
An article by Sydne Smith, RCC, MCPAT
Traumatic memory is encoded differently from ordinary autobiographical memory. Where typical memories form as coherent narratives, traumatic memories are more likely to be stored as sensory fragments, physical sensations, and emotional responses that can surface without context and resist verbal description.
Art therapy works with this reality rather than against it. Creative expression, whether through drawing, painting, collage, or other visual media, provides a way to access, hold, and begin to process material that language alone often cannot reach.
Why traumatic memory does not always respond to talking alone
The part of the brain most associated with verbal language and narrative tends to go offline during trauma. What remains active is the right hemisphere, the amygdala, and the sensory and motor systems. Traumatic experiences are therefore often encoded in right-brain dominant, non-verbal, somatic form. Research on the psychobiology of traumatic memory has described states in which the speech centres of the brain are effectively shut down during re-experiencing, leaving the person unable to put into words what the body is holding (van der Kolk, 1994).
Talking about trauma can be valuable and is often necessary. But it requires the person to narrate something that may not have been stored as a narrative in the first place. For clients working with early trauma, complex trauma, or experiences that predate language development, this becomes a significant obstacle (Gantt & Tripp, 2021).
How art engages the brain differently
Making art engages distributed brain networks across both hemispheres, and directly engages regions associated with symbol-processing, spatial reasoning, and emotional memory - areas less accessible through sequential verbal exchange (Strang, 2024). This makes it a particularly useful modality for reaching material the verbal, analytical mind struggles to access or articulate.
Creating something visual also activates sensorimotor processes: the hand moves, the body is involved, and attention is partly directed toward the physical act of making. This grounding can help a person remain present and regulated while working with material that might otherwise feel overwhelming.
What externalizing trauma through creative expression actually does
One of the clinically significant features of art therapy is externalization: putting something outside yourself, giving it form, and then observing it from a position of some distance (Campbell et al., 2016). A feeling that is entirely internal and shapeless is experienced differently once it has been given colour, texture, or form on paper.
The image that emerges often surprises the person who made it, and that surprise carries information. Something held inside the nervous system becomes something that can be observed, considered, and gradually integrated.
The window of tolerance and why pacing matters in trauma work
Effective trauma therapy keeps the person within what clinicians call the window of tolerance: the zone of activation in which the nervous system is engaged enough to process experience but not so activated that it moves into overwhelm or shutdown. Art therapy offers a degree of built-in pacing that supports this.
A person can approach difficult material obliquely, through metaphor or abstraction, rather than directly. The act of making something provides a mild but real anchor to the present moment, which helps prevent the kind of full re-experiencing that can destabilise rather than integrate. The art itself becomes a container for the material.
What art therapy looks like in practice, and what it does not require
Art therapy in a clinical setting is distinct from an art class in both purpose and expectation. The goal is not to produce something aesthetically pleasing, technically accomplished, or finished. No prior experience with art is necessary and none is expected.
Sessions typically involve the therapist offering a material or an invitation, the client working with whatever arises, and the two of them exploring what has been made together. Research supports the approach: a systematic review of art therapy with adult trauma survivors found significant reductions in trauma symptoms, depression, and anxiety across the studies examined (Schouten et al., 2015). The image opens a door. The work of therapy is what comes next.
Frequently asked questions about art therapy and trauma
Do I need to be artistic to benefit from art therapy?
No prior art experience or skill is needed. Art therapy is a clinical process, not a creative one in the conventional sense. What matters is not the quality of what you make but what arises in the process of making it and the conversation that follows.
Is art therapy as effective as other trauma treatments?
Research supports art therapy as an effective treatment for trauma symptoms, and it is often used alongside other approaches rather than as the sole modality. Its particular value is in reaching material that is difficult to access or articulate through verbal processing alone, which makes it well-suited for complex and early-onset trauma.
What kinds of trauma is art therapy used for?
Art therapy has been used with a wide range of trauma presentations: childhood and developmental trauma, complex and relational trauma, sexual abuse, grief and loss, and trauma related to displacement or violence. It is especially useful for trauma that is pre-verbal, fragmented, or held more in the body than in memory.
What if making art brings up something I am not ready to face?
A trained art therapist paces sessions to your capacity and is skilled at helping you stay within a manageable range of activation. You are never required to go further than feels safe. The materials and invitations offered are chosen with your specific needs in mind, and you can set the pace throughout.
Sydne Smith is a registered clinical counsellor (RCC) and professional art therapist (MCPAT) based in Vancouver and Burnaby, BC and an associate at the Vancouver Therapy Collective. She works primarily with adults navigating complex trauma and abuse, integrating creative expression throughout the therapeutic process. Her practice, The Spiral Path Counselling Art Therapy, offers in-person sessions in Kitsilano and virtual sessions across British Columbia.
If you have been curious about art therapy or wondering whether it might be a useful way into the work, a free 20-minute consultation is a good place to start.
References
Campbell, M., Decker, K. P., Kruk, K., & Deaver, S. P. (2016). Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial. Art therapy: journal of the American Art Therapy Association, 33(4), 169–177. https://doi.org/10.1080/07421656.2016.1226643
Gantt, L., Tripp, T. (2021). The image comes first: Treating preverbal trauma with art therapy. In J. King (Ed.), Art therapy trauma and neuroscience: Theoretical and practical perspectives (pp. 66-99). Routledge.https://doi.org/10.4324/9781003196242
Schouten, K. A., de Niet, G. J., Knipscheer, J. W., Kleber, R. J., & Hutschemaekers, G. J. M. (2015). The Effectiveness of Art Therapy in the Treatment of Traumatized Adults: A Systematic Review on Art Therapy and Trauma: A Systematic Review on Art Therapy and Trauma. Trauma, Violence, & Abuse, 16(2), 220-228. https://doi.org/10.1177/1524838014555032
Strang, C. E. (2024). Art therapy and neuroscience: evidence, limits, and myths. Frontiers in psychology, 15, 1484481. https://doi.org/10.3389/fpsyg.2024.1484481
van der Kolk, B. A. (1994). The Body Keeps the Score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry 1(5):p 253-265. https://doi.org/10.3109/10673229409017088
Desire discrepancy, the gap between how often or how much each partner wants sex, is one of the most frequently cited sources of relationship distress in long-term couples. Research has found it is among the strongest predictors of both sexual and relationship dissatisfaction (Mark & Murray, 2012). It is also among the most misunderstood, because the way couples tend to talk about it, or avoid talking about it, often makes the dynamic worse rather than better.
What desire discrepancy actually is
Desire discrepancy is a difference between two people's baseline levels of sexual interest. That difference can be small or large, stable or fluctuating. It can exist from the beginning of a relationship or emerge over years in response to stress, life transitions, health changes, or shifts in how connected two people feel to each other.
Both partners' levels of desire are real. What creates difficulty is the mismatch, and the meaning each person makes of it.
Spontaneous desire and responsive desire: why the distinction matters
Understanding desire discrepancy requires understanding that not everyone experiences desire the same way. Spontaneous desire arises without a prior trigger: a person simply notices they want sex. Responsive desire works differently. It emerges in response to stimulation, context, or the sense of connection already being established. It does not appear in advance; it arrives once something is already in motion.
Over the course of a long relationship, responsive desire becomes more common for people of all genders. Research examining how women's desire functions found that a circular, responsive model of arousal better represents most people's experience than the linear, spontaneous model (Basson, 2002). A partner who experiences responsive desire may genuinely not feel like having sex before it begins, and may also genuinely enjoy it once engaged. Without this distinction, the lower-desire partner tends to read their own experience as evidence that something is wrong with them, or with the relationship.
How desire discrepancy tends to escalate
Left unaddressed, desire discrepancy tends to follow a predictable pattern. The higher-desire partner initiates and is declined. They try again. Over time, they begin to feel rejected, unloved, or undesirable. The lower-desire partner, aware of the expectation building around them, begins to feel pressured, and pressure is one of the most reliable inhibitors of desire. As pressure increases, desire decreases. As desire decreases, attempts to initiate increase.
Both partners are typically suffering in this pattern, though often in ways invisible to each other. The higher-desire partner may carry shame about wanting too much. The lower-desire partner may carry shame about wanting too little. Neither position is comfortable, and neither is well-served by the conversations couples usually find themselves having about it.
What the lower-desire partner is actually experiencing
The sources of low desire are varied. Chronic stress, depression, anxiety, hormonal changes including perimenopause and postpartum shifts, certain medications, past sexual trauma, and unresolved relationship conflict all affect desire. So does the experience of being perpetually anticipated, which paradoxically removes the conditions under which desire tends to arise for many people.
For some, lower desire has always been their baseline. For others, it represents a shift from how things used to be. The distinction matters clinically because the contributing factors, and therefore the most useful areas to work on, differ considerably.
What therapy for desire discrepancy involves
Therapy for desire discrepancy creates space for both people to understand their own desire, including what supports it and what suppresses it, and to find a shared approach that accounts for both of their experiences. Some of the most useful work involves slowing the pursuit-withdrawal cycle that tends to build pressure on both sides, expanding what intimacy can mean for the couple beyond a narrow set of expectations, and working with the meaning each person has attached to the discrepancy.
When one partner reads it as evidence of rejection and the other reads it as evidence of failure, the underlying relational distress is often where the most significant work needs to happen.
Frequently asked questions about desire discrepancy in relationships
Is desire discrepancy a sign that we are not compatible?
Desire levels vary across individuals, and it is uncommon for two people's desires to match perfectly over the course of a long relationship. Desire discrepancy becomes a concern about compatibility when neither partner's needs can be reasonably accommodated, but many couples with significant differences find approaches that work for both of them.
Is the lower-desire partner always the one with the problem?
Desire discrepancy is a relational dynamic, not one person's failure. The higher-desire partner's way of initiating, the emotional climate in the relationship, the level of stress and competing demands, and a range of other factors all contribute to how desire functions for both people. Therapy tends to work with the pattern rather than with either individual as the identified problem.
Can desire discrepancy improve without therapy?
Sometimes, particularly when it has a clear and addressable cause such as a period of sustained stress that has passed, a medication change, or a hormonal shift that has been treated. When it has become entrenched in a recurring relational pattern, the pattern itself tends to need direct attention. Many couples find that even a short course of therapy produces meaningful change.
Does therapy involve talking about sex in explicit detail?
The level of explicit discussion is shaped by what each person is comfortable with and what is clinically relevant. Therapy for desire discrepancy often focuses as much on communication patterns, emotional experience, and relational dynamics as on sex itself. You set the pace and the level of detail throughout.
About the author: Moha Chaturvedi, RCC
I am a registered clinical counsellor and associate at the Vancouver Therapy Collective. I work with individuals and couples navigating sexuality, intimacy, and the patterns that make relationships feel stuck. My practice, Moha Therapy, offers in-person sessions in Kitsilano and virtual sessions across BC, Ontario, Alberta, Saskatchewan, and several other provinces and territories.
If what you have read here resonates, a free introduction call is a good place to start.
