When Words Aren’t Enough: Creative Expression for Nervous System Regulation, Meaning Making, and Healing in the Perinatal Timeframe

By Madison Petersen, LCSW, PMH-C

PTSD Consciousness Month

“As each a clinician and an artist (with lived expertise with each perinatal loss and a PMHD), I’ve seen how writing and visible artwork can provide form to feelings that always really feel unspeakable and play a significant position in reclaiming your individual voice, making which means, and in the end discovering therapeutic.”

It’s 2022, and I’m taking a look at myself within the mirror. I look drained, stretched skinny, unhappy. It was an evening of “workforce no sleep” as my son was in one more sleep regression. As I looked for one thing acquainted in myself, my two-and-a-half-year-old daughter tugged at my leg whereas my five-month-old cried for my consideration elsewhere. Wants had been asking to be met throughout me. However what about my wants? With the ability to even establish what they had been felt removed from attainable.

As a therapist in the midst of a wrestle with perinatal psychological well being, it felt troublesome to establish precisely what was taking place with my very own physique and thoughts. I used to be struggling, however I used to be additionally originally of a transformative journey. Now, as each a perinatal psychological well being licensed therapist and a lady who lived by a perinatal psychological well being dysfunction, I’ve seen how writing and visible artwork can provide form to feelings that always really feel unspeakable and play a significant position in reclaiming your individual voice, making which means, and in the end discovering therapeutic.

What’s perinatal trauma, and is it at all times PTSD?

Any individual within the postpartum interval is aware of what it feels prefer to really feel a bit disconnected from who they’re. With one out of each 5 ladies and one out of each 10 males experiencing difficulties with their psychological well being throughout being pregnant or postpartum, feeling not like your self isn’t precisely unusual (Postpartum Assist Worldwide, 2014). Even with out clinically important, diagnosable signs in keeping with a perinatal psychological well being dysfunction, this time of your life is attempting. Sleep deprivation, fixed caregiving, bodily therapeutic, shifting household dynamics—it’s loads! 

However there’s a notable inhabitants that does expertise this shift as traumatic. An estimated 9% of ladies expertise PTSD following childbirth (Postpartum Assist Worldwide, 2014). There could be many components that contribute to experiencing PTSD within the perinatal timeframe, together with however not restricted to start trauma, stillbirth and different perinatal loss, start damage, massive deviations in expectation of supply, and speedy start. You will need to keep in mind, although, that trauma isn’t linked to a particular occasion, however to how the occasion is perceived by the person’s nervous system. Westminster School (2021) describes trauma as “experiencing an excessive amount of, too quick, too quickly in such a method that one’s skill to manage is overwhelmed.” Put extra merely, trauma is extremely subjective. This leads me to consider that trauma within the perinatal house is probably going under-recognized, which makes trauma-informed remedy a non-negotiable for all suppliers, particularly psychological well being suppliers who work within the perinatal house.

When discuss remedy falls quick: limitations of discuss remedy and the emergence of bottom-up approaches to trauma remedy.

I started experiencing signs of perinatal melancholy at round 4 months postpartum with my second youngster. My kids had been born virtually precisely two years aside, each speedy births, and we moved properties solely 4 months after my son was born. I used to be additionally navigating persistent ache later linked to undiagnosed endometriosis that vastly hindered my skill to deal with stress (an excessive amount of, too quick, too quickly). At the same time as a psychological well being skilled, the indicators of perinatal melancholy had been troublesome to acknowledge and felt equally as exhausting to navigate when it got here to pursuing steps towards therapeutic.

Understanding the nervous system and its involvement with trauma has been an essential growth in psychological well being, and as extra individuals turn out to be conscious of the nervous system’s position in experiencing trauma, extra persons are in search of methods to heal utilizing somatic practices. As a result of we perceive the character of trauma is embodied—skilled by and saved within the physique—we should attain for therapeutic modalities which can be additionally embodied. I consider contemplating this somatic piece in remedy is important in treating trauma typically, however is much more essential with perinatal purchasers as a result of being pregnant and postpartum are BODY-based experiences. The dramatic shifts {that a} physique goes by throughout being pregnant and postpartum could be traumatic in additional methods than simply bodily. However the bodily drama of this time could be traumatic by itself. So, when trauma explicitly entails an individual’s physique—the expertise of rising one other human within the physique, and that individual leaving the physique in anticipated or surprising methods—we should take into account therapeutic by embodied practices.

A number of evidence-based approaches fall beneath the umbrella of somatic remedy, together with Eye Motion Desensitization and Reprocessing (EMDR), Somatic Experiencing (SE), Accelerated Decision Remedy (ART), Trauma-Knowledgeable Yoga, Somatic Breathwork, Inner Household Programs, and others. Nonetheless, as a social employee, I’m at all times contemplating systemic limitations to accessing such therapies. These therapies could be costly; they should be performed by a licensed skilled; they require therapeutic belief and rapport; and they are often time-consuming (which is possibly the best barrier through the postpartum time). All of those are limitations for the shopper. And there are limitations for suppliers too, as these therapies require superior coaching, which is pricey and time-consuming. Nonetheless, everybody has entry to a pen and a chunk of paper.

Expressive artwork as a bottom-up method to therapeutic.

As I grappled with my very own unraveling psychological well being, I reached for my pen and journal, a well-known place for me to course of my experiences. I had at all times been a author, discovering consolation within the physicality of pen to paper. I used to be additionally in discuss remedy. I had unbelievable household and associates supporting me. And I turned towards my religion to search out which means and power. However I nonetheless was struggling to really feel like myself. The extra I wrote in my journal, the extra I longed for a extra embodied technique to specific my emotions. I couldn’t cease desirous about making visible artwork.

Later that 12 months, visible artwork grew to become a street again to myself. Visible artwork supplied me a protected place to launch what I held certain in my chest. Making grew to become a technique to loosen what my physique carried and what I feared is likely to be “too ugly” if it had been ever seen. I didn’t care if what I made appeared “fairly” or good, I used to be extra centered on the way it FELT to create. One thing within me unlocked as I allowed my physique to information expressive marks—to prioritize my felt expertise moderately than intellectualize or cognitively course of by journaling or discuss remedy like I at all times had. I didn’t notice it on the time, however I used to be accessing a bottom-up method to therapeutic.

Expressive arts remedy is the purposeful software of artwork, music, dance/motion, dramatic enactment, inventive writing, or imaginative play. These are largely non-verbal methods of self-expression. Extra importantly, they’re action-oriented and faucet implicit, embodied experiences of trauma that may defy expression by verbal remedy or logic. (Malchiodi 2020). The externalized, sensory focus related to expressive artwork turns into a key ingredient to addressing the all-too-common internalized disgrace related to perinatal psychological well being issues and trauma. Emphasizing a course of over product method of making removes stress and creates house for purchasers to attach with their expertise and their artwork in a brand new method. Typically, it’s within the course of of creating that you could even acknowledge the burden (or texture, or shade, or form, or magnitude) of what you had beforehand been carrying. Giving form or imagery to experiences could be an approachable technique to start talking about issues that felt too troublesome earlier than.

Why expressive artwork for anticipating and postpartum moms?

Throughout my very own therapeutic, I prioritized time every single day to create. Typically it was quarter-hour with my journal, generally it was just a few hours to attract or paint after bedtime. It felt like one thing that was protected as “mine.” It was simply accessible. It was cost-effective. It was significant. Then, one thing else began taking place. I began sharing my artwork, and it grew to become a connection level for me with others.

Primarily based on present evidence-based and rising brain-body practices, there are eight key causes for together with expressive arts in trauma intervention: (1) letting the senses inform the story; (2) self-soothing thoughts and physique; (3) participating the physique; (4) enhancing nonverbal communication; (5) recovering self-efficacy; (6) rescripting the trauma story; (7) making which means; and (8) restoring aliveness. (PsycInfo Database Document (c) 2025 APA, all rights reserved). In my work with perinatal purchasers, I usually see themes of id pressure both because of trauma or loss, or simply the overall shift that coming into parenthood brings. Exterior of the explanations I’ve already said on this article, like nervous system help, I virtually at all times suggest expressive artwork as a companion to remedy for individuals within the perinatal timeframe for just a few causes:

1. It’s enjoyable, and it’s free. Being pregnant and postpartum are costly and infrequently mundane. There’s freedom that comes once we cease consuming and begin creating. It might probably herald delight and remind us that the current second can maintain magic.
2. It helps you decelerate and get clear. Throughout being pregnant and postpartum, you could be dashing to fulfill wants continuously. Making artwork presents you an opportunity to decelerate to the tempo of your individual ideas and get actually clear about what’s going on within you.
3. Artwork doesn’t require phrases. Artwork helps you’re employed issues out with out speaking. You can provide your “mother mind” a break and make one thing that feels good as a substitute.
4. Artwork reveals to us how we’re doing…actually. Artwork presents you house to be trustworthy about how you’re doing with out concern of how somebody will reply. You may really feel first and interpret later.
5. Artwork issues a lot and doesn’t matter in any respect. As an individual within the perinatal part of life, you’re increasing and altering. And this issues a lot that it could possibly really feel terrifying or paralyzing, main us to really feel caught. Add caring deeply for a child and potential trauma to the combo, and risk-taking of any sort can really feel too threatening to your nervous system. Artwork provides us an opportunity to discover once more in a protected/non threatening method. Once we strive one thing new, take dangers, and permit ourselves to not be “good” at one thing, it’s good follow for parenthood and the numerous adjustments that come together with it. So, artwork deeply issues. Your expression issues. Getting it out issues. In some way, artwork has this energy to guide us again to our personal skill to take dangers in our lives. But in addition, artwork doesn’t matter. That factor you made that you just hate…go forward and throw it away. There isn’t any main consequence for making artwork.
6. Artwork opens the door to connection. In the event you enable your artwork to be a type of meaning-making, it could possibly flip right into a reclamation of your voice and supply a technique to join with others and share your story. For instance (shared with permission), I had a shopper who skilled a stillbirth. She labored with me in remedy and used expressive artwork alongside her remedy periods constantly for a few 12 months to course of her emotions and articulate her expertise. She now makes use of artwork making to attach with different dad and mom who’ve skilled perinatal loss, sending them a home made card for his or her youngster’s birthday. This act connects her to a broader neighborhood whereas permitting for ongoing meaning-making as she grieves and grows.
7. Artwork is therapeutic. You might be deserving of therapeutic. Interval. 

The place do you begin?

A very powerful cause I like to recommend making artwork to my purchasers is that artwork is one thing they will do with out me. The whole goal of remedy is to have a witness to work alongside you till you are feeling assured in your individual skills. I feel that artwork is a ravishing technique to encourage or rebuild self-trust and self-confidence. In the end, I consider that expressive artwork can play a giant position in empowering individuals to reclaim or reorient their id after main life shifts, like having a child. If I introduce you to artwork making to help your psychological well being and you then use it as a supportive instrument for the remainder of your life, I feel I did my job. One thing about instructing a person to fish…or one thing.

In case you are eager about extra info associated to expressive artwork and remedy, I like to recommend wanting into the International Expressive Arts Therapy Association, Neuroarts Research Center, and The Birth Project.

In case you are studying this text and also you need to begin making artwork to course of your individual expertise, YAY, mission completed! My suggestions for how one can begin:

1. Strive expressive writing. Set a timer and write, stream of consciousness, for 5-10 minutes (I prefer to intention for a full web page of writing). No judgment, no enhancing, simply write it out!
2. Begin a visible journal. For one week, experiment with depicting your emotional panorama by shade/form/texture alone. I like to do that in a journal with a taped off 4×4 sq. on each web page. I additionally like to call the piece a easy phrase or phrase to seize the essence of what I’m making an attempt to depict. I additionally like utilizing blind contour drawings as a easy summary train to mark the second, break away from perfectionistic considering, and decelerate to a conscious tempo.
3. Simply play. Get a coloring e book and do it together with your kids. Scribble on a paper. Experiment with collage. Get out the play dough!
4. In case you are in Oklahoma, attain out to me! I’m not a registered artwork therapist, however as a therapist who can be an expressive artist, I typically combine expressive artwork into my remedy modalities. You’ll find me at www.madisonpetersenllc.com or on Instagram @madison.petersenllc.

Citations

Malchiodi, C. A. (2020). Trauma and expressive arts remedy: Mind, physique, and creativeness within the therapeutic course of. The Guilford Press.

Postpartum Assist Worldwide. (2014). Perinatal temper and anxiousness issues truth sheet. https://www.postpartum.net/wp-content/uploads/2014/11/PSI-PMD-FACT-SHEET-2015.pdf

Westminster School. (2021). Impacts of trauma. https://www.westminster.edu/campus/services/title-ix/pdf/impacts-of-trauma-ac.pdf

Concerning the Creator

Madi Petersen, LCSW, PMH-C

Madi Petersen, LCSW, PMH-C, is a spouse, a mother of two younger kids, an artist, and a therapist. Madi has been training psychotherapy since 2015 and opened her personal follow in Tulsa, OK, in 2020. In 2024, she grew to become licensed in perinatal psychological well being.

Madi’s work is centered on supporting ladies by the numerous transformative seasons of life, not simply changing into a mom. She supplies particular person remedy for ladies within the childbearing years, together with these navigating infertility, being pregnant loss, postpartum challenges, subsequent pregnancies, and the transition into parenthood. 

Clinically, Madi integrates evidence-based approaches, together with narrative remedy, cognitive behavioral remedy, inner household techniques, exposure-based interventions, and expressive arts strategies in her work with purchasers. Madi is particularly attuned to the impression of trauma on the nervous system, significantly through the perinatal interval. Madi’s follow is relational, client-centered, and collaborative.

Past the remedy room, Madi additionally supplies help and schooling by workshops, trainings, and neighborhood collaborations. She believes that maternal psychological well being is greatest supported once we work collectively, and finds deep pleasure in connecting with others who share this imaginative and prescient.

Discover these PSI Sources:

Postpartum Planning Class
Free, Online Peer Support Groups
Get Help
Subscribe to the PSI Blog

Join by PSI

Obtain our free app “Join by PSI” in your app retailer to entry PSI help, sources, and knowledge within the palm of your hand.