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Traumatic Brain Injury Patients Paint, Sculpt Way to Recovery

WASHINGTON, July 20, 2016 — As the brushes touch the canvas, the service members pour their thoughts and emotions onto the page, expressing what they haven’t been able to talk about through art.

Like the elements of a painting, doctors from each specialty at the National Intrepid Center of Excellence, a directorate of Walter Reed National Military Medical Center in Bethesda, Maryland, come together to help service members with traumatic brain injuries in an intensive four-week therapy program.

Specialties such as neurology use art to assist with sleep and migraines. family care physicians can use it to assist with physical ailments. Psychiatrists and nutritionists can assist with medications and vitamins, and art therapists can provide emotional support.

The Masks

Melissa Walker, a registered art therapist and healing arts program coordinator at NICoE, said the patients begin their group art therapy session by making masks.

“It’s in this session that I have to explain to them that I’m giving them the means to express and symbolize whatever they would like to about their identities and things they’ve been through,” she said. “I tell them not to worry about the product, but what they would like to express -- what story they want to tell -- and usually that resonates with them.”

She said the patients usually dive in. Even if they were skeptical in the beginning, she added, at the end of the first session, many of them say, “That was really relaxing. I can’t believe I was able to open up about that specific element of my personality.”

Walker said the masks give the patients “a visual voice to their invisible pain or their invisible wounds.” They create the masks in a two-hour group art therapy session and will see them again throughout the four weeks they are at NICoE.

For one sailor, Walker said, the mask project held a special meaning. He had flashbacks for seven years about a bloody face from when he had been injured in a bunker during a mortar attack. He told Walker he had seen the face staring back at him and that it haunted him. He called it “BFIB” for short: bloody face in bunker.

Some patients leave their masks behind to inspire other patients, he said, and when he saw them on the wall, he immediately thought of making a BFIB mask.

“He made BFIB in that session, and instead of thinking of him as something psychologically inside of him, it took on a form of an actual product,” Walker said. “So when he thought about [BFIB], he thought of him sitting in the art therapy studios safe and contained, because he would leave him every day behind,” Walker said. “Eventually, we placed it in a box and [thus] contained the mask, and he said after the entire process [that] he rarely saw the flashback, and it didn’t make him feel anxious, because he knew he was here in this space, safe and contained.”

Other Art Forms

Walker said the patients can use water colors, acrylics, Keva blocks and in some cases, oil. Marine Corps Staff Sgt. Tony Mannino, a former NICoE patient, preferred water colors.

“I chose to work with water colors because it makes it very hard to get the fine details perfect for someone who has struggled with perfectionism and has always been in control of any situation,” the former administrator and machine gunner said. “It really helped me to release and relinquish the reins, to let the colors do what they were going to do on their own.”

He said painting helped bring up different issues about what was going on in his mind, both recently and from his deployment to Iraq in 2007 and 2008.

“I spoke to the art therapist about things that I didn’t even talk to my psychologist about, so it’s really interesting what happens in the art room,” Mannino said. He said the art therapy, as well as his treatment at NICoE, was “one of the best things I’ve done so far. They care a great deal, and they really want you to get better.”

Evolution of Patients

Walker said she enjoys seeing the evolution of the progress of the patients as they become more and more comfortable. As their sleep and pain start to stabilize and as they’re able to start to open up about some difficult things, they start doing the same in their artwork, she said.

One Marine was frustrated, Walker said. He wasn’t initially able to depict anything because he used to love art, she explained.

“He said, ‘I used to love art. I was very engaged in high school, and it’s just not coming to me. I’ve got too much going through my mind.’ By his second or third week, he entered the art room and said, “‘I know what I want to do now,’” she said.

Walker said he recreated a moment he had been grappling with: a time he made a difficult decision in combat. He ended up spending every spare moment working on this project.

“He was really invested in this product, because he was able to take what was for him a traumatic moment and take control of it and begin to really understand it,” Walker said. “At the end, he invited the entire treatment team into the art therapy space, and he shared that story with them, which was a huge step -- to be able to open up to the group that had been caring for him.”

She said he went on to continue to take sculpture classes. Walker said seeing the evolution in patients like the Marine is why she continues performing her mission.

“It is so neat for us, the clinicians, to see the service members change from the first week to the fourth week,” she said. “They walk in here a little uncertain and kind of skeptical initially. You can see that they’re really starting to trust the others. They’ve perhaps been isolated, because they’ve been dealing with these symptoms for so long, and then by that fourth week, it’s amazing watching them walk through the door -- how much brighter they become and how much more comfortable they seem.”

Walker said they seem to really engage with each other, socializing and laughing, and she sees the difference in the artwork as well.

“We see improvement -- that they’re symbolically showing this bright future, perhaps the contrast between how they felt before and how they’re feeling moving forward,” Walker said. “And I’d love to see that next canvas. I hope they continue to explore that.”

Part 3 of a five-part series.

(Follow Shannon Collins on Twitter @CollinsDoDNews)
Distribution channels: Military