Cathy Malchiodi is known among the military as the "rubber duck lady", but she could equally be known as the woman of many masks.
When she introduced her rubber ducks and masks into the military in 2007, she found an unlikely group of art therapy adopters.
![Rubber ducks are used to help children express their fears.](/web/20161105010739im_/http://www.watoday.com.au/content/dam/images/g/s/g/8/x/v/image.related.articleLeadwide.620x349.gsg7hn.png/1478066436040.jpg)
She also found an unparalleled opportunity to see the profound effect on our well-being expression without words can have – not just for those who have experienced trauma, but for us all.
There is something primal in using senses other than speech. Before we learn to speak, we experience the world around us through touch, taste, smell and sound. We learn love through the touch of a parent, we soothe ourselves with the soft texture of a toy and express ourselves in ways that don't involve words that we don't yet have.
![Cathy Malchiodi: "We heal within relationships."](/web/20161105010739im_/http://www.watoday.com.au/content/dam/images/g/s/g/8/x/q/image.related.articleLeadNarrow.300x0.gsg7hn.png/1478066436040.png)
Even as we grow into adults, there is a universe inside us that knows the world without words and tapping into this allows us to access to parts of our brain deeper than language and beyond the rational.
Tapping into this can also be therapeutic.
"We know that, when people are traumatised, many of them literally cannot communicate through words because what is happening to them is too difficult to speak," says Malchiodi, an internationally recognised expert in art therapy and author of nine books on the subject.
"That is something that they've seen now in brain imagery – that when you ask a person to talk about a traumatic event, there is a part of the brain called Broca's area that has to do with language and it literally goes offline.
"My speculation, when people start to express through visual art or music or movement – something very sensory and action-oriented – those language parts start to come back online."
Why? "Trauma is a sensory experience so we often need to use the senses."
It was this understanding that led the military, as it tried to manage the mental and emotional effects of multiple deployments and high rates of post traumatic stress, to ask Malchiodi to develop an arts-based resilience program for service personnel and their families.
Cue the small rubber ducks, brought in for the children who are often stoic about their feelings.
'Rubber duck lady'
Malchiodi would give them a paper plate and various materials – including feathers and glitter – and ask them to create a safe place for their duck along with a story about it.
"They would dive right into that," Malchiodi says. "The stories were absolutely profound, 90 per cent of the time, the stories were about the parent going off to war – it was 'admiral duck', 'captain duck', 'sergeant duck' – the fear or building a safe place for that duck.
"The children in the military don't want to worry the parents but they still worry – this is a way to communicate that."
It wasn't just the children that struggled with verbalising their worries.
"One of the most widely used and popular activities with the adult military is decorating masks," says Malchiodi, currently in Australia conducting art therapy workshops.
"Showing on the outside of the mask how they think they appear to people, the inside of the mask they are asked to put what they really feel – what they don't show to people ... it's amazing what they can communicate through that – things they never had the opportunity to say."
It is also the chance to communicate with others in non-verbal ways.
"We heal within relationships," Malchiodi explains. "All healing before mental health was formalised occurred in communities and relationships. There was activity but really we healed in human relationships with each other."
Art therapy
Art therapy has been a recognised form of trauma treatment for decades, but advances in neuroscience are helping us understand its benefits.
Research has found that 15 to 20 minutes of some form of art, three or four days a week, reduces cortisol, the stress hormone.
"Art, like exercise, gets us into a flow state, which gets you away from all the things we have on our minds," Malchiodi says. "It gets you away from screens, cell phones, messages. When people take the time to do that, they find they are much more relaxed, it's stress reduction.
"Studies done on people with depression and anxiety ... doing handwork of any kind – drawing, knitting, quilting, working in the garden – mediates depression and anxiety.
"The theory is that we may be a little more high on the scale of depression/anxiety in the 21st century because we're less engaged with those things ... people were more engaged in handwork 200 years ago. Now we're involved in a different kind of handwork – tap, tap tapping and it doesn't seem to be making us any happier."
Unlike tapping on our computers, expression and absorption through the arts – be it music or drawing, movement or making something – helps us express ourselves better verbally and relate better to those around us, pulling together all the threads of healing.
Who benefits?
Malchiodi recalls a study from the 1960s where researchers explored who benefited the most from therapy and found it was those who could articulate their "felt-sense".
"It was not how they talked about things, how they rationalised things, but how they felt it deeper down inside. If they thought about 'what do I feel in my heart right now?', 'how do I feel in my gut?', if they could articulate that, those were the ones that got better," she says.
"I think there is a connection there with the arts because it's not about the talk, it's about the doing and the action-oriented and how you feel that sense of things – what colour does this feel to me, what kind of line or shape. So I think there is something really basic there that we've known for quite a while and the art brings that to the forefront.
"I think that's why it works for the military clients I've been working with – how to know exactly how I'm feeling right now, not have to rationalise it or have insight into it. Insight isn't as helpful as knowing what's in your heart and in your gut. The arts bring you to that place."
For more information about Malchiodi's Australian expressive arts therapy and trauma training workshop click here.