Restoring the body: changes in body self in the course of a focusing and arts-based therapy program for female interpersonal trauma survivors


  • Monika Zielona-Jenek Adam Mickiewicz University
  • Olga Sakson-Obada Adam Mickiewicz University
  • Agnieszka Czapczyńska Center for Personal Development and Psychotherapy


Słowa kluczowe:

body image, body self, interpersonal trauma, inner relationship focusing, art-based therapy


The goal of this study was to assess the effectiveness of a therapeutic program for female survivors of interpersonal trauma, among others, of domestic violence. The participating women took part in four two-day modules in a group setting during which they were offered focusing training and arts-based Gestalt therapy. The effectiveness of the interventions was evaluated in terms of improvements in body image and body experience, according to the model of body self as developed by Sakson-Obada.

Participants and procedure
The Body-Self Questionnaire, the Affective Body Image test and the Draw-a-Woman test were administered to 21 participants before and after the program.

After the therapy, the participants reported a reduction of disturbances in their body experience (interpretation and regulation of emotions and bodily needs and in body identity). In the body image domain, increased body satisfaction was observed using both declarative and projective tools – the women were also more likely to draw uncovered parts of the female body. Although improvements were noted in most of the women, three of them reported an increase in difficulties, mainly in the body image domain.

The study demonstrated that: (1) a combination of the two techniques, i.e., focusing training and art included in the Gestalt group therapy program, resulted in satisfactory changes in body image and body experience; (2) the therapy’s effects should be monitored in the context of a woman’s various life situations; and (3) the use of both declarative and non-declarative methods can be recommended to assess the effectiveness of body-centered therapy.


Download data is not yet available.


American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: APA Publications.

Andres-Hyman, R. C., Strauss, J. S., & Davidson, L. (2007). Beyond parallel play: Science befriending the art of method acting to advance healing relationships. Psychotherapy: Theory, Research, Practice, Training, 44, 78–89. 0033-3204.44.1.78.

Baker, F. A., Metcalf, O., Varker, T., & O’Donnell, M. (2017). A systematic review of the efficacy of creative arts therapies in the treatment of adults with PTSD. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication.

Barel-Shoshani, Z. A., & Kreitler, S. C. (2017). Selfperception following breast cancer as expressed in self-figure drawings: present-past. The Arts in Psychotherapy, 55, 136–145. aip.2017.05.001.

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214–227. ajp.162.2.214.

Bray, R. L. (2006). Thought field therapy. Journal of Aggression, Maltreatment & Trauma, 12, 103–123.

Breitenöder-Wehrung, A., Kuhn, G., Gunter, M., & Neu, A. (1998). Vergleich des Körperbildes bei gesunden und psychisch bzw. chronisch körperlich kranken Kindern mit Hilfe des KBMT-K [Comparison of the body image in healthy and mentally or chronically physically ill children with the help of the KBMT-K]. Psychotherapie, Psychosomatik, Medizinische Psychologie, 48, 483–490.

Breuler, J., & Freud, Z. (1893). Über den psychischen Mechanismus hysterischer Phänomene [About the psychic mechanism of hysterical phenomena]. Neurologisches Zentralblatt, 12, 43–47.

Briere, J., & Spinazzola, J. (2005). Phenomenology and psychological assessment of complex posttraumatic states. Journal of Traumatic Stress, 18, 401–412.

Collie, K., Backos, A., Malchiodi, C., & Spiegel, D. (2006). Art therapy for combat related PTSD: Recommendations for research and practice. Art. Therapy, 23, 157–164. 1656.2006.10129335.

Cornell, A. W. (2013). Focusing in clinical practice: The essence of change. New York: W. W. Norton & Company Inc.

Elliott, R., Greenberg, L. S., & Lietaer, G. (2004). Research on experiential psychotherapies. In M. J. Lambert (Ed.), Bergin & Garfield’s handbook of psychotherapy and behavior change (5th ed.) (pp. 493–539). New York: Wiley.

Ely, G. E., Koury, S., Bennett, K., Hartinger, C., Green, S., & Nochajski, T. (2017). “I feel like I am finding peace”: Exploring the use of a combined art therapy and adapted Seeking Safety Program with refugee support groups. Advances in Social Work, 18, 103–115.

Fisher, S. (2014). Neurofeedback in the treatment of developmental trauma: Calming the fear-driven brain. New York: W. W. Norton & Company Inc. Gantt, L., & Tinnin, L. W. (2009). Support for a neurobiological view of trauma with implications for art therapy. The Arts in Psychotherapy, 36, 148–153.

Gendlin, E. T. (1969). Focusing. Psychotherapy: Theory, Research & Practice, 6, 4–15. h0088716.

Gendlin, E. T. (1978). Focusing (1st ed.). New York: Everest House. Gerge, A., & Pedersen, I. N. (2017). Analyzing pictorial artifacts from psychotherapy and art therapy when overcoming stress and trauma. The Arts in Psychotherapy, 54, 56–68. aip.2017.02.001.

Gibbs, G. (2007). Analyzing Qualitative Data. London: Sage Publications. Hass-Cohen, N., Bokoch, R., Findlay, J. C., & Witting, A. B. (2018). A four-drawing art therapy trauma and resiliency protocol study. The Arts in Psychotherapy, 61, 44–56. aip.2018.02.003.

Hayes, J., LaBar, K., McCarthy, G., Salgrade, E., Nasser, J., Dolcos, F., & Morey, R. (2011). Reduced hippocampal and amygdala activity predicts memory distortions for trauma reminders in combat-related PTSD. Journal of Psychiatry Research, 45, 660–669.

Herman, J. (1992). Trauma and recovery: The aftermath of violence – from domestic abuse to political terror. New York: Basic Books.

Kalmanowitz, D. L., & Ho, R. T. H. (2017). Art therapy and mindfulness with survivors of political violence: a qualitative study. Psychological Trauma, 9, 107–113.

Kantor, V., Knefel, M., & Lueger-Schuster, B. (2017). Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: a systematic review. Clinical Psychology Review, 52, 52– 68.

Kruger, D., & Swanepoel, M. (2017). Gluing the pieces together: Female adolescents’ construction of meaning through digital metaphoric imagery in trauma therapy. The Arts in Psychotherapy, 54, 92– 104.

Kubiak, A., & Sakson-Obada, O. (2016). Repetitive self-injury and the body self. Polish Psychiatry, 50, 43–54.

Lobban, J. (2014). The invisible wound: Veterans’ art therapy. International Journal of Art Therapy, 19, 3–18.

Lusebrink, V. B., & Hinz, L. D. (2016). The expressive therapies continuum as a framework in the treatment of trauma. In J. L. King (Ed.), Art therapy, trauma, and neuroscience. Theoretical and practical perspectives (pp. 42–66). New York: Routledge.

Machover, K. (1949). Personality projection in the drawing of the human figure. Springfield, IL: C. C. Thomas. Malchiodi, C. A. (2012). Art therapy and health care. New York: The Guilford Press.

Mlotek, A. E., & Paivio, S. C. (2017). Emotion-focused therapy for complex trauma. Person-Centered & Experiential Psychotherapies, 16, 198–214. https://

Morawa, E., Kolankowska, I., Masko, A., Senf, W., & Tagay, S. (2007). Essener Trauma-Inventar (ETI). Esseński Kwestionariusz Traumy (EKT). Retrieved from rke-pp/projekte/eti_e_polnisch02_04_2010.pdf.

Mullings, B. (2017). A literature review of the evidence for the effectiveness of experiential psychotherapies. Melbourne: PACFA.

Neff, K. D. (2003). Self-compassion: an alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85–101. https://doi. org/10.1080/15298860309032.

Ogden, P., Pain, C., & Fisher, J. (2006). A sensorimotor approach to the treatment of trauma and dissociation. Psychiatric Clinic of North America, 29, 263–279.

Ono, K. (2018). Psychological growth through Person-Centered Expressive Arts Therapy training in Japan. Person-Centered and Experiential Psychotherapies, 17, 91–110. 9757.2018.1440623.

Pyrgiel, K. (2014). Ja cielesne a zaburzenia odżywiania [Body-Self and the eating disorders]. Unpublished master thesis. Institute of Psychology, Adam Mickiewicz University, Poznan.

Rappaport, L. (2010). Focusing-oriented art therapy: Working with trauma. Journal of Person-Centered and Experiential Psychotherapies, 9, 128–143. https://

Rauch, S., van der Kolk, B., Fisler, R., Alpert, N., Orr, S., Savage, C., Fischman, A., Jenike, M., & Pitman, R. (1996). A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script driven imagery. Archives of General Psychiatry, 53, 380–387. https://doi. org/10.1001/archpsyc.1996.01830050014003.

Sakson-Obada, O. (2009). Trauma jako czynnik ryzyka dla zaburzeń Ja cielesnego [Trauma as the risk factor for the Body-Self disorder]. Przegląd Psychologiczny, 52, 309–326.

Sakson-Obada, O. (2010). Changes in sensing, the basic function of Body Ego, as a result of trauma. In A. Widera-Wysoczańska & A. Kuczyńska (Eds.), Interpersonal trauma and its consequences in adulthood (pp. 139–152). Cambridge: Cambridge Scholar Publishing.

Sakson-Obada, O., Chudzikiewicz, P., Pankowski, D., & Jarema, M. (2017). Body image and body experience disturbances in schizophrenia: an attempt to introduce the concept of body self as a conceptual framework. Current Psychology, 1, 1–11. https://

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. Trauma, Violence, & Abuse, 16, 220–228.

Schouten, K. A., van Hooren, S., Knipscheer, J. W., Kleber, R. J., & Hutschemaekers, G. J. M. (2018). Trauma-focused art therapy in the treatment of posttraumatic stress disorder: a pilot study. Journal of Trauma & Dissociation, 20, 114–130. https://

Sherin, J. E., & Nemeroff, C. B. (2011). Post-traumatic stress disorder: The neurobiological impact of psychological trauma. Dialogues in Clinical Neuroscience, 13, 263–278.

Skeffington, P. M., & Browne, M. (2014). Art therapy, trauma and substance misuse: Using imagery to explore a difficult past with a complex client. International Journal of Art Therapy, 19, 114-121.

Slayton, S. C., D’Archer, J., & Kaplan, F. (2010). Outcome studies on the efficacy of art therapy: a review of findings. Art Therapy, 27, 108–111. https://

Talmon, A., & Ginzburg, K. (2018). “Body self” in the shadow of childhood sexual abuse: The long-term implications of sexual abuse for male and female adult survivors. Child Abuse & Neglect, 76, 416– 425.

Talwar, S. (2007). Accessing traumatic memory through art making: an art therapy trauma protocol (ATTP). The Arts in Psychotherapy, 34, 22–35.

Tripp, T. (2007). A short-term therapy approach to processing trauma: Art therapy and bilateral stimulation. Art Therapy, 24, 178–183. https://doi. org/10.1080/07421656.2007.10129476.

van der Hart, O., van Dijke, A., van Son, M., & Steele, K. (2000). Somatoform dissociation in traumatized World War I combat soldiers: a neglected clinical heritage. Journal of Trauma and Dissociation, 1, 33– 66.

van der Kolk, B. A. (1998). Trauma and memory. Psychiatry and Clinical Neuroscience, 52, 52–64. https://

van der Kolk, B. A., & McFarlane, A. (1996). The black hole of trauma. In B. A. van der Kolk & A. McFarlane (Eds.), Traumatic stress (pp. 3–23). New York: The Guilford Press.

van der Kolk, B. A., Roth S., Pelcovitz, D., Sunday S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18, 389–399.

Vantarakis, E. (2014). Trauma, myths, focusing. In G. Madison (Ed.), Emerging practice in focusingoriented psychotherapy. Innovative theory and applications (pp. 24–37). London: Jessica Kingsley Publishers.

Warner, E., Spinazzola, J., Westcott, A., Gunn, C., & Hodgdon, H. (2014). The body can change the score: Empirical support for somatic regulation in the treatment of traumatized adolescents. Journal of Child & Adolescent Trauma, 7, 237–246. https://

Wycisk, J. (2004). Okaleczanie ciała. Wybrane uwarunkowania psychologiczne [Body-mutilation. Selected psychological determinants]. Poznan: Bogucki Wydawnictwo Naukowe.

Young, I. M. (2005). On female body experience. Oxford: Oxford University Press. Zielona-Jenek, M. (2013). Human figure drawings in the diagnosis of child sexual offenders. Potential and limitations of method in psychological forensic evaluation. Problems of Forensic Sciences, 93, 438–449.



Jak cytować

Zielona-Jenek, M., Sakson-Obada, O., & Czapczyńska, A. (2019). Restoring the body: changes in body self in the course of a focusing and arts-based therapy program for female interpersonal trauma survivors. Current Issues in Personality Psychology, 7(4), 324–340.