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Implementing art in therapy with men or women who have been the victims of sexual violence reveals the pain, confusion and impact such violence creates. The impact of sexual abuse and/or assault wounds a person’s spirit, creating a life of continuous confusion, self-reflection and self-devaluation. The journey of self-discovery and emotional healing using art in therapy requires a path walked that as an art therapist I am honored to witness. The images that illustrate this article were created by a female client and are just a very few of the many created that document her journey, a precipitous trip of inner torment and discovery. For reasons of confidentiality the client will be referred to as Susan. A dominant theme with so many survivors of sexual abuse is the confusion of feelings. The painful memories that become hidden secrets fester and build to a point where the emotional release of feelings through tears becomes a fear in itself. I have often heard the statement during a therapy session that “I am afraid if I begin to cry I may never be able to stop.” The first drawing (Image One) reflects the daunting task of keeping painful emotions in control. In this image a single tear spills down an expressionless face. There is a haunting quality and a feeling of isolation. Done in shades of blue and pencil, its starkness defines the controlled emotions that parallel a lifetime of secrets. By creating this image Susan was able to begin to metaphorically step outside herself and view the silent torment of suppressed emotions that she had been holding on to. It was an important beginning, one that may seem trivial at first glance, but to a survivor of sexual violence, it becomes an important step in learning to have and own one’s authentic feelings rather than “deciding what to feel…”
Letting go
Susan continued to create several self portraits depicting the feelings of being overwhelmed with pent up emotions and the isolated existence this creates. In Image Two, Susan’s watercolor painting depicts a small child living in a fog-like existence. She described her image as one of being always alone, even among family or friends. The depth of this emptiness and feeling of being detached or flawed can never really be understood by others that have not been hurt by sexual violence. The feelings of worthlessness left her feeling helpless, hopeless and lonely. The image has a weight to it. We explored the feelings of shame that sexual violence creates and the weight that a sexual violence survivor endures. She seems to be sinking beneath the floating colors and again the images are created in a sea of blues. We discussed the feeling of moving through life as if pushing against a fog, a fog that never lifts. I encouraged Susan to view the painting in another way. To consider the idea of emergence out of the fog, that through the mist she could find her path to self discovery and healing.  The Lost Girl
Susan’s childhood sexual abuse created a world of inner torment that left her feeling flawed and shame-based. These shameful feelings developed into self-devaluating voices that continued to haunt her daily. The voices were her inner dialogue of low self-esteem that created a constant mental battle that felt as though the negative messages of self- devaluation would never be quieted. They felt trapped within her. These voices told her she was flawed, bad, and deserved this life of mental and emotional punishment she was enduring. Images Three and Four depict her feelings about her inner world, the world that she could not explain in words. These images are so powerful that as stand alone art, outside of Susan’s therapeutic journey, they can speak for themselves to any casual observer.  Inner Demons
Untitled
The images of expressionless faces in Image Three are floating and out of control. This out of control image was one that also was a metaphor for how she felt about feeling powerless in her own life. I asked Susan, “If your image would create a sound what would that sound be?” “A droning persistent nagging,” was her reply. Susan discussed how the voices were constant and always there to remind her of her nothingness and worthlessness. These images reappeared in a drawing several weeks later (Image Four) and although they have the same haunting quality they are beginning to show expressions of change. We explored the metaphor of the image of the tree and its symbolic significance of growth and grounding. In many Native American myths the creation of the tree is a symbol of transformation. Susan was beginning to find her own voice, a voice to speak her authentic true self, changing the voices of shame and self-degradation. This is by no means an easy process, but this was a vital step forward. In Image Five, Susan created another self-portrait. It is one of herself as a grown woman, but also within her, a second image of a small girl. The figure is blurred and out of focus, making it hard to distinguish which is the dominate part of the self. Perhaps at this point in Susan’s journey of healing, she was both. There seemed to be a need to integrate the woman with the child to begin Susan’s healing. So often the small child that has been hurt needs to be nurtured and acknowledged for the pain she carries. Susan began embracing this painful part of her, so integral in the healing process. She no longer worked to forget her or wished her not to exist. She was able to begin to embrace her painful inner child and the anger towards her perpetrators and through her art process and cognitive therapy, have these emotions validated. 
The inner child As Susan began to do more art images around this wounded child, her images changed dramatically and began to expound with vivid colors (Image Six). There also was a new image that began to enter all of her drawings and paintings; this was the figure of an angel.  Anger
Susan felt a great deal of suppressed anger and feelings that could not adequately be put into words. She explained the small embryo held within the image as representing the part of her unable to develop into who she truly was. The colors seem to move in chaos around the small suspended embryo, representative of a life out of control. Or was the embryo being protected from the chaos of the world around her, a sacred part of herself wanting to be kept in a deep hidden space We also continued exploring what the angel figure represented, as it was a shape that appeared again and again. At times, Susan was unaware that she had painted it on her canvas. As her therapist, I knew that it was vital for Susan to understand the meaning held by the continued representation of the angel, and when she was emotionally ready she would be able to realize the significance of its presence. In the months to come, Susan created multiple images that vividly spoke metaphorically of her pain and anger. As shown in Images Seven and Eight, she continued to express her inner torment with paintings rife with images of death and pain. Her images often had religious overtones, images of disconnections, stairways leading into the unknown. Continuously, the image of an angel reappeared within most all of her paintings or drawings. At this time a dark shadow first appeared, as seen in the right side of Image Seven. From this point on, the shadow image would present itself more and more throughout her work. The shadow frightened her, but also confused her in its continued appearance. We explored the possibility of it representation; was it the perpetrator, the shame that loomed around her? Or was it the shadow parts of the self that she had buried deep within, a darkness that she could not let surface or could not yet understand or speak to at this juncture in her therapy?  Untitled
 Untitled
The image of the shadow and the angel continued to be part of the many drawings and paintings that Susan would create during our therapy sessions, each with familiar themes of self-devaluation and destruction and what she gradually came to identify as the of loss of her spirit. It was after many such images that Susan came to the difficult understanding of what the violence of sexual abuse and assault had taken from her. It was a deeper wound that continued to invade her images. We explored what the hanging angels in Image Nine could tell her of a deeper pain she was hiding. 
Death of an Angel
This powerful image painted many months later would bring many deeper feelings into the forefront of what proved to be the most painful part of Susan’s journey towards healing. The violence that she had endured through sexual assault and abuse had touched a much deeper part of her; it was a sacred place that had been pure and innocent, but was no longer. The shadow continued to lurk and wait while all around there are teardrops of blood. This cathartic image let out all the deeper parts of Susan’s inner world, the damage that sexual violence created and the inner turmoil and pain that Susan had never revealed, not even to herself. It was the death of an angel, and with great courage and insight she revealed to herself that the damaged angel was her soul and spirit, something that felt damaged and beyond repair. This deeper understanding of why she continued to feel flawed and isolated allowed Susan to view a part of her innermost self that, without the medium of art, she would never really have understood. This also allowed me, as a therapist, to understand a much deeper wound that sexual violence survivors carry; a wound that goes beyond what words can adequately express. Susan’s journey toward becoming her true self continues. It was during later sessions I was presented with this watercolor (Image Ten) as a gift.  Healing and Hope The image spoke of a rebirth. A small child with colorful wings sits and faces the darkness. It was in this inner darkness and torment that, with great courage, Susan faced her fears and began to embrace her freedom and regain her purity of spirit. The child angel figure peers into the darkness watching feathers float down from above. Susan knew I collected feathers and view their symbolic meaning as freedom. If you look closer into the darkness, the entire sky is created and textured with feathers. I continue to feel honored to be of witness to the inner pain that survivors of sexual violence carry. They continue to teach me of the fragility, but also the strength of spirit, and the courage it takes to regain and nourish the deepest parts of the soul.
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