The power of art expression and creation in coping with life under threat – Israel 2001-2002
Tamar Hazut
This chapter pays tribute to the patients and therapists, victims of hostilities in Israel, whom I have met over the past few years. The chapter reveals the power of expression and creation (while focusing on the role of  black) as a unique means of coping with painful losses and grief. It presents the story of a group I guided during the period 2001-2002, which helped the participants to cope with traumatic experiences through the use of techniques I developed for therapeutic intervention through art. I have followed the group in its transition stages from an optimistic start to a dramatic crisis and, from there, to the gaining of strength and hopefulness.
1.      Living in Israel under threat and terror 2000-2002.
Israeli statistics of  March 13, 2003 reported that since September 29, 2000, seven hundred and fifty three  Israelis were killed in the El Akza Intifada and thousands were injured or suffered from shock ( statistics/hebrew;  March 13, 2003). Life in Israel is characterized by a reality of continuous conflict between two ethnic communities.  The El Akza Intifada broke out as an outcome of the failure of the second Camp David Peace Summit held in  September, 2000. This summit, headed by the U.S. President Clinton, was the climax of  long-term, unfruitful negotiations held between the Palestinian and Israeli authorities. The entire conflict is based upon the complex reality of two nations struggling for their right to the same land. Demonstrations, riots and violent acts erupted both among the Israeli and Palestinian Arab populations in mid-October, 2000. The positive relations and trust that characterizes co-existence with the Israeli Arab population for the past 50 years were destroyed due to their growing identification with Palestinian suffering.
Palestinian terror has reached unfamiliar levels of killing and murder of innocent civilians (men, women, and children) and outright lynching. Terrorist organizations and the Palestinian Authority incite the Palestinians to continue the violent acts and regard the suicide-bombers, including teenagers, as saints.
The Israeli population living under continuously stressful conditions has been severely affected and  daily routines have changed, such as: avoiding the use  of buses; refraining from socializing in entertainment centers, coffee shops, etc. This has led to the canceling of activities and events at both the local and national levels. The population is living in a state of continuous, ever increasing, long term anxiety. As a result, the economy has deteriorated and  economic hardships have increased. The public is constantly exposed to the traumatic scenes presented through the media. The viewers are exposed to intolerable sights of horror that add to the already existing deep mental distress.
I am the Head of the Art Therapy Training Program at Haifa University. I also teach the graduating classes of the Special Education Faculty at  Oranim College. In both places, the groups I facilitate are heterogeneous and multi-cultural. They are made up mainly of women - Jewish, Druz, Bedouin, and Arabs – religious and secular – from kibbutzim, villages, and cities. A special complexity exists within the Arab populations: The Druze and Bedouin are Israeli citizens serving in the army and many of their family members have been wounded and/or killed in the Intifada. In contrast, the Arab communities (distinguished as either Christian or Moslem) have undergone increased shock since the El Akza Intifada. The latter are trying to make up their minds over their conflicting loyalty and identification  as Israeli citizens vs. loyalty and identification as Palestinians. All these intricate factors affect the groups I work with,  enormously. The expressive activities carried out in these groups alongside the legitimization of inner difficult and painful feelings become a bridge for non-verbal bonding through a common expression of the collective hurt and anger.
2. Art Expression and its rituals in coping with loss and grief.
Ritual, in general,  plays a role in culture and worship, indicating a belonging to a framework, to the community, and to a faith. The rules of specific rituals have significant influence on the individual’s internal dynamics, some of its functions being designed to preserve and protect while others are designed to alter the individual’s emotional and physiological states (Hazut, 2000). The therapeutic structure of the process of expressing oneself and the way of using materials has ritualistic components. This has a special and unique meaning in the context of coping with loss and deprivation. The process of the therapeutic-ritualistic encounter includes several stages concerning both the patient and the therapist. This includes the preparation of materials and tools to be used, the ritualistic structure of the session, the movements and physical bonding  throughout  the process.
In situations of processing losses and traumas, rituals are of special importance in art therapy intervention. Rituals assist in organization and control diminishing feelings of chaos. Rituals allow  a sense of existence, repetition and continuity,  relieving  destructive and self-destructive feelings resulting from total furious frustration. The therapeutic session with its consistency and order, allows a sense of security and containment versus insecurity and decomposition. Systematic structuring with materials expresses a process of creation and growth in contrast to having to deal with death and loss.
Creation allows symbolic representation and experiential reconstruction of difficult events. Playing with material and projecting inner content into creation may gradually develop a realistic balance of emotions (Case, 1995). The creative activity which includes conscious and unconscious states, allows for control over anxiety and threat. Along with this it allows for holding on to  the concrete existence of the material and the art product in contrast to the “separation and desertion anxiety” that characterizes situations involving loss (Hazut, 2000). Case (1995) stresses the importance of the transition from passive reaction that characterizes depression  to active reaction that is   an activity that takes place through creation or a transition that leads, mentally, to a sense of control over the experience (Kaufman, 1996).
The various art materials (paint, pencils, clay, etc.) can absorb and provide feedback for the expression of varied feelings – from aggression to sublimation – through touching in a non-judgmental and uncritical manner and without fear of destruction of the self and the others (Hazut, 2000).
The “dialogue” created between the creator and his or her creation allows reprocessing of the trauma and loss, leading to the discovery of different perspectives and alternatives to adjustment and to the solution of existential problems.
Facing  fear directly reduces the threat of its existence; the intensity and the resulting empowerment of the individual lead to a capacity to contain and control  the memory of the event. Physical engaging with the materials and physically working  with them might replace, to some extent, the sense of lack of closeness and lack of feeling (Hazut, 2000). Levin (1992, in Kaufman, 1996) maintains that the role of therapy is not to reduce the suffering but to voice it and to find a way of  expressing it. The mere expression legitimizes the right to suffer pain.
Betensky (1995) stresses that artistic expression fills and enriches the creator due to the occupation with materials and the creation of the “existing”, the “new”, out of the “non-existing”. This is perhaps the main reason for the patients’ relief, relaxation and inter- and intra-personal communication at the conscious and unconscious levels.
3. Black also has shades.
Black is not considered a color but it does play an important role as a symbol having different interpretations in different cultures. It has various symbolic meanings such as despair, sadness, melancholia, grief,  and also productivity, black earth, wisdom, and dignity, etc. (Cooper, 1978).
V. Kandinsky (1972) considers black as the eternal silence with no future nor any hope. The use of black is experienced as a need in spontaneous creations by children, adolescents, and adults who cope with sickness, loss,  and trauma. The professional literature has a description of the appearance of a black sun as a major representation of suffering and despair (Betensky, 1995; Skriptchanko et al., 1996; Pintzover, 1987; Hazut, 2000).
I have a special interest in two issues related to my therapeutic work. The first is the unique significance of black in creative expression and therapeutic intervention when dealing with response to trauma. The various uses of “black expression” in the creations of my patients has taught them and me about the “shades of black”. This broad symbolic perception allows them to turn rigid notions about the world and the meaning of life into more flexible ones. I have learned to use this insight for therapy during crisis intervention with traumatized people, sick and grieving patients.
The second concerns the particular method I have developed, which is called Find Your Anchor and is designed for therapeutic intervention in cases of stress and trauma. This method is used for the purpose of  finding inner resources of strength and increasing the ability to hold onto something in times of despair and helplessness.
Recently, I have combined these two themes in my work as a therapist and teacher in coping with traumatic events.
4. “The wounded healer” – healing the healer.
The concept of “the wounded healer” is the nucleus for understanding the meaning of the therapeutic connection according to Jung. It is based on the concept that the healers can only heal their patients’  pain and trauma by understanding  and healing their own  personal pain and trauma. The image of “the wounded healer” appears in mythology as a metaphorical figure, according to which the healing God suffers from some scar that does not heal. This is the basis for understanding the theory of bonding  between the healer and the patient within the relationship  which is based on the mutual recognition of relating to the healing process as one which requires feelings of love and intimacy. Many therapists who use professional ‘protective masks’ are unable to contribute fully to their patients’ needs. In contrast, those therapists who are open to their patients may reach a higher level of cooperation with them during the healing process (Hazut et al., 2002).
Larson (2000) discusses the phenomenon of “compassion fatigue” among trauma workers as defined by Figley (1995; in Larson, 2000),  referring to the rescue workers and therapists who treat disaster and trauma victims: Exposure to long term traumatic situations causes the patient to be overwhelmed, losing the ability to defend himself/heself in situations that evoke excessive feelings resulting from intense empathetic involvement. This is liable to lead to traumatization on the part of the therapist – to fatigue and to symptoms similar to those of  their patients. Trauma therapists must continue to develop new methods for self-reorganization and mental self-support  when confronted with traumatic events.
Art therapists should also be artists who are able to use their own creations to cope with their  own traumatic experiences and to renew and strengthen themselves. The creative activities provide a common operational set-up where therapists and patients are able to share a common language on both conscious and unconscious levels.
Art therapists and patients come in contact, through their creations, with the spontaneous, childlike, and healthy  part existing within themselves. Thus, all of this creates a bridge across the barriers and problems of communication and discussion. The normative and intimate atmosphere which the creation inspires and the feeling of accomplishment that it provides, strengthens the therapeutic relationship and increases satisfaction on the part of both the patient and the therapist (Hazut et al., 2002).
5. Case study: From an optimistic start, to a crisis, towards                         hopefulness.
A case study: Facilitating a group of students coping with crisis:
Background and framework:
I facilitated an experiential group training in Special Education at Oranim Teachers’ College during 2001-2002. This particular seminar group experienced a complex process of transition from optimism in the preliminary and introductory sessions to coping with a difficult trauma when one of the group members (M.) lost her fiancé who was killed in a bus explosion. Part of the process, development, and change was made possible as a result of the extreme contrast created between the color black,  on one hand, and different representations of pink, on the other hand (a phenomena that appears repeatedly in various groups dealing with grief). M. used black  to express her bitter feelings while P. (the eldest woman in the group who had lost her own fiancé twenty-five years earlier) used pink to express her positive feelings. The encounter between black as a symbol of background, darkness, and despair,  and colorfulness as a symbol  of life, optimism, and hope was the major axis for understanding  this group’s unique process.
2001-2002 was a period of many terror attacks and intensive military action: It was impossible to carry out regular routine studies. In all the groups,  I activated special facilitation in regard to coping with pressure and crises situations and to mobilizing defense and strength resources.
Presentation of the group:
The  seminar group, made up of twenty-one women and one man,  met once a week for four hours of activity throughout one year. All the participants were Jewish, aged 24-45. Their social backgrounds were extremely varied. There were those among them (especially the older ones) who had suffered more extreme trauma in the past.
The group included experiencing art making and acquiring skills for group and individually improvised mediation through different kinds of expressive techniques. In addition, each participant researched their own  personal expressive experience with the use of  theoretical resources.
The entire year was lived under the shadow of life-threatening events. Many  attacks occurred while the course was in process, engendering high levels of anxiety, fear, despair, and lack of security, and resulting in decrease in activity and function. Some of the students reported staying at home, halting all activities other than their studies.
As a group each individual experienced deep stress and anxiety  when the fiancé of one of the members was killed in a terrorist attack – an explosion in a bus. The explosion occurred close to the college and greatly effected the students and teachers, some of whom had been witnesses to the event.
The involvement in empowering personal and group expressive process was of great importance throughout the year. I summarize this process as a transition  from an optimistic start – to a crisis – and then towards hope. The following is a partial description of the main themes. This structured and guided process is appropriate to short-term focus intervention:
Beginning: First meeting: 
The first symbolic self-presentations in the group were through color and form, using non-verbal communication. A large black space on the wall was used as a basis for a mural.  I decided to use dark black as an existential background for life and living. Everyone was invited to spread, paste, and  tape their own colored forms, representing their integration within the group space. They then surrounded and defended each of their individual forms with a personally chosen color frame. Finally, they used lines and shapes to connect to and get in touch with the group. I have found this method to be very useful for first group participant introductions. The resulting mural was colorful and dynamic, an indication of the students’ enthusiastic response.  Their cheerful  feelings of  relaxation created an optimistic atmosphere.
First individual process: Symbolization of shape and color as the beginning of the self-search process:
Each participant chose and pasted a colored shape  onto white paper, seeing  this as the beginning of a new personal creation. The participants each took sheets of paper according to the size and shape of their individual choice  and then continued the search process on additional pages. This phase was characterized by unique, personal expressions though  a wide variety of group colors, shapes and movements. Later, each participant chose a partner with whom they felt connected through their mutual images.
This process allowed for more intimate communication among the  students and revealed deeper insight into meaningful, personal themes.
Individual work with pages of various shapes and sizes chosen by the students and the important effect of the shapes and sizes on the creating process:
At this stage the members of the group were asked to paint on different sized paper of their choice. They discovered that the choice of paper effected the on-going creative process. The therapeutic approach that I represent (Haifa University program) uses a standard set of various sized, symmetrical sheets of paper (circular, oval, various rectangular sizes, square, etc.). This method is intended for practicing flexibility in adapting oneself  to various life situations and also for enriching  creative ability.
This external period was relatively calm and this mood was expressed through  a richness of images and colors. Most of the images were clearly constructed in the form of  geometrical shapes, mostly circular. The participants also created circular, wavy, linear forms.  In the majority of the pictures, the white pages were only partially covered by color.
This can  be interpreted as the  students’ conscious and subconscious awareness of their need for  inner order at this stage. As a result, some of them chose to develop their own particular theme which they later developed   in a personal thesis.
Living under external threat: Dramatic increase of violence and terrorist activities against the civilian population:
Fear, anxiety, and anger penetrated the group space. During this period there was unrest in the group. Fear and anger surfaced. There were tears. The individual and group paintings were characterized by restless movements  through the use of lines and shapes. Use was made of black, red, and brown colors and of a great many words such as “frustration”, “tension”, “helplessness”, “tiredness and exhaustion”, “fear”, “blood”, “everything is black”, and “there is nothing anymore”. But, other words and phrases were also expressed: “hope”, “tomorrow the sun will shine”, “dreaming”, “from the black hope we shall rise, we shall live and blossom”, and also “faith”.
During this period every  participant  felt threatened. Everyone  prayed  that they would make it to the group safely for the following session.
Crisis: Tragedy within the group:
M.’s fiancé was killed in a bus that was blown up. That day was one of the most difficult days of the year and it was impossible to teach. M.’s closest girlfriends studied in the same group. Everyone was shocked.
The Jewish mourning customs include rituals that were originally followed by our forefathers as written in the Bible. One Jewish custom is that of  “tearing the shirt” of the closest relatives of the deceased prior to the funeral. This ritual has been a custom since Jacob tore his own shirt when he learned of the “death” of his beloved youngest son Joseph. Another ritual is the Shiva, which is a seven day mourning period that begins immediately after the funeral and allows the mourners to cope with their grief. The mourners do not leave home during this time. During the first week M. sat  Shiva at the home of her fiancé’s parents. A number of her closest friends joined her.
The crisis intervention in reaction to the loss:
I used a technique called “black monuments” for intervention with this group. I find it appropriate to challenge the creative expression through black material and color. This can allow for direct expression of painful feelings.  It can lead  to an expansion of  the creator’s previous rigid world view. I prepared the room before the participants entered. I place a large white rectangle on the floor. In the center of the rectangle I place a black circle made out of a fan of a particular kind of black carton.  The contrast and the closeness of the black and white express the existential contact between “silence of life and silence of death” (Kandinsky, 1911) and between darkness and light. R.M. Simon (1997) relates to the circle in the middle of the square as an integration between the earliest image of  the separate Self in relation to all that is not Self.
One of the older women of the group brought a large bouquet of pink roses that she had picked from her garden and spread them around the black circle. As soon as the other members of the group entered the room, they were asked to take a black cardboard, to tear it, and to recreate a new image. This is a symbolic activity that connects to the Jewish ritual of tearing the shirt upon the death of a loved one. This allowed for the expression of anger and aggressiveness through a process that enables one to take apart and rebuild as a symbol of the anticipated rehabilitation process in coping with loss and grief.
Most of the participants were  isolated in their own thoughts  with an expression of shock and pain on their faces while working intensively. Many were crying. P. got up at a certain point, took a rose,  and started to interweave it within her creation. Others also began to remove the leaves and the petals of the roses and the pinkish, reddish colors became a striking part of the black products. This symbolizes both  life and growth as well as blood and death. The monumental products were very dramatic (Figure 1.1). Most of the products were flatter, some maintaining their original frame, holding on to structure, and  organized form while others were designed in freer and even chaotic form.  Student creations were placed touching each other on the white space becoming one unit. At this stage I asked each participant to draw a brief sketch of the entire creation. The participants were asked to develop the shapes and the forms that evolved into an associative series of drawings. The intention was to create an additional connection to the group as a source of support and encouragement. At this time, they were able to discover new content in the form of verbal association and images. This created an atmosphere of  relief.
During the emotional sharing that was held at the end of the session,  P. told everyone that she had lost her fiancé many years before during his army service. Her wedding gown had been hanging in her cupboard at the time. She, too, had been studying at Oranim and had returned to her studies within a week of her fiancé’s death. She succeeded in rehabilitating herself. She married, raised a family, and was extremely proud of her four sons. During the years, she discovered the force of the color pink which symbolizes optimism and hope for her.
The following week after this session, M. decided to return to the class. I asked the participants to choose group of mono-chromatic oil pastel colors and to draw emotional “scenery” expressing their feelings at that moment. Each of them chose a large variety of color shades and very quickly filled the papers with powerful strokes of color. M. chose a variety of different shades of black and began to cover the page while I sat beside her, supporting her emotionally as well as providing technical assistance. She worked with ferocious movements in different directions. She exchanged her colors for different ones and created massive mounds of black upon black.
At the next stage, I suggested that everyone take their drawings apart and paste the pieces  in different places on a large white surface that I had prepared in advance on the wall along the entire length of the classroom. There is a great deal of importance related to working while standing up and moving around in terms of working with trauma victims. This is a way for them to achieve release and positive reinforcement.
I asked M. to be the first to paste the black pieces of cardboard. The others were asked to join her in order to add a colorful support to the black shapes. P. was extremely excited, running ahead,  and pasted her pink pieces directly beside and touching the black shapes. Gradually, the mural became covered with cheerfully colored pieces surrounding the black shapes (Figure 1.2). Colorful lines were added that connected the shapes to each other and words such as “hope”, “strength”, “to be covered”, “coping”, “love”, “growth”, “not everything is black”, and also “absence” and “emptiness”. The touch and the connection between the shapes defined the feelings of  sharing and the special kind of partnership which had developed within the group.
Finding a safe place and a protective shield:
The following week was dedicated to finding a secure place and mobilizing sources of strength.
During the past two years I have tried to guide all my groups and all my patients towards searching for a protective shield or anchor to serve as a basis for increasing their strength and security. I have begun to develop several techniques in this area since the 1991 Persian Gulf War for coping with reality and for helping children to overcome their fears of entering the sealed room and putting on anti-gas masks. The  process is based on identifying  feelings and experiences in order to learn to contain them and finally, to create a metaphorical anchor intended to symbolize something  to hold onto in very difficult situations. I often suggest preparing protective shields. I asked this particular group to bring objects having important emotional value from home that represent support and offers comfort.  The materials that I provided included a wide variety of paper, colors, and found objects as well as ready made objects. The wealth of possibilities and the different types of material is suitable to working with difficult emotions and with trauma.
At the beginning of the session I placed a pile of separate pieces of paper on the floor. I asked everyone to choose a color and to sketch the movements that corresponded with their inner feelings.  The first choice of color and movement has specific meaning that gets in touch with  the primal and natural emotional  makeup of the individual. Repetition of the same movement induce  concentration on the part of the individual  and a looking inward towards self.  This concentration and focus induces release of emotions and leads to a change in behavior and expression.  The transition from one piece of paper to another,  perhaps forces the person to become detached from the movement and to retest it anew on another blank piece of white paper. This short activity can lead to enormous and speedy change within the scope of the movement, directions, rhythm, focus and organization on the page. At the end of the activity, it is important to look at the “drawings” in chronological order and to check the phenomena pointing to development and change. This can contribute to understanding, focusing on coping and meaningful possibilities for adaptation and change.
Next, each participant chose one of the aspects, added it to the large white sheet of paper, continued to make forceful movements – using more forceful colors  and greater amounts – creating a large picture. Afterwards, each participant was asked to prepare their “anchor” out of different materials and to add to the “anchor” those objects that they had brought from home.
By the end of the session, a number of circles were formed – the external circle included large painted pictures that were hung on the walls in a large room, thus bringing out with great intensity the feelings and emotions of the individuals.
A circle of objects from the personal protective shield that each participant had created was placed on the floor in a circle in the center of the room. A tight circle of the chairs on which we were to sit was placed in a larger circle around the objects.
This formation created a vibration and a non-verbal bond among all of the participants for the closing ceremony at the end of the session. Each person explained the processing that they had undergone, reinforcing the group support.
The last person was P. who had prepared pink glasses – attached to them a picture of her son who was being called up for army service and, through a poem that she had written, summarized the transition from  the dark black to bright pink full of hope. Then she turned to M. and asked to be allowed to hug her. The hug marked the common bond between two women (young and older) having shared a common fate.
Final stage:
These focused interventions made it possible for the class, to find the time, to return to the routine of  studying and carrying out their every day tasks. The continuation of the process for the duration of the year was characterized by processes of creating and personal inquiry in which both difficulties and optimism  stood side by side.
6. Summary: The role of expression and creation in the “work  of
The concepts of “hope” and “hopefulness” are related to a sense of security that is followed by a wish for a positive change. Hope is defined as a mental process that arises in response to threat and pain, designed to cope with and overcome these feelings. Viewing hope as “the work of hope” allows for growth and development and is accompanied by a sense of control, competence and coping. The work of hope always drives forward and  promises us that “tomorrow will be better” (Yakobi, 1987). The “tools” helping in its realization include: an optimistic approach, physical, mental and cognitive activism, future time perspective, the use of imagination and ability to control.
In the expression process, the actor is engaged at every given moment in planning the next stage of expression and experiences tension that stems from exposing the work of imagination and its realization through the images being created. He or she is responsible for and controls the search for effective solutions. The stages, beginning with multi-sensory integration, physical work, thinking and feeling are experienced as “the work of hope”. The term, which has both conscious and unconscious content, could be descriptive, realistic or abstract, conveyed through a personal language of metaphoric signs and symbols (Hazut, et al, 2002).
The focused intervention process allowed the group presented in this chapter to continue to function, learn, and create. M. chose to do her thesis on her coping with her own loss and trauma through her personal creation. She began by  expressing her anger through “action painting” with massive red and black gouache colors. She then moved on to paint colorful and decorative drawings using pastel crayons and Indian ink. Her paintings were organized in the form of small shapes attached to each other. At the next stage, she drew separate, detached, rounded shapes. Her final painting was that of a candle made in the shape of a large question mark. It appears that she succeeded in this way to express her mourning rituals and grieving processes: through the transition from shock and parting from her deceased beloved towards separation through internalization of the loss; finally, to the beginning of  individuation in a process of self-rehabilitation. The entire process was made possible by the intensity of the creation and expression in coping with life when under pressure in the shadow of threat. Throughout the entire process, M. progressively used the various shades of black in her creations. At first, she made intensive use of materials appearing as abstract form, also using  a black background,  and then moved on towards concrete symbolic and linear expressive images. This process paralleled her changing moods which fluctuated between the hope and despair in her life.
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Tamar Hazut: From dark black to bright pink – The power of art expression and creation in coping with life under threat, Israel 2001-2002 In Kalmanowitz D. and Lloyd B. (ed.): Art therapy and political Violence with art, without illusion, pp. 91-105.

Statistics: “Intifada” victims: Sept. 29, 2000 to March 13, 2003.  Retrieved March 13, 2003 from – statistics/hebrew/1.gif.
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