Creativity as the Opposite of Death and Destruction

Elise Bittenbinder is a psychotherapist and works with victims of torture and human rights violations and politically persecuted refugees (at XENION, Berlin). She is president of The German Association of Psychosocial Centres of Refugees and Torture Victims (Bundesweite Arbeitsgemeinschaft der Psychosozialen Zentren für Flüchtlinge und Folteropfer, BAFF). This interview is a continuation of a conversation held at the Neuer Berliner Kunstverein on the occasion of the presentation of the video The Invisible Hero, 2005, a co-production with the Video-Forum at NBK.

Someone who suffers from post-traumatic stress syndrome often forgets not only the experience, but also the accompanying emotions. The traumatized person is left an empty hull. Is my description correct?
“Post-traumatic stress syndrome” is a clinical term. The process described in the question is only part of the definition. The word “trauma” originally comes from the Greek and means “wound”. The term was not applied in psychology until the end of the 19th century. A trauma is an event that exceeds the psyche’s capacity to adequately respond. PTS syndrome is an illness that arises when the event is not processed. It then results in certain symptoms. One of these symptoms can be that when the traumatized person remembers the traumatic experience, she/he can no longer associate the emotions that arise with the event. That she/he is as if dead, fending off emotions, and then ending up in a rigid stance dissociated from events or people.

Is a trauma the beginning of a spiral of “wrong” behavior patterns?
A typical phenomenon with traumatized people is that the trauma is re-experienced again and again, that the emotions or internal pictures connected with the experience constantly repeat themselves and cannot be shut off. In addition, there is also a re-experiencing in “flashbacks”, in which the patient suddenly thinks she/he is back in the traumatic moment and reacts similarly to how she/he would react in the real situation, though it is no longer the same situation. Typical ways people—and not just trauma patients—work through things is to repeat them again and again until at some point a “solution” arises. To escape the same situation in a different way. I wouldn’t say that a trauma is necessarily the beginning of a wrong behavior pattern. Most people do find coping mechanisms or ways to integrate the experience into their lives. Very often they use their creative imagination as a helpful tool.

Can a trauma have consequences for a person’s sex life?
Yes, absolutely. Especially when the traumatic experience is of a sexual nature or when women experience sexualized violence. Torture, for example, often has a sexual character. Sexuality and pleasure are an enormous life power, an expression of the joy of life that the torturer wants to break. The traumatized person later often has difficulties trusting a person again. Sexuality also means letting oneself go. And one can let oneself go only if one has strong trust in oneself and a world around them that is basically supportive.

For my video work The Invisible Hero, I had “visualizations” spoken onto the sound track. The standardized texts I used enable traumatized people to travel into their own (damaged) inner life and are intended to be repeatedly heard. What do you think about this kind of therapy?
If a visualization is carried out with the accompaniment of a good therapist, this can indeed have a healing effect. Of course, there are different schools with different methods. One has to decide case by case which method is the best. I myself use hypnosis a lot, in order to guide a patient back to a certain experience and to overcome it. I don’t use standardized texts or cassettes. I personally find it boring and mostly not useful to make the same journey again and again. I work with extremely traumatized people and would not use standardized texts with them, because I always have to pay attention to how a patient responds and how far I can go and make sure that nothing is triggering an anxiety and could have a re-traumatizing effect.

The internal journey taken during visualizations resembles the shamans’ journeys into the unconscious. Do you think that visualizations take up anew an ancient form of selfhealing?
Definitely. I believe that this is a primal human ability. Since I have a lot to do with people from other cultures, I am also interested in their methods of healing and rituals. There are a great many connections that we have hardly discovered. Hypnosis, or “healing sleep”, for instance, was already known to the Greeks.

There are also so-called affirmative therapeutic texts that the patient must speak repeatedly over a longer period of time. I had the thought that these texts function like a kind of brainwashing. Do you see this similarly?
These texts correspond to certain methods that are often employed in therapy. But I think that they have to be worked out by a therapist in targeted, individual form and that they must really mean something to the person. Otherwise they are “empty” texts.

In your trauma treatment, you work a lot with art therapy. Typical of this form of therapy is that the patients are given no directives. This seems to be the exact opposite of what the aforementioned visualizations do. Am I right? What method do you consider more effective?
One of the means of processing traumatic experiences—here I am speaking of torture or severe human rights violations, i.e., manmade disasters—was always to deal with them artistically. Especially when one person is tortured by another, the victim experiences a feeling of total helplessness. Life and death depend on the other; the victim is deeply shattered in his power to do anything. Creativity means doing something on one’s own and is thus the opposite of death, destruction, and situations that stymie one. If one can produce something using one’s own resources, one is creative and can find a way out of one’s own problems. For this reason, I think that the creative, artistic method in which the patient himself “creates” is more healing than the method of taking predetermined inner journeys.

Art therapy uses art as a form of expression. In your opinion, where does the difference between therapy and art lie?
For me this is a difficult question; good psychotherapy is an art. Art can be therapeutic for certain people. A psychotherapy is a desired ritual of change. The goal is that the patient, together with a therapist, opens himself up to follow a certain method, to take a certain path to achieve a change in his life or to change the way he deals with problems. Now if you tell me what art is, maybe we can work out the difference.

Printed in: Mathilde ter Heijne: If It’s Me, It’s Not Me, pages 14-15