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2- Treating Trauma: The Art of Regulation

Ceramic piece by Meg Hamilton

A large, formless lump of clay sat between myself and the child I was working with.

The child studied it thoughtfully before carefully beginning to shape it. The clay began to take the form of “monsters”, and was shaped into craggy mountains and one dark cave. As the child worked, their focus intensified, and their breathing became more rapid. They used strong, forceful movements to shape the sculpture. After several minutes of work, the piece began to be transformed again, taking on a new shape to offer a place of safety amid a dangerous mountain world. The focus shifted to building this place of safety. The child worked to scrape away clay walls, and build protective barriers. Their movements slowed and softened. Finally, the child released a deep sigh, their shoulders relaxed, and they looked up at me.

When I work with trauma, one of the primary issues I focus on is regulation. Regulation stems from a body and brain that feel safe and secure in the world. Trauma often robs us of a sense of safety, and working to get that back is core to the process of healing.

An experience becomes traumatic when it creates a threat to our well-being and does not have the opportunity to resolve itself or correct itself. We often think of trauma as specific events. This often a part of trauma, however, trauma can also be cumulative and chronic. It can arise from pervasive systemic injustice- racism or transphobia, for example, or from repeated humiliation by a parent. Instead of thinking about trauma as events, for this post I would like to frame trauma as a chronic or easily triggered state of dysregulation. This state is rooted in traumatic experience and memory.

First, let’s break down regulation.

Imagine yourself in your absolute favorite place. Maybe this is somewhere in your home, or a vacation spot you’ve been to before. Maybe on a beach under the warm sun, or in the mountains surrounded by stillness and stars. As you imagine this, notice what happens to your body. My guess is your heart rate might slow, and your muscles might relax as your breathing becomes steady and even. This is a state of regulation. You feel calm, safe, and confident.

Regulation is not just a state of calm relaxation. Think of a day when you were dealing with multiple problems- maybe there were several different stressors to juggle that day, and important deadlines to navigate. But, on this day, you could manage the stress, conflict, disappointment, or whatever may have arisen that day with relative ease. You could solve the problems that needed attention, while also noticing and managing your various emotions. This is also regulation. We are in a state of regulation when we can take on whatever comes our way without being overwhelmed. When we are regulated, we can feel our feelings, manage our difficulties, tolerate distress, learn, and engage in connected relationships with others.

Trauma takes us out of a state of regulation and into a state of self-protection. This happens in response to physical danger or threat, and it also happens in response to emotional or relational threat. We are intricately wired for connection with other humans. Threats to these connections are perceived to be just as dangerous to our safety and survival as threats to our actual physical safety. This is particularly true for children who, at young ages, are reliant upon their caregivers for their understanding of their emotions and themselves. As children get older, they are increasingly able to understand and own their experiences. Young children, though, learn how to manage their emotions and perceive themselves only through the help and feedback of their caregivers. This foundational time creates lasting models of self, and lasting strategies for managing difficult experiences.

When we have trauma, we see these models and strategies played out in our states of dysregulation. Dysregulation sends us to a state of hyperarousal, hypoarousal, or rapidly cycling between the two. In a state of hyperarousal, we might feel rage, panic, and intense fear or anger. We might notice ourselves on the lookout for harm, on the defensive in our relationships, and looking for the nearest escape. We might notice our heart pounding, thoughts racing, and muscles tightly clenched. In this state, it is hard to trust others. This is our Fight or Flight. Children in a state of hyperarousal may be verbally or physically aggressive, experience overwhelming anxiety, or become destructive. Hypoarousal is a state of shut-down, or Freeze. Here, we might feel heavy, numb, or like we are in a fog. It might be hard to pin down thoughts and verbalize experience. We might feel sleepy, forgetful, or blank. Children in this state might seem to day dream or zone out frequently.

We all experience these various states at different times in our lives. However, when we have trauma, our models for how we see ourselves or how we manage difficult emotions are activated any time we experience a reminder of what created that model in the first place. For example, a child who was repeatedly shamed or told of their shortcomings may, in adolescence, enter a state of shut-down any time they face a challenge that might reinforce their low-self esteem. For that child, it is safer to shut down than to experience the feelings of shame and worthlessness again. Or, an adult who was not validated and listened to as an adolescent might respond with swift defensiveness and rage to interruption by their partner in an effort to force being heard.

A key aspect of trauma work is improving regulation.

As regulation improves, we can process and resolve the trauma triggers, reminders, and messages that cause so much difficulty for us. As regulation improves, we are better able to catch and monitor our triggers, labeling them when they arise so we can take a step back and use the skills and strategies to respond to what is occurring in the present moment rather than what has occurred in our past.

As my clients and I engage in the art making process together, I see noticeable shifts and changes regulation. Like the child I described above, I see energy and intensity increase through engagement with art materials. As we work to find techniques, strategies, or images that help us sublimate that energy, I see energy lower, capacity for insight and connection increase, and, often, witness thoughts, experiences and feelings be verbalized in new ways. These things are indicators of improved regulation. They are powerful and important steps on a path towards health.

At the end of an art therapy session, I ask clients what we should do with the piece they created. Should it travel home with them to serve as a reminder of the work the client has done? Should it remain in my office, where it will be stored in a safe, private location? Does it need to be set aside for a time, and returned to later for more work or complete transformation? Should it be destroyed? Often, the art piece stands as a visual symbol of the process of working towards regulation. This last choice- what should we do with the art piece?- is one of my favorites. It invites a moment to reflect on the work, and step outside it as an observer. It often creates a beautiful opportunity to acknowledge and integrate the work that was done that day, and offers an important moment of regulation, grounding and choice. In this moment, both myself and the client have the opportunity witness and reflect on that day’s process of regulation and increased self-awareness. It’s a beautiful reminder of the growth, healing, and connection that is possible

Meg Hamilton, LPC is a therapist practicing in Durham, North Carolina. Meg is an art therapist and specializes in therapy for trauma as well as in supporting LGBTQ+ youth and families. Meg’s work is upheld and informed by a commitment to social justice. Learn more at

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