When the Body Speaks: Trauma, Menstruation and Art Psychotherapy

When the body speaks

Sometimes distress does not arrive as words.

It can arrive through the body: through pain, changes in bodily sensations, feeling “sick”, changes in behaviour, or through the materials a young person chooses to work with.

Adolescence is already a significant period of physical, emotional and relational change. For young people who menstruate, puberty brings a new relationship with the body and with menstruation. When this is alongside experiences of developmental trauma, these changes can become particularly difficult to understand and communicate.

My MA research explored the relationship between developmental trauma, menstruation and menstrual symptoms, and the role that Art Psychotherapy might have in supporting young people experiencing these difficulties.

I became particularly interested in what happens when experiences of the body are difficult to put into words.

Trauma, the body and menstruation

Trauma is not only something that we remember cognitively. It can also be experienced through the body.

For young people who have experienced developmental trauma, the body can become a place where difficult experiences are held, communicated and experienced. Puberty can bring further changes to this relationship with the body, particularly when menstruation begins.

Menstrual pain and other menstrual symptoms are often normalised. Young people may be told that pain is simply part of having periods, or that difficult physical experiences are something they should learn to tolerate.

My research does not suggest that trauma causes menstrual symptoms, and menstrual or physical symptoms should not be dismissed as psychological. Appropriate medical assessment and support remain important.

What interested me was the space in between: how a young person's emotional, relational and embodied experiences might interact, and how we can listen to what the body may be communicating without reducing physical symptoms to psychology.

When words aren't enough

Art Psychotherapy can offer another way of communicating when words feel difficult or unavailable.

Art making can become a form of communication in itself. A young person does not necessarily need to know exactly what they are feeling before they begin to make something.

Within Art Psychotherapy, I might use body scans, creative scales, drawing, painting, clay or other materials to support a young person to explore their experiences. These approaches can provide opportunities to notice sensations, emotions and relationships with the body without requiring everything to be explained verbally.

This can be particularly important when working with trauma, where experiences may not yet have a clear narrative.

The art object is not necessarily the important thing. The process of making, the relationship with the material and the relationship between therapist and young person can become part of the communication.

Why clay?

Clay became particularly significant within my research.

There is something very physical about working with clay. It is tactile, responsive and changeable. It can be held, squeezed, pushed, pulled apart, joined together, flattened and reshaped.

For me, this materiality raised questions about the relationship between the body and the material.

Clay can have associations with flesh, the body and the physicality of being human. It can also offer containment. Something that feels difficult to contain internally can sometimes be placed into a material and experienced differently.

In trauma work, this can be significant.

The material can hold something for a moment while the young person and therapist work together to understand what is happening.

A young person I worked with

As part of my research, I explored a case from my clinical placement with a young person who had experienced developmental trauma and was experiencing difficulties around menstruation and her body.

I have deliberately kept the details of this young person anonymous.

During the work, we explored bodily sensations and emotions through creative activity. At one point, she described herself as feeling “sick” and expressed the idea that women who were on their periods were sick.

What stayed with me was her wish for the word “sick” to be recognised alongside the other emotions.

This was important because “sick” did not necessarily fit neatly into a conventional list of emotions. It seemed to communicate something about her experience that was both bodily and emotional.

Clay also became an important part of our work.

There were moments when the material became very visceral. I found myself noticing my own responses as the therapist: my anxiety, my uncertainty and my attempts to understand what was being communicated.

At another point, the young person gave some of the clay back to me.

I reflected on this as potentially meaningful within the therapeutic relationship. The clay was no longer simply something she was holding herself. It had become something that could be given to another person and held within the relationship.

This made me think about trust, communication and the ways that difficult feelings can sometimes be communicated through materials before they can be communicated through language.

The work also reminded me that art therapy is not necessarily about producing a finished object. It can be about the relationship with the material, the sensory experience of making, and what takes place between the young person and therapist during that process.

Listening to the body without making assumptions

One of the most important things I took from this research was the importance of listening.

It can be tempting to search for a clear explanation for physical symptoms. But when working with young people who have experienced trauma, it is important not to assume that we already know what their body is saying.

A physical symptom is real.

Pain is real.

Feeling sick is real.

At the same time, a young person's emotional and relational experiences may also be part of how they experience their body.

These things do not have to compete with one another.

For me, this means holding space for both the physical and psychological experience. It means taking menstrual symptoms seriously while also being curious about what menstruation, puberty and the changing body might mean for a particular young person.

Why this matters

There are still gaps in our understanding of women's and girls' health, including the ways that menstrual experiences are understood and responded to.

For young people with developmental trauma, there may also be difficulties accessing or communicating their experiences within systems that often rely heavily on verbal communication.

Art Psychotherapy can provide another route in.

Through creative work, a young person may be able to explore experiences of their body, emotions, relationships and trauma without needing to have all the words first.

This does not mean that art therapy replaces medical care, nor that menstrual symptoms should be interpreted as psychological symptoms.

Instead, it offers another way of listening to the whole person.

What I took from the research

My research left me thinking about the body as something that is not separate from emotional life.

The body can communicate.

Materials can communicate.

Relationships can communicate.

Sometimes these forms of communication come before language.

Clay particularly highlighted this for me. Its ability to be changed, broken apart, rebuilt and held made it a powerful material through which experiences could be explored. It also reminded me of the importance of the therapeutic relationship and of creating a space where something difficult can be held without immediately needing to be explained.

Most importantly, the research reinforced for me that we need to remain curious.

A young person's experience of menstruation, pain or their body will not have one universal meaning. Their cultural context, relationships, experiences of trauma and individual relationship with their body all matter.

We need to listen rather than assume.

And sometimes, listening means paying attention to what is being communicated through something other than words.

Art Psychotherapy and the body

For some young people, distress does not arrive as words.

It may arrive through the body, through pain, through changes in behaviour, or through the materials they choose to work with.

Art Psychotherapy can offer another way of listening.

It can provide a space where experiences can be explored creatively and relationally, at a pace that feels manageable for the young person.

For young people experiencing trauma, difficulties with their body, or emotions that feel difficult to put into words, this can create an opportunity to begin making sense of experiences that may otherwise remain difficult to communicate.

And sometimes, before we can find the words, we need somewhere safe to place what the body is already trying to say.