Running Head: REVIEW OF BREAKING THE SILENCE 1

Breaking the Silence:

A Critical Book Review

Jennifer Marchand

Concordia University
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Breaking the Silence: A Critical Book Review

Summary

Cathy Malchiodi is an internationally recognized and widely read art therapist who

continues to author numerous texts and articles on innovative approaches to art therapy with a

diverse range of populations. Much of her work, however, focuses on children who have

experienced profound hardship and trauma, as does Breaking the Silence: Art therapy with

Children from Violent Homes (1997). As the title suggests, this books aims to give mental health

practitioners the tools to “break the silence” that often characterizes children from violent homes

by giving them a voice and a means of expression through art therapy interventions. The book

itself also breaks the silence within the literature of art therapy and related mental health fields as

it is one of the first to explore the impact of domestic violence and sexual abuse on children.

Children who enter women’s shelters and other short-term settings after witnessing and/or

experiencing domestic violence and severe family dysfunction often come with diverse needs.

How they individually respond to domestic violence is influenced by myriad factors, such as their

cultural background, family dynamics, coping mechanisms, and perceptions of abuse. In the

introductory chapter, Malchiodi explains that in her own clinical experiences with children in

women’s shelters, approaching such a heterogeneous group effectively meant finding their

common denominator, which she defines as “crisis”. She uses this theme of crisis as a way to

understand the common emotional and behavioural characteristics between children who were

abruptly removed out of violent homes and everything that is familiar to them (such as school,

friends, and family structure) and are transitioning into a temporary shelter environment, often

confused and unsure of what changes will come next.

According to Malchiodi, developing this theory of crisis was instrumental in structuring

the comprehensive model for working with shelter children that is presented in the Breaking the
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Silence. The emphasis on short-term, art-based interventions involved redefining how art therapy

is traditionally practiced, especially as goals that are often set in longer-term psychodynamic

treatment are not applicable to this population; for example, working towards stabilization,

supporting rehabilitation and adaptive coping mechanisms is more beneficial to than developing

insight into why they are at the shelter. Although I find the emphasis on crisis helpful at times, I

will also discuss its limitations in the last section of this review.

Why I Chose this Book

I personally chose this book because I wanted a very solid framework for working with

children in women’s shelters, including: practical art interventions, treatment plan development,

and a thorough understanding of the lives and challenges of these children. Although this is

indeed what I got, I found that the book’s audience was so broad that many of the chapters did

not apply to my current situation. It is important to note here that the book has been written for

art therapists, both new and experienced, but also for mental health professionals who wish to

integrate art therapy into their practice with victims of domestic violence. At times, this resulted

in an oversimplification of ideas related to art therapy. As I am writing this review from the

perspective of an art therapist in training who has recently begun an internship at a women’s

shelter, the chapters that I deem most relevant and the limitations that I discuss are opinions that

may not be shared by all readers, depending on expectations. For example, chapter seven may be

more relevant for shelter administrators who are thinking of hiring an art therapist and wondering

what this position would entail. For practicing art therapists, however, the basic descriptions of

different art materials and how to use them might be a little redundant. I did, however, benefit

from the suggestion of providing children with an assortment of play figurines that allow them to

replay the trauma and fears of crisis situations, such as ambulances, police officers, and rescue

helicopters.
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Overall, the chapters that I found valuable were chapters two (Working with Children

from Violent Homes), and chapter four (Art Intervention with Children from Violent Homes). I

will now discuss what I found helpful about these chapters, what surprised or disappointed me

about them, and some overall limitations to the book.

Critique

As mentioned, Malchiodi aimed to emphasize emotional commonalities in order to

develop comprehensive interventions with this population. Although I see the benefits to this

approach, practical experience with the children prompted me to wonder about the variations, as

opposed to commonalities, between children in their responses to crisis, such as age,

developmental level, gender, and cultural background. In chapter two, the five main emotional

commonalities—such as need for nurturance, aggression, regression, low-self-esteem, and

symptoms of post-traumatic stress disorders—were extremely helpful in organizing my clients’

behaviors and art expressions. However, the lack of specific information to assess variations,

such as developmental charts, gender differences, and information to support cultural

competence, was magnified by my practicum placement. The majority of the children I am

working with have recently moved from non-Western countries, have different family and belief

systems, and did not seem to fit into the descriptions provided. For reasons such as these, it may

be best to compare the overall objective of Breaking the Silence to that of an instructional

manual, thus recognizing that supplementary research will have to be performed to understand

many contradictions and complexities that arise during practice, and between clients.

I was very impressed with the last section of chapter two, which focused on the inherent

frustrations of work in short-term settings. In only three weeks of work at the women’s shelter,

many of the points raised—such as the ever-changing group dynamics, uncertainty surrounding

termination, and not being able to get past the “testing” phase—are contributing to my sense of
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lack of control in the women’s shelter environment. This section was validating and will

hopefully serve to prevent burn-out as I will be aware that these frustrations are inherent factors,

and are therefore not reflections of my competencies as a therapist.

Chapter four was perhaps the most significant chapter for me. It outlined the fundamental

goals of art intervention—such as learning to communicate safely through metaphor, and giving

the child permission to play—and offered a more thorough understanding of art intervention as

crisis work. Malchiodi walks the reader through intervention from the initial stage, the middle

stage, and then the termination stage, while using case examples and well-presented instructions

to introduce specific art interventions relevant to each stage. The intervention “Draw the

Therapist” (in the middle phase) truly surprised me. Although this activity is used to understand

transference issues which may be carried over from the violent adult family dynamics, and to

assess dependence in the relationship, there is something both humorous and daunting about

suddenly being confronted with subconscious transference issues through a child’s drawing of

you looking at them. (I’ll have to think about the value of this one some more!)

Lastly I would like to say that considering the author and her extensive experience with

this population, I began this book with complete trust that everything I read would be helpful and

relevant and would not to be questioned. However, there are three overall concerns that I have

with this book. Firstly, I find chapter three (Art Evaluations with Children) to be relevant in its

own right, but wrongly placed. This book is an introductory book to working with children from

violent homes, suggesting that art therapists (including those who are not highly trained in

assessments) develop a practice of doing formal drawing assessments with children within 48

hours of their admittance into the shelter causes major ethical concerns, especially as they are

often used to determine the existence of physical and/or sexual abuse. As the children enter the

shelter in a state of crisis, I feel an ongoing evaluation that supports the child in their ability to
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adjust to shelter life would be more beneficial to the child, especially considering that how the

child draws when not in a state of crisis may be significantly different then how they draw after

one week of living in the shelter. Furthermore, it is difficult to control for the therapist’s biases,

especially as many of these assessments are highly projective.

Secondly, the relationship between the father and child is overlooked in a lot of literature

regarding domestic violence, and this book is no exception. In my brief experience, the children

want to know what happened to daddy, if they will see him again, and if they are allowed to draw

him. He is a prominent concern for the children, whether he committed abuse or not, and I am

waiting for more insight as to how I can help my clients to better resolve some concerns. This

brings me to my third and last point: group sessions with the mother. Although this book was

about working with children specifically, mother-child/ren groups have several benefits, such as:

modelling parenting skills, encouraging activities that can be done outside of the shelter, and

creating the space for child and mother to communicate and respond to concerns through the art,

especially those that are too difficult to verbally express, such as daddy’s whereabouts. It is my

opinion that more than half of a page devoted to such groups would be beneficial to the reader.

Overall, the Breaking the Silence gives art therapy a role within women’s shelters and acts

as an invaluable resource for art therapists, mental health professionals, and programming staff

when desiring to learn more about the techniques and benefits of using art therapy to support the

rehabilitation of children from violent homes.

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References

Malchiodi, C.A. (1997) Breaking the silence: Art therapy with children from violent homes (2nd

Ed.). PA: Brunner/Mazel.