Changing the Outcome of Adverse Childhood Experiences: How Interpersonal Relationships, Play, and the Arts Support Posttraumatic growth

Abstract Objective: This dissertation offers a contemporary understanding of childhood trauma, neurobiological principles of prolonged effects of adverse childhood experiences, and the importance of play, in context with nurturing relationships. In this qualitative study, the researcher explored the narratives of adults who had experienced complex and prolonged childhood adversity, which are potentially traumatic events that later contribute to poor health and psychological outcomes, yet who did not experience these negative outcomes to wellbeing. Specifically, the researcher examined the importance of interpersonal relationships in the context of expressive arts (drama, music, dance/movement, art) as protective through childhood and into adulthood. Method: The researcher used grounded theory methodology and recruited 10 adult participants 25 years and older who reported having four or more adverse childhood experiences (ACE), who did not report significant negative behavioral, physical or chronic health conditions. Participants completed two qualitative retrospective interviews including a structured family history and a semi-structured interview regarding important relationships and the arts. Data analysis used the constant comparative method to complete both iterative and theoretical coding. Findings: Interview data supported the importance of nurturing relationships combined with expressive arts, which served as protective factors for adults against long-term health implications of ACEs. Relationships provided a context for identity formation and integration of emotional and cognitive processing in relation to early trauma. Expressive arts enacted in the context of supportive relationships demonstrated how activating therapeutic powers of play, in the forms of self-expression, emotional catharsis, stress management, indirect teaching (learning through metaphor), improved self-esteem, and creative problem solving, diminished the effects of ACEs exposure. Findings conclude that self-care was achieved across the lifespan through continued play and art expression. Participants reported that these two facets, relationships and the arts, together in early life attenuated the impact of their negative childhood experiences later in life. Conclusion: The findings reveal how relationships in combination with the therapeutic powers of play, provide a context for self-expression, self-care, and healing. This potent combination promotes the development of posttraumatic growth following childhood trauma. The systemic health consequences of childhood trauma merit building protective factors into societal frameworks to enhance child health and development. Thus, the implications of this work extend to public health policy and education as institutions evaluate the necessity of public funding for arts programs in schools. Schools utilizing approaches to learning that incorporate the arts in addition to science, technology, engineering, and mathematics (STEAM), may contribute to lessening the impact of trauma