Introduction:

         Art therapy is a form of psychotherapy that uses artistic media as a primary means of expression and communication to address emotional issues that may be confusing or painful. Systematic reviews have concluded that this type of therapy continues to be used in a variety of settings and situations, including trauma (Van Lith, 2016). It is used with people of all ages and across a wide range of difficulties, influenced by psychodynamic concepts and integrating other psychological approaches such as attachment, mindfulness, empathy focus, cognitive analysis, and neuropsychological findings (Haeyen & Wanten, 2024).

Art therapy is offered as both group and individual interventions and is sensitive to cultural and social diversity (Lobban, 2018). Systematic reviews have found that children who have experienced trauma, in particular, benefit from art therapy (Schnitzer et al., 2021), while adults benefit from art therapy for non-psychotic disorders, including relationship development, personal fulfillment, empowerment, and increased insight. Art therapy practices are culturally and socially inclusive (Malchiodi, 2012a, 2012b, 2015a, 2015b; Scope et al., 2017).       

When life becomes overwhelming and chronic pain turns into a constant, draining background noise, therapeutic photography offers a gentle, non-verbal outlet to process what words often fail to capture. It shifts your focus from the internal awareness of physical discomfort and emotional distress to the external world, encouraging a mindful engagement with your surroundings. By searching for light, texture, or a compelling perspective, you are anchored in the present moment, creating a mental sanctuary that temporarily breaks the pain cycle.

Furthermore, capturing specific images allows you to externalize abstract feelings—giving a visual form to grief, frustration, or resilience. Looking back at these photos provides a tangible narrative of your journey, helping you reclaim agency over your body and story, and transforming photography from a simple creative hobby into a powerful tool for self-compassion and healing.

         Perhaps photography, by capturing and memorializing happy moments, can help you forget your pain for a while and truly appreciate life's beautiful instances. This becomes especially vital when life keeps knocking you down with persistent headaches, migraines, and neck pain. When you live with fragile bones, sensitive skin, and an emotional vulnerability that makes daily routines feel overwhelming, it can feel like life is moving too fast—leaving you with a poignant realization that time to find a peaceful, joyful life is limited. This weight is only magnified when you watch one of your parents struggle with illness and is getting old too quickly. In the midst of this, picking up a camera offers a profound way to slow down, capture peace, and find healing. It is incredibly heavy to carry chronic physical pain while also carrying the emotional weight of watching someone you love age. Photography is a beautiful way to gently force the world to slow down, even if just for the second it takes to click the shutter.

         Even when severe physical trauma like having stress fractures, a broken back, pelvis and leg threatens to halt your life, therapeutic photography serves as a powerful testament to your resilience, allowing you to document and process your journey of continuing to move forward despite immense obstacles. By focusing the camera lens on your environment, you can actively shift your attention away from acute physical limitations and redirect it toward capturing small triumphs, hidden beauty, and moments of quiet strength. This creative practice transforms the act of survival into a visual narrative of bravery, helping you reclaim a sense of agency over a body in pain and reinforcing your determination to keep living fully, one frame at a time.

         Therapeutic photography is an umbrella term in the field of health arts, encompassing a wide range of practices, from community-based participatory art (techniques such as photo diaries) to intensive, confidential group therapy (Hogan, 2022). Al-Jundi et al. (2025) noted that photography provides a means of expressing and communicating emotions to others, especially when individuals find it difficult to express their feelings. This can be particularly beneficial for people experiencing conditions such as depression, anxiety, or trauma. Their study also addressed the theme of enhancing positive influence through smartphone photography and its contribution to increasing positive influence.

Tourigny & Naydenova (2020) further indicated that photography is a highly cognitive activity that helps maintain brain health. In her study, participants who engaged in digital photography were able to enhance their episodic memory and logical reasoning skills. Photography is also a therapeutic tool, as some mental health professionals use it as a form of therapy. Patients are encouraged to take photographs that represent their experiences, which can then be discussed in therapy sessions. This can help people better understand their feelings and experiences.

         Therefore, the current study aims to investigate the effectiveness of a photography-based program as an art therapy tool in alleviating the symptoms of psychological trauma (case study).

Literature Review

         Psychological trauma is a complicated psychological disorder that arises due to exposure to stressful experiences like war, violence, abuse, natural disasters, migration, and loss. Psychological trauma impacts emotions, thoughts, behaviors, and bodily functions, leading to problems like anxiety, depression, emotion dysregulation, dissociation, and post-traumatic stress disorder (PTSD). Psychotherapeutic techniques have proven effective in treating trauma; however, many victims find it difficult to describe their traumatic experience verbally since trauma-related memories are often incomplete and emotionally intense (Malchiodi, 2020; van der Kolk, 2021).

In recent years, there have been advancements in trauma-informed mental health care that stress the significance of expressive therapies and arts-based therapies in addition to traditional psychotherapy in the treatment of trauma victims. Expressive therapies provide non-verbal avenues for expressing emotions as a means to cope with experiences that are hard to express verbally. In light of the above, photography has emerged as an effective art therapy technique that facilitates emotional expression, identity reparation, storytelling, and healing (Carr et al., 2022; Kaimal et al., 2023).

         Photography therapy, which can also be termed as phototherapy or therapeutic photography, refers to a therapeutic approach that uses photographs, self-portraits, visual narratives, photo elicitation, and symbolism through photographs. Unlike other forms of art therapy, photography is a form of art that records the autobiographical nature of personal experience and reality. Phototherapy makes it possible for traumatized individuals to safely externalize their painful memories and experiences (Weiser, 2021; Decker & Angus, 2023).

According to neurobiological theories of trauma, traumatic memories are mostly sensory and fragmentary rather than verbalized in coherent stories. The effects of trauma can affect one's ability to integrate memories and regulate emotions, making it very difficult for survivors to disclose verbally about their experiences. Through photography, one can process the traumatic experience by representing it visually and communicating their emotions through symbolism (Malchiodi, 2020; van der Kolk, 2021).

Reconstruction of narratives is viewed as one of the critical aspects of trauma healing because trauma causes disruption of autobiographical continuity and meaning-making processes. It is possible for patients to arrange broken memories in narrative form through photography-based intervention, which will then promote emotional regulation and cognitive processing of traumatic events (Decker & Angus, 2023; Weiser, 2021).

         There is a significant body of literature highlighting the positive impact of art therapy interventions aimed at working with trauma survivors. For example, Schouten et al. (2024) identified significant decreases in the symptoms of trauma, emotional distress, and psychological dysregulation resulting from interventions in trauma-focused art therapy. Emotional expression, self-esteem, and resilience have been improved among participants in this study. Though the research focused on general visual arts therapy, it provides compelling evidence regarding the processes involved in photography-based interventions (Schouten et al., 2024).

There are some distinct healing properties of photography, which are related to the fact that photographs capture actual experiences and personal identities. It can be assumed that personal photographs act as emotional anchors that make it easier for people to recall memories and think about them. Photography therapies are usually based on creating self-portraits, using symbolic images, family photos, and storytelling, thus helping trauma survivors restore their identity after suffering a shock (Weiser, 2021; Killick & Schaverien, 2021).

It is particularly relevant for trauma recovery that the identity of a person can be severely damaged by experiencing trauma. Trauma can cause feelings of shame, helplessness, emotional numbness, and alienation from oneself and other people. Photography provides an opportunity to regain control over one's representation, thus fostering empowerment, self-awareness, and psychological resilience (Henrich & Henrich, 2024; Decker & Angus, 2023).

         Photography therapy is especially useful for people with problems in verbal communication, such as children, teenagers, refugees, and people who have survived abuse or violence. Visual means may help people feel more comfortable about their feelings, allowing them to express themselves in non-threatening ways. Through creative visualization, survivors can indirectly communicate how they feel without compromising their emotional well-being and control (Carr et al., 2022; Kaimal et al., 2023).

Several studies exploring the use of photography as a therapeutic approach among vulnerable groups have demonstrated positive emotional and psychological effects. For example, according to Henrich and Henrich (2024), therapeutic photography interventions among children suffering from life-affecting illnesses helped to validate their emotions, increase hope, boost self-respect, and improve social relationships. While the research mainly considered the problem of medical trauma, its results prove the ability of photography to foster emotional healing and resilience among psychologically distressed populations (Henrich & Henrich, 2024).

         Another important therapeutic approach of photography therapy is distancing. People who have been through traumatic events often find it difficult to deal with their memories when confronted with them. However, photography allows people to deal with their memories and experiences in a symbolic way, making the experience less emotionally overwhelming but nevertheless promoting the process of emotional work. It is possible that the camera itself can serve as an object creating psychological and emotional safety during therapy (Malchiodi, 2020; Weiser, 2021).

Photography can be used as a tool for emotional regulation because it encourages mindfulness and observation. Working with photographs requires focus on visual perception and the interpretation of what is seen, which can promote emotional grounding in people experiencing hyperarousal and dissociation (Kaimal et al., 2023; van der Kolk, 2021).

In recent times, there is more evidence about the efficacy of imagery-based therapies to help treat trauma. According to Son et al. (2024), imagery-based stabilization psychotherapy is effective at improving emotional function and decreasing PTSD symptoms after brief visual intervention in adults suffering from PTSD. Thus, imagery and symbolic processing are vital for trauma recovery and should be considered a priority (Son et al., 2024).

There is also growing interest in using participatory photography in trauma-informed community interventions. Photovoice is a method of creating visual representation and discussing personal stories in a safe environment. This approach is particularly useful for trauma survivors who belong to refugee populations, victims of violence, marginalized groups, and people who experience collective trauma. Photovoice helps recover one's voice, gain social recognition, and feel empowered (Kaimal et al., 2023; Carr et al., 2022).

         Finally, photography therapy can enhance interpersonal relations and social connections. Trauma often undermines trust, causing individuals to withdraw and isolate themselves from others. Group discussion of photographs is a way to increase empathy and validate the participants' feelings. The process of discussing their visual narratives can increase belongingness and decrease alienation (Henrich & Henrich, 2024; Weiser, 2021).

With the greater incorporation of digital technologies in mental health treatments, there have been increased prospects for photo-based therapies. Using smartphone cameras, digital stories, online visual journals, and virtual platforms to share artwork offer means of expressing creativity and emotions. Digital photography interventions could be particularly useful in humanitarian or resource-limited contexts where conventional psychotherapy services are not readily available (Kaimal et al., 2023; Carr et al., 2022).

In addition, neuropsychological studies have underscored the importance of visual interventions in trauma recovery processes. In their systematic review of light interventions for PTSD patients, Millot et al. (2024) showed that visual sensory stimulation plays an important part in regulating emotions and reducing symptoms of trauma. Although light therapy and photo therapy are different, their review highlights the value of visual stimuli in treating trauma (Millot et al., 2024).

Interventions involving photography can also lead to post-traumatic growth, which is defined as positive psychological growth after experiencing adversity. With the help of visual stories, survivors can reevaluate their traumatic experience, realize their strengths, build stronger social connections, and find new meanings in life. The process of photography involves self-reflection and meaning-making techniques that foster psychological development and resilience (Decker & Angus, 2023; Henrich & Henrich, 2024).

Although the effectiveness of photography therapy is being increasingly acknowledged, there are still some limitations associated with the literature on this topic. Firstly, there is still insufficient research specifically focused on photography. Many existing studies use qualitative approaches, case studies, or have small samples, thus making the findings not easily applicable (Carr et al., 2022; Schouten et al., 2024). In addition, the wide range of interventions, participants, and measurements used in different studies makes it difficult to compare the outcomes.

         One more key limitation is associated with the lack of longitudinal research investigating the effectiveness of photography therapy for trauma recovery. Most studies concentrate on evaluating short-term emotional changes rather than symptom reduction in the long term. Thus, future studies should emphasize conducting randomized controlled trials, establishing standardized protocols for therapy, and increasing sample sizes (Kaimal et al., 2023; Son et al., 2024).

The issue of cultural sensitivity and ethics is also relevant for photography therapy. Symbolism, self-representation, and emotional expression are context-specific phenomena, which requires therapists to modify interventions to accommodate specific cultures. Moreover, issues of consent, confidentiality, image ownership, and retraumatization should be considered in the context of trauma-informed therapy (Weiser, 2021; Killick & Schaverien, 2021).

         In general, the current literature provides strong evidence regarding the usefulness of photography as an artistic intervention aimed at relieving psychological trauma symptoms. Photography enables expressing emotions, reconstructing narratives, exploring identity, regulating emotions, and engaging in social interactions, which may be unattainable through other verbal therapeutic interventions. Photography serves as an effective means of symbolic communication through which trauma survivors can process their experiences while gaining resilience and empowerment (Malchiodi, 2020; Schouten et al., 2024).

         Overall, photography therapy has been identified as a valuable treatment method in the field of trauma-informed mental health care. Recent studies show that methods based on photography can be helpful in decreasing trauma-related stress, increasing emotional regulation and awareness, and facilitating post-traumatic growth. While more empirical studies are required to prove the effectiveness of this approach, existing data indicate the considerable therapeutic benefits of photography therapy (Henrich & Henrich, 2024; Kaimal et al., 2023).

Problem Statement

         Applied studies using therapeutic imaging techniques have demonstrated its effectiveness in raising awareness about mental illness and addressing the various problems faced by many (Sheridan, 2013; Stevens & Spears, 2009; Mizock et al., 2015). Numerous previous studies have highlighted the importance of employing photography in the treatment of trauma and mental and psychological illnesses.

         Through my search for previous studies, it became clear that local research lacks studies examining the effectiveness of photography in alleviating the symptoms of psychological trauma. Therefore, given the importance of photography as a form of art therapy and its role in treating psychological trauma and post-traumatic stress disorder, this study is among the first to address photography and its effectiveness in alleviating the symptoms of psychological trauma among children in Palestine. Palestinian children have a unique vulnerability to psychological trauma due to the surrounding political, security, economic, and social conditions, particularly in Gaza, which is currently experiencing a war of annihilation and continuous, intense aerial and artillery bombardment. Undoubtedly, the sounds of these deafening events and their consequences, martyrs, dismembered bodies, and permanent injuries, expose children to profound psychological trauma. This increases the number of children suffering from psychological trauma, regardless of its cause. This study proposes a photography-based therapy program that may contribute to alleviating the symptoms of psychological trauma. Therefore, the main research question representing the problem of this study is:

"What is the effectiveness of photography-based sessions as an art therapy tool in alleviating the symptoms of psychological trauma (case study)?"

Study Questions:

This study seeks to answer the following sub-questions:

1. How effective is photography as a form of art therapy in treating psychological trauma?
2. What are the psychological and emotional effects experienced by the participants after participating in photographic therapy?
3. How can photography assist in emotional regulation and self-awareness among the participants who have suffered trauma?

Study Objectives:

The objectives of this study are as follows:

1. To assess the efficacy of using photography as an artistic therapy method in alleviating psychological trauma symptoms among the participants of the case study.
2. To outline the psychological and emotional transformations that take place within the participant as a result of participating in photographic therapy.
3. To evaluate the impact of photography on self-expression, self-awareness and emotional management.
4. To make recommendations concerning the implementation of photography in psychological and artistic therapy.

Methodology

         This study adopts a qualitative case study design to explore the effectiveness of photography as an artistic therapeutic tool in alleviating the symptoms of psychological trauma. The case study approach is appropriate because it allows for an in-depth understanding of participant’s lived experiences, emotional expressions, and personal interpretations related to photography-based therapeutic interventions. The study also incorporates elements of arts-based research and expressive therapy approaches, focusing on the use of photography as a medium for emotional communication, reflection, and healing.

Population and Sample:

         The study population included adults (20 years and older) suffering from psychological trauma caused by the turbulent situation in Palestine. One of the adult female was involved in the photography therapy during the intervention period.

         The study employed the case study method, in which one female adult participated in the therapeutic photography sessions. The case study called “Christelle”, which is a fake name given to her due to ethical purposes of not mentions the personal information about the participant. Christelle mentioned her story that contributed to suffer from psychological trauma as she said: “It is incredibly heavy when the very thing you are studying starts to mirror the struggles you are experiencing at home. There is a specific kind of exhaustion that comes from analyzing trauma or stress academically while trying to navigate it personally; it can feel like you never get a "break" from the weight of it. “While I am an AI and cannot provide a medical diagnosis or formal therapy, it is important to acknowledge that secondary traumatic stress or vicarious trauma is a very real phenomenon for researchers and students. When this is layered over personal family problems, it can lead to burnout or a heightened state of emotional distress”.

She continued that “There was someone very close to me, someone I considered my safe haven, someone I could talk to without fear or hesitation. One day, I trusted her and confided in her about something very personal, certain it would remain between us. A short time later, I started noticing a change in how people around me treated me, and indirect remarks made me suspicious. Eventually, I discovered that this secret had reached other people, including the very person I had trusted. The shock wasn't just the revelation, but the realization that the security I felt was an illusion. Since then, I've thought a thousand times before saying anything to anyone, and I've developed an inner fear of opening up to anyone, even those close to me. This experience has made me associate trust with harm, and a part of me prefers silence to reliving the same experience”.

         Based on that, the researcher has implemented six therapeutic photography sessions with Christelle, in order to investigate the effectiveness of therapeutic photography into alleviating the psychological trauma symptoms.

Findings:

         “University life combines the allure of ambition with the weight of responsibility, but it can become a double burden when the pressures of intensive study intersect with high parental expectations that may not spare your need for rest. The hardship is compounded when betrayals come from friends; those we thought were our refuge become an additional source of pain and disappointment” Christelle said. This mix of academic and social stress puts the psyche in a state of constant depletion, and this is where phototherapy emerges as a bridge from anxiety to tranquility. It is not merely documenting scenes, but rather a process of "reframing" reality. The camera lens allows you to focus on the small details overlooked by tired eyes, transforming repressed emotions and unspoken traumas into visual images that release pent-up sadness and tension. Focusing on image composition and manipulating light and shadows gives the mind a "respite" from racing thoughts and transforms inner chaos into silent, expressive paintings, helping to restore psychological balance and reduce anxiety through a visual language understood by the soul before words.

         Qualitative reflections have been very insightful regarding Participant’s emotional experience during the course of the therapeutic photography intervention. The analysis of Participant’s reflections indicated the presence of several interrelated psychological, emotional, behavioral, and social heres that prove the effectiveness of photography as a therapy for psychological symptoms caused by traumatic experience.

1. Photography as an Alternative Emotional Language:

         One of the most prominent to be analysed in Participant’s reflections was the function of photography as a means of expressing emotions that cannot be easily communicated. Participant stated that photography provided a means of conveying emotions that were blocked within Participant prior to the intervention.

Participant noted that photographs enabled her to externalise painful memories, in addition to visually supported disclosure reduced pressure of direct disclosure, and  symbolic images assisted her to express the invisible emotions, It was emotional distancing from trauma experiences, as was the act of taking photographs, and this helped her to process the trauma. The camera for the participant was a “voice”, a “mirror” or a “window”, it was a way to make emotions visible.

2. Emotional Release and Reduction of Internal Tension:

         The result indicates that therapeutic photography can be used as a projective therapeutic tool, as it allows people to express suppressed emotions in a less confrontational way than verbal expression. In addition, therapeutic photography is to release and reduce the tension among participant, and a tool for emotional release and reduction of internal tension. Emotional relief was a common comment made by the participant in relation to the photography sessions. The activities were reported to reduce stress level, emotional burden and mental fatigue by the participant.

         As well, the participant reported emotional outcomes including enjoyment of photos, better muscle relaxation, temporary escape from intrusive thoughts, and the release of emotions through visual narratives, after taking photographs, she became more relaxed. In the same time, for the participant there were moments of crying, silence or deep reflection in her experience, while interacting with some images, showing signs of emotional processing and release. The results suggest that therapeutic photography could be helpful for emotional regulation because it enables the participant to work on the unresolved emotions slowly and creatively.

3. Development of Self-Awareness and Reflection:

         The moments of self-discovery were mentioned by the participant frequently during the intervention. The reflections were found to mix up self-analysis and reflection on personal identity, emotional wounds, relationships and life experiences with the help of photography. Participant reported that she learned how to connect with and express her feelings, recognizing personal strengths, developing greater awareness of triggers, and learning from past experience and looking back on it in a new way. The “self-portrait” exercises proved to be particularly influential. At first, the participant reported discomfort in taking her photo, but subsequently reported more acceptance and understanding of her identity. Examples of participant reflections were feeling the sadness of life but not being aware of it, and even if these traumatic experiences have been recognized, the recognition of resilience still has to occur; and viewing herself as a survivor not as a victim.  The intervention seemed to foster reflective thinking and reconstruction of identity as two critical components of trauma recovery and psychological healing.

4. Construction of meaning and reframing of trauma:

         An important finding was the change in interpretation of painful experiences and damaged objects in the case of the Participant. In activities in which it was asked to take some ordinary images or broken images, the participant started to connect with personal resilience, endurance and hope. Christelle explained that broken objects represented survival, neglected places revealed inner emotional suffering or repaired or transformed objects, and represented healing and recovery. The participant reported a change in focus from handling pain to finding meaning in pain experiences over time.

 This represents cognitive reframing, in which the participant reinterprets traumatic experiences in ways that help her to decrease emotional suffering and to increase psychological resilience.

5. Greater Awareness and Awareness of the Here and Now:

         The intervention resulted in increased attention to one's surroundings as described by the participant. She said that “I saw things in everyday life around me that I hadn't noticed before”. These included light and shadows, colors and textures, nature and movement, facial expressions, beauty in everyday things and at every moment. The participant reported that photography helped her to “slow down” and be “emotional” in the moment. This means that therapeutic photography can be helpful in supporting mindfulness practices by helping to shift focus away from intrusive and distracting thoughts and toward current sensory experiences.

6. Positive changes in mood/emotional outlook:

         There was an overall trend of emotional improvement across the reflections over the course of the sessions. Often participant expressed shifts from emotional weight to hopefulness and optimism. There were several visual patterns that arose such as: more pictures of a darker colour taken at the start of the intervention, the lack of visual connections and confined areas, which was followed later on by brighter images, wider angles, and outdoor settings within more colourful and more exciting colours.

For the participant these visual transformations were correlated with internal emotional changes. In terms of visual expression, the series of images could represent a change in attitude from emotional closet to emotional openness, recovery and renewed energy.

7. Boosting self-esteem and self-compassion:

         Improvement in Participant's self-image and emotional relationship to herself was a common here. Therefore, the participant described that therapeutic photography leads to become less self-critical, feeling more comfortable to be photographed, acknowledging personal strengths, in addition to value and respect her individuality. Moreover, Christelle described how looking at photos affected her identity, in which rather than just looking at the negative, she started noticing the positive, the beauty, the strength and the resilience.

         Results indicate that therapeutic photography could be a factor contributing to the reconstruction of self-esteem and the increase of self-compassion in people who suffer from psychological distress.

8. Personalized Learning and Growth:

         Christelle mentioned; sharing pictures and discussing them in the sessions was a way that she gained feelings of understanding and connection to others. The participant reported that after taking photos, her feelings were different than before taking photos, as she was feeling less isolated, understanding that other people felt the same way, an ability to consider alternative perspectives, and greater comfort in talking about emotional issues.

This shared talk about images; seemed to normalize emotional experiences and foster inter-personal communication. Therapeutic photography can promote social support and emotional connection, which are protective factors in trauma healing.

9. The use of photography as a coping mechanism for sustainability:

         Christelle indicated a desire to maintain the use of photography beyond the intervention. The participant planned to document positive memories, photograph calming environments, in addition when taking photos Christelle keeps gratitude journals, adding pictures, and make visual diaries of emotional experiences. Moreover, the participant perceived the sessions of photography as not simply an activity but as a continual coping mechanism for herself. This suggests that therapeutic photography can offer therapy practices that can be sustained beyond the formal therapeutic context.

10. Overall Perceived Effectiveness of Therapeutic Photography:

         The participant's overall experience of therapeutic photography was positive. The majority of the answers indicated that she thought that pictures played a helpful role in emotional healing and psychological support. In addition, the qualitative results indicated that therapeutic photography facilitates emotional expression, reduces emotional suppression, supports self-reflection, enhances mindfulness, strengthens self-esteem, encourages emotional healing and reaches out to hope and resilience.

         The findings from qualitative reflections showed therapeutic photography is a therapeutic art that is meaningful and effective for the psychological trauma and emotional distress. The participant could experience emotions, rework meaning, increase her self-awareness and cultivate healthier coping strategies through visual expression, symbolic communication and reflective engagement.

         The results confirm that photography could be used as an adaptive process in which a student is supported in developing an understanding of her emotions and how to respond to her in ways that help her thrive. In addition, personal practice which is sustainable over time and supports psychological wellness and resilience.

Discussion:

         The results of the current research revealed that photography is an effective art therapeutic method in influencing the symptoms of psychological trauma. The participant's reflections indicated that photography helped her to express her emotions, regulate her emotions, increase her awareness of self, reconstruct her identity, build resilience, become more mindful and build healthier coping strategies. The results support the literature that recognizes the importance of the expressive arts therapies and the use of photography in trauma recovery. Furthermore, the results can be examined in the context of decolonial thinking in Palestine and the psychoanalytical work of Donald Winnicott, specifically his ideas of the ‘true self’, ‘transitional space’ and ‘holding environment'. Trauma is entangled by colonial practices of military occupation, displacement, political violence, surveillance and collective insecurity in the Palestinian context.

         Then, Palestinian psychological suffering is not an individual phenomenon, but also a sociopolitical and decolonial one. Decoloniality focuses on the attempt of the colonial systems to control the narratives, identities, bodies and forms of representation. In these situations, photography is not just a creative pursuit, it is a way of regaining a narrative voice, a sense of 'voice' and visibility, and identity. By using photography, the participant could voice the lack of silence and invisibility in her own history, and visually and emotionally recreate her personal narrative. This resonates with decolonial perspectives which leverage creativity as a means of psychological emancipation and as opposition to systems of marginalization of lived experiences. One of the most salient results of this research was that photography was used as an alternative emotional language by the participant. The participant called the camera “voice”, “mirror” and “window” with which one could express feelings in a non-verbal way. This helps to align with the theoretical conception of Cathy Malchiodi (2020) and Bessel van der Kolk (2021) who suggest that traumatic memories are often held in sensory and fragmented memories and verbal disclosure is challenging for trauma survivors.

         Photography helped the participant to represent painful memories symbolically in a safe manner, thus lowering the pressure of face-to-face verbal communication. Likewise, Judy Weiser (2021) pointed out that phototherapy techniques enable survivors to express suppressed emotions and trauma in imagery and in reconstructing a story. In this study, from the Winnicottian perspective, the process of photography can be viewed as the “transitional space” in which the participant was able to explore an inner conflict, emotions and identity in a safe manner. Transitional spaces provide a way for the person to create a movement and navigate between internal and external reality without fear of being judged or collapsing psychologically, according to Donald Winnicott. The camera and the photographs were objects that served to act as a portal through which the participant could experience the painful feelings and keep herself feeling safe. It was especially noticeable when the participant used the term 'safety' in reference to the photography allowing her to feel safe and less threatened about the need for direct emotional disclosure. The results also indicated that photography helped alleviate the tension within and brought about emotional release.

         The participant said that photography sessions reduced her emotional burden, made her feel calm, helped her to temporarily get away from intrusive thoughts and gave her emotional relief. The results are consistent with those of Kaisa Schouten et al. (2024) which revealed that art therapy focused on trauma is effective in reducing emotional distress and psychological dysregulation in trauma survivors. Also, the findings of the participant corroborate the findings of Girija Kaimal et al. (2023) in her systematic review, which revealed that creative arts interventions are linked to the decrease of psychological distress and increase in emotional regulation. This release of emotion can also be understood as being part of Winnicott's “holding environment”.

         Psychological healing takes place when a person is placed in a safe space with the emotional pain but not the pain of the self, as suggested by Donald Winnicott. Publishing the photos in this study seemed to have provided the participant with a symbolic holding environment to face the painful memories in a gradual, less frightening way. The taking of photographs, her discussion and reflection upon them was a source of emotional containment for the patients, a process similar to Winnicott's therapeutic model.

Emotion processing in the sessions was captured in moments of crying, silence and deep reflection, within this safe therapeutic space. Another significant discovery was in the area of development of self-awareness and reflective thinking. During the intervention, the participant began to become more aware of her emotions, personal strengths, emotional triggers and resilience. Whilst initially uncomfortable, the self-portrait activities helped to increase self-acceptance and awareness of identity. The results are consistent with the findings of Karen Decker and Leslie Angus (2023), who showed the importance of visual story-telling in the reconstruction of personal narratives in the context of trauma.

         This process is also very intertwined with decolonial reconstruction of identity. Trauma from colonization often leads to a lack of identity, attachment, and self-perception, causing fear, disintegration and a sense of powerlessness. The participant was able to create meaning and take ownership of her story through photography. She was able to reshape herself around identities that are formed by betrayal, fear, and emotional suffering, and slowly started to make herself into a resilient and healing being.

         This is a decolonial healing process that involves creating practices that question dominant discourses of victimization and reclaim individual and collective agency. The results also found that photography facilitated the cognitive reframing and meaning-making. The participant started to find the broken or neglected objects "marks of survival, endurance, healing and hope". It's a testament to how photography can be used to change the lens you look at a traumatic situation and bring in a new light. These discoveries align with the post-traumatic growth theory put forward by Karen Decker and Marion Henrich (2024) who believe that visual narratives facilitate the process for the survivors to gain new insights into their traumatic past and unlock new resources of strength and resilience within themselves.

Reinterpreting damaged spaces and broken objects is very symbolic in Palestine, where the experience of damage and fragmentation is integral, from a decolonial standpoint. The conversion of images of the damage into symbols of the survival, is a resistance to the stories of defeat and helplessness. Photography was; and is, then a therapeutic and political way of converting the suffering into testimony, resilience, and meaning.

         The participant also noted an enhanced sense of the here and now and more focus on mundane aspects like colours, shadows, textures, and movement. This represents the benefits of therapeutic photography around mindfulness. As reported by Girija Kaimal et al., (2023), photography can foster sensory grounding and mindful observation, which serve as an effective means to disengage from intrusive traumatic thoughts to focus on the here and now. The grounding effect of visual observation can be particularly valuable in the Palestinian context, where the psychological impact of chronic uncertainty and hypervigilance towards continuous violence and instability may make it a key component of emotional regulation and psychological presence.

         The other significant result was the positive change in the emotional attitude throughout the intervention period. The participant's photographs went from darker, enclosed, and fragmented images to lighter, broader, and more colourful images. These internal emotional shifts seemed to mirror the visual shifts from emotional withdrawal to openness and hope. Marion Henrich and Klaus Henrich (2024) reported a similar effect, stating that a photography intervention resulted in an increase in hope, emotional resilience, and positive self-perception among psychologically distressed people.

This emotional openness is another way of putting Winnicott's concept of the “true self.” Donald Winnicott claimed that traumatic situations or unsafe environments in life would force an individual to create a “false self” that would hide his vulnerability to survive psychologically. The participant becomes more emotionally open and comfortable with expressing herself, indicating movement towards reconnecting with the true self through creative expression and symbolic communication.

         The research also showed increased self-esteem and self-compassion. The participant explained how she felt a lessening of her self-criticism and an increase in appreciation of her strengths, her individuality, and her resilience. The results of these studies align with those of other studies that have shown how a process of empowerment and restoration of identity can be experienced after trauma through the use of photography (Weiser, 2021; Henrich & Henrich, 2024). Photography can help to restore control over self-representation, and this aspect of psychological recovery can be a very important part of the healing process after trauma, which can lead to shame, helplessness and numbness.

Furthermore, the participant said that photography is a means of coping she was going to continue doing after the intervention. She was going to create visual journaling to capture positive memories, calming environments and emotional moments. This finding aligns with the argument made by Susan Hogan (2022) that therapeutic photography can be used outside of clinical therapeutic settings and serve as a form of self-care for the long term.

         The findings of this study are relevant to the Palestinian context, where people experience continuous political violence, instability, displacement, and collective trauma. The participant's trauma experiences around betrayal, emotional insecurity, school burden and social distress illustrate the different kinds of traumas faced by young adults in Palestine. Photography offered a culturally responsive and non-verbal therapy medium and safe space for emotional exploration, rather than confronting difficult memories. This is consistent with the literature that highlights the value of photography-based approaches in humanitarian and resource constrained contexts (Carr et al., 2022; Kaimal et al., 2023).

        Although there are significant findings, there were some limitations. The study was a single qualitative case study design with one participant, and thus, results may not be generalizable. Further, the reflection was self-report which can be subjectively interpreted. Further studies should be conducted with larger sample sizes, longitudinal study designs, and mixed method studies to assess the long-term effectiveness of therapeutic photography interventions for various populations in trauma situations.

         Ultimately, therapeutic photography proves that healing does not require the absence of pain, but rather the presence of hope and perspective. By committing to document everything—from the quiet, mundane details of a difficult day to the rare flashes of joy—you transform the camera from a simple tool into an emotional anchor. Each photograph becomes a tangible piece of evidence that you survived, that you found beauty amidst chaos, and that you chose to keep looking forward even when life’s obstacles felt insurmountable. Through the lens, the act of capturing the world becomes a profound act of reclaiming yourself, turning a landscape of awful difficulties into a beautiful, lasting testament to your enduring resilience and bravery.

         For Christelle, a resilient third-year university student, life lately had felt like an uphill battle. The relentless pressure of her academic workload had left her grappling with study-induced PTSD, a heavy exhaustion compounded by the painful, lingering sting of a deep disappointment from someone she closely trusted. Feeling untethered and overwhelmed, she unexpectedly found her sanctuary behind the lens of a camera. Engaging in therapeutic photography allowed Christelle to externalize the chaos of her mind, turning her unspoken anxieties and heartbreaks into quiet, visual stories. Capturing the world frame by frame gave her a newfound sense of control and perspective, transforming her pain into art and gently guiding her back to a place of healing and peace.

         In general, the results of this study strongly suggest that psychological trauma can be treated effectively using the art therapy technique of writing pictures. In the context of de-colonization in Palestine, photography was used as a therapeutic device but also as a way of reclaiming voice, identity and emotional agency in the midst of trauma and socio-political oppression. Moreover, this study's conclusions reflect greatly the psychoanalytical theories of Donald Winnicott, such as the notions of transitional space, holding environment, and the return of the "true self" through creative expression. Emotional expression, self-reflection, emotional regulation, identity reconstruction and resilience development all came from photography, which allowed for symbolic and creative visual communication of emotion, psychological healing and processes of personal liberation.

Conclusion:

         The present study aimed to investigate the use of photography as an art therapeutic means for reducing the psychological symptoms of trauma in Palestinian context using qualitative multiple case studies. The results revealed that therapeutic photography was an environment that allowed the participant to express, reflect, regulate emotions, reconstruct identity and heal psychologically in a safe space. Photography allowed the participant to express painful emotions and traumatic experiences, which were not easily verbalised, into symbolic images, thereby helping her to release her emotions and gain insight into herself.

Photography was shown to be a useful tool in helping to lower emotional tension, raise awareness, raise self-esteem, build resilience and aid in more positive coping styles. The use of taking, reflecting on and discussing photographs slowly enabled the person to move from suppressing emotions and feelings of psychological distress to an increased awareness of self, feelings of hope and an emotional openness. The changes that happened “visually” during the intervention were a result of a psychological “shift” that took place and was experienced within the person, from suffering to healing, from fragmentation to empowerment.

         The results also revealed the significance of photography in the Palestinian socio-political context, and how trauma is related to instability, violence, loss, emotional insecurity and collective suffering. In this regard, the use of the photo was a therapeutic tool as well as a practice of decolonization of voice, identity, and personal narrative. Visualizing the participant’s ability to reinterpret the painful experiences was a way of resisting the silence, emotional disintegration and imposed narratives of "helplessness". Photography thus became a way to re-engage agency, meaning and psychological presence in an environment defined by an ever-present sense of uncertainty and trauma.

In addition, these results are strongly congruent with the theories of psychoanalysis presented by Donald Winnicott including holding environment, transitional space and the restoration of the true self. The photography sessions provided a safe and secure space to allow the participant to slowly start to address emotions and trauma without being overwhelmed. Symbols became the transitional objects between inner emotional experiences and external reality as the camera and photographs. The participant was able to explore and deepen into more authentic, self-accepting and emotional experiences through visual expression.

         Therapeutic photography acts as a gentle anchor, training our eyes to slow down and find profound beauty in the ordinary. By viewing the world through a lens of mindful awareness, it shifts our focus from life’s anxieties to the rich texture of the present, teaching us to deeply appreciate every fleeting moment. When we use the camera to capture photos for people we love, photography transcends a simple hobby and becomes an act of preservation. Each snapshot freezes genuine connections, raw emotions, and shared laughter in time, ensuring that our greatest memories remain vividly alive. Even as time moves on, these photographs serve as tangible touchstones of gratitude, forever reminding us of the warmth, love, and light that define our lives.

Therapeutic photography serves as a powerful bridge where words often fail, offering a visual voice to those silenced by life's deepest hardships and chronic pain. When emotional trauma or physical suffering makes verbal expression impossible, the camera becomes a gentle tool to break that isolating silence. Instead of searching for words that might not exist, a person can capture textures, light, shadows, and subjects that mirror their internal struggles. This process of visual storytelling externalizes the invisible burden of chronic pain, turning a private, overwhelming reality into something tangible that can be safely examined and shared. By shifting the focus from internal suffering to external creation, therapeutic photography allows individuals to communicate their pain without speaking, reclaiming their agency and finding a profound pathway to healing.

         This study concludes that therapeutic photography is a useful, trauma-informed artistic approach that can have a therapeutic impact and promote psychological resilience. Although the single case qualitative design has its limitations, findings of this study add to the growing body of literature that validates expressive arts therapies, and underscore the need for culturally responsive and nondominant therapeutic modalities in situations that are impacted by chronic trauma and socio-political oppression. Further research is suggested which involves using photography therapy with more diverse and larger populations in Palestine and other trauma hit communities, and to examine the long-term psychological and decolonial effects of the use of this therapeutic approach.

This research article is a continuation of the author's previous study, "Impact of Photography as an Art Therapy on Treating Trauma Disorder." The present study extends the earlier work by further exploring the role and effectiveness of photography-based art therapy in addressing trauma-related psychological conditions and contributing to the growing body of knowledge in this field.