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Olivia Morrison

UHON 1020

Professor Baker

24 February 2017

Art Therapy in a Post-Apocalyptic World: Mental Health in Station Eleven

Emily St. John Mandels novel, Station Eleven, depicts survivors overcoming their

symptoms of depression and Post-Traumatic Stress Disorder (PTSD) after surviving the Georgia

Flu, a pandemic that wipes out the majority of the worlds population. PTSD and the struggle to

cope with it is commonly seen in modern literature, such as Phil Klays short story collection,

Redeployment; however, critics rarely address art therapy as a solution to mental instability.

Mandel portrays two different groups of survivors as they try to establish a sense of normalcy

after the apocalypse. These two groups both unintentionally undergo different types of art

therapy in their journey towards mentally healthy lifestyles. By applying art therapy to several

characters recovery from PTSD, readers can understand how art plays a critical role in the

healing process of trauma survivors both in an apocalyptic scenario and in our world today. This

paper will use the examples of the Severn City airport survivors and the Traveling Symphony to

analyze how beneficial art therapy is in mental recovery. This paper will then analyze each

groups symptoms and coping mechanisms and discuss how art therapy found in the book is used

today in trauma cases.

Post-Traumatic Stress Disorder is a trauma-or stressor- related disorder defined in the

fifth edition of the Diagnostic and Statistical Manual of Mental Disorders as a disorder caused by

a trigger of exposure to actual or threatened death, serious injury or sexual violation (APA).
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This exposure will result in PTSD symptoms that do not go away after an extended time. These

symptoms include: re-experiencing, avoidance, negative cognitions and mood, and arousal. Re-

experiencing includes unprompted memories of the event, reoccurring dreams, and flashbacks.

Avoidance covers distressing memories, thoughts, and feelings related to the experience.

Negative cognition and mood refers to a skewed sense of blame, feeling separated from others,

and even memory suppression, being unable to recall key aspects of the event. Lastly, arousal

includes symptoms such as destructive behavior and hyper-awareness and vigilance. Hyper-

awareness is a state in which a person is constantly aware and agitated, and hyper-vigilance is

when a person is easily startled and irritable (APA). The multitude of possible symptoms shows

how likely a survivor of an apocalyptic pandemic would be to display at least one symptom of

PTSD, as seen in Station Eleven.

Trauma victims have many ways to combat and alleviate the symptoms of PTSD, such

as: counseling, psychotherapy, self-help coping skills, and art therapy. Art dates back 40,000

years to the first cave paintings; however, art therapy as a defined practice did not begin until the

1940s (AATA). Art therapy is a form of psychotherapy involving the encouragement of self-

expression through painting, drawing, or any art media, and is used as a remedial activity or an

aid to diagnosis. According to The American Art Therapy Association, the goal of art therapy is

to improve or restore a clients functioning and his or her sense of personal well-being

(AATA). This form of therapy currently helps those who have experienced trauma, those with

adverse physical and medical conditions, and those with mental disabilities or disorders (AATA).

Art therapy can be practiced as an individual or in a group setting. The three main types of art

therapy effectiveness studies are the single group design, the nonrandomized controlled trial, and

the randomized controlled clinical trial. Generally, these three types of study designs produce
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similar results regarding the positive effects of art therapy (Reynolds 7). The positive effects of

art therapy are the following: an increase of self-expression, better relations with others, and

reduction of depression levels (Reynolds 7).

Art therapy significantly alleviates the trauma symptoms of those suffering from PTSD.

According to research done by Lyshak-stelzer, author and Creative Arts Therapy Supervisor at

NYS Office of Mental Health, when adolescents diagnosed with Post-Traumatic Stress Disorder

underwent art therapy, they saw a statistically significant reduction of trauma symptoms and a

reduction of behavioral incidents and seclusions (Slayton 7). Another example of the

effectiveness of art therapy is the study the University of South Florida did in 2011. The

participants each had higher than the cut off score for clinical diagnoses for PTSD. Of these 97

participants, 79.6 percent experienced symptom burden before undergoing art therapy. Symptom

burden is when a person is unable to live a normal, functioning life due to symptoms of PTSD.

After art therapy, this percentage decreased to 16.7 percent (Kip 12). Art therapy, despite its

effectiveness is not an easily accessible resource to those who have experienced trauma and is

not utilized to its full extent due to it being a newer practice and few having heard of its success.

A fictional example of this is shown in the novel, Station Eleven, by Emily St. John

Mandel. Critics of this book have expressed their love for the focus on art in a post-apocalyptic

world, however, they do not mention how art plays an important role in the mental recovery of

the survivors. Reviews have also focused on the characters connections to one another instead

of the therapeutic effects of art on the characters. New York Times focuses on the connections

between the characters and barely glances over the big role art played in the novel. The Guardian

says that, Mandel isn't interested in how apocalypse might act upon art, completely

disregarding how because of the apocalypse, people turn to art. If critics of this novel instead
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wrote about how hopeful it was that the survivors overcame the trauma caused by the flu

pandemic because of their use of art, then readers would be more likely to recognize art therapy

within the book. By not focusing on art therapy in the story, critics and readers ignore an entire

aspect of the novel that can be closely read in a class setting and for personal enjoyment.

Station Eleven by Emily St. John Mandel is about survivors in a post-apocalyptic world

in which the Georgia Flu kills ninety nine percent of the world population. Two groups of

survivors are successful in creating their own sense of normalcy twenty years after the pandemic.

One is a band of actors and musicians called the Traveling Symphony that move settlement to

settlement performing concerts and Shakespearean plays, and the other is the Severn City airport

survivors that establish an independent, well-ran community. Both of these groups display

symptoms of PTSD in the form of negative thoughts, reoccurring thoughts and memories of the

Georgia Flu, feeling tense, and memory suppression. However, despite their trauma caused by

killing people, missing memories, and lost family, the Traveling Symphony and Severn City

airport survivors are able to mentally recover because they both unintentionally underwent art

therapy. The two communities approach art and recovery in two different ways, however, the

outcome is the same: the ability to cope with the trauma of loss caused by the Georgia Flu.

The first community that undergoes art therapy is the Severn City Airport survivors. This

community is made up of the flu survivors of the surrounding town, Severn City, and the people

whose airplanes were grounded at the airport. This community is the one in the novel that most

closely resembles a highly functioning society. In the beginning, the people of the Severn City

Airport counted time as though they were only temporarily stranded. Year One, Year Two,

Year Three (Mandel 231). This time system shows that the survivors were in denial of the fact

that they would not be rescued by a semblance of their former government, and through this,
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they ignored how traumatic it was losing their families, being scattered from home, and being

hungry in the dark. The survivors at the airport showed symptoms of shock as well as PTSD.

One of the main characters, Clark pretends he is with his boyfriend, speaking softly to an

imaginary Robert, practicing for the future (Mandel 240). Clark refuses to acknowledge the

possibility of the apocalypse never ending and deludes himself with fake images of his lost

boyfriend. This denial and imagination is an example of PTSD symptoms. There were things

Clark trained himself not to think about. Everyone hed ever known outside the airport, for

instance (Mandel 249). This is a form of PTSD symptom called avoidance. Many of the

survivors in the airport exhibited concerning behavior and found relief through the Museum of

Civilization.

The Museum of Civilization is an art gallery created first by Clark for a sense of

normalcy and to put the past in its place. Set up in the Skymiles Lounge, the makeshift art

museum was made up of pre-apocalypse items that people continued to put on display. Clark put

his useless phone first and added a credit card and drivers license that had been left in a

Mexican restaurant. Clark states that he had always been fond of objects, and in his present state

of mind, all objects were beautiful (Mandel 255). Thus, Clark became the curator of the

Museum of Civilization. The Museum of Civilization acted as a form of art therapy for the

people of the Severn City Airport in the form of curation. The survivors were able to both

figuratively and literally put the past in its place. This separation of the past, before the

pandemic, and the present, struggling to recreate a sense of normalcy, is what allows the

survivors to overcome the trauma they experienced. However, they did not put their dark pasts

into a corner and forget about it. They respected the pre-apocalypse civilization by teaching the

children born after Year One what the objects were and how they were used, despite how hard
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to explain (Mandel 232) it was. By making the items of the past art, the survivors were able

categorize and organize their thoughts in relation to the world before the Georgia Flu. They

separated themselves from it in order to move on and create a new mentally healthy lifestyle that

includes: jobs, chores, a community with families, and even recreational activities.

In opposition to the coping mechanisms of the airport survivors, The Traveling

Symphony tried to recreate a sense of the lifestyle they had before the pandemic through the

performing arts. The Traveling Symphony is a nomadic group of musicians and actors that move

settlement to settlement in the post-apocalyptic world performing classical music and

Shakespearean plays. Ran by the Conductor, a woman who was in a military orchestra, the

performing troupe travels caravan style on a two-year round trip, going to all the towns in which

they perform. Because of their nomadic ways, the symphony has seen more of the post-

apocalypse world than most and have been exposed to more trauma then others. Many of the

members have tattoos of weapons going up their arms, a sign of how many people that person

has killed, however, the symphony only does this out of necessity. This shows how they have

been exposed to traumatic experiences such as having to kill another human being. Kirsten, the

main protagonist of the novel and an actress in the Traveling Symphony, states that the company

is made up of undiagnosed PTSD cases (Mandel 47). The company shows symptoms such as

hyper-activity, negative thoughts, and cognition. However, they are able to alleviate these

symptoms through art therapy.

Acting and music are both an escape and homecoming for the members of the Traveling

Symphony. The actors in the performing troupe are able to escape from their everyday lives of

traveling the wasteland of America by putting on costumes. Kirsten is able to pretend she is a

fairy queen with a crown of flowers (57), even if only for a short time. By being able to
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pretend they have different lives, the survivors of the Traveling Symphony overcome the

struggles of living life on the road, facing thieves, violence, and cults, and the trauma symptoms

caused by it. However, the performing arts also establish a sense of normalcy in the post-

apocalyptic world. The motto of the Traveling Symphony is, survival is insufficient (58), and

this depicts how the actors and musicians that make up the troupe want more than to merely

survive after the apocalypse, they want to thrive and truly live. The arts are how they do this.

Before the apocalypse, they were members of military orchestras, child actors, and random

artists that wanted to recreate the life they had before to some degree. Through their attempts to

normalize their new life, the Traveling Symphony healed itself.

One prime example of the necessary role art plays in healing is that of the main

protagonist and actor, Kirsten. Kirsten was only eight when the Georgia Fly pandemic wiped out

most of the world population. Both her and her brother wandered like most other survivors for

the year following; however, Kirsten does not remember that entire year. This is a cognition

form of Post-Traumatic Stress Disorder symptoms, called memory suppression. Memory

suppression is when a person, consciously or subconsciously makes a bad memory disappear

from his or her recall. This is the time in which Kirsten receives a jagged scar on her

cheekbone (57), and her brother says it is for the best she does not remember this period of

time. It is clear that she underwent some traumatic experience that forced her to block an entire

year from her mind, for she was only a child, unable to cope with the trauma of an apocalypse.

However, Kirsten does overcome her symptoms of PTSD through acting again. She joins the

Traveling Symphony and her concerning symptoms such as her memory suppression are well

under control in the positive setting. Kirsten is a good example of how art is beneficial to the
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healing process of survivors because her PTSD symptoms improve after she joins the Traveling

Symphony, which enables her to express herself therapeutically through acting.

Art plays a crucial role in the recovery of trauma victims both in Station Eleven and in

our world today. The characters in Emily St. John Mandels novel display how art can be

necessary in the healing process of PTSD patients and despite not having easy access to artistic

means, the survivors make do and alleviate their own symptoms. While art therapy has been

found to alleviate the symptoms of those diagnosed with Post-Traumatic Stress Disorder, art

therapy is not an easily accessible resource available to trauma survivors in the world today. For

example, war veterans receive very little treatment after they return from the war zone.

According to the Iraq War Clinician Guide, Many will have received some mental health care in

the war zone (e.g., stress debriefing) that will have been judged unsuccessful. Some Veterans

will perceive their need for continuing care as a sign of personal failure (Scurfield). This sense

of failure is due to the flawed warrior making culture of the United States. With such little

treatment after war zone traumas and the idea that being affected by those traumas is a failure,

many veterans are left without treatment or the resources to alleviate trauma symptoms. The

most common forms of therapy for returning soldiers are coping mechanism training, exposure

therapy, cognitive restructuring, and family counseling (Ruzek). Art therapy is not a common

therapy amongst soldiers returning from the traumas of war, despite evidence showing the

effectiveness of art in alleviating trauma symptoms and symptom burden. This shows that there

is a gap in the resources given to trauma victims today. Books such as Station Eleven can

possibly open readers eyes to a lesser known form of therapy, art therapy; however, if literary

critics only focus on how new it is that art is finally shown in an apocalyptic novel, readers are

limited by the lack of representation of how important art can be in coping and recovering from
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traumatic experiences and even depression. This can limit the reading and teaching of the novel

if attention is not put on art as a therapeutic service. Nevertheless, novels like Station Eleven will

continue to inform readers that art is not only a pastime, but is in fact an alternative form of

medicine for those who struggle with tradition therapy and need a more creative approach

towards positive mental health.

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Works Cited

American Art Therapy Association. What is Art Therapy. 2013,

www.arttherapy.org/upload/whatisarttherapy.pdf. Accessed 2 Mar. 2017.

American Psychology Association. Diagnostic and Statistical Manual of Mental Disorders:

DSM-5. Fifth edition. 2013.

Justine, Jordan. Station Eleven Review: Emily St. John Mandels Gripping Apocalypse Novel.

The Guardian. 25 September 2014. Accessed 16 April 2017.

Kip, K. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of

Accelerated Resolution Therapy (ART). Multidisciplinary Digital Publishing Institute

Behavioral Sciences Journal, Vol 2, 2012, pp. 115-134, Pdf. Accessed March 2, 2017.

Knopf, Alfred. Shakespeare for Survivors. New York Times. 14 September 2014. Accessed 16

April 2017.

Mandel, Emily St. John. Station Eleven: A Novel. First edition. New York: Alfred A.K, 2015.

Print.

Reynolds, Matthew W. PhD, Laura PhD Nabors, and Anne ATR Quinlan. "The Effectiveness of

Art Therapy: Does It Work?" Art Therapy 17.3 (2000): 207-213. Print.

Ruzek, J. Iraq War Clinician Quide. U.S. Department of Veteran Affairs,

www.ptsd.va.gov/professional/treatment/vets/treatment-iraq-vets.asp. Accessed

March 2, 2017.
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Scurfield, R. M., & Tice, S. (1991). Acute psycho-social intervention strategies with medical

and psychiatric evacuees of "Operation Desert Storm" and their families. Operation

Desert Storm Clinician Packet. White River Junction, VT: National Center for PTSD.

Slayton, Sarah C. MA, ATR-BC, Jeanne MA, ATR-BC D'Archer, and Frances DA, ATR-BC

Kaplan. "Outcome Studies on the Efficacy of Art Therapy: A Review of Findings." Art

Therapy 27.3 (2010): 108-118. Print.