Body mapping · Atlas

1. Introduction

Version followed: the South African group model of Jane Solomon (Memory Box / Long Life project, Cape Town, 2002–2003), as written up in the UCT AIDS and Society Research Unit (ASRU) Mapping Workshop Manual and described by Solomon in a 2023 interview. Two published facilitation guides are used for format and detail: the five-day workshop toolkit of Gunn (2018, Human Rights Media Centre, adapted from Solomon) and the three-session individual research version of Gastaldo et al. (2012, Toronto). The TICAH five-day workshop with torture survivors (Kenya, 2012–13) is used for trauma-group adaptations. Solomon's own manual Living with X (REPSSI; dated 2002, 2007 or 2008 in different sources) is not drawn on [uncertain].

What it is: body mapping is a facilitated arts-based method, not a stand-alone psychotherapy with its own theory. A partner (or the facilitator) traces a life-size outline of the person's body on large card, paper or canvas, and the person fills it in, exercise by exercise, with colour, symbols, marks, words and images about their body and life. Solomon's model has three products: the visual map, a first-person story (called a testimonio by Gastaldo et al.) and a key explaining the symbols [source: de Jager et al. 2016; Gastaldo et al. 2012]. It is used in three overlapping ways: therapeutic and psychosocial groups, qualitative research, and advocacy or exhibition [source: de Jager et al. 2016].

How change is thought to happen: in a group, people make a layered visual record of their life in and through the body, then tell it and have it witnessed. The ASRU manual places this within narrative therapy (White and Epston): people tell their life story to come to terms with it and make positive decisions, and they learn from each other as peers. Biomedical teaching about body systems sits alongside, so that illness is understood and can be talked about [source: ASRU manual]. Solomon puts the healing in the group: "The group is the therapist, the group contains" [source: Solomon interview 2023]. Reported benefits (a richer sense of self beyond a stigmatised identity, confidence, agency) rest mostly on informal participant reports and "have not been formally evaluated" [source: de Jager et al. 2016].

Origins (as sources give them): Jonathan Morgan, a clinical psychologist at UCT, ran Memory Box work (keepsake boxes and memory books for children, a practice from Uganda) with women living with HIV in Khayelitsha. When MSF made antiretroviral treatment available to the Bambanani Women's Group, Morgan asked artist Jane Solomon to make imagery for a book showing that treatment works. She proposed "one big visual piece", drawing on body mapping from her own growth work and a polarity therapy course [source: Solomon interview 2023; ASRU manual]. Anthropologist Hayley MacGregor (2009) analysed the first maps as part of the Treatment Action Campaign's treatment-literacy activism [source: MacGregor 2009 abstract]. TICAH traces the method to a Ugandan women's HIV organisation via Bambanani [source: TICAH]; the earliest recorded whole-body maps are MacCormack and Draper (1987) [source: de Jager et al. 2016]. Accounts differ on these origins [uncertain].

Professional frame. No regulated profession or credential exists for body mapping. Solomon is an artist ("I'm not trained as a therapist") and always works alongside a trained counsellor [source: Solomon interview 2023]. Gunn requires facilitators with prior trauma experience and, where possible, a clinical psychologist on hand. TICAH's ideal team has convenors, artists, a counsellor and support staff [source: Gunn 2018; TICAH]. When a psychotherapist uses it inside therapy, it falls under their own registration and scope. If you present it as art therapy, the protected-title rules of your jurisdiction apply: in the UK, HCPC registration as an art therapist, usually with BAAT membership; in the US, AATA and the ATCB credential. Without art-therapy training, describe it as a guided drawing or narrative exercise within your own therapy [synthesis; regulatory details uncertain]. Do not run trauma-focused body-map groups without a co-facilitator trained in trauma work [source: Gunn 2018; Solomon interview 2023].

2. Framework

There is no fixed session count. Versions differ widely, and the time available decides how many layers you can do and how fully the map is painted.

Version	Format	Time	Source
Long Life / Bambanani (2002)	Closed group of 13 women, with an artist facilitator and psychologists	About 12 sessions of about 2 hours over 3 months (Solomon, recalled in interview)	Solomon interview 2023; ASRU manual
Solomon's guide	Group	At least five full days, about 30 hours per map (as reported by Gastaldo et al.)	Gastaldo et al. 2012 [guide itself not drawn on]
Gunn toolkit	12–20 participants, single-gender groups where suitable; attendance at all five days required	5 days of about 6 hours	Gunn 2018
TICAH	10–15 participants, residential, team of about 8	5 days	TICAH
Gastaldo et al. research version	One-to-one, with an interview before each mapping session	3 sessions of about 60 minutes, with homework between them; outline-only maps (about 90% less time than Solomon's)	Gastaldo et al. 2012
ASRU workshop sequence	Group, community HIV education	26 steps; about 9 hours for the linked Visual Body Map workshop	ASRU manual
Short demonstration	Students	About 1.5 hours	Solomon interview 2023

Phases. These are drawn out of the published sequences. The labels are my own [synthesis]; the contents and order come from the cited sources.

Preparation and consent. Goal: recruit, screen and agree the terms. Explain the purpose, the materials and any possible public showing before starting, and record consent to recording and photography. Arrange a private room big enough for floor work, which can be locked between sessions. [source: Gunn 2018; Gastaldo et al. 2012; TICAH]
Opening and safety. Goal: build trust and group norms. This covers introductions, ground rules, any opening ritual, a colour or art warm-up, and pair tracing. TICAH does tracing on day 2, after a day-1 warm-up. [source: Gunn 2018; TICAH]
Identity and strength layers. Goal: anchor a resourced self before difficult material. This covers name and birth details, the shadow, hand and foot prints, the power point and personal symbol, self-portrait, first or early-childhood memory and positive memories. Solomon builds identity first, then moves to "the more challenging intimate aspects of the body". TICAH insists the first drawing and sharing are about a positive experience. [source: Solomon interview 2023; ASRU manual; TICAH]
Body-experience layers. Goal: represent marks, injuries, illness, pain and emotions on and under the skin. This is often paired with short teaching on anatomy and illness (skin, skeleton, organs, virus, psychosocial conditions). TICAH alternated difficult and good material. Rape-survivor groups did not address rape directly until day 3. [source: Gunn 2018; ASRU manual; TICAH; Gastaldo et al. 2012]
Support and future. Goal: counter isolation and orient forward. This covers the shadow filled with supporters, strengths, hopes for the future, and a personal slogan or message to others. [source: all four guides]
Narrative and witnessing. Goal: integrate the map into a told story. This covers the testimonio, the key, and presentation to the group or invited witnesses. [source: Gastaldo et al. 2012; ASRU manual; Gunn 2018; TICAH]
Closure and ownership. Goal: end the group, and decide where maps go and how images may be used. This covers the evaluation, a thanks circle, packing and storage, and decisions about exhibition, photos and taking maps home. [source: Gunn 2018; TICAH; Gastaldo et al. 2012]

Criteria for moving on.

Build identity and positive anchors before difficult layers. [source: Solomon; TICAH]
Go further only once group rules, confidentiality and trust are in place. TICAH's confidentiality oath comes on day 1. [source: TICAH]
Watch participants who are lagging behind. Gunn gives them extra help on days 3–5 rather than holding the group back. [source: Gunn 2018]
Do not move into trauma layers while a participant is still dysregulated from the previous one. Check in and offer breaks first. [source: Gastaldo et al. 2012 for check-ins and breaks; the gating rule is synthesis]

Individual therapy adaptation [synthesis]: the published individual format is the Gastaldo research version, not a therapy protocol. For a client in ongoing therapy, a workable translation is:

4–8 sessions of 50–90 minutes, one phase or two layers per session;
a life-size or half-size outline kept safely between sessions;
the narrative and key built up across sessions;
the usual therapeutic processing, which Gastaldo et al. deliberately left out of their research version.

3. Guiding principles

The maker is the author. Solomon: "I would never tell people what to do." Helpers and artists help only when asked and never do the creative work. → Offer techniques and options, never content. [source: Solomon interview 2023; Gunn 2018; TICAH]
Prompt, response, reflection. Each exercise has "a prompt, a response and then a reflection". → Give one clear prompt, allow making time, then invite sharing or reflection every time. [source: Solomon interview 2023]
Layering in order. The map is built exercise by exercise, from identity to intimate material. → Sequence from safe to sensitive; do not open with trauma marks. [source: Solomon interview 2023]
Start positive, then alternate. The first drawing and sharing are positive, and difficult material alternates with good. → Pair each hard layer with a resource layer. [source: TICAH]
We need other people. "You can't trace around yourself, we all need other people." Tracing in pairs and the shadow figure carry this idea. → Use pair work and the support layer deliberately against isolation. [source: Solomon interview 2023; Gunn 2018]
The group contains. → In group formats, use group witnessing and equal speaking time. Do not turn the session into individual therapy in front of an audience. [source: Solomon interview 2023; Gunn 2018]
Meaning belongs to the maker, so a key is needed. The same symbol can mean different things to different people, and maps cannot be read without the maker's key. → Ask, never interpret. Write down the maker's own explanation. [source: Gastaldo et al. 2012]
Not diagnostic. No validated scoring or diagnostic manual exists for body maps. Systematic analysis protocols were still being developed in 2015. Maps are shaped by culture and are not fixed truths. → Never treat marks, colours or placements as evidence of abuse or disorder. [source: de Jager et al. 2016; Sheffield RSE extract; the clinical rule is synthesis]
Consent is a process. Revisit consent, especially about recording, display and emotional state. People may refuse any exercise or withdraw at any time without consequence. [source: Gastaldo et al. 2012; de Jager et al. 2016]
Ownership and public use are agreed up front and revisited. → Discuss exhibition, photos and storage at the start, and come back to them once or twice during the work. [source: TICAH; Gastaldo et al. 2012]
Confidentiality and anonymity. Stories stay in the room, and no one tells another person's story. Use pseudonyms, and leave real names, addresses and identifying places off maps that will be shown. [source: TICAH; Gastaldo et al. 2012; Solomon interview 2023]
Don't reduce people to the shared label (HIV, torture, migration). → Include the whole life: childhood, school, pleasures, hopes. [source: TICAH]
Respect bodily proximity in tracing. → Trace a few inches from the body, or skip sensitive areas and complete them once the person is standing. The person chooses their own posture, including face-down. [source: Gastaldo et al. 2012]
Be firm on time but flexible. → Keep the structure, but give breaks, extra sessions or extra help as needed. [source: Gunn 2018; Gastaldo et al. 2012]
Clarity of role. Gastaldo et al. deliberately left out therapeutic questions in their research version. Solomon, an artist, works with a counsellor. → Know whether you are running research, psychosocial support or therapy, and staff the work accordingly. [source: Gastaldo et al. 2012; Solomon interview 2023]
Context-sensitive knowledge. The original work combined body maps with biomedical treatment literacy and with poverty, stigma and politics. → Teaching about the body and attention to social context belong in the process. [source: MacGregor 2009 abstract; ASRU manual]

Domain safeguards [synthesis unless tagged]

Children and young people. Get carer consent and the child's own assent. Follow local safeguarding and mandatory-reporting duties if a map or story discloses harm. Use generic or half-size outlines, shorter layers and adult support. A UK school resource tells pupils not to share personal reflections with each other and signposts support [source: Sheffield RSE extract].
Touch. Tracing needs proximity but not touch. Ask explicitly before tracing, offer self-tracing alternatives (see 4.4), and never trace close to the genital area or breasts.
Materials. Use non-toxic, washable paints for floor work [source: Gastaldo et al. 2012]. Use spray lacquer (Gunn) only in good ventilation and away from participants. Cover floors [source: Gunn 2018; ASRU manual]. Offer a table for older or disabled participants [source: Gunn 2018]. Provide a basin and towel for washing after hand and foot prints [source: ASRU manual]. If participants kneel or lie on the floor, offer cushions and watch for falls when they get up.

4. Intervention inventory

The exercises are grouped by phase. Not every version uses every exercise, so each is tagged with the version(s) it comes from. All example language is my own illustrative wording unless it is quoted and cited.

4.1 Preparation: materials, room and terms

Purpose. Set up conditions for safe, uninterrupted floor work and informed consent. Use this before any format.
Steps.
1. Book a private room large enough to lay out every sheet with space between them. Gunn suggests at least 0.5 m between sheets of about 2.2 × 1.5 m, a room that can be locked overnight, and plastic sheeting over carpet. [Gunn 2018]
2. Gather the materials. The published lists overlap:
  - large surface: pattern card, heavy paper, primed canvas (TICAH), or newsprint or flattened boxes (ASRU);
  - drawing tools: pencils, erasers, charcoal, black and brown permanent markers;
  - colour: crayons or pastels, washable or powder paints, acrylic or metallic paint, food colourants;
  - brushes, sponges, buckets and a basin with a towel;
  - glue, scissors, masking tape, magazines or a clip-art binder;
  - hand mirrors and an anatomy book or chart;
  - journals and pens, name tags, a bell for timekeeping;
  - a recorder, used only with consent. [Gunn 2018; TICAH; ASRU manual; Gastaldo et al. 2012]
3. Ask participants to wear old clothes. [Gunn 2018]
4. Explain the purpose, show the materials, and say clearly how maps might be shown or published. Record consent to audio recording and photography. [Gastaldo et al. 2012; Gunn 2018]
5. Agree the attendance rules. Gunn allows one missed day by negotiation; missing two days means withdrawing. [Gunn 2018]
6. Arrange back-up: a counsellor or clinician present or on call, and a referral list. [TICAH; Solomon interview 2023]
Example language (illustrative). "Over the next sessions you'll make a life-size picture of your body and your story. It's yours. Nobody will tell you what to put on it, and you can skip anything. Before we start, let's agree what happens to it afterwards: who sees it, whether it's photographed, and where it's kept."
Watch for. Participants agreeing to exhibition without understanding it. Political or legal risk to them if their story becomes public: Gunn says facilitators must protect participants from repercussions where survivor stories are unwelcome [Gunn 2018]. It is working if participants can say back, in their own words, what will happen to the map.

4.2 Introductions: name story or symbolic name tag

Purpose. Open the group with identity rather than problems, and model sharing. [Gunn 2018: name story; TICAH: symbol or colour name tag]
Steps.
1. Name story (Gunn): each person, the facilitator included, gives their name and the story behind it.
2. Symbolic tag (TICAH): as an alternative, each person draws a symbol of themselves, or designs a name tag in colours that reflect how they feel or who they are, then explains it in a sentence.
Example language (illustrative). "Tell us your name and something about where it comes from, who gave it to you, or what it means."
Watch for. People who stay silent. Let them pass and come back to them. It is working when people add detail without being pressed.

4.3 Ground rules, confidentiality oath and opening/closing ritual

Purpose. Create a contained space. [Gunn 2018; TICAH]
Steps.
1. Draw up the rules together and post them on the wall. Gunn's list covers punctuality, respectful listening, confidentiality, phones silenced, active participation, sensitivity and no one dominating.
2. TICAH adds an oath of confidentiality after open discussion. Stories stay in the room, including at meals and breaks. No one tells another person's story. Outside observers come in only with group approval.
3. TICAH opens and closes each day with a ritual: lighting a candle, passing sage smoke round the circle, or a closing song chosen by a participant. Bells, candles or songs are acceptable substitutes. [TICAH]
Example language (illustrative). "What do we each need from this group to feel safe enough to put real things on paper?"
Watch for. Rituals must be culturally owned by the group. Do not import smudging or other ceremonial practices from a tradition that is not the group's own. Use a neutral bell or song unless participants lead their own practice [synthesis]. Confidentiality slips, especially at mealtimes, need to be named early.

4.4 Meaning of colour / art warm-up

Purpose. Lower anxiety about making art, and build a shared, personal colour vocabulary for the map. [Gunn 2018; TICAH]
Steps.
1. Gunn: a scribe records the group's associations with red, blue, yellow, black and white, then with the secondary colours. Stress that meanings can contradict each other. Post the chart on the wall.
2. TICAH: talk about colour, then sketch and paint, alone or together. Participants help each other mix colours and write letters.
Example language (illustrative). "What does red mean to you? It can mean more than one thing, even opposite things."
Watch for. "I can't draw." Reassure people that this is not an art test. It is working when people start experimenting without asking permission.

4.5 Body tracing

Purpose. Create the life-size outline. This is the method's core act, and it relies on another person: "You can't trace around yourself" [Solomon interview 2023].
Steps.
1. The person chooses a posture that represents who they are, their work, or how they feel about their situation [Gastaldo et al. 2012]; or the position they feel best expresses them [TICAH].
2. They lie on the sheet. A partner traces the outline [ASRU; Gunn; TICAH], or in one-to-one work the facilitator does [Gastaldo et al. 2012].
3. Gunn: the first outline is in black marker and the partner's in brown, then the roles reverse on a second card. Pencil first if mistakes need erasing.
4. Keep a few inches from the body. Skip sensitive areas and draw them in after the person stands up [Gastaldo et al. 2012].
5. Gastaldo et al. talk with the person during tracing (in their study, about changes since migration). Afterwards the person chooses colours for the outline and hands.
Example language (illustrative). "Choose a position that says something about you right now. Lying on your back, side or front are all fine. I'll trace a hand's width away from you and skip anywhere you'd rather I didn't. Say 'stop' at any point."
Watch for. Freezing, holding the breath or startle while lying down with someone close. Stop and offer alternatives: tracing while standing against a wall, a generic outline, or a sketched outline the person draws themselves at a table [synthesis]. Choosing to lie face-down affects the self-portrait step: Gastaldo et al. skip the portrait for those participants. It is working when the person relaxes into the posture and comments on its meaning.

4.6 Shadow figure (double outline)

Purpose. Represent the people, ancestors, organisations and beliefs that support the person, against isolation. [ASRU manual; Solomon interview 2023; Gunn 2018; TICAH]
Steps.
1. ASRU: partners trace each other on the same sheet in different colours, overlapping so that the partner's outline reads as a shadow. Repeat on a second sheet so each person has a map.
2. Paint around your own outline in a chosen colour, and colour the partner's outline where it falls outside your body. Discuss what the shadow means, for example supportive people and ancestors.
3. Gunn (day 4): compile the list of supporters gathered from daily homework. Write their names outside the body along the shadow, first in pencil, then in brown marker. Paint the shadow with food colourant.
4. TICAH: trace a second "shadow" body and fill it with names and symbols of the people, ideas, foods, music or beliefs that helped.
Example language (illustrative). "Who has stood behind you? People alive or gone, a group, a faith, a song, a place. Put them in your shadow."
Watch for. Grief when the list is short or when supporters have died. Allow ancestors, pets, beliefs and future supporters [synthesis]. It is working when the person sees more support than they expected.

4.7 Hand and foot prints

Purpose. An embodied, playful mark of presence. [ASRU manual]
Steps. Stamp hands and feet in paint on the map, then wash in the basin. Gastaldo et al. also use handprints to represent supporters.
Example language (illustrative). "Put your hands and feet down where they belong on your map."
Watch for. Some people dislike feeling messy or touching paint. Offer gloves or traced hands instead [Gastaldo et al. list gloves among the materials].

4.8 Name, birthplace and date

Purpose. Anchor the map in identity and time. [ASRU manual; Gunn 2018]
Steps.
1. ASRU: write your name, and where and when you were born, outside the outline.
2. Gunn: write name, surname and date of birth in bold pencil, go over them in marker, and decorate them.
Example language (illustrative). "Sign your map the way you'd like to be known."
Watch for. Anonymity when maps will be shown publicly. Agree pseudonyms first [Gastaldo et al. 2012; Solomon interview 2023].

4.9 Power point and personal symbol

Purpose. Locate strength in the body before any work on pain. [Solomon interview 2023: the "power-point and personal symbol" exercise; ASRU manual]
Steps.
1. ASRU: mark where in the body you feel personal strength.
2. Choose and draw, at that point, a symbol of your strengths. The ASRU manual says strengths and weaknesses.
3. Share the symbols in the group.
4. Gunn (day 3): introduce examples of symbols (an elephant, tree, dove, scales, rainbow, book). Each person draws on A3, in colour, one symbol for their character and strength. After sharing, they draw it large on the map, above the head or on the chest or stomach, in metallic paint if they wish.
5. TICAH "strengths": sketch symbols of strengths and gifts, decide where on the body each belongs, then paint them there.
Example language (illustrative). "Close your eyes for a moment. Where in your body do you feel strongest? Now what image or creature could stand for that strength?"
Watch for. A person who cannot find any strength. Offer a past strength, or a strength others see in them [synthesis]. It is working when the symbol is referred back to in later layers.

4.10 Self-portrait

Purpose. Represent how one sees oneself or is seen by others. [ASRU manual; Gunn 2018; Gastaldo et al. 2012]
Steps.
1. ASRU: a five-minute self-portrait.
2. Gunn: sketch from a mirror, check proportions using the quadrant method and a book balanced on the head, add scars, lines and adornments, then transfer the portrait to the map in pencil.
3. Gastaldo et al.: consider how you appear to others, then draw your face literally or symbolically. This step is skipped if the person lay face-down. One participant's face was reduced to the eyes alone for anonymity.
Example language (illustrative). "Draw your face as you see it, as others see it, or as a symbol, whichever feels right."
Watch for. Self-disgust, or body-image or appearance distress, with mirrors. Offer a symbolic face instead [synthesis].

4.11 First memory / early-childhood layer

Purpose. Bring in a whole life, beginning with early resources. [ASRU manual: "draw and describe your first memory"; Gunn 2018: early childhood writing, drawing, sharing, mapping; TICAH: positive memory first]
Steps (Gunn).
1. Journal prompts on family, home, community, play, caregivers, illness and early memories (about 60 min).
2. Draw a childhood scene and colour it (30 min).
3. Share short summaries in the group, with respectful listening (60 min).
4. Transfer the scene to the left side of the card, in pencil and then marker and colour, avoiding crowding (60 min).
5. Homework: underline the people who loved and supported you (these feed the shadow, 4.6).
Example language (illustrative). "Pick a memory from when you were small, any memory. Where were you? Who was there?"
Watch for. Childhood trauma surfacing. TICAH's rule is to make the first memory shared a positive one. Let people choose which memory to share [TICAH; the choice point is synthesis].

4.12 Lifeline / life-story timeline around the body

Purpose. Place the life story in sequence around the figure, so the map reads as a biography. [TICAH; Gunn 2018]
Steps.
1. TICAH: birth goes at the lower left. The line runs along the bottom and up the right side, and hopes go at the top right. Mark milestones, the best childhood and adult memories, and the worst childhood memory. Introduce the lifeline before the hardest material.
2. Gunn: map the life in stages, each with writing prompts, a drawing, sharing and a transfer to the map:
  - early childhood: left side of the body (4.11);
  - school years: continue anticlockwise round the bottom of the body; prompts cover teachers, subjects, friends, support and reasons for leaving school;
  - life after school to the present: continue anticlockwise up the outside of the body, leaving the top right open for the future; prompts cover study, work, marriage, children, how conflict disrupted life, causes of the conflict and challenges after it.
Example language (illustrative). "Your story travels around your body: born here, growing up along the bottom, and up to now on this side. We'll leave this top corner empty for later."
Watch for. Overcrowding. Gunn warns against cramming, and suggests synthesis and summary rather than putting everything from the journals onto the map. Working sign: the person can point to their life in order and talk about it.

4.13 Journey map (migration journey)

Purpose. Represent a key transition (migration, in the source) and its meaning. [Gastaldo et al. 2012]
Steps.
1. Draw symbols for the home country, the journey and life now.
2. Link them with roads or arrows (about 30 min).
3. Homework: create a symbol for the migration journey and a personal slogan.
Example language (illustrative). "Show where you started, how you travelled, and where you are now, and join them up."
Watch for. Travel trauma, and the risk to undocumented people of showing identifiable places. Gastaldo et al. removed places and other identifiers. The same structure could be used for other transitions, such as diagnosis, a divorce or leaving care [synthesis].

4.14 Marks on and under the skin: scars, birthmarks, injuries

Purpose. Let the body's history (the marks it carries) become speakable. [ASRU manual; Gunn 2018; Gastaldo et al. 2012; TICAH]
Steps.
1. ASRU: mark birthmarks, scars, moles and other marks, and tell the story of each.
2. Gunn "skin":
  - give 10 minutes of information on the skin's layers, colour and marks;
  - participants mark their scars and marks on an A4 copy of a human outline (20 min), then on the card (30 min), with a word for each, in coloured pencil;
  - skeleton and muscles: a short teaching input, then fractures and injuries marked on A4 first and then on the card. Gunn colours fractured bones white and lacquers them.
3. Gastaldo et al.: brainstorm issues at work and turn them into symbols. Then scan the body for scars, injuries, pain or stress, and discuss what the person does to stay healthy.
4. TICAH: discuss the physical and emotional effects of trauma, if helpful with an anatomical model. Maps often combine literal marks (a broken bone) with symbolic ones.
Example language (illustrative). "Some marks we were born with, some came later. Which ones have a story you'd like on your map? You choose how much of the story goes with it."
Watch for. Trauma memories (torture, assault, accidents) flooding in. The A4 rehearsal step creates useful distance before committing to the large map. Pace the work, offer breaks, and have the counsellor available (see section 5). Working sign: the person can name the mark and its story with feeling but without being overwhelmed.

4.15 Body systems teaching and mapping illness or internal pain

Purpose. Health literacy, and representing illness and internal experience. Linking life events to the body was central to the original HIV treatment-literacy aim. [ASRU manual; Gunn 2018; MacGregor 2009 abstract]
Steps.
1. ASRU:
  - mark internal pain, operations or organ damage;
  - mark illnesses such as TB or heart or liver problems, using an anatomical reference;
  - optionally, discuss your last illness;
  - map the effects of HIV, including opportunistic infections and how each was treated.
2. Gunn: short teaching inputs on body systems, each followed by marking on A4 and then on the card:
  - respiratory, digestive and circulatory systems (day 3), with conditions such as stroke, HIV/AIDS or acid build-up shown creatively;
  - reproductive and urinary systems (day 4).
3. ASRU sensitivity rule: drawing sexual organs may cause embarrassment, so an "x" can be used instead.
4. The ASRU Visual Body Map workshop adds a fuller HIV curriculum: cells, immune system, transmission, CD4, viral load, ART, adherence. It uses role plays such as a balloon flu virus and a lock-and-key analogy.
Example language (illustrative). "Here's a simple picture of the lungs and heart. Is there anything that has happened in yours (an illness, an operation, a pain) that you want to show?"
Watch for. Medical misinformation. Have accurate material ready, and refer medical questions to the treating clinicians [synthesis]. Body maps are an adjunct, never a substitute for medical care [synthesis].

4.16 Drawing the illness or virus

Purpose. Externalise and confront the illness. [Solomon interview 2023]
Steps. Solomon gives no step-by-step for this exercise in the interview; only its aim and its importance are reported. Treat it as an extension of 4.15: invite the person to give the illness or virus a form, colour and place on the map, alongside their strength symbol and treatment [synthesis on the steps].
Example language (illustrative). "If the illness had a shape and colour, what would it look like, and where is it in relation to your strength and your medicine?"
Watch for. Morgan, a psychologist, objected that drawing the virus could re-traumatise. Solomon went ahead and calls it "the most important pivotal exercise" [Solomon interview 2023]. The sources disagree here [uncertain]. Use it only once strength and support layers are in place, and stop if it brings fear rather than mastery [synthesis].

4.17 Emotions on the body

Purpose. Locate feelings somatically, and give words to emotional pain. [ASRU manual; Gunn 2018]
Steps.
1. ASRU, early: mark where you feel emotional pain, before the strength point (4.9).
2. ASRU, later: mark emotions on the body, with a sentence for each.
3. Gunn "psychosocial conditions" (day 4): give 30 minutes of information on anxiety, depression, insomnia and stress-related problems. Participants write about their own experience, then add it to the map (60 min).
4. School version (Sheffield RSE pack, Years 10–11): on an outline, mark in colours or symbols where you feel pleasure, pain, shame and pride. Turn the outline into a person, then discuss: markers in unexpected places, several markers in the same place, and how identity (gender, ethnicity, faith, disability, size) shows on the map. Pupils keep their reflections private, and support is signposted.
Example language (illustrative). "When you feel sadness, or fear, or anger, where do you notice it? Put a colour there and one sentence about it."
Watch for. Alexithymic or dissociated clients who "feel nothing anywhere". Accept a blank, or start with physical sensations such as warm, tight or heavy [synthesis]. Working sign: the person connects a place in the body with a life event.

4.18 Body scanning for challenges and strength

Purpose. Name structural stressors and find where strength lives in the body. [Gastaldo et al. 2012]
Steps.
1. Identify challenges linked to status, race, gender or access to services (about 15 min).
2. Find where your strength is located in the body and represent it there.
Example language (illustrative). "What in your situation pushes on you: rules, racism, money, services? And where in your body is the part of you that keeps going?"
Watch for. Systemic injustice framed as personal failure. Name it as structural. Working sign: the challenges are named alongside a clear strength location.

4.19 Group discussion: illness, risk and stigma

Purpose. Peer education, and reducing stigma. [ASRU manual]
Steps. Discuss what makes illness more or less likely, which illnesses are common, rare or feared, and any stigma they bring.
Example language (illustrative). "Which illnesses do people around you fear most, and what do they say about people who have them?"
Watch for. Shaming of people who are present. The ASRU manual reminds facilitators that HIV-positive people may be in the group. Remind people that disclosure is their choice [ASRU manual].

4.20 Hopes for the future / drawing the future

Purpose. Orient forward. [TICAH; Gunn 2018; Gastaldo et al. 2012; ASRU manual: "draw your imagined future"]
Steps.
1. Gunn (day 5): write about hopes (30 min), make a conceptual drawing on A3 in colour (60 min) and share it (30 min). Add the drawing, with a few key words, to the top-right corner. Finish all sections, then paint the inside of the body in a colour that contrasts with the shadow.
2. Gastaldo et al.: show a goal or vision, and place it where on the map it would come true (about 10 min).
Example language (illustrative). "Picture something you want for yourself a year from now. Where on your map does it belong?"
Watch for. Hopelessness or a foreshortened sense of the future. Accept small, near-term hopes [synthesis]. Do a suicide-risk check if the person cannot picture any future (see section 5).

4.21 Personal slogan / message to others

Purpose. Distil an identity statement or a public voice. [ASRU manual: "write a personal slogan"; Gastaldo et al. 2012: slogan, then message to the public]
Steps.
1. Gastaldo et al., homework 1: create a personal slogan. Next session, explain it and choose where it goes on the map (10 min).
2. Homework 2: prepare a message to the public about your current situation. Next session, state it and place it on the map. The facilitator helps make it concise (5 min).
Example language (illustrative). "If your map could say one sentence to the people walking past it, what would it say?"
Watch for. Pressure to produce an upbeat message. De Jager et al. flag the risk of being pushed to tell a positive story. Accept angry or ambivalent slogans.

4.22 Homework between sessions

Purpose. Extend the reflection and save session time. [Gastaldo et al. 2012; Gunn 2018]
Steps.
- Gastaldo et al. set a symbol and slogan, then a message, between their three sessions.
- Gunn sets daily tasks: underline supportive people in the journal, and keep writing if you wish. These lists feed the shadow (4.6).
Example language (illustrative). "Before next time, jot down anyone who's helped you, even once."
Watch for. Homework not done. Do it together at the start of the next session; never shame [synthesis].

4.23 Daily recap, check-out and written evaluation

Purpose. Contain each session and gather feedback. [Gunn 2018]
Steps.
1. Start each day with a recap.
2. End each day with a 10-minute check-out: one word for how you feel.
3. On the last day, a 30-minute written evaluation with open questions: what you learned about yourself and others, favourite and least favourite exercises, whether you will keep writing, and how you feel about the map as a memorial.
Example language (illustrative). "One word for how you're leaving today."
Watch for. Check-out words that signal distress. Follow up individually before the person leaves [synthesis].

4.24 Finishing and decorating

Purpose. Integrate the layers into a whole. [Gastaldo et al. 2012; Gunn 2018]
Steps.
- Add final details and connecting lines.
- If time runs out, the facilitator notes the changes the person wants and completes them later, as the person directs [Gastaldo et al.].
- Gunn: paint the inside of the body in a colour that contrasts with the shadow.
Example language (illustrative). "Step back and look. Is anything missing, or anything you want to join up?"
Watch for. Perfectionism. Map time running out for people who work slowly.

4.25 Testimonio: the maker's own story

Purpose. Turn the map into a first-person story, told as the maker wants others to hear it. [Gastaldo et al. 2012; Solomon's model per de Jager et al. 2016]
Steps.
1. At the end of the last session, the person looks at the finished map and tells their story (about 10 min). Record it with consent.
2. In Gastaldo et al.'s research version, the facilitator later edits it into a short first-person text for a general audience, drawing on the interviews.
3. In therapy, have the client approve or co-write any written version [synthesis].
Example language (illustrative). "Looking at your map, tell your story the way you'd want someone who has never met you to hear it."
Watch for. A facilitator's edit that drifts from the maker's meaning. Check it back with them.

4.26 Body map key

Purpose. Make the map readable on the maker's own terms, since the same symbol means different things to different people. [Gastaldo et al. 2012]
Steps.
1. Write a first-person key describing each element (a symbol, colour or slogan) and what it means to the maker.
2. Gastaldo et al. note that full recordings and transcripts are essential for an accurate key.
3. Check the map and key for identifying details before photographing or digitising them.
Example language (illustrative). "Let's go round your map piece by piece. Tell me what each part means, and I'll write it in your words."
Watch for. Writing your own interpretation into the key. The rule is: the maker's words only.

4.27 Presentation and witnessing

Purpose. Be witnessed, and own the story. [ASRU manual; Gunn 2018; TICAH]
Steps.
1. ASRU: prepare a 5–10 minute presentation.
2. Gunn (90 min):
  - set the chairs in a horseshoe;
  - two participants hold up the map as a backdrop while its maker tells their story from beginning to end;
  - the recruiting organisation and stakeholders may attend;
  - take a group photo only with consent.
3. TICAH: hang the maps. Each artist explains their map and how it felt to make it, and each explanation is recorded. Any group member can veto an outside invitation to the exhibition, and some groups invite no one.
Example language (illustrative). "Take us through your map. We're here to listen, not to comment."
Watch for. Shame or regret about exposure. Offer a private showing to the group only. Some participants later choose public action [TICAH].

4.28 Giving-thanks circle

Purpose. Close the group relationally. [Gunn 2018]
Steps. Stand in a circle. Each person in turn thanks each of the others, moving clockwise (30 min).
Example language (illustrative). "Turn to the person next to you and thank them for something they gave this group."
Watch for. Conflict that has not been resolved. Address it before the circle [synthesis].

4.29 Ownership, storage and exhibition decisions

Purpose. Respect authorship and protect participants. [Gastaldo et al. 2012; TICAH; Gunn 2018; Solomon interview 2023; de Jager et al. 2016]
Steps.
1. Decide how photos may be used, what follow-up there will be, and whether maps go home or into storage [TICAH].
2. Roll maps into cylinders and hand them to the organisation responsible for safekeeping. Encapsulating them is optional and costly [Gunn 2018].
3. Be ready to renegotiate who keeps the original, since makers often become very attached to their maps [Gastaldo et al.]. Gastaldo et al. did not let maps go home because of participants' immigration status.
4. Strip identifying data and metadata from digital images (GPS, names) [de Jager et al.].
5. In Solomon's project, participants were authors who held copyright and were paid an artist's fee when their work was exhibited [Solomon interview 2023].
Example language (illustrative). "This is your map. Do you want to take it home, have us store it, or show it somewhere? You can change your mind later."
Watch for. A clinician keeping maps as clinical records. Agree with the client how the map is kept and documented under your record-keeping rules [synthesis].

4.30 Group body map and social-support hand maps (ASRU Visual Body Map workshop)

Purpose. Group-level health education, and mapping disclosure and support. [ASRU manual]
Steps. The manual lists a group body map in session 1 and social-support hand maps with disclosure work in session 5. Detailed steps were not extracted from the source [uncertain]. Do not run them from this guide without consulting the manual.

4.31 Before-and-after body map (youth work evaluation tool)

Purpose. Light-touch qualitative evaluation of change across a programme, also usable as an icebreaker. [SAGE youth work evaluation tool]
Steps.
1. Draw around each young person.
2. Inside the outline, write who they are: likes, family, home, favourite saying, friends, what makes them happy.
3. Mark how they are applying the course aims, in a separate colour.
4. Outside the outline, write things they want but don't yet have.
5. Photograph the maps, then name and date them.
6. At the end of the programme, tick the outside words now achieved and add Post-its for changes. Ask what helped them change.
Example language (illustrative). "Which of the words outside your body have moved inside since we started?"
Watch for. This is an evaluation tool, not therapy. The source does not cover consent for display; get it [synthesis].

5. Handling problems

Tags: [source] = guidance from a cited source; [synthesis] = my own clinical guidance.

Can't or won't lie down to be traced, or proximity triggers fear.
- Trace a few inches away from the body, or skip sensitive areas and draw them in once the person is standing; any posture is acceptable, including face-down [source: Gastaldo et al. 2012].
- Offer a table for older or disabled participants [source: Gunn 2018].
- Other options: tracing while standing against a wall; tracing only the head and shoulders; a template outline; or the client drawing their own outline [synthesis].
"I can't draw", or freezing at a blank sheet.
- Artists help on request but never make the work [source: TICAH; Gunn 2018].
- Use clip-art binders or magazines instead of drawing [source: Gastaldo et al. 2012].
- Do a warm-up on colour meaning first [source: Gunn 2018; TICAH].
- Offer words-only layers [synthesis].
Overwhelm, flashbacks or tears during trauma layers (scars, torture, rape, virus).
- Plan ahead:
  - start with positive material and alternate difficult with good [source: TICAH];
  - a counsellor observes, steps in during hard conversations and stays available afterwards [source: TICAH];
  - have a clinical psychologist on hand [source: Gunn 2018];
  - provide referral lists [source: Solomon interview 2023];
  - check in regularly and offer breaks [source: Gastaldo et al. 2012].
- In the moment [synthesis]:
  - stop making;
  - ground the person with feet on the floor, orienting to the room, and looking at the strength symbol and the shadow;
  - lower the intensity: make the mark smaller or symbolic, rehearse on A4 first, or work outside rather than inside the body;
  - offer to leave that part of the map blank;
  - before the person leaves, check that they are back within their window of tolerance and assess risk.
- De Jager et al. note body mapping may be unsuitable for trauma survivors in research settings. In therapy, stabilise first [synthesis].
Dissociation. Signs include a blank stare, a monotone voice and losing time, especially while lying down or working on body layers. Respond with orienting questions, sitting up, sensory anchors and briefer layers. Consider deferring the internal-body layers until the client can stay present [synthesis].
Suicidal content or a foreshortened future in the hopes layer. Run a standard risk assessment and safety planning. If means come up, counsel only on storage and removal of means. Do not end the session with the risk unaddressed [synthesis].
Disclosure of abuse or ongoing harm, especially by children. Follow local safeguarding and mandatory-reporting procedure; schools should follow their own procedures [source: Sheffield RSE extract]. Never treat the map itself as evidence: record what the child said, not your reading of the drawing [synthesis].
Embarrassment about sexual or reproductive organs. Use an "x" instead of a drawing [source: ASRU manual]. Consider same-gender groups [source: Gunn 2018]. Rape-survivor groups came to rape directly only on day 3 [source: TICAH].
Domination, interrupting or breaches of confidentiality. Return to the posted ground rules: equal speaking time, no one dominating, nothing repeated outside the room [source: Gunn 2018; TICAH].
Non-attendance, or falling behind.
- Gunn's rule: one missed day can be negotiated; two means withdrawing [source: Gunn 2018].
- Give extra help to those lagging behind on later days, and keep supporting those who finish late [source: Gunn 2018].
- The facilitator finishes requested changes afterwards, as the maker directs [source: Gastaldo et al. 2012].
- Individual therapy: add a session rather than rushing the work [synthesis].
Pressure to tell a positive or 'activist' story. De Jager et al. warn of this [source]. Say explicitly that ambivalent, angry or unfinished maps are welcome, and do not reward only uplifting testimonios [synthesis].
Feeling the facilitator is steering content (a rupture). Solomon's stance is never to tell people what to do [source]. Repair [synthesis]:
- name it: "I think I pushed my idea onto your map";
- hand the choice back;
- offer to paint over or remove the suggestion.
Ownership conflicts, attachment to the map, or regret about display. Renegotiate who keeps the original [source: Gastaldo et al. 2012]. Revisit ownership one or two times during the work [source: TICAH]. Allow consent to display to be withdrawn up to the point of public release [synthesis].
Safety or political risk from being identified (torture survivors, undocumented people).
- Remove names, faces and places [source: Gastaldo et al. 2012].
- Protect participants from repercussions [source: Gunn 2018].
- Allow a veto on outside guests [source: TICAH].
- Plan for participants who find detention easier to discuss than the political activity behind it, and who fear that leaks by their torturers have damaged trust [source: TICAH].
Cultural mismatch (colour meanings, rituals, body taboos). Colour meanings come from the group, and contradictions are accepted [source: Gunn 2018]. Use ritual only if the group owns it, otherwise a neutral bell or song [synthesis; TICAH lists the substitutes].
Medical questions or health anxiety raised by the anatomy layers. Give accurate basic information and refer to the treating clinicians. Do not interpret symptoms [synthesis].
Physical safety. Washable, non-toxic paints and gloves [source: Gastaldo et al. 2012]. Floor protection and space between maps [source: Gunn 2018]. Ventilation for sprays and lacquer, cushions for kneeling, care getting up off the floor, and stain-proof clothing [synthesis; Gunn advises old clothes].
Vicarious impact on facilitators. Hold debriefing meetings for the facilitation team [source: Gastaldo et al. 2012]. Arrange supervision [synthesis].
Using it in individual psychotherapy (not covered by the sources). Spread the layers across sessions; keep the map safe between sessions; process each layer before adding the next; and clarify that the map is therapeutic material, not an assessment [synthesis].

Sources

Sources

Further reading (not drawn on) [uncertain]

Solomon, J. Living with X: A body mapping journey in the time of HIV and AIDS. Facilitator's guide. REPSSI. Sources date it 2002, 2007 or 2008. Its content is described here only through Gastaldo et al. (2012), Gunn (2018) and de Jager et al. (2016).
MacCormack, C. & Draper, A. (1987), cross-cultural study of fertility and women's identity in rural Jamaica and the UK. Cited through de Jager et al. (2016) as the first recorded whole-body maps.
The Long Life book of Bambanani Women's Group body maps (Morgan and colleagues, about 2003). Referred to in the Solomon interview and the ASRU manual; not drawn on.

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