Art Therapy

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Intro to Art Therapy

For many people, the idea of therapy conjures up the image of lying on a couch or sitting in a chair in an office talking to a “shrink.” However, while many people find healing in the various kinds of talk therapy, others might find that idea boring or unhelpful and may benefit from more creative ways to express and discover themselves either instead of or as an adjunct to traditional talk therapy. If this idea resonates with you, you might find art therapy of interest.

The term “art therapy” was first used in1942 by Adrian Hill in the UK after experiencing the healing effects of art while undergoing treatment for tuberculosis. Art therapy then began to spread around Europe and the US. So, what is art therapy? It’s more than just coloring books and doodling, and no artistic skills or talent are required. It can involve a wide variety of techniques in any domain of creative expressions, such as visual (drawing, painting, collage, coloring) music (listening to or creating music, drumming, singing), tactile (sculpting, ceramics, sand tray), writing (poetry, storytelling), movement (dance, Tai Chi, yoga), drama (acting/role-playing, puppeteering), or ritual (ceremonies, offerings, sacred rites). It’s a creative approach to therapy that allows for nonverbal communication and the processing and release of stored emotions that can benefit people of all ages and life stages (child, adolescents, adults, geriatric, and terminally ill). It can improve psychological symptoms such as depression and anxiety, boost self-esteem, reduce stress, help manage disorders such as PTSD, substance abuse, or eating disorders, or help someone cope with disability or physical illness.          

Art therapy is a therapeutic alternative that enables individuals to express themselves creatively to explore psychological and emotional symbolism in their art. A certified art therapist can guide you to understand the deeper meaning in your art as a tool to resolving trauma, conflicts, and other psychological or physical afflictions. Art therapy is based on the premise that art can heal. If you resonate with the idea that art can be deeply healing and nourishing, then read on to learn more and how to find a qualified guide.

Origins of Art Therapy

People have been creating art since prehistoric times, and the healing properties and catharsis evoked by the arts have been informally recognized for millennia. However, art therapy as a formal discipline is a recent development founded in England in the 1940s. Adrian Hill is credited with founding the field after experiencing the therapeutic benefits of art himself while recovering from tuberculosis, and he coined the term “art therapy” in 1942. Hill was an artist, author, educator, broadcaster, veteran, and, ultimately, art therapist. He then began devising methods to share this experience with others battling tuberculosis. By 1945, he published a book on his work, Art Versus Illness. Further, the National Association for the Prevention of Tuberculosis had implemented art therapy programs in more than seventy hospitals and medical facilities.  Edward Adamson (who was also in England) further advanced Hill’s work by offering art therapy in inpatient psychiatric institutions. Margaret Naumburg and Edith Kramer helped bring art therapy to the United States in the 1940s. Kramer primarily worked with children and adolescents, using art therapy to help them express emotions they often had difficulty putting into words. Naumburg was especially influential in promoting art therapy among psychoanalysts who were receptive to her beliefs that art’s symbolic value was worthy of analysis and could help reveal the contents of the unconscious mind. Since art therapy is a hybrid approach that merges the disciplines of psychology with the arts, it continues to evolve as it is adapted to other types of therapy and alternative healing practices.

Some therapeutic modalities art therapy has been influenced by and/or has influenced include:

Psychoanalysis | Gestalt Therapy | Play Therapy | Person-Centered Therapy | Mindfulness-based Cognitive Therapy (MBCT) | Recreation Therapy

Summary of Art Therapy: What is Art Therapy?

The main premise of art therapy is that art is healing. Although there is a difference between art therapy and expressive arts therapy, this article will include both to give you a more general sense of the available services available. Art therapy in its purest form refers to the use of techniques from the visual arts in therapy (e.g., drawing, painting, sculpting, finger painting, carving, making collages, etc.). Expressive arts therapy is inclusive of all the arts, also extending to music/rhythm, dance/movement, drama, and ritual.  

Some art therapists may approach art therapy as a type of depth psychology, believing that the unconscious contents of the psyche are symbolized in the art and projected onto the relationship between the client and the therapist through the art. The two primary types of depth psychology include psychoanalysis (Freudian) or analytic psychology (Jungian). In these approaches, the focus is on the therapist’s interpretation of the client’s process and art. Other art therapists may approach art psychotherapy from a more client-centered perspective and instead focus their interpretation on the client’s verbal descriptions of their artwork. Lastly, other art therapists are less focused on analyzing the art and instead focus more on the creative process as healing. 

Regardless of the form or approach, art therapy is used to help various psychological and psychosomatic disorders, such as:

∙ Depression

∙ Anxiety

∙ Trauma/PTSD

∙ Substance abuse and addiction disorders

∙ Eating disorders

∙ Psychotic disorders

In additions to reducing symptoms associated with mental health disorders, art therapy is also used for alleviating subclinical ailments such as:

∙ Reducing stress/tension

∙ Reducing self-harming behaviors

∙ Improving self-esteem

∙ Improving social skills

∙ Promoting relaxation and wellbeing

Art therapy can also improve symptoms associated with physical and medical conditions, such as:

∙ Alzheimer’s disease  

∙ Pain management/physical tension

∙ Head injuries

∙ Developmental and intellectual disabilities

∙ Physical disabilities

∙ High blood pressure/heart rate

Because art therapy is so diverse in form and application, its benefits and how it works may vary. Most generally, whatever the form, it can reduce stress and agitation, and it can be a mindfulness practice that helps bring one’s attention to the present moment. On the other hand, it can be a great distraction technique for chronic conditions that can reduce the experience of pain. Although art can be relaxing, it can also be energizing, as when using dance/movement therapy, for example. It can also promote motivation toward physical therapy goals by making the exercises more fun. Art therapy is also often used in group therapy settings, which can help to improve self-esteem and social skills.         

Art therapy can be beneficial to individuals working through trauma. The act of coloring, for example, can help a person to stay grounded and present while talking about difficult experiences so that they can process traumatic memories. Moreover, art is an excellent tool for projection, so clients can manipulate artwork symbolic of their traumas as a means of working through it. This externalization of the trauma can also help clients feel safe in their own bodies while accessing and working through traumatic memories.   

Trauma is often at the root of substance abuse and addiction, and art therapy can also be a powerful tool for treating these struggles. The combination of art and therapy facilitate self-exploration into denial, compulsive behaviors, depression, or other factors that perpetuate substance abuse and addictive behaviors. Clients also find other means to feel good without using mind-altering substances. 

Art therapy, especially music therapy, can help to improve memory in dementia patients. Music therapy was studied in this way by Dr. Oliver Sacks. The following video illustrates the seemingly miraculous recovery of memory and sense of self, at least temporarily, by patients with dementia: 

https://www.youtube.com/watch?v=8HLEr-zP3fc&t=185s

If this video interests you and you would like to see more, these video clips were taken from the documentary Alive Inside: A Story of Music & Memory.

Although art therapy sessions may not have any specific structure or rules, here is an idea of what a few types of art therapy might be like:

 Visual/tactile art:  This might include drawing, painting, coloring, doodling, creating collages, sculpting, woodworking, ceramics, or using some other medium. There might be a prompt or theme, or clients might be encouraged to create freely from their imagination and feelings.

Music therapy:  Clients might create a playlist of their favorite music and explore thoughts, memories, feelings, or other evoked associations. Alternatively, a client might play an instrument, such as a drum, to create sounds representing their feelings.       

Movement/dance:  The body stores memories and traumas. Dance or other types of movement can allow for the processing and releasing of memories stored at the somatic level. The movement can be choreographed as in a dance or acting, or it can be free form, letting the body take the lead to express itself in whatever way feels right.      

Creative writing:  This might include writing poetry, autobiographical narratives, or other storytelling forms. 

Art therapy can combine any or all of these techniques with various other therapeutic approaches and modalities. For example, an art therapist might have a client make a mask that expresses feelings they are working through and have that client wear that as they pretend to speak with people in their lives to whom they wish they could express this part of themselves (a technique borrowed from Gestalt therapy). Or, they might make several masks that represent different parts of themselves and wear these masks as a means of allowing different, possibly conflicting, aspects of themselves to communicate (this concept is adapted from Internal Family Systems therapy).  

In addition to the improvements in symptoms and psychological wellbeing, there are physiological benefits of art at the neurological level. Creating art promotes whole-brain thinking, and functions are more widely distributed throughout the brain. This has been shown to be beneficial in stroke survivors. For example, artists (who often engage in whole-brain thinking) were less affected by the stroke and recovered more quickly than non-artists. Dance not only promotes cardiovascular health but can also improve coordination and balance. Playing an instrument or drawing can fine-tune motor skills.

Art therapy has even been shown to help people manage chronic pain and recovery. Although it may not eliminate the pain or need for pain medication, it can help reduce the stress and anxiety it often causes by shifting the focus from the painful stimuli to something more relaxing and enjoyable. Thus, engaging in creative activities can empower individuals who suffer from chronic or temporary pain to improve their mood, emotional state, and quality of life.

It’s important to emphasize that no artistic skills or talents are required to benefit from art therapy. It’s about the process, not the product. Sometimes words aren’t adequate to communicate a feeling or memory. Sometimes a feeling or memory isn’t even consciously accessible. Art provides the body and the unconscious mind a medium to communicate things that might be preverbal, repressed, or somaticized.     

Ultimately, the philosophy underlying art therapy is that artistic self-expression has therapeutic value, and an art therapist can assist their clients in understanding the deeper meaning in their art as a means of healing and self-discovery. An art therapist is trained to interpret how color, texture, form, and other visual components of one’s art relate to their thoughts, emotions, personality, symptoms, or other psychological phenomena. 

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Research & Science Supporting Art Therapy

Although art therapy has been formally practiced as a therapeutic modality since the early 1940s (approximately 80 years at the time of this writing), the research is relatively sparse and often lacks rigor (e.g., randomized controlled trials). However, the research that has been done is promising.

Art Therapy for Depression and Anxiety:

Art therapy research shows that creating art can stimulate the release of the neurotransmitter dopamine. Dopamine release is associated with pleasurable and goal-oriented activities. Thus, it seems that art therapy helps improve mood by increasing dopamine levels in the brain, which can be especially helpful to individuals struggling with depression or anxiety. More can be read about this at: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041074/ 

Literature Review on the Effectiveness of Art Therapy:

Regev and Cohen-Yatziv (2018) conducted a comprehensive art therapy literature review of research from 2000 to 2017. Their paper examined 27 studies on the effectiveness of art therapy for adults of those articles reviewed. They divided the art therapy clientele into seven clinical groups: “cancer patients, clients coping with a variety of medical conditions, mental health clients, clients coping with trauma, prison inmates, the elderly, and clients who have not been diagnosed with specific issues but face ongoing daily challenges.” Their findings were supportive of the potential healing effects of art therapy for these populations. You can read more about their study here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124538/

The Seeker Experience

First, it’s important to know that to call oneself an art therapist, one must complete a Master’s degree in art therapy, complete clinical training, and become licensed. A qualified art therapist will have the credentials ATR (Registered Art Therapist), ATR-BC (Board Certification (ATR-BC), or ATCS (Art Therapy Certified Supervisor) after their name (e.g., “John Smith, ATR-BC”). However, some therapists may use art therapy techniques without an art therapy certification. Such therapists may vary in their level of education and training. Some therapists may informally use art as part of their work, while some doctoral-level programs offer an art therapy specialization. However, be wary of anyone claiming to be an art therapist who doesn’t at least have a Master’s degree and some type of clinical license.  

Art therapists can vary greatly in background, style, and approach. Some art therapy practitioners specialize in one type of therapy and may have gone to a school to be trained solely in that form. There are specialized programs in music therapy, for example, so these practitioners would exclusively offer music therapy. When seeking an art therapist who would be a good match, consider if you are drawn to a particular type of artistic expression or therapy style. For example, if you enjoy dancing, you might seek an art therapist specializing in using dance as part of therapy and who has studied somatic therapy.  

Art therapists work in a variety of settings, including:  

∙ Private practice

∙ Hospitals, psychiatric hospitals, and clinics

∙ Community agencies

∙ Substance abuse rehabilitation facilities

∙ Crisis centers

∙ Nursing homes, senior communities

Finding a Guide & Guide Perspectives

While it can be extremely helpful to have professional guidance with the IFS process, the ultimate goal is self-practice.

There are many books, meditations, and other resources available to help individuals access Self, work with (and ultimately unburden) their parts, and create a harmonized internal family. A practitioner is recommended when beginning, when struggling to unblend from parts, and/or when working with particularly challenging parts. It can also be greatly beneficial to have someone there who sees your blind spots and can skillfully guide the process.

In sessions with IFS practitioners, you may be guided into a relaxed, meditative state, asked to drop your awareness into your body, and explore whatever emotions, sensations, or parts arise. They may address your parts directly or work through you and your Self in a more indirect way. The individual will be communicating and relating directly with these parts to learn more about them, what their role is, what it enjoys or doesn’t, how it feels about other parts, etc… It’s common that our parts don’t realize how old we are and that we’re not stuck in the past – so bringing them up-to-speed in a soft, compassionate way is also part of the general process.

Here are a few personal experiences shared by Seekers who have been through IFS therapy:

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— Kate Arthur

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— Sara Summers

Sorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, Lorem Ipsum is simply dummy text of the printing and typesetting industry.

— Anna Nurse

Potential Drawbacks/Criticisms

As with any form of therapy, uncomfortable or painful memories may arise that are difficult to deal with. This risk is minimized by finding a supportive, qualified art therapist with whom you feel safe.  

Some critics demean art therapy without an accurate understanding of what it is. For example, some people dismiss it as “fingerpainting” or “coloring” and doubt its potential as a viable therapeutic modality.  

Another criticism of art therapy is its lack of evidence-based research. On the one hand, there are ample quasi-experimental and qualitative studies that support the effectiveness of art therapy for many different types of people and disorders. On the other hand, however, the current gold standard in psychological research requires randomized control trials (RCT) to be employed to determine a treatment’s efficacy. Unfortunately, RCT studies are largely lacking in the art therapy literature.

Lastly, as mentioned in the previous section, “Finding a Guide and Guide Perspectives,” there are unlicensed or untrained practitioners who claim to be art therapists but are not. Negative experiences with a practitioner who is not adequately qualified may reflect poorly on the field as a whole.   

Works Cited

Adrian Hill. En.wikipedia.org. https://en.wikipedia.org/wiki/Adrian_Hill. Published 2021. Accessed February 3, 2021.

About Art Therapy. American Art Therapy Association. https://arttherapy.org/about-art-therapy/. Published 2021. Accessed February 3, 2021.

Art therapy. En.wikipedia.org. https://en.wikipedia.org/wiki/Art_therapy. Published 2021. Accessed February 3, 2021.

Art Therapy. Psychology Today. https://www.psychologytoday.com/us/therapy-types/art-therapy. Published 2021. Accessed February 3, 2021.

Art Therapy – Addiction Center. Addiction Center. https://www.addictioncenter.com/treatment/art-therapy/. Published 2021. Accessed February 3, 2021.

Art therapy: Definition, uses, and how it works. Medicalnewstoday.com. https://www.medicalnewstoday.com/articles/art-therapy#what-it-is. Published 2021. Accessed February 3, 2021.

Connecting with My Experience through Art Therapy -. Beatingeatingdisorders.com. https://beatingeatingdisorders.com/2016/11/29/connecting-experience-art-therapy/. Published 2021. Accessed February 3, 2021.

Creativity and Recovery: The Mental Health Benefits of Art Therapy. Resources To Recover. https://www.rtor.org/2018/07/10/benefits-of-art-therapy/. Published 2021. Accessed February 3, 2021.

Creativity From Within. 2021. Risks Associated with Art Therapy | Creativity From Within. [online] Available at: <http://www.creativityfromwithin.co.uk/?q=content/risks-associated-art-therapy> [Accessed 3 February 2021].

Goodtherapy.org. 2016. Art Therapy. [online] Available at: <https://www.goodtherapy.org/learn-about-therapy/types/art-therapy/> Published 2021. Accessed February 3, 2021.

How Art Therapy Can Heal PTSD. Healthline. https://www.healthline.com/health/art-therapy-for-ptsd#How-to-find-the-right-art-therapist. Published 2021. Accessed February 3, 2021.

London Art Therapy Centre. 2021. Adrian Hill, UK founder of Art Therapy by Morgan Bush, Intern. [online] Available at: <https://arttherapycentre.com/blog/adrian-hill-uk-founder-art-therapy-morgan-bush-intern/> [Accessed 3 February 2021].

Patterson, E. 2020. Art Therapy: How It Works & What To Expect. [online] Available at: <https://www.choosingtherapy.com/art-therapy/> Accessed February 3, 2021.

Petcu E, Sherwood K, Popa-Wagner A, Buga A, Aceti L, Miroiu R. Artistic Skills Recovery and Compensation in Visual Artists after Stroke. Front Neurol. 2016;7. doi:10.3389/fneur.2016.00076

Psychology Today. 2021. Art Therapy’s Achilles Heel. [online] Available at: <https://www.psychologytoday.com/us/blog/arts-and-health/201404/art-therapy-s-achilles-heel> [Accessed 3 February 2021].

Solan M. Art therapy: Another way to help manage pain – Harvard Health Blog. Harvard Health Blog. https://www.health.harvard.edu/blog/art-therapy-another-way-to-help-manage-pain-2018071214243. Published 2021. Accessed February 3, 2021.

The Powerful Psychological Benefits of Dance. Psychology Today. https://www.psychologytoday.com/us/blog/the-athletes-way/201805/the-powerful-psychological-benefits-dance. Published 2021. Accessed February 3, 2021.

The Tutu Team. My own personal experience of having Art Therapy. The Tutu Project. https://thetutuproject.com/my-own-personal-experience-of-having-art-therapy/. Published 2021. Accessed February 3, 2021.