Art Therapy: A Creative Alternative to Talk Therapy

Who becomes an Art Therapist?

A registered art therapist has completed a master’s degree and post graduate training, practicum, and clinical supervision. The recognized certification for Art Therapists is an ATR, which stands for Registered Art Therapist. Like other disciplines in mental health, Art Therapists must undergo continuing education in ethics and scope of practice as well as ongoing supervision after completing their formal educational training. They work in a wide range of settings, including hospitals, community mental health, and private practice, with a variety of different populations and mental health needs.

Art Therapy and the Triune Brain:

At the NC Center for Resiliency, we utilize and draw from experiential approaches such as art therapy due to their compatibility with somatic treatments. Somatic approaches, as the name suggests, focus on functions of the body and use the body as a resource for psychological healing and regulation of the autonomic nervous system, which regulates bodily functions that include our fight, flight, freeze survival responses. Unlike traditional “talk” therapy, which tends to focus on words and cognition, somatic therapists highlight sensation, a “felt sense”, and gross motor movements, which are manifestations of the autonomic nervous system. Because art therapy uses the creative process, which can be spontaneous, it allows for access to parts of the brain that may not be immediately accessible through language.

To understand this latter point, it may be helpful to briefly highlight neuroscientist Paul Maclean’s concept and term the “triune brain.“  While Dr. Maclean’s term is a highly simplistic conception of how the brain functions, it is a helpful concept for a lay audience because it distinguishes between the “top, middle, and bottom” parts of the brain and describes the general purpose those areas of the brain serve in terms of human behavior, physiological functioning, and emotional experience, expression, and processing.

Take the neocortex for example. Located literally at the top of the brain, the neocortex is responsible for organizing our cognition, thought, and executive functioning. Treatments attempting to change cognitions and thoughts, such as Cognitive Behavioral Therapy (CBT), are referred to as “top down” treatments, because they target functions of the neocortex. From this treatment approach, by supporting Clients to change their thinking (e.g., cognitions), they can begin to change the feelings and behaviors those thoughts produce. This approach primarily uses talking to accomplish this task, which is why it is one of the most commonly referenced form of “talk therapy.”

From a somatic perspective, change cannot be limited to thoughts if they are informed by functions of the brainstem or the “bottom” part of the triune brain. The brainstem controls and influences automatic bodily functions, such as our heart rate and breathing. Thankfully, we don’t have to “think” in order to breath, we just do it. In other words, when dysfunctional thinking is the result of an automatic, nonconscious function of the body, changing one’s thoughts about it may not be enough to promote healing.

For example, individuals with panic disorder are commonly frightened by changes in their breath as an indication of a potential panic attack. Simply changing their beliefs about the panic may change the cognitive reaction to the panic attack but does not necessarily address the nervous system response to whatever in the environment is triggering the change in breathing initially. By using somatic interventions, Clients are better equipped to shift their breathing before thoughts and beliefs are triggered in the “top” part of the brain. Thus, relying solely on the “top,” cognitive, portion of the brain is considered insufficient from a somatic perspective, because the brainstem is in operation and responding to our environment before we may have thought something about our physiology. Moreover, many individuals coming to therapy cognitively “know” they are not under threat when they are having a panic attack, or logically understand that whatever danger they endured in the past has ended. Nevertheless, they still feel terrified, disconnected from experience, or confused.

It is in this circumstance that art therapy becomes very helpful, because it is experiential and process oriented, which is inherently a “bottom” up approach. The art therapist’s ability to attend not only to what one thinks about their creative process related to experiences, emotions, and perceptions, but also to foster an embodied and somatically enlivening creative process can activate the brainstem in ways that may not be accessible from purely talking about those experiences, emotions, and perceptions. Of course, there are times when a cognitive approach is certainly warranted with some Clients, and perhaps even preferred by them.

Art therapists can meet the needs of these Clients by using interventions that are more precise, such as pencil or pen. An art therapist may also draw on what is called the “expressive therapies continuum” to assess whether a person who prefers a more precise approach has the preference due to comfort or due to limited access to additional creative processes, such as emotional/affective ones or kinesthetic/sensory ones.

For Clients more comfortable expressing themselves without words, orienting toward symbolic and cognitive creative processes can feel natural and very helpful in negotiating their mental health needs. Additionally, if a Client is looking to expand their experience of self and their expression, an art therapist may invite the Client to use paint or watercolors which are “looser” and allow for more access to affective and perceptual creative processes. As the Client is ready to explore spontaneity and perhaps expand and understand their perceptual and sensory experience, creative processes can included shaving cream, foams, and clay as mediums to explore sensory experiences related to touch or scented mediums to elicit smell in the Client’s exploratory process.

Over the course of treatment utilizing art therapy, Clients will find they now have more access to the entire continuum of experience rather than just functions of the brainstem or neocortex. From a self-regulation-based perspective, this integration is essential. After all the heart of somatic treatment is to increase a Client’s capacity to regulate their autonomic nervous system. Art therapy is one way to do so which is why many somatic approaches, such as Sensorimotor Psychotherapy, Eye Movement Desensitization and Reprocessing, or Somatic Experiencing, draw from art therapy techniques to support regulation in any given treatment.

Summary:

As you can see from the information outlined above, art therapy and other creative interventions can be powerful tools in therapy to support Clients. Where words may be a useful tool in many cases, there are often situations and circumstances when Clients are unable to access them due to responding predominantly to information from the lower part of the brain, rather than the neocortex. Such Clients struggle in therapies which rely solely on talking, especially when they are unable to feel safe due to fear-based responses for which they do not have words, but are reacting to very real physiological responses, nonetheless.  At the NC Center for Resiliency, we support and highlight treatments that use creative processes and artistic modalities due to their tremendous ability to support Clients in finding a sense of safety when words have been found to be insufficient.

Citations:

Dana, D. (2018). The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation, New York, NY: W.W. Norton & Company