Expressive Therapy

Recovering from an addiction, or learning to control a mental health issue, means digging down deep into the mind, and expressive therapy can help this process who struggle with the traditional process. Traditionally, through talking, listening, reading and learning, the patient slowly begins to discover how the process began, why it might have gotten worse, and what can be done to control it in the future. For some people, this process is relatively easy. They have the ability to dig deep, think hard and communicate the lessons they’ve learned. But for other people, this process is slightly more difficult.

Years of drug abuse, or decades of mental illness, can cloud the mind and make it difficult for the person to truly understand the issue at hand. It becomes difficult to determine why the person feels a specific way. The medical issue works as a roadblock to exploration. In addition, some people just aren’t verbal. They think in pictures or in movements, rather than in words or phrases, so describing concepts like longing, cravings or loss in words is difficult, if not impossible.

Expressive therapy is designed to help people just like this. Through expressive therapy, people learn more about themselves, and they may be able to adequately explain their issues to other people, including their therapists. It’s a concept we employ with our patients at Axis, and we’re happy to share the results of our work with you. Please contact us to find out more about how we employ this program at Axis or if you have outstanding questions after reading this article.

Understanding Expression

Expressive therapies can use almost any form of art, but according to a book on the topic written by Cathy A. Malchiodi, these specific forms of art are commonly used within expressive therapy, and they can all be considered their own, distinct forms of therapy:

art therapy

  • Art therapy, in which participants use painting, sculpture, drawing or some other visual medium
  • Music therapy, in which participants use drums, bells or other musical instruments to express their inner emotions
  • Drama therapy, in which participants create their own plays or act in the plays of others
  • Dance or movement therapy, which can include choreographed or free-form dances or movements
  • Poetry or bibliotherapy, involving the writing of poetry or prose
  • Play therapy, involving games or other forms of recreational activities
  • Sand play therapy, in which participants are given access to a sandbox and miniature figurines
  • Multimodal therapy, in which multiple arts are used at the same time

Expressive therapy sessions are facilitated by a licensed therapist. The participants aren’t simply turned loose and allowed to do as they please. While it might be fun for people to take time and interact with art, this sort of loose play can’t be considered therapy. Instead, a therapist is involved in each step of the process, helping the participant to get the most out of the experience.

While individual sessions can certainly vary in structure and format, typically the therapist will ask the participant to answer a question with the project at hand. A person might be asked to draw a self-portrait, write a poem about the day or choose an instrument that sounds the most like the tone in the person’s head right now. As the participant begins to use the tools, the therapist continues to stay on hand, guiding the therapy by asking questions.


Goals of Therapy

As Natalie Rogers wrote in her book Creative Connection: Expressive Arts as Healing, the goal of expressive therapy is not to train the participant to become a great artist. While some people, through the course of their therapy, may very well tap into their inner talent and discover that they have latent skills in the medium of their choice, many people simply don’t have this sort of gift. We all can’t be Van Gogh, after all. But, expressive therapy allows people the opportunity to relax and let go. The conscious mind may drift and relax, and as a result hidden meanings may pop up into view. When the hands are busy, and the conscious mind is disengaged, the hidden messages of the subconscious can sometimes become clearer.

When the art project is complete, those messages from the subconscious mind persist, and they’re exposed in a way that they may have never been exposed before. A man who consistently says, “I am fine. I don’t need therapy,” might be forced to challenge that assumption when his therapist points out that his self-portrait is full of black, purple and red colors that are typically associated with death. A woman who reports feeling relaxed and open might discover that she isn’t being quite truthful when a video of her dance shows her in a hunched, tight and defensive position. This is where the training and expertise of the therapist become vital. Participants may not have the ability to unpack the symbols in the works they create, but therapists have advanced training they can employ to uncover those messages.

For some patients, expressive therapy can help them understand the true damage that substance abuse is having on their minds. For example, a researcher writing in the journal Art Psychotherapy wrote that some addicts find, through art therapy, that they cannot move beyond the simple doodling stage. They may want to be creative, but their addictions block their expressive capabilities. This might allow the therapist a wedge or a talking point that could help that person to become more fully committed to therapy and to resolving substance abuse issues over the long term.

Similarly, expressive therapy can help therapists spot some people who are at risk for a relapse and who may need more help. For example, a study published in the journal Art Therapy: The Journal of the Art Therapy Association found that people who produced drawings containing drugs, drawings that contained no people, or drawings that were noticeably abstract or geometric tended to relapse to drug use more often than people who did not produce these sorts of drawings. Art therapists and psychotherapists can work together to help identify these participants and get them the help they need.


Does It Work?

Expressive therapy has been used in a variety of settings including:

  • Counseling centers
  • Halfway houses
  • Prisons

Expressive Music Therapy While many articles detail the results of one person’s experience with expressive therapy and others outline how the therapies might work, it can be difficult to find peer-reviewed studies that prove that expressive therapies work better than other therapies. In order to truly prove that they work, researchers would have to provide the therapy to one group of people and withhold it from another, and the two sets of people would have to be the same in almost every way. This is extremely difficult to do in the field of addiction, especially considering that gains made might be attributed to other factors such as medication, psychotherapies or both. It can be hard to definitively prove that art works.

But, the individual stories of recovery made through expressive therapy can be compelling. For example, an article in The Lancet outlines multiple pieces of art made by addicted patients in recovery. For one man, healing from addiction means remembering the good things that happened, as well as the bad, and trying to integrate the two experiences into a meaningful narrative. His artwork, containing a needle buried within a human figure, aptly demonstrates his idea. It’s worth considering if the man could have come to such an astute conclusion about his addiction without the help of expressive therapy. Perhaps he could, but perhaps he could not.

It is safe to say, however, that expressive therapy is unlikely to cause harm. Unlike medications, which could have side effects, or psychotherapies, which might cause the person to address wounds that haven’t quite healed, expressive therapy seems rather benign. People who don’t enjoy it may face times of boredom, but that’s unlikely to cause any long-term problems. It seems like a therapy that might be worth the risk.

If you’d like more information on expressive therapy, and our full program here at Axis, contact us today. We are here to help.