Expressive Arts Therapy and Self-Regulation

Expressive arts (art, music, dance/movement, drama, and creative writing) therapies can enhance self-regulation in individuals of all ages who are experiencing distress or reactions from psychological trauma. In particular, the kinesthetic-sensory qualities of art, music and movement that include rhythm, movement, touch, and sound potentially mediate lower brainfunctions such as heart rate and respiration through specific approaches. Here are just a few ways that expressive arts approaches support self-regulation:

Not Just Attunement; It’s “Sensory-Based” Attunement. In any therapy relationship, practitioners meet individuals where they are in their reparation and recovery, responding with both insight (knowing what one feels) and empathy(knowing what others feel). Daniel Siegel refers to this as “mindsight” while others refer to it as attunement, the capacity to recognize non-verbal communications, rhythms and responses of others. Similarly, Bruce Perry notes that attunement is the capacity to be able to read the non-verbal communication and rhythms of others.

The unique sensory nature of the “expressive arts therapeutic relationship,” first and foremost, is what differentiates it from verbal therapies in its impact and role in intervention and healing. Attunement works from “bottom up” because how we perceive feelings in others are part of the more ancient parts of the brain—the amygdala, hypocampus and structures underlying the cortex. The expressive arts therapies emphasize senses, feeling and non-verbal communication, establishing a different type of attunement between the practitioner and the individual or group less dependent on words. Additionally, specific relational dynamics are present in each expressive art form and each is characteristically a little different from the others in respect to sensory-based attunement. In art therapy, for example, a therapist is a provider of materials (nurturer), assistant in the creative process, and active participant in facilitating visual self-expression. These are experiences that emphasize interaction through experiential, tactile, and visual exchanges, not just verbal communication, between the client and therapist.

GroundingGrounding is a strategy that is often introduced early to help individuals stop or at least slow down stress responses and emotional or physiological dysregulation. Grounding techniques generally refer to ways for people to focus on some aspect of external reality and often involve using the senses to reinforce being in the here-and-now. The ubiquitous adult coloring book speaks to what many individuals seem to reach for as a way to slow down and narrow one’s focus. However, the advantage of using expressive arts as a means of grounding is that they are also creative ones tailored to developmental, cultural and personal preferences and relevance. One simple art-based grounding technique involves what is commonly called bilateral drawing (see previous post for a more detailed explanation of this process) and can provide a focus; similarly a specific rhythm found in music or movement can support grounding experiences.

AnchoringAnchoring is another term that is sometimes used to describe the process of using specific cues or experiences to bring one’s attention to the present moment or shift sensations from anxious to calm. It is similar to grounding, but in using expressive arts approaches, an anchor usually involves some sort of sensory cue (sound or music) or an object (specific art expression) that the individual can return via procedural memory or ritual for self-regulation. Daniel Goleman’s Focus describes a powerful example of anchoring used as part of “Breathing Buddies” in New York City public school system, a part of the Inner Resilience Program, a curriculum established after the World Trade Center attacks on September 11, 2001. In brief, the program includes an anchoring ritual involving sound (a bell’s chime), holding stuffed animals, and deep belly breathing as a method of anchoring with children. While a variation of mindfulness breathing is involved, the children are provided several sensory-based anchors including sound and a special toy to reinforce relaxation. The goal is self-regulation which when achieved, supports students’ success in class room learning by increasing attention, comprehension and problem-solving. Similarly, an art expression such as special object or image can, along with a specific calming ritual, become an anchor for individuals when experiencing stress or hyperactivation.

Mirroring. Mirroring is another commonly used approach to establish and enhance the relationship between the individual and the helping professional. Within the expressive arts therapies, it is generally described as the embodiment or reflection of an individual’s movement or non-verbal communications. The goal of mirroring is not only imitation of postures, facial expressions and gestures, but also includes attunement between the individual and practitioner. The brain’s mirror neuron system is believed to be at least one part of these experiences of attunement, empathy and mirroring. Mirroring is common to almost all expressive arts approaches, but in particular is relevant to dance/movement therapy because of the kinesthetic level of expression and interpersonal aspects involved in movement. For example, expressive arts therapy group sessions, including those for trauma survivors, often begin with a movement sequence or simple stretches, starting with having everyone reach up to the sky and down to the earth in a rhythmic manner. In art therapy, the practitioner may demonstrate specific art-based processes to encourage participants to mirror sensory or kinesthetic activities for the purpose of self-soothing or stimulating energy, depending on the needs of the individual or group.

©2015 Daily Drawing by C. Malchiodi, PhD
Source: ©2015 Daily Drawing by C. Malchiodi, PhD

Entrainment. Entrainment is often used to support self-regulation; this is also sometimes called rhythmic synchronization. Entrainment occurs when the rhythm of one experience synchronizes with the rhythm of another. For example, babies hear their first rhythm in utero when listening to their mothers’ heartbeats; the natural way to calm infants is to sway, rock or pat them to the rhythm of a resting heart rate. In expressive arts therapy approaches, heartbeat, motor activity and brain activity are sources of rhythm and can be influenced to fall into synchronous rhythms through not only the therapist’s voice, but by introducing sensory experiences that reinforce resting heart rate (60 to 80 beats a minute) or slow down or energize individuals. In brief, one way to apply the use of music as entrainment is through its role as an auditory cue to enhance either experiences of calm or experiences of energy. Because hyperactivation and dissociation impact how individuals “keep the beat,” entrainment through one or more of the expressive arts can help redirect energy and attention toward more positive, self-empowered emotional states.

These are just a few “basics” of expressive arts therapy that support self-regulation. At the core of all the approaches described above, sensory-based attunement to the relationship is the real foundation of not only self-regulation, but also reparation and healing. In other words, it is not just the arts expression that is the reparative agent in expressive arts therapy; it is the therapist who brings the knowledgeable and sensitive relational skills to support actual change and recovery.

Be well and more excerpts from the forthcoming Trauma-Informed Expressive Arts Therapy are coming soon (in preparation with Guilford ©2016),

Cathy Malchiodi, PhD

© 2016 Cathy Malchiodi, PhD www.cathymalchiodi.com | www.trauma-informedpractice.com

To cite this article:

Malchiodi, C. (2016). Expressive arts