Updated: Dec 18, 2019
A creative therapy uses language of the senses and imagination, although words can be involved, too. Creative therapy enables a client, through intensely personal creative expression, to access their inner world. Creative therapy facilitates connection of the inner world with the outer world to generate insights, the possibility of personal growth and healing, and transformation of the personality toward harmony and wholeness.
The unique characteristics of creative therapies
It’s useful to consider two aspects of creative therapies: the question of what sets them off as separate from other therapies, and also, what, if any, myths surround them which we may be advised to debunk if we would understand their true contribution to therapy. Malchiodi has outlined four characteristics she believes make the creative therapies unique: self-expression, active participation, imagination, and mind-body connection.
To understand the role of creative therapies in counselling is to comprehend nuance. We can note that all therapies, by virtue of what they are formulated to do, encourage self-exploration in their clients. Creative/expressive therapies, of course, do that, but they also promote self-expression through one or more modalities that are central to the counselling process. We may be able to accelerate the process of self-exploration through these therapies because people can experience themselves differently, thus beginning to practice new, more adaptive behaviours.
Self-expressive activities such as painting, dance/movement, or poetry may recapitulate troubling past experiences for some clients; for others, they may be cathartic. But neither of these outcomes – the recapitulation or the catharsis – is the essence of self-expression in this case. Rather, with client and therapist working together, that essence is the capacity of the activities to utilise self-expression as a container for feelings and perceptions. Used in this way, it may deepen into greater self-understanding or possibly be transformed, resulting in emotional reparation, resolution of conflicts, and a sense of well-being.
It is important to note that, when clients in creative or expressive therapy modalities draw pictures, create movements or poems, or play, those activities are not generally interpreted by their therapists (in a psychoanalytic sense of interpretation). Rather, the therapists try to facilitate their clients’ discovery of personal meaning and understanding. Thus, it is typical for self-expression in a creative therapies session to include some verbal reflections in order to help clients make sense of their experiences, feelings, and perceptions. For some clients, however, especially young children who do not have the language skills to do extensive reflection, the creative/expressive experience might offer as much therapeutic value as verbal reflection about the product or experience. Merely engaging such activities may be enough in some cases to provide a corrective experience. With clients whose self-expression is repetitive or rigid (say, in cases of severe trauma or abuse), a therapist may use creative techniques to help therapy progress, introducing experiences or directives to help the child transform the storyline to something more satisfying or productive.
Because creative therapies are action therapies, requiring participation and the investment of energy, clients can explore issues and communicate their thoughts and feelings as active participants in the therapeutic process. They may be involved in moving, touching, arranging, gluing, drawing, painting, forming, or any number of tangible experiences. The experience of actively doing and creating can energise clients, redirecting their attention and focus, and alleviating emotional stress, allowing them to fully concentrate on issues, goals, and behaviours. Moreover, they are having sensory experiences, utilising most of their senses in one way or another, and thus redirecting awareness to verbal, tactile, and auditory channels.
This characteristic gives us scope for understanding the high standard to which creative therapists hold “creativity”. While some people prefer the word “creativity” to describe creative/expressive therapies, those working in creative endeavours insist that the word “imagination” is better. Why? For start, imagination is a central concept which informs the understanding of the use of arts and play in therapy. Beyond that, creativity is deemed to occur when “self-expression is fully formed and achieves a novel and aesthetic value” (Malchiodi, 2005, p11). In a creative/expressive therapies session, clients may not always paint, draw, move, or make music that would be considered creative – that is, fully formed, novel, or aesthetic – but in most cases the client needed to use imagination in order to generate self-expression, experimentation, and verbal reflection.
The expressive modalities help clients to move beyond preconceived beliefs through experimentation with new ways of communicating and experiences that involve pretending. Because clients must use imaginative thinking in order to create a song, come up with a movement, or organise figures in a sand tray, they have the possibility of trying out innovative solutions, some of which will be transformational. Clients who may be highly restricted in their ability to use their imagination in other types of problem-solving may find the expressive therapies particularly helpful. A severely traumatised or abused person – especially a child – may either have obsessive thoughts or memories or be emotionally constricted. By being able to therapeutically employ art, music, dance, or play, such clients’ capacity to use imagination is given a boost, helping the person to discover corrective solutions that lead to change, resolution, and ultimate healing.
Therapeutic interventions which are designed to facilitate the mind’s capacity to influence bodily functions and symptoms are defined by the (American) National Center for Complementary and Alternative Medicine as mind-body interventions. The Center considers many of the creative/expressive therapies to be mind-body interventions because they are both modalities of psychotherapy and also therapies that use the senses to effect change. Neuroscience advances, moreover, have shown how conditions such as mood disorders, stress disorders, and physical illness can be improved through the use of mind-body interventions such as the creative/expressive therapies. Here are some examples of specific therapies and the healing effects they demonstrate:
Art, drama, and play: Betters post-traumatic stress and the expression of traumatic memories.Music, art, dance/movement: Induces the relaxation response, for greater sense of calm and confidence associated with wellness and happiness.Writing: Aids emotional reparation and reduces symptoms of chronic illness.General expressive activities: Stimulate the placebo effect through mimicking self-soothing and inducing self-relaxation.
Finally, as more is learned about the importance of secure attachment for brain development, psychotherapy is beginning to see the value of creative/expressive therapies in re-establishing and encouraging healthy attachments through sensory experiences, interactions, movement, and hands-on activities. Dance, art, and play therapies in particular may be helpful in repairing and reshaping attachment through experiential and sensory means, partly because they can tap early relational states before words become dominant. This may help the brain to establish new, more adaptive patterns (characteristics adapted from Malchiodi, 2005).