What is Expressive Arts Therapy? Thoughts from a Toronto Therapist

I was a quiet kid. Words didn't always come easily to me, especially in unfamiliar places. What came more naturally was movement. Looking back, I think that's a big part of what drew me to expressive arts therapy, and why I believe in it so deeply. For many of us, words are only part of the story. Movement is one of our first languages. We express and understand the world from a young age through image, sound and story.

Expressive arts therapy is a form of relational psychotherapy that brings creative processes into the therapeutic space. One of the things that makes it distinctive — and what drew me to it — is that it's intermodal. Rather than being rooted in one art form, expressive arts therapy draws on the full range of creative modalities: movement, visual art, sound, writing, drama, and more. The modalities we use in any given session depend on what the moment is calling for.

So what actually happens in a session?

One of the things people are often curious about is what a session actually looks like. That can be hard to articulate, but there is a shape to it, even if that shape can shift and change depending on what you bring in.

We often start with a check-in: what's on your mind, what's been happening, what you'd like to work with today. Sometimes that check-in takes up most or all of the session. Sometimes it leads us to an art intervention.

From there, we might move into what's called a decentering practice — some kind of art-making that creates a bit of space around whatever you've brought. This can be “theme near” or “theme far.”

Theme near means we address the issue more directly through the art. For example, if you came to me saying you'd recently been laid off and were struggling with what comes next, a theme near approach might be to make an artwork to address what you've lost — the identity, the routine, the colleagues — as a way of sitting with the feelings of loss. Or we might try a decision-making exercise that helps loosen that feeling of anxiety or fear of what comes next.

Theme far is a bit different. It means we intentionally step away from the topic and move into a more open art practice with no obvious connection to your situation at all. You might write freely for a few minutes, circle words that stand out, and see what's there. It might feel unrelated. But what I find, and what many clients experience, is that it works a bit like aerating the soil in a garden. When we hold a problem too tightly, we can get stuck in loops, with the same thoughts, the same feelings, going around and around. Things can feel dense and rigid. Moving your attention elsewhere, even briefly, creates some space. New connections form, and you come back to the problem a little differently.

After the art-making, we might harvest. We look at what was made, or what happened in the body during movement, and we practice what I'd describe as noticing: what stands out? What surprised you? What did you feel in the process of making? Sometimes there's a moment of recognition — something that felt tangled begins to separate or something fragmented starts to come back together. Engaging in the arts often evokes what in DBT they call “wise mind,” the place where feelings and thoughts meet. Or as my Tita Marcie would say, the wisdom that comes “when your head and heart agree.”

In my practice, I sometimes work with people who have a very loud inner critic. When externalizing this critic — drawing what it might look like, giving it a form, a face, or a posture — something shifts. It sits there, on the paper, separate from them. Suddenly, we can speak to it as a third party and even hold a dialogue with it. This has a kinship with parts work, acknowledging the different parts of us and what they might have to share, and also reminding them that they don’t need to take over. This creates space, and sometimes even humor emerges. Laughter can be a part of this work. Difficult feelings are welcome, and so is lightness.