Does Art Therapy Actually Work?

Selma Bortner has created art almost her whole life. Her intricate prints hang in galleries and museums around the world, including the Philadelphia Museum of Art and the San Francisco Museum of Fine Arts.

But it’s the masterpieces she’s created in the past year, in her early 90s, that might prove the most meaningful. After her husband of nearly 70 years, Oscar, died three years ago, Bortner had two strokes that left her unsteady and unsure of her memory. That’s when the Langhorne, Pennsylvania resident began working with art therapist Danielle Brazinski to craft artistic representations of her self-image and emotions.

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Take the piece she’s working on now. It’s a three-foot-tall cardboard depiction of herself as a warrior, arms raised in a jabbing stance. “It’s a reminder to come back to the world and fight to stay alive and be a person, be a part of life,” Bortner says, her near-whispering voice rising and clearing.

Bortner’s increased independence and confidence demonstrates what art therapists have long observed—and researchers have begun to verify. Painting, sculpting, and other forms of visual art offer mental and physical benefits to people with a wide range of conditions, from strokes and dementia to autism to depression and post-traumatic stress disorder in military service members and refugee children.

Whether your style is more Frida Kahlo or fingerpainting, the way art therapy works relates in part to the body’s stress-management system, says Christianne Strang, president of the American Art Therapy Association and a neuroscience researcher at the University of Alabama at Birmingham.

Emotions like fear and sadness aren’t all in your head—they’re physiological phenomena. Many trigger the body’s sympathetic nervous system, putting you into “fight or flight” mode. Before you ever pick up a pen, clay, or paintbrush, art therapists will assess you and determine the type of artistic intervention that might work best for you—say, designing a thank-you card for yourself or crafting a container into which you can stash feelings that are too overwhelming to deal with all at once. That sort of exercise “gives you some choice and agency” over your mental state, Strang says.

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Much like talking aloud to a therapist, drawing or sculpting about what’s bothering you can release tension-producing emotions and activate your parasympathetic “rest and digest” system.

“We are social animals, and we need to communicate authentically with each other,” says Giriija Kaimal, who studies art therapy at Drexel University. “But a lot of our experiences are not necessarily captured in words.” And some people can’t verbalize at all due to their age or conditions like autism or brain injuries. Art offers a viable alternative.

In her research lab, Kaimal is aiming to help establish a body of evidence around art therapy’s effects and the underlying mechanisms by which they occur. In 2016, her team published a paper showing that 45 minutes of making art reduced levels of the stress hormone cortisol in healthy adults, regardless of whether they had previous artistic experience.

That’s important, she and Strang note—you don’t need to know what you’re doing, or have any talent whatsoever, to benefit. Art therapy techniques focus on process over product. Using them, you’ll learn to negate messages you might have gotten from childhood about not being “good enough” as an artist.

In another study, Kaimal used a novel technique called functional near-infrared spectroscopy—involving headbands that use light to monitor brain activity—to assess what happens when participants doodled, colored within the lines of a mandala image, or made free-hand drawings. All three activities boosted blood flow to reward circuits in the brain’s medial prefrontal cortex.

Picking up an adult coloring book or crafting on your own can help calm stress and improve your mood, she says. But working with an art therapist elevates the experience to a new level, improving what’s called your self-efficacy, or your belief in your own ability to succeed.

That’s per a study Kaimal’s group published in the Canadian Art Therapy Association Journal, which compared results of a single session of either independent coloring or therapist-facilitated creation. “We were able to demonstrate that in just 45 minutes, people’s sense of themselves as creative improved,” she says. “There’s such transformative potential to change people’s perception of themselves as being able to problem-solve.”

The research on reward circuitry has Kaimal hoping art therapy could eventually be used to manage conditions like obesity—painting feelings might light up the same feel-good brain areas as indulging our cravings, she notes. Strang and other clinicians already use art therapy techniques to help treat eating disorders. If you can do some artwork when you feel drawn to behavior like bingeing or purging, you might be able to start to regain control and eventually delay harmful habits long enough to lose the urge, she says.

For Bortner, linking her past life to her altered current existence reassures her that she’s still able to transfer her ideas out to the external world—and soothes the pangs of grief that arise each time she remembers Oscar’s passing. “Art therapy has loosened the connections between what I think and what I’m afraid to express,” she says. “It’s shown me that my losses are great, but that I can get over them and go on.”

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