Anxiety is a prevalent condition that does not discriminate by age, gender, ethnicity, or culture. Anxiety, while common, develops from the uniqueness of an individual’s brain chemistry, thoughts, and experiences. It’s often associated with higher levels of stress, fear, or worry, and is considered a highly treatable condition. Treatments range from Cognitive Behavioral Therapy, Exposure Therapy, and Psychopharmacology, but there is also a Creative Arts Therapy approach to anxiety management and symptom reduction.
When an individual is facing anxiety, they often experience quick and intense changes in their thoughts and body that are associated with increased stress in the environment or task obligation. They might feel like mild butterflies in the stomach or strong waves of fear depending on the situation and the level of anxiety one is experiencing. These moments can inhibit an individual’s ability to concentrate at work, focus on tasks at school, attend social functions, or regularly eat and sleep. The impact of anxiety can create social, cognitive, emotional, and educational ripples in an individual’s life.
Creative Arts Therapies uses creative expression, brain stimulation, physiological intervention, and alternative communication approaches to soften the impact anxiety has on these dimensions of life. For example, art therapy can provide a visual representation of anxiety, which the individual may not have been able to communicate otherwise, and a connection with the art materials that provide a soothing and calming experience.
Dance/movement therapy can target the areas in the body where stress and anxiety manifest, and drama therapy can hone in on verbal communication skills surrounding anxiety management. Music therapy offers a therapeutic approach that attunes to the specific areas of the individual’s brain that may be contributing to the symptoms of anxiety. Each of these disciplines can offer a tailored approach to an individual’s unique expression of anxiety.
Creating is one of the most basic human instincts, and art has been a creative process since the existence of cave paintings. Art making, not art for production, is a kinesthetic, sensory, emotional, and cognitive experience. Finger painting is often a sensory experience that most adults can remember doing early in life. Art is not just visual; it’s touch, it’s feel, it’s smell. Using art therapy for anxiety engages the range of experience of that feeling and event beyond verbal description.
It can give language to events as cave paintings and hieroglyphics provided before language existed, but it also reaches a deeper level of cognitive experience that language cannot reach. How can a person fully articulate the “feeling” of panic? For some, it is beyond the words. A portion of that experience is not being explored without the addition of sensory experience.
In an art therapy session, an individual may use a variety of art supplies and methods of art making to depict the content or emotional aspects of an experience. Each medium (paint, pencil, pen, oil pastel) has a different feeling to touch, hold, and move across a piece of paper or canvas and each art process (constructing, deconstructing, representation, and abstraction) has a different cognitive and emotional response.3 The sensory components of medium and the metaphor of the art process are directly tied into an emotional or cognitive response that an individual might experience in art therapy.
Imagine the flow and fluidity of water color and the images or emotions that are brought about from that experience; it could be calming or it could be overwhelming. Art therapy is about tapping into the personal experience with each medium, the experience with different art making processes, and the goals and content of psychotherapy.
Music is often used to uplift a person’s mood or provide a calming environment following a stressful event, but music therapy can be used far beyond emotional management. Music therapy entails playing instruments, singing a song, composing music, and creating of improvisational music for therapeutic change.
The process of creating music facilitates increased flexibility, a sense of personal control of anticipated actions, and an increase in positive chemicals in the brain. As the feeling of anxiety increases cortisol and adrenaline chemicals in the brain, music therapy is used to counteract these chemicals by increasing glucocorticoid in addition to providing an socio-emotional learning process and cognitive restructuring.5
If the brain experienced less stress chemically and the body was able to relax, then an individual could work on the content of thoughts and experiences that drives his or her anxiety. The use of music as metaphor, relatable lyrics, and personal song writing helps communicate the issues and concerns that an individual struggles to deal with. The flexibility attained by altering songs, collaborative instrumental play, and improvisational music making leads to increased stress tolerance, the re-framing of thoughts and beliefs, and the acceptance of mistakes and change.
As anxiety frequently stems from a physiological response to stress or fear that continues to manifest beyond the first stress encounter, dance/movement therapy engages directly the physical body’s response patterns. It connects the mind to people’s physical state of being, their cardio vascular system, their state of consciousness, and their non-verbal patterns of communication and stimulation.2 It can even be used as a form of stress inoculation to anxiety as it prepares an individual to handle stress and grow a tolerance to the anxiety he or she feels in their body.2
Once the individual begins to notice his or her body state, the expression of movement can facilitate emotional alteration by changing the body moves when feeling a particular emotional state. For example, a person can carry anxiety as tension in his or her shoulders and could learn to move in a different manner that would reduce this tension. This can be translated into movement with shoulder rolls and arm extensions.
Language and thought can be applied to the movement as a person can identify particular physical states, positions, or stances to specific emotions, experiences, and thoughts. Fear might be embodied one way for one person and differently for another—one could curl up into a ball while another could shut his or her eyes and clench his or her teeth.
By using the body to express these thoughts in physical stance, individuals become more aware of wholeness of their anxiety, mind and body. They become aware of what they are conveying to those around them, but also how their body language reflects their internal state. A person cowering versus standing straight would communicate a different message to those who are witnessing that position in addition to communicating a message within the person’s own self esteem.
Drama therapy is an embodied expressive form of therapy that utilizes the strengths of body oriented therapies in addition to capturing the essence of human roles, storytelling, and play.4 The power of drama often lies in the imagination and the creativity that is drawn upon to articulate an experience, emotion, or thought. It can be represented in a role play scene or exaggerated comedic or dramatic scene to draw out the emotional content in a fictitious caricature.
The cognitive and physiological manifestations of anxiety are drawn into a story where the individual can represent their fears or worries in a less threatening manner. It provides what is termed aesthetic distance from the issue. It is as if the anxiety is about another person, but it connects to the felt experience of the person playing the role—like asking a personal question for a friend, but it’s really about you. The story can be as real or as fantastical or as catastrophic as the individual would like to explore.
Drama also empowers the individual to re-experience an event from a different perspective by allowing them to assign the therapist to play a particular role or taking on a contrary role themselves. A person can experiment with feeling bold and daring when most of the time he or she don’t feel that way in regular life. They can try on a role in a safe place and practice the experience before attempting it in the outside world. In essence, the individual can give words to a fear or worry that they may not be able to express in a conversation and the process solutions to that issue through enacting a scene and considering alternative approaches.
Imagine a child walking on the playgroup fearful of engaging with friends, an adult who struggles with presentations at work, or a college student who panics while taking the bus. These are all forms of anxiety that can benefit from the creative arts therapies. If these are describing feelings that you have had or someone you know has had, you are not alone and you do not have to continue having these feelings. It’s possible that the creative arts therapies can help.
1 – Bräuninger, Iris. “Dance movement therapy group intervention in stress treatment: A randomized controlled trial (RCT).” The Arts in Psychotherapy 39, no. 5 (2012): 443-450.
2 – Hanna, Judith Lynne. Dancing for health. Conquering and preventing stress. Stress in modern society. Lanham, MD: Altamira, 2006.
3 – Hinz, Lisa D. Expressive therapies continuum: A framework for using art in therapy. New York, NY: Taylor and Francis, 2009.
4 – Johnson, David Read. Developmental transformations: Towards the body as presence. In P. Lewis and D. Johnson (Eds.), Current approaches in drama therapy (2000). Springfield, IL: Charles Thomas
5 – Taylor, Dale B. Biomedical foundations of music as therapy. Barton Publications, 2010.
Marni Rosen, Psy.D., is a clinical psychologist, art therapist, and practice director at the Institute for Therapy through the Arts. She holds a Master's Degree in Counseling Psychology: Art Therapy and a Ph.D. in Clinical Psychology from the Adler School of Professional Psychology, she specializes in art therapy, trauma-centered psychotherapy, and Adlerian psychotherapy. Dr. Rosen's research has appeared in the Journal of Individual Psychology, the Adlerian Yearbook, and the Arts in Psychotherapy Journal. She is a member of the North American Society for Adlerian Psychology and the Illinois Art Therapy Association.