What Really Happens in Art Therapy?

Art therapy is often described as a form of psychotherapy that uses art as part of the therapeutic process. While that's true, it doesn't really answer the question most people have.

What actually happens in art therapy?

People are often surprised to learn that the therapist isn't there to analyse the artwork or tell you what your drawings "mean". There isn't a secret dictionary where a tree means one thing and the colour blue means another. Art therapy doesn't work like that.

Instead, the artwork becomes another way of exploring your experiences. Just as importantly, the process of making it becomes part of the conversation too. The decisions you make, the moments you hesitate, the materials and colours you're drawn to, the emotions that emerge while you're creating, and the finished artwork itself can all become part of the therapeutic exploration.

Art therapy and therapeutic art aren't the same thing

People often use the terms art therapy and therapeutic art interchangeably, but they serve different purposes. Therapeutic art is primarily about emotional regulation. Painting, colouring, knitting, pottery, crafting, gardening, or any other creative activity can help settle the nervous system, reduce stress and provide a break from the demands of everyday life. Many people naturally turn to creativity in this way because it helps them feel calmer and more grounded.

Art therapy goes beyond regulation.

Rather than using creativity only to change how you feel in the moment, art therapy uses it as a way of exploring what's underneath those feelings. The artwork becomes a tool for understanding emotions, beliefs, relationships, memories, patterns and experiences. It can challenge assumptions, raise unexpected questions and offer perspectives that may not have emerged through conversation alone.

That process isn't always comfortable, but meaningful self-reflection rarely is. The goal isn't simply to create artwork. It's to develop a deeper understanding of yourself through the process of creating it and reflecting on it.

Meaning is made, not given

Making the artwork is only one part of the therapeutic process. The conversation that accompanies it is just as important. Together, they create opportunities to notice patterns, explore emotions, ask questions, and develop a deeper understanding of your experience.

An art therapist might notice something and ask about it. They may wonder what it was like to use a particular material, what was happening when one part of the image changed, or why your attention keeps returning to a particular area of the page. Sometimes they might encourage you to look at your work from another perspective or consider a connection that hadn't occurred to you before. These aren't interpretations. They're ways of helping you think more deeply about your own experience.

Sometimes an artwork reflects something you already know but haven't fully recognised. Sometimes it raises a question you hadn't considered. Sometimes it doesn't make sense until you return to it months or even years later. The artwork hasn't changed, but you have. New experiences, new understanding, and new perspectives can all change the way you relate to what you've created.

The language of symbols

One of the reasons art can be such a powerful therapeutic tool is that human beings naturally think in symbols. A symbol is something that represents something beyond its literal appearance. You might draw a bridge. On the surface it's just a bridge, but for you it could represent hope, uncertainty, freedom, transition, or something else entirely. The image itself isn't what's important. The meaning you connect to it is.

The same is true of colours, shapes, textures and abstract marks. Two people could create similar images while expressing completely different experiences. That's why art therapists don't work from universal interpretations. Symbols are personal. They are shaped by your memories, relationships, beliefs and experiences.

Over time, you might notice certain symbols appearing again and again in your artwork. Sometimes those patterns become obvious straight away. Sometimes they only become meaningful when you look back over a collection of work and begin to notice themes emerging. There may also be symbols you don't understand immediately, and that's okay. Meaning doesn't always arrive in the moment. Sometimes it develops gradually, and sometimes artwork reveals something new years after it was created.

One of the first topics I cover in my Art Therapy Video Series is Symbolism in Art, because understanding this changes the way many people think about art. Rather than seeing an image as something to interpret, it becomes something to explore.

Looking at an experience from the outside

One of the unique things about art therapy is that it can help people externalise their experiences. For many people who have experienced trauma, memories don't always feel like memories. They can feel immediate, as though the experience is happening all over again. The emotions, physical sensations and thoughts can all feel firmly rooted in the present.

Creating artwork can change that relationship.

An experience that has existed entirely within you can begin to exist on the page. Rather than carrying it only inside yourself, you can look at it, reflect on it, add to it, change it, question it, or just observe it. For some people, this is the first time they've been able to see part of their experience as something outside of themselves.

Working symbolically can strengthen that process. Rather than approaching an experience head-on, it can be explored through images, colours, shapes or objects that hold personal meaning. That symbolic layer doesn't remove the emotion or minimise the experience. Instead, it can create just enough distance from the experience, memory or belief for exploration to feel possible. Sometimes approaching something indirectly makes it easier to approach at all.

More than two people in the room

A significant part of any therapy is the relationship that develops between the client and therapist. This isn’t just about whether someone likes their therapist. It refers to the trust, understanding and collaboration that develops over time, which allows a person to explore their experiences within the therapeutic space. The way someone experiences this relationship can influence what they feel able to share, question and work through.

Art therapy includes this relationship, but it also introduces another element: the artwork itself.

In art therapy, the artwork is not viewed simply as something that’s been made. It becomes part of the therapeutic process. The person who creates the artwork develops their own relationship with it, and that relationship can change over time. A piece of artwork might feel meaningful, uncomfortable, familiar, challenging, or reveal something unexpected. It can become something that the person returns to and continues to engage with beyond the moment it was created, or something that is kept safely stored away until they are ready to revisit it.

This idea is often described within art therapy through the concept of the triangular relationship, a concept explored by psychoanalysts and art therapy theorists including Melanie Klein. Rather than therapy involving only the client and therapist, art therapy involves three connected relationships: the relationship between client and therapist, the relationship between client and artwork, and the relationship between therapist and artwork.

Each relationship brings something different to the therapeutic process. The artwork becomes another part of the therapeutic space, offering something for the client and therapist to explore together. The therapist is not there to define what the artwork means, but to support the client's engagement with what they have created and the meanings that emerge through that process. The artwork is not separate from the person who made it; it carries their choices, experiences and the meaning they have developed through creating it.

This is also why artwork created within therapy is treated with care and respect. It is not simply a product of a session or something to be evaluated. It is part of the therapeutic work and is approached with the same consideration given to the person who created it.

Final thoughts

Art therapy isn't about producing beautiful artwork, and it isn't about someone else analysing what you've created. It's about using creativity as another way of exploring yourself. Sometimes that means recognising patterns that have been there for years. Sometimes it means finding a symbol for an experience you haven't yet found words for. Sometimes it means seeing something from a perspective that hadn't been possible before. 

The artwork isn't there to be analysed from the outside. It's there to be explored from within.