Estimated Reading Time: 10-12 minutes

What You Will Learn

• Why visual expression and reflective writing can offer different routes into self-reflection.
• What research supports about expressive writing, visual art therapy, and visual journaling.
• Why combining images and words may be useful without relying on outdated left-brain/right-brain explanations.
• A simple step-by-step approach to creating an art-journaling practice.
• How to reflect on artwork without forcing symbolic interpretations.
• Several practical exercises for personal reflection or appropriately trained therapeutic work.
• When creative reflection should remain self-care and when additional professional support may be helpful.

Introduction: When One Form of Expression Is Not Enough

Self-reflection usually brings writing to mind. We journal about what happened, describe how we feel, reconsider a decision, or try to understand why a particular experience affected us so strongly. Writing can be valuable because it requires us to organize experience into language, but language is not always the easiest place to begin. Sometimes an experience feels vague, contradictory, physical, or emotionally complicated long before we know how to describe it. At other times, writing produces the same explanation repeatedly and reflection begins to feel more like rumination than discovery.

Visual expression offers a different starting point. A page filled with color, shape, texture, symbols, collage fragments, or rough sketches does not need to explain an experience immediately. It can represent uncertainty without resolving it, hold several feelings at once, or make a pattern visible before we know what the pattern means. Writing afterward adds another layer by inviting us to describe what we notice, question our first interpretation, connect the image with experience, and decide whether anything on the page deserves further attention.

This combination is often called visual journaling or art journaling. It should not be explained through the familiar myth that drawing activates the creative right hemisphere while writing activates the logical left hemisphere. Both visual and linguistic tasks rely on distributed brain networks, and complex reflection cannot be divided neatly between two halves of the brain. A stronger explanation is simply that images and words are different representational formats. Moving between them can change what we attend to and how we organize what we find.

What Research Can Tell Us About Art, Writing, and Reflection

Expressive writing has one of the longest research histories in this area. James Pennebaker's well-known paradigm invited people to write repeatedly about emotionally significant experiences, leading to hundreds of subsequent studies. The evidence, however, is more mixed than popular summaries sometimes imply. One meta-analysis of randomized trials found little or no overall benefit for broad psychological or physical health outcomes, while particular populations, outcomes, and writing formats have produced more favorable findings in other studies. Expressive writing should therefore not be sold as a reliable healing method simply because thoughts have been put on paper. Its value may depend on who is writing, what they are writing about, how the exercise is structured, and what outcome is being measured.

Visual art therapy has a separate and increasingly substantial evidence base. A 2026 systematic review and meta-analysis of 12 randomized trials involving 741 adults found improvements in depressive and anxiety symptoms associated with professional visual art therapy, although the authors also reported considerable heterogeneity and methodological limitations. This supports visual art therapy as a promising adjunctive intervention while reminding us that clinical art therapy is more than simply drawing in a notebook. The American Art Therapy Association defines art therapy as a mental health profession integrating art-making, psychological theory, and the therapeutic relationship, practiced by clinicians with graduate-level training.

Direct research on combining visual art and writing is much smaller. One qualitative study followed four art therapy interns and four counselling interns who kept visual journals over a 15-week semester. Participants described the journals as useful for reflection, gaining insight, organizing professional experiences, and combining imagery with responsive writing. The participants particularly valued moving between art-making and written reflection, but the study involved only eight trainees and was not designed to establish clinical effectiveness. A separate experimental study comparing writing and drawing about stressful experiences actually found a greater decrease in psychological symptoms in the writing group than in the drawing group, illustrating why we should not assume that visual expression is inherently deeper or more therapeutic than language.

The most responsible conclusion is therefore modest but useful: images and writing can support different forms of reflection, and some people find the movement between them particularly productive. We do not yet have strong evidence that combining the two always produces deeper emotional insight than either one alone.

Why Moving Between Images and Words Can Be Useful

An image can slow down the urge to explain. Suppose you are trying to understand why a particular situation feels overwhelming. If you begin by writing, you may immediately produce a familiar narrative: too much work, not enough time, too many responsibilities. If you begin instead with color and shape, you might create a crowded page with almost no empty space, one tiny figure in the corner, or competing areas pulling in different directions. None of those images has a universal psychological meaning, but each gives you something new to notice. Writing afterward might lead to a different question: Where is there room for me in the way I am currently living?

The reverse can happen as well. Writing may reveal something that is then easier to explore visually. A journal entry might repeatedly use words such as trapped, divided, invisible, or stretched. Rather than analyzing those words indefinitely, you could choose one and create an image of what it feels like. The art does not uncover a hidden truth stored beneath consciousness. It changes the problem from something to explain into something to observe.

This back-and-forth process can also help contain ambiguity. Writing tends to encourage sequence: first this happened, then I felt this, then I concluded something. Images can preserve contradiction more easily. A page can contain anger and affection, hope and fear, attraction and resistance simultaneously without requiring one to win. Reflective writing can then ask how those apparently opposing experiences coexist.

The goal is not to arrive at the “correct” interpretation of the artwork. Meaning should remain provisional and personal. A dark area does not automatically mean depression, a red mark does not automatically represent anger, and a closed door does not prove emotional avoidance. Instead of asking “What does this symbol mean?”, try asking “What does this symbol mean to me today?” The same image may carry a different meaning six months later.

A Simple Art-Journaling Process

A useful art-journaling practice can be structured without becoming rigid. Begin with a question that is open enough to explore but contained enough to give the page some direction. Instead of “What is wrong with me?” try “What feels most important to notice today?”, “What am I carrying into this week?”, or “What feels unresolved about this situation?” You can also begin without a question and simply notice what emerges.

Choose materials that feel manageable. Colored pencils, markers, graphite, oil pastels, collage pieces, or watercolor can all work, but the medium changes the experience. A pen provides more control than wet paint. Collage can be easier for someone who dislikes drawing because the images already exist. There is no therapeutic advantage to choosing the messiest or most expressive material. Use what makes it possible to begin.

Spend five to ten minutes making rather than explaining. You might work abstractly, sketch a scene, create a symbol, arrange collage pieces, or cover the page in lines and colors. Artistic quality is irrelevant. At the same time, avoid the instruction to “turn off your thinking completely.” Judgment and reflection do not need to disappear for creativity to be meaningful. The simpler invitation is to postpone interpretation long enough to notice what you choose.

Before writing, pause. Look at the image as if you had encountered it for the first time. Notice composition, empty space, repeated forms, contrast, movement, and where your attention goes first. Then begin writing descriptively: “The first thing I notice is...” “I expected to draw..., but instead...” “I keep looking at...” “This part feels familiar because...” Description is useful because it delays the temptation to jump straight from image to psychological conclusion.

From there, reflection can become more personal. Ask “What does this remind me of?” “What feels absent from the page?” “What would I ask this image if it could answer?” “What changed in my understanding while I was making it?” If nothing surprising emerges, that is also a valid result. Art-journaling should not create pressure to discover profound insight every time.

Finally, close the page intentionally. You might write one sentence beginning with “What I want to carry forward is...” or identify one practical next step. Sometimes there will be no action to take. Self-reflection can simply mean noticing something more accurately.

Five Art-Journaling Exercises to Try

The Emotion Map begins without requiring emotion labels. Fill a page with colors, lines, areas, or forms representing how the present moment feels. Once the image is complete, write about where your eye goes first, where the page feels crowded or empty, and which part is hardest to describe. Only then consider whether particular emotion words fit. This reverses the usual process of deciding the emotion first and assigning it a color afterward.

The Inner Dialogue Page can be useful when two motivations are competing. Divide the page loosely into two areas. Represent one side visually, then let the other side respond through words, another image, or both. Perhaps one part wants to leave a difficult situation while another wants stability, or one part demands achievement while another feels depleted. Avoid labeling one side healthy and the other dysfunctional too quickly. Ask what each position is trying to protect or obtain.

The Before and Possible Next Page is a gentler variation on the usual “before and after” exercise. Create one image of your current experience, then journal about what you notice. Instead of drawing how you should feel afterward, create a second image representing a slightly more workable next state. This avoids turning reflection into an expectation that you should move rapidly from distress to positivity. The question becomes: What would one degree of movement look like?

The Body Sensation Sketch uses a body outline to represent physical sensations through color, line, pressure, or symbols. Mark only what you comfortably notice, such as tension, warmth, heaviness, restlessness, numbness, or ease. Then write descriptively about the sensations rather than deciding immediately what they “mean.” Body-focused exercises can be activating for some people, particularly those with trauma histories, chronic pain, health anxiety, or dissociation, so this activity should remain optional and easy to stop.

The Insight Mandala uses a circular boundary to contain the page. Fill it with whatever colors or forms seem appropriate, then journal about the process rather than trying to decode the image. You might write about where you began, what changed, which part you enjoyed or resisted, and what surprised you. The value lies in observation, not in assuming that spontaneous imagery carries a hidden message.

Using Art-Journaling in Therapy, Coaching, and Personal Practice

Art-journaling can be adapted to several contexts, but the boundaries between them matter. In personal reflection, the practice can help organize thoughts, explore values, or notice patterns. In coaching, it may support goal clarification, strengths exploration, future possibilities, or reflection, but coaches should avoid using creative prompts as a way to conduct trauma processing or mental health treatment outside their scope.

In psychotherapy, clinicians who are not trained art therapists can use creative exercises only within their own competencies and professional scope. Professional art therapy itself requires specialized clinical preparation. The American Art Therapy Association emphasizes that art therapy is conducted by trained art therapists within a psychotherapeutic relationship and cautions against mislabeling ordinary creative activities as art therapy.

Trauma-related work deserves particular care. Art does not guarantee safe access to difficult experiences, and symbolic expression does not prevent retraumatization. A visual prompt may evoke intense memories unexpectedly. Clients should be able to choose the medium, change the task, work abstractly, avoid particular content, cover or destroy an image, or stop entirely. The therapist should not interpret reluctance as resistance simply because the activity was intended to be gentle.

Reflective writing after art should also be optional. Some people may prefer to remain with the image, talk about it, or leave it unfinished. The integration does not have to end in language every time.

Making the Practice Sustainable

An art journal becomes useful through accessibility rather than intensity. Keep a notebook and a small set of materials where they can actually be used. Five or ten minutes is sufficient for a page, but there is no need to promise significant insight from every short session. Sometimes the page will be revealing, sometimes relaxing, sometimes frustrating, and sometimes ordinary.

Revisiting older pages can be particularly useful because distance changes perspective. Rather than asking whether you have “grown,” look for shifts in the questions you were asking, recurring themes, changes in what receives attention, or issues that no longer feel as urgent. Avoid retrospectively diagnosing yourself from visual patterns. Repetition of a color or symbol may be meaningful, aesthetic, convenient, or accidental.

Privacy also matters. A visual journal can contain highly personal information that is less obvious than written text but still identifiable to the person who created it. Decide where the journal will be stored, whether anyone else may see it, and how you want to handle pages that contain material you do not want to keep.

Conclusion: Reflection Through More Than One Language  

Art and journaling belong together not because one accesses emotion while the other accesses logic, and not because combining them guarantees deeper healing. Their value lies in giving reflection more than one form. An image can hold complexity without immediately explaining it. Writing can organize what the image helped you notice. The two can move back and forth, each changing the questions available to the other.

Research provides good reasons to remain interested in both expressive writing and professional visual art therapy, while direct evidence for combined visual journaling remains comparatively small. A qualitative study of art therapy and counselling interns found that participants valued the combination of imagery and responsive writing for reflection, but the sample was tiny and cannot establish therapeutic effectiveness. This is an area where practice has moved ahead of the research.

That uncertainty does not make art-journaling meaningless. It simply invites more realistic expectations. You do not need to uncover a hidden memory, release an emotion, or create an “aha moment” for a page to be worthwhile. Sometimes reflection means seeing what was already there from a different angle.

Words and images do not complete one another perfectly. They ask different questions. And sometimes, moving between those questions is exactly what helps us understand ourselves more clearly.

References

American Art Therapy Association. (2026). About Art Therapy.

Deaver, S. P., & McAuliffe, G. (2009). Reflective visual journaling during art therapy and counselling internships: A qualitative study. Reflective Practice, 10(5), 615–632.

Guo, Z., Liu, Y., Zhu, S., & He, Y. (2026). Effects of visual art therapy on depressive symptoms in adults: A systematic review and meta-analysis. Frontiers in Psychiatry, 17, 1877502.

Malchiodi, C. A. (Ed.). (2012). Handbook of Art Therapy (2nd ed.). Guilford Press.

Pennebaker, J. W., & Smyth, J. M. (2016). Opening Up by Writing It Down: How Expressive Writing Improves Health and Eases Emotional Pain (3rd ed.). Guilford Press.

Chan, K. M., & Horneffer, K. (2006). Emotional expression and psychological symptoms: A comparison of writing and drawing. The Arts in Psychotherapy, 33(1), 26–36.