Using Art Therapy to Support Emotional Regulation in Real Time

Estimated reading time: 14 minutes

Emotional regulation is not something clients simply “learn” and then apply later. In many therapy sessions, regulation must happen in the moment—while emotions are active, the nervous system is aroused, and verbal processing feels either overwhelming or unavailable. This is where art therapy offers a unique and clinically powerful contribution.

Art-based interventions can function as real-time regulators of the nervous system. They help clients ground, orient, and stabilize while emotional material is present—without requiring immediate verbal insight or narrative coherence. Used skillfully, art therapy techniques support co-regulation, containment, and self-soothing within the session itself.

This article explores how art therapy can be used intentionally to support emotional regulation in real time. Drawing from neuroscience, trauma-informed practice, and clinical experience, we focus on grounding strategies, nervous system regulation, and practical in-session tools that therapists can integrate immediately—whether or not they identify as art therapists.

What You Will Learn

How emotional regulation operates at the nervous system level during therapy
Why art-based methods are effective for real-time grounding and stabilization
Specific art therapy techniques for regulating arousal in-session
How to choose interventions based on client state, not diagnosis
Ethical and clinical considerations when using art for regulation

Why Emotional Regulation Must Happen in the Moment

Many therapeutic models emphasize insight, cognitive restructuring, or narrative integration. While these are essential components of healing, they often assume a baseline level of emotional stability. In practice, many clients arrive in therapy dysregulated—activated, shut down, dissociated, or oscillating between states.

When the nervous system is overwhelmed, verbal language becomes unreliable. Attention narrows, memory fragments, and reflective capacity decreases. Asking clients to “talk through” intense emotion at this stage can inadvertently increase distress.

Real-time regulation is not avoidance. It is a prerequisite for meaningful processing. Art therapy offers nonverbal, sensory, and embodied pathways that help restore enough regulation for therapeutic work to continue safely.

How Art Therapy Supports Nervous System Regulation

Art-making engages multiple systems simultaneously: sensory, motor, visual-spatial, and emotional. This multisystem engagement allows art therapy to influence arousal levels directly, often more quickly than verbal interventions.

From a nervous system perspective, art therapy supports regulation in several ways:

Rhythmic, repetitive movements calm sympathetic activation
Sensory input provides grounding and orientation
Externalizing internal states reduces emotional flooding
Visual containment creates psychological boundaries

Importantly, these effects occur during the act of creating—not only after interpretation or discussion. This makes art therapy particularly suited for in-session regulation.

Grounding Through Sensory Engagement

Grounding involves reconnecting attention to the present moment, the body, and the immediate environment. Art materials naturally facilitate this process when used intentionally.

Simple sensory-focused activities can include:

Slowly shading with colored pencils, noticing pressure and texture
Kneading clay or putty to engage proprioceptive feedback
Tearing and arranging paper to create structured movement
Repetitive mark-making with a single color

The goal is not expression or insight, but stabilization. The therapist may guide attention to physical sensations, rhythm, or breath while the client works. This anchors awareness in the here-and-now and reduces emotional escalation.

Using Art to Regulate Hyperarousal

Hyperarousal states—such as anxiety, panic, anger, or trauma activation—are characterized by increased sympathetic nervous system activity. Clients may feel restless, flooded, or unable to focus.

Art therapy can help downregulate hyperarousal through structured, calming activities:

Contained drawing within a defined shape or boundary
Limited color palettes to reduce sensory overload
Slow, repetitive movements such as spirals or lines
Bilateral activities that engage both sides of the body

The emphasis is on predictability and containment. Too much freedom or emotional symbolism at this stage can increase activation. Regulation comes first; expression can follow later if appropriate.

Supporting Hypo arousal and Shutdown

Some clients arrive in therapy emotionally numb, disconnected, or shut down. This hypo aroused state reflects dorsal vagal dominance and requires gentle activation rather than calming.

Art therapy techniques for hypoarousal may include:

Using brighter colors or varied textures
Standing or larger-scale art-making to engage the body
Tactile materials such as clay, sand, or collage
Prompting choice and agency in materials or process

The therapist monitors for signs of increased engagement—eye contact, posture changes, vocal tone—while ensuring that activation remains within a tolerable range.

Externalizing Emotion Without Overwhelm

One of art therapy’s most regulating functions is externalization. When emotions are placed on paper or shaped in material, they become objects that can be observed rather than fully inhabited.

This distance reduces emotional intensity and supports reflective capacity. For clients who feel “taken over” by emotion, externalization restores a sense of agency.

Examples include:

Drawing an emotion as a shape, color, or texture
Creating a container image to hold difficult feelings
Placing emotions at varying distances on the page
Modifying the artwork to represent increased safety

The therapist’s role is to pace the process, ensuring that engagement remains regulating rather than activating.

Art Therapy as a Tool for Co-Regulation

Regulation in therapy is rarely a solo act. Especially for clients with developmental trauma or attachment disruptions, co-regulation with the therapist is essential.

Art therapy naturally supports co-regulation through shared attention and parallel activity. Sitting alongside a client, quietly engaging with materials, or gently mirroring rhythm and pace can create a felt sense of safety without excessive verbalization.

This shared creative space reduces power imbalance and communicates presence, attunement, and containment. Over time, these experiences contribute to the client’s internal capacity for self-regulation.

Choosing Techniques Based on State, Not Story

A common clinical mistake is selecting interventions based on content rather than state. Art therapy for regulation requires the opposite approach.

Before introducing an art-based tool, the therapist assesses:

Level of arousal (high, low, or within window of tolerance)
Client’s sensory preferences and sensitivities
Current capacity for choice and reflection
Cultural and personal meanings of art-making

The same technique can be regulating for one client and activating for another. Clinical attunement matters more than technique fidelity.

Ethical and Clinical Considerations

Using art therapy for regulation requires ethical care. Therapists should avoid:

Forcing art-making when clients resist
Interpreting artwork prematurely or intrusively
Using expressive techniques when stabilization is needed
Assuming art is inherently safe for all clients

Informed consent, transparency, and collaboration are essential. Art therapy should always serve the client’s nervous system needs—not the therapist’s preferences or theoretical orientation.

Professional guidelines from organizations such as the American Art Therapy Association emphasize scope of practice, training, and ethical responsibility when using art therapeutically.

Integrating Art Therapy Into Non-Art Therapy Practice

You do not need to be a credentialed art therapist to use simple, regulation-focused art tools ethically. Many grounding and sensory-based activities fall well within the scope of general psychotherapy when used for stabilization rather than deep expressive analysis.

Key principles include:

Keep interventions simple and optional
Focus on process, not product
Avoid symbolic interpretation unless invited
Use art as a support, not a demand

When used this way, art therapy techniques enhance—not replace—existing therapeutic approaches.

The Neuroscience Behind Why It Works

Research in affective neuroscience helps explain why art therapy supports regulation so effectively. Creative activity engages subcortical brain regions involved in emotion and sensory processing, bypassing overreliance on verbal cognition.

Work on polyvagal-informed practice, influenced by researchers such as Stephen Porges, highlights the role of safety cues, rhythm, and social engagement in regulating autonomic states. Art-making naturally incorporates these elements when facilitated thoughtfully.

From Regulation to Integration

Real-time regulation is not the end goal—it is the foundation. Once clients experience repeated moments of stabilization within therapy, they develop greater tolerance for emotional exploration and insight.

Art therapy supports this progression by:

Building interoceptive awareness
Strengthening self-soothing skills
Increasing confidence in emotional survivability
Creating nonverbal memory traces of safety

Over time, these capacities generalize beyond the therapy room.

Conclusion: Regulation as a Clinical Skill, Not a Side Effect

Emotional regulation is not something that happens after therapy—it happens within it. Art therapy offers clinicians practical, evidence-informed tools to support regulation in real time, when it is most needed.

By working with the nervous system rather than against it, art-based interventions help clients feel safer, more present, and more capable of engaging in the therapeutic process. Whether used briefly for grounding or integrated more fully into treatment, art therapy expands the clinician’s capacity to respond skillfully to moments of emotional intensity.

In a field that often prioritizes insight and interpretation, art therapy reminds us of a foundational truth: before clients can think differently, they must feel regulated enough to think at all.

References

American Art Therapy Association. (2017). Ethical principles for art therapists.
Malchiodi, C. A. (2020). Trauma and expressive arts therapy. Guilford Press.
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton.
Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Guilford Press.
van der Kolk, B. (2014). The body keeps the score. Viking.

Using Art Therapy to Support Emotional Regulation in Real Time