Research: Understanding the Neuroscience of Art Therapy and Acceptance and Commitment Therapy (ACT)

One of the questions I keep coming back to as an art psychotherapist is this:

What is happening in the brain when someone stops fighting a difficult thought and begins to relate to it differently?

The thought hasn't disappeared. The situation hasn't changed, yet something shifts. Instead of being controlled by the thought, the person begins to have a different relationship with it. In ACT it can be considered as the moment someone "drops the struggle", stops fighting and becomes more curious about the experience they are having. That moment is very interesting to me.

More Than Feeling Better

In therapy, lasting change isn't simply about reducing anxiety or helping someone feel calm or “better”. Often, it's about helping people develop the ability to respond differently to difficult thoughts, emotions and bodily sensations.

Acceptance and Commitment Therapy (ACT) describes this as psychological flexibility. This is the ability to make room for uncomfortable internal experiences while continuing to move towards what matters most.

Over time, repeatedly responding in new ways may contribute to neuroplasticity. This is the brain's ability to strengthen and develop new neural pathways.

Can we identify the moment the brain starts building a different way of responding?

Imagine someone has the thought:

"I'm going to fail."

When this thought stays inside, it often feels like absolute truth. The person can become "fused" with it, the thought then can influence behaviour. Our thoughts usually influence behaviour but when I talk about becoming "fused", I am talking about becoming attached to an "uncomfortable" thought and responding with avoidant behaviours. So someone may avoid the situation associated with "failure" because their mind has convinced them the prediction is reality.

Rather than trying to argue or reason with the thought, ACT encourages people to:

• Notice their thoughts.

• Notice their emotions.

• Notice what is happening in their body.

• Reconnect with the present moment.

• Recognise that they still have a choice in how they respond.

  
  

For people who have experienced trauma, this can create enough psychological space to respond intentionally rather than automatically from fight, flight or freeze.

Why art therapy is unique

This is where I believe art therapy offers something unique. Instead of continuing to hold the thought, or a body sensation, such as anxiety experienced as a tight chest internally, the person creates it through art.

The thought or sensation becomes:

• Visible

• Observable

• External

It becomes something they can look at rather than simply be consumed by. Something that can be expressed differently, rather than relying solely on words.

Instead of saying:

"I am going to fail."

The person begins to notice:

"I'm having the thought that I'm going to fail."

That may sound like a small change, but psychologically it is enormous. The thought is no longer the person - there is no longer fusion. It has become something they can observe with curiosity rather than something they must obey.

It helps strengthen what ACT refers to as, the noticing self. This is the part of us that observes our experiences without becoming those experiences.

Art Isn't About Making Difficult Feelings Disappear

One of the biggest misconceptions about art therapy is that it is simply about relaxation or helping people "feel better." For me, it's something much deeper. Art becomes a place where anxiety, sadness, trauma, depression and overwhelming experiences can be safely held.

The difficult thoughts often remain, the emotions often remain. The urge to avoid may still be there, yet the person continues creating, they continue engaging. They practice allowing those experiences to exist while choosing actions that move them towards the life they want to live. This isn't simply drawing feelings. It's practicing a completely new relationship with them.

Could Neuroscience Help Us Understand Why?

When we begin an art process, we know it usually has an unpredictable element - like the nature of watercolour or creating kintsugi. Like watching the movement of a fire or flowing water, the creative process unfolds in ways we cannot fully predict or control. We learn to accept uncertainty, stay present and respond to what unfolds rather than trying to force an outcome.

Both being in nature and in the art process are inherently dynamic, unpredictable and impossible to fully control, yet they invite curiosity rather than threat. I believe that this primes our brain to accept new possibilities just by the environment. Perhaps this is why some of our most meaningful conversations happen around campfires, while walking in nature or sitting together in an art studio.

These environments naturally slow us down, invite reflection and create space for curiosity rather than certainty. They often seem to encourage people to think more openly, consider different perspectives and arrive at new insights or realisations.

From a neuroscience perspective, the brain is constantly making predictions about the world and updating them in response to new experiences - a process known as predictive processing. Each time we remain engaged with uncertainty instead of avoiding it, we may be creating opportunities for new patterns of thinking, feeling and responding. Repeated experiences like these are thought to support neuroplasticity, strengthening neural connections associated with more flexible ways of responding.

This makes me wonder whether therapeutic art-making provides a unique opportunity and unique supportive environment (like being in nature) to practice psychological flexibility while engaging the neural processes involved in learning and adaptation.

What Could We Measure?

Modern neuroscience gives us opportunities that simply didn't exist a decade ago.

Technologies such as:

• Electroencephalography (EEG)

• Functional near-infrared spectroscopy (fNIRS)

• Heart rate variability (HRV)

  
  

may help us better understand what is happening during therapeutic art-making.

Rather than asking:

"Does art therapy change the brain?"

We could ask:

"How does art therapy change the way we relate to our thoughts?"

Questions Worth Exploring

Some of the questions I would love to investigate include:

• What happens in the brain as an internal thought becomes an external image through therapeutic art-making?

• Does creating a thought visually produce different neural activity than talking?

• What neurophysiological changes occur during ACT exercises such as Dropping Anchor?

• How can neuroscience, Acceptance and Commitment Therapy (ACT), and art psychotherapy work together to better understand the mechanisms of therapeutic change?

Why This Matters

This isn't about replacing the deeply human and relational nature of therapy with neuroscience. It's about understanding it. If we can better understand what is happening in the brain, we may not only strengthen the evidence base for art therapy but also improve how we plan and formulate interventions. This research also helps build understanding and communication across different disciplines.

I'd Love to Collaborate

I believe this is an exciting area of research. If you're a researcher, neuroscientist, psychotherapist, arts therapist, or someone working at the intersection of brain science, creativity and mental health, I'd love to connect.

Some of the most meaningful discoveries happen when different disciplines come together.

References

Clark, A. (2013). Whatever next? Predictive brains, situated agents, and the future of cognitive science. Behavioral and Brain Sciences, 36(3), 181–204. https://doi.org/10.1017/S0140525X12000477

Teufel, C., & Fletcher, P. C. (2020). Forms of prediction in the nervous system. Nature Reviews Neuroscience, 21, 231–242. https://doi.org/10.1038/s41583-020-0275-5

Fletcher, P. C., Anderson, J. M., Shanks, D. R., Honey, R., Carpenter, T. A., Donovan, T., Papadakis, N., & Bullmore, E. T. (2001). Responses of human frontal cortex to surprising events are predicted by formal associative learning theory.Nature Neuroscience, 4, 1043–1048. https://doi.org/10.1038/nn733

Bratman, G. N., Hamilton, J. P., Hahn, K. S., Daily, G. C., & Gross, J. J. (2015). Nature experience reduces rumination and subgenual prefrontal cortex activation. Proceedings of the National Academy of Sciences, 112(28), 8567–8572. https://doi.org/10.1073/pnas.1510459112