ADHD in Adults and The Power of Art
Art therapy, a specialization in the field of psychotherapy, is both an ancient and emerging specialization in the area of metal health. While there has not been as much research in art therapy quantitatively as in other specializations, it is clear to those working in the field that art therapy is beneficial to a number of diverse populations. In my experience art therapy is an especially effective and beneficial way to help adults with Attention Deficit Hyperactivity Disorder (ADHD). Through working with art, adults with ADHD seem to experience a positive shift in the way they relate to themselves and understand themselves. In addition, working with art seems to help adults with ADHD experientially learn self-regulation, connect with their feelings and emotions and practice mindfulness.
Through creating art individuals learn to express their hopes, dreams, fears, and triggers, through a medium that does not rely on verbal language. Although often in sessions we will discuss the art and sometimes even talk to the art, the art making itself is a fundamental part of the process. Most art therapists can relate when I say that art shifts something in the psyche. Modern counselling and psychotherapy often demands detailed explanations as to why we are using particular interventions, what their rates of success are, and what their validity scores are. This sort of data collection seems so distant from the therapy and research that I want to engage in, and yet I understand why it is necessary.
To promote the efficacy of art therapy we need more careful and thoughtful research regarding all aspects of the field. This paper is not a research paper; rather, it is a sharing of what I have experienced and of what I hope will be researched more thoroughly in the future. The act of engaging with art changes people. The act of working with and creating art changes people. I can posture a number of reasons why I think this is the case, but I cannot say that I know what happens, just that there is something that happens. In the future it would be beneficial for the art therapy community to explore quantitative how art making changes the brain and how it changes our experience of ourselves and the world we live in.
Through my work with adults who have an ADHD diagnosis, I have recognized that art is an excellent way for these individuals to be able to express what they are feeling and to explore their emotions. Individuals with this diagnosis are usually hyper-sensitive, which means they feel things in ways that might not make sense to those who are less sensitive, in fact feelings and emotions can be so visceral that they may even feel physically painful.
For an individual with ADHD sadness can feel so intense that it can feel like a sword in one’s stomach, and while talking about this image might be helpful, I have found that it is often even more beneficial to paint the sensation or the image. Somatic therapy can be useful with this as well, however focusing on the body during an emotional take-over can be challenging. By providing a safe space, and art materials I have found that one can encourage the client to connect with their feelings and emotions and really start to come into relationship with them.
Often clients seem to be in a battle with their feelings and emotions, which stagnates growth and healing. In order to start to welcome in their feelings and emotions the client must first come into a conscious relationship with them. The art experience allows the internal to become external, which allows the client to connect more deeply with themselves and come into relationship with their feelings and emotions. This relationship is important for regulation as it is hard to regulate an emotion if you cannot recognize what it is and why it has shown up. Likewise, a feeling which is a conscious experience; whereas, an emotion can be conscious or unconscious, cannot be worked with effectively if the client has not come into relationship with it. An individual who refuses to acknowledge, or tries to repress their feelings or emotions, cannot regulate them.
The art process is important, and I feel must be somewhat planned. Creative accidents are also important, however if they do not have a container, they can be dangerous. I like to prepare for the intense emotions and feelings that are to be welcomed into the room, knowing that more like than not that they will demand attention and want to take up space. When working with clients one never knows what will come into the therapy office that day. By being prepared, and have a space set up to contain that which might arise we set ourselves up to be more regulated and more present for our clients.
I prepare by setting up the art table, which is ritualistic and is generally set up in the same way every session. This provides comfort and safety for clients who might be sensitive to change. The table is set up with pencils if the client needs to be able to erase, pencil crayons if they need to feel the intensity of the pencil on paper, watercolors if they feel drawn to something fluid and less controlled, markers if they feel the need for intensity, pastels if they need to create something smooth and vibrant, and crayons if they need to be able to grip something hard and bear down upon the paper.
I always give my clients at least 3 different sizes of paper to choose from. The paper is usually watercolor paper, and I try to have different grains available. It is amazing how much one can be drawn to a different type of paper depending on the emotion being experienced. By having these materials set out the client does not have to worry about what to choose and does not risk over thinking and therefore losing the intensity of the moment. The paper allows for a quick and easy choice. Paper is disposable and people seem to feel more comfortable using it. Some clients are so worried about using the materials incorrectly or of “ruining” the materials that their anxiety takes over the initial feeling we were working with. This is a great opportunity to create safety with the client. I like to tell my clients, “I might give you a directive but when you get to this table (the art table) there are no rules-other than please don’t eat the crayons!”
When the paper is chosen I always ask the client to put some masking tape on the paper as borders, this is a magical ritual I learned from Janine Ray at Bring to Balance Inc. Boarders contain the art, meaning that whatever is inside the border is safe and secure. Borders also protect the art, meaning that nothing from outside can penetrate the art. This is very important when working with intense emotions. For instance, when a client draws how it feels to be sad, there are usually tears and the piece is usually very emotionally charged. The piece can represent the ultimate vulnerable moment, a glimpse into what that person is truly feeling inside. Sometimes the image can be shocking to both the therapist and the client, which is why I feel that the containment of both the office set up and the borders are vital.
The borders protect the image, and they keep us safe from the image. When the client feels that the image is done we might reflect on the image, sit with the image, talk with the image, or go into the image. When the client feels ready, and the piece is dry, I invite them to take off the borders. On a practical note is very important to use painters tape and to first stick that tape onto your pants or shirt (in an appropriate way!) to make it less sticky. I usually hand my clients pieces of tape for this purpose. It can be quite devastating to take off the borders only to have the paper come away with the tape. If the borders are taken off safely the image looks incredibly pristine, almost as if it has just been framed, which in a way it has. I have yet to see a client not react in awe at how their image looks after the borders are taken off. There seems to come a newfound respect for their art and for their relationship to its creation. Even if the client is unsatisfied with the piece, generally their un-satisfaction will lessen to some degree once the borders are removed.
Exploring feelings and/or emotions with art is a great way for clients to feel understood and to start to make friends with their deep, often very intense feelings and emotions. For people who are hypersensitive, which is most individuals with ADHD, it can feel like you are fighting a battle with your intense feelings. Befriending those feelings and emotions, instead of battling them is important for self-knowledge and emotional regulation. It’s easy to think that anger is an emotion that should be battled with, when really it is a feeling that has a lot to say and often needs to express something that hasn’t been able to be expressed. When clients learn to dialogue with their feelings and emotions through images they learn to slow down and ask why they might be feeling a certain way.
The act of art is an act of mindfulness so not only are clients learning emotional regulation, but they are also practicing mindfulness skills which have been shown to be incredibly beneficial for individuals with ADHD. Notice how in just one therapeutic art activity, the client is learning emotional regulation, connecting to their emotions and feelings, and practicing mindfulness-and all of this is experiential learning, which is, in my experience, the best type of learning.
In conclusion, it is my experience that under the right circumstances and done in a thoughtful, therapeutic space, art allows for the experiential learning of emotional regulation, coping mechanisms, and mindfulness. Additionally, art allows clients to come into relationship with their feelings and emotions in a safe and contained manner. For adults diagnosed with ADHD art can provide an outlet for the expression of emotions and feelings in a way that other mediums simply cannot provide due to the sheer intensity of the emotions and feelings experienced.
Although art therapists know that simply creating art is healing, there is still little understanding of why this is. Hence, it would be beneficial for the art therapy community to investigate with quantitatively means, if possible, how our brains change and respond to art making, and why art seems to be able to profoundly shift our experience of the world.
*Please do not use any of this paper without first asking my permission