Art therapy and self-harm
Self-harm is when someone intentionally causes injury or harm to their own body. Self-harm and self-injury affect people of all genders, ages, and backgrounds.
People may self-harm for many reasons, usually because they feel emotionally distressed. Sometimes people self-harm with the intent to end their lives and at other times to communicate distress or gain relief when overwhelmed. People who self-harm are at higher risk of ending their lives than the rest of the population [1].
Self-harm is difficult to measure accurately and there are numerous estimates. However, a 2019 report found that self-reported self-harm had increased in England between 2000 and 2014. It also stated that in 2014 about one fifth of women and girls between the ages of 16 and 25 reported harming themselves. [2]
Overview
- It is established practice to provide arts therapies for people who self-harm, especially in services for people with personality difficulties [3].
- There is preliminary evidence that art therapy can be helpful for people who harm themselves [4, 5, 6].
Why art therapy may be helpful
Managing emotions
Art therapy aims to enable people to express and experience emotions safely through making art. Service users can feel safer making art and talking about the artwork than talking directly to another person or in a group about their distress [2].
Feeling able to safely experience emotions in art therapy may enable people to take a step back from strong emotions and increase their sense of control. They can then think about and express their emotions in new ways, which helps strengthen their ability to manage them [3, 7].
Group art therapy
If people attend art therapy in a group, they can learn about others’ emotions and mental states as well as seeing their own in new ways [3, 7, 8].
Group members experience regulating their own emotions during facilitated interactions with others. This happens partly by picking up on each other’s themes in a safe environment by seeing each other express themselves through art [3, 8, 9].
In two different qualitative studies, service users indicated that after being able to express and manage strong negative emotions in group art therapy, they were less inclined to harm themselves [3, 9].
Film by a service user
In this video, a service user talks about the film they created with art therapist, Tony Gammidge. The film, titled ‘My Dark Shadow’ explores self-harm and healing.
Evidence sources
- NICE: Self-harm: Assessment, management and preventing recurrence (2022).
This is the England and Wales national guideline on treatment and support when people self-harm.
- Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population
- How can art therapy contribute to mentalization in borderline personality disorder? (2012)
This is a detailed exploration of one service user’s experience of group art therapy in the UK, with extensive quotations from interviews. - Psychosocial, symptomatic and diagnostic changes with long-term psychodynamic art psychotherapy for personality disorders (2014)
A small study carried out in Turkey with pre and post measures. - Efficacy of art therapy in individuals with personality disorders cluster B/C: A randomized controlled trial (2018)
A small randomised trial of art therapy versus waiting list carried out in the Netherlands showing that participants attending 10 art therapy sessions reported improved functioning. - Suicide/ self-harm reducing effects of an Aboriginal art program for aboriginal prisoners (2018)
A retrospective audit of 335 inmates of an Australian prison, finding that reduced self-harm was associated with attending more art therapy sessions. - A systematic review on arts therapies interventions in the treatment of personality disorders (2018)
A thematic synthesis from 17 qualitative studies, 5 mixed methods, 5 case studies, 1 survey and 4 previous reviews. - Short-term day treatment programmes for patients with personality disorders. What is the optimal composition? (2004)
A review of relevant literature including a discussion of the way that art therapy groups may be helpful in enabling increased mentalisation – understanding one’s own mind and the minds of others. - Perceived effects of art therapy in the treatment of personality disorders, cluster B/C: A qualitative study (2015)
Interviews with 29 participants of group art therapy.
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Published: 1 March 2024