The Art of Adaptability: beyond the Diagnosis Through Phenomenological Presence in Expressive Arts Therapy
The Art of Adaptability: Beyond Diagnosis Through Phenomenological Presence in Expressive Arts Therapy
Abstract
This reflective essay explores adaptability as a central practice in expressive arts therapy. Drawing from phenomenology and over two decades of clinical work, I suggest that diagnosis may offer context, but it does not guide the therapeutic encounter. What guides the work is presence: an aesthetic, relational, and responsive way of meeting each person as they arrive. Through practice-based reflection and a clinical vignette, I consider how adaptability—rather than rigid planning—allows the session, the materials, and the client’s own process to reveal what is needed. In expressive arts therapy, meaning is not interpreted for the client; it is discovered through attentive making, sensing, and witnessing.
The Art of Adaptability: Beyond Diagnosis Through Phenomenological Presence in Expressive Arts Therapy
This article emerges from the meeting point between my clinical practice, my personal journey, and my ongoing commitment to an aesthetic way of witnessing human experience. Over more than two decades of being a mother and working with trauma, illness, disability, and resilience, I have come to understand that art does not merely express—it organizes, transforms, and reveals what language is not yet ready to articulate.
In my work, I use intermodal processes that may include visual arts, journaling, ink, watercolor, acrylic, photography, poetry, narrative writing, and collage. These forms are not selected to produce mastery or outcome. Rather, they create a space in which experience can take shape gently, where emotion can be approached through image, material, breath, metaphor, and attention.
Many clients arrive carrying diagnoses, medical histories, evaluations, or clinical labels. These may matter. They offer context. They may shape what the body has endured or how the world has responded to them. But in the session, they do not lead the work.
What leads to the work is presence.
Phenomenological practice invites us to begin with what is here: the breath, the body, the pace, the silence, the material, the hesitation, the gesture, the unfinished image. It asks us to notice before we name, to witness before we explain, and to accompany before we direct. In expressive arts therapy, we do not interpret the client’s image or impose meaning upon their process. Instead, we create conditions in which the client can observe, listen inwardly, and discover what the work is showing them.
This requires adaptability.
I have entered sessions with carefully prepared materials, clear intentions, and structures I believed would serve the client or the group. Yet the therapeutic encounter often asks for something else. Someone arrives dysregulated. Someone finishes too quickly. A group moves more slowly than expected. More people arrive than planned—or fewer. A participant needs more time. Another cannot begin. The energy in the room changes. The image changes. The body says no.
And so the facilitator must change too.
Adaptability, in this context, is not casual flexibility. It is an aesthetic discipline: the capacity to remain fully present and respond to what the session is asking for rather than to what we hoped it would become.
Sometimes this means changing materials: from watercolor to ink, from collage to clay, from image-making to poetry. Sometimes it means beginning with breath rather than artmaking because the body needs grounding before expression. Sometimes it means simplifying the activity, shortening the plan, extending a moment, or allowing a work to end earlier than expected because completion matters more than expansion. In group work, adaptability may mean honoring different pacing without forcing sameness: one participant may be ready to finish while another is only beginning. One may need words; another may need the dignity of silence.
This is not a deviation from the process.
It is the process.
As Herbert Eberhart and Sally Atkins write, “Our way of working with the arts is open and playful. We begin by sensitizing ourselves to the materials to be used. We listen to the possibilities of the media, the materials, colors, textures and sounds, and we listen to the body. The elements become our teachers” (Atkins & Eberhart, 2014). This teaching does not come only from the materials. It comes from the session itself—from each participant, from the group field, from timing, from rupture, from silence, and from what exceeds the plan.
To facilitate expressive arts work responsibly is to be willing to be changed by the session.
One of the deepest lessons in this work is that the facilitator must remain a learner.
If I enter a session believing that I already know what the client needs, what the group should produce, or what a “successful” outcome looks like, I stop listening. Once that happens, my presence narrows.
Phenomenological work asks something more difficult and more humble: that I suspend certainty long enough to perceive what is actually here.
This includes loosening the authority of diagnosis, but it also includes loosening the authority of my own plans. My preparation may be thoughtful. My intention may be clinically sound. Yet if I become attached to it, my ego can quietly take the place of curiosity.
And when curiosity disappears, the work becomes less alive.
In expressive arts therapy, we continue learning because each session is new. Each person enters with a distinct rhythm, symbolic language, and threshold for expression. Even familiar materials become different in different hands. The same collage invitation can evoke grief in one participant, humor in another, and resistance in a third. The same breathing exercise can regulate one nervous system and frustrate another. The same poem can open memory, longing, joy, or silence.
This is not an inconsistency.
It is relational truth.
The facilitator’s task is not to force coherence according to a plan, but to cultivate a space where coherence can emerge from the client’s own experience.
I once worked with an 84-year-old woman who came to therapy after a heart procedure. Before the intervention, she had convinced herself that she would die. She prepared for death. She wrote letters, organized documents, and said her goodbyes. When she woke from surgery and realized she was still alive, she was not relieved. She was angry. What followed was not celebration, but depression.
She began attending sessions. For months, the work was quiet. We used breathing, poetry, and gentle visual processes. There was no pressure to produce insight. There was no need to improve her mood on demand. The work was to accompany her in the strange terrain between the life she thought would end and the life that unexpectedly continued.
About six months into our work together, I invited her to create a vessel with clay.
She smiled and began to shape a small boat.
As she worked, she spoke about her grandson, who was preparing to get married. When the boat was complete, I invited her to write him a letter. Later, when she read it aloud, her voice began to tremble. She paused. Tears came. The room became still.
I did not need to interpret the moment. The work itself was already speaking.
After a while, she said quietly that everything she wished for him—joy, companionship, laughter, shared life—was no longer present in the same way in her own life.
I asked her gently, “If you could choose one of those things to begin again, what would it be?”
Without hesitation, she answered: “To laugh with my husband.”
That moment did not come from analysis. It did not come from an explanation. It came from the sequence of making, remembering, writing, reading, and listening. The clay held the image. The letter gave language to longing. The silence made room for recognition. She came to her own understanding.
Stephen K. Levine writes, “The use of the arts as means of healing the soul testifies to the inherent power of men and women to confront their own pain” (Levine, 1997, p. 3). She did not come to clay to heal. She approached it through the act of making, engaging, shaping, creating. Yet in making, she encountered something that had been waiting beneath the surface.
What followed was not dramatic, but it was real. She made a quiet commitment to laugh again. More than two years later, she continues to attend sessions. She creates. She listens to others. She shares stories. And sometimes she enters the room and says, with a soft smile, “We laughed this week.”
Her healing did not begin because I found the meaning for her.
Her healing began when she was able to recognize a living thread of meaning for herself.
As Levine reminds us, “The world is given to me as a shared phenomenon; I cannot understand my being in the world without reference to others” (Knill, Levine, & Levine, 2005, p. 35). Therapy, in this sense, becomes a shared inquiry: not about determining what is wrong, but about discovering what remains possible.
Creativity, then, is not performance. It is the capacity to discover a new response within a familiar condition, or to recover an older form of vitality in a newly meaningful way. Adaptability is the clinical embodiment of this principle. It is creativity within the therapeutic relationship.
The longer I practice, the less I believe that a good session is defined by how closely it follows the plan.
A good session is one in which something true is allowed to happen.
Sometimes that truth arrives through a completed artwork. Sometimes it arrives through a letter read aloud. Sometimes it arrives through a shared breath, an unfinished image, a silence that finally feels safe, or the moment a client says, “We laughed this week.”
If diagnosis does not lead the session, then presence must.
And if presence is genuine, adaptability must follow.
Adaptability is not simply a technique; it is an ethical and aesthetic stance. It requires humility, patience, and the willingness to let the session teach us. It asks us to remain attentive to the person in front of us, to the materials in our hands, to the pace of the group, to the unexpected shifts in timing, and to the symbolic intelligence of the creative process itself.
To facilitate in this way is to release the fantasy of control.
It is also to recognize that we are not outside the process. We are shaped by it.
Each session becomes a place of mutual learning. Each client becomes, in some way, a teacher. Each group asks us to practice what we invite in others: curiosity, flexibility, courage, responsiveness, and trust in emergence. If we are still learning, it means our ego and judgment are not dominating the room. It means we are open enough to be transformed by what we witness. It means we are living what we practice.
In my own work, I have come to understand expressive arts facilitation as the use of the simplest artistic elements with great presence, accompanied by curious appreciation.
Perhaps this is one of the quiet truths of expressive arts therapy:
We do not only bring the arts to people.
The arts teach us how to be with people.
References
Atkins, S., & Eberhart, H. (2014). Presence and Process in Expressive Arts Work: At the Edge of Wonder. Jessica Kingsley Publishers.
Knill, P. J., Levine, E. G., & Levine, S. K. (2005). Principles and Practice of Expressive Arts Therapy: Toward a Therapeutic Aesthetics. Jessica Kingsley Publishers.
Levine, S. K. (1997). Poiesis: The Language of Psychology and the Speech of the Soul. Jessica Kingsley Publishers.
Abstract
This reflective essay explores adaptability as a central practice in expressive arts therapy. Drawing from phenomenology and over two decades of clinical work, I suggest that diagnosis may offer context, but it does not guide the therapeutic encounter. What guides the work is presence: an aesthetic, relational, and responsive way of meeting each person as they arrive. Through practice-based reflection and a clinical vignette, I consider how adaptability—rather than rigid planning—allows the session, the materials, and the client’s own process to reveal what is needed. In expressive arts therapy, meaning is not interpreted for the client; it is discovered through attentive making, sensing, and witnessing.
The Art of Adaptability: Beyond Diagnosis Through Phenomenological Presence in Expressive Arts Therapy
This article emerges from the meeting point between my clinical practice, my personal journey, and my ongoing commitment to an aesthetic way of witnessing human experience. Over more than two decades of being a mother and working with trauma, illness, disability, and resilience, I have come to understand that art does not merely express—it organizes, transforms, and reveals what language is not yet ready to articulate.
In my work, I use intermodal processes that may include visual arts, journaling, ink, watercolor, acrylic, photography, poetry, narrative writing, and collage. These forms are not selected to produce mastery or outcome. Rather, they create a space in which experience can take shape gently, where emotion can be approached through image, material, breath, metaphor, and attention.
Many clients arrive carrying diagnoses, medical histories, evaluations, or clinical labels. These may matter. They offer context. They may shape what the body has endured or how the world has responded to them. But in the session, they do not lead the work.
What leads to the work is presence.
Phenomenological practice invites us to begin with what is here: the breath, the body, the pace, the silence, the material, the hesitation, the gesture, the unfinished image. It asks us to notice before we name, to witness before we explain, and to accompany before we direct. In expressive arts therapy, we do not interpret the client’s image or impose meaning upon their process. Instead, we create conditions in which the client can observe, listen inwardly, and discover what the work is showing them.
This requires adaptability.
I have entered sessions with carefully prepared materials, clear intentions, and structures I believed would serve the client or the group. Yet the therapeutic encounter often asks for something else. Someone arrives dysregulated. Someone finishes too quickly. A group moves more slowly than expected. More people arrive than planned—or fewer. A participant needs more time. Another cannot begin. The energy in the room changes. The image changes. The body says no.
And so the facilitator must change too.
Adaptability, in this context, is not casual flexibility. It is an aesthetic discipline: the capacity to remain fully present and respond to what the session is asking for rather than to what we hoped it would become.
Sometimes this means changing materials: from watercolor to ink, from collage to clay, from image-making to poetry. Sometimes it means beginning with breath rather than artmaking because the body needs grounding before expression. Sometimes it means simplifying the activity, shortening the plan, extending a moment, or allowing a work to end earlier than expected because completion matters more than expansion. In group work, adaptability may mean honoring different pacing without forcing sameness: one participant may be ready to finish while another is only beginning. One may need words; another may need the dignity of silence.
This is not a deviation from the process.
It is the process.
As Herbert Eberhart and Sally Atkins write, “Our way of working with the arts is open and playful. We begin by sensitizing ourselves to the materials to be used. We listen to the possibilities of the media, the materials, colors, textures and sounds, and we listen to the body. The elements become our teachers” (Atkins & Eberhart, 2014). This teaching does not come only from the materials. It comes from the session itself—from each participant, from the group field, from timing, from rupture, from silence, and from what exceeds the plan.
To facilitate expressive arts work responsibly is to be willing to be changed by the session.
One of the deepest lessons in this work is that the facilitator must remain a learner.
If I enter a session believing that I already know what the client needs, what the group should produce, or what a “successful” outcome looks like, I stop listening. Once that happens, my presence narrows.
Phenomenological work asks something more difficult and more humble: that I suspend certainty long enough to perceive what is actually here.
This includes loosening the authority of diagnosis, but it also includes loosening the authority of my own plans. My preparation may be thoughtful. My intention may be clinically sound. Yet if I become attached to it, my ego can quietly take the place of curiosity.
And when curiosity disappears, the work becomes less alive.
In expressive arts therapy, we continue learning because each session is new. Each person enters with a distinct rhythm, symbolic language, and threshold for expression. Even familiar materials become different in different hands. The same collage invitation can evoke grief in one participant, humor in another, and resistance in a third. The same breathing exercise can regulate one nervous system and frustrate another. The same poem can open memory, longing, joy, or silence.
This is not an inconsistency.
It is relational truth.
The facilitator’s task is not to force coherence according to a plan, but to cultivate a space where coherence can emerge from the client’s own experience.
I once worked with an 84-year-old woman who came to therapy after a heart procedure. Before the intervention, she had convinced herself that she would die. She prepared for death. She wrote letters, organized documents, and said her goodbyes. When she woke from surgery and realized she was still alive, she was not relieved. She was angry. What followed was not celebration, but depression.
She began attending sessions. For months, the work was quiet. We used breathing, poetry, and gentle visual processes. There was no pressure to produce insight. There was no need to improve her mood on demand. The work was to accompany her in the strange terrain between the life she thought would end and the life that unexpectedly continued.
About six months into our work together, I invited her to create a vessel with clay.
She smiled and began to shape a small boat.
As she worked, she spoke about her grandson, who was preparing to get married. When the boat was complete, I invited her to write him a letter. Later, when she read it aloud, her voice began to tremble. She paused. Tears came. The room became still.
I did not need to interpret the moment. The work itself was already speaking.
After a while, she said quietly that everything she wished for him—joy, companionship, laughter, shared life—was no longer present in the same way in her own life.
I asked her gently, “If you could choose one of those things to begin again, what would it be?”
Without hesitation, she answered: “To laugh with my husband.”
That moment did not come from analysis. It did not come from an explanation. It came from the sequence of making, remembering, writing, reading, and listening. The clay held the image. The letter gave language to longing. The silence made room for recognition. She came to her own understanding.
Stephen K. Levine writes, “The use of the arts as means of healing the soul testifies to the inherent power of men and women to confront their own pain” (Levine, 1997, p. 3). She did not come to clay to heal. She approached it through the act of making, engaging, shaping, creating. Yet in making, she encountered something that had been waiting beneath the surface.
What followed was not dramatic, but it was real. She made a quiet commitment to laugh again. More than two years later, she continues to attend sessions. She creates. She listens to others. She shares stories. And sometimes she enters the room and says, with a soft smile, “We laughed this week.”
Her healing did not begin because I found the meaning for her.
Her healing began when she was able to recognize a living thread of meaning for herself.
As Levine reminds us, “The world is given to me as a shared phenomenon; I cannot understand my being in the world without reference to others” (Knill, Levine, & Levine, 2005, p. 35). Therapy, in this sense, becomes a shared inquiry: not about determining what is wrong, but about discovering what remains possible.
Creativity, then, is not performance. It is the capacity to discover a new response within a familiar condition, or to recover an older form of vitality in a newly meaningful way. Adaptability is the clinical embodiment of this principle. It is creativity within the therapeutic relationship.
The longer I practice, the less I believe that a good session is defined by how closely it follows the plan.
A good session is one in which something true is allowed to happen.
Sometimes that truth arrives through a completed artwork. Sometimes it arrives through a letter read aloud. Sometimes it arrives through a shared breath, an unfinished image, a silence that finally feels safe, or the moment a client says, “We laughed this week.”
If diagnosis does not lead the session, then presence must.
And if presence is genuine, adaptability must follow.
Adaptability is not simply a technique; it is an ethical and aesthetic stance. It requires humility, patience, and the willingness to let the session teach us. It asks us to remain attentive to the person in front of us, to the materials in our hands, to the pace of the group, to the unexpected shifts in timing, and to the symbolic intelligence of the creative process itself.
To facilitate in this way is to release the fantasy of control.
It is also to recognize that we are not outside the process. We are shaped by it.
Each session becomes a place of mutual learning. Each client becomes, in some way, a teacher. Each group asks us to practice what we invite in others: curiosity, flexibility, courage, responsiveness, and trust in emergence. If we are still learning, it means our ego and judgment are not dominating the room. It means we are open enough to be transformed by what we witness. It means we are living what we practice.
In my own work, I have come to understand expressive arts facilitation as the use of the simplest artistic elements with great presence, accompanied by curious appreciation.
Perhaps this is one of the quiet truths of expressive arts therapy:
We do not only bring the arts to people.
The arts teach us how to be with people.
References
Atkins, S., & Eberhart, H. (2014). Presence and Process in Expressive Arts Work: At the Edge of Wonder. Jessica Kingsley Publishers.
Knill, P. J., Levine, E. G., & Levine, S. K. (2005). Principles and Practice of Expressive Arts Therapy: Toward a Therapeutic Aesthetics. Jessica Kingsley Publishers.
Levine, S. K. (1997). Poiesis: The Language of Psychology and the Speech of the Soul. Jessica Kingsley Publishers.