Art Therapy and DBT: Mindfulness
As we explored in our previous post, art therapy and Dialectical Behavior Therapy (DBT) work hand-in-hand to foster distress tolerance and resilience. At the core of DBT, however, lies a foundational skill that enhances all others: mindfulness. This week, we’ll delve into how mindfulness is taught and experienced in DBT, and how art therapy can make mindfulness not just a concept, but a lived, felt experience.
What Is Mindfulness in DBT?
Mindfulness, as defined in DBT, is the practice of paying attention, on purpose, in the present moment, and without judgment. It’s about noticing thoughts, emotions, and bodily sensations as they arise, rather than getting swept away by them. In DBT, mindfulness is not merely about relaxation—it’s about building awareness so that we can respond to our experiences, rather than react automatically.
The core mindfulness skills in DBT are divided into two categories:
"What" skills: Observe, Describe, Participate
"How" skills: Non-judgmentally, One-mindfully, Effectively
These skills teach us to notice what’s happening, put words to it, fully engage with the moment, and do so without harsh self-criticism or multitasking.
Why Mindfulness Matters in Therapy
Mindfulness is the gateway to change. Without awareness, patterns remain unconscious and automatic. By cultivating mindfulness, clients can begin to recognize early signs of distress, shift out of autopilot, and make conscious choices about how to cope. Mindfulness also fosters emotional tolerance, reduces impulsivity, and enhances self-acceptance.
The Creative Bridge: Art Therapy as Mindfulness Practice
While mindfulness can be practiced through meditation or breathwork, it can also be expressed through the hands-on process of making art. For many, sitting still and focusing on the breath can feel daunting. Art therapy offers a unique path—one that utilizes creative engagement as a means to cultivate presence and awareness.
How Art Therapy Facilitates Mindfulness
Sensory Focus: Art-making draws attention to tactile, visual, and sometimes auditory sensations. The feeling of clay, the movement of a pencil, the sound of scissors, the sound of paper tearing, or rhythmic, repetitive movements and sounds—these sensory experiences draw awareness into the present moment.
Process Over Product: In art therapy, the journey matters more than the outcome. Clients are encouraged to notice thoughts and emotions that arise as they create, letting go of attachment to perfection.
Nonverbal Awareness: For those who struggle to articulate their inner world, art offers an alternative means of expression. The act of choosing colors, shapes, and materials becomes a mindful exploration of feelings and needs.
Interrupting Rumination: Creative activities demand enough focus to disrupt cycles of worry or self-criticism, providing a break from unhelpful mental loops.
Practical Mindfulness Directives in Art Therapy
Below are a few art therapy exercises that embody DBT’s mindfulness principles:
1. Mindful Mandala Drawing
Clients begin by drawing or coloring a circular mandala shape. The repetitive and rhythmic nature of the task encourages a one-minded presence. Participants are invited to notice the sensation of drawing, their breathing, and any thoughts that arise—returning to the task whenever the mind wanders.
2. Breath and Brush Painting
Using watercolors or ink, clients synchronize their brushstrokes with their breath—inhaling to load the brush, exhaling to create a stroke. This unites awareness of body and action, anchoring attention in the present moment.
3. Five Senses Collage
Clients gather materials that appeal to each of their senses: textured papers, scented markers, shiny stickers, and soft fabrics. Assembling the collage, they are prompted to notice each sensation in turn, practicing mindful observation without judgment.
4. Slow Stitching
Simple, repetitive sewing or embroidery tasks encourage patience and focus. Clients are asked to attend closely to the movements of needle and thread, noticing thoughts and sensations without trying to change them.
5. Observational Drawing
Clients choose an object and spend several minutes observing it closely before drawing, focusing on its details, textures, and colors. This exercise cultivates the DBT “what” skills: Observe, Describe, Participate.
Integrating Mindfulness and Art in DBT-Informed Sessions
For therapists, weaving mindfulness into art therapy means:
Setting an intention for presence at the start of the session
Using gentle prompts to redirect attention when the mind wanders
Encouraging curiosity about the art process, rather than self-critique
Debriefing afterwards to connect the art experience to daily life
Conclusion
In DBT and art therapy, mindfulness is both the foundation and the catalyst for growth—a skill to be nurtured alongside creative exploration. By combining mindful awareness with artistic expression, therapists empower clients to experience true presence in tangible ways. Through mandalas, brushstrokes, or collage, art therapy transforms mindfulness from an abstract idea into something we can see and feel—bringing it off the cushion and into our hands, one mindful mark at a time.
References
Clark, S. M. (2017). DBT-Informed Art Therapy: mindfulness, cognitive behavior therapy, and the creative process. Jessica Kingsley Publishers.
Linehan, M. M. (2015). DBT skills training handouts and worksheets (2nd ed.). New York: Guilford Press.
Linehan, M. M. (2015). DBT skills training manual (2nd ed.). New York: Guilford Press.
Bernier, M. (2023). Process and Materials of Art Psychotherapy II: Painting in Art Therapy [Class handout]. Eastern Virginia Medical School, ATC 524.
