Regulating the Sensory Cortex with Sensorimotor Art Therapy Approaches

Cornelia Elbrecht AThR, SATh, SEP, ANZACATA, IEATA, IACAET 

Increasingly art therapists see neurodivergent children in their sessions, and many struggle with how to address the often-complex needs of these clients. Difficult pregnancies, birth trauma, adverse early childhood experiences or other neurological factors frequently distort the sensory perception of the environment.

I see many children who have sensory processing and integration issues. (Ayres, 2015 6th edition) Many come with a diagnosis of being ‘on the autism spectrum’. Touching textures such as paints or clay, loud noises or shifting from one space to another can be overwhelming for them. They respond frequently with refusing to touch the art materials; or they apply hectic motor impulses to avoid receiving sensory feedback from a haptic encounter. Moving fast also overrides the discomfort about their inability to connect. Their nervous system is at war with their environment, which from their perspective is disorganized, overwhelming and threatening.

What might appear as a temper tantrum or as naughty behaviour however is frequently pure desperation or frustration. Living in a world where there are too many triggers for the autonomic nervous system is extremely stressful. Dan Siegel distinguishes between upstairs and downstairs tantrums. (Siegel, 2013. 2015) An upstairs protest about not getting ice cream before dinner might be designed to push boundaries or test authority figures. Such an event can be discussed, solved through cognitive insight or some form of punishment.

A downstairs tantrum, however, is nothing like the former. Here children lash out due to being overwhelmed, terrified and unable to cope with their environment. They do need safety. They need a caregiver who can downregulate their overactivated nervous system. They need a slowing down of events to be able to receive predictable cues. Stephen Porges likens safety to predictability.

Figure 1: a child client with a sponge and water at the Clay Field

In the art making process it can be important to spend sufficient time with such clients to discover what touch experiences are deemed safe for them. Many children try to wipe clay or paint off their hands as soon as they connect with such textures. The sticky nature of these materials is perceived as threatening. Some children only tolerate warm water. Some enjoy working at the sink playing with flowing warm water or with various containers filled with water. Others spend hours washing the small toy animals or other objects. It might take years to gradually increase sensory tolerance through an added sponge, or a crystal. The therapy might focus on gradually introducing new textures such as shaving cream or kinetic sand, something that is not sticky, or other materials they discover as manageable. (Elbrecht, 2021)

With much patience on both sides, and through creating safety around the creative process, gradual tolerance for sensory feedback can be developed. Most importantly this requires an intentional slowing down of any action cycles. Sensory perception needs time. The hands need to listen and take in what they touch. The world needs to be allowed in as a safe sensory adventure. The touch and connection experience needs to arrive in the body and be registered as manageable and benign. The therapist needs to move slowly, speak slowly and give plenty of time to support this discovery of safe connection.

Figure 2: a teenage client completing a Guided Drawing exercise

It is easy to scare somebody; it takes much more time to make someone feel safe. The neurological pathways that deal with safety move significantly slower than those which have evolved to deal with threat. We can quickly mobilize our defences, it takes much longer to down-regulate afterwards, once the danger has passed.

The dual polarity of sensory perception and motor impulses each play their role in our haptic interactions with the world. Clients who are relaxed can be in their body without paying too much attention to it. At the same time, they have their senses available to take in their environment, observe it, learn from it, orient in it and express themselves in it. For traumatized individuals and many neurodivergent clients however, this capacity to relate is dimmed down or compromised. The feedback loop between reaching out with a motor impulse and receiving an implicit sensory response from their action is dissociated or disorganised, or both.

The exteroceptive division of the sensory cortex represents our five senses through which we perceive the outside world. The interoceptive aspect of the sensory cortex oversees what as adults we call our felt sense. (Gendlin, 1981) It describes how we register and interpret our internal sense such as heart rate, breath, our endocrine and digestive system and sense of balance. 

From an evolutionary perspective the sensory cortex is the oldest part of the brain; we share its focus on safety or danger even with fish. It develops almost from conception onwards. The embryo learns through the mother’s body what safety and danger feel like. This is perceived through the skin boundary. Not just the skin as we know it surrounding our body’s boundary, but through the membrane of every developing cell in utero. The embryo develops from a single cell with a surrounding membrane. The sensory information communicated through the mother’s body, her womb and autonomic nervous system, communicates with every cell membrane as it divides further, forming a foetus. Ray Castellino researched the development of our pre- and perinatal implicit memory differentiating between the blueprint of a cell and the imprints of information it receives from conception onward. (Castellino, 2020)

Every cell undergoes this sensory programming process. Bruce Perry studied pregnant mothers’ states of activation and relaxation. If these were predictably regulated through exercise and sleep cycles, their babies were born with regulated autonomic nervous systems that could tolerate states of intense excitement and deep relaxation. (Perry, 2005) If these mothers were depressed, abusing drugs, unhappy or ambivalent about the pregnancy, their babies’ sensory cortex learnt disorganized imprints. A client of mine worked nightshifts during her pregnancy while studying for her master’s degree during the day - ‘to get it all done’ before the baby’s birth. For the first year her son only slept in 10-minute intervals; he had not learnt in the womb what it felt like to rest.

Stephen Porges’ development of the Polyvagal Theory (Porges, 2011), and his ground-breaking explorations of the autonomic nervous system, have expanded the knowledge of how our physiology detects and processes existential danger and safety. Porges identified two motor branches of the vagus nerve, that provide both motor and sensory pathways between brain stem structures and visceral organs. Consciously working with these sensory and motor aspects is at the core of Sensorimotor Art Therapy. 

Figures 3 & 4: a motor impulse will trigger sensory feedback; the core concept behind Sensorimotor Art Therapy modalities Guided Drawing and Clay Field Therapy

Every time a client sits down in front of a sheet of paper or a Clay Field it requires a motor impulse to reach into out and touch the material. Next the individual will receive sensory feedback from this encounter.  The client’s neurotransmitters, perceived as internal felt sense, will constantly scan this event for cues of safety or danger.

Polyvagal Theory provides a framework for understanding this development from a sensory and motor perspective. The hands touch the art materials, and the sensory feedback signals safety or danger to the brain, which in return responds with a motor impulse. The ANS mobilises, immobilises or socially engages depending on the perceived threat or safety in the setting.  This is the job of our neurons.  

Only when sensory integration of safety has been realized, fulfilment becomes possible. Now the movements slow right down and much time is needed for the repair of broken synaptic connections. This can be a wonderous state to witness, and clients emerge from it feeling “weird”, unfamiliar, or strangely at peace. Children tend to describe it as deeply “satisfying”, experiencing profound nourishment and emotional satiation. They have not made anything, they have not performed or produced something, certainly not created an object to take home, but they have experienced a safe and fulfilling relationship with themselves, often for the first time. This becomes possible through the trauma-informed facilitation of sensory integration, where the client touches the clay, the paint, the shaving cream or crayons and is simultaneously being touched by this haptic event. The haptic connection with an other-than-me has become safe and fulfilling.

Understanding how the body processes information enables the therapist to support the reparation of trauma-induced rupture and the reorganization of synaptic connections.  In all cases the sensorimotor explorations aim to facilitate a fulfilling relationship with oneself and the world.

Works Cited

Ayres, J. (2015 6th edition). Sensory Integration and the Child. USA: Western Psychological Services.

Castellino, R. (2020). https://consciouslyparenting.com/ray-castellino/. Retrieved from Conscious parenting.

Elbrecht, C. (2021). Healing traumatized children at the clay field; sensorimotor embodiment of developmental milestones. Berkley CA: North Atlantic Books.

Gendlin, E. T. (1981). Focusing. Toronto: Bantam Books.

Perry, B. (2005). Applying principles of Neurodevelopment to clinical work with maltreated and traumatized children: The neurosequential model of therapeutics. In Webb, Working with traumatized youth in child welfare (pp. 27 - 53). New York: Guilford Press.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. New York: W. W. Norton Series on Interpersonal Neurobiology.

Siegel, D. (2013. 2015). Brainstorm; the power and purpose of the teenage brain. New York NY: Tarcher Perigee.