What is the Perceptual/Affective Level of the Expressive Therapies Continuum?

If you know your levels of the Expressive Therapies Continuum, then you know that the Perceptual/Affective level lies between the Kinesthetic/Sensory level and the Cognitive/Symbolic level.

But what does that mean?

The Levels of the Expressive Therapies Continuum Are Conceptual

First, you need to understand that the levels of the Expressive Therapies Continuum represent a conceptual relationship among different kinds of experiencing, or information processing, within the nervous system.

The Levels of the Expressive Therapies Continuum Are Probably Related to Neural Networks

The truth of the matter is that these different kinds of experiencing aren’t localized to one brain region or structure each.  Therefore, the levels of the Expressive Therapies Continuum, or ETC, aren’t about isolated brain regions or structures.

They are likely related to neural networks instead.  More research needs to be done to confirm this, but let’s just say each of the different levels is probably comprised of a symphony of brain regions and structures.

The Levels of the Expressive Therapies Continuum Are Developmentally Hierarchical

Second, because there are likely nonlinear neural networks involved, it’s important to avoid the pitfall of thinking that the three levels of the Expressive Therapies Continuum are synonymous with literal hierarchies within the brain.

The Levels of the Expressive Therapies Continuum Are About Different Kinds of Experiencing

Each of the levels of the ETC focuses on a kind of experiencing.  The Kinesthetic/Sensory level focuses on physical experiencing, the Perceptual/Affective level focuses on emotional experiencing, and the Cognitive/Symbolic level focuses on intellectual experiencing.

These kinds of experiencing are developmentally hierarchical but not neurally hierarchical.  You can find a schematic drawing of the ETC’s developmentally hierarchical levels in this article and see how the Perceptual/Affective level is sandwiched between the other two.  

The Perceptual/Affective Level of the Expressive Therapies Continuum is About Emotional Experiencing

Now that we’ve straightened out what the levels of the Expressive Therapies Continuum are, what does the Perceptual/Affective level do?  Well, as the emotional level, it pertains to all things emotional—ranging from emotional containment to emotional expression.  Emotional containment?

Emotional Containment is Part of Healthy Functioning

You read that correctly.  In order for a person to function effectively, they need to be able to do more with their emotions than just express them.  Think of the clients you serve who are in emotional chaos and have no problem expressing that chaos.

What do they need?  Skills in emotional containment.  Emotional containment paves the way for safe access to emotions without spilling them all over the place.

Emotional Expression Needs to Be Balanced with Emotional Containment

Emotional expression is almost self-explanatory if you’re a therapist.  Unfortunately, many non-expressive therapists think that art therapy and the other expressive therapies are all about emotional expression, and they’ll expose clients to nonverbal interventions designed to get people to open up and express themselves.

The problem is that all emotional expression needs to be tempered with some degree of emotional containment in order to safeguard a client’s well-being and psychological stability.  If you don’t have training in how to support nonverbal emotional expression safely, you can overwhelm, regress, or retraumatize a client.

Emotional Homeostasis is Different for Each Client

The Perceptual/Affective level of the Expressive Therapies Continuum is a way to conceptualize treatment that supports emotional containment on the Perceptual end and emotional expression on the Affective end.

The sweet spot in the middle is a place of balance and homeostasis—and that varies from client to client.  Some clients are comfortable with more containment and less expression.  Other clients are comfortable with more expression and less containment.

Rigidity and Chaos Signal Problems on the Perceptual/Affective Level of the Expressive Therapies Continuum

As long as an individual is flexible enough to adapt to whatever their circumstances demand, they’ll be able to adjust their containment-to-expression ratio accordingly.  But if they have problems adapting, that can lead to functional problems.

People who overfunction on the Perceptual end of the Perceptual/Affective level are likely to be lost in emotional rigidity.  Conversely, people who overfunction on the Affective end of the Perceptual/Affective level are likely to be lost in emotional chaos.

The Expressive Therapies Continuum Utilizes a Wholistic Approach to Intervention

Problems with homeostasis are where intervention comes in!  But intervention within the Expressive Therapies Continuum isn’t as simple as only considering the Perceptual/Affective level; a client’s functioning on the other levels has to be taken into consideration for a wholistic approach.

Intervention Within the Expressive Therapies Continuum is Individualized

Sometimes intervention needs to support Perceptual/Affective functioning by targeting one of the other levels first.  Sometimes.  ETC intervention doesn’t lend itself neatly to a blog article, so I’ll point you in the direction of an article about assessment within the structure of the Expressive Therapies Continuum instead.

Hopefully the article will help you understand how individualized the treatment journey really is.

Develop Knowledge and Skills in the Expressive Therapies Continuum

Are you interested in leveling up your understanding of the Expressive Therapies Continuum as a framework for making responsive, outcome-informed decisions in client-centered care?  I studied under the ETC’s co-creators and have been helping art therapists and other mental health professionals grasp the Expressive Therapies Continuum for over 15 years.

Ask Me About Expressive Therapies Continuum Consulting, Supervision, and Training

Please join me in a webinar or other learning opportunities; you can find out about these and more by signing up for my ETC newsletter—you’ll receive a FREE Expressive Therapies Continuum bibliography of written and recorded works by the ETC’s co-creators and their students (and their students).

Do you have a custom need I can help you with?  I am available for speaking engagements and other projects.  Contact me for details.

Do You Need Art Therapy to Help You Create Balance in Life?

I offer Expressive Therapies Continuum-based art therapy services to help adults learn to balance emotional containment, emotional expression, and the other levels of the ETC.  Homeostasis is important, and treatment via the ETC can help achieve that through an individualized approach to honor the uniqueness of each person.

I serve Texas, Indiana, and Arizona via online art therapy, and I’d love to help YOU find your perfect balance in life.  Schedule a FREE consultation call with me to learn how we can work together and create the equilibrium that’s been missing.

References:

Hinz, L. D. (2020). Expressive Therapies Continuum: A framework for using art in therapy (2nd ed.). Routledge.

Lusebrink, V. B. (2010). Assessment and therapeutic application of the Expressive Therapies Continuum: Implications for brain structures and functions. Art Therapy: Journal of the American Art Therapy Association, 27(4), 168-177.

Lusebrink, V. B., & Hinz, L. D. (2020). Cognitive and symbolic aspects of art therapy and similarities with large scale brain networks. Art Therapy: Journal of the American Art Therapy Association, 37(3), 113-122.

VanMeter, M. L., & Hinz, L. D. (2024). A deeper dive into the Expressive Therapies Continuum; Structure, function, and the creative dimension. Art Therapy: Journal of the American Art Therapy Association, 41(2), 107-110.