Improvement of compulsive behavior in an art therapeutic process addressing self-compassion: A case report

This case report explores how anthroposophic art therapy (AAT) contributed to the reduction of obsessive-compulsive and anxiety symptoms in a woman with contamination-related OCD (“Sasha”). The case was drawn from a randomized controlled trial on art therapy for anxiety (Abbing et al., 2019) and selected for in-depth analysis, as Sasha was the only participant formally diagnosed with OCD. Quantitative data (anxiety, distress, emotion regulation, and executive functioning) and qualitative data from therapist notes and interviews were examined using a phenomenological approach. During the 10-week intervention, Sasha showed a marked reduction in compulsive behavior and anxiety. Improvements were also observed in validated measures of emotion regulation and executive functioning, domains often impaired in OCD. Qualitative findings highlighted key therapeutic elements—such as structured art exercises and a supportive, adaptive therapeutic stance—that promoted emotional awareness, self-regulation, and a more compassionate self-relation. Integrating process observations with outcome data suggests that symptom reduction did not occur in isolation, but was embedded in a broader psychological shift toward greater self-compassion. Enhanced emotion regulation appeared to play a central role in this process, supporting increased tolerance of emotional arousal and reduced reliance on avoidant and self-critical coping patterns characteristic of OCD. This case illustrates the potential of art therapy to address emotional and cognitive dimensions of OCD through experiential and compassionate processes. Further research is warranted to examine the effectiveness of AAT for OCD and to explore self-compassion as a potential mechanism of change. • Art therapy contributed to a reduction of OCD and anxiety symptoms • Several aspects of emotion regulation were addressed through art-based interventions • Increased self-compassion was linked to reduced obsessive-compulsive behaviors • Emotion regulation appeared to mediate the relationship between self-compassion and symptom improvement • Anthroposophic art therapy may target underlying emotional and cognitive mechanisms in OCD