The title of this article may sound like the start of a joke, but I want to make the claim that mess, mess-making and messiness are serious matters when we work therapeutically with children, young people and families. Experience suggests that mess of one kind or another is a ubiquitous feature of therapy, where messes, both literal and metaphorical, can usefully help to express, communicate and process a wide range of experiences. 

I start by exploring what ‘mess’ actually means, both inside and outside the therapy space, and share what other writers have had to say about it, drawing on art psychotherapy theory and literature. Finally, I introduce my own model for thinking about orientations towards (or away from) mess, and consider how this simple framework might help us to make sense of the messes that are created in therapy. 

I anticipate that this article might leave you with more questions than answers, and this is no bad thing, since mess can be such a significant part of a therapeutic intervention, for both service users and professionals. So, if this article prompts you to go away and do some further thinking about mess (and your relationship with it), so much the better!

What do we mean by mess?

Mess is a nebulous concept; your mental image of ‘mess’ will likely look and feel different from the mess conjured up in my imagination, or anyone else’s. Nonetheless, dictionary definitions of mess all seem to touch on things that are usually considered to be negative: dirt, confusion, problems, trouble, difficulty and so on. For example, the Merriam-Webster entry includes, ‘…a disordered, untidy, offensive, or unpleasant state or condition’ and ‘…one that is disordered, untidy, offensive, or unpleasant usually because of blundering, laxity, or misconduct’.1

In the counselling room, mess is perhaps easiest to identify when children and young people explicitly create some kind of physical chaos, untidiness or disorder. In my experience, this kind of literal mess-making can involve art materials, toys and any other objects that are present in the space. Messy use of art materials is often described in terms of fluids like water, paint and glue being used as a substrate for processes of swamping, smearing, spilling, pouring, dripping and mixing.2

Solid materials and artefacts (like glitter and small-world figures) may be introduced into the mixtures as required by their makers. There may or may not be an identifiable product at the end of this process, such as a ‘potion’3 or a ‘messy package’4 that the child or young person may wish to either keep or discard. The mess-making may or may not be accompanied by a feeling of overwhelm for the client and/or the therapist, or a sense of boundaries and limits being tested.

A similar kind of chaos can also be created using toys and other play materials, which may be taken out of their storage spaces and quickly discarded, leaving a trail of physical detritus in the client’s wake. Metaphorical messes are also created within therapeutic spaces in a variety of ways. Some clients talk so quickly or persistently that it is difficult for us to keep up with their narrative, or to meaningfully respond. Dramatic or pretend play can become littered with characters or plot developments, or may be so fragmented that we simply cannot make sense of the story that the client is trying to create. Especially for older children, and in our work with their adult family members, mess might primarily present through the verbal narratives they share about their own experiences of trouble, difficulty or confusion. However the mess is presented, we need to consider how we can help our clients to make sense of it and how we might respond. 

How can we understand and work with mess in therapy?

Here, I draw primarily on sources from art psychotherapy, as this is my main modality and the territory with which I am most familiar. Several art psychotherapists have written about ‘an abundance of mess’2 in their work with traumatised children and young people, particularly those who have experienced significant early relational adversities and those who are ‘looked after’. Sagar was one of the first to claim that mess can be a form of symbolic communication, with clients using physical mess-making to express (consciously or otherwise) a sense of chaos or disorder in their internal worlds.4 Putting internal messiness outside of oneself seems to be a useful way for some children and young people to make their emotions observable, such that they can begin to process and make sense of their messy life experiences in a physical, embodied way.5

O’Brien suggests that mess is created by use of ‘…materials, drama and non-relating [to the therapist] to keep thought at bay’.2 In her experience, children who have experienced neglect and abuse, particularly sexual abuse, tend to express their internal messiness in a way that feels dissociative and overwhelming, ‘… a retreat from being with another person’ rather than meaningful symbolisation or processing of experience. Extreme mess-making is used as a kind of physical ‘white noise’ that shuts down the therapist’s capacity to think or respond in the moment. When working with these children and young children, good supervision becomes more important than ever.

For some children and young people, extreme mess-making is a way to test the limits of the therapist and the therapeutic relationship. The implicit communication seems to be, ‘What happens if I try to pour all the paint or glue into this palette, onto the paper, or into the sink?’ Here, the primary need may be for containment and holding (sometimes literal, as when a very soggy image is picked up and carried to a safe space for drying), and to know that a thinking adult is available to intervene if and when the play or creative work threatens to become overwhelming.

It may also be important for a young client to experience that the therapist can tolerate and be with them in their messiness – as a means of testing out whether they can be accepted as they are.5 This might involve the client inviting their therapist to touch or immerse their hands in messy mixtures, or trying to paint the therapist’s body or face. For many of our young clients, this could be an unconscious way of communicating their attachment needs and trying to get them met.

For other clients, mess-making may be used more consciously as a form of communication and processing. Aldridge describes 15-year-old David, who tended to supress emotions outside the therapeutic space but ‘…was able to see that making a mess [in art therapy] was useful in itself. If he had had a bad week he would arrive and say that he wanted to make a mess and did so… the mess needed to contain as many things as possible to be a real mess.’5 For young people like David, the therapist’s primary function seems to be as a witness, and perhaps as a helper in metabolising the mess and making it more digestible.

For this reason, there may be tremendous therapeutic benefit in seeing that messes can be both withstood and also reversed. It may be important for some clients to be part of cleaning and tidying the therapy room, or at least watching the therapist do so, so that they can physically see that very messy spaces can be restored to more orderly ones. Just as mess-making can act as an external representation of internal chaos and disorder, the cleaning and tidying of the therapeutic space can symbolise and make visible an internal process of self-regulation – the restoration of emotional calm and control. For other young people, the important thing might be that they can leave their enormous messes behind for the therapist to clean up on their behalf after the session. I have seen the benefits of both approaches.

Therapeutic skill when working with mess involves being able to assess what is being communicated, attuning to whatever needs are being expressed and finding a sensitive, appropriate response. At times, this will involve a high degree of permissiveness around mess-making; at others, we may need to set more stringent limits. At the other end of the mess spectrum, some clients are so reliant on order, control and neatness that they might actually benefit from being encouraged to get messy, as these young clients can sometimes go under the radar. In the following vignette I describe one such child.

Getting to know our own relationship with mess

Each of us has our own unique relationship with mess. Some of us will have positive associations (such as freedom, autonomy or creativity), others will feel more challenged or disturbed by it. We may have complex feelings that are influenced by whose mess we are talking about. In general, I feel comfortable being with messes that ‘belong’ to others (especially in therapy), but I find it much more difficult to sit with mess in my own life.

In thinking about the wide range of potential responses to mess, I developed a simple diagrammatic model (see right), in which two axes intersect to represent a landscape of possible orientations. On the horizontal axis is our emotional response – do we feel affectionately about mess, or do we experience ‘abjection’,6 a kind of revulsion or horror that is typically linked to the muddling up of
boundaries? On the vertical axis is our behavioural ‘approach/avoid’ response to mess – are we generally inclined to move towards or away from it? One person might feel comfortable with mess (affection), and able to tolerate a high degree of messiness in their life (approach). Another might loathe mess (abjection), but nonetheless find themselves attracting a lot of messy situations (approach). Each of us can lie at any point on the axes, so that any combination of emotions and behaviours is possible.

The model is based on my own lived experience and intuition rather than empirical evidence, so I invite you to test it out in thinking about your own relationship to mess. It might be useful to consider both your emotional and behavioural responses, using my simple framework or something else.

Create space to reflect on your own experience of mess, perhaps through journaling or imagery. You might even take some time to create your own unholy mess! Mess is a serious business in therapy, and we need to develop our reflective capacity to think about it in whatever way feels comfortable. Your clients will benefit from it.

A simple framework for thinking about emotional and behavioural responses to mess
© Sarah Haywood, 2022


1 Merriam-Webster online dictionary: (accessed June 2022).
2 O’Brien F. The making of mess in art therapy: attachment, trauma and the brain. Inscape 2004; 9(1): 2–13.
3 Case C. Reflections and shadows: an exploration of the world of the rejected girl. In: Case C, Dalley T (eds). Working with children in art therapy. London: Routledge; 1990 (pp131–160).

4 Sagar C. Working with cases of child sexual abuse. In: Case C, Dalley T (eds). Working with children in art therapy. London: Routledge; 1990 (pp89–114).
5 Aldridge F. Chocolate or shit: aesthetics and cultural poverty in art therapy with children. Inscape 1998; 3(1): 2–9.
6 Kristeva J. Powers of horror: an essay on abjection. Columbia University Press; 1982.