There is a need for further dialogue on the theoretical basis of art therapy that emerges from the mechanisms of change that are inherent to art. This chapter contributes to that dialogue reflecting on historical and theoretical perspectives and through honoring the artist’s voice in the conversation. This chapter will discuss some of the primary mechanisms of change inherent in art that are central to art therapy theory, including holism, emergentism, homeostasis, flow, the understanding of art as a way of holding both the known and the unknown, and the active role of the artist in the human experience