Psychosomatic art therapy and autonomic nervous system regulation are formed on the basis that psychological, emotional, and physical experiences in the process of health and illness interact with each other, and psychological interventions can affect some physiological processes related to stress in addition to cognitive and emotional changes. The autonomic nervous system plays a role in regulating functions such as heart rate, breathing, blood pressure, digestive activity, and the body's response to threatening situations, and in stressful situations, an increase in sympathetic arousal can be accompanied by an increase in tension, heart rate, restlessness, and defense readiness. In contrast, more active processes related to relaxation and parasympathetic regulation can be associated with a decrease in arousal and a gradual return of the body to a more balanced state. In this framework, psychosomatic art therapy attempts to use the capacity of creative activity to regulate attention, reduce emotional tension, increase a sense of control, and enhance bodily self-awareness. Activities such as painting, drawing, music, creative writing, collage, and artistic movement can shift a person's attention from stressful stimuli to a purposeful activity, helping to create a regular, predictable, and participatory experience. The process of creating a work also allows for the expression of emotions that may be difficult to express verbally, which can help reduce the stress of emotional repression or avoidance. From the perspective of emotion regulation, a person can represent feelings of fear, anger, sadness, or anxiety through color, form, sound, and image, and then reflect on the experience created, so art is transformed from a purely aesthetic activity into a medium for observing and organizing the inner experience. At the psychophysiological level, one of the important hypotheses is that decreased emotional arousal and increased relaxation can be associated with changes in autonomic nervous system activity patterns, but this association should be interpreted with caution and not every physiological change can be directly attributed to art therapy. Some research on art and music-based interventions has reported changes in anxiety, feelings of calm, and some stress-related physiological markers, but the findings depend on the type of activity, the population studied, the duration of the intervention, and the method of measurement. One of the indicators that has been considered in psychophysiological research is heart rate variability, which can provide information about the automatic regulation of the heart and the interaction between neural and emotional processes, however, its use as a direct indicator of the effectiveness of art therapy requires careful research design and control of intervening factors. Art therapy can also play a role in regulating the stress response by reducing rumination and directing attention to the mood process. When a person engages in a creative activity, his attention is focused on choosing color, hand movement, rhythm, structure, and shape, and this focus may provide a short opportunity to distance himself from the cycle of threat-oriented thoughts. In some people, the experience of flow or relative immersion in creative activity can also be associated with a decrease in self-monitoring and an increased sense of presence in the moment. On the other hand, art allows for a strengthening of a sense of agency; a person has discretion in choosing a subject, tool, and method of expression, and this experience becomes especially important in situations where chronic illness or stress has reduced the sense of control. In patients with cancer, chronic diseases, or conditions associated with pain and anxiety, complementary use of artistic activities can be considered with the aim of reducing distress, increasing adaptability, and supporting emotion regulation. In this setting, psychosomatic art therapy can be part of a comprehensive program that incorporates psychological assessment, medical interventions, and social support alongside artistic activity. In terms of clinical application, interventions can begin with simple, low-stimulation activities and focus on building security, predictability, and selectivity, then design activities to express emotion, process bodily experience, and make meaning, according to the individual's capacity. In people who have experienced trauma or intense arousal, direct attention to bodily sensations should be exercised with caution, as focusing on the body may increase discomfort in some people. Therefore, the regulation of the nervous system should not be seen as forcing a person to calm down, but rather the goal is to create conditions to increase self-regulation capacity and make conscious choices about how to deal with emotions. The important challenge in this area is the complexity of the autonomic nervous system and its influence on multiple factors such as medication, sleep, pain, illness, physical activity, nutrition, and the environment. As a result, changes in heart rate or other physiological indicators alone cannot indicate that art therapy was the cause of the change. Another limitation is the heterogeneity of art therapy protocols and differences in the type of media, number of sessions, and therapist skills, which make it difficult to compare the results of the studies. It is also necessary to distinguish between professional art therapy and general art activity, because clinical art therapy is based on assessment, goal therapy, professional relationship, and experience reflection process. Future research can more accurately investigate possible mechanisms of influence by simultaneously using psychological indicators such as anxiety, distress, and emotion regulation, and psychophysiological indicators such as heart rate variability, breathing patterns, and other valid measures. Controlled studies with larger samples, standardized protocols, appropriate comparison groups, and long-term follow-up are also essential to determine the sustainability of the effects. Psychosomatic art therapy can strengthen a person's capacity for stress management and emotion regulation as a complementary and innovative approach in psychological interventions through attention regulation, emotion processing, increased bodily self-awareness, strengthening a sense of control, and creating a meaningful creative experience; however, attributing these effects to direct alteration of the autonomic nervous system still requires more rigorous empirical evidence, and this approach should be applied alongside standard therapies and tailored to each individual's circumstances.