Rationale

III. Healing and the Arts: The Nexus of Art and Healing

By Dr Lisa Bravo

III. Dr Lisa Bravo, DBH, LPC, LISAC, NCC (The BRAVO Effect) Essay on Art and Health (background reading)  Doctor of Behavioral Health and expert with the “I Love You Institute” 

According to the Center for Disease Control (CDC) (2021), heart disease, cancer, and diabetes are among the leading causes of death in America. More specifically, heart disease and cancer were the top 2 causes of death respectively, followed only by COVID deaths, which came in 3rd. It is well documented that chronic illness causes increased stress in all aspects of an individual’s life. Moreover, individuals facing chronic illness must not only acclimate to the inevitable physical changes related to treatment, they must also adapt to increased stress in their daily lives and relationships. Many also develop more pronounced clinical pathology such as depression and anxiety.  It is evident that chronic exposure to these stressors directly impacts health outcomes, thus affecting the patient, family, and the larger society (CDC, 2021).  

 Recently, health psychologists have begun to study the impact that exposure to the Arts has on health outcomes. In 2019, the World Health organization (WHO), after reviewing 3000 studies, identified the Arts as “playing a major role” in disease prevention. While the intersection between the Arts and healing has been well documented throughout history, we, as a society, are just beginning to understand how to measure the influence that exposure to the arts has on positive patient outcomes. In 2018, doctors in Montreal, Canada, became newsworthy when they began prescribing trips to the Montreal Art Museum as an intervention to treat certain pathologies (Lauter, 2021). One study found that cancer patients who were exposed to visual art were more likely to perceive that their care givers as warm and nurturing, and expressed a more positive experience than past hospital visits (Lankston & Cuasak, et. al, 2010). Another study found that patients were more physically active when placed in art filled environments (Nielson & Fitch, et. al, 2017). There is ample evidence to support the notion that exposure to art while healing from disease improves and positively influences outcomes. 

Individual Experience

According to the American Psychology Association (APA) 80% of all primary care visits have a psychosocial component that underlies the ailment for which they are being seen. This means that the vast majority of physical ailments are rooted in psychosocial imbalance or undiagnosed pathology. Integrated health care models have become the gold standard in patient care because of their efficacious impact in improving patient outcomes (APA, 2010). As these models of care continue to evolve, it is important to contemplate the impact that the Arts has on patient care. 

It is appropriate to consider the arts as an integral part of the healing process. Utilizing art as an adjunct to improving patient outcomes is found to assist the patient in accessing unexpressed emotions, address treatment related anxiety, and encourage more healthy dialogue regarding illness (Lankston & Cusak, et al, 2010). One study noted that patients who participated in the art process, by way of observation or activity, were found to express a greater degree of hope and future orientation (Renton & Philips, et. al, 2012). The arts medium inspired a platform for self-expression, a sense of purpose, belonging, and inclusion. 

In settings where visual arts were exhibited on the surrounding walls and in corridors, patients were more likely to take prescribed walks, positively interact with hospital staff, and were more engaged in the healing process. (Lankston & Cusak, et al, 2010) The Cleveland Clinic conducted a similar study, in which they found that exposure to paintings discovered 73% of their patients reported reduced stress symptoms because of the art they viewed, while 39% reported they felt a reduction in their pain (Lankston & Cusak, et al, 2010). Another study conducted by M.D. Anderson Cancer Centers (2008) found that patients who received chemotherapy treatments in rooms filled with nature paintings reported better pain control, reduced anxiety, and reduced stress (Hathorn & Nanda, 2008). For many hospitals, visual ART served multiple purposes: Improved patient experience, decreased anxiety, reduced stress symptoms, positive distraction, and healing (Hathorn & Nanda, 2008).

There are many studies that examine the effect that creating art  had on patients. One group of patients admitted to the coronary care unit found that patients who were directed to draw and write expressed this as a remarkable way to process the grief and trauma associated with their health condition. Further, creating art provided a launching pad for them to identify their feelings and begin to talk to loved ones about their conditions (Karpavičiūtė, & Macijauskienė, 2016). In many cases, visual art was found to provide distraction from painful procedures, while certain color schemes helped patients feel calmer (Nanda &Elsen et.al, 2011).

Brain Health

As scientists continue to unlock the mysteries related to the brain, they are just beginning to understand the impact that introducing positive experiences has on brain and body health. Renowned French neuroscientist, Pierre Lemarquis, studied the neurobiological impact that art has on the brain. He found that both viewing and creating art activates the parts of the brain that process pleasure, thereby releasing hormones and neurotransmitters such as dopamine, serotonin, endorphins, and oxytocin that are known as “feel good” chemicals (Lemarquis, 2020). This chemical cocktail is then released from the brain to the body.  They are instrumental in reducing stress and pain responses, as well as mitigating symptoms related to mental illness and other stress related health conditions (Lauter, 2021).

Public Health and Community

When we consider patient outcomes on the larger scale the focus becomes about understanding the impact of the Arts as it relates to our well-being as a society. Actively creating art together is an act of collective alliance. Working together for a common goal promotes cohesion and a shared human experience. The act of creating and/or viewing art together provides fertile ground for the development of cross cultural and cross generational experiences to propagate. Therefore, implementing the Arts as conduit for exploring wellbeing, wellness, and the healing process from a wider global perspective affords us the opportunity to perpetuate healing on a much grander scale. 

While viewing art and creating art were often researched independently, the thought of combining the two approaches is fertile with possibility. Lemarquis (2020) asserts that the brain does not differentiate between the two in terms of benefit. On the contrary, he found that the same part of the brain was stimulated by both the observer and the artist. Exploring the differences between being surrounded by art and beauty as an aesthetic and actively engaging in the creative process (within the context of healing) have yet to be substantially researched. However, it is apparent that the amalgamation of these two ideas will yield hearty results.  It is likely the public health campaigns of the future will view comprehensive approaches to healthcare to include both. 

As the healthcare field and recent pandemic have recently taken a toll on frontline healthcare workers, it is equally important to consider how they experience their work environment. Retaining employees and promoting healthy work environments is essential as it directly relates to patient care and outcomes. Art in hospitals was viewed as a positive addition by both patients and staff. In fact, one study revealed that 43% of the staff participants believed that art had a positive effect on patient outcomes (Stuckey & Nobel, 2010). 

Conclusion

There is substantial evidence that individual well-being is paramount to cultural efficacy. A healthy individual is one that has achieved a sustained sense of well-being to include both the physical and mental states. The research indicates that when individuals engage in cultivating well-being, they demonstrate more healthy behaviors, are more likely to address mental and physical illness, are more socially connected, and have a more positive outlook on life, longevity, and self-perceived health. Healthier individuals lead to healthier communities and healthier communities thrive in transcendent ways.  

References

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Karpavičiūtė, S., & Macijauskienė, J. (2016). The Impact of Arts Activity on Nursing Staff Well-Being: An Intervention in the Workplace. International journal of environmental research and public health, 13(4), 435. https://doi.org/10.3390/ijerph13040435

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