15th April marked World Art Day - Lina Saadani Allali explores the use of art therapy as an alternative to dialogic focused therapies (CBT and talk therapies). Art therapy allows individuals to express suppressed inner thoughts and emotions through pencil, pen and colour on a canvas.
As a result of Lockdown, many of us found ourselves afflicted with a new-found sense of boredom and a declining mental health, which as a result, made it the perfect time to try taking up a new hobby. It wasn't until I settled on art that I tried a wide range of different activities, from baking to music and Duolingo. My brain was only able to shut off all other thoughts through concentrated work on my canvas, and I really loved how having this kind of activity helped me bring some colour into the days that otherwise would have blended into one another. Having experienced the benefits of art therapy myself, I have written this piece out of an interest in the history, benefits, and potential applications of art therapy in modern medicine and in our everyday lives, using my own experiences to illustrate the point.
What is Art Therapy?
Ruins between Bernafay Wood and Maricourt (Adrian Hill, 1918) Credit: Imperial War Museum
The term “art therapy” was first coined in 1942 by Adrian Hill; a British First World War soldier who used his art skills to draw terrains and plot sniper positions. After contracting tuberculosis, he would pass his time in hospital drawing for fun, and once he recovered began to help other soldiers relieve stress and symptoms of PTSD through art (Art Hives, 2021 ). There are 3 main types of symptoms, or “clusters” people struggling with PTSD face, one of them being avoidance and numbing. It serves as a rather effective protective mechanism to prevent the person from re-living the experience, but repressing feelings never lasts very long (U.S. Department of Veterans Affairs, n.d.). Potential treatments include CBT and talk therapy, however problems may arise when words fail to bring the memories to the surface, or once they do it could result in them re-experiencing their most terrifying memories. The benefit of art therapy is that it can help patients put onto the canvas memories they can’t describe, reveal through the finished piece suppressed emotions or help them explore their past in a safe environment, thereby reducing some of the physical symptoms associated with re-experiencing (Healthline, 2019 ). Although the struggles I've faced in my life are nothing compared to those suffering from PTSD, I believe that art helped me to stop repressing my own emotions, and instead to face them in a safe place: a sketchpad, where they could be expressed freely and without judgement. In doing so I no longer worry about the time they will inevitably re-surface but I’m able to explore them as they come; a process I will continue to use as a future junior doctor during my self-reflective writing sessions. The applications of art therapy are endless and should not be reserved for patients alone or those suffering with complex mental health conditions. It can be used both in a healthcare setting and in our everyday lives to promote safe and healthy reflective practices.
Studies focused on Art Therapy:
Alongside Adrian Hill, Margaret Naumburg, an American psychologist, also advocated strongly for art therapy, as a way for her patients to understand their inner thoughts and feelings, rather than a diagnostic tool for use by doctors. She believed that “the emotional development of children, fostered through encouragement of spontaneous creative expression and self-motivated learning, should take precedence over the traditional intellectual approach to the teaching of a standardised curriculum (The Ontario Institute for Studies in Education of the University of Toronto, 2002)”. The two main points to take away from this quote are how she believed art therapy shouldn’t follow a strict set of rules, and that it should also be self-motivated. Drawing from my own experiences with art therapy, I can agree entirely. If I tried to schedule a set time to draw each week it became a chore, and no longer something I looked forward to doing. In the same way, I didn't take pleasure in art lessons where a strict curriculum was followed and we were given instructions on what to paint, which again links back to Naumburg's point that art needs to be self-motivated.
You do not have to be a especially skilled artists to reap the benefits of art therapy
A study was carried out in 2017 at Drexel University where both artists and non-artists were asked to take part in 3 separate activities: free drawing, drawing within or around a circle marked on a page, and colouring in a mandala (Otto, 2017). During the activities, measurements of changes in the level of blood flow to the brain’s prefrontal cortex (the part of the brain associated with feelings of reward and pleasure) were taken, and it was noted that for all 3 activities and groups of participants there was a significant increase in blood flow, and therefore activity. Although there were some differences in the levels of activity between artists and non-artists, they were not significant, which serves as evidence to support my claim that you don’t have to be an artist to benefit from art. Therefore, whilst developing skills may give patients something to work towards and help ensure their time spent engaging with art therapy is self-motivated, the baseline level of ability is insignificant. Interestingly, the study also showed that out of the 3 activities, the one which produced the largest increase in blood flow was free drawing (Kaimal, et al., 2017). It is a conclusion I can personally relate to since I have tried colouring books for the purpose of relaxing and relieving stress, yet free-drawing has proven to be more effective than colouring books. It should also be noted that the study showed that although there were no statistically significant differences between artists and non-artists, there was a decrease in prefrontal cortex activity for artists as a result of colouring as reported in the study. Consequently, depending on the user's competence level, the activity chosen may need to be adjusted in order to meet the user's needs.
Conclusion:
There are many benefits to art therapy, as we discussed previously. In addition to helping PTSD patients to cope with re-experiencing in an environment that is safe and secure, it has been proven to be an effective tool for revealing suppressed feelings, for patients staying in the hospital for a long period of time as a way to pass the time, and even for those who suffer from addiction by activating the brain's reward system in healthier ways. Moreover, art therapy should not be considered as being a purely hospital-based treatment, but as I have found it is a very effective means of focusing on one task and forgetting what's going on around us, serving as an effective stress-relieving tool as well as soothing escape mechanism.
Written by Lina Saadani Allali | Medical Student
References:
Art Hives , 2021 . Art Hives. [Online] Available at: https://arthives.org/adrian-keith-graham-hill-1895-1977 [Accessed 10 March 2023 ].
Healthline , 2019 . [Online] Available at: https://www.healthline.com/health/art-therapy-for-ptsd#How-art-therapy-can-help-with-PTSD [Accessed 29 March 2023].
Kaimal, G. et al., 2017. ScienceDirect. [Online] Available at: https://www.sciencedirect.com/science/article/pii/S019745561630171X?via%3Dihub [Accessed 12 April 2023].
Otto, F., 2017. Science Daily. [Online] Available at: https://www.sciencedaily.com/releases/2017/06/170613120531.htm [Accessed 12 April 2023].
The Ontario Institute for Studies in Education of the University of Toronto , 2002. History of Education. [Online] Available at: https://schugurensky.faculty.asu.edu/moments/1914naumburg.html [Accessed 10 March 2023].
U.S. Department of Veterans Affairs , n.d. PTSD: National Center for PTSD. [Online] Available at: https://www.ptsd.va.gov/apps/STAIR/Session1/010401----.htm [Accessed 10 March 2023 ].
https://www.iwm.org.uk/collections/item/object/13001