Post on 24-Apr-2015
How Art Stimulates the Brain 1
Running head: HOW ART STIMULATES THE BRAIN
How Art Stimulates the Brain
Kimberly Harper
Texas Tech University Health Sciences Center
School of Nursing
N5372 Fine Arts in Healthcare
Lynda Billings, M.F.A., PhD
April 13, 2011
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Review of Arts in Healthcare
Throughout recorded history, we have seen evidence that pictures, stories, dances, music,
and drama have been central to healing rituals. Today there is a renewed focus on humanistic
care that is leading the resurgence in the knowledge and practice of incorporating the arts into
healthcare services (Rollins, Sonke, Cohen, Boles & Li, 2009). In fact, there is an increasing
numbers of clinicians and other professionals from the medical community that are working side
by side with the arts professionals in both healthcare and community settings, and around the
world the arts are emerging as an important and integral component of healthcare and the healing
process. According to several recent surveys, nearly fifty percent of the healthcare institutions in
the United States reported having arts in healthcare programming (Rollins, Cohen, Boles & Li,
2009). The research demonstrates the benefits of the arts in healthcare in hospitals, as well as
nursing homes, senior centers, hospices, and several other locations within the community. Arts
in healthcare programs and creative art therapies have been successfully utilized in many
different healthcare situations, such as; depression, Alzheimer’s, dementia, neurological
disorders and brain injuries. These art therapies focus on improving the patients’ overall health
outcomes, their treatment compliance, and their quality of life. There is also a rich and growing
body of research connecting arts in the healthcare programs to improved quality of care for
patients, their families, and even medical staff (Rollins, Cohen, Boles & Li, 2009). The
incorporation of the arts into the healthcare setting has proven to be beneficial to the patients by
aiding in their physical, mental, and emotional recovery, including relieving anxiety and
alleviating pain. In a hospital, patients, visitors and staff are often under constant pressure and in
a state of stress and anxiety. The arts can serve as a therapeutic and healing tool, reducing stress
and loneliness and providing opportunities for self expression in an atmosphere where the patient
often feels out of control (Nanda, 2011).
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A large amount of the research literature on the benefits of the arts in healthcare with
patients concerns music, visual arts, dance, literature, creative writing, and storytelling (Rollins,
Cohen, Boles & Li, 2009). For example, music has been found effective in increasing comfort
level, decreasing anxiety, improving depression and coping with stress. Several studies have
dealt with the use of music for coping with stress. Ryan-Wenger and Walsh (1994) reported that
school-aged children with heart disease have identified listening to music as one of the four most
effective and frequently used strategies for coping with their disease. Music therapy has offered
healing to patients of all types, such as, patients with Alzheimer’s who often respond to music
when they respond to nothing else; lowering the heart rates, respiratory rates and myocardial
oxygen demand for patients recovering from myocardial infarction; and even for reducing stress
among visitors in hospital surgery or intensive care unit waiting rooms (Rollins, Cohen, Boles &
Li, 2009).
The visual arts have also been found to be an essential component to the process of healing.
Some of the documented benefits of participating in visual arts or art activities include,
decreasing symptoms of distress and anxiety, improving depression, and strengthening positive
feelings for patients after having a stroke. As with all of the arts, engaging in the visual arts
provide opportunities for individuals to make choices and to be in control at a time when many
things in their lives are beyond their control, an important factor in reducing stress (Rollins,
2007). It has been recognized that drawing abilities and stereovision, imagery, and thinking
three-dimensionally are of great importance in neurosurgery, and in the surgical profession
generally (Madden, Mowry, Gao, Cullen & Foreman, 2010). This is especially important for
patients with brain injuries related to trauma, stroke, and cancer.
Dance therapy has shown improvement in variables related to psychosocial functioning,
self-image, and quality of life. For older adults with neurological disorders such as Alzheimer’s,
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and dementia, the participation in dance therapy resulted in stronger patient satisfaction and
improvement in social interaction parameters as well as, psychomotor functioning (Rollins,
Cohen, Boles & Li, 2009). In an older study by Westbrook & McKibben (1989), which used a
crossover design to compare dance therapy with exercise for Parkinson’s patients, it was found
that only dance therapy improved psychosocial functioning. More recently, the findings
regarding the benefits of dance included that dance therapy was the number one leisure activity
that most contributed to the delay in onset of Alzheimer’s disease for those at risk of the disorder
(Verghese, Lipton, Katz, Hall, Derby & Kolinsky, 2003).
Literature, creative writing, and storytelling have similar benefits to music, visual arts and
dance. In a recent study, the quality of life for cancer patients improved after a single 20-minute
writing session while waiting for their clinic appointment and there was a decrease in physician
visits along with fewer symptom complaints (Rollins, Cohen, Boles & Li, 2009). In addition, the
levels of depression in individuals who were guided to read selected fiction, poetry, or literature
were reduced in comparison to individual who did not participate in the guided reading. Finally,
storytelling resulted in a greater level of relative well-being for individuals with mild to moderate
dementia.
Art and the Brain in the Learning Process
The utilization of the arts in healthcare is a diverse, multidisciplinary field that is dedicated
to transforming the healthcare experience by connecting people with the power of the arts at key
moments in their lives. For example, at infancy a child has all the synapses needed to speak any
language, to learn and appreciate music and movement, and to create visual art; but these
synapses must be used in order to be developed (Church, 2008). Participating in art, music,
movement and storytelling activities not only develop language, mathematics, science, and social
skills, but these activities also strengthen the synapses between the brain cells. Research shows
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that these synapses grow stronger through active participation in the arts (Church, 2008). The
arts stimulate brain growth but they also stimulate healing. Through neurobiology, we can see
how the brain is affected by trauma and how the arts can actually help the brain development of
patients who are exposed to traumatic experiences at an early age. In fact, research has shown
that specific parts of the brain are stimulated by specific artistic enrichment modalities (Church,
2008). For instance, the base or brain stem responds to touch; the midbrain to music-making and
movement; the limbic region to dance, art, play therapy, and nature discovery; and the cortical
region to art, storytelling, drama, and writing (Church, 2008).
According to the National Institute of Neurological Disorders & Stroke (NINDS),
The brain is the most complex part of the human body. The three-pound organ is
the seat of intelligence, interpreter of the senses, initiator of body movement, and
controller of behavior. Lying in its bony shell and washed by protective fluid, the
brain is the source of all the qualities that define our humanity. The brain is the
crown jewel of the human body (2011).
When the brain is healthy it functions quickly and automatically, but when problems occur the
results can be devastating. Some 50 million people in this country suffer from damage to the
nervous system. Some of the major disorders include; cerebrovascular diseases such as stroke
and vascular dementia; degenerative diseases of adult life such as Parkinson’s disease and
Alzheimer’s disease; and trauma such as spinal cord and head injury (NINDS, 2011). Suffering
from a brain injury can be an incredibly traumatic and worrying experience. However; the arts
emphasize the complexity of human experience and the needs of sick people over and above any
type of surgery or treatment. “The arts help remind medicine of its humanistic origins in healing
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as it seeks to provide the most up-to-date scientific care for its patients” (Rollins, Cohen, Boles
& Li, 2009, p. 24).
Art Therapy and the Brain
The application of new techniques in brain imaging has expanded the understanding of the
different functions and structures of the brain involved in information processing (Lusebrink,
2004). For example, visual feature recognition and spatial placement are processed by the
ventral and dorsal branches of the visual information processing system (Lusebrink, 2004).
During art therapy, mood-state drawings echo the difference in the activation of different brain
areas in emotional states. Also, the cognitive and symbolic aspects of memories can be explored
through the activation of their sensory components. The process of expression through art media
and the products created in an art therapy session engage and are perceived predominantly
through the tactile-haptic and visual sensory and perception channels, and than are processed for
their affect, associations, and meaning through cognitive and verbal channels (Lusebrink, 2004).
Hence, the basic level of interventions with art media is through sensory stimulation. Therefore,
artists are in some sense neurologists, studying the brain with techniques that are unique to them,
but studying unknowingly the brain and its organization.
The process of art expression is considered an important part of art therapy and art therapy
research. Several art therapists have pointed out the need for art therapists to become more
familiar with the basic brain structures and functions that support art therapy expressions and
interventions. According to Kapitan (2010), art therapy is a mind-body interaction. A human
being functions as a whole organism, and at any given time, many of the brain processes and
areas are active and involved. For example, the interaction with art media in art therapy can
proceed from the peripheral stimulation of the different sensory modalities or from spontaneous
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expression of emotions, or both. An expression through art media can also originate from
complex cognitive activity involving decisions and internal imagery, thus activating the sensory
channels and motor activity (Lusebrink, 2004). We are starting to appreciate the fact that all
mental processes involved in art therapy derive from brain activity.
According to Perry (2008), art therapy is good for the brain because it involves the following
key aspects; art therapy provides experiences that are relevant and appropriately matched to
developmental needs; art is pleasurable for most people and therefore rewarding; and
experiences that provide positive rewards attract and increase healthy brain activity. In addition,
art therapy elicits cultural expression that is respectful toward people, their families, and cultures.
Most of all, the brain responds to art therapy because it is rational. Kapitan (2010), points out
that because we are psychosocial beings who are hardwired for relational learning, the
interpersonal environment of art therapy creates a foundation of security that is necessary for
brain development. As we learn more about the biological and neurological levels of disease, we
must not focus on the disease so much as too forget the suffering person before us who seeks our
imaginative and empathetic response.
Art Therapy and Trauma to the Brain
Arizona congresswoman Gabrielle Giffords was shot in the head at close range January 8,
2011 while hosting a public event outside a Tucson supermarket (Moisse, 2011). The shooting
became the lead story throughout the United States. The shooting rampage claimed six lives,
including a 9-year-old child and U.S. District Judge John Roll. Thirteen more were wounded at
the scene, including Giffords. Five were listed in critical condition and five were in serious
condition. In terms of the location of Giffords’ injury, the surgical team tells Moisse (2011) that
the bullet entered the left hemisphere of the brain, exiting through the front left front part of the
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brain and miraculously spared any major blood vessels. Although the right and the left
hemispheres seem to be mirror images of each other, they are different. For instance, the ability
to form words seems to lie primarily in the left hemisphere and music generally in the right
hemisphere (NINDS, 2011). The main functions of the left and right hemispheres are commonly
known by art therapists. In fact, protocols like music stimulation and melodic intonation therapy
can help patients with damage to the brain’s communication center, like Giffords, learn to speak
again. Maegan Morrow, Giffords’ music therapist and a certified brain injury specialist stated,
the brain can heal itself if you do the right protocol. Patients can be essentially
mute, unable to utter a single word but put on the Beatles’ “All You Need is
Love” and suddenly patients can sing. If you substitute some the words the patient
is now speaking again. Music is powerful (Moisse, 2011).
Evidence supporting a healing role for music in the recovery from brain injury is mounting, but
many people are still skeptical, and few insurers will cover it. Maybe Giffords’ progress will
change this skepticism. Her recovery has been astounding; she began singing “Happy Birthday”
within the first two weeks of her recovery and she was chanting prayers with her rabbi a short
time after. Music is an important and extremely useful tool in the way we learn and to deny its
power is a waste of a truly wonderful resource.
Art Therapy for Patients with Alzheimer’s or Dementia
Caregivers have observed for decades that Alzheimer’s patients can still remember and
sing songs long after they have stopped recognizing names and faces. Many hospitals and
nursing homes use music as recreation, since it brings patients pleasure. But beyond the
entertainment value, there is growing evidence that listening to music can also help stimulate
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seemingly lost memories and even help restore some cognitive function in Alzheimer’s and
dementia patient (Beck, 2009). By engaging very basic mechanisms of emotions and listening,
music is stimulating dormant areas of the brain that haven’t been accessible due to degenerative
disease such as Alzheimer’s and dementia (Beck, 2009). Dr. Tomaino, who has studied the
therapeutic effects of music for more than 30 years, spearheaded a new program to provide iPods
loaded with customized playlists to help spread the benefits of music therapy to Alzheimer’s
patients even at home (Beck, 2009). In addition, she frequently sees dementia patients make
gains in cognitive function after music therapy. Another music therapist and psychologist, David
Ramsey, held twice weekly music small sessions with Alzheimer’s patients (Beck, 2009). He
sometimes would stop singing and let the patients fill in the blanks on their own. When they fill
in the blanks they are exercising their cognitive brain function just like they exercise their bodies
in physical therapy; the music stimulated the brain (Beck, 2009).
In addition to benefiting Alzheimer’s patients, decades of studies have demonstrated that
music can help autistic children communicate and stroke patients regain their speech and
mobility (Beck, 2009). Today, neuroscientists are starting to identify the underlying brain
mechanisms that explain how music connects with the mind and body, and they are starting to
work hand in hand with music therapists to develop new therapeutic programs for people with
neurological disorders such as Alzheimer’s disease.
Art Therapy & Stroke Rehabilitation
To experience the trauma of stroke is to experience a sudden change in one’s physical and
psychological being that is not anticipated and over which a person has no influence. Many
stroke survivors return to health, however, a considerable number remain moderately or severely
disabled for the rest of their lives (Michaels, 2011). The art therapies in neuro-rehabilitation are
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well established here in the United States. Michaels (2011) suggests that the flexibility and
complexity of art-making, together with its ability to connect physical and psychological
resources, make it well suited to address the wide range of deficits that are associated with brain
injury and stroke. For example, as mentioned earlier, some of the documented benefits of
participating in visual arts or other art activities include; decreasing symptoms of distress and
anxiety, improving depression, and strengthening positive feelings for patients after having a
stroke (Michaels, 2011). The symbolic nature of art and its capacity to hold and express the
unspeakable, as well as to offer opportunities for reflection, and to facilitate choice and control in
the face of loss and powerlessness are strong reasons to use art in rehabilitation of a stroke
patient.
Summary
With the advent of new imaging techniques, we know that the brain is a dynamic, ever-
changing system of interconnecting neurons that work it concert to produce our complex,
dynamic responses to the world around us. The discovery that new networks and connections
may be formed in the brain every time we learn a new skill has implications not only for early
childhood development, but also for potential recovery of function after brain injury (Tomaino,
2009). Evaluations, observation and research findings demonstrate that there are both
instrumental and intrinsic benefits to art therapy. Art therapy can be a powerful thing, and when
we understand its significance, it can bring dramatic and positive changes to the well-being of a
patient with an injury to their brain. Evidence-based practice has also shown that literature,
creative writing, storytelling, music, visual arts and dance have significant healing benefits for
the patients suffering from brain trauma, stroke, Alzheimer’s and dementia.
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The ability of an art therapist to creatively imagine into another’s state of being is at the
heart of art therapy and the most effective and humane environments where healing takes place
(Kapitan, 2010). We are human because of our brain, our hand, and our heart. “Only the human
being can express inspiration and emotion by combining all three and thus produce the
expression of the human condition in writing, poetry, music, dance, visual art and design; all a
creative expression of heart and soul” (Rollins, Cohen, Boles & Li, 2009, p. 16). Whitman &
Rose (2003) also referred to art as a medium for forming or reforming the human soul, the life
spirit. They believe that art captures, expresses, and recreates humanity and life. Today’s
healthcare providers will someday become the recipient of the care as a patient and thus should
always be treating the patient as they wish themselves to be treated; as a human-being with a
mind as well as a heart.
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References
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