Complementary Therapies in Cancer Care: Art Therapy

Dr. Barrie Cassileth PhD Chief of Integrative Medicine, Sloan Kettering discusses the role of Art Therapy in Cancer Care

Art Therapy for Cancer Patients

by Dr. Barrie Cassileth PhD Laurance S. Rockefeller Chair and Chief of the Integrative Medicine department at Memorial Sloan-Kettering Cancer Center.

Art that results from the creative process is an end in and of itself. Art therapy, by contrast, is a means to an end. It uses creative activity as a vehicle for rehabilitation, a means of helping the sick or disabled.

Art therapists believe that everyone is an artist, or can be when left to create freely and without external constraints of judgment or criticism. The very process of creating a painting, sculpture, or any other type of art, including written art such as poetry or stories, can help develop self-awareness and selfesteem. The release of creative energy generates internal activity that helps produce physical, mental, and spiritual healing. For those who cannot themselves create, the opportunity to experience the art of others can produce similar benefits.

Many people, including patients under treatment for physical or emotional illnesses, have difficulty verbalizing their fears. The resulting repressed feelings exacerbate tension andunease. Visual art, followed perhaps by pondering its apparent and symbolic meaning, can be cathartic and rewarding.

What It Is

Visual art therapy is based on the belief that the creative process is intrinsically therapeutic. Therapists provide relevant equipment and tools, technical advice, and emotional support. Patients are free to draw, paint, sculpt, or involve themselves in other forms of visual artistic expression or appreciation as they prefer and are able. Art therapy can occur in people’s homes, in art studios, or in hospital beds. It is used as a means of expressing sometimes hidden emotions and gaining benefits provided by the act of creation.

What Practitioners Say It Does

Some art therapists view the act of creating as the primary goal. In particular circumstances, however, creativity may be less important than gaining insight or expressing feelings. Images are mental constructs— personal messages sent by individuals to themselves. The expression of those images through art offers an opportunity to contact oneself through the senses and to create a tangible record of sensations, perceptions, and feelings.

Art therapy is said to support self-esteem, foster the development of a sense of identity, and promote healing through the maturation of creativity. Feelings expressed by patients’ interactions with clay or paint can be translated into words more readily than can feelings kept inside.

In addition to helping the patient, art therapy can also help those who work with patients. The visual images the patient creates provide a tangible, permanent record of the patient’s state of mind at that time and allow the therapist, artist, nurse, or educator to access the patient’s emotions. Art therapy can create order out of chaos by giving form to images and emotions, and it encourages a silent dialogue between the patient’s inner sensations and external realities. Viewing or producing paintings, drawings, and other forms of art can help keep patients from remaining passive recipients during treatment for chronic or psychiatric diseases.

Beliefs on Which It Is Based

Art therapy is based on the belief that the act of creating or viewing visible product enables patients to express and communicate inner emotions, which is thought to be helpful to the healing process.

Research shows that infants, children, and adults during times of severe stress or life-threatening circumstances typically encode memory visually and through sensory channels, bypassing the conscious or verbal memory systems. Art therapy allows such nonverbal memories and feelings to surface so that they can be confronted and hopefully managed.

Another belief on which art therapy is based is that the beauty of creative works is intrinsically uplifting and refreshing. The timeless nature of great works of art that continue to elicit powerful feelings in people all over the world in all walks of life is testament to the power of art. Part of that power is distraction, the ability of art as we view it to remove us mentally from the constraints and the problems of our physical or emotional pain. This too can contribute to healing by reducing stress and enhancing well-being.

Art therapy was found to support children and parents during painful procedures for leukemia treatment. It had a lasting positive effect on women dealing with breast cancer and its therapy, and another study showed that it decreased depression and fatigue in women undergoing chemotherapy. Several studies show that art therapy improves mental state and behavior in psychiatric patients, those suffering chronic stress, disabled people in rehabilitation programs, and Alzheimer’s patients.

Many medical centers and some cancer centers hold art exhibits of patients’ work, and such work has been published in full-color catalogs by several institutions. The walls of some hospitals display professional works of art. Often these are rotating exhibits donated by local artists or galleries. Professional artists conduct workshops to teach patients, families, and hospital staff how to use art as therapy.

Projects and activities of this kind are believed to foster physical, mental, and spiritual healing and to contribute to the well-being not only of patients but their caregivers and families as well. They are thought to enhance self-awareness, self-esteem, and creative energy and to improve mood and reduce feelings of distress, loneliness, and anxiety.

What It Can Do for You

Art therapy allows patients to express hidden emotions, a process that may encourage or assist healing. Art therapy does not cure disease; it is a supplement to medical practice and a complementary therapy. Some patients can manage only a passive form of art therapy involving viewing displays of art. Other patients may actively create. Either way, art therapy appears to improve wellbeing, enhance quality of life, and provide distractions during times of difficulty. Creative energy—one’s own or another’s—may assist healing and help patients cope with or overcome physical and mental distress.

Art therapy offers cancer patients an expressive outlet and a source of empowerment.

Studio artist Joanie San Chirico was awarded an important, large commission immediately following her first round of chemotherapy for fallopian tube cancer. While the thought of tackling such a huge project in the face of intensive treatment had obvious drawbacks, San Chirico felt she had to step up to the task. “Something told me I had to do it. Otherwise, I’d be sitting around thinking about cancer, chemo and what I couldn’t do,” she explains.

San Chirico moved forward with both her chemotherapy and the commission, which would be installed in a new library not far from her Toms River, New Jersey, studio. Though the project required a terrific amount of work (in addition to creating her paintings, she also coordinated with the architect and the construction crew), the artist reflects on diving into her work during treatment, and shares, “It was definitely the right choice for me,” adding, “Some days I was so busy, I even forgot that I was sick. I think it’s important to stay as physically and mentally active as possible during chemo, even though some days will seem nearly impossible.

Once completed and open to the public, San Chirico’s artwork at the library was received with praise and even greater admiration when the community learned that she had created the collection during her cancer treatment. However, when she heard herself called a “hero,” San Chirico balked. “I’m not a hero—I just did what I had to do to keep me sane!”

The fact is, artistic activities—whether painting, sculpture, drawing, writing, music or dance—can benefit patients facing cancer in countless ways. Creative work can offer distraction from the side effects of treatment, soothe anxiety and create a way to express feelings that might otherwise seem too difficult to share.

Art therapy, which continues to gain recognition for its supportive and healing contributions to patients’ lives, focuses on just these benefits. While the role of art therapy for cancer patients has yet to undergo extensive scientific evaluation, a recent study at Chicago’s Northwestern Memorial Hospital found that art projects did reduce symptoms for cancer patients.[1]

In this way, art therapy is now being recognized as a viable form of supportive care for patients who find relief in exploring artistic pursuits as part of their treatment, and it is now often included in complementary and alternative medicine (CAM) programs offered by comprehensive cancer centers. Stanford Cancer Center (http://cancer.stanford.edu/information/alternativeTherapy/senses/), for example, lists art programs with their supportive care and alternative services.

In various mediums and for artists of experience levels from amateur to professional, art has long been an outlet for fear and sadness, a distraction from illness and a way to share joy and hope. For cancer patients, the creative process can be a powerful source of comfort and strength while facing illness. Sometimes just as necessary, creative activities can also be an effective distraction that forces the patient to focus intensely on something other than cancer. And, cancer doesn’t mean an end to work or other activities—it can in fact be an opportunity to explore interests more deeply or even to embrace a new skill.

For more information about art therapy, visit the American Art Therapy Assication at www.arttherapy.org.

References:

[1] Northwestern Memorial Hospital. Art Therapy Can Reduce Pain and Anxiety in Cancer Patients. Available at http://www.nmh.org/nmh/mediarelations/pressrelease.htm?year=2006&number=1. Accessed January 2008.

Where to Get It

Many hospitals and other inpatient facilities have recreation areas or someone on staff who can arrange an art program.

There are numerous Internet resources, including ANZATA (anzata.org), the professional association for registered arts therapists in Australia, New Zealand, and Singapore. It publishes the Australian and New Zealand Journal of Art Therapy.

The International Expressive Arts Therapy Association (ieata.org) supports artists, educators, consultants, and therapists using multimodal expressive arts.

The American Art Therapy Association (arttherapy.org) provides similar information and services

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