By: Laurel Whidden, Global and Public Health Sciences ‘26
Recent studies have shown that the dynamic intersection of art and biomedicine has the foundation to redefine healing. The traditional biomedical model emphasizes disease-specific causes of death, encompassing experimental, clinical, and epidemiological research [1]. Current investigations and scientific inquiry have called for the possibility of the humanities discipline to be integrated within biomedical research in the form of art. Derived from this educational shift, a new framework has come to light: arts-based research (ABR).
ABR is a type of qualitative research that utilizes participatory arts, such as visual, auditory, or performance, as a way to obtain additional information that may have been inaccessible otherwise, to understand and represent human action and experience [2]. There is growing evidence that participative arts can have a positive impact on health, as art-based interventions promoting well-being play an important role in recovery from mental illnesses such as anxiety disorders, depression, neurodevelopmental disorders, and PTSD [3]. To illustrate, the most widely used art therapy practice for post-traumatic stress disorder is the creation of a visual trauma narrative. The narrative can facilitate new insight, as well as help patients reconstruct their concept of self, others, and the world, and is hypothesized to reduce emotional numbing and avoidance [4]. Other arts-based research practices have employed art journaling as a catalyst for alleviating clinical depression, where the product (the participant's art journal) is used to facilitate conversations around mental illness [2]. Researchers from various disciplines employ ABR practices as a collection of methodological tools throughout all stages of research, encompassing data generation, analysis, interpretation, and representation [2]. These methods involve a holistic and engaged integration of theory and practice, specifically in healthcare settings. Engaging in the visual arts serves as a form of non-verbal communication, often helping patients organize and comprehend complex emotions [3]. By facilitating catharsis, artwork not only serves as an outlet but also provides a means to monitor an individual’s emotional and developmental progress [5,6]. The arts can be profoundly captivating, primarily because they evoke emotions and have the potential to prompt patients to perceive or think differently [7].
The arts can also be harnessed to teach, fostering a depth of understanding that goes beyond “information” [2]. The emerging field of neuroaesthetics considers how our brains make sense of visual art, as Nobel laureate Eric Kandel (2012) explains that visual art activates many distinct and at times conflicting emotional signals in the brain, which in turn causes deep memories [8]. The use of visual art forms such as paintings and film in medical school curricula has been shown to build visual literacy. Broadly referred to as the “medical humanities”, fine art can enhance the skills of medical professionals in training, such as the role of visual arts in the formation of a neurosurgeon [9]. Research has indicated that drawing abilities and stereovision, imagery, and thinking three-dimensionally are crucial in neurosurgery, and the surgical profession generally. This indicates that the arts influence our knowledge-building and transmission practices in the research communities and allow the ability to “see” and produce knowledge in different shapes [2]. The Association of American Medical Colleges (AAMC) advocates for integrating arts and humanities education into medical training to enhance physician skills. Embedding visual arts-based training in the curriculum has demonstrated improvements in observational skills, empathy, introspection, and reduced burnout among medical students. Furthermore, physician empathy serves as a predictor of patient-perceived treatment outcomes [10].
Arts-based interventions include not only visual forms of art but also auditory forms, as research has documented music's efficacy in notably boosting salivary immunoglobulin A (IgA), an antibody that is the first line in the defense against bacterial and viral infections [11]. Studies have revealed that IgA is not only a reliable indicator of the functional status of the entire mucosal immune system but is particularly responsive to music, increasing following exposure to a range of musical genres including both relaxing and stimulating music [12].
Of all the arts disciplines, the performing arts such as drama and theater have been remarkably effective in knowledge building and have been used successfully in medical education. This has been seen in Dwight Conquergood’s arts-based public health intervention at a Hmong refugee camp in Ban Vinai, where he helped design and direct a health education campaign based on native beliefs and values and communicated in culturally appropriate forms. Alongside community leaders, he started a refugee performance company that produces skits and scenarios drawing on Hmong folklore and traditional communicative forms, such as proverbs, storytelling, and folk singing, to develop critical awareness about the health problems in Ban Vinai. This intervention embodied not only preventative public health education, but a holistic, cultural, and humanities-based transmission of information [13]. Similarly, theater-based interventions in the U.S. have been used as a viable prevention strategy for changing sexual health knowledge, attitudes, and behaviors related to HIV prevention [14].
As our understanding of human cognition deepens, it becomes increasingly evident that narratives, stories, and the arts can significantly contribute to the teaching of diverse subjects and connect with individuals on deeper levels. In another sense, art can be a healing process, as seen in the recent integration of arts in healthcare. As Patricia Leavy, PhD., a best-selling novelist and internationally recognized leader in arts-based research explained, “[the arts] can connect us with those who are similar and dissimilar, open up new ways of seeing and experiencing, and illuminate that which otherwise remains in darkness.”
References
Röhrig, B., du Prel, J. B., Wachtlin, D., & Blettner, M. (2009). Types of study in medical research: part 3 of a series on evaluation of scientific publications. Deutsches Arzteblatt international, 106(15), 262–268. https://doi.org/10.3238/arztebl.2009.0262
Leavy, Patricia. “Social Research and the Creative Arts: An Introduction” in Method Meets Art: Arts-Based Research Practice, Second Edition. New York: Guilford Press, 2015, pp. 1-38.
Davis-Manigaulte, Jacqueline, Lyle Yorks, and Elizabeth Kasl. Expressive Ways of Knowing and Transformative Learning. New Directions for Adult and Continuing Education 2006 (April2006): 27–35. https://doi.org/10.1002/ace.205.
Campbell, M., Decker, K. P., Kruk, K., & Deaver, S. P. (2016). Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial. Art therapy : journal of the American Art Therapy Association, 33(4), 169–177. https://doi.org/10.1080/07421656.2016.1226643
State of the Field Committee. (2009). State of the field report: Arts in healthcare 2009. Washington, DC: Society for the Arts in Healthcare.
Rae, W. A. (1991). Analyzing Drawings of Children Who are Physically Ill and Hospitalized, Using Ipsative Method. Children’s Health Care, 20(4), 198–207. https://doi.org/10.1207/s15326888chc2004_2
Sturner, R. A., Rothbaum, F., Visintainer, M., & Wolfer, J. (1980). The effects of stress on children's human figure drawings. Journal of clinical psychology, 36(1), 324–331. https://doi.org/10.1002/1097-4679(198001)36:1<324::aid-jclp2270360146>3.0.co;2-6
Kandel, E. R. (2014, June 5). Nobel Prize Talks: Eric R. Kandel. Retrieved December 14, 2023, from https://www.nobelprize.org/prizes/medicine/2000/kandel/interview/
Pasztor, E. (1993). Parallels between three-dimensional thinking in neurosurgery and the development of perspective in art. Acta Neurochirurgica, 124, 176–178.
Sally Nijim, Isra Hamdi, Stephanie Cohen, Joel T. Katz & Ingrid M. Ganske (2023) Prevalence of visual art education in medical school curricula: a national survey of US medical schools, Medical Education Online, 28:1, DOI: 10.1080/10872981.2023.2277500
Rebecchini L. (2021). Music, mental health, and immunity. Brain, behavior, & immunity - health, 18, 100374. https://doi.org/10.1016/j.bbih.2021.100374
Hucklebridge, F., Lambert, S., Clow, A., Warburton, D. M., Evans, P. D., & Sherwood, N. (2000). Modulation of secretory immunoglobulin A in saliva; response to manipulation of mood. Biological psychology, 53(1), 25–35. https://doi.org/10.1016/s0301-0511(00)00040-5
Conquergood, Dwight. “Health Theatre in a Hmong Refugee Camp: Performance, Communication, and Culture.” TDR, 32 (3) (Autumn 1988): 174-208.
Taboada, A., Taggart, T., Holloway, I., Houpt, A., Gordon, R., Gere, D., Milburn, N., & Lightfoot, A. F. (2016). A Critical Review of the Characteristics of Theater-Based HIV Prevention Interventions for Adolescents in School Settings. Health promotion practice, 17(4), 537–547. https://doi.org/10.1177/1524839916632567
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