The late Madeleine Shields was a gifted artist and teacher here on the west coast of Canada. But more importantly to me, she was MY teacher. Her artistic expression of choice was the mandala, a Sanskrit word for “circle”. The mandala practice of Madeleine Shields was not what you might see in adult colouring books or on painted rocks at craft fairs. Hers was based on an ancient spiritual and meditative practice that she compared to “painting a mirror”. I can sometimes still hear her distinctive voice in my ear asking pointedly, “Did you do it well, or did you do it fast?”
A recent study supports what Madeleine had already figured out 20 years before her death, that art can intuitively reflect our deepest emotions in a surprisingly accurate fashion – and that’s especially true when we become patients.
Dr. Christian Jarrett, editor of the journal, British Psychological Society Research, suggests that art is an approach that can help patients heal.
He cites new research by Dr. Elizabeth Broadbent at the University of Auckland in which patient drawings offer insights that are often missed by healthcare professionals.(1) These insights can help to improve and personalize psychological interventions intended to help patients understand and cope with their illness, treatment and prognosis. For example:
“When patients draw the parts of their body affected by illness, this can reveal how people think about their diagnosis and/or the seriousness of their condition, and may even be able to predict how well they are likely to cope.”
Dr. Broadbent and her colleagues believe that psychologists can use patients’ drawings to improve understanding of the illness experience and to inform the clinical interventions they offer. They can do this through:
- observing the drawing size
- identifying themes in drawings
- looking for distortions or omissions
- studying drawing styles and use of colour
- analyzing facial expressions
The Broadbent research cited a number of studies on what patients’ drawings reveal about many diagnoses. For example:
- ♥ brain injury survivors who drew greater damage on their brain tended to experience a longer recovery time and a worse quality of life
- ♥ kidney transplant patients who drew their kidneys larger tended to have higher anxiety and lower feelings of control
- ♥ research comparing the drawings of healthy and sick children found that sick children’s drawings featured fewer human figures
- ♥ AIDS-affected children featured more bed-ridden people, less beauty and more distress
- ♥ people diagnosed with mental health conditions like depression used fewer colours and more empty space compared to other diagnostic groups
“Where emotions have been drawn,” adds Dr. Jarrett, “the drawing could be a good starting point for a discussion about how the patient has been emotionally affected by the illness.”
This study’s findings immediately reminded me of Alaska’s Dr. Stephen Parker, a cardiac psychologist and a heart patient himself for almost 20 years.
Despite having no art training, Dr. Steve felt compelled one day to start painting a series of 27 images that reflected how surviving a massive heart attack had affected him emotionally.
He called this series, Heart Attack and Soul.
And after he was done, Dr. Steve came to an unusual decision:
“Something in me decided to spend the next 40 days reviewing these paintings and posting a daily comment about them on a new blog.
“Each day I wrestled with how to express how the heart attack had affected me, and then finally posted an illustrative image and a short commentary.
“In that intense process of thinking, painting and writing, a profound spiritual awareness slowly emerged, transforming my perception of myself and the world around me.”
This response to creating art is not unique to Dr. Steve. (A 2016 study, for example, found that 45 minutes of art-making can lower stress hormone levels).
His Heart Attack and Soul project began as a series of these 27 original paintings, then morphed into a blog, then a public art exhibit, and finally a book (sadly, out of print now).
With Dr. Steve’s permission, here’s painting #19 of his heart, along with his thoughtful description of how this painting reflected his own cardiac experience:
© Stephen Parker 2007
“We connect with each other through our wounds.”
~ Rachel Naomi Remen
Emotions of the Wounded Heart
“I experienced so many swirling emotions after surviving this heart attack:
–Relief at survival
–Disbelief and anger that it happened
–Grief for everything that was and will be lost
–Gratitude to those who helped
–Extreme vulnerability in a previously safe world
–Fear of what the future might bring
“I had taken my vitality for granted and assumed that I would have many long and healthy years of life ahead of me. Now, I had no solid ground on which to stand. I was profoundly weak from the injury. I never knew whether or not I would wake up the next morning. I doubted that I would ever be able to return to any kind of normal life again.
“It is as if I had crossed the River Styx to the Underworld and was allowed to return to the Land of the Living, temporarily, for an unspecified period of time.
While the journey has certainly been hellish, at the same time it has given me something important and valuable: I now have an increased compassion for the wounded, a compassion for all those who must cross the River Styx.
“Although the heart attack has broken my heart, it has also opened my heart.”
We’ve known for many years that professional art therapists help people explore and express thoughts and feelings through creativity and art materials.
Creating art can make patients feel better, but emerging research has also suggested it’s not just about making nice pictures, but more importantly – and as patients like me and Dr. Steve have discovered – it can be a form of healing therapy.
Here’s the conclusion from Italian researchers, for example, who were specifically studying heart patients:(2)
“Through the creation of a tangible product, psychologists can better evaluate the emotional and psychological troubles of patients, and provide them and their families with more focused and personalized support.”
It’s important to remember that, unlike most art classes that focus on what art looks like when it’s finished, the focus of art therapy is on the art-making process itself, particularly on the thoughts and feelings that come up for the person creating the art. No artistic talent required!
In that way, it reminds me of my early mandala painting lessons with Madeleine Shields. The only rule was to start with a carefully measured pencil outline, from the first concentric circle of the ring of fire (known as “the outer wall of the world, beyond which lies chaos”) down to the quiet central square of four gates (portals).
But after that simple outline of circles and squares was done, it’s all freehand painting, attention focused only on the tip of the brush, without purpose or even knowing what comes next. The mandala essentially paints itself, as Madeleine used to tell me whenever I started thinking too hard about how the finished painting would turn out, or if I were doing it “right”. (My monkey mind tended to go straight to planning which wall of which room in the house I’m going to hang this thing when it’s done!)
But you don’t need paints or an art teacher to explore this kind of therapeutic expression. Grab a pencil or a felt pen and a clean sheet of paper, and just start drawing what you are feeling today. Don’t think, just feel.
Even without access to an art therapist, you may discover that, as I have found through the mandala, and as Dr. Stephen Parker found after his own heart attack, art can be a powerful creative outlet in support of healing.
A systematic review of patients’ drawing of illness: implications for research using the Common Sense Model”, Health Psychology Review. 27 December, 2018.“
2. E. Quadri et al. “Art therapy for hospitalised congenital heart disease patients”. Pediatr Med Chir. 2012 Nov-Dec;34(6):292-6.
ART UPDATE: Did you know that January 31st is Inspire Your Heart With Art Day? Me neither! I learned about this from Alexia Aspri, a cath lab nurse in Cyprus, who shared this heart drawing:
NOTE FROM CAROLYN: I wrote much more about how we adjust to a serious diagnosis in Chapter 5 of my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon. Or if you order it directly from my publisher, Johns Hopkins University Press (use the JHUP code HTWN, you’ll save 20% off the list price when you order).
Q: Have you used art to express the effect your own cardiac event has had on your life?
- Stone Currents, Dr. Stephen Parker’s remarkable photos of the beautiful stone sanctuary that he built at his Alaska home.
- When are cardiologists going to start talking about depression?
- Pain vs. suffering: why they’re not the same for patients
- More drugs, less talk for post-heart attack depression?
- A foreshortened future
- Canadian Art Therapy Association 🇨🇦
- American Art Therapy Association 🇺🇸
- British Association of Art Therapy 🇬🇧