Complementary Therapies in Cancer Care: Art Therapy

Paints and brushesAn ongoing series highlighting complementary therapies, adapted from The Complete Guide to Complementary Therapies in Cancer Care

By Barrie R. Cassileth, MS, PhD, Chief, Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center

Complementary therapies are noninvasive, non-pharmacologic adjuncts to mainstream treatment. They improve patients’ strength and control of the physical and emotional symptoms associated with cancer and other illnesses. They provide self-help guidance to enhance body and soul at times when one feels vulnerable and life seems out of control. Complementary therapies are used as adjuncts to mainstream care of cancer and other illnesses, not as substitutes. They improve physical and emotional function and manage stress and symptoms of aging, regardless of health status. Complementary therapies are rational, evidence-based practices delivered or taught by trained practitioners. They include mind-body practices such as meditation and self-hypnosis; massage therapies; nutritional counseling; physical fitness, including programs such as aerobic exercise, qigong, tai chi, yoga, and many other practices; music therapy; and acupuncture.

Art Therapy

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.

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