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Cancer, Stress and Art Making
As a cancer patient, stress is an understood part of life. There are countless decisions to make about treatment; there are relational changes, personal changes in the mind and body, and the emotional roller coaster of all of the above. The question is what does the body do with all of that stress? And how does significant amounts of stress over a prolonged period affect a patient’s health?
The body does indeed have a stress management system called the hypothalamic-pituitary-adrenal axis which secretes a hormone called cortisol to help regulate the body’s physiological response to stress (Wan). In normal circumstances, the body can adjust and adapt to the flux of cortisol released into the body; however, when the body undergoes prolonged, extreme stress, there are several negative consequences. These negative effects can include hypercortisolism and hypocortisolism. Hypercortisolism is high levels of cortisol and ‘has been linked to… Cushing’s disease, depression and generalised anxiety disorder” (Wan). Hypocortisolism is low cortisol levels and “[leads] to inflammation and high levels of fatigue” (Wan). Essentially, Hypocortisolism is the result of adrenal burnout.
With consequences of prolonged, acute stress being so detrimental, it is important to institute a way to help manage stress throughout a cancer diagnosis. Research shows that there are various ways to help cope with stress including mindfulness, biofeedback, stimulating the relaxation response and other various methods. But another option is art making. In a study conducted to find the correlation between art making and lowered cortisol levels, researchers found “that a brief experience of art making produced physiological changes in most participants, indicating that art making can lower cortisol levels regardless of prior experience with art, media type, or demographics” (Kaimal). Outside of this singular study, research shows “patients with serious health issues have used art…to help reduce stress and anxiety and express emotions” and that “artistic expression appears to lower stress in various health settings” (Kaimal).
It is these findings along with our personal interactions with patients and their families that encourages us to continue to bring Arts in Health programs to cancer patients. Whether it is making jewelry or painting a box, patients experience the benefits of art making such as joy, self-exploration and a sense of accomplishment while physiologically coping with stress in a healthy way.
References:
Kaimal, Girija, Kendra Ray, and Juan Muniz. "Reduction of Cortisol Levels and Participants' Responses Following Art Making." Art Therapy 33.2 (2016): 74-80.
Wan, Cynthia, et al. “The Role of Stressful Life Events on the Cortisol Reactivity Patterns of Breast Cancer Survivors.” Psychology & Health, vol. 32, no. 12, Dec. 2017, pp. 1485–1501. EBSCOhost, doi:10.1080/08870446.2017.1346194.
Loneliness, Hope and Arts in Health
“No man is an island, entire of itself; every man is a piece of the continent, a part of the main. If a clod be washed away by the sea, Europe is the less…(Donne).” In the world of cancer and terminal illness, there is both the reality of social isolation and loneliness. What is the difference? Social isolation is quantifiable, measurable. How many people does one see in a day or interact with in the course of a week? Loneliness, however, is subjective, a perceived reality in which there is a “discrepancy between desired and actual social relationships (Holt-Lundstad).” What perpetuates loneliness in one person may not cause loneliness in another. Walking through cancer, especially for those who are hospital-bound, often creates unwanted social isolation as well as deep loneliness.
What are the physiological effects of loneliness on the human body? Studies show that the combination of social isolation and loneliness results in poorer sleep, higher blood pressure, higher lipid profiles, and a less responsive immune system (Hold-Lundstad). Because of the severity of negative effects, several studies have been done to further research the correlation between mortality and social connectedness. The findings are staggering, showing that lack of social connection increases the risk of mortality while healthy social connection increases life expectancy (Holt-Lundstad).
These findings are highly applicable for cancer patients dealing with the reality of feeling lonely due to the inevitable repercussions of cancer on crucial relationships and unwanted social isolation as a result of living in the hospital a majority of or the entirety of a diagnosis. While there is no correlation between quality of social connectedness and remission or life expectancy, there is a clear link between quality of life and care for patients and the social grounding that comes with quality community.
Feel Beautiful Today’s Arts in Health programs do not exist to attempt to cure cancer or guarantee remission; rather, they provide a bridge between cancer patients and a caring community. FBT seeks to offer a support system that can be a place to authentically connect with others through creative arts that in turn offers hope, something that unwanted social isolation and loneliness tend to steal. While FBT has no control over the outcome of patients’ diagnoses, it does provide quality programs that help patients feel connected and loved, edging out the negative effects isolation and loneliness can have on patients and replacing those effects with hope and wholeness.
References:
Donne, John. No Man is an Island. https://www.goodreads.com/quotes/tag/isolation.
Holt-Lunstad, J., Smith, T., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10, 227-237.
Arts and Qualitative Research
Empirical evidence within the Arts in Health community is both expected and needed. In an industry known as a science, healthcare relies on indisputable evidence that can be both proven as well as replicated. Quantitative research allows health practitioners as well as researchers to be held accountable to standards while continually exploring the inner workings of the human body and art’s impact on them. But the argument can be made that medicine is not only a science but also an art itself. And art is not only measured quantitatively. By nature, art transcends calculable standards and reaches into the human mind and emotions. Thus, shouldn’t Arts in Health be measured both quantitatively and qualitatively?
In the text book Oxford Textbook of Creative Arts, Health, and Wellbeing: International Perspectives on Practice, Policy and Research’s fourteenth chapter, the argument is made that while quantitative evidence is necessary in arts-based research, it is not all-encompassing. Perhaps the greatest argument for the lack of qualitative research is the inability to verify or reproduce its results. Authors Jill Sonke and associates argue, however, that “many cross-cutting expressions of arts-based human creativity, as applied to public health, readily lend themselves to qualitative as well as quantitative research”.
What is qualitative research? It can include surveys, open-ended questions, and other activities that gauge the emotional, mental and spiritual impact of participating in Arts in Health programs. The benefit of qualitative arts-based research is that it provides a wholistic perspective as well as “ensures that participants in [arts-based research] bring the vital component of socially and culturally determined biases and positions to their meaning making”. In other words, rather than discarding the aspects of humanity that are difficult to replicate or quantify, researchers can assign value to them in better understanding Arts in Health’s positive impact on patients as a whole.
While much of this blog is dedicated to introducing new and upcoming empirical evidence of the impact of Feel Beautiful Today’s Arts in Health programs on cancer patients’ lives, it is worth noting the importance of other measurements of our impact. Every day we interact with patients in infusion and hospital rooms, we are reminded of the unquantifiable impact our programs have on the joy and happiness of each patient. At the end of the day it is about patients’ quality of life, and as long as there is science, it will be impossible to truly measure a life well lived and hope restored.
Resource:
Sonke, Jill, Judy Rollins, and John Graham-Pole. "Arts in Healthcare Settings in the United States." Oxford Textbook of Creative Arts, Health, and Wellbeing: International Perspectives on Practice, Policy and Research. Oxford, UK: Oxford University Press, 201511. Oxford Medicine Online. 201511. Date Accessed 1 Sep. 2016.
Cancer, Depression and Arts in Health
In many pharmaceutical television ads, depression is often depicted as a dark cloud that follows the person around much like an unwelcome shadow. While the stigma surrounding depression is slowly eroding due to the diligence of mental health advocates and nonprofits, it is still an issue that is prevalent yet somewhat overlooked. For many cancer patients, depression is an added difficulty to their struggle towards health and wholeness.
A study on psychological issues in cancer patients shows “Although 53% of the patients evaluated were adjusting normally to stress, the remainder (47%) had clinically apparent psychiatric disorders. Of this 47% with psychiatric disorders, more than two-thirds (68%) had adjustment disorders with depressed or anxious mood… [and] nearly 90% of the psychiatric disorders observed were reactions to or manifestations of disease or treatment” (Massie 57). While different studies show varying results concerning higher rates of depression in men and women, it is agreed that breast cancer in women is “highly associated with depression” (64). Besides affecting mood, depression can also negatively impact the benefits of traditional treatment, further inhibiting emotional health.
It is this continuing occurance of depression in cancer patients that has caused healthcare practitioners to begin looking at ways of treating psychiatric symptoms instead of them going unnoticed and unresolved. One of these ways is Arts in Healthcare. According to Katja Boehm et. al, “Different types of art interventions have been used to alleviate symptoms and [treat] adverse effects in women suffering from breast cancer” (1). Benefits of art interventions include the patients’ ability to express emotions that may be difficult to verbalize as well as “[facilitating] the process of psychological readjustment to the loss, change, and uncertainty characteristic of cancer survivorship” (Boehm 2).
Feel Beautiful Today continues to offer Arts in Health programs to women affected by cancer that include painting, bead work, drawing, decorating and journaling. We have seen time and time again the benefits of accessible creative activities that focus patients’ minds on something positive while allowing the space for individual expression. We continue to seek ways to provide quality programs that combat the negative effects of depression and continue to inspire patients to hope.
References:
Boehm, Katja et al. “Arts Therapies for Anxiety, Depression, and Quality of Life in Breast Cancer Patients: A Systematic Review and Meta-Analysis.” Evidence-based Complementary and Alternative Medicine : eCAM 2014 (2014): 103297. PMC. Web. 18 Mar. 2017.
Massie, Mary Jane. “Prevalence of Depression in Patients With Cancer.” J Natl Cancer Inst Monogr 2004; 2004 (32): 57-71.