Creativity And Creative Therapy
Creativity appeals to the senses and can help people to express themselves in many ways. Many people say that their symptoms tend to lessen when absorbed in creative processes.
The brain has the ability to alter in structure in response to experiences, as has been shown by research into war veterans who acquire new skills to compensate for those lost as a result of injury or trauma. Although the mechanism for these positive changes in the brain is unclear, the important thing is to take advantage of these opportunities. So, even if you dont think you are particularly creative, have a go and you may well be surprised.
The range of creative therapy activities is wide, some of the most popular being:
- art including painting, sculpting and drawing
- music listening to music, playing an instrument or singing, either independently or in a group
- dance – usually in a group exploring a variety of different styles, particularly those that most stimulate and engage participants
- writing both as a therapeutic and creative pursuit, for example keeping a diary, writing poetry or short stories.
Other activities can also be therapeutic, such as photography, jewellery-making or working with fabric or ceramics.
The Old Sailor With Pd
Robert Bartoo describes himself as “an old sailor who has Parkinson’s disease,” but he is first and foremost a storyteller.
“Once you get me started, I spin terrible tales,” he admits. It is an endearing aspect of his personality that has endured despite his diagnosis.
As a young man, Bartoo spent eight years sailing on the Great Lakes. Once he reclaimed his land legs, he decided to open up the Sea Shanty Restaurant, a tavern that turned into an unintentional hot spot for Vietnam veterans to congregate and commiserate.
The stories he heard in that bar were the catalysts that initially ignited Bartoo’s passion for telling tales. “All of my creativity came out of that need to tell their story it just poured out of me.”
Bartoo’s first stage play, “A Night to Remember,” dealt with the difficult homecoming of a Vietnam veteran suffering from both post-traumatic stress disorder and PD. Over the years, it has been performed on multiple stages, was featured at the Vietnam Veterans Memorial in Washington, D.C., and was turned into a 90-minute broadcast for NPR.
The irony is not lost on Bartoo that, years after penning his play, he too was diagnosed with PD.
So he did what all creatives do when they experience pain, he turned it into art. This time he used music to get his message across.
“Music has always been uplifting to me it’s so different, it really carries you away. If I didn’t have music, I don’t think I’d still be around.”
Many Benefits No Side Effects
Rebecca Gilbert, MD, PhD, vice president and chief scientific officer of the American Parkinson Disease Association, who was not involved in either study, told Medscape Medical News that the idea of art therapy for patients with Parkinson’s is “very reasonable.”
She highlighted that “people with Parkinson’s have many issues with their visuospatial abilities,” as well as their depth and distance perception, and so “enhancing that aspect could potentially be very beneficial.”
“So I’m hopeful that it’s a really good avenue to explore, and the preliminary data is very exciting.”
Gilbert also highlighted that the “wonderful” aspect of art therapy is that there are “so many benefits and not really any side effects.” Patients can “take the medsand then enhance that with various therapies, and this would be an additional option.”
Another notable aspect of art therapy is the “social element” and the sense of “camaraderie,” although that has “to be teased out from the benefits you would get from the actual art therapy.”
Finally, Gilbert pointed out that the difference between the current trial and Cucca’s trial is the presence of a control group.
“Of course, it’s not blinded, because you know whether you got therapy or notbut that extra element of being able to compare with a group that didn’t get the treatment gives it a little more weight in terms of the field.”
No funding was declared. The authors have disclosed no relevant financial relationships.
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What Kind Of Art Makes Good Therapy
In my years working with people who have Parkinsons, preferences for art materials have varied as much as personalities. The choices of medium are influenced by each persons progression of symptoms, as well as by the sort of relationship a person is ready to have with those symptoms. I have found that wet-on-wet watercolor painting can be satisfying for many people, as this method of painting easily creates a satisfying mark with minimal pressure. This approach to painting can be soothing, and we already know how much relaxation plays a part in reducing tremor. However, a few members of my current art therapy support group have really appreciated the use of water color pencils, because they add precision to the medium. These artists choose to focus intently on making deliberate, unique marks, knowing that it is a balance between gaining control through attention to movement and putting too much pressure on themselves to make precisely the mark they expect, which brings stress.
Vision Issues And Art Therapy
It is well known that vision issues can be prominent in PD. This includes difficulty with visuospatial perception Poor visuospatial skills affect depth and distance perception as well as navigational skills, which can directly translate into difficulty with activities such as reading, driving, and even walking. As visuospatial challenges increase, so do gait dysfunction and falls.
Problems in a number of eye and brain areas affected by PD can contribute to these difficulties including the retina, the eye movement apparatus and the thinking parts of the brain that process vision and integrate it with other cognitive functions.
Exploring how art therapy may help PD
Currently, rehabilitative strategies in PD do not typically address visuospatial deficits, and this may hamper how much improvement a person can expect from his/her therapy. Whether art therapy, through art creation, can improve these deficits is a promising avenue of investigation. A study underway at the Marlene and Paolo Fresco Institute for Parkinsons & Movement Disorders at NYU Langone in New York City exploring the effects of art therapy on visuospatial deficits was recently described .
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What Are The Benefits
Art therapy may be able to help restore some functional independence and improve the quality of life for people with Parkinsons.1
In treating PD and other conditions it has been reported to improve mood and self-confidence, improve creativity and motor skills and general quality of life. These benefits can be intangible for some, but studies have measured specific improvements in psychosocial well-being including:2,3,5
- Increased pleasure
- Mind-body connection
- Strengthening concentration
The art studio offers a safe space where people find the ability to relax and shift the focus away from their disability. For those with voice impairments it permits non-verbal forms of communication. Everyone has the ability to concentrate on other forms of expression, including social and emotional connections.
Art therapy helps people with Parkinsons better understand their emotions and express them creatively. Improvements in cognitive thought, confidence, and social interaction contribute to ongoing improvement in mental and physical well-being.2
Painting With Parkinsons: All About Art Therapy
Every year, the top Parkinsons experts from around the world who treat people with Parkinsons at a Parkinsons Foundation-designated Center of Excellence convene to discuss the latest Parkinsons research and treatments. This article summarizes the 2018 Center Leadership Conference presentation on art therapy led by art therapist and consultant Kimberly Faulkner, ART-BC, LCAT. Read the articles covering some of the other topics discussed, such: intimacy issues, new therapies in trial, oral health and music therapy.
Center coordinators play a critical role in the Parkinsons Foundation Center of Excellence network. Not only do they support research activities, coordinate clinical trials and plan outreach services they act as the liaison between the Parkinsons Foundation, the centers care team and patients. They advocate for a multidisciplinary approach to PD care, and work with all members of the care team to make Foundation resources available to patients and their families.
While center coordinators stay up-to-date on the latest PD treatments, they rarely get to experience them firsthand. Thats what made their session about the benefits of art therapy for people with PD so unique after watching an educational presentation, coordinators from around the world picked up their paint brushes and became art therapy session participants.
Symptoms reported to improve with art therapy include:
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For People With Brain Disorders Like Alzheimer’s And Parkinson’s The Mere Act Of Painting Or Sketching Can Draw Out Memory And Movement
The two older women sit silently across from one another as Jacqueline Baroch spreads art supplies out on the table. Toni, 58, picks through a set of multicolored markers while 88-year-old Mae slouches deep into her aqua-colored bathrobe, glassy-eyed, appearing not to notice the pens, markers, and colorful pastels laid out in front of her.
Baroch encourages the women to draw pictures of houses that have been homes, and Toni leans forward and begins to sketch the outlines of a building. Mae picks up a pen and listlessly scrawls a line on the paper in front of her. As Baroch gently prods with questions about Mae’s childhood home, about sisters and brothers, about farm animals and flowers, Mae’s posture starts to change. Her shoulders come back and her head lifts. Her eyes brighten and she starts to draw with more focus. The clouds of begin to part, and Mae starts to reminisce about her youth.
Mae’s awakening through the act of drawing allows her to reconnect, for a time, with an earlier self and to retrieve memories that she might not be able to find without a pen in her hand, says Baroch, an art therapist at the Albert Einstein Medical Center in Philadelphia.
No one knows exactly how art taps into physical and intellectual memories muddled by neuro-degenerative diseases. But scientists suspect that the process allows people to find alternate routes to misplaced memories.
Art Therapy For Parkinson’s Disease
Visuospatial symptoms are highly prevalent but poorly recognized symptoms of Parkinson’s Disease.
Cumulative disability arising from impaired visuospatial skills may significantly affect patients’ quality of life.
Effective pharmacological treatments for visuospatial symptoms are lacking.
The process of art making relies on sophisticated neurological functions that may be trained to improve visuospatial symptoms in patients with Parkinson’s disease.
Further studies are warranted to confirm these original findings.
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Icipating In Art Activities Such As Painting And Drawing Can Help Improve Some Disease Symptoms Experts Say
The American Parkinson Disease Association Minnesota Chapter is hosting a free virtual art therapy session Tuesday, Aug. 17, via Zoom. It is open to adults with Parkinsons disease and their care partners living anywhere in the Midwest.
The program, called Connecting Through Art, is a creative arts program that offers people with Parkinsons disease the opportunity to express feelings, emotions and daily concerns through drawing and painting. For people who are dealing with this illness, an art activity can help improve some symptoms, according to the APDA.
There is no charge to participate, but pre-registration is required. To register, call 241-8297 or email .
The virtual Connecting Through Art program was filmed in collaboration with the Parrish Art Museum in New York. The museums art educator, Wendy Gottlieb, will guide participants through a step-by step watercolor painting activity with a special lesson about Fairfield Porter, a figurative painter who created paintings of interior and exterior landscapes around his homes in New York and Maine.
The program will be moderated by Georgia Engebretson, docent at the Minneapolis Institute of Art. One million Americans are living with Parkinsons disease, and 60,000 people are newly diagnosed each year. There is no cure for Parkinsons disease, the APDA said.
Effects Of Music Therapy On The Social And Communication Sphere
Impaired communication is one of the most common symptoms in PD, significantly affecting the persons quality of life. In a study by Tamplin et al. , they consider that singing shares many of the neural networks and structural mechanisms used during speech and therefore has the potential for therapeutic application to address speech disorders. They therefore set out to explore the effects of an interdisciplinary singing-based therapeutic intervention on voice and communication in people with PD, concluding that ParkinSong is an attractive intervention with the potential to increase volume and respiratory function in patients with this condition.
Hypokinetic dysarthria during the disease was analyzed with regard to communication skills as predominant factors in daily life, with the same immediately influencing decreased competence in communication, thereby increasing frustration and a loss of confidence, regardless of the degree of symptoms. Regarding the feasibility and outcome measures, they concluded that there is initial evidence to warrant further study of the protocol. On the other hand, in a narrative review, the role of music therapy in improving aphasia and other neurological disorders was described, underlying the reasons why this tool could be effective in rehabilitation settings, especially in people affected by stroke , in maintaining vocal skills, and in delaying the vocal deterioration that often accompanies PD .
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Effects Of Music Therapy On The Emotional Sphere
PD is a complex diagnosis commonly associated with motor dysfunction, but it is also known to encompass cognitive, psychiatric, and mood disorders. Music has been successfully used to address motor and non-motor symptoms. Morris administered two surveys to 19 people with PD and 15 people without PD to assess their subjective impressions and appraisals of music. They concluded that people with Parkinsons may perceive less of an automatic connection between music and activity than their healthy peers. In addition, those with PD may receive more pleasure and value from music than they anticipate. Taken together, these results suggest that people with PD may require encouragement to participate, as well as to the ability to choose familiar selections to better access music-based interventions and the benefits they may offer. This may facilitate adherence to therapy, as music is engaging and enjoyable , improves mood, depressive syndromes , and thus improves the quality of life for people with PD .
Music Therapy Interventions In Parkinsons Disease: The State
Parkinsons disease is a neurological disorder involving the progressive degeneration of the dopaminergic system, which gives rise to movement-related dysfunctions as well as other symptoms, mainly of cognitive and psychological nature. In the latter case, mood disorders prevails frequently causing anxiety and depression in all phases of the disease, sometimes even before the motor symptoms occur.
Aarsland and colleagues report that 35% of the patients affected by PD present depression, whereas Richard states that anxiety is to be found in 40% of the cases.
The literature shows that playing and listening to music may modulate emotions, behaviors, movements, communication, and cognitive factors, modifying the activity of the brain areas involved in the perception and regulation of these aspects .
Music can produce substantial effects on movement-related symptoms as well as psychological ones in PD treatment. Concerning the first aspect, rhythm has a crucial role in rehabilitation, enhancing connections between the motor and auditory systems .
Literature showed how a rhythmic auditory cues-based training can produce a compensation of the cerebello-thalamo-cortical network leading to beneficial effects, for example, improving not only speed and step length but also perceptual and motor timing abilities .
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Effects Of Music Therapy On The Cognitive Sphere
Spina detected a beneficial effect of music therapy on cognition. There was an improvement at the end of the program in tests that examine frontal lobe function in a pilot study conducted on Parkinsons patients, which suggests that the music-based intervention could improve frontal function by acting as a training ground for these cognitive skills since it stimulates attention and executive functions such as planning, flexible thinking, and execution. Although, according to the authors, this effect tends to disappear after the music therapy program is stopped, so it should be continued for a longer period.
However, another study led by Dalla Bella shows how patients with relatively moderate rhythmic abilities are the most likely to benefit from rhythmic auditory signals. These can be enhanced with the use of technological devices such as cell phones and tablets, among others, which can help to generate, apart from rhythm, the correction of cognitive functions of speech and language. This applies not only to people with PD but to patients such as children and adults with neurodevelopmental disorders.
Art Therapy For Parkinson’s
According to the American Art Therapy Association, art therapy is a mental health discipline, facilitated by a credentialed art therapist, who uses various art forms and materials to engage in the creative process as a way to explore feelings, increase self-esteem and develop social skills.
Its many goals include improving physical functioning and well-being. Projects can include the use of oil or watercolor paints, pastels, clay, and other media based on the project and or physical limitations of the individual in therapy.1,4
Making art involves many neurologic mechanisms some of which may be impaired in people with Parkinsons.2 Difficulty with hand-eye coordination, and perception of objects, among other symptoms, are indicators of visuospatial deterioration. The benefit of art therapy in treating PD is being investigated in a number of settings around the world.
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Art And Pd: Beyond The Physical Benefits
Art therapy may also be a tool that enhances the lives of people with PD more generally. One small study investigated clay art in people with PD and showed improvements in hand dexterity, mood, and quality of life. More studies are necessary to determine whether these effects are clinically relevant and if so, to define the optimal type and duration of the therapy.
Also, despite the visuospatial challenges of some people with PD, there is evidence that people with PD might experience an increase in creativity, or even develop a new interest in creative pursuits with their diagnosis, possibly fueled by dopaminergic medications. An increase in creativity can also accompany other neurologic disorders, unrelated to dopaminergic medication. Therefore, the possibility exists that PD alone can fuel creativity, perhaps in combination with the effects of PD meds.
An increased drive to create coupled with potential neurologic improvement from art creation may lead to an enhanced focus on art therapy for PD in upcoming years.
APDAs Connecting Through Art
Even before definitive studies are done to evaluate the benefits of art therapy in PD, people with PD find happiness, satisfaction, socialization and camaraderie in artistic pursuits.
It may take scientists more time to discover all the relationships between art, art therapy and PD. Until then, feel free to explore your inner creativity!
Tips and Takeaways
Dr. Rebecca Gilbert
APDA Chief Scientific Officer