WelcometotheIntegrativeCommunityPractitionerForum.HostedbyUVMIntegrativeHealth,ajointinitiativeofTheUniversityofVermontMedicalCenter,theUVM CollegeofNursingandHealthSciences,andtheLarner CollegeMedicine.

Thistalkispartofaninter-professionalseriesonnon-drugmethodsthatcanhelpmanagepain.

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Thiseveningwillbebrokenintofourshortsegments:

First, a bitofinfoonArtfromtheHeart,andanintroductiontothefieldofartandhealth.ThenPatriciaFontainewilltalkaboutexpressiveartsandleadanexperientialactivityBuffyDekmar willspeakaboutherexperiencewithconnectingpeoplewithcreativityandwhatsomeoftheresearchispointingtowardAndAnnetteBurgerwilldescribeherexperienceintegratingtheartsintohernursingwork(ininternalmedicine)hereattheMedicalCenter.

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Generousdonors,andtaxpayerdollarshelpedusconnectover5100peoplelastyearwithqualityartsuppliesandthedevotedattentionofartistvolunteers.Theprogramrunseveryday,andsometimesseveraltimesaday,withvolunteersmakingartwithandforpediatricpatients,andsiblings,aswellasadultpatients,familiesandstaff.

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Since1994ArtfromtheHearthasbeenfacilitatingcreativitywithkidsandfamiliesatthehospital.OvertheyearstheprogramhasgrownunderthecareofBurlingtonCityArtsincollaborationwiththeMedicalCenterandwiththeEssentialworkofvolunteers- whoarereallyhowtheprogramhappens.

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ArtfromtheHeartists maketheirrounds,helpingtoconnectpeoplewithcreativityandwiththepartsofthemselvesthatarewell.Weworktocreatewindowsofimaginationonsterilewalls,andopendoorsintojoyfulexperiences.Wevisittomakethehospitalamorecomfortableplaceandempowerpeople– pediatrictopalliative–tobemorethemselves.

Wearenotarttherapistswithacapital‘T’,butartcancertainlybetherapeutic.Artistscanhelptofacilitatethecreativestatethattransportsus,andopensupaccesstofeelingsofflowandperhapsspirituality.Artistsinhealthcarearenotshamansorhealersortherapists– wearefacilitatorsofthetranscendentpowerofart. Andwearetheretosupportcaregiversandstaffintheagonizinglypainful, andimmenselymeaningfulexperiencesofcaringforothers,anddealingwithillness,thecomplexitiesoflife,andofdeath.

Ifsomeonechoosestoexplorethemeaningintheirwork,welistenandhonortheirthoughts,asanyfellowhumanwould.Ifweareconcernedforpeoplewebringtheseconcernstothehospitalcareteam.Wearenottheretoleadpeopletocatharsis,interpretationortherapeuticexploration,And,thecreativejourneyhasmanybenefits- whichIhopeyouwillexperiencetonight.

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Acrosstimehumanshavemadearttohelpunderstandandinfluencetheworldswefindourselvesin– wecanevensaythatartmakingisoneoftheactivitiesthatdefinesusashumans.Theartsseemtoofferanevolutionaryadvantage,asthebehaviorhaspersistedandflourishedformillennia.

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Theprofessionofarttherapy– whichisprimarilyhousedinpsychotherapy- becameformalizedinthe1940s.Artsinhealthcareisprimarilyhousedinthephysical careplacesofhospitalsandnursinghomes,andstarteden masseinthe1990swiththefieldworkingtoformalizeitselfaswespeak, withatrajectorytobecomepartofthealliedhealthcareteam.

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Onewaythatweinteractwithpatientsistoofferartworkforthemtolookat.Oftenwindows– iftheyareluckyenoughtohaveone,lookoutatanotherbuilding.ThisphotooftheWhalesTalesisbyBrianDrourr,whoinadditiontobeingagreatphotographerisasocialworkerhereatthehospital.Weworktoconnectpeopleonthehumanlevel,andbringintheirinterestsandamongotherthings,thesharedcalmingmagicofthenightsky.

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Theimpulsetocreateandexpressdivinemysteriesispartofwhatmakesushuman.Weseeitclearlyinchildren,Anditcontinuesinallofus whetherwethinkofourselvesasartistsornot.

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Weareaboutprocessmore thanproduct.

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Art hasthepowertoholdcontrastsforhowthingscanbebothfunnyandterrifyingallatonce.

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IthinkthereshouldbeasmanywordsforartastheirareInuitwordsforsnow.Therearesomanycomplexformsofart,andsomanywaystothinkaboutitdependingonthecontextthatitisin.Certainly,Somecontemporaryartcanbemoreperplexingthanenlightening.

Butevenifyoudon’tidentifyasanartist,itislikelythatyouturntotheartsthroughthedramaofTV,andmovies,ormusic,dancing,readingandsoon.Theartsintheirmanyformshelpuslearnabout,processandtryonnewrealizations,orfindanescape orentranceintowonder– limitless– andknowing.Thesepowerfulqualitiesarewhatconnectthearts,spiritualityandhealing.

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Overmostofhumanhistorytheartswerenotseparatefromotherdailyactivities,butwereintegrated.TheArtshelptodifferentiateandmaketheordinaryExtraOrdinaryandimportant.

Holygrounds,temples,churches,formalceremonies,music,story,anddancearethingsthataremadeSpecial(Dissanayake)– anddesignedtohelpusshiftintocontemplation.Makingsomethingspecial,orextraordinarytakesitbeyondthemundanetotouchthespirit,andsignifytheimportanceofamoment,aplace,afeelingandsoon.

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Theartscanquietandfocusthemindandallowfordeepconnectionwithimageryandritual.Theyalsofrequentlyinvolvemanymembersofthecommunity,andhelptoknitpeopletogetherinsupportofoneanother, andbringthepatientintothecenterofcare.

Thereisevidenceofsimilarbeliefsfoundallaroundtheworldinearlycultures.Diseaseandpainrepresenteddisruptionsoftheharmoniousrelationshipbetweenpeopleandspirit.Shamansorhealersactasintermediariesbetweentheordinaryvisibleworldandthespiritworld,

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facilitatedbythetoolsofthearts:music,song,drama,dance,andthevisual.

Manypeopletodaycontinuetoworkwithtraditionalhealers,insomepartsoftheworld80%ofthepopulationusestraditionalhealingmethods,ofteninconjunctionwithWesternmedicine (WorldHealthOrganization).

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TheNavajoutilizesandpainting,whichisoneaspectofamultidayceremonythathasdance,drummingandchantingaswell.Thepatientliesinthemiddleofthetribalcirclenexttothepersonchantingandsinging.Atthesametimetheshamancreatesasandpaintingonthegroundthatrepresentsthespiritualandphysicallandscapethatthepatientandillnessexistin.Theimagesaresymbolsthatholddeepculturalsignificance.Originmythsconnectthepatienttotheforcesofcreation,andrecreatingthemselvesinwholenessandhealth.

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Allcultureshaveversionsofamulets.Perhapsyouhaveapieceofjewelrythatholdsspecialsignificance.

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InSufism,whichisIslamicMysticism,healersaretrainedfor12yearsbeforepracticing.Inadditiontodancetheyusedchanting,andhealingwords.Sometimes,Healingwordsandwordsofprotectionarewrittenonapaperandplacedinanamulet.Itisbelievedthatthepowerofthewordsaswellasthepowerofthehealeristransferredtothepersonbywearingtheamulet.

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InancientEgyptamuletsandincantationswereusedtohelpprotectandcure.ImportantdeitiestohealthwereSekhmetgoddessofhealing– Anddestruction –andThoth,thegodofwriting,wisdom,music,andbalance.Interestingly,Thothiscreditedwiththeinventionofbothmedicineandwriting.Sekhmetisfrequentlyshownwithamusicalinstrumentandasnake(snakesaredecorating herthrone),thesearetwothemeswewillfindagainandagain.

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ShrineswithMinoangoddessfiguresover3600yearsoldhavebeenexcavatedintownsandcertainareasofpalaces,suggestingthatthesphereofthese goddessextendedtotheofficialpublicarena.Evidenceisscarceastothemeaningofthem,butbasedonherexposedbreastsandmorerecentappearancesofsnakesandgoddessesandgodswecantakeaprettygoodguessthatsheisaboutfertilityandregeneration.

Thenaga isconsideredaprotectivedeityamongotherthings.

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InthetemplesofAesclepious,theGreekgodofhealing,fastingandmusichelpedpreparepatientsfordreamtherapyordivinesleep.IntheirdreamsAesclepius wouldvisit,andcureyouoradvisetreatment.Dramaplayedaroleinhealingaswellwithcomedyorsatireprescribedfordepressivepatients,andtragedyprescribedformanicones.

“ItwasintheseAesclepions thatHippocrates,thefatherofmodernmedicine,begantodeveloprationalmedicine– anewphilosophyattributingdiseasesnottothegodsorthespiritworld,buttopurelyphysicalandnaturalcauses.

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JumpingtothemiddleagesandtheJudeoChristiantraditions,Godandhiswrathwereconsideredthecauseofdiseaseandsuffering.Faith,prayer,piety,andrepentancewereconsideredcuring.TheidealsandevensomeofthehealingpracticesuponwhichanimismandpaganismarebasedcanbeseeninChristianityduringtheMiddleAgesbutwithanewvocabulary:spiritsandgodsbecamesaints,anddiseaseswerenowthoughttobecausedbySatan,andsin,ratherthanbyspiritsorGods– sothingshadn’tchangedthatmuchafterall.

Thebodywasviewedasnegativeandsinful,whilethesoul,washighlyrevered.WesternmedicaldevelopmentduringthistimewassuppressedwhileGreekandIslamicthinkerscontinuedtodeveloprationalmedicine.

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However,someprogresswasmadeinEuropewithfolkandreligioushealing,forinstancetheworkofHildegardvonBingen (1098-1179)advancedseveralfields.Shewasanabbess,mystic,herbalist,lyricpoet,composerandwriter,Shewrote“two treatises onmedicineandnaturalhistory,withaqualityofscientificobservationrareduringthatperiod”.

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Untilthe1500sinEuropenaturebasedritualscontinued”Scandinavianfiredanceswereperformedtomaintainhealthandtocleansethebodyofillness.Participantswoulddanceallnighttoreachastateoftranscendentspiritualecstasy,thenwouldrepeatedlyleapthrougharagingfiretoburnoffharboringdiseasesandhelprestoreandmaintainhealth.”

Dancehasbeenusedtoachievetranscendenceandhealthacrosstime.TheancientGreeksdancedaroundthesickforhealingpurposesinthe5th CBCEandtheDionysiancultspracticeddancetoachieveecstaticfeelings,SufiwhirlingdervishesandtheSanofSouthernAfricadid,andcontinuetoaswell.Thesearejustafew.And,thinkofdancepartiesyoumighthaveinyourlivingroomoratacluboracelebrationwhichhelpusbeinourbodiesandfeelconnectedwithoneanother.

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WiththeRenaissance,artistsandphysiciansworkedtogethertounderstandanatomyandphysiology,anddevelopnewwaysofexperimentingandteaching.Thispartnershiphelpedmoveknowledgeforward.StunningdevelopmentsweremadeinthefieldofmedicineoverthecourseoftheEnlightenment.

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Andyetthereductionistidealsthatseparatethingsintosmallerpartstobestudied,ultimatelyseparatedmind,bodyandspirit,andweknowthatthingsareinterconnected.Withoutattendingtomanyaspectsofaperson,thecommunity,andourwidelyinterconnectedrealities,wecanfallshortofsupportinghealth.

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TheWorldHealthOrganizationdefineshealthas“astateofcompletephysical,mentalandsocialwell-beingandnotmerelytheabsenceofdiseaseorinfirmity.”http://www.who.int/about/mission/en

Theartsareexperiencingarenaissanceinhealthcaretosupportthisholisticunderstandingofhealth.Theartsandhealinghaveneverbeenfullyseparated,andnowweareseeingthemgrowingtogetheragain.OverhalfofallhospitalsintheU.S.,andnearlyallchildren’shospitals,havesomekindofartsprograming,withmanyofthembeingartondisplayorconcertsinlobbies,andsomeofthemwithhandsonactivitiesaswehavehere.

Andwiththat,itismypleasuretointroducePatriciaFontainewhowillleadusinanexperientialactivity.

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PatriciahasmastersdegreesinCounselingPsychologyandTransformativeLanguageArtsandcurrentlyteachesclassesusingexpressiveartandwritingforpeoplelivingwithillnessandforcaregivers.Herclassesaredrop–inandIencourageyoualltogo.TheyareheldatHopeLodgeandhereattheMedicalCenterintheFrymoyerCommunityHealthResourceCenter.

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EasyExperientialArtActivity withcrayonsandpaper

Foracoupleofminutes,findacomfortableposition,relax,andcloseyoureyesifyouwouldlike. Take3long,slow,deepbreaths,focusingparticularlyontheoutbreath-proventoreallyrelaxthenervoussystem.

Bringtomindsomethingthathasbeenmildlytomoderatelystressfulforyourecently- nothingtooextreme.Noticehowitfeelsinthebodyandwhereyoufeelit(thelowerback,thethroat,thebelly).

Nowimagineyour4yearoldselfcreatingsimpleimages- colors,shapes,andforms-todrawwhatthisfeelslike,orhelpthisstressrelax.

Openyoureyes,pickupyourcrayonsanddrawforafewminutesstraight.Bekindtoyourselfasyouwouldtoafouryearoldwhoisdrawingwithcrayonsandpaper.Allowthedrawingtobewhateveritwantstobe,scribblingifyou’dlike.

Ifyoufeelstuck,justchooseacolorandstartmakingshapes.Remembertoreleaseanyjudgementorcriticism,justasyouwouldfora4yearold.Allowwhatyoudrawto

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feelgoodinyourhand,trustingyourintuitiontodrawwhatfitsforyou.

Iwillringabellwhenitistimetobringyourdrawingtoaclose.

Whenyouaredone,pleaseconsiderthefourquestionsonthescreen,especiallyquestionnumber3.Justwriteafewshortnotestosharewithyourneighbor,rememberingnottoapologizeforyourdrawing,ortoofferanalysistoyourneighbor'sdrawing.Allowyourselftolistenwellandbelistenedto.

Whenyouarefinished,pauseforamoment,closeyoureyes,andnoticeifyoufeeldifferentthanwhenyoubegan.Howisthatplaceofstressinyourbody?Hasanythingchanged?Howeveryoufeelisjustfineforyou.

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NowitismypleasuretointroduceBuffyDekmar,whobridgestheworldsofart,educationandcare.Buffyhastaughtelementaryschoolgrades2,3,+Kindergartenandworkedasaprofessionalphotographer.Herfocusnowis,amongotherthings,onpre-medstudiesandbeingavolunteersupremewith ArtfromtheHeart.OverthelasttwoyearsBuffyhasbeenkeyinhelpingArtfromtheHeartexpandservicetoworkwithadults.ShehaswrittenacomprehensivemanualforArtfromtheHeartandhasbloggedontheexperienceofcreatingwithandforpatientsfortheUVMMC Blog.Hereffortsontheresearchprojectsthatwehavedonehavebeenthoughtfulandessential.FortwoyearsBuffyhastakenadeepdiveintoreadingupontheliterature,examininghowartandhealthwork,andshewillbesharingsomeofherobservationspresently.

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First,I’lladmitthatwhenIbeganvolunteeringwithArtfromtheHeartacoupleofsummersago,IthoughtIwouldsimplybeprovidingpeoplewithfunandcraftywaystopassthetimewhiletheywaitedfor,orrecoveredfrom,appointmentsandprocedures.IknewIwantedtogainexposuretomedicalsettingsasIpreparedformyownmedicaleducation,andIthoughtthiswouldbeawaytousemyskillsfromteachingandbeingaphotographerinthatprocess.Ididn’treallythinkofthisworkasfacilitatinghealingofanykind...Atfirst.

Itdidn’ttakemelongtorealizeourprogramisaboutmorethanjustentertainment.

Weregularlyexperienceinteractionswithpatientsthatseemtobringbeautyandhopeintodark,stressful,sometimesevenfrighteningmoments.

Wearevolunteers.Wearenottrainedtoprovideprofessionalarttherapy.However,ourinteractionswithpatientsaredeeperthanthebasicreliefofboredom.

Notallpatientsneedartandthatisokay.Webelievethatevenifapatientrefusestoparticipateinourcreativeprojects,wemayhavestillimprovedtheirhealthcareexperiencethroughfriendlyconversationorevenbyprovidingthemarareopportunitytosay,“no”tosomeonewhostoodattheirhospitalbedside.However,forthosewhodoparticipate,therewardsareevendeeper.

Iliketothinkofourworkas“artrecreationwiththerapeuticsideeffects.”Weprovideartentertainment,withtheunderlyingassumptionthatitISbenefittingpatientsandimprovinghealthoutcomes.Andasitturnsout,thisisnotjustmyopinion.Ihavelearnedthattheseaspectsofartinterventionsinmedicalsettingshavebeenwidelyobservedanddocumentedbyarttherapists,physicians,nurses,psychologists,and

artists.

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Theworkwedoiscomplexandmulti-tiered.AccordingthetheStateoftheFieldreportfrom2009,researchersofartsinhealthcarefindchallengeinisolatingandquantifyingthecreationofartfromothersubtleelements:communication,choice,soundvibrations,companionship,spirituality,light,color,andtactilestimulation.However,itcanbedone.Ilikethisquotationfromthebook,TransformingtheHealthcareExperienceThroughtheArts.

Forthepastfewyears,ArtfromtheHearthasjoinedforceswithUVMmedicalstudentstomeasuretheresultsofArtfromtheHearthereatUVMMedicalCenter,assessingtheefficacyofourprogramfromvariousangles.WhichIwilltalkmoreaboutinjustamoment.

Inourbackgroundresearchwefoundplentyofstudiessupportingtheincorporationofmusic.Infactthefirstpaperonartsinhealthcaredatesbackto1729,citingareductioninanestheticsandpainmedicationusedduringandaftersurgerywhenmusicwasplayedforpatientsinaveterans’hospital.

MusichasbeenusedtocomfortpatientsANDasapartoftheirtherapyplansforcenturies(Serlin).JillSonke isacurrentresearcheratUniversityofFloridawhohasdonesomeinterestingTedtalksandwritingontheimplicationsofmusicanddanceinclinicalsettings.Idefinitelyrecommendlookingintoherworkifyouhaven’talready.

Intheareasofexpressivewritingandvisualart,whichwearemostequippedtooffer,wehavelearnedthatBenjaminFranklinbelievedsostronglyintheimportanceofcreativitytowellness,thatherequiredpatientsinthehospitalheestablishedtocontributeworksofwritingtothehospital’snewspaper(Serlin)!SinceBenFranklin’stime,psychologistslikeFreudandMaslowhavefurtherexplainedthehumanneedforself-expression,andthecreativeartshavebeenincreasinglyinvolvedineffortsto“rehumanize”patientcaresincethe1970s(Serlin).Anexcitingstudypublishedin2014explorestheeffectsofvisualartonfunctionalbrainconnectivityattheneural

level.

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...Showingsignificantimprovementinpsychologicalresilienceinadultswhoparticipatedinvisualartproduction,comparedwiththosewhoonlyinterpretedart.Itisoneofthefirststudiestobegintoexplaintheconnectionbetweenart-makingandphysicalchanges.

WhilethebiologicalmechanismsofHOWartsimpacthealtharestillbeingdiscovered,humanshaveintuitivelyknownaboutthesebenefitsforcenturies.Recentresearchislargelyqualitativeandanecdotal,butitdoesshowthatcreativeartshaveaplaceinhealthcare.Arttherapyisbeingusedincreasinglyinpsychologicalcare...

...suchastheuseofmaskstohelpsufferersofPTSDandTBI expressandovercomethementalimagesthattormentthem.ThesephotosarefromaNationalGeographicarticlecalled“BehindtheMask:RevealingtheTraumaofWar.”

Iappreciatedthisquotationfromthesamearticle,becauseontopofthelayersofcomplexityofouractualwork,engagingparticipationissometimesthegreatestchallengeofall.Awarveteransaidofthemask-makingart-therapyactivity,“ITHOUGHTTHISWASAJOKE.Iwantednopartofitbecause,numberone,I’maman,andIdon’tlikeholdingadaintylittlepaintbrush.Numbertwo,I’mnotanartist.Andnumberthree,I’mnotinkindergarten.Well,Iwasignorant,andIwaswrong,becauseit’sgreat.Ithinkthisiswhatstartedmekindofopeningupandtalkingaboutstuffandactuallytryingtogetbetter.”---

Expression...

Thisisthefirstonmybrieflistoffivekeyresearch-supportedbenefitsofartsinhealthcare.

Justlikethemask-makingdidforthearmysergeant,creativeartscanaidexpressionofdifficultideas,whichcanelucidateinsight.Youmayhaveexperiencedthis:startingtowriteordrawaimlesslyandsuddenlylookingdownatthepageandlearningsomethingaboutyourselfthatyouhadnotconsciouslythoughtofbefore?Expressivearthasbeenshowntohelppatientsdevelopawareness,gaininsight,andprocessandexpress“subconsciouspsychologicalmaterial.”

HereisadrawingfromastudybyArtTherapistSusanBaergin2003.Theartistofthepiecewasateenagegirlwhowasbeingtreatedforcanceratthetime.Herquotesays,““I’mtheflower…inabigfield...allalone.Nooneelsehasgonethroughcancerandtheirparentssplittingupinoneyear.Thelittlecaterpillariseatingmyleaves.Idon’tknowwhatthatcaterpillaris,whatitstandsfor,butIdon’tlikeit”(quotedinBaerg2003).

Thiswastheresultofsimplybeinginvitedtodrawthewayshefelt.

Baergwrites,“Throughexplorationoftheirartwork,theteensfindvaluablehintstohealing,andgainwisdomandinsightthatbeginstosoothetheirsouls.”

Expressioncanbeassimpleaspenciltopaper,oraselaborateaspaintedpapermacheandothermixedmedia.Broadeningourideaofwhat“beingcreative”meansisagoodstartingplace.Atartfromtheheart,wehavelearnedsubtlewaystomakeartasapproachableaspossible.Insteadofsaying,“CanIbringyousomeARTsupplies?”,weaskpatients,“Whatgetsyouexcitedaboutbeingcreative?Weareheretoconnectyouwiththat.”Theseareafewofourgo-toprojectsforfosteringcreativeexpression.

AccordingtothecasestudybyArtTherapistSusanBaerg,patientsbenefitfromdisplayingorsharingtheirart.Artisautobiographical,anditcanbevalidating,empoweringeven,totellone’sownstoryandtohaveanaudience.

Ourprogramencouragespatientstosubmittheircreationsfordisplay.Wehavefoundthatthisoptionoftenpromotesparticipationandaddstopatients’senseofusefulness,prideandachievement.Wehaveheardfromnursesthatanythingwecandotochangeapatient’soutlook canhaveenormouseffectsontheiroutcomes.

ApatienthereatUVMmedicalcentercreatedthesedrawingsduringhistimeinthehospital.Aswithallart,themescanbeinferred.However,expertscautionagainstover-interpretingpatients’artworktoavoidbringingupunnecessaryanxiety(Angheluta2011).

Secondly,involvementincreativeprojectshasbeenassociatedwithdistractionfromunpleasantcircumstances,feelings,orthoughts.Thisiscloselylinkedtothethirdbenefitonourlist...

Reducingstressandanxiety.Itiseasytoseehowdistractingfromstressorsreducesstress.Artalsohasintrinsiccalmingeffectsasitinvolvesconcentratingoncolors,motions,shapes,repetitiveaction,orinspirationalsubjectmatter.Researchershave,thusfar,foundtheseeffectshardtoseparateandhaveinsteadfocusedonthemeaningofthereducedstressandanxietythatundeniablyresultsfromartinterventions.

Theuseofarttorelievepatientstresshasbeensupportedbystudiesinmultiplefields:oncology,pediatrictrauma,geriatrics,neurology,andpsychiatry.Byreducingstressofbeinginthehospital,artinterventionsimprovehealthcareexperiencesforpatients,caretakers,andhealthcareteams.Weusemandalasandpatterndoodlingoftenfortheirlong-standingconnectionstomeditation,mindfulness,andreflection.

Art’spotentialtoreducechronicstress indicatesthatartmayalsobeaninstrumenttoreducingprevalenceofdiseaseslinkedtostress,suchasdiabetesandcardiovasculardisease.(StuckeyandNobel2010)

Duringourrecentpublichealthresearchproject,nurseshereatUVM reportedobservationsofArtfromtheHeart’spositiveeffectsontheirpatients.MostnursesstatedthatAFTH hadreducedpatientanxiety,improvedpatientmoodsandhealthoutcomes,andhadpositiveeffectsonattitudestowardnurses.Thebluelinesindicatearesponseof“improve,”yellowis“stronglyimprove,”andgreyisneutral.Zeronursesfeltarthadnegativeimpactsonanyoftheseaspects.

Byhelpingpatientsintheseways,artinterventionsnotonlyimprovehealthcareexperiencesforthepatients,butalsomakenurses’workmorepleasant,possiblyreducingburnoutandimprovingstaffretention.

Thefourthbenefitwe’llhighlightistheabilityofarttodecreasetheperceptionofpain,specificallychronicpainwhichmaynothaveaclearbiologicalcause.

AccordingtoanextensiveliteraturereviewpublishedintheCanadianJournalofPsychotherapyin2011,“Regardlessofthenuancesinvolvedinitsdefinition,chronicpainiswidelyacceptedtobeaphenomenologicalexperience.Inotherwords,thechronicpainexperienceisuniqueandbasedontheperceptionoftheindividualexperiencingit”(Angheluta 2011).

Tome,thissoundsstrangelysimilartothewayartisexperienced.Itmakessensethatthetwomightaffecteachother.

AccordingtotheAmericanAcademyofPainMedicine,painaffectsmoreAmericansthandiabetes,heartdisease,andcancercombined:100millionpeople.Chronicpainislinkedwithdepression,inabilitytowork,andlossofsleep,amongotherdebilitatingeffects.

Only58%ofpatientsusingprescriptiondrugs(and41%ofthoseusingoverthecountermedications)forpainmanagementreportthattheirtreatmentisfairlyeffective.Thatisaconsiderablewasteofmoneyandunnecessaryriskofdrugdependency,whichcarriesahostsofproblemsonitsown.

Artisoneofmanyalternativetreatmentsthatmayhelptheseindividualsmanagetheirpainandavoidtherisksinvolvedwithpainmeds.

Numerouscasestudieshavebeenrecordedthatdemonstratetheabilityofarttorelievechronicpainonsomelevel.Inonestory,a79-year-oldwomanexperiencingchronicpaininherbackandshouldersworkedwithanarttherapisttodepictherpainasamonster.Thetherapistdirectedherthroughfindingawaytovanquishthemonsterinherartwork,andthewomanreportedthatherpainsubsided.Ofcourse,casestudiesarenotgeneralizable,butifthereisapossibilitythatartinterventionsmayhelpinpainmanagement,thereareveryfewreasonsnottoatleasttryit.

ThisimagewascreatedbyapediatricpatienthereatUVM livingwithaseriouschronicillness.Wedonothavecommentaryfromtheartist,butitdoesseemtoexpressstrongfeelings!

Themainareasofprogresssupportedbyresearchonarttherapyinchronicpainare:changesinphysicalsymptoms,changesinpsychologicalwell-being,changesinsocialinteraction,andchangesinbodyimage.Obviously,artisnota“cureall”painremedyandresultsarenotalwayspositive;certainactivitiessuchasintricatedetailsandcreatingwithpermanentmarkersandothersmellymaterialshaveactuallybeenshowntoexacerbatesymptoms,especiallywithmigraines.

What’sinterestingthough,isthateventhoughartactivitiesdonotreliablyreducemigrainepain,studiesreportthatsomeartistschoosetocreateartdespitetheirpain.

Thisshowsthatthebenefitsofdistractionandstressreductionarealsorelevantinthecaseforartinterventionsinpainmanagement.Italsodemonstratesthevalueofusingarttocommunicatesymptoms,leadingto“morecomprehensivetreatment”(Angheluta&Lee2011).

Theartistofthispiece,OleaNova,hasanintriguingcollectionofheadache-themedartworkathersite,migraineartworkdotcom,whichprovidesaglimpseintoheragonyforthosewhohaveneverexperienceditandasenseofsolidarityforthosewhohave.

Thistiesintothefifthbenefitofartinhealthcare:improvingcommunicationbetweenapatientandhisorhercareteam.

Thisqualityofour programcametolightinlastyear’spublichealthresearchproject,wherenurseswereinterviewedbymedicalstudents,regardingtheirexperiencewithourartprogramonageneralmedicineinpatientwardhereatUVMMedicalCenter,Baird4.Thisisafloorwherepatientsoftenstayforlongperiodsoftime,waitingforaplacementinlongertermrehabilitationfacilities.

InadditiontoimprovingmoodsandreducinganxietyasImentionedbefore,nursesreportedthatartprojectspromotedconversationbetweennursesandtheirpatients.Onenurseeloquentlystated,“artfromthehearthasopenedupopportunitiesforpatientstobeinteractivewithnurseswhentheywerelimitedintheircommunicationskillsorcognitivelyimpaired.Artisawaytoconnectwithstaffandviceversaforstafftoconnectwithpatients.”

ArtworkdoesnothavetobeABOUTsymptomstopromoteimportantconversations.Severalnursingstaffmembersrecalledusingpatients’artworkasanicebreaker.Youcanimaginehowapatient'sartworkhangingonthewallwouldhelpthenursequicklybegintounderstandmoreaboutthepatientonamorehumanlevelandinitiatenon-medicalconversationusingthepatient’sinterestsasastartingpoint.Itmakessensethatthiskindofcommunicationcouldstrengthenrelationshipsbetweencareprovidersandpatients,leadingtoimprovedcooperation,andmoreopendiscussionofsymptomsandtreatmentoptions.Inthisway,artinhealthcarecanpromotetrustandcompliance,ultimatelyleadingtofavorablehealthoutcomes.

Ourvolunteershavecreatedthese“AboutMe”pages,whichweusetopromotethosetypesofinteractions.

Wekeepastackoftheseinourkit,alongwitharevolvingsetofprojectideas,aimedatsparkingconversation.Thesepagesareavailableoutsideofthevolunteerofficehereatthemedicalcenterforhospitalstaffwhowouldliketousethem.

Insummary,wehavelookedatfiveinterconnectedresearch-supportsbenefitsofartsinhealthcare:facilitatingexpression,distractingfromnegativethoughtsandfeelings,reducingstress,decreasingperceptionofpain,andincreasingcommunicationbetweenpatientsandcareteams.WewouldlovetohearYOURexperienceswithartsinhealthcareordiscussanyoftheseresourcesaftertheprogram.

Fornow,Ihavethehonorofintroducingournextpresenter.

AnnetteBergergrewupinFreiburg,inSouthernGermany,whereshewaseducatedinWaldorfschools,whichincorporateartsintoallaspectsofeducation.AnnetteattendednursingschoolinNorthernGermanyforayear,beforemovingtotheUS,whereshecontinuedherstudiesatVermontTechnicalCollege.SheearnedherLPNin2000andwentontoachieveherRNAssociatesdegreein2008.ShehasbeenadedicatednursehereatUVMfor17years,allwhilealsobuildingafarminSouthHero,TheWellsFamilyFarm!ShecontinueshereducationatSouthernNewHampshireUniversity,andplanstobecomeaNursePractitioner,focusingonIntegrativeHealth.Shehasalwaysintegratedartintocaring,andhasbeeninstrumentalinexpandingArtfromtheHearttoreachadultpatientsoverthepastcoupleofyears.Wewelcomehertonighttosharesomefirsthandexperienceswithartsinhealthcare.

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IworkonBaird4hereatthehospital,anInternalMedicineunit.BairdFourcaresforpatientsinallstagesoflifeandendoflife,withacuteconditionsthatareeasilycured,tochronicconditionsthatarelifeimpacting.Wecareforpatientswithavarietyofconditionssuchasaddiction,dementia,andmanyother complexissues.We dealwiththepsychosocialandpsychologicalissuesoflongtermillnesses.Someofourpatientsmightstaywithusforamonthoreventwofortreatments,orduetoplacementissues.

Thehospitalisbynecessity,asterileenvironment.

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Butitdoesn’tneedtobebleakorstark. Itisanewexperienceentering Baird4nowthatwehaveinteractiveandcolorfulartdecoratingourplainwalls.

Arthascreatedan inviting,comfortingandvisuallypleasingspaceforourpatients,theirfamilymembersandstaff.

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Thisdrawingwasdonebyapatient’shusband.Thepatientwassharingwiththeirnursethatherhusbandwasdrivingher“crazy“,andheneededsomethingtokeephimbusy,asidefromsittingnervouslybesideherwhilewaitingforupdatesfromthedoctor. IofferedartmaterialsandhewasabletochannelthisnervousenergyintothislivelyHalloweendrawingonhiswife’shospitalroomdoorthatotherwisewouldhavebeenplain.Notonlydidhedrawahumorouspictureforhiswife,andallowedhertorest,buthecreatedafunpieceofartthatallowedpeopletotalkabouttheupcomingholidayandthecostumestheywereplanningon.

This drawingandotherslikeit,helpusbreaktheice,engageintotherapeuticpersonalinteractions,thatallowpatientsandtheirfamily/friendstoexpressandsharetheirfeelingandthoughtstroughart.Inmy experience,arthelpsfosteremotionalconnectionbetweenthepatientandtheircareteam.

Ihavenoticedthatmanypatientswho arehospitalizedfordrugaddictions,and facingweeksofinpatienttreatments, makeuseofthearts.Duringthemanyhoursofdowntime,creativitygivespatientsapurpose,ameditative experienceandanemotionaloutlet.

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Forexample,drawingpicturesoftheir childrenwhomtheyaremissing,andsharingtheirgoalthattheywanttobeabletoparentagain. Arthelpsthemedicalteamgettoknowthepatientandtheirdreamsandhopes,whichkeepsourworkpatientcentered.Wecanthenbuild together– Withthepatient– a careplanwithrealisticmedicalgoals,andhelpthemto worktowardtheirhealthandpersonalgoals.

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Anotherchallenginggroupthatourunitspecializesinaredementiapatients. Thisgroupcanbehardtocommunicateandconnectwith.Itcanbe difficulttogaintheirtrustandkeepthemoccupiedandsafeduetosensorydeficitssuchashearingorvisionlossaswellas memorylossand cognitiveimpairment. Asideeffectofthesechallenges,whentheyarenotabletoexpresstheirneedstheycaneasilyfeel threatened,angry,orfrustrated.Thiscan escalatetothepointofneedingsecurity personnel,and/or calmingmedications.Atbest,peoplewithdementiaoftenneedtoberedirectedagainandagain– andthiscanbetricky.

Weworktocreatea rhythmtotheirdays,theAboutMepagehelps us developaroutinedailycareplan,similartotheirhomelifestyle.

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Artworkstohelporientpatients, sotheyhaveaneasiertimefindingtheirroom.Wemightsay“Lookforthebeautifulbutterflydrawingonthedoorwithyournameonit.”Artcreatesabeautiful,comfortingandnurturingenvironments.

Makingart,givespatientsapurpose,it canbeanoutletfor expression,andforreminiscingabout oldtimes.Thesememoriescreatecomfortandbringpleasure.

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Whenpatientsaremakingart,manytimestheywillreportfeelingbetter,lessanxiousandlessemotionalanddecreased physicalpainingeneral.Theyseemtoslowdownandfeelabitbetterabouttheir hospitalizationandthemanythingstheyarefacing. Iseepeople relaxwhentheytalkaboutartpieces thatremindthemofvacationsfromthepast,andotherpositiveexperiences. Theirtoneofvoicechanges,theireyeslightupandtheysmilewhile sharingtheirstory.

Evenwhensomepeoplearenotengagedinthearts,theeffectsrippleouttoothers.Room-matesandstaffwhoarearoundhappierpeoplebenefitaswell.

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Thispaintingwasagifttoa patienttoofferthemsomethingbeautifultolookatfromtheirbed.Thepatientwaswithusforanextendedperiod.Shefoundalotofcomfortinthepaintedgarden,usingitasawaytoescapethesterileanddrearyenvironment,andbetransportedintoalushandsummerygarden.Whenshewasabletogohome,sheframedthe pieceofartandbroughtitbacktoussothatothersmighttakecomfortinitasshedid.Itnowhangsinourhallwayforeveryonetoenjoy.And manymanypeopledo!Itdrawspeople’sattention,andlightensupthier moods,sparkingconversationsandtransformingourhallintoaplaceofbrightsummerescapeandbeauty.

Itisamazinghowonepieceofartcangivesomanypositive experiences.

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AFTH hashelpedusbreakdowncommunicationbarrierswpatients,familiesandlovedones.Theartgivesusawaytoconnectonapersonallevel,itopensupnon-medicalconversations,supportingallofouremotionalwellbeing.Thepatientbecomesaperson,morethanjustadiagnosisoracollectionofsymptoms. Beyondtreatingtheirmedicalneeds,wecansupporttheiremotionalandsocialneeds.ArthelpsustapintoCompassion.Artsupportsahealthyrelationshipbetweenthemedicalteamandpatient- theyarebetterheard,understood,caredfor,andvaluedandremainthecenteroffocus.

IwouldliketoencourageeachandeveryoneofyoutotakeefewminutestoconnectwithpatientsthroughArttoaskopen-endedquestions,andconnectonanonmedicallevel.Thepayoffwillbewellworthit,peoplewillrememberyouforhowyoumadethemfeelthroughyourattentiontotheirstoriesandinterests.Theywill knowyouCare, and whenyoucomebacktotalkabouthealthissuesandgoals– they'llbelistening.Theywillbemoreopentohearingwhatyouhavetosayandoffer.Andthatwillpromoteandfacilitateacollaborativepartnershipbetweenthepatientsandtheirextensivehealthcareteam.

Iwillleaveyouwiththatthought- spendingtimewithpeopleandartdeepensyour

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connection.

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