Chronic Pain and Art Therapy

Pain is a multidimensional experience that affects an individual’s physiological, psychological and social functioning. When pain continues beyond the body’s ability to heal and becomes chronic, the overwhelming stress that can develop in each of these areas of functioning may exacerbate the perception of pain,contributing to prolongation and increased acuity.1 as a result, the pain management community has come to recognize the need for more comprehensive and integrative non-pharmacological adjunctive approaches, such as art therapy.

What Is Art Therapy?

Used clinically for over a century, art therapy uses creative expression to promote emotional, mental and physical well-being. Grounded in the belief that the creative process is inherently healing, the practice of art therapy also includes psychodynamic, humanistic, learning and developmental, educational, cognitive behavioral and other therapeutic approaches. Art therapists are master’s-level clinicians who are trained in psychology, mental health counseling and the visual arts. They assist individuals and groups in using artistic media and techniques as an outlet for self-expression and exploration, offering an alternative form of communication and meaning making.

A primary goal of the art therapist is to provide a safe and stimulating environment in which prior artistic experience is not needed in order to benefit from the creative process. This process, as well as the art materials and final products that emerge, help individuals accomplish a variety of therapeutic tasks. For some, art therapy provides relaxation and stress relief, increases socialization and improves motor skills. The process of art therapy also affords people in pain an opportunity to try something new, examine their thoughts and feelings, resolve inner conflicts, improve self-awareness and self-esteem, manage maladaptive behaviors and mental health issues, and cope with physical and psychological trauma.

Art therapy, which may be long or short term depending on the needs of the client, is offered to individuals of all ages, in a number of settings including hospitals, mental health and rehabilitation clinics, schools and community agencies. Art therapists may provide an array of materials for painting, drawing, collaging, sculpting, photography and more. Art projects are based on an individual’s needs and preferences.

Art Therapy & Chronic Pain

Art therapy is a mind-body therapy that recognizes the important ways in which psychological, emotional and social factors can influence physical health. Often used as complementary or integrative therapy to conventional chronic pain regimens, art therapy can be a useful adjunct in improving many aspects of the chronic pain experience.

Art As Communication

The visual arts can be a valuable tool in conveying aspects of an illness that are often too difficult to verbalize. When used as a means of communication between patient and health care provider, the arts have the potential to improve the medical assessment process, thereby enhancing overall quality of treatment. This concept has been demonstrated by a number of researchers who have found that patients’ pain drawings can help providers assess perceptions of illness and consequent physical and emotional functioning.^2-4 For example, researchers who have looked at artwork and accompanying comments from individuals with chronic pain have identified a number of important themes that characterize the chronic pain experience. Such themes include hopefulness, pain as a journey, gaining pain and losing self, redefinition of self,2 fighting against the “pain identity,”facing new limitations and boundaries and working toward adjustment and acceptance.3

In addition to helping healthcare providers to appreciate nuances about the chronic pain experience that might otherwise go undetected, an individual’s artwork can also help to improve personal relationships. As an “invisible illness,” chronic pain can often be isolating. Using art making to depict hardships honors the individual’s experience and provides a catalyst to new knowledge and understanding on the part of family, friends and caregivers.

Art As Symptom Relief

Pain is largely characterized by the amount of attention it demands of the senses; therefore, focusing on art making can modulate the pain experience by diverting attention toward other sensory modalities. Yet, if attention is directed toward other sensory modalities, overall attentional capacity is lessened and an individual is less able to process painful stimuli.^4-5

Researchers in this area have found that the act of participating in art making has the potential to distract from, and thus alleviate, perception of physical pain.^{3, 6-8} Individuals who were interviewed regarding their experience with chronic pain reported a decrease in their perceptions of pain while participating in art therapy. One interviewee described her experience of painting as “… a whole time when I’m not involved with my pain, nor do I have the pain.”³ Another interviewee described art therapy as an “escape” from her agitation, irritation and pain.³

Art therapy has also been found to be effective in addressing the types of psychosocial symptoms that may exacerbate perceptions of pain. Research shows improved mood⁹ and interpersonal dynamics,¹⁰ as well as decreased stress, anxiety and depression11after participating in art therapy.

Art As Insight

Art therapy provides an outlet for self-expression and is therefore transformative, providing endless opportunities for growth. Whether pounding clay, finding the right shade of sky blue, uncovering personal symbols or sharing one’s story, the tasks involved in art therapy encourage new awareness and insight. In using art therapy with chronic pain, these insights can serve as a catalyst for change — inspiring new perceptions of personal abilities and thereby promoting the acceptance and adjustment needed for self-management.

Art As Personal Fulfillment

Living with chronic pain presents daily challenges and may cause an individual to feel a lack of personal control. Art therapy addresses this issue by using interventions that promote opportunities for problem-solving, decision-making and personal empowerment. The art therapist and client work together to identify and build upon sources of inspiration that will spark the creative process and lead to production of a satisfying final product that highlights the client’s unique strengths. It is no wonder then that many art therapy clients find benefits in continuing the creative process at home and within their communities.

The Future Of Art Therapy With Chronic Pain Sufferers

Research proves that art therapy can be used to address chronic pain issues on a number of levels. As pain specialists continue to broaden their search for effective therapies, integrative interventions like art therapy will continue to serve as a valuable outlet for managing the chronic pain — while offering people in pain a deeper insight into their experience.

ABOUT THE ART: Molly O’Neill Haaga created this artwork in response to her research involving art therapy clients who were experiencing chronic pain. Reflective art making served as an additional way to analyze the narrative data she was gathering and allowed for development of kinesthetic and sensorial understanding, central to examination of the chronic pain experience.

ABOUT THE AUTHOR: Molly O’Neill Haaga, MA, ATR, is a registered art therapist and mental health counselor. As an art therapy educator and doctoral student, she has focused her research on the psychosocial implications of medical illness and the role of art therapy in assessment, treatment and management of medically related issues. Her current research study, Art Therapy and Chronic Pain, aims to examine the effectiveness of art therapy in addressing both the psychosocial and physiological dimensions of the chronic pain experience. www.arttherapyandchronicpainstudy.com/ {PP}

Sources:

1. Loeser, J.D., & Melzack, R. (1999). Pain: an overview. Lancet, 353(9164), 1607-1609.
2. Henare, D., Hocking, C., & Smythe, L. (2003). Chronic pain: Gaining understanding through the used of art. The British Journal of Occupational Therapy, 66(11), 511-518.
3. Haaga, M. (2012). Art therapy and the chronic pain experience: A pilot study. Manuscript in preparation.
4. DePalma, M., & Weisse, C. (1997). Psychological influences on pain perception and non-pharmacologic approaches to the treatment of pain. Journal Of Hand Therapy: Official Journal Of The American Society Of Hand Therapists, 10(2), 183-191.
5. Villemure, C., & Bushnell, M. (2002). Cognitive modulation of pain: how do attention and emotion influence pain processing? Pain, 95(3), 195-199. doi:10.1016/S0304-3959(02)00007-6
6. Trauger-Querry, B., & Haghighi, K. (1999). Balancing the focus: Art and music therapy for pain control and symptom management in hospice care. Hospice Journal, 14(1), 25-38. doi:10.1300/J011v14n01_03
7. Russell, J. (1995). Art therapy on a hospital burn unit: A step towards healing and recovery. Art Therapy, 12(1), 39-45.
8. Ferszt, G.G., Massotti, E., Williams, J., & Miller, J. R. (2000). The impact of an art program on an inpatient oncology unit. Illness, Crisis, & Loss, 8(2), 189-199.
9. De Petrillo, L. & Winner, E. (2005). Does art improve mood? A test of a key assumptions underlying art therapy. Art therapy: Journal of the American Art Therapy Association, 22(4), 205-212.