Like many, Andrea Cooper felt increasingly isolated and lonely during the coronavirus pandemic. Cooper, a retired graphic designer and amateur folk musician who leads a grant-funded art program for cancer patients at Baltimore’s Mercy Medical Center, is a highly social person. So when the pandemic led to the cancellation of many of her activities and events, and caused others to be switched to Zoom, she missed her usual face-to-face connections with others.
As the pandemic dragged on, her mental health began to suffer even more. Eventually, Cooper’s depression got so bad that she had to be hospitalized. As part of her recovery, she participated in a ten-day inpatient program and began working with an art therapist.
Even though she’s an artist herself, Cooper was at first skeptical of the therapist’s prompts, which were meant to inspire Cooper and other patients to draw and paint as a means of working through their pain. But as Cooper spent more time thinking about her mental health, she began to deeply contemplate the therapist’s questions, including one about growth. “I thought about it and knew I was going to have to make some hard decisions in order to grow, that if I kept on the same track, things were not going to get any better,” says Cooper, who is 66.
In the end, she drew pair of pruning sheers cutting one of the stems of a rose bush. On her drawing, she wrote: “Sometimes you have to prune the flower to encourage growth.”
Cooper is one of the many individuals who have experienced the benefits of art therapy, an integrative treatment that uses artistic self-expression as a means of improving mental health and well-being. And as individuals continue to work through the mental health challenges brought on by the pandemic—which triggered a 25 percent increase in depression and anxiety around the globe, according to the World Health Organization—this niche therapy is poised to become even more popular. The pandemic brought up many difficult-to-define feelings and emotions, and making art in the presence of a licensed therapist can be a mindful, low-tech way to work through them.
Making art as a form of mental health treatment dates back to the mid-20th century, when soldiers returning from the battlefields of World War II were left with a condition that was known as “shell shock,” but is now called post-traumatic stress disorder. Veterans painted, drew, sculpted and made other forms of art to help process what they’d witnessed and experienced at war. “They struggled with traditional forms of medical and therapeutical intervention,” says Girija Kaimal, an art therapist at Drexel University and the president of the American Art Therapy Association (AATA). “Experiences like trauma are very difficult to articulate into words, so therapies that can support and connect patients with nonverbal expression are really the foundation of the creative arts therapies.”
The practice has been growing ever since. Today, around 5,000 art therapists practice in the United States, plus more around the world. They use the treatment to help patients in myriad situations. Children in schools have worked with art therapists to deal with social and emotional difficulties, behavioral disorders, ADHD, low self-esteem and other issues. Adults who have experienced some kind of trauma have tried it as well. Therapists have brought art to cancer patients undergoing chemotherapy, teens facing mental health issues, veterans, aging seniors, patients with eating disorders, prisoners and many other groups experiencing physical and mental health challenges.
Therapists offer treatment in groups or in one-on-one settings, and the therapy itself can take on many forms—from unstructured doodling to more specific prompts and activities designed to help patients make sense of their emotions. Patients can initially be reluctant to engage—often because they don’t consider themselves to be artistic or they haven’t made art since childhood—so therapists sometimes have to get creative. “I might ask them to make a gesture or even try to make a sound like a sigh, and then use colors, shapes and lines to show me what that looks like,” Cathay Malchiodi, an art therapist and the director of the Trauma-Informed Practices and Expressive Arts Therapy Institute, told Art in America magazine’s Jacoba Urist in October 2021.
Of course, humans—and our prehistoric ancestors—have been making art since long before art therapy became an established field. Though archaeologists disagree about exactly what constitutes art, they believe the practice dates back to at least the Paleolithic, tens of thousands of years ago. And though no one knows exactly why prehistoric individuals felt compelled to paint on and carve up the walls of caves, based on the amount and geographic reach of prehistoric art, they likely got some enjoyment out of this artistic expression. “Art-making for health and well-being is as old as the hills—it’s not anything new,” says Kaimal. “Every community has creative practices that we’ve engaged in for as long as we’ve been around.”
But why art? When patients have a hard time putting feelings into words, drawing, painting, sculpting, making collages, creating personalized papier-maché masks and engaging in other practices can help them unlock their emotions and translate them into something real. In the process, they’re able to share a bit of what they’re going through with the folks around them. Like other forms of therapy, art is also a safer, healthier way to channel stress and other negative emotions into action compared to destructive or harmful choices, says Kaimal. “Engaging in the artistic practice helps concretize and externalize these difficult inner experiences,” she says. “When we limit ourselves to just words, we’re losing a significant part of our lived experiences. Some people can put their feelings into words beautifully, but most of us cannot. To have additional expressive forms is really just allowing the whole person to present themselves.”
Research has found that making art can activate reward pathways in the brain, reduce stress, lower anxiety levels and improve mood. Various studies have also looked at its benefits among specific populations: It’s been linked with reduced post-traumatic stress disorder and depression among Syrian refugee children and lower levels of anxiety, PTSD and dissociation among children who were victims of sexual abuse, for example. Art therapy can help reduce pain and improve patients’ sense of control over their lives.
Because art therapy can be particularly helpful when folks don’t have the words to describe their experience or challenges, it’s ideally suited for improving mental health and well-being in the wake of the pandemic, which gave rise to abstract emotions like languishing and burnout. In AATA’s May 2020 coronavirus impact report, therapists pointed out that individuals are simply tired of talking about the pandemic and such feelings—and, because of all-day meetings on Zoom, talking in general. During art therapy, they don’t have to say a word if they don’t want to—but they can still work through their emotions. As one therapist noted in the survey, many clients “welcome expressing themselves using art materials, giving their brains a new task and their mouths a break.”
Making art is a hands-on process that requires total focus, which means it also offers a break from screentime, which surged during the pandemic. As Mallory Braus and Brenda Morton wrote in the journal Psychological Trauma: Theory, Research, Practice, and Policy in 2020, “In art therapy, mindfulness is what allows an individual to receive the therapeutic benefit of ‘tuning out’ the daily stress and anxiety and to focus on a single task while also focusing on the materials employed for self-expression.”
Art therapy isn’t a cure-all and it may not be the right approach for everyone—it often works well as a complement to other traditional therapies, Kaimal says—but it can have definite benefits. Still, researchers need to do more to fully understand how, why and when art therapy works. Much of the research draws on the anecdotal experiences of clinicians and patients, and many studies have had small sample sizes, Kaimal notes. Experts need to conduct more randomized control trials and larger-scale quantitative studies to help sway health insurance companies to recognize art therapy as a form of treatment—and pay for it. The field could also benefit from additional evidence around how art therapy affects different populations. “Compared to other mental health professions, we have a long way to go,” she says.