SCIENCE + ART :
THE MENTAL HEALTH BENEFITS OF ART THERAPY DURING COVID–19
On 31 December 2019, a novel viral pneumonia originating from Wuhan, China was announced to the World Health Organization (WHO, 2020a). As of 23 March 2020, this novel coronavirus (COVID-19) quickly spread across the globe, infecting more than 294,110 people in 187 countries and killing 12,944 individuals (WHO, 2020b). Changes to daily life have been swift and unprecedented, as cases of the virus surge, the death toll escalates, and draconian measures to contain the spread of the disease increase across regions of the globe. Although there has been substantial attention to measures to identify people with the coronavirus infection, identifying the mental health care needs of people impacted by this pandemic have been relatively neglected (Xiang et al., 2020).
This is surprising given that mass tragedies, particularly ones that involve infectious diseases, often trigger waves of heightened fear and anxiety that are known to cause massive disruptions to the behavior and psychological well–being of many in the population (Balaratnasingam & Janca, 2006). For instance, in a recent, large survey of people highly susceptible to the coronavirus infection (i.e., Chinese medical workers), the prevalence rate of traumatic stress was at an alarming 73.4%, depression was at 50.7%, generalized anxiety was at 44.7%, and insomnia was at 36.1% (Liu et al., 2020).
Although these findings are disturbing, they are not isolated, as research on the psychological impact of previous global disease outbreaks has demonstrated clear links between pandemic–related anxiety and elevated symptoms of stress, anxiety, contamination concerns, health anxiety, post–traumatic stress, and suicidality (Chong et al., 2004; Wheaton et al., 2012; Wu et al., 2009; Yip et al., 2010).
The purpose of this study was to develop and evaluate the properties of a brief mental health screener that health professionals and researchers can readily use to identify probable cases of dysfunctional anxiety associated with the coronavirus. The CAS is the first published measure of COVID–19 related psychopathology validated on a large sample of adults who reported significant anxiety in the beginning stages of the coronavirus pandemic including a significant sample of people infected with the disease.
Principal component and factor analyses were used to identify psychometrically sound items for the CAS, which was shown to be a highly reliable (a ¼ 0.93), thematically consistent (i.e., distressing physical symptoms associated with coronavirus fear and anxiety), and stable (i.e., CFA confirmed PCA results) instrument. Moreover, the CAS was shown to measure anxiety symptoms in similar ways across demographic groups, with the minor exception that two items were slightly more indicative of dysfunctional anxiety for Whites than non–Whites.
The content validity of the CAS was also demonstrated by the items, which each represent physiological arousal symptoms associated with clinically elevated fear and anxiety (APA, 2013; Barlow, 1991; Cosmides & Tooby, 2000; Ekman, 2003; Ohman, 2000).
For instance, dizziness, which is the first item of the CAS, is a major symptom of panic attacks and an associated feature of generalized anxiety disorder (APA, 2013).
Sleep disturbance, which is the second item of the CAS, is a common symptom of both generalized anxiety disorder and post–traumatic stress disorder (APA, 2013).
Tonic immobility, which is the third item of the CAS, is not a major symptom of any psychiatric condition. However, motor inhibition is an involuntary response to extreme fear and perception of inescapability (Marx et al., 2008) and is typically experienced by victims of highly traumatic situations, such as sexual assault (Moller et al., 2017).
Appetite loss, which is the fourth item of the CAS, is a common symptom of major depressive disorder, a condition that often co–occurs with panic disorder (APA, 2013). Appetite loss is also a noticeable sign of fear because it reflects the biological process of blood leaving the digestive tract into areas of the body that mobilize the person to deal with imminent threat (Cosmides & Tooby, 2000).
Nausea or abdominal distress, which is the last item of the CAS, also captures the digestive changes associated with a fear response (Cosmides & Tooby, 2000). Similar to dizziness, nausea and abdominal distress are also major symptoms of panic attacks and are associated features of generalized anxiety disorder (APA, 2013).
Although the CAS items center on anxiety and trauma related reactions, the fact that they are also exclusively focused on distressing bodily symptoms, make them highly relevant to somatic symptom and related disorders (e.g., illness anxiety disorder), as well (APA, 2013). This is an important quality of the CAS, because many people who are not infected, but believe that they are infected with coronavirus due to the effects of mass hysteria, will seek unnecessary medical evaluations and care (Balaratnasingam & Janca, 2006).
Using mental health screeners, like the CAS, to identify and treat these people with appropriate mental health services before they overwhelm emergency response and medical facilities, is an important step toward combating the COVID–19 pandemic.
The correlations between the CAS scores and relevant measures of disability, distress, and coping, support the construct validity of the instrument. Specifically, CAS scores were strongly, positively associated with functional impairment, alcohol or drug coping, negative religious coping, extreme hopelessness, and passive suicidal ideation. Because these results demonstrate clinically significant disturbances across psychological, interpersonal, and behavioral processes that are attributed to coronavirus related fear and anxiety, the CAS appears suitable for mental health evaluation.
In fact, the finding that those with a positive COVID–19 diagnosis reported significantly elevated levels of coronavirus anxiety compared to their non–infected, but anxious peers, further highlight the clinical utility of the CAS and the importance of assessing and treating the psychological needs of those infected with the virus (Xiang et al., 2020). If some expert opinions are correct, then that would mean that up to 70% of the world’s population could potentially need both medical and psychological care with their COVID–19 infections (Axelrod, 2020).
Many countries have currently imposed either a formal lockdown, or otherwise recommended that people stay indoors in their own homes as much as possible. This form of social distancing will help slow the spread of the coronavirus SARS–CoV–2, but it’s not always easy. However, previous research on isolated groups suggests that art therapy might offer some support.
People in isolation are at increased risk of developing mental health problems, such as depression or increased anxiety. Researchers know this from studies that have previously been done among people who were quarantined during previous disease outbreaks.
In the 2003 SARS outbreak, for example, only those directly at risk were quarantined, and only patients were isolated. But now, during the coronavirus outbreak, many of us are stuck at home. For people who live alone, this situation is also likely to put them at risk of depression or anxiety.
Even though being isolated in this way is new for many of us, there have always been groups of the population who lived with limited social contacts. Think of prisoners, for example, or patients recovering from medical procedures that require a period in isolation. These groups have been well–studied, and researchers know quite a lot about how people fare when they’re spending a large amount of time on their own.
One thing that seems to help is art therapy.
Art therapy is a form of psychotherapy that uses the creative arts as a therapy medium. Instead of talking for an hour, you might be painting or sculpting or otherwise expressing your thoughts through a
creative medium.
As a form of guided therapy, art therapy is well-studied. Research showed that it decreased depression among inmates, and made them feel more in control of their own lives. It relieved anxiety and depression among refugee children, cancer patients undergoing chemotherapy, tuberculosis patients in isolation, people undergoing stem cell transplants or bone marrow transplants, and several other situations where a change in circumstance and increased isolation affected people’s mental health.
In some of these situations, people received group art therapy. Of course that’s not possible during the COVID–19 outbreak, but some art therapists are finding ways to connect with people online. The American Art Therapy Association collected resources for art therapists to help them continue to do their work during the outbreak.
Not everyone has access to a remote therapist to guide their art therapy, so some are turning to online guides. This is different from the guided forms of art therapy that have been proven to work well with people in isolation, so it may not work as well — but with no other option for therapy, making art at home is at least a step in the right direction!
Art – no matter whether you choose to create it yourself or simply observe and enjoy it – is a relaxing and inspiring activity for many people. However, the particular benefits of artistic expression go much further than relaxation and enjoyment.
Studies suggest that art therapy can be very valuable in treating issues such as depression, anxiety, post–traumatic stress disorder and even some phobias. It is a great way to express your emotions without words, process complex feelings and find relief.
In this article, we will take a closer look at art therapy and discuss its mental health benefits.
WHAT IS ART THERAPY?
Art therapy can be defined in many ways, but the simplest way to define it is an application of the visual arts in a therapeutic context. You don’t necessarily have to see a therapist in order to experience some of the therapeutic benefits of artistic expression. There are many simple activities you can try from the comfort of your home such as art journaling, sketching, making collages, sculpting with clay, etc. It doesn’t matter what media you choose. The only thing that matters is that you feel comfortable using it.
However, working with a licensed therapist also has its advantages because a professional can tailor each activity to your own needs. If the activities are done in
a group, they are excellent for building healthy connections with other people, which may be very helpful if you are fighting depression.
The most important thing is that you should try art therapy only if you want it. Expressing yourself through art can be self-revealing and sometimes equally painful as talking. So, if you still don’t feel ready to try it, that is okay.
WHO SHOULD TRY ART THERAPY?
Anyone who feels overwhelmed or pressured by the hectic world we live in should try art therapy. Creating art will give you a chance to slow down and explore any issues you may be having.
Art therapy improves the mental health of people who are dealing with addictions, anxiety, attention disorders, grief and loss, dementia, depression, eating disorders, physical illness, PTSD, trauma, relationship issues and much more.
Since the focus is on the process and not the final product, art therapy is not about becoming a great artist but about finding meaning and connection in your life. All you need for it is a willingness to experiment.
MENTAL HEALTH BENEFITS OF ART THERAPY
Art therapy can be used as a complement to traditional mental health treatment. The aim is to manage behaviors, process feelings, reduce stress and anxiety, and increase self-esteem.
Self-discovery: Creating art can help you acknowledge and recognize feelings that have been lurking in your subconscious.
Self-esteem: The process will give you a feeling of self-accomplishment which can be very valuable to improve your self-appreciation and confidence.
Emotional release: The greatest benefit of art therapy is giving you a healthy outlet for expressing and letting go all your feelings and fears. Complex emotions such as sadness or anger sometimes cannot be expressed with words. When you are unable to express yourself, but you desire emotional release, making art may help you to do it.
Stress relief: Fighting anxiety, depression or emotional trauma can be very stressful for you both mentally and physically. Creating art can be used to relieve stress and relax your mind and body.
It is very important to know that you don’t have to be a talented artist in order to try art therapy. Human beings are innately creative, and all you need to do to complete an art therapy activity successfully is, to be honest with yourself and your emotions. Once you unleash your creativity, your inner artist will quickly wake up.
Studies also show that creating art stimulates the release of dopamine. This chemical is released when we do something pleasurable, and it basically makes us feel happier. Increased levels of this feel–good neurotransmitter can be very helpful if you are battling anxiety or depression.
Mental health professionals and experts agree that art therapy has many benefits, from boosting your self-esteem, and providing you a safe outlet to relieve your emotions, to giving you a sense of control over your life and helping you to get to know and understand yourself better.
During the process of art creation, you will be taking yourself on a journey of self-discovery that will help you eliminate emotional roadblocks, and learn how to communicate with yourself and others.
A FURTHER LOOK AT THE POWER OF ART + ART THERAPY
LINKS TO ADDITIONAL RESOURCES:
Remote Art Therapy Resources via Children’s National
https://childrensnational.org/visit/resources-for-families/creative-services/creative-and-therapeutic-arts/art-therapy/remote-art-therapy
Quarantine Family Took Kit
https://drive.google.com/file/d/1-UyjyRJm3ifZe44St-tiAf9jIf7XrpAJ/view
Guided Art Therapy via Full Circle Art Therapy Center
https://www.fullcircleatc.com/
COVID–19 Pandemic: Resources for Art Therapists and Community
https://www.canadianarttherapy.org/covid-19/
Art Therapy For Home via Youtube
https://www.youtube.com/results?search_query=art+therapy+for+home
CONTRIBUTIONS:
https://doi.org/10.1080/07481187.2020.1748481
https://www.forbes.com/sites/evaamsen/2020/03/30/can-art-therapy-combat-depression-during-self-isolation-and-social-distancing/#7276298034eb
https://www.rtor.org/2018/07/10/benefits-of-art-therapy/
https://www.psychologytoday.com/ca/blog/the-athletes-way/201504/alpha-brain-waves-boost-creativity-and-reduce-depression