SIX women sat at a table covered with colored pencils and pastels, each of them focused on drawing a house with rooms representing their emotions and desires.
Susan St. Jon, 63, made an abstract sketch of an African jungle home, with a circle of blank space in the center of the page. It reminded her of a vacation house in which she'd watched wild animals creep dangerously close. The white space, she surmised, was a window onto her uncertain future. "Wherever it's going to take you, it's going to take you," she said, "regardless of what you do."
The assignment was part of an art therapy support group at UCLA's Ted Mann Family Resource Center. On this, St. Jon's third bout with cancer -- the disease has spread from her breast to her brain and lungs -- she's struggling to decide whether to pursue chemotherapy or give up the battle. "I've already come to terms with death," she said. "I won't panic, and I won't be pushed."
Art therapy harnesses the creative process to explore such difficult issues. It's been used to treat mental and physical health problems for more than 50 years and is offered in schools, hospitals, prisons, hurricane shelters and private practice. But only now are scientific studies beginning to show its effectiveness.
In art therapy, patients express their feelings not just through discussion, but through drawing, painting and sculpting. That's why this type of therapy is thought to be especially helpful for people who have difficulty articulating feelings -- including children and those suffering from Alzheimer's disease, strokes and post-traumatic stress disorder. However, much of the research has centered on cancer patients. In a pilot study funded by the National Institutes of Health, cancer patients who received eight weeks of group treatment sessions of mindfulness-based art therapy (a combination of meditation and art therapy) reported a significant decrease in distress, anxiety and depression. They also reported significantly improved quality of life and vitality.
The study of 111 women, published last fall in the Journal of Psycho-Oncology, did not determine whether the art therapy or meditation component was most beneficial, but "one informs the other," said study author Daniel Monti, director of the Center of Integrative Medicine at Thomas Jefferson University in Philadelphia. "The two sort of work together."
A Northwestern Memorial Hospital study of 50 men and women published in January in the Journal of Pain and Symptom Management found that an hour of art therapy significantly reduced a broad spectrum of cancer-related symptoms such as pain, anxiety, exhaustion, depression, loss of appetite and shortness of breath. Patients rated symptom severity on a scale of 0 to 10 before and after treatment; only nausea was unaffected.
"A lot of people look at art therapy with suspicion. Is it just a diversion, doodling or baby-sitting?" said American Art Therapy Assn. director Cathy Malchiodi. "With research, doctors are seeing how much progress patients are making, and they realize it's not just entertainment."
That's not to say that art therapy is for everyone. Although therapists emphasize that patients don't need any artistic talent to reap benefits, some people feel uncomfortable expressing themselves through art. In the Northwestern study, 63 patients who were approached declined to participate. Some were too sick, but at least one person had tried art therapy before and simply didn't like it. Others prefer tackling problems on an intellectual level, sometimes finding the emotions stirred up by art therapy difficult to tolerate.
"It's not really my cup of tea," said UCLA cancer support group member Caren Desacoff, 54, whose drawing of a house triggered memories of her unhappy childhood. She left the group early after starting to have a seizure. "I shouldn't have been there. I really did feel kind of overwhelmed. I was going into a really dark place."
Most members of the UCLA group, however, described art therapy as relaxing, energizing and cathartic. "It was the most important nonmedical thing I did," said breast cancer survivor Kerry Smallwood, 49, who attended for more than a year. "It was very powerful how the artwork accessed deeper emotions, things that were unconscious, things that you didn't necessarily think to talk about."
Monti, who conducted the NIH-funded study, is currently overseeing another five-year study comparing mindfulness-based art therapy with talk-based support groups for 339 breast cancer patients. It is the largest comprehensive study on art therapy to date. Already, pilot data suggests that the art therapy is more effective in reducing stress and depression.
The reason, Monti posits, is that meditation and art making, when combined with discussions about the meaning of the art and the feelings evoked, engages more of the brain than merely talking. "It provides a means of conceptualizing and expressing the illness experience and ways to cope," he said.