Marked hemispheric dominance and area specialization is also very prominent for music perception. Brain is capable of making new connections, activating new pathways and unmasking secondary roads, it is "plastic".
Music is a strong stimulus for neuroplasticity. Other studies showed the changes in neurotransmitter and hormone serum levels in correlation to music. In a study of patients admitted to a coronary care unit with acute myocardial infarction, Guzzetta found that relaxation and music therapy were effective in reducing stress. The relaxation and music therapy groups participated in 3 sessions over a 2-day period. Stress was evaluated via apical heart rates, peripheral temperatures, cardiac complications, and qualitative patient evaluative data.
Results demonstrated that apical heart rates were lower and peripheral temperatures were higher in the relaxation and music therapy groups than in the control group. Another area of research is the relationship between coronary heart disease and reductions in anxiety states. After listening to relaxing music for 20 minutes, participants exhibited significant reductions in heart rate, respiratory rate, myocardial oxygen demand, and, in particular, anxiety, both immediately after and 1 hour after the intervention.
In their study, Burns et al. They assessed the therapeutic effects on patients of listening to music, both live and recorded, while in a relaxed state, as well as the effects of active involvement in music improvisation.
Results showed increases in well-being and relaxation and decreases in tension during the listening experience, increases in well-being and decreases in tension during the improvisation experience, and decreases in serum cortisol levels during both experiences.
An additional anxiety study 54 sought to investigate the effects of group music therapy combined with other creative art methods on self-reported levels of anxiety, depression, and self-esteem among women who had experienced intimate partner violence. The group met for 6 sessions, each 1 to 1.
Visual analog scales were used to assess anxiety, depression, and self-esteem; the goals of the group were to increase self-esteem and self-expression, decrease anxiety and depression, and increase social support.
Significant decreases in depression and marginally significant decreases in anxiety were observed among the study's 7 participants.
No significant effects were found for self-esteem. Most participants reported that all of interventions were helpful and rated the group therapy as a positive experience. These findings suggest that active music therapy in a group context may be effective in improving mood among women recovering from intimate partner violence. Art helps people express experiences that are too difficult to put into words, such as a diagnosis of cancer.
Some people with cancer explore the meanings of past, present, and future during art therapy, thereby integrating cancer into their life story and giving it meaning. For example, McMurray and Schwartz-Mirman 56 and Reynolds and Prior 57 conducted case studies in an attempt to understand why some people turn to making visual art after a cancer diagnosis and how artistic self-expression might contribute to maintenance or reconstruction of a positive identity.
Table 2 summarizes the use of art therapies in the healing process. Guillemin, one of the first to use drawings in an effort to understand experiences of health and illness, examined how 32 middle-aged women with heart disease understood their condition. The drawings were grouped into 3 themes: the heart at the center, the heart in the lived body, and heart disease as a social illness.
Use of color, spatial organization, and composition were explored. The drawings were considered as both visual products of the women's knowledge about heart disease and processes of embodied knowledge production. It was concluded that having individuals draw how they visualized their condition was an insightful method with which to explore understandings of illness.
Art can be a refuge from the intense emotions associated with illness. In particular, molding clay can be a powerful way to help people express these feelings through tactile involvement at a somatic level, as well as to facilitate verbal communication and cathartic release and reveal unconscious materials and symbols that cannot be expressed through words. Women taking part in a qualitative study focusing on cancer described ongoing cancer-related difficulties such as fear for the future, pain, sleeplessness, role loss, activity restriction, reduced self-confidence, and altered social relationships.
First, it helped them focus on positive life experiences, relieving their ongoing preoccupation with cancer. Second, it enhanced their self-worth and identity by providing them with opportunities to demonstrate continuity, challenge, and achievement. Third, it enabled them to maintain a social identity that resisted being defined by cancer.
Finally, it allowed them to express their feelings in a symbolic manner, especially during chemotherapy. In another study, supportive care providers responding to a survey described the healing benefits of music and art therapy in hospital settings, and these benefits seemed to be clustered around notions of exploration, expression, release, and the healing process. There is also evidence that use of art and music reduces hospital stays, with studies showing earlier discharges among patients taking part in visual and performing arts interventions than among those not doing so.
Two other visual arts studies have focused on the experience of women with cancer. In addition to the introduction of self-care through guided imagery, the art-making therapy involved the women drawing complete pictures of themselves and engaging in yoga and meditation.
The relaxation and symptom reduction produced by creative expression opened pathways to emotional healing. The psychological effects of breast cancer, in particular, may include adjustment disorders, depression, and anxiety, and these symptoms in turn may generate feelings of fear, anger, guilt, and emotional repression.
In their study, Puig et al. This pretest—posttest study included 4 individual therapy sessions conducted over a 4-week period, with each hour-long session comprising guided, semistructured, creative arts therapy exercises involving drawing implements.
Thirty-nine women with stage 1 or stage 2 breast cancer were randomly assigned to an experimental group that took part in an individual creative arts therapy intervention or to a delayed treatment control group.
Analyses of covariance were used to analyze the results, which indicated that the creative arts therapy intervention was not effective in enhancing the expression of emotions or the participants' level of spirituality. Medical professionals are beginning to recognize the role that creative arts play in the healing process; increasingly, arts in medicine programs are emerging throughout the United States and worldwide.
At baseline and 6 months, the study authors administered the Medical Outcomes Study Item Short Form Health Survey SF and Beck Anxiety Inventory to 46 patients and assessed dialysis times, interdialytic weight gain, and predialysis laboratory results.
They also examined relationships between these variables and participation in the arts in medicine program. The intervention, led by artists, included artwork, crocheting, crafts, seasonal displays, poetry, and playing of musical instruments. At 6 months, the participating patients, nurses, technicians, and physicians reported that the program had a positive impact on the unit.
Paired comparisons with baseline data showed significant improvements in SF symptom scores e. In addition, regression analyses showed that high levels of program participation correlated with improved SF social functioning, bodily pain, and physical role functioning scores, as well as a trend toward greater albumin levels, but also higher phosphate and lower calcium levels.
In conclusion, participation in an arts-in-medicine program was related to improved quality-of-life measures, and there were encouraging trends in terms of improvements in depression and certain laboratory and hemodialysis parameters. Walsh et al. The 6-month study was implemented at a regional cancer treatment center. The creative arts intervention consisted of several creative arts activities designed for bedside delivery. The creative arts intervention promoted short-term well-being in this sample of family caregivers.
Caregivers reported significantly reduced stress, decreased anxiety, and increased positive emotions after taking part in the intervention. They also reported increases in positive communications with cancer patients and health care providers. In another study, 61 the specific aim was to determine the effects of a 1-hour art therapy session on pain and other symptoms common to adult cancer inpatients. The Edmonton Symptom Assessment Scale and the Spielberger State-Trait Anxiety Index were used to quantify symptoms, and the 50 patients taking part were asked open-ended questions to evaluate their perceptions of the experience.
There were statistically significant reductions in 8 of the 9 symptoms measured by the Edmonton scale, including the global distress score, as well as significant improvements in most of the domains measured by the Spielberger State-Trait Anxiety Index. Patients overwhelmingly expressed comfort with the process and a desire to continue with therapy. This study provides initial evidence of the efficacy of art therapy in reducing a broad spectrum of symptoms among cancer inpatients.
A growing interest in dance and movement has accompanied recognition of the mind and body benefits of motor activity. Through the movement of mind and body in a creative way, stress and anxiety can be relieved, and other health benefits can be achieved as well.
Table 3 highlights some of the research conducted in the area of movement-based creative expression and dance therapy to promote well-being.
Picard expanded Newman's theory of expanding consciousness to include creative movement as a mode of expression. The results demonstrated expanding consciousness at midlife, with patterns of meaning identified in relationships with others, the self, and spirit as well as challenges associated with loss, illness, and threats to relationships.
The consciousness activities identified were choosing, balancing, accepting, and letting go, and creative movement was shown to support self-awareness. Sandel et al. Results showed significant quality of life improvements in the intervention group. Shoulder range of motion increased, as did body image, at 13 weeks. By addressing posttreatment patients' physical and emotional needs, this program substantially enhanced their quality of life. In the visual arts component, participants speculated on the intention of the art or commented on an ambiguous image.
Participants were grouped into 1 of 3 study conditions: theater arts primary intervention , visual arts non-content-specific comparison group , or a no-treatment control group. After 4 weeks of instruction, those given theater training exhibited significantly greater gains than members of the no-treatment control group on both cognitive and psychological well-being measures, specifically word and listening recall, problem solving, self-esteem, and psychological well-being.
A comparison of theater and visual arts training showed fewer benefits in fewer areas for visual arts. In a different type of movement expression, tai chi, a semimeditative exercise derived from martial arts, has been gaining popularity as an intervention for reducing falls in older adults and improving health status.
One study, 77 conducted among older adults who were becoming frail, attempted to determine whether intense tai chi exercise could improve perceived health status and self-rated health more than wellness education.
The participants were women aged 70 years or older who were recruited from 20 congregate independent senior living facilities. In this week randomized controlled trial, participants were randomly assigned to receive either tai chi or wellness education. Participants were interviewed regarding their perceived health status and self-rated health before randomization and at 1 year.
Perceived health status was measured with the Sickness Impact Profile. Relative to the wellness education group, the tai chi group exhibited significant improvements in physical functioning and ambulation and borderline significant improvements in the Sickness Impact Profile body care and movement category.
Self-rated health status did not change in either group. These findings suggest that older women who are becoming frail demonstrate perceived health status benefits, most notably in ambulation, after taking part in intensive tai chi exercises.
Studies have shown that, relative to control group participants, individuals who have written about their own traumatic experiences exhibit statistically significant improvements in various measures of physical health, reductions in visits to physicians, 81 and better immune system functioning.
Pennebaker 88 — 90 is the leading researcher on the power of writing and journaling for healing purposes. These effects have been shown to hold across cultures, age groups, and diverse samples.
Expressive writing can improve control over pain, depressed mood, and pain severity, as can be seen in Table 4. For example, in a pair of randomized controlled trials, 83 , 84 patients were assigned to write about either emotional or nonemotional topics. In their 9-week study, Graham et al. Results showed greater improvements in control over pain and depressed mood, and marginally greater improvements in pain severity, in the anger-expression group than in the control group.
These findings suggest that expressing anger may be helpful for individuals suffering from chronic pain, particularly if it leads to meaning making. In their study, Petrie et al. Participants who engaged in emotional writing rated their essays as more personal, valuable, and emotional than did control group participants. HIV viral loads dropped immediately after the intervention in the experimental group and increased slightly in the control group.
On the basis of the participants' reports of the value of writing and the study's preliminary laboratory findings, the results suggest that emotional writing may be beneficial for patients with HIV. There is evidence, however, that the benefits of writing may not be maintained over time. Another form of expressive writing, poetry, has long played a role in the art of healing.
According to Carroll:. Our voices are saturated with who we are, embodied in the rhythms, tonal variations, associations, images and other somato-sensory metaphors in addition to the content meaning of the words.
Our voices are embodiments of ourselves, whether written or spoken. It is in times of extremity that we long to find words or hear another human voice letting us know we are not alone. Finding one's voice via poetic means can be a healing process because it opens up the opportunity for self-expression not otherwise felt through everyday words.
One British hospital introduced poetry into the culture of the hospital so that patients could experience other forms of literary work 97 and perhaps experience healing through the short snippets of expressive words and emotions to which they could relate. Expressive writing through journaling is another way to access the unconscious self. Bringing together the Soviet historical experience and Stalin-era art in novels, films, poems, songs, painting, photography, architecture and advertising, Dobrenko examines Stalinism's representational strategies and demonstrates how real socialism was begotten of Socialist Realism.
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