Candace Pert, Explorer of the Brain

Candace Pert, my favorite scientist, died recently from a heart attack…read the New York Times article.

Candace Pert, PhD.

Her book, Molecules of Emotion, had such an impact on me in terms of my work as a painter, and understanding the scientific basis of emotions on health and well-being. In fact, this blog, Creativity in Healthcare, was created based on the interconnectedness  of emotions on health and disease states. You may be interested in seeing a few paintings titled Molecules of Emotion“,  which focuses on the scientific work of Candace Pert.  This series remains a work in perpetual progress.

A bit of background on Candace Pert, PhD: 

As a  graduate student at John Hopkins University School of Medicine, Candace discovered the receptor for opiates like endorphins (natural opiate), morphine, opium, codeine and other pharmaceutical narcotics.  Her discovery  eventually won the coveted Lasker Award, a precursor to the Nobel Price, but was awarded to the chief laboratory scientist, i.e., her boss. Who knows what the real reasons were for Dr. Pert not being awarded the Lasker Award, but she certainly didn’t get the recognition she so deserved!

Recommended Reading and Listening by Candace Pert, PhD.

I strongly recommend Dr. Pert’s book and audio lecture for those interested in learning more about the biochemistry of how emotions affect states of health.

  • Molecules of Emotion:The Science Behind Mind-Body Medicine
  • Your Body is Your Subconscious Mind (audio lecture)

Both are available through candacepert.com and many online book stores.

        Your-body-is-your-subconscious-mind-by-CandacePertPhD

Creative Encounters at University of New Mexico Hospital

A recent CNN article (July 5, 2013) publicized the benefits of an arts-in-medicine program at University of New UNewMexicoHospitalMexico Hospital.  The mission of the  arts program is to “facilitate creative encounters that help patients and their families discover new meaning in life and death, or just for fun.”  Patricia Repar, director of the arts-in-medicine program says sometimes, this can be as simple as playing music at a patient’s bedside to help them calm down or sleep.

Patrica Repar knows from experience the value of engaging in the creative process.  After becoming severely ill during a visit to Ecuador, she states she “…was afraid and lonely and frustrated,” and remembers feeling like she was “tapped on the should by death.”

music-notes2music-notes3music-notes3

music-notes2

She decided the only way she could deal with it was to create collages, images, short and simple “sound” pieces, poetry and narratives.  “The daily art-making kept my life full of meaning,” says Repar, who has a doctorate in music composition. “And I found myself calm and pain-free until I could get further medical care in my home country of Canada.”

Here are the highlights of the article…

singing

How an Occupational Therapist Used Creativity to Help a Child…

Occupational therapists help patients from a variety of backgrounds, from those who have debilitating medical conditions to soldiers returning from war with multiple injuries. My youngest sister has Down syndrome, so she has been working with an occupational therapist since she was a toddler. Kaitlin’s therapists have all been wonderful people. They’ve helped her develop her motor skills, which is a very important part of living a healthy life. However, one of the greatest things that Kaitlin’s occupational therapists have done for her is teaching her the value of creativity.

An occupational therapist’s goal is not only to address their patients’ physical needs, but to take into consideration the social, psychological and environmental factors that impact their patients’ progress. For my sister, especially when she was a baby, getting her to participate in things was not always easy. She would watch, but not join in when her twin brother (who does not have Down syndrome) would play. It wasn’t until her occupational therapist started using the arts in their sessions that Kaitlin started to get involved for the first time.

Creativity Isn’t Just for Artists

In occupational therapy, being able to think outside the box can be extremely beneficial. Occupational therapists have many techniques at their disposal when it comes to utilizing creativity. The arts are more than just tools for self-expression. They are also extremely valuable for hand-eye coordination, spatial reasoning and speech development. For Kaitlin, her journey started with music.

She could make sounds and was very slowly starting to talk. Her occupational therapist started teaching her some songs, both the verbal lyrics and incorporating some sign language and hand gestures. From the very first note, Kaitlin was engaged. She watched intently the first few times. Then she started making sounds along with the music and moving her hands. Soon after, she was starting to learn some of the words and she’d mastered all of the movements. To see this sweet little girl go from knowing a handful of words to being able to sing entire songs was moving beyond belief.

Using the Arts as Patients Grow Up

As Kaitlin got older, her therapists continued to introduce new ways to use art to help aid her development. Since music was so effective, they continued to use songs to get Kaitlin moving and help with her speech development. Once her fine motor skills reached the point where she could hold a pencil on her own, they started using art as well.

I have stacks and stacks of pictures that Kaitlin has drawn for me throughout the years. Not only did drawing and writing help her, it also brought her immense joy. A box of crayons and a notebook are all my sister needs to have a good time. Seeing her skills develop is always wonderful, but seeing her happiness is the greatest gift of all.

Kaitlin is now about to go into high school. The creativity that her occupational therapists fostered in her is a huge part of the beautiful young lady that she has become. She still loves to sing and draw. She also has been dancing since elementary school. Whenever she is performing, she is truly in her element. As I watched her perform during her last dance recital, I thought of how far she’s come from the days when she used to just watch. Every pirouette and plié was a testament to the creativity her occupational therapists applied to her work.

This guest post was provided by Erin Palmer. Erin writes about physical therapy degrees and occupational therapy graduate programs for US News University Directory. For more information please visit http://www.usnewsuniversitydirectory.com

In Defense of Writing…

This post is written by a graduate in English literature turned nurse – Sashana Macatangay.  She is enrolled in the Master’s in Nursing program at Azusa Pacific University.  Sashana believes the act of writing helps with clarity of thought, sharpens critical thinking and observational skills, and last but not least, that the humanities should be incorporated into nursing curriculums.  And why you may ask?  This is Sashana’s story and explanation…

Florence Nightingale, the most celebrated pioneer of the nursing profession, once likened nursing to an art. From Nightingale’s perspective, nursing was, in nightingale-creativityinhealthcarefact, “the finest of the Fine Arts.” She makes a valid argument. In her analogy, Nightingale aptly compares the work of a nurse to that of a painter or sculptor. Both disciplines require exclusive devotion and hard preparation. Both also incorporate a strong human aspect. Because of this human aspect in nursing, it is important that nursing students exercise skills in the Humanities, particularly writing. Good writing skills in any discipline serve the purpose of promoting individuality, sharper critical thinking skills, and the formation of more articulate thought processes. In nursing, specifically, writing skills help to promote professionalism, credibility, and the dissemination of useful healthcare-based knowledge, which is valuable to hospitals, clinics, and care facilities everywhere.

I am contributing to this blog because I wish people to know why I believe writing is necessary in nursing education. I am well aware that the bulk of nursing students absolutely detests writing and do not share the same opinion as I do. Hopefully through this article, I will have provided a solid argument writing-creativityinhealthcaredefending the importance of writing. However, before I expand more on why I believe writing is important to nursing, it should be noted that I might be a little biased due to my academic history. I graduated with a liberal arts degree—more specifically, an English degree. I made the decision to change my career path several years ago, and I am currently more than half-way finished with my second degree in nursing.

But let’s not lie. My initial attraction to the nursing career was a bit more superficial. During my years as an undergraduate student of UC Irvine’s School of Humanities, my goals were much different. I planned on pursuing a career as a music journalist. I dreamed of securing a position at Rolling Stone or Spin. I was determined to get there. However, the sad reality of the music journalism career made itself evident when I applied to a handful of alternative music magazines with no actual success. A long period of taking out odd jobs and engaging in continuous soul-searching prompted me to consider nursing as a way to financially stabilize myself and help provide for my family in the future. It wasn’t the most pure reason for wanting this career, but it’s the truth. I was a girl in her early 20s who loved music, art, and literary prose. I even manned my own radio program as a DJ at Orange County’s KUCI and was heavily involved with the non-profit organization for several years. In the past 5 years, I’m sure that no one would’ve ever guessed that the beats per minute I would be counting would be heart rates, and not the speed of a vinyl record.

However, before you judge me too much about my initial attraction to the stability of the nursing career, please note, that I grew to love it. Why do I love it? Well, while many uninformed people consider nursing to be a mere science, I consider it an art. True, I did graduate with a liberal arts degree, and to many people, this has absolutely nothing to do with nursing. I have a completely different perspective on the relevance of my degree. In my mind, these two different courses of study are similar. The English major analyzes texts from different perspectives in search of literary truths. In a similar vein, the nursing student analyzes data and different variables, from different angles, in search of medical truths in the form of comprehensive diagnoses. I appreciate the multidimensional nature of nursing, and I love the different approaches and interventions that can be taken to address any single problem. Everyday is a constant exercise of critical thinking and creativity.

And believe it or not, I do also love the writing and research aspect that is involved in nursing. Uncovering life-changing data and making a difference in the world through the spread of knowledge and ideas is a very rewarding process that I would like to one day take a part of. For this reason, I’ve always believed that writing is one of the most important aspects of the nursing profession. In fact, according to Provision 7.3 in the Nurse’s Code of Ethics, “…nursing knowledge is derived from the sciences and from the humanities. Ongoing scholarly activities are essential to fulfilling a profession’s obligations to society” (“Code of Ethics,” 2001).

Writing is one of the most important scholarly activities that a nurse can engage in. Eloquence and proficient writing skills in nursing practice indicate competence, expertise, and wisdom in clinical practice. These skills can draw attention not only to the nurse’s expansive and specialized medical lexicon, but also to their extensive knowledge of relevant healthcare-related issues (which proves to be highly beneficial in patient-centered care).

Effective communication skills lend more credibility to the nurse, enabling the nurse to be a more effective and trusted patient advocate. As a result, the nurse may also use her unique writing style to expand and diversify the pre-existing body of healthcare-based knowledge that is used internationally in promoting more effective patient care.

Writing promotes a nursing culture of professionalism and aids in the spread of knowledge and ideas among patients and nurses alike. But if this reason alone is not enough to demonstrate its importance, we must also consider the scarcity of creative assignments in nursing education, which can be all too systematic and structured.

Nursing students rarely get the opportunity to express themselves as individuals. They are mandated to learn the same skills, and they must exercise these skills under a strict protocol. Their form of self-expression is often limited to a mechanical regurgitation of knowledge and hard, scientific facts. Creative processes such as writing promote individuality, critical thinking, and innovation. As nurses, we must exercise writing in order to establish what Theresa S. Drought in The Guide to the Code of Ethics for Nurses describes as “…new ways of understanding disease, health, the human response to illness, and innovations in nursing care” (Drought, 2008, p. 95). Writing is essential for stimulating self-expression, originality, and innovation in a profession that thrives on advanced practice research, evidence based practice, and scholarly inquiry.

Proper writing skills and the exercise of creative thought is paramount to the success of any professional within the healthcare industry. Nursing is certainly not exempt from this. Nursing curriculums often have a heavy emphasis on clinical skills and science-based knowledge. However, what many people fail to realize is that nursing is both a science and an art. Incorporating more writing into nursing education is beneficial because nurses who are strong writers are also strong communicators. Consequently, they are also more vocal patient advocates. As healthcare professionals, we must be aware that the exercise of sharing ideas and contributing interdisciplinary knowledge is a collaborative process that we all should participate in.

If you wish to connect with Sashana, email her at sashanamac@gmail.com.

Brain feels rewarded while looking at art…

Did you know that looking at paintings rather than photographs activates the brain’s “reward system?”  A very small study (8 study participants) by Emory University School of Medicine concludes the brain responds more strongly when viewing a painting than when looking at a photograph.

Volunteers were asked to view paintings by famous and not-so-famous artists and photographs while researcher scanned the volunteers’ brain wave activity using a functional magnetic resonance imaging or fMRI.  Interestingly, the fMRI revealed the ventral striatum of the brain is more strongly activated when viewing a painting rather than a photograph of a similar subject.  Btw, the work of famous artists selected for the study included Monet, Van Gogh, Picasso and others.

According to Krish Sathian MD,  a neurologist at Emory, the ventral striatum and orbitofrontal cortex  (parts of the brain’s reward system) are the areas in the brain that reacts strongly when viewing paintings.  These same areas are also strongly stimulated during high reward behaviors such as drug addiction and gambling.  

Results from the above study is different from other art appreciation studies that used brain scans to examine how the brain responds when veiwing art considered attractive or ugly.  Participants were asked to give a rating based  how well she/he liked it.  These studies have shown that the amygdala, involved in emotional reactions, as well as different regions in the orbitofrontal cortex are involved in aesthetic preference.  See previous post on this study. 

I don’t know how much this matters or even if it’s important, but different areas of the brain are stimulated based on whether one is looking at art for personal preference (aesthetics) and when looking at paintings versus photographs.  In other words, the brain regions activated by paintings (as opposed to photographs) were independent from those brain regions that became active during aesthetic preference.

Interestingly, the results reveal that viewing paintings not only stimulated the ventral striatum, but it also activated the hypothalamus (associated with appetite regulation and other critical functions) and the orbitofrontal cortex (associated with risk-taking, impulse control and detection of social rules).  Assuming these results are correct and can be replicated, a few thoughts arise with regard to incorporating the arts in healthcare…

  • If people/patients are engaged in art-making, would the ventral striatum react even more strongly than simply looking at paintings?
  • If viewing art stimulates the hypothalamus responsible for appetite (one of many functions), one could assume artwork in healthcare facilities may help patients with poor appetites.
  • And lastly, incorporating the arts in healthcare settings will bring about all those associated benefits I wrote about in a previous post, which you can read here.

Source: PsychCentral “Brain feels rewarded when looking at art.”

Note: The study was inspired by the work of marketing experts Henrik Hagtve and Vanessa Patrick. The original purpose was to explore the effects of using a painting on a product’s advertising/packaging makes that product more appealing.

Give Patients A Lift With Music…a hospice story

Vitas Innovative Hospice Care in Miami, Florida has a music appreciation program where volunteers share their musical talents with hospice patients throughout Miami-Dade, Broward and Palm Beach counties.

Volunteers include non-professional singers, certified music therapists, and those with a passion for music and wish to share their talents with patients experiencing end-of-life matters.  According to one certified music therapist volunteer, Jeff Engel, he uses music familiar to patients in order to give them a cognitive workout.  Through his experience,  he found “familiar music and familiar conversation about things that were important to patients many years ago often helps to retard the degeneration of cognitive impairment.”  To read the full story, click here.

In healthcare, scientific evidence of the usefulness or efficacy of medical and non-medical interventions has long been a requirement, and these principles applies to incorporating arts interventions in healthcare.  An article titled “Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data” examines 11 research studies on the effects of music with patients.  Of the 11 studies, 6 are identified as having significant differences supporting the use of music therapy for patients with terminal illnesses.

Reported benefits of music therapy by patients are:

  • Significant decrease in painPre-test and post-test measurements using Short-Form McGill Pain Questionnaire.
  • Improvement in mood and anxiety, and decrease in discomforts .
  • Increase spiritual well-beingMany times people with end-of-life conditions request spiritual or religious music.  One study measured spirituality with the 18-item Spiritual Well-Being Scale (SWBS) and completed by patients after each music therapy session.  Analysis showed a significant increase in SWBS scores on the days music therapy was provided.
  • Enhanced quality of lifeInterestingly, the more music therapy sessions patients received, higher quality of life is experienced even as their physical condition declined.  The quality-of-life tool used in this study was the Hospice Quality-of-Life Index-Revised (HQOLI), a 29 questionnaire completed by patients.  Source: Hilliard R. Music Therapy in Hospice and Palliative Care: a Review of the Emirical Data.  Music Department , State University of New York, New Paltz, NY.  eCAM 2005; 2(2) 173-178.  doi:10.1093/ecam/neh076

 Although the above studies had small sample sizes thereby limiting generalization, the author of the article, Russell Hilliard, stresses the importance of designing music therapy studies that allow for generalization of the results.  And why is all this scientific inquiry in hospice and palliative care important?  Here are a few reasons:

  1. Insurance companies (federal, state and private) seek data/information on the efficacy or effectiveness of a treatment.
  2. Because complementary programs such as music therapy, creative programs, etc. need funding, healthcare administrators  need assurance these programs will enhance and raise the standard of care for patients, families and communities.
  3. If healthcare organizations truly want to be innovative, creative and provide patient-centered care, then a willingness to explore, experiment and research other avenues of treatment modalities is necessary.  ‘Patient-centered care’ is a call to action, not a trendy catch-all phrase mouthed by the healthcare industry and healthcare professionals.
  4. Evidence based practice helps to establish effective treatment interventions or best practices in ensuring high standard of care.

Planetree: a model for Patient Centered Care…

Have you ever heard of Planetree?  I learned of this intriguing non-profit organization a number of years ago and of  their mission to help health care organizations develop patient centered environments.  Their care models focus on “healing and nuturing body, mind and spirit” representing a multi-dimensional, holistic approach and attitude to patient care and treatment.

Planetree’s history is equally interesting.  It was founded by Angelica Thieriot in 1978 after her hospital experience battling a rare viral infection.  Back then, hospitals were hardly examples of healing environments that fostered multi-dimensional recovery from illness.  Focus of health care was on treating the disease or ‘sick-care’ rather than ‘health-care’ of  patients and families.  The medical model took precedence over patient centered approach leading to a depersonalized and fragmented system, and is how health care functioned for decades.  However, all is not lost!

The Planetree model of care is a “patient-centered, holistic approach to providing patient care, promoting mental, emotional, spiritual, social, and physical healing. It empowers patients and families through the exchange of information and encourages healing partnerships with caregivers. It seeks to maximize positive healthcare outcomes by integrating optimal medical therapies and incorporating art and nature into the healing environment.” (www.planetree.org)

I love Planetree’s simple and eloquent,  yet powerful,  philosophical beliefs.  They (and I) believe…

  • that we are human beings, caring for other human beings
  • we are all caregivers
  • care giving is best achieved through kindness and compassion
  • safe, accessible, high quality care is fundamental to patient-centered care

  • in a holistic approach to meeting people’s needs of body, mind and spirit
  • families, friends and loved ones are vital to the healing process
  • access to understandable health information can empower individuals to participate in their health care
  • the opportunity for individuals to make personal choices related to their care is essential
  • physical environments can enhance healing, health and wellbeing
  • illness can be a transformational experience for patients, families and caregivers

To learn more about Planetree, visit them at www.planetree.org.

plane-tree

According to legend, Hippocrates sat under the boughs of the plane tree to teach his pupils the art of medicine.