Tag Archives: neurochemical process

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

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.

“Creativity and Arts in Healthcare” gains support in Kentucky!

Kentucky Center

Here’s an arts organization working to instill art into the healing process – Kentucky Performing Arts Center in Louisville.    In the fall of last year, Norton Hospital and James Graham Brown Cancer Center  in Louisville collaborated with Kentucky Center to have artists work at their healthcare facilites for a short-time with funding from the Humana Foundation.  The premise of the program was to provide diversional activities in the form of arts to patients, thereby helping them feel better.  Finally, a few more  businesses who ‘get it!”

Robin Glazer of the Creative Center in New York knows first hand how creating art helps patients feel better and stated in the article, ” but not all health facilities are willing to invest in these kinds of arts programs.  This is a hard sell for a community that’s never heard of it before.”

However, there are many hospital systems with art and music programs, but what differs between the healthcare facilities in Louisville and the Creative Center and other arts in healthcare programs is,  education in a healthcare discipline.  For example,  Kentucky Performing Arts Center and the Creative Center uses local artists  in providing artistic services to patients.  In both organizations, the “intent of the program is to provide opportunities for patients, their families, for staff to encounter the arts, to have an artistic experience, that we believe will enhance their healing process,” according to the Kentucky Center program director.  Other arts in healthcare programs are structured around the nursing, therapeutic and holistic  models where healthcare professionals are also artists, and may have undergone additional study and/or certification in arts in healthcare courses, and  integrate local artists into their programs.  The model and intent of creative programs will depend on the healthcare organization’s leaders.

Is additional study in this emerging and growing field necessary?  Not necessarily, but I think certification or additonal study will become a trend.  In healthcare, academic achievement in one’s profession is a driving force for many professionals in order to differentiate themselves and to excel in their field.  So, obtaining certifications in developing, facilitating and implementing creativity and the arts for patients and families is not surprising to me at all.

For upcoming posts, I will research whether there are any creative programs in healthcare organization in Georgia, and tell you my findings.  It should be interesting to see who does or doesn’t have creative programs, and whether they’re large, small, educational or innovative healthcare institutions.

Try this simple Creative Intervention…

music-notes1I’d like to introduce and describe a short and simple Creative Intervention to try on your own.  I developed this CI (Creative Intervention) for use in my Creativity Workshops. 

The goal is to visualize the music you hear and transfer these images onto paper.  It will take about 10 minutes to complete the music-notes1exercise, but may be longer depending on how much time is devoted to your drawing; the musical piece is 5:25 minutes long.

But first, read the short list of instructions and then go for it! 

A few Instructions:

1. The music selected for this particular Creative Intervention is Beethoven’s Pathetique Movement 2 by Freddy Kempf.  I chose Freddy beethovenKempf’s version over other artists for his expressiveness and sensitivity in interpeting this piece.

The link below is to a youtube video.  The goal is to listen with your eyes closed. No peeking to watch Freddy during this exercise; you can watch him later!

Note: It’s important to be in an quiet environment for you to benefit from this exercise.  So, close your office door or wait for better time.

2. Gather your supplies: white paper and drawing/coloring tools in different colors (crayons, colored pencils or markers).  Anything you crayonscan draw with is fine, but make sure you have different colors.

3. Listen to the selected piece by clicking on the link. Remember- keep your eyes closed during the entire musical piece.  The goal is to shut out outside visual images and noises, and focus on you.

While you’re listening, picture how the music would look if you could see it.  What are the colors and shapes you see?  Are there lines?  Is it abstract?  What are the rhythms, the melodies and mood(s) you see?  How does the music make you feel?  Are there words or just colors or images? Don’t worry about drawing anything you may not recognize – that’s not important to this exercise.  Remember, there is no right or wrong way of doing this exercise – just your way.

music-notes1

      Are you ready to begin?

Increase the volume on your computer to mid-way – Beethoven’s Pathetique Movement 2 is very soft in certain sections.

CLOSE YOUR EYES and listen for the entire duration.  Click the youtube link below and listen to Freddy Kempf’s version Beethoven’s of Pathetique Movement 2.   According to music interpretation,  Pathetique in its entirety is not a sad song piece.   Beethoven wrote this when he found out he was losing his hearing. The first movement is depicting the rage and sorrow he felt. The  second movement (the youtube video below) is depicting the comfort he receives.  The third movement is almost a testament of joy.


Now, draw what you ‘saw’ when your eyes were closed.  When you’re finished, look at your drawing for a few minutes.  Don’t be critical about it – it is what it is.  Try this exercise with your favorite musical pieces – rock, alternative, classical, pop, etc.  Compare the 2nd, 3rd drawing with the first.

Creative Interventions are not just for patients…

Creative Interventions should be experienced by all healthcare professionals, not just patients.  Who will benefit?  Nurses, doctors, ancillary nursing personnel, social workers, OT, PT, healthcare managers and executive staff, and academicians.  By experiencing and expanding your own definition of creativity, it will ultimately benefit your patients and your daily interactions with others.

 mhand_stem-cell-garden_sm(stem cell garden, Marti Hand 2008)

Guest Writer – Sara Baker

I invited a guest to write this week’s post – Sara Baker. 

Sara is a novelist, short story writer and dramatist. Her works have been published in a number of publications. Her screenplay, ‘Looking for Sylvia’, was a sara-bakerwinner in the Atlanta Film and Video Contest; her screenplay, ‘One of Us’, was a semifinalist in the Cinestory 1997 Screenwriting Contest. She has written three books – 2 novels (Shadow Dance and Horography), and a collection of short fiction titled ‘No Part of the Body is Not Sacred.’  Sara holds a Masters degree from Boston College. She has taught English at the University of Georgia, Georgia Institute of Technology, and Piedmont College. In addition, she has been a Georgia Artist in the schools and conducted workshops throughout the state. Sara created the Woven Dialog Workshops, writing workshops that aid in facilitating the healing process at Loran Smith Center for Cancer Support in Athnes, Georgia.

Read more about Sara at her website Sara Baker titled “Woven Dialog Workshops,” and blog ‘Word Medicine.’

 

And now, here’s Sara…

 

asklepieion_sara-baker1 

Returning to the Roots of Western Medicine

The arts in healthcare are often regarded as a nice but certainly not essential component of patient care, just as the arts in the broader American culture are often considered a valuable but inessential asset. Certainly, they are not considered essential to our well-being. We are a pragmatic nation, proud of our technological prowess. We are more comfortable with the Newtonian idea of the body as a machine to be fixed than as the physical expression of a soul.

Yet the very roots of Western medicine are sunk deeply in a tradition which proceeded from a very different premise. In ancient Greece, the hippocratesill would go to healing temples, or temenos, which means a piece of land cut off or set apart and dedicated for sacred purposes. The temples dedicated to healing were call asclepieia, after the god of healing, Asclepius. The sick would come and bathe in healing waters and prepare themselves for a sacred dream, which they would then report to a priest, who would prescribe a cure. The earliest of these temples date from 420 BC, and both Hippocrates and Galen trained in asclepieia, and Hippocrates traced his ancestry to Asclepius.

What the ancient Greeks understood and what Hippocrates espoused, was that a person carried within themselves the resources to help direct their healing. They understood that the unconscious often held the key to healing and allowed a time and place for that knowledge to arise.

It has been said that if you listen well to a patient, he will give you the key to what is wrong with him. Yet in our modern medical environments, there is little time for truly listening. And the language of medicine is one that often reduces the ill person to a body or a pathology, rather than addresses the emotional and spiritual experience of the person undergoing the experience of illness. (see Arthur Frank, At the Will of the Body). Chaplains and social workers, those assigned to “deal with” these issues, are often overburdened. butterfly1Patients themselves often feel as if they are somehow wrong to have feelings of despair, disempowerment, grief, and stress and lack the language to acknowledge or access feelings which may actually, by their lack of expression, be blocking their healing process.

By providing arts experiences in hospital settings, however, we are providing our own temenos. Here, in the safe space set apart from other concerns, patients are invited to have a healing, although waking, dream. They are able to find the symbolic language to express the crisis they are experiencing, and also, through the process of art, to seek new, imaginative ways to go forward. Thomas Moore, author of Dark Nights of the Soul, talks about the “unfolding self,” the part of us that is always evolving and going through deep transformations. “The unfolding self hungers for symbols and language to understand and mark the transitions it is going through.” (pg. 35) Through the process of creating art, the patient-artist both creates the distance necessary to reflect on his/her experience and honors the transformative process that is always part of the experience of illness.

In many respects, then, incorporating art into the healthcare setting is writingnot something new, but something very old. It is an acknowledgement that healing is not only about curing physical ills, but also about giving patients the tools to cope with the spiritual and emotional dimensions of illness. The science supporting the physical and emotional benefits of arts intervention is growing exponentially (see Marti’s excellent “The Science Supporting Creativity in Healthcare). Medicine has always been a blending of art-intuition, perception, creativity-and science-knowledge, skill, experience. While the current structure of our medical system so often mitigates against providing healing environments that address the whole person, my experience has been that all those involved in healthcare want such environments. By incorporating the arts as healing modalities, hospitals are returning to the roots of Western medicine. ~sara baker.

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Don’t forget to visit Sara at her website Sara Baker titled “Woven Dialog Workshops,” and blog ‘Word Medicine.’

flower-butterfly

Creativity as a Strategy for the Nursing Shortage

 rumimusic-notes1ultimate_creativity_for_sitebob

 Creativity as a strategy for the nursing shortage – seriously?!

Before I explain the use of creativity as a strategy in addressing the nursing shortage, I want to share with you an interesting fact in the 2008 Gallup Survey for honesty and ethics among professions…

gallup

For the eighth consecutive year,  nursing is number #1 for most honest, ethical and most respected profession by the public.  But, I’m not at all surprised. Is there any question why? It certainly isn’t  the money or the hours, although these are important concerns.  In a very unformal survey,  nurses were asked why they became a nurse – the top answer was:

  • “I’ve always had the passion to care for others” = 57.6%
  • A nurse in my life inspired me = 17.5%
  • I wanted a job in healthcare, and nursing seemed to be a good fit = 16.7%
  • Nursing jobs are easy to find, and the pay is good = 5.0%
  • I’m wondering that too, and plan to leave the profession =3.2%        

              (Source: Advance for Nurses. Dec. 29, 2008, 10:27, p11)

Obviously, comfy work conditions, bankers’ hours and great pay are not the top reasons why nurses choose nursing – it’s the desire to make a difference in the world, and empathy for others –  what I consider to be a few key elements of social responsibility.

But, onto the nursing shortage…

In the previous post, I listed a number factors contributing to the critical nursing shortage.  Today, I decided to list a few strategies  involving creative interventions that may be helpful in addressing the nursing shortage, and here they are:

1. Implement Creativity [Arts] Programs for patients and families in inpatient settings, where the need for RNs is most critical.  However, arts programs should darlene2be implemented into every healthcare setting

First, In “The Science Supporting Creativity in Healthcare” located under TOPICS in the left sidebar, I include a study done by The Creative Center of patients’ satisfaction with the ‘art-at-the-bedside’ programs, and nurses’ response to the arts program. Here are the results again…

42.3% of the nursing staff believed the arts program affected their capacity to provide patient care. As you can see in the table below, the nursing staff felt the arts program enhanced their abilities to provide patient care

 Also, nurses’ job optimism and job satifaction increased with the implementation of the creativity program. This information can be useful as a tool in addressing nursing recruitment and retention efforts, and ultimately, the bottom line.

How Program Affected Ability to Provide Patient Care

Effect

N

% of those responding “Yes”

Happy to see patients’ enjoyment

20

38.5

Enhanced my ability to do my job

10

31.3

More optimistic about my job

7

22.6

Facilitated patient interaction

5

16.1

Increased job satisfaction

4

12.9

*Numbers add up to more than 100% because more than one response was permitted. Total number responding was 52.  Source:Final Report:Satisfaction and Outcomes Assessment. Hospital Artist-In-Residence Program of the Creative Center.

drumming2. Offer Creativity Workshops for nurses as a seminar, as a continuing education class for CEUs, as a short retreat.  Large and small businesses have corporate, management and staff retreats for team building purposes, idea generation and strategic planning.  A few workshop/seminar ideas can be drumming circles, painting classes, journaling, creativity theory class…the ideas are limitless.  By caring for professional caregivers (nurses, physicians, physical therapists, occupational therapists, nursing faculty professors, nurse assistants, etc), they will return to caring for patients refreshed, invigorated and more creative in their approach to patient care.

3. If the public identified Nursing as the most ethical, honest and respected professiodollarn in the U.S. – why are salaries lower than attorneys, unionized mechanics, tollbooth collectors, pharmacists, truck drivers, and nearly every other job category?  Do we value the work of mechanics, toll-workers and attorneys more than nurses?  Who are you going to call at 3:00am if you need help or are sick?  A nurse or an attorney?  Have nurses salaries reflect public opinion, including nursing academicians!  The single most important factor in choosing where nurses worked was salary/benefits -> 52.5% (Advance Nurse, Dec 29, 2008). 

4. Creativity Programs for nurses, creative interventions for patients & families – a strategry for nurse recruitment and retention.  With increased job satisfaction and optimism, nurses are much less likely to change healthcare companies.  According to an informal poll by Advance Nurse (Dec 29, 2008), “a good team of co-workers” was rated the highest as the strongest retention tool.  Below is the breakdown of the categories queried:

  • Good team of co-workers -> 59.6%
  • Feeling empowered -> 19.8%
  • Salary -> 15.2%
  • Benefits -> 5.4%

nurse-comradry

Arts in Health Care Program at Shand Medical Center, FL…

lighted-trees

A number of years ago when I first read about integrating the art in healthcare, I read the story how the arts program at Shand Hospital, University of Florida, got started.

Now, there are a number of comprehensive art programs throughout the US, but the AIM Program at Shand Hospital is one of the first I read about and piqued my interest in incorporating creativity into patient care.

The Arts in Medicine (AIM) Program at Shand Hospital started with a dream by a nurse-visual artist, Mary Rockwood Lane, and physician-poet,  John Graham-Pole.  For Mary, the desire to incorporate art-making directly into patient care stems from her personal experience of healing through engaging in the creative process – painting in her case.  She states in one of her articles, “The creative process transformed my life. It was not a 1-hour-per-week visit to a health provider.”  In her case, it was engaging in the creative process that helped her heal, and is the primary topic and purpose of this blog.  Because she is a nurse, she felt compelled to bring the healing power of art to others, i.e, patients.  I, too, am compelled and driven to do the same – to bring the creative process directly to patients, families and healthcare staff.  The physician, John Graham-Pole, had the vision of artists working with students at the medical school. 

Focus now on present day…Shand’s AIM has visual artist-in-residence, musician-in-residence, dancer-in-residence, story teller-in-residence, and a theatre troupe-in-residence.  AIM has become part of the hospital’s infrastructure and mission.  The artists-in-residence work in a variety of units: the BMT unit, pediatric intensive care, diabetic adolescent unit, psychiatry, autistic  children, general oncology, medicine, gynecology, surgery, and mother-baby.

AIM at Shand’s Hospital is a shared vision between artists and nurses..the program is deeply integrated to nursing care, and the nurses are key participants in the program.  Nurses and physicians write prescriptions for creative interventions (art) just like writing a prescription for another treatment, activity or medication.  According to Mary Rockwood Lane, “the art is part of the nurse’s healing modalities in meeting patient outcomes.”  Nurses are the catalysts to help patients and families embrace creative expression in health care settings, and needs to incorporate creative interventions into patient/family care.

To learn more about the Arts in Medicine Program at Shand Hospital, do an internet search…there’s alot of information out there.

Here are excerpts from articles written by Mary Rockwood Lane, RN, PhD:

“…the hospital feels more sensitive, more caring, as a result of this art.”

“The creative process transformed my life…because I was a nurse, I felt compelled to bring the healing power of art to others, to initiate a new program, and to seek out professional allies and build clinically based liaisons.  I believed that, as a nurse, I could reach out and help others.”

“Creative Interventions have been shown to shorten hospital stays and decrease the use of pain medication dramatically.”

“Performances of music, dance, poetry, and theater are put on in the hospital lobby.  Patients are brought from their rooms, and families and staff stop; the music draws people toward its transformational power.  Patients, family, and staff alike leave relaxed and uplifted; they are changed and healed.”

“Patients who are visited by the AIM artists say their whole experience of being ill is changed forever.  They are more hopeful, happier, feel better, and have less pain.  This is true even if the patients do not engage in creative activities themselves but just watch the artists.”

Here are excerpts from an article written by John Graham-Pole, MD:

“The past decade has confirmed my belief that art plays a central role in serving the sick and the overtly healthy among us.  This marriage – the unifying of art and science in medicine – is a present and much needed reality.  It offers a lasting antidote to the epidemic dis-ease of body, mind and spirit…it is no accident we use the word art to describe both the creating of works of beautiful form and the providing of skilled compassionate care.  Art ta[s, for each of us, whatever our circumstances, a deep well of physical, emotional, and spiritual well-being.  It is indispensable to our lives, and to our total health.  Where more apt to invest in it and ensure its flowering than in our nation’s hospitals?”

Although both health care profesionals cited above have written many articles, the excepts are from 2 articles…email me if you’d like the references. Read again the “Science Supporting Creativity in Healthcare” located under Topics in the left sidebar of this blog.

And now…

robert-fritz

“If you limit your choices to what seems possible or reasonable, you disconnect yourself from what you truly want, and all that is left is a compromise.” ~robert fritz