When pain becomes overpowering, a patient's creative impulses may be an important ally.
For some time now scientists have known that a wide range of creative activities, ranging from listening to or performing music, to engaging in an energetic dance routine, may reduce pain felt by persons who are ill.
And more recently researchers have shown that creating a piece of art can do the same thing, even if the art isn't all that great.
In the latest study, 50 cancer patients at Northwestern Memorial Hospital in Chicago lowered eight out of nine symptoms associated with pain and anxiety after spending one hour painting, or drawing, or trying to make a piece of pottery or jewelry.
"There was a lot of creativity going on," says Judith Paice, RN, director of the hospital's cancer pain program and co-author of a study in the current issue of the Journal of Pain and Symptom Management.
The patients, who knew they were taking part in a research project but did not know the precise focus of the effort, reported significant improvement in eight symptoms - pain, tiredness, depression, anxiety, drowsiness, lack of appetite, sense of well being and shortness of breath -- after one hour of "art therapy." The only category that showed no significant improvement was nausea, a powerful symptom that has been unaffected by other similar studies, Paice says.
A number of research projects have shown similar results, although clinicians caution that listening to music or drawing a picture is no substitute for traditional medical treatment. It's not even clear at this point as to the exact nature of the mechanism that makes people believe they're better off after the therapy.
Distraction is expected to be a major player. Trying to create a piece of art draws attention away from afflictions. But Paice thinks there's more to it than that.
Nancy Nainis, an art therapist and lead author of the study, dealt personally with each of the 50 patients, stressing that the art itself wasn't what was important. Instead, Nainis tried to get each patient to discuss whatever he or she was trying to create, and why they wanted to do that particular project.
In the process, Paice says, the patients talked openly about their problems.
"So patients who might not have been able to articulate their fears to a therapist, and would never have considered going to a psychologist, used art work as a vehicle to express their fears," she adds.
That suggests that more than art was at work. Nainis asked the patients to interpret their own art at the end of each session, and in doing so they frequently discussed feelings they might have otherwise kept to themselves.
Nainis says she was particularly surprised that most of the patients reported a reduction in "tiredness."
"Several subjects made anecdotal comments that the art therapy had energized them," Nainis says. "This is the first study to document a reduction in tiredness as a result of art therapy."
The patients were asked to rank their symptoms from zero to 10, with zero being no symptoms (no pain, for example) and 10 being severe. The therapy reduced the symptoms by an average of between one and two points, Paice says.
Similar research has been conducted at the Stanford Cancer Center, and scientists concluded that art therapy was helpful because it encouraged patients to talk about traumatic or painful experiences. They also found that dancing helped, at least among patients who could engage in such physical activity, as well as listening to and performing music.
The caveat in all this, however, is that much more research needs to be done before the therapeutic effects can be fully understood. The American Cancer Society has stated that the research is still inconclusive, although many clinicians believe it helps.
Paice, for one, thinks scientists are on the right track.
"Our study provides beginning evidence for the important role art therapy can play in reducing symptoms," she says.