The Art of Improving Life
Steinhardt and Langone’s multiyear study paints a picture of art therapy’s positive effects on people with Parkinson’s
Over the course of more than three years, five groups of people with Parkinson’s disease gathered inside Steinhardt’s Barney Building to splash watercolors, rub pastels, dab acrylics, mold clay, and manipulate other media of their choosing for 90 minutes twice a week. Before and after each of the 10-week sessions, art therapists and doctors examined the volunteers along with their artwork to assess the rehabilitative potential of art therapy for people with Parkinson’s disease. The project, called ExplorArtPD, was a collaboration between Steinhardt’s Art Therapy program and the Marlene and Paolo Fresco Institute for Parkinson’s Movement Disorders at NYU Langone. Most of the participants had stage 2 or 3 Parkinson’s, some exhibiting more severe symptoms than others, such as frequent tremors. “This research is unique in that it involved both a neurology and art team,” says Ikuko Acosta, director of the graduate Art Therapy program and clinical associate professor at Steinhardt.
What Acosta’s team found was remarkable. “The composition of the artwork was more integrated and the environment was richer, while the [earlier work was] more isolated and empty,” says Acosta. The idea of three-dimensionality—foreground and background—was also in greater evidence, a significant development since Parkinson’s can interfere with visual perception. “Parts of the neural path in the brain get damaged and we can’t do anything about it,” she says. “But somehow the over and over creative experience kind of trains the brain to develop alternative compensatory pathways to bypass the damaged neuropath. We’re talking about basically developing resiliency and problem-solving ability.” Acosta’s colleague Tom Ettinger, a psychologist and adjunct professor in the graduate Art Therapy program, quantified the improved functioning with several scales that he devised. Meanwhile, the findings of the Langone investigators, who employed a battery of tests including brain imaging, eye tracking, and gait testing, aligned considerably with those of the art therapists; they found major improvement in motor skills, visuospatial function, brain connectivity, and other functions.
Just as encouraging were the therapy’s psychological and emotional benefits. “Many came in at the beginning [thinking] I am a person with Parkinson’s disease and that is almost like an identity,” says Acosta. “They can’t forget that part of themselves, but it no longer dominates their thinking, there’s more to their identities.” Clinical assistant professor and program coordinator Marygrace Berberian concurs: “At the end of treatment one participant disclosed, ‘I still have Parkinson’s, but I am also an artist…the Parkinson’s piece is no longer right in front.’ ” The artwork told a story of feeling increased independence as well. “Oftentimes people with Parkinson’s disease lose their sense of autonomy,” says Acosta. “So even the simple experience of making art is an autonomous act. You see some departure from the dependency.” The volunteers’ faithful attendance, in spite of their mobility challenges, was “a testament that they really gained something out of the experience,” says Acosta. Each study cycle culminated in an exhibition of the work, the last of which was Brain Storm: The Art of Resilience at Steinhardt.
Since the study’s conclusion, Acosta and Berberian have facilitated what they call “community-based art therapy” sessions through a telehealth format for those who wanted to keep on going—about half of the study’s approximately 36 subjects. They’ve sent them art kits and encouraged them to use found objects in their homes. “They have been remarkably engaged, spending two hours twice a week,” says Berberian. “This has really diminished the isolation for this community, especially in light of the pandemic.”
For their efforts, Acosta and Berberian have received the American Art Therapy Association’s Rawley Silver Research Award and are hoping their current work with people with multiple sclerosis will have the same profoundly positive effects. “Before, [the Parkinson’s participants] were sitting around kind of giving up,” says Acosta, “but there are many little ways the whole creative ground of art therapy is improving the basic quality of life, their everyday life. That is the most beautiful part of it. We didn’t expect that.”
Every Picture Tells a Story
A house, a tree, and a person. The art therapists asked participants to include those three elements in images they created pre-therapy, post-therapy, and at the end of the community-based sessions following the study. Beyond that, the participants had total freedom. Below, Acosta describes how the art of two study subjects—Dave and Andrea—evolved over the course of this period.
Pre-therapy: Naturally, the art has a lot of emotional psychological symbolization. [When] you think about the psychological aspects, the house itself needs a tree to support it because it’s a treehouse. The person also needs the support of other people to let him into the house. There is some implication that this person and also the tree need external support to sort of make it function or achieve the goal.
Post-therapy: On this particular day, he came in with a tremendous tremor. He couldn’t really steady his hand. As a result, the house ended up crooked. But the content is integrated. He said, “You see this figure right here in the middle? This is his house. He built it. He is holding a shovel and this is a tree that he’s going to plant in the ground and then watch it grow.” If you think about the symbolic meaning, he is the one who is nurturing the tree. He’s the active participant. We look into that kind of psychological sense of autonomy. The emotional content begins to appear more strongly, relying on his own sense of confidence.
Post-study: As a piece of art, this is really beautiful. The tree [has a] much stronger trunk and has become alive; it’s begun to be a house. And a tremendous amount of sun is shining upon this man who looks like a rugged woodsman, holding an ax and venturing into darkness to chop up more trees. He put the footprints behind him to make sure he won’t get lost. He will come back. In many ways, it goes beyond autonomy. The element of resilience is kicking in. He’s totally self-sufficient and warm enough and walking steadily to do more chores to survive in this environment. There’s a very tiny person in the first image [and] it begins to be bigger and more central. This one is taking up a very big space that [indicates] resilience, agency, confidence. He continues to make art outside of the group. Somehow, it’s become part of his survival tools.
Pre-therapy: This is from our first meeting and of course she was a little nervous. The figure of a person is her son saying hello. This is very typical in a first meeting, where someone is really conscious of the viewers, they want to present socially, in an appropriate way. Later on, you can see those things diminish. The line quality is a little bit light, there’s not much pressure and the outline of the building is not quite well-defined. There is a sense of insecurity or tentativeness in her drawing. In terms of integration, the three elements are not necessarily connected to each other.
Post-therapy: The line quality is more confident. There is more pressure and detail. Even the movement, there’s activity, kind of running with a dog. It’s shifted the happiness of the initial drawing. Compared to saying hello to the viewer, her son is enjoying walking the dog. A pathway is connecting with the building and tree so it’s more integrated. And the path is directly leading to the very clearly drawn door, welcoming a person. The color use is more joyful. In the tree you see many colors and the trunk is also sturdy. Oftentimes in our profession, the tree is the unconscious self-image. It needs nurturing to grow and eventually it dies, just like us. It’s simulating the human cycle. When you look at this tree, that trunk is pretty solid and the branches are reaching out to the environment. So we know her attitude has shifted a bit, rather than insecurity.
Post-study: The previous two images had a lot of empty space. This one has not only one tree, but two trees, not only one person, but three friends. And two buildings. There is less of a sense of isolation. She’s drawing the whole community and this is exactly what she experienced in the art therapy sessions. You can see that the road goes way back and there is a foreground and background. There’s a spatial depiction that is much more sophisticated and in proportion. And three people are walking toward the building, maybe visiting friends, so it’s less self-conscious. The building has laundry hung, so there’s a lot of life and the tree has flowers. The door has a welcome mat and there’s a bicycle. Because of the neurological deterioration, they sometimes don’t see the details in the overall big picture. But this is a community that people actually live in—there’s so much more detail.
Photo credit: DrAfter123/Getty Images (top)