Art and bioethics might seem like an odd combination of topics to write about, but it’ll make sense – I promise! I took advantage today of a (temporary?) easing of pandemic restrictions here in Montreal, to go into a bookshop for the first time in months. All but non-essential stores and services had been closed in this area for quite a while, and somehow books weren’t deemed ‘essential’ during that time.
I’d have thought that reading would be more essential now than ever, with everyone’s regular activities cancelled or shut down, but maybe that’s just my perspective. My visit this morning wasn’t to browse and wander through the aisles of books, the way I normally would, but rather to pick up one specific book; Drawing on the Right Side of the Brain (1) by Betty Edwards.
The only copy available was included in a two-part bundle, packaged together with the usually-optional companion Workbook (2). This may turn out to be a good thing for me, as the workbook seems to include simplified explanations and significantly more drawing exercises than the book. Whether it’s used by itself or in conjunction with the workbook, Drawing on the Right Side of the Brain is meant to be a book-based and self-directed drawing course.
This will be something of a challenge for me, for two reasons. First off, there’s the mild cognitive impairment (MCI) with which I’ve been living since the end of 2018. The MCI messes with my ability to concentrate and focus, makes it difficult for me to read more than a few pages at a time, and limits my capacity to follow written instructions and to remember what I’ve read. It also stole my beloved career in bioethics and my dream job from me, but that’s a story for another day.
As for the drawing itself, I’m not sure how that will go either; I have trouble holding a pencil or pen. My right hand and wrist have been significantly affected by the same rare disease that caused my MCI. CRPS is both an autoimmune and a neuro-inflammatory condition, causing neuropathic and arthritis-like pain in my hand and wrist, localized joint and skin issues, as well as full-body symptoms including fatigue, the MCI, and more.
My friends would say that I’m determined and persistent, and I’ll willingly admit that the word stubborn fits me as well! Either way, I’m hoping that I’ll be able to find a passable way to hold a pencil well enough to at least sketch out a basic scene. At this point, are you wondering why I want to learn to draw in the first place?
Last month I started learning to paint, using watercolours, and quickly realized that my inability to sketch out a scene makes it impossible for me to paint it the way I’d like to. Yesterday, for example, I tried to paint these four roosters from photos but wasn’t able to sketch out their proportions or positions accurately; each of them is ‘off’ in slightly different ways.
Landscapes and nature vignettes are what interest me most, so it will be very helpful if I can learn to sketch the basic outlines onto watercolour paper or cotton before I start to paint. If you look closely at a collection of watercolour paintings by professional artists, you might see very faint pencil marks under the paint; it’s considered to be part of process for anything but abstract watercolour art.
Holding a paintbrush is much easier for me than gripping a pencil, by the way, because I’m almost balancing the brush in my hand to caress the watercolour onto the painting. That’s one of the attractions of this medium for me, other than the fact that I adore the look of watercolour paintings. As a bonus, there are no smelly solvents to deal with either – only water.
Learning to paint with watercolours, and this book-based drawing course, are part of the one-of-a-kind and DIY (do it yourself) ‘art as therapy’ program that I’ve created for myself this year, using a mix of virtual courses, workshops, and self-teaching activities. And now this book set, as well.
Therapy
I want to specify here that I’m not an art therapist, and what I’m doing isn’t ‘art therapy’! My overall aim is to use personal art education and training as an informal self-directed adjunct therapy, to help manage the symptoms and impacts of my own chronic pain and cognitive issues. Actual art therapy involves psychology and facilitation, and is professionally guided experience:
Art therapy combines the creative process and psychotherapy, facilitating self-exploration and understanding.
Using imagery, colour and shape as part of this creative therapeutic process, thoughts and feelings can be expressed that would otherwise be difficult to articulate…
In Canada and the United States, art therapists must have at minimum a master’s degree or a master’s level diploma in art therapy before identifying themselves within the profession.
This graduate level education includes supervised clinical practicum hours (minimum requirement for all practicums is 700 hours and at least 350 of these hours should involve direct client contact), thus ensuring the safety of the client as well as professional liability for agencies and employers offering this form of therapy.” (3)
I don’t need any help expressing my emotions, feelings, or thoughts; you might have been able to guess that from this blog! The way I’m using the term ‘therapy’ in terms of my own DIY plan is more as a means to distract my brain from pain – and to keep my brain active on the MCI side. In terms of my pain self-management within this, I’m focusing on this one aspect:
Art therapy helps lower the perception of pain by moving your mental focus away from the painful stimulus.” (4)
Worlds collide
There’s an expression I often use, that “I love what can be learned when my different worlds collide”; usually referring to when my area of expertise in bioethics intersects with my ‘patient life’ as person living with chronic pain and a rare disease. In this case, bioethics overlaps with the arts and creativity in terms of chronic pain therapy.
What does bioethics have to do with art therapy? True art therapy, like so many other therapies for chronic pain – aqua-therapy, exercise therapy, massage, physiotherapy, occupational therapy, and others – are prohibitively expensive for most patients. Even when these therapeutic modalities are reimbursed, for example through group insurance plans, this type of coverage traditionally extends only to a portion of the overall costs of these programs.
The lack of accessibility of these non-pharmacologic options, other than for the most affluent patients, is an issue of equity and justice – placing it firmly within the realm of bioethics. Innumerable patients could potentially benefit from these therapies, but will never have the opportunity to even try them because of their costs.
My original DIY ‘art as therapy’ plan was to have begun in March 2020, based on an impressive variety of in-person courses and workshops, but of course these were all cancelled due to the pandemic before they even started. I had sought out free or low-cost activities offered through local community initiatives, with sessions lasting no more than an hour or two, to accommodate my difficulties with concentration and focus.
My area is home to a number of small municipalities which offer community-based arts and creative activities, all within relatively short distances of each other. This allowed me to pick and choose from the pre-COVID in-person offerings of almost ten different towns in creating my low-cost ‘art as therapy’ plan. I could also drive about an hour to the city centre area, providing an even greater range of activities – although it’s not a pleasant drive during our icy and snowy winters.
That original in-person ‘art as therapy’ plan included an art appreciation series, monthly art history talks, a weekly creative journaling course, a clay modeling workshop, a weekly creative writing class, ‘meet the artist’ sessions once a month at a community art gallery, a wide range of movies about art and artists offered twice a week through a local arts centre, watercolour painting instruction, and more.
I also purchased a one-year membership to the Montreal Museum of Fine Arts (MMFA), which then provided ‘free’ and in-advance access to each of their expositions. MMFA membership also includes exposition-related lectures, films, discussions, and more, so I’d added many of these events to my ‘art as therapy’ schedule.
This intensive schedule, with multiple activities each week, began as an ‘art as therapy’ plan to help me self-manage my chronic pain. Soon, though, I realized that all of this learning – and thinking about things in new ways – is what was being recommended to prevent cognitive decline. This could be a way to help prevent my MCI from getting any worse.
As with everyone else’s plans, though, my ‘art as therapy’ was derailed by the pandemic. With so many programs now being offered virtually due to the pandemic, including virtual museum tours and art courses, in January I decided to I rebuild my DIY ‘art as therapy’ plan; a ‘new and improved’ version, I suppose!
I’ve taken the same approach for the mostly-virtual ‘art as therapy’ activities, trying to schedule several each week to keep my brain active and learning. I’ve adopted something of a ‘use it or lose it approach’ to my brain, to my MCI. Something that’s very important to me in that respect is participating in live events, with personal interactions. Otherwise I’d have focused entirely on free online tutorials!
Unfortunately there are few free (no-cost) live sessions being offered, but I have been able to find some that are quite reasonably priced. If this is something that interests you, it takes a bit of digging but you can probably find some virtual activities offering reduced rates for local residents. If you don’t have cognitive issues, there’s always the book-based option; the book I just bought, for example, is available at my local library.
From a bioethics perspective, I feel that true art therapy should be accessible to those living with high-impact and debilitating chronic pain – along with massage, physical and occupational therapies, and other approaches that have a solid evidence base demonstrating benefits to patients.
Media coverage on the dangers of opioid therapies abound, but no solutions or alternatives are being put forward to lower patients’ reliance on them for debilitating pain conditions. Why not? Because these alternatives are simply out of reach for all but the most affluent patients, and neither insurers nor healthcare systems are willing to foot the bill. Not even here in Canada, where each of us pays for healthcare through taxation.
We don’t ask patients with kidney disease to cover the costs of their dialysis and home-dialysis related products here, but patients living with chronic pain diseases are expected to pay for the on-going and long-term adjunct therapies that they would require to adequately manage their conditions. Does that seem fair to you? It doesn’t to me, from a bioethics perspective, and that’s why I chose to write about the arts and bioethics today.
Physicians should be at liberty to recommend specific evidence-based adjunct therapies to individual patients who live with high-impact and long-term pain conditions, to reduce what public health authorities have taken to calling an over-reliance on prescription of opioid medications.
As always, thanks so much for stopping by. I wish you moments of joy today, and some time to do something just for you. Keep safe, and look after your well-being.
References
(1) National Institute of Neurological Disorders and Stroke (NINDS); the National Institutes of Health (NIH). Complex Regional Pain Syndrome Fact Sheet. Website. Updated 14 Oct 2020. Online:
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Complex-Regional-Pain-Syndrome-Fact-Sheet
(1) Betty Edwards. Drawing on the Right Side of the Brain: The Definitive, 4th Edition. 2013. Penguin Publishing Group. Paperback. ISBN-13: 978-1585429202. Details:
https://www.drawright.com/bettys-books
(2) Betty Edwards. Drawing on the Right Side of the Brain Workbook. 2012. Penguin Publishing Group. Paperback. ISBN-13 : 9781585429226. Details:
https://www.drawright.com/bettys-books
(3) Canadian Art Therapy Association. What Is Art Therapy? Canadian Art Therapy Association website. Updated 2020. Accessed 19 Feb 2021. Online:
https://www.canadianarttherapy.org/what-is-art-therapy
(4) Matthew Solan. Art therapy: Another way to help manage pain. Harvard Health Blog; Harvard University. 12 Jul 2018. Accessed 19 Feb 2021. Online:
https://www.health.harvard.edu/blog/art-therapy-another-way-to-help-manage-pain-2018071214243