Art? Science? Maybe Both!

In Search of the Science Behind the Healing Powers of Art

By RON WINSLOW

Julia Strecher was 9 years old when she had her second heart transplant. Her body had rejected the first heart she received with particular vehemence: She went into cardiac arrest six times in two hours. As doctors struggled to revive her, she recalls, she could hear them debating whether to give up.

“I was trapped in my body,” says Ms. Strecher, now 18. “I was trying to tell people I was alive and not to pull the plug.” A few months after she went home with her second new heart, she began having nightmares in which she watched herself suffering cardiac arrest.

But then, she began writing down her thoughts about being helpless. Eventually she turned the details into poems and stories. “It was extremely emotionally healing and freeing,” she said. “It helped me relieve a lot of stress and provided a distraction from pain and depression.” The nightmares went away.

Ms. Strecher’s case seems a striking illustration of the healing potential of creative expression. But is it science? Can the power of the arts to soothe, transform and inspire be enlisted to treat—and perhaps even prevent—heart disease?

These are the questions driving a fledgling organization called the Foundation for Art & Healing. With the help of an eclectic group of researchers, artists and health-care providers, the Brookline, Mass., foundation is mapping out a research agenda intended to determine whether artistic expression could be a valid clinical intervention—along with exercise, healthy diets and medicines—for reducing the burden of cardiovascular disease.

“We expect doctors to ask us if we smoke,” says Jeremy Nobel, a lecturer at Harvard School of Public Health and founder of the organization. “Should we expect them to ask us, ‘Do you have a creative outlet?’ ”

The idea has already attracted notable supporters. Johnson & Johnson, the health-care giant that markets health and wellness programs, and the U.S. unit of Philips Electronics NV are early corporate sponsors for the foundation. Laurel Pickering, executive director of the New York Business Group on Health, is an adviser.

“It could be an additional tool in our pocket to improve health outcomes,” Ms. Pickering says. But “the business community, in order to support this, is going to have to have some evidence that it does work.”

There’s no lack of evidence linking emotions and heart health. A 2004 study known as Interheart that involved nearly 30,000 patients in 52 countries is just one example. It found that “psychosocial factors,” including depression and stress, were as strong a risk factor for heart attack as high blood pressure and nearly as important as diabetes.

Yet there are few remedies proven to reduce heart attack and related risks by alleviating emotional maladies.

Enter the arts. “By engaging in dance, poetry or music, people are likely to initiate processes that help them manage stress, reduce negative mood states and perhaps change behavior that we know impacts cardiovascular risk and recovery,” says Joshua Smyth, a psychologist at Syracuse University who is another adviser to Dr. Nobel’s project. That’s the theory, but hard evidence is lacking.

Some studies are intriguing. New Zealand researchers asked patients with congestive heart failure to draw pictures showing what they thought their hearts looked like. Those who portrayed their hearts with the most damage turned out to have worse outcomes. That raised the possibility that doctors could use drawings to help change patients’ views of their disease and perhaps alter their course for the better.

Just last week, Italian researchers reported in the journal Circulation that blood pressure and respiratory rates can synchronize with music—increasing, for instance, during crescendos and coming down during pauses or decrescendos. The finding could help guide the use of music as therapy for heart and stroke patients. Other research has shown that music helps prolong exercise by distracting participants from pain.

Even before she began writing about her experience, Ms. Strecher, who told her story to a group of artists and health-care providers Dr. Nobel convened in New York last week, played music on a keyboard in her hospital bed and drew pictures to distract her from her fear and post-surgical pain. About five years after her transplant, she wrote a 2,250-word essay called Winner’s Choice that she says helped put her ordeal into perspective.

In one passage describing her feelings of loss of control, she wrote: “She never saw anyone but her family and she never had a good dream. Every night she died. Every night she fought. Every night she was helpless.”

In another place, she wrote: “She had waited so long to know what she fought for. She had fought so hard and it was worth every drop of blood. ...There would always be blood and pain but she had won.”

The essay enabled her to turn her experience “into something that would later drive me to make the most of my life,” she says. Ms. Strecher just graduated from high school in Ann Arbor, Mich., and plans to enter nursing school in the fall.

Though she makes a strong case, Ms. Strecher also reflects a bias that Dr. Nobel and his colleagues worry about as they seek to establish the science behind art’s healing impact: Examples like Ms. Strecher, whose mother is an art teacher, typically are about people already comfortable and skilled in the arts. One hurdle is determining how to make artistic expression work for people who have little experience painting or listening to poetry or who are intimidated by the process, Dr. Smyth says.

Another, bigger challenge is to extend art’s potential beyond helping individuals and make it a resource that reduces the cardiovascular-disease burden on society. “This isn’t a new cardiac-imaging technology,” Dr. Nobel says. “Many of the things we’re talking about are free or close to free.” All the more reason to understand their impact, he says.