Somewhere between art and mental health
To capture and restore the vital complexities of living we must go beyond epidemiology. Victoria University of Wellington's Annemarie Jutel explains the role of art in understanding mental health.
When we think about deeply-rooted health problems in our communities, we often turn to ‘evidence’ to solve problems, to garner support for initiatives and to develop strategic plans. Evidence is a fine thing, but it’s not the only thing. Yes, evidence shows how variables influence outcomes and provides us with ways of measuring the impact of what we do. What it doesn’t offer is ways of thinking outside the square, because evidence is, by definition, the square.
An evidence-based focus takes something we know, or suspect, and tests whether one approach will lead to a different outcome than another for the problem at hand. It’s about measuring whether something new will work better than the status quo. We need this kind of science. It is the way we can sort out whether a particular approach actually works, rather than is just presumed to work. It is a numbers-based, statistical approach reliant upon observation of complex phenomena. But numbers are just not enough. No one experiences their life as an assembly of statistics, diagnoses or interventions. Individuals are simply too complex and each too unique. To capture and restore the vital complexities of living we must go beyond epidemiology.
The arts provide new ways of thinking, not only about individual experience, but about social and cultural experiences of health. Reading a novel, for example, can take us inside our minds, but also inside the mind of the characters. It can transport us to other worlds, where we can find respite from the strain or trauma of our own lives. Even more, it can return human experience back to us, in all its complexity, subtly clarified, with ways of imagining myriad outcomes. The upcoming event Mataora: Encounters between Medicine and the Arts will highlight just how great the potential of the arts is for understanding our emotions.
No one experiences their life as an assembly of statistics, diagnoses or interventions. Individuals are simply too complex and each too unique.
The arts help us to find other ways of describing the very problems we are trying to solve. Do we, by using medical language to discuss emotion, place our feelings in a pit of pathology that keeps us shackled, rather than open to the normal experiences of sadness and nerves that we can welcome as important feelings that are part of being in the world? Seeking to remedy the scourge of depression and anxiety, we could turn, for example, to poetic thinking. Poetry provides imagery and effect, generating meaning beyond the words themselves. 'The black dog', 'the albatross', 'the darkness' say things about mood that 'clinical depression' simply cannot capture.
But possibly more than words, we need voice, a way of assembling words to explain how we feel, to ourselves and to others. A storyteller doesn’t simply list all the facts, they carefully choose and curate what matters to the tale they are telling. The story of anxiety is one told by weaving together experience and emotion. Looking even at our own stories helps us understand ourselves. It is not surprising that narrative medicine, and narrative therapies, anchor the power of stories in finding a way out of distress.
Countries such as Denmark have recognised the importance of the arts for addressing problems like anxiety and panic. They have implemented a programme called Kutlurvitaminer (literally, 'culture vitamins'), which places individuals who are on disability leave for mental health problems in guided cultural activities, such as visiting the city archive, attending theatre or orchestra performances, reading books and singing. Science can demonstrate the psychological and physiological benefits – increased secretion of dopamine, reduction of stress hormones, improved lung capacity – but it probably can’t capture the pleasure of being greeted at choir practice, the sense of belonging that comes from taking the harmony, and the giggle of the false note.
As we focus on finding ways around society’s most niggly problems, we’d do well to make a call to the arts and the humanities. The creative tools they provide us may just be the key.
Professor Annemarie Jutel is director of Mataora: Encounters between Medicine and the Arts, to be held at Museum of New Zealand Te Papa Tongarewa in Wellington on Saturday 12 October.