The art of healing
Art. We know it can nourish the mind, warm the heart and inspire the psyche. At Ohio State, many are experiencing its power to heal.
Critical thinking: Art analysis helps stimulate neural pathways, offering hope to patients who have lost cognitive function.
If not for her love of art, Tracie McCambridge might well have gone into medicine.
And while the pull of museum education was too strong, her desire to help others find health and healing never left. After joining the Wexner Center for the Arts as the educator for docent and teacher programs, McCambridge found a way to meld these loves.
The result was Art on the Brain, in which McCambridge connected survivors of brain ailment or injury with Wexner exhibits and used the analysis of art to stimulate neural pathways. McCambridge said it was her work guiding others through the step-by-step process of art interpretation that led her to ponder the impact of such critical thinking on those who had lost cognitive function due to traumatic brain injury, stroke, brain cancer or other ailments.
“I started thinking about how the critical-thinking process could move beyond one gallery experience and help people struggling with cognitive processes,” she said. “I thought there could be a way to help them re-create those pathways and neuron links.”
McCambridge took her idea to the neuro-oncologists and speech pathologists at the Wexner Medical Center, and in 2013 developed the Art on the Brain pilot with the support of the College of Medicine’s Medicine and Art Board. Through word of mouth, they attracted 10 patients (and their caregivers and loved ones) with injuries ranging from stroke to brain cancer to severe concussion with memory issues.
Over the course of an hour, the group would delve into art examples, examine their elements and take part in a brain-stimulating activity. Examples included blind drawing — looking at an object and not at the paper to help with proprioception (the sense of one’s limbs and their position in space) — and remembering and analyzing a dance following the performance.
“We only talked about maybe two pieces, but we really went in depth with each piece and had deep conversation,” she said. “The pilot happened with ‘Blues for Smoke,’ which was a really powerful exhibition with a lot of emotion. One of the things we tried to do was get people to think about their identity, how it shifted from who they thought they were. When you have a significant injury, who you were and your place in the world can shift.”
The project continued in 2014 with 11 new participants. McCambridge said the small numbers helped build connections.
“It was a safe place to talk about issues through the art,” she said. “Art held the edge of the conversation. It provided a forum to share experiences with others who could understand. It became a social support group for both the individuals with the primary injuries and the loved ones. I didn’t design the program expecting it to turn into almost group therapy. That was a pleasant surprise.”
That was certainly true for Nancy Snyder of Gahanna, who experienced a stroke in 2011.
When Snyder was released from her rehabilitation assignment after a year and a half, she lost the structure that kept her working toward improvement. Online puzzles and games helped, but Snyder felt she was losing ground. Then she heard about Art on the Brain.
“It got me back up thinking in ways I don’t normally think and seeing in different ways,” she said.
“And I did it with people like me. In rehab, everyone was together — somebody with a shoulder problem, an athlete with a knee injury. But this was all us; everybody there had a shared background. We were all different people there than we were before whatever got us there. It was huge not having to explain that.”
As she moves forward, McCambridge is broadening her approach by connecting with faculty who study disciplines such as mindfulness, meditation, gentle yoga, service learning and even Brazilian jiu jitsu.
She has plenty of anecdotes to show her program is working, but she knows the next step is to explore that formally. To that end, she co-authored a research protocol with Maurice Stevens, associate professor of comparative studies, seeking to examine the program’s results.
“One woman told me, ‘The last time I had a headache like this, I was back in therapy,’ but she kept coming every week, because it was working,” McCambridge said. “Something is happening, and it’s really special.”
Setting the stage for connections: Ohio State's Department of Theatre and the Nisonger Center work to quantify the success of the Hunter Heartbeat Method, better known as Shakespeare and Autism..
At first, the little girl sat on the edge of the group, showing little interest in the interactions before her. While other kids danced or played, she stayed still. She was reserved, quiet, antisocial.
Fast forward a few weeks, and that same girl was in the center of the stage, engaged in a game, giggling so hard she could barely say her lines. She shared her excitement with those around her, her eyes meeting theirs, her laughter infectious.
That progression might be expected in the average after-school program. But this small thespian was firmly on the autism scale, and that meant her behavioral changes bordered on revolutionary.
Proving this achievement can be duplicated has been the goal of Ohio State’s Department of Theatre and The Nisonger Center as they work to quantify the success of the Hunter Heartbeat Method, better known as Shakespeare and Autism.
Developed by Kelly Hunter of the Royal Shakespeare Company, the Hunter Heartbeat Method is a therapeutic intervention based around the rhythm of Shakespeare’s text, characters and storytelling. Hunter frequently uses “The Tempest” and “A Midsummer Night’s Dream” in her work, but she also has worked with “Macbeth” and “Twelfth Night.”
Children on the autism spectrum move through the plays with games that encourage them to make eye contact, take turns, imitate emotion, improvise, communicate and use humor, according to Maggie Mehling, a doctoral student in the Intellectual and Developmental Disabilities Psychology Program.
Hunter began working with children on the spectrum in 2002 and brought the Hunter Heartbeat Method to the Department of Theatre in 2011. (The department had begun partnering with the Royal Shakespeare Company two years earlier.) Her goal: to have her method studied and scientifically quantified through the university’s Nisonger Center, which creates programming for people with developmental disabilities.
A key component of the games is the “heartbeat hello,” said Robin Post, ’06 MFA, director of the campus Shakespeare and Autism program.
“The foundation of [Kelly’s] work is the rhythm of the heartbeat found in Shakespeare’s iambic pentameter,” she said. “We tap it out on our hearts and say ‘hello,’ after which each person in the circle takes his or her turn to say hello while tapping out the rhythm. Following this, facial expressions are introduced — a happy hello, an angry hello.”
Two actors model a game, then two more repeat the game portraying the characters anew. The children see that different people play characters in different ways and that no one way is correct. Then the youngsters participate in the games, reciting lines and using body language to explore and communicate through their characters. Each hour long session ends with a “heartbeat goodbye.”
A 10-week pilot evolved into a 42-week research study. The group included students from three schools and a learning center in the Columbus area.
“We collected data over one and a half academic years,” Mehling explained. “The data from the first half of the study indicates children participating made significant gains in social and communication skills in some measures. We saw them improve in social skills when compared with other interventions they are receiving.”
Post cited the example of one boy who was nonverbal when he joined, but started to speak some words as he grew familiar with the games.
“It was a total shock when things like that would happen,” she said. “We watched astonishing connections between child and actor, more eye contact and trust. [The children] discontinued self-injurious behavior over time. They enjoyed sitting and playing the games and came to enjoy one another. They became experts in making happy, surprised, angry and other facial expressions.”
Post said the rhythm of Shakespearean works makes them ideal for this type of interaction.
“The largess of Shakespeare’s storytelling makes for a wide range of communicative expression” that would not be possible with many other plays, she said. “There is huge expression available when portraying the characters of ‘Midsummer’ or ‘The Tempest,’” she said. “Expression is not subtle in Shakespeare’s plays. Additionally, the rhythm of the poetry seems to really resonate with children on the spectrum.”
Although the original research project is complete, Post followed it up with a Shakespeare and Autism service-learning course for undergraduate and professional students. The mission: to help them learn the approach and spread its outcomes further.
Meanwhile, Mehling is expanding the research to see why this innovative approach is able to connect so well with children on the autism spectrum and offer hope and support to families.
“But no matter what we find,” she said, “it does not change its value.”
Moving toward new abilities: For patients with motor skills diminished by injury or illness, movement is medicine.
Lise Worthen-Chaudhari, a professional dancer-turned-scientist, is helping patients recognize the beauty in that movement, even when performed by a body facing new physical limitations.
A research assistant professor of physical medicine and rehabilitation in Ohio State’s College of Medicine and alumna and affiliate faculty member in the Department of Dance, Worthen-Chaudhari, ’11 MFA, has studied biomechanics as well as dance. She combined those passions to develop a revolutionary new therapy that inspires physical rehabilitation via movement that creates art.
Through the Embedded Arts Project, Worthen-Chaudhari and her team work hand-in-hand with physical therapists, who assign specific exercises, such as balancing on one leg while drawing circles in the air with the other. A motion-capture sensor chronicles the work of the moving leg and relays it to a colorful trace on a computer screen in front of the patient. As the patient moves, a beautiful piece of art emerges.
“For people with neurologic issues — stroke, spinal cord injury or Parkinson’s disease, for example — movement is a potent form of medicine. But the thing they need to do to feel better has become frustrating,” Worthen-Chaudhari said. “Giving people the ability to make interactive art designs while they perform movement therapy shows them beauty and power in their movement. That’s motivating.”
Performing exercises in physical therapy can get tedious, she added. “So far, Embedded Arts data show that people are performing more movement during their physical therapy sessions — a higher dose of movement — and they stick with hard exercises longer, maybe five minutes instead of a minute and a half. So they’re building up endurance. People who have done the study say, ‘Please, can I continue doing this? Because I want to get better, and this helps me do the work.’”
In 2012, Tim Hickey of Columbus underwent chemotherapy that put lymphoma, liver cancer and bone cancer in remission. Down 78 pounds from his normal weight, he began to build his strength and stamina through conventional physical therapy before taking part in the Embedded Arts Project.
“For me, it was a tremendous help,” Hickey said. “I believe it definitely accelerated the process of learning to walk and regain my balance. It helps the recovery process because you’ve got instant feedback. When you get done, you know you’ve worked harder than just doing regular physical therapy.”
The medical field too often looks at art and dance as mood elevators in therapy and not enough as the therapy itself, said W. Jerry Mysiw, chair of the Department of Physical Medicine and one of Worthen-Chaudhari’s collaborators.
“The lessons that therapy can learn from dance make sense,” he said. “Our intent is to incorporate dance into the therapeutic process to facilitate rehabilitation and recovery. We believe that the arts can be used to help drive neuroplasticity.”
That remodeling of the neural system allows the brain to compensate for injury or disease, Worthen-Chaudhari said, adding, “The best way that we know right now to get the neural system to remodel, to rebuild, is to have people get lots of practice in the movements they’ve lost.”
The technology behind the Embedded Arts Project has been licensed to a Columbus-based startup company. The resulting product, Agile Arts, was in beta testing this spring and could be available commercially as early as this summer.
“We know that neurorehabilitation patients need to move to get better,” she said. “But moving can be hard. This arts technology doesn’t make the work go away, but it makes it more doable, more motivating. Interactive art designs are the spoonful of sugar.”