Art as a therapy for Parkinson’s project
Oliver Sacks, opening the First World Parkinson Conference in Washington in 2006 told how his friend’s Parkinson’s tremor stopped when he was painting. And Charles, a member of the Canberra Painting with Parkinsons group observed, ‘When I am sketching I forget about Parkinson’s and Parkinson’s forgets about me’.
The proposed documentary will examine the stories behind these statements to inform audiences about the nature of Parkinson’s disease, its effect on the sufferer and how it can be treated. Input from neurologists with high public profiles, such as Oliver Sacks, would be advisable for this segment. Oliver Sacks would also encourage interest from a worldwide audience.
As Chair of the Creativity and Parkinson’s segment of the World Congress, Sacks, drew unprecedented attention to the vital role of art as a therapy in America. But interestingly the most influential art groups for people with Parkinson’s developed independently in Italy and Australia in 1993 and 1994 and it was the founder of the Australian group who was invited to present her paper on Art as a Therapy for Parkinson’s at the World Congress.
The film project will explain how Nancy Tingey combined her insights into how Parkinson’s affects the way the nervous system works with her experience as an art facilitator to create the optimum environment in which to stimulate people with Parkinson’s to express themselves and communicate through art work. The project will refer to the work of the Meg Morris and Dr Robert Iansek who established the Movement Disorder Clinic in Melbourne, a world leader in the field. It was through consulting this team, working with her husband who has Parkinson’s and studying ways of using art as a therapy for Parkinson’s disease as a Churchill Fellow that Nancy learned the importance of taking ‘one step at a time’ and using clues, triggers and prompts to initiate movement.
Another component of the film will be the role of guided meditation, music, and other methods of calming the nervous system in encouraging creative expression. Reference would also be made to the curious phenomenon of creative ability being enhanced rather than inhibited in people with Parkinson’s.
The Canberra group has now been operating continuously for 14 years and has become the role model for groups in England and Canada as well as throughout Australia, indicating that there is potentially an overseas market for this project.
A particularly successful group which Film Australia might approach, as well as making use of the Canberra program, is the Melbourne group recently established by Anne Atkin who has Parkinson’s. Other resources are archives of original art work, records of exhibitions, radio interviews, and recordings of conference papers as well as video recordings of Painting with Parkinsons in action.
Ideally the project will include original footage which demonstrates the amazing transformation a participant undergoes from being unable to move, or having an controllable tremor, to painting fluently and imaginatively. Magic happens.
Script for video
MAKING A MARK
Art as a therapy for people with Parkinson’s disease
Creative therapies for neurological conditions
Introduction
To show how art activities can help overcome physical disabilities we have taken as an example the work of a group of people afflicted with Parkinson’s disease.
Parkinson’s is a physical disorder in which dopamine, a chemical essential to the smooth running of the nervous system, is in short supply because the cells which make the dopamine inside the brain have died. Due to a lack of dopamine, messages have difficulty travelling from the brain to other parts of the body. The body responds by behaving erratically, which is why Parkinson’s used to be known as the Shaking Palsy. Sometimes movements are exaggerated and at other times the muscles cannot move at all.
As the disorder is in the nervous system rather than in actual brain cells most people with Parkinson’s remain mentally alert. But because the disorder restricts facial expression so sufferers appear not to be responding to other people, and affects manual dexterity so that movements appear clumsy, those with Parkinson’s are often ostracised socially and feel vulnerable in group situations.
Feelings of anger, frustration and fear mount up, to the distress of all concerned. Added to this is the realisation that doors are closing. A career may have to end prematurely, relationships break down and many simple tasks we take for granted, such as getting dressed, become difficult or even impossible.
Sophisticated medication and operations help to modify the symptoms but causes remain unknown and there is still no cure. The struggle to maintain some quality of life is never ending so it is hardly surprising to find that depression is also a common feature of Parkinson’s.
In an attempt to deal in a small way with this deterioration in quality of life, an art group for people with Parkinson’s disease and their carers was founded by Nancy Tingey, an artist and art teacher whose husband has Parkinson’s, in Canberra, Australia in 1994. Through her group Painting with Parkinsons, and overseas studies on a Churchill Fellowship, Nancy discovered that benefits of art activities on neurological conditions such as Parkinson’s could be profound.
Social Benefits
The most obvious benefits are social. Group members comment on an increased sense of well-being and say the art sessions are the highlight of their week. One member (Jack) said he felt better for up to two weeks after painting with the group. For him the group also provided the protection of a sheltered workshop. Members could socialise in a relaxed atmosphere without feeling self-conscious. Gloria says “I live alone. This is my family.”
Gloria and Jack had painted before joining the group. For others, painting was a new interest. For example, Bob, a scientist whose career was severely curtailed by the onset of Parkinson’s says he would probably never have taken up painting if he hadn’t had Parkinson’s disease. To keep mentally active it is important for new challenges to replace those taken away. For Bob there was the added joy of discovering abilities he didn’t know he had.
Art activities provide a new form of communication to replace those affected by Parkinson’s. Speech may be difficult and body language limited. In selecting what to paint and how to paint it the artists express what is important about their lives and how they feel about their situation. Fears and hopes can be described in pictures.
Often people with Parkinson’s lose their ability to write, to ‘make their mark’. Through mark-making with art materials the individuality of each person is respected. No two original paintings are identical.
Philip is the only Australian to have flown with the Red Arrows in Britain. His paintings describe his pride and joy in this high precision work, the thrill and excitement of a life dramatically different from that he now experiences with Parkinson’s.
Each of us at some time or another feels misunderstood. With Parkinson’s frustration at unjust treatment can be intense, as articulated in this poem composed by the group, “I just found out…” describing what it feels like to be diagnosed with Parkinson’s. Gloria’s angry painting has the same title. Painting provides an opportunity to let off steam.
It also helps people escape harsh reality by visualising safe havens on paper. Here are paintings about special places by Ann and Sheila.
Losing yourself in the work helps take your mind off the illness.
Therapy for symptoms
Charles “When I am drawing or painting I find I forget about the tremor and the tremor forgets about me.” (Show vigorous “resting” tremor when anxious versus slight tremor when enjoying drawing. May disappear altogether for a while when absorbed in creative process.)
Cliff – going with the flow – thought laterally when coping with persistent tremor. When making rows of dots with pen and ink he said, “This is easy. I just hold the pen and the Parkinson’s does the rest!” (Humour – the best medicine… show Jack’s “Christmas Pudding; Canberra Fat Cat or Flora Neurologica”.)
In making a painting the ability to draw straight lines, to control materials, is not necessarily an advantage. A straight line is boring whereas a wobbly one, and varying thickness of marks, seem to reflect fluctuating emotional states, perhaps explaining why the art works of people with Parkinson’s are often exceptionally moving.
Philip battles with uncontrollable movements. Early paintings are characterised by violent lines and dark colours. They give way to recognisable shapes and glowing colours as he gains confidence and enjoyment in painting.
Freezing, inability to move
Listening to music or poetry, and relaxing through breathing exercises and other forms of meditation help the nervous system to function smoothly. As tension is released painting begins. Absorbed in the process, movements free up. One thing leads to another. Fred Astaire the dancer used to describe being nervous about playing a stroke at golf. If he took time to perform a few dance steps, defusing a tense situation by subconsciously keying into his creative abilities for a few moments, he relaxed and then returned to play his stroke with ease.
Fred Astaire didn’t, as far as we know, have Parkinson’s but I use his example to illustrate the process which takes placed when a person with Parkinson’s is so traumatised that they cannot move. Creative pursuits seem to defuse stressful situations.
What to paint
It follows that the creative activity should be stress-free for people with Parkinson’s. Worrying about being able to draw or ‘getting it right’ will be counter-productive. The most beneficial subject matter comes from within, from the imagination.
And how do you tap into that? How does the tutor or therapist stimulate creativity?
1. By using appropriate materials
- Materials which are easy to use and encourage rather than restrict the creative process.
- Finger painting.
- Mono printing, (painting freely on a non-absorbent surface then pressing paper over the work to make a mirror image) and other simple print-making techniques. (Show John Pratt’s program.)
- Thick handled materials such as felt pens or oil pastels which are easy to grip.
- Clay suitable for sculpting. Good for coping with aggression! (Show Peter Latona’s program.)
- Paints that spread magically without effort such as the wet-on-wet watercolour technique which art therapist Attlia Cossio uses all the time with her Parkinson’s art group in Italy, following Rudolf Steiner’s theories about the healing effects of gently spreading transparent colour. (Blue is known to be particularly calming for Parkinson’s.)
- The process of applying clear watercolours with rhythmic brushwork also stimulates pleasurable sensations. (see also silk-painting.)
2. By keeping distractions to a minimum and creating a meditative atmosphere
As it is particularly difficult for people with Parkinson’s to deal with several stimuli at once – they cause confusion in already fragile nervous systems – it is important that art activities take place in a calm atmosphere. This can be achieved by starting sessions with peaceful music, poetry reading, breathing and stretching exercises, and other meditation techniques.
3. By using cues and clues
If conflicting stimuli cause confusion it follows that creativity flows best when cues are offered one at a time. (According to Dr Meg Morris and Dr Robert Iansek who pioneered the Melbourne Movement Disorders Clinic, with time and help, people with Parkinson’s can do most things other people can if given the correct cues in the correct sequence.)
By making a mark on a piece of paper the stage is set for the next mark and so on. The creative process flows smoothly. One step at a time… (which explains why it is daunting for someone with Parkinson’s to be confronted by a subject to copy. Not only is the imagination, the subconscious, being suppressed but all the stimuli – the shapes, colours and lines in a composition – are having to be dealt with at once. Panic = stress = freezing.)
The sort of cues which can start the creative process include doodling, - one of the methods developed effectively by Ursula Hulme for her Conquest class in England – working on a simple colourwash background painted by another member of the group, or taking a line for a walk.
Free mark-making with the non-dominant hand or both hands, perhaps with eyes closed to music, encourages the acceptance of drawing as a non-threatening activity, as natural as breathing. For, interestingly, we know that as a result of research by Professor Lakke in Holland, the creative ability of people afflicted by Parkinson’s remains intact, in spite of the neurological disorder. With the right, sympathetic, setting, tools and cues, people with Parkinson’s disease are as able as anyone else to derive satisfaction and enrich other people’s lives through their art work.
Exhibiting work
The Canberra Painting with Parkinsons art group exhibits work regularly to help raise awareness about Parkinson’s disease. We have found that, although shifting the emphasis of the art activity from process to product, exhibiting adds to the sense of achievement, of contributing to society. It creates positive feedback which increases the sense of well-being.
In a way, art activities have the advantage over other creative pursuits, such as music and dance, wonderful though they are for Parkinson’s, in that the evidence remains, after the creative process is over, to remind the artist what the creative experience was like.
(The revised script should mention the importance of only one helper at a time working with the Parkinson’s person to minimise confusion. Ideally the same helper deals with the participant at every therapy session.
Rhythmic sweeping movements of arm and hand while drawing or painting have a beneficial effect, as a form of physiotherapy. Examples of such ‘loosening up’ exercises should be included in the video.)
Nancy Tingey
September 1998
Additions to the script for Making A Mark
Parkinson’s patients are 100% successful in learning new skills. Problems arise when the skill becomes automatic.
A possible reason why painting activity is successful for those who have not painted before diagnosis is that Parkinson’s patients respond well to new concepts which are challenging and focus powers of concentration.
Automatic responses are impaired by Parkinson’s disease therefore artists with Parkinson’s become frustrated by difficulty with pre-Parkinson activities. Changes in materials, style, subject matter or approach can overcome this. (eg Jack changing from pastels to coloured inks)
It follow that the introduction of new materials and techniques helps ALL Parkinson’s patients. Constant stimulation is important. New challenges mean more opportunities to develop powers of concentration. Keep introducing new cues and prompts. Vary the program.
(This information is based on observations recorded at the Kingston Movement Disorder Clinic, Melbourne.)
Nancy Tingey
February 1999