How art therapy research is changing the world (part 1)

Girija has conducted ground-breaking research on the therapeutic benefits of art and making for emotional wellbeing and resilience and the role of artmaking in modern society. Her work has significantly advanced the use of arts-based intervention in healthcare, and the influence of her publications has made her a leading figure in the field, with the publishers Taylor & Francis recently naming her as one of the top 100 women in science.

One of your areas of expertise includes the physiological and psychological health outcomes of visual and narrative expression. What was your journey to this area of focus?

I’d love to say there was a clear path, but when faced with changes or life journeys, I’ve always tried to find a balance between choices that were fulfilling and could also pay the bills. As a woman, it’s essential I am financially self-sufficient, and as a human being, it’s important that I feel I am doing something useful in the world. So, my journey has consistently straddled multiple disciplines.

I love science, the systematic thinking leading to new findings and discoveries, and the joy and fulfilment of creative expression. I was unwell as a child and used drawing to entertain myself and communicate with others. Even after decades of working in this field, I consistently see those fundamental qualities of the arts as a space and sanctuary for ourselves and a bridge to communication.

There have been times when arts and design have been at the forefront of my life. I was a professional designer for a few years and did my undergraduate degree in textile design. I have a political and personal interest in fabrics and textiles as a form of women’s expression, primarily women’s unseen, unheralded expression. But this idea of arts holding parts of ourselves – both in distress and celebration – is a consistent thread. As a designer, I was frustrated that so much depended on whether something sold, not what it meant to people’s lives, and I decided I didn’t want to be held hostage to that constraint when I felt like there was more to human expression, more to the arts. So, I went on to do a degree in art therapy.

After my degree, I wanted to continue researching art therapy. However, at that time there was no PhD specifically in art therapy, so I completed my Doctorate in Education, exploring the narratives of families with depression.

My focus also came from a personal interest, as I come from a family with a long line of individuals who have struggled with anxiety and depression. My research enabled a better understanding of my roots and history, along with the universality of mental health struggles. These experiences vary by culture and context, but we are all human beings with (mostly) 23 chromosomes, so there are many similarities.

I continue to be intrigued by asking ‘What are the things that shape us, biologically, physiologically and psychologically? How might we better understand the role of the arts in helping us as human beings to cope with and live life fully?’

You mentioned there weren’t any PhD programmes in art therapy at the time, so this must have been a real leap of faith for you.

The struggle to sustain working in the arts is real. I see the ease with which people who are in the natural sciences find jobs. Especially in the US, work life tends to be technologically focused, and there are always opportunities for science and technology. But at some point, you must live with yourself and do right by yourself, and I have experienced first-hand what my life is like with and without art.

I know it’s not for everyone, but everyone has an expressive need. It may or may not be visual arts and it might be other areas where aspects of yourself come out, and this outlet becomes increasingly important as we age. The more you focus on livelihood or jobs and suppress these unique self-aspects, the greater are our struggles in later life to be self-regulated and emotionally happy.

So, yes, it’s an occupational hazard – I always had to explain what I do. For a few years, I was an education researcher because I was tired of explaining myself. Then I realised I was paying a cost in making choices that didn’t suit me! So, I thought ‘You know what? If it means that I have to explain myself every day, I accept that price because I love what I do.’ I want the world to know and empower itself around the power of creative self-expression, and I’ll do what it takes to do those things.

In your work, you emphasise the importance of effectively communicating research to the public.

That is becoming more of a priority for me. There are so many people who don’t know how they can empower themselves or seek help in a way that is not traditional verbal psychotherapy. Even 200 years ago, we used to be actively making and doing. We need to recognise that this is how our brains are wired – to make things and do things and actively problem solve with our embodied selves and be very sensorially engaged.

I think one of the more damaging outcomes of the pandemic was people thinking they could live by themselves, online, digitally and in a culture where people consume other people’s creations instead of creating themselves. And I don’t mean you need to be creating paintings every day, but even engaging in physically creative expressive activities we can do to take care of our spaces are acts of creation. When I share this insight around creating more and consuming less as essential to our health (knowledge/awareness/understanding?), more and more people come back to me and say ‘Thank you, I went back to things I used to do as a kid’, or ‘I started dedicating time each week for creative work that is purely for me.’ These are everyday, empowering outcomes. People also say ‘I went to an art therapist because of what you shared with me, and I want my child to become an art therapist because I’ve seen how much it has helped them through their medical or emotional struggles.’

We must allow people to feel empowered and not just feel that artistry is only for professional artists. My message is always ‘Go dance, sing or make art with others.’ It will help you feel like you belong, it will help reduce loneliness, it will help you feel safe – there are so many benefits.

In your research you also explore the benefits of consistency or familiarity with creative expression for wellbeing. Can you tell us more about this?

There is an important element of consistent practice. If you want to lift a heavy object, you train to lift it, and when it comes time you’ll be able to do it, but if you’re not trained, you will hurt your back, right? So, I think of creative practice as a preventive practice.
We’ve seen this in one of our studies, where we offered a session with healthcare providers, caregivers, family members and professional caregivers. We found that those who had some familiarity with, in this case, visual expressive techniques showed better outcomes.

For example, when you’re in distress and try an expressive activity, it may or may not be as helpful as if you’ve actively made time and recognised the role of expressive activities for health and wellbeing. A consistent creative practice ensures that when you face challenges, you and your toolkit are ready.

In your Taylor & Francis YouTube video Ten people whose research changed the world, you describe the brain as more than just a computer, but an incredible creative machine we use for processing and predicting. However, you suggest we don’t maintain or ‘oil it’ as effectively as we could.

We are wired to be imaginative. That force doesn’t go away. It might get rusty, but it doesn’t disappear, you cannot destroy it.

We hurt ourselves when we use our brain mainly for negative outcomes, such as only imagining worst-case scenarios. There’s a great quote I love: ‘The optimist creates the aeroplane, and the pessimist creates the parachute.’ Our brains are always imagining possibilities, and when we use that to some productive outcome, it takes us away from focusing on the negative and feeling anxious – which, as we know, is increasingly prevalent in society.

In your work, you also consider the relationship between art therapy and the arts in health. What do you believe they bring to the table individually, and how do they complement each other or differ?

Unfortunately, we think that art therapy and arts in health are in competition, but we are all marginal professions who absolutely could work together.

The distinction I make between art therapy and arts in health is with the home improvement analogy. There are things we can do ourselves in our homes. We can clean it, replace light bulbs, paint walls and fix furniture, but if something is wrong with the electrical or plumbing system, we can do more harm than good by trying to fix it ourselves.

So, you need a credentialed, licensed professional to take care of things that have needs at a deeper level than is visible. The deeper needs are fewer and far between; not everybody needs a therapist. It’s great if you go through therapy. Therapy leads to a deep understanding of self. It leads to improved problem-solving that is adaptive rather than maladaptive. Art therapists, as credentialed mental health providers, can offer the parts of the arts related to wellbeing, in addition to those aspects pertaining to serious therapy.

Arts and health invite us as human beings to reconnect with our artistic roots and our creative brains. Arts and health can be receptive where you see, watch and listen to things, which is typically how most people engage with the arts in the world. They go to a museum, a show or a performance. Some arts and health initiatives also operate a facilitative or expressive aspect, for example singing together, participating in a drum circle or creating a mural together. All of these have value in terms of connecting or through the fulfilment of working with your hands or your body.

I’m an active artist myself. I know how artmaking helps me, but I also know it’s not the only thing. It’s important to recognise professional differences and limitations. I know of folks who call themselves art therapists with no specific art therapy training in countries where there are no regulations, and I’ve seen how quickly they hit the wall when faced with a clinical case and don’t have the necessary skills or experience to respond. It’s a real thorny problem because people think art is for everyone, that even kids can do it – and it is for everyone. However, there are some real limits when practitioners without prerequisite art therapy grounding are confronted with individuals with significant clinical needs.

I heard a great example from a colleague of how we can frame the different benefits between art therapy and arts in health through how we use spaces. They offer arts and health services in community spaces and art therapy at the bedside because the bedside space is related more to therapeutic and psychosocial needs. In contrast, arts in health is more about community building and joy and bringing the pleasurable aspects of art into spaces with people who might otherwise be struggling to experience positive emotions.

Part 2 coming soon

You can continue reading about Dr Kaimal’s work in part 2 of this interview in our next issue of InSight, coming in Spring 2025.

References

• Kaimal, G. (2022). The expressive instinct: how imagination and creative works help us survive and thrive. Oxford University Press.
• Hommel, S., & Kaimal, G. (Eds.). (2024). Arts-Based Approaches to Promote Mental Health and Well-Being: Supporting Children and Families in Conditions of Adversity. Taylor & Francis.
• Making art is a uniquely human act, and one that provides a wellspring of health benefits, Girija Kaimal, The Conversation, 2024
• Exploratory fNIRS Assessment of Differences in Activation in Virtual Reality Visual Self-Expression Including With a Fragrance Stimulus, Kaimal, G., Carroll-Haskins, K., Topoglu, Y., Ramakrishnan, A., Arslanbek, A., & Ayaz, H, Art Therapy, Journal of the American Art Therapy Association (2021)