< PreviousThe Case for the ArtsBearing high economic and social burdens, the millions ofpeople suffering from chronic neurological diseases andstress don’t have years to wait for new pharmaceuticaladvances, therapies or cures, nor should they have to.They shouldn’t have to pay out of pocket for expensivetherapies that improve their quality of life, functioning,and life outcomes when there is a ready solution: the arts.There is much promising evidence that a variety ofhealing arts and creative arts therapies can improvemobility, mental health, speech, memory, pain, andlearning outcomes, not only improving life for chronicdisease sufferers, but for those experiencing stressassociated with work, poverty, war and inequity. Thesetherapies are timely, responsive, and cost effective. Brain on ArtInteracting with the arts, either as beholder or maker,provides powerful experiences which in turn help buildour brain’s complex and vast neural network. We knowthat the brain constantly changes how it passesinformation between its neurons. This plasticity is a resultof the brain’s constant responses to its internal andexternal environment and experiences. This agility of thebrain underlies our ability to learn, remember and heal.Exposure to the arts, including the visual arts, creativewriting and poetry, music, architecture, dance, andtheatre, creates interconnectivity between different areasof the brain. Brain regions do not work in isolation—thestrengths of the connections build cognitive skills, predictlong-term outcomes in resiliency, social-emotional health,executive function, learning, and memory. The artsengage the whole brain and researchers seek linksbetween specific brain areas and the practice orperception of art.There is promising yet incomplete evidence forarts-based therapiesWhile indigenous societies have acknowledged thehealing power of visual art, dance, music, drama, andstorytelling for millennia, the western world’srecognition of the therapeutic benefits of the arts ismore recent. Its core purpose is far from foreign tomedicine, however. Hippocrates wrote, “The naturalhealing force within each one of us is the greatest forcein getting well.” The arts tap into that natural healingforce by unifying the mind and body and addressingboth biological and psychological symptoms ofdisease—managing patient symptoms while improvingquality of life.33 A 2005 report by the Rand Corporationabout the visual arts argues that experiencing the artsdoes more than improve an individual's life. Rather, it"can connect people more deeply to the world andopen them to new ways of seeing," increasing globalunderstanding, social bonds, and cohesion.34 In a recent review of the literature on the use of arts-based therapies in medicine published in the Journal ofthe American Medical Association, Khan and Moss(2017)35 describe a wide range of studies thatdemonstrate its “significant influence” on improving thehealth care outcomes and experience of a variety ofstakeholder groups, including patients, medicalstudents, and hospital staff. Therapies most commonlyused include music, visual arts, dance and movement,and writing. Broadly, creative arts therapies have beenused with a number of patient populations, includingpatients dealing with pain, psychiatric issues, andneurological disorders as well as military veterans withPTSD and traumatic brain injury (TBI). Research points to a number of benefits of arts-basedtherapies, including managing chronic pain, reducinganxiety, improving social functioning, mood, memoryand concentration, reducing fatigue, and improvingemotional wellbeing and understanding.36 Khan andMoss (2017) focus in particular on music therapy: “Music therapy programs have been found to reduceanxiety, pain intensity, fatigue, and opioid use inpatients with cancer. For patients with coronary heartdisease, music listening may have a beneficial effect onblood pressure, heart rate, respiratory rate, anxiety, andpain control. For patients with depression, musictherapy can not only reduce their depressive symptomsbut can stimulate social engagement in patient groups.Neurologically, music therapy helps improve gait ability,timing of upper extremity function, communicationoutcomes, and quality of life for patients whoexperienced a stroke. For patients with dementia, musictherapy has been shown to encourage recall ofautobiographical memory while reducing agitation andaggressive behaviors. Art-centered experiencesprovide patients with dementia and their caregivers ameaningful vehicle for nonverbal emotional expressionwhile these individuals develop a state of concentrationand pleasure derived from a rewarding activity thatcreates a sense of well-being.” Studies have also examined the role ofdance/movement therapy (DMT) in treating a variety ofbrain disorders. In one meta-analysis, researchers foundthat DMT is effective for increasing quality of life anddecreasing clinical symptoms such as depression andanxiety. Positive effects were also found on the increaseof subjective well-being, positive mood, affect, andbody image.37 While there are many studies on DMT, fidelity ofprogram implementation and rigor of research areissues in furthering the field. Researchers conducting aCochrane Review on the impact of DMT on dementiainitially identified 102 studies, screened 80 at title/abstract level and then reviewed 19 full papers, none ofwhich met the inclusion criteria.38 A second CochraneReview on DMT and depression cited “low number ofstudies and low quality of evidence” in finding it wasnot possible to draw firm conclusions about theeffectiveness of DMT for depression.39 In their “Systematic Review of the Evidence for theEffectiveness of Dance Therapy,” Strassel, Cherkin,Recent advances in brain imaging haveaccelerated our understanding of neuralprocesses. This explosion of knowledge hasbeen deemed the most exciting intellectualperiod since the Renaissance. We can now describe the brain as having onehundred billion neurons, and each of thoseneurons has up to one hundred thousandconnections, changing in response to ourexperiences from nanosecond to nanosecond.Brain imaging allows us to assign specificfunctions to many areas of the brain.Neuroscientists have charted an equivalentmap of the brain’s outermost layer — thecerebral cortex — subdividing eachhemisphere's mountain- and valley-like foldsinto 180 separate parcels. But neuroscience isjust brushing the surface still: Ninety-seven ofthese areas have never previously beendescribed, despite showing clear differencesin structure, function and connectivity fromtheir neighbors. Meanwhile researchers havebeen able to correlate various aestheticperception/ functions to specific parts of thebrain.FRONTAL LOBE Cognitive functions ofreasoning, executive function,parts of speech, voluntarymovement, emotions andproblem solving CORPUS CALLOSUM The corpus callosum ismade up of neural tissue,and it helps the two brainhemispheres communicatewith each other via signalssent through neuralpathway TEMPORAL LOBE Memory and perception as well asspeech and auditory functions (pitch,tone, selective listening) PARIETAL LOBE Information processing of movement,mathematics, orientation, recognitionand perception of stimuli (taste, touch,temperature) OCCIPITAL LOBE Visual processing THE LIMBIC SYSTEM The emotional braincontaining the thalamus,hypothalamus, amygdalaand hippocampus CEREBELLUM The cerebellum is associatedwith regulation andcoordination of movement,posture and balance The Case for the Arts11Mapping the Brain and Aesthetic ExperiencesStuten, Sherman and Vrijhoef (2011) recommended well-performed RCTs and observational studies were neededto “determine the real value of dance therapy.”40Studies examining the role of visual arts and expressivewriting are more limited, but have been shown to helpelderly or chronically ill patients and patients withcancer. These patients learn to express experiencesoften too difficult to put into words while reducing stressand anxiety.41 Promising approaches aid service members Military personnel currently receive creative artstherapies in a number of inpatient and outpatientmilitary treatment facilities as well as in connectedcommunity-based settings. Creative Forces, a uniquepartnership of the National Endowment for the Arts, theDepartment of Defense and the Department of VeteransAffairs, incorporates creative arts therapies into aninterdisciplinary care program for service memberssuffering from PTSD and TBI, as well as their families.Creative Forces recently commissioned a researchsynthesis and gap analysis to inform a research agendawith an emphasis on understanding the biological andpsychosocial benefits and comparative cost‐effectiveness of these interventions.42Much of the extant research cited in the report hinges onself-reported outcomes from service members andveterans, which include improvements in cognitivefunction, such as increased concentration, attention,memory, and organization, as well as reductions innightmares and trauma‐related arousal. Servicemembers participating in creative arts therapies alsoreport increases in positive emotion, emotionalself‐efficacy, and self‐esteem, as well as improvementsin social relationships, including with spouses andchildren. While research on the use of creative arts therapies totreat PTSD and TBI has existed for several decades,report authors concede “it is difficult to draw firmconclusions about the impact of creative arts therapies intreating TBI, PTSD, and co‐occurring conditions forservice members and veterans based on currentpublished literature, given the variability in creative artstherapy models, treatment protocols, and researchmethodologies.”Broader behavioral and learning outcomes arenoteworthy Beyond creative arts therapies, aesthetics enhanced byarchitecture and design are also important to health andwellbeing. Research has shown that patients have lessstress and anxiety, reduced need for analgesia, and areready for discharge earlier when their health care facilityprovides them with views of natural and urban scenery.43 The health care experience of patients and staff is alsoenhanced with arts-based therapies. Studies show thatexposure to the arts can offset the stress of working in ahealth care environment, including building rapportamong staff and patients and improving surgicalaccuracy and speed. Accordingly, medical schools andteaching hospitals are beginning to incorporateexpressive writing, drama, visual arts, and music therapyinto their curriculum as a way to improvecommunication, empathy, and clinical observation,among other benefits.44Hundreds of studies demonstrate the link between artsapproaches and improvements in academic and social-emotional outcomes.45 Students who are highlyinvolved in the arts receive better grades, have morepositive attitudes about school, and are less likely todrop out of high school. Importantly, given the growthof income-based achievement gaps, the differences aremost significant for economically disadvantagedstudents.46 In 2004, the Dana Arts and Cognition Consortiumconvened cognitive neuroscientists from across theUnited States to discuss and debate why arts training isassociated with higher academic performance—questioning whether higher performers are simplydrawn to the arts or if the arts indeed cause changes inthe brain that enhance aspects of cognition. Findings published in a subsequent report of theparticipating scientists’ research programs includedlinks between: high levels of music training and theability in both working and long-term memory;practicing music and geometry skills in children; musictraining and reading acquisition and phonologicalawareness; and acting training and memoryimprovement. As the report’s title, “Arts and Cognition: Findings hint ata relationship,” previews, report editors conclude thatthere are many opportunities for further investigation: “Many of the studies cited here tighten up correlationsthat have been noted before, thereby laying thegroundwork for unearthing true causal explanationsthrough understanding biological and brainmechanisms that may underlie those relationships.”47 A 2017 report from the Brookings Institution echoes thiscall for more research nearly a decade later. Reportauthors acknowledge that while research on therelationship between arts education and a variety ofacademic and non-academic indicators is expansive,studies are mostly small in scale and lack the quality datasources necessary to make strong statements aboutimpact and inform practice. Whereas arts education wasdeprioritized during the No Child Left Behind erabecause of a stringent focus on math and reading, theauthors frame a new opportunity under the 2015 EveryStudent Succeeds Act for states to establish a newdefinition of a well-rounded education, which shouldinclude a focus on measuring the impact of artseducation.48 A call for consensusAcross health, wellbeing and learning domains,researchers, practitioners and advocates alike havecalled for a more coordinated and rigorous researchagenda on the connection between arts and mind. Weknow based on promising evidence that there is aconnection between arts experiences, health, andlearning. Now, we must interrogate the neurologicalunderpinnings of observed changes to betterdocument, refine, replicate, and scale these responsiveand affordable treatments and programs. Becausecreative arts therapies enable biological, psychological,and psychosocial benefits, research must examine bothbehavioral markers and biomarkers together. The fieldof neuroaesthetics is well positioned to play this role. The Case for the Arts13How does the brain process aesthetic experiences?How does our knowledge of basic brain mechanismsinform our understanding of these experiences?These questions are at the heart of neuroaesthetics,an emerging discipline focused on exploring theneural processes underlying our appreciation andproduction of objects, art, and experiences includingperception, interpretation, emotion, and action.49 Neuroaesthetics explores the role of the arts, music,architecture, and natural environments as they alterand shape individual brain responses. The field hasdeep roots in cognitive neuroscience and thehumanities, but it is evolving as a highlyinterdisciplinary opportunity for research-to-practiceapplications in the areas of architecture, education,health, and wellbeing.The newness of neuroaesthetics is exemplified in thefluidity and variety in the definitions of the discipline.Overall, researchers are concerned withunderstanding the basic science of the aestheticexperience. Yet for some, aesthetics does notnecessarily involve beauty. “Aesthetics to me as abiologist involves responding to objects, events inthe external world, with emotion, not necessarilypositive. It has an emotional impact on you, and I'llcall that aesthetics,” says V.S. Ramachandran,50 whohas been described as the “Marco Polo ofneuroscience.”51 History and Definition ofNeuroaesthetics According to researcher Anjan Chatterjee, definitionsare complicated. “Philosophers spend a lot of timetalking about that. I would define aesthetics as a set ofexperiences that occur typically when people respondto beauty, but not only to beauty. There are otherinstitutional ways in which aesthetic context can beprovided, where even typically non-pleasurableemotions can become aesthetic. For example, peoplewill go to movies that are scary, even though in the realworld, they wouldn't approach those kinds of scaryexperiences. Given an institutional context, which is inthis case, a movie theater or a play or even looking at ahorrific painting in a museum, in those contexts, there issomething about that experience that then becomes anaesthetic experience.”52 Neuroaesthetics received its formal definition fromSemir Zeki in 2002 as the scientific study of the neuralbases for the contemplation and creation of a work ofart.liii This definition has expanded throughinterdisciplinary study of the intersection of the arts andmind, drawing neuroscientists and cognitive scientists,architects, artists, designers, musicians, psychologists,philosophers, clinicians, educators, art historians, anddigital media.In recent decades, advances in the imaging andmapping of the brain have galvanized neuroscience andits sub-discipline of neuroaesthetics. Coburn, Vartanian& Chatterjee (2017) succinctly describe the major recentmilestones in the field: “Around 2004, neuroaesthetics arrived at a pivotal pointin its development both empirically and theoretically.The first papers using fMRI to identify neural responsesto art and to critically review the neuropsychology of artwere published. In concert, and perhaps moreimportantly, early models outlining key cognitive andneural systems involved in aesthetic experience were setforth. Previous research had been primarily descriptivein that most studies generated qualitative observationalclaims relating facts of the brain to aestheticexperiences. The pivot initiated a shift from descriptivehypothesis-generating research to empirical hypothesis-testing studies and helped launch the discipline into themainstream of scientific investigation.”53 Another marker of the newness of this discipline is thatits pioneers are alive, working, and collaborating. Themany innovators in this broad multi-disciplinary field aretoo many to list, but represent fields includingneuroscience, cognitive science, psychology,psychiatry, public health, humanities, music, andeducation. TimelineHistory and Definition of Neuroasthetics1740,000 BCCave paintingsEvidence of humanity’s instinct tocreate art1404 - 1518Alberti and LeonardoDefine the biological basis ofRenaissance aesthetics 1852 - 1934Santiago Ramón y CajalGroundbreaking drawings of thebrain exemplify the marriage of artand neuroscience1988Semir ZekiWrites “Art and the Brain” and coinsterm “neuroaesthetics”2010JHU Brain Science InstituteHosts “The Science of the Arts”conference1801 - 1887Gustav Theodore FechnerPioneers the use of psycho-physics tostudy aesthetic appreciation1950s to presentAccelerated neuroscientific discovery New imaging techniques including CAT andPET scans, MRI, fMRI, EEG, and MEG2003Academy of Neurosciencefor ArchitectureFounded2016International Arts + Mind LabFounded010203040506070809Next >