Toby Israel Ph.D.

Design on My Mind

Healing with Imagery: The Brain's Own Natural Bag of Visual Tricks

The next frontier in imagery-> brain-> healing?

Posted Apr 13, 2011

Hospital Electronic Art

Ten years ago, while walking down the stairs, my daughter fell ten steps, hit her head on a sharp edge and landed bleeding and twisted on the floor. She then convulsed and foamed at the mouth. Thank God she woke in the hospital and, remarkably, was just fine. I wasn't. For days afterward my mind kept replaying this horrific scene. Desperate to erase it, I concocted a kind of phototherapy for myself by substituting the fearful image of her tumbling down with a beloved photo of Sarah looking beautiful and happy. It worked. Thus began my interest in using visual imagery as a source of healing.

By reading, Invisible Warriors; Using Visual Imagery with PTSD by psychologist Beth Naparstek, I realized that, neurobiologically speaking, I had relied on my brain's own natural bag of visual tricks, since:

. . . the part of the brain that creates cognition and language takes a hit from the biochemistry of  the trauma experience. On the other hand the imagistic, emotional and metaphoric, and sensory avenues of the right brain are sensitized, hyperacute and overfunctioning. This is why survivors will fall into using it intuitively and naturally even if they haven't been taught to do so. (1)

Naparstek concludes, "It is a sweet irony that something as gentle and undervalued as imagery can carry so much clout for healing such a miserable tenacious and painful condition as post-traumatic stress. (2)

Thus increasingly, the military, many terrific artists, arts organizations, and designers are using the power of art and design to heal. Yet, especially in this age of tech wizardry, I wonder: What's the next frontier when it comes to imagery--> brain---> healing?

Climbing up to the top of the impressive mountain of arts and healthcare endeavors, I see a wagon train of pioneers exploring ways in which electronic media can enhance healthcare settings. Therapists such as those at Walter Reed National Military Medical Center are already using CAREN, a virtual reality machine (one of nine in the world) to create a whole virtual reality room to treat PTSD patients via exposure therapy using programmed imagery. (3) At the Children's Medical Center in Dallas, research indicated that using a plasma screen distraction in the waiting room with rotating art conditions (nature slide show, underwater aquarium scenes, and ambient art) (4) saw an increase in the calm behavior of children in their dental clinic by 7 percent and by 9 percent in their cardiac clinic.(5)

Hospital infrastructure and furniture manufacturers are also getting into the mix. For example, to accommodate such new technology, DIRTT Environmental Solutions (Do It Right This Time) offers a wall system that integrates with both the building and with technology such as LED screens that can display electronic imagery.

Given my use of personal, self-generated, healing imagery after my daughter's accident, the "Open Window Project" based at the National Bone Marrow Transplant unit in St. James Hospital, Dublin, Ireland is of special interest to me. An "ambient virtual window for bolstering wellness and healing potential during a hospital stay,"(6) it's meant to relieve the depression, anxiety and discomfort often experienced by those isolated during bone marrow transplant treatment. The project taps into patient's personal imagery as it video streams/projects onto their hospital room wall, a place chosen by the patient such as a window facing the patient's garden, a room in the patient's home, or a favorite hilltop view. (7) The project includes "Moving Windows," shots by artists with mobile camera-phones--images forwarded to patients that thereby also create communication between the artist and the patient. (8)

"Open Window" was the subject of a five year randomized clinical trail as part of a psycho-oncology grant awarded by the Irish Cancer Society. The research found that patients with access to "Open Window" showed a clinically significant reduction in anxiety. Their overall experience of bone-marrow transplantation was vastly improved. Following the success of the study, the hospital adopted "Open Window" on an ongoing basis. "Open Window" also is being implemented in other long term care centers in Ireland such as hospices, nursing homes and mental health facilites.

In my view, these wonderful initiatives will work best if not compartmentalized--if hospitals, artists, therapists, tech magicians, manufacturers and, of course, design psychologists collaborate together to invent ways that art, technology and hospital infrastructure can best deliver cost-effective, electronically displayed imagery with maximum therapeutic benefit.

For such a collaboration to be more than just a bandwagon approach, many crucial issues will have to be addressed and further researched:

• What are the physiological/psychological benefits of imagery electronically displayed art hospitals?
• Do the benefits of electronically displayed artworks differ depending on the type of artwork displayed i.e. photography, 2-D visual art, or video art in hospital?
• Can artists work in tandem with doctors to create digital artwork prescriptions that have a positive therapeutic impact on patients?
• How can such pioneering artwork be seamlessly embedded in hospital infrastructure to create an oasis by design that is cost-saving, therapeutic and . . . soulful?

1. Belleruth Naparstek , Invisible Heroes: Survivors of Trauma and How They Heal (New York: Bantam Books, 2004) p. 13. Naperstak goes on to write, "If a person has been deeply impacted by trauma, it's more than likely that he first needs to find an oblique route through the imaginal realm, using metaphor and symbolic language, to help him manage his symptoms, find a sense of safety, recontact his wholest self, and make language a viable avenue again." p. 13.

2. Ibid., P. 13. Of course, Naparstek was not alone in recognizing ways we can use the power of visual imagery as a bridge on the path to healing. Freud and Jung, particularly, explored ways to harness the power of metaphors (especially as made manifest in dream imagery) for use as a road map towards wholeness. In this regard, two books discussed in The Asheville Jung Center's internet seminar "Architecture of the Soul: The Inner & Outer Structures of CG Jung" (February 4, 2011) were The House of C.G. Jung by Andreas Jung, et. al., 2006 and The Red Book by CG Jung ( ed. Sonu Shamdasami ), 2009.

3. See Toby Israel, "The Military's Brave New World-Class Hospital" Psychology Today Design on My Mind blog (February 2011)

4. Catherine Mayer Ambient Art TM enabled those waiting to view a painting come to life using color, sound and tempo as it emerged, moved and changed before their eyes. The imagery also included creative open spaces to engage viewers and make them active participants in the story.

5. Research by HKS and American Art Resources.

6. Media Lab Europe: Human Connectedness Research Group, "Open Window" 

7. Ibid.

8. National College of Art and Design website: Research, "The Open Window Project" 

About the Author

Toby Israel is an environmental psychologist who studies design psychology.

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