“A mastectomy is an amputation. I experienced phantom pain and itching. No one tells you about those things.” Lightweaver was diagnosed with breast cancer in September 2007, a few days before her daughter’s first Kindergarten class and four years after undergoing surgery and radiation for Lymphoma. She underwent a bilateral mastectomy that year and had reconstructive surgery in 2008. Through pre-cautionary testing, her doctor discovered she had the BRCA2 gene, which gave her a 50 to 85 percent chance of developing ovarian cancer by 70 years old. Not willing to take those odds, Lightweaver decided to have her ovaries removed in 2009.

© Corinne Lightweaver

Lightweaver was navigating the residual effects of two bouts of cancer, a major surgery, insurance difficulties and depression, all while trying to maintain a sense of normalcy in her household. Despite being a writer, Lightweaver struggled to get in touch with her feelings, even with the support of her writing group.

That all changed when she found art therapy. "I used to say, as many people do, 'Oh, I’m not an artist, I can’t draw a straight line.' But then I discovered straight lines aren’t as interesting,” she recalls. The sessions guided Lightweaver through intense changes in her femininity – before, during and after treatment. “It helps me access those unconscious feelings for healing. It is very meditational. It takes me out of myself.”

After fifty years without formal recognition, a new report from the World Health Organization (WHO) acknowledges the arts as a viable way to improve both mental and physical health. The 57-page report is considered the most extensive evaluation to date, summarizing the findings from 900 global, art therapy-centric studies and publications.

The report cites substantial bodies of evidence detailing the health benefits of the arts, in five broad categories – visual, performance, literature, culture and online. One section focuses on how the arts help people better manage noncommunicable diseases, like cancer. It specifically notes how children and adults can benefit from the arts while going through cancer treatment, reducing common side-effects like anxiety, fatigue and depression.

Jacek Pinski, an oncologist at USC’s Keck School of Medicine, says this recognition is incredibly important in converging what seems like two completely different disciplines – art and medicine. “Any support for art therapy is critical in order for us to really succeed and grow our research. Not only for cancer patients but patients with other diseases,” Pinksi says.

The oncologist went on to detail the physical, psychological, social and behavioral aspects of the cancer experience, also known as psycho-oncology. Evidence is slowly converging in favor of this discipline, which “treats the patient holistically,” Pinski explains.

© Lisa Chakrabarti

While this report shows that a global health influence is finally recognizing the healing benefits of creative interventions, art as a personal hobby must not be confused with art therapy. Dr. Esther Dreifuss-Kattan, a psychoanalyst, psychotherapist and art therapist at UCLA, explains that while the practice of art is always healing, “if you want to work through real issues, you need to work with someone who is trained.”

Art therapists often draw on Sigmund Freud’s psychoanalytic theory in their sessions. Freud believed that human behavior is the product of three conflicting levels of awareness – the conscious, subconscious and unconscious. Freud believed that if people released these repressed emotions and experiences, they could be cured of whatever is ailing them.

“Art therapy is a way to reach much more into your unconscious than you would just talking to a psychotherapist,” says Kattan. She uses Freud’s free association technique, where she asks patients to craft anything that comes to mind. To accomplish this, she’ll pose questions like: what’s inside your head? Or, how do colors communicate? This taps into the unconscious and makes “whatever has to come out, come out,” Kattan says.

Teresa O’Rourke-Shapiro, a former public-school teacher turned educational therapist, has also battled cancer twice. She did six months of chemotherapy to treat her stage 4 lymphoma. The treatment, though initially successful, completely knocked out her immune system. When the cancer came back a second time, Shapiro underwent a stem cell bone marrow transplant, which nearly killed her. “It brings you really close to death,” Shapiro says softly. “I never stopped practicing art therapy, even when I was in remission the first time. Sometimes you don’t really have words. It’s the process, not the product that guides you through.”

© Teresa O’Rourke-Shapiro

“Art therapy is very much process based and the therapist is trained to bring attention and awareness to the nuanced feelings that emerge,” says Zara Drapkin, a Berkeley based art therapist. She once had a patient who drew a self-portrait with their feet not touching the ground. After having a conversation surrounding the piece, Drapkin learned that the patient never feels grounded. “This was something they sub-consciously left out of their image but didn’t really understand until they had someone there to have a dialogue around it,” she explains.

While people can be deterred from engaging in art therapy due to lack of artistic ability, Drapkin says it’s often the other end of the spectrum which proves to be more difficult. “If you have art training, you might be leaning towards a product-based approach.” A person’s knowledge of materials or techniques can hinder their ability to reap the full benefits of art therapy, she explains. To combat this, she'll ask the patient to “finish a piece in five minutes or close their eyes. This allows the person to have a different relationship with art and escape their desire for perfectionism,” Drapkin illustrates.

With 30 years of experience as an art therapist, Paige Asawa agrees “the expressive therapies are not about artistic capability or aesthetics.” The magic, she says, comes when a patient frees themselves from the traditional aesthetic expectations and taps into their subconscious. “The best part is when the patient doesn’t really understand what they’re doing. Because then, we’re bypassing the conscious mind and the conscious image of what art is,” Asawa articulates.

Like most alternative treatments, art therapy certainly has its critics. “Science and the established medical professional world might look at art therapy as not very validated, unlike a solid science like prescribing medication or chemotherapy. People look skeptically at a lot of new ideas. Especially this, because it’s difficult to assess and measure,” Pinksi says.

Only eight states provide licensure for art therapists and each state has different licensing regulations (or none at all). Because art therapists lack official status and recognition in many states, society often belittles their technique, or groups them with closely related fields like social work, psychology or counseling. Becoming an art therapist, however, is no quick feat. Applicants must complete a master’s degree in expressive therapies and 1,000 post-graduate hours of supervised client contact in order to be considered a certified, licensed art therapist.

Despite his deep-rooted scientific background (a PhD in science and an active research laboratory at USC), Pinski sincerely believes “when you go outside of your field of research and think about something completely different and how it could relate, that’s when you spark ideas or inventions.” This mentality drove him and Asawa to launch the new Institute of Arts in Medicine (IAM) at USC.

The institute is developing research studies to assess the benefits of cancer patients using arts-based interventions. One trial will measure depression, anxiety and stress hormone levels in hospital patients receiving chemotherapy. The doctors will measure these levels before and after art therapy treatments. They will then compare the results of each patient group with the control group (the group in the study that does not receive treatment by researchers). They hope these results will bring more scientific validity to the practice of art therapy.

© Lisa Chakrabarti

Pinski goes on to explain that “stress causes the immune system gets weakened, which can lead to an increased risk of cancer or heart disease.” This form of escape into the art world, he says, “could potentially prevent diseases because of the psychologically calming effects.” In those who are already sick, stress can also adversely affect the course of cancer. Knowing this, practices like art therapy have come to the fore, enhancing a patient’s physical and emotional well-being, as well as overall quality of life.

“My mother was a Holocaust survivor. When she was in Nazi occupation in the ghetto, she provided poetry sessions for her friends to overcome the bleakness,” Pinski shares. While Pinski does not have background in art, it’s clear the synergy between creative interventions and psychology runs deeply within him. With determination in her eyes, Asawa stresses the importance of caring for both the physical and psychological aspects of illness. “They go hand in hand. If you’re not treating both you’re missing an opportunity.”