It is a well known fact that symbols hold meaning both in the conscious and unconscious mind. Through the use of images, symbols, or pictures, an organic form of communication is developed. The origin form of communication has the ability to provide more information than mere words. Through the use of visual arts, it is possible for individuals to active self-discovery which may not be possible when using spoken word. Hence, this makes it possible for visual arts to be used in therapeutic processes that are aimed at improving the condition of people mental health conditions. Through visual art therapy, a patient has the freedom to direct his art and express his emotions in a more independent and fearless way than through the use of words. Research has shown that a visual art is effective in helping patients manage stress and improve the symptoms of their mental condition. It has the ability to reduce the lack of sleep, lower nightmare cases, and reduce cases of startle response of waking up. Schizophrenic, bipolar, and depression patients have benefited from the use of visual arts in providing therapeutic solution to their conditions. Hallucinations and delusions are reduced by visual arts therapy. In the recent past, numerous studies have been conducted in an attempt to come up with explanations regarding cognitive abilities to investigate role of art in managing mental health problems. The studies have concluded that art has a huge role to play in the improving the mental condition of individuals. Through the use of different forms of art, the patients with mental health conditions can manage their mental status, and improve their confidence and positive judgment. In the different categories explored, photography has shown the most significant applicability in improving the state the health condition. It has the ability to create a coping mechanism for the patients. Some of the concepts that have been well-explored include photo voice through which the people with the mental conditions can express themselves and communicate with others through the use of photography and narratives. This study will aim to explore the quantitative data gathered on the individual experience of loneliness, and marginalization, and the urge to receive physical and emotional support in attempt to boost the self-belief of the patients with mental disorders.
Photography and mental Health
The word continues to be over-burdened by the treatment of mental health conditions. It is estimated that in the future, it will be one of the most expensive conditions to treat. There are numerous causes of mental health ranging from genetics, and man-made characteristics. One of the major man-made causes of mental conditions in the United States of America is gun violence which has become a common thing in America. It has been encountered in schools, churches, and many other public gatherings. The people who face and survive incidences of gun violence end up with psychological problems as they are traumatized by these unfortunate events. Over a long period of time, narratives have been used as the main source of improving the condition of the individuals as they tell the stories of their experiences (McKay and McKenzie, p5, 2017). As a result of the over usage of narratives, the practical interventions have not been included in the therapy process.
There are numerous studies that have concluded that the use of narratives is an effective approach as the nurses and other healthcare professionals have to use the method that includes the life stories of the patients including their medical history, and their demographic attributes. However, other opposing school of thought has come up and it claims that the use of narratives is not effective in the therapeutic process as it does not include a separation of the theoretical and practice parts. Despite this, narratives continue to the most dominant approach in the interventions applied by nurses and other healthcare professionals.
As a result of the current situation, it is clear that it is necessary to come up with a better and more appropriate practical approach to foster the personal expression of individuals with suffering from mental health conditions. It is also necessary to understand the experiences of the patients of mental health conditions. There is an attempt to incorporate the use of visual alternatives to assist in finding out the problems that face the healthcare professionals. Through the use of visual research, it is possible to understand more about mental conditions and how they can be cured or at least improved. Hence, the main objective of this study is to investigate how mental health is represented by the use of photography and forms of art, and also compare how the old and new techniques differ as therapeutic solutions.
Background of the Study
There are various types of visual arts that can be used in solving mental health conditions. They include photography, painting, and graphic designs. Photography is the main visual art that has been extensively applied in the healthcare sector as an intervention method in the therapeutic process. Basically, the use of photography for this case entails giving the mental health patients a platform through which they can express their feelings and tribulation without any reservation. Various features related to photo-elicitation designs are used in different healthcare facilities as therapeutic options. Through the use of photography, the patients can express their feelings, thoughts, past experiences without any judgment or any need for physical vocal application. Hence, this concept is different from the narrative concept in that the patient does not need to talk about their experiences. In many cases, patients who have undergone traumatic experiences have a problem relaxing the events or vocally expressing the incidents that they encountered. Hence, the use of photography in this kind of therapy provides an alternative to the traditional method of narratives that brings back memories of insecurity to the victims of traumatic events (Quinlan et al., p40, 2016).
As a result of the use of photography in the case outlines above, the healthcare professionals can easily gain an insight into the lives of patients who have problems expressing themselves vocally. The innermost feelings of the patients can be captured through the use of photography and other forms of visual art. When voices are included in the photographic expression, the resulting photo visual effect can result in a more understandable and detailed expression of the patients with mental health conditions (Mizock et al., p279, 2015). However, it is good to mention that the use of photography in solving the problems associated with metal conditions has not been fully exploited and there are numerous gaps when it comes to the research on the above topic.
A photo visual sessions start with an interview being conducted on the patient. In the interview, the patient is asked about their personal experiences in life’s This can include any information regarding their daily lives but the main purpose of the interview is to establish the moments that caused the trauma which in turn, restyled in mental health problems (Ramirez et al., p40, 2016). The patient or respondents are expected to share their information using photographs and other visual arts. By sharing the most relevant moments of their lives, the patients or respondents are able to face their worst fears and also achieve distigmatization moments. Through photography, they are able to express their creative aspects that were hidden by the trauma, depression, or any other form of mental condition.
The procedure adopted by the nurses and other healthcare professionals to use narratives as part of the intervention process emanated from the Ricouer’s philosophy. This philosophy outlines the procedures for establishing communication channels between the nurse and the patient which can be fruitful to the healing process of the patient. In his hypothesize in the hermeneutic circle; Ricouer’s established that the use of narratives is essential in the creation of meaningful conversations between the caregiver and the patient. Additionally, his postulate underlined the need for visual arts such as images, photographs, and graphic designs in easing and opening up the mind of the patient. This, in turn, could lead to possible progress in the mental state of patients with various mental conditions such as dementia, psychosis, and depression. However, due to the limited research available on the impact of visual arts application in the therapeutic process, narratives continued to be the preferred option for most nurses and other relevant caregivers. Therefore, this study made use of Roceur’s hermeneutics as the foundation of the research to establish the eligibility of narratives in the therapeutic process and the potential of photography and other visual arts in the healing process of mental health patients.
Pertinent issues through focused group discussions where photographic materials are analyzed. When the voice is incorporated in the visual narratives, the resulting photo visual effect can stimulate constructive and results oriented dialogue and storytelling. Most importantly photography provides a vast wealth of information through contextual and symbolic representation that evokes incredible self-evaluation that informs caregivers about an individual clients person experiences. Though there has been limited public participation due to the existing knowledge gaps on understanding the prognosis of mental illness. Little has been achieved with regards policy implementation to institutionalize best practices in mental illness management and decision making.
Typically every photo visual session begins with an interview where respondents are asked about their experiences and subsequently invited to share and discuss their photographs to stimulate self-reflection on issues that are most pertinent and relevant to them. The focus group discussions is then used to lobby health to stimulate social change with various policy makers and the community at large .Correspondingly, the pursuit of photography in mental health therapy emanates from the emancipator attributes of photo voice as an exploratory and de-stigmatizing medium for mental illness
Alternatively, the narratives basis for nursing praxis borrows a lot from Ricocur’s philosophy which outlines the communication channels between the caregiver and the patient. Similarly Ricocur’s postulations on the hermeneutic circle suggests that the concept of client narratives continues to play an integral part in creating meaningful conversations on the role of images ,photographs and other visual content in meeting meaning. Essentially, since there was limited literature on the theoretical underpinnings and philosophies informing the use of photography in aiding therapeutic management of mental illness such as psychosis, dementia and depression, there was a need to explore further to identify the appropriate theory to follow. Hence the study adopted the use of Ricocur’s hermeneutics as the primary pillar that revolved around the central meaning of narrative while also unraveling the potential mysteries behind every human action. Invariably, the underlying relation between Ricocur’s works emanates from the practice of nursing where nursing interventions are supposed to help patients with mental problems.
Also informing the need for an appropriate frame work to base the study’s argument leads to derivation of concepts to facilitate the comprehension of meaning in the context of the lives of individuals with mental health illness. Alternatively, some experts postulate the mental illness is influenced by factors such as race with incidences seemingly higher among people of black decent. Therefore the use of mere narratives especially among the black Americans often yield little success because these people have endured historical racism coupled with income inequalities .Such variables form a major contribution toward the mental illness and distress in black communities. Imperatively, stigma and other health care barriers have often led to missed opportunities foe care. For instance, 25% of the African American population seeks mental health compared to 40% of the white population. As such influencing health –seeking behaviors’ among the black population can be seen as failed.
Clinical counseling has proved futile in promoting the therapeutic interventions. Talks have proven ineffective and nurses are turning to more innovative ways to get to understand their clients .Thus these communities resorted to photography in a show of resilience and determination to be heard, recognized and appreciated both in clinical and non clinical environments .The use of photography can therefore not be understood in its role to empower people living with mental illness through a perceived complex imagery. People suffering from depression, for instance, have a way of turning their gloom into a peaceful amity as long as they can efficiently manage to express themselves through art. Moreover ,photography is seen as an opportunity to foster self love over self-loathing while the sufferer of mental illness succeed to find something they can relate to while discovering the inner beauty amidst misery and desolation caused by mental decease. An emerging deterrent to informed care and subsequent management of mental diseases is the ignorance that the community, care providers and health institutions have towards patients suffering psychotic episodes. Hence there is a serious need to unlearn misconceptions and re-educate the community on the salient needs of people suffering from mental problems because communication alone will never result in any milestones.
The present reality is that failure to understand the thought process of a mentally deranged individual leads to auxiliary problems such as institutionalized (confirming patients in need of care to an asylum), forced medication, gross sexual exploitation and depression. Through photographs, paintings and drawings anything perceived as too personal might be revealed as artistic works tends to navigate the intricate systems of mental health care. The use of art as a form of self –assessment helps therefore, to create awareness by stimulating conversations that would otherwise have gone unnoticed. The moment mentally ill patients are diagnosed with chronic disease, they often seek for a vent to let put their inner feelings since severe paranoia and insecurity sets in. Art therefore provides the relaxing and efficient means that these patients achieve positive therapy.
Role of Media in Therapy
The role of media towards art therapy act as a fundamental component of phototherapy in mental health management .Phototherapy materials are therefore interconnected intermediaries that act as a bridge between patients personal feelings, ideologies ,thought processes and concepts. Most importantly ,art therapy act as the external medium through which innate feelings are manifested in a more tangible ,physical and sensual form. There are effectively several sensory components of a complicated communication system that makes the concerned parties in the care provision chain understand their mandate better and influence efficient care intervention. Art therapists are therefore believed to be proficient in interpreting the drawings and paintings of mentally ill patients so as to draw the appropriate inference for interpretation .photography can ,therefore ,be deduced as a creative process in which the media components promotes creative expression among patients .In many occasions ,the patients respond s to art through a mutual connection that manipulates and encourages utility of photography for problem solving purposes and helps them reinvent the true reality of a conscious mind independent of thought . Art provokes the mind and invites a different sensory approach in conscious reawakening which might be tied to the clients perception of modern world. Phototherapy empowers the mentally ill clients to renew their potential ability in effecting emotions and cognitive capabilities.
Seasoned therapists aver letting mental patients interact with artistic materials goes a long way in making sure that they find meaning in creative thinking thus making their life more tenable and meaningful. Phototherapy enables mental sufferers to eventually make the connection between their abstract world and the reality through their personal experiences .Alternatively, the patients is getting more empowered to try new solutions for the life changes. Phototherapy also goes beyond the limited scope of medical care to provide the appropriate opportunity for the patients to reimaging an recreate new ways of expressing themselves using art materials before stimulating changes I their lives. Only then can meaningful and effective discourse on mental health between caregivers and their clients can become more successful in providing appropriate therapeutic measures. Consequently, therapists in their efforts to provide psychological counseling employ the use of varying materials while allowing patients to make their selections on which kind of visual art they wish to pursue as befitting their individual needs and objectives .According to contemporary research on the mental issue, the use of mental imaging and other forms of art presents unique possibilities through which the affiliated can get restitution. Art therapy, therefore, provides mental sufferers with a variety of options including cognitive, emotional and psychological solutions.
Additionally, the use different structures and functionalities of the brain also become activated to facilitate information processing during the engagement exercise with the different art materials which have been found to stimulate external and internal simulation of thought process. Interestingly, care providers are able to evoke the creative expression of internal memories that ordinary conversations cannot highlight. (Stickley et al., 2018) The resulting photographic presentation of internal images which are reciprocal to each other and collectively activate certain mental pathways for ultimate expression .Understanding the brain structure as an essential step towards cognitive empowerment essentially provide paths for evaluating and processing visual and motor information.
Mechanisms of Visual Art Perception
In the last two decades, exceptional progress has been made on the effects of visual arts and other forms of art in the human mind. This has been achieved due to the progress in scientific research and technology. Basically, it has been established that the brain patterns that arise from the perception of music is similar in most individuals. This is not dependent on the artistic creations experienced. Several parts of the brain are activated by the different works of at which in turn leads to aesthetic stimulation (Teti et al., p50, 2017). According to numerous experiments conducted in the field, there is a connection between the affective and cognitive development of aesthetic experiences. However, it is not yet known how the brain stimulation varies with the various forms of artistic expressions.
In the process involved in seeing and perceiving a photograph, painting, or any other visual art, the light enters the eye directly, from which point it is converted into an electrical signal. The electrical signal is the transmitted to the baring through the optic nerve. It is at this point that the image is reconsidered into its constituent elements such as depth, motion, color, and different forms. The cultural experiences of an individual play a huge role in his interpretation of a visual art or any other form of art for that matter.
Studies have been conducted on the emotional reactions of individuals after viewing picture, photographs, or images. Most of the studies showed that the facial expressions of individuals cause emotional responses. Additionally, the intensity of viewing and the length of interest are related to the degree of pleasure derived from the activity of the photographer. There were slight differences observed in the male and female participants but the affective expense was not at all dependent on the personality of the individual. The relationship between color and the emotions it exhibits has been explored in terms of psychological impacts. However, there is still insufficient evidence on how the tow aspects vary. Understanding their relationship is essential because the creation of therapeutic environments is highly independent on the relationship between emotional responses and color.
Photography as a Form of Art Therapy
Phototherapy has been defined as the application of photography in various setting that are therapeutic in nature following the instructions of a trained therapist with the aim of reducing psychological symptoms and also providing a solution of curing mental disorders. Phototherapy has been used since the mid 19th century where it was uses to cure psychiatric patients. In the 20th century, it was used as a means of therapy and entertainment for servicemen so as to get their minds off the hustles of the battle field. It was during this period that the practice was extended to civilian hospitals with an aim for caring for the individuals with physical or psychiatric disabilities. Veterans of war who were dealing with post traumatic stress were exposed to phototherapy to improve their condition.
Advantages of Photography
Most forms of art are not usable by the common adult. This is because most adults stop practicing artwork when they are children during the childhood development stage. Hence, for these adults, photographic provides a better option of art that is more adult-oriented. The use of photography has the potential to reduce the symptoms of mental disorders in adults as seen in most studies conducted over the years (Brady et al., p33, 2017).
An important [point is that the process of drawing can lead to heightened levels of anxiety as it has the potential to trigger unfavorable childhood experiences. Due to the fact that the drawing process is not appealing to most adults, a better option of visual art is used which, in this case, is photography. Despite the fact that photography is described as technical art that is demanding to the practitioner, it is the favored form of visual art that is used in the therapeutic process described in the text.
Proving the participant with a digital camera enables him to delete any photography that did not turn out as he planned when taking it. The participant can replace the deleted photograph by talking another one, and he can also subject a preferred photograph to editing by usi9ng editing software. Basically, digital cameras provide a huge variety of options for the users which make them suitable for obtain results from this study.
Disadvantages of Photography
As much as the use of digital photography is appealing and suitable for manipulation of photos, it also has the potential to hinder the participant in his progress. This is because the possibility of editing or even deleting process can reduce the emphasis on the content of the photo and instead replace the content with quality. It is tempting for the participants to chase the quality of the photos rather than the content which is what is required in this case. In case a film is use instead of digital cameras, the participants have to be careful and patient at the same time to ensure that they capture the moment that they need nit juts any random event that they can delete. Hence, it has the potential of introducing seriousness and concentration in the exercise.
The participant might also be bored by the consistent use of one item that is the digital camera. Hence, by using the camera, the natural expression of the participant can be affected. It is easy to lose focus when an activity becomes monotonous like clicking a camera continuously for several sessions. Consequently, there is a delay in the artistic expression of the participants when using a digital camera. This is because they have time to contemplate on the nature of their photograph and the perceived results that they might achieve in the process. There is a time gap between the time a participant talks about a certain emotion and when he actually takes the real image to express his emotions in that particular situation. As a result of this waiting period, the client may fail to capture the exact emotion that he intended as he is likely to forget or distort his original thought or emotion.
Methodology
The research explored the various contributions of visual arts when it came to achieving positive clinical outcomes for the patients with metal health conditions. It also evaluated how the application of visual arts improved the quality of healthcare provided, and how it expanded the level of skill and knowledge of nurses and other healthcare professionals. The review of the currently knowledge on the mechanism of art processing, perception, and relationship between emotions and at is covered in the study.
The study was conducted through a pragmatic approach from which various methods came up. The concept of pragmatism relies on honesty, truth, and concreteness. Through a pragmatic research, it is possible for the researcher to fiddle with the research design so that it can be compatible with the questions. Hence, several research approaches can be used in the same study by incorporating both qualitative and quantitative measurements. The combination of several methods in one study enables the researcher to deal with metaphysical questions that might prove to be problematic.
Mixed methods are applied in the study. The mixed methods refer to the inclusion of both qualitative and quantitative measurements. Quantitative measurement involves the use of figures and numbers to investigate variables. On the other hand, qualitative research is the collection of data in a natural way or in a natural setting.
Research Questions
The research aims to answer several question regarding the use art therapy especially photography, the symptoms of mental disorders, and art materials. The general research questions include:
1. How might photography reduce symptoms of various mental health patients?
2. What is the extent of the usefulness of photography and visual art in general in the therapeutic process of mental disorders?
Sample Size
The number of participants selected for this study was 15 adults who had cases of mental health disorders. Several mental disorders were included in the study as the participants were not suffering from the same condition. Adults were used in this study as they are more likely to have mental conditions. Additionally, adults are more likely to respond to artistic works when compared to children. The therapist in this case had identified the kind of materials or processes that might cause discomfort to his patients.
Research Design
The research design consisted of a mixture of qualitative and quantitative measurements. Questionnaires issued to the 15 participants were used to collect the quantitative data during the first session. The purpose of the questionnaire was to evaluate the cognitive, somatic, and behavioral aspects of the mental disorders experienced by the participants. The higher the level of scores for the different scales, the higher the effects of the mental condition on the patient. In the questionnaire, a Likert scale is used where the participant is asked to rate their agreement with a certain statement that the investigator asks. The lowest degree is zero while the highest is seven. The purpose of the questions asked in the questionnaires was to evaluate the experiences of the participants during the sessions. The qualitative data was collected through interviews and observation of the behavior and condition of the patients at various selected intervals.
Three therapy sessions were used in the study and it was selected instead of individual sessions due to the lack of sufficient time. The participants were required them to explore their emotions at various interval and then take photographs that described their emotional.
Time Line
The study was conducted over a period of three months. Most part of the first month was spent indentifying and recruiting suitable participants for the study. The sample of 15 members was further sub-divided into groups of three each to make it easier to obtain and evaluate data from all the participants. The group members held a meeting every week during the weekend for the last two months of the study. Most of the activities of the second month involved the carrying out of the sessions of visual art therapy.
Limitation of the Study
The main limitation of the study was that the researcher or observer had to be attentive at all times to observe the reactions of the participants in different situations. This posed a problem in that it was difficult to keep a keen eye on all the participants at all the time during the study. It is also possible that one or more members of the group of participants got bored with the routine used in the study.
Results and Discussion
After the data was collected and analyzed, the results of the study were obtained. In the results, it was found that most of the participants of the study enjoyed photography during the sessions that were conducted. They also strongly agreed that they were comfortable when using the photographic materials. When it came to the other question in the questionnaire, it was found that the use of photography enables the participants to reduce some of the symptoms associated with their mental conditions,. This included depression, stress levels, and anxiety. In most cases, the qualitative and quantitative measures show that the participants had a lower level of symptom exhibition when they were exposed to visual arts.
Another question in the questionnaire asked whether the participants experienced any increase in the level of anxiety after they were exposed to different forms of visual arts. From the results obtained from the filled questionnaires, most of the participants responded negatively to this question. Hence, it would be safe to say that the exposure to different form of visual arts did not negatively affect the stress and anxiety levels of the participants. When it came to the qualitative measures, the most important question the participants were asked was whether the use of visual arts and phototherapy helped them to gain confidence or express they better. From the results, it was found that an overwhelming 99% of the participants reported that the use of photography improved their confidence and their ability to express themselves.
Conclusion
The study involved the exploration of the impact of visual arts especially photography in the improvement of mental condition of mental health patients. 15 participants were selected for the study and three different sessions were designed for the participants. They were issued with questionnaires which would determine whether their levels of anxiety, stress, and depression were affected by phototherapy.
After the analysis of the results, it was found that the use of phototherapy had a positive impact on the mental condition of mental health patients. Most of them reported that they gained more confidence from the sessions and they were also able to express themselves better. Hence, it can be concluded that photography is applicable in the therapeutic interventions for patients with various mental disorders.
References
Brady, C., Moss, H. and Kelly, B.D., 2017. A fuller picture: evaluating an art therapy programme in a multidisciplinary mental health service. Medical humanities, 43(1), pp.30-34.
McKay, F.H. and McKenzie, H., 2017. Using Art For Health Promotion: Evaluating an In- School Program Through Student Perspectives. Health promotion practice, p.1524839917735076.
Mizock, L., Russinova, Z. and DeCastro, S., 2015. Recovery narrative photovoice: Feasibility
