In the process of attempting to find a home for my photographs on the walls of hospitals, nursing homes, hospice centers, physician and dental offices I sought out evidence for what I already knew—that beautiful images can and do contribute to healing. What I found was fascinating and encouraging for serious photographers, amateurs and the public at large. Some of the more pertinent and useful findings are presented here in modified form, enough to demonstrate conclusively that art, and photographs in particular, significantly contribute to health and healing.

My primary source for what follows is A Guide to Evidence-Based Art, by Kathy Hathorn and Upali Nanda.

Art Is A Critical Component Of The Healthcare Environment

• “Hospital interior design features were the most common room features noticed by 380 participants in this study. Their comments relating to décor were often about the artwork in a room.”
• “Of the 2,000 hospitals responding, 73% reported permanent displays of visual art in the hospital. 32% had rotating exhibits, typically of art by local or regional artists. 96% of hospital arts programs were intended to serve patients directly… Benefit to patients was the primary reason (78.8%) given for having arts programs, noting them specifically to be a part of their mental and emotional recovery (72.8 %).”
• Of the hospital arts programs surveyed, 55% “focused on the hospital staff as a way of reducing stress and burnout, which is a monumental problem for hospitals.”

Research conclusion: “The evidence makes a strong case that art is a critical component of the healthcare environment, which can aid the healing process.” (Harris, McBride, 2002)

Evolution Favors Certain Subjects In Art

• “Richard Coss is credited as the first researcher to advance the theory that humans respond to art on an evolutionary level as well as an intellectual or aesthetic level.”

• “Humans are genetically predisposed to notice and be positively effected by smiling or sympathetic human faces.” (Ulrich and Gilpin, 2003). Ulrich has substantiated the above claim with respect to nature art with a preponderance of evidence on how access to nature (even nature in art) affects patients. He found that “postoperative gall-bladder surgery patients whose rooms had windows with views of a park had better outcomes than those patients whose rooms had windows with views of a brick wall. Patients complained less to staff, needed analgesic pain medication of lesser strength, and were discharged earlier.” (Ulrich, 1984).

• “In a study with postoperative heart patients in Sweden it was found that exposing heart-surgery patients in intensive care units to nature pictures improved outcomes. On the other hand, patients reacted in a strongly negative manner to abstract art.” (Ulrich, Lunden, and Eltinge, 1993).

• “In another preference study Eisen (2005) showed that children in hospital settings also prefer representational nature art to abstract art. In fact, contrary to common assumptions that children only like large cartoon-like or fantasy images, a study with patients at Memorial Hermann Hospital in Houston, TX, showed that children highly rate nature images with bright colors, water features, and non-threatening wildlife.” (Nanda, Hathorn, Chanaud, & Brown, 2007).

• “In addition to the preference for natural landscapes, Ulrich and Gilpin (2003) cite previous works by Ulrich (1993), Coss (1968), and Orians (1986) to stress how evolutionary theory is an indicator of subject matter that should be avoided, especially for highly stressed patients. These include natural elements and situations that may be perceived as dangerous or threatening such as snakes and spiders, reptilian-like tessellated patterns, large mammals staring straight at the viewers, and angry or scary human faces.”

• “Based on an extensive body of both scientific studies and anecdotal accounts, Ulrich and Gilpin (2003) have developed the following guidelines for appropriate art content in healthcare settings:
  • Waterscapes: Calm or non-turbulent water
  • Landscapes: Visual depth or open foreground trees with broad canopy savannah landscapes
  • Verdant vegetation
  • Positive cultural artifacts (e.g., barns and older houses)
  • Flowers that are healthy, fresh and familiar
  • Gardens with open foreground
  • Figurative art: Emotionally positive faces, diverse, leisurely

Themes Discovered In Kathy Hathorn’s Study

• Art makes patients and staff feel better.
• Art allows patients and visitors to focus on something other than than themselves and other people’s condition.
• Art contributes to the perception of a caring environment.
• Art makes the hospital less intimidating.
• Patients, visitors, and staff use favorite pieces of art to destress; particularly true for the staff.
• Prominent pieces of art serve as landmarks for patients and visitors.

Nature Art Promotes Restoration

• “Nature art (or art with views or representations of nature) will promote restoration if it contains the following features: calm or slowly moving water, verdant foliage, flowers, foreground spatial openness, park-like or Savannah-like properties (scattered trees, grassy undershot), and birds or other unthreatening wildlife.” (Ulrich and Gilpin, 2003, p.123).

Murals Provide A Distraction From Pain And Anxiety

• “Murals, as a distraction, resulted in a significant decrease in reported pain intensity, pain quality, and anxiety by burn patients.” (Miller, Hickman, & Lemasters, 1992).
• “Evidence from heart-rate recordings and questionnaires showed that stress in a dental clinic was appreciably lower on days when a large mural was hung at the back of a waiting room.” (Heerwagen, 1990).
• “Images of serene nature scenes mounted to the ceiling were shown to highly stressed pre-surgical patients on gurneys; this resulted in lower blood pressure.” (Coss, 1990).

Study Findings Reported In The Wall Street Journal by Laura Landro

• “With studies showing a direct link between the content of images and the brain’s reaction to pain, stress, and anxiety, hospitals are considering and choosing artworks based on the evidence and giving it a higher priority than merely decoration for sterile rooms and corridors.”

• “These are not just accoutrements or aesthetics anymore,” says Lisa Harris, a nephrologist and chief executive of Eskenazi Health, affiliated with the Indiana University School of Medicine in Indianapolis.

• “Anne Berry, 81, says, ‘It makes me think of flying.’ She visits the hospital for procedures and tests such as a mammogram and always takes time to look at the artworks. She has “white coat syndrome,” which makes her nervous about going to a doctor, but she says, ‘I have found the art and the environment at Eskenazi makes it less stress-inducing for me.’”

• “One 1993 study found that patients exposed to a nature image experienced less postoperative anxiety and were more likely to switch to weaker painkillers than those who viewed an abstract image or no image.”

• “A 2011 study found that nature images helped calm restless behavior and noise levels in two Texas emergency department waiting rooms.”

• “In the spring 2014 issue of the same journal, the Cleveland Clinic reported that patients surveyed on its contemporary collection—which includes abstract and nonrepresentational imagery by some prominent artists—reported a significant positive effect on their experience and on mood, stress, comfort and expectations.”

• “The aim is to take your mind away from the disease and replace the time you are losing inside hospital with some beauty.”

• “Some patients in the Cleveland Clinic’s survey reported they were ‘motivated to get out of bed to view the artwork.’ Patients with post-traumatic stress disorder and generalized anxiety disorder reported the most significant positive improvement in mood.”

• “The Mayo Clinic in Jacksonville, Florida, chooses art to create a ‘healing environment,’ says Chrysanthe Yates, director of its Lyndra P. Daniel Center for Humanities in Medicine.”

These studies and comments are significant for photographers whose intention is, at least in part, to produce images that have the potential for healing—by suggesting subject matter. Laura Landro’s finding that “Visual images positively affects stress, anxiety, fear and pain,” in hospital environments says to me that photographs can convey the same benefits in the home. As Linda and I have, I would encourage readers to select one or two of your most beautiful photographs to enlarge, frame and display in your home. If you don’t think you have some images that are suitable, take your camera to someplace beautiful—or find something or someone beautiful—and create.

References

Coss, R. G. (1990). Picture perception and patient stress: A study of anxiety reduction and postoperative stability. Unpublished paper, Department of Psychology, University of California, Davis.

Eisen, S. (2005). Artfully designed pediatric environments. Unpublished doctoral dissertation, Texas A & M University.

Harris, P. B., McBride, G., Ross, C., & Curtis, L. (2002). A place to heal: Environmental sources of satisfaction among hospital patients. Journal of Applied Social Psychology, 32, 1276–1299.

Heerwagen, J. (1990). The psychological aspects of windows and window design. Paper presented at the 21st Annual Conference of the Environmental Research Design Association, Oklahoma City, OK.

Miller, A. C., Hickman, L. C., & Lemasters, G. K. (1992). A distraction technique for control of burn pain. Journal of Burn Care Rehabilitation, 13(5), 576–580.

Nanda, U. & Hathorn, K. (2006). Current Research on Evidence-based Art Programs. Healthcare Design Conference. November 2-6. Dallas, Texas.

Orians, G. H. (n.d.).The Society for the Psychology of Aesthetics, Creativity, and the Arts: An evolutionary perspective on aesthetics. Retrieved Jan, 15, 2007 from http://www.apa.org

Reber, R., Schwarz, N., & Winkielman, P. (2004). Processing fluency and aesthetic pleasure: Is beauty in the perceiver’s processing experience? Personality and Social Psychology Review, 8(4), 364–382.

Ulrich, R. S., Lundén, O., & Eltinge, J. L. (1993). Effects of exposure to nature and abstract pictures on patients recovering from heart surgery. Paper presented at the Thirty-Third Meetings of the Society for Psychophysiological Research, Rottach-Egern, Germany. Abstract published in Psychophysiology, 30(Suppl. 1), 7.

Ulrich, R. (1984). View through a window may influence recovery from surgery. Science, 4647, 420–421.

Ulrich, R. S., & Gilpin, L. (2003). Healing arts: Nutrition for the soul. In S. B. Frampton,L. Gilpin, & P. A. Charmel (Eds.), Putting patients first: Designing and practicing patient-centered care (pp. 117–146). San Francisco, CA: John Wiley & Sons.