Why art? The role of arts in arts and health

Why art? The role of arts in arts and health

This article is an answer to a report called "What is the evidence on the role of the arts in improving health and well-being?" The authors conclude that the arts have an impact on mental and physical health. Yet, the question of the role of the arts remains unanswered. What is and what is not an art effect? Recently, embodied theory has inspired articles on the perception of art. These articles have not yet received attention in the field of Arts and Health. Scholars in psychosomatic medicine have argued for an approach based on recent work in enactive embodied theory to investigate the connection between the body and the mind. The present article examines how key concepts in this theory relate to art. This leads to a discussion of art in terms of empathy-the relation between the internal state of the artist and the internal state of the beholder. I exemplify with a conceptual framework of musical empathy. Implications for health are addressed.

Introduction

In twenty nineteen, the World Health Organization for Europe published a report called "What is the evidence on the role of the arts in improving health and well-being? A scoping review". The report is an evaluation of the field of Arts and Health. It covers, directly or indirectly, three thousand studies. These studies demonstrate wide-ranging effects of a variety of art forms on a variety of health-related variables. Yet, the synthesis question of the role of the arts in Arts and Health remains to be answered. This is the main problem in the field. To present evidence of art-effects demands a definition of art. It is a matter of validity. This poses the field to the challenge to define art. Can this be done?

Discussing art definitions, the authors of the report mention cross-cultural characteristics such as value regardless of utility (as expressed in the phrase "arts for art's sake"), imaginative experiences for both the producer and the audience, emotional response, novelty, creativity, originality, specialized skills, and rules of form. The authors conclude that art is difficult to define. The reasoning results in a presentation of a list of art forms. This list comprises:

... performing arts (e.g. activities in the genre of music, dance, theatre, singing and film); visual arts, design and craft (e.g. crafts, design, painting, photography, sculpture and textiles); literature (e.g. writing, reading and attending literary festivals); culture (e.g. going to museums, galleries, art exhibitions, concerts, the theatre, community events, cultural festivals and fairs); and online, digital and electronic arts (e.g. animations, film-making and computer graphics).

Few of the art forms on the list meet the cross-cultural criteria, suggested by the authors. Crafts, for example, do not have "value regardless of utility" and are not always creative or original. What is the common property on this list, which justifies the label "art"? The idea of "arts for art's sake" separates art from the beholder. This undermines the idea of Arts and Health. The fact that we, humans of any culture, devote work, time, and costs to art, contradicts that there is nothing in it for us, contradicts that art does not resonate with our lives, contradicts that art is just an object in-its-own-right. Art is not for art's sake. Art is for our sake. The question is "How?"

Studies demonstrating change in health-related variables in art interventions are often taken as evidence of an art-effect. Are they? In studies demonstrating that music is beneficial for brain plasticity, the effect is attributed to the rich environmental input. The same effect can be seen in mice in well-equipped cages. Are the changes an art effect or a generic effect of stimulating activity? Do studies showing that choir singing has social health benefits indicate an art effect or do they reflect the mere fact that choir singing is a collective activity? Are benefits from going to a museum an art effect or a walking effect? Are increased heart rate variability and benefits for breathlessness in COPD patients, both caused by the deep respiration in singing, art effects? Is self-esteem following the ability to perform, an art effect? Is the distracting effect of music during medical treatment an art-effect? Is the cardiovascular effect from dancing an art effect? If art is defined by a list of art forms, all these effects are art effects. The evident risk following from the negligence of the validity problem is that the field reports supportive evidence of art effects inevitably compromised by confounding variables. This makes the question of the role of arts legitimate. If the field cannot separate art effects from confounding variables, it cannot answer the question: Why art?

A validation of the art effect requires operational specifications based on a "nominal definition" of art. A nominal definition, as proposed by the seventeenth century philosopher John Locke, is “an abstract Idea to which the Name is annexed".

Defining art is difficult for several reasons:

One. Art is disparate. Some arts are static, others time varying. Some engage hearing, others sight. Some invite participation, others contemplation.

Two. Art is creative. Artists invent new expressions, which do not fit definitions. If there is a recipe, there is no creativity. If it is specified, it cannot surprise. If there is a norm (as in the Soviet Union and in Nazi Germany), it cannot be oppositional.

Three. Art has a connotation of quality. A painting is not art just because it is painted. It is a matter of taste and judgment. A

benchmark for what qualifies as a work of art is the consensus in the "Art World" (artists, critics and the market). This indicates what is considered art, but does not specify what art is.

Can an overarching theory of Art and Health be formulated? The studies in the WHO-report invoke theories from "psychology, psychiatry, epidemiology, philosophy, ecology, history, health economics, neuroscience, medicine, health geography, public health, anthropology, and sociology, among others". The need of an overarching theory has been highlighted. Theoretical awareness is important for linking art to health, for research design, for validation of art effects, and for the progress and refinement of art-therapy. In the end, it is beneficial to the patient.

In what sense does art resonate with health? This question connects with psychosomatic health. What is the link between the mind and the body? The embodied theory of cognition is such a theory. It has inspired articles on the perception of art. Two anthologies have been published: Embodied Aesthetics and Aesthetics and the Embodied Mind: Beyond Art Theory and the Cartesian Mind-Body Dichotomy. Although this massive contribution is relevant to the question of the role of the arts in Arts and Health, embodied aesthetics seems to have slipped under the radar of the field. Kirmayer and Gómez-Carrillo have argued for an approach in psychosomatic medicine "that builds on recent work in embodied and enactive cognitive science".

The application of embodiment to art, is developed in Embodied Aesthetics. An article called "The Embodied-Enactive-Interactive Brain: Bridging Neuroscience and Creative Arts Therapies" has already been presented. This article is however based on the Bayesian approach to cognition and "predictive coding", which implies a computational understanding of the brain. This is at odds with enactive embodied theory.

The aim of this article is to answer the question "Why Art?" The approach is to present and discuss concepts developed in embodied and enactive cognitive science and present a "contextual framework"-"a network of interlinked concepts that together provide a comprehensive understanding of a phenomenon or phenomena". I will refer to research in cognitive science, psychology, philosophy and neurology. Considering the complexity of the neurological response to art, it is a giant step to frame these interdependences. We must take into account that there is "still a long way to go before we understand enough about how large numbers of functionally disparate, interconnected neurons generate and use dynamics to control concerted, whole brain activity".

This calls for limitations:

One. Art is discussed in terms of "aesthetical contextualism". This is just one of many philosophical art theories. This choice will be discussed and motivated.

Two. "Context" is discussed according to "enactive embodied theory". This choice will be discussed and motivated.

Three. The overarching concept "aesthetic empathy" is exemplified with music. This is because music is the most researched art form in neurology. Prerequisites for generalization to other art forms will be addressed.

Four. The theoretical level is limited to a "conceptual framework". This is a first stage of theoretical development.

Five. There is a lack of precision of concepts due to the semantic problem in the construction of a framework overarching behavioral sciences, neurology and philosophy. We have to settle with explanations of correspondences and correlates.