EMERGING PRIORITIES

Art and wellness: the importance of art for Aboriginal peoples’ health and healing

Prepared for the NCCAH by Alice Muirhead and Sarah de Leeuw

Introduction

Upon first glance, the creative arts and health may not seem to have much in common. With greater scrutiny, however, creativity and human well-being – especially the well-being of Indigenous peoples – can be seen as having a long and productive relationship that holds tremendous promise for addressing persistent health inequities between communities and populations.

Patterns of disease and the strategies for understanding and intervening into these patterns are changing around the world. Changes in understanding and interventions are bringing attention to broad and persistent divisions between people’s health, divisions which are especially acute between Indigenous and non-Indigenous peoples. In addition, the causes and outcomes of disease are being re-examined within social determinants of health frameworks, creating new opportunities for research and leading to new treatment and prevention approaches. For instance, instead of fighting infectious disease through prescriptions or individualized interventions, health professionals are being called on to address and manage chronic conditions such as diabetes, heart disease, and cancer through population health approaches that act upon the broad range of factors and conditions that influence health (World Health Organization, 2005). In addition,

sharing knowledge · making a difference partager les connaissances · faire une différence ᖃᐅᔨᒃᑲᐃᖃᑎᒌᓃᖅ · ᐱᕚᓪᓕᖅᑎᑦᑎᓂᖅ issues such as depression and addiction period of relatively peaceful, equitable placement of items of cultural expression are being increasingly recognized as co-existence between Europeans and into non-Aboriginal institutions, and the widespread health problems that must be Aboriginal peoples, colonialism and theft and subsequent selling of artifacts addressed. Treatments for these conditions colonization eventually led to the around the world, amounted to an assault often do not involve a cure or lead to the forceful disruption of traditional on Aboriginal peoples’ identity and what absence of disease. Instead, treatment is Aboriginal culture (Harris 2002, 2004). has, by some, been referred to as ‘cultural aimed at slowing the progression of the Settler colonial laws, policies, practices, genocide’ (Whitelaw, 2006; Harris, 2002; condition, improving the quality of a and structures systematically eroded de Leeuw, 2009). patient’s life, and reducing the impact of sociocultural practices that for generations the condition on their work and family life. had defined Aboriginal peoples. These Despite committed efforts to ‘de- practices – including, amongst many, Indigenize’ the lands now known as The production, deployment, or enjoyment feasting and gifting rituals, petroglyphing, , sociocultural practices survived of creative arts (broadly conceived) has body ornamentation, singing, dancing, (Razack, 2002). Today, the assertion the potential to fit into, impact, and drumming, weaving, basket making, and of culture through these practices is an complement this new ‘health reality,’ carving – were simultaneously art, creative important factor in the wellness, health, underscoring the old adage that medicine expression, religious practice, ritual models and healing of Aboriginal peoples and is both a science and an art. In Canada, and markers of governance structures communities (Chandler & Lalonde, art for health purposes and/or as a healing and territorial heritage, as well as maps 2008; . Provincial tool may be particularly relevant to of individual and community identity Health Officer, 2009; RCAP, 1996; Aboriginal peoples.1 and lineage (Townsend-Gault & Duffek, Archibald, 2008). Indeed, in 1996, 2004; Walsh, 2002). The banning and the Royal Commission on Aboriginal At one time, diverse, healthy, dynamic, subjugation of these practices, through Peoples (RCAP, 1996) documented the sovereign, and self-governing Aboriginal residential schooling, deterritorialization, specific and unique importance of art peoples occupied all the territory now potlatching bans, destruction of totem to Aboriginal peoples, linking various known as Canada. Despite an initial poles and many other cultural icons, creative practices directly to the vitality

1 The term ‘Aboriginal peoples’ is used in this fact sheet to refer inclusively to , , and Métis peoples. When possible, specific terms are used.

2 of individual and collective identity, particular relevance to Aboriginal peoples experiences, or create something that strength, resiliency, and overall well-being. (Ferrara, 2004). others can view and enjoy (Fiske, 1999). A growing body of evidence, explored The process of setting a goal to create herein, documents that art is beneficial Art as a form of treatment or contributing something, and then meeting that goal, in healing processes, cultivation of good factor to well-being may be expanded also has positive effects on self-esteem health, and maintenance of well-being for beyond traditional art therapy processes and self-confidence (Humphreys Weitz, individuals and communities, particularly and environments to include writing, 1996). Creative processes have positive for Aboriginal peoples in Canada. listening to, and creating music, dance, physiological effects which range from photography, sewing, carving, engraving, decreased heart rate and blood pressure Art Therapy and other forms of creative expression. to the release of endorphins – hormones Expanding even further, it can be said that that act like opiates to induce feelings Art therapy, as practiced by art therapists, the process of art making is therapy, not of relaxation (Rockwood Lane, 2005). has been defined as the union of creative just a tool used to facilitate the relationship Art can also have powerful effects on processes and psychotherapy, a union between a therapist and client. The benefits an individual’s perception of pain, their that facilitates the sharing of thoughts of art making then become something attitude, and their emotional state. Health and feelings. Art therapists are specially available to everyone, something that can professionals report that after viewing art, trained and work in a range of settings, make healthy people healthier. their patients are relaxed and more likely to including counseling offices, hospitals, be hopeful and optimistic (Ibid.). elder care homes, and substance abuse Art as a Protective Factor treatment facilities. Traditional art therapy Creative Expression for processes include , drawing, Art, or more broadly creative processes, Community Well-Being and molding with clay ( can be a protective factor that strengthens Therapy Association,2011 ). These individuals and communities and acts as Research indicates strong linkages varied forms of creative expression help a buffer against ill health. The positive between: 1) the vitality and wellness to remove communication barriers by effects of art include enhanced self-esteem of cultural arts and activities within a providing alternatives to verbal dialogue; and self-confidence that occur when an community, and 2) the sociocultural, and a characteristic of art therapy that has individual is able to express feelings or

Art and Wellness: The Importance of Art for Aboriginal Peoples’ Health and Healing 3 physical and mental, health of individuals Confidence and self-esteem, strong cancer among Inuit in Canada that are the within those communities. The value of social networks, a sense of ownership, highest in the world; diabetes rates among art at a community level can be found in and pride in one’s contributions and Aboriginal peoples that are three to five both the process of creative production surroundings are difficult variables to times higher than those of the general and in the enjoyment of a final product or measure quantitatively; however, when population; and rates of tuberculosis performance. The creation of art or group they are strengthened, health outcomes are that are six to eleven times higher in the participation in creative expressions can generally positive. First Nations population than rates in the foster connections between individuals, general Canadian population (Tait, 2008; leading to feelings of belonging and Art and Aboriginal Peoples Health Canada, 2009). These statistics engagement (Health Development illustrate broad trends of ill-health among Agency, 2000). These feelings, often Thousands of unique Indigenous groups Aboriginal people; they do not reflect combined under the term ‘social capital’, and communities exist across Canada. nor can they address, however, the unique contribute to improved self-reported and They differ by language, geography, nature of each band, each community, and measured health outcomes (Kawachi, material wealth, sociocultural protocols, each individual. Subramanian, & Kim, 2008). Art at a and history. Colonial policies further community level can take the form of differentiated them by designations The creative arts may have a valuable organized productions, such as the staging as Inuit, Métis, or First Nation and by role to play in health and sociocultural of plays, musicals, or concerts; or it may classification as status or non-status (under revitalization for Aboriginal peoples be more informal, such as a community the federal ). Despite the in Canada (RCAP, 1996). Evidence art room where people can meet, talk, unique nature of each Aboriginal group, indicates that many of the profound and share space while creating their own all groups are united in the experience disparities experienced by Aboriginal art (Health Development Agency, 2000). of a long history of colonization and peoples are the result of alienation and Activities that beautify or revitalize the marginalization. These experiences have discrimination faced when accessing physical space a community occupies, contributed to disproportionately high or thinking about accessing the health including gardening, and painting rates of ill-health. Examples of the most care system (Smith, Edwards, Varcoe, murals or buildings, create a sense of glaring disparities include: rates of lung Martens, & Davies, 2006). It is difficult, ownership and pride (Semenza, 2003).

4 Using art as a communication tool in a therapy setting is ... an effective way of bridging the divide between primarily non-Indigenous health care systems and providers, and Indigenous world-views and understandings of health.

and even inappropriate, to make broad is not only accepted, but often promoted. In 2007, British Columbia’s Provincial generalizations about preferred means of Using art as a communication tool in a Health Officer’s Report focused on expression or sweeping claims about the therapy setting is therefore an effective way strategies for improving the health value of art for healing across Indigenous of bridging the divide between primarily and well-being of the province’s communities; however, in her work as an non-Indigenous health care systems and Aboriginal peoples. Many of the report’s art therapist with Cree people in northern providers, and Indigenous world-views and recommendations centered on the , Nadia Ferrara (2004) found that understandings of health. need for culturally appropriate health while many of her patients struggled in programs and treatment approaches that traditional modes of therapy involving Beyond individual benefits, creative would ameliorate the road blocks facing verbal communication, in an art therapy and cultural expression can promote Aboriginal people in the current health setting, they felt much more comfortable community strength and resilience, in turn care system. The report cites specific and were able to address various issues. contributing to improved health outcomes. examples of successful approaches, Ferrara attributes this success to the In Indigenous cultures, the production originating at the community level, creative portion of art therapy, in which of artistic works or participation in that include the revival of cultural and people draw or paint what they are creative expression is woven into the spiritual practices (British Columbia, thinking or feeling. In her experience with fabric of everyday life, and can include 2009). The revival, practice, and Cree people, she found that speaking, and the creation of functional items, such as expansion or exploration of culture has the expression of emotions, creates a power clothing and baskets; items of spiritual a profound effect on identity formation hierarchy between the therapist and the significance, such as totem poles and and solidification, and in turn, health and client that does not align well with Cree masks; and participation in songs, stories, well-being. According to Chandler and society, in which individuals are expected and dramas that are used to pass on Lalonde (2008), a strong sense of identity to maintain a level of autonomy and myths and traditions (Dufrene, 1990; is vital for well-being. Knowing who you personal control that allows the collective Harvey, 2000). This contrasts with western are and where you come from, and having to function efficiently (Ferrara, 2004). In conceptualizations of art, which generally the opportunity to practice and express the contrast, in western society this power limit the term to objects or expressions things that define you as unique, creates imbalance between therapists and clients with aesthetic appeal. an incentive to imagine and care for the

Art and Wellness: The Importance of Art for Aboriginal Peoples’ Health and Healing 5 person you will be in the future. Without writers contemplating, through creative break dancing” (Vancouver Art Gallery a strong sense of identity, positive lifestyle expressions, the links between place, [2011]). Also, there is evidence that art choices and health practices become art, and Indigenous peoples’ health and has a role to play in ensuring that future meaningless since there is no attachment well-being (de Leeuw and Greenwood medical professionals are more culturally to the person you are or will be (Chandler 2012). There are other evidences. Until attuned to the health issues, including & Lalonde, 2008). Having your identity 2003, the Historical Canadian Galleries social determinants, facing First Nations recognized, and your expressions valued, in the National Gallery of Canada communities, especially in northern and further reinforces a commitment to self- displayed a history of Canadian art rural places (Klopp & Nakanishi [2012]). care and well-being. devoid of Aboriginal objects (Whitelaw, 2006). This changed in2003 when the These examples are some of the many Healing Between Cultures galleries were re-opened and renamed the Aboriginal art projects and programs Galleries of Canadian and Aboriginal Art, that are not only working to make In addition to improving individual and with pieces of Aboriginal art integrated Aboriginal artistic expression more community health outcomes, art can with Euro-Canadian works. While all widely known in Canada, but working to play a role in healing relations between works in the gallery are framed in terms change perceptions and stereotypes about Aboriginal and non-Aboriginal of western ideas of aesthetic value, the Aboriginal culture and peoples. Changing and, in turn, reduce the marginalization inclusion of Aboriginal pieces does begin perceptions and stereotypes is the first often experienced by Aboriginal people to change perceptions of Aboriginal step to addressing the marginalization and when accessing health services. When cultural productions from anthropological discrimination many Aboriginal people the expression of culture by one group artifacts to objects of value and aesthetic face in general Canadian society and when is valued and respected by members of appeal (Whitelaw, 2006). In addition, accessing health services. other cultures, health and social benefits the for the Arts has to traditional and modern forms of made a strong commitment to supporting Conclusion Aboriginal art has the potential to Aboriginal artists and arts organizations stimulate interest in Aboriginal culture through a variety of grants and publishing In Canada, vast health inequalities exist and respect for the dynamic, resilient, and opportunities (Canada Council for the between Aboriginal and non-Aboriginal unique place Aboriginal peoples hold in Arts, 2008). One example of this work peoples. Addressing health disparities and Canada. This potential was recognized in is the book Expressions, produced by inequalities requires solutions that are Volume Three of the Royal Commission Canada Council for the Arts, which as complex as the problems themselves. on Aboriginal Peoples report where the profiles twenty-seven Aboriginal artists of Solutions must address the root causes authors argued for mutual recognition different mediums from across Canada, of ill-health, the experience of disease, of the value of cultural expressions and with a focus on how their cultural clinical symptoms, and the ways and means practices as a basis for improved relations heritage influences their art (Canada through which Aboriginal peoples interact between Aboriginal and non-Aboriginal Council for the Arts, 2010). Youth are with health care systems. The barriers peoples (RCAP, 1996). playing a growing role in expressing facing Aboriginal peoples in accessing Indigeneity in new and creative ways, as health care, including differences between There are many examples of artistic evidenced by a 2012 exhibition curated a health care system of predominantly projects in Canada working toward both in the Vancouver Art Gallery entitled non-Aboriginal values and modes of revitalizing and increasing Indigenous Beat Nation. The exhibit “reflects a care, as well as Aboriginal world-views health and working toward strengthening generation of artists who juxtapose urban and understandings of health must also positive understandings of Indigenous youth culture with Aboriginal identity be addressed if improvements in health communities by non-Indigenous settlers. in entirely innovative and unexpected outcomes are to be achieved. The most Red Sky is a -based performance ways…[demonstrating that as] signifiers effective solutions will be strengths-based, company that tours the world showcasing of Aboriginal identity and culture grounded in the knowledge, traditions, Indigenous dance, theatre and music. The continue to shift and transform, and older and values of the particular community company also engages with communities traditions find renewed meaning in new or individual. For Aboriginal peoples, through workshops, dialogues on art and forms of expression, one thing remains strengths-based approaches must include culture, and artistic revitalization projects constant: a commitment to politics, to the maintenance and revitalization of (Red Sky Performance, 2011). A recent storytelling, to Aboriginal languages, to culture, something that can be achieved Spring 2012 issue of the journal LAKE: A the land and rights, whether it be with by encouraging artistic expressions and Journal of Art and Environment is devoted drum skins or turntables, natural pigments creative ways of knowing and being. entirely to Indigenous artists and creative or spray paint, ceremonial dancing or

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©2012 National Collaborating Centre for Aboriginal Health. Production of this document has been made possible8 through a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.