Health Studies 301 Complementary and Alternative Therapies

Study Guide: Unit 4

The Arts and Humour in Medicine

Dance, Music, Art, Humour, and Related Therapies

Art therapy session in progress. (CC BY-NC 2.0) Rowan El Shimi

Unit 4 looks at several complementary therapies that have been borrowed from the arts, including the use of humour.

Learning Objectives

Upon completion of Unit 4, you should be able to

• discuss the potential value of various therapies that use the arts, in particular dance and movement, music, art, and humour.
• identify trends and issues involved with therapies that use the arts.

Learning Activities

Study Questions

As you complete the activities for Unit 4, keep the following questions in mind. You may want to use the Personal Learning Space wiki on the course home page and answer these questions as a way of keeping notes to focus your learning.

1. What are some of the ways that the creative arts therapies can facilitate psychological processes?
2. How does the creative process differ between personal expression in the arts and therapeutic contexts?
3. The arts therapies as forms of psychotherapy rely on the therapeutic relationship. How is this connection both similar to and different from the practice of other complementary and alternative medicine approaches?
4. Why are specialized education and training necessary to use arts processes in healthcare treatment? What are they?
5. Is humour part of health and medicine? Why or why not?
6. Has research been performed on humour and medical outcomes? Give examples.
7. Can you think of an experience in which you have either participated or witnessed humour in a medical or clinical setting?

Unit 4 Discussion Forum

When you have completed the other activities for this unit, answer at least one of the questions in the Unit 4 Discussion Forum and respond to at least one post by a fellow learner.

The more questions you answer, the better prepared you will be for the final exam!

Read

In addition to the notes provided here, please read the following chapter from the 5th edition of the textbook:

Nolan, P. and Goodill, S.W. (2015). Creative and Expressive Arts Therapies. In M. Micozzi (Ed.), Fundamentals of Complementary and Alternative Medicine (5th ed.), (pp. 157–171).

The Arts as Therapy

The reading provides an informative discussion of the value of dance, music, art, and writing (including poetry) in health care. It provides much useful information on the outcomes of research studies, especially with regard to children and people with mental illness.

In addition to the evidence referred to in the textbook, numerous other studies have been published. A review was carried out on the effects of music therapy on people with serious mental disorders, such as schizophrenia (Mössler, Chen, Heldal, & Gold, 2011). The investigators selected eight good-quality studies that included, in total, 483 participants. They concluded that “Music therapy as an addition to standard care helps people with schizophrenia to improve their global state, mental state . . . and social functioning if a sufficient number of music therapy sessions are provided by qualified music therapists.”

Music therapy also appears to be of value for depression (Maratos, Crawford, & Procter, 2011). A study of patients with chronic non-malignant pain reported that music caused them to have more power and less pain, depression, and disability (Siedliecki & Good, 2006). Several studies have reported that art therapy can benefit cancer patients in various ways, including improving their mental health (Geue et al., 2010).

Learning Activity

Read

Micozzi, M. (2019). Fundamentals of Complementary, Alternative, and Integrative Medicine. Page 171 (first three paragraphs) and pages 173–185.

Humour as Therapy

The reading provides an informative account of how humour can play a valuable role in the medical care of patients. As the authors make clear, there has been resistance to the use of humour, as it was (and still often is) seen as somehow unprofessional or inappropriate for medical staff to laugh and joke with their patients. However, when used judiciously, humour can help defuse stressful situations and may aid recovery.

Summary

Unit 3 discussed mind–body therapies such as meditation and biofeedback. Those therapies achieve much of their effectiveness by way of stress management and relaxation. There seems little doubt that the therapies discussed in this unit are beneficial for the same reason.

A “one size fits all” approach is not appropriate for any of the therapies discussed in this unit. Some people love dancing but not humour, whereas others are the opposite. Similarly, even where people love to dance, listen to music, and laugh at jokes, there is wide variation in the type of dancing, music, and jokes that people enjoy. Accordingly, these therapies must be practised with care. Indeed, the textbook stresses that much care must be exercised when medical staff joke with patients.

We have already seen in earlier units a lack of clear demarcation between conventional medicine and CAM. Meditation is one such example. We see this again in this unit. Therapies such as dancing and humour may be well accepted in some hospitals and medical facilities, but not in others. For that reason, the therapies discussed in this unit lie somewhere in a grey zone between conventional medicine and CAM.

Another important issue is the challenge of conducting research into these therapies. It is obviously impossible to conduct a double-blind study on the effectiveness of such therapies as music and humour. However, as the benefit (if any) is induced by way of the mind, we do not need to concern ourselves with the placebo effect. A little thought tells us that it is meaningless to dismiss a benefit of music or humour as being merely due to the placebo effect. We can illustrate this by comparing the following two treatments:

Case 1: A patient suffering from arthritic pain is given a drug that has no direct action on arthritis. However, because of the placebo effect, the patient feels less pain.

Case 2: A patient with arthritic pain is treated with music therapy and then feels less pain.

What is the difference between the two treatments? The only real difference is that in Case 1 the patient has been falsely told that the therapy has a direct action on arthritis, whereas in Case 2 no such claim was made. There are probably important differences in the neural mechanisms within the brain by which the two treatments achieved their effects, but does this really matter if the result is that the patient feels less pain?

In many ways, this simplifies the challenge of conducting research. Let us remind ourselves of the challenge in carrying out research on therapeutic touch and reiki. As discussed in the next unit, advocates of these therapies claim that they achieve their benefit (if indeed there are any) by their effects on energy fields. This creates confusion when interpreting results: was the benefit due to an altered energy field, or was it merely the placebo effect? No such confusion occurs with music, art, and humour.

Dance, however, is somewhat different, as physical activity is involved. With dance therapy, therefore, we cannot be sure whether any benefit is due to the physical activity or occurs by way of a direct effect on the brain.

Much of the evidence supporting the therapeutic value of music, art, and humour comes from anecdotal studies. In other words, the medical staff report that patients seem to feel better, such as being less anxious or having less pain. While that type of evidence is useful, it is far from convincing.

Here is an example of a study with a much better design: Older persons in a nursing home in Hong Kong took part in an eight-week humour therapy program (Tse et al., 2010). Patients in another nursing home did not receive the program and served as a control group. There were 36 older people in the experimental group and 34 in the control group. At the end of the program, there were significant decreases in pain and perception of loneliness, and significant increases in happiness and life satisfaction for the experimental group, but not for the control group. The researchers concluded that “The use of humor therapy appears to be an effective nonpharmacological intervention. Nurses and other healthcare professionals could incorporate humor in caring for their patients.”

Learning Activity

Self-test Quiz

Do the self-test quiz for Unit 4 as many times as you wish to check your recall of the unit’s main points. You will get a slightly different version of the quiz each time you try it. (This quiz does not count toward your final grade).

If you have trouble understanding the material, please contact your Academic Expert.

References