Chapter 1

Introduction

Background of the Study

This research was thought by the author because BA Philippine Arts is in the Health Science

University – University of the Philippines Manila, and it is also important to study if art can be

used as an intervention in medicine. This thesis will give the possibility of having a graduate

degree in Art therapy in the University of the Philippines in the near future because of its high

chance of impact to the field of arts and medicine in the Philippines.

This study focused on the physical, emotional, and psychological benefits of Chinese

painting therapy on patients. In definition, Painting is the process in which the artist applies

paint, pigment, color, or other medium to surface. As we can see, there is a painting and an artist

involve in the definition of a painting. To add to that, painting involves a process of freeing out

the feelings and experiences of an artist. That sometimes, in criticizing a painting an art critic

will look upon the context of why the artist mixed this colour, why did he created this lines, why

the subject is sad, petrified, happy, etc. , why does the light hits the object in this angle, .

Examples of artist that conveyed their feelings and emotion through their paintings were Van

Gogh, Pablo Picasso, Matisse, Lichtenstein, Chagall, etc.

It does not mean that art is a kind of an outburst of emotion but art gives the artist an ability

convey their emotions and feelings through painting. It not just a mood, or temporary emotion

but it is an emotional experience that was transcended to the artist’s paintings. It is not just an

emotion of a moment, but a higher emotion that the artist was hiding that only the canvass and

1
the brush can convey. This high emotions and feelings must be analyzed and given importance

because there is a possibility that painting can help individuals having problems hiding their

emotion and feelings.

The thesis of Paguio, Pestano, Pfeiffer, Funk, and other art therapists proved that art therapy

is beneficial as an intervention for anxiety, stress, depression, and behavioral problems of

patients. Art therapy before is often correlated with psychotherapy or the treatment for mental or

emotional disorder or of related bodily ills by psychological means (Merriam- Webster, 2015).

But recently, studies suggest that art therapy is not only beneficial emotionally and mentally

to patients but also physically. Painting therapy can alleviate the symptoms of HIV/AIDS

(Nainis, Williams, et al., 2015). Art therapy is being applied to a wide variety of health issues

including cancer: chronic illnesses such as asthma, epilepsy, and renal disease; neurological

disorders and traumatic brain injuries; physical disabilities; and Alzheimer’s disease and

dementia to improve individual’s wellness, symptoms, and quality of life (Malchiodi, 2013).

This kind of intervention is being studied and done in many countries, especially in European

countries and in the United States of America.

The researcher believes that BA Philippine Arts should also include art therapy in its units of

courses because of its huge benefit to the graduates of the course and also in the field of

medicine in the Philippines. The development of arts in the country should not only focus on

films, advertisements, and corporate but also in medicine.

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Research Question

The present study aims to answer the question:

“How can painting therapy improve and enhance the physical, mental, emotional well-being of
patients?”

Objectives

1. To determine the physical effects of painting therapy on individuals

2. To understand Chinese painting therapy on patients

3. To recommend the use of art therapy to physical and occupational therapists in

rehabilitating motor movement disorder patients.

4. To introduce painting therapy to the University of the Philippines and to have graduate

programs for painting therapy in the near future.

Scope and Delimitations

The Chinese Painting Therapy of the College of Allied and Medical Professions, University

of the Philippines Manila is the chosen subject matter for the study.

Chinese Painting is rooted in a rich tradition of many thousands of years. It is a spiritual

discipline with principles and refined techniques, with purposeful use of brushes, ink, paper,

color and composition. Depicting subjects such as people, birds, flowers, and landscapes, these

paintings represent one of the oldest styles of art in existence today. It is a form of meditative art

because it uses feelings and sentiments of the artist in his/her reality, that is why this research

was created and it is to see if Chinese painting is not only a relaxing, meditative form of art but

also can be used to motor movement disorder patients.

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 This study focused on the physical, emotional, and mental effects of Chinese painting

therapy that is being done to cerebral palsy and stroke patients in the College of Allied and

Medical Professions, University of the Philippines Manila. The physical effects that is researched

in Chinese painting is concentrated in the fingers, eyes, and wrist muscles of the patients because

of the method of the style. The researcher will also venture in discovering the emotional and

mental benefits of Chinese Painting Therapy to motor movement disorder patients. In doing this,

the author enumerated the emotional, physical, and mental effects of art therapy to patients

conducted by researchers in different countries. Also, interviews to the practitioners were

conducted in the College of Allied and Medical Professions about this new kind of therapy.

The methods and instruments in Chinese Painting therapy that were conducted to patients

were recorded and given observations. Also, the brief history of the founding of this kind of

therapy in the Philippines was included. The development and the training for this kind of

therapy were discussed. Background regarding the methods and the spiritual context of Chinese

Painting therapy were also included in thesis. Also the people behind must be given importance

in the thesis, because they started this new kind of therapy to cerebral palsy and stroked patients.

Looking closely, the research could establish the basis for giving more funding and development

to this therapy to help more patients having this kind of disorder.

This research did not go through the experiments to found out the emotional and mental

effects of Chinese Painting therapy to the patients because many researches have been done to be

used as references in this part. The research only gave a brief explanation of the effects of

Chinese Painting therapy to the emotional and mental to the patients through observation and not

through tests or experiments. But in the physical effects, tests and experiments were conducted

which will be further discussed in the succeeding parts of the chapter.

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Significance of the Study

Since art therapy is new to the country compared to other forms of therapy, a lot of art

majors could be very interest in this. Also the huge impact of this kind of therapy will be greatly

experience in patients having problems with their motor movements (Parkinson’s disease,

cerebral palsy, stroked patients, traumatic brain injury, etc.). A new breed of artists will be

created if this thesis will be given more development and research, those artist who does not only

create works of art for corporation, entertainment, and visually, but also for patients having not

only mental and emotional problems but most importantly, physically.

This may be the first study for the effects of painting therapy to stroke and cerebral palsy

patients in the Philippines and this will yield huge benefits not only to patients but also pride and

glory to the University and the course. The researcher may be insufficient in some areas like in

the field of therapy and psychology but this research will spark more researchers in studying this

field of art and therapy. This will give a wider scope of art in the society and country.

By studying this matter of therapy, universities and hospitals may find the probable

implications of this therapy to society. And will lead to opening courses in art therapy and

opening jobs for art therapists in the future. In conclusion, this research can be a benefit not only

to the patients but also to the country as a whole.

Research Design

Quantitative and Descriptive research design

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Methodology

Qualitative and Descriptive research designs were used in the thesis. The challenge for

the author is describe the process of Chinese painting and find the effects of it through a

qualitative research design approach. The researcher’s duty is to understand the probability of

Chinese painting therapy to be used as a beneficial for patients having motor movements

disorders, although it is being conducted already. The experiments and tests that will be

conducted will be guided by professional physical therapists to do the experiments properly.

An interview is vital in knowing the background, the process, and the proper guidelines

that were used in conducting Chinese Painting therapy to the patients. The interview with Prof.

Arnold Esguerra, the therapy facilitator, was vital because he gave the proper methods and the

instruments to be used in the therapy. Also he gave the reason why Chinese painting therapy is

more useful for motor movement disorder patients. Lastly, library research and internet research

on Chinese Painting by for articles, journals, and theses created in the field of Chinese painting

therapy will be used to know the method and way of practicing the painting style these were

several ways to conduct the study in order for the researcher to discuss the benefits of art therapy

in the patients’ emotional and mental status.

Observation will also be conducted by the author to know the psychological and

emotional effects of Chinese Painting to the patients. Also participative observation will be done

by the researcher to feel the essence and effects of Chinese Painting therapy personally to create

a bigger and wider analysis of the therapy. Through observing the process, and jotting down the

visible joy and happiness of the patients undergoing the therapy will also prove the benefits of

painting therapy emotionally and mentally.

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 Lastly, the interview with the Clinical Supervisor, Ms. Jennifer C. Guevarra, OTRP, is

vital because she sets the proper guidelines that is to be followed in conducting the therapy. It

must be understood and taken into account in the research the guidelines for the therapy, because

improper procedures can lead to more disorders than of rehabilitation.

To measure the physical effects of Chinese painting therapy to patients through their

hand and wrist muscle coordination. Dynamometer wrist and strength manual testing will be

conducted with physical therapists to know the efficiency of the therapy to them. Patients will be

measured one week before their sessions and will be measured after the week to know the

efficiency of the therapy. The process of measuring will be done by a license physical therapist

or occupational therapist. The data and measurements were analyzed and were included in the

thesis. The researcher will go undergo the interviews after the session will be made.

Schedule:

January 7, 2015

- Give consent letter to patient or to his/her guardian

- Measure the dynamometer wrist and the strength of the wrist to one cerebral palsy patient

and one stroke patient

- Give consent letter to Prof. Arnold Esguerra for the interview

January 14, 2015

- Interview Prof. Arnold Esguerra

- Give consent letter to Ms. Jennifer Guevarra

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January 21, 2015

- Participative observation, attend the session to experience the emotional and psychological

effects of Chinese Painting therapy to the patient

- Observe the patient’s behavior during the session

January 28, 2015

- Measure the physical effects of Chinese Painting therapy to the patient

- Measure the dynamometer wrist and the strength of the wrist of the two patients

- Analysis of data

8
Operational Framework

Motor Movement Disorder Patient

Observation Status of the wrist and hand muscle

coordination of the patients before the
art therapy

Chinese Painting therapy

Emotional and Mental effects of Measurement of the impact of art therapy to

painting therapy to the patients the patients: Dynamometer wrist and strength
manual testing

Improved Self Esteem and

decreased anxiety levels Better hand and wrist control
and movements

Better Social Adjustment

After the researcher introduced the topic and the problem of the research, the researcher has

come up with the conceptual framework of the research. The framework of the study is a step by

step procedure for knowing the benefits of art therapy to patients having motor movements

9
disorder. First, the researcher will choose one stroke patient and cerebral palsy patient who is

currently in the Chinese Painting therapy session by understanding that the patient is able and is

capable of having his/her strength tested and measured. The choosing of the participant will

handled with great precautionary measures because the research may be able do more harm than

good. The patient will be observed and measured (by a certified physical therapist) both

physically and psychologically before he/she will undergo the session. And then, the session will

commence.

After the session, the patient will be observed by the researcher and his/her wrist and hand

muscle coordination and will be measure via dynamometer wrist and wrist control strength

manual testing. And then, all the data, measurements, and observation will be written in the

thesis and conclusion, recommendations, and summary of findings will be included.

The interviews to Mr. Esquerra and Ms. Jennifer, will be used as data for the

recommendation of the thesis. Their inputs will be used for the development and more funding of

the art therapy. Also, their inputs will be used by the author to push his objective to introduce art

therapy as a course that universities should think about and in the future will be an undergraduate

or graduate course in the university and spark the need of art therapists in every hospital in the

society.

The operation of the research must not be changed or else the data and the measurements of

the research will be changed, knowing that it must be avoided in a quantitative research.

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Definition of Terms:

Art therapy - Art Therapy is a mental health profession in which clients, facilitated by the Art

Therapist, use art media, the creative process, and the resulting artwork to explore their feelings,

reconcile emotional conflicts, foster self-awareness, manage behaviour and addictions, develop

social skills, improve reality orientation, reduce anxiety, and increase self-esteem (American Art

Therapy Association, 2015).

Dynamometer wrist – Accurately measures the strength of the wrist muscles during flexion,

extension, abduction and the forearm muscles during supination and pronation, (Rehabmart,

2015).

Strength Manual Testing - It is done to assess muscle strength of a patient, which can provide the

physical therapist (PT) details that can assist him or her in planning appropriate interventions or

therapy (Mangusan, 2014).

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 Review of Related Literature

The review of the literature for this study focuses on the effects of painting therapy and

its benefits to people experiencing depression, anxiety, stress, and trauma. This RRL also focuses

on the possible use of Chinese painting therapy as a means of aiding patients mentally,

physically, and emotionally. The chapter begins with the proven effects of art therapy to patients

having chronic illnesses and mental problem. Also this chapter gives some insights to the

benefits of painting therapy in the spiritual aspect of the patients and gives a discussion on how

art can heal a person. The research outcomes to the potential benefits of art therapy in terms of

physical, mental, emotional, and spiritual aspect of a person, the spiritual context of Chinese art

therapy, and the harmonization of art and science in healing a person.

Potential Benefits of Art Therapy to Patients

Many researchers proclaimed that there is indeed a potential benefits of art therapy to

patients in terms of physical, mental, emotional, and spiritual. Dominic Paguio’s thesis entitled,

“Effectiveness of Art Therapy in Improving Self-esteem and Alleviating Anxiety among

Children with Cancer (Paguio, 2005)”, proved the effectiveness of art therapy in improving the

self-esteem of children with cancer. He found out that art therapy for cancer patients can improve

self-esteem and alleviates anxiety to children with cancer. He even recommended that art therapy

must be included to the care to children with cancer because of its proven potentialities.

Both self-esteem and anxiety levels are the main problems medical practitioners face

when intervening patients with chronic illnesses. The ‘will to fight and live’ of the patients

cannot be cured with medicine, especially patients with cancer. Knowing that cancer and chronic

illnesses not only are detrimental to the body of the patients but also they have damaging effects
12
to the psychosocial aspect of the patients. This is when art therapy intervention follows, to help

patients cope with their situation and give them hope for the future.

According to Katherine Pfeiffer in her thesis entitled, “Art Therapy as an Anxiety

Reduction in Pediatric Patients Preparing for Surgery: Descriptive Report on Designing an

Empirical Art Therapy Research Protocol (Pfeiffer, 2012),” the author developed an

experimental design that aims to find out whether using art therapy with pediatric patients before

surgery and other procedures requiring anesthesia can reduce patients’ anxiety. The author also

explained the effects of various art therapy intervention techniques on anxiety. Lastly, the author

emphasized that quantitative research and evidence-based practice is the future of art therapy.

This only proves that art therapy is not only in qualitative in nature, but can be objectified

and measured with concrete evidence. Its effects has integers and can be measured

quantitatively. Pfeiffer’s research only proves that the there is a future for art therapy use in

healing patients mentally and emotionally. But what was interesting is the research is when the

author uses a quantitative research design to the research, because qualitative research design is

always used in research art therapy. This just means that art therapy can be measured

quantitatively because its effects is evidence-based and quantifiable.

According to Caroline Even in her thesis entitled, “Making Time for Culture Change:

Therapy as Method for Cultivating Lived Time in Dementia Care,” and Doric-Henry’s article

entitled, “Pottery as Art Therapy with Elderly Nursing Home Residents. Art Therapy”, Art

therapy can be a useful and fulfilling activity to help elderly psychologically. Art, dance, and

music inspire people suffering from frustrating circumstances (being old, unable to express

oneself, etc.) to connect with others. Both studies proved that art therapy can improve the

13
psychological well-being of the elderly. Lastly, art therapy can be used to nurture relationships

throughout the community.

These two researches proved that art therapy can connect people in a community. Art

therapy not only can be used to an individual but to the community as a whole. An artwork can

convey messages and can be used as a symbol to groups of people. Their researches is a vital

part of the research because it will be used as a basis of community painting therapy.

According to Nainis, Williams, et al. in their thesis entitled, “Art therapy for Relief of

Symptoms Associated with HIV/AIDS”, art therapy can be used to manage the symptoms of

HIV/AIDS and can be used as care management to the patients. Their study shows that the

physical symptoms of the HIV/AIDS victims were better after attending one art therapy session.

They conclude that there is indeed potential benefits of art therapy in relation to symptoms

associated with HIV/AIDS.

This research will be used as part of the benefits of art therapy to patients in the thesis.

Included in this research will be formulating recommendations in intervening diseases, because

the author believes that not only medicines, antibiotics, or surgery can heal someone but also to

heal a person, he/she must be healed physically, mentally, emotionally, and spiritually.

Art therapy is being applied to a wide variety of health issues including cancer: chronic

illnesses such as asthma, epilepsy, and renal disease; neurological disorders and traumatic brain

injuries; physical disabilities; and Alzheimer’s disease and dementia to improve individual’s

wellness, symptoms, and quality of life (Malchiodi, 2013).

Art therapy is not only done to patients to give them hope and make them feel ‘good’ but

art therapy has quantifiable and detectable effects to patient’s wellness and health. Art therapy is
14
better to be coined as ‘medical art therapy’ because of its benefits and implications to the welfare

of the patients. The research of Malchiodi, proved that a box of crayons and papers can create

big benefits to the patient’s health and wellness. Restoration is the key in completely healing a

patient.

The book of Hass-Cohen entitled, “Art Therapy and Clinical Neuroscience,” shows that

art therapy has a role in giving patients positive outlook in their illnesses, art therapy can be used

together with treatments to cure diseases. This book further proven that art therapy can be used

as a medical practice in curing diseases and illnesses.

Another book which shows the healing effects of art therapy to patients is the book

entitled, “The Healing Flow – Artistic Expression in Therapy (Schnetz, 2005)”, its states that art

can heal the emotions of patients by healing the psyche of the patients when they created their

image, wherein they can share their grievances and frustrations that will heal their inner self,

giving them a positive outlook on life even though facing diseases or illnesses. This research will

be used as a basis for proving the healing capabilities of art therapy to patients, thus stressing that

art therapy must be correlated to medicine to heal a person more efficient.

Art therapy is firmly grounded in scientific research, according to the book by Frances

Kaplan entitled, “Art, Science, and Art Therapy”, art and science can relate through the

application of one to the other. Both a science of art and an art of science are conceivable, art

making is inherently therapeutic, art therapists offer something that other professional is unlikely

to provide. Art also has characteristics that can be tailored to alleviate specific types of problems.

Art is a form of cognition; it is means of ordering experience; it can serve as an alternative

method of communication; it can promote group bonding; and facilitate creative problem

15
solving; it can provide success experiences for the severely impaired; and it can ‘make special’

the rehabilitative environment.

The book proves that art has the capacity to enhance quality of life and can improve the

health of both the sick and the healthy. By giving concrete evidences of the linking of art and

science, art therapists can further research about science not only art as therapist but also science

as an art therapist.

Art therapy is not only applicable to patients having illnesses but also to people having

behavioral problems. In the thesis of Sabina Pestano entitled, “Visual Arts as Adjunct Tool in

Counselling Adolescents with Behavioral Problems”, it is concluded that group counselling for

adolescents having behavioral problems is more efficient if art therapy is included to it. Thus,

visual art activities can help counselling for the behavior problems of the adolescents.

Art therapy can help children experiencing traumatic grief re-engage developmental

coping strategies in order to work through grief and trauma symptoms through creating a warm

therapeutic alliance, with engaged and sustained reciprocal communication (Lu, 2007).

The research performed by Lu, also concluded that artist is different from art therapists.

Because art therapists need to follow rules and guidelines to not harm the patient, art therapy

must be done by professionals who had proper training because it can lead to worsening of the

illness. This research will be used by the thesis to further explore the critical parts of art therapy,

to proper recommend guidelines and rules to follow to future art therapists.

Also, art therapy can be a vehicle for a social justice. Art can serve as a healing and

politicized vehicle of agency, voice, and visibility for those who have experienced trauma related

to oppression (Funk, 2012). Therefore, art therapy spaces can promote healing, connection, and
16
movement within the lives of individuals and communities while also facilitating movement

toward social justice.

This only proves that art therapy is a very big topic that have a very huge potential. Art

therapy not only affects the lives of individuals but also the community as a whole. It can help

people who experienced trauma, political violence, and pacification. Art therapy can serve as a

medium of voice them, thus giving them connection and healing in themselves.

But according Edith Kramer, although art therapy have a great impact and huge potentials

as a healing tool for patients or individuals (Kramer, 2000). There must be limitations and there

must be certain rules and guidelines to follow before doing the therapy. An art therapist need to

be prepared to administer psychological first aid in terms of crisis, he/she needs to understand

his/her limitations, and art therapists must adapt to the style and imagery of their clients or

patients when they function as art therapists.

This just shows that art therapy has many limitations because it is still under research.

The thesis that will be done not only will shed light to the subject of the potentials of art therapy

but also the limitations of it.

Chinese Painting Therapy

Chinese Painting Therapy is being done in the University of the Philippines Manila for

stroke and cerebral patients to improve their motor skills. This research is intended to promote

the therapy group to the population of the university. But not only does Chinese painting therapy

improve the motor skills of the patients but according to researchers it has more benefits to the

patients.

17
 In the book of Kalmonowitz entitled, “Art Therapy is Asia: To the Bone or Wrapped in

Silk”, Chinese traditional painting may be seen as an aid to meditation, an opportunity to ponder

on life and provide material for deep thinking (Kalmonowitz, 2012). The practice of Chinese

Painting also can cure insomnia and depression and it can be used as a spiritual exercise to foster

spontaneity and creativity. Chinese traditional painting is also used to bring persons to a

spontaneous sensing of what arises in them of what they are doing, feeling, and planning.

Chinese painting therapy have a huge potential to be used as the basis for painting

therapy for patients. Not only it teaches patients self-control, but also inner peace, a medium of

thinking, a spiritual exercise, and give the patients to contemplate their lives and their plan for

their future. It must be inferred that Chinese painting also has a spiritual context to it.

In fact according to Mimi Farelly-Hansen, in her book entitled, “Spirituality and Art

Therapy - Living the Connection”, art therapy is a language of the heart and soul. It can be a tool

so that patients can voice out their inner grief, frustrations, and disappointments to their lives. Art

therapy also can help patients contemplate their value in the society and their value to their self

as persons. And by reaching the spirit of the patient, art therapists can give them more hope and

show them happiness and positive way of thinking (Farelly-Hansen, 2001).

Painting therapy gives patients a sense of fulfillment and hope. Not only does painting

therapy aids in healing patients physically (e.g. cerebral palsy and stroke patients) but also

spirituality. And as according to Maslow’s hierarchy of needs, self-actualization is the highest

need of every human in the world. That is why painting therapy holds a huge potential in

research and medical aspect.

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