The Use of Arts in Healing and Medicine SoundPractice Podcast Transcript

We will be talking with Christopher Bailey, Art and Health Lead for the World Health Organization. The World Health Organization (WHO) helped host a symposium at the Metropolitan Museum of Art focused upon this topic.

Join us for a discussion of evidence-based use of the arts to promote health and healing and social prescribing. This is an important topic with one of the world's foremost experts.

Mike Sacopulos:
My guest today is Christopher Bailey. He is the arts and health lead at the World Health Organization. Mr. Bailey is heavily engaged in using the arts in the COVID-19 global response. He was also instrumental in The Arts and Wellbeing, a one-day symposium at The Metropolitan Museum of Art. Christopher Bailey, welcome to SoundPractice.

Christopher Bailey:
Hello, thank you for having me.

Mike Sacopulos:
What does the portfolio of responsibilities for the arts and health lead at the World Health Organization look like?

Christopher Bailey:
Well, I think at the simplest level, it falls into three baskets. The first basket is the research agenda. As the World Health Organization and a public health agency, we don't take too kindly to base our opinions and recommendations on anecdote or feeling, we need evidence. And so having a robust mechanism to look at the evidence of what are the health benefits of the arts is a key part of our program. The second is looking at the use of the practice of community-based arts interventions for health at the local level, particularly in recent support settings and in WHO priority areas. And that's extremely important because it has to be more than just a measurement or an academic exercise, you have to get your hands dirty, there always has to be an iterative process there.

And beyond research and practice, there's policy, being able to convene policymakers, not just health ministers, but ministers of culture, to start having a conversation about what are the best practices, what are the evidence, and what are the health benefits of investing in the arts as a society? That completes the triad.

Cutting across all of these is working with media companies, global and local media companies of all sorts, whether it's an opera house or streaming movie service, or perhaps the gaudiest example of what we've done is the “Together at Home,”concert that we organized with Lady Gaga at the beginning of the pandemic, which arguably reached more people at a “crucial time of a global health emergency than any other arts culture event that we can name. It was a pretty phenomenal event when you think about it.

Mike Sacopulos:
Can you give me a sense of the history of arts in medicine.

Christopher Bailey:
Oh, boy. Well, how far back do you want to go? On one level, if you just look at WHO, the arts have always been a part of what we do. In that sense, my program is not new, since the 1940s and 1960s using the arts as part of health promotion is not controversial in any way. If you go back to the rollout of the anti-HIV programs in East Africa, we used radio, we used street performers, we used soap operas to help destigmatize the disease, to promote the program. And that was repeated with other diseases, with any number of different vertical programs. But it was usually done in the context of the health message that the medium was carrying.

What's different about my program is that we're also looking beyond just health promotion. Is there any intrinsic health benefit to engaging in the arts, regardless of the message? Is listening to music or watching or participating in a dance, is there an intrinsic health benefit regardless of what message you're trying to get across? What's interesting about the evidence is that increasingly the answer is yes.

If you wanted to go way back beyond WHO's experience, you'd have to go back 70,000 years to the midpoint of our short history of the human race, to the cognitive revolution, wherein our midbrain we develop this ability to start imagining things that don't exist in nature, or don't yet exist in nature, or haven't been perceived by us as existing in nature. And that magic is what if, that ability to create, to imagine is the root of both the arts, obviously, but also science, because all science is based on hypothesis. If you can't imagine it, then you can't test it, you can't prove that it's there or build it if you're an engineer.

If you go back to that Ancient East Africa now extinct lake where homo sapiens first gathered, you'll find these ceremonies of people that came together. And that ceremony, there was no difference between a healing ceremony, a performance, an athletic event, or a religious ceremony, it was all the same thing. And over the millennia, these things have kind of split off into separate categories for some very real reasons, but they still share some common DNA. And part of that common DNA, in my opinion, is this sense of compassion, this sense of coming together, asking these questions, finding a path forward through storytelling, through dance, through song, through movement, through dealing with the past, and imagining of a future. And that primal use of the arts to imagine a way forward in the face of misfortune is something that I think became intuitively obvious during the pandemic as well. It's a very old idea.

Mike Sacopulos:
The earlier part of your answer flirted on the edges of neurobiology. Let’s spend a little bit of time discussing objective results that you have been finding. My guess is we have some people listening to this podcast who critics of the ability of arts to enhance healing in medicine. Perhaps you could speak to those skeptics out there.

Christopher Bailey:
I think, first of all, let's talk about what we're not talking about. I think there is a difference between curing a condition and creating a healing environment. If we go back to the WHO definition of health in the 1947 WHO Constitution, it quite clearly states that health is not merely the absence of disease, it is the attainment of the highest level of physical, mental, and social wellbeing. And if that's our definition, then I think it becomes a little more intuitively clear how the arts can play a crucial role.

From a measurement standpoint, I would refer people to our 2019 report that came out of our Copenhagen office, Dr. Daisy Fancourt from UCL/London was the lead author on it. And it looked at over 5,000 studies and the health benefits of the arts and amongst the width and breadth of this survey, you find things like using cortisol levels in hospital wards to measure stress and how the arts can be used to lower cortisol levels to create a more healing environment, to speed recovery, to potentially by extension prevent some of the chronic and acute conditions that can result from sustained high-level exposures to cortisol and to stress. There are specific measures out there that are compelling.

One study that I recall of a physical rehabilitation work, where you had a series of physical movements from someone recovering from an injury or a surgery that was a specific repeated pattern. And that same pattern was done with another group except set to music and with the group where the same physical recovery routine was done with music, the recovery time was 50% faster. And that is an argument that, for instance, insurance companies will pay attention to, these are the kinds of measures that are out there.

But I think even more important than some of the KPIs that you can cleverly design to show some of the connections, there's also the more qualitative aspect of it. If you have somebody who is suffering from cancer, involvement in the arts may help by lowering stress levels. But let's say, listening to music is not going to cure your cancer, but if for instance the worst should happen and you do die from the condition, then that end of your journey may have more meaning. Through the arts, you may find more comfort in that critical stage of your life story, not just for yourself, but for the loved ones and the caregivers around you. And so the benefits are more than just medical benefits, they allow you to create, to curate the story of your life.

Mike Sacopulos:
That's fascinating. To the best of your knowledge, is this body of evidence taught in medical schools?

Christopher Bailey:
Well, I think we're at the beginning of taking this more seriously in the sense of rigor and I think we're seeing in different institutions around the world it becomes more incorporated into the course of study. I think that's a very fertile ground for future investigation and not just in medical schools, but also in primary and secondary education with children. The argument that has often been used of funding the arts in education systems, whether it's at the professional level or the primary or secondary level, is a more utilitarian argument, to use the argument of the creative economy, that if you invest in the arts there are these ancillary benefits of the leisure industry. Or, if you teach it to children, their grades in other subjects will improve, which I think is fine.

But I think a more compelling argument that's coming out of neurology is that when you become proficient at the arts, things like your executive functions become strengthened, your ability to cope, to plan, to be persistent, to solve problems, to work as a team, all of these things become strengthened. And the more objective evidence we see of that, the more I think it will become intuitively obvious why we need to invest in the arts in our educational system to become a whole person.

And that gets back, frankly, again to the fundamental definition of health. At least in the English language, the word ‘health’ comes from the Anglo-Saxon which is cognate with the whole. Being healthy is not about the absence of disease, being healthy is about becoming a whole human being, and creativity and empathy and interaction and communication and harmonizing, and imagining a common solution together is part of what makes us human.

Mike Sacopulos:
Are there some cultures that are more receptive to this than others?

Christopher Bailey:
Well, yes. I think with advanced industrial economies or post-industrial economies, we've moved further and further away from thinking about these things in an integrated or holistic way for some very practical reasons. And part of it is the commodification of the creative economy, that if you are not the expert, if you're not making money off of it, then somehow it's amateurism, you write it off. I think a deeper understanding that the creative act is something that all of us do anyway, whether we recognize it or not and it's a key part of our daily health.

And that became more and more apparent in the pandemic, for instance. One of my favorite quotes is from Carl Yung, the Swiss psychologist who said, "Loneliness is not the absence of people, loneliness is the inability to express what matters to you most." And I think during the pandemic, during the darkest days of the lockdown, we felt that properly, not only were we physically alone but many of our assumptions about how we relate to ourselves, to each other, to society, to the environment were proven untrue. And the deepest needs that we felt in our heart of hearts were not being addressed by society. I don't think the Black Lives Matter resurgence or the MeToo resurgence during the pandemic was an accident. I think this crisis was more than just a medical crisis, it was a social crisis and a solution to these issues has to be a creative solution as much as a technological solution.

Mike Sacopulos:
Since we're on the topic of the pandemic, unfortunately, as you and I speak, we're still amid a global pandemic of COVID-19. Can you tell me about how the World Health Organization is using arts to respond to COVID-19?

Christopher Bailey:
Well, on the one hand, there is the sort of big-ticket event like the “Together at Home” concert, like working with movie television companies to put out pro-health messaging, to build a sense of solidarity of working together and not against each other. All of this I think is very important. But also, working with Google Health and some other groups out there trying to give people the tools, the confidence to practice creativity in their lives on an individual and daily basis as well. It's not just about messaging from above, it's about healthful practice in your lives.

At the height of the pandemic, making sure that you're eating well, that you're paying attention to the needs of the spirit of relationships, of society where you can, being able to volunteer in your community to create together a path forward. These are all healing actions. The WHO has been through a variety of different methods supporting this kind of empowerment and I think it's important to note that this is about supporting people's creative reflex as an important part of their health. It's not about top-down messaging per se, it's not about telling people what to think or what to feel, it's about encouraging them to think and to feel with each other.

Mike Sacopulos:
You and your team put on a one-day symposium at The Metropolitan Museum of Art focused upon healing in the arts. Can you tell our audience a little bit more about that and also its availability via the Internet?

Christopher Bailey:
If you go to the MET website, you'll see YouTube links where you can watch it streaming. It's available to anyone. It's a day-long symposium and it is structured around this three-part theme of research, practice, and policy. We will have experts, policymakers, researchers, and practitioners talking about it. It's also important when we are in the field of arts and health to not just talk about it, but to do it. And experiencing it is half the battle. You talked earlier about skeptics that may not see this as obvious, of the arts having any kind of healing quality. And yes, I can point you to data, I can point you to studies, but at the end of the day, what convinces you is the experience. And maybe if I might, I can take three minutes and attempt to give you that experience right now.

Mike Sacopulos:
Please do so.

Christopher Bailey:
One thing that we haven't mentioned because it isn't directly relevant to this conversation, is that I happen to be nearly completely blind. I have over 95% vision loss. I suffer from terminal glaucoma; my optic nerve has withered away to 5% of its normal mass. And this happened relatively recently and during that period of loss, it was more than just a physical loss. I felt emotionally exiled from the world. I felt that much of the way that I experienced beauty and joy had disappeared. And in a way, it was like a death, and like death, I experienced it in different phases.

There were times when I felt tremendous grief at the loss of what I no longer had. I felt anger, "Why me? Why is this happening to me?" I also went through periods of denial, "This is not happening to me," and I refused to use the cane. I refused to use the filtered lenses. And I even went through a bargaining phase, "If I eat differently, will my optic nerve regenerate?" And then like death, you eventually slowly enter an acceptance phase where I did start using the cane, I did start using the tinted glasses.

But unlike death, there's a phase afterward which I call the transcendent phase. And in the case of the impaired or the blind, it's a neurological transformation. The neuroplasticity of the brain begins to rewire, since the visual cortex is not getting enough information from the optic nerve, it begins to create new neural pathways to the other senses. And slowly what began to emerge was this aural landscape as I began to learn echolocation, and this world was not nearly as acute as the visual world, but somehow was more palpable, more immediate because when you think about it, what is sight? Sight is the reflection of the surface of things, sound passes through matter, it's in some ways more connected to the environment.

Rather than feeling exiled, suddenly I felt more connected to the world around me. I saw the darkness, not as isolation, but as a profound opportunity for contemplation. Just as you might willingly close your eyes to better savor a glass of red wine. Just as you might willingly close your eyes to better embody a beautiful piece of music, just as you willingly close your eyes to trace the gentle slope of a lover's forearm, so too do I accept the closing of my eyes to better share this moment with you.

Mike Sacopulos:
Thank you for sharing that.

Christopher Bailey:
That's the healing power of art, to take misfortune and create meaning in it.

Mike Sacopulos:
As we wrap up our time together, maybe you can tell me what's on the horizon for you and the World Health Organization?

Christopher Bailey:
Well, in the arts and health area, one of the things that I'm very excited about is something that we're calling the Healing Arts Lab. We're going to do a deep dive into the evaluation of these arts-based community projects for health, and to do a serious look at deepening and broadening the evidence base more systematically and working with organizations like the NIH and others on a proper evaluation and indicator framework so we can compare apples to apples. And that's not just quantitative, but qualitative as well because I think it's important to look at both sides of the coin.

We also have activations coming up next year, one in Houston in January which I'm very excited about. There is also one that we've committed to in Rwanda in November of next year, which is going to kick off a collaborating center from the University of Global Health Equity in Kigali that is going to look at the evidence base for arts and health in African medicine, both traditional and more modern medicine. And I'm very excited about these upcoming events and there is a number that hasn't been quite finalized yet that are also on the horizon. So I think next year is going to be a very exciting year for this field.

Mike Sacopulos:
This has been a fascinating discussion. I can’t thank you enough. For purposes of our audience in the show notes, I will post links to the WHO/MET symposium. information.

Christopher Bailey:
My pleasure. I would say to the skeptics out there that there's nothing wrong with being skeptical, we do need evidence and skepticism is healthy. But I remember when I first began to propose this project at WHO there were some that sort of wrote it off dismissively as recreational. And I said, "Well, listen to that word, recreation, that's healing."

Mike Sacopulos:
It is indeed. My guest has been Christopher Bailey, the Arts and Health Lead for the World Health Organization. Mr. Bailey, thank you very much for being on SoundPractice.

https://www.metmuseum.org/events/programs/met-speaks/healing-arts

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