Unplug that Plasma Screen, Take-Two Doses of Nature
– and call me in the morning.
Can HDTV beat Mother Nature?
Do our senses really know the difference between a high-density image of nature on a television screen and the real thing? And which one is better at reducing minor stress—mountain scenery on your HD plasma TV or Doses of Nature itself?
Ask most health practitioners or psychotherapists and you will find that they intuitively agree that direct experiences with nature, such as gazing at a mountain vista or a stroll by an ocean or lakefront, have a positive effect on the body. But how do today’s technology-generated visual images of nature compare to experiences of seeing those same scenes in reality? And can we substitute this technology with individuals who may not have access to nature and obtain the same effects? As the visual images we see on our HD plasma TVs become increasingly detailed, are these images perceived in the same way we perceive that mountain vista or waves crashing on a favorite beach?
University of Washington researchers recently set out to examine whether the actual experience of nature or nature depicted on a high-density plasma screen could affect stress levels in the body in 90 college students. To do so they measured heart rate recovery from minor stress when participants were subsequently exposed to a natural scene through a window [thus eliminating sounds and smells of nature], the same natural scene on an HD plasma screen, or a blank wall. The heart rate of those individuals who looked at the natural scene through a window decreased more rapidly than in the two other situations. In fact, the HD plasma screen had no more effect than the blank wall on heart rate recovery.
Increased Blood Flow to the Brain
In May 2011, Robert Mendick, a reporter for The Telegraph, wrote an article (https://www.telegraph.co.uk/culture/art) about an experiment conducted by Professor Semir Zeki, chair in neuroaesthetics at University College London. Zeki explained, “We wanted to see what happens in the brain when you look at beautiful paintings.” The experiment concluded when you look at art “whether it is a landscape, a still life, an abstract or a portrait – there is strong activity in that part of the brain related to pleasure.” The participants underwent brain scans while being shown a series of 30 paintings by major artists. When viewing art they considered most beautiful their blood flow increased in a certain part of the brain by as much as 10%, which is the equivalent to gazing at a loved one. Paintings by John Constable, Ingres, and Guido Reni produced the most powerful ‘pleasure’ response.
The idea that nature affects our bodies’ ability to recover from stress or illness is not a new theory. In fact, the field of hospital design has been investigating the role of nature in patient recovery for quite a few years. As early as 1984, Roger Ulrich conducted a study of patients recovering from gallbladder surgery and found that those with views of trees from their hospital windows experienced better outcomes than those looking at brick walls. Those looking at nature went home almost a day earlier, had $550 lower hospital costs, used fewer medications, had fewer minor complications, and, in general, had a more positive sense of well-being upon discharge. Ulrich’s studies and subsequent research have provided a strong argument that medical environments should be constructed to support physical recovery.
Evidence-based design is now included in most healthcare institutions because it can make measurable differences in patients’ health and hospital stays. Gardens in healthcare facilities are one of the most common design elements. They are often placed in specific locations so individuals in waiting rooms can have access to the view or near treatment areas for oncology and post-op patients. “Healing” plants—plants that have medicinal purposes—may also be included to capitalize on the notion of herbs providing certain types of pharmacological intervention.
As an art therapist, I regularly prescribe artmaking experiences that include nature and some time spent in an outdoor environment as a method of reducing stress. Clients may be sketching their impressions of a landscape or tree, painting plein air, or simply meditating on the images and sensory experiences found in nature and writing their thoughts in a journal. I wonder if people, and particularly children, are losing their direct experiences with nature and its benefits, as we come to depend on the Discovery Channel as a substitute for the outdoors. Technology is amazing, but apparently, our bodies are not fooled by it when it comes to an azure blue sky, rhythmic ocean waves, or a pine tree forest. In this time of concern for the health of our planet, it’s good to remember that by taking care to preserve nature, we are also taking better care of ourselves when it comes to stress reduction.
Reference: Journal of Environmental Psychology, 2008
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It is widely accepted that artworks can contribute to healing in the healthcare environment but, explains HenryDomke, images of nature can have a particularly powerful effect.
If patients were more like machines, hospital environments wouldn’t matter. Targeted medical therapy would be enough. But healthcare providers and designers recognize the growing evidence that a sense of place, appealing space, and human grace do matter in the healing process. And nature art has a role in that whole-patient prescription.
Before I explore the practical side of putting art to use in healthcare settings, I want to share a very personal perspective. A middle-aged woman with cancer made regular trips to her local hospital for therapy. She noticed a picture in the waiting area. It was a photograph of a big oak tree in a summer forest with the morning sunlight streaming through the branches, illuminating the forest floor. She started coming in early for her appointments so she could look at the picture and meditate before going in for chemo. She told her cancer nurse that with the way the sun shined through the trees she almost “felt like God was going to walk out”. Whatever she saw there, brought her a sense of peace and comfort during an incredibly stressful and frightening time in her life. I don’t know the woman’s name, but I do know the picture. It was one purchased by Blessing Hospital in Quincy, Illinois. The nurse was struck by its impact and wrote to let me know.
As a family practice physician, I understood the value of treating the whole person. As an artist, I appreciate the support that the right art can provide to the healing process. However, selecting the right artwork is not as easy as you might think. When selecting art for healthcare, it is critical to understand that the viewers of that art are under stress. All people in hospitals are under stress, whether they be patients or visitors. People are anxious because they are wondering: “Is this pain caused by cancer?
Will I be able to return to work after this heart attack?” Even under happy occasions like the birth of a child, many people are anxious with questions: “Is the baby healthy? Did the mother have any problems?” The all-pervasive anxiety in healthcare settings makes selecting the artwork different than in other settings, such as retail or hospitality. In the latter settings, stimulation and excitement are often part of the desired ambiance. In contrast, art in healthcare needs to be comforting and reduce stress.
Because of the special requirements for art in hospitals, art selection should not be delegated to a committee of staff members. Ideally, the staff would give input but an interior designer or art consultant with proven healthcare expertise would select the art. They are most likely to be aware of the current research and are more likely to create an appealing and cohesive design. A mishmash of color, style, and inappropriate content is more often the result of the local committee approach. Designers who select the appropriate art for healthcare settings satisfy not only the patients, they also create a more appealing environment for the staff and patients’ families.
Nature art is the best
Nature art is clearly the best choice for healthcare for several reasons. Firstly, it is the people’s choice. Many studies investigating people’s preferences for art have been done around the world in different cultures and with different age groups. Every study shows the same thing: the vast majority of people prefer realistic nature art. A study by Hathorn and Ulrich found that irrespective of race or ethnicity, patients rated nature art the highest (1).
A more recent study of art preferences in patients concluded: “A quantitative study with the survey results yielded statistically significant results for the popularity of nature images, over best-selling abstract or unique images.”(2)
By nature art I mean ‘happy’ nature art in which the foliage is lush, the plants look healthy and the spaces are inviting. Bleak, cold, parched scenes, or images with threatening weather are not what people like to see when they are sick. Winter scenes suggest death, while pictures of threatening weather suggest trouble.
This preference for realistic nature art may not hold true for the small segment of the population that is highly visually trained – people like architects, interior designers, and art consultants. This can create a problem because such people may assume that their educated tastes should dictate the art selection. Perhaps they think that presenting the general public with challenging art will raise their appreciation for art. This is a worthy goal for galleries, schools, and museums, but not in healthcare settings. Patients don’t need to be challenged in new ways. They are challenged enough.
Contemporary art in galleries and museums is often conceptual. In order to understand it, you need to read about it or have someone explain it to you. Nature art is easy for people to understand; they intuitively ‘get it; they don’t need an owner’s manual. Perhaps that’s because we are hard-wired with an inherent tendency to appreciate the natural environment. Biophilia is the term Edward O Wilson coined to describe this phenomenon (3). Research across a variety of fields suggests a basic human need to maintain a connection to nature. Author Richard Louv addressed this in his book Last Child in the Woods: Saving our children from nature-deficit disorder (4).In addition to its basic appeal, nature art can trigger positive memories. Many times I had patients in my medical clinic point to one of my landscapes as they were smiling and ask: “How did you find my grandfather’s farm? I used to play in that stream as a child.” Of course, the scene was from a totally different location, but it triggered the memory. This positive distraction provided welcome relief from the frightening clinical environment.
Abstract art is the worst
The preference studies that show that ‘regular’ people prefer nature art also show that abstract art is the least popular. And not only is it least popular, some people actively dislike it. By abstract art, I am referring to art where the subject is ambiguous; it is unclear. When untrained people are presented with abstract art, they often try to find the subject matter. Imagine a child in a museum looking at a large abstract painting trying to find hidden objects. They see it like a game. Perhaps they imagine that they are seeing a flock of birds flying overhead. When people are stressed or in pain they tend to interpret ambiguous images negatively. Now they may imagine that painting depicts vultures coming to eat them after they die. In this way, abstract art can make their anxiety worse.
Evidence-based design is great, but…
Evidence-based design (EBD) is a revolutionary idea that promises to use design to improve healing. Scientists perform controlled trials and carefully measure the impact of design on patient outcomes. The goal is to find proof (scientific evidence) that one kind of design is better than another. Using EBD to inform design decisions is tremendously promising. Skeptics are concerned that mixing science with the art of design is like mixing oil with water – it can’t work. Despite those concerns, academic researchers have already completed several important studies. One of the earliest studies in EBD pertains directly to the use of art in healthcare.
In 1984 Dr. Roger Ulrich reported in Science that gall bladder surgery patients who got to look out a window at nature went home about one day sooner and took about half as much pain medication when compared to those whose rooms had a view of a brick wall (5). This lends further support to the idea that nature art is best in healthcare.
Dr Upali Nanda, one of the leading researchers in evidence-based design has written: “Viewing artwork with appropriate nature content has been seen to reduce stress and pain perception, as measured by physiological outcomes such as blood pressure, heart-rate and skin conductance, in addition to self-report measures such as pain-rating scales and surveys.”(6)
Despite the promise of EBD, beware of claims that products or designs have scientific evidence to support them. Doing good research is expensive and time-consuming. The researchers that I spoke with said that less than 2% of design decisions are based on solid evidence. Much of what people claim is ‘evidence’ for EBD has not come from rigorous studies and is a preliminary impression. The best places to keep up on this evolving field are the International Academy for Design & Health (www.designandhealth.com) and Center for Health Design (www.healthdesign.org) websites.
Colours and healthcare
There are also many theories about how people respond to colors. Designers are often taught that certain colors are calming while others make the heart race. To determine whether there is any hard evidence to support these theories, Dr. Ruth Brent Tofle did a careful literature review of all the published articles on this topic. She concluded that “the use of color in healthcare settings currently is not based on significant research” (7). In other words, there is no evidence to support any theories on the use of color in healthcare settings.
Henry F Domke MD is an artist and a physician who lives on a nature preserve in the middle of the US. He now works full time creating nature art for healthcare.
1. Hathorn K, Ulrich R. The therapeutic art program of Northwestern Memorial Hospital. In Creating environments
that heal: Proceedings of the Symposium on Healthcare Design; 2001.
2. Nanda U, Eisen SL, Baladandayuthapani V. Undertaking an art survey to compare patient versus student art
preferences. Environment and Behavior 2008; 40:269-301.
3. Wilson EO. Biophilia: The human bond with other species. Cambridge: Harvard University Press; 1984.
4. Louv R. Last Child in the Woods: Saving our children. Chapel Hill NC: Algonquin Books; 2005.
5. Ulrich RS. View through a window may influence recovery from surgery. Science 1984; 224:420-421.
6. Hathorn K, Nanda U. What is Evidence-based Art? FacilityCare 2007; 12(3).
7. Tofle RB, Schwartz B, Yoon S, Max-Royale A. Color in healthcare environments. San Francisco, California: The
Coalition for Health Environments Research (CHER); 2004.
The benefits of wall graphics within our artwork programs for healthcare settings have become one of the fastest-growing trends. It’s not hard at all to see why. An enlarged image or text can look amazing on a wall. Wall graphics are versatile and can be a beautiful focal point in an area that has a lot of space or in a long narrow hallway where there may not be room for framed artwork. Wall graphics/ coverings are now available in so many different materials including those that can withstand the need to be bleached or sanitized.
“It’s also important to consider that healthcare environments tend to experience abuse from cart traffic and aggressive cleaning protocols. Designers should seek the owner’s input about locating certain substrates in challenging locations and testing surfaces with environmental services staff. Many custom-printed substrates, like vinyl wall covering and resin, will withstand bleach cleaning, but it’s important to know in advance. Another option is to sandwich an image between two layers of more durable material, such as glass if cleaning chemicals are a concern.” (Blake)
The Art Consultants at Health Environment Art Services will work with your project manager and staff to ensure durability concerns and find an image or custom graphic design that will fit your needs as well as your budget. We have Graphic Designers on staff that can help create a design as well as an extensive library of imagery such as natural landscapes to choose from. HEAS has completed many projects featuring wall graphics and we know that we can help you with your needs too!
Contact us today to get started!
Health Environment Art Services
76 West Seegers Road, Arlington Heights, Illinois 60005, United States
We are happy to announce “Butterflies” by artist Priscilla Robinson and “A Gathering at Dusk” by Greg Grove is open for viewing at the Mount Prospect Public Library. These brightly colored handmade paper pieces bring positive energy to the space. This is one of the multiple installation projects we have completed for the library over the years. Their growing collection is enjoyed by the many patrons that frequent the library and is perfect for the spaces they are featured in. Our design team provides a high level of creativity, project leadership, industry knowledge, innovative solutions, and customer service. We see your space for what it could be. Let us help you transform your space today. Contact info: Chicago Office (Corp Headquarters):(847) 843-3636 Email: Denise@corporateartworks.com Nashville Office:(615) 224-3091 or contact us