The emotions associated with a breast cancer diagnosis and treatment are sometimes too overwhelming to put into words. When there are no words, many breast cancer patients and survivors opt for pictures instead.
Most hospitals and cancer treatment centers now offer art therapy workshops geared specifically toward cancer patients or can provide information about local art therapy groups and licensed art therapists.
Susan Hedlund, director of patient and family services at the OHSU Knight Cancer Institute in Portland, is a strong advocate for creative therapies for cancer patients. She said it’s important to remember no one therapeutic approach is going to be helpful for every cancer patient, but tapping into creativity can open additional avenues for processing the experience of living with cancer.
“It’s an option for people who are less verbal in terms of expressing themselves and also allows them to create things of beauty,” Hedlund said. “It can be almost like a meditation where you’re not having to talk, you’re not having to process a lot cognitively, but it can be something that keeps your hands busy, keeps you distracted and keeps you in the moment.”
Art accesses a different part of the brain, Hedlund said, a deeper part where images and metaphors can take the place of words. Hedlund mentioned a former patient whose chemotherapy so depleted her energy that she couldn’t attend traditional therapy sessions or sometimes speak at all. Drawing became a vital communication tool.
“Her husband went and got her pastels and workbooks and she just drew and drew and drew,” Hedlund said. “She drew a dragon with a little blue butterfly sitting on its nose. She said, ‘I may be fighting a dragon but I’m a butterfly and I can fly around its head and drive it crazy.’ She was too exhausted to talk but she could lay in bed and draw.”
Margaret Hartsook is a board-certified art therapist and licensed professional counselor at Legacy Health’s cancer center in Salmon Creek. She runs art-based therapy groups that are open to anyone who has cancer, no matter where they’re receiving cancer treatment.
“What my job is and what many art therapists do is to facilitate people’s creativity,” Hartsook said. “We lift them up and give them the skills to make it accessible to them. We try hard not to offer things that are complicated, things that require this art background.”
Hartsook said art therapy groups connect cancer patients to a supportive community at a time when they’re most isolated — not just because of COVID-19, but also because their friends and family don’t understand what they’re going through. Breast cancer patients in particular may be contending with the loss of hair or breasts, resulting in a deeper identity shift that can be difficult to process, she said.
“People with cancer, their stress levels can be very high because of treatment and pain and all the things they’re going through, including fear of recurrence,” Hartsook said. “They come to the group and they know that for an hour they can just ‘download’ and let things go. We help them through reading, guiding them, and then making art.”
Hartsook’s art therapy groups are currently meeting online because COVID-19 presents too great a risk for immunocompromised patients. She facilitates Virtual Community Open Studio, a twice-weekly session focused especially on reducing anxiety and stress.
It meets on Mondays and Fridays so that patients can “begin their week and end their week in this safe place,” Hartsook said.
Confronting Breast Cancer
In spite of the virtual format, Hartsook said that a strong community has developed among group members. In many cases, online video meetings are easier for cancer patients because they don’t even have to get out of bed to join the group.
The class usually starts with a prompt, Hartsook said, and then moves on to art-making. Hartsook often uses collage because it’s accessible even for those who don’t consider themselves artistic.
“Last fall we called it ‘comfort pages.’ We sent a lot of images like beds and blankets and kitties and fireplaces, and then we had people choose their own images and create a collage,” Hartsook said. “The takeaway is that they feel part of a community and they’ve gotten away from the daily stresses of their life. It’s less overt mindfulness and more just making art.”
The benefits aren’t just emotional, Hartsook said. Creativity can also be a tool for pain management. Hartsook acknowledges that it’s different for everyone, but in general, she has observed many patients over the years who report reduced pain and anxiety during art therapy sessions. Learning to make art gives them a new tool to address worry or discomfort outside of therapy or after cancer treatment ends. Sometimes, Hartsook said, the people who get the most out of art therapy are the ones who least expect to.
“We have a lot of people who wouldn’t identify as a super-creative person but they are open to trying and they need something different. That is the kind of person who gets the most from it,” Hartsook said.
Sometimes cancer spurs people to attempt things that they wouldn’t have considered in their pre-cancer lives. For others, art builds a bridge between a person’s pre-cancer and post-cancer life, she said.
“There are a lot of people that go on and spend a lot of time making art post-cancer. It can create an identity for people at a time that can be so hard. That’s one of the weird silver linings that we get to see at times,” Hartsook said. “For some people, it’s just a stepping stone, but we set up everything so that whether you’re an experienced artist or you’re someone that wants to create but doesn’t really know how, we try to offer things that are friendly to everyone.”