Tag Archives: Provence

vitamin G for green

After getting off of the train in Avignon and feeling the sun hit my un-sunscreened shoulders, my mood undeniably approved. It was a definite upgrade from the cold and drizzly weather we had just escaped from in Paris. Whether it was the sunshine induced drowsiness or the gelato produced lethargy, I seemed to move at a much slower and relaxed pace this weekend. I often find myself hustling to get from departure point to destination during the week, sighing impatiently at the slow walkers leisurely strolling on the sidewalk who have the audacity to slow me down.  In Provence, I didn’t feel the need to obsessively make schedules and instead just enjoyed the new surroundings.

The southern France, creek wading Irena is definitely much more carefree and relaxed than urban Paris, coffee chugging Irena.

I thought back to our journal topics about Van Gogh and his mental health and remembered how the film we watched had portrayed his mood. Van Gogh had written about the countryside in Arles and how it had improved his spirit (up until that whole ear incident). Van Gogh talked about how much time he was spending outside and how productive his work output was during the time he could paint en plein air. I think this is something that we can all relate to; the first day of being outside in the warmth and sunshine after weeks of winter stuck inside avoiding the Atlanta rain can make me feel like I escaped something just shy of seasonal affective disorder. Well besides you and me, it seems that others have been onto this phenomenon for a while now too. In fact, the term “ecotherapy” has been coined as “an umbrella term for a gathering of techniques and practices that lead to circles of mutual healing between the human mind and the natural world from which it evolved”  (Chalquist, 2009).

Courtyard garden in an Arles hospital where Van Gogh stayed briefly and his painting of it

It has been documented that merely looking at nature or natural elements can provide restoration from stress and mental fatigue while reducing feelings of anger, frustration and aggression. This has indicated that the “aesthetic experience of nature” can play a beneficial role in affecting mood (Groenewegen, van den Berg, de Vries, & Verheij, 2006). Some studies utilize the visual sensory system in order to test the effects of nature images on neural processing and well-being; however, the experience of nature cannot be reduced to singular modalities but rather is holistic and encompasses all the sensory systems in the body. Therefore, many of the studies that I looked at examined and quantified aspects of well-being that are harder to measure. A study of 57 people with serious and persistent mental illness was conducted where they participated in an outdoor adventure program involving weekly full day outings for 9 weeks. At the end of the study, there were statistically significant increases on the Generalized Self-Efficacy Scale (a 10-item psychometric scale that assesses optimistic self-beliefs to cope with a variety of difficult demands in life) in the experiment group compared to the control group that did not undergo outdoor exposure. The experimental group also showed significant reductions in scores on the Anxiety and Depression subscales of the Brief Symptom Inventory (BSI), a test that evaluates psychological distress and psychiatric disorders. Patients with affective or schizoaffective disorders, mental health disorders we discussed Van Gogh having the possibility of having, showed an increase in scores on the Trust and Cooperation Scale, and decreased BSI Hostility and Interpersonal Sensitivity (Kelley, Coursey, & Selby, 1997).

General mechanisms to explain relationships between green space and health, well-being, and social safety

In a 2010 meta-analysis (a statistical procedure for combining data from multiple studies) that analyzed 10 UK studies of environment and health that involved over 1252 participants, every green environment improved both self-esteem and mood with the presence of water generating greater effects. Outcomes were identified through a subgroup analyses, and dose-responses were assessed for exercise intensity and exposure duration. Based on this meta-analysis, the mentally ill showed one of the greatest self-esteem improvements based on exposure to green environments and nature (Barton & Pretty, 2010).

The number of participants, activity types, environments, and cohorts from each study from the meta-analysis  

Ecotherapy studies have also begun a foray into a crossover intervention with art therapy, as both approaches have research supporting their success in the reduction of physiological and psychological symptoms associated with a variety of diagnoses in numerous settings. While a statistically significant correlation between ecotherapy and art therapy has not yet been found, there are many qualitative and case-study research designs that demonstrate the effectiveness of art and eco-therapy interventions (Bessone, 2019).

This weekend in Arles, we saw the various locations around town that Van Gogh drew inspiration from for his paintings, making it quite evident that he was closely connected with his environment. While eco/art therapy are no substitutes for comprehensive mental health care, I hope that Van Gogh was able to find temporary reprieve in his artistic work and the natural beauty of southern France during his time there.

Landscape picture of Arles, France

 

Bibliography

Barton, J. & Pretty, J. (2010) What is the Best Dose of Nature and Green Exercise for Improving

Mental Health? A Multi-Study Analysis. Environmental Science & Technology, 44, 3947-3955.

Bessone, E. (2019) Implications and Applications of Eco-Therapy on Art Therapy. Expressive Therapies Capstone Theses. 155.

Chalquist, C. (2009) A Look at the Ecotherapy Research Evidence. Ecopsychology, 1, 64-74.

Groenewegen, P.P., van den Berg, A.E., de Vries, S. & Verheij, R.A. (2006) Vitamin G: effects of green space on health, well-being, and social safety. BMC Public Health, 6, 149.

Kelley, M. P., Coursey, R. D., & Selby, P. M. (1997). Therapeutic adventures outdoors: A demonstration of benefits for people with mental illness. Psychiatric Rehabilitation Journal, 20(4), 61-73.

Image 1: my own picture

Image 2: from https://www.marvellous-provence.com/arles/what-to-see/in-the-footsteps-of-van-gogh

Image 3: from Groenewegen, van den Berg, de Vries, & Verheij, 2006.

Image 4: from Barton & Pretty, 2010

Image 5: from https://steemit.com/landscapephotography/@schmidthappens/landscape-photography-the-inspiring-arles-france

 

Lust for Answers

This past weekend, our group went to Provence, a province in southeast France, and visited the city of Arles where Vincent van Gogh lived for two years painting some of his most famous works such as Yellow House, Starry Night Over the Rhone, and Bedroom in Arles.

A map of some of the locations in Arles where van Gogh painted some of his most famous works.

Before going there, we saw in class the movie, Lust for Life, a 1950’s biographical movie about Vincent van Gogh’s life highlighting his interactions with other painters, his family, and his surroundings (Lust for Life – Trailer, n.d.). The movie touches on Van Gogh’s lifelong mental strife showing that while we revere him as an artistic genius now, very few people understood him including himself.

It seemed the depression that Van Gogh experienced subsided according to his letters to his family and friends, but in the movie, they show the manic way he painted constantly covered in paint and obsessed with catching the light to paint landscapes and field laborers. When the fall and winter came around, he could not go outside expressing how he felt trapped. His condition worsened where outside painting did not work anymore leading up to him to cut off his ear with a variety of possible reasons that no one could confirm. He eventually was admitted to a hospital where his hallucinations continued with blocks of time missing from his memory and his alcohol abuse addressed. He still continued to paint famous pieces such as The Courtyard of the Hospital at Arles 1889 that are preserved to this day.

A picture at the hospital courtyard where van Gogh was attempted to after cutting off his ear.

We looked at his doctor’s notes categorizing his condition as epilepsy because of his ongoing non-lucid episodes, so we started looking into different mental conditions that related back to the ones we know today as major depression disorder, bipolar disorder, schizophrenia, and more. This eventually led us to see what type of treatments would be available for the people with dementia praecox: a term coined by Emil Kraepelin to describe lesions in the cerebral cortex that mild dementia (Adityanjee et al., 1999). I couldn’t find much in terms of treatment, but it got me thinking about what we have today to help alleviate the effects of mental illnesses such as bipolar disorder, schizophrenia, and depression. As well as my interest being piqued through exploring Van Gogh’s life, there is a high probability I will see these novel practices implemented in the future.

The School of Nursing at Emory does a good job of teaching us the evidence-based practices that we follow for patient safety and comfort, but the patients have the autonomy in most cases to deny treatment, do something different than recommended to treat their ailments , or ask about new upcoming treatments. Because of this, it is important to know recent research about various types of treatment practices to be better support the patients.

van Gogh’s self portrait fading away during the Atelier des Lumieres of all of his works.

One that was really interesting to find out was the possible implementation of brain-derived neurotrophic factor (BDNF) to help treat neurodegenerative diseases as well as mental health disorders. It is a growth factor that is used in neurogenesis or the formation of new neurons which is not common for adults; in most of the brain, there are no new neurons created from the ones at birth, but there are some brain areas that still have new neurons created which is where growth factors like BDNF are used those new neurons (Bathina and Das, 2015). This is also used for synaptic plasticity in which there is a consistently strong or diminished communication between the neurons depending on how strength and importance of the signal is between the two neurons (“What Is Synaptic Plasticity?”). There is also evidence that a depleted amount of the class of factors BNDF belongs to can possibly be an indicator for neurological disorders such as Parkinson’s disorder and Alzheimer’s (Bathina and Das, 2015). While BNDF has the ability for synaptic plasticity, a study done with mice found that inhibition of one of the receptors BNDF can bind to shows a decrease in long term depressive behaviors without affecting its synaptic plasticity function in other brain areas (Woo et al., 2005). Researchers also theorize that people with reduced BDNF levels might have a decreased synaptic plasticity in the hippocampus which prevents the body from going back to homeostasis taking them out of their stress related depressive states (Phillips, 2017). The second type of receptors that BDNF does the opposite effect by producing synaptic plasticity; this receptors’ activation and an BDNF increase is seen in the presence of certain antidepressive pharmacologic therapies (Phillips, 2017).This is now being used as an indicator for future drug therapies as a measure of effectiveness.

A watercolor painting I did in class depicting the sensory neurons in the eye.

Going away from the pharmacological side, I started to think about Van Gogh and how his art was a source of peace and strife for him. At some point, painting couldn’t help in him in the way it did before. This is not to discredit the effects that art and other alternative therapies have on supporting those with symptoms similar to his; a study had 58 patients diagnosed with schizophrenia do art therapy twice a week for twelve weeks (Montag et al., 2014). They found that those who had committed to the program had less negative symptoms which include a loss of interest and a lower affect as well as less positive symptoms of schizophrenia such as auditory hallucinations compared to the control group who did not receive the art therapy (Montag et al., 2014)  (“Symptoms,” 2017). This support the idea that Van Gogh’s art was a therapeutic event for him up until everything became too much. It’s fascinating to how we reverie Van Gogh’s coping mechanism after his death with his few family and friends supporting his ability to paint. It makes you think about those that we have forgotten about who are tucked away in our society creating the next artistic masterpiece of our time.

 

 

References

Adityanjee, Aderibigbe, Y. A., Theodoridis, D., & Vieweg, W. V. R. (1999). Dementia praecox to schizophrenia: The first 100 years. Psychiatry and Clinical Neurosciences, 53(4), 437–448. https://doi.org/10.1046/j.1440-1819.1999.00584.x

Bathina, S., & Das, U. N. (2015). Brain-derived neurotrophic factor and its clinical implications. Archives of Medical Science: AMS, 11(6), 1164–1178. https://doi.org/10.5114/aoms.2015.56342

Lust for Life – Trailer. (n.d.). Lust for Life – Trailer. Retrieved from https://www.youtube.com/watch?v=WUHL0h_kQ6s

Montag, C., Haase, L., Seidel, D., Bayerl, M., Gallinat, J., Herrmann, U., & Dannecker, K. (2014). A Pilot RCT of Psychodynamic Group Art Therapy for Patients in Acute Psychotic Episodes: Feasibility, Impact on Symptoms and Mentalising Capacity. PLoS ONE, 9(11). https://doi.org/10.1371/journal.pone.0112348

Phillips, C. (2017). Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection. Neural Plasticity, 2017.https://doi.org/10.1155/2017/7260130

Symptoms. (2017, October 23). Retrieved June 10, 2019, from nhs.uk website: https://www.nhs.uk/conditions/schizophrenia/symptoms/

What is synaptic plasticity? (2016, November 22). Retrieved June 9, 2019, from https://qbi.uq.edu.au/brain-basics/brain/brain-physiology/what-synaptic-plasticity

Woo, N. H., Teng, H. K., Siao, C.-J., Chiaruttini, C., Pang, P. T., Milner, T. A., … Lu, B. (2005). Activation of p75NTR by proBDNF facilitates hippocampal long-term depression. Nature Neuroscience, 8(8), 1069–1077. https://doi.org/10.1038/nn1510

Picture #1: [Screenshot of the walking tour of Van Gogh’s art in Arles]. Retrieved from https://www.google.com/maps/d/u/0/viewer?mid=1014-AkOjbBzXEQQLcxz8NGxa10Oo1bGN

Picture #2 and #3: Taken by me

Picture #4: Painted and picture taken by me