Tag Archives: Van Gogh

Views (not from the 6)

Throughout our time in Paris, we have seen beautiful artwork in the form of paintings, music, sculpture, dance, and much more. Art is all about perception and I have been so grateful to be able to see and experience Monet’s use of color or Van Gogh’s use of texture. I have had the opportunity to be moved by their brush strokes and see the way they can turn an ordinary scene into a masterpiece. As I walked through the Musée d’Orsay and Musée Rodin, I was in awe of what I was seeing. I could see the level of detail and the individual brush strokes that were so meticulously planned. I had a completely different understanding of how they viewed the world because of their artwork. Looking at Monet’s series of the water lilies, I could tell how light affected his work. Seeing Rodin’s Thinker in real life showed me how much he focused on the hands and facial expressions. Just by seeing the artwork, there was so much I could discern about the artist and time.

Van Gogh’s Wheat Fields

Rodin’s Thinker

 

 

 

 

 

 

 

However, not everyone has the same privilege as I do. People suffering from visual impairments, specifically cortical blindness, do not have the same opportunities as I do to experience and appreciate the visual arts. The way they can perceive art is significantly different because they can’t see the details like we can. This, however, doesn’t mean they can’t be a part of the visual art world! There are a lot more ways to engage visually impaired patients and bring their perspectives of the world to the forefront.

A study done in Poland has suggested that even those with visual impairments can create artwork that is recognizable by individuals without impairments (Szubielska, 2018). In this study, the author asked patients with cortical blindness and others less severe forms of visual impairment to come explore the arts in Poland through guided tours. The author wanted to allow the patients to feel more comfortable with visual art before asking them to attempt to make their own. These visually impaired individuals were given the opportunity to go through art workshops and at the end, their work was displayed to the public for exhibition (Szubielska, 2018). The artwork was shown in very dim lighting or

Sculpture made by visually impaired artist

viewers were given blindfolds to recreate how a lot the visually impaired artists perceived the world. The author found that sculptures made were easier to make out because of their three-dimensional characteristics (Szubielska, 2018).  Even though there was no analysis or calculation of significance, this study shed light on the effects of visual impairments on creativity and helped the general public understand that art can be created without sight (Szubielska, 2018).

 

Through this new platform, people walked through the exhibit and got to experience art through a unique perspective and comprehend the struggles visually impaired people face every day. For example, one visually impaired artist drew a stairwell as a way of expressing his voice that stairs are difficult to maneuver for visually impaired people (Szubielska, 2018). Exposure to this typeof art help shape perspective because recurring experiences help shape the way we perceive the world (Snyder et al, 2015). By displaying the artwork and allowing visually impaired individuals to express themselves creatively, the increase in attractiveness of their work increases because repeated perception of the same stimulus makes them more attractive (Snyder et al, 2015). Overall, even though this exhibition in Poland was very subjective, it was a great start to demonstrating differences in perception and how these experiences can help us gain a broader perspective. Hopefully it can lead to exhibitions by visually impaired artists in Paris and work by Van Gogh and Rodin displayed for visually impaired people to enjoy and appreciate as well!

 

References

Snyder JS, Schwiedrzik CM, Vitela AD, Melloni L (2015) How previous experience shapes perception in different sensory modalities. Frontiers in Human Neuroscience9.

Szubielska M (2018) People with sight impairment in the world of visual arts: does it make any sense? Disability & Society33:1533–1538.

 

Imagaes

Photo 1 and 2 were taken by me

Photo 3: Szubielska M (2018) People with sight impairment in the world of visual arts: does it make any sense? Disability & Society33:1533–1538.

Hallucinations or Chromesthesia?

When we visited the Musée D’Orsay a couple of weeks ago, I was disappointed to hear that The Starry Night painting by van Gogh was at another exhibition; I had looked forward to the opportunity of seeing it in person. Although this was not possible, this past weekend we travelled to Arles, the town where van Gogh lived most of his life. It was a wonderful experience to walk around the areas where he painted his most famous works! Vincent van Gogh, one of the most famous painters from the mid-1800s, was also a man who lived a struggling life. Being somewhat of an outcast, he was ostracized by his community leading him to live a life of loneliness. Over the years, he spiraled into a routine of drinking absinthe that eventually led to the deterioration of his health. He was diagnosed with epileptic seizures and lived in and out of an asylum in Arles, France. Few know that he did his most famous works while he was suffering from these manic and depressive episodes. Seeing as how we have learned so much about him and even visited his hometown, I decided to look more into his medical diagnosis.

Starry Night: One of Vincent van Gogh’s most famous paintings

When you look at The Starry Night, you probably wonder how is it that van Gogh was able to see those colors in the sky when you can only see dark shades of blue at night. There are various theories as to why he decided to paint it that way, but one of those theories was that van Gogh had synesthesia. Synesthesia is a condition when stimulation in one sense automatically leads to sensations in another sense (Bradford 2017). For example, a person might see a letter and automatically associate it with a color. In the case of van Gogh, there is some evidence that points to him having chromesthesia. Chromesthesia is a subset of synesthesia in which certain sounds are associated with colors. “Vincent Van Gogh explained in his letters that for him, sounds had colors and that certain colors, like yellow and blue, were like fireworks for his senses” (Katie 2018). Could it be that he had synesthesia.

A famous cafe in Arles, France painted by van Gogh

Synesthesia is still a widely unknown occurrence. There are 6 regions in the brain, primarily in the motor and sensory cortex, where higher activation levels are observed, V4 (involved in color perception) being one of them (Rouw et al. 2011). For this reason, there are two differing hypotheses as to how it arises, one of them being that there is somehow a disinhibition when relaying back sensory information to the different brain areas, meaning that essentially anyone has the potential to develop synesthesia. The other theory is that there is a cross-activation mediated through white matter pathways that occurs between the different sensory cortex areas; this is something you are born with, so only those people are able to develop it.

To test this out, researchers performed a visual imagery task to induce synesthesia in a group of individuals (Nair and Brang 2019). They were put in a dark environment to simulate visual deprivation and were then asked about the shapes of multiple letters through audio. The results show that there was significantly more visual imagery when a sound was presented right after the audio recording. The fact that it took approximately 5 minutes to induce these sensations points to the theory that everyone is born with the capacity to be synesthetic, but it only appears when one of the other senses is deprived.

Could this be what van Gogh was experiencing? In a 2016 case study, they describe how a 20-year-old woman who was diagnosed with social phobia and schizophrenia due to her avoidance of social groups and claims that she could see colors when she heard sounds. The doctors thought that she was suffering from hallucinations. In reality, she had savant abilities and synesthesia. To have someone be misdiagnosed only a couple of years ago, makes you wonder if maybe the doctors missed something when diagnosing van Gogh. At a young age, when he took piano lessons, he described the experience as overwhelming because each note was associated with a different color He was disregarded and His teacher believed him to be insane and wouldn’t allow him to continue the lessons (Taggart 2019). Could it be that he was never understood because he did in fact think distinctly due to his ability to perceive the world in a different way? A question that may never be answered, but could give us a little more insight into one of the greatest artistic minds of that time. Maybe for van Gogh, the sky was in fact joyous and explosive, not just a simple color.

 

The cafe that inspired van Gogh’s painting

References

Bradford, Alina. “What Is Synesthesia?” LiveScience, Purch, 18 Oct. 2017, www.livescience.com/60707-what-is-synesthesia.html.

Bouvet L, Barbier J, Cason N, Bakchine S, Ehrlé N (2017) When synesthesia and savant abilities are mistaken for hallucinations and delusions: contribution of a cognitive approach for their differential diagnosis, The Clinical Neuropsychologist, 31:8, 1459-1473

Katie. “Vincent Van Gogh and the Power of Synesthesia in Art.” Exploring Your Mind, Exploring Your Mind, 20 June 2018,

Nair A, Brang D (2019) Inducing synesthesia in non-synesthetes: Short-term visual deprivation facilitates auditory-evoked visual percepts, Consciousness and Cognition, 70: 70-79.

Rouw, Romke, et al. “Brain Areas Involved in Synaesthesia: A Review.” Journal of Neuropsychology, John Wiley & Sons, Ltd (10.1111), 16 Sept. 2011

Shovava, and Shovova. “5 Synesthesia Artists Who Paint Their Multi-Sensory Experiences.” My Modern Met, 28 Feb. 2019

Picture 1: https://www.overstockart.com/painting/van-gogh-starry-night

Picture 2: https://en.wikipedia.org/wiki/Café_Terrace_at_Night

Picture 3: https://fineartamerica.com/featured/cafe-van-gogh-forum-square-arles-aivar-mikko.html

Now You See It, Now You Don’t

With 3 weekends having gone by already, I can easily say that this past weekend’s excursion to Provence was the most enjoyable one yet. The countryside in Provence was beautiful and the sights were breathtaking. From the Palais de Papes in Avignon to Pont du Gard to the city of Arles, this weekend gave me an enlightening glimpse into life in southern France. Earlier this week in class, I learned how Van Gogh spent the last years of his life in the Provence region, more specifically in the city of Arles. While in the city, I was able to visit the places around Arles that Van Gogh captured in many of his artworks. Van Gogh’s impressionistic paintings seem to have a life of their own, with golden strokes and dark blue swirls that seem to come right off the page. Standing in the same town that Van Gogh once called home and created masterpiece after masterpiece left me feeling in such a state of wonder. My state of wonder then began to stray away from the aesthetic aspect of his paintings towards pondering how did such a town inspire so many priceless works of art. I thought back to class when we discussed what Van Gogh’s life in southern France was like and the hardships he endured. Looking out over the Rhone, I began to ask to what level did Van Gogh’s mental state affect his work?

Actual location for the inspiration behind Van Gogh’s “La Nuit Etoilee”.

Amidst the beauty of these masterpieces lies hints toward the state of mind of Van Gogh. Surprisingly, many famous artists, inventers, composers, and the artistically creative show manic-depressive tendencies (Z. Janka, 2004). As discovered in class, Van Gogh was in fact plagued by many mental ailments, including hallucinations, seizures, night mares, insomnia, anxiety, manic episodes, depressive episodes, and alcohol abuse. One of Van Gogh’s most famous pieces, “Starry Night”, is thought to be inspired by a hallucination as he was admitted to a mental asylum at the time with no view of the cityscape accessible to him. Based on his reported behavior and mental ailments, I would most likely diagnose Van Gogh with bipolar disorder. Bipolar disorder is characterized by the National Institute of Mental Health as manic and depressive episodes that can be accompanied by psychotic symptoms (hallucinations and delusions) as well as substance abuse (NIMH). Approximately 15% of those with bipolar disorder have visual hallucinations and 28% have auditory hallucinations (F. Waters et al., 2014). The notion that multiple of Van Gogh’s artworks may have been a result of a hallucination intrigued me, as his paintings appear highly vivid, rich in color, with realistic yet whimsical details. Upon investigation into the neural mechanisms behind hallucinations, I learned that there are multiple ways that neurocircuitry plays a role in producing hallucinations.

When a sensation is perceived, let’s say a visual sensation, information from that sensation is sent from the retina to the visual cortex (V1). This is called bottom-up processing. When the brain first perceives a stimulus and then uses previous knowledge to influence what you are perceiving, it is known as top-down processing (A. Engel et al., 2001). A popular theory to the occurrence of hallucinations faults failures in either top-down or bottom-up processing that results in a perceptively false experience (L. Zmigrod et al., 2016). In psychiatric disorders such as bipolar disorder and schizophrenia, signals between top-down and bottom-up processing may become tonically hyperactive, causing top-down sensory expectations that result in false conscious experiences, otherwise known as a hallucination (S. Grossberg. 2000).  Another theory behind the manifestations of hallucinations focuses more strongly on bottom-up processing. When visual hallucinations occur, there is heightened activity in secondary and association visual cortices, the occipital lobe, and in visual processing areas in the parietal lobes. This hyperactivation of different brain regions may cause over-perceptualization which results in a change in activity in areas such as the prefrontal or premotor cortices, allowing for individuals to have a false sense of agency and perceive their own internal auditory or visual activity as “vivid external percepts” (L. Zmigrod et al., 2016). Either way, these false senses of stimuli or experiences cause an individual to perceive a false reality, hallucinating visual or auditory experiences and believing them to be authentic.

Diagram comparing top-down processing to bottom-up processing

Even given Van Gogh’s medical history, his personal account of his struggles, accounts from people who interacted with him, it is still difficult to fully understand the impact that his mental/physical  health had on his work. Was “Starry Night” a complete illusion? Did Van Gogh cut off his ear due to an auditory illusion? While we may never know the true answers to the questions, we can still infer that Van Gogh was, at the least, influenced by his possible bipolar disorder and the hallucinations that may have accompanied it.

Map of Arles, France

 

Works Cited

Engel, A. K., Fries, P., & Singer, W. (2001). Dynamic predictions: oscillations and synchrony in top–down processing. Nature Reviews Neuroscience2(10), 704.

Grossberg, S. (2000). How hallucinations may arise from brain mechanisms of learning, attention, and volition. Journal of the International Neuropsychological Society6(5), 583-592.

Janka, Z. (2004). Artistic creativity and bipolar mood disorder. Orvosi hetilap145(33), 1709-1718.

NIMH: Bipolar Disorder. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

Waters, F., Collerton, D., Ffytche, D. H., Jardri, R., Pins, D., Dudley, R., Larøi, F. (2014). Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease. Schizophrenia bulletin40 Suppl 4(Suppl 4), S233–S245. doi:10.1093/schbul/sbu036

Zmigrod, L., Garrison, J. R., Carr, J., & Simons, J. S. (2016). The neural mechanisms of hallucinations: a quantitative meta-analysis of neuroimaging studies. Neuroscience & Biobehavioral Reviews69, 113-123.

Would Lithium be a Good Treatment for Vincent Van Gogh?

I am not an art enthusiast, but this summer of my junior year in college has brought me closer to the life of perhaps the most famous painter in the history of western art, Vincent van Gogh. Before I traveled to Europe this summer, I watched two recent movies “Loving Vincent” and “At Eternity’s Gate” that were made based on the life of Vincent van Gogh. My summer started in the Netherlands, and I traveled down to Belgium, Paris, and Provence. This route coincidentally followed van Gogh’s path of mental deterioration, which eventually ended with his suicide in 1890 at the age of 37.

Self Portrait (1887), Rijksmuseum, Amsterdam

Van Gogh Self Portrait (1889), Musée d’Orsay, Paris

Garden of the Hospital in Arles (1889), Espace van Gogh, Arles
Van Gogh was committed after the infamous episode of cutting off his left earlobe in December 1888.

The mental state of van Gogh has long been a subject of controversy. Three years ago, mental health doctors and art history experts came together at the Van Gogh Museum in Amsterdam to find a diagnosis for him (Siegal, 2016). (Read more at https://www.vangoghmuseum.nl/en/stories/on-the-verge-of-insanity) After having a thorough examination of the medical record of his case as well as personal letters, the doctors failed to come to the conclusion of a single diagnosis. Though there might be more than one illness van Gogh has suffered in his life, most analytics, including American Psychiatrist Dietrich Blumer, agree on that van Gogh has displayed many symptoms of bipolar disorder (Blumer, 2002).

Professor Isabella Perry first assigned van Gogh with a diagnosis of bipolar disease (Perry, 1947). People with bipolar disease have recurrent episodes of elevated mood and depression, together with changes in activity levels (Anderson, Haddad, & Scott, 2012). Van Gogh’s life has been also associated with periods of intense activity and depression (Perry, 1947). Bipolar disease is the 6th leading cause of disability worldwide and has a prevalence of about 1-3% of our general population (Moreira, Van Meter, Genzlinger, & Youngstrom, 2017). This particular psychiatric illness has also been linked with creative accomplishment and many names in the history of creative art. Writers Ernest Hemingway, Virginia Woolf, Composer Robert Schumann, Painter Jackson Pollock and most likely Vincent van Gogh are all among the list (Rothenberg, 2001).

Lithium has been used as the main treatment for bipolar disease for the last sixty or more years (Won & Kim, 2017). Lithium has also been demonstrated to reduce suicide rates and prevent manic episodes in bipolar disease patients (Anderson et al., 2012). However, only one-third of bipolar disorder patients respond to the treatment. Why this treatment works in some patients and does not work in other patients is unknown (Tobe et al., 2017). Although the therapeutic pathways of lithium are complex, through recent research, lithium’s exact mechanism is progressively being clarified. It is becoming more evident that biological systems modulated by lithium are deeply intertwined with biological disruptions associated with bipolar disorder (Won & Kim, 2017).

A recent study published in PNAS used stem cells (cells that can differentiate into other cell types) to unravel lithium’s target and therefore gave the scientists an opportunity to look deeply into the cellular mechanism of bipolar disorder. In this article, the authors have cleverly used lithium, the most common treatment for bipolar disorder, as their “molecular can-opener for prying intracellularly to reveal otherwise inscrutable pathophysiology” in bipolar disorder. They mapped the “lithium-response pathway” which functions to govern the phosphorylation of a protein called CRMP2 involved in the neural network. Normally, the “tug-of-war” between the inactive state (phosphorylated) and active state (non-phosphorylated) is all done physiologically inside our brain. In bipolar disease patients, this “set-point” has gone all wrong. So, the role of lithium is to operate as a “referee” to normalize that set-point (Tobe et al., 2017). Though the “lithium-response pathway” is certainly not a complete picture of bipolar disorder, it helped us to gain significant insights into how lithium modulates our body and alleviate symptoms for patients with the disease.

(Watch Principal Investigator Evan Snyder explains this study)

Psychiatrist Albert Rothenberg argued in his paper that research has shown that lithium treatment has the risk of cognitive impairment and decreased productivity. Another impediment is that many creative people hold the false belief that there is an intrinsic connection between suffering and mental illness. Some believe that tampering with their illness will also destroy their creative talents. And therefore, non-compliance with the doctor’s prescription is fairly common (Rothenberg, 2001). Even if van Gogh had treatment available, whether he would have complied remains questionable.

So, to answer my question raised in the title of this blog post, yes, lithium could have been a useful treatment. But considering the fact that only a third of patients respond to treatments and also the fact that van Gogh had a history of drinking absinthe regularly, lithium would not a magical pill that will fix all the problems with him. By focusing our research on the molecular mechanism of lithium on bipolar disorder, we would be able to map out bipolar disorder in the brain and help these people suffering from this disease. Who knows, the next van Gogh might be among them.

Reference

Anderson, I. M., Haddad, P. M., & Scott, J. (2012). Bipolar disorder. 345, e8508. doi:10.1136/bmj.e8508 %J BMJ : British Medical Journal

Blumer, D. (2002). The Illness of Vincent van Gogh (Vol. 159).

Moreira, A. L. R., Van Meter, A., Genzlinger, J., & Youngstrom, E. A. (2017). Review and Meta-Analysis of Epidemiologic Studies of Adult Bipolar Disorder. The Journal of clinical psychiatry, 78(9), e1259-e1269. doi:10.4088/jcp.16r11165

Perry, I. H. (1947). VINCENT VAN GOGH’S ILLNESS: A Case Record. Bulletin of the History of Medicine, 21(2), 146-172.

Rothenberg, A. J. P. Q. (2001). Bipolar Illness, Creativity, and Treatment. 72(2), 131-147. doi:10.1023/a:1010367525951

Tobe, B. T. D., Crain, A. M., Winquist, A. M., Calabrese, B., Makihara, H., Zhao, W.-n., . . . Snyder, E. Y. (2017). Probing the lithium-response pathway in hiPSCs implicates the phosphoregulatory set-point for a cytoskeletal modulator in bipolar pathogenesis. 114(22), E4462-E4471. doi:10.1073/pnas.1700111114 %J Proceedings of the National Academy of Sciences

Won, E., & Kim, Y.-K. (2017). An Oldie but Goodie: Lithium in the Treatment of Bipolar Disorder through Neuroprotective and Neurotrophic Mechanisms. 18(12), 2679.

The Starry Dream

“For my part I know nothing with any certainty, but the sight of the stars makes me dream.” This quote by Vincent Van Gogh sums himself up perfectly. It is known that he had various psychotic symptoms, such as auditory and visual hallucinations, and it is still disputed whether some of his works are accurate portrayals of reality, or simply representations of his “dreams.” Fortunately, our class had the opportunity to visit Arles this past weekend, the small town in Provence where Van Gogh famously stationed himself and painted many of his most famous pieces. We were able to witness many of the things we had previously seen only in his paintings. For example, we saw the river painted in “Starry Night over the Rhone” and the garden portrayed in “Garden of the Hospital in Arles.” Van Gogh certainly had no trouble capturing the full beauty of these places with his paintings, but was his abstract and unique style just an artistic twist, or was it really how he perceived these locations?

“Garden of the Hospital in Arles” by Van Gogh

A photo from our visit to the garden of the hospital, which is much less yellow in real life

There have been many retroperspective diagnoses of Vincent Van Gogh. It is most commonly believed that he suffered from bipolar disorder. However, he was known to have been an avid absinthe drinker, a drink reported to cause hallucinations. Thus, my first inclination was that Van Gogh’s psychotic symptoms must have been due to his absinthe abuse. When in Arles, some friends and I went to “Le Cafe Van Gogh”, the cafe where Van Gogh spent most of his time drinking. We noticed the menu had a cocktail called “Le Van Gogh” which contained some absinthe, so, as any good scientist would, we ordered some. Surprisingly, the absinthe didn’t have much effect, and certainly didn’t cause any hallucinations. Possibly, I was wrong and it wasn’t the absinthe that caused Van Gogh’s psychosis.

The famous Cafe Van Gogh

It is widely believed that the active hallucinogen in absinthe was thujone, which comes from the wormwood oil included in the beverage. Studies have even shown that thujone is a neurotoxic compound, with the ability to inhibit GABA receptor activity (Hold et al., 2000). GABA is an inhibitory neurotransmitter and is involved in calming the body, such as relieving anxiety. Inhibition of GABA receptors, as caused by thujone, may produce mood elevation (Olsen, 2000).

Another recent study found that thujone has inhibitory effects on serotonin receptors too (Deiml et al., 2004). Serotonin is an excitatory neurotransmitter that has been shown to play a role in various psychiatric conditions, such as depression, anxiety, and obsessive-compulsive disorder (Dayan and Huys, 2008). Inhibition of GABA and serotonin on their own hasn’t shown any signs of causing hallucinations, but recent evidence shows that together, they could have. A study suggests that an imbalance of excitatory and inhibitory influences on the brain could cause be the cause of hallucinations (Jardri et al., 2016). Perhaps, the mixture of serotonin and GABA inhibition by thujone, causing simultaneous excitatory and inhibitory signals, was the culprit in Van Gogh’s insanity.

However, contrary to this, recent studies also suggest that absinthe has never contained enough thujone to actually cause psychiatric symptoms; rather, the amount of thujone required to cause hallucinations would poison us to death before causing this phenomenon (Padosch et al., 2006). This doesn’t mean that Van Gogh’s absinthe abuse didn’t account for any of his symptoms, though, as new research presents evidence that alcohol on its own can cause psychosis in some individuals (Salen and Stankewicz, 2018). Alcohol-induced psychosis is a recently defined disorder in which certain individuals experience hallucinations, paranoia, and fear during or shortly after alcohol consumption (Salen and Stankewicz, 2018). Although this is an extremely rare condition, possibly Van Gogh was one of the few unlucky (or lucky) individuals to suffer its consequences. If this were the case, absinthe would have only exacerbated the symptoms of the condition due to its extremely high levels of alcohol, rather than its thujone content.

Regardless of the cause of Vincent Van Gogh’s insanity, one thing’s for sure: it led to the creation of some of the greatest, most unique artwork of history which he will always be remembered for.

Location of Arles

Sources:

Höld KM, Sirisoma NS, Ikeda T, Narahashi T, Casida JE. (2000). Alpha-thujone (the active component of absinthe): gamma-aminobutyric acid type A receptor modulation and metabolic detoxification, Proc. Natl. Acad. Sci. USA, 97(8):3826-31

Olsen R, (2000). Absinthe and γ-aminobutyric acid receptors, Proc. Natl. Acad. Sci. USA, 97(9): 4417–4418

Deiml, R. Haseneder, W. Zieglgänsberger, G. Rammes, B. Eisensamer, R. Rupprecht, G. Hapfelmeier, (2004). α-Thujone reduces 5-HT3 receptor activity by an effect on the agonist-induced desensitization, Neuropharmacology 46(2): 192-201

Peter Dayan and  Quentin J. M Huys, (2008). Serotonin, Inhibition, and Negative Mood, PloS. Comput. Biol. 4(2): e4

Renaud Jardri, Kenneth Hugdahl, Matthew Hughes, Jérôme Brunelin, Flavie Waters, Ben Alderson-Day, Dave Smailes, Philipp Sterzer, Philip R. Corlett, Pantelis Leptourgos, Martin Debbané, Arnaud Cachia, Sophie Denève, (2016). Are Hallucinations Due to an Imbalance Between Excitatory and Inhibitory Influences on the Brain?, Schizophr. Bull. 42(5): 1124–1134

Stephan A Padosch, Dirk W Lachenmeier, and Lars U Kröner, (2006). Absinthism: a fictitious 19th century syndrome with present impact, Subst. Abuse. Treat. Prev. Policy. 1:14

Holly A. Stankewicz and Philip Salen, (2018). Alcohol Related Psychosis, StatPearls [Internet]

Image:

https://en.wikipedia.org/wiki/Hospital_in_Arles#/media/File:Van_Gogh_-_Garten_des_Hospitals_in_Arles1.jpeg

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

Name that Painting

Bonjour from France! I am so excited to be posting my first blog here in Paris. I have had such an amazing first week and a half. This city is so beautiful and has so much to offer. One of the parts of Paris I was so excited for before coming here was the art. Paris is known for its beautiful art and amazing museums. One of my favorite artists is Van Gogh (cliché, I know. But his paintings are beautiful). So you can imagine my excitement when we had the opportunity to go as a group to the L’Atelier des Lumières. This is a beautiful experience where art is projected onto the walls of the room, with background music and movement as opposed to the normal still painting. One of the exhibits is called Van Gogh Starry Night, and it includes many of his different paintings come to life before your eyes.

The Olive Trees by Van Gogh at L’Atelier des Lumières

One of the things that has always fascinated me most about Van Gogh’s paintings, and post-impressionist paintings in general, is the ability for us to recognize the scene even though it is never perfectly clear. I realized this is an amazing task that our mind is able to achieve through object recognition. Object recognition is just what it sounds like, but the mechanisms supporting it are very complicated, interesting, and intricate. Object recognition calls on many regions including the visual cortex as well as many structures in the temporal lobe of the brain (Bar et al., 2001). Object recognition calls on bottom-down processing, which is a process in which we receive visual information and then call on higher processes to understand the full picture. However, it has also been observed that top-down processing is more important than previously realized. Top-down processing is when higher functions, or previously stored information, affects the perception we are creating. For example, our memory can have an effect. Our brain takes information from our memory system to fully fill in the details of the image we are looking at (Bar et al., 2007). This may explain why I could recognize which painting was being displayed in the exhibit even before it was fully in my view.

Only Part of Starry Night shown at L’atelier des Lumières

Along with this, partially analyzed images or incomplete images can be recognized before all of the information is received (Bar, 2003). This is why even when an object in a Van Gogh painting isn’t blurry or not the full picture, we can still recognize the scene in front of us.

Wheatfield with Crows by Van Gogh. The image is blurry and a bit unclear, but you can still tell what it is.

Another fascinating thing about object recognition is the emotion we feel when viewing certain objects. I am sure everyone has an experience with art that has made them feel some sort of emotion, as I did at the L’Ateliers exhibit. Before studying this topic, I would assume that the emotion we feel comes after we are able to detect an object. However, there are multiple studies that now say our emotions can actually affect our final perception of an object. One study says that our prediction of an object includes its relevance and value, before we are consciously aware of the object we are observing (Barret and Bar, 2009). Another study expanded on this, looking at our emotional perception of faces and the way it can be influenced without our knowledge. If a happy or negative face is shown quickly and not entering consciousness, then we will perceive a neutral face shown directly after as having more emotion (Siegel et al., 2018).

This was very interesting to me, because it means the context or environment around us, or even the mood that we are in, may completely change our perception of an object. The feeling that I perceive when looking at Van Gogh’s Starry Night will be different than someone else’s. Also, as stated above, our different memories and experience could change the way in which we perceive the painting as well.

It is amazing what our brain is able to accomplish. Not only are we able to recognize objects before we have the entire picture, but our emotional processing of that object starts very early on in the process as well.  This is just part of the reason Van Gogh’s painting have always amazed me. He has the ability to create a scene that isn’t quite right, but we know what it is showing anyway. He is able to let your mind fill in the rest of the details. Not only this, but each perception of his paintings are completely different based off our own experience. I know my personal experience leads to a beautiful painting with lots of emotion.

Self Portrait by Van Gogh shown at L’Atelier des Lumières

 

 

Works Cited

Bar, M., Tootell, R. B., Schacter, D. L., Greve, D. N., Fischl, B., Mendola, J. D., . . . Dale, A. M. (2001). Cortical Mechanisms Specific to Explicit Visual Object Recognition. Neuron,29(2), 529-535. doi:10.1016/s0896-6273(01)00224-0

Bar, M. (2003). A cortical mechanism for triggering top-down facilitation in visual object recognition. J Cognitive Neuroscience,15, 600-609.

Bar, M. (2007). The proactive brain: Using analogies and associations to generate predictions. Trends in Cognitive Sciences,11(9), 372. doi:10.1016/j.tics.2007.08.004

Barrett, L. F., & Bar, M. (2009). See it with feeling: affective predictions during object perception. Philosophical transactions of the Royal Society of London. Series B, Biological sciences364(1521), 1325–1334. doi:10.1098/rstb.2008.0312

Siegel, E. H., Wormwood, J. B., Quigley, K. S., & Barrett, L. F. (2018). Seeing What You Feel: Affect Drives Visual Perception of Structurally Neutral Faces. Psychological science29(4), 496–503. doi:10.1177/0956797617741718

Image 1,2 and 4-  my own images

Image 3: Wheatfield with Crows – Van Gogh Museum. (n.d.). Retrieved from https://www.vangoghmuseum.nl/en/collection/s0149V1962