Photography for mental illness

History

Creative therapies have been utilized for mental illness for thousands of years. Ancient Egyptian and Chinese medical texts mention the use of music as a healing treatment. In the 1940s music therapy began to develop as an organized medical profession.1 Art therapy is another creative therapeutic approach with potential origins in mid-20th century Europe. It first gained widespread use in tuberculosis wards to provide a creative outlet to patients.

The history of photography is a lot shorter than some of the other arts such as music and painting. Photography began in the 1830s in France where the first permanent photograph was taken. Photography was not widely available until a company called Kodak was started in the 1880s. This used rolls of film instead of hard metal plates to project the image onto. The World Wars really spurred how widespread photography was because people saw the power of showing and sharing real world images from around the world. Camera’s continued to progress and the first digital camera began available in 1991 and the first cell phone camera in 2000.

This widespread availability of cameras does not have a long history, but it does have an impactful one. Many people take pictures for social media or photo albums but the therapeutic use of photography is in its infancy.

Background

Photography includes many components that can be good for mental health. Often, photography has people spending more time outdoors. A study from the University of Michigan found that spending 20 minutes outside, three times per week was beneficial for anxiety and depression.2 The next benefit of photography is related to exercise and being active. Often hiking, climbing, or even just squatting is needed to get the best angle and the best photo. A study found that both aerobic exercise and resistance training three times weekly improved anxiety scores within four weeks.3 Mindfulness is also a component of photography. Staying present and focusing your attention on your subjects is needed to get the best photos. A study compared mindfulness to physical activity for five weeks during participants lunch breaks. Both groups had less perceived stress at the end of the study.4 Finally, activating creative parts of the brain can be a helpful tool of expression. For example, one study found that art therapy decreases heart rate, and anxiety while improving cognitive function.5 The overall evidence of photography for mental health is just emerging, but it may become a more common form of therapy.

Effectiveness

An interesting study in the United Kingdom gave ten participants a disposable camera to take photographs of their experiences and perceptions of mental illness. The participants were between the ages of 18 and 25 and were given one week to take 24 photographs of how they visualized their everyday experiences of mental health. Then, semi-structured interviews about the photography was conducted that allowed the participants to show their feelings and enrich their storytelling about mental wellbeing.

A few images stood out to me. One was empty benches from the participant’s college. The participant said that the photo represented that they sometimes felt excluded at college and represents how they feel on their own. Another picture was a somewhat blurry makeup image. It was bright, colorful and had pink throughout. The participant stated that the makeup was significant because when they felt bad on the inside, they hid behind the makeup and used it as protection.

This study showed a unique approach to connect with the challenges of young people. Using a disposable camera may be a way to connect with patients.6

An interesting study out of New York City used photovoice to help adolescents to open up about their mental illness. Photovoice is a method that involves the use of cameras to visually capture their reality and express themselves through photography. This study included four adolescents (three from Hispanic descent and one of European descent) from a mental health clinic.

The first session was an introduction and then participants had two weeks to take photos. The second session was designed to share photos between participants and discuss. The individuals selected five photos each and the third session included presenting the selected photos to the clinicians.

One participant had a photo of tree branches illuminated by the sky and said the following, “What I thought is like a whole thing of darkness and the holes are the light and you have to decide which path to go to. There are millions of paths, different sizes and you have to choose which one you want to take.”

Another participant said the following about a photo they took of a fountain with dirty water, “…this water thing in front of my building. You can see it has litter and dirt and it is tinted. I feel this is how it was there originally to be something nice and pretty. Something to add into it, but I feel like it some way it represents to me as it is life. As I was growing up I was just turning worse and worse… brownish with garbage in it.”

This study concluded that giving adolescents space helps them to share important insights about their conditions. Photovoice has the potential to be a powerful therapeutic strategy.7

Another study used daily photography as a self-care method. Eight participants were recruited and utilized a “photo-a-day” site for two months. After that, the participants were interviewed. The participants acknowledged how photography can be a form of self-care.

One participant said, “Photography has been quite good for me over the years because I think it forces me to look at the world again. And also there’s a postural thing. If you’re only looking down, when you’re depressed and hunched over, it encourages you to look up or at least squat down and look at something different and to stop and smell the flowers … So I find it to be a very versatile self-care technique.”

Another said, “It’s really good to be able to take that five minutes every day to do something slightly creative, which I enjoy doing and I think is good for well-being. It’s positive in that it gives me something to look for. Like I was saying earlier, with looking for novel experiences. I think that’s very good for someone’s well-being. So there’s a lot that does contribute to it.”

Others commented that it helps them to feel mindful and gives them a reason to get out of the house. The authors concluded that a photo-a-day project can be a tool to improve mental wellbeing and connectivity between people.8

References:

  1. https://www.musictherapy.org/about/history/
  2. Hunter MR, Gillespie BW, Chen SY. Urban Nature Experiences Reduce Stress in the Context of Daily Life Based on Salivary Biomarkers. Front Psychol. 2019 Apr 4;10:722. doi: 10.3389/fpsyg.2019.00722. PMID: 31019479; PMCID: PMC6458297.
  3. LeBouthillier DM, Asmundson GJG. The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial. J Anxiety Disord. 2017 Dec;52:43-52. doi: 10.1016/j.janxdis.2017.09.005. Epub 2017 Sep 23. PMID: 29049901.
  4. Díaz-Silveira C, Alcover CM, Burgos F, Marcos A, Santed MA. Mindfulness versus Physical Exercise: Effects of Two Recovery Strategies on Mental Health, Stress and Immunoglobulin A during Lunch Breaks. A Randomized Controlled Trial. Int J Environ Res Public Health. 2020 Apr 20;17(8):2839. doi: 10.3390/ijerph17082839. PMID: 32326082; PMCID: PMC7215846.
  5. Abbing A, de Sonneville L, Baars E, Bourne D, Swaab H. Anxiety reduction through art therapy in women. Exploring stress regulation and executive functioning as underlying neurocognitive mechanisms. PLoS One. 2019 Dec 3;14(12):e0225200. doi: 10.1371/journal.pone.0225200. PMID: 31794566; PMCID: PMC6890254.
  6. Charles, A., & Felton, A. (2020). Exploring young people’s experiences and perceptions of mental health and well-being using photography. Child and adolescent mental health, 25(1), 13–20. https://doi.org/10.1111/camh.12351
  7. Vélez-Grau C. (2019). Using Photovoice to examine adolescents’ experiences receiving mental health services in the United States. Health promotion international, 34(5), 912–920. https://doi.org/10.1093/heapro/day043
  8. Brewster L, Cox AM. The daily digital practice as a form of self-care: Using photography for everyday well-being. Health (London). 2019 Nov;23(6):621-638. doi: 10.1177/1363459318769465. Epub 2018 Apr 7. PMID: 29627990; PMCID: PMC6745599.

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