Idea Transcript
Community arts interventions: exploring the concept of wellbeing Rachel Swindells, Rebecca Lawthom & Carolyn Kagan
Abstract Economic uncertainty and accompanying austerity has prompted renewed debate about how best to conceptualise and measure wellbeing. This paper considers theories of psychological wellbeing in relation to research on community arts participation. Wellbeing is a complex and contested construct, which has been approached from two distinct positions: hedonism and eudaimonia. In the hedonic model, wellbeing is synonymous with happiness and the absence of negative affect/pain. In contrast, the eudaimonic approach takes a longer-term perspective emphasising the centrality of intrinsic goals, meaningful relationships and the development of innate interests and capabilities. Drawing on data from two arts for health initiatives for older adults and adults with mental health problems (Pathways, 2004-5, and Invest to Save, 20047), this paper points to an inherent compatibility between eudaimonic frameworks and the ethos underpinning community arts interventions: notably both regard wellness/human flourishing as more than transient feelings of happiness or the absence of disease.
Introduction A growing body of evidence suggests arts participation benefits wellbeing. However, the field of arts and health lacks well developed frameworks in which to evaluate the more subjective impacts of participation (Daykin et al., 2010), and there are repeated calls for further research to identify the creative and bio-psycho-social mechanisms underpinning such initiatives. While this is essential to informing practice and influencing health-service commissioning, a major stumbling block remains confusion about what is meant by ‘wellbeing’. Even the World Health Organisation, which has included wellbeing in its definition of health for over 60-years, appears to have had trouble reporting on it, focusing instead on more quantifiable measures of “death, disease and disability” (Owen, 2013). The wider context for this discussion is a political arena in which, following the global financial crisis, there has been renewed debate about what constitutes the ‘good life’. In 2010 UK Prime Minister David Cameron instructed the Office for National Statistics (ONS) to develop new ways of measuring personal wellbeing in recognition of the limitations of financial indicators such as gross domestic product (GDP) to accurately reflect the relative contentment of a population. At the same time a shift in UK public health policy has also seen greater emphasis placed on the promotion and maintenance of wellness/wellbeing at a local/individual level.
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The aim of this paper is to contribute to the discussion by considering theories of wellbeing in relation to findings gathered as part of two community arts programmes for older adults and adults with mental health problems evaluated by the Research Institute for Health and Social Change (RIHSC), Manchester Metropolitan University (MMU): Pathways (2004-5) and Invest to Save (2004-7). Both of these schemes sought to enhance mental health and social connectivity through involvement in creative activity. Each comprised a range of distinct projects and art forms – from music and creative writing to photography, painting, ceramics and craft activities – which were delivered in community settings across Greater Manchester (for more information see: Sixsmith and Kagan, 2005; Parkinson, 2009; Swindells et al., 2013). The case will be made that there is compatibility between eudaimonic wellbeing and the ethos underpinning community arts interventions with implications for both research and practice.
Theorising wellbeing Two theoretical frameworks dominant in psychological literature are hedonic and eudaimonic approaches. The hedonic model sees wellbeing as synonymous with happiness/pleasure and the absence of pain and is typically assessed using self-reported measures of positive and negative affect and relative life satisfaction (Diener, 1984). In contrast eudaimonic models move beyond transient feelings and consider wellbeing as a more dynamic approach to living (Ryan & Deci, 2000). Eudaimonic wellbeing is characterised in terms of the realisation of inner potential through meaningful relationships and purposeful activity. A criticism of eudaimonic constructs is that there remains no clear consensus as to appropriate objects/units of measurement (Diener et al., 2009). Also confusing matters is the fact that most researchers agree that both hedonic and eudaimonic frameworks contribute to wellbeing, with studies indicating a high degree of correlation between the two. Of particular relevance to arts and health practitioners/researchers, though, is that eudaimonic accounts offer insights into the maintenance of wellbeing over the longer-term. Ryan, Huta and Deci (2008) acknowledge that while both hedonic and eudaimonic wellbeing may be subjectively experienced as ‘feeling good’, the ongoing pursuit of eudaimonia-enhancing goals has been found to raise an individual’s baseline levels of wellbeing; hedonic pleasures tend to be less enduring. One explanation for this is what has been dubbed ‘the hedonic treadmill’ (Brickman et al., 1978), a phenomenon whereby individuals become habituated to their external circumstances and require increasing levels of reward to maintain stable levels of satisfaction. This is one reason 2
why external circumstances such as marital status and income account only for 10% of variation between individuals in measures of life satisfaction/happiness. Interestingly, while a further 50% of variance in wellbeing appears to be relatively fixed due to genetics and personality traits, 40% is amenable to change through engagement in 'intentional activities'. Research suggests that eudaimonia-enhancing pursuits are likely to work best, notably those which are self-selected, involve challenge and effort, and cultivate social relationships. These attributes will now be discussed in relation to select qualitative findings from the Pathways and Invest to Save programmes.
Eudaimonic wellbeing and arts participation Autonomy and intrinsic motivation Autonomy and intrinsic motivation are central to most definitions of eudaimonic wellbeing. Ryan and Deci (2000) consider autonomy to be a basic psychological need the satisfaction of which fosters wellbeing. Defined here as the experience of volition, it is closely related to the concept of intrinsic motivation and the pursuit of a behaviour or activity for its inherent satisfactions rather than external rewards. Findings from the Pathways and Invest to Save programmes indicate that arts participation contributed to meeting autonomy needs in several ways. Notably, participants in both schemes were given freedom in terms of determining the direction, pace and scope of their involvement. This included deciding which workshops to attend, whether to attend at all, as well as if and when to divulge personal information to others. As noted by Sixsmith and Kagan (2005), for many vulnerable people, exercising choice plays little part in their everyday lives. I allow them to drop in and out of the session as they please. I think at that age if you feel like you’ve got to do something, it can make you kind of not want to do it [Artist, Invest to Save] The arts also afforded a more unique and activity-specific experience of autonomy by providing a space for personal expression through the open-ended decision-making processes and playful use of symbols implicit in creativity activity. Participants reported being encouraged to experiment and move beyond thinking in terms of ‘wrongs and rights’. This was experienced as exhilarating for participants used to more prescriptive ways of working.
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When I write I feel that I am transformed into another world. Writing to me is an art form where I use colour, smell, taste and so much more. It is an adventure [Participant, Pathways] Within Deci and Ryan’s (2000) model, autonomy also encompasses the feeling that behaviour emanates from the self in accordance with core values and interests. Thus it is closely associated with self-identity. Returning to Pathways and Invest to Save it was found that arts participation provided those taking part with opportunities for self-reflection and to reimagine aspects of their inner and outer reality – sometimes seeing themselves in a different way. It might be a story but it’s also me. I’m in there and I can look at myself and see me there, even just a little bit, but me. I see me and I can write me and that’s what helps to make things a bit clearer, more clear on who I really am [Participant, Pathways] Waterman (2007) has emphasised that it is not possible to realise one’s potential in an environment which thwarts the unfolding of one’s authentic self or ‘daimon’.
From a
eudaimonic perspective any intervention aiming to enhance wellbeing must unearth participants’ intrinsic interests and aptitudes. This was frequently found to be the case in the projects examined here. I’ve always, despite being a scientist, I’ve always thought that there might be some creative aspect to my personality shall we say [Participant, Invest to save]
This does, though, require a degree of self-knowledge and awareness of the options available. Artists working on both programmes spoke of the importance of providing individuals with opportunities to try out different art forms in order to enable them find out what it is they enjoy or might be good at.
I feel passionate about this. That people should be allowed to find out whether they like poetry or whether they like dance... unless you’re exposed to it how are you ever going to know? [Artist, Invest to Save]
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Challenge and competence Eudaimonic wellbeing requires involvement in activities which may be effortful. According to Deci and Ryan’s (2000) model, optimal challenge is vital to wellbeing because it fulfils a need for a sense of competence. Waterman (2007), however, argues that what counts is not the successful outcome of any endeavour but the process of deploying and developing talents. A recurrent finding in the Pathways and Invest to Save programmes was the value participants placed on having an opportunity to engage in activities that provided a sense of purpose in lives otherwise characterised by boredom and loneliness. Some participants, described days occupied only by television, eating and sleeping. Tellingly, these are activities usually considered as sources of hedonic gratification for individuals otherwise meaningful engaged, illustrating the limitations of a purely hedonic approach.
[The project] got me out of the flat so not sat in it all day [Participant, Pathways] During the day I would literally go back to the flat and lie on the bed and listen to the television. I’ve got to do something else now because I know I’m coming [Participant, Invest to Save]
For a few individuals, concentrating on artistic activity enabled them to refocus their attention to the extent that they were able to temporarily forget problems and even physical pain. Another finding common to both programmes was that participants gained self-confidence as they acquired new skills. For many participation enabled the fulfilment of ambitions that had remained dormant since childhood.
I love to do writing as I want to keep my mind active. And I have come to do art (painting) as I would like to prove to myself that this can be achieved by me myself [Participant, Pathways] In some cases taking part in the various projects led to a passion for art and represented a first step towards further engagement in education and training opportunities. According to Waterman (2007), ongoing challenge is essential to maintaining eudaimonic wellbeing and lessening the chance of hedonic adaptation: the intrinsic rewards of participation along with growing feelings of accomplishment motivate continued engagement. The majority of artists involved in running the projects seemed to be intuitively aware of this fact.
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It’s about challenging them maybe just a little bit; but it's still enough of a challenge to make a difference… people thrive off that as a bit of challenge rather than just keeping them on a safe level [Artist, Invest to Save] Relatedness Some eudaimonic models also consider interpersonal relationships as central to psychological health. For Deci and Ryan (2000) relatedness – described as a desire to feel socially connected to and cared about by others – is the third psychological need mediating wellbeing. Findings from the Pathways and Invest to Save programmes showed that taking part in the various activities led to new friendships, expanded social networks, and a chance to develop social skills. Focusing on arts activities was identified as enabling those lacking in confidence to form relationships in their own time while concentrating on something else. The act of tackling new challenges together and helping one another to take creative risks was also said to promote feelings of belonging and solidarity. Some projects capitalised on this by building in additional free-time for more informal socialising. They now always meet early so that they can always have cups of tea and coffee together and we have a Christmas lunch together [Artist, Invest to Save] The artists were also pivotal to meeting participants’ relatedness needs. They all spoke about the importance of being friendly and approachable in order to put participants at ease, positioning themselves not as teachers or therapists but as co-contributors in a nonhierarchical collective activity. At other times, however, the artists described standing back to create a contained space for participants’ to exchange their own views and experiences. They also provided important sources of social support for those with communication difficulties or more debilitating medical conditions. Several spoke of working on a one-to-one basis with individuals who were unable to interact more freely in the wider group. It gives you confidence, with people not talking down to you, on an equal level. And the facilitator’s not teaching you, but helping you to see things differently, in art and in your life… So after a lot of help like this, I can talk to people like I’m talking to you now. I couldn’t have done this (interview) a year ago [Participant, Pathways].
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Conclusion This paper has reviewed findings from two community arts programmes in relation to theories of wellbeing. It suggests that there is an affinity between the domain of arts and health and eudaimonic approaches. Both regard wellness/human flourishing as something more than the absence of disease and consider human beings to have innate needs/potential. In addition, while hedonic models prioritise feelings of happiness, eudaimonic wellbeing does not preclude painful emotions when considered a healthy response to difficult circumstances (Ryff & Singer, 1998); certainly arts projects do not only aim to make people feel good but also provide opportunities for them to express difficult feelings in symbolic form. While future collaborations might usefully explore this compatibility, it should also be recognised that the eudaimonic view presents challenges in health and social care contexts subject to commercial pressures. Conceptualisations of wellbeing are not politically neutral, with various commentators suggesting that hedonic models are more congruent with capitalist economics: the transient nature of hedonic satisfaction fuels consumerism (Kasser et al., 2007). In contrast, eudaimonic living prioritises the attainment of intrinsic goals over secondary/external rewards such as financial recompense. It also values collaboration over the ‘winner takes all’ mentality of a competitive market economy (ibid.). A key issue is that eudaimonic happiness comes from sustained engagement in growth-promoting activities. While a common criticism of arts evaluations is a failure to prove the long-term efficacy of an intervention, the promotion of eudaimonic wellbeing cannot be a quick fix solution. Eudaimonic models blur the boundaries between health, education and purposeful leisure and prompt questions about the cultural scaffolds that are in place to support lifelong learning for all communities. In a recent conference speech, Lord Haworth of Newport acknowledged that the values underpinning arts and health practice challenge dominant politico-economic ideologies and illuminate a wider existential choice facing Western societies.
Are we, in our society and in our public services, to embrace the values of creativity, humanity, empathy and reciprocity? Or are we to continue with the barrenness of materialism, competitive self-seeking, anomie and bureaucratic crassness? (Haworth, 2013) Developing consensus as to what happiness and wellbeing really mean for individuals, communities and society at large represents an important step in informing that choice.
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