Why Creativity Is The Most Powerful Health Tool You’re Not Using with Professor Daisy Fancourt #654

26:36It almost feels like there's like junk food and perhaps junk arts maybe. There definitely is a state now where even if we do arts, We tend to be doing it in the background. So lots of us listen to music, but we'll often put music on, like plug in and then zone out and do something else. It's like we won't actually just sit and listen to and enjoy the music as the primary focus. And you're right that actually a screen based arts engagement is growing. And actually in art here, I'm probably quite rude, but I call screen based arts engagement the ultra processed food of the art world. because although we do see benefits from like watching dramas on TV or going to the cinema, like there are still definitely benefits from those activities.

27:17But they tend to be a bit more muted when we look at studies that directly compare screen-based arts to actually engaging in real life ourselves. So there's something around perhaps the slightly more passive engagement or the screen itself or the lack of other people in that engagement that means it doesn't have as great a benefit for our health. So I think there is a real need for us to sort of question what behaviors are displacing the time that we used to spend on arts effectively. Yeah, I definitely want to talk about more benefits like on lung health and wound healing and the immune system and reduction in pain and all kinds of things, right?

27:55But I think it'll be worth just pausing for a moment to define what you mean when you say engaging with the arts. you just mentioned there an example, you know, music is art, right? I think if you ask most people, you know, does music qualify as engaging with the arts? I think many people would probably say yes. But you're saying that that background music listening whilst you're doing something else perhaps doesn't have the same benefits. So help us understand what are the kinds of arts that we should be thinking about engaging with in order to get all of these incredible benefits.

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32:31So arts engagement is typically defined as sort of a creative practice that's engaged in primarily for the emotional involvement or for the beauty or ideas that are in part of it. Now, that normally means activities that involve that multisensory stimulation, creativity, imagination, aesthetics. So we often think of things like performing arts, visual arts, literary arts, like reading books, crafts, or going to exhibitions, galleries, gigs, concerts, the cinema. But I also argue in the book that I think we need to consider some other activities that actually share those common ingredients, but we don't always think of intuitively.

33:10So things like culinary arts, like baking and decorating a cake, that's got all of those same creative processes, imagining the recipe, how you want it to look, the tactile involvement. Horticultural arts, so like growing and arranging flowers, has got that same focus on sensory stimulation and beauty and form. And things like circus arts as well. I talk in the book about things like magic tricks that, again, share all those ingredients, but we sometimes forget that there are activities that we could be doing as well it feels like there's an active component in terms of our relationship with with those activities compared to a passive one like we can passively consume arts can't we we can as you say listen to music we can sit on the sofa and watch a drama I guess you're watching a drama in some way you're actively engaging because you're having to follow the story and imagine that you're the character or what might you do in that situation but but is part of the distinction passive versus active yeah I tend to prefer the term receptive because you're not completely passive are you if you are if you are responding to characters as you're thinking things through.

34:21But again, if we think about this in terms of sort of ingredients, then if you are receptively engaging, yeah, you're kind of receiving things, but you're not having to do as much. You're not having to use your hands or to use your body. You're not having to come up with the ideas yourself that have that process of imagination and invention yourself. So we see that for some outcomes, like for example, for mental health, actually, both receptively and actively engaging, both actually have very, very similar benefits for things like reductions in symptoms of depression. But there are other outcomes where we find that participating is particularly key, particularly for a lot of cognitive outcomes and particularly for more kind of physiological outcomes when we're thinking about some of the longevity-based things as well.

35:03But I think the most important thing is giving it attention if you're actually doing it. There are still benefits to having music on in the background as a kind of background stress relief whilst you're doing other tasks. But it's just important that we make sure we do give arts active attention within each day as well. If we're going to get the benefits off the arts, do they need to be something that we enjoy? I think that's always better. It doesn't mean though that it has to be something that has got positive emotions attached to it. And there's a clear distinction here because studies have shown that if you force people to listen to music that they hate, they actually don't get the benefits, for example, for mood, for dopamine.

35:41So there's no point forcing yourself to do something that you're not actually finding pleasurable. But it doesn't mean you always have to, for example, listen to happy music or read happy books in order for it to benefit your mood. One of the really fascinating things that's come out of research is that even like reading sad stories or watching horror films or listening to angry music, all of those things actually also have benefits for mental health. And this is really because in real life, if we had events that gave us those negative emotions, it would negatively affect us. But when it's art, we know it's art, which means that our brain processes it a bit differently.

36:16We have a bit more of an aesthetic distance between us and what we're consuming or watching. So it means that we often experience positive emotions alongside the negative ones. So it can be beneficial to sort of cathartically experience those negative emotions and to feel that sense of like resonance listening to a sad song and you feel like the songwriter really got how you were feeling in the moments. But because your brain knows it's not real it sort of contemplates that emotion but without having to panic or actually think about how it would respond in the real world yeah it reminds me of the conversation i had with daniel levitin a few months ago daniel's a neuroscientist musician a record producer and i'm pretty sure in that conversation we spoke about you know when people are feeling sad they perhaps don't want to listen to a happy song you want to you know if you're going through a breakup listening to a breakup song is one of the most beautiful things that an individual can do because it's you know i guess it's connecting you to wider humanity it connects you to oh i'm not alone feeling this way somebody else has literally articulated how I'm feeling in their lyrics, right?

37:31So there's something about that, isn't there? And also I know, you know, some of the things you write about in the book are how engaged with the arts build our sense of identity. I wonder how much of that is also coming from, as you just said, you know, we're in make-believe world in the arts, right? So it's not real. so we can imagine what it might be like to feel angry, to feel upset. You know, maybe it's a way that we can experience the full range of human emotions in our minds without actually having to do it in real life. Without having to face the consequences. And that's actually really good for our brains because our brains are prediction machines.

38:12They're constantly having to navigate an unpredictable world around us. And actually what's been coming out of neuroscientific research recently on the arts is showing that when we engage with the arts, we're essentially feeding our brain with lots of different emotions and scenarios, which help it to hone its abilities to regulate our emotions or to plan how we might respond if it were the real world. And that is what's called our predictive coding abilities of our brain. And it actually helps us then to be more resilient and better able to adapt and tackle those challenges when they really do come along for us in real life.

38:46There's research, isn't there, about dementia and music, which I want to talk about. Before we do that, one thing that's just come to mind is for whatever reason at the moment, I'm loving listening to 90s music. And in my head, it's because it takes me back to a really influential time in my life when I saw possibility and the future. And, you know, I was imagining what I could become or whatever it might be. As someone who's studied the arts and music for many years, is there anything to that at all? There is. I mean, it suggests that that's music where you've got particularly strong dopamine tags.

39:28And actually, we often find that that is music for people in their adolescence, because that's when all of our emotions are pretty highly charged. But I think it's also a really good reminder about why we often get strong emotions from music or from arts, because it does give us those memories that are associated, which often can be really lovely. But I guess it also kind of gives me a caveat to some of the things we've just been talking about. Because actually, if an arts experience triggers memories or thoughts about a really negative experience in your life, then actually, that's one of the times when it doesn't come with positive emotional benefits.

40:01And equally, we were talking about like horror, horror films, for example, some people, including me really hate horror films. I actually genuinely find them scary and I find that I'm not getting positive emotions and that's because we're forgetting that it's art. So this is a really important caveat that if you are engaging in art forms that might be giving you more negative or challenging emotions or scenarios you have to be able to remember it is art and you also have to make sure that you're kind of confident enough in your own emotions to be able to manage those when they come along. So sometimes if people are feeling vulnerable then actually listening to really sad songs is something that can actually be a little bit triggering so there's a balance to be struck here it's such a subjective experience isn't it engaging with the arts because you were just sharing about if it take you back to a negative time and I totally get that and it made me think of a playlist that I recently put together for Apple and one of the tracks I put on it was from an album that I listened to pretty much on repeat in my car on CD after my dad died in 2013 and it was sung by Matchbox 20 called The Way and whenever I hear it now I actually don't feel sad it really connects me to a really important part of my life and it's kind of interesting isn't it you know that it is such a subjective thing to someone else they may not want to hear a track that they listen to in the aftermath of a parent's death But for me, it actually connects me to that moment in time.

41:35And I think this is actually what's so wonderful about the arts when we're thinking about lifestyle advice. Because, you know, often if people are being told to like take pills and things, it's quite an inhumane thing to do. But actually with the arts, part of the way they affect us is the kind of raw ingredients that they give us. And we know there are certain things like the tempo of a song that affects our arousal levels in a pretty universal way. but the other part of it is about the perception of that art form which is about our own personality memories experiences so that does mean that two people can have quite different experiences even to the same art form I'm sure we've all been in the cinema with a friend one of us loved the film one of us hated it but it also means that this is some of the most joyous lifestyle advice that you can have because it allows you to have that personal connection and that sense of personality in how you're going to how you're going to engage in the arts it feels that this is such an important message for the current age in which we live there's so much instability unhappiness stress burnout frustration about the future or or uncertainty about the future i guess out of all the things we could think about introducing into our lives, it feels that at the very least, engagement with the arts is going to give us a shot of joy and vitality.

43:02And, you know, what are you asking us to do? You're saying, you know, obviously you don't have to enjoy it, but you're basically saying go and do enjoyable things that get you to imagine the possibility and feel different emotions. That's quite a nice thing to hear from a scientist, isn't it? It's a nice feel good message. But actually we tend to be much better about thinking about what our physical needs are compared to our psychological needs. And within psychology, we understand that we as humans have got a whole set of core psychological needs in our lives if we're really going to feel happy and flourishing.

43:33And some of this is about us having a sense of control in our lives, something that's increasingly hard in the world around us. But a lot of studies show that engaging in arts gives you that sense of control, sometimes just in the activity and the craft that you're doing. But actually that gradually starts to sort of seep out into affecting your how in control you are feeling more generally. Arts also help to give us a sense of meaning of purpose in our lives, which are very difficult things to achieve, but things that are fundamental if we really want to have high levels of well-being. I remember a story from your book, Daisy.

44:07I think it was a palliative care ward in Chelsea and Westminster Hospital. Yes. And from recollection, please correct me if I haven't quite got this rights but from recollection there was a gentleman on that ward and people came in or someone came in and it was playing acoustic guitar and singing and I think he said that it helped give him a sense of meaning yes this is something I worked in the NHS for a number of years and I kept seeing this time and time again that you know there were people who were in hospital for conditions where you know medicine was helping parts of the condition but there were broader aspects of the psychological and social experience they were having, where there wasn't a medical treatment that was supporting those.

44:49And actually bringing the arts into that hospital was a really pertinent, powerful way of supporting people holistically. And I think there's no better example of this when we're thinking about end of life care, palliative care, and also thinking about bereavement and grieving. If we look all around the world, arts are something that we instinctively turn to in those phenomenally difficult moments. People use songs and poems and photographs and and crafts and memory books as a way of remembering people. They're things we instinctively turn to. But actually, we don't really acknowledge this enough.

45:21We don't consider how we should be valuing the arts more within end-of-life care. And I remember times in the hospital when it was people's final hours and they were asking to have music there with them and they were having their relatives singing along. And times like that were incredibly, incredibly powerful examples of how much the arts can do for us. Yeah. I went to see my mum last night and I told her that I was talking to you today about this topic and she said oh you know what are you going to talk about I said well mum you know Daisy's written this cool book and she's talking about the benefits of the arts on our health and well-being and you know mum's 85 not in fantastic health anymore unfortunately and you know I think I said something to her about the benefits of music and she said yeah of course so whenever I felt down in my life or low or stressed I'll just sing and play songs and sing or listen to music.

46:19And, you know, mum hasn't done any of the scientific research on this, but it was quite interesting to me that she just knew straight away she wasn't even surprised when I told her. She goes, yeah, of course. It is an age-old wisdom. I don't think people are surprised by the idea of this. I think people are often surprised by the depth and rigor of the science. Exactly. But even though it is wisdom, like I was saying earlier, we all engage so little on average. We know the wisdom, but for some reason we're not putting it into practice. We're not prioritizing it in our lives. Yeah. One of the things that I reflected on as I was reading your book was children and bringing up children and how important the arts is.

46:55I'm super lucky because the school my children are at have just the most incredible and inspiring head of music who, you know, I was at their spring concert recently where both my kids were performing and there was other kids from the school performing and orchestras and choirs and street drumming and all sorts of things. But the head of music had such passion for each and every track and all the children who were engaging. And it's such an inclusive school about trying to get people to engage in the arts in whatever way they want to. I don't think I really realized how fantastic that is for my kids and other kids at that school until I read your book I was like oh this isn't just an enjoyable thing to do it is that and there are all of these other benefits clearly not every school has that kind of relationship with the arts and music.

47:59And you are a mother, I think, of two children. What do you think your research is going to do? Or how do you think that's going to influence the way you parent as your children get older? Well, I think there are two things here. One is about what we do as parents, but also one is about what we need schools to do. Because actually, we've got ourselves in a bit of a mess at the moment. We've really deprioritised arts within schools, taking them off curricula. We've had massive decreases in the number of students that now get to engage in the arts at school and take art subjects. We've now got whole schools have absolutely no arts in them.

48:34And this is really problematic because arts are so beneficial for children's development in terms of cognitive development, particularly in terms of mental health, identity formation, self-esteem, and also nurturing these core skills like creativity, curiosity, compassion, like some of the skills that we want young people to have the most as they're heading out into the world. But we're not making it equally available. And the challenge then is it means that it really rests on them where the children have got opportunities to do the arts outside school. And there's a huge social gradient in that.

49:04So some families are lucky enough that they might have the time or the resources to be able to do arts outside schools. Others don't. So I do think we have an issue here because if children don't engage in the arts as children, they're also way less likely to engage as adults. And therefore that's huge groups of people who'll be missing out on the health and well-being benefits across their whole lives. One thing you challenge right at the start of the book is the idea that some people will say, the arts are not for me, Daisy. I'm not creative. I'm not artistic. What do you say to those people?

49:37We are literally born artistic. Babies are responding in utero to music when they hear it. If you sing to a newborn baby a song and then a song with an altered, like a wrong note in it, They can even spot the difference within a few weeks of being born. So everybody has the innate creative potential here, but it comes down to opportunities and access. So, yeah, if you're someone that has had no exposure to the arts across your early years, your education, then it's not surprising that you might not feel creative or artistic. But I talk in the book about actually lots of people who've entered the arts as an adult, often through things like being referred to it by a doctor.

50:12So they're not choosing, they're kind of being recommended it. and in the process gone from thinking that they weren't artistic it wasn't for them to realising how much they love it. And this I think is so powerful in showing that if people can give things a go and sort of have that try, people are often surprised actually that the response they have when they actually enjoy it much more than they thought. That's what happened to Russell, isn't it? It is, it is very much. Can you tell us a little bit about Russell? Yeah, Russell is someone I met nearly 10 years ago when we both went on to BBC Breakfast to talk about this scheme that was rolling arts on prescription out within the UK.

50:46And Russell was a construction worker from Gloucester. And one day on the way to work, he had a stroke and it caused severe neurological damage and he had to relearn how to walk again, how to talk again. In the process that he lost his job, his relationship fell apart. And he said that he was just in bed all the time with chronic pain. It caused so many issues for him. So he said he got more and more and more medication trying to deal with things, couldn't sleep. And eventually his doctor said like, enough, we need to try something new. So he prescribed an arts class for Russell. And Russell said he was just so not artistic.

51:21It really wasn't him. But he said he's not even sure why he agreed to go along. But in that first class, he said there was just something about it that kind of piqued his curiosity. And as he started going back, he started actually drawing and painting and realizing how much he loved it. And sort of fast forward, he actually found that he was feeling happier, his pain was lower, his sleep was better. He and his doctor actually started to reverse the pills that he was on. It gave him this whole new lease of life. And actually now, 10 years later, Russell, in fact, longer than that now, but Russell is now actually an artist and he does his own painting.

51:54He's had exhibitions from Gloucester Cathedral to the Tower of London. He also leads his own art workshops in the community for other people like him, sort of saying to them, you haven't got to be an artist, you can do this. And he said he's not even on any medication anymore. I think he also says that art saved his life. Yeah, I said, I was trying to ask him to sort of quantify how big this effect was. And yeah, he said it saved his life. And I've met so many people over the years who use those same words, like whether it's been art that's actually brought them back from the brink of taking their own life or art that's given them a whole new lease of life in the way that they're able to engage with and enjoy things day to day.

52:30Before we get on to practical tips in terms of how people can think about introducing the arts into their lives, I just want to close the loop on dementia we mentioned that a couple of times and I know just from talking to a lot of my audience a lot of people do fear getting dementia that they they've seen it in family members and one of the most striking things I heard you say was that if patients with dementia are played songs from their youth at bathing times and at mealtimes, it can reduce emotional agitation. Now that I think has so many practical applications. I've spoken to a lot of carers and a lot of them will say that those are the times where there's a lot of tension.

53:31There's, you know, someone doesn't want to be bathed, but for hygiene, they need to be bathed. And it seems as though the arts may have a particular role here, right? They do. This is actually a really important area to think about because, again, it's one where it can be quite hard. We haven't really got medical solutions for some of the challenges psychologically and socially that people with dementia experience. And one of the things is that when people have dementia, it can be much harder to rationalise things that are going on, like the noise of a bin lid clanging, for example, is something that causes a lot of distress on hospital wards for people who have dementia.

54:05Things like bathing and mealtimes, if you've forgotten what that is, it's quite an overwhelming thing to be plunged into water or handed a plate of colourful food and implements and you don't remember how to use them. So playing calming music is a really effective way of just relaxing people, activating that relaxation response so that they're calmer in those moments. And also playing something that's familiar can help to buffer out those background noises that might be upsetting people. When I worked at Chelsea and Westminster Hospital, we also did a lot about wayfinding. Like if someone with dementia needs to go to the loo, they might have forgotten the way there.

54:40And actually, if everything is white, if it's white corridors, white walls, white doors, white Lucy, it can be almost impossible to distinguish where they're going. That's one of the things that's affected in dementia. So things like coloured pathways on the floor, being able to use artwork so patients remember which bed is theirs, changing the colour of surfaces. These kinds of interior art-based things are really powerful. But there's also a reason why music is particularly helpful in dementia. And this is because the region of the brain that's involved in long-term musical memory is one of the last to be affected by Alzheimer's disease.

55:14So many people will say that their relative might have forgotten who they are, but then they'll remember a song and they'll sing along. and this is because of this particular region in the brain being preserved very late in Alzheimer's. So playing music to people, particularly music that's got a lot of dopamine attached, that pleasure hormone we've been speaking about, is really effective and particularly dopamine is good because dopamine is not only involved in pleasure, it's also involved in long-term memory consolidation, which is why it's often the music from people's adolescence where they've got those very strong dopamine tags, music from people's childhood or from really positive emotions and their experiences in their lives that they're most likely to remember even in the late stages of dementia.

55:55So someone who's listening to this who may have a family member who is perhaps struggling with dementia, one immediate take home might be they could start playing for that individual music from their youth. Yeah, find a playlist of the music you know this person used to love listening to and watch them closely, like make sure it's not causing distress, but it can be a really lovely thing to do. Also think about calm background music at the times they normally get agitated. Think about the environments they're in and how you're using colour in them so that you're trying to make sure that they can have easy navigation and it's calming environments around them as well.

56:31Wow. And I think you did touch on it earlier in the conversation, but just to cover it again here whilst we're talking about dementia and brain health, you have found research, haven't you, showing that regularly engaging with the arts preserves our cognition for longer and delays the onset of dementia. Is that right? That's what we're seeing. We're seeing that people who are regularly engaged in the arts have better preservation of cognition for longer and a reduced risk of developing dementia. And this is through what's called cognitive reserve. So building the resilience of the brain against cognitive decline.

57:05So it basically means that even if your brain is starting to accumulate the kind of physical signs of dementia, then you're able to compensate for longer. You're sort of able to cover it and manage cognitively for longer before it actually starts to affect your life. And we're seeing this with delayed brain aging through arts experiences too, like I mentioned earlier. Yeah. For people who've heard enough of the benefits to go, So yeah, she's convinced me. I would like to engage with the arts more. There's a really nice section at the end of the book where you, I think it's called how to fix things, right?

57:39So can you walk us through some of the practical things that we can think about if we want to introduce the arts into our life?

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59:50so i think a great way of thinking about it is a bit like how we think about our diets so we all know the concept of like have your five a day for your fruit and veg whatever well think about what your equivalent can be for the arts to make sure you get some kind of artistic engagement every day even if it's just 10 15 20 minutes that's a really great way to start also think about variety just like we used to say an apple a day keeps the doctor away but now we focus on like variety of plants in our diet it's similar with arts experiences so if you're someone that loves reading well that's great but also think about how could I bring in another art form that might bring some different kind of ingredients so like might be dance that would bring in the physical or that might be like making music sort of so really focusing on that cognitive challenge of it as well I also say like don't think that you have to be a great chef like to cook good food you've not got to be really brilliant at art.

1:00:41You've not even got to think that you're an artistic or creative person because for our health, it genuinely is the taking part, which brings so many of those benefits. You mentioned reading a book there. Does reading a book count as engaging with the arts? That very much is an art form. Yes, that is one of the arts activities you can be doing. But that's why I say it brings certain benefits. It brings like narrative storylines that will be challenging your brain to think differently about the world. It brings emotional experiences that can be helping to give you that sense of emotion regulation.

1:01:13It's a relaxing activity, but obviously you're not generating, you're not physically doing things as well. So it's just good to have balance with other arts activities too. Is going to the theatre similar to going to the cinema? This comes back to that ultra processed food metaphor that I used for thinking about screen-based arts activities.

1:01:35So our mental health, for example, when we look at them in studies. But actually for like cognitive outcomes, we see much stronger effects for going to watch live arts events like concerts or gigs or going to the theatre or going to exhibitions than we do from the more screen-based engagement like watching dramas on television or going to the cinema. So it's important to sort of think, yeah, engage in the cinema and things if you're enjoying that emotionally, but try and mix it up by also bringing in arts experiences that might be more cognitively or physically beneficial. Have we seen a decline in our engagement with the arts since COVID?

1:02:12And the reason I asked for that is I think one thing I've seen a lot is that COVID broke certain patterns, social patterns, hobby patterns that we all had. And people who, for example, used to go to a once a week yoga class in their local town centre, realising COVID that they could do it on YouTube or online. And of course, there can be loads of benefits of doing that for people, especially if they live remotely and they don't have time, whatever. So I'm not criticising that. But it's not the same thing as doing a yoga class as an example with other people in your community. have we seen a similar thing with arts where people used to go out to the theatre and to concerts and, you know, museums, whatever it might be?

1:03:07Covid put a stop to that. And has there, in your view, been almost a collective inertia that has set in, which we really need to urgently start to rebalance? There are definitely things where we've seen a change that hasn't fully rebounded. Like if you look at footfall going through museums, for example, then actually that is still down in many places compared to before COVID. But I think it's not always just our fault. There are also really challenging societal circumstances, like lots of arts venues have closed. Lots of libraries have closed. Cost of living crisis, you know, there can be much higher now costs to actually go to some of these things.

1:03:43So that it sort of makes it partly about us thinking, how can I get more active, but also partly about us thinking, how can we talk about this more? and how can we maybe change awareness politically about the funding that goes in to enable us to engage? Yeah. One of the bits I enjoyed the most because I'm very passionate about this towards the end of the book is how difficult it is now for artists to make a living. And you wrote a little section on Spotify and, you know, how little artists make when their tracks are streamed and how the whole commercial model of music has changed. That is going to have an impact, isn't it?

1:04:24Because yeah, we can engage ourselves, read a book or whatever it is we enjoy doing. But also if as a culture, we're going to get the best out of art, we need artists. We need musicians. We need actors. We need people to be able to devote themselves to these things and perform for us and create music for us. But if people are literally getting pennies for doing that, actually, yeah, we can want to engage, but societally we're going to have less things to engage with, right? Yeah. If we want to have arts in society, we need artists to be leading those groups, to be putting art out there for us.

1:05:08And I've got so many friends who are artists who are just experiencing such challenging working conditions. It's sort of like if you want to be an artist now, You've got to do it for the passion rather than being able to make full livings out of it for many people. And this is really problematic. It's about how little we value the arts within society. And I don't think it's any coincidence that we see that professional artists in general have higher levels of well-being than the general population, but also higher levels of stress and anxiety and depression. Because the circumstances they're put in to try and craft careers out of this is just so difficult now.

1:05:42as I was reading your book I was thinking about Keith Richards from the Rolling Stones and the reason I was thinking about him was there are lots of musicians that I see certainly in the sort of music I'm interested in who seem to still be performing in their 70s touring playing long shows Bruce Springsteen still does three hour sets right and he's, you know, he's not a spring chicken anymore. It's interesting to me. Yes, they're engaging with something, but these guys are constantly writing new music. They're trying to still stay relevant, you know, tell stories in their music that speak to the culture today, just as it did when they were in their 20s.

1:06:28What's your take on that? You know, am I barking up the wrong tree or could there be something to it? I mean, there are always random, lucky combinations of genes. Of course. So I think that's something that's important to caveat up front. But there is something to the saying of use it or lose it. And actually, one of the things that we see from the arts is that they're so powerful at giving us a sense of purpose. And a sense of purpose is one of the big drivers of a longer health span. So like staying healthier for longer, as well as a longer lifespan. So I think it's probably not a coincidence that we see that people who've got that real passion for the art that they're doing, that that really does drive them and help them to have that continued purpose, that continued activity that supports their health.

1:07:09Yeah. Going back to the similarities I see between reading this and some of what Tommy Wood writes about, you know, Tommy talks a lot about how damaging retirement can be for our brains. Yes. And if we think about it through the lens of what I just said about musicians, of course, if you just forget the arts and forget all those benefits and put them to the side for a minute, even the fact that people are not retiring, they're still engaging in their passion, they're writing, they're performing, they've got a reason to get up and get out there and do something and engage in communities. And it's not just done in isolation, it's done with other people in a live venue.

1:07:54That in and off itself is going to be beneficial, isn't it? It is. And a lot of the work that I've done has been looking at older adults. And we found that as people retire, as they sort of head into later 50s, into 60s, we see that people who are more regularly engaged in the arts have a reduced risk of developing depression over the following decade or so, a reduced risk of becoming frail, of developing age-related disability, of developing problems like chronic pain. We really do see this link with a longer health span as they get older. In your practical section at the end of the book, there's two things that I wanted to ask you about.

1:08:28One was identify your chicken soup and one was plan your meals out. What do those two things mean? The chicken soup is about the fact that when we're ill, we often know there are things that make us feel better. For some people, that's like a homemade chicken soup. But I think it's often when we're ill that we don't think as creatively about what's going to help us. We often go in a kind of protective survival mode. So it's sort of easy to sort of lie on the sofa and just binge watch Netflix. So my point is think in advance. What are the books that you really love reading, like the comfort reads that you could return to when you feel ill?

1:09:04What's the music that really relaxes that you could put on and listen to? Are there crafts or things that, you know, you could even just spend a few minutes doing that actually could support your mood as well as your relaxation? And this is really important because it sort of brings us onto the issue of inflammation, which is one of the areas that we've got really exciting evidence coming up on about the impact that arts have. Not only do the arts relax us in terms of stress response, but they also affect levels of inflammation in our immune system, which means that if we engage, we actually have reductions in inflammatory markers, things like cytokines, which are these chemical messengers in our immune system.

1:09:42And over time, we see that people who are more regularly engaged in the arts have lower inflammatory profiles. And inflammation is not only linked in with our physical health, but also with our mental health. so it's really important when we're ill like when we're in that kind of inflammatory state that actually doing things that will improve our mood can actually help with that recovery as well one of my favorite studies that you wrote about was the drumming study right when you studied people who were drumming for six weeks and you showed that four inflammatory cytokines went down I mean, basically, this is kind of the point we're trying to sort of highlight in this conversation, Daisy.

1:10:24We might think drumming's good. You know, it's a fun activity. You enjoy drums, you play. But it's so much more than that. It's changing the inflammatory milieu inside your body. That's really exciting. Can we say that that's exclusive to drumming? or do we think other forms of arts or even musical instrument playing would do similar things? We've seen this from a range of art forms now, from dancing, from singing, from making visual art as well. So it's certainly not just a drumming effect, but it's really relevant because a lot of people live with chronic inflammation, which puts you at a higher risk of type 2 diabetes, of cardiovascular events, as well as depression.

1:11:07And we've actually looked really broadly now, if people are regularly engaged in the arts, do they have different inflammatory profiles? We've just completed a study where we looked at over 200 different proteins in people's bloods. And we found that people who've got more regular arts engagements actually have patterns of protein abundance that show they've actually got lower levels of inflammation. They've actually got a dialing down of inflammatory pathways in their bodies. And so we see this, we sort of see short term effects, like lower little dips in inflammation from just half an hour or an hour of engaging.

1:11:39But we see this adding up more and more over the weeks and months, so that overall people who've got those higher patterns of engagement, lower levels of inflammation. There was a study on wound healing and in particular expressive writing, which I found really interesting because initially when I thought about what does it mean to engage with the arts, I didn't necessarily think of expressive writing. And then I thought, well, why not? You know, journaling and writing out your emotions and trying to process them. Well, we know that's really beneficial. Does that count as engaging with the arts?

1:12:20And then also, could you talk about that study? If you can recall, I know there's like hundreds of studies in the book, so you may not have them all to hand, but it was pretty powerful to see that expressive writing could speed up wound healing. This was a really cool study where they were looking at if people could do writing, where they're getting their emotions and things out there. Would it actually affect inflammation levels? and would it help with things like wound healing? For this particular study, they gave people a punch biopsy, so they deliberately gave them a small wound and then they measured it every day.

1:12:49And they found that the group that did expressive writing had significantly faster healing of that wound and changes in their inflammatory levels. And actually this feeds into a sort of much bigger literature that shows that if we're doing this regular arts engagement, we can actually see it affecting these quite physical aspects of our illness, of our recovery. Yeah. Yeah. So would you say expressive writing could count as arts? Definitely. It's creative writing. That's one of the core art forms out there. Is that different from journaling about your own life? Well, interestingly, in this study, they actually had a control group, which was having to write about how they were planning their time, I believe it was.

1:13:28So quite boring writing. And they didn't see the faster wound healing in that group. So this was very much something that was happening from that creative, that expressive process. Yes. Listening and or making music can enhance our immune system, can't it? It can. We've run studies where we've looked at these cytokines, these chemical messengers, and shown that if people are making music for sort of an hour or so, they actually have a short-term boost in their immune activity, kind of activation of the cytokine network. And then over time, we do tend to see that this rebalancing towards lower inflammatory profiles that we've just been talking about.

1:14:01So it's really nice to see that's another whole biological system that's influenced by arts engagements yeah when we think about music and we can engage in music actively or passively i guess active might be us playing something or we're listening intensively and you know my wife and i for example we engage with music in very different ways like if we're listening to music she's more drawn to lyrics than i am like I'll hear the different layers. I'll hear what the bass is doing, what the guitars, I'm like, oh my God, did you, did you hear what the bass player just did? And of course, as we're saying, it is a subjective experience, but you also, you write about Brian Eno and what I think is called ambient music.

1:14:48Can you explain what ambient music is and then how that fits with this whole idea that to get the benefits or to get most of the benefits from art, perhaps we want to be more active when we engage with it than passive. Does that make sense? No, it does make sense. I'm sure everyone's had that situation where you're in an elevator, you're in a lift, and there's that really annoying kind of tinny background music that's supposed to make you feel calmer, but basically you end up feeling more and more wound up by it until you can't stand it anymore. So that lift music was music that was created, particularly trying to combine the elements that we know are most relaxing for us.

1:15:27But in the process, it's so bland and it's so predictable that actually we don't have that tension resolution thing that I was speaking about in terms of dopamine response earlier. So we actually don't find it something that triggers dopamine. We don't find it something that's particularly enjoyable. So what Brian Eno came up with was a different concept. Well, he said, we don't want things to be too predictable. But what if we take those relaxing elements, like the slow beat, like the nice tones, sort of consonant tones, relaxing instruments. But we actually put them on tape loops so they'll play in random combinations.

1:15:59So you can't predict what's coming, but it's inherently got the relaxing ingredients. And that was the genre of ambient music. And personally, I find it so much more enjoyable listening to that than listening to elevator lift music. But Brian, you know, I met when I worked at Chelsea Westminster Hospital because we had this big problem around anxiety in surgical settings. Like quite understandably, people were coming in for surgeries. They were put in kind of toilet-sized cubicle booths and told to wait for hours until their operation. They got more and more anxious. And that then meant they were often having to have anti-anxiety medication to calm them.

1:16:33It was taking more sedatives. It was taking more pain relief after and creating a kind of spiral of medication that wasn't necessary. So what we did with Brian is we said, well, could we use his ambient music in the hospital setting? and we combined it with these incredible digital artworks that he created that again had this randomness. They kind of gradually changed over time but in a way you couldn't predict. And we found that the patients who went into these booths with this artwork and music actually had this incredible relaxation response. And so many studies now have shown that if people are more relaxed through music then they actually need fewer sedatives, they need fewer opioids afterwards.

1:17:09And in fact, studies that have directly compared giving people anti-anxiety medication or music before surgery show that you get a greater relaxation response from music compared to the drugs. I mean, this has implications individually for that patient, but also the potential for massive cost saving in the health service is absolutely there, isn't it? Absolutely. Same for vets as well. Dogs respond the same way. Really? Yeah. Wow. But this is really important because I think we're actually being less safe, less ethical by not offering arts in these settings compared to offering them. It's kind of interesting, isn't it, that there is all this research there.

1:17:54We've already spoken about the high blood pressure studies. but I think you sort of wrote about this you know in your book this idea that when was the last time your doctor prescribed listening to music it's very clear from your research and the data that actually it should be one of the many tools we have in our toolbox you know well already this concept of being able to prescribe arts is out there I mean depression is a really good example of this because with depression, many people with mild and moderate depression, antidepressants don't really help them. And there can be side effects as well.

1:18:32There have now been so many studies that have said, well, what if people did six or 10 weeks of weekly arts classes? And they've actually found that the reduction in symptoms is actually very similar to what you get from either psychological therapies or from medication without the side effects and without the waiting lists. And actually, if it's offered alongside, side, we've actually found that it can augment the benefits. So studies that have shown people who've been offered medication or psychological therapies or that plus arts therapies have actually found that there's even greater benefits.

1:19:03In fact, nearly twice the improvement in symptoms within three months if people have both together. And I just got back from Greece last week where we've been running this incredible four-year program saying, well, what if we actually fully integrated arts on prescription as part of psychiatric care? So we were working with, in the end, a thousand adults in Greece who had diagnosed severe mental illnesses, and they were referred to 12 weeks of arts on prescription. They could choose whether they went to book clubs, theatres, galleries, like they made arts in classes. And we found there were 30 % reductions in anxiety and depression within those 12 weeks, to the point that Greece has actually now announced a new law last week, making arts on prescription formally part of all psychiatric care in the country.

1:19:44And we've already got similar things in the UK. We've got arts on prescription as part of social prescribing within GP practices so your GP can make a referral to these activities but I just don't think we're giving it enough recognition or prominence or letting people know they could be talking to their doctor about this. Yeah it's also very important in terms of the outcome you know if we whole bodily you know believe in something and talk about it and say look this is going to be really really helpful that's very different from saying there's a nine-month waiting list for taught therapy so in the meantime we'll get you some art therapy do you know what i mean so it's the same thing but but the message we give to the pages is very different you're waiting for the big for the main thing this is whilst you're waiting do a bit of art on the side you know even that needs to potentially change i think people need to know these effect sizes that are coming through from trials they need to have the choice so they can be told these are all the options available and you get to have a say in which one you think is going to suit you and if that one doesn't work you can be trying the other options one of the things i think listeners to this podcast will be particularly interested in daisy is your work stating that people who engage with the arts are more likely to engage with other health promoting behaviors tell us a little bit about that super interesting so this is something that we're consistently seeing now in studies is that engaging in arts means you're then more likely to do more exercise or to eat more healthily or to stop smoking.

1:21:15And partly this is something which is spillover effect. If you do one health promoting behavior, you are more likely to sort of catalyze a virtuous cycle of other health promoting behaviors. But it's also because when we engage in the arts, it helps with a lot of psychological processes. It builds our sense of self-control. So a lot of randomized trials. So you have higher levels of self-control if you've taken part in several weeks of arts activities. And And that can help with inhibiting behaviours you might not want to do. And it also helps things like self-esteem. Self-esteem is a major driver of our behaviours and one of the big things that's supported through engaging in the arts.

1:21:49So essentially we're sort of giving ourselves some psychological toolboxes that support positive behaviour change through arts engagement. I wonder how much of that could be increasingly relevant or even more relevant in what we would call socially deprived communities. because of course cost and access to things can be a huge issue in those communities but lots of art forms are not that expensive right so yes going to the theater for example that there was a cost associated with that um reading a book singing listening to music these things are perhaps a little bit more accessible and I guess if we're saying that engagement with the arts changes how we feel about ourselves increases our empathy increases our self-control in some ways it could be quite a low cost intervention that could have some quite profound effects even in deprived populations actually even more so some of the studies that we've done have shown that people who come from more deprived areas geographically actually benefit from arts engagement even more, like disproportionately more than people who are engaging who already live in more affluent areas.

1:23:10Similarly, people who are already experiencing mental health challenges, they often have even greater improvements in mental health through arts engagement compared to someone who doesn't really feel like they're struggling particularly. So actually, I think it's a point we need to try and improve the equity of access even more because actually those people who aren't engaging are probably the ones who could stand to benefit the most. You also write about some of the benefits that people in prison have had from engaging with the arts. I think there was one, what was something called the Shakespeare behind bars that I heard you talk about.

1:23:46Can you explain what sort of things the arts have been shown to do for people who are in prison? These are incredible programs that are trying to integrate arts within criminal justice systems, recognizing that actually engaging in arts, doing things like drama, gives people a chance to build their sense of confidence, their new identity. Actually, when we're doing things that are particularly acting-based or involving stories, we're also helping to build our imagination. Actually, higher levels of creativity and imagination help people to navigate complex life choices. It helps them to have more creative solutions to problems.

1:24:20There's actually amazing research showing that these sort of narrative art forms that particularly will challenge us and give us new perspectives. We're more likely to take that information in if we're experiencing it through a story compared to if someone's having a conversation with us or giving us a leaflet to read. On the subject of stories, your book is full of real life stories of people who've improved their lives through engaging with the arts. As well as those stories though, you shared a very personal story of your own about what happened when your daughter Daphne was born and how the arts had a pretty big effect.

1:24:58I wonder if you'd be open to sharing that. Yes, I want to say that all the stories in this book are real people with their real names, which actually is quite unusual to have people who are happy to be identified in that way. But there are such incredible stories. I really wanted it to be authentic things that people are reading. But obviously there is a vulnerability in sharing stories. So it only felt fair to offer up one of my own. And yeah, my younger daughter, Daphne, unfortunately was premature. And when she was five days old, she contracted meningitis. and we had an absolutely horrific time in intensive care with her.

1:25:25And I remember feeling so powerless, there was nothing I could do. I wasn't even allowed to touch her. But I remember these studies that I'd read about 10 years previously that had been about the impact that singing to premature babies has on them in intensive care. There were stories that showed that babies had reductions in their stress response, they have reductions in their heart rate, their blood pressure, even improvements in their oxygen saturation. and so I sang it was Christmas time so I sang Christmas carols to Daphne for hour after hour and I could see on the monitors those improvements I could see that there were these slight increases in her oxygen levels that there were these reductions in her stress stress response and for me it was the most profound arts experience I had because there was nothing else that I could have done that I had at my disposal in that time but it was something that I could see was benefiting her and also undoubtedly had huge benefits for me in terms of coping in that time too.

1:26:18Wow thank you for sharing that I think there's been quite a lot of research now hasn't there in terms of the benefit of music in neonatal insensitive care units Absolutely and some of this is a little bit like the dementia things we were talking about where there are lots of really weird high-pitched scary noises in intensive care and if you're thinking about premature babies they should still be in the womb they should still have those low deep sonorous noises instead so buffering those out with calming music is something that we can do which is very simple. But also there's something about that human interaction.

1:26:52Babies can tell if it's their own mother singing to them. They can even tell if it's their mother singing live compared to in a recording. So having that voice, which is the most dominant sound they'd have had in the womb, but having that in intensive care is something that seems really important, not only to babies in the moment in terms of their physiological response, but actually we're starting to learn that it could be having cognitive benefits for them in the months and years that follow. Wow, it's absolutely incredible. Honestly, Daisy, I had no idea there was that much research on the benefits of the arts until I read your book.

1:27:27I think you've done a fantastic job. We've not even scratched the surface today in terms of things that you have written about. I mean, in the book, there's all kinds of things. The benefits of engaging with the arts include increasing happiness and its associated neurotransmitters, fulfilling our fundamental human needs, giving us peak moments of joy and euphoria, building our well-being and resilience, preventing and managing symptoms of depression and anxiety, helping us regulate our emotions, broadening the ways we think and act, supporting our cognitive development, enhancing learning, enhancing neuroplasticity, and the list goes on.

1:28:05It's utterly incredible. If there was anything else doing this, if there was a pill that could do all those things, we would be hearing about it. but thanks to your book now we're learning about the benefits of the arts and what the arts can do for all these areas so first of all thank you for writing it thank you for giving the arts the PR job that you are giving them um to finish off Daisy if there's someone listening who has realized throughout this conversation that the arts just doesn't feature in their life maybe they weren't exposed to it. Maybe they feel that they're too busy for it or it's something they associate with being a kid and not an adult.

1:28:50What would you say to them? Give it a go and start small and manageable. I made a swap last year, which has been one of the biggest beneficial behaviours I could have done, which is that we hear a lot about active commutes to work. I can't active commute. I live too far away. So I've gone for creative commute. So now instead of scrolling the news on my phone and stressing myself out on the way to and from work. I read a book every day on the way to work on the train. And on the way home, I listen to music to calm myself down. And it has made such a difference bookending my work day in that way.

1:29:23And I think that small shifts, swaps in our lives like that are very simple to do, but you could be surprised at how quickly you feel the benefits and how quickly you want to try even more things. Yeah, I love that. A creative commute. What a lovely thought to finish this conversation on. The book is called Arts Cure, the science of how the arts transform our health. Thank you so much for coming on the show. Thank you.

1:29:49Really hope you enjoyed that conversation. Do think about one thing that you can take away and apply into your own life. And also have a think about one thing from this conversation that you can teach to somebody else. Remember when you teach someone, it not only helps them, It also helps you learn and retain the information. Now, before you go, just wanted to let you know about Friday Five. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I've been consuming, and quotes that have caused me to stop and reflect.

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