Interview with Stephen Legari, Art Therapist at the Montreal Museum of Fine Arts

The Montreal Museum of Fine Arts is during these months under the attention of humanistic experts and clinicians. Here doctors are able to prescribe free art museum visits to patients with a range of ailments, from depression to diabetes to chronic illnesses. The museum will allow doctors to prescribe 50 free visits a year for a patient and caregivers. Each prescription will allow entry for up to two adults and two children age 17 or under. In this way, the culture prescription could be therapeutic not only for those who are already suffering due to illness, but also as preventative care for visitors who accompany patients.

Why this project? The reason is already clearly explained by neurosciences, since being in contact with Beauty, and the creation of something of that holds personal meaning or aesthetic value activate the release of those neurotransmitters related to wellbeing (Marini MG, The languages of care, Springer Edition, 2018).  However, the prescribed connection between art and wellbeing, wherein patients are physically directed towards a fine art museum as part of their treatment plan, has remained elusive to the medical community until now.

I had the pleasure to interview Stephen Legari, Art Therapist and coordinator of the museum’s Art Hive. This community open studio is co-faciliated by art therapists and mediators is a free, accessible space within the museum where visitors can create at their own rhythm within a mandate that promotes social inclusion and well-being through art. Stephen additionally runs art therapy groups, supervises interns and collaborates on research with partnering universities, clinics, and community organizations.

While preparing myself for the interview I discovered the background and the pillars on which this experiment originates: Montreal is a city full of Art Hives.

 

Montreal and the Art Hives

“Stephen Legari, why all of this is happening in Montreal?”– Stephen, very kindly shared with us the history of art “activism” in this city.

Art Hives in part come from within the tradition of art therapy: open art studios were places where patients could come and talk, and do something different from their concurrent clinical treatments and therapies, also including psychotherapy. In Montreal, the creation of the Art Hives is due to Professor Janis Timm-Bottos at Concordia University in Montreal. Tmm-Bottos is an art therapist and scholar with a sustained research practice investigating the community art studio as a therapeutic site for individual, family and community healing. She is founder of Art Street, an art studio with Albuquerque Health Care for the Homeless, OFF Center Community Arts Project, an arts-based public homeplace in Albuquerque and “Kitchen Table Arts,” which was housed in a thrift store in Nelson, seeded “Children of the Seams” a youth collective that remakes fashion from discarded clothing. She formed herself in the Unites States where she worked with home less artists, but she decided quit that environment to be less influenced and free to develop her ideas of art, crafts, cooking, to embrace the city for community organizations. She created the Hives as a model of public engagement in art and activities: spaces are free, accessible to everyone, the sick and poor people together with the healthy and wealthy people: the ideal hive has people of every kind so that everyone can both benefit from the inclusion of the diversity of life; the community helps to create stability for those may be living with a variety of problems inlcluding mental health issues and social isolation…”

“Art can also help to expand people creatively, those that may be overly structured or rational. But why does this miracle happen is Montreal?”

“Montreal, in Quebec, is an art destination: many young artists come to live here because it is affordable, and it because it has a long history in the art. The “Quebecois” have a very rich cultural history and the city is very cosmopolitan and multicultural. From a political point of view, it has a history of inclusion, based on a more socialist ideology; the Hives are a very sustainable model that have caught the attention of philanthropy, in some cases they are financed with municipal funds in other cases they enjoy the support of donors and family foundations. However each hive is autonomous and individual.”

“How many hives are there?”

“There are more than thirty Hives in Montreal and two hundred worldwide, that is to say that 15% of the hives are here in this city.  The most important thing is that they are public, accessible to everybody, with no payment needed.”

 

The clinicians

“What about art hives in hospitals?”

“We definitely want to expand hives into the hospital: the adaptations to the clinical environment can provide something that fosters wellbeing in patients and providers of care through an arts based experience.”

“Are there any resistance by the clinicians in embracing these art therapy activities?”

“I’m very much interested in resistance. Our medical systems are founded on hierarchy. One of the most difficult things is to flatten the hierarchy. Participating in the arts for clinicians and physicians may feel undesirable as it somehow shows the vulnerable parts, the fragility of a person, as well together with the stronge parts: however, with art one can be moved by what is seen and created and feel heard. Therefore, in a hierarchical world, one does not want to expose the fragile humanity of the very self.”

Personally, I think that the best leaders were and are those able to show also their human face, able to understand the others and to encompass his/her own fragility.” – Legari continues. – “I see that the engagement with art and healing as a developmental process. We work with groups of medical students brought to the Museum to stay in contact with art: we selected some “oeuvres” that we use to show sickness in all its nuances and explore empathy. These pre-med students react in a wonderful way “

 

The art prescription project

“Now that we have understood the background which was a catalyst to the experiment of prescription, could you tell us a little more about this extraordinary project?”

“As far as I know, all of the physicians are family physicians who prescribe this visit to the museum verify the presence of motivation by the patient, that this person could take advantage of this prescription. The prescription is for one, for a couple or for a family all together. It is nice when all the family system comes to the museum, I am a family therapist also, and I think that the achieving of wellbeing is much faster when the whole family is engaged.  They will have the possibility to increase the sense of wellbeing, the opportunity to have positive emotions. Neurologically, we hope this will have a positive impact on the activity of the amygdala and that some degree of emotional regulation will be enjoyed. The museum prescription can take different froms: from a tour with a guided visit, to an independent visit, to an art therapeutic referral.

In this first year, the patient come and present the prescription, and they are given an evaluation form to fill in at the end of the visit: people will have the power to impact the future of this program. The visiting patient will be able to enjoy the 5 pavilions of exhibited art, take a tour, enjoy free family activities or attend the art hive.”

“What about the choice of the medical prescription and not only  social prescribing?”

Legari says: “We are building upon on what it exists and doing something more directed. There are cases in UK of social prescribing and there are other places where museum prescriptions are catching on now”

“Yes, we also have in Milan guided visits with art therapist counselled by doctors for chronic mental and physical disabilities but never a medical prescription”.

“Here, although prescribed by the doctors, the cultural prescribing is not intended to replace a medication but we indeed are interested in reducing the dosage of drugs for treating pain or depression. There was a study just completed at our museum with art an activity for seniors and it showed have  that there is a positive impact on their quality of life with an increase sense of wellbeing. This is where research is pushing us: art related to clinical outcomes.”

In the Hive, the mieux-etre – the well-being is tied to the fact is treated as an artist: artists are people who create” The poiesis is  the creation activity: if we go back the Greek root, to create is an overstructured word, because the basic meaning of creating is  simply “doing”, whatever doing, a cooking pastiche, a new cloth form old rugs, a watercolour from make-up colours or poetry with logical and irrational words.

Maria Giulia Marini

Epidemiologist and counselor in transactional analysis, thirty years of professional life in health care. I have a classic humanistic background, including the knowledge of Ancient Greek and Latin, which opened me to study languages and arts, becoming an Art Coach. I followed afterward scientific academic studies, in clinical pharmacology with an academic specialization in Epidemiology (University of Milan and Pavia). Past international experiences at the Harvard Medical School and in a pharma company at Mainz in Germany. Currently Director of Innovation in the Health Care Area of Fondazione ISTUD a center for educational and social and health care research. I'm serving as president of EUNAMES- European Narrative Medicine Society, on the board of Italian Society of Narrative Medicine, a tenured professor of Narrative Medicine at La Sapienza, Roma, and teaching narrative medicine in other universities and institutions at a national and international level. In 2016 I was a referee for the World Health Organization- Europen for “Narrative Method of Research in Public Health.” Writer of the books; “Narrative medicine: Bridging the gap between Evidence-Based care and Medical Humanities,” and "Languages of care in Narrative Medicine" edited with Springer, and since 2021 main editor for Springer of the new series "New Paradigms in Health Care."

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