Arts and Aesthetics: What If We’ve Never Had a Choice?
As the Arts on Prescription Field Guide is read and shared around the world, I hear from more and more people about integrating arts with healthcare and other settings—from workplaces to schools to social service agencies. Others mention wanting to enhance wellbeing by creating aesthetic experiences for the people who come into their building or space.
I love this growing interest and expanded imagination!
And it’s reminding me of a few key steps on my journey…
Getting Intentional
For a few years in graduate school, I taught rhetoric and writing to first year college students. Most students came in assuming that communication skills were only useful for really “high stakes” situations—speeches, letters to congresspeople, cover letters. In these situations, students naturally paid more attention to their words’ effects, and wanted to apply rhetorical skills to get optimal results.
But each semester as we dug in, students were surprised to find that all communication uses rhetoric, and it’s always having an effect.
All communication involves word and tone choices, whether we’re intentional about them or not. And we all use ethos, pathos, and logos—regardless of whether we know what these terms mean, and regardless of whether we use them skillfully.
In short, students learned that rhetoric isn’t something you can just choose to add when you really want to up your communication-game. You’re already using it. And if you’re not aware of this fact, you might be using it poorly—with unintended consequences.
Our failure to consider how a message will come across doesn’t render the effects of that message neutral. This is exactly how a lot of arguments begin, right? Someone blurts something out without thinking about its effects, and the result is…disaster.
So when it comes to communicating, the choice is NOT between whether to have an effect that you intend and work hard for, or no effect at all. You’ll have an effect either way.
The only choice is whether your effect(s) will be intentional.
Art is Not Always…Great.
A similar truth came up in 2019 when I was invited to speak at an international health innovation summit. I could have hyped art’s health benefits, sharing why integrating the arts with healthcare is a great choice.
Instead, I told my audience that they don’t actually have a choice.
Just as my students were using rhetoric whether they wanted to or not, I told my audience: Your health spaces are already infused with art. It’s just often… bad art, because you haven’t thought about it.
And whether you think about it or not, that art is having effects on patients, clients, and staff.
Let me give you a few examples.
When you check in as a patient at a typical clinic, they ask you to fill out patient intake forms. Most of these forms use a small, crowded font, and they’re often blurred because they’ve been xeroxed a thousand times.
Intake forms are a kind of art! They’ve been designed. But it’s usually bad art and design…because it wasn’t intentional. There was no thought about effects.
But failing to think about effects doesn’t render them neutral.
Intake forms affect everyone who has to deal with them: patients, staff, clinicians.
(At a recent appointment, a nurse confided in me that I was the first patient to fill out my form correctly, insinuating that previous patients hadn’t paid attention or couldn’t “get it.” What hadn’t occurred to her is that the form itself was to blame. If hundreds of patients don’t “get it,” the problem isn’t the patients! In this case, the awful design was resulting in incomplete information, potential risks to care, and wasted time as staff worked with patients to correct data.)
The posters and signs that clutter waiting rooms also affect patients, staff, and clinicians. These too are forms of art, and they’re rarely… great.
Last example: Consider the experience of sitting in an exam room, waiting for a clinician. The room’s often overly cold or warm, the standard fluorescent lights can be awful, there’s awkward silence combined with noises from adjacent rooms…and then there’s the vulnerability of waiting and waiting.
This exam-room experience is its own “immersive aesthetic experience” ...and it’s often a negative one. With potentially negative effects.
My point here is that regardless of what you know about the health effects of arts and aesthetics, your spaces are already using both. And your patients and staff are already experiencing the effects. If you’re not creating those effects intentionally, then you don’t even know what they are—let alone how they’re impeding or advancing your goals.
In short, we don’t get to choose whether to integrate the arts with healthcare, or with education, social services, or other settings. They’re already there.
Our only choice is whether they—and their effects—are intentional.
Intentional Aesthetics?
My background is in public health, where we regularly discuss the immense health disparities caused by what one could describe as negative aesthetics: noise pollution, light pollution, lack of green space, failures to address litter or dilapidation, and more.
So when I began research in neuroaesthetics—a field devoted to understanding brain and body responses to aesthetics and built environments—I expected to find studies not only of responses to positive aesthetics, but to their absence. (What are the effects of being unable to access beauty?) I also expected to see studies about how negative aesthetics affect humans.
As it turns out, such studies are relatively rare. Right now, the greatest excitement in the field lies in uncovering the many positive effects of positive aesthetics, including why and how these effects occur, and how we might optimize them.
So I began referring to this research as intentional aesthetics. Because most studies weren’t looking at aesthetics overall, but at what happens when we get intentional about them.
And this distinction matters.
The danger in focusing exclusively on the positives is that we depict aesthetics as a nice extra you can add if you choose to… Which gives the impression that if you don’t choose to add aesthetics, then you just keep your current, neutral spaces that have no aesthetics and no effects.
But of course, there is no neutral. Our spaces are either intentional or not.
What we need is a commitment to intentional spaces.
Getting Honest and Explicit
The phrase “intentional aesthetics”—as well as “intentional art,” “intentional rhetoric,” “intentional spaces”—offer built-in reminders that UNintentional versions exist, and they too have measurable effects—including harm.
And occasionally, the harm is intended. Music has been used in torture. Bus stop benches are often designed to prevent comfort or lying down. I’ve spent years working with youth in carceral facilities, where the “immersive aesthetic experience” is intentionally punitive: creating a sense of repression, disconnection, and despair.
Clearly, art and aesthetics can be intentional or unintentional. And their effects can be negative, positive, or somewhere in between.
When we get honest and explicit about this, we can reckon with the fact that what we don’t know and don’t intend can cause harm. We can embrace the opportunity before us to ask new questions, discover new approaches, and reimagine “how we’ve always done it.”
The status quo isn’t fate; it’s just our starting point. And it is never neutral.
Recap: Intention Matters
My goal isn’t to change everyone’s language. I’m personally not going to STOP using phrases like “integrating the arts” or “injecting creativity into” healthcare, workplaces, schools, and more. These offer a great shorthand for the intentional work most of us seek to do.
But too much focus on the exciting outcomes afforded by the arts can make it seem like we’re talking about a cool new nice-to-have. We risk giving the impression that people can either “add” arts and aesthetics to optimize their outcomes… or go on without them, and keep their neutral status quo.
And that’s a dangerous misunderstanding. Our current spaces are not art-less, aesthetics-less, or neutral. What they are, quite often, is unintentional.
The reality is, we don’t get to choose whether to integrate art and aesthetics into our spaces and our work. Our only choice is whether to do so intentionally.
We don’t get to choose whether arts and aesthetics will affect the people who encounter them. Our only choice is whether these effects will be intentional.
One or the Other
We face an immense opportunity to shape spaces that heal rather than harm…
…But doing so requires us to reckon with the reality that all spaces are always doing one or the other.
As architect Tye Farrow has said, “there's no such thing as a neutral space.”
What could be possible if we committed to creating intentional spaces—from clinics to classrooms to offices, and beyond? What could we get done if we acknowledged that the status quo is never neutral?
What could happen if we admitted that art is not just an interesting option, but an inevitable aspect of our day to day lives—and that it’s having effects, whether we notice them or not?
We don’t have a choice about “integrating the arts.”
But now that we know this, a world of options opens up.
What choices will you make?
