Eva Bojner-Horwitz

Picture: Kirsi Karppinen

Eva Bojner-Horwitz, The Royal College of Music (KMH)

Could you tell something about yourself and your relation to arts and wellbeing?

I presented my doctoral thesis in 2004 in the area of social medicine, where I evaluated what dance and music do with our bodies. I was measuring biological markers and did hormonal analysis with stress hormones. I was also evaluating movement patterns pre and post dance and music activities, and used drawings. It was interventions with music, dance and drawings. I was also specifically interested in how a person nonverbally explains the changes of the inner emotional world after such intervention. This was not that easy to understand how we evaluate another person’s changes over time emotionally, so I introduced the self-figured drawing (SFD) concept in my thesis. I standardized the self-figured drawing material by counting number of colors used, and the size of the SFD and the paper. We did a scanning of the different self-figure drawings, and we also evaluated the amount of body parts that was represented in the self-drawing and we also measured things verbally pre, during and after the dance and music activities. So, I have tried to give an overview of different possibilities when evaluating the art for exhausted patients with chronic pains with self-figure drawings and video interpretation technique. With my doctor thesis we have the visual part, the stress hormones, blood analysis and saliva tests and also methods explaining movement changes overtime. We made video recordings of body patterns and body movements and also of course we used a lot of verbal questionnaires to be able to see if we verbally could synchronize and see if words are related to what was going on in the inner part of the body. And we saw that the biological markers were very, very slow in that sense to signal changes over time after artistic implementation, after intervention with arts, in relation to body pattern changes, the body movements were very fast in signaling what was going on after the intervention. So that was a new area for me to continue exploring and since then I´ve been working with different kinds of artistic methods: music, dance, drawing and theater with patients and also with students, teachers and researchers in school systems and health care systems. Today I am working as a professor of music and health here in Sweden. I am affiliated with the Karolinska Institute, and I am also giving lectures here at the Royal College of Music in Stockholm and in other universities. So, this was this sort of the entrance into this world of artistic methodologies and evaluation methodologies.

How do you see the importance of art and creative approach in health care processes?

For me it’s quite easy to answer to that question because normally in health care you use words. We think that the patients are aware of which words to use. But we know that it’s very hard to explain with words those processes going on inside the body. And therefore, we need nonverbal methods to get an idea of what is going on within the patient and also within the health care staff. I think the importance for me is to continue my research on the importance to give not only the patients and the health care system but also our politicians knowledge about how our brain communicate embodied changes over time. I also work with seminars for politicians for example in relation to my thesis work because we know that there are many people who have difficulties to verbalize their emotions and to open up the amygdala system, the emotions. We need to communicate also nonverbally. Let me give you an example. How would you communicate what you feel in your body right now by using your body movements and dance for example? Or maybe you could draw a self-figure drawing that could be the recite for how you feel right now. And how can we measure things going on in the body such as the immune system the autonomic system, nervous system. How do we listen to those systems? Do we have any sound from the body that we can listen to? So, you see this nonverbal way of understanding our wellbeing, we can’t understand it through just using words. The art is actually the key to open up this communicate door to understand how we truly live our lives in this world. So, for me the art is a meaningful symbol of how we need to explore and continuously help our world to understand that the art is part of the original communication. When we go back in time, when we didn’t have words or symbols the first primary thing, we used to be symbols. And those symbols we can read in our old caves for example, those symbols are much richer than the words because words are late “constructions”. And I think this is of global interest. We forget very much about the origin of the arts. Therefore, also in the IO3 we are doing a review of the literature of the historical use of esthetics and the arts, so we won´t forget where we came from.

Royal College of Music educates musicians and music teachers. What music means to you in your personal life?

Well, I think I already answered to this. Music opens up parts of our amygdala, the emotional brain, and for me personally, music is a way to get in contact with my body, get in contact with my emotions and also to tune in into what is important in life. So, it’s a dual opener for myself, to be more aware of my body and the embodied knowledge of my body. If I am only working with the frontal part of my brain, the frontal lobe, I´ll not be as authentic as I ’d like to be. I use music to be able to be more in connection with myself and myself in the world.

What are your professional highlights in field of arts and wellbeing?

I ’d like to highlight the cultural palette work. I had funding to be able to work with different artistic work/expressions in the health care systems here in Sweden. I was introducing artists in health care system for exhausted women. We invited a musician, a dancer, an artist, an actress, and a mindfulness therapist. We organized, which was quite hard, cause in Sweden we normally don´t invite artists into the health care waiting room, so we did this in a systematized way for 3 months one time at a week. We had a new artist coming to this group of exhausted women every week to see what happens with their pain, with their wellbeing pre, post and after 3 months with this specific intervention. What we saw was, when we compared this to control groups (that didn’t t receive any artistic intervention), that the amount of alexithymia decreased in the intervention group. Alexithymia is the difficulty to verbalize emotions. What we saw was that the patients within this cultural palette started to increase their capacity to verbalize their emotions compared to the control group. We also saw that the amount of wellbeing increased. That was a highlight for me to see how easily we can use and systematize artistic work in health care centers and hospitals and be able to embody a more embodied and emotional language.
We have also worked a lot with performance evaluation where we can see what is going on in between the audience and artists, for example dancers and musicians, and what is going on with the so-called flow. We have started to evaluate flow through heart rate variability measurements, so we see what is going on in between musicians, how they support each other, how do they communicate and how do they synchronize their work and how is this spread and contained out to the audience. We have studied flow mechanism and we have also so-called knowledge concerts when we have musicians and we communicate, for example we had the #metoo theme when we had satellite seminars, knowledge seminars, in relation to strong music concerts. We see that this can also increase the learning in the audience when we add arts into contexts like this.
We are also right now working with kids in school who are 3-5 years old. We let them enjoy live classical music and we see how they perceive it and look at their responses. We have seen in school system in Sweden that it´s very rare, very original to listen to live classical music. Because if you don´t listen to it at home and you don´t play any instrument it´s very rare to have this possibility. We videorecord the students and the small 3-5 years old and see how they connect to each other during this listening session.
At the other continuum we are looking at the end of life and funeral music. How does it affect the families when they know they play the music that was wished for during the funeral and how does that affect their capacity to cope with the sadness and sorrow?
I think I have been engaged in the hole lifespan here.

Would you recommend studying in KMH to students who are interested in arts and well-being and why?

KMH do have courses which are called music, health, and well-being where I give lectures. These are courses you can choose during different program. We have music teacher program, musician programs, Music therapy programs, performing and composing programs and we also have program for directors and producers. So, we recommend students to do couple of those courses in music, health, and well-being. And we give lectures in sustainable musician courses and entrepreneurship, how to take care of yourself.
We have developed those courses for our students. During the Covid pandemic we have also organized retreats for students and researchers to take care of yourself. Because if you can´t take care of yourself, if you are a student, a teacher or a researcher, it´s hard to talk about art and well-being.

Why and how did you get involved in this Arthewe project?

The ten-step program is a program I have been working with scientifically and popular scientifically. I can show you the book, it´s this book Kultur för hälsan (Culture for your health). It is a summary of the research I have been doing. I have tried to, in a popular scientific way, present this ten-step program as a way for patients and to be able to find out about pre signals of stress in the body by using arts. Burnout and negative stress are unfortunately a very common thing within our students lives. To reduce stress or to buffer students against exhaustion very early on is the purpose of the program. The purpose is to help students in an easy way to take care of themselves through arts. I have used different methodologies from my research and evaluated this ten-step program clinically and now we are doing it in the IO4 package. The program has been used for patients, but we are creating it for students. We use self-figure drawings to be aware of different self-conscious levels and we work through movement and of course music. So, it´s to open your awareness via movements. We are evaluating the program right now and doing video recordings for students to be able to do pilots with our students.

How have you shared leading with David Thyrén?

We are working very close with a lot of research projects right now and I asked David to join Arthewe project because it we collaborate very well. We have different specialties, and we have a lot of respect and trust within our work. We are also giving lectures together. It´s like one plus one is three here. We also have a wonderful chief, our boss within our academy, who has also agreed on our collaboration. When you feel you get creative and have a lot of work done together with someone, it´s a good collaboration. It´s a gift when you find one. It´s about trust actually and empathy in this working progress.

What do you think about this way of working when all will happen through internet and virtual meetings? What strengths and challenges might appear?

In the beginning I found it was quite alright. But now when we have landed in different concrete things, we´d like to do, I really miss the IRL meetings because you can´t read in between the lines of your colleges online. That is much easier to do when you meet with your body. This reading in between lines is actually impossible to do via screen. And also reading trust within colleges, all of a sudden there are ethical issues we need to bring down to the paper which if we had met wouldn´t been an issue. Because we had been more capable if we meet towards to read the trust between the group participants. The positive side is that we don´t need to travel so much, for the climate etc, but now in the process I really miss IRL meetings. Because we are bodies and artwork is very much non-verbal so when we are using only frontal part of our brain, we miss a lot of especially the ethical part and the trustful part. It´s so easy to manipulate with words. You say that you do something and then you see that a person does not do as they tell, which may lead to misunderstandings and also negative processes that evokes from not meeting irl.

What kind of skills/competences do you expect from the students that are participating this project?

If I answer the other way around. The end product is to increase the body awareness, to be very much aware of your needs in the body. I think it requires a motivation and a willingness to change your priorities when it comes to cognitive knowledge and embodied knowledge. I think the motor into being open for the change it´s like to be open to transform your own ideas about the uniqueness of yourself and your body and also be open to read pre signals from your body. I think we have a lot of students who are not aware of where they have their bodies in all the different conscious levels. The capacity to use their inner imagines, to use their hands, to use music, dance movements, role play. But if you have an interest in this and you also know there is research, a lot of research and evidence through which you can increase your well-being via the arts and transform yourself into more authenticity, this motivation is needed.

What are your expectations about this project and collaboration with professionals/students from different fields?

My expectation is that this is going to be something that is going to be running in all our educational programs. An easy access, the digital program, a platform for the ten-step program and also train the trainers onboard. That we have a representative of ten step program in each educational system that can help the students in the beginning of their educational program to be aware of what is important to them and to make their work and body a sustainable one.