Painting your feelings

Dr Eugen Koh - director of The Dax Centre
Programs based around the use of art and creativity to promote mental health
Making and viewing art creates space for understanding, empathy and healing

The pain of mental illness and trauma can be too searing to articulate. But it can be expressed and communicated through art, opening the way for healing. Today's guest in The Zone has found a fascinating and powerful overlap between art and mental health, and is helping many people manage and recover from problems, while giving those who do not have mental disorders a better understanding of those who do.

For the past 12 years, psychiatrist and psychotherapist Dr Eugen Koh has been director of the Dax Centre, an independent non-profit organisation situated in the grounds of University of Melbourne.

The centre is home to the Cunningham Dax Collection, 15,000 works of art by people who have experienced mental health issues and/or trauma. It is one of the few heritage-listed art collections in Australia.

I visited it last week and found it compelling; it delivered insights - sometimes haunting, sometimes uplifting - into the experiences and emotions of the artists.

In our interview, the full transcript of which, as well as a short video statement, is at, Koh explains how and why using art is improving the lives of many people throughout Australia.


''The Dax Centre is about the use of art to create a space to bring people together; using the space to get people to think about and reflect on and explore some really painful and difficult issues either for themselves or society at large.''

The collection contains works by people who have experienced depression, anxiety, schizophrenia or trauma. There are works by survivors of the Holocaust, the Boxing Day tsunami in Sri Lanka, the Black Saturday bushfires and child abuse.

''For the individual, that experience is too painful to be faced, and the creating of artwork creates a space for them to slowly, in little bits, encounter their traumatic experience … But this extends beyond that, because art viewing can also create a space for the viewer - which may be an individual, it may be the community, it may be a large population - to come together to encounter these painful histories and painful experiences.''

Almost half the population will experience a mental disorder at some time in their life, and at least a third of the population will have that experience before the age of 25. Each year, as many as one in five adults in Australia will have a mental disorder. Anxiety disorders affect about 14 per cent, while depression affects around 6 per cent.

There is an urgent need to help people. Not only is there the pain and practical difficulties associated with mental disorders - on the part of the sufferers and those close to them - they can often be a matter of life and death.

Research released last month by the University of Western Australia and the University of Queensland found mentally ill Australians are dying an average of 16 years earlier than the general population - and the gap is widening. The study used data gathered over two decades from almost 300,000 people.

Most of the early deaths were from physical causes - primarily cancer and cardiovascular disease - and suicide accounted for 14 per cent. The life expectancy gap for the mentally ill is as big as that between smokers and the general population and indigenous Australians and the general population.

Koh sees empathy and compassion by people who are well as central to improving the lives of those experiencing mental disorders.

''The definition of empathy is to be able to put oneself in another person's shoes. It requires us to understand the experience of another. Art is immensely powerful for that. One of the problems we have though is when we come to the area of mental illness there is a great deal of fear. Once there is fear, people put up a screen, put their defences up.''

Empathy and compassion are crucial if the general population is to overcome fear of mental illness. Fear is the foundation of stigma, which Koh sees as one of the greatest barriers to people experiencing mental disorders seeking help.

''If people want to understand why the Dax Centre needs to exist, they need to understand the problem of stigma. Stigma is a huge problem. We talk a lot in mental health about the importance of early intervention. If stigma prevails, nobody is going to want to acknowledge that they have got a problem. And if you do not acknowledge that you have a problem, you will not seek help. So stigma is one of the biggest barriers to early intervention. It is a barrier against people seeking help. It is one of the major factors in suicides.''

Stigma, which is born not only of fear but of ignorance and prejudice, creates social exclusion, Koh adds.

''Many of my patients often talk to me about it, if they suffer from schizophrenia, for example. They say to me, 'Doctor, the schizophrenia is not so bad; it is the rejection by my family and my friends that I cannot take.' So stigma is a big problem that diminishes the effectiveness of the millions of dollars that we put into mental health.''

Koh and his team are having a remarkable impact. The Dax Centre runs a series of programs, including for students from primary and secondary schools, and takes selections from the art collection on tour - an initiative called Dax on Tracks.

Many rural and regional communities, for example, have experienced wrenching trauma, including elevated suicide rates, because of the stress caused by drought. When a well-known organisation - which Koh does not want to name - that raises awareness about depression organised a public event in Mildura, which has a population of 30,000, Koh says fewer than 20 people turned up. When Dax on Tracks went there, 4000 people attended the exhibition. It was a similar story in Morwell in the La Trobe Valley, where part of the collection was shown three years ago.

''These programs have been so effective that we have recently had independent valuation. The independent evaluators were surprised to find that three years after we left Morwell, for example, that group of people that would otherwise not meet have continued to meet each year after we have left, using their local art exhibitions to create a space for the community to come together.''

I was at that gallery last week and the people of Morwell were still excitedly extolling the benefits of having experienced the Dax Centre's program. Disparate organisations including the local GP groups, local schools, the Lions Club and the Rotary Club have come together to help people deal with mental disorders.

Koh is running a project in central Australia to help indigenous people deal with the trauma associated with myriad health and social and economic problems. The women elders are grieving a lack of connection with their young people, as well as the violence and substance abuse those young people are experiencing. When Koh suggested they paint what they are feeling, they were bewildered.

So he told them of a project he did with the Holocaust Museum in Melbourne. First-generation Holocaust survivors, many of whom do not speak about their experience, painted their feelings. The younger generations asked to do the same.

''The children looked at their parents' work and said, 'Why didn't you tell us what happened? Why didn't you tell us what happened, because we were bewildered with your angry outbursts, we were bewildered by your sadness?' And then when the parents saw the children's work, they said, 'Why didn't you tell us you were so upset. Why didn't you tell us?' There was really a moment of coming together for two generations.''

As soon as the Aboriginal elders heard this, they embraced the idea. When their children and grandchildren discovered that, they immediately asked to participate. All three generations are busily painting - and Koh believes the project will help unite a fractured and disengaged community.

Koh and his team have developed an innovative program for primary school children, using art to enhance their emotional literacy. Children who understand their emotional experiences are more resilient. He tells of an 11-year-old girl who exclaimed, ''Now I know what this is about; art teaches me about me.''

This reinforced for Koh that the space, literal and metaphoric, he and his colleagues have created is working. And it has helped him formulate a distillation: ''Art teaches me about me - and also about others.''
