One of the more complete summaries of the matter can be found in the review article Mechanisms underpinning the mental health impact of arts engagement, published in March 2026 in Nature Reviews Psychology by Daisy Fancourt, researcher at the Department of Behavioural Science and Health at University College London; Argyris Stringaris, Professor of Psychiatry at University College London and at the National and Kapodistrian University of Athens, Greece; and Pier Luigi Sacco, Professor at the Department of Neuroscience, Imaging and Clinical Studies at the University of Chieti-Pescara, Italy, as well as founding member of the CCW – Cultural Welfare Center.
The authors have drawn on and debated evidence spanning psychology, neuroscience, psychiatry, psychobiology and social science, with the aim of understanding which mechanisms can influence the processes that support mental health and the recovery from various types of mental health issues.
This has led to an interpretation that goes beyond the idea of a single mechanism responsible for the benefits observed. Indeed, the arts don't act via a single pathway, nor do they generate the same results in everyone. On the contrary, each artistic experience activates a network of processes that simultaneously involves emotions, cognitive function, microbiological systems, social relations and the construction of personal identity. It is this very multidimensional nature that makes it difficult to assimilate cultural engagement with other activities that support mental health.
One of the more credible aspects to emerge from the literature concerns emotional regulation. Artistic experiences allow us to come into contact with various emotional states within a context perceived as safe, offering a space to explore complex feelings without becoming overwhelmed by them. Listening to music, going to the theatre, reading a novel or observing a work of art often means recognising emotions that are also part of our own experience, understanding them better and giving them meaning. This process takes on special importance in situations of psychological distress, in which emotional regulation is one of the main challenges.
Artistic activities seem to facilitate different strategies: a temporary distraction from intrusive thoughts, the cognitive reprocessing of experiences, or the acceptance of difficult emotions. Studies show that the arts offer a broader repertoire of available strategies, encouraging greater psychological flexibility (Fancourt et al., 2019).
This same principle is especially effective for so-called “negative” emotions. Contrary to what we might think, sadness, melancholy and nostalgia provoked by an artistic experience find their own safe place. This safe place allows us to maintain a certain distance from these emotions, observing and understanding them with having to immediately respond , as we might have to in our daily lives. Art thus becomes a space where we can test, interpret and refine our ability to deal with challenging situations (Winner, 2018).
The narrative arts – novels, cinema, theatre and storytelling – also enable us to temporarily see things from another’s point of view, encountering experiences, emotions and conflicts that are different from our own.
This exercise of the imagination fosters the capacity to understand others’ mental states, intentions and emotions — what psychology calls Theory of Mind. It is an essential skill for developing empathy (Sacco, 2026).
Alongside the emotional sphere, neuroscience shows how the cognitive processes associated with an artistic experience – attention, memory, imagination, the ability to interpret and mental flexibility – involve cerebral networks connected with learning, attention regulation and reward mechanisms, fostering neuroplasticity, which is one of the prerequisites of psychological adaptation.
The concept of flow takes on particular significance within this context, as developed by Mihály Csikszentmihalyi (1990), a Hungarian psychologist and one of the main exponents of Positive Psychology. The psychologist argued that, during a deeply engaging creative activity, people can experience a state of full immersion in which their sense of time diminishes, their focus is on the task and any repetitive thoughts – which so often accompany anxiety and depression – are reduced. Numerous studies associate such states of intense engagement not only with reduced psychological distress but also with a strengthened sense of one’s abilities, independence and personal significance, aspects closely linked to mental wellbeing.
Artistic experiences also appear able to generate measurable physiological benefits, helping to regulate the systems involved in the stress response that, if they continue to undergo dysregulation over time, can lead to the onset or persistence of mental health issues. For example, various studies show that activities such as listening to music, artistic engagement and dancing can influence the autonomous nervous system, helping to lower heart rate, arterial blood pressure and levels of cortisol, the hormone most involved in the stress response. At the same time, they help boost the indicators associated with relaxation and physiological recovery (Fancourt et al., 2021).
The most recent research suggests that artistic engagement can also impact more deep-rooted biological mechanisms. Some experimental studies observed a reduction in markers of chronic inflammation and an improved regulation of the immune response following engagement in artistic programmes over time.
This is especially significant since a growing body of evidence associates chronic inflammation with the development and persistence of various mental health disorders (Bullmore, 2018).
The neurobiological and cognitive processes involved in the aesthetic experience are closely tied up with the relational dimension. Most artistic activities are indeed conducted with other people: we sing together, we attend workshops, we visit exhibitions, we go to shows, and we read and discuss books, all with other people. This type of shared experience fosters the development of mutual trust, strengthens our sense of belonging and helps to combat loneliness, recognised by the World Health Organization as a major risk factor for mental health, as shown in the report From loneliness to social connection: charting a path to healthier societies. Shared artistic activities also facilitate cooperation, empathy and the understanding of emotions in others, fundamental skills for building meaningful social relationships.
The relational aspect of the artistic experience also helps in the construction of personal identity. Singing in a choir, attending a painting workshop or joining a theatre group means taking on a role and a sense of belonging that leads us beyond the limitations imposed by mental illness, by work and by the challenges of everyday life. For those undergoing a period of psychological distress, being able to build a positive and socially recognised identity is one of the elements that the literature identifies as central to a path of mental health recovery.
In opening up new possibilities for research into the relationship between culture and mental health, the review article introduces the concept of the arts exposome, inviting us to consider not only the benefits of individual artistic experiences but also the whole range of cultural exposure that is part of people's lives. The term takes the concept of the exposome – used in health science to describe the series of integrated environmental influences that impact an organism over its entire life – and applies it to artistic and cultural engagement.
Art, then, doesn't just act on a single front: it regulates emotions, strengthens relationships, modulates stress and contributes to the construction of a more robust identity. A legacy that builds, one experience after another, throughout life.
Further reading:
Catterina Seia e Elena Rosica, L’epidemia della solitudine: una fragilità collettiva, 30 maggio 2025
Catterina Seia e Elena Rosica, Arte e salute: un legame dimostrato, 25 aprile 2025
Catterina Seia e Marta Reichlin, Flourishing: fiorire attraverso le arti, 30 aprile 2024
Catterina Seia, Giovani. L’espressione creativa come antidoto alla depressione, 30 gennaio 2024
Catterina Seia e Neve Mazzoleni, Leggere: la strada per la qualità della vita, 12 ottobre 2021