Making pretty: Occupational therapists and psychologists have found that colouring-in – alone or in a group – is good for people of all ages and health stages.
Making pretty: Occupational therapists and psychologists have found that colouring-in – alone or in a group – is good for people of all ages and health stages.


About 15 years ago, I introduced colouring-in circular and geometric patterns to my occupational therapy groups for people with dementia who had been admitted to hospital. Because of their dementia, they found it difficult to concentrate, complete steps of familiar tasks or follow a conversation.

The effect was remarkable. The calm in the room, attention to detail and satisfaction with even a half-finished product made me feel I was contributing to improving their quality of life, even in the face of a devastating degenerative illness. But there was a challenge: it was hard to find age-appropriate pictures

to colour.
Fast forward to 2015, and Amazon stocks 5?528 different Coloring For Grown-Ups books. This week I counted 23 different adult colouring-in books at my local bookshop in Cape Town. My regular news-agent also stocks at least three different adult colouring-in magazines (much more affordable) – with free pencils and other goodies to collect each week. The titles of these books promise stress relief, inspiration, creativity, calm and happiness. The question for me is not so much whether colouring-in really has these benefits, but why they may do us all good regardless of whether we have mental health problems or not.

Creative thinking
Colouring-in is good for us because it is a creative activity. In Art as Medicine, Shaun McNiff describes creative activities as “soul medicine”. This suggests that being creative can help us repair ourselves, as well as fulfil our own possibilities.

A 2011 systematic review in the Journal of Psychiatric and Mental Health Nursing of all research articles linking creative activities, mental health and mental wellbeing found that, although there was some evidence that creative activities reduce stress, they can also make us feel more relaxed, more optimistic and happier.

The challenge of colouring-in is also “just right”. In 1999 occupational therapists Karen Rebeiro and Jan Polgar developed a theory of creating optimal therapeutic experiences that suggests we are more motivated to participate in activities when there is just the right balance between the demands of an activity and our ability to do the activity.

Adult colouring-in books offer those of us who like to be creative but are not very good at drawing a less demanding activity that we are realistically able to do. Also, some pictures are easier to colour-in than others – especially those with a repetitive pattern or a circular design, like the mandalas I used with my dementia patients.

In the moment
Finding the “just right” challenge leads to a state of “flow” – described by Mihaly Csikszentmihalyi, distinguished professor of psychology and management at Claremont Graduate University. Being in a state of flow is that magical moment when you become completely absorbed in what you are doing and lose track of time.

Colouring-in also creates time and space to be mindful. Mindfulness is probably the most talked-about alternative to psychopharmacological treatment for a variety of mental health problems, including stress, anxiety, depression and substance dependence. At its core, mindfulness is about being intentionally aware of, and accepting, an experience you are having in the present moment, without being judgmental.

Being mindful is a skill that needs to be learnt and improved with daily practice. Colouring-in for five to 10 minutes a day creates a designated time and space to be mindful.

It helps us get the balance right. Having a balanced lifestyle is something we are told is good for us. The problem is that balance is understood in many different ways. Also, having too little to do can be just as bad for you as having too much to do.

The definition of balance I prefer comes from a concept analysis carried out by researchers at Sweden’s Jönköping University. They define balance as a person’s own perception that they have the “right mix” of activities in terms of how much they do and the different things they do in their everyday life.

In my view, adult colouring-in contributes to a balanced lifestyle by being something “different” to do.

Colouring-in provides opportunities for both solitude and sharing.

Perhaps one of the things I love the most about adult colouring-in is it can be easily adapted. It is an activity enjoyed by people of all ages and stages – from my three-year-old, who likes to spot the hearts and flowers in designs, to the older people with dementia I used to work with.

My children love gathering around an A2 or A3 print and agreeing who gets to colour-in or paint which part of the picture.

In a home for the aged, an occupational therapist colleague cuts out residents’ circular designs and uses them to decorate an otherwise drab and sterile lounge area.

It is also an activity you can choose to do alone to get peace and solitude.

Mindful gift
So if reading this has sparked an interest, or given you an idea for that hard-to-buy Christmas present, there are a few things to think about before opening your wallet. Choose something you’re interested in – whether it is flowers and birds, geometric designs or a colouring-in book related to your favourite TV series – I found three different ones related to the popular Game of Thrones.

There really is something available for everyone. Think about whether you want something small that you can carry around, or a larger book in which the pictures are easier to see and to share. Also think about what you are going to use to colour-in.

There are a wide range of pencils on the market now, but for my older people with dementia, koki markers worked the best – the bright colours were easier to see against the black- and-white background of the page, and made more impact in a picture that wasn’t complete because the effect of the colours was seen more quickly than with pencils. And if in doubt, there are lots of free prints to download and try out.

It might just improve your mental wellbeing.

Dr Nicola Plastow is a senior lecturer in the department of occupational therapy at Stellenbosch University

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Nicola Plastow is an Associate Professor, and Head of the Division of Occupational Therapy.