Painting Therapy for Cancer-Related Fatigue

Dagmar Brauer, Cristina Mösch de Carvalho

Last update: 04.02.2020

The following suggestions for painting therapy exercises have been selected for their relevance to the different levels of cancer-related fatigue (CRF): the level of vitality, the level of emotions and the level of cognitive activity. These exercises were used in a multimodal CRF study, and they have also proven their worth for people who have fatigue syndrome in general (1). They are suitable for group and individual therapy when the main complaint that painting therapy is being used to treat is CRF.

On the level of vitality, CRF is associated with an extraordinary lack of strength and a reduction in performance, with daytime sleepiness and a greatly increased need for rest. Emotionally it is associated with lack of motivation, as well as depressive and anxious moods. Cognitively there are difficulties with concentration and memory.

This makes all painting therapy exercises relevant which can serve to strengthen etheric processes, such as “breathing color” exercises, light/dark rhythms, movements of color and form, and exercises which strengthen mental processes, such as experiencing formative and creative forces when drawing, or when painting and developing an (individual) motif, as well as exercises which work with directed attention, with the person’s own creative activity, and which honor and integrate artistic/cultural experiences in the specific life situation of the cancer patient (2).

Exercises to strengthen vital and rhythmic forces

  • Variations of blue/yellow mixtures (“green” exercises) in a wet-on-wet or watercolor layering technique.
    Paint generous surfaces of green. Yellow and blue combine in green as light and dark.

  •  Figure-eights and simple basic forms copied from nature in all variations.

  • Rounded or closed movements from form drawing, which can be enlarged and reduced rhythmically and playfully.
    “Rhythm carries life.” (3, p. 435)

  • Light and dark exercises, painting contrasts between light and dark,
    such as with coal pigments. This offers the person’s soul a way to experience tension and resilience through an artistic experience, which can have a physiological effect on the person’s etheric body.

  • Green as an afterimage
    To do this exercise, fasten a piece of red paper at least 30 x 30 cm in size to a white wall and have the patient look at it from a distance for about half a minute to one minute. Then remove the red paper, in the place of which the viewer should see bright green. The afterimage lives in real perception and is only projected onto the outer surface through the person’s gaze. This physiological sensory process is a good indicator of how powerful the person’s capacity for etheric formative activity currently is.

To strengthen the soul’s emotional forces

All the following exercise pictures guide the soul’s life between light and darkness into a logical color sequence of pictures. We use art to stimulate the experience of a day/night rhythm.

  • Suitable for facilitating the way into the wet-on-wet painting technique is a simple light and dark exercise as a seven-part series of pictures, such as those illustrated by a group of colleagues in the book "Therapeutic Drawing and Painting" (4, p. 431).

  • Very suitable is the nine-part painted breathing exercise by Dr. Margarethe Hauschka (5), which in terms of color completes the path from a strong midday red to a colorful afternoon, a calm sunset, the cool colors of evening and then a blue night mood, followed by a moonrise, which changes into a colorful early morning mood and finally into a bright sunrise.

  • Working with Rudolf Steiner’s training sketches “Sunrise”, “Sunset” and “Moonrise”, “Moonset” is also useful in painting therapy (6).

  • Free painting of development in a series, taking the following principles into account: from surface to form, from color unity to color multiplicity, from darkness to light. The intention is to increasingly call upon the person’s creative forces.

To strengthen cognitive forces

  • Drawing more demanding figures from form drawing, which are done with flowing but at the same time differentiated swinging movements.

  • Creating one’s own color sketches after observing the change of light in nature between sunrise and sunset (e.g., with pastels).

  • Joint contemplation of pictures on the theme of “sunlight” and “moonlight” from, for example, Caspar David Friedrich’s subtle daytime cycle “Morning”, “Noon”, “Afternoon”, “Evening” (all from 1821/22) as well as other works of art.

To strengthen individual formative and creative powers

  • Encourage painting of the patient’s own motifs and “life pictures” by having the person paint biographical, literary or fairy-tale images, especially with specific, detailed depictions.
    This is where the ‘I’ of the person with cancer can become involved and try to counteract the form and structure-destroying disease process from this artistic level.


  1. Brauer D, Mösch de Carvalho C. Das Erschöpfungssyndrom als Herausforderung in der Maltherapie mit onkologisch Erkrankten. Der Merkurstab 2017;70(5):400–405. DOI:
  2. Brauer D, Asmussen A, Müller U, Gonsior E. Anthroposophische Maltherapie in der Onkologie. Der Merkurstab 2009;62(4):373–377. DOI:
  3. Hauschka R. Wetterleuchten einer Zeitenwende. 3rd ed. Berlin: Salumed Verlag; 2012.
  4. Mees-Christeller E, Denzinger I, Altmaier M, Künstner H, Umfrid H, Frieling E, Auer S (eds.) Therapeutisches Zeichnen und Malen. Anthroposophische Kunsttherapie vol. 2. 2nd ed. Stuttgart: Verlag Urachhaus. Download free of charge from:
  5. Hauschka M. Eine malerische Atemübung. Sonderdruck aus dem «Staedtler-Brief» Nr. 16. Nuremburg: J. S. Staedtler (undated).
  6. Steiner R. Schulungsskizzen “Naturstimmungen” für die Malkurse von Henni Geck. In: Steiner R. Das malerische Werk. Dornach: Rudolf Steiner Verlag; 2007.

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