A winding slide and a flamingo’s arcing neck. A ruffed lemur and one of van Gogh’s “Sunflowers.” A walrus and a bunch of bananas. The image pairings in Laurence Aëgerter‘s new series of photobooks are wholly unexpected but draw subtle, witty connections between unrelated scenes. While they make for general, lighthearted perusal, they are primarily intended as cognitive tools, specifically to help people with dementia exercise their minds. Aëgerter has worked with experts in the fields of neurology and gerontology over the past year and a half to develop these books as therapeutic treatment, and a number of nursing homes in the Netherlands — her current base — are now sharing them with their patients.
Published by Dewi Lewis, Photographic Treatment comprises five slim books that each hold 30 paired, uncaptioned photographs. Aëgerter sourced the vast majority of them online, searching for Creative Commons images, and photographed about a tenth of them herself to fill in any gaps she felt were lacking.
Some record famous paintings or monuments, others show animals, food, or smiling individuals; Aëgerter was mostly concerned with finding images that stimulate a positive reaction in a viewer. She then coupled them to create matches based on shared compositions, shapes, textures, and surprising resemblances in subject matter. The resulting visual dialogues are charming: the whiskers of a man getting a haircut are similar to those of a portly seal; the dangling tubing of a stethoscope echoes delicate carriage reins that decorate a clock.
Like many activities meant to engage dementia patients, looking through Photographic Treatment, Aëgerter believes, is most effective as a two-person or group exercise. But unlike card games, puzzles, coloring books, or other diversions, the photobooks don’t rely on a system of right versus wrong; they instead promote free association. Caretakers page through the books with patients and prompt them to share their thoughts on the images and pairings, giving them opportunities to think creatively. Instead of asking questions, caretakers say things like, “I didn’t expect that!” or, “That’s curious!” to encourage expression.
“It is really a trigger for their fantasy, because their world becomes so small in this care environment — very protected, without any surprise, and totally dull,” Aëgerter told Hyperallergic. “People are sometimes treated too much like children. I thought, ‘What about triggering the mind, but in a way that’s less confronting?’ This project really leaves people in their own value, and there is no quiz, and there is no shame to have.”
Prior to beginning the project, Aëgerter had only a basic understanding of dementia. She came to the topic as she had been exploring ideas related to transience and the elasticity of time through a former photo project, Cathédrales. She also happened to meet the director of the National Museum for Psychiatry at a gallery showing of that series; their conversations about dementia led to her interest in creating work that did not serve as a commentary on the disease nor its patients but as a tool, grounded in science, that would stimulate the brain and also improve moods. Experts estimate that up to 40% of people who suffer from Alzheimer’s also face depression.
One of Aëgerter’s many research advisors was Dr. Dick Swaab, a professor of neurobiology at the University of Amsterdam, whose “use it or lose it” principle she cites as the foundational science behind Photographic Treatment. The concept, simply put, argues that the more often your neurons are activated, the slower your brain degrades. She also spoke with scientists about mirror neurons, which enable us to feel empathy. While her curation process was largely based on an artist’s intuition, she also sought out images that would stimulate these neurons to create an experience that fosters empathy in patients. Part of her research involved showing different sets of photographs to 40 patients during individual, 30-minute sessions to study their responses.
“There is so much money put into research for a cure, which is very wonderful,” Aëgerter said. “But on the other hand, I think the money put in search for better care is really is disproportionate to this.” The walls of many care facilities she’s visited, she added, are covered with drab posters of flowers or celebrities — aesthetically fine, but essentially just decorative pictures.
“Images have such as such a huge impact on people, both consciously and on the unconscious,” she said. “These spaces could be empowered, with added value that improves the mood of people.” But even meaningful images on walls, she noted, should have to be changed frequently so people can look at different pictures over time. To introduce further spontaneity into the project, Aëgerter also created 100 blocks printed with pictures from the photobooks. These have been used in group sessions where patients are able to create and discuss new combinations.
So far caretakers at nine facilities have worked with Photographic Treatment, but Aëgerter hopes the series will become a staple resource for anyone taking care of someone suffering from dementia. In about a month, she will send out a newsletter to care institutions around the Netherlands to propose that they try her photographic form of therapy. She is also continuing to work with researchers and plans to attend symposia related to dementia to advocate for the power of the image.
“I am very honored that the little bit I did has led to enthusiasm from scientists and involvement,” Aëgerter said. “I know there is so much to do with the project, and I see that there is so, so much that can be done.”
Photographic Treatment is available through Dewi Lewis.