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Zentangle and the Art of Meditative Drawing

Creative art method of intricate designs and repetitive brushstrokes helps cancer survivor focus on living

By Barbra Williams Cosentino

Miriam Zimms, a 58-year-old first generation Guatemalan American artist from the Tampa Bay area, has a megawatt smile that can light up the darkest room. And Zimms, who refers to herself as a two-time survivor-thriver, has endured long bouts with cancer, numerous surgeries and some very, very dark rooms.

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Credit: Courtesy Miriam Zimms

Thirteen years ago, she had breast cancer surgery, chemotherapy, breast reconstruction and removal of her ovaries and fallopian tubes. Just as she was recovering from that trauma, doctors discovered she had chondrosarcoma, a devastating bone cancer that led to a 10-hour surgery in which most of her left pelvis, hip ball and the top part of her femur were removed and then reconstructed. Zimms laid flat on her back in bed for seven endless months, receiving at-home physical therapy and then, with the support of her husband, Mitch, spent two arduous years learning to sit up, stand and walk again.

Without a touch of self-pity, Zimms, who says that artist Frida Kahlo is one of her muses, explains that she has 17 scars on her body, including one that is 3-feet long. "People don't talk about body trauma after cancer. Scars are part of an art canvas on my body," she says.

While being treated at Moffitt Cancer Center's Arts in Medicine Program, an art therapist handed her a pencil, a square of paper and a pen, and introduced her to a meditative art method called Zentangle.

"Cancer took away so many things from my life," Zimms explains. "My illness taught me about living one miniscule moment at a time and that every day was a gift." That was quite a shift for this type-A personality who before her illness was a very successful national environmental consultant. She adds, "I had to lean into the loss, feel it, embrace it so that I could move forward, and that's when art came into my life." Zentangle helped her to explore the process of letting go, and, she says, "allowed me to understand that life is perfectly imperfect."

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Miriam Zimms.jpg  |  Credit: Courtesy Miriam Zimms

"This meditative and healing arts therapy for mind, body and spirit has been part of my daily art practice for the past 12 years," she says.

What is Zentangle?

Zentangle, which celebrated its 20th anniversary in 2024, was first developed by Maria Thomas and Rick Roberts of Whitinsville, Massachusetts. The art form, requiring only a pencil, a pen and a 3.5-inch by 3.5-inch piece of paper called a tile, combines delicate patterns, repetitive brushstrokes and intricate designs.

Roberts, who lived as a monk for 17 years and also has worked as a photographer, cabdriver, lifeguard and flute-maker, and his wife, a lettering and stationery design artist, calligrapher and botanical illustrator, created the process together.

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"The Zentangle method is an easy to learn, relaxing and fun way to create beautiful images by drawing structured patterns," the couple's website says. "It's a fascinating mix of structure or scaffolding that sets up a framework upon which there's tremendous freedom of creative expression," In fact, Roberts jokes, "Anybody who can sign their name has already done all of the basics in the Zentangle method."

While the word zen in Zentangle refers to a calm and focused state of mind, it is not directly related to Buddhism and has no religious focus, although the concept of mindfulness is important in both.

A Zentangle creation, which includes drawing straight or curvy lines strung together and making tangles, is done in eight basic steps:

  • Taking a breath and thinking about gratitude
  • Making corner dots
  • Drawing a border by connecting the dots
  • Making a string that divides the space into sections
  • Making tangles or structured patterns designed from a combination of five simple shapes of dots, lines, simple curves, s-curves and orbs (circles)
  • Shading
  • Initialing and signing the front of the tile
  • Standing back and appreciating the creation

Benefits of Zentangle

The benefits can include achieving a relaxed, dream-like state of flow, increasing focus, letting go of perfectionism and enhancing creativity. Also, "Unlike meditation, which can take a long time to learn, Zentangle is about the simplicity of taking pen to paper," co-creator Thomas says.

"Unlike meditation, which can take a long time to learn, Zentangle is about the simplicity of taking pen to paper."

A study in Current Psychology found the art form is an effective alternative treatment approach for older adults with mild to moderate depression. Another study, conducted during the pandemic, showed that an eight-week Zentangle mindfulness-based group art therapy program had positive effects on participants' anxiety levels and feelings of happiness as well as on their manual dexterity and fine motor skills. Other research from the Women's Brain Health Initiative found that Zentangle can improve sleep, lower blood pressure, reduce stress, increase self-compassion and self-confidence and even improve memory, concentration and problem solving.  

Zimms, who at times still struggles with PTSD, anxiety and chronic pain, has learned much from Zentangle, prompting her to become one of the more than 8,000 certified zentangle teachers (CZT) in more than 80 countries. Some of the lessons she has learned include that anything is possible one stroke at a time; that there are no mistakes, only opportunities; that "errors" are to be embraced rather than judged, and can get incorporated into the work; and that life is an art form and every individual is an artist.

Barbra Williams Cosentino
Barbra Williams Cosentino RN, LCSW, is a New York-based psychotherapist and writer whose specialties include chronic illness, health, aging and parenting. Bylines include HealthCentral, the New York Times, Today's Geriatric Medicine, Forward Magazine (Fox Chase Cancer Center), BabyCenter and many others. Read More
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