Arts, Crafts and Dignity in Care

I'm delighted to have been involved in this project, which brought together care and arts practitioners from Dorset, Somerset, Northern France, Belgium and Holland in a new experiment to discover how the innovative sTimul experience can impact on the provision of creative workshops in care homes, day centres and other settings all over the EU.

The sTimul immersive training session I attended in Belgium last year was designed to give practitioners a real sense of what it might be like to have a disability and to require support with everything from meal-times to leisure activities.

Watch this video that describes the experiences of a group of care-givers at the sTimul experience a few years ago:

In the course of my two days there, I assumed the role of an elderly woman with a learning disability, who had virtually no speech. The experience was very challenging, and provided me with a real insight into what caregivers and support workers have to do.

Above all it left me with the absolute conviction that my approach to musical inclusion is the model that best supports people with a wide range of abilities.

A Tapestry of Music

I'm setting up instruments whilst my client ("G") vocalises enthusiastically and with great flexibility. He uses all the registers of his voice, as well as laughing a great deal. One by one I set out drums, a tambourine, a small squeeze-box, some boomwhackers and a 1/3-sized guitar. I put them with as much space as possible in a sort of crescent moon around G's chair, so that if he looks at a specific instrument, I should be able to identify which one has caught his attention.

The moment he begins to pound on the large adapted djembe by his side, I "meet him in the middle", rhythmically speaking, playing a djembe of my own, leg bells and a tambourine with my foot. He stops after a moment but keeps eye contact, so I continue, improvising quietly on the syllables of his name.

He laughs. I laugh too. I keep playing whilst he vocalises. He looks at my recording device and suddenly vocalises in a way that is delicious. I 'cook' with it, turn it into ... something. Singing it back to him, like a song by Moloko.

I pull up the sleeve over G's twisted right hand so that he can clap against the back of it, then start on another rhythm. G vocalises, and laughs. Together we weave sounds into a Persian rug. He scratches the webbing straps on his wheelchair and I scratch the drum skin. As he is so vocal, I offer him an echo-mic, which he throws gleefully over his shoulder.

The tapestry of sound is interrupted frequently by silences.

When G looks crestfallen - as he does quite often, suffering from some malign internal pain - I play quietly, steadily for him. Almost without warning his head will jerk upwards, he will smile and laugh and rock madly in his chair, eliciting a cacophony of squeaks from chair's components that were surely never designed to be put through such stresses.

I ask him if he'd like his guitar and he smiles. I tune it for him. He strums and sings. I do the same, tapping on a drum. He rocks and crams his hand into his mouth, then makes more sounds before smacking the guitar with his fist and then clapping. My singing invites him to play more. G bangs his drum with the back of the guitar.  I start to strum it more for him, playing a sequence of chords, and he sings short punchy phrases.

I switch to my guitar. It sounds like the beginning to "Brimful of Asha", so I try and remember the words. It is surely one of the most un-inspiring songs of the early 2000s, so I stop pretty quickly. G makes some wild-sounding noises. So do I. That's what we do. It's all music.

(from a Wednesday morning session late in November 2011)

Starting From Scratch

I have a client with whom I've been working for an hour a week for several years now. The last month or so I've felt a distinct sea-change in what we're doing. To my surprise, we're moving further and further away from music-making and, in so doing, we are making more music. Weird, I know.

This client - let's call him James for now - has never really, looking back, been all THAT interested in the actual making of music. His attention span ranges from a few seconds to about a minute. But he enjoys my company, and he enjoys interacting with me. We've developed our own familiar games; for example, trying to match opening and closing our hands on the flat of a drum skin so we are perfectly matched, without resorting to a rhythm .. pretending to be soldiers drilling on the parade ground (with Boomwhacker rifles), or gorillas having a conversation, or pirates, or Amazonian Indians. stalking prey.

We have 'Talking Drumsticks', 'Count The Shaker Eggs' (as we pick them up with chopsticks), 'Echoes' (with Swanee whistle/bamboo flute or harmonica/accordion); we use puppets, hats and iPad sound effects. We knock on a thousand imaginary doors and ask "Who's there?" We balance drumsticks on our upper lips and become mustachioed sergeant-majors.

I daresay anyone watching us might think us quite bonkers. We move from game to game and evoke character after character almost seamlessly. We're in our own little world. I'd become worried that this wasn't the activity James's support workers and parents had engaged me for. But I no longer feel that way. Although we're not making recognisable pieces of music together (except occasionally), we are still using sounds to communicate and express ourselves and, in the spirit of "Every sound you make is musical" I now accept that what we are doing is indeed very valuable, even if I'm screeching like a banshee whilst imitating the sound of an ambulance siren.

SoundZen screen
Once I'd reassured myself about this, I must have relaxed. James, a very empathic young man, started to play the keyboard a lot more, in a musically more recognisable fashion, as well as the harmonica. We improvise with as many different instruments and sounds as possible to an iPad backing track (courtesy of SoundZen.) We're now in the process of developing a new game to add to our repertoire. I'm not sure how to describe it. It involves picture cards and corresponding sound effects; the casting of dice, picking of cards and moving of things around on an old Ludo board. We take turns. We identify colours, and numbers, and the names of things.

James always wins, and then we celebrate with raucous shouts and high-fives. It's great.

Our new game.

My Client Gives Me The Finger.

A while ago now, whilst writing for another blog, I did a post about how valuable I was finding my iPod Touch.

For some time now I have been working with Henry, a man who is virtually unable to make any deliberate movement with his limbs, and who has a marked preference for sleeping - or at least semi-consciousness - when we work together. His particular array of ailments and the cocktail of drugs that he takes mean that he is rarely what one would call "awake" and, when he is, his limbs are locked tight like pieces of wood. I count it as a good session if he opens his eyes at all during a typical 45-minute stint with him and his partner, Paul.

Something last week made me decide to take along my husband's iPad, and I am very glad that I did. The iPad is loaded with various bits and pieces of easy-access music software that I have collected along the way whilst working with my iPod Touch, and I've transferred these over to the iPad.

My favourite one was first shown to me when I took a course as a Lifemusic Facilitator. It's called "Bebot"

I decided to try it with Henry.

After a little while, to my surprise, he opened his eyes and looked at me.

His shave was haphazard and there was still dried Weetabix around his lips. One of his eyes was still clagged up with sleep, or perhaps he had a cold, or maybe even conjunctivitis.

As I said before, Henry doesn't look at me very often so his gaze was greeted by the picture of me with a delighted grin on my face. I'm still not altogether sure whether or not he recognises me. I greeted him and asked permission, then began the process of stretching out one of his arms (his fists were clenched up under his chin). I asked if I might "borrow a finger, please" and after a minute or so a digit does indeed emerge from his left fist. His carers often laugh about Henry "giving me the finger".

The extended finger was all I need to get Henry started on the iPad (though I subsequently discovered that his knuckles and/or fists works well, too.) He began playing on Bebot. His eyes flickered open and closed. He looks at everything and at nothing. Together we moved his hands over the screen of the iPad. Paul beat a slow, sombre tattoo on the floor tom. I started to sing a wordless improvisation along with the notes generated by Henry's hands, resting and sometimes moving (whether by accident or design, it was almost impossible to tell) over the screen of the iPad.

I looked up again just in time to see a tear leaking out of Henry's left eye and experienced a strong moment of connection with him. But then, he may just have conjunctivitis.

Challenging the Challenging.

I'm reading this book at the moment:

- but had to stop just now. I was literally crying with anger. I had just read about how, in less "enlightened" times, a man who continually threw himself out of his wheelchair - repeatedly breaking his legs - eventually suffered a double amputation at the behest of an ignorant (and, presumably, very frustrated) and deeply unethical medical team.

A humanistic music therapist might have been able to interpret the man's continuing tendency towards self-harm (also called, get this! 'Challenging behaviour') as some form of communication. He was attention-seeking. He was looking for attention from other human beings. Uh-huh, I get that. And the problem with that is ..?

Quite apart from what seems like a self-evident need for someone to design and construct a chair from which he was unable to throw himself, it seems to me that the man's fundamental need to express his emotions in whatever ways were available to him were being ignored.

Imagine if you are in a land where you do not speak the language, and no one can understand you. You are physically almost helpless, and people can see that easily. You are cared for. Your basic physical needs are met.

Naturally, you long for some kind of more meaningful communion with others but find it impossible to convey this in a way that your carers can understand. Eventually frustration causes you to repeatedly injure yourself. You have noticed, learned, been conditioned to the fact that you have more interaction when one or both of your legs is broken. It's worth it, in spite of the pain.

One day, those responsible for your care drug your food and take you to an operating theatre where they carefully and quickly and neatly remove both of your legs just above the knee.

The story tells me how important it is for me to value all human emotions, even those that seem to be unpleasant or unwarranted - anger and jealousy, for example. And it isn't just in other people that I should respect emotional outbursts - I should listen also to my own emotional responses to things, even if the feelings are what might be called negative or undesirable.

People should treat not only each other but also themselves with more respect than was afforded to this man. Don't dismiss your feelings because you consider them unworthy, or because you think it represents "challenging behaviour." And above all, do not dismiss the feelings of those who are struggling to communicate them.

The Wonders Of A New Instrument

I bought a new instrument -

I'd first used one of these on a Lifemusic workshop in Chichester and had unashamedly coveted it since that time. My latest round of investment in my business included a plan to buy one of these instruments - a metallophone from Ghana in West Africa. It was made by a craftsman called Christopher Doozie   and sold by Ghana Goods in Bristol.

(The box it came in proved a popular acquisition, too. Ahem.)

I went to see my client J yesterday and took the new metallophone with me. J is occasionally an excitable, boisterous fellow and can put instruments through their paces, so I bear that in mind when deciding what to take with me. I want him to have the physical freedom to really beat the drums etc if that is what he wants and needs. He can also be incredibly gentle - for example when playing a cymbal with some jazz brushes. Many of my African instruments are especially hardy - being made to be played in a hearty way rather than a delicate way.

The other thing with J is that he is often wary of new instruments. He likes me to put them somewhere in plain sight - but out of his way - for two or three sessions while he gets used to them.

Not so the metallophone.

Although J didn't play it himself, he indicated in his way that he wanted me to play it instead and we had a long improvisation back-and-forth between me on the metallophone and J on a pair of bongoes and a conga. He played a phrase, I played one back. He laughed and smiled. So did I for that matter, because it was ten minutes of real musical communication between the to of us - a conversation. J sometimes has a very short attention span which can preclude he possibility of making longer improvisations with him but, as I said, this one went on for a good ten minutes.

Now. What instruments shall I buy next?? *rubs hands gleefully*