Rapport médical #4 (en anglais)
Title: African
drumming and psychiatric rehabilitation.
Author(s): Longhofer, Jeffrey and Floersch, Jerry
Source: Psychosocial Rehabilitation Journal; Apr93, Vol. 16 Issue 4, p3, 8p
Document Type: Article
Subject(s): PERCUSSION ensembles, PSYCHOTHERAPY patients -- Rehabilitation, DRUM,
MUSIC therapy
Geographic Term(s): AFRICA
Abstract: Focuses on a study that established an African polyrhythmic
drum ensemble program at two Kansas City community support programs and its role
in psychiatric rehabilitation. Information on Dagbama music; Results and conclusions.
AFRICAN DRUMMING AND PSYCHIATRIC REHABILITATION
Abstract: An anthropologist, a social worker, and
two professional musicians established an African polyrhythmic drum
ensemble program at two Kansas City community support programs. We
discovered that clients had no disability to learn Dagbama music, and,
moreover, their musical talents were underdeveloped. We describe the
program, the setting, and its results. Particular attention is focused
on the ways in which the ensemble program uniquely complemented the
goals of psychiatric rehabilitation.
Introduction
"African drumming at the mental health center?" the executive director
asked with a skeptical gaze. "How will that serve our clients in the community
support program?" A connection between drumming and mental health services
does seem puzzling at first glance. In this article, we describe how an anthropologist,
a social worker, and two professional musicians established a performing drum
ensemble at two Kansas City metropolitan mental health centers.(n1) We argue
that the polyrhythmic music of the Dagbama from West Africa has characteristics
that uniquely complement the community integration goals of psychiatric rehabilitation.
Our program provided community support program clients the opportunity to become
musicians. The establishment of an African polyrhythmic drum ensemble led to
outcomes that complemented psychiatric rehabilitation: clients felt a sense of
accomplishment (improved their sense of competency); they formed an identity
with a group (strengthened environmental supports); and, through concerts and
performances (improved vocational outcome), clients realized a need to make recognized
contributions to society (Anthony, Cohen, & Farkas, 1990, p. 65). Our teaching
philosophy was not focused on a participant's lack of knowledge and experience
of music: these were not deficits to be overcome (Rapp & Wintersteen, 1989).
It was not a requirement that clients have musical backgrounds, nor did we select
clients with musical sensibilities. We knew from our experience with public school
students that we had a kind of music that was accessible, yet complex and beautiful.
We asked the participants to learn the culture and the music of the Dagbama people.
Clients were not to experience the cathartic effects of music or rhythm passively.
They were to become musicians.
We will first briefly describe Dagbama music, then we will discuss the way in
which the project unfolded. Particular attention is focused on how the program
articulated with the goals of two community support programs. And, finally, we
will present results along with some concluding thoughts about the effectiveness
of the program.
Dagbama Music
West Africans often use their music as a means to integrate the individual formally
into community institutions (Chernoff, 1979, pp. 33-37). The adoration of a newborn
is not merely accompanied by music and dance; music and dance become one way
that a child is recognized as a new member of the community. So it is with puberty,
marriage, and death. Music and dance recreate and recognize the individual's
role in the community (Chernoff, 1979, pp. 159-161; Nketia, 1974, pp. 21-34).
The Dagbama people live in the northern region of Ghana, West Africa. Their history
begins with the migration (1100 A.D.) of horsemen who conquered the agricultural
peoples of the region and established a kingdom known as Dagbon (Staniland, 1975;
Chernoff, 1979; Locke, 1990). In Dagbani language, the term luna refers not only
to the drum but also to the drummer. The origin of the lunsi, drumming guild,
is told through the story of Bizum, an outcast who often begged and played a
drum to console himself (Locke, 1990, pp. 11-12; Nketia, 1974, p. 45). A chief
became so charmed by Bizum that he organized a drum guild charged with telling
the political history of the Dagbama. The lunsi became a formal social group
whose members took great pride in their community status:
Their dance drumming not only makes irresistible music, but contains pithy wisdom
that is linked to social history. Dancers can consider the history of their famous
ancestor and connect his situation with their own problems with family and friends.
It is in this sense that the lunsi are simultaneously historians and counselors
(Locke, 1990, pp. 12-13).
The Dagbama tonal language is transposed to a double-headed tension drum, which
imitates their spoken tones (Chernoff, 1979, pp. 43-44). Drum language is then
put into a polyrhythmic framework, creating one of the most complex musics of
the world (Nketia, 1974, pp. 129-138). Each musical part in an ensemble is elegantly
juxtaposed to other parts (Chernoff, 1979: pp. 44-61). The lead drummer calls,
others respond, and a unity of sound results. Our musicians have developed a
teaching technique that breaks down the drum parts so that they can be easily
taught. This is one of the distinct advantages of teaching Dagbama music over
Western musics, which can require months to learn the technique and prior knowledge
of music theory.
Program Description
One afternoon we invited case managers and clients from two mental health center
community support programs to an African rhythm workshop. Fifty individuals attended.
We described the project as experimental and made clear that participation was
voluntary and required a commitment of only 1 hour a week. Although we emphasized
that enjoyment was primary among our expectations, we boldly stated that our
goal was to create a performing drum ensemble. We were aware that our program
had to quickly gain the confidence of both staff members and clients: the mental
health centers had agreed to a trial program based on client participation.
The social worker and the anthropologist participated as drummers and as consultants
about group process and community support programs. The musicians had no prior
experience with the severely mentally ill; therefore, they had no idea what differentiated
an affective from a psychotic disorder. Participants were viewed as potential
musicians, not as manic-depressives or schizophrenics. As others have observed, "rehabilitation
research indicates that the psychiatric diagnostic system has little to offer
the rehabilitation approach" (Anthony, Cohen, & Farkas, 1990, p. 29).
No time was wasted in long descriptions about our program and its goals at the
first meeting. Quickly we divided the audience into four groups of 10 to 15.
Drums were distributed, and within 10 minutes the first group had performed a
Dagbama piece, Damba Sochandi. One by one, each group demonstrated the accessibility
of the music and how exhilarating it was to play. The workshop ended with an
invitation to attend our practice sessions. A dozen clients expressed a willingness
to participate. This positive response facilitated our negotiations with the
mental health centers: each agreed to a 6-month trial program.
After scheduling a time and establishing a location, we settled into a comfortable
routine of weekly 50-minute sessions at one of the mental health center facilities.
Some clients attended only once, others trailed in and out, but a core of 10
returned every week to drum, sing, and dance. At each session we discussed the
Dagbama people, engaged in dialogue about client perception of the music, and
brainstormed about the ensemble name and future performances. We kept an open-door
policy and expected interest as the only precondition for participation. New
drummers were able to listen during the first half hour but always played by
the end of the session. Those, however, who kept returning to practice became
hooked not only on the music but also on the group process. Three months later
we held our first performances at several mental health center banquets.
Practice sessions involved everyone in the same activity and at the same levels
of stimulation. In teaching the music, we break it down into parts and restructure
the parts back into a whole, which gives the sessions a distinct structure that
easily assimilates everyone. With practice essential to the formation of an ensemble,
each session provided a way to measure progress. The clients heard their gains
each week, providing a distinguishable way to test concrete reality: we recorded
sessions to compare past with current playing abilities.
As a core group formed, we utilized group process issues to facilitate social
skills development (Anthony, Cohen, & Farkas, 1982). Questions emerged that
required group decision making: the ensemble had to decide how practice attendance
would be connected to concert performance, the rules for participation, the name
of the ensemble, the kind of costume, and performance schedules. The naming process
helped to forge a sense of group identity, while the decision-making process
gave the group ownership of its direction.
One participant related the following to the group:
What should we call ourselves, a band or drummers? What should we be considered?
Yesterday I told someone that I was in a band, and it was really funny. I walked
into a music store, and this guy was a real good salesman (he was being nice;
he wanted a sale). I was wearing my baseball cap that has "talking drums" written
on it. The salesman asked me, what are talking drums? Talking drums are African,
I said. We are taught by authentic teachers. It's drumming the way Africans used
to, or still, do it. I told him that I belonged to a talking drum band.
Following our first performances at mental health center banquets, the group
became committed to the ensemble goals. We concluded that the program had achieved
one of the fundamental goals of the International Association of Psychosocial
Rehabilitation: An effective social/recreational program offers group experiences
that are designed to enhance individuals' skills and to foster a sense of community
and healthy participation in normalizing adult activities.(n2)
Results and Conclusions
After 6 months, 45 different individuals have tried drumming at least once; of
these, from 12 to 15 attended on a regular basis. A new face appears in every
session. The open-door policy had not disrupted our pedagogy, and the participants
never intimidated newcomers with their new talents. Those who came only once
helped the regular members by allowing them to compare someone just starting
with their 6-month experience. Although males numerically dominated females (26
to 19), gender made no difference in drumming. The women, however, were more
comfortable with learning dance; but gender never became a barrier to full participation.
Race, moreover, was not an obstacle; at most times we had a near 50150 ratio
of African-Americans and Hispanics to European-Americans.
The type of psychiatric diagnosis did not differentiate the nonparticipants from
participants. The group represented the spectrum of major psychiatric illnesses:
schizophrenia, manic depression, and one instance of multiple personality disorder.
Our program staff members often wondered who had what diagnosis and claimed that
they couldn't tell any difference in symptomatology. In comparing client-musicians
to our high school students, we discovered that mental health problems posed
no barriers to learning Dagbama music. Indeed, the client-musicians were often
more motivated and more open to learning than our other students.
The mental health center staff members had discussed with us a document stating
the goals of therapeutic recreation: 1) focus on integration; 2) focus on skill
building reaching a client's needed skills; 3) focus on ability rather than disability;
and, finally, 4) assume that social interaction is significant to recovery. In
order to achieve these goals, a recreation program should provide moderate levels
of stimulation, consistent reality testing, and leisure education; it should
focus on controlling symptoms through leisure and provide structure, clarity,
and accountability; and it should offer social skills training, help clients
define and deal with problems, and promote self-esteem. The fit between the ensemble
program and these goals could not have been better.
First, our style of teaching was inclusive. It created a context wherein everyone's
musical ability was appreciated and recognized. Because Dagbama music is polyrhythmic,
it is unusual to someone familiar with Western music: thus, no client, even those
with past musical experience, started at a competence level above another. This
aspect of the music acted to level the experiential differences between participants,
made clients equally capable, and blocked the usual feelings of inadequacy and
insecurity associated with learning new behaviors. One drummer who was asked
why he liked playing said: Participation is the thing. If you have never done
something, there is a doubt in the front of your mind. Believing in something
and doing it are two different things. And when you come and do it, the doubt
leaves the front of your mind and goes to the reserve, opening it up even more.
You imitate a beat and put yours into it, and then you got two beats, two beats
make four, then a dozen; this is what makes them talking drums.
Second, Dagbama drum history provided us with an allegorical way to introduce
ourselves and a rationale for the ensemble. The story of Bizum's outcast status
connected the drumming to the client's experience of being stigmatized. Bizum
overcame his disadvantage through drumming and, as a consequence, was meaningfully
incorporated into Dagbama social life. So we communicated to the participants
that we wanted to experiment with Dagbama music and discover whether or not it
would also help them discover meaningful ways to participate in their community.
Our program maximized the involvement of the client (Anthony, Cohen, & Farkas,
1990; p. 164). With the establishment of a performing ensemble, the project had
a purpose beyond that of being an activity hour. We promised participants that
we could deliver on our claim of making them musicians if they would only take
the creation of an ensemble seriously enough to stick with the weekly practice
sessions. These mutual expectations laid the foundation for respect, communicated
to the clients that we believed in their potential (building self-dignity), and
focused the activity on be-coming and not over-coming:
A real-life situation is created with practical demands and responses; a healthy
interdependence exists between the program, staff personnel, and its members
when a sense of hopefulness encourages participation (Pascaris, 1991, p. 48).
We intend to make the ensemble performances community events (phase two). As
multicultural education has become a new program focus at schools, and multiculturalism
a topic for debate throughout society, we plan to schedule performances at daycare
centers, schools, churches, and businesses in order to educate the community
about the music and culture of the Dagbama people. We believe that concerts,
then, will meaningfully integrate them into the community (Anthony, Cohen, & Farkas,
1990, p. 70), and as performing musicians, facilitate a vocation (Brooks, 1981)--the
second and third ways in which we complement rehabilitation goals.
From the perspective of the mental health center staff, then, our project provided
a unique opportunity to those clients who used day program resources. Our open-door
policy was compatible with the center's day program philosophy: anyone who wanted
to come to the group, even if only once, was welcome (Pascaris, 1991, p. 47).
If one conceptualizes a day program as offering a smorgasbord of resources from
which the client actively chooses, Dagbama music provides a resource that fits
the psychiatric rehabilitation goals of self-determination and empowerment (Cnaan,
Blankertz, Messinger, & Gardner, 1988). And because we were not community
support staff personnel and our musicians were not therapists, we were seen as
community resources even though we practiced at the center's facilities. Only
one staff member regularly attended our sessions, but he did so because of his
interest in learning the music; at no time did he intervene in his role as therapist.
The client-musicians were able to think of us as teachers, not social workers,
and of themselves as musicians, not "chronics."
We conclude that the unique "apart" playing of Dagbama music is the
essential component of the program that facilitated the successful articulation
with community support program goals. Each drummer plays a part which forms a
unity and totality of sound. No single drummer can play Dagbama music. The highly
participatory and easily accessible nature of apart playing provided clients
the opportunity to occupy a productive and satisfying position (each as a drummer)
within a larger totality (ensemble), from which their illness often excludes
them: for example, a worker within the economy; a student of higher education;
a parent, husband or wife within a household or domestic unit. A person afflicted
with a major mental illness is not often afforded the same opportunities to be
a part of a functioning social totality. The drum group first provided the participants
with a meaningful group role and, second, it gave them access, through performance,
to other community institutions. One drummer summarized his motivation for playing: "I
like to get up before an audience." Another 50-year old participant said, "I
had no opportunity by nature or law to do this as a youngster, but now I don't
hold it back."
People with severe mental illness have few opportunities to perform meaningful
social roles. This experiment with Dagbama music has corroborated assumptions
that recreational programs can act as vehicles to help clients develop important
social and work skills (Admundson, Dyer, Henderson, & Rathbone-McCuan, 1991;
Pascaris, 1991; Seilheimer & Lee, 1987; Coviensky & Buckley, 1986; Moriarty,
1976; Sheppard, Olson, Croke, Lafave, & Gerber, 1990). We are confident that
phase one of the project increased their self-esteem, built a supportive peer
group, and fostered skill development. The success of the ensemble also demonstrated
that the musical talents of the clients had been underdeveloped. Their performance
capabilities, moreover, have encouraged us to enter the second phase: community
concerts. The clients have made it clear that they want to perform, not just
practice. They have said more than once that they would like to be paid for concerts,
not play for free. At this time, we see no reason why their expectations can't
be met; after all, these are the same expectations of most musicians.
We would like to thank Leslie Young, Steve Solomon, Tim Sandusky, David Wiebe,
Kirk Fowler, Ronna Chamberlain, and Michael Clark, who stretched their imaginations,
believed in us, and gave us the opportunity to work at their mental health centers.
The two musicians, Douglas Goodhart and Bird Fleming, from the Center For World
Music, provided the talent, enthusiasm, and openness to take their music into
new arenas. Finally, to all those individuals who courageously stepped forward
to drum, sing, and play, we can never thank you enough.
(n1) The drumming project has two phases: 1) establishment of the drum ensemble,
and 2) community concerts. The second phase has just begun. We are raising local
monies to establish a fund to compensate our client-musicians for community performances.
We strongly believe that monetary compensation is essential to the program's
success. At this time, then, we can only report those findings associated with
the first phase of the project.
(n2) This was taken from a document adopted in June of 1985 by the Board of Directors
of the International Association of Psychosocial Rehabilitation Services. It
was a working document that described the definition and principles of psychosocial
rehabilitation.
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~~~~~~~~
By Jeffrey Longhofer and Jerry Floersch
Jeffrey Longhofer, Ph.D., teaches anthropology in the Department of Sociology
at the University of Missouri-Kansas City
Jerry Floersch, L.M.S.W., is employed as an evening crisis counselor for the
Johnson County Mental Health Center in Mission, Kansas.
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Source: Psychosocial Rehabilitation Journal, Apr93, Vol. 16 Issue 4, p3, 8p
Item: 1443864