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Experiences of mental illness through music

Sean Baumann, psychiatrist, talks about his motivation for making this cantata.
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I embarked on this project, called Madness: Songs of Hope and Despair. Partly out of an exasperation and an anger, in a way, at what I considered to be the misrepresentations of mental illness in film and the theatre. And the concern that this misrepresentation contributed to the burden of stigma, and hence to the exclusion of those with severe mental illnesses. These representations, of course, are extremely various, but, in part, that people with schizophrenia-like disorders, were either foolish or violent. And, on the other hand, that doctors and nurses were somehow unimaginative, and acting in the role of social policemen.
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And that only with an improved understanding of differences, that the whole problem of mental illness would simply dissipate, and there would not be a problem. I’m trying to address these issues in this project. I encourage you to watch this cantata from the beginning to the end. It is quite complex, and there are… I’ve really tried to put a lot into it, i suppose but, I think, to me, every point is significant; contributes to what I’m trying to communicate. But I would really… In a way, it is an experiment, and the comments… your comments would be extremely valuable to me. Because, in a way, it’s…
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it is an ongoing project of trying to change ideas about serious mental illness, because I do think that impacts importantly on how we manage these disorders in a more imaginative, and respectful, and effective way. And another motivating factor, was the need to address the subjective experience, to adopt a more phenomenological approach, to really bring to the foreground, the subjective experience of being in a psychotic state. Which, I think is very much neglected in the more confined biomedical context. I think the third person perspective, the objective, in the conventions of current scientific practice, is necessary, but it’s insufficient.
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And I think it’s to me, it’s critically important to address the subjective experience, the first-person perspective, because I think there’s enormous amount of valuable information that could be gained from including patients’ first-hand experience. Perhaps more complicated, is… and another motivating factor, is to address, to give an account of the strange beauty of some of these accounts. I am concerned about romanticising this, for the reasons that I’ve just mentioned, but I do think it’s incredibly important that we, in some way, give an account of these persons’ attempts to make sense of their experience. I think, again, there’s valuable information to be gained in those, sometimes, imaginative innovative strategies, to cope with anomalous experiences.
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And I also, I suppose, wanted to pay tribute to the courage and the kindness of many of our patients.
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Just, for example: one of the… I think probably the most common content of the delusions that have been described to me, is the wish to, or the belief that, my patients are healers, and want to help; want to help themselves; want to help each other. With regard to the form of a cantata, at the beginning, because of the need to do something that I felt was respectful and authentic, I’ve included the first-person account. The words that I’ve used, are the words of my patients. I’ve also tried to include as diverse a number of perspectives as possible. So, not just this dyad of the conventional dyad, the doctor, the patients, but also the nurses, importantly.
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But, also the lover of the patient; the mother of the patient. But, also, importantly, in one section there’s a song which involves a conflict between a neuroscientist and the doctor. And in another song, there’s a debate between a traditional healer, a priest, and the nurse. Trying not to give prominence to any particular perspective, it was just to give some idea of the wide range of perspectives that contribute to this field. So, the idea had really been to include, with the voices, music, and imagery in an attempt to convey some of the complexity, and the drama, and the intensity of these psychotic experiences. But, I’ve also tried to do something, perhaps a little bit more ambitious.
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Through, for example, with regard to imagery, scratching over diagrams, or with music creating discordance, and shifting with harmonies, to get inside the psychotic experience. To, somehow, give some impression of a mind in a state of turmoil.

Sean Baumann is a senior specialist psychiatrist in UCT’s Department of Psychiatry and Mental Health. He has long been frustrated by misrepresentations of mental illness, and in attempting to move beyond a reductive medical model, Sean has used music to offer rich representations of mental illness.

Sean decided to use music to offer a different, more realistic and respectful view of mental illness. People who go through episodes of mental illness are often seen as foolish, crazy and violent. Doctors and nurses are sometimes seen to be attempting to impose a social order, and considered unimaginative and coldly objective. So Sean decided to make a creative musical piece – a cantata – to try and show a more sympathetic, genuine and subjective side of mental illness. Sean thinks that using art like music and imagery helps us to think more imaginatively and sympathetically about treating mental illness. In this way art can enrich medical science. Listen as Sean talks through his motivations for making this cantata.

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Medicine and the Arts: Humanising Healthcare

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