[Special Issue on Music Therapy and Disability Studies]
Music... to Cure or Disable”: "Therapy for Whom?"
By Stefan Sunandan Honisch
Abstract
This article responds to two intertwined questions: “What is the role of a Disability Studies perspective within music therapy?” And: “What is the role of music therapy from a Disability Studies perspective?” Exploring some of the congruities and tensions that have emerged in recent years between music therapy, and the burgeoning field of Disability Studies in Music (Lubet, 2004 & 2010; Straus, 2006 & 2011; Straus & Lerner, 2006), I argue that both Disability Studies in Music, and music therapy can benefit from greater acknowledgement of music's capacity to constrain and enable the human body in complicated ways. This article imagines music therapy as a a reciprocal encounter in which diagnoses and intervention are replaced by a spirit of collaborative learning. The article pushes music therapy towards the idea of ability and disability as bodily performances (Sandahl & Auslander, 2005; Straus, 2011), rather than either exalted or pathological states of being, and suggests that in taking such a perspective as a point of departure, both music therapy and Disability Studies in Music will find new pathways between their respective theoretical and methodological environments.
Keywords: disability, selfhood, music therapy, Disability Studies in Music, reflexivity, accessibility, performance
Polar Opposites? Finding an Accessible Passage between Music Therapy and Disability Studies in Music
The invitation to write this article came with a suggestion to take up one of the following two questions as an anchor point: “What is the role of a disability studies perspective within music therapy?” And: “What is the role of music therapy from a disability studies perspective?”(Hadley, personal communication).[1] In what follows, I place these questions side by side, working through some of the implications of an encounter between Disability Studies in Music and music therapy, and reflecting on the complementary, yet possibly conflicting roles that each field might play relative to each other. Because of my own background and research interests, there will be a decided emphasis on the first question, that is, what disability studies might contribute to the theory and practice of music therapy.
The title marks the two disciplinary poles from whence these questions arise. Juxtaposing an insight from disability studies in music (Straus, 2011) with a fundamental question in the field of music therapy (Michel & Pinson, 2012), I signal the larger aim of this journey: to search for a navigable passage between their diametric perspectives on bodily differences, and on the place of music within and between different bodies, while also identifying the coordinates of regions not yet troubled by sustained scholarly exploration, and, therefore, sitting atop possible common ground. In the first polar region, we find the full range of effects that music can have, for good and ill health (Horden, 2000; Straus, 2011). Recent voyages by scholars of disability studies in music have identified numerous moments in the history of human experience in which “language about music and music itself may be understood both to represent and to construct disability” (Straus, 2006, p. 114). In our first polar region, music swirls around the body, carrying it across time and through places in which waves of sound have been harnessed for multiple and sometimes contradictory ends: “to cure or disable” (Straus, 2011, p. 158). At its antipode, we encounter a long-standing question hovering above a landscape through which beliefs in the curative rather than disabling powers of music run deeply and swiftly. Scholars and practitioners who live and work in this environment have asked: for whom is music therapy? (Michel & Pinson, 2012, p.89).
The Importance of Disability Studies in Music for Music Therapy: So Far and Yet So Near
What are the ways in which music has the power to disable? Beliefs in the power of music to accomplish various kinds of individual and collective transformation are familiar both in the arcana of scholarly inquiry, and in quotidian social interaction. After the pianist Nobuyuki Tsujii shared the gold medal with the sighted pianist Haochen Zhang at the Thirteenth Van Cliburn International Piano Competition in 2009, the competition’s namesake was quoted thus, in response to Tsujii’s music-making: “His performance had the power of a healing service. It was truly divine.”[2] Even leaving aside questions of veracity, or accuracy, that is, whether Cliburn said this, or something like it, the statement itself exemplifies a widespread tendency to link disability and the divine, in general, and blindness, and divine inspiration, in particular. If Cliburn felt that Tsujii’s music-making as a blind pianist had spiritual meanings, his was not a purely subjective response, but rather a mode of reception steeped in the history and culture of Western art music. The ties that bind disability and the supernatural together continue to bind the popular imaginary to the idea that the absence of external sensory ability can be read as a “marker for a higher inner vision” (Straus, 2011, p. 18; see also, Sacks, 2007).
How exactly it is that music prevents some people from accomplishing a full, normal selfhood (Cumming, 2000; Straus, 2006), and, in related fashion, how it is that music can be used in support of pervasive dichotomies inclusive of ability and exclusive of disability (Lubet, 2004 & 2010), are some of the troublesome questions frequently absent from popular invocations of the power and transcendence of music. Pursuing Cliburn’s evocative statement about Tsujii, his invocation of God, which, as I have noted is a unifying thread in the reception of musicians with disabilities, creates a further contradiction through its dependence on the idea that the loss that disability causes is somehow compensated for by the salutary effects of musical performance. At the same time, however, this pervasive mode of receiving musicians with disabilities suggests that a musical encounter locates musicians such as Tsujii as “disabled” and, in this regard, transforms a musical performance into a therapeutic encounter, in which everybody present is somehow healed, and society somehow delivered from a collective illness.
There is, perhaps, a sense in which disabled artists working in any medium call into question the forms of seeing, hearing, feeling, and thinking accepted as necessary to the legibility of that medium. In making art, the disabled body transcends “rigid aesthetic conventions” (Sandahl & Auslander, 2005, p. 4) gesturing defiantly at the formulaic meanings traditionally ascribed to the art made by disabled people. For a predominantly able-bodied culture, the visual, audible, and kinesthetic expressive utterances of disabled people have been received with the best of intentions, within a framework that attaches these people to bodily misfortune, and recuperates the meaning of disability through the interventions of art therapy, or other forms of rehabilitation (Barnes & Mercer, 2001, p. 529).
What if music therapists were to align with disability studies in receiving disabled people differently? Such a move requires engaging a different set of critical concerns, beginning not with medical or clinical diagnosis, but rather with reflexivity, digging at the methodological foundations of both scholarly research, and the philosophical assumptions of therapeutic practice. What if music can be used not to overcome, nor yet to accommodate something wrong, but rather to reveal what simply “is,” an “equality of condition” that demands acceptance on its own terms (Overboe, 1999, p. 23). Repositioned thus, therapist and client can, in (disability) theory, take part in a reciprocal encounter in which diagnoses and intervention are replaced by a spirit of collaborative learning. As James Overboe explains, in his explication of what it means to value disability as an unanswerable difference, rather than to think of difference as answerable to predefined norms: “No longer would we [people with disabilities] be ‘done to,’ and ‘done for,’ and even ‘done with,’ as so often...with the restrictions of an ableist sensibility” (pp. 23-24).
Having left aside the assumptions and aims of the music therapy field, might actual clinical practice still achieve its larger goals, by “bracketing out” avowed outcomes? Or does this attempt to incorporate disability studies instead drain music therapy of its particular identity, turning it into an extension of disability studies, rather than a distinct society of practice? Answers from Disability Studies are not plentiful, not least because of the fundamental critical impulse which has led its scholars and activists away from the interventions of medicine and science, and towards interventions of their own, making and remaking the institutions of politics, society, culture and the arts, and demanding accessibility and equality (Barnes & Mercer, 2003; Linton, 1998). In the search for common ground, it is therefore necessary to begin with music therapy, and then listen for consonant reverberations with Disability Studies, more generally. Having done so, the more specific task of finding points of contact between music therapy and Disability Studies in Music can proceed with greater assurance. It is to this initial work that I now turn, and I retrieve from its perch at the top of this article the question that I suggested, at the outset, is important for bringing music therapy and Disability Studies in Music into a collaborative rather than oppositional relationship: music therapy for whom?
Kenneth S. Aigen (2014) has reflected on an internal conflict between interpretive modes of therapeutic practice based on attentiveness to psychological factors, and a therapy more clearly through music, in which linguistic mediation is secondary, or absent. Central to his discussion of this conflict and its possible resolution is an emphasis on “forging an equal partnership between therapist and client.” (p. 98). Aigen’s approach harmonizes with the insistence among Disability Studies scholars that people whose bodily differences signify “disability” to scientific, medical, and vocational communities of practice, must be regarded as full and complete selves: disability should be understood as a way of encountering the world differently, rather than as “limit without possibility” (Titchkosky, 2012, p. 82).
However, Aigen’s description, later on, of the therapist’s role suggests that there is no great mystery in the question: for whom is music therapy? Aigen’s account of the relationship between a non-disabled music therapist, and a disabled client, is an explanatory gesture that runs up against the insistence by Disability Studies scholars that traditional modes of receiving disability be reimagined, and if found disabling, then discarded. Aigen suggests that “in the initial stages of the therapeutic relationship, the therapist must be a benign presence who establishes pleasurable, expressive musical experiences without challenging the client” (Aigen, 2014, p. 109). Although such a definition would seem, at first, to promote music therapy as a means of facilitating a client’s capacity for self-expression, Aigen’s formulation implicitly represents the person “for whom” music therapy is done as fragile, in need of compassion and understanding, rather than of inclusion. Disability Studies asks that we think of this client not as "a recipient of care," based on an assumption of loss, and corporeal deficit (Straus, 2011, p. 158), but rather as a full participant in social and musical interaction based on an assumption of the equality of two complete persons which disability does not lessen. It is this latter construction of an encounter between able-bodied and non-disabled people that is the starting point for Disability Studies analyses (Overboe, 1999; Linton, 1998; Straus, 2011). The crucial point here has little if anything to do with the relative expertise on the body and its various symptoms and performances of ability and disability, or even the relative musical skills of therapist and client. Were differential skill levels in music a primary criterion for raising questions about potentially disabling effects, then any musical activity involving people with sometimes sharply divergent levels of musical knowledge and capacity, whether in the teaching studio, masterclass, or concert hall, could be considered worthy of analysis and subject to the particular complaints that disability studies has made against the exalted status accorded to ability (Garland-Thomson, 2005; see also, Lubet, 2004 & 2010). Yet, the starting assumption of this essay, which brings a Disability Studies perspective to bear on music therapy, is that there is something fundamentally different about disability as a marker of individual and collective identity: a person with a disability, people with disabilities.
Following the summary of a clinical case study describing how music therapy intervention helped to normalize the motor skills of a young man, described in the case study as projecting a “will to survive that was nothing less than outstanding” (Michel & Pinson, 2012, p. 88), Joe Pinson recollects that initially he was discomfited by the man’s appearance, and sceptical that the latter’s participation in public musical performances would elicit “sympathy and understanding” from the audience. Subsequently, however, having witnessed an emerging rapport between audience members and this same man discussed in the case study, Pinson came to question his prior beliefs: “[t]he dramatic change in my own attitude reminded me of the phrase offered to me by the first music therapist I ever met, who frequently pointed out that in this business, the real question is ‘therapy for whom?’” (Michel & Pinson, 2012, p. 89; emphasis in original). That Pinson’s account of this transformation appears in the context of a case study of a man with whose music-making and bodily appearance —Pinson was initially profoundly uncomfortable— demonstrates some of the stark contradictions which music therapy, and by extension, therapists, face, even prior to any encounter with the critical interventions of disability studies.
At this point it will be helpful to consider how music therapists themselves have marked the boundaries of the “is” and “is not” of music therapy. Leslie Bunt (n.d.) in his entry for the New Grove Dictionary of Music and Musicians offers a concise statement:
Music therapy is not about developing musical skills or teaching people to play an instrument, though these may be unintentional by-products of the therapeutic process. Therapy implies change, and many definitions refer to the development of therapeutic aims and the dynamic processes that are at the core of a therapeutic relationship as it evolves (para.1).
Given Leslie Bunt’s distinction between the educative and the therapeutic aspects of guided musical experience, a difficult question emerges and demands attention: are the aims of music therapy antithetical to those of disability studies? If so, what possibility is there for rapprochement, given that music therapy is an applied field for people with disabilities, offering treatments and interventions based on a set of assumptions about bodily difference that disability studies approaches resist? If this article can do no more than point in the direction of future solutions to these perplexities, it is nonetheless the case that, in this questionable matter of whether the “change” and “dynamic processes” which Bunt locates as central to the “therapeutic relationship” can be squared with the critical analyses developed by Disability Studies scholars and activists, music therapy scholars and practitioners will have to find a way to communicate within and navigate a contested space. In less pessimistic terms, one might think of this contested space as one of creative experimentation, to find out what conditions of equality between scholars from the two fields, and their audiences, might be necessary to create James Overboe’s (1999) “equality of condition” and thus to embrace the able-bodied and disabled within this more inclusive space.
Disability Studies in Music: For Whom?
The question that music therapy asks its practitioners to consider (Michel & Pinson, 2012) can be extended to the region in which I locate my own research: Disability Studies and Music. For whom is the burgeoning scholarship in this latter field, and what place is there for music therapists in its critical project?
This article, as a whole, joins a conversation between music therapy and disability studies in music that has only just begun (Lubet, 2010; Straus, 2011; Tsiris, 2013). To be sure, a note of discord has sometimes broken the silence between music therapy and disability studies endeavours. Introducing his 2010 book Music, Disability, and Society, Alex Lubet describes music therapy and special education in music as “largely medicalized” in contrast to disability studies in music approaches which have embraced the “social model of disability.” According to this latter theoretical framework, what it means to have a disability is shaped by external historical, cultural and social narratives and is distinct from what it means to have an impairment, that is, a certain set of bodily attributes which are transformed into disability (see also, Straus, 2006 & 2011). Lubet (2010) quickly tempers this characterization of how music therapy positions the disabled body, explaining that he intends no “rebuke” to these applied fields, but needs, instead, to separate the particular ways of understanding corporeal difference that help to define Disability Studies approaches, from those that inform music therapy and Special Education in Music (p. 7).
From further within Disability Studies we find many ripostes, pushing back against years, decades, and centuries of well-intentioned work to normalize the lives of people with disabilities. The following excerpt, quoted at length, vividly illustrates the view from outside music therapy:
Medicine, rehabilitation, special education, sociology, psychology, and a panoply of sub-specialities have all established their scientific and social credentials (as well as their very professional legitimacy) through the ‘humane’ study and provision of services to disabled populations that are at the outermost margins of social interest and cultural value. In fact, the value of these ‘healing professions’ has been largely secured by their willingness to attend to populations seen as inherently lacking and unproductive within the social circuit. We rarely consider that the continual circulation of professionally sponsored stories about disabled people’s limitations, dependencies, and abnormalities proves necessary to the continuing existence of these professional fields of study. Disability has spawned and bolstered an array of professional and academic fields by symbolizing the purest example of a ‘special needs’ community (Mitchell & Snyder, 1997, p. 1).
What David T. Mitchell and Sharon M. Snyder collectivize here as the “healing professions” are located within an invidious history which burdens and may possibly hold back whatever efforts are already underway to form an alliance that equitably represents the concerns and commitments of scholars, practitioners, educators, recipients of care and, ultimately, the human community, in which, as Joseph Straus (2011) insists, people with disabilities need to take the rightful place long denied them (p.159). In response to the burdensome history of disability in the arts, Disability Studies scholars have consigned artistic practices to the margins of inquiry (Sandahl & Auslander, 2005, p. 6). There has been a strong sense that clinical practitioners in “the arts,” broadly construed to include everything from the visual to the aural, were part of the problem, namely the social construction of disability, rather than potential allies in the solution, the formation of a positive disability identity: “Art as therapy” explain Carrie Sandahl and Phillip Auslander in the introduction to Bodies in Commotion: Disability & Performance has been viewed as responsible in many ways for the disabling of some bodies (the recipients), and the enabling of others (the practitioners). Activists and scholars “who were diligently redefining disability as a minority culture” and discarding “the label of pathology with its concomitant demand for cure” (Sandahl & Auslander, 2005, p. 6) have had little time for practice-oriented disciplines which aimed to bring the disabled body in line with the social, cultural, educational norms of bodily comportment in the ambient society.
Almost two decades later, the battle lines thus drawn between disability studies and the disciplinary and professional objects of its critical analysis have not necessarily weakened, even if there are tentative efforts from the opposing sides to find something in the way of common ground. In what follows, I use Giorgos Tsiris’s (2013) response to Joseph Straus’s (2011) Extraordinary Measures: Disability in Music as a case study (broadly defined), to explore and mediate some of the more noticeable areas of disagreement, and to find areas of common ground upon which to build roadways for future intellectual commerce between the polar regions of music therapy and Disability Studies in Music. My aims in this regard have more to do with extending and supporting the discussion already begun, than with rehearsing or adjudicating opposing points of view.
Giorgos Tsiris’s (2013) essay “Voices from the ‘ghetto’: Music therapy perspectives on disability and music” is, by his own admission, partially a review of, and partially a response to Joseph Straus’ (2011) Extraordinary Measures: Disability in Music, the latter stance indicated by the parenthetical enclosure of Tsiris’ title (omitted here for the sake of clarity and readability). For the purposes of this essay, I shall concentrate upon the third and fourth sections of Tsiris’ essay, the parts in which he respectively characterizes music therapy as a “misunderstood guest” (p. 337) within music and disability scholarship, and offers an assessment of how music therapy and Disability Studies in Music might proceed with greater reciprocity in the future. To begin with, however, Tsiris credits Extraordinary Measures: Disability in Music in particular, and the larger field of disability studies in music, more particularly, with opening up a series of compelling questions that he sets forth later in his essay:
What kind of disability narratives does a client express through their music? What kind of narratives do I (as a therapist) express through my music? How do clients and therapists meet and co-shape each other’s musical and disability narratives? (Tsiris, 2013, p. 340)
Important as these questions are, however, they are incomplete, from a disability studies perspective, in general, and sisability studies in music, more specifically, because of the failure to acknowledge two fundamental circumstances: first, the power differential that obtains in the encounter between an individual designated by the profession as an expert (even if an individual therapist resists such status); and second, the continuation of “ability” as an unmarked, and unremarkable, state of being. In other words, Disability Studies teaches us to question not only what it means to be disabled, but what it means to inhabit, and move through the world with a body that is readily accepted as able, healthy, functional ( Barnes, Barton, & Oliver, 2002; Barnes & Mercer, 2003, 2010; Linton, 1998; Oliver, 1990; Straus, 2011). The vital questions that Tsiris identifies can be enriched by greater attention to the collective, rather than individual manifestation of bodily difference, in other words a turn from the medical to the social, in which direction Tsiris has shown a willingness to move. To illustrate what I have in mind, I turn to Straus’ exhortation, at the end of “Extraordinary Measures” to be mindful of the limitations that the normal imposes: and to seize the opportunity to “extend our communal sense of how to hear music” (p. 181). I would go even further, and to suggest that to speak so often in terms of “hearing” music, is to restrict the possibility of thinking in deeper ways about what it means to experience music through all of our senses. Granted, Straus’ account of what he calls “disablist hearing” makes room for non-literal hearing, but one might go further in questioning the hierarchies of mind and body, and of the senses, which separate the sights, sounds, and textures of musical experience. In this sense, I would argue that both music therapy and disability studies in music could find another entry point into collaborative work by rethinking how such hierarchies continue to hold (unnecessary?) sway over therapy, pedagogy, and research.
For Tsiris, it is nonetheless the case that scholars of music and disability have not yet seized the opportunity to learn from music therapy practitioners. Extending the metaphor of music therapy as misunderstood guest, Tsiris writes: “She is outside waiting and willing to engage in constructive exchange and dialogue. She rings the doorbell … Will you open?” (p. 340). While Tsiris’ metaphor is evocative, and compels attention, it would be every bit as plausible to take the opposite tack, and to identify disability as a “misunderstood guest” long neglected by many scholarly disciplines, even as particular sorts of bodies have been received in less than hospitable ways by other disciplines and practices through which disability has been (mis)identified as a problem in need of a cure (Linton, 1998; Tremain, 2005).
Tsiris observes that music therapists have done much to enrich the lives of people with disabilities (2013, p. 336), positioning his own experiences in relation to such beneficial work, and finding a gap between perspectives on music therapy from within the field, and those that have developed from outside, in this case within the territory defined by Disability Studies in Music (p. 337). From a Disability Studies perspective, however, it is necessary to ask what Tsiris does not question: namely, how have the knowledge and experiences of people with disabilities enlivened and contributed to the development and sustenance of music therapy, both as a field of scholarly inquiry, and as a practice-oriented enterprise? Susan Wendell’s (1996) exhortation to value “disability as differences” (p. 84) offers a philosophical orientation that clarifies what has remained largely absent, without voice, as it were, in fields of study, and professional practice guided by a belief that disability requires intervention on the part of experts, in order to change individual bodies. Instead of seeking to cure, an ethos of “disability as differences” emphasizes sociability. Shifting the focus from intervention to education, broadly construed, thus steers disciplines and professions concerned with (and, often, by) the body in a direction in which the imperative of “seeking out and respecting the knowledge and perspective of people with disabilities” (Wendell, 1996, p. 84) is at the center of both theory and practice. Going further, Wendell (1996) explains that “disability as differences” (rather than as problems), pushes those responding to her call “to learn about and respect ways of being and forms of consciousness that are unfamiliar,” and, on a larger scale, to relinquish “the myths of control and the quest for perfection of the human body” (p. 84).
Tsiris (2013) insists that music therapy enables and empowers rather than normalizes people with disabilities, pointing to a number of scholarly works in the field to buttress his argument that even the very terms of the therapeutic relationship, practitioner and client, have been, if not jettisoned, then at least critiqued. What is missing from this argument on behalf of music therapy, from a disability studies perspective, however, is inclusion of the subjectivity, including the socially validated (and unmarked) position of able-bodiedness, from which the music therapist comes. If valuing “disability as differences” (Wendell, 1996, p.84) is to be a welcome guest (to take up Tsiris’ evocative metaphor of music therapy as “misunderstood guest”), within music therapy, then to the extent that music therapy aims to empower and enable, it is necessary to ask from whence comes the authority to define individuals and groups in need of such empowerment and enablement. I have already noted that in his critique of music therapy from a Disability Studies in Music perspective, Joseph Straus (2011) uses very similar language, illustrating the complexity of moving beyond certain fundamental assumptions, assumptions which might even seem inevitable, in reflecting on the potentially disabling effects of music.
Tsiris expresses consternation over Straus’ description of music therapy as an intellectual ghetto, and suggests that such a framing of music therapy is “disabling” (Tsiris, 2013, p. 337). It is here that two problems arise. In disability studies scholarship, what it means for a given set of practices or cultural representations to be "disabling" is connected specifically to barriers, whether material or attitudinal, that isolate people with disabilities from mainstream society. Within the context of research aimed at removing such barriers, "disabling" has an even more precise meaning, indexing the privileged status of the "normal" "able" body, as the following excerpt clarifies: "...within an emancipatory disability research framework, any discussions of disabled peoples' experiences, narratives and stories, are couched firmly within an environmental and cultural setting that highlights the disabling consequences of a society organized around the needs of a mythical, affluent, non-disabled majority" (Barnes, 2006, p. 353). Tsiris' ascription of a "disabling" process to Straus' critique of a site of practice (music therapy) that has long sustained the power of medical definitions of disability is highly contestable, from a disability studies perspective, and veers rather too closely to a simple reversal of oppositional discourses of the body, such that critiques of potentially disabling practices (based on the medicalization of bodies) are themselves construed as oppressive to those practices which have long dominated and normalized particular types of bodies. The emerging dialogue between music therapy and disability studies in music is thrown further off course here by Tsiris’ misleading interpretation of the passage (which he quotes at length). What Straus is arguing is not that music therapy is itself a ghetto, but rather that the pathological treatment of disability within music therapy has served to undermine music making by people with disabilities, placing such activity into an isolated region, a ghetto, controlled by medical expertise, rather than by aesthetic concerns.
Terminology as Contested Space
As I noted at the outset, a core tenet of Disability Studies in Music is that both language and music are implicated in how disability becomes meaningful, individually and collectively (Straus, 2006). The idea that language makes a difference, or perhaps, that language makes difference, is a familiar topic of conversation in Disability Studies, achieving its most recognizable connection to everyday life in questions over “people-first” language (Campbell, 2009; Michalko, 2002; Titchkosky, 2011 & 2012). Music therapy has moved in a similar direction, although without the political overtones that resonate in disability studies:
Given the range of practices and contexts in contemporary music therapy, we do not apply one generic term for the people benefiting from the services of music therapists. In some texts the term ‘client’ is used but it is not appropriate in all contexts. We have therefore chosen to use ‘patient’ in medical contexts, ‘student’ or ‘child’ in schools, ‘participant’ in more community-oriented practices, and so on. (Bunt & Stige, 2014, p. 3)
The authors explain that their usage of several different terms, namely “patient/participant,” “player” and “person” to signify the beneficiary of music therapy, points up the importance of context, the sheer variety of situations in which music therapy takes place (Bunt &Stige, 2014, p. 3). The philosophical tenets of Disability Studies put pressure on this seemingly unproblematic delineation of terms. While the rejection of monoliths locates music therapy in a parallel relationship to Disability Studies, the latter field of endeavour demands that we dig at the foundations of the multiple spaces in which music therapy occurs: the medicalization of disability is itself the problem; although the term “patient” might be suitable to the specific context being considered, Disability Studies demands that we delve into the processes that choreograph what music therapists and patients do in a clinical or hospital setting.
Tsiris' (2013) most pointed objection to the framing of music therapy within Disability Studies in Music, and in Straus’s “Extraordinary Measures” is conveyed in his rejection of the idea that music therapy is in any way a “normalizing enterprise”:
Music therapy is not something that music therapists do for or to people who are passive ‘recipients of care.’ Music therapy is something that music therapists do with people. The expert-patient dichotomy between therapist and client has no place here. In contrast, there is an emphasis on collaborative approaches where therapist and clients are equal and active participants in a musical therapeutic relationship which is mutually empathic and empowering. (Tsiris, 2013, p. 339)
Thus far, I have been considering the distance between Disability Studies in Music and music therapy. The task of exploring the proximity of these two fields shall fall to the ensuing pages.
Philosopher Licia Carlson (2013) observes that “[i]t is often assumed that living a life with a disability necessarily diminishes one’s quality of life, an assumption that has been vigorously challenged by many in the disability rights community and by disability theorists and philosophers of disability” (p. 94). And yet, as we have seen, scholars and practitioners working in fields of endeavour often blamed for perpetuating such assumptions—fields such as music therapy —have not given either a straightforward or universal endorsement of disabling beliefs (Tsiris, 2013, p. 399). Further compounding the miscommunication, Carlson (2013) does not specify which communities of practice subscribe so readily to the framing of disability as an impoverishment of being-in-the-world, thereby creating what might be, ultimately, a rather misleading opposition between Disability Studies and its others.[3] Turning to Tsiris (2013), we are reminded that music therapy is very far from being a monolith, not only because of its sheer diversity of approaches, but also because of its reflexive engagement with, and questioning of, the pathologization of disability and its bodies (p. 338), a point to which we will return in greater detail presently.
Ethnomusicologist John Blacking (1995) explains that music’s salutary effects extend from the individual to the collective, that "the function of music is to enhance in some way the quality of individual experience and human relationships” (p. 31). Within this expansive space we can recall one of the principal questions to which this essay posits a response: namely, “What is the role of a Disability Studies perspective within music therapy?” A Disability Studies perspective on music therapy would understand music’s function as a reciprocal exchange founded on the belief that intervention, amelioration, and cure are antithetical to the social model of disability. It is not merely that the therapist intervenes musically in the life of a client in order to change behaviours, symptoms, and bodily performances that fall outside the limitations on human experience imposed by medical norms, but that the individual and shared experiences of music within the therapeutic enterprise, considered in relation to the counter-normative critiques of Disability Studies, hold the possibility of transforming the therapeutic relationship into a performative rather than medicalized space.
Given that the most daunting challenge that Tsiris offers to Disability Studies in Music concerns the medicalization of disability that supposedly defines music therapy as an interventionist practice, a characterization of his field that Tsiris criticizes as distorted, it might seem that my own approach, which begins with the more general question of the nature and function of music within music therapy and Disability Studies in Music is much too distant. Here is what Tsiris (2013) has to say about the resistance against disability-as-pathology within music therapy. My own reasons for emphasizing musical practice rather than with the disabled body arise in response to Tsiris' argument.
“Across the different music therapy approaches,” writes Tsiris, “and their diverse theoretical and philosophical frameworks (at least within the wider European music therapy community), one could say that a unifying element between most of them is their opposition to reductionist medical models and to any kind of ‘normalizing’” (Tsiris, 2013, p. 338; emphasis added).
Given my unfamiliarity with music therapy, as I noted earlier, it is not my goal to adjudicate this matter, and to explain which side—music therapy or Disability Studies in Music— makes the most compelling argument as to how their counterparts understand disability the “wrong” way. Moreover, even if I had the required background knowledge to proceed in this fashion, such a procedure would swim against the current of reciprocity which this essay navigates.
If music therapy, following Tsiris’ statement, cannot be represented with any great accuracy as a normalizing endeavour (pace Straus, 2011), then intervening in music therapy’s understanding of disability will not help answer the main question of this section: what is the role of Disability Studies within music therapy? Instead, as I have already suggested, we would do well to begin with understanding how music therapy researchers and practitioners understand the function of music in ways that might both align with and clash against the sub-disciplinary perspectives on music brought to bear by music theorists, musicologists, ethnomusicologists, performers and composers working in Disability Studies in Music.
Pointing to several recent scholarly works on the theory and practice of music therapy, Tsiris explains that:
Music therapy is something that music therapists do with people. The expert-patient dichotomy between therapist and client has no place here. In contrast, there is an emphasis on collaborative approaches where therapist and clients are equal and active participants in a musical therapeutic relationship. (2013, p. 339)
The problem from a Disability Studies perspective with this way of laying claim to a dialogical and collaborative, rather than hierarchical, relationship between music therapist and patient concerns the foundational assumptions which inform this view of music therapy as a relational practice. From a Disability Studies perspective, and here it is necessary to read backwards to the passage which sets the above quotation up, the reference to “a process of empowerment and enablement” (Tsiris, 2013, p.339) glosses over the very terms on which this process is enacted.
Returning to the titular question of the present essay, “Music therapy for whom?” must always be, from a Disability Studies perspective, in whose name, on whose behalf a therapeutic intervention is performed. “Empowerment” and “enablement” cannot be as easily taken up, as Tsiris would like, without asking who is empowering whom, who is enabling whom? It is worth recalling that the question therapy for whom? has been identified within the music therapy literature itself as central (Michel & Pinson, 2012). If this relationship is construed as unidirectional, then a Disability Studies-informed critique would immediately ask why, and would question an enterprise that too readily grants the authority to empower and to enable to one person in that relationship. If, however, there is a willingness to countenance the possibility that all the individuals participating in the therapeutic relationship might be empowered and enabled, then it is possible to begin the difficult work of asking just what this might involve.
Meeting in the Middle: Music Therapy as a Performance
This essay has worked to deepen a conversation already begun, rather than, primarily, to challenge or confront the very foundations of the conversation, or to rehearse a list of failures, and shortcomings, theoretical and methodological. By lending support to the critical project of thinking about music therapy as a mode of performance, and seizing upon those instances in which Disability Studies in Music scholars and music therapy scholars and practitioners come close to speaking in unison, this essay departs from the often disruptive and “unruly” atmosphere which Disability Studies, in its socio-political critiques, often fosters (Campbell, 2009).
In searching for a way to meet in the middle, I turn once again to Tsiris (2013) who points to an absent space in the representation of music therapy by Disability Studies in Music. It is this space of absence which I would like to imagine as the future meeting place of music therapy and Disability Studies approaches to the musical experiences of bodies disabled and otherwise: “In this context, health (as an integral part of one’s identity) is not viewed as a separate static entity, but as a dynamic, living process that is performed through the way that people act and relate to each other and to the environment around them” (Tsiris, 2013, p. 336). Outside of Disability Studies in Music, scholars working at the borders between Disability and Performance Studies (Sandahl & Auslander, 2005) have used “performance” as a theoretical scaffolding by means of which to renovate arts-based interventions into the disabled body, in which therapeutic impulses have long held sway. This is not to say, of course, that therapy needs to be replaced, that therapy is an “unwelcome guest,” but rather to find the congruities between arts-based and therapy-based initiatives. For example, Melissa C. Nash (2005) thinks of “performance” as a communicative medium through which individual and group identities are negotiated (p. 191) and presents the findings of her research into the work of Entelechy, a “participatory arts company” (Entelechyarts.org) that choreographs a “creative dialogue” between dancers, able-bodied and disabled alike, built upon the premise of equitable, rather than hierarchical participation by its members (Nash, 2005, p. 191).
Although “performance” seems like a viable meeting ground for Disability Studies in Music and music therapy, performers with disabilities have not been outside the purview of the pathological interventions from which a great many societies seem to suffer:
The disabled performer is marginalised and invisible—relegated to borderlands, far outside the central area of cultural activity, into the discourses of medicine, therapy and victimhood. At the same time, people with physical impairments are also hypervisible [sic], instantly defined in their physicality. The physically impaired performer has therefore to negotiate two areas of cultural meaning: invisibility as an active member in the public sphere, and hypervisibility and instant categorisation. (Kuppers, 2001, p. 25; see also, Kuppers, 2013)
Pursuing this idea of music therapy as an intervention not merely between individuals in a clinical setting, but into a social order which sustains the exclusion of people with disabilities structurally and attitudinally, let us consider what lies at the heart of the existential dread that a number of Disability Studies scholars have located as a prominent feature on the landscape of collective responses to bodily difference. Lennard Davis (2006) suggests that disability haunts us, cast to the shadows of the world of mortals, glanced at timidly, “an actively repressed memento mori for the fate of the normal body” (p.1).
My thinking in this direction is also influenced by Rod Michalko (2002) who explains that normative definitions of disability within the framework of medical pathology confer upon society a “responsibility to disability in the provision of preventive, curative, and rehabilitative measures” (p. 6). The ordering is not incidental: rehabilitation is the measure of last resort when prevention and cure fail to correct the malfunctioning (read: disabled) body.
Michalko’s line of thought leads us in a rather complicated direction, in search of an answer to “for whom is music therapy?” The acquisition of a disability, as Michalko explains, calls normative representations of selfhood into question: “‘Who am I now that I am disabled?’ The biomedical model [of disability] provides an easy and attractive answer to this question: ‘You are who you always were...You remain an individual, a person with a disability’” (2002, p. 7).
Tsiris moves in a particularly intriguing direction when he suggests that Disability Studies approaches in music have not sufficiently considered the musical practices and experiences of people with disabilities who fall outside the category of expert or virtuoso:
An interesting additional perspective would have been the exploration of narratives that are ‘told’ by the music of disabled people who are not famous, or may not be perceived as musically ‘talented’. A source for such narratives can be found in the practice and literature of music therapy as well as of special music education where people with (often complex) disabilities participate in music-making processes, including improvisation, song-writing and composition. The addition of such narratives would have provided a more inclusive ‘sample’ in Straus’s study [sic]. (Tsiris, 2013, p. 340).
Alex Lubet (2004) has explained that the tendency for Western art music to either exalt musicians with disabilities when they reach the height of their professions, or to ignore them when their musical skills fail to rise above the average, or less than average, is a function of this tradition’s value system, in which the (composing, performing, or listening) body is regarded as the means to a musical end, rather than as an inseparable component of musical experience. A similar point has also been driven home with great clarity in Joseph Straus’ (2011) discussion of “Prodigious Hearing” (pp. 151-152), and “Disablist Hearing” (especially pp. 157-160). However, in Straus’ argument, the field of Music Therapy is faulted for its credulous incorporation of medical discourses that construe disability as a problem, a way of representing corporeal difference which Disability Studies scholars have theorized as the “medical” model of disability.
Straus acknowledges that “music therapy encourages and enables music-making" and therefore that it "makes a valuable contribution to the lives of people with disabilities” (2011, p. 158). However, this acknowledgment appears to be at odds with his criticism of music therapy for its aims to intervene, normalize, and cure. As he puts it, music therapy is "subject to the more general critiques of the medical model undertaken throughout Disability Studies, and to specific questions about its therapeutic efficacy” (p.158). I would suggest that this contradiction is productive when viewed from a Disability Studies perspective: the way Straus modulates his critique of music therapy invites us to scrutinize the ontological and epistemological assumptions running through music-therapy discourses and their critiques. These discourses center on the issue of how people with disabilities might be "enabled" to benefit from inclusion in musical activity. What Straus does not ask is: whose knowledge is considered legitimate when it comes to deciding how to include people with disabilities in musical activities and experiences? (Goodley, 2010, p. 23). The unasked is revealing.
On the one hand, Straus’ critique places him within the (relatively young) tradition of Disability Studies. On the other hand, however, Straus reproduces a system of beliefs according to which it is indeed possible for music therapists to “encourage” and “enable.” In the therapeutic environment, however, who decides that music can be an encouraging and enabling medium? And, in the case of a client who is non-verbal, and whose performances of disability might too readily be accepted as symptoms of diminished personhood (Overboe, 1999; see also, Titchkosky, 2012), how is effective communication to be secured, in order to prevent music's curative possibilities from being used in disabling ways?
Lubet’s (2004 & 2010) repeated assertions that Western art music presents a singularly hostile environment to musicians with disabilities are not entirely convincing because of their lack of empirical basis; instead Lubet presents brief case studies that support his larger claims, without adequately drawing out the complexities, indeed contradictions in specific instances of musicians with disabilities participating in this tradition. However, the point at issue here, is that there is a sharp line between musicians with disabilities who achieve star status in the galaxy of Western art music, and those whose participation is unheeded because of an ensemble of structural circumstances which privilege, not so much the able body, but rather ways of making music, whether through composition or performance, and of receiving music, as in music theory and ethno/musicology, that are indicative of exceptional, rarified music making.
Locating the body, able-bodied and disabled, in the theoretical framework of performance, opens up a way of thinking beyond bodily attributes, and instead, to inflect the relationality central to music therapy, with a level of meaning that brings the body into (contact with) the world. If “ability” and “disability” signify doing rather than being, (Sandahl & Auslander, 2005, p. 10), then Disability Studies in Music and music therapy, once having fully embraced the performativity of different bodies, can move in “commotion” in the collaborative sense of "moving together" (Sandahl & Auslander 2005, p. 10). Musical narratives both extraordinary (Straus, 2011) and ordinary (Tsiris, 2011), studied within and across the two polar regions are an hospitable environment for a theoretical and practical shift in understanding for which this article has argued. The conversation started by Tsiris’ (2013) thoughtful response to Straus’ (2011) path-breaking study, shows that the polar regions which initially seemed forbiddingly distant, are in commotion, drifting slowly together, with the not-so-distant promise of a future meeting.
Notes
[1] I would like to thank Professor Susan Hadley (Slippery Rock University of Pennsylvania) and Associate Professor Randi Rolvsjord (University of Bergen, Norway) for their helpful critique of earlier drafts of this article. I thank Olivia Gomez (St. John's College, University of British Columbia) for lending a fresh pair of eyes to the final draft of this article. I have also benefitted from discussing a number of ideas in this article with Dr. Craig Smith. In addition, conversations with my sister, Professor Erika Supria Honisch (Stony Brook University), and with my parents Martin and Usha Honisch helped me clarify both my thinking and writing.
[2] A recent (2014) notice for a performance by Tsujii with the Liverpool Philharmonic likewise quotes Cliburn's statement. Curiously, the notice does not mention Tsujii's blindness: http://www.liverpoolphil.com/?lid=14298. I have quoted this version in order to highlight the sometimes ambivalent position of disability.
[3] Readers may (not) recognize the allusion to “Western Music and its Others” (Born &Hesmondhalgh, 2000). Despite its very different aims, and the distance of its specific themes from those of the present essay, I allude to it here in order to signal a larger point of contact, related to how music, both its practices and its scholarship, creates an “Other” in opposition to which an entire musical tradition, in this case, Western art music, draws lines of demarcation. Just as music, broadly construed, raises questions such as “must the recognition of difference in music—necessarily be fictive and divisive, ideological and hierarchical? Or can it be allied to a reflexive, analytical project?” (p.2), so too, in broadly similar fashion, Disability Studies perspectives, including those embraced by scholars of Disability Studies in Music, must proceed in a manner that prevents critique from descending into the “fictive and divisive, ideological and hierarchical.” Working in this more euphonious vein does not require that we shy away from “reflexive” analysis of disabling practices. Instead, such an approach introduces a note of self-reflexivity, cultivating greater sensitivity to how Disability Studies has created a series of “others” in a manner that parallels, even if from a position of lesser, or at least, different, institutional power, the processes analyzed in the book I have referenced here.
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