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   <front>
      <journal-meta>
         <journal-id journal-id-type="DOAJ">15041611</journal-id>
         <journal-title-group>
            <journal-title>Voices: A World Forum for Music Therapy</journal-title>
         </journal-title-group>
         <issn>1504-1611</issn>
         <publisher>
            <publisher-name>GAMUT - Grieg Academy Music Therapy Research Centre (NORCE &amp;
               University of Bergen)</publisher-name>
         </publisher>
      </journal-meta>
      <article-meta>
         <article-id pub-id-type="doi">10.15845/voices.v21i3.3305</article-id>
         <article-categories>
            <subj-group subj-group-type="heading">
               <subject>Research</subject>
            </subj-group>
         </article-categories>
         <title-group>
            <article-title>Music in a Concussive Monologue</article-title>
         </title-group>
         <contrib-group>
            <contrib contrib-type="author">
               <name>
                  <surname>Gilbertson</surname>
                  <given-names>Simon</given-names>
               </name>
               <xref ref-type="aff" rid="S_Gilbertson"/>
            </contrib>
            <contrib contrib-type="author">
               <name>
                  <surname>Hebert</surname>
                  <given-names>David Gabriel</given-names>
               </name>
               <xref ref-type="aff" rid="D_Hebert"/>
               <address>
                  <email>dgh@hvl.no</email>
               </address>
            </contrib>
         </contrib-group>
         <aff id="S_Gilbertson"><label>1</label>Grieg Academy-Dept. of Music, University of Bergen,
            Norway</aff>
         <aff id="D_Hebert"><label>2</label>Western Norway University of Applied Sciences,
            Norway</aff>
         <contrib-group>
            <contrib contrib-type="editor">
               <name>
                  <surname>Silveira</surname>
                  <given-names>Tanya Marie</given-names>
               </name>
            </contrib>
         </contrib-group>
         <contrib-group>
            <contrib contrib-type="reviewer">
               <name>
                  <surname>Gumble</surname>
                  <given-names>Maevon</given-names>
               </name>
            </contrib>
            <contrib contrib-type="reviewer">
               <name>
                  <surname>Street</surname>
                  <given-names>Alex</given-names>
               </name>
            </contrib>
         </contrib-group>
         <pub-date pub-type="pub">
            <day>1</day>
            <month>11</month>
            <year>2021</year>
         </pub-date>
         <volume>21</volume>
         <issue>3</issue>
         <history>
            <date date-type="received">
               <day>8</day>
               <month>4</month>
               <year>2021</year>
            </date>
            <date date-type="accepted">
               <day>25</day>
               <month>8</month>
               <year>2021</year>
            </date>
         </history>
         <permissions>
            <copyright-statement>Copyright: 2021 The Author(s)</copyright-statement>
            <copyright-year>2021</copyright-year>
            <license license-type="open-access"
               xlink:href="http://creativecommons.org/licenses/by/4.0/">
               <license-p>This is an open-access article distributed under the terms of the
                     <uri>http://creativecommons.org/licenses/by/4.0/</uri>, which permits
                  unrestricted use, distribution, and reproduction in any medium, provided the
                  original work is properly cited.</license-p>
            </license>
         </permissions>
         <self-uri xlink:href="https://voices.no/index.php/voices/article/view/3305"
            >https://voices.no/index.php/voices/article/view/3305</self-uri>
         <abstract>
            <p>The co-authors, a music therapist and a musicologist who suffered a concussion,
               collaboratively develop an autoethnography detailing the phenomenological experience
               of concussion and the gradually increasing role of music throughout the recovery
               process. Along the way, they discover new things about music, the mind, scholarship,
               and themselves. </p>
         </abstract>
         <kwd-group kwd-group-type="author-generated">
            <kwd>head injury</kwd>
            <kwd>concussion</kwd>
            <kwd>autoethnography</kwd>
            <kwd>collaborative writing</kwd>
         </kwd-group>
      </article-meta>
   </front>
   <body>
      <!-- sec lvl 2 begin -->
      <sec>
         <title>Prelude</title>
         <p>
            <italic>Sometime in October 2016, two colleagues in deep discussion…</italic>
         </p>
         <disp-quote>
            <p>“What about David? I was wondering if we could have him as a keynote speaker?”</p>
         </disp-quote>
         <disp-quote>
            <p>“He hasn’t been really very well Simon” Jill replied. “Perhaps you haven’t heard.
               Something happened with his head. He’s been away from work for quite some time
               now.”</p>
         </disp-quote>
         <disp-quote>
            <p>“That’s a pity. It would have been great. Do you remember he was my respondent when I
               gave that quirky presentation, ‘Music therapy for the inseparable human.’ His
               comments were a gift on that day.”</p>
         </disp-quote>
         <disp-quote>
            <p>“Yes, I got a sense that he found something useful somewhere in what you’d said.”</p>
         </disp-quote>
         <disp-quote>
            <p>“I wonder how he’s doing.”</p>
         </disp-quote>
         <p>Quietly, Simon’s mind raced—with concerns for David, and also flashbacks from nearly two
            decades of music-making with people affected by severe traumatic brain injury in early
            neurosurgical rehabilitation.<sup>1, 2, 3</sup>
         </p>
         <p>
            <italic>Many months later, David and Simon at a research seminar dinner…</italic>
         </p>
         <disp-quote><p>“You know Simon, I think I have something we might talk about. Well, you know that I
            experienced severe concussion from a fall a while back?”</p></disp-quote>
         <disp-quote><p>“I heard about that, David. We should try and find a time to talk soon when the seminar
            is over.”</p></disp-quote>
         <p>
            <italic>Some months later and an introduction to the text…</italic>
         </p>
         <p>Far from any treatment center or therapy room context we met via Zoom on five occasions
            in Spring 2021 for extended conversations. As two friends and professionals with
            experience in music performance, composition, education, therapy and research we
            explored the intersections of concussion, music and recovery in a collaborative,
            conversational and co-constructive process which we document here. We both shared the
            sense that this exploration felt worthy particularly in the light of the counted and
            uncounted millions of people every year that suffer concussion throughout the world,
            through war and violence, sports and hobbies, and everyday incidences like tripping and
               falling.<sup>4</sup>
         </p>
         <p>The text is an intentional experiential narrative that we created collaboratively. Some
            qualities of disorientation and dislocation may be experienced when reading. The voicing
            shifts at times between us invisibly, the text fluidly moving between David’s
            description of the events and Simon’s witnessing of these descriptions. In contrast to a
            single-person autoethnography, the process of further developing the manuscript,
            engaging with the reviewers’ supportive and helpful suggestions, and finalizing the text
            has been done dialogically. We add imagined both future injured (“I”) and future
            care-givers (“you”) at different points to highlight some of the ways we have
            experienced that care is needed in engaging with music after concussion. We have marked
            the sections regarding future injured and care-givers in italics. We end by sharing core
            aspects of our learning and remaining questions so far.</p>
         <p>
            <italic>Some weeks later, notes from our Zoom sessions take shape, emerging as a musical
               autoethnography</italic>
            <sup>
               <italic>5</italic>
            </sup>
            <italic>…</italic>
         </p>
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>A monophonic monologue</title>
         <p>He is only 4 years old. He knows no different.</p>
         <p>He shoots up the concrete steps, disappears through the shady bushes onto the busy road
            chasing his older cousins, squawking in each other’s delight. I lurch through the house,
            scream after his presence, and chase the remnants of his voice. The California sun
            blinds my retinal control. The ground parts away from my poorly shod feet, no time for
            laces. Falling, failing. Have I failed my son? He knows no different. A nuclear bomb
            goes off in my head. The concrete step is oblivious to the contrecoup injury it inflicts
            to my brain. Motionlessly rising it crushes the sense of self out of me. My soul’s
            habitat is deleted temporarily without me being informed in advance. It’s unbelievable,
            earth-shattering, like what the end of the world would sound like. I reach up to my head
            sure that my brain is starting to pour out. I sense I may only have a few more seconds.
            Such a shame, really. Things had only just started to turn out good in my life. I
            crawled. I called.</p>
         <p>Bled, bandaged. My parents, sister and various doctors helped me. They said I needed
            rest and needed to be patient. They couldn’t say for how long. I was grateful and
            relieved my son was fine. After a miserable journey back from the USA, I somehow
            returned to my Norwegian dwelling. It was new, tiny, foreign, and pain-filled, with
            complete isolation. No wife (divorced), no child (doing fine with his mother), no
            parents (still in California). No colleague (off-work), no self. That self could not be
            located. Not yet. Still dislocated by concussion. The pain increased steadily over the
            first weeks. Incessant, relentless pain. I wasn’t able to sleep. I was so scared that I
            wouldn’t wake up again if I did. I hallucinated a cartoon-shaped golden lightning bolt
            in front of my eyes that would never go away. Imagine that.</p>
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>The first 50 days at zero beats per minute</title>
         <p>
            <italic>Darkened, silenced, huddled away from painful stimuli of all types. Music
               soothes not this soul. Not now. Dark glasses, shooting range ear protectors.</italic>
         </p>
         <p>I no longer knew how to make that food where you put something in-between something like
            bread. It was too difficult. I just went back to bed hungry. Sometimes, in a time-window
            of about 40 minutes each day, I felt strong enough to get up. But I was unsure of the
            route along one single road; just back and forth from my home to the grocery store, and
            back again. On one occasion, during the return, I stood on the spot looking around
            without knowing what I was searching for. I walked straight ahead and was lucky to get
            home.</p>
         <p>Somehow, as a result of the fall, I disappeared from myself. I was inside of a body that
            looked familiar, but I didn’t recognize myself by my thoughts, or my ideas, or
            capabilities. The real me was gone and I missed him. I yearned. I wanted to get back to
            normal. To find myself. I couldn’t figure out where I was. Imagine that.</p>
         <p>I tried listening to music, but immediately experienced pain. I just wanted anesthetic
            sounds that would help me easily let the few hours that I was awake, or at least barely
            mentally functioning, to go by as quickly as possible. I just wanted to get through as
            many days as quickly possible. All music was pain-ridden.</p>
         <p>I returned to silence.</p>
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>The next 50 days</title>
         <p>
            <italic>Concussion, confusion, dis/location. Calling out to you for sensorially-attuned
               companionship.</italic>
         </p>
         <p>At recovery’s rubato, without cadence or harmonies stealing my momentary grasp on
            reality. One note at a time, a pause, and then the next. That was the limit. Drones and
            harmonium. Breath and silence. These were the only ways to musically locate myself and
            find refuge from pain.</p>
         <p>My inner-voice relentlessly repeated, “I can’t continue like this. I can’t find me”.</p>
         <p>I couldn’t read. Audio books were fine as long as the stories were short. Raymond
            Carver, Chekhov, Tolstoy, Maupassant, and Borges. One story per day. Maybe. Ernst Hans
            Josef Gombrich’s <italic>A Little History of the</italic>
            <italic>World</italic>
            <sup>6</sup> reminded me that it is important to hear about people that I had never
            heard much about, like the Peloponnesians. Imagine them.</p>
         <p/>
         <p>I had some good days when sounds that attuned to my attentional progression were
            welcome. There is still so much to learn about how pain is elicited by music content,
            structure and form. Between all the other sounds and my mind, I placed the industry’s
            finest noise-cancelling headphones. Music’s ubiquitous nature is cancelled. Noise
            cancelled. </p>
         <p>My pain-directed stillness may seem wrong to you and in need of activation by
            stimulation and training. My pain-directed stillness calls you, however, to place your
            prescription protocol for “orientation and activation” elsewhere. It’s not my previous
            musical preference that you need to find out, it is my current musical state.</p>
         <p>
            <italic>And here is my challenge to you: I know where I am—I am there where I cannot be
               found and it is there that I need you to help to look with me. That is the
               orientation that you will require to join me and others in the process of recovery. I
               need you to find me in the musical place in which I am, in this present.</italic>
         </p>
         <p>I first looked for anesthetic sounds—ones that removed my consciousness. Music that did
            not destruct my capacity of attention, but then I looked for analgesic music that could
            help lessen the pain I was experiencing. I looked for those tunes in the minutes and
            hours each day that I was surviving well.</p>
         <p>
            <italic>This is the tune, the timbre, the timing that I—and you—need. Join me in my
               temporal survival of pain.</italic>
         </p>
         <p>I would have wished to have someone who could have joined me in my nuanced interest in
            the layers and shifting leaves of David Sylvian’s shifts with Holger Czukay in
               <italic>Flight and Premonition</italic>,<sup>7</sup> with Arvo Pärt’s breathing in
               <italic>Für Alina,</italic>
            <sup>8</sup> Hindustani drones in my brain,<sup>9</sup> and Dali’s melting clocks in his
            painting, <italic>The Persistence of Memory</italic>.<sup>10</sup> Harold Budd’s “As
            Long as I Can Hold my Breath”<sup>11</sup> gifted me the space I needed to be able to
            listen without increasing pain and suffering. These were the musics and sights of my
            recovery.</p>
         <p>The music, and the slow tempo, hinted at my need for a different sense of time. More
            importantly I experienced music of a different sense of acceptance. The music aided me
            in not being so angry and frustrated—it gave me the sense that it’s okay to be in this
            very slow groove. Somehow the music was needed to help reinforce the idea, “You are
            stuck here, and it is okay for now.”</p>
         <p>
            <italic>The apparent idiosyncrasy of peoples’ needs of music during recovery and care
               are mistakenly narrated as they are based only on visible observations. At an
               invisible musicological level, the need for timelessness is congruent with the
               timelessness of recovery and lack of bar lines in the nature of change and
               acceptance… </italic>
         </p>
         <p>
            <italic>So, I ask you to imagine something else.</italic>
         </p>
         <p>
            <italic>Leave your claims of the nature of music’s languages. Or your random
               control.</italic>
         </p>
         <p>
            <italic>Sing with my cries of loss that are for the person I cannot help you
               locate.</italic>
         </p>
         <p>
            <italic>He is that person. </italic>
         </p>
         <p>
            <italic>He is that person who is not there.</italic>
         </p>
         <p>
            <italic>You will not find him in your simple bars, nightclubs, or pounding beats of
               social time-wasting. </italic>
         </p>
         <p>
            <italic>Do not bang around on inclusions’ drums for the concussed. For the percussive is
               as concussive as it is discursive. What the concussed human needs is selective and
               dialogical shared attention. The most important thing for a healthy, functioning
               brain to do is not to pay attention to everything.</italic>
         </p>
         <p>I had lost control of my ability to concentrate, to ignore, and to get my brain to
            selectively attend to that thing that matters at that time. You can’t listen to rhythmic
            music when you can clearly hear the rasping sounds made by the legs of a fly on a window
            at the opposite side of the room. I could only let a small amount of matter into my
            brain’s nuclei. A quantum at a time.</p>
         <p>The tempo of recovery is known only by the improvisatory unfolding of incomplete
            attempts of utterance. It must be possible to reject one’s own attempts of attention and
            choice. To end listening when it mutates into pain without anyone else noticing. It is
            like the phraseology of those first tears and cries of failing, of falling. With the
            hard concrete step of the initial fall no longer before me, it is a continuous falling
            forward. A sequence of failed closure, cadential interruptions layered upon cadential
            interruptions that match painlessly the scope of attention that is gradually
            convalescing, quietly, and at the speed of consistent pain.</p>
         <p>Even though I was making minute progression, there was no scope for joy. The rejection
            of joyous frivol during concussion is not caused by the sadness of a broken heart
            however, but by the resilience of throbbing minds in the unending course of every solo
            attempt uncompleted.</p>
         <disp-quote>
          <p>“But there are things to be done and I can’t be patient,” I cry.</p>  
         </disp-quote>
         <disp-quote>
            <p>“There are people relying on me! I can’t wait any longer to for my life to begin again if you’re not recognizing that this is how my life is progressing.”</p>
         </disp-quote>
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>Beyond the first 100 days</title>
         <p>Over time, slowly, the concussive disordering calms and, in time, but long overdue, the
            pain resides and I emerge to myself through myself. The lightning bolt hallucination
            unnoticedly disappeared. It was probably only a blond eyebrow hair hanging far down into
            my eye all the time anyway.</p>
         <p>Work resumed, the load picked up, edited books became published, concerts given,
            positive reviews from students again. It becomes possible to judge that things are once
            more fine. I know which end of the street is home.</p>
         <p>In company and conversation, the shifts forward are accompanied in embodied resonance.
            Finally witnessed via Zoom. The incredible slowness of the recovery, the recovery of
            each slither of light, each nanosecond of sonic data of esthetic. Noted, followed, felt,
            transcribed.</p>
         <p>We asked each other whether it could be musics’ role in this narrative to live
            responsively with the person with concussion? Shouldn’t music help people understand
            more together, with another, about another, for another? Can we develop the sharing of
            interest in how the beginning, middle, and end of a single breath has an inseparability
            with the beginning, middle, and end of a North Indian improvisation, a single note on
            the shakuhachi flute, or the albums <italic>Stan Getz with Strings</italic>
            <sup>
               <italic>12</italic>
            </sup> or Miles Davis’s <italic>In a Silent Way</italic>
            <sup>
               <italic>13</italic>
            </sup> in understanding a concussive monologue through musicological attention? Should
            compositional attention to music and sound attract and establish a mutual immersion in
            recovery and care, idiosyncrasy and togetherness, conversing and writing?</p>
         <p>We thought so.</p>
         <p>And then more questions whisper in warm breath between us, “What have You learned? What
            can I learn?”</p>
         <p>Well, we get on with the learning that lies further ahead and begin at, or as David Boje
            suggests, begin before the beginning, searching out the ante-narrative.<sup>14</sup>
            Share, re-iterate. Play the trumpet again. Sing with my full voice. Be a person for
            others. Make a contribution that benefits others. Be a fragile human amongst others. Be
            a musician. Be writers together.</p>
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>What next?</title>
         <p>There are many pathways in learning about concussion, music, and caring for oneself and
            others outside of therapy and within therapy. Similarly, there are many open avenues for
            future research, practice development and public discourse that may be explored.</p>
         <p>Early on in this process we experienced that it is important not to wait to find time,
            but to establish and secure time for exchanges between those who have experienced
            concussion and those who care for people who have experienced concussion.</p>
         <p>We have also learnt that our convergence as two musicians, researchers, and teachers
            affords the opportunity to learn more about the presence and absence of concurrent
            multiple theoretical layers of discourse about music and health.</p>
         <p>We have strongly felt the need to better understand idiosyncrasy through the sharing of
            re-educative examples, and the politics of variability and difference.<sup>15</sup>
         </p>
         <p>We feel that there is an acute need for musicians and music therapists to consider and
            examine the significance of extreme slowness as an unavoidable pre-requisite for the
            development of the arts, health care and contemporary society (beyond immediate
            emergency response situations). Long term attention needs to be given to those
            recovering and to extremes of idiosyncratic temporality. Through these opportunities we
            sense the importance of more actively seeking out community with those who hold
            phenomenological insights into ontological diversity.<sup>16, 17</sup>
         </p>
         <p>We have also experienced a shift toward creative autoethnographic writing away from an
            epistemological research commitment that might search for “elicited” categories in
            transcripts. This new approach invites expression of ontological exploration and
            critical reflexivity.<sup>18, 19</sup> As scholars choosing creativity, we will at times
            also trust the pen in nights of doubt.<sup>5, 20, 21, 22</sup>
         </p>
         <p>We have experienced the significance of taking time to be with those who have concussion
            and those who chose to care for them. We have experienced the significance of immersing
            ourselves in the listening choices of others. We have been challenged to pause our own
            musicological consciousness, and learn more about the idiosyncratic neurological
            improvisation of recovery, and are grateful to be able to contribute to the
            thousand-year-old musical narrative<sup>23, 24, 25</sup> of recovery and concussion.</p>
      </sec>
      <!-- sec lvl 2 end -->
      <!-- sec lvl 2 begin -->
      <sec>
         <title>About the authors</title>
         <p>Simon Gilbertson<bold> </bold>is an Associate Professor of Music Therapy with the
            University of Bergen, Norway, where he leads the Grieg Research School for
            Interdisciplinary Music Studies. He serves on several editorial boards, is a contributor
            to major research handbooks, and co-author of the book Music Therapy and Traumatic Brain
            Injury: A Light on a Dark Night.</p>
         <p>David G. Hebert is a tenured Professor of Music at Western Norway University of Applied
            Sciences (Bergen), where he leads the Grieg Academy Music Education (GAME) research
            group. He is manager of the Nordic Network for Music Education, Professor II at Lund
            University, and Honorary Professor with the Education University of Hong Kong.</p>
      </sec>
      <!-- sec lvl 2 end -->
   </body>
   <back>
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