Back at base now, I can reflect with relish on three days of thought provoking, multi-disciplinary input at Belfast’s beautiful Lyric Theatre, which was our centre of gravity during Arts Care’s ‘International Arts in Health Conference: Sustainable Creativity in Healthcare’ this week.
It was hugely stimulating exchanging perspectives with delegates from far and wide (including Australia, USA, Canada, Finland, Holland, Britain and Republic of Ireland) carrying their nuanced visions of ‘arts and health’ activity but refreshingly without any wish to draw up boundaries or battle lines over definitions. Interdisciplinarity beckoned. The delegate list included esteemed academics from fields as diverse as arts practices, neuropsychology, medical education, medical humanities, nursing education and anthropology, as well as numerous practitioners including arts therapists, community artists, hospital clowns, musicians, lots of dancers, clinical and health practitioners, and finally policy officers, CEOs and lobbyists for arts and health work.
Amongst the expert thinkers and writers cited in keynotes and panel presentations our own Jane Macnaughton featured prominently as an authority in the field, Mike White and Martyn Evans also made appearances, and Durham’s CMH carried significant kudos as a leading arts and health/medical humanities research centre. I was very proud to carry the CMH banner, invited to present findings from my doctoral research in the UK and Mexico, showing indications of a transnational core practice in community arts and health.
With such a packed programme of presentations and workshops, perhaps too little opportunity was made for interactivity between delegates to explore the evident interdisciplinarity of perspectives in more dynamic ways. However as the programming allowed items to collide and counterpoint, (sometimes with seemingly wild thematic or methodological abandon), it was still possible to draw fascinating lateral links between the perspectives of contributors. In my own experience of the conference I found myself at many turns deeply drawn into entirely different worlds:
- Inspired and energised by the opening address from Arts Care CEO, active dance artist and researcher Dr Jenny Elliott who set the tone for the conference using the Arts Care ethos and framework – that this is a work of passion, and is a practice based in ‘the relationship’ – with self, with others and with the environment. But that this is not a health practice; rather it is an arts practice, and demands high artistic ambition and commitment, as well as challenge;
- Then appreciating the bleak reality of acquired brain injury, through consultant clinical neuropsychologist Dr Marie Goss’s comprehensive exposition of the clinical challenges of facilitating a complex rehabilitation process, involving a reinterpretation if self-identity at the deepest level, and the unique role the arts can play here – an account which I was able to bounce against personal experience of singing regularly with a stroke survivor;
- Then fascinated and intrigued by the colourful exposition of the phenomenon of ‘Clowndoctors’ by Magdalena Schamberger, CEO of Edinburgh based Hearts & Minds, home of the Clowndoctors programme in Scotland); embodying the paradoxical idiom of the ‘learned fool’, using the twin symbols of the white coat to denote the ‘learned’ doctor and the red nose to denote ‘foolish’ clown, these are mood-shifters who bring wellbeing through laughter; they are ‘in the moment’ (not past or future), accompanying patients and their families through the sometimes paralysing, anguished liminal space between prior health and the uncertain future, and guided by principles of respect, empathy, shared vulnerability (embodied in the emblematic low status of the marginal clown character), and what Magdalena claimed is ‘genuine friendship’. The creativity of this work has been discussed and theorised by Oliver, in his piece Creativity as openness: Improvising health and care ‘situations’, in Health Care Analysis, 2009 17(4) as creating ‘communitas’ through interrupting structure, to create moments for collective improvisation. (I have summarised his ideas in our article – Raw et al, (2012) ‘A hole in the heart: Confronting the drive for evidence-based impact research in arts and health’ in Arts & Health: An International Journal for Research, Policy and Practice, 4(2), 97-108);
- Then critically and productively engaged with the arts-based evaluation methodology ideas of Prof Brendan McCormack, Director of Nursing Research at University of Ulster, who in seeking an ‘authentic dissertation’ defies every other research methodological paradigm by placing arts processes and creative expression itself in the centre of data generation, analysis and reporting (accepting a position eternally in the methodological ‘edgelands’, where evaluators might for example dance their findings); his ‘Critical Creativity’ framework, developed with collaborator Prof Angie Titchen, seeks to use the languages of creativity and creative processes to explore and describe the value of arts to health and flourishing. A related exploration using a different framework and appreciation of the links between arts processes and processes of change is currently being piloted by CMH partner arts organisation Pioneer Projects in Bentham using a system known as DOT (‘Discovery Outcomes Tool’), developed by Ali Clough… a synchronicity in ideas which may bear some linking and exchange of perspectives;
- Then absorbed in the 20 year journey of consultant with Arts & Health Foundation, Australia Helen Zigmond’s pioneering work with the programme Creative Well, using story, puppets and drama with critically ill children; resisting throughout, like so many other artists now working in the field, the ‘therapeutic’ label for the work, and the associated ‘symptoms-based’, medicalised framing of patients in hospital settings as ‘cases’ and ‘case histories’, in favour of a positive, normalising perspective of patients as people with stories to tell and dreams to explore, and seeing arts and health work as normalising and re-humanising;
- And finally, chiming with the ideas of anthropology compadre Dr Jonathan Skinner, senior lecturer in social anthropology, Belfast Queen’s University, whose current research is investigating an anthropological perspective on creativity, through the medium of dance in health settings. His questions focus on the identity and roles of practitioners, how and where their creativity arises, whether through the situation, or as a specific contribution originating in the individual artist, and acting as creative catalyst within the situation. Interesting stuff.
There was so much to take from this 3-day encounter, particularly the individual discussions in-between presentations with practitioners and thinkers who were open to reflecting discursively on their approaches and their experiences. I wish I could have bottled the atmosphere, and brought it back to continue the dialogue – which of course many of us will be doing independently via email and other media.
For me there was an optimistic ending to the proceedings when, provoked by my own restlessness at the persistent focus within the arts and health sector on outcomes and stories of success, at the expense of perhaps deeper analysis and reflective discussion, I was driven to challenge the conference and the sector: I suggested that the time has come to move into the perhaps more conflicted territory of seeking to understand, analyse and communicate a coherent arts and health methodology – the actual processes and mechanisms by which the work is perceived to achieve positive outcomes; lest the message of ‘value’ become, as Christine Putland (2008) puts it: ‘Lost in translation’. The responses to this provocation from delegates in the closing plenary were in agreement that the sector is ready and willing to take on this challenge, and that this is the next step. Thanks Arts Care, and… Bring it on!
Putland, C. (2008). Lost in translation. Journal of Health Psychology, 13(2), 265–276.