People in distress often find it difficult to interact; such difficulties are often amplified by the range of ‘conditions’ individuals in distress are said to suffer from. For Eddie, it was the case that his high functioning autism spectrum disorder contributed to his difficulty to understand other people, and indeed for other people to understand him. Symptomatic to such situations is the overt avoidance of personal and physical contact with others.17 Whilst this potentially acts as a logical unconscious defence mechanism, or cognitive coping mechanism, the result of such situations is an increase in isolation, potentially resulting in the intensification of mental distress symptoms.18 And so the cycle continues and often spirals downwards to the final situation in which a person is socially withdrawn and arrives at Eddie’s position. But as we witnessed in the section above, there are spaces in which people can leave their identity as ‘patient’ behind and go and have fun with a group of people they probably don’t know or would be likely to meet in their everyday lives. This place not only enables that, but it also appears to offer individuals the chance to overcome what could be seen as ‘symptoms’ of their ‘condition’.
For example, as Christina observes in her Canadian group, ‘I’ll look at attention to be able to sit in the seat, sit beside someone that perhaps would have been very uncomfortable because of some sort of trauma you know and girls sitting beside a guy there’s a lot of that kind of stuff, the whole sensory need learning to relax, listen to each other, that sort of thing so I mean we are able to, it’s quite lovely when we can pull that together.’ Bruce makes similar observations in Canada with regard to the individual attending the group that have autism. He comments how, like we have seen with Eddie throughout this chapter, people with autism often struggle with noise, personal space and social interaction. However, with the group in Canada, around 40 are all in a room at once, often learning a song or talking in-between songs. This situation would therefore appear very uncomfortable and potentially very threatening to many autistic people, but as they are specifically there to engage in a shared goal (see section above), and to sing as part of a group, this potentially difficult situation actually acts as a method to help the individual overcome this element of distress. As Bruce comments, ‘there’s a lot of noise so autistic people that are able to tolerate closeness and loudness a lot better as a result of being in the group’.
For people who experience both psychological and physical symptoms, the groups can offer something really unique. The motor and learning skills the singing groups implicitly enhance can have a real effect on an individual’s physical ability. Whilst there are of course currently rehabilitation clinics which utilise expertise to enhance someone’s physical/motor abilities, the difference with the singing group is that there isn’t the explicit focus on improving these abilities and thus there isn’t the associated pressure. Rather as Christina (Surrey Place Centre) comments, ‘We have people also who are not ambulatory so you, one person, pretty affected in a wheelchair, speech is actually quite affected but he loves to sing even though he, he had trouble forming words at all and he’s sometimes delayed but between everyone else ironically he is probably one of the smarter of the group so there’s that you know carried out like misconceptions so he’s actually really into opera he keeps wanting to sing opera with us.’
Much research has focused on the links between social isolation and pathologised conditions such as depression and anxiety. But trying to get individuals who are often very anxious about social situations to socialise in order to help combat some of their distress is very difficult, and at times very problematic.19 However, within the UK singing groups, the effects on people’s experiences of being diagnosed with depression, and experiences of happiness, are clear to see:
From the first evening when I went home with a big grin I have been really enjoying it. I have been quite down and the choir has been part of my recovery (Participant from focus group)
In the last 12 months I’ve been juggling with medication and I am now on a full dose of medication. It’s the first time I’ve been up to that level. So my mental health has definitely improved since I’ve been singing in the choir but how much is because of the medication and... I think it’s probably some and some. I’m definitely in a better place than I was in March before the choir started (Jayne)
I had a nervous breakdown in 1996 and when I was well enough I went to a singing and movement group. It was lovely (it offers you) the chance to sing, to move, to relax. It cheers people up it makes people smile (Darren) You feel a lot better by being in the groups. You’re so busy thinking about the songs that any other problems you’ve got you forget about (Luke)
I have been less stressed and singing helps ... I love hearing the sound we all make, when we are singing I don’t think about anything else, I just think about the singing (Francesca)
Unlike the group in Canada, these individuals in the UK were not in a formal mental health intervention/treatment system; rather the groups were community based and run for anyone. Yet as these individuals clearly articulate, singing groups offered a significant improvement to how they perceived their mental well-being.