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[1]
Philosophy, Art, Therapy
Volume 1
[2]
Special Edition
Therapies: Theory & Practice
Co-editor: Dora Psaltopoulou PhD, MA-CMT
[3]
Part Two/ Μέρος Δεύτερο
Therapies in Theory & Practice
Co-editor Dora Psaltopoulou
Opening Notes to the English Special Edition Dora Psaltopoulou 5
i The Concept of Therapy in Ancient Greek Texts and Dance Practices Anna Lazou 7
ii Aesthetics & Therapeutic Practices Anna Lazou-Ioanna Mastora 25
iii Die „grosse Vernunft“ des Leibes und das Über-sich-hinaus-Schaffen. Eine Interpretation
zur vierten Rede Zarathustras Nikolaos Loukidelis 33
iv Qu’est-ce qu’on sublime? Sophie de Mijolla-Mellor 43
v Participatory Art in Dialogue with Agricultural and Post-Industrial Land Emilia Bouriti 73
vi Acting Code Christos Prosylis 79
vii Dramatherapy Workshop. A Myth on Modern Fluid Reality. Portraying Elements of the
Odysseus Myth through the Dramatherapy Approach Fofi Trigazi 85
viii Comments on the History of Culture. How did we evolve into this: Sex(es) and Gender(s)?
Vuk Trnavak, Marijana Bojic 87
New Books & Research on Philosophical Anthropology, Art & Medicine Anna Lazou 103
Critical Book Reviews: Atkins, P. (1992) Creation revisited: Chaos, Consciousness
& Nothingness Dimitrios Galanis-Kolintzas 105
Music & Arts Therapies in Healthcare Settings
Selected Articles from the 2019 C.A.I.P.T. Pre-Conference 121-292
Music & Arts Therapies in Healthcare Settings. Presentation of CAIPT Pre-Conference 2019
Dora Psaltopoulou 121
Union and collaboration in the arts therapies Richard Hougham 125
Dramatherapy in Greece Spread-Application-Education Stelios Krasanakis 129
i The Impact of Music on Elderly People Suffering from Depression, Melancholia and/or
Nostalgia Angeliki Chatzimisiou 135
ii Vocal-Development Music Therapy (Vocal-Dev) and early symbolization in adult psychiatric
patients Xanthoula Dakovanou 145
iii Drama and Movement Therapy. The Sesame approach Rosina-Eleni Filippidou 153
iv The essential role of Music Auditory Training for the Rehabilitation of Dyslexia
Argyris V. Karapetsas, Rozi M. Laskaraki, Maria D. Bampou 161
v “The Little Drummer”: A Clinical Case Study Vasiliki Liali, Dora Psaltopoulou,
Makaria Psiliteli, Chrysa Lampropoulou 167
vi Music Family Through the Family /Systemic Approach Olympia Pampoukidou 179
vii The use of voice in healing: Breast cancer and trauma Elena Pasoudi,
Xanthoula Dakovanou, Dora Psaltopoulou, Elsa Stournara 187
viii Music Therapy and Autism: Μoving towards Meaningful Communication.
Vignettes from a Relevant Case Dora Psaltopoulou, Nikoleta Gamagari 197
[4]
ix The therapeutic relationship as a fundamental condition for change in music therapy
Dora Psaltopoulou, Apostolis Laschos 213
x The Contribution of Psychodynamic Music Therapy in Children who have been Sexually
Abused Dora Psaltopoulou, Katerina Mavrodi 223
xi “Dark Sessions” a MUsic therapy clinical intervention for substance abuse rehabilitation
Dora Psaltopoulou, Andreas Asimakopoulos, Alan Turry, Theano Chatzoudi,
Stelios Giouzepas 239
xii Music Therapy: Music at people’s service Krzysztof Stachyra 247
xiii Music Training for Aural Rehabilitation in Children with Cochlear Implants: Current Trends
Dimitra Trouka, Georgios Papadelis 257
xiv The use of Mandala Assessment Research Instrument (MARI ) into Guided Imagery and
Music (GIM) sessions Vasiliki Tsakiridou 267
xv The Effects of Neurodevelopmental Delay in Body Image Perception Through Arts (Painting)
Anastasia Varsamopoulou 277
Members of the Editorial Board 293
[5]
Overture
Philosophy, Arts, Therapies: PATh!
A path toward a human protective life through Philosophy, Arts and Therapies! An
innovative, interdisciplinary and humanistic approach for a life with meaning and
freedom.
Every paper opens a new path for self-awareness, meaningful communication with
significant others, solidarity and creativity as the healthiest approach to human growth.
Philosophy as well as the arts contains the potential for humans to exceed the limits of
physical existence and transcend self so that man rises above mundane needs to reach
elevation. It is when emotional and spiritual transcendence occurs through the innate
healing qualities of philosophy and arts that man can become a man. Moreover, the
fathers of psychoanalysis, humanistic and existential psychotherapies, i.e. Sigmund
Freud, Carl Jung, Jacques Lacan, to mention a few, supported their theories and practice
through philosophical currents and some of them, i.e. Carl Jung, Rollo May etc., derived
profound inspiration from the arts.
Helen, a 19 years old young woman, who suffered from schizophrenia of puberty, said
after three months of a very fruitful, interactive music therapy process, that music therapy
was the third way for her. As she was already on heavy medication and verbal
psychotherapy, she felt that music therapy that helped her most was this third way of
treatment. I couldn’t agree more with her and, as a matter a fact, I would like to outbid by
stating that all creative arts therapies are this third way as they offer the appropriate
ground for non-threatening relationships, sublimation into symbolic realms, playfulness,
creativity and many more interesting ways for self-growth and transcendence.
In this PATh’s Special Edition, several articles on music interventions and creative arts
therapies are selected according to their impact on the participants of the pre-conference
of CAIPT (Creative Arts Interconnection, Paideia-Therapy) under the title Music & Arts
Therapies in Healthcare Settings.
Each paper or opening speech opens new paths for self-discovery, for effective support
and treatment of all kind of pains and wounds of people in need, as well as for evidence
of the wonderful contribution of philosophy and arts at the service of humanity.
Moreover, every paragraph tells a story about the author’s journey in this polyphonic,
multifaced world of the creative arts therapies and therapists.
Since, unfortunately, only music therapy has been academically established at some
Greek universities, I would dare to call this special issue of PATh a pioneering work, as it
opens the path for the official recognition and growth of creative arts therapies in the
academic world of the country.
Dora Psaltopoulou, 2020
[6]
[7]
The Concept of Therapy in Ancient Greek Texts
& Dance Practices
Anna Lazou
Abstract
In the context of the research effort of the Ancient Orchesis Study Group to reconstitute
the philosophical and wider cultural presuppositions that define the ancient Greek dance
culture, from which the Greek-speaking and Roman world was removed, to return with
the Renaissance in a new European context, along with the recognition of the basic
anthropological, on the one hand, aesthetic, on the other hand, criteria and principles of
art and, in particular, of dance expression, we attempt a review of certain concepts like
θεραπεία, κάθαρσις, ἔρως and finally δρᾶμα, χορός & ὄρχησις -which stand for
characteristic phenomena of ancient Greek culture. This article plays the role of an
introduction into the philosophical-historical investigation and understanding of concepts
of intrinsic importance in the question about relating philosophy with art and therapy in
the ancient world.
Key words: Therapy, orchesis, embodiment, poetry, drama, dance, catharsis,
interdisciplinarity, education, ancient Greek culture, eros, Persians, Eumenides,
Aeschylus, Sophocles
Towards an Interdisciplinary Approach of Ancient Greek Culture
In the beginning of human civilization, art and philosophy were incorporated in the
established efforts of therapy & healing of the suffering man. This practically meant that
the ‘therapist’ of the community or tribe used all mental and physical skills available in
combination with every art form that was available (music, painting, and dance in
particular), with its unique intention to ‘cure’. Later, with the progress and increase of
knowledge in human societies, these branches were separated. Philosophy became mainly
a logical search of truth through concepts, art became autonomous with the main goal of
aesthetic pleasure and the healing practices became medicine. We reached the 21st
century AD, to ‘rediscover’ and state once more the ancient bonds that unite philosophy,
art and healing. So, for example, now there are psychoanalytic methods in use of the
creative writing aiming at a psychological kind of therapy, there are also plays conveying
philosophical ideas, which they implement on stage (let us remember here Sartre e.g.),
but there are also trends in the medical community who talk about the need for a more
‘holistic’ approach to therapy, beyond the strict confines of biochemistry and
pharmaceutical medicine. Given our intention to contribute fruitfully and authentically to
a more effective approach of the links between philosophy, art and healing (therapy), all
of us who have contributed to this journal with our research, as members of the same
research community, we strive to bring to the fore the promising ‘wholeness’ and
reconsider the object of our research with a fresh and authentic look.
[8]
In my opinion, the constant and uninterrupted history of the interest for the
understanding, interpretation, and knowledge of all the elements that illuminate the
values and deeds of ancient Greek culture can be explained by the perspective of its
physicality, the uses, and functions of the human body in relation to them. Studying and
understanding this perspective is not limited to access to the literary sources of ancient
writers, even in a wide historical spectrum, but also involves other sciences and methods,
which will be briefly presented as an attempt to found a systematic methodological
approach in this area of research (Lazou, 2019).
1
In this regard, one of the essential tools for the philosophical understanding of the
subject, I consider to be provided by the interdisciplinary or interpretive archaeological
research that focuses on how the art of depicting the body conveys or translates structures
and functions of human society and the era that produces these artistic forms. The method
of interpretive archeology (ΙA) e.g., uses concepts produced by power relations and by the
ways that culture incorporates human activity (agency) and tangible experience. In
contrast to the semantic and linguistic expression of kinetic systems as relations of bodies
in space and by reference to wider environments - abstract systems of continuously
changing relations, ΙA provides physicality with historical depth and perspective of
changes in social life forms, but at the same time watching the solid or static object of the
image, that is preserved as it is, even worn or broken in the excavation soil. We will then
see an application of this interpretive approach to ancient or -even- lost dance
descriptions, with the example of one of the many monuments depicting dance, the
famous Oinochoi of Dipylos (Annibaldis, Vox, 1976; Powell, 1988).
2
To return to the
methods of Interpretive Archeology that considers images and objects as supposed
vehicles of description – ‘translation’ of authentic realities, and how it is applied in the
case of the understanding of the Oinochoi of Dipylos, the interest is transferred from the
epigraphic text to the construction of Oinochoi itself, in its very shape and image. The
working hypothesis here is that in earlier historical eras where these works were
produced, there were simultaneously changing perceptions and practices of the body
associated with the changing forms of life – biocosm or ‘lifeworld’.
3
In a thorough
1
Previous publications focusing on both the theoretical premises as well as practical applications of the
orchesis method of the Athens study group of orchesis, are taken over by Irini Kosma and the author during
the International Colloque of Theatre Translation, in Belo Horizonte, on May, the 30th, 2016 and was
recently published by T. V. Ribeiro Barbosa et a. (edit.), Teatro e traducao de Teatro, Estudos v. 1, Belo
Horizonte Minas Gerais University Publication, 2017. Another version of that paper accompanied by a
demonstration of the teaching technique was presented by Irini Kosma and the author, during the World
Dance Congress of CID on June, the 30th – July, the 2nd, 2016, in Athens, while in June 2018, with Dr.
Ath. Sakellariades, we presented a more advanced form of the research about ὄρχησις during the Ioannina
Symposium, How the Brain Learns, organized by the Medical School and Universities of Ioannina and
Western Greece (Consciousness and Form in Philosophy and the Art of Dance). Cf. Λάζου, 2019.
2
Cf. https://www.archaiologia.gr/wp-content/uploads/2011/06/6-5.pdf
3
Here the term ‘biocosm’ is to be related in reference to the late Jurgen Habermas’ key concept of
‘Lifeworld’ meaning the particular way of understanding human beings within nature and society as arising
from a systematic net of communicative actions. See, mainly, Habermas, J. (1984). The Theory of
Communicative Action, Vol. 1, Heinemann, London; Habermas, J. (1987). The Theory of Communicative
Action, Vol. 2, Polity Press, Cambridge, U.K. Alternatively, the term reminds of the ‘Biocosm Hypothesis’
as the new evolution theory of the cosmic regeneration developed by the philosopher and biologist James
N. Gardner supporting that intelligent life is the ‘architectural’ cause of the Universe. See Gardner, J.
[9]
approach of the archaic Corinthian angiography by Michael Shanks (1995), the work of
the archaeologist is presented as a description of different techniques of depicting the
bodily self, at that time, which should be explicitly correlated with the ideological
structure underneath the dominant technology of power therefore. This technology of
power is always alive in human societies as a struggle with violence, barbarism,
threatening alienation or inferiority and social exclusion, according to interpretations of
anthropologists such as Jean-Pierre Vernant and René Girard and thinkers such as Gilles
Deleuze and Félix Guattari, Michel Foucault, etc., relevant explanations float on an
inaccessible ocean of movements and actions of the human bodies, but also animals, as
well as gods and monsters. While the complexity of the meanings of the movements
remains as high as the complexity of the language codes, it is the power of the object, the
material rescued product, that allows the world of agents to survive through time and
conveys valuable information of their expressive aesthetics to the present. We attempt a
theoretical approach of these concepts as representative but also as phenomena
characteristic of the ancient Greek dancing and therapeutic culture.
Ὄρχησις (‘dancing with song’)
What is orchesis and why is it important for the study of the ancient Greek drama?
Human dancing, which, in ancient Greece represented every kind of movement of the
feet, hands, head or even the eyes, did not constitute a self-contained art. It was combined
with music and the recitation of lyrics, even with an individual or a collective dramatic
action.
Literature and more specifically, poetry, was tightly linked with music and dance, from
the earliest eras of its existence. Greek poetry’s evolution was very much influenced by
the appearance of dance -as the use of the word πους, which means foot, indicates, among
other elements, a part or a metrical unit of a verse. Regarding to this, a fragment of
Libanius, a Greek teacher of rhetoric of the Sophistic school, is frequently cited:
“Dancing is not made complete by songs, rather it is for the sake of dancing that the
songs are worked out”.
4
Recent research
5
about ὄρχησις focuses on the poetic as well as
(2003). Biocosm: The New Scientific Theory of Evolution: Intelligent Life Is the Architect of the Universe,
Inner Ocean Publishing. This is connotation does not connect with my use of the term ‘biocosm’.
4
Lib. Or. 64.88 [(trnsl.) M.E. Molloy, Libanius and the Dancers, Olms-Weidmann, 1996: 86-87]. Cf. Lib.
Or. 64.4-5: a refutation of a lost work by Aelius Aristides, in which the latter might have been engaged as
well as in the discussion about the relationship between the verbal and the kinetic components in
pantomimic dancing and possibly in Greek dance in general. Citation by Anastasia-Erasmia Peponi (2013,
28, note 58).
5
It is well known that ancient Greek dramas combine speech with music and movement, the intention of
that presentation being to show how Orchesis studies might contribute to a deeper understanding of the
ancient dramas. Subsequently, with Irini Kosma we have attempted to highlight how ὄρχησις can stimulate
and enrich the procedure of teaching, dramatizing and translating the Greek dramas by means of a
contemporary body – movement language either on stage or in class. Finally, we have aimed to feature the
contribution of studying ὄρχησις to the evolution of the contemporary dramatic literature and performing
arts. The word ὀρχῆσθαι has a much more extensive sense in the Greek language than the English term to
dance. The term οrchestés (dancer) was regularly used in Greek texts for the pantomimic dancer or actor,
while the Latin term is Pantomimus. Cf. Lucian, De Salt., 67.
[10]
on the philosophical texts of antiquity but also taking into account more principles and
criteria of the interdisciplinary investigations, such as i) religious and cult rituals and
myths, ii) various dance practical skills and dexterities, iii) aesthetic excellence, iv)
social, educational and therapeutic functions of body and dance practices, v) self
knowledge and personal development and vi), the philosophical interpretation of human
dancing activity and other theoretical presuppositions. As the working hypothesis of this
research approach is to be taken the significance of the organic unity of three elements -
spoken word (λόγος), melody (μέλος) and physical movement (κίνησις)- that incorporates
in rhythmic forms of spoken word the primary identity of these three aspects appearing in
the ancient Greek civilization that is expressed both in the forms and the way of life
(athletics, education, politics, medicine, everyday life), as well as in specific artistic
creations (theatre, sculptures, paintings and poetry). Secondarily, philosophical thought
emerges to seal the summit and unprecedented threedimensional identity of ancient
Greek art and culture. The multidimensionality and interdisciplinarity of the orchesis
research may be paradigmatically illustrated by the investigation of ἔρωςas a concept in
ancient literature and a cultural phenomenon.
Ἔρως (‘love, desire’)
The focus on the theme of ἔρως is due to its uniqueness, variety and multidimensional
use in almost all aspects and expressions of the ancient Greek cultural structure, but also
to its timeless dominance - through its transformations in almost all historical periods
until today.
Ἔρως is referred to by the tragic poets as a wise entity or being, but also as a natural
force inherent in every living creature, that continues and explains its attractive
relationship with other beings of the world. On the basis of this main axis of meaning of
the concept, the relationships in which love engenders beings and especially human
beings, acquire many different qualities and particularities that enrich the content of a
complex and largely realistic psychology of the myths that the dramas of tragic poetry
deal with. As well as a series of concepts describing or interpreting human functions and
situations of life (friendship, war, state, education, etc.) ἔρως too occupies a wide range
of texts and interests of the corpus of the ancient Greek literature, presenting both a
philosophical, as well as a cosmological and psychological thematic scope.
If we were to draw a general conclusion as to how dramatic poetry approaches the issue
of έρως, before we see the corresponding subject in epic and lyrical poetry, or in the
platonic dialogues, we could reasonably formulate the view that ἔρωςin our three tragic
poets is a popular theme, both as a constitutive force of the mythical plot, as well as an
anthropomorphic deity explaining the human sufferings being dealt with.
In the famous stasimon of Sophocles’ Antigone, which can be compared to similar
thematic choruses of Medea and Hippolytus by Euripides, there is a climax of gloomy
and negative forces with which tragic poetry connected ἔρως.
6
It is a factor of eras,
6
Ἔρως ἀνίκατε μάχαν, Ἔρως, ὃς ἐν κτήμασι πίπτεις, ὃς ἐν μαλακαῖς παρειαῖς νεάνιδος ἐννυχεύεις, φοιτᾷς
δ᾽ ὑπερπόντιος ἔν τ᾽ ἀγρονόμοις αὐλαῖς· καί σ᾽ οὔτ᾽ ἀθανάτων φύξιμος οὐδεῖς οὔθ᾽ ἁμερίων σέ γι᾽
ἀνθρώπων. ὁ δ᾽ ἔχων μέμηνεν. σὺ καὶ δικαίων ἀδίκους φρένας παρασπᾷς ἐπὶ λώβᾳ σὺ καὶ τόδε νεῖκος
ἀνδρῶν ξύναιμον ἔχεις ταράξας· νικᾷ δ᾽ ἐναργὴς βλεφάρων ἵμερος εὐλέκτρου νύμφας, τῶν μεγάλων
πάρεδρος ἐν ἀρχαῖς θεσμῶν. ἄμαχος γὰρ ἐμπαίζει θεὸς, Ἀφροδίτα. (Sophocles’ Antigone, 441b.C, v. 781-
796).
[11]
tribulations and misfortunes, as dominant in both the realms of immortal gods and mortal
men.
7
A common place among the poets -traditional or artful- concerns the fragility of
the victims of love, as victims of an unpredictable and irresistible attack, while the poetic
icons are complemented by numerous illustrations of similar issues in vases and
sculpture.
Ethics of sexuality is a central theme within the Greek thought - at least concerning the
free males - as a form of relationship expressing the exercise of the individual’s freedom
of power and as an access to truth. The access to truth is characteristic of human nature
and is revealed through man’s relationship with the other human beings and thus the
realization of man’s ability to discover and preserve the connection between ἔρως and
truth.
In philosophical literature ἔρως is identified as the power that tends to integrate and attain
immortality. As a primary attraction, it is a force capable of classifying and giving life to
everything. It forms different steps, from a fine sky to a tangible land, on each level there
being a different form of love. And to get to the essence of love, we must learn how to
climb a ladder starting from beauty; beauty existing in the bodies, souls, in actions, and
the laws of nature, in science and in art, and further on we reach the beautiful as a pure
idea, in the abstract form of beauty, fine and flawless, but which also coincides with what
is good (ἀγαθόν), just (δίκαιον) and truth itself (ἀληθές).
Claude Calame furthermore makes a systematic inquiry into the sexuality of ancient
Greeks and attempts to outline the physiognomy of the power that the Greeks deified
with the name ἔρως.
8
He starts from the physiology of love, he then studies literary
expressions and artistic depictions, and goes on to examine the institutions that support
love, as well as the places where ἔρως exercises its power.
9
The glorification of love,
7
Compare with Sappho (630 – 570 π.Χ.), fr. 130 εις E. Lobel & D. Page (ed.), Poetarum Lesbiorum
Fragmenta, Oxford University Press, Oxford,1955. Cf. «µηδὲ κρεισσόνων θεῶν ἔρως ἄφυκτον ὄµµα
προσδράκοι µε. ἀπόλεµος ὅδε γ᾽ ὁ πόλεµος, ἄπορα πόριµος·» (Aeschylus, Προμηθεύς Δεσμώτης, v. 895 –
904), «Phaedra: τί τοῦθ’ ὃ δὴ λέγουσιν ἀνθρώπους ἐρᾶν; Nurse: ἥδιστον, ὦ παῖ, ταὐτὸν ἀλγεινόν θ’ ἅμα.»
(Euripides, Hippolytus, 428 b.C., v. 347– 8 & 392) and «λεπτός—ἀλλ’ ἐπίφθονος λόγος διελθεῖν, ὡς Ἔρως
σ’ ἠνάγκασε τόξοις ἀφύκτοις τοὐμὸν ἐκσῷσαι δέμας. ἀλλ’ οὐκ ἀκριβῶς αὐτὸ θήσομαι λίαν· ὅπῃ γὰ»
(Euripides, Medea, 438 b.C., v. 530), «ἔρωτες ὑπὲρ μὲν ἄγαν [στρ. ἐλθόντες οὐκ εὐδοξίαν οὐδ’ ἀρετὰν
παρέδωκαν ἀνδράσιν· εἰ δ’ ἅλις ἔλθοι Κύπρις͵ οὐκ ἄλλα θεὸς εὔχαρις οὕτως. μήποτ’ ὦ δέσποιν’͵ ἐπ’ ἐμοὶ
χρυσέων τόξων ἐφείης ἱμέρῳ χρίσασ’ ἄφυκτον οἰστόν. στέργοι δέ με σωφροσύνα͵ [ἀντ. δώρημα κάλλιστον
θεῶν· μηδέ ποτ’ ἀμφιλόγους ὀργὰς ἀκόρεστά τε νείκη θυμὸν ἐκπλήξασ’ ἑτέροις ἐπὶ λέκτροις προσβάλοι
δεινὰ Κύπρις͵ ἀπτολέμους δ’ εὐνὰς σεβίζουσ’ ὀξύφρων κρίνοι λέχη γυναικῶν.» (ibid., v. 627-662).
8
See Calame, Cl. (2013). The Poetics of Eros in Ancient Greece, Princeton University Press: the author in
this recently published study of his, offers a synthetic outlook in the investigation of sexuality using both an
anthropological and a linguistic approach of Eros revealing its functions in initiation rites and celebrations,
educational practices, the Dionysian theater of tragedy and comedy and in real and imagined spatial
settings plus the difference between men and women love practices and rituals.
9
One of Calame’s earlier studies entitled Eros in ancient Greece, published by Metaichmio, Athens, 2006.
This book is related to an earlier article of his, Love in Ancient Greece: Social Figures (Ο έρωτας στην
αρχαία Eλλάδα: κοινωνικά σχήματα), published in Archeology & the Arts, v. 10 on Eros in antiquity and
Byzantium (1984). The author focuses on the theatrical and poetic depictions of love in lyric and epic
poetry. In that earlier article of Claude Calame, love and sexuality had been explicated both as a concept
with a central function in the system of concepts with which ancient society represented its origins and
activity but we see it in practice through the descriptions that ancient Greeks gave to their sexual life, so
that love becomes one of the main foundations of the social relations that these sexual customs and morals
[12]
however, does not only mean depicting love affection but also exploring it by means of
the concept of social practice. Poetry and iconography motivate their recipients to reflect
on the functionality of love by means of the institutions of the city.
Ὄρχησις throws its light on ἔρως in Sophocles’ Antigone
The third stasimon of the third episode of Sophocles’ Antigone, following the dialogue
between Creon and Haimon, praises love, the driving force in everything, in the tragic
context of the opposition between the customary law and the laws of the city. This
vicarious anthem begins with a definition of love. Initially, the predominant concept,
έρως, is presented and then it is analyzed. The choral system chosen by the poet is
strophe and antistrophe. In the strophe, love emerges as a creative force for life (verse
781-790), while the antistrophe is related to the plot itself, so, there is an evolution from
the general to the particular. In fact, the features of the personified winged deity are
outlined and its omnipotence and dominance in the terrestrial and heavenly world are
emphasized. The extent of έρως’ dominance coincides with the intensity in which έρως’
acts are expressed through verbs indicating movements (πίπτεις, φοιτᾷς, μέμηνεν,
παρασπᾷς, νικᾷ, ἐμπαίζει) and epithets (ἀνίκατε, ἀγρονόμοις, ἀθανάτων, ἁμερίων,
εὐλέκτρου, ἄμαχος) identifying images that signify the irresistible nature of love. The ode
starts with the word ἔρως, which is repeated in the same position of the next verse and
ends with the invocation of the name of Aphrodite (θεὸς, Ἀφροδίτα). The chorus
attributes the characteristics of the personified deity: a) it is invincible in the battle,
therefore allpowerful, b) ‘fills’ the creation with its momentum, c) overnights on the
tender cheeks of the maidens, d) ‘travels’ around in the sea and in the fields, e) captures
without distinction mortals and immortals, f) fools anyone who gets caught by ἔρως.
The culmination of ἔρως’ essence, i.e. madness to which ἔρως (δ᾽ ἔχων μέμηνεν) leads to,
has as a reasonable consequence the antistrophe, that follows. In particular, it is
emphasized that: a) ἔρως ‘vanquishes’ (φρένας παρασπᾷς) the mind of the righteous, b)
has brought the dispute (νεῖκος) between father and son to the royal family, γ) ‘the desire
on the eyelids of the beautiful bride’ (βλεφάρων ἵμερος εὐλέκτρου νύμφας) wins over
(νικᾷ) and love presiding together with the major institutions (pudency - αἰδώς, justice -
δίκη, νέμεσις), goes beyond the power of the natural and the moral laws that regulate the
order of the universe. Ἔρως, under the auspices of the playful goddess Aphrodite, has a
superhuman impact and an irresistible power. Following the escalation of the
determinations of its essence, ἔρως moves to a transition from tenderness and lightness to
cruelty and reverence. Love leads to madness, surpassing the power of the natural and
moral laws that regulate the order of the universe, having a catastrophic impact. It is even
mentioned in the desperate father-son confrontation and in the erotic madness inspired by
Aphrodite. With a unique stability in the use of verbal terms and references, one might
claim, this chant retains its inwardness and depth of philosophical meaning, while
establish with their polymorphy. The author examines the centrality of sexuality in explanations of ancient
Greek society in analogy with the socio-anthropological analysis of forms of power in societies like in the
work of Maurice Godelier about the Papua tribes of the New Guinea Highlands (The Making of Great Men:
Male Domination and Power among the New Guinea Baruya, Cambridge Studies in Social and Cultural
Anthropology, CUP, 1986). See Cl. Calame, Ο έρωτας στην αρχαία Eλλάδα: κοινωνικά σχήματα, ibid.
[13]
dancing with a rhythmical series of steps and gestures that indicate this content, follows
as a logical consequence of the very idea of its poetic structure and the actual meaning of
the words.
Investigating the way of life, the texts and sculptures of the ancient Greeks, we realize
that it is inconceivable to interpret dramas and tragic poetry leaving aside expressive
movements or some kind of bodily expression but with a static engagement of speech
only. Having solely read the text, we feel the vibrations that are reproduced by it and lead
to the undisputed conclusion that the chorus is moving and even dancing as there is no
other way to express these concepts. Thus, we conclude that the essence of its meaning
lies in the somatization of speech, by ‘dancing’ and ‘singing’ the words and syllables.
Through the reconstruction of a bodily meaningful whole consisting of steps and
gestures, while being a kind of dance that belongs to the contemporary era, specifies and
illuminates at the same time the actual functions of dancing and chanting as a
diachronically meaningful human activity with both therapeutic applications and artistic
values (combining beauty with creativity). But this effort is mainly and basically
interdisciplinary, it is a way of connecting or ‘translating’ theory into practice and vice
versa, or even ‘reading’ with the body, and its language those procedures and forms of
understanding that concern the mind and its conscious elaborations of reality. What is
important in this experiment of revival is to learn how to connect and critically reconsider
the established knowledge of the past and expressing this new conjunction with a
beautiful series of meaningful movements.
As archaic painters insist on the repeatability and order of the depicted, imposing an
organic regularity on the forms, their society also insisted on the emergence of structured,
subtle actions, thus imposing a steady group of correlations that encapsulate and
inactivate conflicts and threatening contrasts. A similar tactic of opposing forces can be
seen in the structure of ancient choruses as metrical poetic rhythmical forms. If today, for
example, we want to represent one of these choruses, we must move from the ‘body’ of
the text to the ‘body’ of concepts and the human subjects that inspired or created them;
ultimately, of course, to the systems of these subjects’ relations. In our own tangible
representation, we will set the boundaries and rules of new relationships and
interpretations that concern us.
By reference - among many examples - to the example of a sociological interpretation of
a subject, such as the erotic behavior of a past civilization, a theme that literally involves
the ‘ancient body’, I try to show the multidisciplinary and interdisciplinary nature of the
study, from which valuable information can be obtained allowing for a comprehensive
training on the issues involving the human body with its physicality and beyond the
textual philological -historical- linguistic approach. In addition, how poetry and vase
representations or sculpture depicted the human body, alongside with how the
philosophical reflection spoke of it, contribute to one thing: to provide valuable material
to the socio-historical understanding of the meaning and use of the body.
10
10
Such as it is also exacerbated by the three volumes of a study by Michel Feher et al., compared with the
work of Jonathan Crary and Sanford Kwinter: Feher, M. et al. (1989). Fragments for a History of the
Human Body (3 vols), New York (NY), Zonar; Crary, J. & Kwinter, S. (eds.), (1992). Incorporations, New
York (NY), Zonar.
[14]
The visual images of the depicted bodies refer to relationships and imply moral, political
relations - sociology insists on relations of power and the dynamic imposition of a system
of relations on another: complexes of actions and tools, choices and technical
possibilities, personal motives and environments - frameworks, concepts and perceptions
of the self and the body, which are therefore suited to the indicated interests and
objectives.
Interdisciplinary Research and the Cooperative Practices of Art & Philosophy
At this point I would like to refer in an introductory way to certain theoretical
presuppositions supporting those collective efforts in arts and humanities that I propose
with my approach.
11
We suppose that in the various instances of cooperative relationships that compose the
web of such social designs, as in the artist-creation relationship, therapist and patient or
philosopher and student etc., there is a specific connection of normative or ethical
parameters that can be diagnosed and which determine the special quality and
psychological content to these (John-Steiner, 2000; Lazou, 2016, 38). According to such
a point of view the common characteristics allowing for a methodological convergence of
these areas derive from their cooperative and dialectical nature. Recent literature
following this line of approach also shows the influence of sociopsychology of Lev
Vygotsky
12
in theater in education (Davis, Ferholt, Grainger Clemson, Jansson,
Marjanovic-Shane, 2015), while its most specific therapeutic model is the theater of the
oppressed by Augusto Boal (Boal, 1995). Litterally, in The Psychology of Art (Vygotsky,
1971 [1925]) and during his early phase of the exploration of consciousness under a
cultural-historical perspective –characterized now as yet unexplored though- Vygotsky
attempts to reconcile the marxist approach to the human being with recent behavioral
trends in the Soviet scientific psychology (Pavlov, Bekhterev). Similar applications
deriving from these theories can be seen in the field of children education (Kontopodis,
Wulf, Fichtner, 2011).
In the philosophical-psychological premises of these studies we find a non-cartesian
explication of the self, which attributes particular priority to the human subject, socially
selfidentified and places the tangible existence of people at the center of events and
phenomena under investigation. Such theories (in which we compile the literary criticism
of Mikhail Bakhtin, the anthropolinguistics of George Lakoff and Mark Johnson and
Antonio Damasio’s Neuroscience) focus on the relation between mind and language and
develop through socio-psychology the idea of the collective identity of the self.
13
Concluding this introductory note, within the limits of my article, we owe a special
mention to Ludwig Wittgenstein, as the philosopher who, although belonging to the
11
These ideas have been already stated in 2016, in my article in Greek for the collective volume Lazou, A.-
Patios, G. (eds.), Art, Philosophy, Therapy, vol. A΄ (Lazou, 2016: 117-162).
12
Recently (Jornet & Cole, 2018, Leontyev, [1979] 1997) the philosophical inspiration to the whole of
Vygotsky’s thinking development –from his early phase up to the end of his life- through Spinoza’s theory
of emotions as he refers to Spinoza as early as in his doctoral thesis, The Psychology of Art.
13
John-Steiner, 2000, 124. A respectable number of young scholars of education follow this direction
today, which Blunden places historically and philosophically, as we have seen, in the german-idealistic
romantic roots of Marxism.
[15]
tradition of analytical thought, distances himself from the philosophy that attempts to
extract the meaning of words from the logical context of propositions and, on the
contrary, considers the meaning of a word as revealed through the explanation or
description of the way in which the word operates and is performed within a language
game, that is, in the social context of an act and its appropriate rules.
Moreover I would like to point to the interdisciplinary and holistic approach as necessary
for the understanding of concepts like catharsis, mimesis, orchesis and drama as well as
their function. According to Andy Blunden, the unified concept of human activity
(Activity/Tätigkeit),
14
arising from the combination of hegelian social philosophy, the
marxist analysis of social phenomena and Vygotsky/Leontiev’s social psychology
(Blunden, 2010a, 14),
15
allows the application of an interdisciplinary field of research and
explanation of all cultural products -art, science and philosophy, all theoretical-practical
forms of expression, outside the hermeneutic vicious circle. Vygotsky, in Blunden’s
outlook, believes and emphasizes that everyday concepts can be true because they
represent different institutions of the social structure - art, religion, economics, politics,
science, philosophy- demonstrating the intersection of different and multiple
universalities of understanding, in the experience of life (Vygotsky, 1987, 285 [Cited by
Blunden, ibid], Blunden, ibid, 162). The concept of understanding, as used here, is to be
considered as different from the hermeneutic cyclicality,
16
when in fact the interpreter-
reader encounters texts of different historical origin or different cultural traditions,
although, for Blunden, and for us, the essence of understanding lies in the relation of the
elements to each other, in their sharing of a common meaning.
I believe that the above constitute a systematic theoretical premise guiding our study of
how to approach concepts like catharsis, orchesis and drama and relevant phenomena of
ancient art and therapeutic practices. More particularly these concepts are to be connected
with their social and historical background in parallel with their philological and textual
appearance, in order to be fully illustrated and successfully used in artistic, educational
and/or therapeutic expeditions.
Experiential Examples
I am going to list moments - or situations – out of my personal experience, where art and
philosophy were interacting in order to illustrate their impact in educational practice with
14
Blunden attempts a synthesis of concepts derived from the hegelian ethics in terms of Tätigkeit that
draws from Goethe and suggests a process of externalization of the subjective spiritual world, through
practical work. In his comments on the Phenomenology of Spirit by Hegel, mentions that “ubrigens ist mir
alles verhasst, was mich bloss belehrt, ohne meine Tätigkeit zu vermehren oder unmittelbar zu beleben
[Goethe to Schiller, December 19, 1798]).” (Cf. The Origins of Cultural Historical Activity Theory,
[Blunden, 2010c: http://home.mira.net/ ~andy/works/originschat.htm; Blunden, 2009, et al.])
15
Influenced by Georgi Plechanov, Lev Vygotsky in the Russian Pre-Revolution years was involved in the
controversies of Symbolists, Formalists, Futurists and Domists, while he turns his attention to issues of
interpretation and semiology in his work Psychology of Art. Andy Blunden supports that in this work
Vygotsky does not seem to have been so influenced by Hegel as much as by Plechanov (Blunden, 2010,
122).
16
Where the cyclicality of the interpretive act of ancient languages is determined, between whole and part
and vice versa (Gadamer, [1960] 2005, 291-293. Quoted by Blunden, ibid., 186). Cf. Gadamer, H.-G.
2005 [1960]. Truth & Method, Continuum, New York, NY.
[16]
emphasis on the therapeutic key role of their combinatory presence. These experiences
may be classified according to two different ways -or paths- that art and philosophy can
be interconnected: a) The first path -how to understand and approach art through
philosophy, along with other issues vital to human life, has become a popular and
widespread issue in the history of ideas and recent aesthetics. The timeless interests of
philosophy to define art and some related phenomena of the human culture prove the
practicality and applicability of philosophy through art - and specifically the art of theater
- in everyday life (Pelegrinis, 2002; 2008). b) The reverse path -how to enrich, shape or
transform philosophy through art, whether investigation of the classical philosophical
questions can be illuminated and even transformed by applying art in teaching, is a recent
and still open question for examination. In this respect our examples constitute a rather
original experiential material, based on which our theoretical documentation attempts to
establish conditions of systematic negotiation.
i Aeschylus’ Persians
As a starting point of my practical experimentation and reflection on art, philosophy and
therapy,
17
I consider Aeschylus’s Persians, a performance by Mirka Gementzakis and a
Symposium at the University of Gävle, in Sweden (1988), when I presented for the first
time the discussion about the so-called body-mind problem and tried to recognize in the
actor’s relationship with the body a model for solving the well-known philosophical
problem. Then, I was given the opportunity to study the relevant presocratic notions of
body-mind (soul/ψυχή) identity imprinted in Aeschylus’ poetry and thus connect the
dramatic figure of Xerxes, as one example - from the field of drama- nevertheless, of the
inseparable bodily-mental whole, which is justified by the theatrical depiction of the
hero’s mental illness by Aeschylus’ poetic metaphors; I later analyzed further the
hypothesis of considering the actor on stage as a paradigmatic instance of human nature
as an integral whole, in opposition to the newer positivistic divisive approach (Lazou,
2009).
In our example, of the stage action of the tragic actor, we find with him ideally, the
material for such findings: If the psychological states, our linguistic structures describing
mental events (mental attitudes or intentional states) ‘resist’ the explanatory power of the
language of natural science (naturalized epistemology) and whether the modern
conceptual schemes adopted by the actor and the spectator necessarily presupposes the
use of a natural language and the physical scenery practice, then only with reference to
natural facts and terms can the actor understand and represent the mental state of the
tragic hero.
17
My examples are drawn from four areas of experiential activity, which span over a period of about three
decades: from the creation and coordination of the Theatrical Initiative of Youth Drys within the Cultural
Student Group of the University of Athens (1991-2008), the activities of research and art of in Athens
School of Philosophy DRYOS TOPOI (2004 – until today), the organization of the self-financed University
Festival ECO-STUDENT FORUM at the University of Athens (2011-2013) and from a series of
international experiential workshops for life learning and non-formal education in collaboration with many
different institutions (2007 - present).
[17]
The actor who is expected to incorporate the dramatic persona of Xerxes in Aeschylus’
Persians (normally a male actor), attempts to understand the text, the instructions and
perceptions of the director, transform these perceptions into an action understandable
respectively to the audience. The actor is worried about ‘how to play’ Xerxes and his
psychic disease, observes the way that the poet describes the behavior and supposed
mental state of the dramatic -at the same time- historical personality.
In the process of working with the text, one perceives that understanding the term
‘φρένες’ in the literary context of its use alone is not enough for the theatrical act of
representing a mad hero, as Xerxes appears in the play; further reference to specific facts
and events is required that concern neurophysiology and physical anatomy, the actual
physical structure of the human body that is the actor’s tool of artistic representation.
The use of the term ‘φρένες’ and the homonymous as well as synonymous words and
phrases in the text of the Persians indicate moreover the metaphorical denotation of
mental states and specifically the mental pain and passion of the hero referring to
particular physical events and body metaphors:
- 749-750: θνητὸς ὢν θεῶν τε πάντων ᾤετ᾽, οὐκ εὐβουλίᾳ,
καὶ Ποσειδῶνος κρατήσειν· πῶς τάδ᾽ οὐ νόσος φρενῶν
εἶχε παῖδ᾽ ἐμόν;
- 765: Μῆδος γὰρ ἦν ὁ πρῶτος ἡγεμὼν στρατοῦ·
ἄλλος δ᾽ ἐκείνου παῖς τόδ᾽ ἔργον ἤνυσεν·
φρένες γὰρ αὐτοῦ θυμὸν ᾠακοστρόφουν.
- 845: ΒΑ. ὦ δαῖμον, ὥς με πόλλ᾽ ἐσέρχεται κακῶν
ἄλγη, μάλιστα δ᾽ ἥδε συμφορὰ δάκνει,
ἀτιμίαν γε παιδὸς ἀμφὶ σώματι
ἐσθημάτων κλύουσαν, ἥ νιν ἀμπέχει.
- 991: ΞΕ. ἴυγγά μοι δῆτ᾽ [ἀντ. γ.]
ἀγαθῶν ἑτάρων ὑπορίνεις,
‹ἄλαστ᾽› ἄλαστα στυγνὰ πρόκακα λέγων.
βοᾷ βοᾷ ‹μοι› μελέων ἔντοσθεν ἦτορ.
The literary analysis and interpretation of the theatrical text ‘feeds’ the actor with certain
tools for a deeper understanding of the material related to the role. The focus is on
working with the terms appearing in the text and the variant meanings that indicate
different ‘ways’ of understanding the intentions of the poet in relation to the historical
data of certain linguistic uses of the period that the text had been created.
Dealing with language descriptions as well as working out how to render with the
physical/bodily acts, at the same time the actor deals with various conceptual forms (the
actor’s, the director’s, the poet’s, the spectator’s, the scientist’s, etc.); as to how f.e. to
understand, describe and finally represent -rather than imitate- Xerxes’ ‘mental illness’
(‘νόσος φρενῶν’) in a persuasive way on stage (Lazou, 2009).
ii Eumenides
The second example of the therapeutic uses of drama refers to Aeschylus’ Eumenides on
the occasion of my participation to the stage production of this drama by the Orchesis
[18]
Study Group of Dora Stratou Theatre, in 2012-13 in Athens. In tragedy, ‘therapy’ as
restoration of the disturbed balance with a consequent painful process of purification
takes place first within the limits of family relations and then extends to the limits of the
city. In order to understand further the political message of this specific Aeschylus’
tragedy, we should start from invetigating the house-city relationship it narrates. This
therapeutic -in the above sense- process is remodeled in an exemplary way in Eumenides.
If, following the literature on the subject, we assume that Oresteia is a political project
that historically coincides with the emergence of cities as a result of previous struggles
mainly about -among others- the issue of justice, then a reasonable conclusion would be
that the moral-philosophical ideas and the conflicts among the human persons, they
imply, are presupposed and have explanatory significance as to the actions of the heroes
and their choices in the mythical plot. These are the deepest ideas that constitute the truth
about human reality that are channeled through the poetic text, into the action of the
heroes, but above all into the masterful operation of the 12-member group of Aeschylus’
chorus. The chorus represents thoughts and feelings, conveying knowledge and
information and mediating between the ‘world’ of the people attending (audience of the
citizens) and the ‘world’ of myth and heroes (the actors and dancers in the orchestra).
Eumenides is a drama of transformation; we may recognize in the fear caused by Erinyes
to Orestes, and then in the transgressors of the primordial institutions of law, a trick
aimed at reaching a consensus between rival forces that appear as adversaries in a court
founded and organized by a deity, Athena. It is the reconciliation between adversary
powers in society that finally balance and cure the tragic pathos of revenge and violence.
Throughout the evolution of the tragic myth, with the aim of purification at the end, it is
revealed how the good, light and balance derive from the profane, impure and terrible.
Thus, from this transformation that takes place in the context of the Eumenides, it is
knowledge and truth being produced by a process of dark rivalry.
What should be further emphasized in relation to the therapeutic and educational
functional role of drama especially in the case of Eumenides, is the priority of the system,
the whole (laws, choral group actions, institutions and traditions, the city), over the
individual act or the individual character. The grid -or flow- of events, according to
which the stage actions of the hero (Orestes), trying to bring about a dramatic situation in
consistence with the tragic ethos and poetic intellect, in order to test their correctness and
efficiency, develop here with the purpose of highlighting the moral lesson coming out of
the disastrous consequences of human mistakes. In Eumenides -this grid is not composed
of the actions and commands of gods (Apollo-Athena), who intervene occasionally in the
plot, but from the dominant throughout the play action of the chorus -as Erinyes being
transformed to Eumenides- while the main hero, Orestes, is finally forced to accept as
inevitable the logic of tragic ethos, rationalizing the irrational, understanding the
supernatural and ultimately paying the price with his own body, with pain and
punishment.
[19]
Conclusions about the Therapeutic Uses of the Tragic Chorus
in Aescylus’ Persians & Eumenides
In archaic Greece, where Aeschylus
18
was born, everything that is at stake around
people’s lives is closely linked to the demand for the moral unity that the institution of
the family and the solidarity and interdependence of its members ensure. Hence the idea
of hereditary guilt and transferable punishment, a common feature of early civilizations,
composes the context of actions and poetic compositions of both dramas. Thus we see
evil starting from the act of the ancestor and darkening the mind of the son and his
grandson. The vengeful spirit leads the victim to the criminal act. Even the evil spirit of
the house, Alastor, contributes to this.
The afterlife for the soul, however, which was imagined by the theologians and the
interest in the fate of the dead after death are not found in his works. For him everything
is fulfilled in this world.
There is faith in justice and the power of souls, as well as in the world of demons and
their action. They are the forces of evil that always act and influence the judgment and
actions of man. Surely Aeschylus is difficult to convince us that he reconciles the guilt of
the perpetrator with the imposition of his unjust act by a higher power. On the one hand
he accepted the action of the demons and on the other in his choruses he interprets the
world of his heroes in a higher way, invoking the existence of a rational justice, a harsh
moral law represented by the action of gods. Certainly, in his time a progress was made.
Arbitrary divine powers were replaced by the idea of secular Justice, but this was linked
to the existing primitive conception of the family and thus a new social ethic was not yet
established. Only later, under the influence of Greek rationalism, did the weight of
religious sentiment diminish and the religious law change, giving the individual the
opportunity for personal responsibility and personal rights.
Aeschylus lived in the world of faith in the demons but tried to give them a higher
interpretation as we see in Eumenides and to show through Athena how the world can be
transformed into a new world of rational justice. The other two poets, Sophocles, and
Euripides, being ‘children’ of another era, challenged the existence of older beliefs
through logical and moral arguments. Ancient family conflicts that constitute –more or
less- the ground of the transformative procedure from hybris to rehabilitation, liberation
and therapy of the hero among the gods and the chorus (as the collective action of the
many) in Aeschylus’ dramas, become less important than the rights of the individual and
the independent of the family circle circumstances, for both Sophocles and Euripides.
The heroes of Aeschylus are guilty of a primordial crime (Xerxes, Orestes) but many of
the Sophocles and Euripides’ heroes (Antigone, Oedipus, Alcestis or Hippolytus) are
genuinely innocent, and their misery is brought to them by divine plans or their enemies
in society. The Aeschylian setting of the transformation is more drastically ‘therapeutic’
placing mental disease or revengeful passion at the center of the procedure. It is not about
18
Aeschylus was born in 525 BC. in Eleusis and is mentioned as a follower of Pythagoras and with
possible participation in the Eleusinian mysteries.
[20]
a rational choice in moral action that saves or liberates the hero’s soul which would show
a direct influence of the philosophical doctrines that later dominated but poetry itself with
its spiritual activity and imitative power to cure the wounded consciousness of the hero,
that prevails in Aeschylus, in contrast to the rationality of the next centuries with the
subsequent degradation of the great drama. Religion and cult practices invoking those
traditional myths known and perhaps unpredictedly established in popular consciousness
with a high pedagogical role embedded in them and had only to be transformed into
Aeschylus’ dramatic techniques with a unique indeed poetic skill so that would help
people connect the old with the newer perceptions and to some extent reconcile it. The
‘newer’ beliefs concerned philosophical inquiry as the cornerstone of the interpretive
approach to life and were manifested in the Platonic world affecting the evolution of
theatre somehow dissolving its older therapeutic functions.
Aeschylus’ dramas introduce on the hand, a strong relationship between justice and
medical healing; this allows us to recall the relevant medical metaphors of Aristotle in the
discussion of problems of politics and ethics, as to music and theatre (tragedy). Mainly
based on the Aristotelian notions of equality, freedom and justice, measure or mediation,
we may start understanding the very notion of therapy as an ongoing process of balancing
and restoring the social and physical conflicts of individuals and social groups (Λάζου,
2000).
Further Therapeutic Applications of the Dancing Revival of Antiquity
Which is therefore the core of the therapeutic function of tragedy and Greek drama
according to modern philosophical approaches and theories? Our work hypothesis directs
us to the investigation of dance as a constitutive element of Greek drama and wider
cultural heritage. Apollonian rationality and Dionysian ekstasis - as aspects of the same
primordial human condition - function in a complementary way by the alternation of
order and discipline with expressiveness and ecstatic freedom. Indeed, in dance, man acts
both as a unit and as part of a collective entity, despite the pain and suffering involved in
the effort of integration of the opposed aspects -partial / totality- which means nothing
else but the pain of life. Only in dance one can seek solace for this conflict situation. The
role and functions of dance –in the chorus schemata are representative examples of the
‘healing’ process of the tragic drama.
Dionysian elements of dance–more particularly- are therapeutic both because of the
psychological and its biological functions and influences, as well as for its socio-political
dimensions. We discover the healing power of dance in the views attributed to ancient
Greek writers up to the early antiquity, in parallel with the historical -social, educational,
and political- uses of dance during this period (Homer, Plato, Aristotle, Xenophon,
Plotinus, Athenaeus, Lucian, Plutarch, Nonnus and Libanius). The fact that the dances
were of religious nature and had social functions (therapeutic, political, and educational),
or philosophical connotations, may be regarded as an essential element of their meaning
and not as a restriction in applying a universal system of concepts in dance interpretation
(References to Friedrich Nietzsche, James Miller, Evangelos Moutsopoulos eta.).
19
19
Λάζου, 2015; Lazou, 2006.
[21]
To move on to the issue of dance and the way we are called today to understand it, as a
vehicle for overcoming fear following the example of Eumenides, we will refer to
Friedrich Nietzsche’s philosophy of tragedy: Nietzsche insists on the central role of the
choral performance and its emotional impact on participants. Thanks to his emphasis on
tragedy as a theatrical art and its documentary function, as reflected in the song and the
dance, Nietzsche appears as a forerunner of contemporary trends in the philosophical
critique of tragedy.
The aesthetic-therapeutic uses of modern dance, theater can be examined and
philosophically justified as overcoming the pain of the human condition through the art
of dance -starting with the Nietzschean approach of the Dionysian. This perspective is
mainly found in the Birth of Tragedy, while in Nietzsche’s attitude towards art and its
metaphysical-ontological dimension there are a series of philosophical references to
dance but also to ancient drama and art in general: Through the conception of an
“artistically defined metaphysics” Nietszche of the Birth of Tragedy captures the concept
of man as a means for selfcreation. Thus, man as an artist-creator guarantees to be both
an implementer and a spectator of a process intrinsic and –at the same time- greater than
oneself.
Recently, there is a discussion about revival or –in other words- reconstruction of ancient
tragic choruses and dances with the help of technological and scientific possibilities and
with the purpose of aesthetic crystallization on theatrical stage or in virtual reality, of
relevant research as an attempt to capture linguistically and illustratively, the rhythmic
and musical process that took place far in the past, all the way expressing by means of
movements and gestures, but also with vocal sound, emotions and thoughts of ancient
people. Is this project ‘therapeutic’ of our contemporary world and individual lives? Can
we face the horror of the real state of humanity in contemporary society with the
therapeutic vehicle of tragic dance, reviving in the orchestra or in an educational dance
procedure, so that we lead ourselves towards a new transcendence of the human
negativity? In another sense, following the historical heritage of an Isadora Duncan or an
Eva Palmer of the 20th century, may we recognize in modern dance revival of antiquity
the medical -literally and metaphorically- uses and applications of ancient dance and
drama?
These questions, also taking under consideration the great educational and
philological/linguistic applications of the studies in orchesis and ancient drama, today,
lead to specify the beneficial effects of such studies to the fields of translation and
adaptation of classical dramas, offering more liberties by applying to the suffering,
thinking, liberating –therefore dancing body- of the contemporary man.
The aesthetic directions and criteria in today’s revival of ancient cultural forms can be
given now a moral meaning, ‘therapeutic’ in the broad sense, relevant with the needs of
the modern man and even beyond scientific fidelity. It can be seen as a part of the self-
analytical, self-aware and self-healing of the human being that penetrates into the
collective unconscious in order to dig out the forgotten sources of the vital part of the
soul and remember the everlasting harmony of the dream world of a unifying identity
with the whole. In view of certain contemporary developments in the fields of performing
arts, the identification of the body with its somatosensory sensibility, the discovery of the
semiotic-phenomenological body, the methodological significance of ‘embodiment’ for
[22]
the understanding of ancient art and the liberation of the artist from the unique meaning
and the text-centered interpretation, I propose to ‘move away’ of the idea of the learning
brain and ‘approach’ the idea of the learning dancing body, where the body (sense -
mind) is that entity that thinks and remembers, by playing and representing, speaking,
translating and contemplating.
20
After all, it is good to remember that Sophocles, one of the three ancient Greek tragedians
whose plays have survived, renown as the great innovator of ancient drama, was himself
a poet, dancer and musician of the highest quality, at the same time, a reality that might
use as a justification for attempting an all including orchestic interpretation of the famous
stasimon on Eros– by means of music, words AND dance- as therapy and education of
the people.
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________ (2010b). The Origins of Cultural Historical Activity Theory,
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Boal, A. (1995). The Rainbow of Desire. The Boal Method of Theatre and Therapy,
(trnsl.) A. Jackson, Routledge, London.
Davis, S. eta. (2015), Dramatic Interactions in Education: Vygotskian and Sociocultural
Approaches, Bloomsbury Publishing.
John-Steiner, V. (2000). Creative Collaboration, Oxford University Press, Oxford UK.
Jornet, A., Cole, M. (2018). Introduction to Symposium on Vygotsky and Spinoza. Mind,
Culture, and Activity. 25 (4): 340–345.
Kontopodis, M. eta. (2011). Children, Development and Education: Cultural, Historical,
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Λάζου, Ά. (2000). Θεραπευτική Δικαιοσύνη (Justice as Therapy-Justice for Therapy), Η
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Αριστοτελικών Μελετών «Το Λύκειον» Αθήνα: 285-297.
________ (2009). Ψυχολογικά γεγονότα και σώμα: Η περίπτωση της επί σκηνής δράσης
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Θεατρογραφίες (Theatrographies) 15: 24-33.
20
Cf. modern teaching techniques and experiential forms of education, which can be used for the teaching
of the ancient Greek language – or other languages as well - with the help of ancient Greek dance or other
processes involving the body, apart from the textual approach.
[23]
_______ (2015). Φόβος-εκδίκηση-θεραπεία: μια ανθρωποφιλοσοφική προσέγγιση του
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_______ (2019). Η αθλητική τέχνη της ορχήσεως & η αρχαία σωματικότητα: βίωμα
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[24]
Photos of Orchesis Study Group
& Dryos Topoi Research & Artistic Ensemble Activities
[25]
Aesthetics & Therapeutic Practices
Anna Lazou, Ioanna Mastora
Abstract
The concept of art is not only associated with that of the ‘beautiful’ but can also be used
as an important therapeutic tool. Its significance has been emphasized by eminent ancient
philosophers such as Plato and Plotinus, who pointed out its role in approaching the
divine. However, in modern science, art has also a therapeutic character since its
applications have been compatible with psychology and counseling. This practice has its
roots in ancient Asclepieia, healing temples, where medical treatment was combined with
arts and aesthetics such as theater. Based on the ancient and modern findings of different
humanities, especially philosophical and psychological counseling, experts use practical
and applied ways that enhance the quality of human life (Knapp & Tjeltveit, 2005). In
addition, theoretical and practical knowledge are applied to all age categories, the general
education, and the practice of creative arts.
Key words: arts, medical treatment, healing, philosophy, consulting, Asclepieia
Philosophical and historical review
The beginnings of this approach are initially found in the philosophical thought of
Plotinus,
21
who claims that nature imitates the idea, but art is not only an imitation, but
something also that had been supported by Plato (Plato, Rep., X, 597).
On the contrary, the creation of a thing is based on the inner species that the maker has
within him (Plotinus, Enneades, I, 6, 3, 6-16). Plotinus’ influences originate in Egyptian
mysticism. He argued that art, in addition to mimicking nature that is an imitation
(reflection) of the idea, has the additional property of directly communicating with the
idea, due to the artist’s ability to directly communicate with the idea of divinity. Plotinus
tries to fit the experience of ‘beauty’ into drama of ascent to the first principle of all. In
this respect, Plotinus’ aesthetics is inseparable from his metaphysics, psychology, and
ethics.
22
21
The three basic principles of Plotinus’ metaphysics are called by him ‘the One’ (or, equivalently, ‘the
Good’), Intellect and Soul (see V 1; V 9.). These principles are both ultimate ontological realities and
explanatory principles. Plotinus believed that they were recognized by Plato as such, as well as by the
entire subsequent Platonic.
22
As in the case of virtue, Plotinus recognizes a hierarchy of beauty. But what all types of beauty have in
common is that they consist in form or images of the forms eternally present in intellect (I 6. 2). Stanford
Encyclopedia of Philosophy https://plato.stanford.edu/entries/plotinus/#HumaPsycEthi
[26]
According to the philosopher, not everyone sees the various subjects in the same way,
looking at them with the eyes (the senses), but when one recognizes the imitation of a
real text within the intellect, is led to the memory of truth, from which love derives
(Plotinus, Enneades, II: 9 16, 45-48). In addition, he emphasizes that the imitation that
takes place through the artwork should not be ignored, as otherwise the artist could be
considered as an absolute creator of something that is not in line with his ontological
system (Anton, 1967-1968, 94).
He also introduces the so-called imaginary (imagination), which is not intellectual (i.e. a
product of pure, realistic thinking), but neither sensation (since it is a reason for arousing
emotions and not a sensory stimulus) (Pollit, 1974: 57). It is no coincidence, that both in
ancient times and nowadays, artists are surrounded by a mist of mysticism. According to
Plotinus, people, while still alive, can with ecstasy (the posture that is outside, that is, the
escape outside the material body, therefore also of the material world, that is, the
distorted world, the world of imitation of ideas) leave the body and approach the deity
(absolute truth, that is the ideas according to Plato, in a broader sense). Plotinus narrates a
similar experience, saying that many times I came out of my body inside myself, seeing
all things from the outside (I am not myself) and the wonderful beauty (IV, 8, 1 etc.).
Asclepieion
In the ancient times, people resorted for healing to Asclepieia,
23
where experimental
therapeutic methods were provided, though combined with religious elements. There
were also special buildings and facilities for other uses such as theatrical spaces and
conservatories, baths, stadiums, which contributed to the physical exercise and recreation
of patients (Melfi, 2007). The preliminary treatment for admission into the Asclepieions
was katharsis or purification. It consisted of a series of cleansing baths and purgation,
accompanied by a cleansing diet, which lasted several days.
24
One of the most important monuments is the Asclepieion of Epidaurus, the largest
sanatorium in the ancient world. Many people know Epidaurus only for the ancient
theater but are unaware of the existence of one of the most important monumental
ensembles of Greece. The sanctuary of Asclepius was an organized sanatorium, a medical
center that marked the transition from the ‘theological’ to the real ‘medical’, based on the
diagnosis, the application of appropriate treatment on the guidance and supervision of the
Divine (Stavropoulos, 2000).
Asclepieia spread the medical and surgery science not only in Greece, but also in the
wider Mediterranean region, with the creation of over than 300 subsidiary sanctuaries.
Those spread medical science through therapeutic worship in Attica, the Aegean islands,
Marseilles, in Taranto, Pergamon, Cyrene, in Africa, on the island of Tiberias in Rome
(also known as the island of Asclepius since antiquity). There was a temple dedicated to
Asclepius, nowadays also functioning as a hospital Ospedale San Giovanni Calibita
23
Asklepieion (Ancient Greek Ἀσκληπιεῖον, Asklepieion; Ἀσκλαπιεῖον in Doric dialect; Latin aesculapīum)
healing temples, often located in secluded locations -like the surrounded modern spas- or mountain
sanatoriums.
24
https://en.wikipedia.org/wiki/Asclepeion#cite_note-greekmedicine.net-4
[27]
Fatebenefratelli, where special reference is made to the findings from the ancient
Asclepieion.
The experiential approach of art opens new ‘paths’ in education of all levels and in
lifelong learning (Mastora, 2013 & 2015). It is proven by philosophical knowledge as a
method with excellent results in all phases of the history of civilization - from antiquity to
the present - and with deep roots in the distant past of human history. The excellent
architecture and acoustic theater that we all know was an important aspect of worship and
healing. According to Soranos (2nd cent. AD), those who suffered from nervousness
should watch tragedies and those who suffered from melancholy should watch comedies.
Galen (2nd cent. AD) attributed to Asclepius the instruction that those who had mental
disorders should watch pleasant spectacles and musical events. Some of the patients were
cured at this stage and did not need to undergo the main treatment based on ‘sleep’; the
priests administered specific herbs to the patients who sacrificed animals to the god.
Then, they entered the ‘avaton’ (ἄβατον) and were forced to sleep on the sacrificed
animal. Especially in Epidaurus, the patient was forced to cross a twisted underground
corridor, under the dome. The priests visited them at night, disguised as Asclepius. At
times, the god’s sacred animals, snakes, and dogs, licked the sick to heal them. Patients
were easily persuaded, as they were under the influence of ‘substances’. Under their
influence, patients had strange dreams. In the morning, based on the patients’ narration,
the priest would then interpret the dream and prescribe a cure. The priests used the
beneficial properties of magnetism, with the help and support of the ritual process, which
framed the treatment and led the candidate patient to his subconscious, where the
treatment and restoration of his health took place.
Modern medical science has not yet explained how the brain ‘persuades’ the body calling
this mystery ‘placebo’. It is the ineffective medication that produces fictitious or real
improvement, because only the one, who follows it, believes that it will cure him/her. The
same term is used for placebo administered under simulation conditions (Finniss et al.,
2010).
25
However, the ‘sleeping’ practice may even have been used in surgeries, such as opening
an abdominal abscess or repairing a wound. It is therefore reasonable to assume that the
patient should indeed be asleep due to the use of hypnotic substances such as opium
(Askitopoulou et al., 2002). A famous Asclepieion was founded in Pergamon, in the 3rd
cent. B.C., from Archias of Pergamon, who had been healed in Epidaurus and considered
it right to introduce the cult of Asclepius in Asia Minor.
Pausanias also mentions the hymns that had to do with the treatment of Telephos, the son
of Hercules and Avgi, daughter of Aleos.
26
In 293 BC, it was the turn of the Romans to
25
Furthermore, clinically relevant evidence demonstrates that placebo effects can have meaningful
therapeutic effects, by virtue of magnitude and duration, in different patient populations. Although
substantial progress has been made in understanding placebo effects, considerable scientific work remains
to be done in both laboratory experiments and translational clinical trial research, with the ultimate aim of
harnessing placebo effects to improve patient care (Finniss et al., 2010). https://www.ncbi.nlm.
nih.gov/pmc/articles/PMC2832199/
26
He was abandoned by his grandfather on the mountain but a deer undertook to breastfeed him until some
shepherds found him and raised him. Growing up, the oracle of Delphi ordered him to go to Teuthrania.
There, he found his mother, the wife of King Teuthrantas, who adopted him, gave him his wife, his
[28]
join the cult of Asclepius, establishing an Asclepieion on one of the islands of the river
Tiber. The cause was an epidemic that broke out in the city. The Romans fled to
Epidaurus, from where they received a ‘sacred snake’, which they carried to their
homeland and settled in the sanctuary of their new god (Compton, 2002).
In Attica, the cult of Asclepius came from Epidaurus. First in Piraeus and then in Athens,
where, on the initiative of a Telemachus from Acharnes, in 420/19 BC, a sanctuary was
founded on the southern slope of the Acropolis, near the theater of Dionysus (and in
Marathon, the tomb of Asclepius is adjacent with the temple of Dionysus). The priests of
Eleusis hurried to spread that the god was initiated in the Eleusinian Mysteries and lived
in the temple of Demeter, until his own sanctuary was built. The Athenian Asclepieion
gained a great reputation and operated until the end of the 5th cent. A.C., when the
Christians turned it into a church in honor of the healing saints. After all, the ‘role’ of the
healer Asclepius was succeeded in the Christian religion by many holy healers.
Modern Innovative Methods in Education
In antiquity, illness was seen as the result of complex and negative interactions of
environmental, social, psychological, spiritual, emotional and physical factors and health
care seems to have aimed at normalizing conflicts and restoring harmony between those
factors.
Nowadays, therapeutic practices and counseling through aesthetic and artistic education
are addressed to specialists, scientists and professionals, who wish to expand their
knowledge and use a new different pedagogical, artistic and psychotherapeutic approach,
such as dance therapy, drama therapy, music therapy as well as other forms of alternative
therapies and practices and apply them to professional environments of education and
counseling psychology. In fact, many scientists believe that counseling through
philosophy serves people even in areas such as decision making (Knapp & Tjeltveit,
2005). Philosophical counseling deals with values and beliefs and helps to identify,
clarify, analyze and sometimes change them. It serves as a means of rational conflict
resolution and is very useful in guiding an organizational change.
27
The educational
methods and teaching-learning techniques applied use as an original combination of
traditional and innovative forms of education and include:
- theoretical lectures;
- presentation of kinetic and expressive forms and systems with individual examples and
teaching practical skills to the trainees;
- use of audiovisual media and materials in theoretical and experiential laboratories;
daughter, Agriopi, and made him his successor. The Achaeans came to the area, thinking it was Troy,
attacked, repulsed and were forced to leave. Achilles, however, overtook and wounded Telephos, whose
wound, according to the oracle, could only be closed by the one who injured him. After wandering,
Telephos located Achilles. Thetis’ son put a magic herb in his wound and made her heal. In turn, Telephos
showed the Achaeans the right course for Troy.
27
https://advice4finance.com/philosophical-consulting-for-businesses/
[29]
- encouragement of improvised creativity in writing, creative writing and participation in
a collective artistic work;
- analysis, collection of empirical data;
- implementation and evaluation of therapeutic practices;
- the correlation of the learning experience with everyday life and modern problems;
- cooperation, interdisciplinary approach, production of the ‘thematic field’ of the project
to be processed, which is closer to the trainees’ interests and skills (painting, dance,
photography, theater, music, etc.).
The trainees gain experience of the therapeutic practices through art and the ‘know-how’
strategies of their application, to
1) improve their interdisciplinary and specialized knowledge for the utilization of the
applied arts in education and counseling, in order to respond more fully and effectively;
2) distinguish psychological trends and directions in the field of art and education;
3) identify the most important philosophical currents that support the relationship
between art and education;
4) coordinate their scientific specialization with the experiential application and action in
modern professional environments;
5) cultivate their creativity through traditional and contemporary arts (visual and
documentary); and
6) apply an ongoing self-formative assessment.
Philosophy and Consulting
Learning Outcomes. i Theoretical training in the fields of philosophy and psychology, ii
Skills for resolving emotional conflicts, verbal communication, iii Dialectical and social
interaction and self-development, iv Ability to handle psychoanalytic tools.
Introduction to Fine and Performance Arts
Learning Outcomes. i Theoretical training in the history and philosophy of art with
emphasis on the ancient legacy and the ancient Greek drama, ii Skills of aesthetic
awareness of verbal communication, in fine and performing arts.
Experimental Education Laboratories for all Age Categories
Learning Outcomes (by age category). i.Training in methods of handling psychological-
educational needs, ii Ability to manage group and social contents and relevant activities.
Therapeutic Practices
Learning Outcomes. i Introduction and theoretical training in therapies with the use of
fine arts, ii Skills in design and practical application of modern therapeutic practices and
methods.
New Technologies
Learning Outcomes. i Knowledge of methods and tools, ii Ability in digital recording and
evaluation applications using new technologies.
[30]
Educational methods and activities
i Theoretical lectures-distant learning seminars, ii Collaborative method-interactive
teaching (educational visits), experiential workshops (artistic creation), iii Study and
analysis of the relevant literature. This procedure concerns those involved in the
development and implementation of programs in the following:
• Private and public pedagogical institutes and institutions,
• Private and public counseling psychology programs,
• Art workshops and schools of art education (actors, dancers, musicians, artists),
• Training programs of Company executives,
• Lifelong learning programs of Municipalities and other cultural organizations and
institutions,
• Psychoanalysis and psychotherapy centers that wish to integrate new psychotherapeutic
techniques through the arts.
Epilogue
Summarizing from the above, it is understood that art, apart from its philosophical
aspects, which consists in the relationship between humans and the divine, has been
inextricably linked since antiquity with health treatments, healing and cure. Nowadays, in
the context of Philosophical Counseling, it is possible to create educational interventions
that will combine art, philosophy and new technologies in order to manage emotional
problems and self-development.
References
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Aesthetics and Art Criticism, 26: 94.
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by Sleep Induction as the Asclepieion of Epidaurus, International Congress Series
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healing environment, Archives of Hellenic Medicine. 27 (2): 259-263.
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Melfi, M. (2007). I santuari di Asclepio in Grecia, Roma, L’Erma di Bretschneider.
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Philosophy and Education, Arnaoutis Publications, Athens. Under the auspices of the
UNESCO International Dance Council.
Mastora, I. (2000). The cultivation of Aesthetic Education through sport and dance,
Giossos, I. (ed.). Olympic and Sports Education, Pedagogical logos, Propompos
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http://idve.teiath.gr/?q=therapeutikes_praktikes
[32]
[33]
Die „grosse Vernunft“des Leibes und das Über-sich-hinaus-
Schaffen.
Eine Interpretation zur vierten Rede Zarathustras
Nikolaos Loukidelis
Die aktuelle Situation der Nietzsche-Forschung zeichnet sich durch besondere
Lebendigkeit aus. Nietzsches Werk und seine Person stehen überall auf der Welt im
Zentrum eines regen, vielseitigen und wachsenden Interesses, das sich u. a. in der
Erscheinung von hoch spezialisierten Untersuchungen manifestiert. Diese
Untersuchungen bauen zwar auf vorherigen auf, die bereits wichtige Sachverhalte geklärt
und bemerkenswerte Interpretationen vorgelegt haben, versuchen aber zugleich sie zu
ergänzen und – nicht selten – zu widerlegen. Dabei lässt sich auch die Wirksamkeit von
verschiedenen Forschungstraditionen bzw. Forschungsgruppen feststellen, die einen
spezifischen methodischen Ansatz anwenden und sich oft sogar institutionalisiert haben,
indem etwa ihre Resultate in einem eigens zur Verfügung stehenden Rahmen
veröffentlicht werden.
Ein markantes Beispiel hierfür ist die Quellenforschung, deren Herausbildung Mazzino
Montinari viele wichtige Impulse verdankt und deren dynamische Präsenz u. a. in den
letzten Bänden der Nietzsche-Studien dokumentiert wird.
28
Ihre Aufgabe besteht in der
sich historisch-philologischer Mittel bedienenden Rekonstruktion des Dialogs, den
Nietzsche mit verschiedenen Autoren und Traditionen geführt hat. Dabei kommt dem 19.
Jahrhundert besondere Bedeutung zu, da es Nietzsche – trotz seiner Selbstinszenierung
als unzeitgemäßer Denker – tief geprägt hat.
Zwei weitere aktuelle Richtungen sind hier zu nennen. Die erste ist im Rahmen der
Verfassung eines Nietzsche-Wörterbuchs entstanden. Gemeint ist die unter der Leitung
von Paul van Tongeren und Herman Siemens stehende Nietzsche Research Group, die in
der Form des ersten Bandes des Wörterbuchs bereits ein fruchtbares Zeugnis ihrer Arbeit
vorgelegt hat.
29
Die in Rede stehende Forschungsgruppe wendet primär einen
semasiologischen Ansatz an. Dies bedeutet, „dass an erster Stelle nicht der Begriff,
sondern der signifiant steht und als Lemma verwendet wird“ (Tongeren u. a. 2004, XI f.)
und dass der Akzent auf die „Verschiebungen von Bedeutungen, [die] neue[n]
28
Siehe die Rubrik Beiträge zur Quellenforschung, die aus Abhandlungen und Nachweisen besteht.
29
Dieser erste Band wurde zu einem bedeutenden Teil von Gerd Schank verfasst (Tongeren u. a. 2004,
IX), der inzwischen unerwartet verstorben ist.
[34]
Bedeutungen sowie die Verknüpfung von Bedeutungen und Konnotationen“ (ebd., XII)
in Nietzsches Werk gelegt wird.
30
Die zweite Richtung stellt der sich in Vorbereitung befindende Kommentar der Schriften
Nietzsches dar, der von Jochen Schmidt, Barbara Neymeyer und Andreas Urs Sommer
verfasst wird.
31
Dieses Vorhaben widmet sich gezielt vor allem Nietzsches Büchern (und
nicht Entwürfen oder literarischen Projekten, die zeit seines Lebens nicht veröffentlicht
wurden bzw. für die Veröffentlichung nicht bestimmt waren) und sein Ziel besteht in der
Beleuchtung der Form und des Inhalts dieser Bücher durch eine Kontextualisierung. Der
in Rede stehende Begriff wird hier in einem weiten Sinne gebraucht: gemeint ist nicht nur
der Kontext des einzelnen Buches, sondern auch der des entsprechenden Nachlasses, der
Lektüren und Begegnungen Nietzsches und der allgemeinen historischen Situation, in der
das jeweilige Buch entstanden ist.
32
Wenn man dazu berücksichtigt, dass der Ansatz der Kontextualisierung aktuell durch
Werner Stegmaier bestärkt wird, der ein gut fundiertes Programm für eine neue
Nietzsche-Philologie im 21. Jahrhundert formuliert,
33
dann kommt man um so natürlicher
zu dem Schluss, dass die eben angeführten Forschungsrichtungen (Quellenforschung,
Nietzsche-Wörterbuch, Nietzsche-Kommentar) eine noch bis zum Ende des 20.
Jahrhunderts vorherrschende Tradition der Nietzsche-Forschung in den Hindergrund zu
verdrängen tendieren. Gemeint ist die systematische Nietzsche-Interpretation, zu der
Untersuchungen von Karl Löwith, Arthur Danto, Jean Granier und Josef Simon – um nur
wenige wichtige Interpreten anzuführen –
34
zuzuordnen sind. Auch wenn niemand an der
Legitimität und der Notwendigkeit von systematisch orientierten Interpretationen zweifelt
und viele Studien dieser Art immer noch erscheinen, gibt es in der Tat gegenwärtig ein
Zurückgehen ihrer Zahl, das wenigstens vier Gründe hat.
Erstens hat die systematische Nietzsche-Interpretation bereits viele Beiträge vom
bleibenden Wert geliefert, so dass oft der Eindruck entsteht, in vielen Themen sei bereits
ein befriedigender Konsens erreicht. Ein repräsentatives Beispiel hierfür ist Wolfgang
Müller-Lauters Rekonstruktion des Willens zur Macht.
35
Zweitens hat der systematische
Nietzsche-Interpret des 20. Jahrhunderts nicht wenige Male seine eigenen Interessen und
Ansichten in Nietzsche derart hineingelegt, dass dabei Nietzsches Gedankenwelt und
Selbstverständnis aus dem Blick gerieten. Das gilt etwa für einen großen Teil der
30
Insofern durch die Rekonstruktion des semantischen Feldes, „in dem ein Wort seine Bedeutung(en)
erhält“ (ebd., XII), diese festgelegt werden, „kommt“ zusätzlich zum semasiologischen „ein
onomasiologischer Ansatz zum Tragen“ (ebd.), der zur Erschließung von vielen in Nietzsches Werk
vorkommenden Begriffe beiträgt.
31
Das unten folgende Referat über den von der Heidelberger Akademie der Wissenschaften getragenen
Nietzsche-Kommentar basiert auf einem Vortrag, den Andreas Urs Sommer am 20. Mai 2009 im Berliner
Nietzsche-Colloquium gehalten hat. Zum Konzept des Kommentars vgl. auch http://portal.uni-
freiburg.de/ndl/forschung/nietzsche
32
Nach diesen Ausführungen ist es leicht ersichtlich, dass die Quellenforschung als ein selbstständiger Teil
des kontextualistischen Ansatzes betrachtet werden kann.
33
Stegmaier, 2007; Stegmaier, 2009.
34
Exemplarisch sei hier jeweils eine aus der Feder dieser Interpreten stammende Studie erwähnt: Löwith,
1956; Granier, 1969; Danto, 1980; Simon, 1985.
35
Müller-Lauter, 1971, 10 ff., 66 ff., 95 ff.; Müller-Lauter, 1999a.
[35]
klassischen zweibändigen Monographie von Martin Heidegger.
36
Drittens ist bei
Nietzsche ein durchaus antisystematisches und sogar antitheoretisches Moment
vorhanden, das er durch Inhalt und Form seiner Schriften bewusst pflegt und den
vorsichtigen Interpreten skeptisch gegenüber groß angelegten Rekonstruktionen stimmt.
Und viertens sind wichtige Aspekte von Nietzsches Werk wie versteckte Verweise auf
von ihm rezipierte Autoren, die verschiedenen Nuancen seiner sorgfältigen Wortwahl
und der Zusammenhang zwischen den einzelnen Teilen seines Werkes (z. B. zwischen
den Aphorismen der Morgenröthe) bei weitem noch nicht erschlossen.
Es ist deswegen folgerichtig, dass sich viele Forscher primär diesen Themenbereichen
zuwenden, und man darf auf die entsprechenden Ergebnisse gespannt sein. Es wäre
trotzdem einseitig, wenn die Nietzsche-Forschung sich nur auf eine derartige
Erschließung von Nietzsches Werk beschränken würde, so grundlegend und ertragreich
diese Erschließung auch sein mag. Denn Nietzsches „Leidenschaft der Erkenntniss“ (s. z.
B. M 429, KSA 3, S. 265, FW 123, KSA 3, S. 479)
37
bezieht sich auch auf Inhalte –
Inhalte, die ihn im 20. Jahrhundert zu einem wichtigen Gesprächspartner für Vertreter so
unterschiedlicher Disziplinen wie Physik, Biologie, Psychologie, Soziologie, Klassische
Philologie, Literaturwissenschaft und Philosophie gemacht haben – und es wäre
bedauernswert, wenn diese Inhalte in der Nietzsche-Forschung nicht weiter
hervorgehoben, rekonstruiert und gegebenenfalls auch kritisiert würden. Dabei muss man
freilich sich besonders davor hüten, den inneren und äußeren Zusammenhang des
Nietzscheschen Werkes zu vernachlässigen. Vielmehr sollte dieser Zusammenhang bei
der Darstellung nicht nur berücksichtigt werden, sondern einer ihrer wichtigsten
Stützpunkte sein.
Der vorliegende Beitrag versucht, eine im eben vorgetragenen Sinne systematisch
orientierte Interpretation zur vierten Rede Zarathustras zu liefern. Er ist zwar aus der
ursprünglichen Absicht hervorgegangen, diesen Text in seiner Ganzheit heranzuziehen
und eine umfassende Interpretation von ihm vorzulegen. Da aber die Realisierung einer
solchen Absicht den Rahmen dieses Beitrages sprengen würde, wird hier versucht, an
Hand der Kommentierung von nur drei Passagen aus der vierten Rede, die im Laufe der
Darstellung zitiert werden, einige bedeutende Aspekte von ihr hervorzuheben.
38
Besondere Aufmerksamkeit wird dabei den Formeln der „grossen Vernunft“ des Leibes
und des Über-sich-hinaus-Schaffens geschenkt werden.
Schon bei einer ersten Lektüre der vierten Rede Zarathustras fällt die Gleichsetzung von
Leib und Selbst
39
auf. Am charakteristischsten kommt sie in der folgenden Textstelle zur
36
Heidegger, 1989a; Heidegger, 1989b. Vgl. auch die entsprechenden Bände der Heidegger-
Gesamtausgabe, z. B. Band 43 und 48.
37
Zu dieser Formel Nietzsches vgl. Montinari, 1982; Brusotti, 1997.
38
Eine umfassende Untersuchung zur vierten Rede sollte sich auch mit den einschlägigen Ausführungen
von Ludwig Giesz, Karl Jaspers, Friedrich Kaulbach, Stephan Grätzel, Günter Abel, Annemarie Pieper,
Wolfgang Müller-Lauter, Volker Caysa, Volker Gerhardt, Christian Schmidt und Eckhard Frick ausführlich
auseinandersetzen (Giesz 1950, S. 23 ff., Jaspers 1974, S. 218 ff., 314, Kaulbach 1980, S. 13 ff., 289 ff.,
Grätzel 1989, S. 118 ff., Abel 1990, S. 105 ff., Pieper 1990, S. 149 ff, Müller Lauter 1999b, S. 126 ff.,
Caysa 2000, 271 ff. Gerhardt 2000, Schmidt 2008, S. 138 ff., Frick 2009, S. 208 ff.). Im vorliegenden
Beitrag muss darauf – abgesehen von gelegentlichen Bezügen – verzichtet werden.
39
Zu dieser Gleichsetzung vgl. Giesz 1950, S. 27 ff.
[36]
Sprache: „Hinter deinen Gedanken und Gefühlen, mein Bruder, steht ein mächtiger
Gebieter, ein unbekannter Weiser – der heisst Selbst. In deinem Leibe wohnt er, dein
Leib ist er.“ (Za I, Von den Verächtern des Leibes, KSA 4, S. 40). Bekanntlich gibt es in
unserem alltäglichen Sprachgebrauch eine klare Unterscheidung zwischen Leib und
Seele, die sich auch in vielen philosophischen Theorien (z. B. in der Lehre Descartes’)
widerspiegelt. Die Frage die sich also hier erhebt, lautet: Wie kann Nietzsche einem
ziemlich fest etablierten Leibverständnis widersprechen und diesen Begriff mit dem des
Selbst gleichsetzen, dem – traditionell der Seele zugeschriebene – Eigenschaften wie
Unausgedehntheit und Unsichtbarkeit zukommen?
Die Antwort auf diese Frage tritt deutlich zu Tage, wenn man Nietzsches Aufnahme des
physiologischen Modells von Wilhelm Roux berücksichtigt, wie es in seinem Werk Der
Kampf der Theile im Organismus (Roux, 1881) dargestellt wird. Roux eignet sich ein
wichtiges Motiv vorsokratischen Denkens, das des Kampfes, an. Auch wenn er dabei die
Bedeutung Heraklits anerkennt (Roux, 1881, 65),
40
orientiert er sich vor allem an
Empedokles, der annahm, dass der Kosmos insgesamt und die in ihm wirkenden
einzelnen Wesen „durch die Kräfte der Liebe und des Hasses“ (ebd., 1) gestaltet werden:
„In diesem mit zwei einander entgegenwirkenden Kräften versehenen Stoffgemenge
musste ein lang dauernder Wechselkampf [Hervorhebung, N. L.] stattfinden, aus welchem
blos die dauerfähigen Aggregationen schliesslich allein übrig bleiben konnten, da alle
gebildeten Gruppirungen so lange immer wieder gelöst werden mussten, so lange in der
Wechselwirkung noch stärkere Conglomerate sich bilden konnten“ (ebd.). Empedokles
hat auf diese Weise nach Roux als erster das Prinzip des Kampfes für die „Entstehung
sogenannter zweckmässiger Einrichtungen auf rein mechanische Weise“ (ebd., 2)
fruchtbar gemacht, das viele Jahrhunderte später Alfred Wallace und Charles Darwin
wissenschaftlich fundierten und zur Erklärung der Entstehung der Arten gebrauchten
(ebd., 3). Die Wirksamkeit desselben Prinzips behauptet nun Roux auch fürs Innere des
einzelnen Organismus, und zwar für die Vorgänge auf der Ebene der Zellteile, der Zellen,
der Gewebe und der Organe (ebd., 64 ff.). Nietzsche, der sich bekanntlich sowohl für die
Vorsokratiker als auch für die zeitgenössische Physiologie interessierte, hat sich mit
Roux’ Buch intensiv auseinandergesetzt.
41
Im Umkreis dieser Auseinandersetzung
42
ist
die folgende nachgelassene Aufzeichnung entstanden:
„Am Leitfaden des Leibes erkennen wir den Menschen als eine Vielheit belebter Wesen,
welche theils mit einander kämpfend, theils einander ein- und untergeordnet, in der
Bejahung ihres Einzelwesens unwillkürlich auch das Ganze bejahen.
Unter diesen lebenden Wesen giebt es solche, welche in höherem Maaße Herrschende als
Gehorchende sind, und unter diesen giebt es wieder Kampf und Sieg.
40
Vgl. auch das berühmte Polemos-Fragment (Kirk u.a. 1999, S. 193).
41
Dazu ausführlich: Müller-Lauter, 1999b.
42
Roux’ Buch entnimmt Nietzsche wahrscheinlich sogar ein Argument für folgende Feststellung: „Wir
nähern uns heute allen jenen grundsätzlichen Formen der Weltauslegung wieder, welche der griechische
Geist, in Anaximander, Heraklit, Parmenides, Empedokles, Demokrit und Anaxagoras, erfunden hat [...][.]“
(Nachlass 1885, 41[4], KSA 11, S. 679)
[37]
Die Gesammtheit des Menschen hat alle jene Eigenschaften des Organischen, die uns
zum Theil unbewußt bleiben zum Theil in der Gestalt von T ri eb en bewußt werden.“
(Nachlass 1884, 27[27], KSA 11, 282)
Im eben zitierten Text tritt eine Bedeutung des Leibbegriffes deutlich zu Tage und eine
weitere wird impliziert. Es handelt sich zum einen um den Leib als Gegenstand der
Physiologie, in dem eine Vielheit von lebenden Wesen, ein Kampf dieser Wesen mit
einander und daraus entstehende Gebilde zu beobachten sind. Zum anderen wird
behauptet, dass „[d]ie Gesammtheit des Menschen [...] [durch] alle jene Eigenschaften
des Organischen“ (ebd.) durchtränkt ist, was bedeutet, dass Phänomene wie Denken,
Fühlen und Wollen, die in der Tradition oft für Akte einer vom Leib klar unterschiedenen
Entität gehalten wurden, nun als Produkt einer im Organischen wurzelnden
psychophysischen Einheit aufgefasst werden.
43
Diese Einheit ist als „Organisation und
Zusammenspiel“, als „Herrschafts-Gebilde, das Eins bedeutet, aber nicht eins ist“ zu
verstehen (Nachlass 1885-1886, 2[87], KSA 12, 104). Sie stellt das Geschehen, das wir
selbst sind, dar, d.h. unser Selbst.
Hiermit ist nicht nur die Frage nach der Gleichsetzung von Leib und Selbst beantwortet.
Zugleich wird klar, was Nietzsche mit den folgenden in der vierten Rede enthaltenen
Worten meint: „Der Leib ist eine grosse Vernunft, eine Vielheit mit Einem Sinne, ein
Krieg und ein Frieden, eine Heerde und ein Hirt“ (Za I, Von den Verächtern des Leibes,
KSA 4, S. 39). Die Formel der „grossen Vernunft“ des Leibes weist auf das Geschehen
hin, das wir selbst sind und das sich durch Merkmale wie Pluralität, Agonalität, Über-
bzw. Untergeordnetsein und Fluktuation auszeichnet. Diese Merkmale sind auch in den
Formeln „Vielheit mit Einem Sinne“, „Krieg und Frieden“, „Heerde und Hirt“
wiederzufinden.
44
In der vierten Rede begegnet uns sogar ein Versuch, der Grundtriebfeder der großen
Vernunft des Leibes auf die Spur zu kommen. Das wird deutlich, wenn man die Stelle
berücksichtigt, in der Nietzsche den Verächtern des Leibes attestiert, dass selbst ihre
Leibverachtung ein Ausdruck ihres Leibes ist:
„Noch in eurer Thorheit und Verachtung, ihr Verächter des Leibes, dient ihr eurem
Selbst. Ich sage euch: euer Selbst selber will sterben und kehrt sich vom Leben ab.
Nicht mehr vermag es das, was es am liebsten will: – über sich hinaus zu schaffen. Das
will es am liebsten, das ist seine ganze Inbrunst.
Aber zu spät ward es ihm jetzt dafür: – so will euer Selbst untergehn, ihr Verächter des
Leibes.
Untergehn will euer Selbst, und darum wurdet ihr zu Verächtern des Leibes! Denn nicht
mehr vermögt ihr über euch hinaus zu schaffen.“ (Za I, Von den Verächtern des Leibes,
KSA 4, S. 40 f.)
43
Dazu vgl. Loukidelis 2009, S. 37 ff.
44
Die vorliegenden Ausführungen zum Verhältnis Nietzsche-Roux haben sich auf den klassischen Aufsatz
von Wolfgang Müller-Lauter (Müller-Lauter 1999b, insbesondere S. 105, 111, 127 f.) gestützt. In ihnen
sind jedoch die Anlehnung von Roux an Empedokles sowie die Bedeutung der Aufzeichnung 27[27] vom
Nachlass 1884 für Nietzsches Konzeption des Leibes stärker zum Vorschein gekommen.
[38]
Bei der oben angedeuteten Grundtriebfeder handelt es sich um das Über-sich-hinaus-
Schaffen. Es stellt einen konkreten Impuls dar, der auf eine Disposition des Leibes zum
Schaffen zurückgeht. Dieser Impuls offenbart sich im Akte der Zeugung. Damit sind
erstens die geschlechtspezifische Dimension des Terminus gemeint, zweitens Leistungen
des Geistes und der Kultur und drittens die Selbstgestaltung des Menschen: „Ein höheres
Wesen als wir selber sind zu schaffen, ist u ns er Wesen. Über u ns hi na us
sch a f f e n ! Das ist der Trieb der Zeugung, das ist der Trieb der That und des Werks“
(Nachlass 1882-1883, 5[1], KSA 10, S. 209).
45
Das Über-sich-hinaus-Schaffen gehört
neben dem Übermenschen, dem Willen zur Macht und der ewigen Wiederkunft zu den
wichtigsten Formeln von Also sprach Zarathustra.
46
Eine umfassende Befassung mit ihr
steht in der Nietzsche-Forschung noch aus. Im Folgenden sollen einige Bausteine zu ihrer
Rekonstruktion vorgelegt werden.
Was die Entstehung des Über-sich-hinaus-Schaffens betrifft, sind zum einen der
Schopenhauersche Willens- und der platonische Erosbegriff von großer Bedeutung (s.
etwa WWV I, Viertes Buch, § 60, Symp. 201d-212a) und zum anderen liegt es nahe, die
Wirksamkeit von Impulsen zu vermuten, die von Nietzsches Beschäftigung mit der
zeitgenössischen Physiologie ausgehen.
47
Systematisch betrachtet soll zwar die
Bedeutung der menschlichen Sexualität – im umfassenden Sinne des Wortes – und der
Formen ihrer Sublimierung bei Nietzsche herausgearbeitet und betont werden. Eine
Heranziehung der entsprechenden Theorien Freuds würde sich bei der Rekonstruktion der
oft bruchstückartig vorgetragenen Thesen Nietzsches als durchaus hilfreich erweisen.
48
Wichtiger aber noch ist, dass man alle Antriebe, die Zeichen einer Steigerung des
Lebensdarstellen, ins Auge fasst,
49
ihnen in Nietzsches Werk nachspürt
50
und sie
ausführlich thematisiert.
Mit einem Wort kann man das Über-sich-hinaus-Schaffen als das kreative Potenzial im
Menschen bezeichnen, das ihm deutliche Signale zur Gestaltung seines Lebens gibt. Eine
Verdrängung dieses Potentials resultiert nicht nur in ein Gefühl des Unerfülltseins,
sondern führt oft zu einer psychosomatisch bedingten Krankheit. Nietzsche wurde mit
dieser Tatsache in seinem eigenen Leben mehrmals konfrontiert. Ein charakteristisches
17 Vgl. ferner Za I, Von tausend und Einem Ziele, KSA 4, S. 75, Za I, Von Kind und Ehe, KSA 4, S. 90, Za
II, Auf den glückseligen Inseln, KSA 4, S. 111 f.
18 Zwischen dem Über-sich-hinaus-Schaffen und dem Begriff des Übermenschen besteht ein enger
Zusammenhang (dazu s. N 1882-1883, 5[1], KSA 10, S. 209, Za I, Von den Verächtern des Leibes, KSA 4,
S. 40 f., Za II, Auf den glückseligen Inseln, KSA 4, S. 111 f.). Arnold Gehlen hält den mit dem Über-sich-
hinaus-Schaffen zum Ausdruck gebrachten Sachverhalt sogar für die eigentliche Grundlage des
Übermenschen und des Willens zur Macht und der ewigen Wiederkunft (Gehlen 1997, S. 323 f.). Ob diese
Auffassung berechtigt ist, muss hier dahingestellt bleiben.
47
Dazu vgl. z. B. das folgende Exzerpt aus Schneider 1880: „‚Alle Handlungen der Larven kurz vor der
Verpuppung gehen nicht auf die eigene Erhaltung, sondern auf die des fertigen Insektes hinaus, sie
entsprechen nicht den Bedürfnissen des Larvenstadiums, sondern denen des vollständig entwickelten
Thiers‘ usw. Schneider I p. 58“ (Nachlass 1883, 7[237], KSA 10, S. 314).
48
Unter den zahlreichen Studien zum Verhältnis Nietzsche-Freud ragt Gasser 1997 heraus.
49
Wertvolle Bemerkungen hierzu findet man in Gehlen 1997, S. 321 ff.
50
Solche Antriebe werden z. B. in N 1887, 9[102] genannt; ein charakteristischer davon ist der Rausch (s.
auch GD, Streifzüge eines Unzeitgemässen, 8).
[39]
Beispiel dafür ist in einem bedeutenden Brief an Wilhelm Vischer-Bilfinger überliefert,
in dem sich Nietzsche – damals Professor für klassische Philologie in Basel – „um die
durch Teichmüllers Weggang erledigte p h il osoph isch e Pr of es su r “ (Brief vom –
vermutlich – Januar 1871, KSB 3, S. 175) bewirbt. Seine Bewerbung begründet er zum
großen Teil durch die Schilderung eines Grundproblems seiner Basler Existenz. Er teilt
nämlich mit, dass er „in einem eigenthümlichen Konflikt“ lebt, der seinen „Körper
erschöpft“ und sogar bis zu unerträglichen „Leiden anwächst“ (ebd.). Der Konflikt
besteht darin, dass er zwar „[v]on Natur auf das Stärkste dazu gedrängt [ist], etwas
Einheitliches philosophisch durchzudenken und in langen Gedankenzügen andauernd und
ungestört bei einem Problem zu verharren“, sich aber „durch den täglichen mehrfachen
Beruf und dessen Art hin und her geworfen und aus der Bahn abgelenkt“ fühlt, so dass
seine „eigentliche Aufgabe“, nämlich die „p h il o s op h i s ch e “ [...] zu einer
Nebenthätigkeit erniedrigt wird“ (ebd.).
51
Abgesehen von dieser persönlichen Mitteilung
finden seine Beobachtungen zur Entstehung von psychosomatisch bedingten Krankheiten
durchaus Eingang in sein Werk, wie etwa folgende Passage nachweist:
„Jenes verborgene und herrische Etwas, für das wir lange keinen Namen haben, bis es
sich endlich als unsre A u fg a be erweist, – dieser Tyrann in uns nimmt eine
schreckliche Wiedervergeltung für jeden Versuch, den wir machen, ihm auszuweichen
oder zu entschlüpfen, für jede vorzeitige Bescheidung, für jede Gleichsetzung mit
Solchen, zu denen wir nicht gehören, für jede noch so achtbare Thätigkeit, falls sie uns
von unsrer Hauptsache ablenkt, ja für jede Tugend selbst, welche uns gegen die Härte der
eigensten Verantwortlichkeit schützen möchte. Krankheit ist jedes Mal die Antwort,
wenn wir an unsrem Rechte auf u ns re Aufgabe zweifeln wollen, – wenn wir anfangen,
es uns irgendworin leichter zu machen. Sonderbar und furchtbar zugleich! Unsre
Erl e icht erun g en sind es, die wir am härtesten büssen müssen! Und wollen wir
hinterdrein zur Gesundheit zurück, so bleibt uns keine Wahl: wir müssen uns
sch w ere r belasten, als wir je vorher belastet waren ...“ (MAM II, Vorrede, 4, KSA 2, S.
373 f.)
Aus den obigen Ausführungen geht unmittelbar hervor, dass Nietzsche zu den
Vordenkern einer psychosomatischen Anthropologie gehört. Sowohl ersterer als auch
letztere plädieren für eine Überwindung der traditionellen Trennung zwischen Leib und
Seele und betonen zugleich die Bedeutung des ungelebten Lebens für die Entstehung von
51
Nietzsche hat zu jener Zeit unter einer „Magen- und Darmentzündung“ (Brief an Franziska und Elisabeth
Nietzsche vom 6. Februar 1871, KSB 3, S. 181) gelitten. Pia Daniela Volz meint, dass diese Entzündung
„nicht nur als Reaktion auf die Überanstrengung durch die Professur [...], sondern auch als Nachwirkung
der Dysenterie anzusehen“ ist (Volz 1990, S. 120), die infolge einer im September 1870 zugezogenen
Infektion auftrat (ebd., S. 119 f.).
[40]
Krankheiten.
52
Anders als bei einer einseitigen Orientierung am kranken Menschen, wie
sie meistens in der Literatur zur Psychosomatik vorkommt, richtet sich Nietzsches
Interesse am Umgang des Menschen mit seiner Kreativität nicht nur auf
Grenzsituationen, sondern auf die Lebensgestaltung überhaupt.
53
Die Art und Weise, wie
jeder von uns mit den Impulsen des Über-sich-hinaus-Schaffens in sich umgeht, ist für
ein gelungenes Leben von entscheidender Bedeutung.
Bibliographie
Nietzsches Schriften und Briefe werden nach den folgenden Ausgaben zitiert:
Sämtliche Werke. Kritische Studienausgabe in 15 Einzelbänden. Herausgegeben von
Giorgio Colli und Mazzino Montinari. München/Berlin/New York, 21988. (KSA)
Sämtliche Briefe. Kritische Studienausgabe in 8 Bänden. Herausgegeben von Giorgio
Colli und Mazzino Montinari. München/Berlin/New York, 1986. (KSB)
Folgende Abkürzungen werden gebraucht:
WWV I: Arthur Schopenhauer, Die Welt als Wille und Vorstellung, Erster Band, in:
Werke, Erster Band, herausgegeben von Ludger Lütkehaus, Zürich, 1988.
Symp.: Platon, Symposion, in : Ioannes Burnet (Hg.), Platonis Opera. Tomus II (1901), S.
151-222, Oxford, 21910. Zitiert wird nach der Stephanus-Paginierung.
Übrige zitierte Literatur
Günter, A. (1990). Interpretatorische Vernunft und menschlicher Leib, M. Djurić (επιμ.):
Nietzsches Begriff der Philosophie, Würzburg: 100-130.
Brusotti, M. (1997). Die Leidenschaft der Erkenntnis. Philosophie und ästhetische
Lebensgestaltung bei Nietzschevon Morgenröthe bis Also sprach Zarathustra, Berlin/New
York.
Caysa, V. (2000). Leib/Körper, (Hg.) H. Ottmann, NietzscheHandbuch. Leben-Werk-
Wirkung Stuttgart.
Danto, A.C. ([1965] 21980). Nietzsche as Philosopher, New York.
Frick, E (2009). Psychosomatische Anthropologie. Ein Lehr- und Arbeitsbuch für
Unterricht und Studium, unter Mitarbeit von Harald Gündel, Stuttgart.
Gasser R. (1997). Nietzsche und Freud, Berlin/New York.
Gehlen A. ([1940] 131997). Der Mensch. Seine Natur und seine Stellung in der Welt,
Wiesbaden.
52
Vgl. hierzu Frick 2009, S. 52, 224 f. Frick integriert in seiner Konzeption auf bemerkenswerte Weise den
Selbstbegriff der vierten Rede Zarathustras (Frick 2009, 208 ff.).
53
Zu diesem Thema vgl. Schmid, 1992.
[41]
Gerhardt, V. (2000). Die „grosse Vernunft“ des Leibes. Ein Versuch über Zarathustras
vierte Rede, in: Ders. (Hg.), Friedrich Nietzsche. Also sprach Zarathustra, Berlin: 123-
163.
Giesz, L. (1950). Nietzsche. Existenzialismus und Wille zur Macht, Stuttgart.
Grätzel, S. (1989). Die philosophische Entdeckung des Leibes, Stuttgart.
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Paris.
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Philosophierens, Berlin/NewYork.
Kaulbach, F. (1980). Nietzsches Idee einer Experimentalphilosophie, Köln/Wien 1980.
Kirk, G.S., Raven, J.E., Schofield, M. (Hg.), [(1957), 21999]. The Presocratic
Philosophers. A Critical History with a Selection of Texts, Cambridge.
Löwith, K. ([1935] 21956). Nietzsches Philosophie der ewigen Wiederkehr des Gleichen,
Stuttgart.
Loukidelis, Ν. (2009). Zu Nietzsches Begriff vom menschlichen Leben, in: Simon
Springmann/Asmus Trautsch (Hg.): Was ist Leben? Festgabe für Volker Gerhardt zum
65. Geburtstag, Berlin: 35-39.
Montinari, M. (1982). Nietzsches Philosophie als „Leidenschaft der Erkenntnis“, in:
Ders., Nietzschelesen, Berlin/New York: 64-78.
Müller-Lauter, W. (1971). Nietzsche. Seine Philosophie der Gegensätze und die
Gegensätze seiner Philosophie, Berlin/New York.
____________ (1999a). Nietzsches Lehre vom Willen zur Macht, in: Ders., Über Werden
und Wille zur Macht. Nietzsche-Interpretationen I, Berlin/New York: 25-95.
____________ (1999b). Der Organismus als innerer Kampf. Der Einfluß von Wilhelm
Roux auf Friedrich Nietzsche, in: Ders., Über Werden und Wille zur Macht. Nietzsche-
Interpretationen I, Berlin/New York: 97-140.
Pieper, A. (1990). Ein Seil geknüpft zwischen Tier und Übermensch. Philosophische
Erläuterungen zu Nietzsches erstem „Zarathustra“, Stuttgart.
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Experimente des Leibes, Berlin/Münster/Wien/Zürich: 133-150.
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[43]
Qu’est-ce qu’on sublime?
Sophie de Mijolla-Mellor
Les satisfactions substitutives
Sublimer avec sa connotation idéalisante, reste le plus souvent assimilé à renoncer à une
réalisation pulsionnelle pour assurer son propre bonheur. L’époque ne porte t’elle pas à la
régulation chimique des humeurs et à l’affirmation que le meilleur des mondes est à
portée de main pourvu que l’on sache appliquer les bonnes recettes en matière de gestion
personnelle?
Oubliant que le bonheur vient en général au détour d’autre chose et que lui courir après
risque fort d’engendrer non seulement la déception mais le découragement de se voir
incapable d’y accéder, la cuisine du bonheur n’en continue pas moins de faire florès. Le
résultat est promis au prix modique du petit carnet où les mauvaises expériences du jour
se voient soigneusement consignées opposées aux bonnes mais avec les meilleures
méthodes pour augmenter la proportion dans le bon sens le jour d’après.
La psychanalyse, à l’inverse, se voit accusée de cultiver le malheur, soupçonnée de
gratter indéfiniment là où cela fait mal au lieu d’aider par de bons conseils à positiver
l’expérience quotidienne. Qu’a-t-elle en effet à offrir en matière de cette légitime quête
du bonheur?
Freud a rappelé de multiples fois le fait que les ‘satisfactions substitutives’, l’art et
l’attitude esthétique, mais aussi le labeur intellectuel, l’activité de l’esprit et plus
généralement tout ce qui résulte de la ‘transposition’ des pulsions de telle sorte que le
monde extérieur ne puisse plus leur opposer de déni ou s’opposer à leur satisfaction et il
s’avance même jusqu’à dire que “La destinée alors ne peut plus grand-chose contre vous”
(Freud, 1930).
Perspective néanmoins immédiatement nuancée par le rappel que cette démarche ne
protège pas des coups de la destinée, pas plus que de la souffrance corporelle, et qu’elle
n’est pas accessible à tous en raison du degré de culture impliqué, encore qu’elle puisse
être étendue, selon le mot de Voltaire, au fait de ‘cultiver son jardin’, c’est-à-dire
d’exercer un métier librement choisi.
Il est intéressant de voir que dans ce passage de ‘Malaise’, Freud est très proche d’une
avancée décisive sur la sublimation et sa fonction mais qu’il continue à opposer ces
satisfactions “plus délicates et plus élevées” à l’“assouvissement des désirs pulsionnels
grossiers et primaires”, et surtout qu’il y affirme que la psychanalyse n’est pas encore en
mesure d’en expliquer les mécanismes métapsychologiques. Cette modestie freudienne
doit être réinterrogée et il faut clairement marquer que la psychanalyse ne se désintéresse
[44]
nullement du bonheur (Mijolla-Mellor S. de, 1992) ou de la guérison de la souffrance
psychique. Je développerai dans ce qui suit la manière dont je conçois sa force efficace
soit la capacité d’investir le manque dont elle dote le sujet. Une telle capacité lui confère
en droit une ouverture illimitée et en fait un authentique facteur de progrès.
L’ aspiration indéfinie au progrès est la marque de l’appartenance érotique de la
sublimation dans la mesure où il s’agit à un niveau ‘désexualisé’ d’une quête d’objets, qui
auraient pour caractéristique de se situer dans la dépendance du Moi. On sait toutefois
que Freud dans Au-delà du Principe de Plaisir, est loin d’une telle perspective puisqu’il
parle d’une illusoire “pulsion de perfectionnement”, bien éloignée de l’optimisme de Lou
Andréas Salomé quant à l’avenir ‘prométhéique’ de l’homme (Andreas-Salomé, 1913). Il
distingue la tendance au développement comme conséquence des forces extérieures qui
poussent à l’adaptation et la “poussée inlassable à se perfectionner toujours plus” qui
n’apparaît que chez une minorité. Cette différenciation, sans qu’il la précise d’ailleurs,
reprend celle qu’il a depuis longtemps établie entre les sujets qui subissent la sublimation
par la voie de la civilisation et ceux qui, par leurs sublimations individuelles créent ou
relancent la précédent.
54
Ces derniers présentent, de manière plus ou moins accentuée,
une tendance à être incapables de se satisfaire d’une situation établie et à vouloir toujours
aller de l’avant.
Cette apparente ‘pulsion de perfectionnement’ va être ramenée par Freud du spirituel à
l’organique, car elle ne fait finalement que manifester à l’échelon individuel la
particularité qui est celle des pulsions de vie en général, à savoir de compliquer le
parcours qui va vers la mort.
De la même manière que les cellules germinales répètent indéfiniment le jeu auquel elles
doivent leur apparition, on peut penser que les sublimations poursuivent, à leur niveau, un
effort semblable en liant, par exemple, les éléments de pensée entre eux et en faisant
toujours surgir à nouveau des questions qui en relancent d’autres.
La comparaison pourrait être poursuivie à partir de l’‘immortalité’ de la communauté
scientifique opposée à la vie nécessairement éphémère de ses membres. Le ‘progrès’
prend ainsi un tout autre sens, ainsi que Freud le note dans un ajout de 1923 à Au-delà du
Principe de plaisir. Il ne s’agit pas de ce mouvement “qui se hâte vers l’avant afin
d’atteindre le plus tôt possible le but final de la vie” car celui-ci poursuit une réalisation
pulsionnelle immédiate contrairement au but visé par le perfectionnement.
Paradoxalement le progrès serait lié au mouvement inverse qui “se hâte vers l’arrière
pour recommencer ce même parcours en partant d’un certain point et en allonger ainsi la
durée”. Ce qui sur le plan dynamique apparaît comme une aberration, se conçoit en
revanche d’après la suite du propos de Freud. En effet “la voie rétrograde qui conduit à la
pleine satisfaction est, en règle générale”, écrit-il, “barrée par les résistances qui
maintiennent les refoulements de sorte qu’il ne reste plus d’autre solution que de
progresser dans l’autre direction de développement qui est encore libre, sans l’espoir
d’ailleurs de pouvoir achever le processus et d’atteindre le but” (Freud, 1930).
On a toutefois dans ce passage une représentation métapsychologique du fonctionnement
de la sublimation que l’on pourrait décrire comme un phénomène de reflux qui, trouvant
54
Processus croisé dans lequel j’ai proposé de voir une ‘ruse de la civilisation’.
[45]
la voie permettant d’aller vers arrière barrée, devrait rebondir en avant avec d’autant plus
de vigueur que l’intensité du flux rétrograde était élevée. Là encore, la primauté de la
dimension économique s’affirme déterminante car le schéma topique et dynamique est le
même pour tous.
Il s’agit toujours de la même tentative impossible pour réduire l’écart entre le plaisir
exigé qui est en fait la satisfaction complète, et le plaisir obtenu, limité, car “toutes les
formations substitutives et réactionnelles, toutes les sublimations ne suffisent pas à
supprimer la tension pulsionnelle persistante”.
D’où vient alors que certains individus semblent habités par une soif de progrès et
parviennent effectivement à des résultats dont ils font profiter une civilisation sans en être
eux-mêmes pour autant satisfaits?
A cette question dans laquelle se résume la notion de sublimation, Freud donne en 1920,
sous une forme élargie et à partir d’un modèle de type ‘biologique’, une réponse qui
prolonge ses premières définitions de la capacité de sublimer:
55
il s’agit de l’intensité de
la pulsion chez quelques-uns d’où le fait que la prétendue ‘pulsion de perfectionnement’
soit loin d’être le lot de chacun.
Les conditions dynamiques de son apparition, écrit-il, sont, il est vrai, généralement
présentes mais les conditions économiques ne semblent favoriser ce phénomène qu’en de
rares cas. Le caractère éthéré et ‘sublimé’ que connote le terme de sublimation apparaît
décidément bien peu apte à rendre compte d’un processus qui ne doit son existence qu’à
la violence pulsionnelle.
Toutefois, pour mieux préciser le schéma dynamique évoqué plus haut, il faudrait pouvoir
se figurer les voies par lesquelles le flux libidinal se précipite dans son mouvement de
rebond. Peut-être est-il possible à ce niveau également d’imaginer un processus
dynamique, tel qu’un appel (au sens où on parle d’un ‘appel d’air’) constitué par un vide
ou un manque.
Nous développerons ce point ultérieurement à partir de l’hypothèse que les instances
idéales et le travail de deuil qui en sous-tend la formation par le biais des premières
identifications constituent pour la libido un appel de ce type.
En 1920, Freud insiste de manière plus générale sur cette sorte de fuite en avant que
constitue tout mouvement de progrès. Il en vient même jusqu’à l’identifier au processus
de formation d’une phobie: “les processus en jeu dans la formation d’une phobie
névrotique, qui n’est pas autre chose qu’une tentative de fuite devant une satisfaction
pulsionnelle, nous fournissent le modèle de la naissance de ce qui se présente comme
‘pulsion de perfectionnement’”. Cette assimilation, quelque peu réductrice de la pulsion
de perfectionnement à la phobie repose sur fait commun de l’inhibition, que Freud
définira dans ‘Inhibition, symptôme, angoisse’ en 1926, comme ce que le Moi s’impose
pour éviter de se trouver envahi par l’angoisse née des revendications de la libido. La
comparaison se limite en fait à décrire la genèse de la pulsion de perfectionnement et non
son fonctionnement qui se différencie de la phobie par son aspect dynamique opposé au
renfermement de cette dernière.
55
Cf. Chapitre V-1 “Genèse de la capacité de sublimer”.
[46]
Peut-être en revanche que tout progrès est en fait le résultat d’une fuite avant, bien loin
d’être un mouvement naturel de progression. Mais quels sont les contenus spécifiques des
sublimations au pluriel et comment retracer leur origine pulsionnelle?
Sublimer le sexe qu’on n’a pas
Le lien direct entre sublimation et abstinence sexuelle repose pour Freud sur une
dichotomie absolue entre le domaine sublimé et le domaine sexuel, sans tenir compte de
la reconversion possible de l’un dans l’autre. Cette position radicale est liée à une
définition restreinte de la dimension du sexuel, fréquente sous sa plume opposant le
plaisir sexuel assouvissant des ‘désirs pulsionnels grossiers et primaires’ aux activités
sublimées mais aptes à fournir seulement un plaisir affaibli. Paradoxe que ce retour à une
définition à la fois moraliste et physiologique de la sexualité, bien différente de celle de la
psychosexualité, telle qu’on la trouvait explicitée dans A propos de la psychanalyse dite
sauvage: “En psychanalyse, le terme ‘sexualité’ comporte un sens bien plus large, il
s’écarte tout à fait du sens populaire et cette extension se justifie au point de vue
génétique. Nous considérons comme appartenant au domaine de la sexualité toutes les
manifestations des sentiments tendres découlant de la source des émois sexuels primitifs,
même lorsque ces émois ont été détournés de leur but sexuel originaire ou qu’un autre but
non sexuel est venu remplacer le premier.” (Freud, 1910 k)
L’image d’un organisme multipolaire ou, pour reprendre celle chère à Freud d’une amibe,
peut nous éclairer: De même que l’extension du pseudopode de celle-ci dans une
direction se fait nécessairement aux dépens des autres, le choix que le sujet peut faire,
parmi les nombreuses directions de sa libido, implique des abandons au moins
momentanés. Le processus sublimatoire ne fait que suivre ce mécanisme général qui
caractérise le destin des pulsions, il en subit la loi dans la mesure où les sublimations ne
sont jamais acquises une fois pour toutes et que le processus de désublimation peut
ramener la libido à sa forme originelle.
Si l’on considère la multiplicité bisexuelle chez tout sujet, on peut donc partir de
l’hypothèse que l’énergie libidinale qui nourrit les sublimations n’est pas nécessairement
soustraite à la vie sexuelle du sujet mais provient de sa constitution originairement
multipolaire.
Sur le plan dynamique, une telle hypothèse s’inscrit dans le jeu entre sublimation et
refoulement, tel que Freud le décrit dans “Un souvenir d’enfance de Léonard de Vinci”:
“Le refoulement sexuel a bien aussi lieu, mais il ne réussit pas à entraîner dans
l’inconscient une pulsion partielle du désir sexuel. Au contraire, la libido se soustrait au
refoulement, elle se sublime dès l’origine en désir de savoir.” (Freud, 1910 c, mars).
C’est avec la même précocité que l’un des deux pôles de la bisexualité subit soit un
refoulement - qui conduit le sujet à assumer une identité sexuelle, manifestée d’abord
dans les caractères sexuels psychiques et secondairement dans le mode du choix d’objet-
soit une sublimation.
Le quantum de libido en cause va donner lieu ou bien à un Ersatz sous la forme de
symptôme, ou bien à une dérivation sublimatoire qui conserve la marque de son origine.
C’est là où le ‘choix de la sublimation’, choix qui se produit dès l’origine, est
déterminant. Le plus souvent bien entendu, c’est une ‘solution’ mixte à la fois
symptomatique et sublimatoire qui se dessine.
[47]
Comment sortir de l’alternative entre vie sexuelle et sublimation que nous a laissée
Freud? Si l’on part de l’hypothèse d’une libido bisexuelle, celle-ci peut donc soit
s’exprimer dans le symptôme, soit se réaliser avec un objet d’amour, soit être sublimée.
Mais la complexité du jeu des identifications et les significations multiples de l’élection
de l’objet, qui peuvent n’être qu’apparemment conformes à un choix homo ou
hétérosexuel, rendent presque impossible d’appréhender synthétiquement une
représentation de ces diverses issues.
Le point de vue de Freud est que les issues sublimatoires sont compatibles avec la vie
sexuelle dans la mesure où elles empruntent leur énergie libidinale à la voie ‘abandonnée’
lors du choix de la position sexuelle. En revanche, la sublimation peut en un second
temps gagner davantage de terrain et absorber la libido venue des deux pôles de la
bisexualité, donc aux dépens de la vie sexuelle elle-même. De même les sublimations
peuvent se défaire et renvoyer le sujet à l’obligation de disposer autrement du stock d’une
libido bisexuelle gérée au moyen d’identifications et de courants libidinaux opposés.
Dans cette perspective, la part de libido consacrée aux activités sublimées s’avère non
seulement variable d’un individu à l’autre mais modifiable en fonction des aléas que
traverse chaque sujet dans sa vie sexuelle, sentimentale ou professionnelle.
Cette conception du destin de la bisexualité s’accorde avec ce que Freud pose dans Le
Moi et le Ça (Freud, 1923 b, fin 1922) concernant l’existence de quatre courants
libidinaux composés à partir d’un courant négatif et d’un autre positif, chacun visant
séparément le père et la mère. Lors de la destruction du complexe d’Œdipe, ces courants
s’associent pour former d’une part une identification avec le père prenant le relais tant du
penchant libidinal vers la mère que de l’hostilité envers le père et d’autre part une
identification avec la mère venant à la place du penchant hostile à son égard et de
l’attachement envers le père. Jeu complexe en effet, car il ne répond pas du tout à
l’attente qui serait que le Moi absorbe l’objet aimé auquel il a renoncé, mais qui donne
une idée de la possibilité de faire coexister des destins de pulsions contradictoires.
De la même manière, la sublimation s’établit dans une situation non d’exclusion mais de
coexistence avec les autres issues possibles. Comment sublimer le sexe qu’on n’a pas?
On sait que la sublimation de leur part féminine ou plutôt maternelle, est fréquemment
évoquée chez les créateurs. Il est en effet d’usage courant d’exprimer la création en
termes de maternité fantasmatique et peu d’auteurs, hommes ou femmes, échappent aux
métaphores de grossesse, d’accouchement ou de couvade lorsqu’ils évoquent la
production de leurs œuvres. Ils n’en parlent pas en termes d’acte sexuel – sauf les poètes
lorsqu’ils évoquent leur Muse - comme si cette maternité parthénogénétique constituait
en elle-même une sorte de sublimation de la sexualité.
Partant de l’hypothèse du lien entre le pôle de la bisexualité opposé au sexe
anatomiquement défini et la sublimation, on peut s’interroger sur la relation entre la
‘passivité’ féminine et l’intuition de l’artiste ou la représentation de l’œuvre comme un
enfant de l’esprit.
Christian David (1975) fait un rappel des différents auteurs qui se sont exprimés sur ce
thème, notamment: Stoller à propos de la corrélation entre ‘1’extrême féminité’ et le
talent artistique, Meltzer qui souligne l’usage du terme brain child à propos de la
créativité, Winnicott à propos des origines de la créativité et Ehrenzweig qui donne
[48]
l’indifférenciation sexuelle structurale comme catalyseur de la création. La position de
Winnicott qui fait de la bisexualité une position du soi mérite particulièrement attention:
Pour lui l’élément masculin fait (does) alors que l’élément féminin (chez les hommes
comme chez les femmes) est (is) (Winnicott, 1975). Ce qui signifie pour lui que l’élément
féminin dans les deux sexes correspond à l’identification primaire du bébé au sein,
identification qu’il a par ailleurs décrite et dont on sait qu’elle inaugure non seulement
toutes les expériences d’identification qui vont suivre mais constitue aussi la base de la
découverte du soi et du sentiment d’exister.
L’opposition entre l’élément féminin et l’élément masculin repose donc sur la différence
présente entre le sentiment de soi tel qu’il s’élabore dans cette relation primaire à la mère
d’une part,
56
et d’autre part la motion pulsionnelle qui fait suite à l’établissement de ce
sentiment, tel qu’à partir de lui l’enfant puisse reconnaître et viser un objet: “After being-
doing and being done to. But first, being;” écrit Winnicott (1975). On conçoit dans ces
conditions que la totalité de la bisexualité soit nécessaire à la création.
La capacité de sublimer reposerait donc sur l’intégration de ces deux éléments tandis que
leur clivage, quel que soit le sexe envisagé, serait un facteur d’inhibition. Il faut bien voir
que l’intégration dans cette perspective ne signifie pas l’établissement d’une sexualité à la
fois homo et hétérosexuelle.
Bien au contraire, l’homosexualité effective, qu’elle soit d’ailleurs inhibée dans sa
réalisation ou pratiquée, correspondrait plutôt à une carence de cette intégration de la
bisexualité impliquant que le sujet devrait se compléter lui-même aux dépens de son
partenaire.
57
C’est donc de l’élément bisexuel non clivé mais intégré qu’il peut y avoir sublimation.
Le lien entre sublimation et bisexualité est formulé, chez les autres auteurs précédemment
cités, essentiellement à partir de remarques concernant le rôle de la féminité dans la
création chez l’homme, alors que Freud s’intéresse davantage à celui qu’il établit chez la
femme entre masculinité et intellectualité. Dès 1896, à propos d’une comparaison sur le
rôle de la bisexualité dans les deux sexes, il note que chez un sujet ‘purement viril’ la
sexualité produit plaisir et perversion, alors que chez un sujet purement féminin elle
engendre déplaisir et défense névrotique. La conclusion qu’il tire de cette idée sans la
développer est intéressante: “C’est de cette manière que se confirmerait d’après ta [il
s’adresse à Fliess] théorie la nature intellectuelle des hommes.” (Freud, 1950 a-
1897/1902, Lettre du 6/12/96)
L’investissement sublimatoire de l’activité de penser formerait la ‘nature intellectuelle’,
lié au pôle masculin, opposé au refoulement (féminin selon Freud à cette époque) et, par
voie de conséquence, rattaché à l’autre issue, celle de la perversion. Dans ce contexte il
ne s’agit pas bien sûr de structure perverse telle qu’elle sera définie ultérieurement mais
56
Celle que Freud décrivait dans la phase hallucinatoire de satisfaction du désir, et dans laquelle la mère ou
le sein ne constituent pas un objet puisque l’objet est confondu avec le sujet lui-même.
57
Tel est par exemple le point de vue de Joyce McDougall pour qui la femme homosexuelle est celle qui
“rencontrant des obstacles à une évolution harmonieuse n'a pas pu réaliser l'intégration de son
homosexualité. A cette lacune correspond la faille dans le sentiment d'identité, les angoisses de la relation
avec autrui et les graves inhibitions dans l'activité sublimatoire.” (Mc Dougall, 1972)
[49]
plutôt d’un prolongement du polymorphisme sexuel infantile non entravé par le
refoulement. Le lien entre perversion et sublimation réapparaîtra dans la suite sous la
forme de cette aptitude particulière à sublimer que Freud reconnaît aux homosexuels.
Critiquant dans les Trois Essais sur la théorie de la sexualité la formule par laquelle les
invertis définissent leur nature (“un cerveau de femme dans un corps d’homme”), l’auteur
proteste: “Nous ne savons pas ce que c’est qu’un cerveau de femme.” (Freud, 1905 d)
Attribuer un sexe au cerveau, ou du moins lui reconnaître une appartenance sexuée, peut
sembler en effet difficilement démontrable, mais pour Freud c’est carrément le fait qu’un
cerveau puisse fonctionner autrement que sur un mode masculin d’activité et d’emprise
qu’il conteste! Ainsi, tout en ajoutant que ces distinctions sont plus conventionnelles que
scientifiquement justifiées, peut-il écrire à propos de la jeune homosexuelle qu’il traite:
“On pouvait aussi rapporter à la nature masculine quelques-unes de ses qualités
intellectuelles ainsi que l’acuité de son intelligence et la froide clarté de sa pensée.”
(Freud, 1920a)
Cette misogynie, propre en partie à son époque, fait que Freud néglige les
développements sublimatoires de la féminité de l’homme comme si la féminité chez un
sujet masculin ne pouvait aller que vers une issue perverse ou para-perverse
(homosexualité) ou être sinon refoulée.
Dans le même texte où il évoque l’analyse de la jeune fille homosexuelle aux qualités
intellectuelles si développées, il fait aussi part du cas d’un jeune homme artiste, aux
dispositions incontestablement bisexuelles, chez qui l’homosexualité avait fait son
apparition en même temps qu’un trouble de travail. Comme pour la jeune homosexuelle,
la position dite inversée de l’Œdipe occupe le devant de la scène, le sujet s’identifiant au
parent de sexe opposé et se ‘désistant’ de son identité sexuelle pour plaire au parent de
même sexe. Pour le jeune artiste, la réalisation de cette inversion dans l’homosexualité
effective marque la fin de la sublimation. On peut donc en déduire que la sublimation
s’appuyait antérieurement sur le même élément que celui qui se trouve réalisé dans
l’homosexualité effective: l’élément féminin opposé au sexe anatomiquement défini.
On voit dans cet exemple que la sublimation est mise en échec, non pas en raison d’une
concurrence liée à la réalisation sublimatoire elle-même, mais parce que l’élément
féminin de la bisexualité du jeune homme se trouve utilisé pour la satisfaction sexuelle
directe (puisque le renoncement aux femmes est suivi d’une position homosexuelle) et
donc retiré de la voie sublimatoire où il s’était précisément engagé.
Dans un autre cas, sous un aspect un peu différent c’est en fait le même processus de
rabattement de la libido vers l’élément bisexuel féminin qui devient origine de la position
libidinale non sublimée et cause de la désublimation. L’inhibition pour la musique dont
souffre ce jeune homme vient de ce que son frère aîné, bien que moins doué, partage la
même activité. La musique comme phallus imaginaire devient du même coup
inaccessible et c’est de l’autre (dans une position féminine) que le sujet l’attend.
L’identification œdipienne inversée invisible sous la forme de la sublimation du pôle
féminin de la bisexualité devient inutilisable pour la sublimation à partir du moment où
elle s’actualise dans l’attitude libidinale du sujet. Parmi les disciples de Freud qui se sont
penchés sur cette question du lien entre bisexualité et capacité créatrice, on peut rappeler
l’analyse de Federn, notamment dans sa réponse à la conférence de Freud sur Léonard de
[50]
Vinci (ler Décembre 1909), “L’Anlage, bisexuelle du génie a souvent été soulignée: le
grand artiste doit être non seulement le père (masculin, celui qui engendre les idées), mais
aussi la mère qui porte jusqu’à terme ce qui a été conçu et le met au monde. Ainsi, pour
créer jusqu’au bout (Ausschaffen), une certaine part de sexualité féminine doit être
artistiquement sublimée. Léonard n’a pas réussi cette sublimation des qualités
maternelles qui sont restées dans le domaine de la sexualité, et c’est pourquoi l’élément
masculin a pu engendrer en lui plus que ce que l’élément féminin n’a pu mener à terme.”
Freud, 1976, 345, 346)
58
Le féminin est ici confondu avec le maternel et l’hypothèse de Federn suppose que les
deux pôles de la bisexualité doivent être sublimés pour que l’oeuvre, qui a besoin d’un
père et d’une mère, puisse être créée. Echappant ainsi au refoulement, l’un des pôles de la
bisexualité peut donc être sublimé tandis que l’autre continue de fonctionner dans la vie
sexuelle. La conclusion de Freud selon laquelle des éléments psychiques masculins et
féminins issus de motions pulsionnelles appartenant à l’un et l’autre sexe existent, selon
des compositions variables chez tous les individus est la seule qui soit compatible avec ce
que nous apprennent tant la théorie que la clinique psychanalytique.
Plus généralement on peut penser que c’est à partir, non de l’un des pôles de la
bisexualité de manière exclusive, mais du polymorphisme bisexuel de la pulsion que la
dérivation sublimatoire doit être abordée. Cette caractéristique, comme nous l’avons vu à
propos de l’érotisme prégénital, est susceptible de créer un reste impossible à intégrer
dans la vie sexuelle du sujet qu’il pourra, suivant ses capacités, utiliser d’une manière ou
d’une autre, la sublimation constituant alors l’un des choix possibles.
59
L’idée que des objets et des voies différentes doivent être donnés aux désirs masculins et
aux désirs féminins chez un même individu s’accorde avec l’hypothèse d’une
sublimatoire privilégié pour l’élément féminin chez l’homme et le masculin chez la
femme.
Cette bisexualité serait aussi analysable à partir de la dynamique oedipienne elle-même,
comme le double de l’autre sexe qui existe dans le désir parental, quel que soit le sexe
réel de l’enfant, et vis-à-vis duquel celui-ci doit prendre position, quitte même à devoir
parfois s’y identifier afin de s’accorder au désir des parents, ou à celui qu’il leur prête.
Plus fondamentalement toutefois, on peut considérer que le fantasme d’un Moi bisexuel,
paradis perdu du temps où le Moi croyait être tout, constitue un point d’attraction
privilégié pour les motions pulsionnelles.
58
1976, Minutes de la Société psychanalytique de Vienne, II, Paris, Gallimard: 345, 346.
59
Sans que la sublimation soit explicitement évoquée on trouve d’ailleurs l’expression de ce point de vue
dans Malaise dans la Civilisation: “L’homme est lui aussi un animal doué d’une disposition non équivoque
à la bisexualité (...). Nous avons coutume de dire: tout être humain présente des pulsions instinctives,
besoins ou propriétés autant masculines que féminines; mais l'anatomie seule, et non pas la psychologie, est
vraiment capable de nous révéler le caractère propre du ‘masculin’ ou du ‘féminin’. Pour cette dernière
l'opposition des sexes s’estompe en cette autre opposition: activité-passivité. Ici c’est alors trop à la légère
que nous faisons correspondre l’activité avec la masculinité, la passivité avec la féminité. Car cette
correspondance n'est pas sans souffrir d’exceptions dans la série animale.” (Freud, 1930 a).
[51]
Renoncer à être à la fois homme et femme s’obtient au prix d’un travail de deuil auquel la
sublimation prête un appui précieux, ce qui nous ramène à la capacité propre à cette
dernière pour investir et donc transformer le manque.
Sublimer l’amour interdit
La possibilité de la cure analytique repose paradoxalement sur la sublimation alors que
tout nous rappelle qu’il s’agit d’un choix qui n’a rien d’évident.
Sont en effet au programme à la fois l’éprouvé de sentiments parfois hostiles mais aussi
amoureux ainsi que l’obligation tant d’en faire part à l’analyste selon la règle
fondamentale du ‘tout dire’ que de n’en rien faire puisqu’il s’agirait alors d’un ‘acting’
rendant impossible l’interprétation selon laquelle le vécu est enu à la place d’un souvenir
ancien refoulé.
Dès 1905, à propos de l’analyse de Dora, Freud souligne l’intervention de la sublimation
dans le transfert ou plutôt dans ‘les transferts’ qui viennent remplacer la création de
symptômes. “Certains sont faits avec plus d’art, ils ont subi une atténuation de leur
contenu, une sublimation, comme je dis, et sont même capables de devenir conscients en
s’étayant sur une particularité réelle, habilement utilisée, de la personne du médecin ou
des circonstances qui l’entourent. Ce sont alors des éditions revues et corrigées et non
plus des réimpressions.” (Freud, 1905 e-fév. 1900)
Au prix d’une rationalisation (“en s’étayant sur une particularité réelle habilement utilisée
de la personne du médecin ou des circonstances qui l’entourent”), ce contenu peut même,
nous dit Freud, devenir conscient tant l’opération de sublimation a effectué une
transformation propre à la rendre acceptable aux yeux de la censure. “Vous venez de faire
un transfert de M. K. sur moi. Avez-vous remarqué quoi que ce soit vous faisant penser
de ma part à de mauvaises intentions analogues à celles de M. K. de façon directe ou de
façon sublimée (je souligne), ou bien avez-vous été frappée par quelque chose en moi, ou
encore avez-vous entendu dire de moi des choses qui forcent votre inclination comme
jadis pour M. K.?” (ibid). Ce n’est pas sur les sentiments de Dora que porterait ici la
sublimation mais sur les intentions sexuelles de Freud ou le fantasme qu’elle s’en
formerait. Ses sentiments restent non sublimés, comme en témoigneront d’ailleurs sa
fuite, mise en acte répétitive qui montre bien qu’il ne s’agit pas d’une ‘édition revue et
corrigée’ du transfert capable d’accéder à la conscience.
La question posée par Freud à la jeune fille revient donc à lui demander si elle a cru qu’il
cherchait à la séduire. La sublimation dans ce contexte camoufle la séduction, mais aussi
de permet d’en parler avec une adolescente. Par la suite, la différence entre la pure
répétition ou la répétition qui débouche sur une remémoration et une élaboration passera
par la dialectique transférentielle elle-même qui fait de ‘l’acte itératif’ une répétition
élaborable.
La névrose de transfert, répétition et présence en acte du passé, n’est pas la seule
fascination passive du sujet, mais une reproduction qui inclut un élément créateur. Dans
“La dynamique du transfert”, Freud se demande pourquoi le transfert dit positif constitue
lui aussi une résistance puisqu’on pourrait s’attendre au contraire à ce qu’il ‘facilite la
confession’. Son analyse renvoie à ces sentiments ‘génétiquement apparentés à la
sexualité’, tels que l’amitié, la sympathie, etc. qu’il a désignés dans d’autres textes
comme sentiments sublimés, quitte d’ailleurs, comme on l’a vu, à signaler la fragilité de
[52]
ces inhibitions quant au but, en particulier dans le cas des sentiments sociaux des
homosexuels. L’explication va reposer sur la distinction de deux moments dans le
transfert positif: celui qu’on pourrait dire illusoire, c’est à dire reposant sur un
refoulement inconscient de la source érotique du sentiment positif, et un autre qui
correspondrait au contraire à la liquidation par la prise de conscience de cet élément
érotique.
Ce sentiment positif, dont l’origine a été mise au jour et dépassée, et qui subsiste dans son
aspect positif donne une bonne image de la sublimation: la relation ne passe plus que par
la récapitulation d’une ‘histoire’. Dans ce cas, la sublimation n’est pas l’affaire du patient
tout seul, mais celle de la cure elle-même, ce qui nécessite de la part de l’analyste d’en
faire ni trop ni trop peu
60
car l’analyse joue précisément sur ces désirs comme forces
motrices vers le changement.
61
Ultérieurement, la sublimation, qui n’est ni une espèce de
transfert, comme Freud le pensait à l’époque de Dora, ni le résultat d’une injonction, peut
éventuellement constituer l’issue de la cure. De plus, la situation transférentielle dans
l’analyse dévoile ce qui peut passer inaperçu dans la vie normale.
Elle montre par exemple la labilité du choix amoureux puisque la patiente répète un
scénario infantile, et aurait agi de même avec un autre analyste. Plus grave, le fait que
derrière le but conscient et avoué de se faire aimer se cachent d’autres visées moins
évidentes comme: “briser l’autorité du médecin en abaissant celui-ci au niveau d’un
amant”, ou “mettre à l’épreuve l’austère analyste et lui attirer une rebuffade s’il se
montrait consentant” (Freud, 1915 a). Quant à l’analyste, il doit lutter “au dedans de lui-
même contre les forces qui tentent de l’abaisser au-dessous du niveau de l’analyse.”
(ibid)
Céder à cette tentation équivaudrait, à préférer une unique saucisse à un plus lointain
chapelet des mêmes ou bien se laisser avoir par un bonimenteur en oubliant la sainte
mission pour laquelle on l’avait rencontré! Le but est donc de préserver l’analyse comme
objet d’investissement privilégié, ce qui est en soi de nature sublimatoire puisque ce but
requiert non seulement l’abstinence mais la dérivation qui permet de collecter l’énergie
libidinale nécessaire à l’investissement.
Toutefois, il serait erroné de considérer que l’analyse implique obligatoirement la
sublimation, elle peut tout au plus la requérir comme un idéal. L’impossibilité de
l’imposer au transfert amoureux des patients doit d’abord concerner le contre-transfert de
l’analyste lui-même y compris les sentiments négatifs d’indifférence et de
60
Dans Observations sur l’amour de transfert, Freud s’interroge avec une feinte naïveté sur la conduite que
l’analyste doit adopter lorsque, comme le feu qui éclate pendant une représentation théâtrale, la relation
analytique vient à être troublée par les manifestations d'amour tumultueuses d'une patiente: “Inviter la
patiente dès qu’elle a fait l'aveu de son transfert amoureux à étouffer sa passion, à renoncer, et à sublimer,
ne serait pas agir suivant le mode analytique mais se comporter de manière insensée.” (Freud, 1915 a)
61
Dans les touts débuts de leur correspondance Freud confirme à Jung, alors engagé dans les débuts de
l’affaire passionnelle que l’on sait avec Sabina Spielrein, que toute guérison grâce à la psychanalyse ne
peut s’opérer que ‘par l’amour’. Jung lui avait écrit, afin disait-il d’ ‘abréagir’, le récit que la jeune
étudiante russe lui avait fait de ses pratiques masturbatoires. Freud entend le trouble induit chez ce non
moins jeune médecin mais, loin de l’inviter à s’en défendre, il lui souligne au contraire qu’il a touché là le
seul levier thérapeutique de l’analyse, soit la mobilisation de la libido.
[53]
désinvestissement. La sublimation requise de l’analyste, concerne les sentiments
d’hostilité tout autant que d’amour et si ce n’était pas le cas, l’analyste se trouverait
inhibé dans l’acte d’interpréter qui comporte toujours une violence, certes mesurée.
62
Le processus de l’analyse repose sur le double mouvement de saisie par la psychè de
l’analyste du matériel inconscient communiqué par le patient et de traduction dans
l’interprétation. Mais tout réside en fait dans la copule: une saisie sans traduction
déboucherait sur un passage à l’acte et une traduction interprétative sans saisie, c’est à
dire sans mobilisation libidinale de l’analysant et de l’analyste, serait un rabâchage
obsessionnel à visée défensive. On voit que l’espace de l’analyse et donc de l’alliance
thérapeutique s’en trouvent clairement délimités: Quelque part au croisement entre
l’émotion érotique et le plaisir de pensée, faisant de l’intellectuel hystérique un sujet
particulièrement apte à la démarche analytique.
Les conditions se résument dans le pacte
63
sur lequel repose la cure qui donne le cadre où
peut advenir la sublimation sur laquelle repose le travail de l’analyse. Le Moi du névrosé
est, selon Freud, ‘accablé’, ‘affaibli’ voire ‘paralysé’ par des conflits internes entre le Ca,
le Surmoi et la Réalité, qui rivalisent d’exigences contradictoires. Seule la rupture avec la
dernière serait éventuellement possible, au prix il est vrai de se soumettre de manière
psychotique à l’emprise du monde intérieur, ce qui n’arrange rien en matière de conflit.
Face à cette guerre civile, l’analyste apparaît comme un allié du dehors qui va se liguer
avec le Moi en s’appuyant sur la réalité pour emporter le morceau.
64
Mais il est pour sa
part tout au plus un guide de montagne rémunéré en vue d’une difficile ascension….
Or, dans la situation analytique, l’amour de transfert a les exigences normales de tout
amour, c’est pourquoi il ne peut que conduire à un moment donné à la frustration et donc
au risque du retournement du transfert. Le patient se sent alors offensé, délaissé, il peut
même aller jusqu’à haïr son analyste comme un ennemi et être de ce fait tout prêt à
abandonner son analyse. Comme l’écrit Freud: “Il oublie le pacte auquel il a souscrit au
début du traitement et devient incapable de poursuivre le travail en commun.” (Freud,
1915 a). Mais qu’est-ce que l’oubli du pacte sinon la preuve de la partie implicite qu’il
62
Freud parle de manipuler le ‘ferrum’ et 1’‘ignis’ à côté de la ‘medicina’ et si la ‘furor sanandi’ n'est pas
recommandable, on ne peut attendre du psychanalyste qu'il se contente de méthodes douces et inefficaces,
c’est à dire d’une simple écoute passive. Remarquons au passage que l'utilisation inopinée de cette série
d’expressions latines a une valeur de symptôme. Le latin ou les langues étrangères sont utilisées, surtout à
l’époque de Freud, pour masquer le sexuel ou du moins permettre aux initiés de cacher qu'ils en parlent.
L’écueil le plus irréductible n’est pas tant l’amour de transfert que la haine et la sublimation contre-
transférentielle de celle-ci passe par l’investissement ‘chirurgical’ de l'outil analytique.
63
“Un pacte est conclu. Le moi malade du patient nous promet une franchise totale c’est-à-dire la libre
disposition de tout ce que son auto perception lui livre. De notre côté, nous lui assurons la plus stricte
discrétion et mettons à son service notre expérience dans l’interprétation du matériel influencée par
l’inconscient. Notre savoir compense son ignorance et permet au moi de récupérer et de gouverner les
domaines perdus de son psychisme. C’est ce pacte qui constitue toute la situation analytique.” (Freud, 1915
a)
64
On sait que, si l’analyste n’apparaît plus que comme un élément de cette réalité qui a été abandonnée, il
n’y aura pas de possibilité d’établir ce pacte, d’où les limites de la thérapeutique analytique en matière de
psychose, limites extensibles il est vrai car, on le sait, le Moi ne se détache jamais totalement de la réalité
même dans des états confusionnels aigus.
[54]
contenait: non pas le simple échange ‘sincérité contre discrétion’ mais l’amour permettant
de retrouver l’amour de soi.
Cependant, comme l’objectif inclut aussi la phase d’après c’est à dire la capacité du
patient de retrouver ultérieurement l’amour d’un autre qui ne soit pas l’analyste, cet oubli
du pacte est un arrêt en chemin et serait un échec s’il n’était pas possible de poursuivre.
La méthode suivie par l’analyste pour tenter de parer à ce désastre est instructive: il s’agit
“d’arracher le patient à se dangereuse illusion”, de l’“éclairer sur la nature véritable des
phénomènes de transfert”, bref il s’agit non plus d’amour mais de connaissance.
On en revient donc à quelque chose qui concerne non pas la sincérité mais la vérité et la
manière dont elle va pouvoir constituer une alternative sublimée à l’amour de transfert
sous sa forme basique. On ne s’étonnera pas de retrouver à la fin de l’article, parmi les
facteurs favorables au travail de l’analyse: “La capacité de sublimation des instincts dont
dispose le sujet, sa faculté de s’élever au-dessus de la vie pulsionnelle grossière et aussi la
relative puissance de ses fonctions intellectuelles.” (Freud, 1915 a)
Le pacte analytique apparaît dès lors comme comportant un double implicite qui va bien
au-delà de l’échange “sincérité contre discrétion absolue”. Il repose en réalité sur une
exigence très lourde qui est loin d’être donnée à tout le monde à savoir: accepter de se
laisser aller à l’amour tout en admettant que l’autre y réponde en dérivant l’amour en
retour - qu’il aurait peut-être donné dans d’autres circonstances - vers la construction
d’un projet commun soit la découverte de la vérité inconsciente du sujet.
En d’autres termes nous dirons qu’il s’agit d’un amour et d’une sublimation de cet amour.
Celle-ci vient au point précis où de la frustration et de la haine auraient été éprouvés.
Guide de montagne rémunéré, l’analyste offre avec son contre-transfert non pas
seulement l’émotion ou la compassion qu’il peut de fait éprouver, mais sa compétence, sa
propre expérience de l’analyse, son inconscient vivant tel qu’il va se manifester parfois
lui aussi par des rêves et plus habituellement par ces ‘Einfalle’ sur lesquelles se
construiront les interprétations.
Bref, comme ce guide, il offre sa passion pour l’effort, le risque de l’aventure jointe à sa
certitude d’en tirer un gain de plaisir partagé. Nous dirons qu’il offre la part de
sublimation qui le maintient dans sa fonction. C’est ce gain de plaisir anticipé qui peut
permettre au processus sublimatoire du patient de s’installer à son tour, non pas dans sa
vie mais d’abord dans l’analyse. Et ce dernier repose sur l’amour de la vérité, seul
élément éthique de la psychanalyse.
65
C’est le partage de l’amour de la vérité qui est l’élément sublimé fondamental de la cure
et pourtant, pour Freud, le but de la cure n’est pas la sublimation et la vérité est toujours
suspecte d’une confusion possible avec l’esprit de système.
66
Elle se voit en tant
qu’absolu, reniée et rejetée du côté des métaphysiciens, mais par ailleurs convoitée
65
“Le grand élément éthique dans le travail psychanalytique est la vérité et encore la vérité et ceci devrait
suffire à la plupart des gens;” écrit Freud à Putnam en 1914.
66
Freud n’était pas animé par la sorte de quête amoureuse de la vérité qui caractérise le philosophe, mais
s’apparentait plutôt à cet égard, ainsi qu’il le reconnaissait lui-même, au juge d’instruction et même au
policier.
[55]
comme résultat d’une démarche rigoureuse et reconnue comme condition indispensable à
l’existence même de la cure.
Il ne s’agit pas d’une vérité pirandellienne propre à chacun, mais de la ‘Vérité’, telle que
Freud l’a traquée toute sa vie, et dès le début auprès de ceux qui étaient le moins aptes à
répondre à une telle exigence: les malades hystériques caractérisés par le ‘mensonge’.
Aussi, à travers l’artifice d’une rencontre entièrement codifiée et contractuelle et par le
biais des illusions transférentielles, des mensonges et des demi vérités par lesquelles
patient et analyste s’assurent chacun de leur rôle et de leur identité, s’échange néanmoins
un projet de vérité fondamental qui concerne l’inconscient. Cette vérité de l’inconscient,
c’est bien l’objet de la demande paradoxale adressée au patient de dire ‘ce qu’il ne sait
pas’. Pour oser la concevoir il faut que l’analyste ait fait lui-même (et soit capable de
continuer de faire) l’expérience de la perception endopsychique de cette ‘pensée
archaïque’ qui est la source de toutes les autres et qui, du pictogramme au fantasme,
représente la possibilité de toute fécondité interprétative pour peu qu’il soit possible de la
traduire en idée communicable.
La vérité est donc bel et bien présente pour les deux protagonistes. L’analyste n’attend
pas de son patient qu’il dise la vérité mais qu’il croie la dire, et surtout qu’il accepte de la
rechercher. La vie n’est pas comme la situation analytique dont Freud rappelait encore à
la fin de sa vie qu’elle “est fondée sur l’amour de la vérité, c’est-à-dire sur la
reconnaissance de celle-ci, ce qui doit exclure toute illusion et toute duperie” (Freud,
1937), mais elle en conserve quelque chose pour ceux qui sont passés par l’analyse.
L’éthique de l’analyse -et en cela pratique et théorie se rejoignent- consiste à supporter de
laisser béante la place de l’ignorance et de l’incompréhension et à supporter la blessure
narcissique qu’elles infligent. En ce sens, l’amour de la vérité dont Freud fait le
fondement de la situation analytique est loin d’être idyllique et apparaîtrait plutôt comme
l’injonction d’aimer ce qui fait souffrir, car la vérité est souvent blessante en un premier
temps et donc spontanément rejetée.
La vérité offre un champ d’extension indéterminée dans la mesure où seul peut en être
découvert et partagé dans l’analyse le désir de la rechercher, c’est-à-dire l’investissement
de soi-même qu’implique la découverte de son absence et la confiance dans le fait qu’elle
existe néanmoins. A l’opposé de cette démarche serait non seulement la transgression
contre transférentielle dans l’amour et dans l’hostilité mais plus sournoisement toutes les
positions de pouvoir dans lesquelles l’analyste peut être tenté de s’installer du fait de la
confiance de l’analysant.
On sait que celle-ci, lorsqu’elle a été déçue et trompée dans l’enfance peut conduire le
sujet à l’offrir de manière aveugle à celui ou celle qu’il ressent comme surpuissant parce
qu’il faut enfin trouver la réponse qui a tant fait défaut.
C’est là où l’on voit en quoi la sublimation de l’analyste, c’est-à-dire tout simplement le
plaisir personnel qu’il trouve à être analyste et à respecter pour cela le pacte et ses
contraintes, est nécessaire à l’analysant. Car, si la dimension de la quête de la vérité y
occupe une place centrale, la cure psychanalytique n’est en aucun cas un processus
intellectuel, c’est une démarche fondée sur la force qui anime cette ‘attente croyante’, la
même que l’on retrouve dans toutes les relations fortes qu’elles unissent les amants ou les
groupements politiques, religieux de toute nature. La plupart des transgressions, qu’elles
[56]
soient sexuelles ou autres, se fondent sur l’infatuation de l’analyste vis à vis de cette
situation d’objet idéalisé dans lequel l’attente croyante du patient le place. Mais alors,
l’analyse s’arrête non pas parce qu’on ne doit pas mélanger les genres pour des raisons
d’éthique professionnelle mais tout simplement parce que le ‘charme’ au sens du pouvoir
magique du transfert est rompu.
C’est parce qu’il en est persuadé que l’analyste sera apte à transformer le matériau qui lui
est offert par l’attente du patient en autre chose que la relation amoureuse apparemment
demandée. Et c’est parce que malgré la frustration le patient l’accepte qu’il va pouvoir
s’approprier cette sublimation, qui est d’abord celle de l’analyste, grâce à laquelle il
pourra quitter le divan en conservant l’essentiel de ce qu’il y aura rencontré dans une
épreuve de vérité toujours difficile à traverser.
Si la capacité de sublimer constitue presque une sorte de réquisit pour le transfert et la
cure, peut-on considérer que Freud ait vu pour autant dans la sublimation l’issue naturelle
ou souhaitable de la cure? Sa position est claire, exprimée dès 1909 dans la deuxième des
Cinq leçons sur la Psychanalyse (1910 a-Sep. 1909) où la sublimation apparaît, à côté de
l’acceptation totale ou partielle du désir et sa condamnation, comme une parmi les
diverses issues possibles pour le refoulé qui a été ramené au plein jour. C’est pour éviter
le poids d’un jugement qui exclurait l’acceptation du désir que le sujet est amené à diriger
celui ci “vers un but plus élevé et pour cette raison moins sujet à critique” C’est, ajoute
Freud, “ce que je nomme la sublimation du désir.”
En réponse à la question “Que deviennent les désirs libérés par la psychanalyse?” (ibid),
on retrouve exactement la même problématique avec une légère différence dans la
présentation: La condamnation y figure comme la première issue mais Freud n’y insiste
guère, tandis que les deux autres (acceptation du désir et sublimation) sont mises en
opposition.
La sublimation absolue est irréalisable, mais, dangereuse pour l’individu, elle ‘tentante’
aux yeux d’un idéal collectif:
67
le bien de l’individu entre ainsi en conflit avec celui de la
société, puisque la sublimation a pour corrélat l’abstinence sexuelle.
Remarquons que la métaphore du cheval de Schilda, qui finit par mourir d’inanition du
fait de la restriction croissante de sa ration d’avoine, donne du désir sexuel humain une
représentation, là encore, purement quantitative ce qui, au regard de la conception
psychanalytique, réduit le modèle de la sexualité à celui de l’autoconservation dans la
perspective qui était celle de Freud à propos des névroses actuelles. Il faut donc se
rappeler que: “Chez toute personne capable de sublimer, le processus de sublimation se
réalise de lui-même dès que les inhibitions ont été levées” (Freud, 1912 e). L’influence
‘éducative’ du médecin est donc soit nulle, puisque le malade qui peut sublimer le fera de
toutes manières, soit dangereuse, puisque celui qui n’en aurait pas été spontanément
capable y sera amené artificiellement par le biais de l’attachement transférentiel et aux
dépens de sa santé psychique. Ce que peut faire l’analyse c’est donc remettre, au moins
partiellement, le patient en situation de choisir à nouveau le destin de ses pulsions. La
cure rendant une certaine liberté aux pulsions et levant les inhibitions, le processus
67
“Sans doute il est tentant de transfigurer les éléments de la sexualité par le moyen d'une sublimation
toujours plus étendue pour le plus grand bien de la société.” (Freud, 1914d)
[57]
pourrait se rétablir et la capacité originelle être mise en acte dans la réalité. La possibilité
non seulement de transférer les désirs inconscients sur l’analyste mais aussi de dériver au
moins en partie l’énergie libidinale ainsi mobilisée vers l’analyse elle-même, nous est
donc une condition du travail de la cure. La sublimation y est présente comme
investissement du projet analytique partagé avec l’analyste dans le cadre du contrat que
passent ensemble et avec l’institution analytique les deux protagonistes.
Peut-on dire pour autant que la psychanalyse soit une sublimation, comme l’écrit par
exemple Daniel Lagache? Si l’on entend par là qu’elle pourrait s’y résumer ou qu’elle
devrait nécessairement y conduire, certainement pas. La position de l’auteur à cet égard
est beaucoup plus floue que ne l’étaient celles de certains contemporains de Freud et, en
intitulant son essai “La psychanalyse comme sublimation” (Lagache, 1984), c’est d’un
usage très vaste de ce terme qu’il se réclame, soulignant le fait que la psychanalyse est
porteuse de valeurs culturelles élevées.
Tout en énumérant les raisons, tant du côté de l’analyste que de l’analysant, qui lui
permettent de parvenir à cette conclusion, il note néanmoins la distance entre les
principes et la réalité de l’analyse. Position difficile à tenir en effet car elle impliquerait
de rejeter comme non analytique tout ce qui dans la cure ne répond pas aux exigences de
l’idéal ou d’élargir suffisamment les bornes de la rigueur analytique pour y faire entrer
tout ce qui s’échange entre patient et analyste.
Ces deux possibilités partagent un même inconvénient: utiliser la notion de sublimation
comme une évaluation renvoyant elle-même à on ne sait quelle échelle de valeurs sans la
prendre comme un processus de transformation pulsionnelle.
Il est intéressant de constater qu’à bien des années de distance le texte de Lagache repose
les mêmes questions que celles qui avaient fait l’objet de la controverse entre Freud et
certains de ses correspondants, notamment Pfister et Putnam.
Le point de vue de Freud apparaît une fois de plus opposé à toute espèce de dérivation
‘sublime’ de la psychanalyse, tant du côté de l’analyste que de l’analysant. Bien loin de
considérer la pratique de l’analyse comme une forme de sublimation, il va même jusqu’à
évoquer dans une lettre à Lou Andréas Salomé à propos de Rank: “la pratique de
l’analyse, laquelle ébranle toutes les structures artificielles et annule éventuellement chez
l’analyste même la sublimation.”
68
Perspective parfaitement cohérente avec celle qu’il
exprimait sur les effets tumultueux du transfert et les dangers de son maniement.
Si le déchaînement des pulsions dans le transfert et le contre transfert va dans le sens
inverse de la sublimation ou plutôt le cas échéant en dénonce la fragilité peut-on dire que
pour Freud la sublimation demeure cependant l’idéal vers lequel doit tendre la cure? Sa
position à cet égard est à la fois nuancée et ferme.
Comme je l’ai dit plus haut, la sublimation constitue pour la cure une issue positive mais
d’une part ce n’est ni la seule ni nécessairement la meilleurs et d’autre part elle ne saurait
être donnée pour but. Car, face à la misère névrotique, elle apparaît comme un luxe et il
faut plutôt se réjouir “que l’on puisse vivre” (Freud à Jung).
69
68
Correspondance Freud/Lou Andreas Salomé (1966a), Lettre du 27-nov 1923.
69
Freud, 1906-1914, Paris Gallimard, 1975.
[58]
Pour Putnam, autre correspondant de Freud sur ce thème, elle est ce qui rend supportable
la psychanalyse car l’élévation finale peut seule justifier cette investigation dans les bas
fonds troubles de la sexualité. Mais la notion même de sublimation chez lui se trouve
déviée de son sens freudien dans la mesure où il l’assimile en fait à l’idéal religieux.
Freud reste ferme sur le point technique concernant la sublimation: “Plus on s’attaque
énergiquement au problème sexuel, plus vite l’on a de chances de procurer au moins un
soulagement. Là où la situation n’est pas à ce point désespérée, la sublimation engendre
d’elle-même de nouveaux buts, sitôt résolus les refoulements.”
70
Putnam n’est pas pour autant découragé et il expose ses vues plus en détail, en multipliant
les arguments pour justifier que selon lui les patients “doivent vouloir souhaiter se
‘sublimer’ et qu’il leur faut consentir à faire des sacrifices et à se conformer à leurs
idéaux.” Ses arguments sont les suivants: la psychanalyse devrait expliquer les
motivations qui poussent vers l’idéal, aucune guérison n’est totale si elle n’inclue pas un
progrès moral, réciproquement le dit progrès aide à guérir et enfin, la psychanalyse
“implique une conception de la vie humaine” qui justifie que l’on se soucie des
problèmes d’éthique. (Lettre fin Mars 1911)
Freud marque son désaccord mais aussi l’importance qu’il attache à cette controverse.
Il ramène Putnam aux bases de la théorie: “La théorie psychanalytique (...) enseigne
qu’une pulsion ne peut être sublimée tant qu’elle est refoulée et que la chose est vraie de
chacune de ses composantes. C’est pourquoi il est nécessaire de résoudre le refoulement
en surmontant les résistances avant d’aboutir à une sublimation partielle ou complète.
C’est là le but de la thérapie psychanalytique et le moyen par lequel elle promeut toutes
les formes de développement plus élevées.” (Freud, Lettre du 4 Mai 1911)
Le but de la psychanalyse est donc bien d’abord la levée des refoulements, le reste: la
sublimation et, dirait-on après Lacan, la guérison, viennent ‘de surcroît’, c’est à dire non
pas comme un luxe inutile mais comme une possibilité qui s’ouvre sans être visée
directement comme telle. Cette distinction est capitale car elle situe la cure
psychanalytique à l’opposé d’une action éducative ou thérapeutique, comme un moyen de
restitution au sujet des choix multiples que l’entrée dans la névrose lui a rendu
inaccessibles.
La position de la sublimation dans la cure découle logiquement de cette position de
principe sur laquelle Freud ne variera pas et qui constitue le point de clivage de la
psychanalyse d’avec tous les autres types de psychothérapies et toutes les déviations
idéalistes et idéologiques passées ou à venir.
On le sent s’agacer progressivement de l’insistance de Putnam et, après lui avoir rappelé
que ses propos éducatifs sont disproportionnés avec les capacités de la majeure partie des
patients (Lettre du 14 Mai 1911), il attaque sur le thème de l’analyste ‘parangon de
vertus’: “Que la psychanalyse n’ait pas rendu meilleurs, plus dignes, les analystes eux-
mêmes, qu’elle n’ait pas contribué à la formation du caractère reste pour moi une
déception. J’avais probablement tort de l’espérer.” (Freud, Lettre du 13 Novembre 1913)
Et quelques mois plus tard, dans une lettre du 30 Mars 1914: “Quant aux analystes, ils
sont eux-mêmes fort éloignés de l’idéal que vous exigez d’eux. Dès qu’ils sont investis
70
Correspondance Freud/Putnam (Freud 1971 a), Paris, Gallimard, 1978.
[59]
de la tâche de guider le patient vers la sublimation, ils se dépêchent d’abandonner les
devoirs ardus de la psychanalyse pour reprendre les fonctions beaucoup plus confortables
et satisfaisantes de professeur et de parangon de vertu.” (ibid).
La surdité de Putnam rejoint celle de Pfister qui correspond avec Freud sur le même
thème à peu près à la même époque et auquel Freud accorde “qu’un succès durable de la
psychanalyse dépend des deux issues qu’elle réussit à ouvrir: la décharge de satisfaction
d’une part, la domination et la sublimation de la pulsion rebelle d’autre part.”
71
Puis viennent des recommandations plus directes: “Le prude souci de s’assurer qu’il
n’advient aucun dommage à ce qu’il y a de plus élevé chez l’homme ne convient point à
l’analyste.” (27/07/1922). Sur le plan technique, Freud insiste exactement sur les mêmes
points que ceux qu’il souligne à Putnam: “Pour ce qui est de la sublimation, on dépendra
moins de ses propres intentions que des dispositions du patient. On fait ce qui se laisse
faire.” (Freud, 19/07/1910).
Cette méthode ne concerne pas que la question de la sublimation, elle résume l’essence
même de la cure: “En science, il faut d’abord décomposer puis reconstituer. Il me semble
que vous cherchez la synthèse sans analyse préalable. Dans la technique psychanalytique,
il n’est point besoin d’un travail spécial de synthèse; cela, l’individu s’en charge mieux
que nous.” (Freud, 9/10/1918)
La synthèse, les sublimations et le reste se produisent d’eux-mêmes lorsque les
conditions les rendent possibles. Il semble que l’on rejoigne ici la sublimation sous un
autre angle, bien que Freud n’en parle pas expressément.
La sublimation de son désir d’emprise sur son patient n’est elle pas la condition pour que
l’analyste puisse analyser sans se transformer en éducateur ou en maître de quelque
nature? L’ ‘abstinence de l’âme’, expression que j’emprunte à Robert Musil, est une autre
forme du travail sublimatoire et elle exige en l’occurrence de renoncer à ce besoin d’avoir
raison dont cet auteur disait qu’il se confond avec la dignité humaine. La synthèse est un
instant de jouissance pour l’esprit qui s’accommode du déplaisir de l’analyse, voire
parvient à y trouver du plaisir, dans l’espoir d’une meilleure synthèse et fantasme que, tel
un étau, il se referme sur ce qui ne peut désormais plus lui échapper.
Y renoncer est une des tâches les plus ardues du psychanalyste et demande une vigilance
constante afin que ce processus n’entraîne pas chez lui pour autant un désinvestissement
du patient. S’il respecte cette clause, il se produit en général l’effet paradoxal qu’il se
trouve totalement incapable d’émettre un jugement global sur un patient dont il a pu
cependant mieux que tout autre démonter les mécanismes psychiques cachés.
L’analyse se fait au jour le jour, séance après séance et le travail de perlaboration qui
revient au patient est aussi un travail de synthèse dans lequel il se retrouve seul, même
s’il peut faire appel à des images intériorisées et d’abord à celle de son analyste, pour le
mener à bien. Est-ce cela que Freud avait dans l’esprit lorsqu’il écrivait à Pfister “Comme
toutes les autres voies de la sublimation qui nous tiennent lieu de religion sont trop
pénibles pour la majorité de nos patients, notre cure débouche le plus souvent sur la
recherche de la satisfaction.” (Freud, 9/02/1909)
71
Correspondance Freud/Pfister 1909-1939 (1963 a), Paris, Gallimard, 1966.
[60]
L’abstinence de l’âme de l’homme irréligieux qui ne propose pas non plus d’idéologie ou
de Weltanschauung qui tienne lieu de religion est une sorte d’ascèse à laquelle ne peut en
effet se comparer “la forme la plus commode de sublimation, la sublimation religieuse”.
Comme l’écrit Freud avec un mélange d’envie et d’ironie: “Vous avez le bonheur de
pouvoir conduire ce transfert [celui qui s’établit sur la personne de l’analyste] jusqu’à
Dieu et de rétablir ainsi ces temps bénis - du moins sur ce point - où la foi religieuse
étouffait les névroses.” (ibid)
Toutefois, une dizaine d’années plus tard, les positions des deux correspondants n’ayant
pas bougé, Freud emploie un autre ton: “Je ne peux que vous envier au point de vue
thérapeutique la possibilité de la sublimation dans la religion. Mais ce qui est beau dans
la religion n’appartient certainement pas à la psychanalyse. Il est normal qu’en matière de
thérapeutique nos chemins se séparent ici et cela peut demeurer ainsi. Tout à fait en
passant, pourquoi la psychanalyse n’a-t-elle pas été créée par l’un de tous ces hommes
pieux, pourquoi a-t-on attendu que ce fût un juif tout à fait athée?” (Freud, 9/10/1918)
Toutes les tentatives pour entraîner la psychanalyse vers des déviations ‘anagogiques’,
idéalisantes donnent une idée du motif de conflits que pouvait représenter la notion de
sublimation pour Freud. Notion explosive dans la mesure où elle a une fâcheuse tendance
à se transformer et à entraîner dans son mouvement la théorie toute entière.
On ne peut dans ces conditions s’étonner que Freud, tout en y revenant sans cesse dans
son œuvre, ne l’ait en fait jamais réellement approfondie, comme s’il lui fallait s’en tenir
à des définitions liminaires pour ne pas lâcher la bride au cheval de Troie tout prêt à faire
entrer en fraude dans la théorie psychanalytique le vieil arsenal des valeurs et des
croyances philosophico-religieuses.
Sublimer l’identité impossible
L’identité impossible que je désigne ici est celle du ‘Moi-idéal’ telle qu’elle se retrouve
dans les idéaux du Moi ultérieurs.
Les diverses formes de la dépression et sa somatisation ou ses échappées vers les
addiction nous montrent quotidiennement que l’on peut mourir de l’insatisfaction
névrotique d’être seulement soi ou au moins que l’on peut en souffrir cruellement et
durablement. La surestimation dans laquelle le Moi hisse son idéal est issue de
l’idéalisation qu’il a pu faire de ses parents qui en étaient les premiers représentants. Mais
celle dont ce même Moi a joui dans l’enfance, son Moi-idéal, est aussi le prolongement
de la manière dont il avait été été placé en position d’être “His Majesty the Baby”.
Toutefois les parents eux-mêmes n’auraient pas soutenu une telle affirmation autrement
que sur un mode tendrement humoristique, et sinon il est fort probable que les
conséquences auraient été lourdes d’inhibitions ultérieures pour l’enfant. La majesté en
question est donc toujours à venir, dans l’espoir de la réalisation des vœux auxquels les
parents eux même avaient dû renoncer. C’est précisément cette différence qui nous
permet de penser la place de l’idéal dans la sublimation.
Je fais l’hypothèse que le processus sublimatoire rétablit une distance temporelle du
même ordre vis-à-vis des requêtes de l’Idéal du Moi et c’est la raison pour laquelle il
s’inscrit toujours dans une durée et dans l’espace d’un travail. D’une manière générale, si
les exigences de l’Idéal peuvent être supportables et motrices pour le Moi c’est parce
[61]
qu’il retrouve son attitude infantile qui le faisait s’imaginer capable de les atteindre plus
tard, “quand il serait grand”. En proposant d’envisager la notion de sublimation à travers
celle d’un travail sublimatoire, ce n’est pas le processus de transformation de la pulsion
sexuelle que je considère, mais les conditions d’une articulation topique susceptible de le
rendre possible. On pourrait formuler la question en ces termes: s’il ne suffit pas
d’échanger son narcissisme contre la vénération d’un Idéal du Moi élevé, quelle est donc
la relation entre le Moi et son Idéal qui peut favoriser l’émergence des processus
sublimatoires? Elle est en réalité liée à l’investissement d’un temps futur et au travail
pour y parvenir.
C’est la raison pour laquelle on peut légitimement rapprocher la sublimation de ces
moments de réélaboration identificatoire que constituent tant le travail du deuil ou celui
de l’humour que le temps de la période de latence, voire celui de la cure psychanalytique.
Il ne s’agit là que d’exemples et une étude plus approfondie de ce “temps de la
sublimation “, entendue comme moment de rupture et de réélaboration où la possibilité
de nouvelles sublimations se dessine, aurait demandé de prendre en compte aussi d’autres
situations.
Ainsi l’adolescence, le fait de devenir père ou mère, celui d’arriver à l’âge de perdre ses
propres parents constituent autant d’étapes de ce type, propices à l’exercice de ce que
Freud appelle Innenforschung, force d’auto-investigation qui caractérise l’action de
l’Idéal du Moi.
La même activité psychique qui a pris en charge la fonction de la conscience morale se
met au service de l’introspection qui livre à la philosophie le matériel pour ses opérations
de penser et va servir aussi le cas échéant pour paranoïaques à la construction de
systèmes spéculatifs. Cependant cette introspection est aussi la possibilité pour le sujet de
peser et de décider des choix fondamentaux de sa vie.
En fait, si l’Idéal du Moi est bien conforme à son objectif originel (selon Freud, devenir
comme le père), c’est à toute espèce d’activité en relation avec ce but qu’il incite le Moi,
dans la mesure où cette activité est susceptible de lui renvoyer une image identificatoire
valorisée.
Que devient ce troisième terme, l’identification, précédemment introduit pour penser la
différence entre sublimation et idéalisation? L’étude de la notion de « caractère » du Moi
permet de comprendre en quoi l’identification est fondamentale pour penser la
sublimation. A un moment où il n’est pas encore en possession de l’apport théorique que
constituera la théorie du narcissisme, Freud propose de considérer que les traits de
caractère sont déterminés à partir des composantes érogènes prévalentes chez un
individu. Ce faisant, il va illustrer ce qu’il n’avait jamais fait qu’énoncer comme une
proposition théorique: le lien de la sublimation avec la libido perverse polymorphe issue
des zones érogènes-sources. Ultérieurement, la théorie du narcissisme -et surtout son
extension dans Le Moi et le Ça définissant la sublimation comme un processus qui
s’effectue “par l’intermédiaire du Moi” grâce à la transformation de la libido sexuelle
dirigée vers l’objet en une libido narcissique- limitera la possibilité de relier directement
ou indirectement les caractéristiques des activités ou des traits sublimés aux pulsions
partielles déterminées en fonction des seules zones érogènes.
Dans la proximité conceptuelle de la notion de travail du deuil comme incorporation de
[62]
l’objet perdu, on peut en revanche comprendre la formation du caractère comme résultant
de l’introjection des qualités de l’objet par le Moi, lequel retrouve alors à l’intérieur de lui
l’objet sexuel auquel le Ça avait dû renoncer. “Cette substitution [c’est-à-dire la
substitution de l’identification à l’objet sexuel perdu], écrit Freud, joue un rôle de premier
ordre dans la formation du Moi et contribue essentiellement à déterminer ce qu’on
appelle son caractère.” (Freud, 1923 b fin 1922) Ce dernier ne se trouve alors défini ni
par des impressions venues laisser des traces dans l’inconscient, ni par une dérivation
directe (sublimatoire) ou indirecte (formation réactionnelle) issue de composantes
érogènes déterminées mais par l’histoire des modifications du Moi en fonction des choix
d’objets sexuels successifs d’un individu. C’est ce même modèle du travail de deuil sur
l’objet, par lequel on peut caractériser le processus sublimatoire ou du moins sa
motivation. Mais le fait que le caractère du Moi résulte de ces choix d’objets perdus
n’implique pas qu’il y ait eu une sublimation. Ainsi l’idéalisation va introjecter des
identifications inconscientes empruntées aux objets de l’Oedipe sans qu’il y ait eu la
moindre élaboration de type sublimatoire.
Je propose donc de considérer que la sublimation travaille sinon sur le deuil du Moi lui-
même du moins sur le deuil du Moi-idéal tout puissant. La clinique nous montre que
l’enfant se croit aimé à la mesure et selon les contours de l’omnipotence qu’il croit
sienne. En grandissant et en perdant plus ou moins cette illusion, il pense perdre aussi la
relation que l’objet investi avait avec lui. Trouver un substitut ne peut alors se limiter à
introjecter les vertus de l’objet car ce qui a été perdu c’est la qualité idéale du Moi. Il faut
alors substituer au Moi-idéal, qui s’est avéré illusoire, un objet, une activité, une œuvre,
que le Moi donnera pour sienne. Il est attendu de cette image nouvelle d’un Moi en
devenir qu’elle permette de remplacer non l’objet idéal mais le Moi-idéal. La
représentation sublimée de soi est liée à un projet précis et limité dont la quête elle-même
aura le pouvoir de renvoyer au Moi l’image de lui qu’il a perdue. Il pourra alors
seulement retrouver l’amour de l’objet qu’il risque fort sans quoi de ne pouvoir
rencontrer parce qu’il s’est enfermé lui-même dans le vécu dépressif de la perte. En
d’autres termes, pour aimer et accepter d’être aimé il lui faut redevenir aimable à la
mesure de l’image idéale à récupérer.
L’hypothèse freudienne d’une définition globale de la “voie générale de toute
sublimation” à partir de la transformation de la libido d’objet sexuelle en libido
narcissique, reposait en fait sur la contradiction entre l’impossibilité pour le Moi d’être
investi par une libido sexuelle provenant du Ça et la nécessité de se proposer néanmoins
comme objet substitut. Mais pourquoi ce travail compliqué aussi bien sur la libido que
sur le Moi lui-même? N’aurait-il pas été plus “économique” que le Ça investisse un autre
objet éventuellement ressemblant au précédent? Le seul motif susceptible de l’expliquer
est que le Moi ne se propose pas ainsi à l’amour du Ça uniquement dans le but bien
illusoire de le maîtriser, mais parce qu’il n’a pas d’autre choix. L’objet n’est pas
remplaçable parce qu’il s’agit du Moi-idéal sous sa forme idéale archaïque, mélange tant
de l’objet que du Moi du temps où tous deux étaient indifférenciés, préforme mythique
perdue mais jamais oubliée.
Si cette dernière soutient la série des objets-substituts, elle peut aussi pour un temps
s’incarner dans un objet privilégié. S’il y a perte, celle-ci réactive ce qui avait été le
mécanisme des premières identifications selon le modèle du deuil. C’est alors que le Moi,
[63]
qui a expérimenté une solution de remplacement sublimatoire primitivement inventée
disposera de moyens pour retrouver non pas l’objet mais lui-même. Ou plutôt ce qu’il est
capable de faire, voire de créer.
Cette conclusion n’est pas économique, nous avons vu même qu’elle est dangereuse,
mais les modifications profondes qu’elle requiert ouvrent la voie vers ce qui serait sans
cela resté en dehors des visées de la libido, c’est-à-dire les réalisations sublimées.C’est le
modèle de l’humour, en créant une autre interprétation de la réalité que celle imposée par
les circonstances, qui illustre au mieux ce travail de reconstruction sublimatoire du Moi
dans le Moi. Il constitue une victoire contre ce qui aurait dû normalement se développer
en dépression, sentiment d’injustice ou de vacuité. En ce sens il n’est pas exagéré de dire
que tout choix sublimatoire s’effectue contre le glissement vers la voie la plus directe,
celle qu’indique la pulsion de mort comme désir de non-désir, indifférence pour ne plus
souffrir.
A l’inverse toute sublimation est un défi lancé à la réalité et à ses limites. On le voit de
manière particulièrement nette lorsqu’il s’agit de réalisations d’ordre sportif, par
exemple, qui semblent braver les lois de la pesanteur et les possibilités d’un corps ou de
la création d’une néo-réalité par l’œuvre artistique.
Quoique plus modestement, le travail de pensée aussi utilise les difficultés voire les
échecs vécus dans le quotidien pour en faire l’occasion d’une recherche et la quête d’une
explication, et relève donc bien du même mécanisme.
On sait que les bornes imposées par la réalité ne sont jamais vécues par un sujet de
manière anonyme mais comme la manifestation d’une instance parentale interdictrice,
voire persécutrice s’il ne s’agit pas seulement d’une barrière mais d’une atteinte imposée
au Moi. Le déplacement topique propre à la sublimation implique l’identification à
l’instance idéale protectrice et son surinvestissement mais il se double d’une victoire
contre cette même instance sous sa forme négative et critique, d’où l’émergence de
l’affect de triomphe si caractéristique de l’humour mais présente aussi dans le plaisir
sublimé.
On se rapprocherait par-là du modèle de la manie ou de ce que Freud soulignait, dès
“Totem et tabou”, à propos de la fête rituelle: “Nous savons que les membres du clan se
sanctifient par l’absorption du totem et renforcent ainsi l’identité qui existe entre eux et
leur identité avec lui. La disposition joyeuse et tout ce qui en découle pourrait s’expliquer
par le fait que les hommes ont absorbés la vie sacrée dont la substance du totem était
l’incarnation ou plutôt le véhicule.” (Freud, 1912-1913)
La possibilité d’un gain de plaisir dans la réussite ponctuelle d’une activité soutenue par
un processus sublimatoire ne se produit donc pas uniquement sur le fond d’une
identification à un père protecteur. Elle implique toujours (et c’est pour cela qu’il peut y
avoir plaisir dans le triomphe) la victoire sur un parent haï, intériorisé sous la forme d’un
Surmoi interdicteur et cruel. Rappelons à ce sujet la fête maniaque définie dans «Deuil et
mélancolie» selon un étrange crescendo: “Dans la manie il faut que le Moi ait surmonté
la perte de l’objet [Ce serait alors l’issue normale du deuil, mais Freud nous a dit que le
travail du deuil, en épuisant l’énergie libidinale, ne connaissait pas de tel sentiment de
triomphe] ou bien le deuil relatif à cette perte [Ce serait alors la situation d’un Moi
reprenant en main les bribes de libido détachées une à une de l’objet, mais un tel
[64]
enthousiasme n’est guère concevable qu’à l’issue du travail et donc ne laisse pas
d’occasion pour une décharge aussi importante] ou bien ce peut être l’objet lui-même.”
(Freud, 1917e, mai 1915) Il ajoute que cette dernière possibilité demeure de toute
manière ignorée du Moi qui ne sait pas ce qu’il a surmonté et ce dont il triomphe.
La relation de haine destructrice est transposée à l’intérieur de la psyché, l’instance idéale
exigeant que le Moi s’abandonne lui-même mais, simultanément et grâce à cette
opération, le Moi s’identifie aux aspects positifs de son Moi-idéal aimé et détruit.
Face à l’angoisse de mort qui “se joue entre le Moi et le Surmoi” (Freud, 1923b, fin
1922), l’humour et la sublimation offrent des réponses chacune à leur manière.
Par l’humour, le Moi refuse de s’abandonner lui-même et se rebelle contre l’Idéal du Moi
en s’appuyant pour cela sur les aspects positifs de son Surmoi.
Les formes de sublimation qui mènent à la production d’une œuvre (ou de manière
beaucoup plus générale sur un travail) situent la relation entre le Moi et le Surmoi d’une
manière différente: Le Moi contraint le Surmoi à l’aimer en renonçant à la forme illusoire
du Moi-idéal critiquée par ce dernier et en édifiant par son travail sublimatoire une forme
nouvelle du Moi sur le même modèle mais lié à une réalisation objective.
C’est en ce sens qu’il me semble que l’on peut comprendre la sublimation comme une
érection ou un rétablissement du Moi dans le Moi après que ce dernier ait pu ou ait risqué
de faire l’objet d’une perte. La perte primaire qui induit la potentialité des premiers choix
sublimatoires est celle du Moi-idéal mais bien d’autres choix sont possibles et notamment
tous ceux qui reposent sur l’aliénation idéalisante à un objet extérieur. A cet égard, la
sublimation apparaît bien différente du processus d’identification qui érige l’objet dans le
Moi, de même que du processus d’idéalisation qui met l’objet à la place de l’Idéal du
Moi. Pour assurer ce rétablissement, le Moi retrouve et oppose à la situation actuelle ses
premières identifications, celles qui ont été pour lui fondatrices des images d’idéal et de
la constitution du Surmoi. S’il lui a été alors possible d’établir avec ce dernier une
relation qui ne soit pas seulement critique mais aussi de protection et de reconnaissance
identificatoire, il peut par la suite y trouver une solution pour répondre à l’angoisse de la
perte du Moi-idéal. Par là se confirmerait l’idée exprimée par Freud dans le Léonard que
la sublimation est un processus fixé dès l’origine.
Le processus sublimatoire joue sur la durée, car il n’implique pas que le Moi coïncide
d’emblée avec son Idéal mais que l’instance critique puisse lui reconnaître de se
consacrer tout entier à un tel objectif. Un tel résultat ne serait probablement pas possible
si le narcissisme ne venait pas apporter son concours sous la forme de la surestimation.
Même chez le plus sceptique, il n’y a peut être pas d’activité sublimée qui ne se soutienne
du fantasme que le Moi pourra un jour, même partiellement, coïncider avec l’Idéal et
apporter ainsi la sensation de triomphe tant désirée. Dans l’espoir d’une telle issue, le
sujet peut jouir du plaisir mesuré qu’offre la satisfaction sublimatoire, toujours opposée à
un risque de perte qui s’apparente bien plus à une perte du Moi qu’à une perte de l’objet.
[65]
La capacité d’effectuer un tel travail intrapsychique n’est cependant pas donnée à tout le
monde, comme le rappelle Freud à propos de l’humour.
72
Mais l’usage de la sublimation
ne lui parait guère plus aisé: “Le point faible de cette méthode est qu’elle n’est pas d’un
usage général, mais à la portée d’un petit nombre seulement. Elle suppose précisément
des dispositions ou des dons peu répandus, en une mesure efficace tout au moins.”
(Freud, 1930a)
Pourquoi Freud fait-il une métapsychologie de l’humour alors qu’il se contente d’affirmer
dans “Malaise dans la civilisation” que les satisfactions sublimatoires “possèdent une
qualité particulière qu’un jour nous saurons certainement caractériser de manière
métapsychologique”? Et lorsqu’il se propose de rendre compte de la “satisfaction que
l’artiste trouve dans la création ou éprouve à donner corps aux images de sa fantaisie ou
celles que le penseur trouve à la solution d’un problème ou à découvrir la vérité” (ibid) à
nouveau l’analyse s’efface devant le jugement de valeur et il se borne à conclure qu’elles
paraissent “plus délicates et plus élevées”. Il est clair que modifications topiques
impliquées par le travail de l’humour et de l’identification fournissent de solides
hypothèses concernant la caractérisation métapsychologique de la sublimation conçue en
fonction du jeu entre le Moi et ses instances idéales.
Mettre en échec la pulsion de mort
Le ‘travail de sublimation’ s’effectue et surtout se prolonge grâce à une tension qui n’a
rien de naturel ni d’automatique et dont le but est de permettre au Moi de rejoindre au
moins partiellement les exigences spécifiques que lui pose son idéal. La pulsion de mort à
l’ inverse impose le retour répétitif sur les mêmes échecs, les mêmes souffrances
auxquelles le sujet ne peut renoncer, jouissant douloureusement de l’injustice du sort qui
est le sien. Il faut donc passer par un travail de deuil du Moi-idéal qui est la condition de
la mise en échec de la pulsion de mort qui se détourne de tout désir parce que le sujet n’y
croit plus.
Le travail de sublimation peut à l’inverse conduire à la reconstruction du Moi dans le
Moi, formule qui paraphrase celle utilisée par Freud pour décrire le travail du deuil
(Aufrichtung des Objekts im Ich), soit “l’érection de l’objet dans le Moi”.
Lorsque Freud écrit à propos du deuil que l’ombre de l’objet tombe sur le Moi, cette
image d’obscurcissement illustre parfaitement la mélancolie, et la folie d’un Moi, clivé
entre une instance critique et une partie de lui-même habitée par l’objet perdu (qui est
aussi celui qui a abandonné) ce qui déchaîne un conflit interminable. Mais quand il
revient en 1921 dans Psychologie collective et analyse du Moi et en 1923 dans Le Moi et
le Ça sur le processus d’identification à l’objet perdu, Freud fait appel à une métaphore
beaucoup plus nette que celle de l’ombre et qui souligne précisément l’aspect topique de
sa théorie: l’érection de l’objet dans le Moi (Aufrichtung des Objekts im Ich). Erection,
redressement ou rétablissement, cet acte en répète un autre plus ancien et l’objet est en
fait érigé à nouveau (wieder aufgerichtet), ce qui s’entend si l’on considère que c’est à
partir des investissements narcissiques primitifs qu’une partie de libido a été prêtée à
l’objet pour l’édifier une première fois.
72
“Tout le monde n'est pas apte à l'attitude humoristique; c'est là un don précieux et rare et beaucoup sont
même dépourvus de l'aptitude à goûter le plaisir humoristique qui leur est communiqué.” (Freud, 1927d-
aout)
[66]
L’ombre qui obscurcissait le Moi s’est transformée en un monument, statue ou stèle
funéraire plantée au milieu du Moi pour attirer sur lui l’investissement autrefois dévolu à
l’objet, et le cas particulier de l’identification mélancolique ne tient pas à la nature du
mécanisme en cause mais au lien de haine qui unissait primitivement le Moi à l’objet
perdu.
Ce même mouvement qui conduit non seulement à redistribuer les investissements
objectaux, mais aussi à remodeler l’équilibre interne du Moi lui-même, peut constituer la
base d’un renouvellement de la théorie de la sublimation.
Le mécanisme de l’humour, qui permet de tirer du plaisir pour soi-même et pour autrui de
sa propre souffrance, repose sur la capacité de sublimation du créateur de l’humour. Il est
particulièrement intéressant de voir que Freud tente d’abord de mettre ce dernier du côté
des mécanismes de défense mais, bien qu’il propose d’y voir “la manifestation la plus
élevée de ces manifestations de défense”, il souligne simultanément qu’il s’agit en fait de
tout autre chose.
L’humour se produit aux frais “des affects négatifs”, il leur emprunte leur énergie et la
convertit en un affect opposé, source de plaisir grâce à un développement qui inhibe
l’évolution de la douleur et porte l’investissement sur un autre point.
Le processus qu’il décrit ressemble beaucoup plus à une sublimation qu’à du
refoulement: l’humour triomphe de l’automatisme de défense en maintenant présente à la
conscience la représentation douloureuse et en la surinvestissant, ce qui le rapproche du
travail du deuil. Il ne se contente pas d’inhiber le développement de déplaisir, mais opère
une véritable transformation de l’énergie liée à l’affect pénible en lui offrant une voie de
décharge. Comme pour toute sublimation, la dérivation assure ici non un blocage mais la
continuité d’un processus dynamique, et c’est autour de la production d’un plaisir que
tout se joue. Parce que l’humour est producteur de plaisir et témoigne donc de la
possibilité de déplacer un but sans faire perdre son intensité à la pulsion, il se distingue
radicalement d’une défense et s’apparente à un mécanisme sublimatoire.
Comment se produit ce déplacement et quelles sont les modifications topiques qu’il
implique? L’humour, nous dit Freud, se présente comme protecteur et consolateur. “Seule
notre enfance, écrit-il, connut des affects, alors fort pénibles dont, adultes, nous sourions
aujourd’hui tout comme l’adulte, en tant qu’humoriste, rit de ces affects pénibles de
l’heure présente.” (Freud, 1905c) L’élévation du Moi dont témoigne le déplacement
humoristique aurait donc pour origine la comparaison que l’adulte peut faire entre son
Moi actuel et son Moi infantile.
Si l’adulte peut mépriser ce qui lui arrive en se projetant dans un temps futur où toutes
ses souffrances actuelles n’auront pas plus de sens pour lui que n’en ont actuellement les
petits ou grands chagrins de son enfance, c’est à une toute puissance de type infantile que
nous ramène l’humoriste. On lit à la fin du Mot d’esprit: “Cette euphorie à laquelle nous
nous efforçons par là d’atteindre n’est rien d’autre que l’humeur d’un âge où notre
activité psychique s’exerçait à peu de frais, temps auquel nous ignorions le comique,
étions incapables d’esprit et n’avions que faire de l’humour pour goûter la joie de vivre.”
(Freud, 1905c)
En 1927 Freud confirme, dit-il, les vues ‘timidement suggérées’ auparavant: l’humoriste
est installé dans une identification paternelle qui lui permet de traiter les autres mais
[67]
surtout, lui-même, comme s’il s’agissait d’un enfant. L’auteur de l’humour est finalement
le Surmoi, car la personne de l’humoriste a retiré l’accent psychique de son Moi et l’a
déplacé sur son Surmoi. On peut utiliser le schéma explicatif de l’humour parallèlement à
celui du deuil pour penser celui de la sublimation.
Le modèle de l’humour, proche du travail du deuil, permet donc de comprendre comment
le Moi est amené à détruire et à reconstruire non pas l’objet dans le Moi comme le fait le
deuil, mais le Moi dans le Moi. Loin de se détourner de la représentation cause de
souffrance et de tenter de l’oublier, le sujet s’en rappelle intensément l’existence. En ce
qui concerne le deuil, Freud insiste sur le fait que cette tâche est longue et qu’elle est
accomplie “avec une grande dépense de temps et d’investissement”. Ce surinvestissement
a une fonction précise: devant chaque détail remémoré concernant l’objet perdu, le Moi
doit choisir de partager son funeste destin ou “se laisser décider par la somme des
satisfactions narcissiques à rester en vie et à rompre sa liaison avec l’objet anéanti.”
(Freud, 1917e, 1915) Si l’on considère que pour l’endeuillé la seule manière de conserver
encore en vie l’objet perdu est de le garder vivant dans sa mémoire, le travail du deuil
consiste bien effectivement, comme l’a dit Lagache, “à tuer le mort.”
L’identification peut proposer son soutien pour renoncer à l’objet et l’édification de
l’objet dans le Moi, en le délivrant de l’obligation de conserver ses investissements
bloqués, permet alors au sujet de partir à la recherche de nouveaux objets.
On peut penser que l’humour transporte ce même processus à l’intérieur du Moi, car c’est
celui-ci qui se trouve alors menacé. Le sujet, blessé dans son narcissisme et humilié par
ses échecs, abandonne ce Moi auquel il confiait tous ses espoirs et le décrète naïf, comme
le serait un enfant. Il s’en écarte, le regarde comme un objet comique et s’identifie à celui
qui rit de cette partie récusée de lui-même.
Le même remaniement topique mis en œuvre pourrait convenir à rendre compte du
travail de sublimation. Pourtant Freud, qui considère l’humour, selon ses termes, “comme
une des manifestations psychiques les plus élevées et les plus chères aux penseurs”
(1905c), n’a fait appel pour en expliquer les mécanismes ni à la notion d’idéalisation ni à
celle de sublimation.
L’humour peut offrir un modèle analogique pour concevoir le travail de la sublimation
parce qu’il constitue une forme de triomphe contre la souffrance et se fonde sur la
modification topique suivante: le sujet surinvestit son Surmoi afin de sauver son moi et ce
déplacement de l’énergie d’une instance à l’autre permet que l’intensité pulsionnelle se
conserve.
Si l’on considère que l’objet perdu est une partie de l’investissement narcissique, ce
processus qui a plus d’un lien avec le deuil offre un modèle pour le travail sublimatoire.
Une différence fondamentale demeure néanmoins: l’humour, contrairement à la
sublimation, se produit dans l’immédiateté, ce qui est l’origine de l’effet comique. Si la
distorsion due au surinvestissement du Surmoi ne débouche pas sur une issue
pathologique mais, en l’occurrence, sur le plaisir de l’humour, c’est parce qu’il n’est pas
présent en tant qu’instance interdictrice, sévère, voire cruelle, mais comme un
représentant de la fonction consolatrice et protectrice occupée par les parents dans
l’enfance. Le besoin de protection par le père, que Freud considérait comme une des
composantes originaire de la psyché, est désormais assuré par le Surmoi qui peut
[68]
s’adresser ainsi au Moi: “Regarde, voilà donc le monde qui parait si dangereux, un jeu
d’enfant, tout juste bon à faire l’objet d’une plaisanterie.” (Freud, 1905c)
Ce lien entre l’humour et le Surmoi relance une question fondamentale: pourquoi le
triomphe sur la souffrance, propre à l’humour, a-t-il un effet comique au lieu de se
contenter de forcer le respect comme une marque de grandeur d’âme ou d’élévation de
pensée philosophique? Selon Freud, c’est le tempo rapide du processus, différent en cela
de la sublimation, qui explique cette particularité: En 1905, c’était le caractère
préconscient et “automatique” du processus qu’il considérait comme responsable de
l’effet comique. En 1927, c’est le mode de surinvestissement du Surmoi qu’il met en
cause. Il s’agit en effet de le surinvestir ‘brusquement’. Par cette référence à une absence
de durée et donc d’élaboration, on voit que l’humour se situe du côté du triomphe du
principe de plaisir et de l’action de Thanatos.
Pour qu’il y ait détente et donc effet comique, il faut que le processus ne soit pas investi
par un excès d’attention et qu’il puisse se dérouler inaperçu en restant à un niveau
préconscient. L’effraction du rire dans le tourbillon même de la passion déchaînée se
produit comme une décharge automatique là où l’émergence d’une souffrance aurait dû
avoir lieu.
On peut bien sûr se demander si le rire est alors bien une expression du comique ou s’il
ne se donne pas plutôt comme un équivalent d’un sanglot, à la manière dont pourrait
l’être un spasme respiratoire, une crise de migraine ou toute autre expression somatique.
L’explication de l’humour et non de l’effet comique ponctuel, en fonction d’une
modification des investissements topiques, invite à voir le premier, non pas comme une
production aléatoire mais comme un trait de caractère, une disposition du Moi
appartenant à l’image identificatoire qu’un sujet peut avoir de lui-même. En quoi peut-on
l’apparenter à quelque chose de l’ordre d’une sublimation?
Je fais l’hypothèse que le travail sublimatoire, en empruntant les mêmes mécanismes,
parvient en effet non seulement à s’inscrire dans une durée, mais à produire un objet que
le sujet peut offrir comme le représentant de lui-même et vis à vis duquel il entretient une
relation privilégiée, toutes ses autres relations étant le cas échéant tenues de passer par la
médiation d’un partage avec cet objet. Posséder une disposition psychique propre à
l’humour, c’est finalement être capable de retrouver le cheminement qui avait permis, au
début, de surmonter les premières blessures narcissiques. La représentation d’un temps
futur (“Quand je serai grand”) est ce qui permet à l’enfant de se défendre contre cette
souffrance.
Dans le cas de l’humour, l’évocation de cette victoire passée offre au Moi le pouvoir de
se sacrifier sous sa forme actuelle en surinvestissant son Surmoi. C’est aussi en ce sens
que la disposition d’esprit humoristique se différencie du travail du deuil dont par ailleurs
tout semble la rapprocher. Dans le deuil, le moi se soumets au verdict de la réalité qui lui
impose de retirer la libido des liens qui l’unissait à l’objet perdu. C’est l’évaluation de la
somme des satisfactions narcissiques opposées à l’attachement à l’objet qui le pousse à
choisir de rester en vie et de rompre sa liaison avec l’objet anéanti. Si l’on considère que
dans le cas de l’humour cet objet apparaît comme étant le Moi lui-même, on a, comme je
l’ai dit plus haut, un schéma à la fois proche et différent de celui du deuil. La distinction
touche au caractère grandiose et exaltant de l’humour, qui s’explique par le fait qu’il soit
[69]
lié au triomphe narcissique, à l’invulnérabilité victorieusement affirmée du Moi.
73
La
possibilité, grâce à un remaniement topique, de faire d’un traumatisme qui aurait pu être
passivement subi l’occasion de gagner du plaisir est ce qui définit, selon moi, l’essence
même du travail sublimatoire. Le plaisir ainsi obtenu n’atteint jamais, comme le dit
Freud, “l’intensité du plaisir pris au comique ou au mot d’esprit, et il ne se prodigue
jamais en francs éclats de rire.” (Freud, 1905 c) De la même manière, selon Freud, les
sublimations n’offrent jamais des décharges de plaisir aussi intenses que le sont les
satisfactions sexuelles directes.
L’humour n’a rien de naturel, il est opposé au mouvement narcissique spontané qui
conduit au dépit, à la colère ou à la souffrance. De la même manière que le lézard qu’on
attrape n’hésite pas à abandonner un morceau de son anatomie pour garder le reste libre
et intact, l’humoriste sacrifie son Moi en le ramenant aux dimensions d’un Moi infantile
et en se hissant lui-même au niveau de sa propre instance idéale. Il ne s’agit pas comme
dans l’idéalisation de vénérer un Idéal du Moi élevé mais extérieur. L’humour ne se
rapproche ni de l’humilité ni de la résignation philosophique, laquelle n’aurait, selon
Freud, en elle-même rien d’amusant.
74
Mais la philosophie se résume t’elle à la résignation? La prise de distance par le comique
apparaît au contraire comme l’un de ses thèmes classiques et l’on pourrait s’étonner que
le père de la psychanalyse n’y fasse aucune allusion s’il n’y n’avait pas d’autres exemples
de la méconnaissance fréquente dans laquelle il la tient. Le rire philosophique a le sens
d’un déplacement du point de vue exactement analogue à celui du Surmoi, il signifie que
le sujet s’est haussé à une dimension plus vaste que celle qui concerne son individu et se
sent supérieur voire invulnérable. Rire c’est d’abord se moquer du ‘ridicule’, le sien et
celui d’autrui. Le rire immotivé de Démocrite, ainsi que le rapporte Juvénal, apparaissait
à tous comme une folie jusqu’à ce qu’Hippocrate y voie une suprême sagesse. Le
philosophe, comme certains schizophrènes, riait de ce qu’il ressentait comme absurde
dans la vie des autres et en l’occurrence dans l’agitation frénétique des marchands qu’il
observait. Savoir rire et faire rire de soi est une position inexpugnable puisque
l’humoriste enlève toute prise à la dénonciation du ridicule étant donné qu’il s’en est
servi en premier. De plus, l’humoriste ne fait rire de lui que pour autant qu’il utilise sa
propre personne pour dénoncer des situations dans lesquelles il n’est plus. Le pas de côté
que constitue le rire permet de s’abstraire tant sur le plan moral que métaphysique, il est
donc philosophique par essence.
Nietzsche en fait, avec le jeu et la danse, l’une des puissances affirmatives de ce qu’il
appelle la ‘transmutation’: la danse transmue le lourd en léger, le jeu de dés projette le
bas vers le haut et le rire renverse la souffrance en joie. Il s’agit moins d’ironie ou de
73
Comme l’ écrit Freud: “Le Moi se refuse à se laisser offenser, contraindre à la souffrance par les
occasions qui se rencontrent dans la réalité; il maintient fermement que les traumatismes issus du monde
extérieur ne peuvent l'atteindre; davantage: il montre qu'ils ne sont pour lui que matière à gain de plaisir.”
(Freud, 1905 c)
74
Ainsi que le rappelle Freud: “Dans le cas ou un homme triomphe de son affect douloureux en comparant
l'immensité des intérêts mondiaux à sa propre petitesse, ce triomphe n'est pas le fait de l’humour mais de la
pensée philosophique.” (ibid.)
[70]
moquerie et encore moins de mépris que d’un souffle libérateur. La dimension maniaque
de triomphe contre l’adversité et plus profondément contre la finitude, anime le rire.
Comme l’écrit Gilles Deleuze à propos de Nietzsche: “Rapportés à Dionysos, la danse, le
rire, le jeu sont les puissances affirmatives de réflexion et de développement. La danse
affirme le devenir et l’être du devenir; le rire et les éclats de rire affirment le multiple et
l’un du multiple; le jeu affirme le hasard et la nécessité du hasard.” (Deleuze, 1967)
Retrouver la capacité de rire dans la séance d’analyse est le signe d’une connivence
précieuse avec l’analyste dans un plaisir partagé. C’est aussi le gage qu’un pas a été
franchi contre l’enfermement névrotique et la jouissance dépressive.
C’est le modèle de l’humour, en créant une autre interprétation de la réalité que celle
imposée par les circonstances, qui illustre au mieux ce travail de reconstruction
sublimatoire du Moi dans le Moi. Il constitue une victoire contre ce qui aurait dû
normalement se développer en dépression, sentiment d’injustice ou de vacuité.
Bibliographie
Andreas-Salomé, L. (1913). Journal, 11 mai.
David, C. (1975). La bisexualité psychique, XXXVè congrès des psychanalystes de
langues romanes, RFP, 5-6.
Deleuze, G. (1967). Nietzsche et la philosophie, PUF, Paris.
Federn (1976). Minutes de la Société Psychanalytique de Vienne, II, Gallimard, Paris.
Freud, S. (1905a). De la psychothérapie, la technique psychanalytique, trad. A. Berman,
PUF (1970), Paris.
_________ (1905c). Le mot d’esprit et ses rapports avec l’inconscient, trad. M.
Bonaparte, M. Nathan, Paris.
_________ (1910 a). Cinq leçons sur la psychanalyse, Petit Payot (2004), Paris.
_________ (1912e). Conseils au médecin dans le traitement analytique, OCF.P., XI: 143-
154.
_________ (1912-13a). Totem et tabou, OCF.P., XI: 189-386.
_________ (1915a). Observations sur l’amour de transfert, la technique psychanalytique,
trad. A. Berman, PUF, (1970), Paris.
_________ (1917g). Deuil et mélancolie, OCF.P.: 261-280.
_________ (1921). Psychologie des masses et analyse du moi, OCF.P., XVI: 1-84.
_________ (1923b). Le moi et le ça, OCF.P., XVI: 255-302.
_________ (1927d). L’humour, OCF. P., XVIII, 133-140.
_________ (1930a). La malaise dans la culture, OCF.P., XVIII: 245-333.
_________ (1937). Analyse terminée et interminable, Revue Française de Psychanalyse,
XI-No 1. Collection Analectes, Paris; janvier 1970.
_________ (1909-1939). Correspondance Freud/Pfister, Gallimard, Paris.
[71]
Lagache, D. (1984). La psychanalyse comme sublimation, La sublimation et les valeurs,
OCV, PUF, Paris.
Mc Dougall, J. (1972). Relations d’objet dans l’homosexualité féminine, La sexualité
perverse, Payot, Paris.
Mijolla-Mellor, S. de (1922). Le plaisir de pensée, PUF, Paris.
_________ (2005). La sublimation, Que sais-je?, PUF Paris.
_________ (2009). Le choix de la sublimation, PUF, Paris.
Mijolla-Mellor S. de sous la direction de (2012). Traité de la sublimation, PUF, Paris.
Winnicott, D. (1975). Jeu et Réalité, Gallimard, Paris.
[72]
[73]
Participatory Art in Dialogue
with Agricultural & Post-industrial Land
Emilia Bouriti
Abstract
This article is a reference to participatory art and the dialogue it develops with the rural
and post-landscape of Aspropyrgos. The reference point is the international Amoli
Programme which has been taking place through the artistic platform Syn+ergasia since
2016 in the area of Aspropyrgos. The program consists of two main axes of Art and
Culture. It is a collective project in the Agricultural, Post Industrial and Multicultural
Community of Aspropyrgos. Participatory art is expressed through the Amoli program
with experiential, participatory, visual works, educational programs and international
workshops. It processes the strength of the community based on food, cultivation, the
rural and post industrial landscape, the rural energy community, multiculturalism and the
rural landscape of Aspropyrgos. I note that the latter is treated not only as the organic
power of the earth but as an element of cultural heritage, where it is not stagnant in time
but the opposite, it is a changing energy field that absorbs and transforms dynamic
elements such as experiences, memories and human situations. The methodology of the
article has the following structure: Reference to the concept of participatory art,
underlining its connection with the site specific art, the concept of landscape (rural and
industrial) and the definition of the community. Then, I refer to my choice as an artist and
researcher to deal with the rural and post-industrial area of Aspropyrgos, and finally to
the methodology I use to create framework for participatory art and the participation of
local communities in it. In conclusion, I will argue that participatory art is the main tool
to transfer the energy of art to the power of the community and through this dialogue,
which takes place in the specific rural and post industrial environment of Aspropyrgos, to
pave the way for evolutionary processes both in the artistic field and in the collective
expression of the community.
Site Specific Art
Before seeking the concept and action of participatory art as mentioned, it is important to
explore the art of the locally defined space ‘Site Specific Art’, because participatory art,
in most of it, takes place in non formal artistic spaces and the Amoli program takes place
in rural and outdoor spaces.
According to Miwon Kwon (Kwon, 2002, 1), site-determined, site-oriented, site-
referenced, site-conscious, site-responsive, site-related are the terms used by artists and
critics to approach the site specific art. This practice is linked with the anti-idealistic and
anti-commercial site specific practices at the end of 60s and the beginning of 70s, which
incorporated the natural conditions of a specific site as an integral part of the production,
[74]
presentation and understanding of art. This aesthetic aspires to broaden the boundaries of
traditional artistic means such as painting and sculpture as well as their institutional
environment.
The site specific projects operate within the environmental elements of the given space.
The scale, size and location of the works are determined by the topography of the site
regardless of whether it is urban or country or architectural. The works become part of
the space and reconstruct its organization in concept and perspective (Kwon, 2012, 12).
The above statement of Miwon Kwon explains the importance of site specific art and
contrasting this statement with the works of participatory art of the Amoli program, I
could say that these works could have no other structure but the one which was received
from the properties of the space, where the works were created and presented.
Participatory Art
In the mid 1990s, a shift in art began in the social sphere and in the ‘commons’.
According to Claire Bishop (Bishop, 2012, 1) the expanded field of ‘post-studio’ practice
have many names such as: Socially involved art, participatory art, community art,
interactive art, collaborative art, experimental communities, conceptual art and lately
social practice. Bishop refers to this expanded field by the term participatory art as this
implies “the participation of many people, as opposed to the one-to-one relationship
concerning ‘interactivity’” (Bishop, ibid).
In the 1990s there was a need to overturn the traditional relationship between the art
object, the artist and the spectators. The artists until then in their largest ensemble had the
role of individual object producers and not the role of collaborators and creators of
situations. The artistic work as a stable marketable product is revised as a work in
duration with a vague beginning and end while the audience, designated as a viewer, is
redefined as a ‘co-produce’ or participant (Bishop, ibid, 3).
Bishop’s above comment is important because it underlines that the creation of the
participatory work concerns not only the artist but also the public, since the latter is
defined as a ‘co-producer or participant’.
Some Greek artists associated with participatory art are: Mario Spiliopoulos, Maria
Papadimitriou, Eleni Girtzilakis and some foreign ones are: Anna Halprin, Mayer
Harrison, Temporary Services, Tania Burgera, Lucy Orta, Thomas Hirshhorn, Vik Muniz,
Superfl ex, Jeanne van Heeswijk, Annika Eriksson.
Community - collegiality and society
The French philosopher Jean-Luc Nancy says that the interaction (with the community)
stems not from an individual desire or collective insecurity but from a basic element of
human action, a passion for ‘sharing’.
By giving a status of ‘inertia’ to the community, Nancy does not see it as a dysfunction or
a failure, but a spontaneous tendency that the community has for a connection where
there is no purpose, or reason for it, but only the tendency itself. Nancy believes in a
community which lives with its potential in the present and not in a distant lost dream of
an ideal community that characterizes communist ideology (Nancy, 2020, quick
reference).
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With reference to the above I agree with Nancy that the connection with others i.e. with
the community is beyond a personal need for the safety of the many and I extend this
thought by saying that the connection is a key characteristic of the man who at the
archetypal level unites him with the collective dynamic of the group-community, with the
group soul or else with the collective ‘body’ whose strength is diversity and that is why
he can fit all individualities as long as each of them trusts the bond with the community
and thus each individuality to realize the importance of its presence and diversity in order
to make the collective body of the community healthy.
The rural landscape and the post-industrial city
Before referring to the rural landscape of Aspropyrgos, I will summarize the elements
that make up the city's course. Aspropyrgos is a city with a lively presence from the past
to the present day, with a rich history and cultural heritage. Known as the arable land of
Thriasio field, it never ceased to be cultivated until today. For me/ I could say that in
Aspropyrgos the goddess Dimitra presents her rural site while in Eleusis her hieratic one.
The violent industrial development experienced in the middle of the 20th century, the
transformation of the place from rural to industrial, and its transition in recent decades to
the post industrial phase are reflected in the landscape of the region. In direct connection,
the intense migratory activity at different times shaped the multicultural figure of
Aspropyrgos today. Understandably, the course of Aspropyrgos acts as a miniature of the
course of Europe, a continent that experienced at different speeds the stages of
agriculture, industrial development and the post- industrial phase, while today in plagued
by the economic crisis and the migration flow.
The rural landscape of Aspropyrgos belongs to the rural zone of the city and is scattered
among the industrial, commercial and residential zone. These agricultural fragments of
land were valuable for the participatory projects developed through the Amoli
programme. The Arvanitic and the Pontiac community that participated in the
participatory projects testified body and soul since memories, personal stories concerning
the land and the rural place came to be a key element of the works.
I note that for the purposes of the creation of participatory projects, the rural landscape of
Aspropyrgos was approached through multiple readings and practices after becoming a
field of memory, walking path, participatory action, rural cultivation, experiential
practice, artistic, research and educational activity. It is useful here the reference of
Theano Terkenlis, where she states that “The landscape reflects a layout of reality from
different perspectives: vertical and oblique, objective and subjective, functional and
moral-aesthetic as well as real and ‘fantastic’, natural and man-made, distant and
involved, mechanistic and experimental, and so on.” Through these experiences and
processes, which always favour certain perspectives, views and angles of view of the
landscape, the relationship between man and the environment is referred to multiple
realities in space, time and cultural contexts, as demonstrated by the history of the
landscape. The context in which the observer operates and its position in relation to the
landscape reveal the relativity, complexity and variability that distinguish these localities.
Locality -by definition always in relation to the observer- is much more than just a
relationship between subject and object (Terkenli, 2005, 82, 83).
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The Choice of the Rural and Post-industrial Area of Aspropyrgos
as a Place for the Practice of ‘Participatory Art’
An important element that influenced me in the selection of the rural landscape of
Aspropyrgos for the creation of works of participatory art and the realization of the
international program Amoli was my origin. I was born in Aspropyrgos to parents-farmers
and ranchers, with an Arvanitic mother. My artistic journey has been sealed by the power
of the earth and its main expression is the human BODY. What has nurtured me to
communicate with the Arvanitic and Pontiac community, who I work with, and to
understand their code which stems from the relationship with the land is my vivid
memories of the rural cycle of time, and the rural Arvanitic community who helped each
other and at the same time shared intense communication experience through their rural
work.
The Methodology of Participatory Art Through the Work Amoli
My methodology starts with the relationship I build with the landscape. It is a
relationship of experiential, deciphering messages and vibrations that I feel possessed as I
wander the landscape.
I walk, listen, open the senses, let the body wander, and build bridges with the landscape.
I feel that I am energetically united with it and then the landscape is revealed to me
along with the concept of sanctuary for the land, the plants and the people of the region.
Ultimately, what I have to do is leave space for the above elements creating a situation, a
skeleton where I will contain them. However, the dynamics of this situation are
determined by the participants.
The process of organizing the project takes time because I share with the participants the
wanderings in the landscape, experiences of our lives but also the elements that everyone
from the community wants to share through confessions, storytelling, singing, preparing
food, or meditative silent meals.
This participatory process results in the formation of an integrated work, in Greek it is
translated as a complete work but I will prefer the term combined work since it contains
participatory action, personal performance by me the other artist, audiovisual material,
walking path and interaction of the audience.
The essence of participatory art as I see it emerging through the Amoli program is the
deep human relationship that is built as we share with the community time and
experiences. The relationship I have also developed with the community is interwoven
with issues related to the everyday life of the community and the city. Like the
environmental problem, the right of the rural community to cultivate in a post-industrial
environment. The continuation of the existence of the oral Arvanitic local dialect that is
endangered since it is the last generation that speaks the dialect. Also a key element of
communication with the community is respect for the pace at which the community
participates in the above actions. I believe that in order for the artist to have a meaningful
relationship with the community, he must develop the element of listening to the needs
and the limit that each person in the community puts forward in the process of action. The
community is a network of living relationships and the success of participatory art that
the artist organizes depends on the principles of self- respect, solidarity, self-expression
and the cultivation of true interest in the need of members of the whole community.
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In conclusion, the article approaches participatory art and its action in the rural and post-
industrial landscape of Aspropyrgos with references to the international Amoli program.
It was mentioned how participatory art met the rural landscape of a fragmented post-
industrial city such as the city of Aspropyrgos.
It was stressed that in order to have participatory art it needs the participation
(involvement) of the community. The artist’s true selfless interest in the community will
give the ground to build participatory art.
Artists to work creatively with the community must forget their egos but not their artistic
work where the community itself is co-creator. The experiential practices used in the
Amoli program at the individual, artistic and collective level created the conditions for the
development of participatory art in Aspropyrgos.
In conclusion, I feel that at a time when economic insecurity, mental poverty and
isolation are at the fore, with reality TV leading the way and underlining that most
tragically face instead of our real human needs, that is, respect for the uniqueness of each
person, space for self- expression and the real relationship with the community which is
based on sharing and on the testimony of a soul.
Participatory art has the power to embrace the above human needs by giving artists
freedom and responsibility for realization.
Bibliography
Bishop, C. (2005). Installation Art: A Critical History, Routledge, New York.
________ (2012). Artificial Hells: Participatory Art and the Politics of Spectatorship.
Verso Books: London and New York.
Kwon, M. (2004). One Place after Another: Site Specific Art and Locational Identity, The
MIT Press, Cambridge, Massachusetts.
Nancy, J.L. (2020). Inoperative Community, Oxford University.
Greek bibliography
Zika, F. (2011). From the ‘death of the author’ to the live ‘performance art’, Chronicles of
Aesthetics, P. & E. Michelis Foundation: 183-194.
Lazou, A. (2015). Philosophy is taught through art, A. Lazou & G. Patios (eds.), Art,
Philosophy, Therapy (Vol. A). Athens: Arnaoutis Publications.
Terkenli, Th. (2005). A Place Many Landscapes: Agricultural Approaches to Locality,
Scientific Symposium: The Rural Landscape, The Palimpsest of Centuries of
Agricultural Toil, Merkouri Estate, Athens: 77-88.
Related websites
Syn+Ergasia Art Platform. Amoli International Program
https://synergasia.wixsite.com/synergasia
http://www.emiliabouriti.com/
[78]
[79]
Acting Code
From the ancient Greek philosophical systems to the Acting Code system, the
contemporary advanced acting and directing technique for theatre, film and the
performing arts. An Introduction.
Christos Prosylis (a.k.a. Prossylis)
The present article -as a prepublication- is the presentation of the introduction chapter of
the book under publication under the title Acting Code. Advanced acting and directing
technique for theatre, film and the performing arts. An Introduction. (Prosylis, 2020,
USA)
In our modern times, a complex of technological life parameters affects our daily life,
including among others the creative process of the artists. There is no doubt that affects
dramatically the creativity of the actors, directors and performers, either for films or stage
plays and performances of any kind.
‘Traditional’ well known methods and techniques of acting and directing have limitations
in this modern technological environment, due to the simple reason that they are created
and designed for a different creative environment, far away from the social,
technological, practical, artistic and philosophical needs, of our contemporary life. As far
as, the art is part of life, the old well known methods are still good, but unfortunately with
limitations in our modern digital and post-digital life environment, internet connected
life, artificial intelligent and robotic evolution, 3D and 4D graphics, digital stage and
cameras evolution and so on.
However, it seems like there is a very important link between the past and present: the
philosophical and practical understanding of the means of the term System of the ancient
Greek philosophy, which connects the past with the theoretical practice of the modern
actor and director, either for film or the stage. This connection works as a kind of matrix,
which gives birth to a really effective creative work in this modern environment.
As I am working for more than two decades upon this research, the Acting Code is really
my brainchild, which has one an only aim: to be a method that will offer solutions and
creative ways of work, to directors, actors and performers from across the world.
But, what is the Acting Code in a few words?
Acting Code is a state of the art of complete acting and directing technique for theatre,
film and the performing arts, which creates a ‘code’ that works metaphorically as a
computer ‘operating system’ for humans.
Upon this ‘operating system’, Acting Code builds metaphorically as an open source code,
‘programs’ or ‘apps’ for tailored made ways of acting and directing; builds techniques,
applications and creative solutions for artists, actors or directors, according to their
personalities, skills, knowledge, cultural background, the technology they use and their
artistic aesthetics, aims and expressions.
[80]
Therefore, the Acting Code technique works as a tailored made ‘computer machine’, a
‘tool’ for the artists, in order to discover effective creative solutions for their work,
maximizing the artistic results.
As the traditional ways of acting, directing and performance, created mainly under the
older 19th and 20th century philosophical and creative approaches, the new technological
and global thinking philosophy and life style, is very difficult to adapt and use
successfully these old ways of work.
The Acting Code organizes and manages the creative environment, resources and
processes for actors, directors and performers, either for film, theatre, performance of any
kind, interactive video games, artificial intelligent environment, web or anything else in
these fields, in the most simple, powerful and effective way, as an operating system doing
that for computers.
This computational philosophical and practical thinking during the process of the Acting
Code technique, overpowering the expressing means and the multifunctional and
multitask contemporary human philosophy and personality, due to the modern
technological environment and life style we have.
Inspired by these facts, the Acting Code organizing everything as the computer operating
system does, creating an ‘interface’ between the person and the artistic environment,
resources and process, either for acting, directing or performing; maybe in the future and
in other kinds of artistic or scientific works and projects.
After that, the method offers an “open source code” way of work, in order to create easily
a ‘program’ or ‘application’, that is possible to fit it very well to the artist’s ‘operating
system’; therefore to be fully functional and effective in the most simple and positive
process, for the artistic work that the artist wishes to use it.
The Acting Code technique includes twenty nine levels of training. In the Acting Code –
Advanced Acting and Directing Technique for theatre, film and the performing arts. An
Introduction book, I describe each level separately in the simplest way I can. I am
offering also a couple of training examples for each level.
Obviously, this book offers the basic information, the basic codex, the manuscript, the
basic description of the Acting Code technique. This is not a self-training or self-teaching
book. You need a tutor, at least in Master 1 level, in order to start the training upon this
technique.
Let’s take a look in some terms, which are useful to know in order to understand the
description of the technique.
In computer science, an Operating System (OS) is computer system software, which
manages computer hardware and other software resources; provides also services for
computer programs (Stallings, 2005: 6).
In Acting Code Operating System (ACOS) we create metaphorically a ‘human system
software’ that manages metaphorically the artist’s ‘hardware and other software
resources’, such as body, mind, skills, psychological status, emotions, talents, previous
training and so on.
ACOS-Script. As the software does, ACOS includes also a script with a code, in order to
be easy for the artist to write and re-write the code ‘on paper’. This is the ACOS-Script.
[81]
A computer program is with simple words, a code of instructions for the computer, in
order the computer to solve a problem, to complete a task and so on (Rochkind , 2004).
In Acting Code, the program or application (AC-Program or AC-App), is a code of
instructions for the artists’ Acting Code Operating System, in order to solve a problem, to
complete a task and so on.
In Acting Code, the terms of ‘interface’, ‘metaphor’ and ‘catharsis’ are very important, as
well.
Catharsis is a critical process in Acting Code. Very important, coming from the ancient
Greek tragedy, helps in the interface of Acting Code to transfer between systems, and
serve as a metaphor, as a catalytic philosophical element in the acting and directing
process via catharsis.
Interface in computer science, is in simple words a shared frontier across which two or
more separate parts of computer system (hardware, software, devices, humans etc)
exchange information. A keyboard or touch screens are interfaces (Hookway, 2014: 1-
58).
In Acting Code, interface is exactly that: the shared frontier across which the artist (via
the Acting Code Operating System) exchanges information of all kinds (actions, words,
feelings, movements etc.) with other systems (actors, production staff, play or screenplay,
stage design, music, audience etc.).
Metaphor in simple words in literature is a figure of speech that directly refers to one
thing by mentioning another.
75
In Acting Code, I am using a combination of this meaning of metaphor with the ancient
Greek roots of the word. Metaphor coming form the ancient Greek ‘μεταφορά’
(metaphorá), meaning ‘transfer’ from μεταφέρω (metaphero) ‘to carry over’, ‘to transfer’;
from μετά (meta ‘after, with, across’) + φέρω (phero: ‘to bear’, ‘to carry’).
So, in Acting Code the metaphor transfers between the systems data, codes, actions, tasks
etc, according to the artist’s Acting Code Operation System activities, programs etc., as
the artist wish to do. The same time, as a code, creates unlimited artistic approaches.
Catharsis is a critical process in Acting Code. Aristotle defined catharsis as the end cause
of a play and describes it as the pleasurable release of emotions, specifically those
emotions evoked by the action represented by the characters in the play. In other words,
catharsis is an audience process, as other processes result in ‘staging’ reality.
These two processes (metaphor and catharsis) are teleologically linked.
The Acting Code advanced acting and directing method, offers twenty nine levels of basic
training:
1. Induction Level
2. Self-Understanding
3. Self and Cosmos
75
The Oxford Companion to The English Language, 2nd Edition (e-book). Oxford University Press. 2018.
[82]
4. Acting Code Operating System and Cosmos
5. My Operating System
6. Understanding the Interface
7. Codex Authoring
8. Creating Programs and Apps
9. Metaphor and Catharsis
10. Cosmos and Stage
11. Self and Stage
12. Acting Code for the Stage
13. Cosmos and Camera
14. Self and Camera
15. Acting Code for Camera
16. Cosmos and Computers
17. Self and Computers
18. Acting Code for Computers
19. Cosmos and Interactive and Artificial Intelligent Environment
20. Self and Interactive and Artificial Intelligent Environment
21. Acting Code for Interactive and Artificial Intelligent Environment
22. Cosmos and Internet
23. Acting Code and Internet
24. Text and Hypertext
25. Connecting Systems and Cosmos
26. Meta-Practice and Self Evaluation
27. Working Upon Open Source
28. Updates and Code Corrections
29. My Operation System and the Ancient Greek Roots.
76
Apart from these, there are four more levels, for teaching the Acting Code (level 30),
coaching and meditation (level 31), researching, management and development (levels 32
and 33), according to training and experience:
Level 30 - Tutor Levels (3 degrees)
Level 31 - Coaching and Meditation Levels (2 degrees)
Level 32 - Master Level (2 degrees)
Level 33 - Grand Master
76
These levels (1 to 29) will be described in the book Acting Code. Advanced acting and directing
technique for theatre, film and the performing arts. An Introduction. (Prosylis, 2020, USA)
[83]
As the book ‘Acting Code. Advanced acting and directing technique for theatre, film and
the performing arts. An Introduction.’ (Prosylis, 2020, USA) is a manuscript of the
method, will give you all the necessary information you need, in order to understand how
Acting Code works.
However, this is not a self-training or self-teaching book. You need a tutor, certified at
least in Tutor 1 level, in order to start the training upon this technique.
Obviously, special editions (books, texts, video tutorial etc) will be published for specific
issues of the Acting Code, the training and its levels, the teaching of the method, the
coaching, the theoretical practice, and so on.
Key words: Acting, Code, Directing, Theatre, Film, Cinema, Technology, Art, Drama,
Ancient, Greek, Philosophy, Performing, Arts, Method, Digital, Computers, Operating,
System, Prosylis, Prossylis
Bibliography
Aristotle (1995). Poetics. Edited and translated by S. Halliwell. Cambridge, Mass.;
Harvard University Press, USA.
Hookway, B. (2014). ‘Chapter 1: The Subject of the Interface’. Interface. MIT Press.
Rochkind, M.J. (2004). Advanced Unix Programming, 2nd Edition. Addison-Wesley.
Stallings (2005). Operating Systems, Internals and Design Principles. Pearson: Prentice Hall.
Websites
www.prosylis.com
www.actingcode.com
Christos Prosylis, Ifigeneia Narrative. Michael Cacoyannis Foundation, February 2020.
Video art installation and performance, using Acting Code techniques.
[84]
[85]
Myth on Modern Fluid Reality.
Portraying Elements of the Odysseus Myth
through the Dramatherapy Approach
Dramatherapy Workshop
Fofi Trigazi
With the collapse of the post-war model, when, as it was to be expected, the narrative
was about safety and success viewed as autonomous and progressing in a linear manner,
several political, economic and social changes have taken place across the world. The
term ‘fluid modernity’ (Bauman, 2000: 130) indicates that concepts such as transient,
short-term, ephemeral and insecurity acquire increasing importance when it comes to
understanding today’s precarious and volatile reality. Man uses ‘the minimal self’ (Lasch,
1984, 48-83) as a survival mechanism, meaning that not only does he not invest, but on
the contrary he disinvests from such an insecure world. The process triggers stress and
restricts the ego’s anti-traumatic resources and psychological movements.
However, the degree of a person’s psychological resilience, which determines his unique
way of responding to today’s fluid, traumatic reality, depends on whether his personal
traumas, especially ones reaching back to infancy, have been adequately processed.
In psychotherapy, we use myths to process themes that concern modern man, in order to
support him on his path. This, however, is not a new idea. On the contrary, myths are a
living part of psychoanalytic culture (e.g. the myth of Oedipus and the myth of
Narcissus).
Myth is not a simple narrative, but symbolic representations of great archetypal value, a
creation of the collective unconscious. The main template of the majority of myths is the
hero’s journey (Campell, 1949, 69, 125, 245); the hero moves away from one situation
and through obstacles to reach a new place, richer and more mature than before
(departure-initiation-return). The concept of quest, a common theme in myths, also
indicates that the quest is a persistent pattern/model in human thought. Transformations,
with conventional death, mourning and resurrection being the main pattern, are another
theme of myths. The development of man consists in a series of such transformations,
physical, mental and relating to consciousness. Compared to gods, heroes are much
closer to human nature; they can be the perpetrators and the victims, the good guys and
the bad guys. They are, in other words, whole persons.
In psychoanalytic terms, according to Melanie Klein (Segal, 1964, 53, 119), the journey
brings to mind the transition from the schizoid-paranoid position, where magic,
omnipotence and primary defences prevail, to something that is closer to the depressive
position and is reflected on the realisation of individuality, of responsibility and of guilt,
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something which constitutes a type of maturity and self-knowledge. Each man has a
‘personal myth’, which is a structure mirrored in a more archetypal heroic structure.
Processing in psychotherapy is but a reconstruction of the personal myth and the personal
truth so that man can become what he really is.
I chose to recount the myth of Odysseus, centred however on the women he meets along
the way. So, in a parallel process, that of the formation of the identity of the subject-
person (the question of who one is raised several times in the myth and each time is given
shape by Nobody as the Stranger, as the Recognition of the Face), one can see powerful
women who are different personifications of the primary object, i.e. of the ‘Other’.
Beyond their differences, these women share a common characteristic. They are weavers,
they weave the hero’s new clothes − perhaps a new ego at the symbolic level, a skin for
him to continue his journey. There is also the symbolism the active erotic coupling
between the warp yarn and the spindle. Odysseus having saved himself from the
castrating charm of powerful women, Circe, the Sirens, Scylla and Charybdis, reaches the
island of Calypso (the name means the one who covers) alone, and for seven years lives
with her, merging into her cave in a newfound narcissistic condition, forgetting his return,
his past and himself. He meets the ghost of his mother Anticlea and bids it farewell
before meeting Penelope, who in her turn thinks, organises, allows, prohibits, sets her
own rules, but above all endures and survives, herself also changed by her own journey.
The women of Odysseus, initially immature representations of the self, hold him back,
but do not obstruct him; each helps him to his next step, and with each step they too are
changed, up to the moment when the significant other in the form of Penelope finally
constitutes herself as a whole at the same time as the hero constitutes himself. Only then,
will the two conventionally become the Whole (animus-anima, according to Jung).
After the theoretical part, the audience was asked to react to the myth, and they were
given clear instructions to create a dance-happening. They were told to use elements of
the movement of the ancient Chorus: the direction, the deixis, the shapes and, through
free association, words and phrases from the myth. The prop used was a ball made of
triangular pieces of cloth indicating the sails used during the journey, during every
journey.
Key words: ‘fluid modernity’, myth, ‘an Odyssey of women’, dance-happening.
References
Bauman Z. (2000). Liquid Modernity. Cambridge Policy Press.
Campbell J. (1949). The Hero With a Thousand Faces. Bollingen Faoudation Inc.
Joyce J. (1942). Ulysses, The Modern Library, NOY.
Lasch C. (1984). The Minimal Self. Survival in Troubled Times. W.W. Norton &
Company, NOY.
Segal, H. (1964). Introduction to the work of Melanie Klein, Hogatrh Press. UK.
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Comments on the History of Culture
How did we evolve into this: Sex(es) and Gender(s)?
Vuk Trnavac, Marijana Bojić
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Abstract
Our main interest in this work is to show in which ways we can find (multivocal)
answer(s) to the question “how we evolved into these concepts of sex and gender?” We
applied two main ways, with “socio” perspective as the first one and the “bio” view on
that subject as the secondary one. We were influenced by many theories, mostly by the
work of Konstantinos Maritsas, but in regard to his research conclusions we adopt a
slightly different position.
Key words: sex, gender, male, female, masculine, feminine, man, woman
Introduction - How it all started, and what is “today state”?
The question imposed in title of this work can act both as an interesting and not
completely clear one concerning what is truly in question asking about. Namely, our
research deals with the philosophy of nature, but above all, with the human nature, as an
integral part of Nature. For us it is clear that this topic needs to be approached in the
same way as Aristotle approached in his Metaphysics the explanation of how being
should be pronounced, and of course, it can’t be determined in one univocal way.
At the course of our research Spirtus movens has been an accidentally read article from
the Internet (Flam, 2006) that poses a similar question, and thus opened “the
phenomenological horizon” that we expanded during our work, precisely because of the
impossibility of giving an appropriate (univocal) answer to it. The reasons that led us to
approach this timeless topic is its actuality, to which various theories have already tried to
formulate their judgment.
When we ask ourselves about the history of research on this topic, we can say that
Aristotle was already the pioneer in philosophical research on biological issues. He was
the first one to try, through experience (we can say it was the first proto-experimental
method), to reveal the secrets of living beings and then interpreting them philosophically.
In his work De Partibus Animalium, Aristotle highlighted the problem (function) of
reproduction as a separate topic (Aristotel, 2009: 7 and footnote no 1).
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He pointed out
that reproduction is not a function of the same order as organs of vital importance, since,
77
Final paper submitted to the course Philosophy of Nature at the Department of Philosophy, School of
Philosophy on NKUoA, Athens, Greece, June 2019. Mentor Anna Lazou, Assistant Professor, PhD. E-mail
addresses: vuktrnavac@gmail.com, maja2.bojic@gmail.com.
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Explanations on this topic by the translator and editor Slobodan Blagojević.
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in his opinion, reproduction organs are not vital organs (such as heart, lung or liver). The
difference between them is that the survival of an individual animal depends on the vital
organs, and the survival of the genus depends on the reproduction organs (ibid). The
reproduction organs are the eidos of alive, and therefore their difference has the status of
the principle (arhai) “of the birth” (genesis) (ibid, 87). His research found that the animal
exists to propagate, and therefore its body should be completely subordinate to the non-
vital mating function - and he believes that the weak males and ugly females are out of
mating, which is probably the reason for female indulgence (Aristotle, 2009, 7, especially
footnote no 1),
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(for example, in peacocks) and since “nature avoids infinity”, and “what
is incomplete” -“it always seeks the purpose” (ibid, 10) the essential need of the genus is
that females are paired and bring to the world a vital offspring (ibid, 7).
In addition to full reproduction, Aristotle in this section also speaks of unisexual
reproduction, which occurs in specific animal groups that according to his opinion “are
not on the ground”, such as insects, bees, etc. He explains this by the fact that through the
mating of the same species of animals we get related offspring similar to them.
Otherwise, for those that are not born of animals, but ones which were born from a
“rotting substance” (matter-hyle), give birth to a different kind of gender, and it becomes
neither male nor female and Aristotle said that it occurs in certain cases like
aforementioned insects (ibid, 9).
From a different perspective, some contemporary sources on this topic mentioned that
first sexual beings emerged perhaps before 2,5 billion years ago and they are according to
our “inspiration text” more like “Adam and Steve” than “Adam and Eve”, because as it
was written in the article: which is a little like being homosexual or simpler, as biologists
like to say they were isogamous (Flam, 2006). Other more recent authors, who in our
opinion are more reliable, claimed: “The origin of sexual reproduction in prokaryotes is
around 2 billion years ago (example Gya) when bacteria started exchanging genes via the
processes of conjugation, transformation, and transduction.” (Otto, 2014, 2008)
So, based on contemporary researches, we get the information that the transition from
asexual (prokaryotic) to sexual reproduction of eukaryotes occurred somewhere between
2.5 and 1.6 billion years, which means significantly earlier “development of the first
animals with neurons capable of assessing pleasure.” (Ibid)
This scientific knowledge is extremely in favour of ‘us’ as ‘philosophers’ who consider
that many of the things of today’s science are already (‘un’)consciously anticipated in
ancient philosophy as the ‘empirically-research-oriented’ Aristotle, and in the work of his
teacher, the first systematic ontologist, who is of course Plato.
Namely, everything that Aristotle presents in the De Partibus Animalium is guided by the
basic option of the concepts of Necessity (‘Nature’) and the Nous (‘The Purpose’), that
Plato established mainly on the ontological level, in Timaeus (Aristotle, 2009, 7-8
[footnote no 3]).
One of such claims is Aristotle’s belief that ‘the female is matter (hyle)’ (ibid, 88 [pag.]
732a 10), which originally came from Plato’s Timaeus in which he wrote it as a ‘second
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As above.
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gender (specie) of being’, which the author
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of this paper determined to contain in
Plato’s ‘concept of matter’ (Platon, 1995, 102 [pag. 49a], 104 [pag. 50b-c], 106 [pag. -
51b]).
In Jostein Gaarder’s novel we could find that one of his reinterpretations of Aristotle’s
claims, i.e. “In the reproduction process woman plays a passive and receiving role while
man is active and giving” (Gaarder, 1996, 148), is quite similar to the view which we
already described. In this way posted discourse can easily lead us to the debate at Plato’s
Symposium where Socrates reported to others that Diotima of Mantinea told him about
the genesis of Eros (Deretić, 2010). According to that myth, he is actually the child of
“the one who has the road to the power and abundance”, Poros, who, during the
celebration of the birth of Aphrodite, while sleeping and inebriated with nectar in the
Garden of the god Colossus, Penia (need, poverty, weakness) managed to exploit him
sexually and in that way they gave birth to Eros (Platon, 1985, 73-74 [pag. 203a-d and
footnote no 1]).
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In addition to this, for our discourse, another myth from Symposium is crucial when it
comes to what we have just stated as being genius in these ancient philosophers, and this
is the (un)consciously anticipation. However, as we clearly stated that modern science
has confirmed that asexual beings were evolving in the evolution process before sexual
ones, so in Aristophanes’ speech within the same Plato’s dialogue, it is said that at the
beginning there were three genera, beside for male (which origin is from Sun) and female
(which origin is from Earth), exists a third one in which are these two combined:
androgenic genus-hermaphrodite (which is origin from Moon). The mythological genesis
of hermaphrodite, except for the Empedocles, in Plato, is expressed through the love of
Hermes and Aphrodite which resulted with hermaphrodite as child.
So, Aristophanes explains that people originally had 4 legs, 4 arms, and a head with two
faces with two sets of male and female genitalia. Nevertheless, after this, because of
Zeus’s hybris, this being, or the original man was divided into two parts, and was
condemned to find his other half or soul mate (ibid, 52-53 [pag. 189d-e and 190a-b]).
We think that now, at the end of this introductory chapter, is the right moment to point
out what is precisely the concept of ‘sex’ and from where we encourage the etymology of
the term sex. We will say it is from the Latin words-secuto, secui, sectum (to cut, to
divide), what is very similar to the ‘concept of this word’ in the Slavic languages where it
is pol; пол ‘sex’ and from polovina from ‘halfway’, poloviti-‘to make half’ (pola; пола-
‘half’), an also pol as ‘North and South Pole’.
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On the other hand, the etymology of the
term gender comes from an ancient Greek genus (from Plato magiste gene in Sophist and
Aristotle’s genus from Metaphysics and Organon mainly), and for sure also from old
French word genre (ibid, 16).
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See Trnavac, V. (2020). Platonovo konstituisanje „materijalizma” -to be publised soon. Matter is passive
because everything is received by it and so to be identified with a woman’s (female/feminine) sex or
gender?
81
Explanation by the translator and editor Miloš No Đurić (Čika Mika/Miša☺).
82
Compare with Maritsas, 2018, 45-47.
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Why etymology and why Sex(es) and Gender(s)?
In this paper, the etymology helps us to have a clear idea of what the difference is
between words and sex, then, man, woman and homo. Etymology helps us in the sense
that there is always something that is constantly in its changes. So, no matter how the
word is interpreted today, there is always the origin of the word, the root of the word.
Thus, in the book The Origin and transformation of Sexes, we find relevant information
about why our etymology is significant in this domain, for as K. Maritsas explains
“etymology is derived from the Greek (etymologia), itself deriving from (etymon),
meaning ‘True sense’ and the suffix ‘logia’, denoting ‘the study of’ (ibid, 45). The reason
why this is relevant to our research is to put a clear distinction between the word sex and
gender and thus develop the main idea of this paper, which is how we evolved into these:
male/masculine/female/feminine?!
This was exactly what the author, Kostas Maritsas, held when he explained the history of
the term gender, he stated the following: “In our day, we have not only sex; we
predominantly have gender. The history of the term gender is amusing. If we correctly
read this text, we will find that it repeats the whole story of civilization. The term was
proposed in 1955 by John Money, a man. His goal was to make a terminological
distinction between biological sex and gender in relation to society.” (Ibid, prologue, 9)
So, the difference between sex and gender is the following. As for gender, we have
gender identity. Gender identity is how you, in your head, think about yourself. It’s, we
have gender identity. It’s the chemistry that composes you (e.g., hormonal levels) and
how you interpret what that means. This explains the concepts of Woman, Genderqueer
and Man.
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Next, we have Gender expression-is how you demonstrate your gender (based on
traditional gender roles) though the ways you act, dress, behave and interact. So,
Feminine, Androgynous and Masculine. It should be noted that Gender counts 33 types
and more, such as: female, male, bigender, androgyne, neutroys, agender/genderless,
intergender, demiboy, demigirl, etc. (Maritsas, 2018).
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As for sex, we have Biological sex which refers to the objectively measurable organs,
hormones, and chromosomes. Female=vagina, ovaries, XX chromosomes: Male=penis,
testes, XY chromosomes; and we also have intersex=combination of the two.
Next, we have Sexual Orientation is that you are physically, spiritually, and emotionally
attracted to, based on their sex/ gender in relation to your own. This explains the concepts
of Heterosexual, Bisexual, Homosexual or Pansexual.
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In our opinion, gender is a notion of the concept of sex, because this term explains the
personality as a person in totality (here, among other things, I alliterate to the concept of
civilization, which I will deal with later in more detail), in relation to the notion of sex
that relies more on one-sided biological line (ibid).
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https://www.geneseo.edu/lgbtq/gender-identity
84
All 33 types described in pages 25-30.
85
https://www.geneseo.edu/lgbtq/gender-identity
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Socio perspective of the question of the Gender(s) [Sex(es)]
At the beginning of this section we should first mention why the notion of civilization in
this paper is significant and what it represents. The difference that arises now is that we
reject the old definition of civilization that is anthropocentric (Maritsas, 2018, 77). Now
we use this term exclusively with one domain and correlation, which is CIVILIZATION-
NO AGGRESSION, the state of the weaker. It should be emphasized immediately that
this state is contrary to the state of nature (that is, the necessity that we identify with
aggression). How the attention is paid to this and the author: “Man (referring primarily to
males), weak and helpless against natural forces, was subject to destruction for two
reasons: he was easy prey to predators, and males died in inter-species battle.” (Ibid) This
explains the state that man had to become weak and that through interaction he subdued
others and tried to cultivate through “song, beauty and gifts.” (Ibid, 51)
“A little by little bit aggression has lost its role in human survival, and the nature of
completeness has taken on this role. Actually, the woman began to choose the language,
music, word, beauty, decoration, fashion, art and gifts (wealth, property).” (Ibid) The
final non-anthropocentric definition of civilization would be: “Civilization is the survival
of the weak!” (Ibid)
Civilization is about human beings. Consequently, we associate concepts such as song,
beauty and possession with civilization, while on the other hand we associate aggression
with nature because: “In nature, the one who is stronger, more powerful- survives; while
in civilization the one who is more communicative, more handsome and richer-
survives.” (Ibid, 79)
Attention should also be paid to concepts such as natural selection and cultural selection.
“‘The swift’ (natural selection) would represent logical winners, based on natural
selection, in peaceful human communities, the winner is the ‘the orator’ (cultural
selection), who is not a product of natural selection.” (Ibid, 62)
Namely, what leads us to think is what is the difference between animals and people in
this domain, because how people managed to civilize (and not animals) and through
philosophy, science and art managed to find the measure and self-liberation and they
become an aggressive creature. There are many questions on this subject, there are also
many answers, but no answer gives the final picture of it. One important item in this book
is On the Origin of Species by means of civilization or the preservation of favoured race
in the cooperation for life, which has led me to think: “Since his creation man was the
weakest and most helpless living creature on our planet, while having the largest brain.”
(Ibid, 172) This in fact means that natural aggression has forced us to ask ourselves
questions that we cannot give a final answer, such as the immortality of the soul,
freedom, death; but it has encouraged us to ‘approach’ these issues and become civilized,
non-aggressive, cultivated, and unclean. In this we are different from the animals. Natural
selection has given us the task, through self-liberation, to become “controlled” without
aggression in order to survive as gender, and through progressive (ibid, 172) self-
liberation approximate those items.
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Also, what interests us here and what is common in these domains is evolution, but the
evolution of two different directions, both natural and civilized. We will name a couple of
definitions of Civilization. Maritsas in his text offers to us some interesting definitions:
Definition 1: “The methodical sacrifice of libido, its rigidly enforced deflection to
socially useful activities and expressions, is culture.” (Ibid, footnote [Marcuse, op.cit, 3]).
Definition 4: “In Greek antiquity, civilization was the education which the city offered to
all its citizens. The citizen bearing all legal rights received his education through
theatrical plays, religious ceremonies and festivities, dance and music.” (Ibid, 172-173
and footnote [“Introduction, in 1998. Polis and Civilization (Πόλις και πολιτισμός),
Αθήνα (Athens), Tipothito (Τυπωθήτω), 9]).
Definition 5: “A culture is like a big organization which assigns each of its members a
place where he can work in the spirit of the whole; and it is perfectly fair for this power
to be measured by the contribution he succeeds in making to the whole enterprise.” (Ibid,
173 and footnote [Wittgenstein, op.cit, 6]).
Civilization and Men
Here we distinguish the behaviour of animals and humans. In the animal: “the man is the
one who swarms, and is selected by the female specimen, woman. Man goes hunting and
fights. In civilization, man began to be chosen on non-natural criteria: song, beauty,
possession. The weak man survived and reproduced.” (Ibid, 225)
Civilization and Women
“Woman, the female individual is principally created with a great moral duty and
responsibility: the conversation of the species. Woman is responsible for the future
generation!” (Ibid)
Also, men and women were obsessed with nature. We all wonder how life originated. At
the beginning, people found various comparisons, symbols in nature, and the first rituals
were conducted in the cave, evidencing the thoughts of the gods (ibid, 303), because of
their favourable orientation, allowed for the light of the Sun to penetrate to their farthest
end (ibid). Obviously, this was possible for just several days during the year -and this was
the cause of the discovery of the calendar (ibid).
Bio view of the problem of the Sex(es) [Gender(s)]
In this part of work, it is really important to explain how ‘our thing’ is going on
biological level. According to Charles Darwin’s theory, the existence of the biological
sexes, male and female, is so important, that it leads to ‘sexual selection’, which
dominates over the “natural selection” (ibid, xi and Darwin, 1871, 398; Darwin, 18725th).
Darwin’s follower and winner of the Nobel Prize in Medicine, Francois Jacob, in his
book, the Logic of Life, in the introductory chapter, states that a living being is not a
product of Reason or the Will and explains the organism in the same way as Hegel in τηε
chapter of Teleology in Science of Logic (3), where he explains the notion of The
Cunning of Reason, which appears when ‘purpose’ sets an ‘inserted object’ in relation to
the ‘means’ and in Jacob’s case The Purpose does not exist, its purpose is just
‘propagation by itself’. On the other hand, if in Hegel’s thought there is no such inserted
object, which, in his case, he calls The Cunning of Reason and then there is a question
about The Violence! (Hegel, 1979, 162)
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Jacob has an explicit explanation that the organism is merely a stage between what has
been and what will be, and that there are no exalted purposes. “The Organism” has
become a program of prescribed inheritance and in the idea of the program, it combines
concepts of memory that imply memories of parents inherited by their children, thus
forming a continuous circle and a project that conducts details to form an organism
(Žakob, 1978, 10). He also thinks that “everything in the living being is set for
reproduction” (ibid, 13) and that the “famous struggle for survival is essentially just a
competition for the offspring” (ibid, 14).
We claimed all of this, because we will better understand from which perspective he
argued, when in the first chapter of his book Logic of Life on visible structure he spoke
about scientific evolution when it came to biological observation of the relationship
between males and females.
He clearly states that Antoine van Levenhuk in the 17th cent., found that in female sex
there exist eggs, and in the male animaliculs (ibid, 68-69).
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Again, with similarity to Hegel and his explanation of the ‘dialectical process’ in the
introduction of the Phenomenology of the Spirit through the examples of the ‘Oak and
Acorn’, he also states that the germ has already been realized in full, which leads to
creation of a new being.
Then, we could find out that Jacob agrees with Aristotle’s claim that every living being
originates from something that resembles him, and on the basis of this he asks, as he
considers the ‘key question’, in connection with the development: which of these two
seeds contains a male or female germ? Jacob says that there are certainly two schools that
both of them can support, and that’s ‘a female’ to appear in the egg and ‘male’ to place
the call in the animaliculs that swim in male seeds. In a very interesting process of
argumentation, and referring to several authors, including Nikola Malbransh, concluding
that the germs of all possible people in all possible times exist from the Creation of the
World, and according to Swamerad’s view, they can be found in Eve or Adam’s bodies.
Therefore, depending on whether the germs are stored in the egg or the animaliculs,
following things could happen: in the first case if the germ is in the egg then the females
of those animals were responsible for creating all the other animals of that species; in the
second case if we decide to see the germ in the animaliculs then the first males were
created with all the other males of that species who were or will be born.
In either case, in both systems, male germs and germs of females are different, because if
one contains only a small being which will be born, the other, in addition contains the
germs of all of their offspring that are connected to each other as Russian dolls
(babushke), and from generation to generation the size of the babushkas decreases in
proportion: from the organism towards egg (ibid, 69-73).
We think that this view was important for the sake of its conclusion, and the point is that
the very temporality of the origin of biological male and female sexes is not the least
important, and since the simultaneity, they don’t have better answer. However, apart from
the Hegelian ‘order of time’, the ‘order of the term’ is important, and because of that we
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The Dutchman Antoni van Levenhuk (1632-1723) described the animaliculs as round, wrist and spiral
forms after seeing them with a microscope of their own design, in 1676.
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want to explain in some sense let’s say ‘ontology of the biological concept of the sex’,
but from the perspective of science, so it will absolutely serve us, the idea(s) of genes and
chromosomes.
Other thinkers that we follow are not like the previous, ‘atheistic-oriented’, but a little
more influenced by religion. He is Theodosius Dobzhanski who in his book The
Evolution of Humanity presented various theories of evolution differently interpreting
changes in biological evolution, that is, they can stimulate them from inside or outside,
from internal or external causes. The genetic gift of the species or population, or the
structure of society, can shape the environment according to ectogenetic theories, while
in the autogenous environment it plays a small role, because evolutionary changes largely
originate from the organism (Dobžanski, 1982, 27).
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It is not overwhelming that the first
(ecto) was more popular in the countries of the ‘Eastern Block’ during the twentieth
century, while in the west, the second (acto) was dominant.
However, we will ignore the politics now and return to biology, as our primary interest in
this chapter, which is certainly important in order to mention Gregor Mendell, who was
in the 19th cent. the first one who showed that the inheritance was not spilled blood, but
that it was a particular, or rather a set of more or less separate units -the gene. He was
crossing varieties of peas, established the rules and thereby laid down the laws of
inheritance, that is, he became “the father of modern genetics”. By using his formulas and
tables, it was later established that a human female can produce at most 200-300 mature
eggs during the reproductive period of her life, although the number of fertilized eggs is
much smaller, because it is limited by the long pregnancy, which is characteristic of
mammalian females, and not the number of mature egg cells. The number of
spermatozoids created is far greater: one male ejaculation may contain about 200 million
spermatozoids, while the heterozygous individual per 31 pairs of genes could generate
over 2 billion types of spermatozoids with different genetic sets -as much as there are
people today on Earth (ibid, 41-44).
We are inclined to interpret this scientific fact in a philosophical way from the
perspective of Aristotle’s theory of potency and action (dynamis-energeia). In our
opinion according to this theory ‘the male’ here would surely be ‘being of potency’,
while the ‘female’ is the ‘being of action’ as realization of this potency.
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In this sense, we come to the relationship between genes and chromosomes on which
Dobzanski interprets Morgan: “The gene is determined by the amount of material in the
chromosomes that can be separated from it and replaced by the corresponding part (but
none of the other) homologous chromosomes.” (Ibid, 47) The work of Mendel’s school
transformed the gene as an abstract symbol that the early Mendelians imagined in the
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For autogenetic theories, he says that they conceive the living world as something like a music box
whose spring is strained on the day of creation and which can play the melodies inserted in it from the
beginning, but not the new one (op.cit., 28).
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For Konstantinos Maritsas “The woman is memory and truth, the man is an experiment. A man-male is
just a male. The woman is all the rest.” From Katya Melamed, PhD, February 2018 (Maritsas, 2018, x).
Scientific theories can agree maybe with the statement that man is an experiment, because it is proved that
it is much harder for Nature to make Y than X chromosome, since the female who gives birth is more
useful for Nature.
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gene as a part of the chromosomes. Another major advance in understanding the
mechanism of inheritance has led to the study of the chemical composition of
chromosomes. A very interesting fact is that the chromosomes of all organisms from free
bacteria, through higher plants and animals, to humans are quite similar in composition.
Not only the different genes of the same organism but also the genes of different
organisms are composed of the same class of chemicals called nucleoproteins. As we
know from the elementary school, the ‘genetic alphabet’ is composed of four known
nucleotides: adenine, cytosine, guanine, and thymine, which in the majority of organisms
(in the case of plant viruses is RNA) are the chains of deoxyribonucleic acid (DNA).
Each metaphase chromosome consists of two sister chromatides containing one molecule
of DNA, and since they are formed by replication, these molecules are completely equal
in the content of the gene - therefore, chromates are called sisters (ibid, 48-50).
We have not accidentally resorted to a ‘slippery field’ of natural sciences such as
chemistry and biology, because now we will try to present them from a different
perspective, mainly from the book The origin and transformation of Gender of
contemporary researcher Kostas Maritsas.
However, the XY sex-determination system of chromosomes occur in humans, as well as
in most other mammals, in some insects (Drosophilia) and the Ginkgo biloba (ibid, 32)
plant about which Goethe spoke as well. Usually, females have two same kinds of sex
chromosome (XX) which calls homogametic sex and males have two different (XY) and
are called heterogametic. In the case of birds, and most of the insects are same situation
but just with distinct marks ZZ and ZW (ibid).
This phenomenon of diversity within a species between male and female is called sexual
dimorphism, and although it occurs in humans with other living things, things are
different, so there are cases of real, and not just mythic hermaphrodite (ibid).
Science is known from medical practice also, for instance chromosomal anomalies are
called aberrations, and that it is possible that in some part of the organism the
chromosomes are XX, and in the second XY, thus, besides the transgender and at the full
level or biological level, transsexuality occurs or just sexual polymorphism which we will
explain now.
For example, Klinefelter’s syndrome appears in cases of male and is marked like ‘XXY’;
this syndrome can reduce fertility and appears in 1 per 500 to 1000 newborns. The other
syndrome ‘XYY’-called ‘SUPERMAN’, increases growth and aggression and this
combination has no health effects. The case of triple X chromosomes –‘XXX’, appears 1
per 1000 newborn babies and is called ‘SUPERWOMAN’. Turner’s syndrome is
‘monism of X’ -with the genotype X0, appears 1 on 5,000 and sometimes causes sterility
and small growth (ibid, 33-35).
89
In addition to the above-mentioned chemical substances, which we can clearly see that
have an impact on human health; ‘in the game’ we will certainly insert a hormone that is
89
For some „other” sources see Rujević-Stefanović, 2012. “The Queer theory is not a monolithic entity!”
See also Foucault, 1990 and Butler, 1993. Not about monoliths, but about megaliths and language Kostas
Maritsas has two more books, Megaliths in the past and present (2010) and Hermeneutics of Megaliths
(2017).
[96]
important to us in this discussion. That’s certainly the main hormones that the male (in
many species) possesses -testosterone. Of course, again from ‘primary school’, it is
known to us that it causes changes in primary and secondary sexual characteristics during
puberty, but also, what happens to men who have testosterone deficiency. It is interesting
for us to present the theories of some modern scientists who say that testosterone is a
hormone that not only controls reproductive processes but also aggression.
“Suddenly, both acts appear at once, so it can be said that aggression accompanies the
reproduction.” (Maritsas, 2018, 36-37)
90
As this problem reflects on the natural selection from the theory of ‘the famous British
guy’ who we mentioned at the beginning of the chapter (Darwin, 1872, 59 and 81), we
will also try to explain it, using the theory of the interpreter Maritsas, which work we use
in a good part of this research.
“The winner in the struggle for survival is for those according to Darwin the one who
succeeds most to reproduce (Dobžanski, 1982; Žakob, 1978), or in the case of males, the
one who fertilizes the (most of) females.” (Maritsas, 2018, 39-40). Therefore, the
selection is realized among the males, but in ‘this way’ males would have improved, and
females would have remained unchanged, therefore, they are improving together, but still
‘male is (a) test’, and ‘female is (a) memory’ (ibid).
Following these assertions, Maritsas tries to point out in a mini-chapter Violence as the
desire for reproduction about the relationship between these two concepts, that is, the
aforementioned aggression, as violence originally appearing in the interior, primarily a
testosterone-enclosed man (ibid, 40-41).
91
According to that, he claimed he is impressed
by the similarity of the Greek words βίος (bios ancient and vios modern - life) and βία
(bia/via - violence), as in Latin vitality and violence and their meaning as well. He tried to
explain with many sources as etymology meaning in culture and of course by the use of
science sources (example ‘WHO’) (ibid, 41-46).
92
To conclude, in the second chapter of Natural selection, from this much quoted book in
our work, Maritsas uses the subtitle “From hermaphrodites to sexes”, in which he claims
that violence is a completely erotic phenomenon, by pointing:
“The source of sexual excitement was not the woman as an object of desire, but the fact
of the victory over the rival.” (Ibid, 46)
He continues in the next page of his book “The violence is present; it accompanies and
stimulates reproduction since the time of the hermaphrodites. According to the ‘First
Hunter’ - the Platyhelminthes or Plathelminthes (who has reproductive organs of both
sexes, and can be “topic of tabloids”) they have fought who will win and who will
fertilize.” (Ibid, 47) In Illustration no 1, the structure of the Flatworm is shown:
90
According to Menelaos L. Batrinos, 2012.
91
For the bibliography on this subject see Miller, 2005.
92
See also http://www.archive.org/details/Dictionnaire-Etymologique-Grec
[97]
(Pokhrel, 2015)
“The winner Plathelminth has ‘the right’ and duty to acquire offspring because he is more
powerful. The loser (=weak male, female) has a duty to give birth to offspring. In other
words, Plathelminth possessing more testosterone became a father and respectively,
plathleminth possessing less testosterone became a mother.”
He concluded that more violence-more reproduction and more reproduction more
violence! (Ibid, 47) Maritsas gives other examples about the first organism which sexes
were created as well as the bipolar reproduction as the Microbrachius dicki is an antiarch
“were copulating 365 million years ago which were among the first jawed fish, shakes
the very foundation of this claim.” (Ibid, 48)
Microbrachius. Illustration no 2 (Townsend, 2014)
This organism was the inspiration for Maritsas to make one of the several final figures (3
or 6 depending on how we see) (Ilustration no 3) in his book, and this one is about the
relation between Nature and Aggression, Life and Violence, and for sure bipolar
organism hermaphrodite and sexes (Maritsas, 2018, 49). That looks like this:
Illustration no 3 (Maritsas, 2018, 49, fig. 2-4)
Nature – aggression.
Male
Increase in
testosterone
Hermaphrodite
Decrease in
testosterone
Female
Sex
Gender
Gender
Sex
Fig. 2-4. Nature: from hermaphrodite to gender and finally to sexes.
[98]
With the help of this illustration, Maritsas explains the transition from hermaphrodite to
bipolar type and concludes that it does not happen only once but also with the
contemporary concept of gender. Combinations (more than 30) from both sexes of this
time reappear more in socio-cultural sense of the “identity and the feeling of my body”,
then biologically predisposed.
“Natural selection has simulated the rise in testosterone and the ultimate differentia of
both sexes. The gender disappeared for a short time.” (Ibid)
93
On the very ending of this chapter with a mini-chapter Aggression-the Beginning,
Maritsas pointed out: “The violence is present; it accompanies and stimulates
reproduction since the time of the hermaphrodites” - “Therefore, the aggressive-male and
passive-female are created by the level of bacteria.” (Maritsas, 2018, 50)
This is not the final aim of the book, though and this is shown in the following:
The conclusion of Maritsas’ work on this topic is that “Civilization is the survival of the
weak!” (ibid, 97) He was answering to Richard Dawkins and his work The Selfish Gene
(Dawkins, 2006) with these words: “Yes dear Mr. Dawkins, in civilization we may have
dozens of gender, of which two (2) are reproductive sexes, and all the rest are auxiliary
gender to ensure: Control over aggression, and control over hyper-population. On the
utmost end of the book he put the quote of Margaret Wente: “Man wants more
testosterone; the world needs less.” (Maritsas, 2018, 101). And after that appears the final
figure with all previous included, which calls of the “cycle of testosterone in Nature” or
just testosterone cycle (illustration no 4) and which looks like this:
94
From aggression as from the “beginning of Nature”, we have come to “post-
phenomenological civilization”, where we all just should be “phenomenological-
testosterone-reduced (epoched)” for and from violence to be “(a) live-absolute
beginners”, as in the song of David Bowie!
95
93
After this, Maritsas used one quote from Otto Weininger (1906, 3), in order to explain better the sexual
dimorphism and “abnormal hermaphroditism” which are appearing in some cases in the animal kingdom.
94
Illustration no 4. from Maritsas, 2018, 102, fig 6-2.
95
David Bowie, Absolute beginners: https://www.youtube.com/watch?v=o_cHvtPB2dY
Aggression - Nature.
Male
Increase in
testosterone.
Androgynous.
Decrease in
testosterone.
Female
Sex
Gender
Gender
Sex
Sex
Gender
Gender
Sex
Male
Dicrease in
testosterone.
Androgynous.
Increase in
testosterone.
Female
No aggression - Civilization.
Fig. 6-2. The testosterone cycle.
[99]
Conclusions
Anyway, in the first part of the conclusions we want to link what we claimed in our “Bio
chapter” with the idea of “anticipation of contemporary scientific theories” from the
period of antique thinkers which we also mentioned in the introductory chapter.
Namely, according to the most recent biological research it has been found that ‘Y
(ipsilon) chromosome’ will be extinct in the near future, but surely fertilization will not
be able to happen without males, when we are speaking about our human race and
species.
96
Who will say that Plato’s philosophy has anything to do with this, but maybe it could
have some relation? In his “ancient” period there was inequality between males (man)
and females (woman), so pretty same as in his ontological structure of the “World of
ideas” of the noeton and the “world of visible horizon” (horaton) supported by
“comparison with a line from” his Politeia, where only with mind (Nous) we can come to
the “World of ideas”, so as chromosomes can just be a ‘biological concept’ equality or
inequality of sex(es) - gender(s).
Nevertheless, if the ‘Y chromosome’, which Plato in our opinion anticipated using the
nous is the only constant “inheritance factor” of being and our possible knowledge about
being.
Now, if we fuse that with the National Geographic research about the ‘scientific Adam’
(Zimmer, 2004), which has confirmed that “we all (males [men]) have one and the same
Y chromosome of the scientific Adam”,
97
we will have again pretty similar situation as in
Plato’s concept of Idea of Goodness which is giving to all the other ideas - what they are,
and ability to “they are” (their essence and existence) and to us ability that we could see
(our possibilities like our potential) them by our anamnesical soul(s) and mind(s).
The relationship between Plato’s “comparison with line” which includes concepts of
nous-ideas, dianoia-mathematical things, pistis-things, and eikasia-shadows of things
with YX-XX structure of the male-female chromosomes can be established as
correspondence of each letter of the chromosomes with one concept from the line in order
(male=YX, female=XX).
This method is justifiable especially when we know that his concepts from Politeia
(Platon, 2002, 196-205 [paginations: 505-511]) is supported by Plato’s last work Timaeus
with his cosmological claims, where, as we mentioned in the introduction, the second
kind of being is compared to those “female-feminine”, now known as XX, while the
source of truth, the One that is constant, appears like ‘Y male chromosome’ (which also
contains “unchangeable and very important stuff for heritage”) with the other X
appearing like nous with dianoia.
96
Y chromosome disappears - what will happen to men? Main source THECONVERSATION.COM Find
in https://naukaitehnologija.com/y-hromozom-nestaje-da-li-znaci-da-ce-muskarci-izumreti/, 2018 or https://
www.b92.net/zivot/nauka.php?yyyy=2018&mm=02&dd=01&nav_id=1353606, 2018; on the same site
look Trnavac, 2013.
97
https://en.wikipedia.org/wiki/Y-chromosomal_Adam, last enter: 01.07.2019.
[100]
We are considering that this parallelism is very interesting and could be a potentially
productive ground for further source academic research on this subject, perhaps by the
authors themselves.
About the Socio perspective of the question about sex(es) and gender(s), we can
somehow agree with Maritsas’ thesis that civilization is the weaker’s survival.
Nevertheless, we are more inclined to look at the evolutionary process through the model
of the aforementioned hegelian The Cunning of Reason (‘craftiness of the mind’), by
which we have become increasingly civilized through violations of natural reproduction.
At the very outset, civilization was accomplished through the making of tools and cave
art of the ‘scientific Adam’, through an original kind of techne; the moment when man
began to think and create, was the very moment when man became a human(s) being.
Later, (s)he attained an increasing degree of self-knowledge in civilization through
religious performances and through the God-man Jesus, who is also Lord’s The Cunning
of Reason. After Jesus, historically speaking, civilization followed by many centuries of
domination of theological paradigma, up to the modern scientific and technological
discovery of the new century to the present day.
Nevertheless, the The Cunning of Reason should be viewed closely through the prism of
the philosophically-scientific system, which of course in some way was appearing in
Hegel’s philosophy of history, but also in History after Hegel, which we are hoping is
able to (re)interpret all of these civilizations and cultural phenomena, developing at an
ever-increasing speed, and for us being ‘new’ various “place of intertwined cunning
spots” which Foucault admits that Hegel posted to intrigue above all of us (Fuko, 2007,
54).
According to our approach of Hegel’s The Cunning of Reason we could say: Civilization
is a process of liberation from the initial violence of biological reproduction to every day-
absolute beginners-beings! In that sense, from the perspective of Hegel’s ‘dialectical-
speculative’ philosophy, ‘male/masculine’ - in terms of Hegel’s notion forms will be
‘being of development’, while ‘female-feminine’ would be ‘being of concrete’. In our
time we just perhaps need Derrida’s deconstruction in relation with these “concepts”!
Thanksgiving note(s)
We would like to thank Dr Konstantinos Maritsas for his help with ideas, advices, and
collaboration with his books as our main literature.
As well, we want to thank PhD candidate in Archaeology at the University of Avignon,
MA Milan Marković for his help in tutoring.
References
Aristotel (2009). O rađanju životinja, Paidea, Beograd.
Butler, J. (1993). Bodies That Matter: On the Discursive Limits of “Sex”, Routledge,
New York.
Darwin, C. (2009). The descent of man and selection in relation to sex, Cambridge
University Press, New York.
_______ (18725th). On the Origin of Species by Means of Natural Selection; or, the
Preservation of Favoured Races in the Struggle for Life, D. Appleton, New York.
[101]
Dawkins, R. (2006). The selfish gene, Oxford University Press Inc., New York.
Dobžanski, T. (1982). Evolucija čovečanstva, Nolit, Beograd.
Deretić, I. (2010). ZAŠTO DIOTIMA SAOPŠTAVA ISTINU O EROSU?, u Arhe VII,
13.
Flam, F. (2006). How we evolved into male and female, The Seattle Times (Health),
Seattle. (https://www.seattletimes.com/seattle-news/health/how-we-evolved-into-male-
and-female/), Scitable. Retrieved 26.06.2019.
Foucault, M. (1990). The History of Sexuality. Vol. 1, An Introduction, Penguin, London.
Fuko, M. (2007). Poredak diskursa, Karpos, Loznica.
Gaarder, J. (1996). Sophie’s World, Berkeley Books, California.
Hegel, G.W.F. (1979). Nauka logike 3, BIGZ, Beograd.
Maritsas, K. (2018a). On the origin of species by means of civilization or the preservation
of favoured races in the cooperation for life, Kastella M Company Ltd, Sofia.
_________ (2018b). The origin and transformation of Gender, Kastella M Company Ltd,
Sofia.
_________ (2018c). The origin and transformation of Sexes, Kastella M Company Ltd,
Sofia, 2018.
Otto, S. (2014 [2008]). Sexual Reproduction and the Evolution of Sex,.
(https://www.nature.com/scitable/topicpage/sexual-reproduction-and-the-evolution-of-
sex-824) Scitable. Retrieved 26.06.2019.
Platon (2002). Država, BIGZ, Beograd.
_____ (1985). Ijon, Gozba, Fedar, BIGZ.
_____ (1995). Timaj, Eidos, Vrnjačka Banja.
Žakob, F. (1978). Logika živog, Nolit, Beograd.
Weininger, O. (1906). Sex & Character, William Heinemann, New York.
Additional (internet) sources
http://www.archive.org/details/Dictionnaire-Etymologique-Grec
https://www.geneseo.edu/lgbtq/gender-identity
Evolution of sexual reproduction, Wikipedia:
https://en.wikipedia.org/wiki/Evolution_of_sexual_reproduction, Scitable. Retrieved
26.06.2019.
Rujević, G., Stefanović, M. (2012). UoKVIRivanje identiteta, Gerusija lecutre:
https://www.youtube.com/watch?v=TZQxAMXvnWQ, Gerusija, Novi Sad.
Y chromosome disappears -what will happen to men? Main source:
THECONVERSATION.COM https://naukaitehnologija.com/y-hromozom-nestaje-da-li-
znaci-da-ce-muskarci-izumreti/
[102]
or
https://www.b92.net/zivot/nauka.php?yyyy=2018&mm=02&dd=01&nav_id=1353606;
On the same site see: Trnavac, V. (2013). About the origin of philosophy and
mathematics:
https://www.b92.net/zivot/nauka.php?yyyy=2013&mm=11&dd=16&nav_id=778303.
https://en.wikipedia.org/wiki/Y-chromosomal_Adam and for the same research:
Zimmer, C. (2004). Adam and His Eves, National Geography:
https://www.nationalgeographic.com/science/phenomena/2004/08/23/adam-and-his-eves/
Ilustrations
Illustration no 1. From Pokhrel, P. (2015). Information about Platyhelminthes:
In Biology http://microbiologynotes.com/information-about-platyhelminthes/
Illustration no 2. From Townsend, D. (2014). The origin of sex has been discovered by
scientists in Express: https://www.express.co.uk/news/nature/524728/Extinct-fish-
Microbrachius-dicki-origin-sex
Illustration no 3. From Maritsas, K. (2018b). The origin and transformation of Gender,
Kastella M Company Ltd, Sofia, 49, fig. 2-4.
Illustration no 4. From Maritsas, K. (2018b). The origin and transformation of Gender,
Kastella M Company Ltd, Sofia, 102, fig. 6-2.
[103]
New Books & Research
On Philosophical Anthropology, Art & Therapy
Zistakis, A.H. (2017). Politics of Representation: An Essay in the Phenomenology of
Expiration or Theory in the Era of Sophisticated Mindlessness, Nova Science Publishers.
________ (2018). The Origins of Liberty: An Essay in Platonic Ontology, Vernon Press.
Ind, R. (2019). A House with one Column. Athens-Small Houses & their Ancestors, North
Hill. rosemaryind@greenbee.net.
Marinoff, L. (2020). Therapy for the Sane: How Philosophy Can Change Your Life,
Waterside Productions.
__________ (2020). The Middle Way: ABCs of Happiness in a World of Extremes,
Waterside Productions.
In Greek
Κεχρολόγου, Χ. (2013). Η Επικούρεια φιλοσοφία. Άτομο και κοινωνία, Ερωδιός.
Purves, D. (2019). Η μουσική ως βιολογία, Κάτοπτρο (Music as Biology. The Tones We
Like and Why, Harvard University Press, 2017).
Σακελλαριάδης, Θ. (2020). «Ψυχής πείρατα». Στα μονοπάτια της συνείδησης, Gutenberg.
Scheffler, S. (2019). Θάνατος & η ζωή μετά, (μτφρ.) Κ. Κουκουζέλης, (εισαγ.) N.
Kolodny, Αρσενίδης (Death and the Afterlife, Oxford University Press, 2013).
Wulf, C. (2019). Ανθρωπολογία. Ιστορία-Πολιτισμός-Φιλοσοφία, (επιμ.) Μ. Κοντοπόδης,
Εκδόσεις Πεδίο (Anthropologie. Geschichte-Kultur-Philosophie. Cologne, 2009).
[104]
Silence, by Dimitrios Galanis-Kolintzas
[105]
Critical Book Reviews
Atkins, P. (1992) Creation revisited: Chaos, Consciousness
& Nothingness
Dimitrios Galanis-Kolintzas
Abstract
By presenting the main contribution of Physics to our own dominant, scientific
worldview, Peter Atkins stands in favor of an extreme reductionism of everything to the
simplicity of chaos (Atkins, 1996). Atkins tries to give a solid scientific account of the
universe’s evolution. His aim is to make clear the fact that the universe does not require a
divine creator so as to exist. Creation Revisited enhances the view that the cosmos is self-
created and it totally excludes a place reasonable to be for a transcendent creator. In the
present article I will try to indicate that Atkins’ argumentation about the reason why our
universe exists appears to be too firm and lacks in acknowledging other possible
perspectives on the meaningfulness of cosmos. I am not intended to neglect or diminish
his point of view about chaos, simplicity and nothingness. What I want to do is to bring
attention to the fact that Atkins’ argumentation, stretched over in his book Creation
Revisited, is not the only one available in order to approach, both philosophically and
scientifically, the meaning of our world in its totality.
Key words: chaos, cosmos, universe, physics, simplicity, complexity, final cause, cosmic
self-efficiency, divine creator, consciousness, emergence, deeper structure, unfoldment,
nothingness, mystery, self-realization.
Preface
This paper has been written in order to offer a critical review of Atkins’ book by the title:
Creation Revisited, a book that causes a great impact on the transaction of Physics to
Philosophy. The main theme upon which that book is centered is the question about the
meaningfulness of cosmos. This paper is not a mere book presentation; it is rather a
contemplative article. The objective of this article is to provide -both critically and
productively- a philosophical approach to the simply outlined, yet ever well-enriched,
Atkins’ thoughts about our universe in its wholeness.
Atkins relates cosmos to chaos and chaos to the ultimate form of simplicity. For Atkins
(1996), the impressiveness of the universe in which we live is nothing more than a
production of chaos’ simplicity. Everything emerges from chaos; even consciousness is
but an emergence from the chaotic evolution of the universe (Atkins, 1996). Chaos
appears to be both the matrix and the final cause of the world; the pure, conjunctive net of
cosmos.
[106]
The article is divided into two chapters. In the first chapter I am going to reflect on
Atkins’ account of chaos. It will become clear how Atkins rejected a divine creator of the
universe and proposed, instead, that chaos itself can be the very reason why cosmos
exists. I will show that, even if he wants to exclude an ultimate goal towards which our
cosmos is constantly led, he finally promotes the faith in a sternly accepted final cause for
the entire universe. This final cause is chaos itself again. I will also discuss his ideas
about the “cosmic self-efficiency” and the simplicity governing chaos. The second
chapter is devoted in the importance of consciousness as a part of our cosmos. In that
section I will critically interpret Atkins’ account of consciousness and I will try to form a
more inclusive way of viewing at the beautiful complexity of our world. I will refer to the
brain – cosmos coordination hypothesis and I will test how far such a hypothesis can be
reasonable enough so as to regard that a completed form of knowing the ultimate reality
can be fully attained by man.
My intention is to give a succinct, yet profound and critical view of the self-created
cosmos hypothesis and to provide the reader with the ability to meditate on our tendency
to reduce the mystery of cosmos into our simplified scientific explanations. In the
afterword I will try to render feasible such a meditation by intriguing the reader with deep
questioning over our fixation of beliefs about the universe and our place in it. The main
purpose of the afterword, subtitled Physics and Self-Realization dynamics, is therefore to
offer a meditative, rather therapeutic account of our self-realization process got
influenced by the science of Physics.
I. Atkins’ Conception of Chaos: the Hypothesis of the Self-created Universe
1. Chaos and ignorance
Speaking about chaos theory in 21st century should not be seen as an outstanding effort to
give a coherent account of our world in its wholeness, nor should it be regarded as
something trivial. Chaos theory remains a new and exciting field of scientific inquiry and
has triggered a great amount of philosophical both questions and answers. Today, chaos
theory is seen as one of the most notable since the discovery of the quantum world
(Sardar & Abrams, 2013). What has now become really clear is the fact that the classical
approach of science as a system of simple deterministic equations has been proved quite
insufficient and highly arrogant in front of the advent of chaos and complexity theories
(Sardar & Abrams, 2013).
Chaos has set in forth a new way of understanding nature and ourselves. It has revealed
that uncertainty and complexity must be regarded as constant limits which our yearning
for knowledge incessantly runs up against (Sardar & Abrams, 2013). Now, with chaos
theory, scientists can “escape from ignorance of their ignorance” (Sardar & Abrams,
2013, 23) and they can realize that science can offer neither an ultimate nor a final
account of cosmos’ complexity. Today, we may know that our understanding really
confronts the dynamical complexity of the natural world in its deeper and deepest
structure underlying the physical phenomena.
Atkins’ work (1996) has given a grand defense of chaos theory but, surely, not toward the
above stated realization of ignorance. Atkins’ scientific vision, outlined in his book
Creation Revisited, might not allow a clear defense of our fundamental ignorance about
the deepest aspects of cosmos. Atkins’ extreme reductionism of everything into the
[107]
deterministic nature of chaos gives the sense that a faith that science can offer a total,
final and fixed knowledge about everything may be promoted in his work. In some parts
of his book chaos seems to be a new candidate for being a theory of everything. But, if
we look closely at his account of chaos as the simplicity which pervades cosmos and
produces complexity (Atkins, 1996), we might feel that this simplicity can also remain an
ever-open possibility of rethinking and retesting our sense of knowing in general. Thus,
chaos does not necessarily lead us to the revealing of an ultimate truth.
2. Chaos as the matrix of the universe.
For Atkins (1996), chaos is regarded as the source of the universal wholeness. This
source is neither a starting point nor a grain from which universe got flourished and
expanded. This source is everywhere in our universe - it pervades and organizes cosmos -
and it always remain simple, since it originates from ‘the ultimate simplicity’ that existed
before time got started, before the universe got borne (Atkins, 1996, 161). This “ultimate
simplicity” is the “almost nothing” from which everything emerged (Atkins, 1996). With
the advent of time the universe started its grand expansion ex nihilo. And, reversely: with
the uprising of complexity from simplicity, time became the source of order. Time is the
main factor of creation according to Atkins (1996). Its irreversibility has a constructive
role for the universe (Sardar & Abrams, 2013). Without time the distinctive forms of
natural complexity could not come to existence and, in case of its absence, all complexity
would fall apart into nothing again (Atkins, 1996). Therefore, chaos, together with all
nature, is intimately related to time. But time did not started before “the ultimate
simplicity” had acted as a chaos governing the blooming of cosmos. This means that
simplicity of chaos is what created Nature’s richness of complexity (Atkins, 1996).
According to Atkins (1996) the universe did not need a divine creator so as to come to
existence. Chaos is what can be seen as the very matrix of the universe, the very source
of everything that exists. Since chaos pervades the net of the entire cosmos, its form of
simplicity is what might better stand for the creation of the wondrous complexity of the
natural world. Given that chaos itself has the ability to produce complexity from
simplicity (Sardar & Abrams, 2013) we may stop feeling the need to call for a creator
able to design and responsible for the creation of the natural complexity. Thus comes to
be the title: Creation Revisited. Cosmos is not depended upon the arbitrary will of a
divine creator. For Atkins, cosmos exists by its self and it is grounded on its self. But this
kind of argumentation is not something new in the history of ideas. What is new is the
fact that chaos replaces the divine creator. And chaos is able to deal such an audacious
replacement because of its self-productivity. But we will elucidate more these themes in
the fourth part of this chapter.
Chaos is the matrix of the universe because it both drives forward and stays the world
(Atkins, 1996). It makes the natural forms of complexity stable and everything is an
outcome of chaos’ apparently random orchestrations (Atkins, 1996). The whole
evolutionary process of our expanded universe can be seen as “a constant and
orchestrated diffusion of energy” (Atkins, 1996). And where we detect energy diffusion
we perceive the chaotic properties of nature (Atkins, 1996). The complexity of natural
organization and order is fueled by chaos (Atkins, 1996). Therefore, chaos seems to be
the source of all creation found in our universe. Chaos is simply the reason for which our
universe exists. We could say that chaos is the substructure governing the laws of the
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natural structure of our cosmos. Nevertheless, chaos is not just seen as the matrix of
cosmos in Atkins’ Creation Revisited. In my personal view, Atkins stands in favor of a
simplistic view of nature. For him, cosmos not only is driven by chaos but it has an innate
inclination to chaos as well.
3. Does cosmos have an ultimate reason of existence? Chaos as the final cause of the
universe.
The question about why our universe exists is one of the most ancient questions with
which human understanding has been deeply preoccupied. Before we answer to such a
deep and age-old question, we shall firstly have to set as central and crucial to our
investigation the enquiry about the theme of the genesis of cosmos. According to Atkins
(1996) the cosmogony problem has not had a fixed or a final scientific answer.
As soon as we don’t know accurately how exactly and why our universe came to be, we
cannot know either if cosmos have an ultimate reason of existence. Therefore, science
cannot give an absolute knowledge or an ultimate truth as far as the meaningfulness of
cosmos is concerned. But this view seems to be rather confronted with Atkins’ claim that
“the full knowledge is now reachable” by our scientific understanding (Atkins, 1996,
191). Nevertheless, I will support the mostly moderate view that this claim should not be
strictly seen as an affirmation of the faith in a scientific theory of everything. This claim
should be better interpreted as the realization that a total form of understanding would be
deprived of the overambitious aspirations of knowing everything that could be known.
For Atkins (1996) coming face to face with ultimate reality means that you end up to
acknowledge a profound simplicity from which everything emerges once again. For me,
this acknowledgement, that from simplicity emerges everything, has the strength to be
ever open to various approximations and ever-changing forms of knowing and
understanding.
Atkins attests many times in his book that the universe has not a final cause toward which
it is directed (Atkins, 1996). Since a divine creator has been rejected, cosmos itself has
not been created in order to arrive at a defined end set before its creation. Only if a God
had created cosmos our universe would have had an a priori defined end (Davies, 2009).
But cosmos, according to Atkins (1996), came out from nothing and chaos governs its
evolution. The ‘diffusion of energy’ happens all the way naturally and automatically
(Atkins, 1996). Cosmic evolution is rather an automatic, chaotic process. Thus, cosmos
has not a final cause of its evolutionary existence.
Nevertheless, Atkins says that “everything is directed by the purposeless, without
incentive disintegration” into chaos (Atkins, 1996, 39). He also speaks about the “natural
inclination [of cosmos] to chaos” (Atkins, 1996, 57). Thus, chaos seems to be both the
initial form and the final form of the universe. But here exactly is where the crucial
question arrives: does the universe have an end or not?
I believe that Atkins promotes a teleological view of cosmos; a teleological view that
appears to be defined both positively and negatively in his book Creation Revisited. The
teleological view of cosmos is formed and defined since Atkins accepts that everything is
directed toward chaos, thus revealing what he himself calls the “purposeless collapse into
chaos” (Atkins, 1996, 35). This direction, even if he refuses accepting it as a final cause
of the universe, remains an end of the universe. We can see that the “purposeless collapse
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into chaos” is the affirmatively defined end of cosmos. Atkins wanted to eliminate a final
cause of the universe but he ended up accepting such a cause even under a negative point
of view as well. Since there is not a final cause of the universe according to him, cosmos
is directed toward a “purposeless collapse into chaos” (Atkins, 1996, 35). As a result,
cosmos has an end, but this end is defined negatively, so it is defined and thus can be
defined positively: the end of cosmos is chaos itself. Well, what Atkins surely makes
clear is the fact that such a negatively defined end of the universe has not been designed
by a divine creator and so it is not external to its very existence. For one more time
Atkins wants to defense the ‘cosmic self-efficiency’ (Atkins, 1996, 177) and maintain the
philosophical view that cosmos is grounded in nothing more than its self.
4. Simplicity, ‘cosmic self-efficiency’ and the rejection of the divine creator.
Atkins persists in the self-productivity and self-efficiency of cosmos and offers a wide
explanation of how the physical laws generate its wondrous complexity. For Atkins
(1996) the universe can be randomly emerged from nothing, without any interference.
This kind of emergence is not regarded as a miraculous one. Atkins’ account of ‘cosmic
self-efficiency’ (1996) is what can remind us that the existence of cosmos does not entail
a divine creator able to design and willing to act productively. Chaos is mainly
characterized by self-productivity (Sardar & Abrams, 2013). This is why Atkins replaces
the divine creator with the creative properties of chaos.
Chaos has the property to create the wondrous complexity of dynamical physical systems
only throughout its form of simplicity grounded in its laws of creating. This means that
chaos has the property to render complexity’s richness be “self-organized” only by chaos’
deterministic simplicity (Sardar & Abrams, 2013). Thus, chaos is the creator of the
universe and universe’s rules are in their deepest form simple ones. It might well be seen
as a difficult effort to “reconcile a complex universe with the presumed simplicity of its
rules” (Sardar & Abrams, 2013, 170) but this is exactly the case in which chaos plays a
vital role.
For Atkins (1996), what we, humans, ought to understand is the fact that beneath all
forms of cosmic complexity lays the simplicity of the deterministic rules of chaos.
Simplicity is acknowledged as the very meaningfulness of cosmos. Atkins insists that
science’s task is to find always the simplest possible answer (Atkins, 1996, 79). This
mindset, however, is not the undoubted canon with which all the science of physics must
be compatible. Other physicists have pointed up the fact that the advancement of science
does not mean that only simple answers must always arrive at the forefront of the
scientific worldview. Among those physicists we can distinguish David Bohm. Bohm’s
work has given outstanding theoretical evidence that the natural laws are not always
compatible with the simplistic and abstractive forms of reasoning which characterize our
scientific worldview in general and our scientific practices in particular. For Bohm (1984,
2002), science does not but constructs abstractions from the deeper reality of cosmos.
Bohm’s notion of the “implicate order” of nature reminds us that our understanding has
unpassable limits to acknowledge. This means that the deepest structure of our universe
(what Bohm calls “the implicate order”), either it is governed by a form of simplicity or a
form of intricacy, is “unknowable” and “unanalyzable” by man (Bohm, 2002).
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Thus, simplicity is not the canon of science and, even if we perceive simplicity as the true
meaningfulness of cosmos, then, this very notion of simplicity should be open to be
interpreted under various points of view. Another possible point of view, radically
different and alternative to Atkins’ theory of the self-created cosmos, is the view that the
universe evolves as a “vast living organism” in the rules of itself, yet by the fundamental
power that a divine creator has set in it from its very coming to existence (Polkinghorne,
1997). But, for Atkins (1996), the reference to a divine creator is totally redundant and
unneeded. Besides, the mere existence of cosmos could never be an unshakable proof of
God’s existence. Finally, accepting a divine creator or not is about to be only “a question
of faith” (Davies, 2009, 299). What I find out that Atkins omits in his own point of view
is the fact that the demonstration of chaos, simplicity and “cosmic self-efficiency” does
not necessarily lead to the firm conclusion that a divine creator does not exist. Chaos can
be compatible with the point of view that a divine creator might have acted or continues
to act upon cosmos’ existence. Nothing prevents the existence of a divine creator as soon
as nothing requires it. In this theme Atkins seems to promote a rather dogmatic scientific
worldview, meanwhile Bohm, for example, offers the opportunity to contemplate in a
more freely way on the deep questions about the nature of the universe in its wholeness.
II. Atkins’ Account of Consciousness: the Realms of Knowledge & Nothingness
1. The emergence of consciousness from nothingness.
It has been widely accepted that chaos theory can stand for a radical re-evaluation of our
approach to the phenomenon of consciousness (Sardar & Abrams, 2013). One of the
discoveries of chaos theory is that brain’s complexity is organized by chaos (Sardar &
Abrams, 2013). According to Atkins (1996), chaos is everywhere and everything is an
unfolded production of chaos’ self-efficiency and self-productivity. Our brains and
consciousness are not but an unfoldment of the chaotic evolution of the universe.
Consciousness appeared in the cosmic history after a vast amount of energy had been
diffused and had been self-organized to complex systems such as the human brains
(Atkins, 1996). For Atkins (1996), the property of consciousness appears to be a quality
possessed only by man. Howbeit, this apparently unique possession is regarded neither as
something special nor as an outstanding highlight of the universe. Consciousness is a part
of cosmos and has been emerged from chaos (Atkins, 1996) and its presence does not
declare but chaos’ unmeasurable ability to self-create. In more detail, consciousness
emerged from chaos not necessarily but randomly and we, humans, are not but “the
offspring of a purposeless happenstance” (Atkins, 1996). There is not a special design for
the appearance of consciousness in our universe. Thus, the emergence of consciousness
from chaos seems to indicate just a random emergence, which could have never been to
fulfillment or which could have appeared many times in the past of cosmic history as
well (Atkins, 1996).
Consciousness is just one of the features of our universe and it is not viewed as the
cosmic fact upon which all sense of mystery must be centered. Besides, for Atkins,
consciousness does not force us to start contemplating about what is going to be
acknowledged as its possible source. Since consciousness is found to appear in cosmos,
the very source of consciousness is cosmos and chaos itself (Atkins, 1996). No reference
to the spirit or to the divine act of creating is needed (Atkins, 1996). Atkins persists
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(1996) that there is no reason to speak about the realm of spirit as an exterior reality
which merges with cosmos. Consciousness is not related to forms of another kind of
reality, others than that of our universe in which it exists. Consciousness is not produced
by spirit; it is a mere emergence from nothingness (Atkins, 1996) and cannot indicate but
chaos’ self-productivity and “cosmic self-efficiency”.
Atkins (1996) renders totally clear the fact of interconnectedness of everything in our
universe. This is what primarily gives evidence of the “cosmic self-efficiency”. All the
dynamical, natural systems share both the common origin and the rules of chaos’ creative
simplicity (Atkins, 1996). Nature is an organic whole and its conjunctive net is chaos.
Inside this vast wholeness of cosmos consciousness is a mere part of it. But, since the
pure content of the universe is nothingness (Atkins, 1996), consciousness is an
emergence of nothingness as well. This perception of interconnection can be clearly seen
in the fact that “everything is made up with the same material” (Atkins, 1996, 23). We
are not but galaxy’s dust and we will not but return to galaxy’s dust (Atkins, 1996).
Whatever exists in our universe shares the common matrix of cosmos; everything is
unfolded from chaos’ simplicity.
In the context of this mindset, consciousness cannot offer us the sense that the meaning of
our existence can be found in a reality other than that of cosmos. For Atkins (1996), we
shall realize that simplicity of nothingness is what created the complexity of the universe.
This is the way in which chaos acts. Nothingness became a chaos and thus chaos
pervades everything in Nature. Therefore, nothingness is perceived as the very essence of
all existence, regardless of how absurd might appear such a philosophical statement.
2. Is cosmos fully understandable? The hypothesis of coordination between the brain and
the deep structure of the universe.
Even if consciousness itself does not possess a central role in Atkins’ argumentation
about the meaningfulness of cosmos, man remains always the “interpreter of Nature”
(Atkins, 1996). This means that, when we intend to understand the universe, we find out
that mathematical logic conquers everything that can be understandable for us. According
to the principles of the extreme reductionism, which pervade Atkins’ work, mathematics
seems to be acknowledged as identical to the very process of understanding (Atkins,
1996). This claim, however, is rather unfair for human existence.
Atkins does not refer to how other forms of human understanding can produce different
forms of knowledge. Art, literature, philosophy and human feelings are exempted from
the state of knowledge. Someone could easily, yet superficially assert that these forms of
knowledge have to do only with the human world. But, even if we accept that we
investigate only the natural world, then, we should keep in mind that “there is more to the
world than mathematical models” (Smith, 2007, 53). But Atkins seems not to realize such
a statement. For him, mathematics has the ability to reveal the underlying structure of the
universe. Therefore, what just remains in Atkins’ Creation Revisited are mathematics and
a perception of science which, in fact, narrows our potential of free and creative forms of
knowing reality in its wholeness.
Nevertheless, Atkins proposes in his work (1996) a really interesting idea about how the
universe can be fully understandable by consciousness’ ability to form mathematical
reasoning. For him (1996), cosmos can be fully understandable because of science’s
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strength of knowing the deeper reality of the world. It is about to be a weird, yet deep
similarity between mathematical logic and cosmic reality (Atkins, 1996). This similarity
might also be a true identity between reality and mathematics (Atkins, 1996). It seems
that mathematics is a logical system “imitating the ultimate structure of the universe”
(Atkins, 1996).
Atkins proposes (1996) that the fact that we can be conscious of the world is, in the
deeper level, an expression of the coordination between the deep structure of the brain
with the deep structure of cosmos. With other words, Atkins supposes that we can have
knowledge of the natural world because of the property of the natural world to share
along with human brains a common deeper structure. This sounds quite reasonable and
offers a really beautiful and dynamical insight in our age-old investigation about the
epistemological questions that traditionally agonize both science and philosophy.
Perhaps, the very essence of consciousness is just an unfoldment
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of the deepest cosmic
structure, an output of the deepest rules governing the universe. And, perhaps, this is why
knowledge can be achieved; because knowledge is a property that belongs to cosmos and
expresses cosmos in the emergence of consciousness. The existence of consciousness can
thus be seen as an evidence that cosmos creates its self-realization. Besides, according to
Atkins (1996), space-time itself has self-awareness. And, perhaps, this is why this self-
awareness can be expressed in the clear emergence of consciousness. What majesty!
Consciousness can be viewed as the innate property of cosmos to produce - by chaos
itself - its own self-understanding. Consciousness can thus be seen as the primordial
holder of cosmos’ ability to possess self-acknowledgement.
This account of consciousness, however, is not found only in Atkins’ argumentation.
Other physicists, such as Bohm again, have proposed a similar account of consciousness’
genesis. Bohm (2002) had proposed that consciousness is an emergence from cosmos’
deeper structure. He had indicated that consciousness is an unfoldment of the deep and
unknown laws governing the “implicate order of nature” (Bohm, 2002), which is the
“single origin of everything” that exists (Galanis-Kolintzas, 2020). This means that, for
Atkins (1996) and for Bohm (2002) as well, consciousness is not an external quality
found inexplicably in the universe, but, it is rather an unfolded expression of universe’s
deeper structure.
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The main difference between Atkins and Bohm is the fact that, whilst
in Atkins’ work (1996) consciousness can attain a full knowledge of reality, in Bohm’s
work (2002) consciousness can never attain such an ultimate form of knowledge since it
is only a part of the “implicate order” of nature and, thus, it cannot have cognitive access
to the wholeness of implicate order’s “unknown depths”. As a result, Atkins promotes the
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The terminal “unfoldment” is consistently used in Bohm’s work [See: Bohm, D. (2002) Wholeness and
the Implicate Order, London and New York: Routledge classics]. For Bohm (2002), consciousness is an
“unfoldment” of “the implicate order” of nature. Here it matches clearly with Atkins’ account of
consciousness as an “emergence” from “chaos”. What is “the implicate order” for Bohm seems to be
“chaos” for Atkins, namely “the single origin of everything that exists” [See: Galanis-Kolintzas, D. (2020).
The Universe and the limits of Knowledge: Bohm’s notion of the Implicate Order of Nature. Epistemes
Metron Logos, issue 4, pp. 32-49]. Thus, Bohm’s characteristic terminal of “unfoldment” can be used as an
alternative word for Atkins’ terminal of “emergence”.
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For Bohm (2002) the deeper structure of cosmos is “the implicate order”, while for Atkins (1996) the
deeper structure of cosmos is “chaos”. [See also the above - No1 - footnote].
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faith that the universe can be fully knowable by man, whereas Bohm alert us that the real
depths of cosmos are truly “unknowable” and “unanalyzable” by the human intellect
(Bohm, 2002).
Nevertheless, claiming that cosmic reality is identical to mathematical reasoning can be a
very destructive statement. This kind of statement seems to neglect the fact that
mathematics is a mere production of human logic which is projected onto the natural
world. Bohm had emphasized that scientific reasoning should not acclaim being an
ultimate form of knowing reality in its wholeness (Bohm, 1984, 2002). Whitehead had
pointed out also the fact that mathematics does not reveal in an undoubted, fixed or
absolute way how the universe is. He believed that “there is no more greater an error in
science, than to believe that just because some mathematical calculation has been
completed, some aspect of Nature is certain” (Whitehead, 1953). That could be also the
case in which chaos’ mathematical models do not exhaust the ultimate reality of cosmos.
Penrose (2005) emphasizes that chaos theory has not yet provided the needed answer to
the mystery of mentality. Penrose (2005) also retains a mostly moderate view of
mathematics’ rigorous explanations. He sets under real investigation the question if
mathematical understanding does represents some kind of contact with a deeper reality or
if we each are just “independently recreating all mathematical concepts as we think
through our logical arguments” (Penrose, 2005, 208).
Therefore, believing that science can offer the true knowledge of the world appears rather
as a “question of faith”, similar to that one of the faith in God’s existence. What man is
ever certain about seems to be arbitrarily adjudicated by him. Perhaps, as Wittgenstein
had pointed out, the absolute certainty that we, humans, believe to attain, is only a
question of our attitude toward life and knowledge (Wittgenstein, OC, 404)
100
. Perhaps,
finally, what we view as the absolute truth is only determined by ourselves and not by
Nature.
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3. Nothingness and the openness to the mystery: another possible reflection on the
meaningfulness of cosmos and our existence.
The above-analyzed brain-cosmos coordination hypothesis has managed to offer a
beautiful insight into the very essence of knowledge. Regardless of if such a hypothesis
might be real or not, what is clearly seen in Atkins’ work is his intention to express the
interconnectedness of everything through chaos’ simplicity and “cosmic self-efficiency”.
Cosmos’s chaos creates consciousness and consciousness can understand how the
universe works.
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Wittgenstein, On Certainty, § 404. Wittgenstein enhanced a rather skeptical view of our beliefs’ system.
If we prefer to have a moderate attitude toward certainty we might end up claiming neither attaining an
undoubted knowledge nor knowing an ultimate truth. But this kind of attitude might deprive us from
common or useful beliefs. Therefore, “missing out on useful beliefs is [indeed] the price we pay for
extreme skepticism” (Nilsson, 2014: 36).
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See: Dear, P. (2007). The Intelligibility of Nature: How science makes sense of the world. Chicago and
London: University of Chicago Press, p. 194, where Dear points out that: “The world pictures that we
believe in owe much more to what we find plausible than to the way the world really is: their acceptance,
rather than being determined by the natural world itself, depends on the ways in which we choose to live in
the world”.
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In Atkins’ Creation Revisited (1996) man appears to be able to attain a “full knowledge”
of cosmos strictly grounded on science. Nevertheless, this kind of knowledge seems to be
a form of nihilism. According to Atkins (1996) the pure content of the universe is
nothingness. Nothingness is the other name of the “ultimate simplicity” as well (Atkins,
1996). From nothingness emerged the something and, thus, the something is not but an
elegant reorganization of nothingness (Atkins, 1996). As a result, all the creations of
chaos’ self-productivity are not but elegant reorganizations of nothingness itself (Atkins,
1996). When man realizes that everything has come to be from nothing and all forms of
complexity have come to be from an “ultimate simplicity”, then he achieves to arrive at
the end of the problem (Atkins, 1996). Howbeit, for me, the arrival at this realization is
not at all the end of the problem but, to the contrary, it is the very beginning of the
problem, that is to say the beginning of the really deep questioning about the meaning of
our existence and the meaning of our world.
At the end of his book, Atkins (1996) seems to equate the final form of the “full
knowledge” with the knowledge of nothingness. He insists that we can be certain that we
have arrived at the end of the cognitive process only if the cosmic structure will have
been so much investigated so as to remain “no more structure” (Atkins, 1996). Only then
we can have the knowledge of the “ultimate simplicity”. The very meaningfulness of this
kind of knowledge, however, seems to be either a hush of vacuity or a glory of mystery.
But Atkins appears to regard the “ultimate simplicity” as the absolute scientific
knowledge.
We should always keep in mind that Atkins firmly believes that science can attain a
completed knowledge of the deeper cosmic structure and, thus, he does not render the
realization of the “ultimate simplicity” able to be interpreted in alternative ways. For
Atkins (1996) science can lead us to the acknowledgement of the “ultimate simplicity”,
namely to the nearly nothingness. His concept of interconnectedness does not promote
the cultivation of a sense of mystery around cosmos’ existence and our existence as well.
The final sense, given at the end of his book, is rather a sense of nothingness.
If Atkins’ account of the “ultimate simplicity” governing cosmos could be open to a
sense of mystery and did not only remain an acceptance of nothingness, then, the sense of
our communion with the natural world and the sense of the unity of Nature in general
could act for us as notions directing our forming of cosmos’ meaningfulness in a broader
way. But Atkins does not refer to any sense of mystery of the world. His scientific
worldview ends up being too strict. He does not promote, for example, senses of humility
toward the mysterious well-spring from which everything has been emerged. If he could
acknowledge the possible fact that the real depths of cosmos’ source are ineffable and
“forever resistant to conceptual articulation and understanding” (Cooper, 2018), then, he
could also offer the potential to realize that any world able to be articulated by our
scientific reasoning might not be reality ‘as such’. Perhaps, true understanding is
something ultimately simple, but, this claim does not necessarily leads us to the realm of
nothingness; it can lead as to the realm of mystery as well.
What I want to say is that, while Atkins views the “ultimate simplicity” as something
final, someone else could attest that such an “ultimate simplicity” is not necessarily the
end of the meaningfulness of cosmos but it is rather the very start from which man can
feel deep senses of mystery. Such senses of mystery could remind us that science does
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not conquer cognitively the wholeness of our world and, thus, the interpretation of the
‘ultimate simplicity’ could be ever-open to different possible insights. The answers to the
great questions of why cosmos exists and why consciousness is a part of it would be able
to promote senses of mystery and not find an end in the mere acceptance of the “ultimate
simplicity”. As a result, this kind of possible answers could provide us also with ideas
other than those of the “cosmic self-efficiency” and “nothingness”. What kind of ideas
could be produced is a theme that will be more elucidated in the afterword.
Afterword
Physics and Self-Realization dynamics
Here we arrive at the end of our critical contemplation. Until now we have seen that, for
Atkins (1996), chaos is the matrix of the entire universe and at the same time it is the
force which reigns over the laws of the evolutionary process that can be found
everywhere in the natural world. All of us, we are parts of the universe, and cosmos has
been totally emerged from nothingness (Atkins, 1996). Cosmos gets borne by the
absolute vacuity of the “ultimate simplicity” and tends to collapse into the simple
emptiness of chaos (Atkins, 1996). Consciousness, in its turn, is acknowledged as a mere
production of chaos’ property to create high forms of complexity (Atkins, 1996).
Consciousness renders knowledge feasible. Knowledge of the universe is totally
accessible by our consciousness since our brains share with cosmos a common deeper
structure (Atkins, 1996). This is in general the great picture that Atkins draws about the
natural world. We also viewed that his claim that scientific knowledge meets an end in
the perception of the “ultimate simplicity” governing cosmos does not necessarily set an
end for our overall potential to meditate upon the meaningfulness of our world and
ourselves. At this point we shall mostly center on the dynamics of self-realization as
these get influenced by physics.
What we can say is that our forming of the meaning of cosmos and ourselves can be
highly influenced by physicists’ account of the natural world. We can feel our
interconnection with everything existing in the universe and we can deeply acknowledge
that we are parts of cosmos’ self-productivity. The difficult question is how we, in a final
account, can know in general. Is there coordination between our brains and the universe
(Atkins, 1996) or the deeper reality of cosmos can be never fully known by man (Bohm,
2002)? “Regardless of our personal beliefs on the existence of Truth, chaos has forced us
to rethink what it means to approximate Nature” (Smith, 2007, 160). Besides, “chaos has
provided much new cloth for our study of the world, without providing any perfect
models or ultimate solutions” (Smith, 2007, 161). Therefore, chaos theory should not be
regarded as a new candidate for being a final, fixed and absolute theory of everything.
Our self-realization can be benefited from the fact that scientific knowledge cannot bring
us face to face with the ultimate truth of reality. Where science ends, new forms of
cognitive insights might emerge. Cultivating a deep sense of mystery is maybe the most
suitable attitude to keep after the end of scientific reasoning. This kind of sense can act
for us under a freely way. We may feel that the source of cosmos is in its deeper core
ineffable. We may create new ideas about what could be the consequences of accepting
the ineffability of the cosmos’ deeper reality in our daily lifestyles. We may feel more
humble and gracious. Finally, we may better understand the fact that every system of
human, scientific knowledge about the world is fundamentally incomplete; that it is, and
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must always be, constantly subjected to reconsideration (Rucker, 1982) and re-evaluation
as well. This realization can impose us on getting a glimpse of an affirmation of the
infinite process of both creative thought and dialectics. Human intellect attains high
standards of complexity and it can produce simplicity from complexity and complexity
from simplicity. The very process of understanding seems to be succumbed to a
fundamental flow of infinity. This could also be one of the reasons for which our
scientific explanations are constantly led to “ever-changing forms of insight” (Bohm,
2002). As a total result, we may feel a mostly Hegelian account of reality. Flowing of
infinite dialectic may lead us to arrive at the end of a mystical silence. This silence might
have a therapeutic impact on our mentality. In such a mystical silence new horizons
might emerge.
And what if we want to “break” silence in order to get progress in our science? How
could we feel if we finally realized that “we can only say things about reality” without
being able to say what reality is (Nilsson, 2014, 66)?
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In fact, this is a highly important
realization not hidden in physicists’ theoretical works. Nevertheless, it is not found
everywhere in the scientific books. Some scientists maintain the view that science can
provide us with fully completed knowledge. However, this claim is not compatible with
the ubiquitous statement that “all scientific knowledge is subjected to change” (Nilsson,
2014).
What we should always keep in mind is that physics, as a form of science, can provide us
with a great amount of ideas and contemplation about the meaning of cosmos and
ourselves. It is mainly up to each of us how we are going to make good use of these
potentialities. Science, silence and deep senses of mystery about the world might all
together be a more holistic way of living and knowing.
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_______ (2002). Wholeness and the Implicate Order. 2nd ed. London and New York:
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We can think about it parallel to Niels Bohr’s statement that “it is wrong to think that the task of physics
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2014, 66).
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Galanis-Kolintzas, D. (2020). The Universe and the limits of Knowledge: Bohm’s notion
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Whitehead, A.N. (1953). Alfred North Whitehead: Αn Anthology; Selected by F.S.C.
Northrop & M.W. Gross. Cambridge University Press.
Wittgenstein, L. (1969). On Certainty. Edited by G.E.M. Anscombe & G.H. von Wright.
Blackwell Publishing Ltd.
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Selected Articles from the 2019 C.A.I.P.T. Conference
Music & Arts Therapies in Healthcare Settings
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Introduction
Music & Arts Therapies in Healthcare Settings
Presentation of C.A.I.P.T. Conference 2019
Dora Psaltopoulou-Kamini
“And through their sound, for an instance sounds return,
from the first poetry of our Lives… As… Music…”
Chorus Hymn to Nemesis 2nd cent. B.C. in Dorian mode
Any human, being involved with the arts, projects own feelings on the artifact and the
artist, sympathizes and identifies with them. Thus, through this internal process, the aim
of the arts becomes the quest for inner truth, for virtue and for… ‘knowing thyself’.
The arts as therapy and in therapy, offer human beings a safe and creative path toward
alternate states of consciousness through transcendence and sublimation, leading
ultimately at therapeutic changes. Creativity, as an innate quality of all human beings
regardless of age, genre, psychopathology or race, is man’s golden road to the discovery
of self and to a meaningful life with empathy and freedom.
Music derives from the word muse which embodies all arts together. The
word music comes from the Greek mousikê (tekhnê) by way of the Latin musica. It is
ultimately derived from mousa, the Greek word for muse. In ancient Greece, the
word mousike was used to mean any of the arts or sciences governed by the Muses.
Later, in Rome, ars musica embraced poetryas well as instrument-oriented music. In the
European Middle Ages, musica was part of the mathematical quadrivium: arithmetics,
geometry, astronomy and musica. The concept of musica was split into three major kinds
by the 5th cent. philosopher, Boethius: musica universalis, musica humana, and musica
instrumentalis. Of those, only the last—musica instrumentalis—referred to music as
performed sound. https://www.princeton.edu/~achaney/tmve/wiki100k/docs/
Definition_of_music.html
In Greek mythology, the Muses were a sisterhood of spirits who ruled over the arts and
inspired the creative process. They were daughters of Zeus, king of the gods, and
Mnemosyne, goddess of memory. The Muses are the goddesses of beauty and truth and
they are still referred to as sources of inspiration. Thus, the arts are interconnected and
can serve in therapy and paideia in the broader sense of training and care for the person
as a whole (body, mind, emotions, psyche and spirit) with a broad enlightened maturity
harmoniously combined with intrapersonal, interpersonal and transpersonal development.
The integrative master program at the School of Music Studies, Aristotle University of
Thessaloniki, is the only one in Greece that holds an academic position on the subject of
Music Therapy.
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Since 2011, the School has been organizing several conferences in the country while
hosting pioneers from all creative arts therapies’ areas, around the world.
Since 2019, Aristotle University has been the representative of Greece at ECArTE
(European Consortium for The Arts Therapies: http://www.ecarte.info/) as an associate
member (http://www.ecarte.info/membership/member-institutions.htm). In 2019, 27-29
of March, the School of Music Studies hosted the General Assembly of ECArTE.
Unfortunately, the other creative arts therapies are not yet officially included in the
country’s academic education.
Since 2016 the University of Macedonia offers a two-year master program in Music
Therapy.
With respect to the spirit mentioned, the Two-Day Preconference Symposium, under the
title: “Music & Arts Therapies in Healthcare Settings” was successfully held in March
30-31 of 2019, at the Thermi Campus of the School of Music Studies, Aristotle
University of Thessaloniki. It preceded the 5th international scientific conference of
Creative Arts Interconnection-Paideia-Therapy (C.A.I.P.T.) under the title: Arts’ Rhythm
Transcending Self (A.R.T.S.). The Symposium chairs were Dora Psaltopoulou-Kamini,
Yiorgos Papadelis and Nikolaos Zafranas (https://caipt.mus.auth.gr/).
The nature of this Symposium was:
• Multimodal, featuring all of the creative arts therapies: Music, Drama, Movement,
Dance, Art, Play, Expressive Writing.
• Intermodal, emphasizing collaborative workshops by 2 or more specialists.
• Multidisciplinary, including professionals and content from other fields.
The Symposium hosted with great honor the representatives of ECArTE: the president
Richard Hougham, and the members Brenda Naso, Jaap Welten and Stavroula
Demetriou. Among the international pioneers who supported the Symposium with
interesting presentations and workshops were dr. Dorit Amir, dr. Alan Turry, dr. Stelios
Krassanakis, dr. Anna Lazou, dr. Xanthoula Dakovanou, Timurthy Sairam, Krysztof
Stachyra and dr. Lida Stamou, the head of the unique Music Therapy Master Program
(University of Macedonia) in the country. The eleven graduate students of this master
program who presented their research projects, conducted in Greece, have effectively
contributed in setting the foundations for the official recognition of the profession in the
country.
The rich variety of topics, of populations, ranging from premature infants to geriatrics,
from normal neurotics to psychiatric patients, substance abuse, hearing impaired, autism,
mental retardation, emotional disturbances and people with disabilities in all different
school and clinical settings around the world, attracted the attention of the participants
and turned the Symposium into a seedbed for inspiration, for further fruitful exchange of
ideas and practices.
The wide range of topics and interventions, all included in eight main sessions, opened
the path for further interdisciplinary discussions and collaborations for innovative
projects.
Topics:
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1. Different perspectives on Arts Therapies.
2. Research issues in Music/Arts Therapies.
3. Music/Arts Therapies in healthcare settings.
4. Music interventions for the hearing impaired.
5. Music therapy for neurological and neurodevelopmental disorders.
6. Music/Arts therapies in educational institutions.
7. Community Music/Arts Therapies.
Sessions:
1. Opening session.
2. Music interventions for the hearing impaired.
3. Music Therapy-Vocal interventions.
4. Music and Art Therapy for neurological and neurodevelopmental disorders.
5. Music Therapy and Autism.
6. Drama and Dance Therapy.
7. Music Therapy special issues.
8. Closing ceremony.
Furthermore, an impressive Community Music Therapy and Creative Dance Therapy
Performance of SOTIR (Centre of Rehabilitation & Social Support for People with
Disabilities), under the guidance of Apostolis Laschos, music therapist MA, and Natassa
Damaskou, dance therapist, showed evidence of the creative arts therapies’ positive
contribution to the inclusion of people with disabilities in society and to the importance
of the interdisciplinary collaborations.
Furthermore, an impressive Community Music Therapy and Creative Dance Therapy
Performance of SOTIR (Centre of Rehabilitation & Social Support for People with
Disabilities), under the guidance of Apostolis Laschos, music therapist MA, and Natassa
Damaskou, dance therapist, showed evidence of the creative arts therapies’ positive
contribution to the inclusion of people with disabilities in society and to the essential
value of the interdisciplinary collaborations.
Last but not least, it is important to express a deep gratitude for all the pre-conference
participants who shared their knowledge, expertise, personal and professional experience,
with a positive regard and open soul to the creative arts therapies, as well as with genuine
care for a human life with safety, meaning, creativity, empathy and freedom. At this
point, it is important to especially thank the drama therapist Roselina Filippidou for her
essential contribution to the realization of the ECArTE General Assembly and the
Symposium.
The Symposium’s success promises an even more interesting main conference C.A.I.P.T.
in the future.
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Painting by Yiannis Kaminis-Poster CAIPT 2019
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Union and Collaboration in the Art Therapies
Creative Arts Interconnection-Paideia Therapy C.A.I.P.T.
Richard Hougham
Good morning to you all.
I am very pleased to be opening these two days of symposium. This is an important
moment in bringing together arts therapists, students, artists and scholars to further the
development of training, practice and research in Greece. It is an opportunity for ECArTE
to support and be involved in an event that continues to underline the importance of the
arts in psychological health and treatment.
I begin with a nod to the happenings in Europe and the United Kingdom as we gather
here the very day after the UK was due to leave the European Union. I need to be careful
that as an Englishman trying to recover from the turmoil and fragmentation of the British
parliament, that I do not hijack this welcome. In addition, from speaking with colleagues
and friends here in Greece I am increasingly aware of the turmoil and crisis that has beset
this country over the past decade. However, this moment in time does give me a point of
departure. As a counterbalance to this fragmentation and to the insidious nationalism that
is spreading across the continent, I would like to offer a few thoughts on the
psychological idea of wholeness as outlined by Jung and discuss how this is relevant to
the development of the arts therapies both here and globally.
First, a few words about ECArTE. The European Consortium of Arts Therapies
Education has 32 member Universities from 16 different European countries. We are
delighted that the University of Aristotle has also (since Wednesday) joined the
community as an associate member. Since 1992, ECArTE has been developing
benchmarks for standards of education and training in the Arts Therapies in Europe and
supporting new and emerging programmes in Universities and the public sector. I am
proud to say the spirit of ECArTE is one of collaboration and shared visions of the
healing power of the arts across cultures and peoples.
The work of previous ECArTE conferences and publications has sought to engage with
pressing and contemporary concerns, social, political and psychological. For example, the
conference in Palermo Sicily in 2015 explored the theme of ‘Cultural Landscapes in the
Arts Therapies’ and the most recent conference in Krakow, Poland in 2017 looked at the
problem of ‘Traditions in Transition’. We look forward to the conference in Alcala de
Henares, Spain this September, with the title of ‘Imagining Windmills’ and a full
programme of workshops and papers which address questions of trust, truth and the
unknown in the arts therapies.
Evident within the work of the conferences and publications is the Arts Therapies’
capacity to acknowledge, express and examine individual and cultural difference within a
psychodynamic frame. In other words, it proposes that there are levels of understanding
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and experience that are not always conscious and part of the work of the arts therapist is
to examine and reflect on these layers of the psyche. This, in turn, can support an
understanding and acceptance of ‘the other’, both in the Self and in relationship,
ultimately fostering a sense of wholeness.
So, some thoughts about wholeness. One of Jung’s main observations about the psyche
was an innate search for wholeness, a natural impetus to bring together the opposites in
the Self. This psychological task requires reflection on the disenfranchised, repressed and
alienated parts of the personality and the integration of these through, for example,
reflections on dreams, complexes and moments of synchronicity. One could say this
belongs to a very old tradition of psychic healing which considers therapeutic whole-
making experiences to occur when the personal or conscious psyche is brought back into
a vital relationship with the archetypal, deeper instinctual fundament of the human being.
The vehicle for this experience is the symbolic image, particularly that which Jung called
the uniting symbol (Jung, 1981, 189).
The arts therapies can listen to the uniting symbol as the currency that bridges conscious
and unconscious contents. The arts allow for and can express the dim, uneven, instinctive
parts of the personality, giving them room to breathe, and making them manifest. It is the
antithesis to fragmentation. The French philosopher Gaston Bachelard explores the nature
of the symbolic image and the process of reflection and integration in his ‘Poetics of
Space’. This offers an analogy to beginning to see the specifics and differences, not as set
up against each other, but as part of the whole. Bachelard mentions that ‘the image
touches the depths before it stirs the surface’ and that one should be cautious not to jump
to interpretation too quickly. He offers the doublet of ‘resonance’ and ‘reverberation’ as
distinct ways to listen in to how the image unfolds:
“The resonances are dispersed on the different planes of our life in the world, while the
repercussions invite us to give greater depth to our own existence. In the resonance, we
hear the poem, in the reverberations, we speak it, it is our own. The reverberations bring
about a change of being.” Bachelard, G. (The Poetics of Space: xxii)
This doublet (of resonance and repercussion) strikes me as primarily auditory and
therefore good for discussion here. It is about soundings, resonance and reverberation. It
is tonal, sonic. Moreover, in Bachelard’s writings we sense he acknowledges the
mysteries of the source of the images, which also strikes a chord with this symposium:
“After the original reverberation, we are able to experience resonances, sentimental
repercussions, reminders of our past. But the image has touched the depths before it stirs
the surface.” (xxiii)
So how might this relate to your explorations and improvisations during these days? As
was mentioned in the outline of the symposium organised by Dora, Georgios and
Nikolaos, the etymology of the word music is the muse. The Muses were a sisterhood of
spirits who ruled over the arts and inspired the creative process. Perhaps, a pathway in the
search for wholeness is staying mindful of not jumping in too quickly to interpret or
understand its meaning. Perhaps it might be that we give more time to the reverberations
– those moments of a change rather than giving in to the compulsion to understand it
cognitively. How might the sonic image touch the depths before it stirs the surface? The
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search for wholeness may be partly a result of understanding, but is also partly an
aesthetic endeavour.
I would like to leave you with a final image that I consider cuts across both the personal
and the cultural. It is emblematic of a fragmented Europe, and speaks of a divided self,
but with a possible route to wholeness.
The Parthenon marbles, as I am sure you know, are a collection of sculptures that were
originally part of the temple of the Parthenon and other buildings of the Acropolis in
Athens. When Greece was under Ottoman rule in the early 1800’s, an English Lord, by
the name of Elgin shipped some of the sculptures back to the UK -only for the ship to be
hit by a storm and sink off the Greek island of Cythera in 1804. However, the entire
cargo was recovered and -to cut a long story short- has ended up in the British museum
ever since. Despite many attempts by the Greek government for the return of this treasure
to the Acropolis museum in Athens, it remains in London to this day.
One of the regrettable parts of this ongoing saga is that the arguments are in legal and
corrective language. Rather than thinking about the proper thing to do for the cultural
artefacts themselves, which would be to stand together as the Frieze -or for Poseidon’s
head to be re-united with his body- the argument becomes reductive and pedantic about
ownership and protectionism. However, imagine if the driving forces in this cultural
fiasco were the search for the whole and the moral and aesthetic imperative. This would
enable the reunion of these pieces of art and their standing in the region of their making.
Such a move would display and evidence a psychological movement within the humans
responsible for such an act. It would demonstrate a willingness to bring about wholeness
as an imperative, rather than hold on to the divisions and partisanship, which has held
them apart for too long.
I hope that in your work over these next days, there will be moments of reconnection-
showing once again that through art we have the capacity to heal the split and reconstitute
a sense of wholeness in both the individual and our cultures.
Thank you.
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CAIPT 2019
Workshop CAIPT 2019-Photos by Yiannis Kaminis
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Dramatherapy in Greece
Spread-Application-Education
Stelios Krasanakis
The journey of Dramatherapy in Greece began in 1985 and I will talk about it through
my personal experience as I was there with the first generation of dramatherapists.
George Polos invited Sue Jennings to Greece for a seminar and this was the beginning.
Quickly the first group was formed and an informal education began at the Center for Art
and Psychotherapy that housed other art therapies as well.
I was fortunate enough to belong to this group where we had the opportunity to meet with
other important pioneers of Dramatherapy like Robert Landy, Steve Mitchel, Mooli
Lahad, Ann Catannach and others.
Later we started our practices in psychiatric hospitals and rehabilitation settlements and
we were accepted with enthusiasm from the psychiatric community. And by this
Dramatherapy began to open up to the public.
Then we continue in settings for people with special needs (children, adolescences and
adults). A lot of other day-care centers public or private wanted to collaborate with new
dramatherapists.
In all these clinical settings the application of Dramatherapy was either as stand-alone or
as a complementary method.
I directed for many years drug treatment centers where Dramatherapy was one of the
main psychotherapeutic procedures.
The theater performance Petheno san hora (Dying as a country, 1989) was an important
milestone of the Dramatherapy recognition. The play was presented by the Drug-
Treatment Center 18ANO of the Psychiatric Hospital in Athens, as a result of the
Dramatherapy group I was leading at the time.
The publicity of this performance and TV views and interviews attracted made
Dramatherapy known to a wider audience and was connected to Drug-Treatment
methods.
In 1989 the first association of Dramatherapists and Playtherapists was formed “Theatro
kai Therapia” (“Theater and Treatment”). I had the honour to be its first president and to
know first hand the characteristics, its specific features and difficulties, but also the
acceptance this newborn psychotherapeutic approach in the psychiatric facilities.
The following years a lot of Dramatherapists invited for oral presentations or workshops
in many Psychiatric Conferences. Additionally a lot of articles, theoretical or experiences
were published in scientific books, journals and reviews.
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Dramatherapy met from the beginning a special acceptance by the psychiatric world,
something that did not happen in other countries.
We will have to underline the fact that in Greece Dramatherapy is considered a
psychotherapeutic method. As a profession does not have a typical recognition, but an
essential from the moment that dramatherapists get hired in public hospitals to apply
Dramatherapy.
I have to mention that no other psychotherapeutic method is recognized in Greece as an
independent profession.
It was considered to fulfill all the psychotherapeutic principles. This conception was
strengthened during the next years and by 2005 Dramatherapy associations became
members of the European Association of Psychotherapy (EAP).
We cannot say the same for the artistic community and I think that the appreciation of
Dramatherapy from the artists is not very strong in our country.
The Association of Dramatherapists had undertaken training from the outset, which
created a variety of problems which came on me because I was the president.
I left the Association in 1993 and in 1994 I created the Dramatherapy Institute ‘Aeon’.
In 1997 problems got so big that the Association was broken in two, another
psychotherapeutic split, the Pan-Hellenic Professional Association of Dramatherapists
and Playtherapists (PPADP) was born.
So we have two professional unions and their members work all over the country, in
many clinical settings with different populations, applying almost all models of
Dramatherapy. We worked all together against the arising problems to bring Greece to
the top countries in Europe according to the number of dramatherapists (almost 200), as I
am able to know from my position on the Board of Directors of European Federation of
Dramatherapy (EFD). Greece is a founding member of EFD and I represent both
Associations.
We met a lot of obstacles in that Journey, but we also received a lot of help from the
psychiatric community even from publishing houses. In 1998 I started editing the series
Roles in life and roles in theater with Robert Landy’s book as our first Persona and
Performance, and Phil Jone’s Drama as Therapy, Theatre as Living following.
In 2004 the Association ‘Theatro kai Therapia’ stopped training new dramatherapists and
was renamed to Hellenic Association of Dramatherapists and Playtherapists (EDPE).
This was the time when I returned to the Association.
Training at the Dramatherapy Institute ‘Aeon’ continue until today and is the formal
training of the Association.
PPADP supports its formal trainings in Athyrma and by 2013 in Herma.
The private educational trainings that exist in Athens and Thessaloniki (Epinio and Roes),
provides a four years education of high standards, while require personal therapy of the
students (about 1450 hours). In these educational programs a lot of important
international dramatherapists have invited as educators not only of the first generation but
of the second as well. Unfortunately Dramatherapy Education is still not part of the
academical status and only during the past four years I started teaching Dramatherapy in
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a course at the University in the Department for Theater Studies of the National and
Kapodistrian University of Athens.
Dramatherapy in the 2000’s became widely known and began to harness its assistants,
face its obstacles and be applied in a variety of clinical settings.
We are proud for all important international conferences of Dramatherapy in Greece, in
which this CAIPT organization is included.
In 2007 EDPE organized the 1st Conference in Harokopeio University with keynote
speakers Robert Landy, Mooli Lahad and Sue Jennings.
In collaboration with Harokopeio, EDPE organized the 2nd (2010) and the 4th Conference
(2016).
The 3rd International Conference was organized with the collaboration of the EDPE,
University of Peloponnesus and the Institute ‘Aeon’ in Nafplio; so we had the chance to
visit and work in theater of Epidaurus and Asclepieio. Keynote speakers for all these
Conferences were David Read Johnson, Marina Jenkins, Anna Seymour and Brenda
Meldrum.
In Harokopeio two big Dramatherapy Symposiums were organized by the Dramatherapy
Institute ‘Aeon’ in 2014 and 2017, with keynote speakers Sue Jennings, Anna Seymour,
Brenda Meldrum and Avi Goren-Bar.
In Harokopeio the 1st European Conference of Dramatherapy (2015)-Opening the Map
was organized by EFD in collaboration with EDPE and PPADP.
PPADP organized two International Conferences in Athens 2012 and 2018 in the School
of Fine Arts.
It has been a long journey from the beginning until now and the most appropriate way to
describe it dramatherapeutically is through The Hero’s Journey; meaning that the Greek
dramatherapist’s journey had a lot of obstacles and many helpers.
E la nave va!!!
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Selected Articles
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The Impact of Music on Elderly People
Suffering from Depression, Melancholia and/or Nostalgia
Angeliki Chatzimisiou
Abstract
It is widely known that music has healing powers and is often used as a way of treatment
for various diseases. Of course, music cannot cure a disease, but it can help us to deal
with whatever pain or distress we have in our lives, and that can ultimately make us
healthier. However, is it possible that listening to music could have the opposite effect?
By the time of my research I was not yet a Music Therapy trainee, but a Concert Pianist.
Therefore, my research is not focused on the different methods that music therapists use
in order to control or heal depression in elderly people, but in the different types of music
that can help or even have the opposite effect on people suffering from mental diseases.
In this article I am going to analyse how listening to music, and especially live piano
performances, not only can have positive effects and improve the health and well-being
of people dealing with depression, melancholy or nostalgia but can also create a tristful
and overwhelming environment that increases these feelings.
Elderly people can often suffer from mental health diseases, ranging from a mild form of
nostalgia to severe cases of depression due to several causes. My research reflects that
according to the characteristics of the music performed these psychological disorders can
either be treated or can lead to a recrudescence of senile melancholy.
Key words: depression, melancholia, nostalgia, piano performance, old age, music
therapy, adult mental health, piano repertoire
Introduction
Depression is defined as “a state of mind characterized by negative mood, low energy,
loss of interest in usual activities, pessimism, unrealistically negative thoughts about self
and the future and social withdrawal” (Matsumoto, 2009). Personal losses of various sorts
can normally lead to a depressed mood. Only when it persists for long periods and affects
the daily function is it considered to be a disorder. Rehm (2010) suggests that there are
different forms of depression caused by different factors; biological, psychological or
environmental. But the majority of depression disorders is a result of a combination of
these factors.
It is quite often that people may confuse depression with the depressed mood of
melancholia, and although they seem quite similar, they have some important differences.
These two terms differ in terms of origin, psychopathology and treatment. The Japanese
author and psychiatrist, Ohmae (2012) has researched in detail their differences. He states
that “according to the DSM-IV-TR criteria for major depressive disorder, depression
corresponds closely to A1 “depressed mood”, while melancholia is roughly compatible
with A2 “markedly diminished interest or pleasure.”
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After DSM-III depression is considered as a diagnosis of a mental health illness and it
refers to a deepened or prolonged sadness in daily routine. Before DSM-III, depression
was one of the symptoms of neurasthenia, psychasthenia, nervousness and neurosis.
Melancholia on the other hand, had been mentioned in Hippocratic times and it is an
occasional emotional situation that lasts for shorter periods and cannot be interpreted as
severe depression. Treatment is also different for depression and melancholia. Rest, talk
therapy, amphetamines (1930s), meprobamate (1950s), and benzodiazepines (1970s)
have been used to treat depression. While somatic therapy, such as electroconvulsive
therapy, and tricyclic antidepressants, is a way of treatment for melancholia. (Ohmae,
2012)
Old Age Depression
There are many factors that can cause a person to become depressed in old age. Late life
depression is linked to loss of life purpose, self-care and economic problems (Sözeri-
Varma, 2012) as well as other physical and neurological illnesses. For example:
depression following stroke, associated with Parkinson’s disease, depression in the
context of dementia etc. (Fiske, 2009). It is also possible that some medical treatment that
promises improvement of the biological status of elderly people can also be associated
with the increase of depression (Alexopoulos, 2005).
Furthermore, it is suggested that the lack of events with positive outcomes for older
adults can explain the behavioural aspects of depression. The self-critical thoughts of a
depressed person’s activities can often have a punishing effect which leads them to deny
engaging in activities (Lewinsohn et al., 1986).
The basic differences between early and late life depression are related to the rate of
cardiovascular diseases, physical and cognitive dysfunctions, apathy and psychomotor
changes which are all higher in late than early life (Sözeri-Varma, 2012). Despite the
same neuroanatomic structures in both forms of depression, they have different
pathophysiology (Papazacharias et al., 2010).
Depression in older adults is usually pharmacologically treated, starting with a low dose
of medicines that increases gradually (Yüksel et al., 2003). Cole and Dendukuri (2003)
also suggest the treatment of insomnia can prevent future depressive episodes. Other
forms of treatment include electroconvulsive therapy (ECT) (Kelly & Zisselman, 2000)
and mindfulness-based psychotherapies such as acceptance and commitment therapy
(Hayes et al., 1999), and mindfulness-based cognitive therapy (Segal et al., 2001).
Methodology
For my research I focused on a specific group of people: the elderly living in care houses
in London. By visiting regularly two of the largest care houses in London and performing
a different repertoire each time, I was able to observe differences in their mood before
and after the performance as well as between the sessions. One hundred people aged from
65 to 88 years old participated in my research.
I asked the senior people living at these care houses to complete a questionnaire each
time before the concert. For research purposes, I used the Hamilton Depression Rating
Scale (HDRS) (1960) which is the most widely used clinician-administered depression
assessment scale. That way I could compare the data on a weekly basis. A further
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communication with the nurses informed me about some changes regarding the
psychology, the relationship with others and even the appetite of some people who
participated as an audience.
Repertoire
The first recital was focused on Baroque Music and the Classical period and I performed
the following repertoire:
• Johann Sebastian Bach (1685 -1750), English Suite No. 5 in E minor BWV 810
• Wolfgang Amadeus Mozart (1756-1791), Piano Sonata No.18 in D major, K.576
• Joseph Haydn (1732-1809), Piano Variations in f minor, Hob.XVII/6
• Johann Sebastian Bach, Fantasia and Fugue in A Minor, BWV 944
In the second one I performed works of classical music where the folk element
dominates:
• Franz Liszt (1811 - 1886), Hungarian Rhapsody in D minor No. 7
• Manos Hadjidakis (1925 - 1994), Six Popular Pictures
• Arno Babajanian (1921 -1983), Elegie
• Sergei Lyapunov (1857-1918), Variations and Fugue on a Russian Theme O49
• Mily Balakirev (1837 - 1910), Polka in F sharp minor
The third recital included works that praised the Romantic and Impressionistic era:
• Maurice Ravel (1875 - 1937), Jeux d’eau
• Frédéric Chopin (1810 - 1849), Nocturne in C minor, O48, No. 1
• Frédéric Chopin, Ballade No. 1 in G minor, O23
• Claude Debussy (1862 - 1918), Arabesque No.1 and No.2
• Robert Schumann (1810 -1856), Piano Sonata No.2 in G Minor, Op.22
Last but not least, I performed a piano recital focused on the 20th and 21st cent. music:
• Sergei Prokofiev (1891 -1953), Piano Sonata No. 7 in B♭ major, O83
• Komitas - Arrangеment by Georgi Sarajyan (1919-1986), Krunk
• George Gershwin (1898-937), Three Preludes
• György Ligeti (1923-2006),
Musica Ricercata No.1 & 2
• Tōru Takemitsu (1930-1996),
“Litany - In Memory of Michael
Vyner” I. Adagio
• Federico Mompou (1893-
1987), Pájaro triste from Impresiones
intimas
• Arno Babajanian (1921-
1983), Poem
Figure 1
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Analysis of the results
There were not significant alterations in people’s mood after the recitals. It is worth
mentioning, however, that during the Folk Recital some of them seemed to have a
tendency to weep, while others actually did break into tears. During the period of the
study, while some participants complained about not feeling any strong emotions, they
also reported physical symptoms or various bodily pains that affected their mood. (Figure
1)
Berrios et al. (1992) suggested that there are two
types of feelings of guilt in major depression:
‘delusional’ guilt or shame, and ‘affective’ guilt
(general feeling of unworthiness). Some of the
patients had these feelings, especially after the Folk
recital (Figure 2). After communicating with some
of them, I realised that folk melodies reminded
them their country of origin, their family and their
youth and started unconsciously to blame
themselves for their situation (being alone in a
foreign country’s care home).
Thoughts of death are a very common outcome of
depression and suicide among older
adults is associated with late life
depression (Conwell & Brent, 1996). The
passive wish “not to wake up in the
morning,” or beliefs such as “it would be
better for others if I did not exist” are
usually dominant. After a conversation
with some of the patients, they said they
had all those thoughts that lead
to suicidal ideation because they
were feeling that the obstacles
to their life seemed
insurmountable, they also
suffered from inability to
predict some joy or satisfaction
in their lives, or the desire not to
burden their family. With a
great pleasure I found out that
people having suicidal thoughts and ideas reduced from 19 to 13 (Figure 3). It might not
Figure 3
Figure 2
Figure 4
[139]
sound like a great decline, however, when it comes to human life it is important and
promising to realise that music can actually help people dealing with late life depression.
These seniors found themselves participating physically and mentally in a larger group
through music, and that enabled them to have a “sense of being part of something
meaningful in the here-and-now” (Maratos, 2011).
An overlooked factor for late life depression is insomnia (Fiske, 2009). Indeed, sleeping
disorders are often the main therapeutic demand of people coming to treatment. Through
these piano recitals the results suggest a possible mild improvement in the quality of
sleeMore specifically, after the recital dedicated in Romanticism and Impressionism
people were able to sleep better (Figure 4). Of course, this small improvement could be
due to other factors not controlled
for in the study.
Loss of pleasure is always present
in depressive episodes, to a greater
or smaller extent. Anhedonia is a
distinctive quality of depression as
discussed in psychiatry (Ohmae,
2012). The nurses informed me,
confirming the results reported in
Figure 5, that after the Recitals
dedicated to Folk music and the
Romantic period, some of the
patients found their hobbies less
interesting, they were feeling
fatigue or weakness related to
activities they used to enjoy
before, and they were “not interested anymore”. It is interesting however, that the
percentage of participants who had lost their interest
in activities or hobbies reduced dramatically after
the contemporary recital (Figure 5).
There were not significant changes in the mobility of the patients. A slight decline of the
fidgetiness of the patients
was noted after the 3rd and 4th
week (namely after the Folk
Recital and the Recital
focused on the Romantic and
the Impressionistic era). But
this amount returned to the
initiative values after the
Contemporary recital which
caused some extra agitation
to the patients (Figure 6).
Figure 5
Figure 6
[140]
Anxiety-related disorders can be risk factors
for late life depression (Hettema et al., 2006)
and a combination of those makes the
treatment even more difficult (Andreescu et
al., 2007; Schoevers et al., 2003). It is
important that during these weeks of
performing recitals a large number of
participants stopped worrying about minor
maters. However, the fears expressed without
questioning increased for some of them after
listening the repertoires of Folk and
Romanticism (Figure 7). In terms of the
somatic anxiety, which includes
physiological concomitants of anxiety (such
as: Gastro-intestinal, Cardio-vascular,
Respiratory, Urinary frequency, Sweating)
there were not significant changes during
the study (Figure 8).
There was a deterioration related to the
eating habits of the patients after the Folk
Recital, where almost half of the people
participating in the research had difficulty
eating without staff urging. Also, after the
Folk and the Romantic/Impressionistic
Recital half of the seniors mentioned
heaviness in limbs, back or head,
backaches, headaches, muscle aches
and/or loss of energy and fatigability. These feelings reduced after the Contemporary
Recital (Figure 9).
Figure 8
Figure 9
Figure 7
Figure 10
[141]
During the course of the study, normal fluctuations were observed in the preoccupation of
the seniors with their own health (Figure 10).
In major depression disorder, changes in
appetite may involve either a decrease or an
increase (Simmons et al., 2016). Some
patients said that they were pushing
themselves to eat nearly every day, especially
after the Recital on Romanticism and
Impressionism. Others ate more and asked
for specific types of food, such as
carbohydrates or sweets. Despite these, the
nurses reported they managed to stabilise the
appetite of the residents who were having
troubles on a daily basis before the recitals
took place (Figure 11).
Finally, the number of seniors
acknowledging their depression gradually
reduced, while the number of people who
were aware of the illness yet believe it to be
attributed to external causes like bad food,
climate, physical illness or need for rest,
gradually increased (Figure 12).
Discussion on results
All in all, it is undeniable that these piano recitals were successful in promoting to some
degree the well-being of the seniors that attended them. It is not clear if the specific
choice of the repertoire or the mere organization of the recitals (a new event outside their
routine taking place) caused the changes in their mood. It is also possible that other
factors apart from music affected the fluctuation of the seniors’ mood.
What was unexpected, however, was the fact that for a significant number of patients,
familiar melodies that were played during the second recital (focused on Folk music) and
a little less on the third one (which included pieces from the Romantic period), did not
necessarily act as a healing method. On the contrary, it made them feel a bit more
depressed.
Figure 11
Figure 12
[142]
After a conversation we had with some of the seniors at the end of the study, I thought of
applying the Nostalgia Scale by the Southampton University
103
(Routledge et al., 2008 &
Barrett et al., 2010) to investigate the hypothesis that the depression-like feelings were
due to nostalgia rather than depression disorder.
Nostalgia
The New Oxford Dictionary of English (1998) defines nostalgia as “a sentimental
longing or wistful affection for the past” (1266). Wildschut et al. (2006) explored the
content of nostalgic episodes by analysing personal nostalgia stories. Their study revealed
that the nostalgic episodes were associated
with personal relationships, important life
events, pets, objects or physical settings.
Additionally, these stories had an overall
sense of bittersweetness and a more positive
than negative affect.
Music had the same effect of nostalgia on
these people, who either had abandoned their
countries years ago and started a new life in
the UK or left their home and family when
they needed professional care for their
wellbeing. It was quite expected that the
majority of people felt more nostalgic after
the recitals focused on Folk and Romantic
music (Figure 13). That can explain the
increased depressed mood in some tenants
during these weeks. As Barrett et al. (2010) points out, a piece of music can be
“autobiographically salient, arousing, familiar, and eliciting a great number of positive,
negative and mixed emotions” evoking nostalgia levels.
But not every nostalgic episode provokes depressed mood. Recent research associated
nostalgia with savouring
104
as one of the factors that causes nostalgia. Savouring positive
past experiences may invoke greater nostalgia once a person reflects on them.
Retrospectively savouring provides optimism for the future life experiences (Biskas,
2019).
Indeed, after the Contemporary recital, one of the tenants approached me with a big smile
on his face. He told me that he studied music himself and that he used to be a composer.
We discussed about modern styles of music composition, his style, our musical
preferences etc. I felt very honoured when he also suggested that I perform one of his
pieces for piano in a future recital at the care home (although that was supposed to be the
last recital there-at least related to that specific project).
103
The 7- item version is a new version which adds two new items to the original 5-item scale reported by
Routledge et al. (2008). It was first reported by Barrett et al. (2010).
104
‘Savouring’ in psychology refers to the procedure in which a person is able to recognize and appreciate
positive life experiences through reflection (Pitts, 2019).
Figure 13
[143]
Conclusions
In conclusion, music offers a simple and elegant way to treat anhedonia, the loss of
pleasure in daily activities. However, different types of music can have a different effect
on the elderly’s psychology. Baroque and Classical music can have conclusive beneficial
effects on depressed patients, while Folk and Romantic music can strengthen the feeling
of nostalgia which may create the delusion of depression. Finally, Contemporary music
intrigues elderly people and increases positive feelings and interest in hobbies and
activities.
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[145]
Vocal-Development Music Therapy (Vocal-Dev)
and early symbolization in adult psychiatric patients
Xanthoula Dakovanou
Abstract
This article concerns the presentation of the Vocal-Development music therapy model of
Xanthoula Dakovanou for adult and adolescent psychiatric patients, as well as its
particular indication in symbolizing early childhood experiences.
Our theorical background is based on the psychoanalytical theories of Piera Aulagnier,
Donald. Winnicott, Didier Anzieu, Edith Lecourt and Xanthoula Dakovanou, which
propose concrete models of early tactile, visual or sonar mental representation in the fetal
and young baby's psychic apparatus and brain. It is also based on research in the domain
of music psychology concerning the origins of music and its link to fetal sonar
representation (Parncutt).
Our clinical work in the domain of vocal music therapy follows a developmental model.
It focuses on stages of early child development which are described in psychoanalytical
bibliography. We work on these stages of early development trough concrete vocal
exercises in group settings, in order to provoke a regression to these stages of early infant
development and to work upon them.
This clinical work with populations of psychotic, borderline and also neurotic adult and
adolescent psychiatric patients provides material which confirms the theories mentioned
above. It demonstrates how vocal music therapy can help patients who suffer from
pathologies where a lack in symbolization is observed regress towards primitive stages of
their individual development and work upon the symbolization of states of ‘primitive
agonies’ (Winnicott) of their early childhood.
Thus, we demonstrate that the vocal medium, when used in analytical music therapy
according to the Vocal-Dev model of Xanthoula Dakovanou, offers a chance to symbolise
these experiences, and permits them to become ‘thinkable’, thus predictable and less
threatening for the patient. Examples of case studies illustrate our presentation.
Key words: Vocal-Dev, music therapy, maternal voice, psychoanalysis, symbolization,
child development
[146]
Maternal voice and early child development
The importance of maternal voice in early child development has been demonstrated by
various interdisciplinary studies throughout the last 30 years.
Neuroscience and music psychology data show the impact of maternal voice in the
development of the fetus and young baby's brain. Voice itself is a priority stimulus for the
human brain, which analyzes voice quicker than any other sound. The human brain
‘recognizes’ voices, as rapidly and as well as it recognizes faces (De Lucia et al., 2010).
In particular, maternal voice is the sound which the fetus is more often exposed to, in
utero (Fifter et al., 1994): it is heard louder than all other voices of the surrounding
environment (Richards et al, 1992), which are also audible in utero by the fetus. It is thus
the most important sonar stimulus of intra-uterine life. Parncutt (1993) describes that a
classical learning procedure by association takes place in utero: the fetus associates sonar
and movement patterns with emotional content related to its mother’s physical and
emotional state. Furthermore, Parncutt believes that music itself originates from prenatal
exposition to body rhythms and to the maternal voice.
Studies confirm that a new-born baby is capable of responding to the emotional content
of speech, in the maternal language (Mastropieri et al, 2001). The capacity of recognition
of the emotional content of the voice is acquired thus before birth, as the fetus starts
learning to decode the maternal voice in utero.
After birth, ‘babytalk’, a particular way of mothers talking to babies -which is preverbal
and extremely musical- is used by mothers in order to communicate to their children their
emotions and intentions (Fernald, 1991). Numerous studies show the importance of this
‘babytalk’ or ‘motherese’ or ‘parentese’ to the affective bond of mother and child: babies
move, vocalize and change their face expressions while listening to ‘babytalk’ (Castarède,
2001), which is itself a way of talking that is marked by an exagerated prosody, a high-
pitched voice and a playful tendance with the dynamics of the vocal volume and
rythmical regularity (Trehub, 2009). Fernald (Fernald, 1991), who studied precicely this
way of vocal adressing to children, describes four stages of development of the
‘babytalk’, which evolve progressiveley as the baby grows. ‘Babytalk’ is using the
musical parameters of the maternal voice in order to stimulate or to calm the baby, in
order to aid emotional emergece and in order to encourage or discourage the child. Last
but not least, Monnot (1999) arguments that ‘babytalk’ is important for the emergence
and evolution of speech in preverbal children.
Studies also show the importance of the singing maternal voice for child development.
Trehub (2009) found that not only babies prefer the singing voice of their mother to her
speaking voice, but she also demonstrated important psysiological reactions of the baby
responding to its mothers's singing voice (augmentation of cortisol production in baby's
salive), compared to her speaking voice. These findings show the importance of maternal
singing for child development.
The importance of maternal voice in child development, in utero as well as in early
infancy, is also demonstrated in psychoanalytical bibliography.
Starting from the intra-uterine life, Maiello (1991) considers the maternal voice as the
[147]
first partial object, instead of the maternal breast. She believes that the fetus is first linked
to the maternal voice object in utero before being linked to the partial object of the breast,
after birth.
Concerning early symbolization in the young baby, Piera Aulagnier describes the concept
of pictograms, an archaic form of infant affect and representation proto-symbols, which
form in the newborn and young infant’s brain (Castoriadis-Aulagnier, 1975). In the same
direction, Dakovanou (Dakovanou, 2018) describes the sonograms, analogous to
Aulagnier’s pictograms, but forming in the fetal brain in utero as well as after birth, and
links them to the maternal voice. According to Dakovanou, the sonograms are archaic
forms of mental representations which form in the fetal brain, linking affect (mother's
emotional state, felt in utero by steroid hormone circulation which passes the placenta)
and sound patterns audible in utero (maternal voice musical characteristics, maternal
heart beat, maternal breath movements and body movements etc.), in order to form these
archaic mental representations in the fetal brain. Consequently, maternal voice is capital
to the formation of the first mental representations of the fetus and young infant, thus to
the first human thoughts.
The importance of maternal voice in the formation of a mental “sonar skin”, which
functions as a container of the young infant's psyche, is also demonstrated by various
psychoanalytical studies. In 1985, Anzieu describes the « sonar envelope » of the psychic
apparatus of the baby, analogous to the Ego Skin at the sonar level. In 2003, Lecourt
precises this sonar envelope and names it «musico-verbal envelope» which is composed
by two sides: a verbal side and a musical side. The sonar envelope is composed by
introjecting the maternal voice as well as the early vocal environment in which the baby
is exposed to. Morever, according to Castarède (2001), after birth the baby incorporates
the maternal voice just as it is incorporating her milk, during the oral psychosexual stage
of development, in order to constitute its ‘vocal envelope’. Finally, according to
Dakovanou (2012) the first sonar link to the first object (the mother) is the preverbal
voice: the maternal voice is the first ‘melody’ which the baby is exposed to. This first
melody becomes a transitional space game for the baby, functioning thus as a bond
between mother and child and consolating the baby from their separation.
Summarizing all this interdisciplinary data, we may conclude that the maternal voice is
capital for child development and for the emergence of speech. Thus, the use of the vocal
medium in music therapy may be extremely useful to regress to stages of early child
development and work upon them.
Vocal-Dev, a vocal music therapy model of Xanthoula Dakovanou,
based on stages of early child development
Vocal-Dev is a vocal music therapy method developed by Xanthoula Dakovanou. It uses
the vocal medium in a music therapy context, in order to help patients regress to early
stages of child development and work on early symbolization, which normally takes
place during the first years of infant life. Vocal-Dev is inspired from psychoanalytic
theories concerning early child development and symbolization as well as simple musical
structures used in all musical cultures of the world, which are vocalized in individual or
in group music therapy sessions.
[148]
According to psychoanalytical theories, the normal baby is growing from fusion to
individuation, from its birth until the first year(s) of its life.
In 1969, Mahler described a normal stage of symbiosis (fusion) of the baby with its
mother, which is observed in child development, before the stage of individuation-
separation can take place. It that stage, the baby feels ‘one’ whith its mother, not knowing
yet, but starting feeling their physical separation.
Gradually, in the following months, the tactile, audio and visual perceptions as well as the
contact with the mother will help the baby construct its own body perception, its Somatic
Ego (Haag, 2000) and its Ego Skin (Anzieu, 1985). This latter ‘contains’ the psychic
elements of the baby just as its skin contains its physical body. Gradually, the baby
arrives to what Lacan (1949) called the ‘mirror stage’. This is known as a critical point
where the baby recognizes itself in the mirror as a different, separate being from its
mother. In order for this to take place, visual ‘recognition’ of the baby from the mother is
necessary – the baby must “be seen”, “feel seen” by somebody else before it can
recognize itself in the mirror.
Early sonar exchanges with the mother are extremely important for all these stages, and
for the normal process of individuation-separation to occur. Besides the visual mirror
stage described by Lacan (1949) and Winnicott (1975), Anzieu (1985) also describes the
sonar mirror stage, which occurs before the visual mirror stage in infant development: it
takes place during the vocal interactions between mother and baby. Stern (1991) notes
that one of the earliest vocal mother-baby exchange is that of talking in unison, but also
that of mutual alternation of responses. This is a sonar mirror game of the mother and
infant couple, symbolizing fusion and individuation (Dakovanou, 2018). According to
Winnicott (1975), the ‘good enough mother’ provides her ‘holding’ to the infant, which is
introjected, permitting thus the child to move towards autonomy. If the ‘good enough
mother’ is introjected, then the baby can feel safe to be alone, it can invest a ‘transitional
object’ and it can play. The capacity of being alone and of creating in adult life relies on
this introjection of the ‘good enough mother’.
Dakovanou (2018) arguments that early stages of child development may correspond to
concrete basic musical structures used in all musical systems of the world, such as
unison, antiphony, musical ‘holding’, improvisation on a stable ostinato/drone/rhythmical
pattern etc. Dakovanou suggests that unison may correspond with fusion with the mother
in early stages of life, antiphony may correspond with Lacan, Winnicott and Anzieu’s
mirror stage developed above, musical structures such as ostinato/drone/rythmical
patterns may correspond with Winnicott’s holding, improvisation may correspond with
playing as an attempt of individuation etc. Our vocal music therapy technique -Vocal-
Dev- is based on these observations and is recreating a musical environment that imitates
these first sonar mother-infant exchanges. By using these concrete basic musical
structures in vocal music therapy settings, we help patients regress to early stages of child
development and we work on individuation-separation, on ‘subjectivation’ and on the
way our patient relates to others. From our experience in groups of patients and education
groups in vocal music therapy, we may classify the experience of basic musical structures
mentioned above as following:
• The experience of vocal unison is usually verbalized as a feeling of “being well
[149]
together, a sensation of euphoria and calmness”, as it provokes regression to the fusion
stage within the big and safe maternal body.
• The experience of mirror vocal responses usually feels like “I am heard, I am
seen, I exist”, as it provokes regression to the mirror stage and to early mother-infant
sonar interactions.
• The experience of vocal ‘holding’ usually feels like “I feel safe, I am held and I
feel stable, I can try my own steps and walk towards autonomy”
• The experience of vocal improvisation on musical ‘holding’ usually feels like “I
can have the pleasure to play!”
This classification concerns how the majority of participants express verbally their
feelings while experiencing the musical structures mentioned above. In psychopathology
though, the same musical structures may be experienced in a different way, mobilizing
threat, anxiety, even agony on behalf of the patient. These feelings correspond to relevant
feelings that used to be felt during early stages of life. They are reflected to the voice and
to the music produced by our participants, which might themselves reflect all the feelings
of not being seen or head, not feeling safe, not feeling held etc. mentioned above. An
interpretation of our own countertransference during these exercises, musically and
verbally, may cause a different physical and psychological experience to our
patients/participants and may start causing a gradual change of their “being among
others”, that of feeling seen and heard, that of feeling safe and held etc.
Through this kind of work, we also offer to our patients/participants a chance to
symbolize, to work upon early experiences that have not been symbolized before. For
example, when we name verbally our countertransference feeling of ‘unstableness’, this
may permit to our patient to relate to his/her own feelings of “not having been held”.
Symbolization permits mental representation; if the events become ‘thinkable’ we can
work upon them, in psychotherapy.
Summarizing, through Vocal-Dev we can thus work upon fusion and individuation, but
also upon the sonar (vocal) envelope of our patients, upon their ability to play and to be
alone, upon the place of the individual in the group and upon early symbolization of
experiences that could not have been symbolized before.
Clinical example: Christine
The following clinical example illustrates how unison may be experienced as threatening
and stressful instead of safe and euphoric, if the ‘sonar / vocal envelope’ of the baby
could not have been constructed in early life, because of a non-introjection of the partial
object ‘maternal voice’.
Christine was a middle-aged psychologist, participating in an educative group of music
therapy where we worked with the Vocal-Dev method of Xanthoula Dakovanou during
several months. In the first session, she experienced physical sensations related to
important stress reactions, such as a subjective anxiety feeling but also tachycardia and
sweating, when participating to exercises which evoke regression to the fusion stage
(vocal unison exercises). She also experienced difficulty to ‘play’ during vocal
improvisation exercises with vocal ‘holding’ from the group, which also provoked to her
feelings of stress and anxiety.
[150]
Christine verbalized her stress during these exercises, not having been able to understand
yet its origin. As the sessions advanced and she started feeling safe in the group, a
preverbal melody emerged in her turn to improvise, while the group was providing her a
stable and containing vocal ‘holding’. A ‘babytalk’ regression emerged, that was not in
french, which was her mother tongue, but in portugese. Christine then shared to the group
that she had passed the first six months of her life with with her french mother, who
suffered from post-partum depression at the time. Apparently, the sonar exchanges
between mother and daughter were not “good enough” at that time, which is the reason
why she experiences stress and anxiety when regressing to these stages, during our vocal
exercises. According to our theoretical research, these early infancy ‘primitive agony’
experiences related to the mother’s post partum depression appear in our impovisation in
the form of a ‘stress sonogram’ (Dakovanou, 2018).
After the sixth month of her life, her portugese grand-mother arrived to take care of the
baby, establishing a containig and “good enough” physical, sonar and eye contact and
exchange with the baby. Apparently, the preverbal voice and language that served as a
‘vocal milk’ for baby Christine was that of her portugese grand-mother, instead of the
french-speaking voice of her mother. It is for that reason that when she starts feeling safe
in the group she regresses to her grand-mother's voice and portugese ‘babytalk’ appears’,
which feels safe and happy.
Clinical example: Amanda
Amanda was a 60 year old woman who participated in a vocal music therapy group for
adult patients. From the beginning of our sessions, she experienced a difficulty in
emitting her diaphragm-based voice, especially concerning bass frequencies, which
vibrate the lower parts of the body. She manifested a general difficulty following the
tonic pitch of the voice (melody) during the vocal exercises of the group for several
months, and when the exercise demanded a lower pitch and focus on pelvis and perineum
area the voice would not follow, staying in a higher pitch. She described verbally her
physical experience as if “the voice would not be able to pass below the diaphragm”, and
as if “the body was cut in two parts”. She could only make vibrate with her voice the
upper part of the body, higher from the diaphragm. After several months of participation
to our vocal music therapy group working with Vocal-Dev (Dakovanou), one day she
managed to emit lower frequencies with her voice and achieve to vibrate the lower part of
her “felt like cut-in-two” body. That day, she shared with the group a sexual abuse
experience of her childhood, when an old man attempted to rape her. She described being
so afraid, that her body became “stll, like a statue”, so still that the violator could not
accomplish the violation act. Terror is ofter felt as a ‘breath cut’, and this woman was
feeling often, ever since, as if her breath could not become profound and deep – neither
her voice. The day that her voice managed to vibrate the lower part of her body, she
managed to talk to our therapy group about her terrifying sexual abuse experience that
she kept secret for years. In this case, the vocal work helped symbolize a primitive agony
which was kept as a physical memory for years, without being verbally expressed -
although it had been named some years after the abuse itself, when the young girl
understood that her terrifying experience with this man was a sexual aggression. We were
able to work upon the difficulties of this woman when she felt safe enough to trust us this
past. The physical sensation of being terrified no longer had a reason to exist among us,
[151]
as it was named, shared and contained.
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Dakovanou, X. (2018). Représentation musicale et representation psychique:
applications cliniques, Thèse d’Etat sous la direction de S. De Mijolla-Mellor, Université
Paris Sorbonne Cité, Paris.
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nous est révélée dans l’expérience psychanalytique, in R.F.P., XIII, 4: 449-55.
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Paris.
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Infantile Psychosis, Chatto and Windus.
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Analysis, Rivista Internazionale di psicoterapia clinica, Anno 2 No 3: 245-268 (trad. fr.
L’objet sonore. L’origine prénatale de la mémoire auditive; une hypothèse, Journal de la
psychanalyse de l’Enfant, n° 20: 40-66.
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responsiveness to vocal expressions of emotion, Development Psycobiology, 35: 204-214.
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443.
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Psychology, Oxford University Press, Oxford.
[153]
Drama and Movement Therapy, the Sesame approach
Rosina Eleni Filippidou
Abstract
Drama and Movement Therapy, also known as the Sesame method, is a mythopoetic
dramatherapeutic approach, which incorporates the dramatic symbolic myths based on
Carl Jung’s theories of the unconscious, the therapeutic use of Rudolf Laban’s Movement
Observation, Billy Lindkvist’ s work with Movement with Touch and Sound, as well as
Peter Slade’s play therapy theory. Within the therapeutic process, the participant
elaborates on the metaphors and symbols through drama, movement, touch and
storytelling.
Jung asserts that individuation is the psyche’s lifelong opus to integrate its conscious and
unconscious elements, into a well-functioning whole. Following that belief, within the
ritualist structure of a Drama and Movement Therapy session, the participant embodies
different types of roles, explores patterns of behaviour and develops functional ways of
encountering life’s contradictions. Within a non-confrontational psychotherapeutic frame,
based on the knowledge that difficulties can be revealed through symbols and metaphors,
the individual can express all kinds of emotions and thoughts, in order to develop its
confidence, deepen its self-knowledge and facilitate the communication with others.
In this article I discuss the interconnections between the ritualistic structure of Drama
and Movement Therapy, myths, archetypes and the process of individuation.
Key words: Drama and Movement Therapy, dramatherapy, enactment, symbols,
archetypes, individuation
“... nothing produced by the human mind lies absolutely outside the psychic realm. Even
the craziest idea must correspond to something in the psyche.” (Jung, 1969, 259)
Introduction
Dramatherapy is a psychotherapeutic method that uses drama to promote creativity,
imagination, knowledge, inner change and evolution. A ‘symbolic’ and ‘mythopoetic’
pedagogical approach to dramatherapy is Drama and Movement Therapy (Pearson, 1996;
Hougham, 2017), in which the client and the therapist elaborate on the metaphors and
symbols through drama, movement, touch and storytelling (Natan, 2017). Drama and
Movement Therapy is also known as the Sesame approach, named after the story of “Ali
Baba and the Forty Thieves”, in which the password “Open Sesame!” unlocks the
entrance of a cave, revealing the treasures hidden within it. Following the symbolism of
[154]
the story, Drama and Movement Therapy incarnates the key to unlock the gate of the
human psyche.
Drama and Movement Therapy, incorporates the dramatic symbolic myths based on Carl
Jung’s (1917, 1993) theories of the unconscious, the therapeutic use of Rudolf Laban’s
(1971, 1984) Movement Observation, Billy Lindkvist’ s (1998) work with Movement
with Touch and Sound, as well as Peter Slade’s (1965) play therapy theory. At the same
time, it gains knowledge from anthropology, developmental psychology (Winnicott,
1992; Gerhardt, 2004; Rayner, 2005), Psychodrama (Moreno, 1946), Transactional
Analysis (Berne, 1964) and the Gestalt method.
Through role-playing, and the acquaintance with different forms and modes of
movement, participants are given the opportunity to experiment with alternative ways of
behaving and dealing with situations in their lives. In a non-confrontational
psychotherapeutic framework, based on the knowledge that difficulties can be revealed
through metaphorical concepts, they have the opportunity to relive their personal
experiences and experiment with new solutions and capabilities. Through the safety
provided by the use of the arts, members of a group can express all kinds of emotions and
thoughts, in order to develop their confidence, deepen their self knowledge and facilitate
their communication with others (Hougham & Jones, 2017).
Symbols, archetypes and individuation
Symbols and metaphors are important components of the Sesame approach. According to
Jung (1990), man uses symbols in everyday life, in order to describe terms that are not
fully comprehended or understood by his consciousness and their meaning goes beyond
the obvious. Symbolic images can also be revealed in fairy tales and myths. In these
cases, symbols are used as mediators, bringing together the personal psyche and the
archetypes (Hougham, 2017). The archetypes are motifs and images dwelling in the
collective unconscious (Stevens, 2006. Ekstrom, 2004. Jung, 1969). Jung first introduced
the concept of such a universal womb, ‘incorporating the entire psychic potential of
humankind’ (Stevens, 2006, 75). Collective unconscious can be distinguished from the
personal unconscious because it does not contain personal experiences, which at some
point in life have been conscious but eventually disappeared from consciousness.
Collective unconscious consists essentially of archetypes. Arthur Schopenhauer on
archetypes, quotes Plato’s doctrine:
The things of this world which our senses perceive have no true being; they always
become, they never are: they have only a relative being; they all exist merely in and
through their relation to each other; their whole being may, therefore, quite as well be
called a non-being. . . . The real archetypes, on the other hand, the eternal Ideas, the
original forms of all things, can alone be said to have true being (οντως ον) because they
always are, but never become or pass away. (Schopenhauer, 1922, 221–222)
Archetypal theory can be substantiated by their powerful narrative nature. Bruner (1986)
proposes that in contrast to scientific explanation, which requires evidence of
verification, in the narrative domain of human actions, the answer could be that it “feels
as right” (52). According to Jung (1985) “the archetype is the introspectively
recognizable form of a priori psychic orderedness” (140).
[155]
Archetypes appear in myths of all cultures but can also be revealed in dreams (Goodwyn,
2013. Knox, 2001. Walker, 2014). When looking into one’s dreams and fantasies, it is
impressive that their connections with myths are not directly apparent to the individual.
Dreams’ substances remain outside of consciousness and flood the dreamer with ideas of
mysterious and frightening omens, or even with the fear of madness. However, if we
closely examine their content, we can have a better understanding of the archetypal
nature of their images (Jung, 1985). According to Landy (1986), Jungian analysis relates
directly to dramatherapy because of the emphasis it puts upon the re-creation of ‘myths
and archetypes through internal dramatizations found in dreams, reflections and
fantasies’ (23). By viewing dreams to be parts of a person’s life scenario, the dream itself
can be perceived as a drama, embodying the essential themes of human existence (Landy,
1986).
Jung uses the term individuation, in order to describe the process by which a person
becomes an indivisible unity. The opus of the psyche is to bring its two parts together, the
conscious and the unconscious. This is an extraordinary task, because the unconscious is
per se unknown. Even if one understands some of its hidden contents, it does not mean an
assimilation of all its depth (Jung, 1969). A totality however, cannot be viable if one side
of a whole suppresses or damages the other and even if there is a fight, it should at least
be in between equal parts. Since conscious and unconscious are parts of life, both
fundamental psychic facts should be allowed to guard their entity and exist. A Drama and
Movement therapist can guide and stand by a person through the therapeutic process of
uniting and provide a safe space where all aspects of one’s psyche can be expressed. Such
a work though, does not mean that the individual should be devoured by its darkness but
instead bring it symbolically into light, so as to examine and eventually come in terms
with it. Only then, the conflict between what we wish we were, what we are afraid of
being and what we actually are, can be alleviated, new conscious understandings can
emerge and inner peace can be gained. Jung (1969) calls this union of opposites the
“transcendent function” (269).
The ritualistic structure of Drama and Movement Therapy
Sesame sessions have a very organised structure, with a ritualistic essence. Rituals are
used to allow people to order and honor their experiences. Rites of passage can be
distinguished in three types; rites of separation, rites of transition and rites of
incorporation (Forth, 2018). Van Gennep (1909) separates the preliminal, liminal, and
postliminal rites, according to the rituals’ function. These logically follow one another in
a linear sequence, even though their duration can differ substantially. In Drama and
Movement Therapy structure, we can find a parallel sequence (Hougham, 2006). The first
three parts of a session are the Focus, the Warm Up and the Bridge In. During these, the
participants are guided to leave their daily life, enter the fantastic world and take a step
towards the realm of symbols. These correspond to the stage of separation, as they
promote a change of place and a deviation from current status (Forth, 2018). This journey
is accomplished through the warming up of the body and voice, with the use of games,
improvisation exercises and guided visualisations. In addition, people usually work
within circles, which act as a container, giving them a sense of unity, belonging and
equality (Jung, 1969).
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The next stage in a Drama and Movement Therapy session is the Main Event. This can be
viewed as similar to the phase of transition (Hougham, 2006). During the main event, the
participants engage in improvisational and ritualistic enactments of the narrated myths
and stories, form own roles through drama or movement enter a dramatic reality and
elaborate on the images of the mythical narrations. This is the part of the session that
nurtures the experimentation of alternative ways of being and the consideration of
different possibilities and denouements. Bakhtin (1984) suggests, that in Venezian
carnival, people did not wondered around with masks just to celebrate, but it was an
opportunity for them to experience a different world, where there were no social ties to
pre-arranged structures and that way they could escape from society’s norms. Alongside,
Turner (1982) highlighted that rituals and theatre were the depiction of actual reality
through performance, while these art forms provide a way of dealing with major issues.
Through role-playing, acquaintance with novel ways of moving, and nonverbal
expression of emotions and thoughts, individuals are given the opportunity to understand
their psyche in greater depth. This liminal stage is described by Turner (1967) also as a
stage of reflection.
The final parts of the session are the Bridge Out and the Grounding. During these, the
therapist guides the clients back to the here and now, back into the actual working room.
This happens through rituals and symbolic acts, such as removing the costumes of the
roles they embodied, shaking off the dust of the story, leaving into the story stage what
they do not wish to keep or take what meant something for them. This phase can be
compared with Van gennep’s reincorporation stage of ritual process (Hougham, 2006).
The aim, as the name suggests, is to incorporate the newly acquired experience into the
Self, in order to develop a better knowledge of it (Jacobi, 1973). This enhances the
understanding of personal internal processes and alleviates the ways one relates to own
identity and ultimately with others’.
The use of myth in Drama and Movement Therapy
Dramatherapy is based on the assumption that the images of myths and stories can
represent an objective or subjective perception of internal, as well as external reality.
However, elaborating on the portrayed image, does not change the external reality, but is
likely to modify the internal one and as a consequence bring about change in the way
external reality is perceived and encountared (Lahad, 1997). The dramatherapy stage can
provide a space, where symbolic images can be safely represented and the chaos can be
contained (Jennings, 1987).
An important element of the therapeutic effect of myth narration, is the exploration of
archetypal images within the ritualistic structure of Drama and Movement Therapy
(Hillman, 1997). Jung writes that when a fairy tale is told, or a myth is enacted, the
healing factor affects whoever has been moved by it. This happens through the
connection of the individual with the archetypal form of that situation (Jung & Von-
Franz, 1986). Following that belief, in a dramatherapy session, the therapist narrates a
myth, story of fairy tale, that has been selected in relation to the archetypal images and
symbols it contains and their correspondence with the clients. Then each one chooses a
role and the magical scenery is “opened”. The enactment is mainly non-verbal, but props,
costumes, sounds and musical instruments might also be used (Watts, Pearson & Smail,
2013). The participants may enact the whole myth, or parts of it. The therapist might
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retell the story or not, during the enactment but the play is improvisational (Jones, 1996;
Emunah, 2019). Using the language of the stories and understanding the inner journey of
the client through metaphors, enables the therapist to accompany the person through this
journey of growth and change (Lahad, 1997).
However, through embodying a role in a story, a paradox is created. Even though the
enactment is invented, it is also real and exists in some way, in the actor’s reality.
Dramatherapy uses dramatic projection, to emotionally and intellectually engage
participants in confronting their difficulties, giving them the opportunity to experience
different aspects of themselves (Jones, 1996; Johnson, 1992). However, the use of
metaphors and imagination is likely to change an individual’s internal balance. The place
where it is safe to play the role of the actor, remember and relive the past, while
simultaneously retaining the role of the observer, is that of an aesthetic distance (Landy,
1986, 113). This is the location centered between overdistance and underdistance, two
notions characterised by their range of closeness and separation. At this point, an
individual is able to be emotionally and mentally balanced because there are concrete
boundaries between person and persona, between one role and another (Landy, 1986).
In a Drama and Movement Therapy enactment, participants in a group or in individual
therapy are encouraged to choose a role that appeals to them. A role doesn’t have to be a
human’s but can also be an animal, object, element of nature or anything that, for some
reason, makes sense to them. According to Landy (1993), a person owns a system of
personal roles, whose existence is not conscious and their repertoire is not explored.
Furthermore, this system changes in accordance with the specific needs the person has
during different periods of life, places and conditions. The main objective of
dramatherapy, is for the client to increase the repertoire of the roles he/she can play and
develop the ability to play a single role more complete (Landy, 1993. Landy & Butler,
2012). Landy parallels the theatrical types of roles to Jung’s archetypes, because they are
universal forms that repeat themselves in clinical cases as well as in everyday life.
Furthermore, he also proposes that archetypal roles should be recognised and interlaced
into the structure of a personality in order to develop psychologically functional (Landy,
1993). This process resembles the one of individuation.
Conclusion
Drama and Movement Therapy, also known as the Sesame approach, is a mythopoetic
psychotherapeutic method that explores metaphors and symbols through drama,
movement, touch and storytelling. It incorporates Jung’s belief that man uses symbols in
everyday life, in order to describe terms that are not fully comprehended by his
consciousness. These symbols are used as mediators, bringing together the personal
psyche and the archetypes. The archetypes are motifs and images, dwelling in the
collective unconscious. This constitutes a universal womb, which can be distinguished
from the personal unconscious because it does not contain personal experiences. Jung’s
understanding of the term individuation, describes psyche’s lifelong opus to become an
indivisible unity, by bringing together its conscious and unconscious parts. Alongside, in
Drama and Movement Therapy, the therapist can guide the individual through the
therapeutic process of uniting and provide a safe space where all aspects of its psyche can
be expressed, elaborated and be gradually accepted.
[158]
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Ekstrom, S. R. (2004). The mind beyond our immediate awareness: Freudian, Jungian
and cognitive models of the unconscious. Journal of Analytical Psychology, 49: 657-682.
Emunah, R. (2019). Acting for real: Dramatherapy process, technique and performance.
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Forth, G. (2018). Rites of Passage. University of Alberta.
Freud, S. (1905). Freud Complete Works. Fragment of an analysis of a case of hysteria:
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________ (1912). The Dynamics of Transference. The Standard Edition of the Complete
Psychological Works of Sigmund Freud, Vol. 12: 97-108.
Gerhardt, S. (2004). Why Love Matters: How Affection Shapes a Baby’s Brain.
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Goodwyn, E. (2013). Recurrent motifs as resonant attractor states in the narrative field: a
testable model of archetype. Journal of Analytical Psychology, 58, 387-408.
Hillman, J. (1997). Archetypal psychology: A Brief Account. Spring Publications.
Hougham, R. (2006). Numinosity, symbol and ritual in the sesame approach.
Dramatherapy, 28: 3-7.
Hougham, R. (2017). Symbolic Attitude. R. Hougham, B. Jones (eds.), Dramatherapy,
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Jennings, S. (1987). Dramatherapy and groups. In Jennings, S. (ed.) Dramatherapy.
Theory and practice 1. Routledge.
Johnson. D.R. (1992) The dramatherapist “in-role”. In Jennings, S. (ed.) Dramatherapy.
Theory and practice 2. Routledge.
Jones, R. (1996). Drama as therapy. Theatre as living. Routledge.
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[161]
The essential role of Music Auditory Training
for the Rehabilitation of Dyslexia
Argyris V. Karapetsas, Rozi M. Laskaraki, Maria D. Bampou
Abstract
This paper is focused on the significance of Music Auditory Training to
Neurorehabilitation. Objective: The purpose of this study was to investigate the
usefulness of music in clinical rehabilitation practice for children with Developmental
Dyslexia (DD). Participants and Methods: 45 third- and fourth-grade students with DD
and a matched control group (n=45) participated in this study. At the beginning, students
underwent a clinical assessment, including both Electrophysiological [i.e. Event Related
Potentials (ERPs) esp.P300 waveform] and Neuropsychological tests, being conducted in
the Laboratory of Neuropsychology, at University of Thessaly, in Volos, Greece. Results
of initial assessment revealed statistically significant lower performance for children with
DD, compared to that of the control grouAfter assessment, a subgroup of children with
dyslexia participated to a Music Auditory rehabilitation program, designed for the
children. The program included digitized musical exercises, being converted to sound
files and focused in discrimination of musical elements. Results: The electrophysiological
results obtained after the rehabilitation program revealed that children had similar P300
latency values to that of the typical readers, thus children addressed their difficulties and
became successful readers. Conclusions: The outcomes of the current study suggest that
Music plays a vital role in Rehabilitation settings, providing systematic therapeutic
practice for children with DD and enabling crucial improvements in both linguistic and
non-linguistic variables.
Key words: Learning Disabilities, Dyslexia, ERPs, Rehabilitation, Music
Introduction
Developmental Dyslexia (DD), defined as one of the most common learning disabilities,
is a neurodevelopmental disorder of neurobiological origin, being characterized by
severe difficulties in learning to read. Individuals with Developmental Dyslexia (DD)
present difficulties with accurate or fluent word recognition despite adequate instruction,
intelligence, and sensory abilities (Venkatesh et al., 2011; Gori & Facoetti, 2015;
Karapetsas, 1988, 2015). Despite of these deficits, numerous scientific data reveal that
neural deficits can be ameliorated by therapeutic training programs due
to brain plasticity. Indeed, numerous scientific data have shown that rapid and crucial
improvement in reading skills can result from auditory interventions, including music
education activities (Reifinger, 2019). Recent research reveals that music and language
[162]
share common processing mechanisms and due to this correlation music plays potential
role in rehabilitation of language - related disorders, including dyslexia (Vidal, Lousada
& Vigário, 2020). Music training (formal/informal music training - instrument playing -
or just listening to music) may results to this neurological renormalization at all system
levels and enhance higher – level auditory processing, one mild deficit that is often
associated with DD (Hämäläinen, Salminen & Leppänen, 2013; Flaugnacco et al., 2015;
Karapetsas & Laskaraki, 2018).
Participants and Methods
Forty five (n=45) third-, and fourth-grade students with DD and a matched control group
(n=45) participated in this study. The study included three phases a) Assessment b)
Intervention c) Re-assessment phase, after student’s participation to the intervention
program.
At the first phase of the study, subjects underwent a clinical neuropsychological
assessment, being held in the Laboratory of Neuropsychology, at the University of
Thessaly. Assessment included both Neuropsychological and Electrophysiological Event
Related Potentials (ERPs) recordings.
Indeed, the following tests had been carried out:
Neuropsychological tests
• Raven’s Progressive Matrices.
• A neuropsychological test battery for Specific Learning Disabilities (Prof.
Argyris Karapetsas, 2000).
• Five subtests of Wechsler Intelligence Scale for Children -III (WISC- III): a)
Comprehension, b) Similarities: c) Vocabulary d) Digit Span e) Block Design.
• PMMA - Primary Measures of Music Audiation (Gordon, 1979 - standardized on
Greek population by Stamou, Schmidt, & Humphreys, 2010).
• Auditory musical discrimination abilities test-A Battery For Measuring Musical
Ability (Karapetsas & Laskaraki, 2013).
Event Related Potentials (ERPs)
After psychometric tests, children had been assessed via Electrophysiological recordings
and ERPs esP300 waveform recordings. The P300 brain potentials are extracted from
brain electrical activities as a sign of the underlying electrophysiological brain responses
to the external or internal changes and events (Karapetsas et al., 2019).
ERPs were obtained from 3 electrode sites (both sides of temporal lobe and the center of
the brain (T3, Cz, T4) according to the 10 – 20 International System (Jasper, 1958), plus 2
reference electrodes at the mastoids of each ear and one ground electrode at the Nz (nose)
site, to both groups. Meanwhile, impedances for all electrodes were kept below 5 kohms
and P300 waveform was measured.
Initial assessment’s results confirmed statistically significant lower performance for
students with DD, compared to that of the control grouRegarding the neuropsychological
tests, students with DD scores indicated auditory processing deficits, working memory
deficits, phonological awareness difficulties and musical abilities deficits (deficits in both
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pitch and rhythm processing). Also, as shown in Chart 1, ERPs recordings revealed that
students with DD scored longer P300 latencies and abnormal cerebral lateralization.
Chart 1 ERP’s esp.P300 latency values (measured in milliseconds - msec) for the two groups
(control group & children with dyslexia). ERP’s were recorded from central (Cz) left temporal
lobe (T3) & right temporal lobe (T4) positions.
Rehabilitation Program
After assessment, part of the group of children with dyslexia participated in an
intervention program, being conducted in 45 minute sessions, once and a week for a five
- month period. The program designed by our Laboratory, included musical exercises,
being digitized through music notation and music making soft-ware’s and applied
through PC. Indeed, the Auditory Music Training (AMT) was based on activities aimed to
train auditory skills and focused on the perception, discrimination and reproduction of
basic music elements such as pitch, rhythm, metre and melody. It is of great significance
to be reported that for the design of the auditory games we utilized digital musical
instruments and music notation software’s that are available and of low cost or free of
charge.
Results
After the intervention period, children underwent a new ERPs recording for evaluating
the efficacy of the intervention. Indeed, Assessment took place one month after the end of
the intervention period, so to ensure that the possible observed brain activity alterations
would be attributed to the remedial effects of the applied program. Data analysis revealed
shorter P300 latency values for children with DD, resulted from their involvement to the
Auditory Music Training program. Actually, as shown in Table 1 & Chart 2, the
electrophysiological results revealed that the two groups (children with DD & control
group) had similar P300 latencies in all the electroencephalographic sites, being assessed.
Also, another promising result was the observed brain normalization, as children at the
end of intervention achieved normal left hemispheric lateralization, similar to that of the
control group.
Table 1 ERP’s esp.P300 latency values (measured in milliseconds - msec) for control
group & children with dyslexia after their participation to the rehabilitation program).
ERP’s were recorded from central (Cz) left temporal lobe (T3) & right temporal lobe
(T4) positions.
0
50
100
150
200
250
300
350
400
Cz T3 T4
321,13
311,15 318,25
370,23 378,71 372,88
control group
children with
dyslexia
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*p>.05
Chart 2. Children with DD achieved similar p300 latencies with the control group after the five-
month rehabilitation program.
Conclusions
The present study provides evidence that children with dyslexic difficulties may be
enhanced by specific intensive individualized interventions. Brain activation profile may
be altered and deficits in functional brain organization underlying dyslexia can be
reversed and altered, after systematic rehabilitation training. Given neuroplasticity,
appropriate training can lead to lasting improvements in underlying neural systems
responsible for reading (Karapetsas, 2011, 2018; Karapetsas et al., 2019). In addition,
basic skills required for reading acquisition, such as auditory temporal processing and
rhythmic skills, seem to be significantly enhanced through music, making it an
important tool in both remediation and early intervention programs (Flaugnacco et al.,
2015; Habib et al., 2016; Karapetsas & Laskaraki, 2015, 2018, Reifinger Jr, 2019).
Moreover, research data reveal that music can be also used efficiently to the prevention
of dyslexia and not only as a post-diagnosis remediation approach, due to the high
correlation between musical and literacy skills (Gordon, Fehd & McCandliss, 2015;
Virtala & Partanen, 2018). It seems that the music room provides great opportunities for
Brain Region
Children
With
Control
Sig.
Dyslexia
Group
P*
Μean
S.D
Μean
S.D.
Central Area
318.16
19.69
326.09
.457
3.38
Left
temporal
313.77
16.37
303.15
.315
lobe
10.36
Right
temporal
323.04
19.97
318.25
.688
lobe
10.85
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children not only to receive extra reading support and cope with their auditory processing
deficits but also enhances them to lessen their frustration and fear of failure due to their
difficulties. Apart from that, music class enables children regardless of their difficulties,
for emotional adjustment and interaction with their peers, thus making the rehabilitation
session, a joyful experience. These results provide new additional evidence for using
music both as part of systematic therapeutic and instructional practice for children with
dyslexia.
References
Flaugnacco, E., Lopez, L., Terribili, C., Montico, M., Zoia, S. & Schön, D. (2015). Music
training increases phonological awareness and reading skills in developmental dyslexia: a
randomized control trial. PloS one, 10(9).
Gordon, E.E. (1979). Primary Measures of Music Audiation. Chicago: GIA.
Gordon, R.L., Fehd, H.M. & McCandliss, B.D. (2015). Does music training enhance
literacy skills? A meta-analysis. Frontiers in psychology, 6: 1777.
Gori, S. & Facoetti, A. (2015). How the visual aspects can be crucial in reading
acquisition: The intriguing case of crowding and developmental dyslexia. Journal of
vision, 15(1): 8-8.
Habib, M., Lardy, C., Desiles, T., Commeiras, C., Chobert, J., & Besson, M. (2016).
Music and dyslexia: a new musical training method to improve reading and related
disorders. Frontiers in psychology, 7, 26.
Hämäläinen, J.A., Salminen, H.K. & Leppänen, H. (2013). Basic auditory processing
deficits in dyslexia: Systematic review of the behavioral and event-related potential/field
evidence. Journal of learning disabilities, 46(5): 413-427.
Jasper, H.H. (1958). Recent advances in our understanding of ascending activities of the
reticular system.
Karapetsas A.V. (2011). Contemporary Neuropsychology themes. Volos: University of
Thessaly.
_________ (2015). Dyslexia in the child. Re-edition. Volos, 2015.
_________ (1988). Human developmental neuropsychology. Athens: Smyrniotakis.
Karapetsas, A. (2018). Remediation effects on P300 waveform in school aged children
with developmental dyslexia. Dialogues in Clinical Neuroscience & Mental Health,
1(s1).
Κarapetsas A.V., Laskaraki Ir. R.M. (2015). Special Assessment and Diagnosis
techniques for Reading disorders. Dyslexia in the child. Re-edition. Volos: 75-90.
_____________ (2018). Reading disorders & Interventions Techniques, 6th Pan-Hellenic
conference on Developmental Psychology, 10-13 May, Thessaloniki.
Karapetsas, A.V., Laskaraki, R.M., Karapetsa, A.A., Mitropoulou, A.G. & Bampou,
M.D. (2019, June). The Essential Role of Innovative Technologies in Assessment and
Rehabilitation Settings. International Conference on Digital Transformation and Global
Society (672-679). Springer, Cham.
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Reifinger Jr, J.L. (2019). Dyslexia in the Music Classroom: A Review of Literature.
Update: Applications of Research in Music Education, 38(1): 9-17.
Stamou, L., Schmidt, C.P. & Humphreys, J.T. (2010). Standardization of the Gordon
primary measures of music audiation in Greece. Journal of Research in Music Education,
58(1): 75-89.
Vidal, M.M., Lousada, M. & Vigário, M. (2020). Music effects on phonological
awareness development in 3-year-old children. Applied Psycholinguistics, 41(2): 299-
318.
Virtala, P. & Partanen, E. (2018). Can very early music interventions promote at‐risk
infants’ development? Annals of the New York Academy of Sciences, 1423(1): 92-101.
[167]
“The Little Drummer”: A Clinical Case Study
Vasiliki Liali, Dora Psaltopoulou-Kamini, Makaria Psiliteli, Chrysa Lampropoulou
Abstract
Case study is perhaps one of the most powerful tools for showing and demonstrating the
effectiveness of the clinical application of Music Therapy. The flexibility in its structure
allows the examination of a phenomenon in real-world conditions, by studying a
multitude of variables of interest. This particular work was implemented in the context of
my clinical practice and presents a case study of an 8-year-old boy, diagnosed in the
spectrum of autism, who participated in individual weekly Music Therapy sessions.
Through the description of a series of sessions, an overall change in the clinical picture of
autism will be shown and demonstrated. Within a mere six months, visible changes have
been identified, with particular emphasis on communication, on contact with the Other
and Self, on interaction, expression and playing. Although the results of case studies do
not tend to generalize, the data and the findings from this study are sufficient to reinforce
and support the argumentation of the beneficial role of the therapeutic use of music in
cases of autism. However, the extension of studies to a larger population number is
strongly encouraged. At a time when the implementation of Music Therapy in Greece is
at the stage of recognition and development, every new research and study, contributes to
the enrichment and autonomy of Greek literature.
Key words: Autism, case study, clinical picture’s change, humanistic approach, music
therapy
Introduction
As cited in Liali (2019: 35-36, 67), “Autism tends to be associated with Autism Spectrum
Disorder (Exkornl, Volkmar, 2005), thus covering a wide range of symptoms, which
could be included in the context of its diagnosis. It is a developmental disorder and more
specifically, based on DSM-5 diagnostic criteria, it is a neurodevelopmental disorder
(Gotzamanis, 2015). The disorder is located at three basic levels: communicative,
behavioral, and social interaction. The nature of the cause of the origin of autism does not
find a complete scientific explanation, however, neurological studies show that there are
several neurological differences and differences in brain structure, in relation to
standardized individuals (Carpente, LaGasse from Wheeler, 2015).
According to the humanistic model (as cited in Scovel, Gardstrom, 2012), dysfunction or
disorder is described as the consequence of an individual’s inability to act and take
responsibility for both himself/herself and others around him/her and as a consequence of
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the obstruction of the meaning of his/her existence and life, as well as his/her path to
development.
Maslow (as cited in Scovel, Gardstrom, 2012) describes a disorder as a possible condition
that can affect a person due to his or her withdrawal from the self-actualization process,
as he or she fails to manage important and fundamental life issues. So, in order, for an
individual to move on to a healthy way of development,
105
it is necessary to emphasize
those needs that will enhance his/her functionality.
Individual’s functionality, contact with the Self and others and the process of healthy
development, often tend to be further burdened and hindered (“blocked”), if a healthy and
safe acceptance setting for expression, release, and processing is not available.
Thus, individual seems to be trapped in his/her symptom (= disorder - disability), using it
as a shelter of apparent protection, since it isolates him/her and distances him/her, both
the acceptance of his/her personal truth, and from his/her external environment. At the
same time, such a condition represents the denial of the whole state of existence, as the
adoption of an interpretation of the disorder that identifies it as a whole and not as part of
the Self, can lead to the formation of an identity and the creation “of a pseudo-form of
life”, without any important essence, “value or meaning” (Psaltopoulou - Kamini, 2006:
91-92).
Inspired by the Lacan’s approach to psychoanalysis, some of his ideas are listed at this
point, in order to enhance the interpretation and understanding of the phenomenon under
consideration in this paper. The psyche’s structure and the development of a “normal”
neurotic person consists of three orders, the Symbolic order, the Imaginary order and the
Real, which are in constant interaction and connection with each other. In the case of
autism, the individual’s psyche structure is significantly differentiated, as the symbolic
order seems to be absent (Psaltopoulou-Kamini, 2015).
In the process of Music Therapy, through the formation of a therapeutic setting and the
establishment of a trusting therapeutic relationship, characterized by stability, safety,
confidence and acceptance, a significant change for the individual seems to occur. This
change reflects the image of a person acting and functioning “as if he/her has been
healed/cured” (64). This change affects the individual’s whole clinical picture of Autism,
where the image of the symptoms is significantly reduced. The contribution and role of
music is crucial. Its clinical use in Music Therapy, through the therapeutic relationship,
enhances and allows the entrance of the individual to the Symbolic order, resulting in
sufficient functionality and acting with all three levels in sequence and connection, and
not interconnection though, through the big ‘Other’ (A). The term that comes to interpret
and more accurately reflect this situation, as introduced by its creator, Dora Psaltopoulou
-Kamini, is called “FA-foni
106
“ (64).
105
In Eddington, N. & Shuman, R. (2016). Healthy Personality. Presented by Continuing Psychology
Education Inc.: 1-14. https://www.texcpe.com/html/pdf/mi/OMIHP.pdf
106
In Psaltopoulou-Kamini, D. (2015). Μουσικοθεραπεία: ο τρίτος δρόμος. Αθήνα: Σύνδεσμος Ελληνικών
Ακαδημαϊκών Βιβλιοθηκών: 64.
[169]
Case study presentation
107
The purpose, through the description of a series of sessions, is to promote and emphasize
the contribution and positive effect of Music Therapy through an overall change in the
clinical picture of autism.
Personal information
At the time we started Music Therapy sessions, G. was 8 years old and he was a pupil at a
Special Primary School. As he was bilingual, he was familiar with both Russian and
Greek languages. G. lived with his mother, younger brother and grandmother, while his
father passed away.
History – Clinical picture
The official diagnosis for G. reports Pervasive Developmental Disorder-Autism, with a
total disability rate of 85% and an IQ index under 30. His clinical picture showed the
following: hyperactivity, difficulty in concentrating, impulsivity (both in speech and in
movements) and inability to control his reactions, movements, expression and behaviors.
Although his speech did not show complete development (e.g. lack of dialogue and
communication), we encountered several samples of verbal communication, but in the
absence of elements of structure and clarity. He often incorporated elements of both
Greek and Russian languages. He seemed to understand and respond to a significant
extent to verbal instructions, and we did not have a clear picture of his common
stereotypical behavior.
Goals
The goals set, during the process, concerned short-term and long-term ones and were
defined and adapted according to the needs of the child. They were formed as follows:
Short-term: Involvement in establishing a relationship and in making contact with the
Other, Acceptance of structured setting and boundaries, Development and enhancement
of communication, through music, Development of a meaningful eye contact, through
music. Long-term: Sense of Self, Impulse Control, Discovery and enhancement of
creativity and the creative Self.
Sessions’ basic information
The Music Therapy sessions took place at a Day Center for Children, Adolescents and
young adults with Disorder in the Spectrum of Autism. There, G. completed a total of 21
sessions, over a period of 6 months, which took place once a week for 30 minutes. It is
worth noting that, at the request of the Board of Directors and the scientific staff, we
proceeded to include another therapist of the Center in the process as an observer.
My personal approach, on which my clinical practice relied, is based on the principles of
the humanistic, person-centered approach, inspired by the humanistic, music-centered
approach of Nordoff & Robbins and by a psychoanalytic understanding, from which I
borrowed the basic techniques and interventions, I used during my sessions.
107
The participants’ completed names are hidden, due to issues related to the protection of personal data.
[170]
Data and findings
Subsequently, excerpts from the videotaped material that was collected and selected from
all the sessions that took place with G. are a concise analysis of the course and evolution
of the Music Therapy process and a brief presentation of the overall effect, response and
change, in the case of a child with a severe type of autism.
An attempt was made to categorize the sessions into 5 key themes, depending on the
processing of the respective issues and needs that emerged during the process:
1. Familiarization and acceptance of the new therapeutic condition – Contact with music
2. Involvement in making contact and establishing a trusting relationship with the music
therapist, through music
3. A special relationship within the therapeutic relationship and the therapeutic context
4. Acceptance of adding structure and boundaries – response
5. Closing process
Therapeutic process
Sessions 2-3
In the 2nd and 3rd sessions, the therapist of the Center, who participated in and observed
the Music Therapy process, as an assistant, told me that G. was asking her to bring his
drum (a plastic toy-drum) into the sessions. His choice was certainly accepted in the
process. So, in the two sessions mentioned above, he came with his own drum. He hung it
around his neck and held two small plastic drum sticks in his hand, ready to discover, to
take and find his place and to make his own space in music.
I called him “The Little Drummer”. I would not forget that pure and cute image of an
authentic childhood and how happy and excited I felt about our joint journey, which had
just started.
In the first sessions, G. was distant and detached. He chose to sit alone and quiet with his
drum in a specific corner of the room, right across from each other. However, he had
shown to familiarize himself with and accepted this new condition, uneventfully. His
contact, connection, relation and interaction with music, seemed to occur in a natural way
(he gave the rhythm, he was dancing). This ultimately constituted a key factor in the
formation of a safe setting for his expression and participation. The dynamics in his
playing could be characterized by the term ‘fortissimo’.
G. seemed to recognize, experience and enjoy his special relation with music, in contrast
to the contact and connection with the Music Therapist, which was still in a stage of
processing. The main goal was to strengthen and encourage, unconditionally, his
expression in order to release significant aspects of self, through the creative process. I
followed him and reflected him, with the piano. More specifically, I followed his
rhythmic elements, intermittent pauses, tempo, tension and dynamics, trying to reinforce
and encourage his own playing, which got space and meaning in and through music.
In G Major Scale I first created an improvisational melody keeping the bass steady and
improvising at high notes. Then, holding the bass pattern I started using my voice and
singing lyrics as “G. gives rhythm to the music, to his drum, on its drum”, with sequence
of I-IV-VI-I chords (meaning and clear structure in his activity).
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In this way I started to form a safe therapeutic setting of acceptance, in which G.’s
activity was encouraged and contained. Music provides a sense of holding. Although G.
was in a process of establishing trust with Music Therapist, music made space for
authentic and spontaneous sharing of his experience, enabling experimentation with the
new one. Despite this “temporary distance” (first contact, not connection) between us, he
participated in music and interaction and played with me in an extremely creative way,
proceeding in a state of coordination.
Sessions 5-6-8
As his Music Therapist, I decided to move on a gradual and discreet approach of him.
This means that I started to convey my presence closer to him for greater immediacy in
communication and interaction. G. proved ready to accept this change and withdrawal,
responded as he needed to engage more actively in relationship, contact, communication
and interaction with the Music Therapist. The trusting therapeutic setting and
relationship, which had been characterized by acceptance, support, safety and respect,
greatly reinforced the confidence, liberation and elevation of the aspects of self.
From the 5th session, I decided to approach him, going with my guitar near him. There
was no negative reaction and response. He seemed to accept me and responded very
positively. He started approaching me too. He stood next to me and tried to play the
guitar, in a scratchy way. Then, he touched my hand, took it and placed it on the guitar,
so that I could play too. First signs of communication with and acceptance of the Music
Therapist and our emerging relationship.
From the 6th session, a musical transition took place. A transition from the toy-drum to a
bigger and real drum, with natural sound. Music Therapist introduced a kind of hand
percussion, which called tumpeleki and two small wooden drum sticks, into the process.
The transition did not seem to be particularly difficult.
Music Therapist continued to approach him with the guitar and he, since he had gradually
become acquainted with this direct contact and interaction, stayed close to her, playing
music in the music, together. Music structured with G. playing on the drum and Music
Therapist playing the guitar. Circularity and repetition in melody and pattern offered
safety, stability and structured activities within a context, which encouraged the child to
stay there, in the “here and now”, create and express freely in an acceptable way.
Gradually, he started to add his voice, either verbally or non-verbally. In the 6th session,
he started with an “Ai”, which was added to the music as a key part of its structure. We
had then created music and composed a song, in which the relationship, the contact, the
connection, the collaboration among us and the creative process-result were clearly
visible.
From the 8th session, G.’s expression of emotional state and mood “came to” be added to
the issues and needs of therapeutic process. In those sessions G. expressed feelings of
safety and comfort, which seemed to be facilitated and accepted by the therapeutic setting
and relationships. This condition emphasized a need for relaxation, rest and withdrawal
from any other pressure and obligation. So, either he lied on the floor, looking calm, or he
imitated that he was sleeping and responded verbally with “shhhhh”. The next time he
used a pillow and he lay down on it. It was one of those moments where the music power
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became visible. Through music, therapeutic setting and therapeutic relationship function
as a shelter that embraces individual and accepts to exist exactly as he/she is.
Session 9
At the point where G. entrusted the Music Therapist and the therapeutic setting, he started
to express a desire to invite the Speech therapist - observer of the Center in the process, to
become more active and to participate in music with us. It is very important to mention
that their relationship, out of the Music Therapy process, was already characterized by a
strong and special bond. As his Music Therapist, it was impossible to dismiss his desire,
so we asked Chr., if she wanted to come with us in music. She participated as an
assistant. In Music Therapy process, the addition and inclusion of a pre-existing
relationship which is redefined within different criteria and through music, acquires a
different composition, structure and form. This means that G. is now the one who is
guiding it. He seemed to co-exist, to participate, to propose, to share, to collaborate, to
accept, to play and to create. Music Therapist now focuses on reflecting (mirroring) the
relationship between G. and Chr. and, respectively, music acts as a holding, containment
and reinforcement.
G. seemed very happy. At first, he did not come near us, he started hiding and showing in
a cute way that he was shy. Then he approached us, he took the second drum stick and
started playing with Chr. (she held the first drum stick) on the drum, at the same time.
Then, he started showing her, pointing at her and explaining to her kinetically, how to
play on the drum. Either while they were playing together at the same time, or first
playing him and then, after showing her the drum stick, urging her to play after him or
with him. He obviously encouraged her to imitate him (he told her “let’s play”). He took
on a leading and guiding role, as if the roles were reversed. Now G. was the one who
guided, set the boundaries and the rules in the process and learned and showed Chr. what
to do and how to play the drum. As Music Therapist, I reflected, reinforced, held,
supported and showed encouragement.
Sessions 11-17
One of the most critical issues we were called to process in the subsequent sessions was
G.’s impulsivity and extreme reactions and behaviors control and management. Since the
11th session, we made an effort to introduce structure and boundaries, through music.
Music in a natural and non-exuberant way, integrating and incorporating the elements of
G.’s personality, Self, needs and mood, set the limits of his behaviors and manifestations,
offering structured play, structured communication and participation, pauses, holding,
control and management, through the creative process. This condition has certainly
intensified and greatly enhanced the experience and sense of pleasure, enthusiasm and
joy.
A typical example is those of the 11th, 16th and 17th sessions. G. became overly expressive
and impulsive. Specifically, in the 11th session, G. came in an over-excited state, which
led him to an uncontrollable behavior, such as throwing the drum sticks with force high,
jumping and running all over the room and shouting “yes, yeeees”, loudly. I decided to
keep this “yes” and including it in a structured activity. In this way we contained and
maintained his hyperactivity in a more structured and delimited participation in the
interaction. At the same time, Music Therapist reflected on his mood, showed
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encouragement while the music contained all his experience and elements of self that
emerged, in an acceptable way. It is the music that set boundaries and structure.
The activity was structured in C Major, with sequence of I-V chords. In this condition, an
intervention was made with the assumption of roles, in order for everyone to say “yes” in
their turn, after a pause. In this way, G. would get acquainted with the concept of “I’m
waiting for my turn” or do what the song says, when requested.
Thus, the goal proceeded with changes in dynamics, with different music styles and with
lyrics that defined the turn each time, such as “Now G. will shout… (G. responded
“yes”), in the music, now Mrs. Chr. will shout (Mrs. Chr. responded “yes”)…., now G.
and Mrs. Chr. will shout… (both “yes”), in the music”. The response was at high levels.
G. participated, played, interacted, rejoiced, clapped and communicated.
In the 16th and 17th sessions, G. started to add, gradually and discreetly, “hide-and-
seek”. After a personal discussion with his mother she told me that “hide-and-seek” is a
game he usually played it at home with his grandmother, as he loved to hide. Many times,
while the game was in progress, he often mentioned the word “grandmother”. “Hide-and-
seek” in itself was an important game for the child and his choice to add it to the sessions
and play with us, was crucial.
The key element on which the activity – game was based and structured was the
following: either he hit the wall or on the floor, intermittently, with his hand and then he
said “it’s me”. The main question was how to transfer this condition and incorporate it
into the music. The first intervention that occurred included the following: Music
Therapist was asking verbally: “Knock, knock, who is it?” and made space for G. in
music to answer: “it’s me”. Later, Music Therapist moved on transmitting and containing
Chr.’s knocking sound (with her hand) on the drum (tumpeleki). Then, everyone had their
own space and time to answer the question below, depending on what the Music
Therapist asked for. So, when G. knocked on the floor, or on the door, or on the wall, he
would answer and when Chr. hitting the drum respectively, she would answer.
Simulation – examples: 1. Music Therapist was giving the sign to Chr. Chr. was
knocking the drum. Music Therapist was asking: “who is it?” and Chr. was responding:
“It’s me!” 2. Music Therapist was waiting for G.’s response. When G. was knocking on
the door, or the wall, or the drum, Music Therapist was asking: “who is it?” and G. was
answering: “it’s me!”
Throughout the process of emerging issues and needs, G. seemed to drift several times.
This means that some of his reactions, in the activity below, showed impulsivity and
uncontrollability. As a result, 1. he responded many times in Chr.’s turn or asked the
question “who is it?” by himself and answered it on his own. 2. When it was his turn and
he answered “it’s me”, Music Therapist encouraged him with enthusiasm, singing “yes,
it’s G.”, using the exaggerating and extending techniques (Psaltopoulou, 2015: 70-71).
This intervention was intended to give meaning to G.’s existence and emphasized its
acceptance and the ability to engage in interaction and communication, through music.
However, this addition seemed to make space for G.’s over-activity, over-enthusiasm and
hyperactivity to return and to be increasing in high levels.
Sessions 19-20
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Sessions 18-21 were basically preparing the closure of the sessions’ period. At this point,
we noticed that the state of impulsivity returned with more intense and gradual climax. A
major change had emerged. His overall image could be described by the maximum of
energy, excessive enthusiasm, hyperactivity, “lightning” (very, very quick) games’
changes (swifts/switches). This means that one game succeeded the other in a very short
time, within the same session, including and using all the possible and available means
for more choices in the game (e.g. balls, rackets, trampoline, mattresses, etc. The Music
Therapy room was also used as a gym). G. started to invite us to become part of this
condition he created, in various ways, such as taking us by hand and drawing us close to
him. It seems important for him to encourage us and invite us to be engaged and
participate in all the activities that he created and organized. He was always there to
excite us and invite us to a constant fun.
All this increase of his impulsivity and energy made me feel a sense of incompletion.
Most specifically, I felt that his impulsive reaction and behavior originated from an inner
need to prevent the end of our journey. This fact had troubled me enough. After many
hours of supervision, we concluded that their activation was most likely influenced by his
own recognition, awareness and understanding of “the end”. G. seemed to realize the
gradual process to completion and that was his own way to expressing it. So, he invented
as many games as he could play with us, making quick changes from one to the other, as
if he wanted to catch up as many as possible. A significant emergence of emotions.
Finally, he seems to be happy and enjoy the relationship among as all which reinforced
the view of achieving a state of deeper connection.
Results
Communication. The creation of a safe therapeutic setting characterized by trust and
unconditional acceptance seemed to work and have a significant effect on the emergence
of the desire for communication and consequently on the processing of G.’s issues and
needs. The limited verbal expression and communication (which, however, was part of
the process) did not seem to hinder either the gradual opening or the emergence of the
inner Self or the movement observed in his levels of functionality. The music worked in
two ways (activating both verbal and non-verbal sources/forms of communication): on
the one hand, as the means that encouraged and reinforced the need to share experiences,
information and material concerning his potential. On the other hand, as the tool through
which and with which G. highlighted all the above.
Contact with the Other (A) and Self. From the first session G. presented and shared an
important element for him directly related to the creative Self. His familiarity and contact
with music but also his direct and original acceptance within the therapeutic context
contributed as an important factor in his movement from isolation and introversion, to
sociability, to the acceptance of the Other (A: important others – correlation) and the
external environment. Yet, in contact with them, in the externalization, in the acceptance
and in the experience of the state of the Self.
108109
Two important issues emerged at this
108
According to the person-centered approach, the self is a continuous and flowing state, which is located
on two levels, the ‘Real Self’ and the ‘Ideal Self’. In order for the individual to reach a state of complete
functionality, an agreement must be reached between these two levels.
[175]
point: 1. The redefinition of an already existing relationship between G. and the therapist
- assistant of the Center, named Chr., through music and 2. The contact with the Music
Therapist and the recognition, the acceptance and her inclusion in the therapeutic context,
by G., through music and through the elaboration of the pre-existing relationship with the
therapist of the Center.
In essence, the transition from an intra-personal state of being to an extra-personal and
later inter-personal one followed the stages bellow: 1. Connection/Reconnection with
music, integration into the therapeutic context, exploration and finally acceptance (this
stage does not include connection with the Music Therapist, only contact), 2. Redefining
the relationship and connection with the Center’s therapist-assistant, using music within
the therapeutic context, 3. Addressing the Music Therapist, accepting and connecting
with her, finally creating a “tridimensional” relationship (G. – therapist Center –Music
Therapist, communication, operation, music editing).
At the point where the creation of a kind of “tridimensional” relationship seemed to be
revealed and emerging, we proceeded to sessions’ closing, leaving in some way a
pending effect and function that this relationship may have had in the later developmental
path of the child.
Interaction
The most important issue we were asked to manage in the Music Therapy sessions with
G. was impulse control. His energy and hyperactivity were found at very high levels.
This clearly made him non-functional, especially in the process of interaction. With the
contribution of music, which offers structure, boundaries and context, G. started to
redefine this particularly intense behavior and individual reactions, with activities and
crucial interventions that seemed to enhance his participation and response in a joint
engagement, with alternations, exchanges, pauses and make the engagement in the
relationship clearer, more active and creative. These are essentially ways that lead the
child, in a non-directive way, to the awareness and management of important issues and
suggest new and more creative ways of participation, functioning and engagement in the
interpersonal and, consequently, at the social level.
Expression
Music seemed to activate and mobilize all the levels of G.’s Self. The acceptance and
inclusion of his needs, desires and experiences by the structured therapeutic setting and
his individuality, moved to the gradual awareness and acceptance of himself. A space for
expression, revelation, discovery and sharing was created, through music and the creative
process. In addition, the presence of facial expressions (however, no eye contact with
meaning, or clear direction), emotional expression and flexibility in mood changes
seemed to be awakened in the process.
Playing
Playing was a concept that evolved, during the Music Therapy sessions, and seemed to
gain significant meaning and value for G. Playing contributed significantly to the
revelation of aspects of himself and provided information about his potential. The
109
The Gestalt approach also adopts the view that self is a continuous state, but identifies the self in three
levels, ‘Ego’, ‘Id’ and ‘Personality’, which are in interaction and sequence with each other.
[176]
simultaneous involvement and addition of music in the process and the processing of
each game and consequently their subsequent combination was a way of developing
communication and coordination, at the interpersonal level and the level of interaction, in
the therapeutic context and in the therapeutic process.
Playing in the process of Music Therapy and especially ‘hide-and-seek’ (a game with
meaning and significance), revealed a dynamic emergence of the Self and, consequently,
the need for a new opening in the world, the need for change.
Conclusions
Through the description of a series of sessions, an overall change in the clinical image of
the symptoms of autism was evidently presented. Within a mere six months, visible
changes have been identified, with particular emphasis on communication, on contact
with the ‘Other’ and the ‘Self’, on social interaction, expression and playing. Music
Therapy seemed to have a positive effect on G.’s developmental process and to suit his
personal potential. Music functioned as an important means of responding and expressing
G.’s needs and desires. At the same time, however, it functioned as a means of emerging,
recognizing and processing important issues. G. led the music and music was adapted to
his needs. Through Music Therapy, it seemed that G. managed to reach points of
coordination with the Self, the external environment and others around him, and most
importantly, to relate to them and to exist with acceptance, in the “here and now”. G., as a
child, invented and used playing as a way of expression and as a way of liberating an
aspect of the Self that sought recognition, understanding, acceptance, and processing.
Music had strengthened, encouraged, contained and embraced this condition and created
the space to exist, to be heard, to communicate and to act.
References
In Greek:
Gotzamanis, K. (2015). Διαγνωστικά κριτήρια από DSM-5. American Psychiatric
Association. Αθήνα: Ιατρικές εκδόσεις Λίτσας: 27-31.
Liali, V. (2019). Η συμβολή του Φωνητικού Αυτοσχεδιασμού στην ανάδυση Εαυτού, με
άτομα στο φάσμα του Αυτισμού. Μια ανασκόπηση της βιβλιογραφίας και κλινικών
παραδειγμάτων. Μεταπτυχιακή Διπλωματική Εργασία. Πανεπιστήμιο Μακεδονίας,
Θεσσαλονίκη, Πρόγραμμα Μεταπτυχιακών Σπουδών Μουσική και Κοινωνία.
Psaltopoulou-Kamini, D. (2015). Μουσικοθεραπεία: ο τρίτος δρόμος. Αθήνα: Σύνδεσμος
Ελληνικών Ακαδημαϊκών Βιβλιοθηκών.
________ (2006). Μουσικοθεραπεία: Αναπηρία και ψυχοσωματική αναδιαμόρφωση
μέσω της διαδικασίας της ‘αναμόρφωσης’. Στο: Μουσικοθεραπεία και άλλες μουσικές
προσεγγίσεις για παιδιά και νέους με αναπηρίες (Πρακτικά συνεδρίου, Οκτώβριος 2006),
Τμήμα Μουσικών Σπουδών, Ιόνιο Πανεπιστήμιο: 90-101.
In English:
Ahmad Hislam Ismail, N., Tekke, M. (2015). Rediscovering Rogers’s Self Theory and
Personality. Journal of Educational, Health and Community Psychology. Vol 4, No 3:
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Dell’ Anno, (2013). How can the Self be described in Gestalt Therapy. Counselling
Directory. https://www.counselling-directory.org.uk/counsellor-articles/how-can-the-self
be-described-in-gestalt-therapy
Eddington, N. & Shuman, R. (2016). Healthy Personality. Presented by Continuing
Psychology Education Inc., education course by the Michigan Board of Social Work for
Michigan social workers via approval by the National Association of Social Workers, and
the California, Texas, New Jersey, Illinois, and Florida State Social Work Boards: 1-14
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Exkorn-Siff, K., Volkmar, R.F. (2005). The Autism Sourcebook. Everything You Need to
Know About Diagnosis, Treatment, Coping, and Healing. New York: Harper Collins
Publishers Inc.
McLeod, S.A. (2014). Carl Rogers. Retrieved from www.simplypsychology.org/
carlrogers.html
Nordoff, P. & Robbins C. (2007). Creative Music Therapy. A Guide to Fostering Clinical
Musicianship. Second Edition. Gilsum NH: Barcelona Publishers: 227-271.
Rogers, C.R. (1959). A Theory of Personality and Interpersonal Relationships, as
Developed in the Client-centered Framework. From: Psychology: A Study of a Science.
Study 1, Volume 3: Formulations of the Person and the Social Context, edited by
Sigmund Koch. (NY: McGraw-Hill, 1959: 184-256). https://pdfs.semanticscholar.
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Scovel, M. & Gardstrom, S. (2012). Music Therapy within the Context of Psychotherapy
Models. Music Faculty Publication. Paper 8. http://ecommons.udayton.edu/mus_fac
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Wheeler, B. (2015). Music Therapy Handbook. New York: The Guilford Press: 148-160,
183-195, 290-301.
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[178]
[179]
Music Therapy through the Family/Systemic Approach
Olympia Pampoukidou
Abstract
This article presents a bibliographic review and a critical reading on Music Therapy
through the Family-Systemic approach. In particular, it presents the results of research
and treatment in different population groups such as patients in hospitals, nursing staff,
children with developmental disorders, people with dementia and non-clinical population
of families or couples. Music and Music Therapy seems to have positive effects on
patients and in on their environment. Music Therapy is proved to be a useful tool for
evaluation in families as it is associated with lower levels of stress during the process.
There is a discussion about the cultural background and the Mediterranean culture of the
Greek reality. The article also highlights the need for a widespread use of Music Therapy,
including the whole system of each individual.
Key words: music therapy, music, family, systemic-family approach, autism, dementia,
psychotherapy services, hospital environment
Introduction
According to Minuchin, treatment and relief of symptoms are achieved with changes in
family systems. This article presents music therapy as an effective form of art therapy
that can involve the whole family or the entire system depending on the context in which
it is addressed. It emphasizes the integrity of the family system, the influence of the
family hierarchical organization and the interdependent operation of its subsystems as the
most important factor in determining the well-being of its members. It is emphasized how
the cultural background of each individual influences the treatment process. In addition,
professional music therapists and family psychotherapists are motivated to incorporate
elements of family therapy and art therapies into their own field.
Definitions
Music therapy is defined as the recognized health specialty with a purely therapeutic
character. It seeks neither entertainment nor musical education but is used to help treat a
person’s physical, emotional, cognitive and social difficulties. It offers a way of
communication and expression, when verbal communication and psychotherapy are
insufficient or impossible. Music therapists use music and its individual elements
(rhythm, melody, etc.) as a means to achieve non-musical goals.
It is based on evidence and is directly related to scientific research. Regarding the
scientific background of music therapists, it requires knowledge in psychology, medicine
and music (International Association for Music Therapy).
[180]
The Systemic Approach analyzes the internal organization and operation of systems, as
well as their interaction with the external environment. Thus, every phenomenon is
studied as a whole, with the logic of the circular relationship and not the linear causality.
Systemic approach is specially applied on the family, which is examined as a system with
mutual dependencies.
Analysis
Family psychotherapy and art therapies
The involvement of children in family therapy provides the therapist with a more
accurate assessment of the dynamics, interaction of roles and rules as “families change
more and more slowly when children are not part of the treatment” (Keith and Whitaker,
1981). In addition, attention is diverted from the patient and as it is emphasized the idea
of a family interaction problem (Taibbi, 2007).
There is evidence to suggest that early, intensive, family-friendly programs that respond
to individual differences between children and families are particularly beneficial in
supporting social communication skills and specifically in supporting children with
‘Diffuse Developmental Disorder’ (Roberts, 2006).
For example, a family that does not know how to express their feelings directly may find
a way to do so when they are given the opportunity to design or paint (Klorer, 2006).
Play and art therapies differ from traditional verbal therapy as they engage emotions in a
direct and natural way that allows customers to express their problems and conflicts
(Malchiodi, 2005).
Liana Lowenstein (2010) argued that these approaches provide families with the
opportunity to laugh, create, work as a team, learn more about each other, explore their
thoughts and feelings, and have a different relationship experience with each other. Thus,
it is possible to increase emotional intimacy, which can be a safe basis for the
development of the family.
The Influence of Music on the Family Context and the Wider System of Interaction
McDermott et al., (2014) conducted a qualitative study on the musical experiences of
people with dementia to explore the importance of music in their lives. Interviews were
conducted with people with dementia, their families and clinic staff. The accessibility of
music to people at all stages of dementia was considered very valuable, the ties between
the members of the system were strengthened, the feeling of personal identity and the
strengthening of relationships was facilitated.
Important were the findings of Garland (2007), who highlighted the simulation of the
presence of a family member and the preferred music as the most effective for reducing
physical disorders. In particular, the simulation of human presence has resulted in a
significant reduction in verbal disorders.
Also, songs seem to be part of children’s social, emotional and cognitive development
and music can facilitate and enhance parent-child relationships (Wetherick, 2009). It is
important that family health care workers encourage the use of music between them and
their children. In cases of developmental delay, disability, serious illness or family stress,
music seems to play an important role in supporting children and their parents (ibid).
[181]
Apart from the songs, the voices of the parents seem to play an important role in
communicating love and sensitivity, as well as in supporting self-regulation for the secure
attachment between the baby and his parents. Under the most adverse conditions such as
premature birth, the voice of the parent directed by the baby takes on another important
and healing role, as premature infants lose the auditory stimulus of the uterus and the
connection with the mother (Haslbeck et al., 2016).
Thus, the experience of listening to music seems to contain significant levels of
emotional support, contributes to the promotion of new and positive memories and
provides short periods of rest and feelings of well-being even in periods of crisis
(Marshall & Shibazaki, 2016).
Music Therapy and the Family-Systemic Approach
The aim of Clair’s study, A. (2002), was to examine the effects of music therapy on
participants with dementia and their caregivers. Music therapy has been shown to be
effective in increasing mutual involvement and facilitating relationships. In addition, it
appeared that as soon as a commitment was made between them, the results were
transferred “out” of the Music Therapy process.
Regarding family music therapy, parents responded positively and were able to come up
with new ideas for themselves and their children (Allgood, 2005). A similar study looked
at the effectiveness of group music therapy by focusing on marginalized parents and their
children on ages 0-5. Musical activities were used to promote positive parent-child
relationships, behavior as well as the communicative and social development of children.
Significant improvements have been found in behavior, educational activities at home
and parental care for mental health, children’s communication and social skills
(Nicholson et al., 2008).
In addition, through the application of Music Therapy on the family, it was observed that
parents had the opportunity to gain new knowledge about their relationships with their
children as they were used to focus first on the child’s difficulties and then on treatment
and on family relationships. In many cases, non-verbal communication through music,
free improvisation and playful music seem to have been key components in facilitating
family interactions. Parents have also reported that the gender and the experience of
music therapists can be a point of reference for certain families (Oldfield et al., 2012).
The application of family educational music therapy to psychiatric patients and their
families has shown high levels of enjoyment of the process by participants and high rates
of willingness to intervene. In addition, lyrics, songwriting and problem-solving
techniques have had positive effects and motivated future dialogue (Silverman, 2013).
Approaching the phenomenon of domestic violence through family Music Therapy
through the constructive approach, Pasiali’s (2013) study had positive results in
establishing routines, participating in common tasks and emerging family ideas to
consolidate it.
Regarding stress levels in families with emotional neglect problems, the application of
music therapy to families appeared to have a positive effect on both verbal and nonverbal
communication between emotionally neglected children and their parents (Jacobsen et al.,
2014).
[182]
“Parents found it easier to talk and understand their children, reported less stress, higher
levels of empathy, and felt more enthusiastic about them, compared to the standard
treatment group. For children who are emotionally neglected, music therapy seems to be
able to give them a chance to respond to a safe and non-threatening environment”.
Jacobsen recommends starting a music connection early.
“Singing together or singing to the baby or toddler can be a very intense engagement
activity for some families. What I ask them to do in music therapy is not to talk. It does
not include words and this helps me see some of the patterns and habits that exist in
family interactions. The sooner you start interacting non-violently with your child in a
meaningful way, the more you see or feel the benefit.”
He also stressed that interactive family music therapy can be used as an evaluation tool,
with the aim of evaluating and treating family members in a more effective way
(McIntyre, 2009; Nemesh, 2016). He claimed that it is a less stressful process than
psychological tests, where “they are asked to fill out questionnaires with many questions
they do not understand, while in music therapy all they have to do is show up and try to
have fun with their children”. Music seems to be a tool to show parents what children
need in the most direct way. Regarding the therapist’s position in Music Therapy, he
shows how an exercise should be done without overshadowing parents.
Aside from the majority of cases that use Music Therapy in clinical population and
families with disabled children, the Nemesh study (2016) is considered unique because it
expands the use of family music therapy to a wider range of population. Combining
Alvin’s free improvisation model and Satir’s experiential family therapy, the study
focused on family members in mutual musical improvisation. He examined the clinical
application and therapeutic value of short-term music therapy with three families in a
community setting. Family music interventions seemed to use resources to promote
family and individual reconciliation and well-being.
Smith & Hertlein’s (2016) research focused on the integration of Music Therapy in
couples’ therapy. Participants reported multiple positive outcomes for themselves, their
relationship well-being, and a sense of significant change in their marriage.
Finally, in a recent study, Thomson (2019) attempted to incorporate Music Therapy into
the child’s daily routines at home. He highlighted this approach as particularly useful for
young children with autism spectrum disorder as it promoted interpersonal commitment
and developed early social and communication skills.
In addition, Music Therapy experience seems to influence family perception of patients’
symptoms and family satisfaction levels regarding the amount of care they received. It is
also associated with perceptions of significant psychological support and reduced
breathing problems (Burns et al., 2005). More specifically, parents described Music
Therapy in a corresponding study on pediatric palliative care in the final stages of a
child’s life-threatening illness as important for improving their child’s quality of life and
physical symptoms, providing comfort and endurance. Despite the significant challenges
that parents faced during this difficult period, they described many positive experiences
in Music Therapy (Lindenfelser, K., Hense, C. & McFerran, K., 2011).
[183]
Discussion
According to the above findings, there is lack of studies concerning the Greek population
and comparative studies on intercultural differences applying Family-systemic Music
Therapy.
Little research has been conducted on the effectiveness of Music Therapy in a purely
family-systemic context. Most of the studies where qualitative, which is related to the
research material (videotaped sessions, recordings, etc). In most of the studies, either the
family therapist incorporated music therapy into the sessions or the music therapist
incorporated family into the therapy. Apart from this there is a need to define more
accurately the knowledge (appropriate therapeutic approach, type of music therapy, etc.)
that is necessary for a therapist to carry out Family-systemic Music Therapy.
Finally, there seemed to be a lack of comparative studies on Music Therapy and other art
therapies in the family context.
Based on the above, it would be useful to adapt a research on the Greek population and
Family-systemic Music Therapy. In addition, it would be interesting to conduct a
comparative study with other art therapies such as dance and drama therapy in a mixed
survey on a qualitative and quantitative database in order to increase the reliability and
validity of the results.
Conclusions
Family-systemic Music Therapy with the family’s active participation is a recent “entry”
in the research field. It is important to make a clear distinction between the types of
approaches (systemic, anthropocentric, etc.) and the types of Music Therapy (individual,
group, etc.). The findings were encouraging in research and treatment in many different
population groups such as patients in a hospital setting, children with developmental
disorders, people with diagnosis of dementia and non-clinical population of families or
couples. It would be useful to open the horizons in the field of Music Therapy to the
Greek reality as Mediterranean countries with strong bonds would benefit from a more
holistic treatment. Thus, the family with the reported “patient” will be able to move from
the position of the “observer” and take an active role in the therapeutic “change”,
enhancing in this way the sense of “responsibility” throughout the system.
References
Ackerman, N.W. (1970). Family therapy in transition. New York: Little, Brown.
Allgood, N. (2005). Parents’ Perceptions of Family-based Group Music Therapy for
Children with Autism Spectrum Disorders. Music Therapy Perspectives, 23(2): 92-99.
doi: 10.1093/mtp/23.2.92
Burnham J.B. (1986). Family Therapy. London; Routledge.
Burns, D., Perkins, S., Tong, Y., Hilliard, R. & Cripe, L. (2015). Music Therapy Is
Associated With Family Perception of More Spiritual Support and Decreased Breathing
Problems in Cancer Patients Receiving Hospice Care. Journal of Pain And Symptom
Management, 50(2): 225-231. doi: 10.1016/j.jpainsymman.2015.02.022
Clair, A. (2002). The effects of music therapy on engagement in family caregiver and
care receiver couples with dementia. American Journal of Alzheimer’s Disease & Other
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2016.1180086
Garland, K., Beer, E., Eppingstall, B. & O’Connor, D. (2007). A Comparison of Two
Treatments of Agitated Behavior in Nursing Home Residents With Dementia: Simulated
Family Presence and Preferred Music. The American Journal of Geriatric
Psychiatry, 15(6): 514-521. doi: 10.1097/01.jgp.0000249388.37080.b4
Haslbeck, F., Loewy, J., Filippa, M., Hugoson, P. & Kostilainen, K. (2016). Sounding
together: family-centered music therapy in neonatal care from a European
perspective. Nordic Journal of Music Therapy, 25(sup1): 90-90. doi:
Jacobsen, S., McKinney, C. & Holck, U. (2014). Effects of a Dyadic Music Therapy
Intervention on Parent-Child Interaction, Parent Stress, and Parent-Child Relationship in
Families with Emotionally Neglected Children: A Randomized Controlled Trial. Journal
of Music Therapy, 51(4), 310-332. doi: 10.1093/jmt/thu028
Keith, D.V. & Whitaker, C.A. (1981). Play therapy: A paradigm for work with families.
Journal of Marital
Klorer, P.G. (2006). Art therapy with traumatized families. In L. Carey (ed.), Expressive
and creative arts
L’Abate, L. (2013). Review of “Creative Family Therapy Techniques: Play, Art, and
Expressive Activities to Engage Children in Family Sessions,” by Liana Lowenstein. The
American Journal of Family Therapy, 41(3): 275-276. doi: 10.1080/01926
187.2012.688008
Lindenfelser, K., Hense, C. & McFerran, K. (2011). Music Therapy in Pediatric Palliative
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10.1177/1049909111429327
McIntyre, J. (2009). Interactive Family Music Therapy: Untangling the
System. Australian and New Zealand Journal of Family Therapy (ANZJFT), 30(4): 260-
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Malchiodi, C.A. (2005). Expressive therapies. New York: Guilford.
Marshall, N. & Shibazaki, K. (2016). Seeking Asylum. Asian Journal Of Human
Services, 11(0): 18-30. doi: 10.14391/ajhs.11.18
McDermott, O., Orrell, M. & Ridder, H. (2014). The importance of music for people with
dementia: the perspectives of people with dementia, family carers, staff and music
therapists. Aging & Mental Health, 18(6): 706-716. doi: 10.1080/13607863.2013.875124
Nemesh, B. (2016). Family-based music therapy: from dissonance to harmony. Nordic
Journal of Music Therapy, 26(2): 167-184. doi: 10.1080/08098131.2016.1144638
Nicholson, J., Berthelsen, D., Abad, V., Williams, K., & Bradley, J. (2008). Impact of
Music Therapy to Promote Positive Parenting and Child Development. Journal of Health
Psychology, 13(2): 226-238. doi: 10.1177/1359105307086705
Oldfield, A., Bell, K. & Pool, J. (2012). Three families and three music therapists:
Reflections on short term music therapy in child and family psychiatry. Nordic Journal of
Music Therapy, 21(3): 250-267. doi: 10.1080/08098131.2011.640436
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Smith, K. & Hertlein, K. (2016). Integrating Music Therapy Into Marriage and Family
Therapy: Theoretical and Clinical Perspectives. Journal of Family Psychotherapy, 27(3):
171-184. doi: 10.1080/08975353.2016.1199767
Silverman, M. (2013). Effects of family-based educational music therapy on acute care
psychiatric patients and their family members: An exploratory mixed-methods
study. Nordic Journal of Music Therapy, 23(2): 99-122. doi: 10.1080/08098131.
2013.783097
Thompson, G. (2012). Family-Centered Music Therapy in the Home Environment:
Promoting Interpersonal Engagement between Children with Autism Spectrum Disorder
and Their Parents
Pasiali, V. (2013). A Clinical Case Study of Family-Based Music Therapy. Journal of
Creativity In Mental Health, 8(3): 249-264. doi: 10.1080/15401383.2013.821925
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Complex Needs. British Journal of Music Therapy, 23(1): 46-47. doi:
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[186]
[187]
The Use of Voice in Healing: Breast Cancer and Trauma
Elena Pasoudi, Xanthoula Dakovanou, Dora Psaltopoulou, Elsa Stournara
Abstract
This essay examines the close relationship between breast cancer, trauma and voice. It
includes a case example, which will enable exploration of how music therapy and
especially the use of voice, contributes to the processing of a breast cancer survivor’s
traumatic experience. The woman in the case example was involved in group music
therapy sessions, conducted by two music therapy trainees. These were realized
throughout a 4 month period on women who were breast cancer survivors. Through the
analysis of the therapeutic work, it was noticed that they all had a common behavioral
pattern that negatively affected the quality of their lives. This pattern which has been
recognized by other researchers too is characterized by, among other things, a denial or
suppression of an individual’s own personal needs and difficulty in expressing ‘negative
feelings’ (anger, depression, fear, disappointment). Related literature in this area will be
summarized. The focus of this essay is on showing how the use of voice and the
existence of a safe ‘music therapy group’ environment enabled one woman to release her
emotions in a contained way. She was able to express her fear and pain in relation to her
traumatic experience, overcoming the behavioral pattern within the group environment,
which seemed to be otherwise prevalent in her life.
Key words: music therapy, group therapy, voice, breast cancer survivors, trauma.
Introduction
Through the analysis of the group music therapy sessions with women with breast cancer
survivors, it was noticed that all women had a common behavioral pattern that negatively
affected the quality of their lives. Being curious by the mutuality of these characteristics,
the music therapy trainee started conducting a literature review, as part of her thesis, in
order to investigate if other researchers in the past had observed similar connections
between personality and breast cancer. Most of the paper is retrieved from this
unpublished thesis (Pasoudi, 2018). The finding of the review was that a lot of
researchers mainly from the psychoanalytic field, observed the same mutual
characteristics and behavioral pattern. This essay focus on three of these mutual
characteristics, which are: the denial or suppression of an individual’s own personal
needs, the difficulty in expressing ‘negative feelings’ (anger, depression, fear,
disappointment) and the experiencing of traumatic events. The first part of this essay is a
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summarized literature review, focusing on these characteristics. The second part is a case
study from the group music therapy sessions. The third part is an analysis of how music
therapy and especially the use of voice can help these women overcome their behavioral
pattern, express their “negative” feelings and work on traumatic events.
Literature review: The connection between breast cancer, personality characteristics,
coping strategies and traumatic experiences.
Over the years there has been observed a relationship between cancer, personality
characteristics, coping strategies and traumatic experiences. Starting from Hippocrates
(460-370 BC),
“who referred to the contribution of psychological variables and the development of
disease, as well as the use of the term cancer in its medical sense” (Rigatos, 1992).
“In the second century AD, Galen observed that cancer occurred more in women with a
melancholic temperament” (as cited in Fernandez-Ballesteros, Ruiz & Garde, 1998). In
1759, surgeon Guy, emphasized “such disasters in life, as occasion much trouble and
grief” in the causation of cancer (as cited in Butow et al., 2000).
In the first half of this century the search focused on external explanations for illness,
influenced by Descartes, who viewed the mind as distinctly separate and an unrelated
entity from the body. Renewed interest in the mind-body relationship over the past three
decades parallels our increasing understanding of the complex interrelationships between
the immunological, endocrine, and nervous systems. There is mounting evidence that
stress can disturb many areas of the immune system and that impaired immune system
function predisposes to malignant growth (Butow et al., 2000: 169).
From 1974 through 1995 the interest in the contribution of psychological factors to the
aetiology of cancer has grown. Among these factors, stressful life-events, personality
characteristics and coping styles have been investigated as important (Fernandez-
Ballesteros et al. 1998).
Wilhelm Reich (as cited in Hiller, 1989) “maintained that the chronic repression of
emotions led to cancerous changes at the cellular level”.
Bacon, Renneker and Cutler (1952) (based on their analysis on 40 patients) found that
young women with breast cancer had an inability to discharge or deal appropriately with
anger, aggressiveness or hostility covered over by a facade of pleasantness.
In addition, they observed that the pattern of caring for the needs of others rather than
their own gradually assumed a coloring of superficial cheerfulness and pleasantness.
Concerning this pattern, van der Ploeg et al. (1989: 223) in their study, found two factors
that seemed to characterise these women: 1) ‘acting rational and reasonable’ and 2)
‘trying to understand other people’, both ‘in spite of negative feelings’. “These factors
implicitly require the suppression and repression of hostile feelings, irritation and anger,
or at least the control of anger by means of rational behavior and trying to be nice toward
others.”
Studies have shown that women with breast cancer probably had gone through a difficult
childhood. Reznikoff (as cited in Fisher & Cleveland, 1956) reported that they are more
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likely to have carried a heavy load of responsibility for the caring of younger siblings
during childhood.
LeShan (2006), an American psychologist-psychotherapist, evaluated in his report of a
research project carried out over 12 years, the emotional life histories of 450 adult cancer
patients.
He found a specific pattern of development and relationships in 72 per cent of the cancer
patients and 10 per cent of the equated controls. In this review, the focus will be only on
the parts of this pattern that are connected with the behavioral pattern that are mentioned
above.
LeShan observed that early in life, apparently during the first seven years, damage was
done to the child’s developing ability to relate. Often this was accentuated by a traumatic
event, such as the loss of a parent, the death of a sibling or something of this sort. From
his experience at this time, the child learned to feel that emotional relationships brought
pain and desert, so it stopped relating so much with other people and felt lonely. Other
people saw the grown – up child as a ‘good’, ‘decent’, ‘benign’ person who used very
little aggression in expressing or defending his own wishes…
Becker (as cited in Hiller, 1989) found that his patients have been exposed to an above-
average degree of traumas in early childhood, that most reported a hard youth without
love, affection, or tenderness and that within in the marriage, in active life, and above all
in their careers, the patients show a striking degree of ambition and activity.
As an explanation for his observations, Becker appealed to the Greek myth of the
Amazons:
The Amazons, the ‘breastless ones’ were a warlike race that only had intercourse with
men once a year and burnt out one of their daughters' breasts so that it was no hindrance
when using a bow. Our patients showed a very active, combative attitude in that they
were ready to take on roles which are normally the preserve of men, this frequently
developed into a self-destructive tendency (as cited in Hiller, 1989: 13-14).
Following an extensive research program on personality and cancer Eyesenck (1994:
168) summarizes the different characteristics that constitute type C (cancer prone) as:
“Being over co-operative, appeasing, unassertive, overpatient, avoiding conflict,
suppressing emotions like anger and anxiety, using repression and denial as coping
mechanisms, self-sacrificing, rigid, predisposed to experience hopelessness and
depression.”
Other researchers have given emphasis to particular characteristics of type C, that relate
to the coping strategies of cancer patients. The words “coping strategies” are used as
Folkman and Lazarus (1980: 219) defined that “the cognitive and behavioral efforts made
to master, tolerate, or reduce external and internal demands and conflicts among them.”
Kneier & Temoshok (1993: 145) pointed out that
“coping strategies in which anxiety-provoking events, emotions, or ideas are denied,
suppressed, repressed, minimized, rationalized away or otherwise avoided, are often
associated with higher incidences of cancer and with poorer prognosis.”
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Greer & Watson (1985: 774) emphasized that “suppression of emotional responses,
particularly when angry, appears to be central to this behavior pattern.”
The repression, suppression, the control and the denial of ‘negative’ feelings have been
related through many researches to the initiation and development of cancer (van der
Ploeg et al., 1989; Fernandez-Ballesteros, Zamarrón, Ruiz, Sebastian & Spielberger,
1997; Fernandez Ballesteros et al., 1998; Brown, 2006; Cooper & Faragher, 1993;
Fischer & Cleveland, 1956; Greer & Watson, 1985).
These constructs, according to Swan, Carmelli, Dame, Rosenman and Spielberger (1991:
553),
“can be viewed as defenses against intense emotion that have physiological and,
ultimately, disease consequences”. Through their analysis the researchers found that the
factor “Anti-emotionality, which may be defined as the specific avoidance of emotion in
interpersonal situations, represents the most toxic element of the total construct”.
Cooper and Faragher (1993: 654) in their research maintained that women diagnosed as
having cancer tended to use strategies such as avoidance/denial and to internalize their
problems. They appeared generally reluctant to seek out support from family and friends,
or to find some outward expression of their emotion through strategies such as
tearfulness. Instead, they preferred to bottle up their emotions and to induce a state of
self- imposed personal isolation. Finally, the cancer group was found to use significantly
fewer coping strategies than other women to deal with stress.
Watson et al. (1991) found a connection between emotional control and a helpless stance
towards cancer and therapy, particularly 1-3 months after the diagnosis.
This stance may also include hope, but as Hutchnecker (as cited in Papadatou &
Anagnostopoulos, 2012) defined ‘passive hope’. Hutchnecker specifically distinguished
two types of hope that have different consequences to the cancer treatment: 1) the active
hope and 2) the passive hope. He defines active hope as the inner energy that motivates
the person for action. The patient moves towards a specific direct or distant goal, trusting
his abilities. Active hope is a source of inspiration and power. On the other hand, the
person that is characterized by passive hope, relies on dreams and hopes that a miracle
will happen and the difficulties will disappear… this person avoids being active and lives
more in his fantasy, rather than in reality.
As analyzed above, many researchers seem to agree that there is probably a close
relationship between breast cancer, traumatic experiences, personality characteristics and
coping strategies.
Case study
In this essay, the focus will be on one member of the music therapy group, Georgia. The
name of the person has changed, so that the person is non recognizable. Georgia is 76
years old, widow and mother of two children. She has retired. During the initial diagnosis
Georgia had stage two breast cancer. She was given a total mastectomy and lumpectomy,
radiotherapy and chemotherapy. Since the end of her treatment, 17 years have passed.
The group music therapy sessions were realized in an association for women with breast
cancer. The group consisted of 5 women with breast cancer survivors, 2 music therapy
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trainees and it lasted 4 months. The sessions were taken place weekly and the duration of
each session was 90 minutes.
The approach that was followed by the music therapy trainees was humanistic with
psychoanalytical understanding. The focus was on ‘the here and now’ and on the feelings
that the women were bringing in each session.
Already from the 3rd session the group had started to observe the common characteristic
that was bonding the women, the suppression of their ‘negative feelings’ (anger, sadness,
fear, disappointment). Women seemed to ‘cover’ and deny these feelings, in order not to
bother other people.
Georgia on the 7th session shared with the group, her belief that the suppression of her
fear, anger and anxiety led her to breast cancer.
During this session and after a free group improvisation, Georgia remembered a
traumatic event, which she experienced when she was only 7 years old. During the civil
war in Greece (1946-1949), as she was walking, she saw young people, lying dead at the
edge of the road. They had killed them and putted them there for intimidation… She was
explaining to us how painful it was for her to see these young people with bullets on their
chest and how she had to keep walking next to them, so she can finally go home.
Music therapy trainees proposed to the group to improvise all together, supporting
Georgia and giving her the space to express these painful feelings.
Georgia chose to play the shaman drum and to use her voice. The rest of the group picked
other instruments to accompany her: ocean drum, xylophone, two tone agogo, hand drum
and maracas. One trainee used her voice and the other used bongos and her voice too.
Georgia’s voice, as she was playing the shaman drum, was incredibly strong and
intense…
Her voice started piano, followed by a big crescendo, staying there and then closing again
till pianissimo. The trainee’s voice in the beginning was all the time an octave lower than
her voice, supporting her, holding and mirroring her and when Georgia’s voice was
strong enough, the trainee went higher, to meet Georgia, singing different musical
phrases around her voice tone.
The women were stunned by how her voice came out so deep, clear, loud and for such a
long time. As one of the women said, “With your voice you got wings and you flew
away”.
Georgia shared with us that she was feeling like a mother that was saying goodbye to the
children, she was mourning them…. “It is the first time in my life that I am doing this… I
didn’t even mourn my parents…”
When the improvisation ended Georgia shared with us,
“I erased them… ashes ... I needed this for years…. What a power the musical
instruments can give you…. I couldn’t believe it… I finally expressed these feelings for
the first time in my life, after 70 years… I don’t know how you see me, thankfully I see
you looking at me with love… I feel released, I took them out of me, I opened my self….
I was ashamed and afraid…I felt that I had to release this voice, I felt pain, sorrow for the
lost youth, about life and how it is, how people make wars, in the chaos I was feeling the
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injustice….my legs, my hands were shaking…. I was sweating and tears were running
from my eyes….”
Georgia’s choice to use her voice, in order to express her feelings, is not accidental…
Voice, trauma and music therapy
The manifestation of human life is vocal (Moses, as cited in Tyson 1982: 6). It is the
reflex cry of the newborn infant, by which the respiratory tract is cleared of mucus to
make way for the first breath. That first cry in all infants is at or near ‘concert A’ or
440cps, the pitch to which all Western musical instruments are tuned! (Luchsinger and
Arnold, as cited in Tyson, 1982: 6)
The belief that there is a relationship between respiration and mental functioning can be
tracked back to ancient Greeks, who believed that the diaphragm was the center of the
soul and of the emotions. The word psyche was etymologically connected in Homeric
Greek (8th century BC) with breathing (from the verb ψυχώ, which means I blow) and the
latin word anima is related to the Greek word αήμι which also means to blow and to the
word άνεμος which means wind.
Our voice is our instrument. When we sing, we feel the vibrations produced by our body.
Georgia’s singing was actually a ceremonial experience, which was possible through
music improvisation. Living this experience was very important for processing Georgia’s
trauma, because as Robert Johnson (Johnson, 2014: 52) cites “a symbolic experience is
real and affects one as much as an actual event”.
As Herman (2015: 110) explicates, trauma recovery unfolds in three stages. The central
task of the first stage is the establishment of safety. The central task of the second stage is
remembrance and mourning. The central task of the third stage is reconnection with
ordinary life.
In this case study the second stage is being observed, remembrance and mourning.
Georgia is re-experiencing the traumatic event, but this time she is not alone. The group
and the trainees are with her, supporting her, witnessing her story. Her memory of this
traumatic scene is like a black and white picture, without colours. Music now is her paint.
She goes again to this memory, but now she can colour it through music with her
feelings.
Healing depends on experiential knowledge. “A narrative of the traumatic event that does
not include the traumatic imagery and bodily sensations is barren and incomplete.”
(Herman, 2015: 126)
When you sing, you reconnect with your center; your focus goes again to your body.
Sometimes it is difficult to bring painful traumatic events back to your memory, but our
body never forgets…
“Traumatic experiences disturb the sense of bodily connectedness. Music therapy can be
of use to those vulnerable to the effects of trauma, because of these qualities of musical
embodiment.” (Sutton, 2002: 35)
Music is a very powerful tool, which helps the therapist to access the unconscious and
bring memories, thoughts, feelings, images back to consciousness. In order to sing you
need to breathe deeply and the exhaling process, so often related to the fear of letting go,
helps you to release emotions and feel open to receive whatever life brings you.
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Austin (2009: 132) explicates that singing is a catalyst for self-expression and is a
powerful way to open the heart and release grief, and grieving is necessary to let go of
past and present losses in order to accept the present and who you are today.
In Georgia’s case, singing helped her to mourn for the first time in her life and express all
this pain that was trapped inside her…
Conclusions
As other researchers noticed too, there seems to be a connection between breast cancer
and trauma. Studies show, that personality characteristics, coping strategies and
childhood experiences are also factors that may contribute to the initiation of cancer. It’s
important to point out that breast cancer itself is a traumatic experience, because it forces
the patient to face his mortality.
Through this case example, it has been observed how music therapy and especially the
use of voice, can help people suffering from trauma to recover. Music therapy provided
to these women a safe and trustful space to share their negative feelings, that they
couldn’t easily share with other people.
This essay was an exploration around these relationships and the presentation of some of
the music therapy trainee’s observations and research from her work with this clinical
population.
Of course, further research is necessary in order to develop evidence-based outcomes and
use these conclusions as guidelines, when working with women with breast cancer.
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[197]
Music Therapy and Autism: Μoving towards Meaningful
Communication. Vignettes from a Relevant Case
Dora Psaltopoulou, Nikoleta Gamagari
Abstract
The present paper is structured into two main parts: In the first part, psychoanalytic terms
and concepts are mentioned and explored; moreover, psychoanalytic theories, related
both to the theoretical background of a number of music therapy approaches, and to the
music therapy clinical practice, are also discussed.
The second part provides a brief presentation of a relevant case. The client is an eleven-
year-old boy, diagnosed with autism. The music therapist adopted the humanistic
approach for her music therapy clinical work; however, certain therapeutic aspects are
also viewed through a psychoanalytic perspective. The aim is to study and present the
interrelation of the fields of music therapy and psychoanalysis within the context of the
clinical process.
A brief synopsis of the main clinical issues, analyzed in the case, is provided in the
conclusions’ section; at the same time, the parts where the psychoanalytic theory is
relevant in the clinical reality of the music therapy process are emphasized.
Finally, suggestions for further research with regard to issues of interconnection between
various psychotherapeutic approaches are provided.
Key words: music therapy, psychoanalysis, case study
Introduction
Music Therapy is considered to be an effective intervention for individuals in the autism
spectrum (Psaltopoulou, 2015; Bruscia, 1989; Nordoff-Robbins, 1977); they seem to feel
enough safe in the therapist-music-client therapeutic relationship to freely express
themselves and interact verbally and nonverbally, to be playful and creative, and finally
move towards meaningful communication.
The present paper is structured into two main parts: In the first part, psychoanalytic terms
and concepts are mentioned and explored; moreover, psychoanalytic theories, related
both to the theoretical background of a number of music therapy approaches, and to the
music therapy clinical practice, are also discussed.
The second part provides a brief presentation of a music therapy case of an eleven-year-
old boy with autism. The music therapist adopted the humanistic approach for her music
therapy clinical work; however, certain therapeutic aspects are also viewed through a
psychoanalytic perspective.
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The main aim of this paper is to study and present the interrelation of the fields of music
therapy and psychoanalysis within the context of the clinical process. Particular emphasis
is given to specific parts of the music therapy process where the psychoanalytic theory is
relevant in the clinical reality.
Part of the paper is retrieved from an unpublished master thesis on Music Therapy
(Gamagari, 2020).
Part I: A psychoanalytic theoretical background. Terms and Concepts
The first part of the paper provides a brief theoretical background. Relevant definitions of
terms widely used in the psychoanalytic theories are mentioned to facilitate the reader’s
comprehension of the theory behind the case study.
Primary maternal preoccupation
“In the object relations theory of British psychoanalyst Donald Winnicott (1896-1971), a
state immediately following childbirth in which a mother becomes preoccupied with her
infant to the exclusion of everything else, which permits a heightened sensitivity to the
child’s needs” (APA Dictionary of psychology, 2020, Primary maternal preoccupation,
retrieved at June 7, 2020, from https://dictionary.apa.org/primary-maternal-
preoccupation)
In order for the mother to respond to the function of motherhood as such, she relies
heavily on empathy. She needs to realize what her child wants; she needs to use her
imagination and dream about it. As early as the last month of pregnancy and for the first
months of labor, the mother, according to Winnicott (2002), is mentally experiencing an
emotional state called primary maternal preoccupation. In this situation the mother
returns to and reconnects with her infant relationship with her own mother and this
regression opens a path of identification with her child. Through this identification, yet,
knowing at the same time that she is now in the position of the mother herself, the
process of empathy is set to work, and she can have fantasies for her child
(Ksanthopoulou, 2016).
Holding
“It is the mother’s natural adaptation to every movement of the baby and, generally, her
behavior that stems from her intuition about what her baby needs. Characterizing a period
where baby and mother are an undifferentiated whole, in a symbiotic relationship, the
baby does not realize that the mother is a separate person” (Psaltopoulou-Kamini, 2015,
57).
According to Margaret Mahler this stage is called Normal autistic phase (Mahler et al,
1975).
Mirroring
“By holding her baby, the mother is connected to it physically and mentally. By looking
at her the baby sees himself/herself in the mother’s face. The mother is present only for
her baby (identification), as the baby feels, and, in her gaze, in the expression of her face,
the baby recognizes him/herself… Holding and mirroring create the field for a primary
sense of ‘existence’ in the infant: ‘I exist, because someone sees me’.” (Psaltopoulou-
Kamini, 2015, 57).
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Good enough mother
“In the object relations theory of British psychoanalyst Donald Winnicott (1896-1971),
the ordinary, devoted mother who provides an adequate or good enough environment for
the growth of the infant’s ego to express its true self. The good enough mother begins
mothering by adapting entirely to the infant and providing an environment free
of impingements, but later she gradually and inadvertently creates small failures of
adaptation that allow the infant to tolerate the frustrations of reality” (APA Dictionary of
psychology, 2020, “good enough mother”, retrieved at June 7, 2020, from
https://dictionary.apa.org/good-enough-mother).
According to Melanie Klein (Geissmann & Geissmann, 1998), the mother’s initially
‘perfect’ adaptation to the infant’s needs -that is, her immediate response and in the most
direct way to the satisfaction of his/her desires, helps in the development of the baby’s
primary creativity. Through the mother’s adaptation, the baby’s good relationship to the
reality is also established, as his/her desire is heard and met in a ‘magical’ way. Why,
though, the discussion is about a ‘good enough mother’ rather than a ‘perfect’ mother?
In order for the infant to develop the ability to perceive him/herself, or even experience a
sense of being separate from the union with the mother, the mother will gradually have to
“reduce” the immediacy of her adjustment in terms of satisfying his/her desires, so as to
leave the field open for the first experiences of cancellation to occur. Thus, the illusion of
omnipotence and “magical thinking” starts to fade. This “absence” of the mother, which,
essentially, is a relative delay in meeting the infant’s needs, is also a determining factor in
the development of primary creativity, as the baby develops the ability for internal
representations and memories so as to cover the frustration caused by the mother’s
absence.
According to Winnicott (1953), the ‘good enough mother’ initially adjusts almost
absolutely to her baby’s needs. Gradually, she adjusts less and less perfectly, as the
baby’s ability to cope with her ‘failure’ increases.
Influenced by Freud’s thought, Klein (Geissmann & Geissmann, 1998) argues that our
psyche comes to life governed by the conflict between two impulses (libidinal and
destructive). She differentiates herself, however, from Freud’s thought, conceptually, and
as a consequence, according to her view of the psyche, she replaces the concept of
opposite impulses with the concept of emotion. Therefore, the drive for life is called love
and the drive for death is called hatred/envy. Being in a relationship with the ‘good
enough mother’, the infant is confronted with two aspects of the mother’s existence, or
with two mothers, the ‘good’ and the ‘bad’ one. In this way, the infant, being related to
these two aspects, s/he is also related to the outside world, with emotions that are initially
placed in this duality: love/hate. The field in which these primary emotions begin to take
shape is, according to Melanie Klein, the infant’s imaginary, the unconscious
imagination. The infant is imaginatively related to the mother since the beginning. The
infant’s mental development is based on this imaginary relationship, which will
determine the rest of his/her mental life and reality.
Therefore, the mental and emotional development of the individual, as well as his/her
mental growth, cannot be defined, nor can they take place within an already non-existent
individuality, but they can be understood through the prism of this primary relationship
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with the mother - with the imaginary mother. According to Lacan (Evans, 1996), the
mother has the role of the ‘primary Other’ for the child, as she is the one who will
validate the baby’s cries, giving them specific meaning.
Transference
“The transfer on to the therapist of desires and feelings, first created in relation to other
people, and mostly related to primary important objects, usually in childhood. The
analysis of the transference aims at understanding the emotions expressed in the
therapeutic relationship and their connection to events, conflicts, relationships of the past
(and current).” (Psaltopoulou-Kamini, 2015, 31).
Countertransference
“The therapist’s responses and feelings towards the analysand in the context of the
therapeutic relationship” (Psaltopoulou - Kamini, ibid).
Freud introduced the term to describe the analyst’s unconscious feelings and thoughts
about the analysand, even though he rarely used it. After his death, this term began to be
used much more frequently and became even a point of arguments among various
psychoanalytic schools.
Melanie Klein and the advocates of object relationship theory, with Paula Heimann as a
main supporter, argued that many of the analyst’s feelings can function as an index as to
the analysand’s mental state; thus, it is considered quite safe, or even beneficial to use
countertransference as a psychoanalytic technique that can guide the analyst’s
interpretations.
During his teaching, Lacan gradually developed a firm opposition to the term
‘countertransference’. He considers the term inappropriate, emphasizing that the
transference in itself is a relationship in which both the analyst and the analysand are
involved, even though in different ways.
Thus, using the term countertransference, the function of the transference as a
relationship and as a phenomenon in which two subjects are involved is canceled. In his
teachings, especially those dating from 1960 and onwards, Lacan (Evans, 1996) uses the
term ‘transference’ and ‘analyst transference’ exclusively in the cases where he would
refer more specifically to the role and position of the analyst in this relationship (Evans,
1996).
Psychoanalytic theories. Lacan’s ‘Mirror Stage’ and the connection
with clinical improvisation in Music Therapy
The initial inspiration for the development of the ‘Mirror Stage’ theory was drawn from
the ‘mirror test’ experiment of the French psychologist Henri Wallon in 1931 (Evans,
1996). According to this experimental study, the six-month-old human infant appears to
present differences to the baby chimpanzee, which is considered to be the human’s
closest relative in nature. The differentiation observed in this experiment concerns the
reaction of each of the subjects to their mirror image. The human infant seems to be
seduced by his/her reflection and, thus, seems to adopt this image as his/her own, unlike
the baby chimpanzee that quickly loses interest in the image, realizing that it is deceptive.
The concept of the mirror stage goes beyond the limits of the experiment and represents a
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crucial part of the growth process of the individual, functioning as a foundation for the
subject’s mental structure, and the structure of the psyche.
Initially, during the teaching period 1936-1949, Lacan (Evans, 1996) seems to place this
stage at a very specific period of time: a 6-to 18-month-old baby. In the following years
of his teaching, the content of the concept is softened. Lacan (Evans, 1996) no longer
addresses the stage as a phase of the infant’s developmental process, but rather as a
continuum, as it is constantly playing a fundamental role in the individual’s sense of
subjectivity.
The great importance of the mirror stage lies in the fact that the person begins to acquire
a sense of self-image and self-perception through the identification process (Evans,
1996). The person identifies oneself with the reflection of his/her image, the mirror
image. “We have only to understand the mirror stage as an identification, in the full sense
that analysis gives to the term: namely, the transformation that takes place in the subject
when he assumes an image-whose predestination to this phase-effect is sufficiently
indicated by the use, in analytic theory, of the ancient term imago” (Lacan in:
Stavrakakis, 1999: 30).
To understand the complexity and importance of this phenomenon, the developmental
process of the infant will be described according to Lacan’s (2006) ideas. At the age of
six months, the infant has not yet attained neuromuscular coordination, but his/her visual
system is relatively developed, which means that s/he can recognize his/ her image in the
mirror before gaining complete control of his/ her movements. This inability to control
movement and coordination is experienced by the infant as a sense of a fragmented body.
In the mirror stage, the infant sees his/her image in the mirror as a whole, as a
composition; this perception, by contrast, leeds the infant to perceive his own body - still
lacking motor coordination at this stage- as divided and fragmented. The stress caused by
this sense of fragmentation mobilizes the identification with the mirror image, by means
of which the ego is formed. This moment of identification with the mirror image is
described by Lacan (1988) as a moment of triumph, as it functions as an imaginary sense
of control. The child expects a sense of physical coordination that s/he has not
experienced until now (Evans, 2006).
Therefore, since the person imagines himself/herself in a new situation, the mirror stage
essentially introduces the subject to the Imaginary dimension. At the same time, there is
an important Symbolic dimension: the image of the adult, who holds or supports the baby
and, who, at that moment, validates through his/her gaze the process of identification,
becoming a symbol of the big Other.
At this point we can identify a connection between the fields: psychoanalysis and music
therapy. One of the most commonly used clinical interventions in various music therapy
approaches is the mirroring technique. A situation where, within the context of the
“lingual therapeutic relationship, [the person] hears oneself being heard” (Psaltopoulou-
Kamini, 2015, 58).
Through clinical improvisation, a sonic - in this case - image is created. This image is a
composition where all the aspects of the self that come to the surface, even those that are
experienced by the person as unconnected and fragmented, are included.
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The orders of the psyche - the Imaginary, the Real and the Symbolic- (Evans, 1996) are
all interconnected, since the therapeutic process takes place in the here and now,
belonging to the dimension of the Real. The musical and non-musical elements derived
from the client are contained by the therapist within a musical continuum; during this
process, an audio image emerges, where the client can identify with the self as a whole.
Within this identification process, therapist and client encounter the dimension of the
Imaginary in resonance to the mirror stage. The Symbolic dimension is represented by
the therapist figure who supports the client in the mirror stage process to “hear himself
being heard”; this takes place in correspondence to the mirror stage, where the mother
figure, or any caregiver adult who holds and supports the infant, acquires a symbolic
quality. Furthermore, the therapist validates this audio image of wholeness, by creating
the music through the cues s/he received from the client in the here and now, assuming
the role of the big Other (Lacan, 1993). Music and artistic expression within the
therapeutic process are, in this case, a manifestation of the Symbolic, where music
functions as a language (Psaltopoulou-Kamini, 2015).
In Revolution in Poetic Language, Julia Kristeva (1974) introduces the Platonic term
Chora, which is a hypothetical space or phase which precedes the child’s acquisition of
language, and which, according to Kristeva, is prior to Lacan’s Mirror Stage theory.
Kristeva describes this preverbal chora as rhythmic, nourishing, maternal, and as formed
by what Freud defined as drives.
In order for symbolic and linguistic representations to exist, Kristeva suggests that there
must be a primary point, impulsive and emotional, an intrapsychic womb, a birthplace
(chora) of such symbolic representations, as found in the Platonic philosophy. In this
field, messages and information of the outside world are ‘filtered’ through the mother’s
body, figure and gaze, and take up residence as recordings within the subject’s psyche. In
this pre- linguistic field, the discourse is impressed and acquires meaning through its
prosody.
Expanding this thought, it could be suggested that the mental starting point of music,
which also assumes the function of a ‘language’ (Psaltopoulou-Kamini, 2015: 58) and
has a symbolic function, could also be located in this Chora. In this regard, and within
the process of music therapy, we can address this field of the psyche, which, albeit pre-
linguistic, yet enables language to emerge in any form, as, potentially, in the form of
music. The implications of such a suggestion would mean that even in cases where the
person lacks the ability to speak, as observed in many cases of autism, we can still come
into contact with this (preverbal) field, working on the individual’s ability to express
him/herself in another form of language.
This approach combines the psychoanalytic interpretation of psyche’s phenomena with
the humanistic principals, where the therapy is based on a person’s healthy and creative
potential, or, in other words, on the individual’s ‘possibility’ rather than their (his/her)
weakness.
The concept of small a (petit a) and the symbolic castration
When the baby is born, it loses the placenta which is about half of its body in weight and
volume, thus also losing his/her sense of nourishment and security. During the first
period of the baby’s life, it is the mother who gives meaning to his/her movements and
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expressions, offers him/her a sense of protection, warmth and security, and keeps
providing him/her with nourishment. The baby, for a while, continues to feel “one” with
her, desiring to experience this sense of absolute bliss s/he had when in the womb. This
lost “paradise” to which human desire is directed, and which cannot be precisely
conceived of and verbalized, is called by Freud (1915) ‘das Ding’ -the ‘Thing’- and
according to Lacan (Evans, 1996), it is precisely the object of desire, whose totality is
beyond symbolism.
“It is the mother-child union, within which the child experiences feelings of bliss similar
to those experienced when in the womb. For the rest of one’s life, the individual seeks
such moments. These moments may occur to some by means of sexual intercourse,
sublimation through the arts, addiction, sports or anything else creating similar feelings of
union. The person seems to lose sense of the limits of one’s body and existence as s/he
becomes “one” with anything else potentially carrying some meaning to him/her. Similar
feelings of bliss-ecstasy may be experienced by listening to or playing music in special
moments of one’s life” (Psaltopoulou - Kamini, 2015: 60).
The symbol a (being both the first letter of the word autre in French and the first letter of
the Greek word άλλος-other) is one of the primary signs of the Lacanian algebra,
introduced in Lacan’s teachings along with the L-scheme in 1955 (Evans, 1996).
The ‘small’ a (petit a) represents the little other as distinguished from the ‘big Other’ (A)
which constitutes the ‘radical’ otherness.
It is “the other which isn’t another at all, since it is essentially coupled with the ego, in a
relationship which is always reflexive, interchangeable. In schema L, then, a and a΄
designate indiscriminately the ‘ego’ and the ‘COUNTERPART/SPECULAR IMAGE’,
and clearly belong to the Imaginary order.” (Evans, 1996: 128)
This concept refers precisely to the symbiotic mother-infant relationship, the stage of
“normal autism” (Mahler et al, 1975) as already described above, where the infant does
not recognize his/her existence as somebody different from the mother and experiences
absolute bliss as if s/he were still in the womb (see sch. 1).
1. The L-scheme in Psaltopoulou-Kamini, 2015, 59
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Symbolic Castration
In order for the child to perceive him/herself as other than the mother and to enter to the
society, it is necessary that their symbiotic relationship, within which the child
experiences a kind of identification with her during the mirror stage, is disrupted. This
process of rupture is mediated by a third factor, which in psychoanalysis is called
symbolic castration.
The castration complex is the culmination of the oedipal complex, as Freud analyzes it,
and, according to Lacan, represents this determinant moment in the same way for both
sexes: the relationship with the phallus is established without taking into account the
anatomical difference between the sexes (Evans, 1996).
In his IV seminar, Lacan (1956-7) divides the oedipal complex into three phases.
In the Pre-oedipal phase, where the child begins to realize that s/he is not the mother’s
only and absolute desire, as the mother desires something beyond the child: the
imaginary phallus. S/he also realizes that if the mother desires something that must mean
that something is missing, or that she lacks something. Therefore, s/he tries to become the
phallus of the mother or for the mother.
In the next phase, the imaginary father (to be described below) will introduce the taboo of
incest, the prohibition. The child here will feel deprived; s/he will feel that s/he cannot be
‘one’ with the mother (incestuous desire).
The castration is complete in a third and final phase, with the intervention of the real
father, in the sense that he is the one actually owning the phallus; thus, the child must
accept that s/he cannot be the phallus for the mother (see sch. 2).
2. L-scheme in Psaltopoulou-Kamini, 2015, 61
Lacan argues that the castration process places the individual in front of a choice; to
accept castration or to deny it. The subject can reach a degree of psyche’s normality only
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by accepting castration. In other words, the assumption of castration has a ‘normalizing
effect’. It is the denial of castration that lies at the root of all psychopathological
structures. However, since it is impossible to accept castration entirely, a completely
‘normal’ position is never achieved. The closest to such a position is the neurotic
structure, but even here the subject still defends himself against the ‘Other’ by repressing
awareness of castration. This prevents the neurotic from fully assuming his/her desire,
since “it is the assumption of castration that creates the lack upon which desire is
instituted. … more radical defense against castration than repression is disavowal, which
is at the root of the perverse structure. The psychotic takes the most extreme path of all;
he completely repudiates castration, as if it had never existed” (Evans, 1996: 24).
1.10. The Father - Real, Imaginary and Symbolic dimensions
The Real Father is the carrier of castration, the one who contributes to the operation of
symbolic castration (Lacan in: Evans, 1996). The issue of the real father is not a matter of
biology, as it does not necessarily involve the biological father - even though it might as
well do - nor need the biological father necessarily be present. The concept of the real
father is intertwined with the concept of the child’s social environment. He is the one
who is said to be the father and the one who will give his name. The real father is
therefore the result of the entrance to language and not biology (Evans, 1996; Kyvelou,
2007).
“The imaginary father is an imago, the composite of all the imaginary constructs that the
subject builds up in fantasy around the figure of the father. This imaginary construction
often bears little relationship to the father as he is in reality” (Evans, 1996, 63). These
imaginary constructions can bear elements of the ideal-a God-protector, as found in
religions - or they may even present features of a frightening and ruthless figure, as the
imaginary figure of the father is the agent of the deprivation of the incestuous desire. In
any case, he is an omnipotent father.
“The symbolic father is not a real being, but a position, a function, and hence is
synonymous with the term ‘paternal function’. This function is none other than that of
imposing the LAW and regulating desire in the Oedipus complex, of intervening in the
imaginary dual relationship between mother and child to introduce a necessary ‘symbolic
distance’ between them […] The true function of the Father […] is fundamentally to
unite (and not to set in opposition) a desire and the Law.” (Evans, 1996, 63)
The intervention of the Symbolic Father as a third factor in the mother-infant symbiotic
relationship presupposes that the mother will accept him as such, that she will place the
Real Father within the child’s field as the one who owns the phallus, and, thus, the one
who can be declared a Symbolic Father.
Lacan names this significant function the Name of the Father. The child realizes, not only
that s/he is not the mother’s phallus, but also that s/he does not has it, as someone else
does. Thus, the signifier Name of the Father replaces the object of the mother’s desire -
the phallic object. This metaphor, in the sense of symbolism, is called by Lacan (1957)
paternal metaphor (métaphore paternelle) and helps the child enter to symbolism and
language (Evans, 1996; Kyvelou, 2007).
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The concept of the ‘big Other’ in Lacanian Psychoanalysis and its connection
with FA-fonie (‘FA – voice’) and the field of Music Therapy
According to the definition drawn from the Stanford Encyclopedia of Philosophy
(Johnston, 2018):
The capital-O (A) Other refers to two additional types of otherness corresponding to the
registers of the Symbolic and the Real. The first type of ‘Other’ is Lacan’s ‘big Other’
(A) qua symbolic order, namely, the overarching “objective spirit” of trans-individual
socio-linguistic structures configuring the fields of inter-subjective interactions.
Relatedly, the ‘Symbolic big Other’ also can refer to (often fantasmatic/fictional) ideas of
anonymous authoritative power and/or knowledge (whether that of God, Nature, History,
Society, State, Party, Science, or the analyst as the ‘subject supposed to know’ (sujet
supposé savoir) as for Lacan’s distinctive account of analytic transference). …There is
also a Real dimension to ‘Otherness’. This particular incarnation of the Real, about which
Lacan goes into greatest detail when addressing both love and psychosis, is the
provocative, perturbing enigma of the ‘Other’ as an unknowable ‘x’, an unfathomable
abyss of withdrawn-yet-proximate alterity.
Another interesting definition is provided by the Introductory Dictionary of Lacanian
Psychoanalysis (Evans, 1996, 136).
“The ‘big Other’ designates radical alterity, an other-ness which transcends the illusory
otherness of the imaginary because it cannot be assimilated through identification. Lacan
equates this radical alterity with language and the law, and hence the ‘big Other’ is
inscribed in the order of the symbolic. Indeed, the ‘big Other’ is the symbolic insofar as it
is particularized for each subject. The ‘Other’ is thus both another subject, in his radical
alterity and unassimilable uniqueness, and also the Symbolic order which mediates the
relationship with that other subject.”
FA-fonie (‘FA-voice’)
FA-fonie (‘FA-voice’) is an innovative musical term to support an innovative theory in
music therapy (Psaltopoulou, 2015). As a starting point for the formation of the theory we
find one of the most significant topological elements in Lacan’s teaching, the Borromean
node (Evans, 1996: see sch. 3).
3. The Borromean Node, retrieved from; https://www.lacanticles.com/2016/12/13/the-small-s-
big-s-distinction/
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According to Lacan (1977), the structure of the psyche consists of three core orders, the
Symbolic (S), the Imaginary (I) and the Real (R). These mental levels are in a relationship
of dynamic interaction and they are organized in a node, which indicates that the absence
of one would lead to the collapse of the rest; “each term is sustained only in its
topological relation with the others.” (Lacan, 1977: 89)
The unbreakable Borromean node concerns the topology of the neurotic structure. Its
disconnection is found in the psychotic structure, as well as in autism. In these cases, the
Symbolic field is missing.
According to Lacan’s teaching (1977), a factor that can limit psychotic development is
the creation of a fourth order-ring with the role of holding the three other, which he
named ‘sinthome’ (Σ, see sch. 4).
4. ‘Sintome’, retrieved from; http://stodivanimetolacan.blogspot.com/2012/11/sinthome.html
In music therapy, there is an analogy with Lacan’s ‘sinthome’ in the theory of FA-fonie.
The fields of the psyche can be connected, as the Symbolic is introduced, through the
clinical use of music, within the therapeutic relationship in a structured environment.
The term FA-fonie could be analyzed according to the phallic function of capital F, as the
autistic-psychotic structure of the psyche is symbolized, where the autistic or the
psychotic person is him/herself like a God who is not acknowledging any other law than
his/her own in its course towards the -f (‘minus f’), symbolized in Lacanian thought as
the ‘normal’ neurotic condition, where the person is well functioning in the society,
acknowledging and respecting the laws. At the state of FA-fonie we see a condition
where the autistic and/or the psychotic person is functioning like being at the normal
neurotic state (-f).
In music therapy, the individual recognizes the existence of other people through the
therapeutic relationshiS/he addresses the ‘Other’ realizing the existence of rules and
boundaries and can proceed to create social bonds. His/her voice is not aphonic (Lemoine
in: Psaltopoulou-Kamini, 2015) here, it is not without address. It is not completely phonic
as in the neurotic structure. However, it acquires a phonic quality, a quality of direction
and meaning. This voice is called Afoni (‘Aphonic’) which is with a capital A because it
is no longer the mute cry which the aphonic voice represents. It has become Afonie
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(‘Aphonic Voice’) with a resonant formed sound that belongs to a structure of signifiers
and involves the development of the mute-aphonic cry.
Correspondingly to Lacan’s ‘sinthome’ (Σ), that is, the existence of a formation that can
hold the fields of the psyche, in FA-fonie these fields -along with the Symbolic one- come
into contact. This connection is the ‘big Other’ (A). The individual’s inner movement
from a state of isolation to a new state, where s/he desires the encounter with the ‘Other’
(A), through the process of Music Therapy. Therefore, FA-fonie is a functioning state of
being, where the image of the autistic symptoms is significantly reduced. In the music
therapy process, the clients with a psychotic structure of the psyche or autism, start from
the phallic state (F-Φ) they already are at and gradually they connect with and express
their unique ‘Voice’ (‘Fonie-Voice’).They also connect and meaningfully interact with
the ‘Other’ (A) and then, they entered the ‘Symbolic’ order (FA is a symbol for the pitch
of F). Eventually, they experience functioning moments in life (-f. –φ, ‘symbol for the
normal neurotic’) with significant decrease of the psychotic or autistic symptoms,
reaching the state of FA-fonie.
Vignetes from a Relevant Case
The second part of the paper is devoted to a short reference on a relevant music therapy
case, supported by the aforementioned theories.
Brief history and background information
Alex was eleven years - old when he was reffered to music therapy. He is the only child
of a core family. As a baby, he was described as a hyperactive and restless baby. He said
his first words at the age of three and he developed a more structured but echolalic speech
at the age of four and a half. According to the pediatrician, signs of disorder began at the
age of three, and, eventually, Alex was diagnosed with autism.
Alex was attending a conventional school and his key strength was math. As his teacher
noted, when he was tired, he got hyperactive, he walked around the room reciting fairy
tales and, if he was angry, he slaped his cheeks. He also presented sudden changes in the
expression of his emotions; for example, he could move all of a sudden from anger to
laughter.
The clinical work of the therapist was based on the principles of the person-centered/
client-centered humanistic approach (Rogers, 1961), with a psychoanalytic understanding
of the phenomena (Freud, Lacan). It was also inspired by the music-centered approach of
Nordoff & Robbins (1977) and by the clinical techniques and interventions presented in
Kenneth Bruscia’s work Improvisation models of music therapy (1987).
The sessions took place at a Center for Creative Activities for Children with Disabilities,
once a week for a sixteen months period. For reasons of personal data protection, neither
the child’s name nor the exact name of the institute is mentioned. Both the recording and
the videotaping of the sessions were allowed after a written consent form provided by the
child’s mother.
Short description of the process
The music therapy process was completed in three periods; the first period lasted five
months, the second 8 months and the third 3 months.
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First Period: 5 months duration-‘Sense of Self’
When Alex first came to music therapy his emotional state was expressed through
stereotypical types of behavior and hyperactivity. He was extremely tense, he made no
eye contact, he expressed himself through uncontrolled loud screams or laughter and he
referred to himself in the second person.
During this first period of sessions, the therapist faced particular difficulties in her
attempt to approach him through music, and she had to be very creative in her
interventions. Due to the fact that the Institute could not provide a classical piano for the
music therapy sessions, the therapist used a keyboard, something that proved to be a
distracting factor for him. He wanted to listen to the prerecorded songs of the keyboard
repeatedly, or he would just press the on-off button or the other buttons in a stereotypical
way.
Vocal and percussion improvisation, at first, encouraged the establishment of a trusting
relationship between Alex and the music therapist. Gradually, the therapist introduced
small melodies and motifs at the keyboard, so as to mirror and also contain Alex’s body
language, moves, gaze and voice. The clinical interventions mostly used in the clinical
improvisations were mirroring, containing, holding.
Phenomena of transference and countertransference that occurred in this first period
played a significant role in the development of the therapeutic process. In this lingual
music therapy relationship, as soon as trust was established, Alex started to express
himself with spontaneity and genuine creativity, experiencing meaningful moments for
the first time in his life. His parents and the helping staff of the institution stated that
Alex showed major changes at all levels; he started to make meaningful eye contact and,
as he was getting a sense of self, he began to refer to himself in the first person.
Moreover, his destructive behavior diminished significantly, as he found a way to
sublimate this type of energy into creativity.
Second period of sessions: 8 months duration-‘Newborn Self’
In the following stage - due to Alex’s developmental changes - new issues came to
surface. These were related to his exhibiting dominant behavior and to his acting as if he
were hearing voices. As a result, the content of the sessions changed completely. He
started to experiment with linguistic boundaries, and he created his own auditory and
language formations - his own words - which he used in songs to express his new self.
Through the clinical supervision, the therapist observed that Alex would falsify and
reshape the words in such a way that they would perfectly fit into the musical flow and
the rhythmic and melodic phrases, as it happens, for example, in the jazz song. In this
way, he would create and express an absolute musical representation of his inner world.
The music therapist would play along with him, supporting and containing his singing
and his playing on the percussions, so as to set boundaries, and provide a safe nest to
protect this new self.
This phase lasted for about three to four months and then sessions stopped for the
summer break-for two and a half months.
In one of the first sessions after the summer break, Alex wanted to sing a precomposed,
popular song, which he renamed; “sothika” which means: “I am saved”. A very
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interesting point is that while singing the song he was playing with the accent of this
word. Sometimes he would sing «só- thi - ka» (I am saved) and at other points he would
sing «so-thi - ká» which means ‘entrails’, the insides of the body.
This particular session marked the end of a chapter in Alex’s therapeutic process and the
beginning of a new one.
Third period of sessions: 3 months duration-‘Whole Self’
In this new phase, major changes took place within the context of the sessions. Alex no
longer expressed the need to experiment with language while singing. He wanted to play
and sing together with the therapist popular songs, with respect to the exact form and
lyrics.
After a short period of time, Alex was ready to move to the next stage: he expressed his
desire to perform a song in front of an audience. It was the first time he felt the need to
share his meaningful moments with A, the big Other (Lacan, 1988).
In a following stage, clinical improvisation was taking up much less space of the session,
while Alex expressed his desire to work with the therapist on specific songs. He chose the
songs himself; he was listening to them with the therapist and then he searched for the
lyrics on the internet. Each song was ready to perform in two session; at first Alex and
the therapist listened to it together and talked a little about different ways of performing;
i.e. the therapist asked Alex how he would like the song to be heard, how to accompany
him on the piano, while suggesting him some alternatives etc.. In the second session they
played the song together. There were, also, times when they would return to free
improvisation (piano - drum), usually during the goodbye song.
Discussion-Conclusion
This brief reference on the case of a young boy with autism shows evidence that the use
of humanistic clinical work in combination with psychoanalytic understanding was very
effective for the child’s growth. The process of the therapeutic changes that occurred
through the music therapy journey indicates the boy’s movement towards more and more
moments of meaningful interaction and communication.
As the therapist, in this specific case, works clinically on the basis of the humanistic
approach and, at the same time, “reads” and understands the sessions’ information
through a psychoanalytic lense, as described in the model of music therapy synthesis
(Psaltopoulou-Kamini, 2015), she can be particularly clear about her clinical intentions,
enrich her creativity and provide effective therapeutic interventions. The humanistic
nature of the clinical improvisation could meet the here and now child’s needs with
unconditional acceptance and respect to his every moment choices. The psychoanalytic
understanding could keep the three dimensions of the psyche - the Real, the Imaginary
and the Symbolic- in a balance in the here and now while the name of the father could
offer the child the necessary safety and boundaries for the emergence of his new,
spontaneous and creative self. In this sense music becomes a living organism, a third
person in the therapist-client relationship.
Through this kind of clinical improvisation, Alex moved from a ‘silent’ stage of isolation
- characterized by a solitary and stereotypical behavior - to the discovery of his unique
self and voice leading to spontaneity, to creative and meaningful self-expression, as well
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as to inclusion. Alex felt also enough safe to share his new self with significant others
outside the music therapy room. As his parents and helping staff stated, his
communication and socialization skills were significantly enhanced.
From a psychoanalytic overview of his therapeutic journey, Alex, an autistic boy, came to
music therapy with a distorted sense of self while experiencing a severe social interaction
deficit. Through the interpersonal relationship created within the context of the music
therapy sessions and through the resulting artistic expression, a mental place (sinthome)
(Lacan, 1977) seemed to start being organized within himself, keeping the fields of the
psyche in an interacting relationship with each other: the Symbolic, the Imaginary and the
Real, as described in FA-fonie (Psaltopoulou-Kamini, 2015). Thus, Αlex seemed to be
acquiring a sense of self, a vivid personal voice and a strong desire. As he reached the
state of FA–fonie (Psaltopoulou-Kamini, 2015) he could be a whole person, expressing a
strong desire to share his new creative self, to communicate with other people and to
engage in meaningful interaction. He was finaly able to build functioning human
bondings.
Moving on to the conclusion, the importance of enriching the literature and research on
issues related to the interconnection of psychotherapeutic approaches (psychoanalytic,
humanistic, etc.) is underlined. Further research on this issue is higly recommended.
Researching and fostering the interconnection of the various psychotherapeutic
approaches, could enrich the mental experience of the therapist, providing him/her with
new tools valuable to his/her clinical work.
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[213]
The Therapeutic Relationship as a Fundamental Condition
for Change in Music Therapy
Psaltopoulou Dora, Laschos Apostolis
Abstract
According to many researchers in psychotherapy, the quality of the therapeutic
relationship is a strong prognostic parameter of the therapeutic change, regardless the
therapeutic approach (Cooper, 2008; Beutler et al., 2004; Wampold, 2001). Music
therapy encourages relational experiences based on the expressions and desires of the
individuals. Invites the individual to express, interact, and communicate, verbally or non-
verbally, through music. Music enhances interaction among the senses, among emotions,
and creates a dynamic system in which the body, the brain, and the environment interact
simultaneously (Lim, 2007). The aim of this study is to highlight the significance of the
therapeutic relationship, between the therapist and the client in music therapy, in
improving the latter’s quality of life. The issue will be examined through relevant experts
from a pilot study on the music therapy process of a 9-year old girl in the autism
Spectrum. The data collection, process and analysis followed the descriptive
phenomenological analysis.
Key words: music therapy, psychotherapy, therapeutic alliance, therapeutic relationship,
autism, communication
Introduction
Children with Autism Spectrum Disorders, otherwise autism, often experience deficits in
their skills concerning socialization and verbal communication with others. The positive
impact music has in children with autism, their innate perceptual ability, their natural
response to music, their strong desire for music that in many cases creates positive
experiences for their growth, are often mentioned and even highlighted in the worldwide
literature. However, most researchers investigate music’s influence in areas such as the
development of speech, social and communicational skills, without exploring in depth the
role of the therapeutic relationship between the child and the music therapist.
This study has focused on investigating the relational parameters of verbal psychotherapy
such as therapeutic alliance, parental responsiveness and interpersonal synchrony
(Mössler et. al., 2017), as they have an impact on the music therapy process of a 9-year-
old girl with autism.
The research questions are:
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Could these relational parameters apply at the therapeutic relationship in music therapy
with a girl in the autistic spectrum?
How could they be developed?
How could they enhance social and communication skills?
In this paper, the relational parameters are investigated through the tri-dimensional
relationship of ‘Therapist-Music-Child’ in three main areas:
i) the relationship of the child with the music
ii) the role music plays in the relationship between the therapist and the child, and
iii) the relationship between the therapist and the child.
The therapeutic relationship in Psychotherapy
In 1913, Freud introduced the term “therapeutic alliance” as a synonym to the term
‘therapeutic relationship’. This term refers to a kind of alliance/cooperation, which is
developed between the therapist or analyst and the person in therapy or the analysand, in
order to work on the problem of the latter (Stalikas, 2004), as well as on the safe ground
to support the therapy (Bowlby, 1988). As a concept, the therapeutic alliance includes
three parameters: the bond, the goals, and the therapeutic activities (Bordin, 1976). The
term “therapeutic relationship” refers to the relationship which is established between the
therapist and the person in therapy from the first moment of their collaboration (Stalikas,
2004) and, according to Mahoney (1991), it constitutes one of the three dimensions of
every phychotherapeutic approach.
As Fonagy (2001) (as cited in Sonkin, 2005) believes that the non-verbal communication-
most important for music therapy- between the therapist and the person in therapy, is of
great significance to their communication in psychotherapy. Something relevant happens
in the relationship between the parent and the child from infancy, when speech is not
developed yet. The role of the therapist, as it happens in the case of the parent, is to find
the non-verbal cues of the child, observe them, interpret them and respond to them
appropriately. The ability of the therapist to reflect the emotional experience of the
person in therapy, to interpret and process the nonverbal cues is fundamental in
establishing a safe bond with attunement and responsiveness from both sides (Sonkin,
2005).
Bordin (1976) argues that the person in therapy, when well allied to the therapist,
responds more positively to the therapist’s techniques and interventions. On the other
hand, when the therapist’s interventions are well planned and effective, the trust of the
person in therapy is enhanced and the therapeutic alliance in the relationship is
strengthened. Therefore, according to Bordin (1976), the therapeutic relationship is not
considered therapeutic in itself, but is more like an important dimension that helps the
person in therapy accept the therapy more easily.
Carl Rogers (Psaltopoulou, 2005) has a different point of view. He writes about an
authentic, sincere, non-judgmental, with a positive regard and unconditional acceptance
therapeutic relationshiThe necessary actions and conditions for a successful therapy are
established through the therapeutic relationshiTherefore, the relationship itself becomes
the therapeutic agent in the psychotherapy process. Rogers developed the Person
Centered- Client Centered Therapy and was mainly based on the concepts of humanistic
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psychology. His basic assumption was that everybody is worthy of trust, that the clients
are able to be aware of themselves and solve their problems, without the therapist’s direct
intervention, because they are able to orient themselves towards self-growth, as long as
they are engaged in a therapeutic relationship (Psaltopoulou, 2005).
As Beutler et al. (2004) & Cooper (2008) mention, the quality of the therapeutic
relationship in psychotherapy is a strong prognostic factor of the therapeutic change,
regardless of the therapeutic approach (Wampold, 2001). In a recent study on autism, the
relational factors in a therapy setting, such as therapeutic alliance, parental
responsiveness and interpersonal synchrony, were especially emphasized as significant
prognostic factors of potential results (Mössler et. al., 2017). However, there are very few
data on how these factors contribute to the overall changes of the autistic features due to
the minimal social interaction of the individuals with autism (American Psychiatric
Association, 2013, as cited in Mössler et. al., 2017). If we assume that social interaction
is a process that involves at least two individuals in a psychotherapeutic process or in a
music therapy process, for example the client and the therapist, then it is of special
importance to investigate the interactive parameters that influence the way persons with
autism participate or fail to engage in relationships (De Jaegher, 2013, as cited in Mössler
et. al., 2017).
Music Therapy
Music has now been widely recognized as a therapeutic medium since the very old ages.
Maybe it was even the first art form that was used as a therapeutic means. More
specifically, many specialists used music as a means for relaxation and pain relief, as well
as a therapeutic medium not only for physical but also mental illnesses during many
historical periods and in different cultures (Alvin, 1975). Nevertheless, music therapy
started as an organized profession after World War II, around 1950. Since then,
specialized educational programs in universities, both in the States and in Europe, at an
undergraduate and postgraduate level, as well as relevant associations, and special
research programs were founded (Bruscia, 1989).
Music therapy, according to the American Music Therapy Association (2014), is a main
or complementary therapeutic intervention, through which music is implemented, in an
appropriate and evidence based way, by a music therapy specialist, so that it will help
children, adolescents or adults in a therapeutic relationship, to improve the quality of
their lives. Bruscia (1989) mentions that music therapy is a tri-dimensional relationship
of “science, art, and interpersonal relationship” and, of course, deep knowledge and
appropriate training in psychology, psychotherapy, and music is required (Psaltopoulou,
2015). Through the Music Therapy interventions the following are achieved (American
Music Therapy Association, 2014):
• well-being
• stress management
• pain relief
• physical rehabilitation
• expression of emotions
• enhancement of memory
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• improvement of communication
According to Nordoff & Robbins, there is a ‘music child’ inside everyone that at any
time and situation appears in a natural way, as an instinct. Every human being, regardless
of the problem they may deal with, is responsive to the sounds and the musical patterns
showing that s/he naturally understands the structure and the characteristics of music
(Bruscia, 1987).
In music therapy, and more specifically in interactive music therapy, the music therapist
and the child-client-music child together create music so that they develop a more
communicative relationship, a two-way lingual relationship that they experience in the
here and now. The music therapist uses the musical clinical improvisation in a way that
s/he accepts the child, involves it, and empathizes with it, while conveying through music
what the child expresses in a non-verbal way and cannot communicate verbally
(Psaltopoulou, 2015).
The music therapist listens carefully and responds to the ‘aphonic’ cry (the loud or silent
cry that does not address anyone) of an individual as if it was “phonic”, that is, as if it
was addressed to somebody (Psaltopoulou, 2015, 63). Music therapy resembles a family
of three that provides with laws and limits, warmth and acceptance, and unlimited
possibilities for self-expression and creativity through music as an art in service of the
human existence (Psaltopoulou, 2013, as cited in Psaltopoulou 2015, 63).
According to Psaltopoulou (2015, 63), the music therapist: listens with unconditional
acceptance, empathizes, is genuinely present, participates actively, interprets sounds and
physical expressions, sets limits, supports, contains and holds, encourages, suggests.
Music experiences can offer an existential experience with the flow in meaningful time,
as well as they could actually be the symbol, the environment, the limits set by music’s
structures, the mirror of the child-therapist relationship, the projective object, the
companionship and engagement, the aesthetic pleasure, the vitality. The client
experiences: freedom in expression, self-awareness, insight, acceptance, experience of
the self as a whole, peak experiences of wholeness, ecstasy and joy, anger, fear, pain,
surprise, beauty and inspiration, intimacy with self and others, inner transformation.
Through the process of music therapy, Nordoff & Robbins (1977) mention that the
individuals are able to live up to their deepest desires and sublimate their thoughts
coming from the illness and all the negative perceptions to a creative self.
The Therapeutic Relationship in Music Therapy
Breath, physical movement, the sounds the client expresses in the process of music
therapy, are/create/produce music. The musical, clinical improvisation is used so that the
music therapist meets with musical flexibility the client at the level that s/he is at the
moment. This is usually realized through the musical modes (ancient modes such as the
dorian, the phrygian, the lydian etc.), scales (major, minor, pentatonic, whole tonic etc.)
musical instruments such as piano, guitar, percussions, the human voice, as well as
various other stringed and brass instruments. That way the music therapist creates the
appropriate non-threatening atmosphere and ‘mirrors’ the ‘music child’ of the participant
(Bruscia, 1987).
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The musical elements, such as the rhythm, the dynamics, the timbres, the structure-forms,
the melodic motifs work as the tools in the “Therapist-Music-Child (Music Child)”
relationshiIn music therapy, the therapist uses the musical elements in order to give
meaning to the ‘here and now’ needs of the child, so that the therapeutic relationship can
be established (Psaltopoulou, 2015).
Music therapy is an important therapeutic approach for individuals with autism, as it
enhances the relational experiences based on their emotional expressions and their own
areas of interest (Carpente 2016; Geretsegger et al., 2015; Mössler et al., 2017). It
influences significantly their most central non-developed functions, such as their
communicative skills and social interaction (Geretsegger et al., 2015; Wheeler et al.,
2008). It is often assumed that the relational factors in music therapy, especially the
musical emotional processes of attunement between the child and the music therapist
contribute significantly to the therapeutic process (Geretsegger et al., 2015; Schumacher
et al., 2013).
As it was mentioned above, individuals with autism very often deal with deficits in their
verbal communication and socialization; as a consequence, they find it very difficult to
express and communicate their needs. In this study, music is the medium so that the child
with autism can express non-verbally what she cannot express verbally, what she feels in
the therapeutic relationship with the music therapist. It may be difficult for children with
autism to engage in a therapeutic relationship, in some cases impossible, due to their
deviant behavior and their lack of social skills. On the other hand, the music therapist, in
his effort to meet the child in her emotional level uses the techniques of the mirroring,
imitation, involvement, and support through music, in order to develop the following
relational parameters: the therapeutic alliance, the parental responsiveness and the
interpersonal synchrony (Mössler et. al., 2017).
This encounter of the music therapist with the child in her psycho-emotional level aims at
the musical-emotional attunement. The musical-emotional attunement enhances the
organization and regulation of the intra and interpersonal experiences, in a similar way
with the development of the human interaction and contact during early childhood. This
special participation in the musical interaction allows the child to experience various
sides of the concept of “relating” and can help to facilitate understanding and connection
between the emotional situations and the relational intentions in social interactions
(Geretsegger et al., 2015; Schumacher et al., 2014; Trondalen, 2016).
Methodology
The qualitative methods offer important research tools for psychotherapy, as well as for
music therapy, as they focus on subjectivity, on personal experience, on deeper
comprehension and on holistic exploration of the phenomena (Rennie, 1994).
McLeod (2011), Morrow (2007), Morrow & Ponterotto (2005) (as cited in Morrow,
2007) state that the qualitative methods are very well connected to the psychotherapy
values and practice, as they offer space for freedom of expression while recording with
objectivity the client’s reality and experience. The emphasis is rather on ‘how’ a
phenomenon is evolving than on ‘why’.
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Wheeler & Baker (2010), McFerran (2009), Daveson, O’Callaghan & Grocke (2008), as
well as Amir (1993) (as cited in Ludlam, 2011, 15) agree that qualitative methods are
entirely compatible with the music therapy philosophy and practice.
48 individual weekly music therapy sessions were carried out and videotaped in a
specially adapted room with percussions, brass instruments, guitar and piano, with Fani, a
9-year old girl in the Autism Spectrum. The main intervention was clinical improvisation,
inspired by the Music centered/Humanistic approach of Music Therapy (Psaltopoulou,
2005) and based on Carl Rogers’ Client-centered/ Person-centered Theory (Pervin &
John, 2001). The data collection, process and analysis followed the descriptive
phenomenological analysis (Georgiadou & Kostitsis, 2012).
Since the therapeutic relationship is based on hard to measure music experiences of both
therapist and client, qualitative research tools have been selected to investigate the
relational factors of the therapeutic alliance, the parental responsiveness and the
interpersonal interaction, through the tri-dimensional relationship of therapist-music-
client in three areas:
1. The child’s relationship to music (music is used as a means for the establishment
and development of the therapist-child therapeutic alliance).
2. The role music plays in the music therapist-child relationship (music is used as a
means for parental responsiveness).
3. The music therapist-child relationship (music as a means of interpersonal
interaction and resonance).
Findings-Fani’s key-moment
This chapter provides a report on Fani’s denial in the beginning of the sessions, a short
description of the key-moment that opened the path for the establishment of trust in the
therapeutic relationship and an overall narrative of her growth.
Fani is a 9-year-old girl with autism. She has very little verbal communication,
stereotypies, hyperactivity, self-aggression and self-harming. She participates in music
therapy individual sessions. During the first sessions she shows denial to participate. She
is moving restlessly and meaninglessly in the space with stereotyped hand movements
towards whatever is surrounding her. The music therapist’s initial clinical intention
through music is to meet, match and resonate with her psycho-emotional level, to reflect,
hold and contain her emotions through piano and voice improvisation, aiming at making
contact and engage in interaction; with no obvious results though, most of the times.
In the 12th session Fani starts crying and hitting herself furiously as she is sitting on a
chair. She expresses herself with the word “neither”, showing denial towards the music
therapist’s interventions, either verbal or non-verbal. The therapist uses pauses, allowing
her space for her denial while accepting her desire for no activity ore sound during a large
time period. After a while, she stands up and falls down lying on the floor. Through
music in low dynamics and slow tempo, improvising quite legato, the therapist is making
an effort to create a safe therapeutic environment. Fani was very upset in the beginning of
the session; therefore the moment she fell down on the floor quite inspired the therapist to
provide for her a sense of caring, hugging, understanding and containing of her mood
through soothing music. Her face from being gloomy, full of tension, turns calm, and her
body posture seems careless and relaxed, showing that she has been enjoying a
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meaningful moment. She starts beating rhythmically the carpet with a stick in a way that
shows she is finally connected to the music and her creative side. Towards the end of that
session, during the musical farewell, Fani reacted by saying: “bye daddy”. She may have
had a kind of transference: the face of her father to the face of the therapist. According to
the therapist’s assumption, Fani may have experienced the same acceptance and care she
received from her father.
From the following session and on, Fani decided to play music. She was approaching the
piano and she was playing with tension and loud; she was hitting the keyboard hard,
expressing intense emotions; sometimes it seemed as anger, some other times as
enthusiasm, enjoyment of the moment, which was in fact pleasure. After a period of time,
she was eager to meaningfully respond to the therapist’s musical interventions, to interact
with him, to communicate more verbally and non-verbally while maintaining eye contact
and engaging with obvious pleasure and enthusiasm to the ‘call-response’ activities.
Discussion
According to the findings all three relational factors concerning the therapeutic alliance,
the parental responsiveness and the interpersonal interaction, through the tri-dimensional
relationship of therapist-music-client will be briefly discussed.
The session in which Fani cried, then fell on the floor and started tapping at her own
rhythm, is considered to be a pivotal moment of therapeutic change for her growth. From
that moment on, the trust in the therapeutic relationship was established and provided a
stolid basis for the whole therapeutic process to develoFani had significant experiences of
feeling enough safe as to trust the music therapist by accepting and responding positively
to his interventions, by cooperating and interacting with him; this is the ‘therapeutic
alliance’ between the therapist and the person in therapy that Freud introduced in
psychotherapy (Stalikas, 2005). The permissive and non-directive attitude of the music
therapist (Rogers, 1957), was decisive for the establishment of the therapeutic
relationship.
As far as “parental responsiveness” (Mössler et. al., 2017) concerns, it seems that Fani
felt that her needs were understood and met, as they were mirrored in the clinical
improvisation. She felt accepted by the music therapist who, through his genuine
presence in the here and now and his empathic attitude, supported, contained her mood
and her emotions musically, and encouraged her to move on the therapeutic change.
Before this session some things seemed to merely happen without being fully
experienced, without a meaningful mutual interaction. In the course of the process
though, evidence shows that Fani progressed.
The third factor -the interpersonal interaction in synchrony and resonance- was realized at
first through music -one of the three dimensions of the therapeutic relationship- at the
place of a living organism. When Fani moved down on the floor and started tapping at
her own rhythm, she initiated a clinical improvisation. Nevertheless, she did not have any
conscious intention or perception that her tapping on the floor was revealing her mood,
her level of energy and her personal choice about the way she desired to live in the music
therapy room in the here and now. Without her knowing, Fani expressed her desire to
make contact with the therapist, who immediately responded by mirroring her music. It
was the first time she initiated a rhythm and engaged in a music interaction with the
[220]
therapist. It seems that it was safer for her to interact with the therapist through music
than with him in person. Fani heard herself being heard by the music that the therapist
provided, and she was led to connect with her inner music, with the creative, healthy side
of hers. As a result, she felt safe enough to make contact with the person who played this
music that was familiar to her, the therapist. She moved towards the piano, next to the
music therapist, engaging in ‘interpersonal synchrony’ (Mössler et. al., 2017), primarily
through music, which was her main means of expression. The non-threatening
therapeutic relationship created the path to a meaningful encounter from music to the
therapist and provided a way out of her isolation, stereotypes, self-harming, social silence
and hyperactivity. Her movement to the piano was a strong statement of her conscious
desire to share the instrument with the therapist with her clear intention to express herself
creatively, to share her feelings, to stay focused on call-response activities and to engage
in meaningful communication.
Conclusion
Evidence shows that the therapeutic relationship functioned as the fundamental condition,
as the therapeutic agent, that led Fani to a significant personal change. During the music
therapy sessions, as she was getting a sense of self, Fani could be more of herself and
express herself as she really desired. Music was the medium so that the music therapist
would meet Fani each time at her psycho-emotional level, turn her mood into music,
mirror her mood and approach her aiming at the musical and emotional attunement. As
Rogers states (Corey, 1991, 205, as cited in Psaltopoulou, 2005), the effective course of a
therapeutic process depends on the attitude and the personal attributes of the therapist, as
well as, certainly, the quality of the relationship created between the therapist and the
client.
Music was the only means that encouraged Fani to feel safe enough to express her
emotions, to interact and communicate with the music therapist. It was the object of
projection of her inner world. She was creating different music at her moments of
tension, different music at her moments of peace, different music at the moments of her
interaction with the music therapist. In Music Therapy though, the use of music alone is
not enough. The most important parameter is the bond in the relationship. Through this
relationship the client’s needs become understood, as she can express more freely herself
as she engages in meaningful interaction with the therapist. The clinical intention of the
music therapist is not to play some notes but connect with the client’s needs for personal
growth, meet her where she is at each time and at any way she chooses. That way these
notes have meaning for her, for her condition and for her overall growth.
Therefore, the relational factors of the therapeutic relationship -the therapeutic alliance,
the parental responsiveness and the interpersonal interaction- through music led Fani to
move out of her silence and engage in a functional bonding.
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The Contribution of Psychodynamic Music Therapy in Children
who have been Sexually Abused
Dora Psaltopoulou, Katerina Mavrodi
Abstract
Children who have been sexually abused, thus traumatized, avoid talking about their
traumatic experiences in verbal psychotherapies. Music therapy provides the safe
environment for the children to express and share nonverbally and verbally their
emotions. Among other music therapy approaches, this paper aims to investigate and
focus on the contribution of psychodynamic music therapy with children who have been
sexually abused. A narrative review literature is used. The research papers published up
until today, on psychodynamic music therapy approach with children who have been
sexually abused, have been studied. The underlying philosophy, the techniques, the use of
clinical improvisation, the use of symbolism, and the safety boundaries have been also
examined. Music therapy provides a safe environment for the children and allows access
to the traumatic experiences. The philosophy of psychodynamic approach about the
processes of the unconscious material have been found very useful to the children who
tend to repress the traumatic event. Evidence shows that children in psychodynamic
approaches are able to reveal, express and process their repressed material in nonverbal
and verbal ways. While the children express their feelings through music in a therapeutic
relationship, they have the chance to take the responsibility to move on a healthier
growth. Psychodynamic music therapy seems to be an appropriate approach for this
population. Further clinical work and research is recommended.
Key words: Music, therapy, psychodynamic, psychoanalysis, children, sexual abuse.
Introduction
This paper aims to investigate, through a narrative literature review, the overall
contribution of the psychodynamic music therapy approach with children who have been
sexually abused. Indicative reports concerning the legal actions that have been taken so
far on the sensitive subject of the child-victim of sexual abuse at an international level
show evidence of the difficulties that the legal communities face to effectively deal with
the issue. Furthermore, the children might have experienced psychological trauma with
negative consequences in their growth. Music usually can make all children feel at
‘home’ and may have a positive impact on the brain. According to the literature review,
the psychodynamic music therapy approach provides a safe and non-threatening
environment with creativity, playfulness and symbolism to enhance the children’s
potential for wellbeing.
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Since music therapy is a new profession worldwide, some special issues of the music
therapist’s training are also mentioned briefly.
Part of this paper is retrieved from an unpublished music therapy master thesis (Mavrodi,
2018).
Child sexual abuse
In the recent years, at an international level, two important initiatives have been
undertaken:
1) The International Convention on the Rights of the Child (drafted by the UN in
1989) protects the rights of children.
2) The World Health Organization raises the problem of violence against children to
a public health problem and strongly encourages relevant research projects, trainings and
political interventions (WHO & ISPCA, 2006).
Sexual abuse of children is an international phenomenon and it is observed in all social
classes (Αvagianou, Asonitou & Markos, 2016: 38). Strehlow (2009: 169) provides a
definition about child’s sexual abuse;
“Firstly, child sexual abuse is any sexual action with or witnessed by a child. Secondly,
the perpetrator abuses his authority and power and also abuses his close and trusting
relationship to the child. He is satisfying himself at the expense of the child. Finally, a
central point is that the child is not allowed to talk about the abuse.’’
More specifically
“There are four parameters of abuse: neglect, physical abuse, sexual abuse, and emotional
abuse, with the understanding that in many cases when one type of abuse is occurring
there may be others operating also.’’ (U.S. National Clearinghouse on Child Abuse and
Neglect, as cited in Edwards and McFerran, 2004, 338).
Furthermore, the event of abuse is very difficult to disclose. Children usually do not talk
about it for the following reasons,
“a) due to the shock of the overall experience b) because they are threatened by the
perpetrator c) because the emotional stress fragments the details.’’ (Strehlow, 2009, 168)
Concerning the adult survivors of sexual abuse, Jane Edwards & Katrina Mc Ferran
(2004) stress out the fact that when some clients begin music therapy sessions, they are
not fully aware of sexual abuse that happened in the past. But even if some of them are
aware of this traumatic past event, they do not realize the effect that continues to
influence their lives.
Beka (2006) reports that the perpetrators are usually familiar to the child, they may
belong to the wider family environment or they are members of the close family
environment. The author also states that only a 10% -30% of perpetrators are persons
unfamiliar to the child (2006, 357).
The author (Beka, 2006: 356) also reveals the fact that children with a history of sexual
abuse very rarely testify. And even if they do, they often withdraw their testimony either
after an adult’s intervention or for other reasons. Since the incidents that are officially
recorded are much less than the reality, it is obvious that the biggest and most important
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issue has to do with children who usually hide their sexual abuse. Therefore, the problem
cannot be officially measured.
Another important issue is that of the legal evidence of the child’s sexual abuse. The
credibility of the child’s testimony lacking forensic evidence is a major issue. The
protection though of underage children through specific legislation is of most importance.
Due to the fact that children are invited to testify in various settings they experience
secondary traumas and feel re-victimized. For these reasons, in the United Kingdom, in
1992, a special protocol was drafted, called the “Memorandum of Good Practice on
Video Recorded Criminal Proceedings’’ (Themeli, 2014).
It provides a thorough description of the interviews proceedings and it is addressed to all
those who work with underage victims-witnesses of abuse. Cyprus adopted this protocol
and, since 2016, the Child’s Home, a caretaker institution for children-victims of sexual
abuse, has been applying it (Philenews, 2019). As a result, children testify only once, the
interview is video recorded, and it can be used by any legal setting.
In Greece, only in 1992 the appropriate legal framework for the protection of these
children has been established under the Law 2101/1992. This Law was modified in detail
by Law 4226/2014 (Government Gazette 137/Α/12-06-2014), in order to incorporate the
EU Directive 2011/93/Ε.U. about the child pornography on the internet. Also, the
Children’s Health Institute has published a guide on the recognition and treatment of
child abuse and neglect, where it is stated: “in Greece, a study by the Agathonos &
Ferreti (1992), in 18-20 year old students, showed sexual intercourse before the age of
18, 17% in girls and 7% in boys” (Agathonos, 1998, 27). This guide adopts the model of
Filkenhor (Filkenhor, 1994), which defines the conditions of children’s sexual abuse.
Unfortunately, so far, there hasn’t been established any special examination system for
underage witnesses, which raises the need for a special code of ethics, as well as for the
conduction of further research. And, although, Zafeiris and Mouzakitis (1990) identify
the problem in their research of 1987 and they report that there are 1194 known cases of
sexual abuse in our country per year, there is not enough research on child sexual abuse.
Psychological trauma
A psychanalytic definition is provided by Garland (1998, 9), “Trauma is a kind of wound.
When we call an event traumatic, we are borrowing the word from the Greek where it
refers to a piercing of skin, a breaking of the bodily envelope.’’
Interestingly enough, Triplett, Tedeschi, Cann, Calhoun & Reeve (2011, 400) define with
simple words the meaning of traumas, stating that they “are considered to be events
which have negative consequences such as causing persons to fear for their lives or the
lives of loved ones, causing physical or emotional distress, and/or causing major
disruption in their lives”.
According to Tselepis (2011: 18), “a potential psychotraumatic experience is not a
disorder in itself and does not constitute necessarily a pathological situation. However,
the appearance and perseverance of specific reactions and symptoms is an indication for
the development of some kind of post-traumatic stress disorder condition.”
Additionally, Van der Kolk (2002) claims that children who have been sexually abused
are likely to experience post-traumatic stress disorder syndrome. They can possibly
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struggle with trauma, which it can be the cause not only for psychological distress, but
also for the experience of some kind of posttraumatic growth (Joseph & Linley, 2008;
Tedeschi & Calhoun, 1995).
“It has been assumed that the experience of trauma often threatens or challenges the core
beliefs individuals hold that define their assumptive worlds. Posttraumatic growth is a
potential consequence of the cognitive effort to redefine those beliefs and to rebuild the
assumptive world.” (Calhoun & Tedeschi, 2006; Janoff-Bulman, 1992, 2006, as cited in
Triplett et al, 2011, 400)
This paper examines the contribution of music therapy as a therapeutic intervention that
provides a non-threatening environment with meaning and playfulness for the children to
feel safe enough to express and sublimate in forms of arts their negative feelings and
experiences, aiming in well-being.
Music, brain and psychological trauma
Through the literature review, it has been found that there has been extensive research on
the trauma’s affect in brain functions (Bremner, 2007; Karl A, Schaefer M, 2006;
Kaufman & Plotsky, 2000; Rinne-Albers, 2013; & Nemeroff, 2011; Southwick, Davis,
Aikins, Rasmusson, Barron, Morgan, 2007; van Harmelen AL & van Tol, 2010). A
special emphasis is given on research about music and the brain, whereas only a few
studies investigate the functions of the brain during a music therapy session (Fachner,
2019; Sang Eun Lee, 2013).
It is worth mentioning, in this paper, some important research discoveries about the
trauma, the manner it is captured in the brain, as well as about the ways the traumatic
experiences are accessed and processed in music therapy.
Julie Sutton & Iain McDougall (2010, 91) argue that
“the amygdala, hippocampus and frontal lobe are of greatest importance to us with
regards to emotion, trauma and music. Amygdala in combination with the
hypothalamus is essentially a center for such as our instinctual response to fear,
and sexual and aggressive impulses. The hippocampus is the storage for initial
conscious memories, including the physical aspects of any event or experience.
The amygdala may also act as the location of the unconscious memory.”
In a few words, the amygdala and the hippocampus work together to enable a person to
manage a traumatic event.
Andersen and Tomata (2008) in their research through MRI scans, about the effect of
childhood sexual abuse on regional brain development, found that the hippocampal
volume and the corpus callosum were reduced, while the frontal cortex was attenuated. It
seems that the vulnerability of the brain in association with traumatic experiences, is a
very crucial field for further investigation.
According to Van der Kolk and Saporta (1991), there is a serious difficulty in verbal
disclosure about the trauma, especially at early ages. The childhood traumatic
experiences, due to the immaturity of the brain functions, cannot be easily translated to a
symbolic language, which is indispensable for the linguistic retrieval. As a result, the
emotional expression and verbal therapy are impeded.
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Therefore, it is essential to offer the children a safe environment with easy and playful
access to the unconscious material, with a variety of means for expression at all levels, as
it is the case of the arts.
“The arts, not as an object, but rather as a living organism, when being the means and the
medium in communication processes at individual and/or group settings, guided by
experienced expressive arts psychotherapists, inherit a primary therapeutic quality,
facilitating, as well as encouraging personal change and growth. The re-creation of the
psycho-social conditions through the arts, in a consistently safe environment, offer
unlimited possibilities in the awakening of every human’s being innate ability for
creativity, unravelling the inner ‘artist’ (Bloom, 2006; Jennings & Minde, 1993; Karkou
& Sanderson, 2006; Laban, 1950, 1966; Stanton-Jones, 1992; Landy, 1993; May, 1975).
Freedom of imagination and creativity in verbal and non-verbal modes offer the
“potentially unlimited” in paths for self-discovery, self-expression, self-awareness and
self-actualization” (Psaltopoulou et al., 2014, 94).
Among all art forms, music can be a key tool in the tri-dimensional ‘therapist-music-
child’ relationship in music therapy.
“Music Therapy is a tri-dimensional therapy in a polyphonic relation between three
components: science, interpersonal process and art. In this “fusion of music and therapy”
science offers “objectivity, collectivity…and truth. Interpersonal process offers empathy,
intimacy, communication, reciprocal influence and role relationships. Art offers
subjectivity, individuality, creativity and beauty” (Bruscia, 1989, 8).
In this sense, “Music Therapy seems to be like a core family with science playing the role
of a guiding father, the interpersonal relationship playing the role of a caring mother and
the art playing the role of a creative child” (Psaltopoulou, 2013, 10).
Through music, the children can have a non-threatening access to unconscious material,
and they can express in a symbolic language what cannot be expressed in common verbal
ways of communication.
In this paper the emphasis is rather on the psychodynamic music therapy than on any
other approach, since it is very important to have access to the unconscious material of
the traumatized children.
The contribution of psychodynamic music therapy with children
who have been sexually abused
The spirit of psychodynamic music therapy and practice
The psychodynamic music therapy approach shapes its theoretical background based on
psychoanalysis. According to Isenberg (2015), the ideas of Freud, Jung, Winnicott, Bion,
Klein, and of other schools of psychoanalysis have inspired music therapists to use
principles, techniques and interventions aligned with psychodynamic and/or
psychoanalytic approaches. Among the first music therapists who transferred the
psychodynamic/psychoanalytic ideas in music therapy clinical practice were Juliette
Alvin and Mary Priestley in the UK, and Florence Tyson in the USA.
Jolly (1998) formed a music therapy model of practice for witnessing the healing of adult
survivors of childhood sexual abuse. Rogers (1992, 1995, 2003), Robarts (2003, 2006,
2009), Strehlow (2009, 2019), Caughman (2012), Amir (2004), Thompson (2007),
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Henderson (2007), Wesley (2012), Schönfeld (2012), examine the influence of
psychodynamic music therapy on children who have been sexually abused. Bruscia
(1991), Tasney (1993), Ventre (1994) through case studies, they show evidence of
positive influence of Guided Imagery and Music method on adult survivors of child
sexual abuse. All authors are deeply concerned about issues of transference,
countertransference and projective identification, traumatization of the pre-verbal self and
relationship traumatization.
More specifically, Robarts (2003,6) claims that
“psychodynamic understanding can help the therapist to ‘map’ the complex
psychic phenomena that arise within the music and the music therapy relationship
which can be understood through transference and counter-transference”.
Adopting Bion’s ideas about projective identification, Rogers (1995, 26) goes back to
early experiences of anxiety, at the early stages of children’s growth in the mother-infant
relationship and states about transference;
“The newborn infant will encounter frustrations and anxieties from birth and will
evacuate these feelings through projective identification with the mother. The
mother’s task is not only to identify with the projected feelings, but through her
reverie, process them, detoxify them, and make them available for re-
introjection...Through projective identification, clients unconsciously attempt to
stimulate and provoke the therapist to behave according to their unconscious
expectations and in this way, the history of the patient’s object relations come alive
all in transference.”
The child transfers the traumatic experiences in the tri-dimensional ‘therapist-music-
client’ relationshiThe traumatization of the relationship with the abuser is usually one of
the most prevalent issues that emerge in the sessions. With respect to the principles of
psychoanalysis, as they are expressed by Winnicott, Bion, Stern and Fonagy, Gitta
Strehlow (2009, 172-173), in her rich music therapy experience with children victims of
sexual abuse, discovers that
“There are three other aspects arising from the traumatization of a relationship,
which require particular attention, during therapy: a) The destroy of instances of
good relationships, whereby trust is destroyed in a person who should be
responsible for the protection of the child... b) The sexualization of the
relationship... The perpetrator splits off his own feelings of guilt and expects from
the child to behave seductively. As an introject the child adopts the perpetrator’s
belief about his/herself as being seductive and therefore changes his/her ideal self.
c) The restriction of the ability to mentalize...To mentalize is the capacity to reflect
upon oneself and others, and to recognize that internal thoughts and feelings are
connected with the outside world...The reactivation and encouragement of the
ability to mentalize is therefore a fundamentally important therapeutic goal when
working with children who have been sexually abused.”
Common interventions used in psychodynamic approach
Rogers (1995, 10-11) states that
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“many clients find it difficult to examine their experiences in a direct manner and
prefer to keep distance from real-life roles. Sometimes ‘‘the child projects his own
experiences on to another child...or refer to the abuse to the third person...The client
may assign symbolic roles to different instruments...It is extremely important that
the therapist recognizes that any symbolic interpretations can only come from the
child...Children with a history of sexual abuse may use the instruments in a sensual
manner... They may exhibit a marked preoccupation with their own genitals, or they
can use the beaters to stroke their own bodies.”
Mirroring, holding and containing seem to be the most prevalent interventions used by
psychoanalytically informed music therapists to meet the child’s needs for a safe and
empathic environment with creativity, freedom through symbolism and unlimited
possibilities for self-expression.
The mirroring stage at infant-mother relationship can even define the child’s growth.
Donald Winnicott (1991, 194-195) discusses the mirroring technique and examines it in
relation to the mother’s face;
“When the baby looks at the mother, he/she sees him/herself at the mother’s face. If
the mother’s face is unresponsive, then the mirror is something you look at, but you
are not seen in it. In this case, the infant grows in confusion about mirrors and what
a mirror can offer.”
During the session, the music therapist uses mirroring interventions so that the child will
be able to mentalize, meaning to be able to recognize his feelings and connect them with
the external reality.
The lingual relationship in Music Therapy improvisation is formed in the same way. The
music is structured as a language. According to Lacan (1973),
“the unconscious is structured as a language”, and, in psychoanalysis, “I am what I say”,
“I speak through my symptom”, as well as “I see myself being seen”. Therefore, “I am
also that which I express with my music, that which I play, that which I sing”, “I play and
sing through my symptom”, as well as “I hear myself being heard”. Hence, the client’s
breath, voice, body movements and musical expressions on instruments become the
audio-musical representation and reflection of his/her psychosomatic condition. The
emotional condition, its reservations, the traumas, the developmental stage, the age, the
comfort or discomfort with the body, the environment and so on, are all reflected in the
client’s voice and body movements…” It is like creating the unique music placenta for
the client. At those moments the client usually feels heard, accepted, safe at a warm,
familiar place, where he/she can experience feelings of euphoria and ecstasy; feeling one
with this particularly designed for him/her music. Those moments of wholeness could
resemble to the symbiotic phase of child development.” (Psaltopoulou, 2013, 13-16).
Thus, the child is given the appropriate environment to feel safe and contained.
As Jaqueline Robarts (2003, 9) states,
“The concept of containment was developed by Wilfred Bion (Bion, 1962a and b)
from Melanie Klein’s original ideas of transference and the related intra-psychic
processes of projection, introjection and, projective and introjective identification.
To this concept of containment he added the idea of transformation to describe what
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happens when the mother/therapist receives the projections of infant/client,
understands and thinks about it (which he termed ‘maternal reverie’), and then gives
it back in a useful form, that can be felt with less anxiety, and perhaps (at the right
time) thought about.”
The music therapist needs to take prompt decisions about both the nature of the
interventions s/he is going to use and the music elements. Robarts (2009, 10) describes
eloquently the thinking process of the music therapist during the session;
“The musical aspects of containment and transformation, for instance, might
involve phrase length, harmonic texture, pace or tempo. Is the music too ‘spicy’ or
too bland? Is the child responding to a 4-measure phrase or this indigestible, and
would a 3-note motif be something the child can take it more easily?”
The use of songs in music therapy sessions offers also a non-threatening access to the
traumatized pre-verbal self through identification and symbolism. As Robarts (2003, 8)
states,
“song can bring forth emotions and images from pre-verbal self and visceral levels,
beyond conscious and verbal recall...”
Gitta Strehlow (2009, 171) notices two important steps;
“During the music therapy sessions, the first step involves the therapist letting
himself become emotionally entangled... During the second necessary step, the
therapist reflects from an outside view and this allows the therapist to get an
understanding of the symbolic meaning on the whole scenario.”
She also divides her case study in three scenes:
“In the first scene music is used to establish distance. In the second scene, music
helps to provide the child with good and secure experiences with the therapist...In
the third scene, music makes the horror associated with the traumatization both
audible and perceptible” (Strehlow, 2009, 175-176).
In other words, parts of the traumatic relationship are re-experienced in a safe therapeutic
relationship through music. Therefore, “when negative emotions are expressed, shared
and sublimated, positive effects emerge for the individual” (Psaltopoulou, 2014, 104).
This observation corresponds with Jung’s ideas,
“Jung believed that a real liberation comes not from repressing pain but only from
experiencing these painful feelings to the fullest. He saw such moments of
liberation as transformative experiences and called them experiences of rebirth, in
which the self becomes new and is rejuvenated” (Jacobi, as cited in Amir, 2004,
97).
Therefore, music, as the main tool of music therapists, has an essential role in the
sessions, the role of a living organism that offers possibilities for meaningful experiences.
Strehlow (2009, 181) makes a decent attempt to describe it through relevant images;
“…music as a way out of silence, as a space for good and secure experiences, as a
projection plane, as a way of mirroring emotional experiences, as a space for
pleasurable experiences, re-enactment of traumatic relationship patterns through
musical interactions, music lets traumatic emotions be perceptible, music as a way
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of clarifying, preserving and modulating unbearable experiences, music as a space
for experimenting with new experiences of relationships.”
Music, as a living organism, could be also play the role of the co-therapist when needed
during the session;
“Within the therapy interaction, the child shows the therapist through free
improvisation, composed music or singing songs in which problems the child is
getting involved in...Through improvisation, sexually abused children show typical
interactions such as being overwhelmed, feeling used, helpless and powerless...
Finding suitable words is necessary in order to express and reconstruct the
traumatic experience of sexual abuse, so that the child can integrate the experience”
(Strehlow, 2009, 171).
Dorit Amir (2004) seems to agree with Strehlow when she quotes that
“Jung describes the conscious mind as having order and organization while the
unconscious is chaotic in its character. Usually the more the client’s playing touches
unconscious material, the more it becomes chaotic, confused and impulsive.” (98)
Therefore, music improvisation opens the path for communication at conscious and
unconscious levels.
Robarts (2003, 7) creates a model in music therapy, inspired by the ancient Greek verb
‘poiein’. It is called poetic process in music therapy and spans three levels of response;
“Τhe neurobiological level of tonal-rhythmics sympathetic resonance, where
experience is embodied as ‘procedural memory’. This leads to increasingly
defined self-expression in musical-aesthetic forms that may culminate in
metaphors of the child’s autobiographical self within the music-therapeutic
relationship.”
Chantal Jolly (1998) proposes the dream work during music therapy session. The client
and the therapist through music improvisation could ‘play’ the story of the dream with
the musical instruments. The author suggests that the music therapist through holding and
containing could support the client to ‘replay’ his dream. Another way to work with
dreams is guided imagery and music. “In this way, the music can keep the survivor
moving through process, so as to avoid getting stuck in the dream.” (Jolly, 1998, 141)
Role playing is a technique that could be used for adult survivors of sexual abuse. The
relationship between the abuser and the client could be explored through the music
improvisation. (Jolly, 1998)
Special issues for music therapists
“As the documented evidence grows that indicate that there are an overwhelming
number of citizens who have had unwelcome, inappropriate contact of sexual nature
with an adult during their childhood years, music therapists can no longer consider
that work with sexually abused clients is a minority or special category of clinical
work.’’ (Edwards & Mc Ferran, 2004, 336)
Edwards & Mc Ferran (2004) propose one or two lectures per year, in order to educate
the music therapist students.
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Music therapists, when working with children-victims of sexual abuse, face some
particular difficulties. Strehlow (2009, 174) observes some common characteristics in the
first sessions: ‘‘the child takes full control, does not say much and leaves very little space
for me’’ (the therapist).
A Nordoff-Robbins music therapist, Jaqueline Robarts, seems that she has adopted a
psychodynamic perspective when she is stating that Alvarez is writing
“in working with very disturbed children who have a fragile core sense of self, the
therapist may need to be able to hold onto these projected anxieties for much no
longer than with clients with a stronger ego function.’’ (Alvarez, as cited in Robarts,
10)
With sexually abused children the use of boundaries provides a vital containment.
Sessions occur in the same room, at the same time each week, and always last for the
same amount of time as it is essential for the child to feel safe in the music therapy
relationship and environment.
“Music therapists might place music instruments on the floor in the same order
from which the child can select. By maintaining the same order and allowing the
child to make selections, the child may develop a sense of safety and predictability
and a personal sense of control over the room and instruments. Variations on similar
session structure can contribute to a sense of mastery.’’ (Strehlow, 2019, 65)
“The establishment of clear boundaries is critical when working with the abused
child. An abused child in a dysfunctional environment faces a constant violation of
boundaries; this is particularly true of the abused child whose own body boundaries
have been broken and who has been used as a source of sexual gratification.’’
(Rogers, 1995, 27)
Therefore, it is crucial for the therapist to respect the physical boundaries of the child.
The therapist must be sure if, when and where she/he is allowed to touch the child. Both,
personal therapy and supervision can help the therapist keep the boundaries for the sake
of this particularly challenging population. Supervision of his/her clinical work may also
be proven very useful.
“Supervision is essential in order to bring a degree of objectivity to what is a very
subjective experience. It enables a clearer understanding of the transference and
countertransference issues occurring within the therapeutic relationship.’’ (Rogers,
1995, 14)
There is a possibility that the therapist could suffer from vicarious traumatization.
Vicarious traumatization describes
“the cumulative transformative effect upon the trauma therapist of working with
survivors of traumatic life events, and the world as a result of prolonged trauma
work.” (Pearlman & Mc Ian, 1990, 31) “The symptoms of Vicarious Traumatization
are free floating anger, lose sleeps over patients, dreaming about their client’s and
clients’ traumatic experience, overwork, exhaustion, blaming others...poor
communication, detachment, withdrawal and isolation from colleagues, difficulty
having rewarding relationships, hopelessness.’’ (American Counselling Association,
2011)
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Discussion-conclusion
In this literature review, most of the published material has been referred to the
psychodynamic approach more than all other approaches in music therapy with clients
who have a history of sexual abuse.
Probably the reason lies in the fact that in psychodynamic music therapy, the therapist is
trained in recognizing and processing the unconscious phenomena, as well as s/he is
deeper informed in processing projective identification, transference and
countertransference issues, making enough space for the client to emerge and to exist.
Additionally, the psychodynamic oriented music therapist is trained to use the symbol
and let the interpretations come from the client, while s/he is aware of the origin of the
projective material, meaning that s/he knows whether theses interpretations come from a
dark or a light side of the client’s psyche.
Considering one’s access to the unconscious material through music (Sutton &
McDougall, 2010), combined with the non-threatening nature of therapy due to the
expression and sublimation of emotions through music, we can conclude that music
therapy is a valuable tool for the treatment of children with a history of sexual abuse.
Children who are in music therapy do not need to feel pressed to talk about the details of
the event, nor to name the painful feelings they experience.
Expression of feelings through musical clinical improvisation seems easier, safer and
familiar to the children. Listen to and make music, write songs, where in the lyrics can be
said anything, since it is a work of art, is essentially a process of liberation. Children find
it meaningful and creative to project their experiences, the material that it is repressed
into the unconscious, in their music, in their songs. Their playful expression in forms of
art, like music, drawing to music, moving and making verses and stories, is symbolical.
The expression and sublimation of feelings through the awakening of music creativity
helps children feel free and not threatened by the therapist and the therapeutic process.
An important issue is that “some abused children, despite treatment, either do not
improve or get worse...It is unclear whether (or which) asymptomatic children should be
treated” (Nucombe, Wooding, Marrington, Bickman, & Roberts, as cited in Edwards &
McFerran, 2004, 340).
Based on all the findings that derive from the analysis of the bibliographical sources, we
could conclude that the access to traumatic experiences - as they are recorded in the
human brain through music - and the non-threatening environment of music therapy, can
become a useful tool in the hands of the music therapists supporting children who have
been sexually abused. A special training in psychodynamic and psychoanalytic theories
and practice seems to be very important for the music therapist who works with this
sensitive population.
A further study is highly recommended.
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[239]
“Dark Sessions” a Music Therapy Clinical Intervention
for Substance Abuse Rehabilitation
Dora Psaltopoulou-Kamini, Andreas Assimakopoulos,
Alan Turry, Theano Chatzoudi, Stelios Giouzepas
Abstract
A clinical intervention for an unstructured improvisation is presented. This innovative
intervention -named “dark sessions”- has been used clinically for clients with Substance
Abuse Disorder (SUD) in the ARGO rehabilitation facility in Thessaloniki, Greece.
The key difference of this activity from other improvisation activities is the complete
absence of light. All room lights are turned-off throughout the session. It is a relatively
easy activity to implement. Together with this blackout condition, a ‘dark session’
activity is a variation of the traditional drum-circle enhanced to include the
improvisational use of voice and the emotional investigation of the emerging
soundscapes.
Background
Music Therapy (MT) and music-based interventions (MBI) are increasingly accepted as
complementary therapeutic modalities in substance addiction treatment programs
(Cevasco et al., 2005). Studies have shown that group music therapy, mainly through the
use of percussion, can facilitate substance addiction treatment by promoting verbal and
non-verbal communication, reducing isolation, and increasing self-esteem (Gallagher &
Steele, 2002).
Additionally, there is evidence of therapeutic benefits of MT and MBI on mood, stress,
motivation, emotional expression and social cohesion of substance addicted individuals
(Hohmann et al., 2017). Music activities such as drumming seem to be particularly
effective in improving mood (Maurer et al., 1997), while improvisational music therapy
can further reduce negative affective states, such as stress, anxiety, anger and depression
(Rio, 2005; Hwang & Oh, 2013), with no known side effects (Albornoz, 2011).
A key component in the successful outcomes of Music Therapy is associated with the
active participation of the client. Research reports (Hwang & Oh, 2013) have emphasized
that the outcomes of the therapy program are influenced by the client’s active
participation and preference for activities. The active participation of the client in MT
processes seems to be positively correlated with the amount of perceived pleasure from
the clients (Rio, 2015); studies show evidence of significant increase in positive
emotions, such as joy and happiness, and reduction of negative ones, such as anxiety,
depression and anger (Gardstrom et al., 2013), which could further increase engagement
to treatment and potentially enhance therapeutic outcomes. This may be of great
[240]
significance, as sustaining engagement to treatment and alleviating or managing negative
emotional states are major therapeutic targets in the different stages of substance
addiction treatment. For instance, negative emotional states can induce high levels of
stress and are associated with substance use and relapse (Hohmann et al., 2017), as they
can trigger craving for the substance of abuse in an effort to alleviate the negative affect.
It is, thus, possible that MT interventions may be capable of facilitating to address this
therapeutic target.
The capacity of music to induce relaxation and elicit positive emotions in substance-
addicted individuals (Gallagher & Steele, 2002) has been hypothesized to result from
music-induced dopamine release in the mesolimbic system of the brain (Sutoo &
Akiyama, 2014), which can lead to the reduction of stress and anxiety (Hohmann et al.,
2017; Hwang & Oh, 2013). Dopamine (DA) synthesis in the brain is associated with
euphoric emotions and states and it is highly disturbed by substance abuse (Sutoo &
Akiyama, 2014). Sutoo and Akiyama claim that, music can improve dopaminergic
neurotransmission in the brain and that music could contribute to the rectification of
symptoms in diseases associated with DA dysfunction by regulating the related brain
functions.
Of importance, decreased dopamine activity in the brain is associated with depression
(Diehl & Gershon, 1992) and the development of SUD (Blum et al., 2014). Thus, MT
interventions could potentially contribute to counterbalancing the insufficient
dopaminergic activity in the brain and thus facilitate the reduction of depression
symptoms, anxiety (Strauser, 1997) and the associated craving for substance use and risk
for relapse.
Additional studies have further suggested that MT interventions can alleviate and
facilitate to manage the negative affective states, such as stress (Hohmann et al., 2017),
anger and depression (De l’Etoile, 2002; Fritz, 2015), highlighting the potential
contribution of music to address the aforementioned therapeutic targets. One of the MT
interventions commonly used to this end is group drumming. Of interest, group
drumming seems to modulate specific stress-related hormones (Bittman et al., 2001) and
to be capable of inducing relaxation and brain synchronization in substance-addicted
individuals (Winkelman, 2003; Maxfield, 1990). The use of music improvisation seems
to be highly recommended in this context (Winkelman, 2003).
According to Bruscia (1987), a music improvisation in reference to aspects other than
music itself is called referential improvisation (i.e. improvising to feelings, events, etc.),
while an improvisation based strictly on music considerations without representing or
referring to any other aspects is called non-referential improvisation. Improvisational
music therapy involving group drumming is currently widely used in substance addiction
treatment; as previous studies have shown, it motivates clients to explore who they are,
without experiencing fear when sharing difficult life events. Furthermore it enhances
mood and general well-being (Rio, 2005).
Aims
One of the first observations that the music therapy trainee noticed, while working with
SUD, was that clients were very reluctant to use their voice and to improvise, while being
judgmental for themselves and others. In this case, after trust was established with the
[241]
group, it was proposed to have an improvisation in complete darkness. This would
enhance the therapeutic outcome by greater music immersion for the clients and by
diminishing any shelf-punishing thoughts or feelings of shame for their musical ability.
Physiologically, light modulates brain function and cognition (Vandewalle et al., 2009),
while there is evidence that it provokes and modulates emotions that induce alerting
responses (Rautkylä et al., 2012). Psychologically, darkness is already being used as a
tool to reduce anxiety and depression, and promote well-being (Malůš et al., 2014). There
is also strong evidence that anxiety is connected with light sensitivity (Bullock, 2017).
According to the trainee’s observations, darkness dramatically reduces the ‘fear of
mistake’ and any judgment of others, while it boosts creativity (Steidle & Werth, 2013)
and imagination.
Consequently, the aims of this intervention were primarily the unblocking of creativity,
the ‘opening-up’ of each client and the encouragement of improvisational vocal use.
Secondary aims were group bonding, listening to (and interact with) each other and
activating imagination through aural stimuli.
Method
The population was individuals with SUD. The activity was applied in the ARGO
rehabilitation center (website hyperlink in the reference section), during the music
therapist’s internship period, in a group that had already graduated the detoxification and
rehabilitation program. ARGO (Alternative Therapeutic Program for Addicted
Individuals) is a non-residential, drug-free therapeutic program. It pertains to the Greek
National Health System and, specifically, to the General Hospital of Thessaloniki ‘G.
PAPANIKOLAOU’ -Organic Unit Psychiatric Hospital of Thessaloniki. It deals with any
kind of dependency from illegal drugs (heroin, cocaine, cannabis, stimulants etc.) and
other addictive behaviors (internet addiction, gambling, prescription medicine etc.).
The group structure was a traditional drum circle, in a dedicated space that the program
provided, with the facilitator of the group and the music therapy trainee (playing electro-
acoustic guitar instead of percussion) equally participating in the circle. The group met on
a weekly basis to improve their creativity, interact socially and stay in touch with the
program and a healthy way of living. The group consisted of 5-8 people.
The first session was considered a ‘one-off’ activity, but it continued on a weekly basis
after group request. Before the session, group members chose cymbals like maracas,
triangles, tambourines, guiros, etc in addition to their usual instrument (djembe, bongo or
derbuka). Once the lights went off and the session started, group members were free to
play whatever they wanted with the instruments they had chosen. They were also free to
sing whatever they felt like. The only ‘rule’ was consideration, acceptance and
respectfulness of other group members’ music for a collective result.
12 twenty-minute dark sessions were held in 12 consequent weeks with that group; it was
a free clinical improvisation with percussions, voices and guitar, while all the lights were
turned-off. The therapist used a humanistic/music-centered approach inspired by
Nordoff-Robbins. The sessions were videotaped and supervised. Also a 6-item
feelings/mood questionnaire (Marteau & Bekker, 1992) was filled-in by the participants
before and after the activity for monitoring purposes.
[242]
After every session, a brief focus group of the participants was held. It was an
unstructured interview with open questions regarding their experience of the activity,
feelings and present mood. These clients’ responses together with their questionnaire
scores were assessed qualitatively to obtain a perspective on their subjective state and the
impact of the activity on their mood.
Results
The clients in dark session conditions seem to be less fearful of mistakes or self-
judgment, since they are feeling more “protected” in the absence of light. In comparison
with their usual drum-circle activities, in “dark sessions” they tend to use their voices
more, improvise more freely and use their percussion or cymbal in any musical way they
want with significantly less self-judging thoughts. Even the act of pausing and just
listening seemed to be considerably easier in a dark session. The aforementioned
observations from each session recordings imply the significant boost of clients’
creativity and vocal use. Group interaction and coherence was also affected positively.
After the first 6 sessions the group facilitator stated that the activity “seems to get better
every time” and all the group members agreed. Every participant without exception
seemed to be very keen for this activity and they reported feelings of relaxation, and even
journey-like experiences in some cases, afterwards. The questionnaire results confirm the
above showing mood improvements and even a mild lassitude lift.
Another positive side-effect of ‘dark sessions’ is the possible increase of program
engagement, since group members were very keen on the activity and looked forward to
it. This is important, particularly if one considers the usual high ratio of “drop-outs” in
this population.
As a final note, the music therapy trainee would like to report a personal observation
regarding his playing and the interaction with the group. Darkness seemed to facilitate a
better understanding of group dynamics and needs; there was stronger focus on the music
and clients’ interactions, without the effect of visual stimulus altering his perception. It
seems that the activity has a heavy impact on the therapist as well as on the group, in a
positive way.
A Metaphor
The significant results of the ‘dark sessions’ group music therapy innovative intervention
with interactive improvisation among SUD clients and the music therapy trainee offer a
fertile ground for assumptions through a psychoanalytic lens. As shown in the results,
clients felt safer in the dark to express themselves creatively and with great pleasure. This
situation can be seen as a metaphor of a womb-like experience; where the fetus feels safe,
in total unity with the mother, without any sense of physical boundaries, swimming in an
ocean of euphoria. The SUD pleasure-seekers are similarly led to an alternate state of
consciousness, through the use of substances, where the physical boundaries loosen up
and they are getting lost in hallucinations, oceanic feelings of bliss or blessedness. As if
they are reliving in the ‘lost paradise’ of being in a womb. Soon though, after the use,
they realize that this is not an everlasting experience; like the babies who, at birth, lose
the placenta, which is half of themselves, and they start seeking substitutes of safety and
euphoria. Therefore, the users seek the experience of an extremely pleasurable state of
[243]
pseudo-euphoria, which when it is repeated at a regular basis, it can be the dominant and
omnipotent desire for the whole being.
During rehabilitation time, SUD clients complain about lack of pleasure-anhedonia.
Interestingly, dark sessions provide the space, the time and the means for pleasurable
experiences, similar to those of substance use. Although in this case, experiences allow
the space for safety, meaning, creativity, solidarity and freedom of expression, which are
important life values for every human being.
Conclusion
The music therapy intervention of dark sessions is a clinical improvisation for SUD
clients with promising pilot results. It boosts client creativity and vocal use, promotes
group bonding and interaction, and improves mood in a playful, yet evocative way.
Among other group activities, “dark sessions” is one of the most favorable with clients
reporting relaxation and mood improvement.
Further Research
Additional research is needed with a better experimental design to evaluate personal
observations and client reports. Other sub-activities might also be worth of investigating,
for example having a pre-defined emotional theme like “how sadness/happiness/
fear/love/etc could sound like?”
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[247]
Music Therapy: Music at People’s Service
Krzysztof Stachyra
Abstract
Music Therapy is a dynamically developing field all over the world. However, with the
growing interest in the possibilities it offers, there are more and more misconceptions
about what forms of contact with music can be referred to as music therapy. There are
publications where either the area of music therapy is significantly decreased or, on the
contrary, all forms of contact with music are attributed to music therapy. The author tries
to clarify what lies behind the term ‘music therapy’, refuting at the same time myths that
appear in the media and popular opinions around the world. At the same time, he uses
this polemic as a background to show the humanistic nature of this form of therapy and
the role of music in it.
Key words: music therapy, theory and practice of music therapy, defining music therapy
Introduction
Music therapy is not the property of one culture, country, race or gender. It is something
universal, just like music is universal. The beginnings of therapeutic use of music can be
traced back to the times of primitive tribes, where the shaman played the role of “music
therapist”. It was believed that evil spirits were responsible for the disease, which
possessed the body and soul of the sick. Each disease was assigned a different spirit,
which is why in its ritual of chasing away appropriately selected songs, dances or other
healing rituals were used. They combined elements of trance, suggestion, and the actual
healing effects of music, singing and dancing. At that time, faith in the power of sound
resulted from the belief that the voices of nature are the voices of totemic spirits and
gods, and that due to the strength of sound, evil spirits are as defenseless as man
(Galińska, 1992).
With the development of knowledge, changes in the perception of the world that have
taken place for tens of thousands of years, both the music and the perception of the
possibility of its use have changed. In ancient Greece, it was noticed that music works not
only on the person actively participating in it through dance and singing, but also on the
listener. It was thought that harmonious listening to music could lead to so-called
‘Catharsis’ or ‘purification of the soul’, which helps to achieve internal harmony
(Belfiore, 2016). In the following centuries they appeared more or less sensible from the
current point of view trying to explain the way music affects people. Music and emotions
were more and more often combined, and the most frequent recipients of “music
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therapeutic” activities were people with emotional disorders or mental illness. However,
with the development of medicine and pharmacotherapy, the trend based on music
therapy has been losing importance, and the use of music in medical terms has become
more conditioned by the beliefs of people trying to use this idea in practice than the
generally recommended form of therapeutic interaction (Schwabe, 1969).
The distinct return of interest in the possibilities of using music in therapy and
development activities takes place in the mid-twentieth century, first in North America
and a little later in other areas of the world. This time it occurs in conjunction with
scientific studies confirming the effectiveness of this form of therapy (Davis, Gfeller &
Thaut, 1992).
In recent decades, the growing popularity of music therapy has meant that more and more
websites with ‘music therapy’ in the title have appeared all over the world, with programs
on this form of therapy featured on the radio and seen on television screens. This is also
reflected in the growing number of publications on the subject of music therapy, although
it does not necessarily go hand in hand with their quality. It turns out that, on the wave of
popularity of this field, some authors of publications try to smuggle (under the
increasingly catchy slogan ‘music therapy’) various forms of modern shamanism. It
happens that the music therapist is presented in them as a ‘shaman’ who possesses
esoteric knowledge and performs healing miracles in an incomprehensible way using
recordings with “magic” properties or mysterious gongs or tuning forks (Romanowska,
2018). Others go in the opposite direction and try to convince you that music therapy is
only associated with the ability to use recordings of classical music, preferably ‘great
masters’ only (Maman, 1997). Comparing the therapeutic use of music to the principle of
the ‘pill’ in medicine and pharmacotherapy is not only incorrect, but it does great harm to
the field of music therapy, disrupting its true image and harming qualified music
therapists who can logically and systematically help those in need. Therefore, it is
particularly important to start this text with terminological explanations of the music
therapy field in the space of theory and practice.
A little handful of terminological explanations
There is no single definition of music therapy because its shape in different countries and
national associations is influenced by many different factors. The process of defining
music therapy is a result of the way it is carried out, the philosophy adopted by the person
or persons conducting it, the various theoretical approaches preferred in a given area,
traditions, and cultural differences. This is due to the wide variety of practice.
110
In
addition, each definition is only the “essence” of the perception of a given field, it can
give general guidance, but will not be able to explain in detail what the discipline consists
in practice. Transferring this to the field of music therapy, no definition will make us able
to determine immediately whether the situations we observe should be qualified as music
therapy or not.
110
These claims result from the experience of the author of the article, who has been a member of the
council of the World Federation of Music Therapy (WFMT) chairing the Accreditation and Certification
Commission.
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Let this be confirmed by the definition of music therapy presented by the World
Federation of Music Therapy (WFMT), in which the cultural, social and even political
aspects are perceived:
“Music therapy is the professional use of music and its elements as an intervention
in medical, educational, and everyday environments with individuals, groups,
families, or communities who seek to optimize their quality of life and improve
their physical, social, communicative, emotional, intellectual, and spiritual health
and wellbeing. Research, practice, education, and clinical training in music therapy
are based on professional standards according to cultural, social, and political
contexts.” (WFMT, 2011)
There are currently several dozen definitions of music therapy around the world. Usually
each country uses its own. However, trying to find their common points, one may be
tempted to state that practically all of them emphasize the fact that music therapy takes
place when the music therapist, i.e. a qualified person properly prepared, intentionally
uses music or activities related to it to support changes in the session participant, teach
him a new skills, conflict resolution strategies, dealing with emotions etc. It is important
for these activities to have the features of a process managed or supervised by a specialist
- a qualified music therapist. It therefore excludes the incidental use of music by someone
who does not know where he is going in his activities and how to deal with the
consequences of evoked emotions or states, even if such action resulted in a satisfactory
result for its recipient. It is emphasized that - in contrast to healing or a miracle – every
therapy is a process. In music therapy, this process is based on the relationship between
its three basic components: session participant(s), music, and therapist. Therefore, music
therapy should not be called a series of accidental events or unexpected experiences
related to music, the results of which are only a coincidence (Bruscia, 1998).
Music therapy is always active (versus passive) because it involves the client’s
activity.
111
Therapy is change and therefore activity. However, during the session, the
activity, involvement of the session participant may occur in the physical and mental, or
only mental aspect. Hence, the methods and techniques offered as part of the music
therapy session were usually divided into two categories: active, in which the basis of
interaction is the involvement of people participating in the session through various
musical activities (singing, playing instruments, movement, improvisation) and receptive,
based on listening to music, relaxation and imagery (Bruscia, 1998; Konieczna-Nowak,
2013; Stachyra, 2017).
It is important to emphasize that music therapy can take an individual or group form. It is
addressed to all people who need therapy or support, regardless of the level of musical
skills or efficiency of the hearing organ. Actually, the only contraindications refer to
people with musicogenic epilepsy, which manifests itself in triggering an epileptic attack
as a result of exposure to music or its elements (rhythm, sound, etc.), and sometimes only
to one specific song (Jędrzejczak & Mazurkiewicz-Bełdzińska, 2017). Caution should
also be exercised when working with people in acute psychotic conditions although the
111
In music therapy, depending on the adopted philosophy and music therapy approach, the term ‘patient’
or ‘client’.
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possibility of including music therapy at this stage of treatment is still possible (Unkefer
& Thaut, 2005).
After listening to the music I felt much better...
There are a large number of distortions in the media about what music therapy is. There
are publications where either the area of music therapy is significantly decreased or, on
the contrary, all forms of contact with music are attributed to music therapy. In the first
case, music therapy is usually perceived very unilaterally, associated mostly with
relaxation/meditation with music, or sounds of nature. In the second, everything that has
anything to do with music and its impact on humans is defined as music therapy. Such
experiences as listening to the sounds of nature, singing together in a karaoke club, or
even listening to music while driving are credited as ‘music therapy’. Everyone can do
‘music therapy’ if he/she thinks that the effect of this contact with music or sounds is
satisfying for him/her. This is obviously not true, despite the fact that these activities can
have a positive effect on well-being or other aspects of functioning.
It is worthwhile to stop for a moment with this phenomenon, and analyze it through the
prism of the definition presented above. Let us remind you that to be able to classify a
given activity for music therapy, the presence of music or sound is not enough, but you
have to deal with a process managed by a qualified music therapist. A process which by
definition is directed towards a specific developmental or therapeutic goal. You can
immediately realize that just listening to the sounds of nature has nothing to do with
music therapy despite the fact that at a music therapy session it might happen to be
combined with music assuming that it can help you achieve a state of relaxation. So
where is the border that qualifies a given situation as music therapy? In this case, it is the
presence of a qualified music therapist who decides to introduce specific actions during
the session. He/she must assess the psychophysical state of the session participant,
considering that he is ready to relax with the music (contrary to popular belief, too high a
level of arousal is a contraindication in this case). If the music therapist considers that
music relaxation is advisable at the moment, he/she chooses its form, deciding about the
kind of induction, type of music used during the session, which is very much associated
with the chosen form of relaxation, etc. And only at the end of the process is the possible
inclusion of nature sounds considered, analyzing whether it is justified and can help
achieve the intended goal. The sounds of nature often evoke in the listeners positive
associations related to rest in a meadow, by the sea, etc. But what if a person feels fear of
water? What if the sounds of the humming sea evoke difficult, traumatic memories?
What if someone is afraid of insects - will buzzing bees and other insects lead to
relaxation, or rather an escalation of tension? There may be many similar situations. I do
not think that then the person subjected to them would still be willing to describe such
experience as music therapy.
The main difference between ordinary listening to the sounds of nature and music therapy
here depends on the presence of the therapist and the goal of the actions. As long as these
two elements are missing, it will be ordinary listening to the sounds of nature, which
evokes (or does not) some kind of reaction (nice or difficult for the recipient). Only a
qualified music therapist who knows the goal of his work with a specific person will be
able to transform this situation into a therapeutic one. And it doesn’t matter if it’s
pleasant for the participant or not. If the heard sounds calm the client down, are
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conducive to obtaining a state of relaxation, they can be successfully used to obtain or
maintain such a state. In turn, anxiety reactions can help the client, thanks to the
therapist’s support, to reach their real causes, and then enable them to work through using
appropriate methods or techniques.
Similar criteria apply to all other forms of contact with music. Even the presence of
music during a therapeutic session led by a psychotherapist does not determine that it is
music therapy. Verbal psychotherapists usually do not have any preparation in the area of
conscious use of therapeutic values resulting from contact with music. And if they decide
to include music in the therapy process, they are usually limited to presenting relaxing
music in the background of such activities. Music therapists, on the other hand, have a
qualification and competence enabling them to use the full potential of music, both in a
receptive form, based on listening, as well as active music making together with the
client(s). Despite this, as has been emphasized before, it is a common situation to assign
any activities with background music to the ‘music therapy’ category. Interestingly, this
is not the case with other forms of therapy. Just look at something as basic as talking to
other people. Just like listening to music, talking to a friend can improve your mood and
sometimes even help to resolve a serious life problem. However, are we inclined to
define such a conversation as ‘verbal psychotherapy’? Certainly not.
Music in Music Therapy
It is enough to look closely at people to notice that music connects man with the
surrounding reality, culture and the environment in which he lives. Everyone reacts to
music; educated musicians and people without musical talent, children and the elderly,
healthy and sick. You can enjoy it yourself or share it with others. In relation to music, all
people are equal, regardless of social status, language they speak, or problems they face
every day (Schneck & Berger, 2010). At the same time, music in a considerable degree
refers to the inner world of man - emotions, memories and experiences. Everyone will
probably agree that music evokes emotions, but only the researchers of these issues see
that it also creates the possibility for the recipient to choose how deeply it will be
admitted, because paradoxically it can be emotionally both near and far at the same time.
As Kenneth Aigen rightly notes, music is located between the external and internal world
of man - moreover, it can combine both these spheres of functioning, which opens up a
huge area of music impact (Aigen, 1991).
Thanks to its extraordinary properties, music can be a great and powerful therapeutic
tool, reaching people without the need to engage their attention. It can also be
improvised, created live, reflecting the experiences occurring during the session, as well
as generally in the patient’s life, which is very evident in the model of creative or
analytical music therapy.
The impact of music on man can be compared to the action of metaphors in language.
The meaning it carries goes directly to the recipient, bypassing conscious control, and
thus not causing intellectual resistance, which often occurs in word-based interactions
(Taylor & Paperte, 1958). It can also directly stimulate adaptive and autotherapy
mechanisms, what is sometimes called ‘supporting human biology’ (Hyman & Liponis,
2003).
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Music is one of the most humanistic human creations. And especially in the field of
music therapy music cannot be considered in isolation from man. It is always associated
with its specific recipient and it is the recipient (his mood, expectations, preferences,
personality, experience, associations) that has the final impact on how a given music will
be received by him, how he will react to it. As Thomas Clifton wrote, “music is what I
am when I experience it” (Clifton, 1983, 297). For this reason, it can be stated with
conviction that human perception of music bears the hallmarks of creative activity,
because by processing music in its own way, its recipient becomes somehow a creator of
its strength and direction of influence on the body. At the same time, despite the
enormous complexity and diversity that individual music pieces present, as well as the
psychophysical individual differences that characterize individual audiences, people’s
responses to music show greater convergence than would be expected. It concerns not
only the subjective assessment of the moods carried by music, but is also visible in
objectively measurable physiological reactions. It also refers to other reactions, such as
changes in aural hallucinations in mentally ill people. Perhaps this is the result of
perceiving music as a set of information, which is coded at the acoustic level (through
sound features such as pitch, volume, duration and timbre), semantic (contained in its
content and form) and aesthetic (transmitted by the musical expression given by the
composer/performer and picked up by the recipient, in which the musical taste of the
recipient and the way the performer performs the composition is important) (Natanson,
1979). This is another argument to say that when analyzing music through the prism of
impact on man, one should consider not only the essence of music as such, but also the
perception of it by the recipient. This is the essence of music therapy.
It would seem that music in music therapy is the basis, it is the most important. Nothing
could be more wrong - music in music therapy is a means. It is a statement that is often
difficult for music lovers or people educated to be professional musicians. It refers to an
object that for many is ‘holiness’ in itself. In music therapy there is no division into
genres more or less valuable artistically because it is not artistry that is the goal of
activities. Here in the center remains a human, participant of the session. It is he who,
thanks to various forms of contact with music, is to receive support in dealing with his
problems and needs “of emotional, physical, mental, social or spiritual nature” (Stachyra,
2014a, 27). If during a session music becomes more important than a patient, then its
selection is distorted by preferences, the musical tastes of the person conducting the
session, and the needs of its participant are pushed into the background, they must give
way to music. In music therapy, music is there to serve people. An educated musician
finds it difficult to agree to this state of affairs, especially when the course of the session
requires reaching music that does not meet his sense of aesthetics. It is not uncommon to
observe such a situation in young music therapy adepts who, due to their experience in
contact with music, are able to focus so strongly on it and follow it that they seem to
forget about their role and the purpose of their activities. You have to “agree” that
improvised music together with the session participant may not have artistic values that
would satisfy us as musicians. Singing of a mentally handicapped person may differ from
all the standards taught at a music school, yet can carry a lot of emotion and content. For
the same reason, classical music will not always be suitable for relaxation, due to its
complexity, and perhaps it will be much better to reach for something much more
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‘trivial’. It is not easy for everyone and not everyone manages to accept it immediately.
However, following the music therapist’s thinking, it is essential not only what music
will be used during the session, but above all how it will be used. The decisive factor is
the right choice for a specific person, a specific technique, and a specific situation.
The arguments cited above can be illustrated by a simple example referring to the tempo
of the song. The music is often divided into stimulating and calming music. These terms
alone indicate their connection with the recipient (by default: music is stimulating for a
particular person listening to it, not stimulating ‘in itself’). This stimulating or calming
effect is commonly associated primarily with the tempo of the music, using a simple
division into calming music (at a rate below 80 BPM
112
), moderately stimulating (pace
from 80 to 120 BPM) and stimulating (pace above 120 BPM) (Kierył, 2004). In fact, as a
result of the author’s many years of observation and experience, music at a rate of 100
BPM can be both stimulating and calming with respect to the same specific recipient.
This is because the starting point is the psychophysical state of the recipient while
listening to it. Physiologically, the state of arousal or silence of a person is usually
determined, inter alia, in relation to the value of the pulse, i.e. heart rate. Assuming that
the person switching on the music at a rate of 100 BPM is very relaxed at the moment
and his heart rate oscillates around 60 beats per minute, it can be assumed that the music
will have a stimulating effect on him. However, in a situation where the same person is
strongly excited when the music is started, with a heart rate much above those 100 BPM,
the same music will be able to soothe him. This is obviously a very simplified situation,
because the music is not based on the tempo itself. There are many more elements
affecting the recipient in music -it is worth mentioning rhythm, melody, harmony, timbre
and dynamics.
Therefore, one may be tempted to state that de facto there is no stimulating or calming
music, but only music that affects a given recipient in a given situation. Here and now.
The presented example is limited to illustrating the likely impact of tempo, which, like
rhythm, has the greatest impact on the physiological sphere of the recipient (Gaston,
1968). Looking at the basic elements of music, you can be tempted to sketch their
potential impact on the recipient. And so, the rhythm, like the tempo, is mainly related to
the physiological sphere (the rhythms of the human body: heartbeat, breath, etc.). Melody
and timbre relate primarily to emotions, recalling memories and associations. Harmony
and dynamics influence emotions, building and releasing tensions. Only the sum of all
these elements together with a reference to the current state of the recipient will finally
decide on the recipient’s reaction to the music. To further complicate this issue, one must
also take into account the associations that a given music evokes in a specific recipient,
because their strength can be so significant that the emotional response to music will
seem completely independent of the listed elements of a given music piece.
When writing about the impact of music on the recipient, one cannot ignore the iso
principle, which prompts a person who wants to use music at work with people, in which
direction to go. This term is used to describe the basis for the compatibility of music with
the behavior or mood of the person (Michel & Pinson, 2004). According to the iso
principle, in order to effectively use music, you should initially refer in its selection to the
112
BPM = beat per minute.
[254]
current state of the recipient. His preferences and personality are also significant. The
music is to be similar to the state in which the therapist finds the client. If the participant
in the session is aroused, the music should reflect his arousal energy, thus giving the
opportunity to release tension. Similarly, a person with a low mood is initially
recommended to present music of a similar nature (Stachyra, 2014b). It also results from
the assumption that music is to be an authentic companion of the participant of the
session, without trying to either deny or neglect his feelings. By choosing or creating
music during the session, the music therapist focuses on all aspects of the patient’s
functioning, not only on the level of arousal or the direction of emotion.
At this point it is worth dealing with one more myth about music in music therapy. Well,
contrary to the expectations of people not familiar with music therapy, classical music is
rarely used in this form of therapy. Actually, the only method of music therapy based on
classical music is The Bonny Method of Guided Imagery and Music (BMGIM). This
choice of musical genre results from the specificity of this method where music is
listened to by a client in an altered state of consciousness in order to facilitate access to
unconscious content. Music is given the unique role of a co-therapist to help stimulate
images, memories and emotions. For this reason, classical music, as the most variable,
diverse, surprising listener, works perfectly. Although, again, the genre and title of the
composition alone does not matter. Highly important is performance, which through
specific features can dramatically change the perception of a given musical piece.
Conclusion
As it can be seen from the above descriptions, working with music cannot be schematic,
because the processes occurring during its perception depend not only on the music itself,
but a multitude of other factors. That is why the humanist aspect of reaching for music
should be emphasized again and again. Precisely because of the complex nature of the
impact of music on man, the presence of man is always invaluable in the selection of
music. Through ongoing observation (assessment) of a client in a music therapy session,
a trained music therapist will be able to make a decision about choosing certain music
and not other music (or play, improvise music) that will meet the needs of that person in a
given place and time. No machine or computer program does this. Man is necessary for
this. This is another argument, besides the individual impact of music on the recipient,
that prompts the conclusion that the creation of the so-called ‘Musical first aid kits’, or
sets of specific compositions intended to always affect the audience in the same way,
have no justification.
To conclude this brief introduction to issues related to music therapy, it is worth pointing
out that music therapy is not listening to the sound of gongs, Tibetan bowls, relaxing with
music or ‘comforting by music’ of a person experiencing depression. It is a conscious and
intentional use of music or its elements in relation to the entire sphere of human
functioning, reaching for such important, and often disturbed by illness or dysfunction
issues, such as relationship building, expression of emotions, reaching and exploring
processes that are unconscious for the client but affect his life. Sometimes ‘only’ physical
improvement or action to increase mood can occur. Each time it is a conscious choice of
the use of music, based on scientifically proven knowledge, which has a specific goal and
is directed by a person with appropriate competences: a music therapist. Then the musical
mystery has a chance to materialize...
[255]
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[257]
Music Training for Aural Rehabilitation in Children
with Cochlear Implants: Current Trends
Dimitra Trouka, Georgios Papadelis
Abstract
This review provides evidence for the effect of music training on the auditory and music
perception skills of children with Cochlear Implants (CIs) who suffer from a degraded
perception of critical elements of music (i.e., rhythm, pitch, and timbre). In recent years,
there has been a growing interest in the design and implementation of music training
programs adapted for CI users as a means to maximize the benefits of aural training
provided by other more traditional methods such as speech therapy. Even though there is
no strong consensus on their efficacy, the existing studies provide enough promising data
to urge for further research. Additionally, several studies have demonstrated a beneficial
connection between music training and speech perception, as they share common
cognitive and sensory mechanisms, suggesting a transfer effect that eventually leads to
enhanced speech intelligibility. Even though these studies have revealed some positive
correlations between parameters from the two domains, the empirical data is quite
limited, prompting for further exploration. This article is an overview of recent research
in the field and summarizes the main hypotheses, experimental approaches, outcomes,
and limitations while recommending directions for future studies.
Key words: Cochlear implants, Music perception, Speech perception, Music training,
Children/Pediatric
Listening with a Cochlear Implant
A Cochlear Implant (CI) is considered as a technological miracle since it partially
restores a lost sense and provides a bionic ear to those who suffer from severe to
profound hearing loss. Instead of amplifying the sound level of the acoustical signal as
generally done by the conventional hearing aids, its novelty lies on the direct electrical
stimulation of the remaining functional neurons in the auditory nerve bypassing the
impaired or even lost hair cells of the cochlea (Zeng, Rebscher, Harrison, Sun & Feng,
2008). Through constant exposure to the acoustical stimuli, the auditory brain adapts to
this new way of “hearing” and translates the acoustic signal as a sound.
While CIs are quite efficient in transmitting coarse spectral cues to the auditory system,
they fail to deliver frequency resolution of the same quality compared to normal hearing
(Limb & Roy, 2014). This is pretty adequate for speech comprehension in non-noisy
[258]
environments and rhythm perception in music listening (Roy, Jiradejvong, Carver &
Limb, 2012). However, it is merely enough for perceiving more complex aspects of both
speech and music that require higher amounts of fine-structure information of the sound
to be sufficiently represented in the auditory system, along with listening under
challenging conditions. Such conditions could include speech comprehension in social
gatherings, telephone communication, listening concerts, lyrics comprehension by adult
CI users, or speech intelligibility in noisy playgrounds and classrooms by paediatric
users.
Even with the most advanced technologies that are likely to shape the near future of CI
systems, it appears that fine-grained representation of a sound in the signal encoded by
the device will still be far from being close-to-normal. As a consequence, intensive and
structured aural rehabilitation will continue to be of significant importance for CI users to
achieve maximum benefit from their device. Further research is also required in order to
establish alternative ways of aural rehabilitation other than classical speech therapy. As
such, a mounting body of literature suggests that music-based aural training could hold
the key to a productive, cheap, and non-invasive auditory remediation method for CI
users.
Music perception in Cochlear Implant users
Music perception and appreciation are considered of utmost importance both in Normally
Hearing (NH) individuals and CI users. As Gfeller & Darrow (2008) point out, music is
an acoustic phenomenon culturally present in every society that contributes to mood
regulation, expression of feelings, memory association to important events, and social
cohesiveness. Several studies have also demonstrated the multifunctional influence of
music in the human nervous system. Music can activate large neuronal networks in the
brain related to attention and arousal, along with syntactic and semantic processing and
motor-related operations (Kraus, Skoe, Parbery-Clark & Ashley, 2009; Herholz &
Zatorre, 2012). In a study of 2008, Leek, Molis, Kubli, & Tufts found among others that
music was an integral part of the daily routine in over two-thirds of the hard-of-hearing
participants surveyed, thus showing the significance of music in their lives. However,
Philips et al. (2012) found that 82% of the CI users of their study with post-lingual
deafness (N = 40) characterized music listening as being unnatural, indicating struggles in
terms of music enjoyment. This finding is consistent with a broader consensus among
related studies that CI users face difficulties in understanding the fundamental elements
of music, such as pitch, melody, harmony, and timbre, leading to limited perception and
appreciation. In agreement with Kang et al. (2009), Sucher and McDermott (2009) found
that CI users perform significantly worse in ranking musical intervals of both six and one
semitones, as compared to NH listeners. Several studies have also reported similar
findings related to harmony and melody perception, where CI users face significant
deficiencies in polyphony perception (Donnelly, Guo & Limb, 2009) or in identifying
familiar melodies (Gfeller et al., 2005; Brockmeier et al., 2011).
Interestingly, there is evidence that accuracy levels on pitch perception can increase with
the presence of temporal cues (rhythm) in the melody. Kong, Cruz, Jones & Zeng (2004)
found that accuracy scores in melody recognition among CI users were around 60% when
temporal cues were present and dropped to around 10% when these cues were absent,
pinpointing the importance of rhythm on pitch perception. The presence of rhythm seems
[259]
to influence further the perception of other musical elements (e.g., timbre). Kong,
Mullangi, Marozeau & Epstein (2011) found that temporal cues played a dominant role in
the timbre perception abilities of adult CI users, thus providing an assisting tool for pitch
perception enhancement on CI populations.
Despite the problems that CI users face when listening to music, much work has been
carried out on the value of music training as an aural rehabilitation tool for these
individuals with a strong focus on pediatric populations. In one of the first approaches to
this issue, it was reported that 11 weeks of music training could significantly improve
timbre perception in adult CI users (Gfeller, Witt, Stordahl, Mehr & Woodworth, 2000).
Similarly, Galvin, Fu & Nogaki (2007) found that performance on melodic contour
identification improved from around 15% to 45% after music training (up to two
months). Therefore, it has been strongly suggested that performance levels of CI users
could be improved in all areas of music perception (e.g., pitch, timbre, harmony) through
structured music training.
Studies in NH listeners have well established that extensive musical training can result in
plastic changes of multiple brain areas (Pantev, Engelien, Candia & Elbert, 2001; Hyde et
al., 2009; Li et al., 2018), which further led to the hypothesis that this transformative
effect could also be beneficial for CI users. This approach is mainly based on the idea
that musical training can induce plasticity to the impaired auditory system as the brain
gradually adapts to the restored auditory input after the acquisition of a CI and boost the
brain’s ability to learn and, most importantly, relearn. As a consequence, it has been
proposed that cortical plasticity might enable CI users to overcome the technological
constraints of the device and foster the development for improved perception of auditory
and musical patterns via training (Fu & Galvin III, 2008). Given the fact that there is even
more room for neural plasticity in younger brains, the effects of music training and
auditory rehabilitation in paediatric CI users has become an issue of significant
importance.
Exploring the benefits of music training in children with Cochlear Implants
Although research on typically developing children has already demonstrated a long-term
enhancement of music training on a variety of perceptual and cognitive domains, there is
still considerable controversy surrounding this issue in the case of hard-of-hearing
children that use Cochlear Implants. Chen et al. (2010) found that pediatric CI users
demonstrated significant enhancement of pitch perception after 2 to 36 weeks of music
training. However, it has to be noted that in this study, two of their subjects have
previously attended formal music lessons making it hard to conclude the effectiveness of
the training program per se. On a subsequent study of Di Nardo et al. (2015), findings
seem to comply as paediatric CI users demonstrated enhanced performance on melody
identification and pitch discrimination following a music training program of six months.
Interestingly, training-induced improvements have also been observed in other music-
related abilities, such as timbre identification and discrimination. Petersen, Mortensen, &
Vuust (2011) investigated the effect of weekly music training sessions on 21 prelingually
deaf preschool children with CIs for duration of three months. Even though the study
suffered from the relatively small sample (N = 21) and heterogeneity issues, results
indicated significantly improved performance on instrument identification tasks, as
subjects increased their performance scores by 32.3% indicating better timbre perception.
[260]
Kosaner, Kilinic, & Deniz (2012) designed and implemented a music training program -
named EARS- for 25 paediatric CI users based on singing activities, song recognition
tasks and timbre-related activities. Results demonstrated that after 18 months of training
with this program, there was a great improvement in all trained skills, also indicating
improved pitch perception. Despite these promising results, a serious drawback of this
study was that the assessment method was based on questionnaires rated by the same
trainees, emerging issues of subjectivity and false interpretation of the subjects’ actual
performance. Torppa, Huotilainen, Leminen, Lipsanen, & Tervaniemi (2014)
investigated the effect of singing and instrument playing on the auditory processing of
children with CIs. Children attended the music sessions from 14 to 17 months, and results
indicated improved performance on auditory working memory. However, this study
shares similar methodological limitations with that of Kosaner et al. (2012), due to the
use of similar assessment methodology (questionnaires filled by the parents), thus raising
questions for the validity of the experimental data. Moreover, seven of the study’s
subjects had attended music lessons with their parents before the start of the study,
making it difficult to attribute music’s efficacy on the training program, since existing
musical experience could possibly confound the results. Positive effects of music training
results were also demonstrated by a study of Fu, Galvin III, Wang, & Wu (2015) in
which they designed a computer-based melodic contour identification task for children CI
users. After four weeks of training, participants showed a marked enhancement on all
trained tasks. The authors stated that this training effect was present even in a subsequent
assessment after 18 months post-training, highlighting a long-term influence of music on
auditory-related skills. Even though the study did not suffer from major limitations, a
very small sample of children (only six) participated in the training group, making it hard
to draw robust conclusions and, further, pinpointing the need for future studies with
larger samples. In another study with positive results (Yucel, Sennaroglu, & Belgin,
2009), the investigators administered a music training program (rhythm production,
melody singing, music listening, and dancing to music) to parents of 18 paediatric CI
users. After two years of training, ratings from a questionnaire have shown a clear
improvement in all trained musical activities, along with an enhanced pitch and rhythm
perception. However, it cannot be ruled out that the results could be a biased product
since the parents performed the evaluation. Nevertheless, the authors concluded that
music could be used as a powerful tool helping towards a user’s auditory rehabilitation.
Music’s positive effect can also be seen in the study of Hidalgo, Falk, and Schon (2017),
where 15 children with CIs received training with aural-motor and rhythm exercises,
including sensorimotor synchronization tasks and rhythm imitation of different songs.
Analysis of the experimental data showed that musical practice could facilitate the
improvement of the participants’ anticipatory skills both in music and speech. The
authors claimed that this enhancement could benefit their temporal adaptation in more
complex speech contexts. In addition to the previous study, recent data appear to
positively associate the effect of music training on auditory brain areas not solely related
to music, such as speech-relevant areas (Kraus & Skoe, 2009; Shahin, 2011). This finding
could be proved extremely helpful in the first post-operative phase, where the vast
majority of the users attend speech therapy sessions to deal with language-related
deficiencies. Choi, Oh, & Bahng (2017) tried to investigate the effect of music on speech
recognition abilities of seven children users of CI aged between 5 and 6 years old.
[261]
Training included tasks with melodies, rhythm and instrument playing. After ten weeks
post-training, results indicated a strong enhancement of speech recognition abilities. This
finding is consistent with a more recent study of Cheng et al. (2018), where prelingually
deaf children with CIs demonstrated enhanced abilities on sentence recognition and
lexical tone recognition, after an eight-week musical program based on melodic contour
identification tasks. Moreover, the authors claimed that the observed training effect could
have been even greater if the mean age of the children was slightly higher (mean age was
only 6.3 years).
Despite the above encouraging findings, a part of the previous research could not verify
music’s efficacy on all of the auditory-related abilities they investigated, hence providing
mixed results. For example, Roman, Rochette, Triglia, Schön & Bigand (2016) recruited
19 paediatric CI users, but could not obtain a positive correlation between training and
Auditory Scene Analysis (ASA) skills. On the other hand, they did succeed in providing a
positive correlation between training and discrimination skills, along with identification
and auditory memory ones. These findings, however, could also be attributed to
shortcomings of the experimental design, along with the use of non-appropriate training
tasks and assessment protocols. As such, one of the major drawbacks of this study is that
the control group did not participate in the training program, even if it was initially part
of the training protocol. As the researchers claimed, this change possibly doubts the
positive outcomes, as they could be a finding that emerged from the participants’ general
auditory stimulation and not the program’s exclusively. Another study with mixed-results
was the study of Lo, Looi, Thompson & McMahon (2020), where 14 CI users between
the age of 6 and 9 participated in music therapy sessions and received additional training
through online music apps for duration of 12 weeks in total. Even though the
investigators found significant enhancement of timbre and spectral resolution, results
were not that encouraging concerning pitch perception, where there was no significant
change in post-training scores. Moreover, positive improvements were observed on
emotional speech prosody and question/statement prosody. However, it is clearly stated
that the correlation was weak, and it could also be the result of natural maturation
enhancement.
Without questioning the validity of the studies mentioned above, this review would not
be complete if other studies with negative results were not included in this text. Petersen,
Mortensen, & Vuust (2011) recruited 21 children with CIs that participated in a
computer-based training program concerning music instrument identification and pitch
change detection for three months. For the purpose of the study novel music tests were
designed in order to measure the children's skills on familiar melody identification, pitch
change detection, and musical instrument identification. Even though the methodology of
the study was carefully designed, the authors failed to provide any improvements
associated with the training. Nevertheless, the researchers did find a weak positive
correlation between training and assessed skills, but it was not that prominent to be
interpreted as being important. Possible reasons for the negative results could be
attributed to some of the study’s limitations, such as its small sample size and its
evaluation method, which was based on parental assessment, leading to potential
mistakes and biases. Results from an analogous study of Innes-Brown, Marozeau, Storey,
& Blamey (2013) come in agreement with the study of Petersen et al. (2011), as there
[262]
was no significant difference between the pre- and post-training assessment. More
specifically, Innes-Brown et al. (2013) recruited six paediatric CI users (nine normal
hearing and five with hearing aids) to assess their auditory abilities on pitch pattern
discrimination, timbre recognition, and rhythm perception. After the completion of a
training period of 24 weeks with music lessons that integrated Karl-Orff and Kodaly
techniques, the authors administered standardized musical tests. However, no significant
improvements were found in all of the tested domains. This lack of significant
improvements could lie in the accuracy levels of the pre-training assessment that were
relatively high, making it harder to detect any further improvements. Additionally, the
authors claim that motivational factors might have played a significant role, reducing the
efficacy of the training, which led to poor concentration and low levels of attention
during testing.
Future Directions
According to the studies reviewed above, it is pretty clear that there is little general
agreement on the music’s efficacy and rehabilitative value for people with compromised
auditory abilities, such as paediatric CI users. The body of literature is still limited, but as
every experimental agenda has a starting point, year by year, it has started to take its very
first steps as well. However, the knowledge gained so far has uncovered the most critical
methodology inadequacies, mainly pinpointing to the inappropriate selection of
assessment methods, along with the use of small and heterogeneous samples. Regarding
assessment methodologies, it is strongly suggested that they should mostly rely on more
quantifiable procedures and not solely on qualitative data such as responses to
questionnaires, as they have frequently been responsible for unreliable results. Moreover,
this research area urgently needs larger samples and subjects that maintain their
consistency in participation for the whole duration of the study, so the researchers would
be able to obtain higher statistical power and concrete experimental evidence.
Particularly, the employment of large-scale randomized controlled trials will minimize
biases and reduce the number of confounding factors (Jadad & Enkin, 2007). Future
studies should also concentrate on improving the design of existing training protocols or
develop new ones to fit better the hearing profile and the age of this particular population.
This is an issue that will challenge researchers in the field for years.
The potential of music training to improve speech-related abilities in paediatric CI users
is still a largely unexplored and vital issue for future research. Many CI users, especially
children, suffer from various speech deficiencies, forcing them to attend years of speech
therapy sessions, which in many cases display ceiling effects before the achievement of
the desired outcomes. It is broadly known that music and speech share common sensory
and cognitive mechanisms, but the processing of music places higher demands on those
mechanisms in comparison to language (Patel, 2011). Playing music requires a highly
developed skill of temporal synchronization and advanced employment of prediction
models of the subsequent events, similar to those obtained in speech perception and
production (Pesnot Lerousseau, Hidalgo, & Schön, 2020). Music frequently contains
textual content (lyrics) appropriately aligned with the rhythm of a musical piece or song,
with the stressed syllables typically placed on strong positions in the meter flow. This
alignment leads to robust alterations in the listener’s brain activity, which generally
enhances speech processing and lexical decision (Gordon, Magne & Large, 2011; Schön
[263]
& Tillmann, 2015). This is consistent with previous results in musicians with normal
hearing that show enhanced speech and language skills in various conditions (Strait &
Kraus, 2011; Parbery-Clark, Tierney, Strait, & Kraus, 2012; Zendel, Tremblay, Belleville
& Peretz, 2015). It would be, therefore, reasonable to hypothesize that this skill transfer
across different perceptual domains should also occur in populations with non-normal
hearing, such as paediatric CI users. Although the current research cannot yet provide
strong experimental evidence in favour of this transfer, the prospect of uncovering the
beneficial effect of music training on music, speech, and language perception serves as a
continuous impulse for further investigation.
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1. Celtic Cross. It combines two dynamic
symbols: the circle, indicating infinity of
the eternal and the cross, indicating the
physical world. The circle indicates the
feminine principle and the cross the
masculine principle (Fontana, 2006).
The use of Mandala Assessment Research Instrument (MARI
)
into Guided Imagery and Music (GIM) sessions
Vasiliki Tsakiridou
“Music, mandalas and archetypes transcend words and thought. Each of these forms
allows us to gain creative access to a world linked universally to every other person
(Bush, 1988). Thus, as we tap into our own creative
forces, through our involvement with music, mandala
and archetypes, we can also gain strength from the
creative forces inherent in all of us.” (Ventre, 1994:
35) In this article will be described the importance of
mandala for therapeutic purposes, followed by the
analysis of a diagnostic tool called Mandala
Assessment Research Instrument designed by the art
therapist Joan Kellogg. Then, Guided Imagery and
Music, a form of receptive music therapy, will be
outlined, in which two expressive therapies are
combined harmonically giving a significant result.
Finally, there will be some suggestions in using
MARI in GIM sessions giving a new insight for the
practitioners to assist their clients.
Carl Jung first introduced the idea of the mandala to
contemporary psychology based on his own
personal experience in mandala creation (Fincher,
1991, as cited in Wagner, 2012). Mandalas are depictions created by putting color and
design to a blank circle (Bruscia, 2002).
As a spheroid art
design, the mandala is
an archetypal symbol
standing for wholeness
(Bush, 1988). It
represents a visual
portrayal of the
difference between
conscious and
unconscious processes
(Wagner, 2012). Images added in a mandala lead to a
deeper awareness, making insights possible to be projected outside of the creator (Tucci,
2. Designed cards.
3. Color cards.
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1961, as cited in Wagner, 2012). The meaning of
the mandala is interpreted based on color,
geometric elements, symbols and culture (image 1)
(Jung, 1972).
The Mandala Assessment Research Instrument,
developed by Joan Kellogg, is a significant tool of
assessment and evaluation (Kellogg, 1978). In
accordance with this ‘card test’, the client is
presented with thirty-nine clear plastic cards, each
imprinted with certain designs, (image 2)
recognized by Joan Kellogg as archetypal, and
forty-five color cards (image 3). The client chooses
five designed cards and five color cards and s/he is
encouraged to pair the preferred designs with the
preferred colors. Then s/he is asked to choose one
designed and one color card that s/he does not like
and pair them together. The ‘tester’ then puts the selected cards on the MARI board, the
‘Great Round of the Mandala’ created by Joan Kellogg (image 4) (Bruscia, 2002).
The Great Round is a spheroid arrangement of the thirteen archetypal symbols structured
into distinct developmental stages. The card choices and their placement on the Great
Round are investigated and interpreted according to instructions proposed by Joan
Kellogg (Bruscia, 2002). Each of these combinations has an objective analysis and a
client’s potential subjective one. The cards are connected to each other forming a bigger
picture (Kellogg, 1978). This, in turn, provides a path through which clients could
express, in color and shape, the feelings emerging during the music therapy process. In
addition, the Great Round may be used to evaluate the process itself (Bush, 1988;
Ventre,1994).
Guided Imagery and Music (GIM) is a receptive music therapy
113
method invented and
developed by Helen Bonny in the 1960’s. This method utilizes the inherent qualities of
classical music masterpieces to stimulate deeper levels of the psyche, while revealing
feelings and making their release easier. This is achieved within a dream-like associative
state supporting the inner traveler to connect with the wide range of phenomena related to
the human consciousness (Bush, 1995). The music not only induces interesting and,
sometimes, unexpected imagery, but at the same time assists the traveler in experiencing
and uncovering aspects of the unconscious. The unconscious is being aroused, revealing
material buried in the deeper mind. Music selections chosen based on features as
instrumental timbre, vocal color, rhythm, dynamics of pitch, intensity and harmony help
gently, though powerfully, in setting the mood, while also facilitate emotional
involvement and insightful reflection (Bonny, 2002). Classical music, through its
complex structure, functions as a form of “screen” upon which an unlimited variety of
imagistic forms may be projected. These forms may involve visual, auditory, visceral or
113
In receptive music therapy the client listens to music that the music therapist chooses, while s/he
responds verbally or not. This experience can assist the client physically, mentally and/or spiritually
(Grocke & Wigram, 2006).
4. The Great Round of the Mandala.
Copyright 1993, 2005 MARI Resources,
LLC. All rights Reserved.
3) Colored cards.
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kinesthetic, memory recall, and intuitive imagery (Bush, 1995). This is accomplished
employing the ‘iso’ principle (Altschuler, 1948), which is a method of mood management
in psychotherapy.
114
In music therapy, the ‘iso’ principle is applied by providing music
that matches the client’s mood and encourages the rapid progress of his/her feelings
(Bonny, 1990; 2002). Through this kind of ‘journeys’ the client is able to get access to
material otherwise out of reach. GIM is a profound and revealing process allowing the
investigation of levels of consciousness not frequently accessible on the basis of normal
awareness (Bonny, 2002).
The structure of a BMGIM
115
session is the following:
- Pre-Talk: In the first session, the therapist takes personal history and makes the process
clear to the client. A discussion about the reason that the client decided to have a BMGIM
session takes place and the BMGIM therapist investigates the client’s issues, needs and
unrevealed material. The therapist and the client determine the objectives of the session
together and a question is addressed to the inner self. The following part involves the
relaxation induction. The client lies down, closed eyes, and the therapist sits near
him/her. The therapist then helps the client to relax and concentrate to the intention, so as
to assist him/her in entering an altered state of consciousness. After the induction, the
central part of the session follows, that is the music journey (Bonny, 2002).
- Music selection: The music program is selected by the therapist according to the ‘iso’
principle and lasts approximately 30 to 40 minutes. In BMGIM, this principle helps the
therapist/guide to make decisions on the most suitable music program to use at the
beginning of the music journey, as well as at various points during the session when/if the
client needs it (Bonny, 2002). Helen Bonny had a classical training and developed an
expertise in choosing music capable of taking the listener on long inner journeys.
According to C. Bush (1995),
“Music is chosen for its therapeutic value and is not meant for entertainment […]
Classical music, with its universal themes and intricate composition, is supremely suited
for the imagery experience. Other types of music have the capacity to stimulate imagery,
but the depth of the experience can be limited by the simplicity of the composition. They
do not contain the universal qualities of classical music to evoke the depths of the human
psyche […] It (classical) is a great music that has survived time and change that carries
the archetypal quality of universal themes.” (Bush, 1995, 78-79)
- Music journey: While the music is playing, the therapist (guide) and client (traveler) are
communicating. The therapist’s presence assists the client in his/her reflection process,
but also encourages and reinforces whatever imagery experience is shared. S/he deepens
the imagery that comes to surface, allowing the client to focus on and engage in both
imagery and emotion (Bonny, 2002).
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“The guide will attempt to echo the feeling states of the clients. If an atmosphere of fun, frivolity, or
delighted surprise is being experienced, laughing along with the traveler encourages those responses to
continue. A client’s attitude of seriousness, sorrow, warmth is likewise to be responded to in kind.” (Bonny,
2002, 288)
115
The Bonny Method of Guided Imagery and Music (BMGIM) refers to the individual form of GIM, which
has very specific characteristics. Other forms of individual and group receptive music therapy inspired by
Helen Bonny are classified under the general name of GIM (Bruscia, 2002).
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- After talk: After the music ends, the therapist helps the client return gradually and safely
to the ordinary state of awareness. Then, a discussion takes place concerning the imagery
through verbal sharing. Also, the client is invited to draw a mandala and discuss with the
therapist the issues that reflect the initial objectives set (Bonny, 2002).
It is very important though to mention that
“GIM is only useful with those populations in which the client:
• Is capable of symbolic thinking
• Can differentiate between symbolic thinking and reality
• Can relate (his or her) experience to the therapist
• Can achieve positive growth as a result of GIM therapy” (Summer, 1988: 31).
Also, according to Bruscia (1992),
“BMGIM is contraindicated, whenever the client lacks:
• The medical and physical stamina needed to experience the music and the images
that may arise from the music;
• The emotional stability and ego strength needed to undergo the feelings that may
arise in response to the music and images evoked;
• The intellectual abilities needed to understand his/her own experiences in
BMGIM, and not be dangerously overwhelmed or confused by them;
• The verbal abilities needed to dialogue with the guide during and after the
imagery experiences;
• Sufficient reality orientation to distinguish between the imaginary and real words;
• The ego boundaries needed to maintain a separate sense of self after deep imagery
experiences where boundaries between self and other (or environment) may merge” (as
cited in Bruscia, 2002, 274).
The music therapist Helen Bonny and the art therapist Joan Kellogg worked together at
the Maryland Psychiatric Research Center, giving music sessions, followed by the
drawing of a mandala, as a form of a short-term, thorough psychotherapy. After each
session, Joan Kellogg made a diagnostic interpretation of the mandala, which was used
as a diagnostic instrument by Helen Bonny, indicating present positive or negative
tendencies; these were very useful to the music therapist in her decisions concerning her
work with the client. Τhe integration of the BMGIM method in psychotherapy sessions,
accompanied by the drawing of a mandala at the end of each session, has turned out to be
an innovative combination of these two expressive types of therapy. The mandala
drawing eventually became an important part of a BMGIM session (Bonny, 2002).
There is a reason why a mandala is preferred instead of any other type of a
sketch/drawing. In clinical settings, music and mandala have been used to achieve
therapy goals, including the following: to enhance receptivity, to stimulate or relax, to
evoke affective states and experiences, to evoke imagery and fantasies, and to stimulate
peak and spiritual experiences (Bruscia, 1998a, as cited in Wagner, 2012).
In BMGIM, the mandala helps the client to establish a connection between unconscious
and conscious. The client expresses him/herself through it, while his/her psychic state
takes shape and is expressed symbolically (Clarkson, 2009). Moreover, during the after-
talk, the drawing of a mandala offers the client the opportunity to create a solid
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representation of the non-verbal elements of his/her musical experience and process the
emerging material of the music journey (Edwards, Young & Nikels, 2016). Finally, the
mandala helps him/her experience a gentle and pleasant re-entry into the ordinary
conscious state.
By drawing a mandala, the client makes an aspect of the self-concrete in color and form
(Jung, 1972). This process supports the client contain feelings of fear, potentially aroused
by the music and imagery. The boundaries provided schematically by the mandala circle
establish a safe space within which the client’s consciousness can be expressed in the
form of shapes and colors (Wagner, 2012). While there are many theories on the meaning
of color and mandalas, Joan Kellogg (1978) suggests that, when working with a client,
theories should be set aside and the therapist should focus on the particular individual.
Example: Mark
Mark is twenty-five years old. He is homosexual. He is a nurse and lives with his parents.
In the discussion he has with the music therapist
who uses MARI and GIM as part of her training,
Mark tells her that his parents are too controlling
and that he suffers at home. Mark wants to move
out and be free. Then, the music therapist presents
the cards and Mark chooses six designed and six
color cards and the tester places them on the board
(image 5).
In MARI, there is not a specific point from which
to start the interpretation; this rather depends upon
many factors. This time, the music therapist starts
form stage three. This stage is called ‘the
Labyrinth or the Spiral’ (Ventre, 1994: 27) and it
is the stage of energy and movement. The symbol
below could indicate that there is an energy flow, while
the color red, specifically at this stage, could indicate anger, passion, a will for life or that
there is something important to uncover. Mark tells the music therapist that he often
works overtime in order to avoid being at home, while he is currently saving money to
move out. The music therapist then, asks him about color red. Mark likes that color; he
finds it strong and ‘alive’. The music therapist takes into consideration the client’s
subjective interpretation, which is a positive one, and makes the assumption that the
specific design combined with the specific color indicates Mark’s will to live and be
himself. Mark mentions then that his parents do not know he is homosexual and this is an
important reason (for him) to move out. He wants to be himself, but he believes that his
parents will never accept him. At stage seven there is the symbol of ‘squaring the
circle’.
116
This symbol shows that someone is determined or has come to a decision.
Mark is ready to tell his parents that he is homosexual, even though, according to the dark
orange color, this is too difficult and painful. The stage eight is the one of ‘Functioning
ego’ (Takei, 2006, 99) and identity. When the music therapist tells that to Mark, while
116
The ‘squaring the circle’ is one of the many archetypal symbols which form fundamental patterns of our
dreams and fantasies (Jung, 1972).
5. Mark’s MARI
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showing him the symbol, Mark responds “Oh, that’s me, like a propeller all the time!”
Clearly, there is some movement in this symbol. When the music therapist asks him what
he means by this, Mark responds that he works too much and this makes him feel like a
“wheel that never stops rolling”. It is also interesting to mention that hues of turquoise,
among others, stand for healing and care and Mark is a nurse. However, a dark turquoise
hue as the one represented in the picture above, indicates something unhealthy, a
burdened healer or mediator. This makes the music therapist ask Mark how he feels about
his job and whether he likes it. Mark responds “No”. He wants to do something else; he
does not know what yet, but he needs the money from his current work in order to move
out. Ten is the stage of endings, or ‘the Gates of Death’ (Ventre, 1994, 33). Mark knows
it is time for a change and he is ready for the next step. At stage seven they talk about
how determined he is to come out to his parents, but, simultaneously, how painful this
would be. However, at the ‘endings’ stage (10), the color yellow shows that Mark has the
inner strength required to cope with the pain. He is capable of meeting the challenges.
Then, the music therapist asks Mark what he thinks about the symbol at stage twelve
(‘Transcend Ecstasy’, Ventre, 1994, 33). Mark tells her that he sees it as a bird. Then, the
music therapist asks him, “If this bird were you, what you would leave behind? Where
would you want to land?” Basically, she asks him to create an image. Mark responds
telling that, he is an eagle leaving a dessert full of carcasses and going to a land full of
green trees (green card) and river with waterfalls. It seems that Mark is thirsting for
freedom and life. Thus, the music therapist together with Mark sets the following
intention: “Imagine that you are a big eagle going to a new land.”
The music therapist selects a program, called ‘explorations’.
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The music journey is
cathartic for Mark, who explored this new land as a reflection of his inner world. During
the process, Mark gradually gains the strength to build boundaries and protect himself. In
the after-talk, Mark draws a big grey eagle in the center that his wings go out of the
circle. All around it there is light blue water, based on an image he had, flying above a
river with crystal clear fresh water (during Parchelbel’s ‘canon in D major’). He entitles
the mandala ‘The road towards freedom’.
The altered state imagery of BMGIM, the interpretation of mandalas, and the Mandala
Card Test are interconnected and enhance each other. When combined they function as a
complete assessment and therapeutic process (Bush, 1988). There are several ways to
possibly use MARI in a GIM
118
session:
Before the journey:
Sometimes a client comes for a GIM session only out of curiosity and is not very clear or
specific as to what s/he wants to discuss. In such cases, MARI can provide a projective
screen of what is going on in the unconscious or what the client does not tell. This way,
through MARI, areas of the unconscious can be revealed to the client, upon which s/he
117
‘Explorations’ program is ideal for first-time travelers, as it is gentle and can provide useful information
about where the client is at the moment. This way, the therapist may have a better understanding of his/her
client in order to assist his/her to the most (Bonny, 2002).
118
The use of MARI in GIM sessions is a modification to GIM and thus, it is not following the specific
characteristics of BMGIM. These kinds of modifications in GIM are allowed and encouraged (Muller,
2014).
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9) MARI
cards.
can choose to work. Moreover, in certain occasions, a client may have so many things to
talk about, or many things going on in his/her life, that he/she may feel confused or
overwhelmed. MARI can help the client to identify and address what is most important
to work on at the current moment. Like in Mark’s example, MARI can assist in finding
a clear intention. Another way to work with the intention in Mark’s example would be by
focusing on Mark confronting his parents, but this would not be the ideal intention for a
first-time traveler.
After the journey:
MARI can provide an even more detailed and objective interpretation of the non-verbal
elements of the journey, while it is more powerful as a projective device than a single
mandala.
It also allows for comparisons with previous MARI tests in order to identify potential
change. With MARI, there is also room for experimentation, through the change of
colors and symbols creating a new picture of the journey. Another way to work with it
could be to use a single mandala (images 6, 8) and associate it with the colors and
symbols of MARI (images 7, 9). The client could just draw a mandala in the after-talk
similar to a MARI card. In this way, richer material could become available for an
objective interpretation.
6. Personal archive.
7. MARI cards.
8) Bonny, 2002.
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There are certain music associations for every MARI stage suggested by the MARI and
GIM community, offering a more profound exploration of the stages. For example, the
track On Becoming Human by Peter Kater is suggested for stage 0, while the “Humming
Chorus” from Puccini’s Madame Butterfly is suggested for stage 1. Given that the above
involves mere suggestions offered by the MARI community, it will not be further
discussed within the present article. Anyone interested though can investigate and
experiment with music and stages and create their own track list.
References
Altschuler, I.M. (1948). A Psychiatrist's Experience with Music as a Therapeutic Agent.
In D. M. Schullian & M. Schoen, Music and Medicine. New York, Schuman: 266-281.
Bonny, H.L. (2002). Music Consciousness: The evolution of Guided Imagery and Music.
Gilsum NH, Barcelona Publishers.
Bonny, H.L. & Savary, L.M. (1990). Music and Your Mind: Listening with a New
Consciousness. New York, Station Hill Press.
Bruscia, K.E. & Grocke, D.E. (2002). Guided Imagery and Music: The Bonny Method
and Beyond. Gilsum NH. Barcelona Publishers.
Bruscia, K.E. (1992). Manual for Level One Training in Guided Imagery and Music.
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_________ (1998a). Defining Music Therapy (2nd ed.). Gilsum, NH, Barcelona
Publishers.
Bush, C.A. (1988). Dreams, Mandalas, and Music Imagery: Therapeutic Uses in a Case
Study. The Arts in Psychotherapy, 219-225.
_________ (1995). Healing Imagery and Music: Pathways to the Inner Self. Portland:
Rundra Press.
Clarkson, G. (2009). Mandala Analysis: A Clinical Case Study. Journal of the
Association for Music & Imagery, 75-93.
Edwards, J.K., Young, A. & Nikels, H. (2016). Handbook of Strengths-Based Clinical
Practices: Finding Common Factors. Abingdon: Routledge.
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Shambahala.
Fontana, D. (2006). Meditating with Mandalas. London: Duncan Baird.
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Music Therapy Clinicians, Educators and Students. London: Jessica Kingsley Publishers.
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Kellogg, J. (1978). Mandala: Path of beauty. Belleair, Fla: AMTA.
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Takei, S. (2013). MARI Mandala Assessment and Research Instrument. Raleigh, NC:
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Archetype of the Mother, Mandala, and Music. Music Therapy, 19-38.
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Relationship in a Therapeutic Day School. Qualitative Inquiries in Music Therapy, 1-32.
[276]
[277]
The Effects of Neurodevelopmental Delay in Body Image
Perception through Arts (Painting)
Anastasia Varsamopoulou
Abstract
Wide research has been performed in exploring the link between body dissatisfaction and
an increased risk of perceived negative health and poor psychological well-being. In
contrary, there is little research regarding the link between the effects of
neurodevelopmental delay and body image perception. Hence, we explore in a qualitative
pilot study if there is a connection between body image perception and perception of
neuromotor delay of the central nervous system.
We use neurological evaluation with neuropsychological standard tests from the INPP
program for primitive and postural reflexes and their connection to the sensory and
proprioception systems for every participant. With the basic requirement of participants
not knowing the test results and their neuromotor deviation, we note the neurological
immaturity of the participants, children or adults, and then give them material for
drawing/painting themselves. We investigate whether body parts involved in neuromotor
delay are depicted in drawings or paintings. For this, we rely on principles of art therapy
and take advantage of the knowledge on its application. Our methodology consists of
qualitative research and interpretive phenomenological analysis. The results of the
application suggest that there is activity of expression and depiction of neurological
dysfunctions through painting using the technique of body image perception. Confirming
the presence of neurodevelopmental delay through painting can help identify the causes
of symptoms in differential diagnosis, among other health problems that are not visible in
other ways.
Of course there are several research problems which we will further explore in a larger
sample of participants, demarcating the expressions of the painting activity.
Key words: art therapy, neurodevelopment, body image perception, art perception,
primitive reflexes, postural reflexes, sensory system, proprioceptive system, INPP
program.
[278]
Introduction
What is art therapy?
Art therapy is a well-established therapy that facilitates nonverbal emotional expression
and therapeutic communication and is ideally suited for working with early
developmental trauma and other concepts in mental health. Although the core of art
therapy is the belief that art making benefits the therapeutic mechanism of expression,
transformation and self-awareness, there has been little art therapy research that explores
and discerns the unique and specific role that art making holds within the profession. Art
therapy works projectively in projecting personal experiences, thoughts and in general the
sense of self through the process of painting.
Segal (1974) writes:
“In projective identification parts of the self and internal objects are split off and
projected into the external object, which then becomes possessed by, controlled and
identified with the projected parts. Projective identification has manifold aims: it may be
directed toward the ideal object to avoid separation, or it may be directed toward the bad
object to gain control of the source of danger. Various parts of the self may be projected,
with various aims: bad parts of the self may be projected in order to get rid of them as
well as to attack and destroy the object, good parts may be projected to avoid separation
or to keep them safe from bad things inside or to improve the external object through a
kind of primitive projective reparation.” (27-28)
Projective identification is a form of adaptation, communication, defense, and creative
expression that permeates the core of many psychotherapeutic treatments. A gradual
mutual understanding by the patient and therapist of its multiple meanings within the
therapeutic relationship and its place in the patient’s unconscious functioning is crucial to
the working-through process.
When we observe the client making a drawing, we understand their state of mind through
synthesis; but by conducting art assessments we acquire the same knowledge through
analysis in bits and pieces while supporting the validity and reliability of the analysis.
On a neurological basis, we can identify that art therapy is recognized as an intervention
that facilitates the expression of mind-body connectivity (Achterberg et al., 1994; Hass-
Cohen, 2003; Kaplan, 2000; Lusebrink, 2004). Mind-body-based interventions are also
characteristic of health psychology, medical arts and sports psychology.
Based on scientific research, we believe that expressive therapies, where art therapy is
involved, can access silent thoughts that are not based on thinking and verbal connection
and are therefore a suitable intervention for trauma-related disorders (Gantt & Tinnin,
2009; Tripp, 2007). If we look at neurodevelopmental delay as a trauma because its
existence takes them away from normal everyday life, we can use the same identification
techniques that are used in art therapy.
Neurodevelopmental Delay
It is well known that our perception of reality and the sense of the world is influenced by
our neurophysiology (Siegel, 1999). Changes in the systems of the brain and other
relevant parts of the body affect our perception and mood, as well as our thoughts and
[279]
feelings. Also, communication between our cells, the flow of blood and oxygen and the
secretion of hormones are directly the way we experience our reality. The traditional
models of mental health often separate knowledge from the body, but now we have a
greater understanding of how the body informs and influences our thoughts and cognitive
function (Damasio, 1999).
Ιt is important for our research that, at the beginning of the twentieth century, Adler’s
theory of holism considered there was no separation between the brain and the body (as
mentioned in Mosak & Maniacci, 1999). At the same time, in Freud’s theories of the
unconscious, chemical reactions and complementary systems have been identified as key
parts in a continuous game that exists within our brain and outside our consciousness.
This is now referred to as implicit communication (Siegel, 1999). Damasio (1999)
reported that language is an interpretation of concepts that are already known in the body
and Bollas (1987) referred to this idea as ‘Unthought Known’. Moon (2010) noted that
the work of art therapy is found in the exchange of practical and nonverbal applications.
That’s why we use the principles of art therapy in our research.
Since the 1970s, ‘neuromotor immaturity’ (NMI) is reported as a neurological
dysfunction and is defined by the Institute for Neuro‐Physiological Psychology (INPP) as
(1) the continued presence of a cluster of aberrant primitive reflexes above six months of
age and (2) absent or underdeveloped postural reactions above the age of three and a half
years. Also, Scaramella‐Nowinski and Madden (2006) concluded that
“Neurodevelopmental Delay” has multiple etiologies, as it is clinically correlated with
electrophysiological abnormalities/dysrhythmias. Neuromotor functioning provides an
indication of maturity in the functioning of the Central Nervous System (CNS) (Goddard
Blythe, 2005). It is also linked to the functioning of the vestibular, proprioceptive, and
postural systems, which cooperatively provide a stable platform for centers involved in
oculomotor functioning and subsequently visual perception. Individuals with neuromotor
immaturity (NMI) frequently experience difficulties with related skills such as balance,
coordination, and visual perception, which can affect behavior and educational
performance in children and manifest as chronic anxiety and emotional sensibility in
adults (Goddard Blythe, 2004).
Through the body, the brain receives sensory information from the environment and
reveals its experience of the environment. Immaturity or conflict in brain–body
functioning affects the brain’s ability to assimilate and process information and to express
itself in an organized way.
One method of assessing maturity and integrity in the functioning of the CNS is through
the examination of primitive and postural reflexes. The presence or absence of primitive
and postural reflexes at key stages in development provides ‘windows’ into the
functioning of the CNS, enabling the trained professional to identify signs of neurological
dysfunction or immaturity. The Institute for Neuro‐Physiological Psychology (INPP) has
been a pioneer in researching the effects of immature primitive and postural reflexes on
learning and behavior, developing protocols for the assessment of abnormal reflexes and
related functions, and has devised a specific method of effective remediation (the INPP
method) (Blythe, McGlown, 1979).
[280]
The use of standard tests to assess retention of primitive reflexes, development of
postural reactions and other tests for “soft signs” of neurological dysfunction at key
stages in development provides acknowledged signposts of maturity in the functioning of
the CNS. Primitive reflexes emerge in utero, are present in the full‐term neonate and are
inhibited in the first six months of postnatal life when connections to higher cortical
centers and frontal areas develop. Primitive reflexes are also suppressed and integrated
into more mature patterns of behavior in the course of normal development as postural
reactions and muscle tone develop. Postural reflexes can take up to three and a half years
to mature (Blythe 2017, John Wiley & Sons (Wiley)).
Abnormal primitive and postural reflexes provide diagnostic signs of immaturity in the
functioning of the CNS which can act as barriers to optimal cortical functioning. The
central nervous system acts as a coordinating organ for the multitude of incoming sensory
stimuli, producing integrated motor responses adequate to the requirements of the
environment (Bobath, 1978). When the CNS is working well, the cortex is free to
concentrate on “higher” functions involved in intention and motor planning and not on
the detailed mechanics of movement. The cortex knows nothing of muscles, it only
knows of movement (Hughlings, 1946).
Neurodevelopmental Delay as Trauma
The reason we use art therapy to confirm or rule out the possibility of deficient
neurodevelopment through body image painting is that neuroscience research widely
accepts that vivid, unprocessed traumatic memories are stored mainly in the right brain
hemisphere, exactly where painting works and where there is no narrative organization
and cognitive perspective (LeDoux, 1996; Schore, 2009, 2012). We treat ‘neuromotor
immaturity’ (NMI) as trauma because of the frequently experienced difficulties regarding
related skills, such as balance, coordination, and visual perception, which can affect
behavior and educational performance in children and manifest as chronic anxiety and
emotional sensibility in adults.
Researchers of mental trauma agree that traumatic memories are stored primarily in the
nonverbal right hemisphere of the brain, where such memories do not have access to the
left hemisphere’s analytical ‘thinking brain’ (Courtois & Ford, 2013; Schore, 2009; van
der Kolk, 2003, 2006). It is very important to note that preverbal, implicit memories of
trauma appear to be retained in fragments and manifested in physical senses and common
forms of action that are separated from ordinary narrative memory and disconnected from
the person’s self-awareness (Chu, 1998; van der Kolk & Fisler, 1995).
Therefore, flashbacks interfering between thoughts and images, as well as the unnoticed
sensations of the body, are reminders of past traumas that are experienced as if they were
present, largely inaccessible to conscious recall or control (Caruth, 1995; Chu, 1998).
Here, painting becomes the driving force for the projection of the trauma that has been
experienced as a dysfunction, has caused trauma to the body and is depicted on the parts
of the body, similar as placing cities on a map.
[281]
Working with Trauma
Studies in neuroscience give us important information about how we can work with
traumatic memory. The ‘bottom-up’ (nonverbal) rather than the ‘top-down’ (cognitive)
approach is indicated as a more effective method associated with the therapeutic
intervention in the process of art therapy. This is confirmed by contemporary writers who
have described the lasting positive effects on early childhood trauma (Gaensbauer, 1995;
Karr-Morse & Wiley, 1997; Lipsitt, 2012; Perry & Szalavitz, 2007; Terr, 1988, 1990).
Thus, it is now accepted that traumatic memory is encoded through visual images and
physical sensation, rather than through language or cognitive information. It is also
known that unresolved traumatic memory can seriously jeopardize the cognitive function
of the brain (Van der Kolk, 2006, 2014).
The structure of the human brain itself is such that trauma is particularly resistant if it
occurs before the age of three and before the intermediate corpus callosum acquires the
myelin sheath, allowing the two hemispheres to communicate (Tinnin & Gantt, 2014).
This resistance can be bypassed using the principles of artistic expression to explore and
make visible the invisible.
Methodology
The method we use is qualitative research and interpretative phenomenological analysis.
Qualitative research examines the way people make sense out of their own concrete real-
life experiences in their own minds and in their own words. This information is usually
expressed in everyday language using everyday concepts. Qualitative research thus
contrasts with quantitative research, which focuses on the way the world is understood in
researchers’ minds, usually using abstract scientific concepts and terminology.
Quantitative research also examines differences in the amount or level of the variables
being studied while it creates and affects relationships between them, whereas qualitative
research is concerned with the patterns and forms of such variables. The two approaches
are not rivals but are complementary (Hawking and Mlodinow, 2010).
Hypothesis
There is a connection between ‘body image’ perception through painting and perception
of neuromotor delay in the central nervous system.
Ethical Considerations
We protect confidentiality by not mentioning the names in the drawings. For data
collection, we maintain clear boundaries between participants and therefore the process is
individualized. Furthermore, each participant has agreed to participate in the research
study.
Research Process and Sample
Basic design of the study for a representative sample of 4 people.
We use INPP tests for a complete neurological evaluation. We investigate mainly
primitive and postural reflexes and their connection to the sensory systems for every
participant, whereas it is a basic requirement that the participant does not know the test
results and his neuromotor deviation. We record the neurological immaturity of the
participants, with INPP tests (Blythe, McGlown, 1979) in children or adults, and then
[282]
give them material to draw themselves, using the Goodenough test (Goodenough, 1926),
or the technique of body image drawing. The materials can be black pencils and A4 size
paper or the use of drawings of the whole body on white paper in actual body size. We
investigate whether body parts involved in neuromotor delay are depicted in the drawings
or paintings. The process is individualized for every participant. The participant in the
study chooses his own position for drawing on the paper, an approach that will ensure a
position that will not make him feel threatened by the intervention of the therapist. Such
interventions, which the client may interpret correctly as a requirement for change, signal
a threat (Porges, 2013) and the threatened clients have little access to advanced ways of
participating. Attaining safety promotes allostatic balance and adjustment which is
interpersonally and socially mediated (Schulkin, 2011). The free choice of body position
for drawing helps to negotiate interpersonal space and ways to calm the internal freezing,
depicting the principle of creative integration. Actual and creative embodiment of
movement has additional neurobiological advantages, as movement can assist in rewiring
cognitive functions (Timmann & Daum, 2007).
Participants are persons who have been diagnosed earlier with the INPP tests and have
been found to have neurodevelopmental delays.
Analysis of the data
Participant A
20-year-old man with Asperger Syndrome
The presence of asymmetrical tonic neck reflex (ATNR) prevents the full perception of
the parts of the body associated with this reflex, hands neck and lack of independent
synchronization in bilateral movement, lack of awareness of hand mapping.
Asymmetrical tonic neck reflex (ATNR) is a primitive reflex that is found in newborn
babies and normally remains until around 6 months after birth. If it continues to be
activated, it prevents the emotional and cognitive development of the brain.
Draw a man: sketch on A4
paper
[283]
Participant B
33-year-old man with Asperger Syndrome. In his painting, he expresses the parts of the
body that suffer.
With INPP neuromotor tests we found that all primitive reflexes are present. This is
expressed in the painting as well, emphasizing the points that are most dysfunctional to
his body.
Draw a man: sketch on paper
in actual body size
[284]
Participant C
11-year-old girl with learning difficulties,
redness on knees and feet, muscle
dysfunction and pain in the parts of the body
shown on the photos. In her painting she
expresses the parts of the body that suffer.
Participant D
10-year-old boy with Asperger Syndrome
Draw a man: sketch on paper
in actual body size
[285]
After his evaluation with the INPP tests, we found that reflexes are
present, indicating the Babkin response: Present palmar, sucking and
rooting reflex. When there are retained oral reflexes, they are often
present in combination with other tactile reflexes such as the palmar
reflex and the Babkin response. This neurological loop means that there
can be problems in the development of independent hand and mouth
movements resulting in “overflow”. This continued immature sensory–
motor connection can be observed when a child tries to write, draw, or
use the hand for a skilled activity. Hand movements are accompanied by involuntary
mouth movements such as chewing, sucking, or biting the tongue; when speaking or
eating, the child may have difficulty in keeping the hands still.
In his painting he expresses the parts of the body that
reflexes are still present.
Draw a man: sketch on paper
in actual body size
[286]
Conclusions and discussion
We know that the somatosensory cortex and the motor strips are further contributing to
the connections between the body and the brain. The somatosensory strip, also called the
primary somatosensory cortex, holds a map of the body, and the motor strip links motor
activity with visual spatial information. For children, engaging in sensory-based activities
provides a crucial foundation for future, more complex learning and behavior (Roseann,
Schaaf and Miller 2005: review).
‘Art as therapy’ activities have the potential to activate neural pathways related to tactile
and kinesthetic sensations, associated with the primary somatosensory cortex. Sensory
experiences include touch, movement, vision and sound. Junctures where different areas
in the brain meet, such as the superior temporal gyrus (Figure 1), are areas of polymodal
integration.
Expressing, experiencing and learning how to regulate effects can perhaps happen more
easily through sensory integration activities and kinesthetic movement associated with art
therapy activities (Hass-Cohen, 2008). We see this happening to our participants in this
pilot study.
In this indicative sample of persons with neurodevelopmental delay, we can see a
depiction (απεικόνιση) of the body parts affected by the dysfunction of the central
nervous system through drawing/painting. Participants do not know in advance the result
of their neurodevelopmental evaluation, so the drawing of their body is not affected.
The depiction of the body through drawing/painting, either on A4 paper or on paper of
the same size as that of the body
reveals the dysfunction that the
body feels. This way, we can
confirm the results from the
neurological tests for neuro
development and make a ‘diffe
rential diagnosis’ (διαφοροδιά
γνωση) with respect to other
diseases. If we take into account
that almost no health specialist
evaluates primitive reflexes, it is
important that through this
research we begin to take them
more seriously. It may be helpful
for health professionals who
apply the INPP treatment
program to use the body image
test through drawing/painting in
their reassessment.
Figure 1
[287]
It is necessary to further define the boundaries of the process of artistic expression in
order to limit the variables in the study of the results. Such variables can be
environmental stimuli of the participant, age and sex. The implementation of the study in
a larger number of participants will provide greater insight regarding the correctness of
results and limitations that we must integrate in the implementation of the evaluation
through artistic expression.
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Workshop CAIPT 2019-Photos by Yiannis Kaminis
[293]
Members of the Editorial Board
Anna Lazou. Born in Athens, Assistant professor in Anthropological
Philosophy Athens University Anna Lazou studied Philosophy and
Theatre in Athens and London. She has received a theatre acting diploma,
a diploma in music (classical guitar and theory). She lives in Athens and
works for amateur theatre plays that she creates with her students and other
artists that follow her artistic groups Drys and Dryos Topoi. Author of
various dissertations and articles, among them, Orchesis. Texts on Ancient
Greek Dance -in English (2003) and Man, the Creator (2016), Orchesis and
Athletics (coedit.), 2015, Art, Philosophy, Therapy (coedit.) v. A & B,
2016, Interpreting Ancient Greek Dance-Workbooks 2013-2018 (editor) 2018 et a. Occasionally
she publishes poetry and theatre. At present she teaches philosophy and runs experiential
workshops for adults and younger people; she composes and directs plays for University theatre
and dance theatre and coordinates the Ancient Orchesis Study Group of Dora Stratou
Theatre. She intends to start an international program of body and dance techniques and
philosophy for life long learning and therapy in the context of Athens University and finalise her
long term research on ancient Greek dance and drama for a future publication. She collaborated
with cultural organizations and Universities for the investigation (theory & practice) of Orchesis.
Dr. Dora Psaltopoulou-Kamini is an Assistant Professor at the Aristotle
University of Thessaloniki-Greece (A.U.Th-GR). She is a music-
psychotherapist Ph.D, MA-CMT, a psychoanalyst and a visitor Lecturer at
the master level programs at the University of Macedonia (Music
Therapy), at the University of Nicosia-Cyprus, at the University of
Thessaly, at TEI of Larissa and at Aegean University-Greece. She has
published in Greek two academic e-books: ‘Music Therapy: The Third
Way’ and ‘Communication in Music Therapy-Paideia. The Co.M.P.A.S.S
Approach’ (www.repository.kallipos.gr). She is Greece’s representative at
ECArTE, and a member of the Accreditation/ Certification Commission (World Federation of
Music Therapy). Her music therapy life journey has been published in 2017 at ‘Lives of Music
Therapists’ (Vol. I, Barcelona Publishers).
Xanthoula Dakovanou is a Medical doctor (National and Kapodistrian
University of Athens), music therapist (Paris Sorbonne V University) and
Doctor in Psychoanalysis and Psychopathology, specialized in ‘Music and
Psychoanalysis’. Her thesis was supervised by S. de Mijolla-Mellor (Paris
Sorbonne VII University). She has taught music therapy, voice and
psychoanalysis as a visiting lecturer in the following universities: Paris
Sorbonne VII, Paris Sorbonne V, University of Nantes, and the University of
Macedonia. She has published scientific articles in Greek, French and English and she is the
creator of the therapeutic protocol ‘Analytical Musicodrama’. She has edited 2 personal musical
albums as a composer and she has participated as a singer in concerts, theater presentations,
musical albums, radio and TV emissions and cinematographic production all
over Europe.
Dimitrios Galanis-Kolintzas, studied Philosophy in the National and
Kapodistrian University of Athens, Greece. His research interests, at the level
of master studies, are mainly centered upon Philosophy of Science, Philosophy
of Nature and Philosophy of God. He regularly writes articles in peer-reviewed
both scientific and philosophical journals and he is a highly active, newly rising
researcher and writer in the wide field of Philosophy.
[294]
Τίτλος/Title
Φιλοσοφία, τέχνη, θεραπεία/ Philosophy, Art, Therapy-PATh
Πληροφορίες της έκδοσης/Publication Info
Επιστημονική επιμέλεια, εκδότρια/Editor, publisher – Copyright Αθήνα 2020:
Άννα Λάζου/Anna Lazou
Ειδική έκδοση/ Special Edition – Co-editor: Ντόρα Ψαλτοπούλου/ Dora Psaltopoulou
Επιστημονική & συντακτική επιτροπή/Scientific & Editorial Board: Μ. Βενιέρη, G. Voutos,
Δ. Γαλάνης-Κολίντζας, Ά. Γούναρης, Δ. Δήμου, Κ. Γογγάκη, A. Zistaki, A. Irvine, Φ. Ίσαρη,
Κ. Καλαχάνης, Β. Καλδής, Χρ. Κεχαγιάς, Ε. Κοτρώτσιου, Α. Λεύκα, Ν. Λουκιδέλης,
Λ. Καραλή, Α. Κτενά, Α. Μουρίκη, Σ. Μπεκάκος, Φ. Μυλωνάς, Ξ. Ντακοβάνου,
Π. Πανταζάκος, Γ. Πεφάνης, Θ. Σακελλαριάδης, Στ. Τσινόρεμα, Ντ. Ψαλτοπούλου.
Υποστήριξη/Supporters:
• Ερευνητικό Πρόγραμμα ΕΛΚΕ – ΕΚΠΑ/Research Program SARG-NKUoA
• Εργαστήριο Φιλοσοφικής Συμβουλευτικής & Αυτογνωσίας – Τμήμα Φιλοσοφίας
ΕΚΠΑ/ Laboratory of Philosophical Counseling & Self Knowledge – Dep. of Philosophy
NKUoA
• Εργαστήριο Πληροφορικής στις Ανθρωπιστικές & Κοινωνικές Επιστήμες – Ιόνιο
Πανεπιστήμιο/ https://hilab.di.ionio.gr/path
Ιστοσελίδα: Διεθνής Επιστημονική Εταιρεία Αρχαίας Ελληνικής Φιλοσοφίας/ www.deeaef.gr
ISSN 2732-7345, ISSN 2732-7353 (ηλεκτρονική έκδοση/online)
