Last Thursday, singing leader Richard Lawton woke up planning to head to the Royal Melbourne Hospital as he has done for the past eight weeks where he runs a singing group for outpatients living with an eating disorder. Except last Thursday Richard felt “a bit crappy with bit of a headache and feeling sludgy.” He could feel his resistance before he’d even emerged from under the covers.
“I was wondering ‘do I have to?… I’d rather stay in bed …’ and it’s a familiar voice in my head because as a card carrying introvert, every night before choir (I have four now) I have to walk myself through this, and it’s the same voice that says ‘I really don’t want to expose my self and be seen by a room full of people’ which is of course what a singing leader does.”
So last Thursday morning, Richard persevered and as he reached the entrance of the hospital it dawned on him how he probably wasn’t alone in his thoughts and how difficult it might well be for the outpatients heading along to his group. Anxiety and eating disorders are good friends, and eight weeks is a relatively short period of time in which to feel completely at ease in a new and unfamiliar situation. Richard senses an element of uncertainty lingering among his singing group at the Royal Melbourne and works to create a welcoming environment in which the outpatients can let down their guard and relax in a safe and fearless space.
“The chairs all have cushions on, and for the first couple of weeks people would come in, sit down and put a cushion on their lap. So they were putting up a defence immediately… There’s a lot of shame involved among patients with eating disorders and it’s important to be mindful of this as somebody encouraging them to open up and let go.”
Supported by a psychologist from within the department, Richard takes guidance from the singing group about ways to put the singers at ease and overcome challenges particular to them, often having to modify approaches and practice he would use readily with his other groups.
Care also has to be taken around use of words. No allusions to image or physicality or exercise. These boundaries are set by the singers who make it clear that to do so will provoke unnecessary anxiety among them. The group Richard works with does not comprise solely of the stereotype teenage girl. Participants range in age from Year 12 to their 40s and while there are guys in the inpatients at the hospital, Richard’s current singing group is all female.
Not knowing the background or the trigger of the illness among the individuals with whom he is working, it is also important that Richard allows them the freedom to choose which songs they sing to avoid material with unsuitable content or unwelcome connotations which may, again, instigate anxiety and prevent people from taking part. “The Cups song from Pitch Perfect is a favourite, and ‘Titanium’ is another one they like.”
Early on, in the inpatient program, only a handful of patients chose to take part in the singing group and it was a challenge to get those who did come along to sing at all during the hour long session. They looked so glum, Richard was wondering if he’d ever be able to break through. It was feedback from the psychologist which encouraged him to keep going in those initial weeks. Even if few of the patients were singing for the entire session and giving no outward signs of engagement or pleasure, their feedback was that they found it relaxing. In the outpatients program, more of them are singing and the numbers have increased.
“Anxiety levels are high. You want control. The thing about purging and eating is that you feel like you don’t have control over your life or your environment and this is one thing you can control. So when they talked about finding singing a relaxing thing, I thought, “oh right, so it’s doing something.”
One exercise Richard uses to combine movement with sound encourages everyone to stand up and shout as if hailing a taxi: Hey! Heeeey! HEEEEEEY!.. with each exhalation and sound growing louder and more sustained. The group cooperate well with this one, becoming less self conscious and more engaged as time goes on. It’s an activity that produces good vibration and masses of endorphins, too.
“When you enter the building everything is so quiet but when the group leaves, they are vocal and enlivened. They have found their voices. They also appreciate the act of singing together, of doing something with other people.”
Anyone who has sung regularly with a singing group will identify with the sense of connection which develops between members of the group. The act of singing facilitates this bond and even aligns the heartbeats of people singing together. Experiencing this sense of connectedness is an important contributor to mental health recovery and a sense of individual peace and wellbeing.
Richard works to empathise with the group, sharing his own doubts and insecurities. The more they feel at ease, the more they will open up and sing. The more they sing the better they will feel and hopefully, the stronger they will grow. And it really seems to be working.
“Last week, when I started the session I could tell that a few of them were having a rough day and I told them a story about how the night before I’d gone to a Contact Dance class for the first time in months. Contact Dance is something I used to be very good at, but it’s mostly a young person’s form, and my mind was coming up with all the familiar excuses as to why I should stay home. Then, when I was almost there I couldn’t find the venue, and almost turned back. Eventually I got through the door and it was wild – I had a ball.
When I told the singing group that story, a couple of them said ‘yes, I had so many excuses for not leaving home today,’ and ‘I got as far as Central station and very nearly turned back.’ So we talked about the importance of ‘getting through the door,’ and how so many times in life we allow our fears to hold us back, and how important it is to get ourselves through the door…
The door metaphor is about how we sometimes shy away from the very thing that is good for us. We know that singing makes us feel better and yet sometimes it still feels too hard.”
For Richard who leads the singing group on a voluntary basis, reward comes from feeling his work is having a positive impact on the lives and the recovery process of the singers.
“I think what touches me about working there is about those days when my skin feels too thin to be out in the world, to be seen, to have to show up, (and as a white male I have it stacked in my favour). When I’m with these women who are wrestling with the human condition there’s a part of me that’s very humbled. And there’s another part of me that wants to wave a magic wand so they can see how most of the negative thoughts they have about themselves are a cruel illusion. “
While magic wands are scarce, Richard’s work in the outpatients’ department might be the next best thing. The group reports feeling calm, more free and relaxed after singing together. “A lot of them are perfectionists, seeking something they can never have. Eating disorders are one of the few mental illnesses which can kill you or from which you can make a full recovery. It is very hard to measure the success rate of patients who are discharged as they go off and live a full life.”
As each weekly session ends, the group leaves and the hospital corridor echoes with voices raised in more chatter with less silence. The soothing balm of singing works its wonder, the endorphins flow, and the world feels a better place for it. Just last week, Richard heard from the supervisor how after the group had finished, the singers went out to a café where they were much more upbeat and talked about how much they’d enjoyed getting up on their feet and singing and moving that day. That’s pretty magical.
Written by Deb Carveth, Online Editor for Community Music Victoria, with Richard Lawton.