African drumming and psychiatric rehabilitation.

Longhofer, Jeffrey and Floersch, Jerry - Psychosocial Rehabilitation Journal; Apr93, Vol. 16 Issue 4, p3, 8p

Abstract: Focuses on a study that established an African polyrhythmic drum ensemble program at two Kansas City community support programs and its role in psychiatric rehabilitation. Information on Dagbama music; Results and conclusions.


Abstract: An anthropologist, a social worker, and two professional musicians established an African polyrhythmic drum ensemble program at two Kansas City community support programs. We discovered that clients had no disability to learn Dagbama music, and, moreover, their musical talents were underdeveloped. We describe the program, the setting, and its results. Particular attention is focused on the ways in which the ensemble program uniquely complemented the goals of psychiatric rehabilitation.

"African drumming at the mental health center?" the executive director asked with a skeptical gaze. "How will that serve our clients in the community support program?" A connection between drumming and mental health services does seem puzzling at first glance. In this article, we describe how an anthropologist, a social worker, and two professional musicians established a performing drum ensemble at two Kansas City metropolitan mental health centers.(n1) We argue that the polyrhythmic music of the Dagbama from West Africa has characteristics that uniquely complement the community integration goals of psychiatric rehabilitation.

Our program provided community support program clients the opportunity to become musicians. The establishment of an African polyrhythmic drum ensemble led to outcomes that complemented psychiatric rehabilitation: clients felt a sense of accomplishment (improved their sense of competency); they formed an identity with a group (strengthened environmental supports); and, through concerts and performances (improved vocational outcome), clients realized a need to make recognized contributions to society (Anthony, Cohen, & Farkas, 1990, p. 65). Our teaching philosophy was not focused on a participant's lack of knowledge and experience of music: these were not deficits to be overcome (Rapp & Wintersteen, 1989). It was not a requirement that clients have musical backgrounds, nor did we select clients with musical sensibilities. We knew from our experience with public school students that we had a kind of music that was accessible, yet complex and beautiful. We asked the participants to learn the culture and the music of the Dagbama people. Clients were not to experience the cathartic effects of music or rhythm passively. They were to become musicians.

We will first briefly describe Dagbama music, then we will discuss the way in which the project unfolded. Particular attention is focused on how the program articulated with the goals of two community support programs. And, finally, we will present results along with some concluding thoughts about the effectiveness of the program.

Dagbama Music 
West Africans often use their music as a means to integrate the individual formally into community institutions (Chernoff, 1979, pp. 33-37). The adoration of a newborn is not merely accompanied by music and dance; music and dance become one way that a child is recognized as a new member of the community. So it is with puberty, marriage, and death. Music and dance recreate and recognize the individual's role in the community (Chernoff, 1979, pp. 159-161; Nketia, 1974, pp. 21-34). 
The Dagbama people live in the northern region of Ghana, West Africa. Their history begins with the migration (1100 A.D.) of horsemen who conquered the agricultural peoples of the region and established a kingdom known as Dagbon (Staniland, 1975; Chernoff, 1979; Locke, 1990). In Dagbani language, the term luna refers not only to the drum but also to the drummer. The origin of the lunsi, drumming guild, is told through the story of Bizum, an outcast who often begged and played a drum to console himself (Locke, 1990, pp. 11-12; Nketia, 1974, p. 45). A chief became so charmed by Bizum that he organized a drum guild charged with telling the political history of the Dagbama. The lunsi became a formal social group whose members took great pride in their community status:

Their dance drumming not only makes irresistible music, but contains pithy wisdom that is linked to social history. Dancers can consider the history of their famous ancestor and connect his situation with their own problems with family and friends. It is in this sense that the lunsi are simultaneously historians and counselors (Locke, 1990, pp. 12-13).

The Dagbama tonal language is transposed to a double-headed tension drum, which imitates their spoken tones (Chernoff, 1979, pp. 43-44). Drum language is then put into a polyrhythmic framework, creating one of the most complex musics of the world (Nketia, 1974, pp. 129-138). Each musical part in an ensemble is elegantly juxtaposed to other parts (Chernoff, 1979: pp. 44-61). The lead drummer calls, others respond, and a unity of sound results. Our musicians have developed a teaching technique that breaks down the drum parts so that they can be easily taught. This is one of the distinct advantages of teaching Dagbama music over Western musics, which can require months to learn the technique and prior knowledge of music theory.

Program Description 
One afternoon we invited case managers and clients from two mental health center community support programs to an African rhythm workshop. Fifty individuals attended. We described the project as experimental and made clear that participation was voluntary and required a commitment of only 1 hour a week. Although we emphasized that enjoyment was primary among our expectations, we boldly stated that our goal was to create a performing drum ensemble. We were aware that our program had to quickly gain the confidence of both staff members and clients: the mental health centers had agreed to a trial program based on client participation.

The social worker and the anthropologist participated as drummers and as consultants about group process and community support programs. The musicians had no prior experience with the severely mentally ill; therefore, they had no idea what differentiated an affective from a psychotic disorder. Participants were viewed as potential musicians, not as manic-depressives or schizophrenics. As others have observed, "rehabilitation research indicates that the psychiatric diagnostic system has little to offer the rehabilitation approach" (Anthony, Cohen, & Farkas, 1990, p. 29).

No time was wasted in long descriptions about our program and its goals at the first meeting. Quickly we divided the audience into four groups of 10 to 15. Drums were distributed, and within 10 minutes the first group had performed a Dagbama piece, Damba Sochandi. One by one, each group demonstrated the accessibility of the music and how exhilarating it was to play. The workshop ended with an invitation to attend our practice sessions. A dozen clients expressed a willingness to participate. This positive response facilitated our negotiations with the mental health centers: each agreed to a 6-month trial program.

After scheduling a time and establishing a location, we settled into a comfortable routine of weekly 50-minute sessions at one of the mental health center facilities. Some clients attended only once, others trailed in and out, but a core of 10 returned every week to drum, sing, and dance. At each session we discussed the Dagbama people, engaged in dialogue about client perception of the music, and brainstormed about the ensemble name and future performances. We kept an open-door policy and expected interest as the only precondition for participation. New drummers were able to listen during the first half hour but always played by the end of the session. Those, however, who kept returning to practice became hooked not only on the music but also on the group process. Three months later we held our first performances at several mental health center banquets.

Practice sessions involved everyone in the same activity and at the same levels of stimulation. In teaching the music, we break it down into parts and restructure the parts back into a whole, which gives the sessions a distinct structure that easily assimilates everyone. With practice essential to the formation of an ensemble, each session provided a way to measure progress. The clients heard their gains each week, providing a distinguishable way to test concrete reality: we recorded sessions to compare past with current playing abilities.

As a core group formed, we utilized group process issues to facilitate social skills development (Anthony, Cohen, & Farkas, 1982). Questions emerged that required group decision making: the ensemble had to decide how practice attendance would be connected to concert performance, the rules for participation, the name of the ensemble, the kind of costume, and performance schedules. The naming process helped to forge a sense of group identity, while the decision-making process gave the group ownership of its direction.

One participant related the following to the group: 
What should we call ourselves, a band or drummers? What should we be considered? Yesterday I told someone that I was in a band, and it was really funny. I walked into a music store, and this guy was a real good salesman (he was being nice; he wanted a sale). I was wearing my baseball cap that has "talking drums" written on it. The salesman asked me, what are talking drums? Talking drums are African, I said. We are taught by authentic teachers. It's drumming the way Africans used to, or still, do it. I told him that I belonged to a talking drum band.

Following our first performances at mental health center banquets, the group became committed to the ensemble goals. We concluded that the program had achieved one of the fundamental goals of the International Association of Psychosocial Rehabilitation: An effective social/recreational program offers group experiences that are designed to enhance individuals' skills and to foster a sense of community and healthy participation in normalizing adult activities.(n2)

Results and Conclusions 
After 6 months, 45 different individuals have tried drumming at least once; of these, from 12 to 15 attended on a regular basis. A new face appears in every session. The open-door policy had not disrupted our pedagogy, and the participants never intimidated newcomers with their new talents. Those who came only once helped the regular members by allowing them to compare someone just starting with their 6-month experience. Although males numerically dominated females (26 to 19), gender made no difference in drumming. The women, however, were more comfortable with learning dance; but gender never became a barrier to full participation. Race, moreover, was not an obstacle; at most times we had a near 50150 ratio of African-Americans and Hispanics to European-Americans.

The type of psychiatric diagnosis did not differentiate the nonparticipants from participants. The group represented the spectrum of major psychiatric illnesses: schizophrenia, manic depression, and one instance of multiple personality disorder. Our program staff members often wondered who had what diagnosis and claimed that they couldn't tell any difference in symptomatology. In comparing client-musicians to our high school students, we discovered that mental health problems posed no barriers to learning Dagbama music. Indeed, the client-musicians were often more motivated and more open to learning than our other students.

The mental health center staff members had discussed with us a document stating the goals of therapeutic recreation: 1) focus on integration; 2) focus on skill building reaching a client's needed skills; 3) focus on ability rather than disability; and, finally, 4) assume that social interaction is significant to recovery. In order to achieve these goals, a recreation program should provide moderate levels of stimulation, consistent reality testing, and leisure education; it should focus on controlling symptoms through leisure and provide structure, clarity, and accountability; and it should offer social skills training, help clients define and deal with problems, and promote self-esteem. The fit between the ensemble program and these goals could not have been better.

First, our style of teaching was inclusive. It created a context wherein everyone's musical ability was appreciated and recognized. Because Dagbama music is polyrhythmic, it is unusual to someone familiar with Western music: thus, no client, even those with past musical experience, started at a competence level above another. This aspect of the music acted to level the experiential differences between participants, made clients equally capable, and blocked the usual feelings of inadequacy and insecurity associated with learning new behaviors. One drummer who was asked why he liked playing said: Participation is the thing. If you have never done something, there is a doubt in the front of your mind. Believing in something and doing it are two different things. And when you come and do it, the doubt leaves the front of your mind and goes to the reserve, opening it up even more. You imitate a beat and put yours into it, and then you got two beats, two beats make four, then a dozen; this is what makes them talking drums.

Second, Dagbama drum history provided us with an allegorical way to introduce ourselves and a rationale for the ensemble. The story of Bizum's outcast status connected the drumming to the client's experience of being stigmatized. Bizum overcame his disadvantage through drumming and, as a consequence, was meaningfully incorporated into Dagbama social life. So we communicated to the participants that we wanted to experiment with Dagbama music and discover whether or not it would also help them discover meaningful ways to participate in their community.

Our program maximized the involvement of the client (Anthony, Cohen, & Farkas, 1990; p. 164). With the establishment of a performing ensemble, the project had a purpose beyond that of being an activity hour. We promised participants that we could deliver on our claim of making them musicians if they would only take the creation of an ensemble seriously enough to stick with the weekly practice sessions. These mutual expectations laid the foundation for respect, communicated to the clients that we believed in their potential (building self-dignity), and focused the activity on be-coming and not over-coming:

A real-life situation is created with practical demands and responses; a healthy interdependence exists between the program, staff personnel, and its members when a sense of hopefulness encourages participation (Pascaris, 1991, p. 48).

We intend to make the ensemble performances community events (phase two). As multicultural education has become a new program focus at schools, and multiculturalism a topic for debate throughout society, we plan to schedule performances at daycare centers, schools, churches, and businesses in order to educate the community about the music and culture of the Dagbama people. We believe that concerts, then, will meaningfully integrate them into the community (Anthony, Cohen, & Farkas, 1990, p. 70), and as performing musicians, facilitate a vocation (Brooks, 1981)--the second and third ways in which we complement rehabilitation goals.

From the perspective of the mental health center staff, then, our project provided a unique opportunity to those clients who used day program resources. Our open-door policy was compatible with the center's day program philosophy: anyone who wanted to come to the group, even if only once, was welcome (Pascaris, 1991, p. 47). If one conceptualizes a day program as offering a smorgasbord of resources from which the client actively chooses, Dagbama music provides a resource that fits the psychiatric rehabilitation goals of self-determination and empowerment (Cnaan, Blankertz, Messinger, & Gardner, 1988). And because we were not community support staff personnel and our musicians were not therapists, we were seen as community resources even though we practiced at the center's facilities. Only one staff member regularly attended our sessions, but he did so because of his interest in learning the music; at no time did he intervene in his role as therapist. The client-musicians were able to think of us as teachers, not social workers, and of themselves as musicians, not "chronics."

We conclude that the unique "apart" playing of Dagbama music is the essential component of the program that facilitated the successful articulation with community support program goals. Each drummer plays a part which forms a unity and totality of sound. No single drummer can play Dagbama music. The highly participatory and easily accessible nature of apart playing provided clients the opportunity to occupy a productive and satisfying position (each as a drummer) within a larger totality (ensemble), from which their illness often excludes them: for example, a worker within the economy; a student of higher education; a parent, husband or wife within a household or domestic unit. A person afflicted with a major mental illness is not often afforded the same opportunities to be a part of a functioning social totality. The drum group first provided the participants with a meaningful group role and, second, it gave them access, through performance, to other community institutions. One drummer summarized his motivation for playing: "I like to get up before an audience." Another 50-year old participant said, "I had no opportunity by nature or law to do this as a youngster, but now I don't hold it back."

People with severe mental illness have few opportunities to perform meaningful social roles. This experiment with Dagbama music has corroborated assumptions that recreational programs can act as vehicles to help clients develop important social and work skills (Admundson, Dyer, Henderson, & Rathbone-McCuan, 1991; Pascaris, 1991; Seilheimer & Lee, 1987; Coviensky & Buckley, 1986; Moriarty, 1976; Sheppard, Olson, Croke, Lafave, & Gerber, 1990). We are confident that phase one of the project increased their self-esteem, built a supportive peer group, and fostered skill development. The success of the ensemble also demonstrated that the musical talents of the clients had been underdeveloped. Their performance capabilities, moreover, have encouraged us to enter the second phase: community concerts. The clients have made it clear that they want to perform, not just practice. They have said more than once that they would like to be paid for concerts, not play for free. At this time, we see no reason why their expectations can't be met; after all, these are the same expectations of most musicians.

We would like to thank Leslie Young, Steve Solomon, Tim Sandusky, David Wiebe, Kirk Fowler, Ronna Chamberlain, and Michael Clark, who stretched their imaginations, believed in us, and gave us the opportunity to work at their mental health centers. The two musicians, Douglas Goodhart and Bird Fleming, from the Center For World Music, provided the talent, enthusiasm, and openness to take their music into new arenas. Finally, to all those individuals who courageously stepped forward to drum, sing, and play, we can never thank you enough.

(n1) The drumming project has two phases: 1) establishment of the drum ensemble, and 2) community concerts. The second phase has just begun. We are raising local monies to establish a fund to compensate our client-musicians for community performances. We strongly believe that monetary compensation is essential to the program's success. At this time, then, we can only report those findings associated with the first phase of the project.

(n2) This was taken from a document adopted in June of 1985 by the Board of Directors of the International Association of Psychosocial Rehabilitation Services. It was a working document that described the definition and principles of psychosocial rehabilitation.

Amundson, R., Dyer, L., Henderson, W., & Rathbone-McCuan, E. (1991). Vacation therapy: A community normalization experience for persons with long-term mental illness. Psychosocial Rehabilitation Journal, 14(3), 81-91. 
Anthony, W. A., Cohen, M., & Farkas, M. (1982). A psychiatric rehabilitation program: Can I recognize one if I see one? Community Mental Health Journal, 18(2), 83-96. 
Anthony, W. A., Cohen, M., & Farkas, M. (1990). Psychiatric rehabilitation. Boston: Center for Psychiatric Rehabilitation. 
Brooks, G. W. (1981). Vocational rehabilitation. In J. A. Talbott (Ed.), The chronic mentally ill (pp. 96-100). New York: Human Sciences Press. 
Chernoff, J. M. (1979). African rhythm and African sensibility. Chicago: University of Chicago Press. 
Cnaan, R. A., Blankertz, L., Messinger, K. W., & Gardner, J. R. (1988). Psychosocial rehabilitation: Toward a definition. Psychosocial Rehabilitation Journal, 11(4), 61-77. 
Coviensky, M., & Buckley, V. (1986). Day activities programming serving the mentally impaired chronic client. Occupational Therapy in Mental Health, 6(2), 21-30. 
Locke, D. (1990). Drum damba: Talking drum lessons. Crown Point, IN: White Cliffs Media Company. 
Moriarty, J. (1976). Combining activities and group psychotherapy in the treatment of chronic schizophrenics. Hospital and Community Psychiatry, 2 7(8), 574-576. 
Nketia, J. H. Kwabena (1974). The music of Africa. New York: W. W. Norton Company. 
Pascaris, A. (1991). Social recreation: A blind spot in rehabilitation. Psychosocial Rehabilitation Journal, 15(1), 43-54. 
Rapp, C. A., & Wintersteen, R. T. (1989). The strengths model of case management: Results from twelve demonstrations. Psychosocial Rehabilitation Journal, 13(1), 23-32. 
Seilheimer, T., & Lee, M. (1987). Community integration through therapeutic recreation: The Scorpions' second season. International Journal of Partial Hospitalization, 4(3), 235-240. 
Sheppard, J., Olson, A., Croke, J., Lafave, H., & Gerber, G. (1990). Improvisational drama groups in an inpatient setting. Hospital and Community Psychiatry, 41 (9), 1019-1021=. 
Staniland, M. (1975). The Lions of Dagbon: Political change in northern Ghana. Cambridge: Cambridge University Press.