Grace Meadows offers a perspective on safety and risk in arts and health.
“You can’t kill someone with a paintbrush”, so I was once told by a medical professional, with a wry smile. We were discussing risk at an initial consultation workshop on professional regulation for healthcare professionals in 2016. It hadn’t occurred to this medical professional that engaging in an arts therapy (art, music, dramatherapy) could cause harm. “Why would it?” they said, “it’s just a bit of painting or music”. And therein lies the trap: ‘it’s just a bit of…’
The arts don’t tend to just be ‘a bit of…’, they are powerful, creative channels that can and do play significant roles in our lives. If I asked you to describe what the arts mean to you, you probably could, quite easily, by talking about a piece of music, a poem or play that’s moved you; its impression has left a lasting footprint in your mind and soul. I’d class that as more than ‘it’s just a bit of…’. That kind of encounter can be life-changing.
One of the reasons why it can be life-changing is because we form connections with others as we make, do, create, participate in an arts-based experience. The arts innately create opportunities for experiences that can be shared with others and this can take us beyond the ‘it’s just a bit of…’.
When we have an encounter with another, something fundamental happens. It takes us outside ourselves and we begin to see ourselves in relation to others. We begin to form relationships and connections with our wider worlds. They too create and leave footprints and impressions which can have positive and negative influences.
The arts act as a medium empowering people to communicate ideas, feelings, thoughts, emotions in ways that circumvent the need for language. They are subjective and most certainly emotive. They have the power to awaken, enliven, stimulate, and walk us down memory lane. There’s an unpredictability, an unknowableness about what will resonate with what when we sound that opening chord or make that first mark on a page.
But within an arts, health and wellbeing context, do we really understand what we are undertaking when we open up a dialogue with someone through an artform?
In making that first sound, we are exposing something of ourselves. We are making ourselves vulnerable, we’re opening up and beginning a connection of sorts; perhaps it’s an invitation. If this is how we might be feeling, then how might our ‘client’, ‘service user’, ‘participant’ be feeling? Being aware of this vulnerability is vital in helping to ensure that we are remaining aware of how the other might be experiencing this encounter and staying alert to the nature of the relationship that is forming. In thinking about relationships, we cannot avoid referencing intimacy. Intimacy is created through the sharing of experiences. We need to remain mindful of this in our encounters and be aware of how that experience might be perceived or interpreted by the other. This is something we cannot predict but it is something that we can be prepared for in order to help us manage this element of relationships.
As arts practitioners (I use this in the broadest, most inclusive sense), we have a sense or awareness of what we hope or intend to do when we set out to work with people through or using the arts, and also a sense of our own vulnerabilities. But simply the intent to do good doesn’t mean that we’re not doing harm. What we have the capacity to do is limit the extent of any potential harm or risk to the other by being fully aware of our own limits, both personal and professional.
What we might not always know is the story of the other that we are working with. Have we had the opportunity to find out what they are bringing to the encounter? Do we know why they come to our singing group or why they attend the weekly drawing class? The arts resonate with all of us and we each have a story to tell about our relationship or connection with them. For many who have experienced mental health issues, trauma, difficulties in their lives, the arts can provide a sanctuary, relief, stimulation, hope, and a way in which to process and move on from their experience.
In music therapy we talk a lot about working with someone’s potential, regardless of their illness, injury, disability / impairment, life experience. Conversely, we are also acutely aware that there is likely to be an implicit or explicit impairment that we might not always fully understand the extent of until we have established the therapeutic relationship. As arts practitioners, that is where our professional and ethical responsibilities come in, regardless of whether or not we are regulated – we must be acting within our scope of practice.
Just as we talk about there being a spectrum of arts practitioners, there is also a parallel spectrum of risk and vulnerability that the people that we work with bring with them. We must be aware of and alert to this at all times. This is what keeps the work safe, the people we work with safe, and ourselves safe. I see this being balanced by a continuum of knowledge and skill – similar to that moment when the shapes inside a kaleidoscope come together and the image becomes clear.
One fundamental way in which we can ensure that the experiences stay safe for all, is by assessing our own skills sets and being honest about what level of risk and vulnerability we are capable and skilled to work with. Knowing when to signpost to other services or collaborate with others, contributes to making the experience safe.
Working with or through the arts is often perceived by others as doing ‘good’. I know, as a music therapist, that people often respond to my role by saying what a ‘good’ job it must be, music is wonderful, it’s like a kind of magic or a magic pill for all kinds of ills. Well, I believe there are two kinds of magic – good and bad. With music I have the potential to do good by offering a positive experience. But I’m also acutely aware that I have the power to do harm, however unintentionally, and this is where the importance of professional, ethical and skill knowledge comes in.
When we are working beyond our scope of practice and knowledge, damage can be easily done. Regardless of how we create our spectrum of arts, perhaps what we, as a collective body of practitioners, should all be holding at the centre of our work is a person-centred approach – ‘who is this person that I’m with’, ‘is what I’m providing / offering what they need / want?’ Thinking from the person outwards, towards what else might be available for them. We must not lose sight of the individual and their needs, their context, how we understand and support them in their endeavour.
How ready are you for that unpredictability, and unknowableness around what will resonate with what when we sound that opening chord or make that first mark on a page?
Grace Meadows (Watts) is the former Development Director for the British Association for Music Therapy www.bamt.org. She is currently the Music and Dementia Programme Director for The Utley Foundation alongside her role as a senior music therapist in the Music Therapy Team at the Cheyne Child Development Service, Chelsea and Westminster Hospital NHS Foundation Trust