Theatre for Children in Hospital: The Gift of Compassion

Theatre for Children in Hospital: The Gift of Compassion

by Persephone Sextou

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Product Details

ISBN-13: 9781783206452
Publisher: Intellect, Limited
Publication date: 12/15/2016
Pages: 205
Product dimensions: 6.60(w) x 9.00(h) x 0.40(d)

About the Author


Persephone Sextou is a reader in applied theater and research director of the Community and Applied Drama Laboratory at Newman University, Birmingham, UK.
 

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Theatre For Children In Hospital

The Gift of Compassion


By Persephone Sextou

Intellect Ltd

Copyright © 2016 Intellect Ltd.
All rights reserved.
ISBN: 978-1-78320-647-6



CHAPTER 1

A TCH definition and more ...


Applied theatre in hospitals

I position my TCH bedside methodology broadly under applied theatre. Applied theatre is an inclusive term used to host a variety of powerful, community-based participatory processes and educational practices. Historically, applied theatre practices include Theatre-in-Education (TiE), Theatre-in-Health Education (THE), Theatre for Development (TfD), prison theatre, community theatre, theatre for conflict resolution/reconciliation, reminiscence theatre with elderly people, theatre in museums, galleries and heritage centres, theatre at historic sites, and more recently, theatre in hospitals (Nicholson 2014).

'Applied' refers to an act that takes theatre practices out of the obscure black boxes and brings them back to the 'open air' [...] [It] should be understood as a contemporary theatre practice that has many different histories and varied rationales depending on where it is happening.

(Thompson 2012: xix)


Thompson concentrates on the evolving process of applying theatre to community audiences and invests in learning about being human, being a citizen and being empowered to think and act in the particular moment and context within which theatre takes place. He also argues that the 'act of applying [theatre] is an unfinished process that encounters situations that are themselves evolving and not fixed examples of social practice' (Thompson 2012: xxi). But aren't all arts an unfinished process? Arts change over the years because humans change and environments change. Different styles of theatre and forms of theatrical applications outside traditional venues have been discovered, without which we would still be making theatre for middle-class audiences who can afford to attend.

From my research of applied theatre interventions in healthcare, I believe that theatre in hospitals is an unfinished process for many reasons. First, it encounters examples of an artistic practice that is continually evolving within the development of the arts in healthcare settings. This is the growth of the arts and health field that I discussed in the introduction. Second, TCH is the product of an unceasing experimentation with the art form in clinical contexts and environments, an artistic need to move on to new discoveries of the way theatre works in the community, investigating the needs of communities. As with all experimental practices, it desires answers. Questions created by the needs of hospitalized children, the specific demands of clinical space and time, the physical and emotional condition of the audience, the opportunities for making a difference in children's lives, and the occasional disappointment of having opportunities denied, are central to the experimentation with applied performance in hospitals. Third, TCH is an unfinished process of articulating the experience of hospital performance in words that make sense to those who have been involved in the experience, both the artist and the audience. The artist often struggles to find meaning in illness and pain: whether that is in direct relationship with family members or in professional relationship with audiences. Holding onto the principle, 'theatre for all, the sick, the poor and the sufferers', is a strong starting point, a creative motive, an enthusiastic beginning towards understanding theatre and communities in contexts of illness. Finally, TCH is an ongoing cultural process with potential to develop further from its strong interaction with children in hospital and the surrounding setting. The setting is an important aspect of TCH work but not more important than performance itself. Theatre that is 'applied' to community settings does not lack in aesthetic integrity (Brodzinski 2010). It is only fair to say that TCH, as all applied theatre practices, is rooted in the role of the space, the story, the characterization and the audience–artist relationship. At the same time, hospital performance develops in a continuing dialogue with the setting and the clinical context. TCH is always in transition and thus, perfectly positioned in applied theatre's unfinished businesses.

TCH is an interdisciplinary process. The act of applying theatre in relation to illness, like other research in this field, takes the artist into related disciplines including health and medical humanities, child wellbeing, the philosophy of illness and psychology. Primarily, the artist serves the arts and although they familiarize themselves with other disciplines, and learn from them and through them, they exercise learning from the perspective of the art form. The TCH artist uses knowledge from other disciplines to inform practice in hospital and create portable, child-centred, entertaining and relaxing performances that are offered to sick children while undertaking treatment. The objective of TCH is to harness theatre as an art form to improve child wellbeing in hospital while contributing to the wellbeing of those who care for them, such as their parent/carers and by extension, the wider family. The artist becomes a 'guest' in the house of illness but never stays too long. They enter the world of sickness for a while, bringing to the lives of children an air of normality that is associated with life outside the hospital, and they exit quietly – no applause and no 'bravos'. Working on the margins of the healthcare system is not necessarily a bad thing. 'One of applied theatre's strengths is in its status as the outsider, the visitor and the guest' (Thompson 2012: xx).

This viewpoint encourages me to say that the outsider artist works in collaboration with healthcare but does not serve it nor interrogate it, which reminds me of the role of the TiE practitioner who works in but does not serve the educational system. The artist's job in hospital is to reconnect the arts with wellbeing, which suggests a holistic approach to illness and healing that is rooted in ancient civilizations and systems of treatment and cure. For example, Hippocratic medicine treated the patient as a 'whole' (body, mind and spirit) and not just the symptoms of the disease. Hippocrates 'prescribed' massage, herbal diet, hydrotherapy, sea bathing (Osborn 2015) and theatre performances in the open-air Theatre of Cos Island in Greece to treat the body, the mind and the spirit. These experiences were enriched by worshipping and participation in religious ceremonies, and offered the patient a rounded caring experience and improved wellbeing. Although no claim can be made that my TCH practice draws on Hippocratic values exclusively, one sees a connection between believing in alternative supportive treatments and offering theatre as an alternative method of supporting patients. The TCH artist enters healthcare with the belief that theatre works as a complementary 'prescription' to medication and clinical remedies. Whereas many people in western societies speak with confidence about traditional medicine and how it works for the patients, TCH makes a holistic proposition.

Research evidence strengthens this view. Kostenius and Öhrling (2009) and Aldiss, Horstman, O'Leary, Richardson and Gibson (2008) argue that theatrical interventions can reduce child pre- and post-operative clinical stress and enhance their wellbeing. The TCH artist can use these findings to inform their practice. This perspective insists that there is no professional from within the healthcare system, no doctor, nurse or therapist, who can claim holistic practice because their practice is constructed around traditional medicine. Even if they do support holistic thinking, they are usually limited by medical regulations not to apply it to their patients. The visitor-artist faces no such limitations. The artist brings into healthcare a non-medical approach to illness and a system of values that is new to the clinical context. Those values – aesthetic, social, cultural, and ethical – may be incomplete and even irrelevant to the hospital context but they may generate an integration of artistic and clinical values (I oppose the imposition of artist values upon the clinical and vice versa) with aesthetic fulfilment. A commitment to these values explains why being a guest in healthcare is a good thing. TCH seeks to benefit children's wellbeing in ways that the healthcare system cannot achieve alone.

Those artists who engage in TCH, as many applied theatre practitioners do, are often motivated by the desire to make a difference to the lives of children through theatre. In that case, they may be elevated by idealism and altruism, courage and compassion. They come from outside the healthcare system to help and support children, give them normality and hope, bring a smile to their faces and change the ways they experience illness during their hospital life. This is the 'guest in applied theatre' position that I discussed earlier. What can be wrong with that? Nicholson (2005) suggests that working in a context (clinical) that is not theirs may create an 'uneven balance of power' between altruist (the applied practitioner) and recipient (the audience) and she argues that

Because practitioners often work in contexts in which they are outsiders, for all kinds of reasons their good intentions about 'helping' others in 'need' may be construed as patronising or authoritarian, contributing to keeping 'others' on the margins rather than taking centre stage.

(Nicholson 2005: 30)


From this standpoint, Nicholson (2005) discusses the reciprocal relationship between altruism and self-interest, between the artist and the community in applied theatre practice, and the effect of this relationship on the development of social citizenship. In its best collective form, applied theatre is offered to the community as a gift. It is, nevertheless, not always obvious why and how people need help and thus, what is intended to be beneficial for the audience often turns out to be more beneficial for the giver, the applied theatre artist. This is because the diagnosis of the 'needs' of others may fall into personal interpretation. The artist, for example, assumes that a child in hospital needs a performance for a reason. The artist might assume that one child needs the performance more than another does; a child with critical illness needs it more than a child who is in hospital for a short stay, but again this is only an assumption. In fact, the artist does not know which child needs the performance and therefore they rely on the children themselves to decide if they want the entertainment or not. The artist does not know what it is exactly that the child needs. Therefore, they cannot make any accurate predictions about the ways in which the performance will support each child. Altruism sometimes acts as a blind person who cannot see with their objective senses but can only perceive things with their minds. Moreover, because the blind man has a desire to see, his perception of what might be there can almost feel real. The altruistic artist can sometimes perceive the needs of the audience from such a personal and subjective perspective as if they were blind. They are passionately motivated to benefit children in hospital but can only perceive and interpret things through filters of personal understanding. However, altruist's authority to make interpretations of the child's needs and decisions about the work needs attention. In my experience, the artist occasionally perceives their role as rescuers who enter hospitals to show their ability to love and perform for those who are in need. However, the performance is clearly not a heroic act, and certainly should not appeal to the artist as a victory in the battle with the child's illness. Applied theatre practice is a process that may require bravery, care and compassion, especially in communities that have experienced suffering and trauma, but it should not be seen as a relationship between artists who act as heroes and audiences who are victims waiting to be saved.

Calvert (2015) summarizes deep-seated concerns about heroism in applied theatre work as these have been developed from provocations presented at the Theatre and Performance Research Association (TAPRA) Tenth Anniversary Annual Conference, 3–5 September 2014. Calvert discusses shared anxieties amongst TAPRA applied and social theatre working groups about 'the relationship between heroism [...] and the inflections of risk, bravery, care and compassion that identify the hero, and the tensions between individual and collective empowerment' (Calvert 2015: 175).

In addressing these concerns, applied theatre becomes an exercise in resolving the tensions of power and control between the practitioner and the audience, the individual and the community, the artist who is representing others and the others who are dependent on them as the representors of their own stories and rituals. Applied theatre practitioners should be aware of the idea of giving and what this 'giving' can teach them about the act of applying theatre to communities. We should be wary of egoism. Theatre should be a gift that the artist gives to themselves, a special feeling of completion and happiness, but it is also a gift to the audience. There should be no expectations of return or ownership. What a dishonest and dangerous image of the community artist that would be! Thus, the emphasis on altruism and heroism in a TCH context should be countered with an alternative view that rejects egoism and self-centred attitudes towards acting for children who are sick, and holds that the value of the work lies in encouraging the children to work together with the artist to make performance happen in the moment. This type of encouragement is complex, but suggests a shift in the power that a child experiences when they are ill, as the artwork is created and offered to the children with scope for activating them, engaging and involving them in it, at various levels. The notion of 'empowerment' in applied theatre and what it means in relation to hospital audiences is a good starting point for the discussion of the fictional as a deviation from painful realities. But first-place is given to the definition of hospital audiences.

TCH audiences consist of children of all health conditions during their stay in hospital and children of all age groups till early adolescence, from babies (months old to toddlers), and early years up to 12. TCH audiences usually lie in their beds but if their condition permits it, they may also move to the hospital's play centre, education centre and school or physiotherapy room, if this is the only other suitable space for TCH to happen. Very few hospitals have their own theatre and even then, some children are unable to leave their beds to visit another room where a theatre performance is taking place. So, often the artist resolves, with the support of the nurses and play specialists, to overcome this difficulty by performing bedside or in other hospital rooms convenient to the child. TCH's chosen audiences are considered by society as 'patients' but TCH 'disturbs' the norm and treats them as audiences. The artist invites them to collaborate and participate in a performance that is distinctive for its intimacy, sensitivity, generosity and respect for the person, the individual – not the child labelled as 'patient'. Every performance in hospital is different. Every artist takes a different ownership of the theatrical event in the space where it takes place. Every child embraces the opportunity to participate in the performance in different ways. In this way, the artist and the child get involved in different aspects of the play, taking away different benefits from it. This personal experience of TCH makes every performance unique, unpredictable and unrepeatable. It makes every child in hospital special, every participant exceptional.

Returning to the idea that TCH is a process of 'empowerment' in performance, I need to clarify that for ease of expression I use the term 'empowerment' throughout the book, but the meaning I give to the word is specifically related to the child's personal awareness that they have the power to participate in the performance. The artist by no means gives power to the child to play, but rather creates the dramatic conditions and playful atmosphere to encourage the child to use their own power and ability to play. In the absence of an English word, at least to my knowledge, that defines the power of being aware of having it, I cautiously use 'empowerment'. I spent a lot of time working on the concepts of applied theatre practice and empowerment in my doctorate thesis (Sextou 2004), from which I borrow some ideas for this book. Empowerment (in translation) has been used as a term for democratic audience treatment by Augusto Boal to describe his ideas about awakening critical consciousness. Boal is known for encouraging spectators to participate actively in performance and become actors (thus, the audience became spect-actors). He writes in his first and most influential book, Theatre of the Oppressed, that

the liberated spectator (the one who discusses plans for change, makes decisions, tries out solutions and trains himself for action), as a whole person, launches into action. No matter that the action is fictional; what matters is that it is action!

(Boal 1979: 122)


(Continues...)

Excerpted from Theatre For Children In Hospital by Persephone Sextou. Copyright © 2016 Intellect Ltd.. Excerpted by permission of Intellect Ltd.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents

Foreword vii

Prologue ix

Introduction 1

Motivation and beliefs 3

Arts and health 5

The structure of the book 11

Chapter 1 A TCH definition and more… 19

Applied theatre in hospitals 21

Theatre as an 'antidote' to clinical stress 32

A playful 'marriage' of two cultures, the artistic with the clinical in audience participation 37

The artist-child synergistic relationship 44

Ethical concerns 47

TCH and therapy 51

Chapter 2 The distinctive features of TCH practice and research 57

Background information of the study 59

Understanding the clinical context 60

The study: Methodology 64

Findings and discussion: TCH practice comes alive! 70

Chapter 3 TCH as a choice: 'I want to make a difference!' 109

A philosophical approach to TCH 111

Aristotle 112

Heraclitus 119

My philosophy 125

Chapter 4 Concluding thoughts 127

Summary 129

The future of TCH 132

Appendices 143

Appendix 1 Breathing with Love, the script 145

Appendix 2 The shape of our bedside theatre rehearsals 149

Appendix 3 Writing a TCH proposal plan (hid) 154

Appendix 4 Example of application letter 156

Appendix 5 Guidance for applying for NHS Research Ethics Committee approval (for researchers only) 159

Note on the author 161

Bibliography 163

Index 175

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