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The Arts in Psychotherapy, Vol. 23, NO. 2, pp. 105-l 12, 1996 Copyright 0 1996 Elsevier Science Ltd Printed in the USA. All rights reserved

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THE BODY, ITS POLITICS, POSTURE AND POETICS

DAVID ALDRIDGE, PhD*

We can easily enough understand that acting and dancing are the projection of the body into an aesthetic medium-for in those cases the body is, in some way, the aesthetic medium. Nor should we have difficulty understanding that we apprehend an actor’s or a dancer’s per- formance through our own body.

(Benzon, 1993b, p. 274)

The initial impulse for this volume came out of discussions with fellow creative arts therapists in practice and from discussions about research. At the heart of this debate lay the dualism underlying mind and body and how often the mind, and its influence on the body, was ignored in many medical discourses. Indeed, already some readers will be raising their hands in horror saying how can he write such things. Some will insist upon a Cartesian dualism of mind and body, arguing for separate phenomena. Others will no doubt be crying “Reductionist,” asserting that mind and body cannot be separated, and it is such a separation that has confounded our thinking regarding the creative arts therapies. I must confess a sympathy for the latter argument and have in various publica- tions argued for an holistic perspective on human be- ings as Beings in a phenomenological sense. How- ever, I believe that we are indeed in danger of losing that very understanding that is central to the corpus of our work, the body. Crossley (1994) pointed to the subtle distinctions that social scientists make about the body: “The sociology of the body addresses itself to the epistemological, ethical, and aesthetic technolo- gies which variously discipline, adorn, punish, cel- ebrate, etc. ‘the body’ ” (p. 43). Yet, he called for a

carnal sociology based on the writings of Merleau- Ponty that concerns itself with what the body does, the active body in social life. This carnal sociology will reveal the way that “self,’ ’ “society’ ’ and “sym- bolic order” are constituted through body work and is a contrast to an externalizing sociology that alienates the doing agent from her, or his, body.

I, too, refer to the body politic, as it is through this body that we choose to influence others and not solely by words. Actions shout. Performance whispers. Movement seduces. A body of work can convince. Yet even moving away from these analogies, the body can be used in a political role. Suffragettes chained themselves to railings to accent their cause. Monks have immolated themselves to highlight their plight.

While carrying out a research project into suicidal behavior in 1983 (Aldridge, 1993), I came across a group of patients on a hospital ward who were sys- tematically starving themselves and another group of women who were mutilating themselves. Although the process of self-starvation was considered to be a consequence of a disease, anorexia nervosa, the ex- planations underlying the self-mutilation were more concerned with deviance than with sickness. Differing discourses were invoked for differing behaviors in- volving disturbed relationships with the body. At the same time, within a cultural context, the Irish pa- triot-or terrorist depending on which set of descrip- tions the reader wishes to invoke-Bobby Sands, was starving himself to death in jail. No one described this behavior as being an illness or considered that Bobby Sands was anorexic. The problem was seen as being a legitimate action, for some, in the line of traditional Irish martyrs. For others, the British Government, his

*David Aldridge is Professor for Clinical Research Methods, Faculty of Medicine, Witten/Herdecke University, Germany.

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act was an illegitimate claim to political status. The axis of judgment was not that of health and illness but that of legitimacy of behavior.

My question was, at the time, “If Bobby Sands’ behavior of self-starvation was seen as a means to gain political concessions, what political concessions within the family were to be gained by young women starving themselves to death”? (Aldridge, 1985). Similarly, I questioned the role of martyrdom by daughters in families. At the same time, my Family Therapy colleagues were referring to the works of Selvini Palazzoli (1974) and Minuchin, Rosman and Baker (1978) who saw the refusal to eat as a message- laden activity in a particular relational context, the family. The body, and what we do with it, has rami- fications for both the person and those with whom their life is performed. From a Foucauldian perspec- tive, the body is a surface on which the social is inscribed (Rail & Harvey, 1995). In these families of self-starvation the role of feeding and nurturing was evident in the body of the presented patient. Lieber- mann (1995) refers to a “rule” in families where a member starves herself as being preoccupied with the “tyranny of appearances” (p. 136). For the young women who were mutilating themselves, the pain of their varying personal and relational difficulties was indeed inscribed upon their bodies.

Posture also refers to the stance that we take with our bodies. Again there is a relational element that places our personal identities for validation within a cultural milieu. How the body is presented to the world is related to our understanding of who we are and how we wish the world to react to us. It is a performance and, in being a performed reality, is the location for a therapeutic endeavor. Whether we con- sider the performance of music, dance, movement or dramaturgical evocation, the body is involved. Even as far as painting and sculpture we find descriptions of the process of creating that is pertinent to the body. Fashion and dress are examples of performances that are relevant for many young people within our cul- ture. In performance art we have the deliberate choice of clothes and their colors in deliberate ritual trans- actions (Phelan, 1995). Perhaps the supreme manifes- tation of body and art is skin and painting, the tattoo.

Poetic refers to the performance that our bodies have that may be beautiful. This is not simply the body beautiful as perceived, the commodity of adver- tisements and as image. This is the body as done. A body performed, as personal form realized with the basic materials that one has to hand or foot. The mu-

sicologist/semiologist Nattiez (1990) referred to the aspect of performance as “poietic process” and the aspect of listening, and making sense, as “esthesic process,” with the reality of the work itself as a ma- terial object, “the trace.” In health terms we can also see the process of becoming healthy and what we do to become healthy, the understanding of our own health and the material traces that those activities leave in our bodies. Indeed the body, like the musical work, is the trace of our health activity.

By concentrating on the modem sense of self, there is also a focus on the body. Our corporeality is both objectified and subjectified in that the body has be- come the major site of subjectivity and agency (Wa- terhouse, 1993). When identity is constructed and tra- ditional values, like gender, are challenged, there are times when individuals seek to establish identities that can be variously interpreted. White and Gillett (1994) illustrated this in terms of the muscular body of body- builders that are seen as a reaction to the erosion of power felt by men in the face of emancipatory forces that seek to challenge the ideology of gender differ- ence. “Bodywork,” a term that occurs in numerous complementary medical approaches, locates cultural disciplines within a particular site, the body. The body becomes a commodity; it is seen as natural and cul- turally desirable and is developed through techniques (diet and training) and display. The individual is linked to the social. Feeling naturally superior, with a muscular self-made body, brings a link with social desirability and thereby coherence and meaning. However, this identification, within a plurality of cul- tural identifications, may be interpreted as offensive to others who are not masculine or, indeed, not so muscular. Furthermore, as White and Gillett argued,

Because real-power is located in economic and political structures, bodybuilding constrains the construction of identity to the pursuit of self as commodity. And, ironically, the elusiveness of the muscular ideal makes the self-transfor- mation process . a self-disciplinary dream rather than a lived reality. (p. 35)

Erdman (1994) reiterated this point with regard to women who are fat. A woman’s size and shape are influenced by cultural aesthetic factors that include those put forward by the media, in terms of fashion and leisure activities and medicine. She reminds us that the “fat is bad” perspective is a modern socially- constructed reality that emphasizes women’s selves as

THE BODY, ITS POLITICS, POSTURE AND POETICS 107

located in how they look and simultaneously ignoring the evidence that fat is healthy. An historical perspec- tive serves to highlight the importance of the body in judging personal nature and that the ideal body size varies from epoch to epoch. She argues that informa- tion showing that fat people do not eat more than thin people, that they can be healthy and there maybe health benefits related to being fat, that weight is not always controllable by diet and that fat people are as emotionally diverse as thin people. She challenges the notion that fat equals pathology and invites women to trust their bodies and voices as a part of the diversity of human sizes and to see themselves as “beautiful, functioning and healthy, no matter what their shape or size” (p. 172). Thus is the aesthetic related to the functional.

Although body size and shape are aspects of per- sonal identity, it is how the body is interpreted, the aesthetics of health beliefs that play an important role in forming identity. Such beliefs play an active part in how we recognize illness and what therapy we choose (Aldridge, 1992). Meanings provide a bridge between cultural and physiological phenomena. The diagnosis of a medical complaint is also a statement about per- sonal identity (van der Geest, 1994) and the stigma that may be attached to such an identity (Crossley, 1995; Goffman, 1990). Symbolic meanings are the loci of power whereby illness is explained and con- trolled. Such loci are now shifting from the educated health professionals and therapists to the increasingly better-educated, and health-conscious, consumers. These consumers are no longer passive in their con- sumption and may perhaps better be regarded as per- formers. The social stage on which our dramas are enacted is daily life. For some, the screen upon which their personal story is projected is the skin.

Health, the Body and a Performed Identity

In modern times, health is no longer a state of not being sick. Individuals are choosing to become healthy and, in some cases, declare themselves as pur- suing the activity of being well. Being recognized as a “healthy” person is, for some, an important feature of a modern identity. Being “healthy,” being a “cre- ative” person, being a “musical” person and being a “spiritual” person are all considered to be possible significant factors in the composition of an individu- al’s lifestyle. Rather than strategies of personal health management in response to sickness, we see an assem- blage of activities like dietary practices, exercise prac-

tices, aesthetic practices, psychological practices, spiritual practices designed to promote health and pre- vent sickness. These activities are incorporated under the rubric of “lifestyle” and sometimes refer to the pursuit of “emotional well-being” and are intimately bound up with how a person chooses to define him or herself. Thus modern identities are constructed and, although these identities are bound up with cultural values, focus primarily on the body. The body is the canvas upon which our various identities are painted, the stage upon which our various dramas are per- formed or, from my own particular perspective, the music that we perform. My preference for a musical metaphor is because music can be understood hori- zontally-it occurs in time, and vertically-there is the component of harmony, several voices performing together. Furthermore, although music can be an in- dividual activity, it also occurs as an activity with others, and is above all cultural-sounds are recog- nized as music through cultural attribution. In addi- tion, we need to consider that “body work” as an aesthetic achievement, this embodiment of culture, this corporeality of expression, is a pleasurable activ- ity, often recreational and simply not medical. Indeed, the body is expressive.

The Expressive Body

The dynamic interplay of maintaining our personal identity is an expressive activity akin to improvising music (Aldridge, 1989). Some young people do re- gard themselves against a background that is musical and some people refer to themselves as being “mu- sical” (Ruud, 1995). An extension of the understand- ing is the notion of being as it is characterized by the tradition of phenomenological philosophy, which looks toward “being in the world” as a unified ex- perience. This phenomenological approach sees a cor- relation between musical form and biological form. By regarding the identity of a person as a musical form that is continually being composed in the world, a surface appears on which to project our understand- ing of a person as a physiological and cultural being. The thrust of this endeavor is to view people as “sym- phonic” rather than “mechanic.” By considering how persons come into the world as whole creative beings one can speculate on their potential for health and well-being.

What links the performance of music and the per- formance of health is the element of participation.

108 DAVID ALDRIDGE

If we can argue from a conventional perspective that medical traces, plots and graphs of physiological change are articulate forms of an inner reality, so can we argue that the objects of art represent an expres- sive reality. Art products exist as articulate forms; they have an internal structure that is given to percep- tion. However, whereas the graph is a regularized form whereby factors internal to the individual, as content, are charted upon given externally derived axes, as form, the art object is both expression and the axes of that expression (i.e., form and content). Whereas science requires the graph for regularity- that is uniform-art requires that forms are given a new embodiment; they can be set free to be recog- nized-that is, unique. A reliance on machine expres- sions of our inner realities assumes that all that we are is measurable and material. A performed expression assumes the possibility of becoming something new, and that surely is the goal of many therapies, is tra- ditionally the role of development and strikes at the very heart of a culture trying to maintain the status quo. However, once we accept the status quo as being in a continual state of flux, then performing health reflects an ecological reality. We can begin to under- stand people as they come into the world as works of art, composed as a whole yet continually improvising on varying themes to adapt to life’s contingencies. Those themes are our identities, the performance of which is our health repertoire. In terms of sickness, our repertoire may be reduced to the singular litany of pain (Aldridge, 1991). Thus is performance restricted.

The Expression of Health

Thus feelings lose nothing by not being ex- pressed. Perhaps they even gain in sincerity and intensity the less they are verbalized . . there is a fundamental communication which embraces all forms of existence and which, because of its immediacy, must abandon the medium of words. (Herrigel, 1988, p. 97)

If consideration is given to what constitutes people as identity, attention may be better directed to how they are composed as musical beings in regard to relationship patterns, rhythms and melodic contours. Perhaps when a sense of that order is lost a person experiences a loss of health. When we seek to estab- lish order, the flexible, kairotic, performed order of music, song or dance, then perhaps we are moving toward health. In the same way we could argue from

traditions of Indian and Oriental medicine that the pursuit of changes in breathing and posture or the rhythmical changes from herbal medications are es- tablishing an order of the same dynamic dimension.

The problem of causal thinking is that, although the influence of nature on the individual is explained, there is no allowance for the spontaneity of the living being (Tsouyopoulus, 1984). Therefore any change, whether it be described as developmental or therapeu- tic, must include an element that is dynamic. What is being argued here is that our struggle to maintain our identity-whether it be regarded as immunological or psychological-is indeed a dynamic process of equi- librium and self-regulation that demands spontaneity (Tauber, 1994). Achieving the new becomes an inten- tional act, promoting sustaining activities by creating the optimal conditions-physical, psychic and cul- tural-that some may call an ecology (Bateson, 1978, 1991) and others may refer to as a milieu (Tsouyo- poulos, 1994). Expressive arts represent such a spon- taneous activity. Improvisation demands the mainte- nance of a theme that must change to gain liveliness. So are our lives improvised, from the cellular to the cerebral, to maintain our identities intact. In all such processes, listening to each other is a central method for gaining information and maintaining credibility, whether it is the cell communicating with the cell, person with person or community with community.

However, we must return once more to the central role of the body in modem society. The relationship with the self is with the body; it is here that we have the interface of internal and external. How we en- counter the unfolding of our experience is reflected in our bodies. The body tells us how language works, the meta-communication as it were. The reason that the expressive arts as therapies are so powerful is that they emphasize the lived body as being sensed, not only as being said. So expressing ourselves as a mu- sical identity, or as danced piece, even as a dramatic event, may stay closer to the reality of symptoms as they are expressed. Expressive culture is the projec- tion of the body into an expressive medium. Manip- ulation of that medium is expressiveness, and culture is dedicated to understanding how to use that medium. Form is given to feelings and cognitions. Symptoms too are bodily expressions involving feelings and cog- nitions, sometimes conforming to a medical interpre- tation, but also demanding an existential interpreta- tion that cannot be spoken. From this perspective, we can perhaps understand that some seemingly chronic diseases, and predominantly those seen as psychoso-

THE BODY, ITS POLITICS, POSTURE AND POETICS

matic, are problems that are being dynamically ex- pressed upon the stage of the body and sometimes fail to be interpreted adequately in the context of treat- ment. Although symptoms are the embodiment of dis- tress, it is in the arena of their performance that we are engaged as practitioners and researchers. The means we use to understand that drama is being questioned by those persons who claim an identity other than that of the stigmatized sick. How we enter into that drama as practitioners with those whom we label patients is currently a challenge to our healing identities.

If the big narratives of modernism are now being replaced by our own personal sets of meaning made locally with those whom we seek to live (Warde, 1994) then we need to understand more about the person who sits before us in our studio. How that person creates an identity will be indicative of how that person will resolve his or her problems. How that person seeks to be identified will guide his or her health care activities. Some will seek medications; others will imbibe herbal preparations; others will seek to be physically manipulated; others will seek to be psychically manipulated; yet others will exchange energies both subtle and cosmic; some will search for the laying on of hands in a ritual way-whether it be from a medical doctor or a spiritual healer (both re- quire their own brands of faith); some will sing to relieve their souls and others will dance to their heart’s desire. Each of these, the bodybuilder and the disciple, the artist and the atheist, the athlete and the allopath, will demand a recognition for whom they are as a person, and for that recognition to be included in treatment decisions. Indeed, the route to treatment will be guided by an itinerary pertinent to personal identity. Health is something that is done, a performed art.

What we singularly fail to see is that our current thinking about health is dominated by a medical thinking that ignores much of the reality of the per- sons we intend to treat and support. Few people, when they are sick, respond by seeking a health care prac- titioner (Andersen, 1995). Perhaps even fewer consult a therapist about staying healthy. What we do, outside of an academic life thinking about such lofty matters, is eat, drink, sing, dance, amuse ourselves, love our nearest and dearest, walk the dog, chase pieces of leather across field (both dogs and football players), without thinking of medical consequences. Maybe our health care assumptions are so narrow that they have little relevance for others who do not bow down at the altars of epidemiology and empiricism. Many lay ap-

praisals of health care activity seem be based upon holistic considerations that include feelings of mood and vitality (Andersen & Lobe], 1995). If, as in tra- ditional Chinese medicine, for example, health seek- ing becomes a pleasure, that sequesters “a body that can not only taste sweetness but be sweet, not only report painful symptoms, but also dwell on and cul- tivate the quiet comforts of health” (Farquhar, 1994, p. 493) then maybe we can understand that the seek- ing of a positive identity in a post-modem world is an activity that can be enjoyed without experts and the grand narratives of science and medicine. We may indeed have to learn to seek out those personal and local truths that our patients are themselves choosing to embody; maybe these truths are better played, in the widest sense, than said. Perhaps the consequences of prolonged fun, extended enjoyment and drawn-out pleasure are beneficial and that most of our non- clients and patients know this. Only we as practitio- ners, locked in with our patients, have forgotten a basic truth.

What I am arguing for is that if science is a creative doing of knowledge, then the way that we can do knowledge about being human is not restricted to in- strumentation through machines, rather, knowledge is something that can be sung or played or danced or acted. Underlying this approach is a philosophy of the world that moves away from a solely materialistic perspective to a perspective that sees the world as a living organism improvised in the moment in which we are all taking part. This is a move away from the Cartesian position that separates mind and body as reflected in cogito ergo sum-1 think therefore I am. What I am proposing here is ago ergo sum-1 perform therefore I am.

We have properties that are concerned with a cre- ated knowledge. As clinicians and researchers our task is to ask of ourselves, and then of our patients, “How can we create ourselves as a work of art?” (Bamason, Zimmerman & Nieveen, 1995; Tang, Yao & Zheng, 1994). The implications of this thinking for clinical and research practice is that we can encourage people to develop an articulacy of self based on their own expressive realizations as music or pictures or stories. A major criterion, then, for assessing thera- peutic change will be aesthetic. (When we consider, for example, those patients suffering with anorexia nervosa, their criteria are personal and principally concerned with the aesthetic of the body in contrast to many of their clinicians who are concerned with cri- teria that are medical. Both sets of criteria are present

DAVID ALDRIDGE

in our culture.) In terms of research documentation, we need not solely rely upon the graph and the chart as the traces of change, but the story that the person tells, the picture that he paints or the song that she sings will also have validity.

The Papers In This Issue

In the following pages the reader will see several of these issues raised as they occur in the context of therapy. Patrizia Pallaro, a dance/movement therapist, brings to our acquaintance the “performed self” of the body as personal agency. She argues for the emer- gence of the personal identity as the child separates from the mother. It is the maintenance of a coherent personal and social identity that is at the crux of many of our artistic endeavors. In this way our identities are created, improvised anew, not simply given (Ald- ridge, 1989).

Another dance/movement therapist, Marcia Plevin, describes the course of recovery in therapy for a woman who has abused varying substances. She uses the striking metaphor of someone coming to her senses. In many ways this is what lies at the heart of much of our work where we come to our senses quite new and fresh. Indeed, in music therapy many of us have the impression that, before we can actively im- provise with others, there is the need to come to the sense of listening first. We know too that to be able to draw accurately we have to be able to see clearly. In terms of child development, it is the active integration of senses that proves to be central (Aldridge, Gustorff & Neugebauer, 1995). There is every reason to be- lieve that such sensory integration, as it occurs in performing together, stays with us through our cre- ative lives.

It is this level of performance, too, that Stephen Levine takes up in his paper concerning the expres- sive body and the way that body is sometimes expe- rienced as fragmented. He relates his writing to ideas put forward by Jacques Lacan and Merleau-Ponty. It is the work of the latter that has perhaps had a sig- nificant impact on many current writers about the body in that Merleau-Ponty concentrates on the “lived body.” Roger Grainger also broadens the de- bate to include sociological aspects of the body as they may be applied to the creative arts. Ilene Serlin also widens the psychological and cultural debate about the alienated body, grounding her ideas in state- ments taken from psychiatric patients.

Peter Kellermann gives a concrete example of such

fragmentation as pain in his description of psycho- drama with a young woman named Eva. Jacquelyn Gillespie gives examples of how the body is rejected by women who have eating disorders and how their discontent with an inner self is projected into images that can be externally viewed. Michael Gtinter re- minds us of Freud’s proposal that the ego is formed from body sensations and goes on to describe the value of body representations for psychotherapy in terms of both intrapsychic and interpersonal pro- cesses.

Living As Jazz

Classical music is the expression of a fully formed culture. Jazz, however, is the creation of people under constant pressure to conform to conditions imposed on them.

(Benzon, 1993a, p. 408)

Music and the expressive arts represent a sponta- neous activity. Improvisation demands the mainte- nance of a theme that must change to gain liveliness. So are our lives improvised, from the cellular to the cerebral, to maintain our identities intact. In all such processes, listening to each other is a central method for gaining information, negotiating relationship and maintaining credibility whether it is the cell commu- nicating with the cell, person with person or commu- nity with community. If our selves require a sponta- neous adaptation to survive, if our existence depends upon expression, then living is jazz.

The body has a central role in post-modern society. The relationship with the self is with the body; it is here that we have the interface of internal and exter- nal. How we experience the unfolding of our experi- ence is reflected in our bodies. The body tells us how language works, the meta-communication as it were. The reason that the expressive arts as therapies are so powerful is that they emphasize the lived body as being sensed not only as being said. Expressing our- selves so, as a musical identity, or as a danced piece, even as a dramatic event, may stay closer to the reality of symptoms as they are expressed. Expressive cul- ture is the projection of the body into an expressive medium. Manipulation of that medium is expressive- ness and culture is dedicated to understanding how to use that medium. Form is given to feelings and cog- nitions. Symptoms too are bodily expressions involv- ing feelings and cognitions, sometimes conforming to a medical interpretation, but also demanding an exis-

THE BODY, ITS POLITICS, POSTURE AND POETICS

tential interpretation that cannot be spoken. From this perspective, we can perhaps understand that some seemingly chronic diseases, and predominantly those seen as psychosomatic, are problems that are being dynamically expressed upon the stage of the body and failing to be interpreted adequately in the context of treatment.

Although symptoms are the embodiment of dis- tress, it is in the arena of their performance that we are engaged as practitioners and researchers. The means we use to understand that drama is being questioned by those who claim an identity other than that of the stigmatized sick. Patients perform their lives before us. How we come to realize that potential as enhanc- ing, as aesthetic, is the task of the creative arts thera- pist. Demonstrating the benefit that that performance may have for people in their daily lives is the task of creative arts therapy research. Benzon (1993b) re- minded us that the evolution of an expressive culture, however we project our experiences into an expres- sive medium, depends upon our ability to use that medium. Hence the need for the skilled practitioner, the artist therapist who can orchestrate, compose, cho- reograph with the patient.

We have to understand how people “do” their lives, not simply what they think and say about their lives. It is in the body that individual identity is ex- pressed, and the body is the interface between the individual and society. It is what people do together that binds them together with the groups with whom they perform their lives. This performance will be bound up with lifestyle, leisure activities, exercise, dieting and dress. In the sense, “lifestyle” is not something that can be read about in books, it is an activity. Making sense of the world is an activity achieved through the body. Swimming cannot be learned by reading about it or by gathering together a band of expert swimmers to tell you about their ex- periences nor by attending a conference of hydro- physicists. At some time we have to jump into the water and, through experience, swim. The body grasps what it needs to do. Having a teacher in the water certainly helps.

So too with health and a change in lifestyle. If we wish to encourage people to do something differently, we have to understand that it will be intimately con- nected with their identity as a people and those with whom that identity is validated. Change is brought about by influencing small groups and understanding their way of being in the world. Music therapy offers the chance to do something differently. A new iden-

tity can be performed. However, the patients are not left alone to find their own way; the music therapist accompanies them. Rather than describe the way for- ward for someone, we accompany them along part of the way reviving the old notion of therapist as one who attends to the needs of a fellow traveller as well as the musical accompanist who provides a basis from which the other can perform.

One factor that we must take into account is that the serious business of living can also be fun. Al- though we know a lot about health care activities and their impact, we know little about the importance of leisure activities and their ramifications for health. Positive emotions, according to new thinking, influ- ence our health status for the better. Optimism and a sensual pleasure in everyday activities and situations are valuable for promoting personal health. The ab- sence of symptoms and a sense of enjoyment coupled with a zest for living appear to play a significant role in the subjective assessment of health (Wenglert & Rosen, 1995). Once more, health may be described as an activity with sensual ramifications concerned with pleasurable activities that are themselves integrated with an overall sense of lifestyle. This may be more appealing than our current unilateral exhortations to follow expert health care prescriptions based on warn- ings and denial. Music has a vast potential for plea- sure. Music is to be played. Play can be a serious business, as any child will remind us. Perhaps for adults too we can be reminded that play is not a trivial activity, and a little bit of fun is a powerful medicine.

As a personal note I would like to express the difficulty that I have with the writings of a number of authors who continue to write about anorexics and bulimics or a case of particular disorder. Surely if in the creative arts therapies we are trying to put forward an argument that we offer an endeavor that positively challenges the fragmentation of modern living, against alienation, then a significant step forward would be for us to start talking about people we work with, not cases. The people with whom we perform are not solely explained by a disease classification system. As Lee (1995) reminds us, there is no natural history of anorexia nervosa, only a social history, and the biomedical classification is a cultural fallacy. How can we hope to make any headway for the expressive arts as having a unique value that respects the whole individual if we continue to use art as an allopathic medication. To do so would require us merely to give a shot of painting after meals or the right measure of music three times a day perhaps with a prescription

DAVID ALDRIDGE

for dance before going to bed. Is this really what encouraging the creative body is all about, performing with cases? Although I understand the need for dis- ease classification, it is my personal wish that in the creative arts therapies we can speak about the person who has a problem that may be classified according to a particular system. But that person is not a disease or a case.

Finally, there is an old notion taken from the Chris- tian Bible, reflected in other doctrines, that although we are many we are one body (Aldridge, 1987). Al- though many of our endeavors are to encourage others to perform themselves authentically, we can some- times discern that what is performed by our sisters and brothers has ramifications for the way in which we have our own being.

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Aldridge, D. (1987). One body: A guide to healing in the Church. London: S.P.C.K.

Aldridge, D. (1989). A phenomenological comparison of the orga- nization of music and the self. The Arts in Psychotherapy, 16, 91-97.

Aldridge, D. (1991). Physiological change, communication, and the playing of improvised music: Some proposals for research. The Arts in Psychotherapy, 18, 59-64.

Aldridge, D. (1992). The needs of individual patients in clinical research. Advances, 8(4), 58-65.

Aldridge, D. (1993). Observational methods: A search for methods in an ecosystemic research paradigm. In G. Lewith & D. Al- dridge (Eds.), Clinical research methodology for complemen- tary therapies. London: Hodder & Stoughton.

Aldridge, D., Gustorff, D., & Neugebauer, L. (1995). A preliminary study of creative music therapy in the treatment of children with developmental delay. The Arts in Psychotherapy, 22, 189-205.

Andersen, J. 0. (1995). Lifestyles, consumption and alternative therapies. Troense, Denmark: International Network for Re- search in Alternative Therapies, internal seminar March 22nd.

Andersen, M., & Lobel, M. (1995). Predictors of health self- appraisal: What’s involved in feeling healthy? Basic and Ap- plied Social Psychology, 16, 121-136.

Bamason, S., Zimmerman, L., & Nieveen, J. (1995). The effects of music interventions on anxiety in the patient after coronary artery bypass grafting. Hearf and Lung, 24(2), 124132.

Bateson, G. (1978). Mind and nature. Glasgow: Fontana. Bateson, G. (1991). A sacred unity. New York: Harper Collins. Benzon, W. (1993a). The United States of the blues: On the cross-

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