Archive for the ‘Uncategorized’ Category

Keeping the Performing Arts Workforce Healthy: Performing Arts Health Champions

Tuesday, October 15th, 2019

Research into poor mental and physical health within the performing arts workforce consistently finds that 70-75% of our population report both mental and physical health problems. That’s much higher than the national average. Over 80% of arts professionals are freelancers, which makes delivering solutions to improve their health more complex. Improving performing arts health relies both on action from the industry and the individuals who work in it. Crucially, organisations and businesses need to provide healthy environments in which creative professionals are empowered to take responsibility for their own health. This can be complicated by the solitary nature of some performance work and the many stakeholders involved in the industry.

November 2018 figures from the Department for Digital, Culture, Media & Sport reveal that the creative industries made a record contribution to the UK economy in 2017, breaking through the £100 billion mark for the first time to hit £101.5bn. In June, the CBI reported in Getting Young People Work Ready that UK jobs in the creative industries are expected to grow by 5.3%, double the rate of average employment, creating approximately 120,000 jobs. It is critical that, to continue the clear growth in this vital sector of the UK’s economy, its performance professionals, many of whom have to take on second jobs to survive, can maintain good health and can access clinicians with experience of working in the performing arts quickly and easily if there is a problem.

To highlight these issues and the fundamental importance of ‘best practice’ in continuing to resolve them, the British Association for Performing Arts and Medicine (BAPAM), Musicians’ Union, Equity, Help Musicians UK (HMUK), PPL , Music Support, One Dance UK  and the Centre for Performance Science are combining their expertise to recognise Health Champions in 2020.

This is the first time so many key players supporting health in the performing arts have collaborated in such an initiative.

Who are our Health Champions?

Health Champions are people or organisations who drive change to improve health in the wider performance environment ecosystem in which they operate. We want to encourage and celebrate Champions from all the performing arts, recognising work done locally or nationally, individually and for venues, companies, orchestras, bands and organisations at all levels and all budgets.

Health Champions will be able to demonstrate what they are doing and how they have achieved it so that best practice can be disseminated and picked up by others. The aim of the campaign is to raise awareness that all organisations and individuals have the capability to improve health throughout our performance environments and that action can be taken.

What happens next?

In the next few months we will be publishing some of the risk factors associated with ill health in the performing arts and we want to start a conversation and hear your stories – what approaches are working? What does a healthy performance environment look like and how has positive change been achieved?

We’ll be reaching out for submissions, and later in 2020 we will share news of our Health Champions awards ceremony and a series of “how to” guides so that good practice can be picked up and implemented more widely in our arts community.

The Awards Working Group Members

Matt Hood: Equity and BAPAM Trustee
Diane Widdison, Musicians’ Union and BAPAM Trustee
Sarah Wall: PPL
Jonathan Morrish: PPL, independent communications consultant and BAPAM Trustee
Claire Gevaux: Help Musicians UK
Eric Mtungwazi: Music Support
Erin Sanchez: One Dance UK
Michael Durrant: Centre for Performance Science
Dan Hayhurst: BAPAM
Claire Cordeaux: BAPAM

A BAPAM patient story

Tuesday, October 15th, 2019

At BAPAM we support a wide range of performers suffering all kinds of health issues. At the various stages of contact with patients we do our best to get a coherent idea of their issue and advise them about a treatment pathway.

22-year-old saxophone player Murphy Robertson is one such patient who came to BAPAM at a particularly low point in May 2019, during her fourth and final year at Guildhall School of Music and Drama.

The final year for most degree students is a busy period, but for Murphy the year has been quite relentless. It was all systems go for her ever since things kicked off in September 2018. On top of university commitments, she was also working as a peripatetic music teacher in schools, while regularly performing in shows outside her degree.

So what specifically brought her to BAPAM?

She says things started to really deteriorate in March 2019 while she was working on an exam piece. She felt severe cheek pain and pain around the mouth, recalling how she thought her mouth would “fall off”. It was then she realised she needed to tell someone. She went to her saxophone teacher and head of music department, who suggested she come to BAPAM for an assessment.

At BAPAM she saw assessing clinician and GP Dr Tamara Karni Cohen. Before the assessment Murphy said the uncertainty about what it could be caused her a lot of nervousness. But once she saw Dr Karni Cohen she felt a huge sense of relief and recalls breaking down at hearing it wasn’t all just “in her head.” She says she had been dismissing the issue and admits having a medical professional listen and understand was very reassuring and validating.

Dr Karni Cohen says: “Here at BAPAM we see a wide range of vocational related issues with a wide range of performers.  Murphy was a very interesting case, demonstrating symptoms of muscle fatigue after a grueling and long recording session.  The facial muscles can also present with a ‘repetitive strain’ type picture.  Muscles being overused can overtire easily and we have factsheets on our website on how to maintain good physical shape as a performer. This includes the importance of strengthening, maintenance and appropriate rest intervals.”

Murphy was recommended a few options like osteopathy or physiotherapy, and Feldenkrais and was told that a consultation with a musculoskeletal or head and neck specialist maybe required if symptoms didn’t improve. As Murphy is a music student and matched the eligibility criteria for charity Help Musicians UK’s Emerging Musicians Health Scheme for financial support towards treatment, Dr Karni Cohen was able to help support her through filling out a funding application.

Looking back on the experience Murphy feels a combination of overplaying and lack of sleep and only one day off between September and March also contributed to the issue. She says juggling life as a final year student, working as a peripatetic teacher 6 days a week and other performing commitments created a lot of stress and exhaustion.

She also likens not being able to play for months to a “purgatory state” and says, “people start treating you differently, you feel like you lose your value.”

Dr Karni Cohen says cases like this show how physical symptoms like this can have an impact on mental health. She says; “When I see patients at BAPAM I like to cover all aspects of symptoms, including how it is affecting their psychological wellbeing. There is a lot of overlap between the mind and body, especially when it comes to a performer’s life. The impact physical symptoms have on people like Murphy, can really take their toll. As she aptly mentioned, people start to address you differently.  We are trying to improve the stigma related to conditions, how they affect performers and how often they are not going to impede them on their overall abilities, especially once addressed and treated. Especially when it comes to mental health related issues – these are still unfortunately stigmatised but there is a wave of change happening.  I always like to encourage performers to be open and connected with their mental and physical health. Prevention is key but recognition early leads to early intervention and prevention of chronic conditions.”

So how is Murphy doing now?

Murphy was successful in receiving funding from Help Musicians UK and has been using the funds to get treatment with a physiotherapist who has experience of treating performers. The treatments she has been receiving includes jaw massage, acupuncture and physiotherapy from the shoulder up. When we spoke to Murphy at the end of September 2019 she had received 5 sessions and said that even though the pain was easing she was still unable to play for very long. She also admitted she had underestimated how long the recovery would take.

What advice does she have for others who maybe in a similar situation?

Despite the challenges she has faced Murphy feels positive about the experience. She says it enabled her to take a step back and realise that she can’t do everything at once. Her advice to others is “don’t push it” and to stop and assess the situation sooner rather than later.

Guest Blog: Getting to know your emojis : )

Thursday, October 3rd, 2019

In a guest blog for BAPAM, psychotherapist Fiona Macbeth considers the importance of emotional awareness for performers and some simple techniques for managing overwhelming feelings. Fiona ran the counselling service at one of the bigger London colleges for the performing arts, helping many young performers, as well as seeing established artists in her own practice. She helps performers overcome problems including low self-esteem, performance anxiety, perfectionism, confused identity, repressed emotions, distress due to physical injury and eating disorders. She currently sees clients in Brighton and London. Find out more at www.fionamacbeth.co.uk

Psychotherapist, Fiona Macbeth

Between the ages of 2 and 12 we’re taught lots of useful skills. How to read, write, cross the road safely, eat with a knife and fork and possibly say please and thank you ; )

What we are not taught is a vital skill which can make a huge difference to how we live our lives, and the lives of people around us.

We are not shown how to deal with difficult emotions and calm ourselves when we feel overwhelmed. We are just expected to “pick up” this complex and incredibly difficult skill and develop it unaided. No training, no text books, no user manual – no guide to our emotions and how to manage them : (

To make matters worse, many performers may have “missed out” on real life social opportunities where they might have developed these skills. Maybe they prioritised the dancing competition over the sleepover, were learning lines for an audition when there was a school trip, and their best friend was their dance teacher. So these feelings, which are difficult at the best of times, may be totally overwhelming and terrifying. When we feel so angry we just want to hurt someone. When we feel so jealous of someone getting that part we worked so hard for that we can’t breathe. When we feel so uncomfortable and awkward in new situations that we want to run and hide.

Often young performers overwhelmed in these situations look to someone else to “deal” with it. That person is likely to already be a major influence in their performing life, such as their dance teacher or a parent. Unfortunately they may offer unhelpful advice, along the lines of  raw emotions don’t fit well in a performance personality so it’s better to bury them or repress them. There may be pressure to adopt the “right” personality to do well in Musical Theatre, and exclude these uncomfortable emotions such as anger, jealousy and shame.

In my therapy practice, I see a lot of clients who say “I don’t do conflict and anger.” What they mean is they can’t cope with it or don’t do it well. And believe it or not, there is a good way of doing anger, or even confrontation. By expressing yourself in a calm rational way, and if necessary asserting yourself, you can develop heightened self-awareness. Then you are processing the anger instead of repressing it.

Repressed emotions don’t go away, they just lurk and pop out at inappropriate times. They can come out as a panic attack, as inexplicable and unstoppable crying or hysterical laughter. But they don’t go away unless they are explored, communicated and understood.

Left unattended, they can lead to other unhealthy actions. For example, binge eating as a distraction from emotions you can’t handle. Restricted eating or anorexia giving a false sense of control when emotionally you feel out of control.

Ideally they need exploring in a safe and controlled environment, such as counselling. This will help develop self-awareness, challenge dysfunctional behaviours, tackle underlying issues such as anxiety and increase our chances of being happy! However this can be a lengthy process and in the meantime rather than repression a healthier approach is for everyone, and especially performers, to develop a “toolbox” of techniques to help calm themselves when things are starting to feel out of control.

This can be as simple as a breathing exercise. Either find a quiet corner, or just do it quietly, and breathe in for the count of five and breathe out for the count of five. And whilst you are doing this just concentrate on the breathing. If your mind wanders, bring it back and think only about the breathing in this moment. You can do this for three breaths or three minutes, but practise it and it does work. It works best before things have got really out of control. This is because our emotional brain is triggered almost instantly and our rational brain is slower to kick in. So if you are facing a difficult situation, or something you know from experience might “press your buttons”, do some preparation with the breathing before the event, or entering the room, or seeing that teacher or director.

Free meditation apps work well for some people. Insight Timer and Headspace are very popular. Enter how much time you’ve got, what the issue is e.g. low self-esteem, motivation or anxiety, put your headphones on and zone out.

Visualisation needs practice but can be very effective. Visualise a calm and safe favourite place, such as a beach or wood, and expose all your senses to what that place would be like if you were there now.

Favourite photos of reassuring people or scenes on your phone can help.

Explore, experiment, practise and learn what works for you. Work with your emotions and don’t be taken hostage by them.

Have your say on the government’s occupational health consultation

Friday, September 13th, 2019

You may not have heard about the current government consultation: “Health is everyone’s business: proposal to reduce ill-health related job losses”.  The consultation seeks views on different ways in which government and employers can take action to reduce people falling out of work because of ill health.

While much of the document is focused on employers, there is a significant section in chapter 3 which includes proposals to improve access to high quality, cost-effective occupational health services for self-employed people and suggests that a direct subsidy or voucher scheme might be a solution.

Given that about 85% of the performing arts sector is freelance and 75% of artists will experience an occupational health problem, some form of subsidy could transform  the health of performers.

We’d encourage performers, performance professionals, industry organisations and anyone else interested in the health of the performing arts workforce to have a look at this consultation and respond to government to ensure that the needs of our sector are well represented. You only need to complete the bits of the survey that are relevant to you. You have until October 7th.

BAPAM welcomes PR Guru Jonathan Morrish as new trustee

Thursday, September 12th, 2019

BAPAM is very lucky to be adding to its list of trustees, a real stalwart in the world of public relations. 

Jonathan Morrish started in the music industry as a freelance music writer in the seventies, contributing to a number of different publications. Then in 1975 he joined Sony Music Entertainment, formerly known as CBS Records, as a house writer. Three years later he went on to manage their Press Office and worked closely with many of the company’s artists including amongst many, ABBA, the Beach Boys, Michael Jackson, Jamiroquai, Billy Joel, Meatloaf, Sade, Shakin’ Stevens, Wham! (with whom he went to China in 1985) and George Michael (including the famous court case in 1994. In 1995 he was appointed VP Comms and Corporate at PR Sony Music Europe.

In more recent times he held the post of Director of PR and Corporate Communications at music licensing charity, PPL for 8 years. He currently consults for them and a number of other companies on PR issues.

Besides the above he is also a trustee of The BRIT School in Croydon, and trustee of the BRIT Trust, the major charity of the British record industry. So on his recent visit to BAPAM, we jumped at the opportunity to talk to him about his illustrious career and his visions for our charity.

How do you feel about becoming a trustee at BAPAM? Why did you want to come on board?

I’ve been in the music business all my life. I’m completely not a musician but have always loved music and it’s always done a lot to me. I think music probably comes before language and if there is a universal language then it has to be music. It potentially binds people together and that is very powerful. I started life writing about music, one thing led to another and I joined a major record company in the 70s and in that time I worked with lots of different artists. I have seen some of the issues they had to go through, which in a funny way is as tough at the top of the tree as it is at the bottom. I have worked with people right at the top of the tree.

I think it’s very difficult to be a working musician in today’s world. Most people fail even if they have been signed to a record company as there’s only ten places in the top 10. So this is a tough place. I don’t think musicians are recognised, in fact it’s the same with all the creatives, because without them there is no industry. You can be as damaged by issues around you when you’re famous as you can be when you’re struggling to make your way. So for me working with BAPAM is really a chance to put something back. I’m also a trustee at the BRIT Trust which I love and am motivated for the same reasons, which is to be able to get kids in to the creative industries. So when CEO of PPL Peter Leatham and chairman of BAPAM approached me to join the charity it was a natural decision. The issues surrounding musicians is massive and this is a chance to harness a lot of what I think this organisation is capable of achieving.

It’s fair to say you have devoted your life to music and musicians, can you explain your passion for this industry?

I started as a press officer in the mid-seventies and really enjoyed being around musicians. I admire people who take it up as a profession. I like musicians, to me music is a kind of form of magic and I think the way it interacts with the brain is fascinating and that intrigues me. Music is a hot medium, it engages you. I look at the BRIT school and I see the way it brings people together and teaches you to be a team player.

…..During my time away at boarding school music was my outlet. This was in a world long before mobile phones and all of that. I would listen to the radio at prep school after lights out knowing that if I got caught I would get beaten. So music has always played a huge part in my life. It was a really different time back then. It’s hard for this generation to appreciate just how different it was. There were very few radio stations and now there are over 300. I can put on Spotify and just think about what I want to listen to. So that’s where we have to be careful and not cheapen music. What we have done in the process of having music on tap like water, is not to appreciate enough the people that make it and what they go through to make it. If you bought an album in 1964 the equivalent today would be over forty pounds, so music was expensive. I’m not necessarily saying that was right – it’s just the way the market was – but as the price of music has fallen so has the perceived value of musicians and that’s why what BAPAM is doing is so important. It’s recognising their health matters, health is everything. A healthy musician is going to perform better than an unhealthy musician.

Are there any particular projects you are excited about?

I think potentially looking at doing some awards, because what I think is really important is to raise the profile of BAPAM and then position it within the wider music business in a more recognised way than it is at the moment. These are areas where I think I can help.

 

BAPAM nominated for Industry Minds Awards

Friday, August 30th, 2019

BAPAM has been nominated for its work in supporting the mental and physical health of those working in the performing arts industry.

The nomination is part of the inaugural Industry Minds Awards which takes place this September. Industry Minds is a mental health podcast which has been running since last year and aims to break stigma around mental health in the creative industry.

BAPAM has been nominated for the Healthcare and commercial enterprise award, as an organisation which has undertaken pioneering action for health in the creative arts.

The event takes place on September 22 at the Piano Works West End in London.

Many of our clinicians, board members and office staff will be attending. It’s a ticketed-event and proceeds will go towards funding of a free counselling service which is offered to anyone in the arts via free Skype and telephone sessions.

Healthy Performance Training Series

Tuesday, August 27th, 2019

BAPAM is proud to announce the start of a series of training sessions for performers to keep them healthy and able to sustain a performing arts career.

The sessions kick off in Belfast at the Oh Yeah Music Centre this September, with more planned in cities across the UK including Glasgow, Leeds, Birmingham, London and Cardiff.

The introductory sessions will be led by experts and aims to empower those within the performing arts industry to look after their health.

The session focuses on evidence-based practical skills and draws from research findings, performance experience, and proven clinical pathways.

For more information on each session and who’ll be leading them and how to book click on this link Healthy performance training series

BAPAM flying the flag stateside at PAMA 2019

Tuesday, July 30th, 2019

This report gives a small flavour of some of the highlights of a packed conference programme with content covering all forms of the arts and many of the conditions that performing artists suffer from. It was a wonderful opportunity to hear from experts across the world, including Australia, Austria, Canada, Denmark, Germany, Spain, UK and USA who are researching and implementing best practice in performing arts health.

Apart from the chock-full official conference programme, there were several opportunities to network and lunch-breaks provided opportunities to attend special interest meetings such as the Research Committee, and a chance to discuss the needs of PAM research with a broad range of interested and enthusiastic colleagues. A research workshop also provided food for thought on improving the quality of PAM research to ensure optimum ‘performing artist-centric’ care.  Performers experience several health problems as a result of their work, and it is our task to develop solutions that work for, and are acceptable to performers.

Dr. Victor Dzau of the National Academy of Medicine, outlined the work being undertaken to prevent clinician burnout, and made the comparison with performing artists. Both professions aim to improve the lives of the public and both suffer health problems as a result. Dr. Dzau recommended bringing together stakeholders to collaborate on solutions to support the workforce.

One fascinating area of development in the USA is new research coming out of the National Center of Complementary and Integrative Health, particularly in the application of complementary therapies to chronic pain. We heard now the opioid epidemic in the USA has resulted in opiods being the leading cause of death in under 50s. Often caused by over-prescription of painkillers, US policy makers and practitioners are seeking alternatives to manage pain. What this means is that significant randomised control trials are now being conducted which will give much better evidence on the use of complementary medicine as part of standard of care. This will be something to watch over the next few years.

Still on the theme of improving health, there were several presentations on techniques to prevent overuse injuries and in one of them renowned drummer Joe Corsello spoke about how his playing had been affected after performing for years and demonstrated techniques to avoid injury. We also heard several examples of how multidisciplinary teams of clinicians, therapists and educators had worked with patients to create holistic treatments to enable them to overcome injuries, including dystonias, enabling them to return to performing. It was humbling to hear from several elite performers whose own injuries had caused them to develop an academic career investigating and evidencing solutions to enable other performers to avoid similar problems in the future.

Dr Dan Bernadot, a nutritionist working with athletes outlined his approach to supporting performers to understand the importance of diet and hydration so that they have the energy to do what they need to do and how to manage this in the context of performance schedules.

In a series of moving presentations, we heard about the culture of bullying and harassment in some music conservatoires that had come out after the #metoo campaign and how one performing arts education provider was changing attitudes by bringing in policies to reduce the possibility of this happening by introducing regular training to all teaching staff; having glass doors on all teaching rooms; acting on all rumours  about suspect behavior and forbidding any student/teacher fraternization beyond the professional relationship.

A mental health panel, led by Dr Susan Raeburn, considered the mental health issues that particularly affected popular musicians and how these were exacerbated by life on tour. We heard about the personal experiences of artist Darren Hayes and the therapist Dr. Nancy Sobel who had worked with a number of top bands and soloists in the USA.

This in no way does justice to the many insightful presentations we heard over the four days and we’d like to thank Mike Shipley and Phillip Rudge for their financial support in enabling us to attend. We were excited to learn that the PAMA Committee has decided that the 40th conference in 2022 will hopefully take place in London and we look forward to supporting the development of an equally memorable event in the UK.

Written by Claire Cordeaux, Diane Widdison, Dr. Finola Ryan

Day dedicated to Performing Arts Medicine

Tuesday, July 30th, 2019

Attended by doctors, physiotherapists, osteopaths and a number of students
and professional performers, PAM day at UCL offered time for networking and discussions on the health and rehabilitation of performing artists. The day consisted of talks by experts in performance anxiety, hypermobility in dance, musical theatre performer rehabilitation, circus artists injuries and musicians’ clinical assessment. Delegates also got a chance to hear research studies from  MSc graduates of the course and have a workshop on musicians’ warm-up by our current MSc students.

BAPAM is closely involved with the MSc and our clinicians and registered practitioners are integral to the delivery of UCL’s Performing Arts Medicine MSc. Programme lead of the MSc and organiser of the PAM day Dr Hara Trouli is also an assessing clinician at BAPAM.

BAPAM also presented an update on current activities and plans for the future and several BAPAM practitioners also attended as part of their annual training scheme. PAM DAY offers 5 Learning hours on a UCL Certificate of Participation.

BAPAM resources used in PhD research on pain and discomfort in string players

Tuesday, July 16th, 2019

The International Journal of Music Education has published an article based on a PhD research which featured a BAPAM produced health resource.

The research looked at playing-related discomfort and pain among two groups of music students in a higher education establishment in Australia. The data was collected from 2007 till 2011 and students were given a copy of the BAPAM resource “Fit to Play” (which is currently being updated).

We spoke to researcher, Dr Megan Waters, who explained the reason behind the study was to gain a better understanding of the perceived impact of personal circumstances, past and present learning environments, and musical culture on the development of playing-related pain and injury among tertiary level string students.

The cohort included 29 participants and was made up of violinists, cellists and viola players. Results showed students consistently reported a high incidence of playing-related discomfort and pain which was contributed to factors related to studying music at the graduate level, orchestral rehearsals, practice, technique as well as non-playing-related activities.

The research suggested the need for educational institutions to adopt a range of preventative strategies to approach issues of playing-related pain and injury, which were recognised to be caused by multiple factors.