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date: 23 June 2021

Unchained Melody: The Rise of Orality and Therapeutic Singing

Abstract and Keywords

This chapter explores therapeutic approaches to singing with regard to personal and cultural developments, and includes several diverse strands of musicking: creating, composing, performing, and listening. The chapter explores this topic through the lens of contemporary culture and research, and gives a special emphasis to orate singing traditions—those which do not use a written notation system. By revaluing thesetraditions, possibilities for therapeutic uses of singing have been liberated. The author’s work has demonstrated that singing has the ability to strengthen people physically and emotionally. It also indicates that therapeutic work (in this case, singing) must bring individuals and communities together in order to provide healing at the deepest level.

Keywords: therapeutic approaches, orate singing traditions, musicking, culture, healing


No one knows what music is. It is performed, listened to, composed, and talked about; but its essential reality is as little understood as that of its cousin, electricity. We know it detaches the understanding, enabling thoughts to turn inward upon themselves and clarify; we know that it releases the human spirit into some solitude of meditation where the creative process can freely act; we know that it can soothe pain, relieve anxiety, comfort distress, exhilarate health, confirm courage, inspire clear and bold thinking, ennoble the will, refine taste, uplift the heart, stimulate intellect, and do many another interesting and beautiful things. And yet, when all is said and done, no one knows what music is. Perhaps the explanation is that music is the very stuff of creation itself.

(Lucien Price 1883–1964, quoted in Exley 1991, n.p.)

Such writing occurs regularly in the history of Western philosophy/theology but often fails to inform the way we see singing in music education or in the wider culture. In this chapter I will explore therapeutic approaches to singing related to personal and cultural developments and including various areas of musicking (Small 1998)—creating/composing, performing, and listening. I will explore some of these claims in the light of contemporary culture and research, particularly the rise of orate singing traditions (Ong 1982).1 This chapter is an interdisciplinary weaving together of philosophy, music, (p. 936) poetry, musical practice, and experience in the form of a crystallization project as described by Ellingson:

Crystallization combines multiple forms of analysis and multiple genres of representation into a coherent text or series of related texts, building a rich and openly partial account of a phenomenon that problematizes its own construction, highlights researchers’ vulnerabilities and positionality, makes claims about socially constructed meanings, and reveals the indeterminacy of knowledge claims even as it makes them.

(Ellingson 2009, p. 4)

I will start by examining the social context in which the esthetics of singing have developed in Western culture and the changes in this context that have enabled therapeutic approaches to singing to develop.

Value systems

The upsurge of new themes in relation to singing in contemporary society represents a rise of value systems which have traditionally been subjugated in Western culture (Foucault/Gordon 1980). In the early twenty-first century attempts are being made to restore an imbalance that has developed within the intensely rationalistic culture of the West. Following a social constructionist view of knowledge (Gergen 1985), a culture is seen as favoring (in terms of financial support, publicity, indices of esteem, educational curricula) a particular set of values. Within any culture, a diversity of value systems will exist, but some are subjugated and embraced by groups of people who are not, in general, in positions of power (whether economic, political, or military). Individuals within a culture will also have a preference for a particular way of knowing/valuing based on their enculturation and personality characteristics. In a society where an individual’s way of knowing is in tune with those in power in the wider society the person is more likely to be seen as well adjusted and will suffer less stress and disease (Boyce-Tillman 2000a). Table 48.1 (based on Boyce-Tillman 2007) shows the values that have been subjugated by the dominant classical music tradition. The dominant value systems in the UK are on the right-hand side of this table and the subjugated value systems are on the left-hand side (based upon Boyce-Tillman 2006, p. xiv).

The development of the singing traditions with therapeutic intention can be seen as an upsurge in the previously subjugated value systems in an effort to find acceptance by those in authority. It is most clearly seen in the growth of community choirs:

Unfortunately despite the availability of music as a consumer item in many different formats, it is extraordinarily easy for people to become separated or cut off from music making and singing, as indeed from other direct experiences of the arts.

(Morgan and Boyce-Tillman 2016, pp. 53–4)

The dominant singing traditions—often called classical—valued products rather than process, individual achievement over community building, challenging entry routes divorced from nurture, and unity within its structures rather than the encompassing of diverse traditions and styles. So in the early twenty-first century there are two esthetics alive that are associated with singing in UK society: (p. 937)

Table 48.1 Dominant and subjugated value systems in the UK. These value systems need to regarded in relationship with one another; there needs to be a flow between them rather than a polarization. The rise of orality and therapeutic approaches to singing represents an attempt to bring some of these subjugated values into relationship with the dominant value systems

Subjugated value systems

Dominant value systems

















  • The classical perspective on singing emphasizes performance, perfection, and virtuosity—the standard or “taproot” esthetic2 that has been recognized in music education since its inception in the mid-1800s.

  • The second esthetic for singing stresses community building, diversity, group collaboration and relationship (Pascale 2005, p. 167, author’s quotation marks).

The title of this chapter is designed to show that the dominance of the classical perspective has resulted in the imprisoning of people’s natural ability to sing. In the opinion of the author, in line with Christopher Small’s idea of musicking (1998), singing is a universal human attribute. Turino describes this process of musical disempowerment as demusicalization (Small 1998, p. 210; Turino 2008, p. 25). Sarah Morgan describe her own “demusicalization” and concludes: “Those involved in less formal music making (often identified as music making ‘just for fun’), will say ‘I’m not really a musician,’ regardless of how significant a part music plays in their lives” (Morgan and Boyce-Tillman 2016, p. 53).

The result is the downplaying of orate traditions which are regarded as of less value than the dominant literate tradition. It is this dominance that causes people who may be skilled in orate traditions to define themselves as not musical. However, although this chapter is largely concerned with the re-establishment of the valuing of orality in therapeutic approaches to singing, it does not deny that many people participating in the literate classical esthetic would claim similar benefits to those that this chapter explores. It is not a binary opposition but an acknowledgment of difference and an acceptance of the validity of the two esthetics discussed above, as well as a desire to have both traditions valued by the dominant culture.

(p. 938) The revision of the value system from a product-based esthetic to one more inclusive of process led to the inclusion of intention in the planning and description of musicking. This led to research into the broadly therapeutic effects of musicking.3 Gradually, in the latter part of the twentieth century, a variety of intentions emerged in the area of the orate traditions of singing:

  • Restoring: healing, strengthening individuals and communities, as in community music and music therapy using the benefits of the music itself, which can contribute to inner peace, learning how to transform energies, improving self-esteem, developing the capacity to create; also giving persons the possibility to question their ways to act, or to react, changing their way to be.

  • Affirming: legitimizing and stabilizing societies, as in national anthems and giving groups of people an identity.

  • Resisting: opposing, protesting against perceived injustices, as in such phenomena as protest songs.

  • Creating: inventing, promoting new ways of organizing society, as in music as a way of conflict transformation by peaceful means (Urbain 2008).

There is now considerable research on the way these intentions play out in contemporary society in areas like sociology, therapy, and ethnomusicology. Since the middle of the twentieth century this has resulted in an increase in literature researching that singing in various contexts can:

  • provide social, emotional, and physical benefits (Clift and Hancox 2001)

  • improve life-satisfaction (VanderArk et al. 1983)

  • improve well-being, social benefits, lifestyle, functional ability, improvements in breathing, breath control, and physical health for people with COPD (Clift et al. 2013)

  • improve well-being, communication, cognition and understanding, relations with others, organization and structure, skills and physical ability for people with Parkinson’s (Vella-Burrows and Hancox 2012)

  • decrease stress and promote relaxation

  • decrease behavioral and psychological symptoms of dementia (i.e. delusions, agitation, anxiety, apathy, irritability, and night-time disturbances)

  • promote the recall of personal histories; improve mood, orientation, remote episodic memory, and to a lesser extent also general cognition

  • enhance caregiver well-being, when they are engaged in the singing activities.

As can be seen, there is considerable Western interest in the therapeutic effects of singing.

The rest of this chapter will explore the development of the area of the therapeutic use of singing under the following themes, which connect with the emerging subjugated value systems described above:

(p. 939)

  • orality and the valuing of process

  • embodiment

  • transformation within the self: de-integration and re-integration and the valuing of the more chaotic

  • expression and the valuing of the emotional

  • empowerment associated with the rise of nurturing in a challenging tradition

  • transformative relationships—building community including the birth of new choirs

  • getting it together—musical inclusion, rather than exclusivity

  • liminality, which may be seen as representing the restoration of spirituality to musicking.

Therapeutic uses of singing

Orality and the valuing of process

In all of this therapeutic literature the processes that are being described are mostly orate ones. The establishment of the dominance of literacy over orality in the area of words is well described by Walter Ong (1982) as part of the colonial enterprise; the result is that orate traditions are regarded as inferior. This is also true in singing:

The concept of informal or amateur as the “lesser version” points us back to the comments of John Julius Norwich, or to our unachievable ideal. The worth and status of oral, improvised, informal or amateur music making can be eroded both explicitly . . . and in more subtle ways, by use of terminology such as high or low culture, amateur and professional musician, national, or local performer, and so on.

(Morgan and Boyce-Tillman 2016, p. 57)

In the UK, Frankie Armstrong played an important part in the re-valuing of the orate through establishing the welcoming climate of the Natural Voice Network:

Natural Voice is about celebrating the voice you were born with, rather than trying to train it to an ideal of perfection. It’s about building accepting, non-judgmental communities that sing together. It’s about welcoming all voices into a group without audition and working from there to make a group sound. It’s about making learning by ear accessible to the whole group so that nobody needs to be able to read music.

(Natural Voice Network 2014)

So now there is a more of a sense of valuing the orate for itself and not simply as a stepping-stone to the literate traditions. It is a continually changing tradition always being recontextualized; in it there is scope for creative re-interpretation of material on the part of performers. We see this process of contextualization in the adaptations made to a literate tradition of hymnody in black singing traditions:

The oral tradition introduces itself again; the “standard” or well-known, Euro-American hymns require no special instruction for black rendition. The Black religious community instinctively knows how to sing them. The mode of singing is common to the Black religious experience and is passed from one generation to another via an oral tradition in Black sacred (p. 940) music. Rather than retaining the Euro-American structure, hymns were reshaped or improvised or “blackenized” as a means of contextualization.

(Cited in Costen 1993, p. 43)

The orate traditions are much more fluid, ever changing, and capable of being re-adapted: “Because much of my material is folk based, I also explain that the music is usually just a guideline or a reminder, not a set of precise instructions—a river rather than a road” (Morgan and Boyce-Tillman 2016, p. 60). This fluidity enables the therapeutic approach to singing to flourish in a variety of contexts; it is flexible and adaptable to a variety of circumstances.

To summarize, the rise of the valuing of process as well as product has enabled orate traditions to be re-evaluated; this freed up singing for many people who had been trapped by their inability to grasp the principles of the literate musical traditions.


The dominance of the literate tradition in singing has meant that a great deal of energy in music teaching has been on the cognitive aspects of deciphering the notation. Consequently, the physical effects of singing have sometimes been lost. A work that I created (PeaceSong 2005) included a procession carrying candles in which the participants sang the word shalom on a single note. One of the participants reflected on her own experience of singing:

I have sung for many years but it always meant working out if the next note was a G sharp or G natural and a crotchet or a quaver. Because you only asked me to sing a single note I was aware of the breath entering and leaving my body and it became a meditative experience.

(Morgan and Boyce-Tillman 2016, p. 210)

A holistic approach to singing sees it as a physical, mental, and spiritual activity. Brendan Doyle describes the physical effects of singing the chants of Hildegard of Bingen. When they are sung, the control of the breath required to manage the long phrases is seen as a physical meditation associated with the Holy Spirit (Doyle 1987, p. 364).

Striking work has been done in this area at the Sidney De Haan Research Centre for Arts and Health at Christchurch Canterbury University (see the chapter by Clift and Gilbert in this volume).4 One project consisted of setting up a weekly community singing session for people with chronic obstructive pulmonary disease (COPD). They assessed impact on lung function, functional capacity, breathlessness, and quality of life over the period September 2011 to June 2012. The St Georges Respiratory Questionnaire (SGRQ), MRC breathlessness scale, EQ-5D, and York SF-12 were administered at baseline, mid-point, and end of study; spirometry was used to assess lung function at baseline and study end. Written feedback from participants was also analyzed. The results were that health-related quality of life assessed by SGRQ showed a 3.3 point change in the direction of health improvement. Improvements were also found in FEV1 percent (a percentage between the measured and statistically expected value for an individual on the forced expiratory volume in one second test), FVC (forced vital capacity), and FVC percent (a percentage between the measured and expected (p. 941) value for an individual on the forced vital capacity test). Qualitative evidence showed that the singing groups were enjoyable social events and participants reported improvements in their breathing, activity levels, and well-being. A decline in health would normally have been expected over a ten-month period with this disease; so the study supports the physical effects of regular singing.

Similar effects were found in the Elevate project in Salisbury hospital (Preti and Boyce-Tillman 2014). Artists working in Salisbury hospital saw physical changes in patients when they sang:

you create something either out of memory or imagination; you create or recreate another world in the place between the two of you . . . I’ve seen people, the muscles on their faces change as they follow the path into the wood, you know, as they begin to recollect the place where they used to swing or something that had happened there. And they can very physically change in front of you when that happens, and that’s wonderful.

(Preti and Boyce-Tillman 2014)

Kate Numger describes the physical aspects of the Threshold choir singing at the bedside of the dying:

Two to three singers will go to a bedside, and they pick songs based upon what a patient or the patient’s family wants . . . Sometimes, the recipient will move a finger, mouth a “thank you” or will change their breathing and relax their muscles. At the end of life, when human functions began to slow and cease, the signal for “I like this” can be as simple as a blink.

(Threshold Choir 2014)

Here we see how psychological and spiritual changes are reflected physically and brought together by singing.

To summarize, in the literate Western classical music tradition much stress has been laid on the cognitive aspects of musicking. The rise of the orate traditions and their therapeutic possibilities has enabled an increased awareness of the physicality of singing.

Transformation within the self: de-integration and re-integration

All descriptions of the processes of creativity include a measure of chaos or darkness—a time when the whole appears to fragment before it re-establishes itself again in a different configuration (Wallas 1927). The notion of a steady progress towards an integrated self underpinned Jungian psychotherapy; but psychologists like Thomas Fordham have challenged this, suggesting that the process of living is more one of de-integration and re-integration (Jennings 1999, p. 45). Because of the high premium placed on integration, de-integration is frequently pathologized and people who are diagnosed as ill are experiencing a de-integration of the self.

A classic example of de-integration is the grieving process. When a loved person, animal, or object disappears, the integration within the self is disturbed. The self has to de-integrate in order to re-integrate with a previously essential part missing. In former times protected time was given for this process to happen with rituals associated with grieving. With the contemporary requirement that life go on as “normal,” the self has huge problems (p. 942) in re-integrating, which it would do quite naturally, given time and support. I have found in my workshops that the acceptance of multiplicity within the self enables people to see singing, especially song creation, as a way of re-integrating the self. The philosopher Gillian Rose calls us to work in what she calls “the broken middle,” which has within it the necessity of living with the contradictions:

In the middle of imposed and negated identities and truths, in the uncertainty about who we are and what we should do. [ . . . ] She [Gillian Rose] commends us to work with these contradictions, with the roaring and the roasting of the broken middle, and to know that it is “I”.

(Tubbs 1998, p. 34)

The acceptance of the more fragmented aspects of the personality leads to a “re-membering” of the person. In Beethoven’s sketchbooks, for example, we have a record of Beethoven wrestling with the process of “re-membering” himself. The use of fragments generated by improvisation is used in music therapy in a process that is essentially one of self-transformation. The ability to enter that chaos, with tools for handling it, would seem to be what differentiates the experienced composer or music therapist from the less experienced musician or music therapy client:

What we need is to fumble around in the darkness because that’s where our lives (not necessarily all the time, but at least some of the time, and particularly when life gets problematical for us) take place; in the darkness, or, as we say in Christianity, “the dark night of the soul.” It is in these situations that Art must act and then it won’t be judged Art but will be useful to our lives.

(John Cage, quoted in Ross 1978, p. 10)

In encouraging people to make up their own songs or even just improvise freely with no product they are entering into a process familiar to established composers (Boyce-Tillman 2018, p. 406). Sometimes the songs generated in this way can be empowering not only for the person themselves but also their carers and relations: “I have worked with a number of groups in the hospice Day Unit and in a variety of care homes . . . One group wrote three songs, the melodies came from music we improvised as a group” (Dives in Hartley et al. 2008, n.p.).

In a recent project with young people with special needs run by La Folia5 in Salisbury Cathedral, I saw how small sung motifs could create impressive musical structures. The motifs, which had been created by the youngsters in response to the Magna Carta document on display at the cathedral, formed the basis of a number of improvisatory pieces in various parts of the cathedral. Around the themes of protest, reflection, asking for help, power, struggle, feeling safe, protection, and freedom participants sang fragments with texts such as:

We need a system bigger than we are

We need lots of help

We have a voice that’s strong enough to say “no”!

With the help of an actor, dancer, and various instrumentalists, these were impressively woven into fascinating soundscapes that empowered the participants and also fascinated the (p. 943) visitors to the cathedral. It was a real example of the process of reintegration of ideas, people, and musical motifs achieved through group improvisation.

The process of humming and whistling, which was more common in past ages, allowed people to play with small motifs and so reconstruct themselves:

  • The Symphony
  • He sits beside his mother
  • Cuddling his four years on the planet
  • The train bleats
  • And he improvises a symphony
  • Around its falling minor third
  • He has yet to learn
  • That he cannot compose.
  • But we will soon teach him.

(Boyce-Tillman 2004)

The process of listening to singing can enable the listener to participate in this process of the composer; listeners are called to enter into the processes of the performer and composer. The listener shares their journey and is reassured by the fact that another person has been into that chaotic place that they are experiencing. In listening we can be taken into a different world by a composer/guide, who leads us through it musically. The composer, together with performer, becomes a therapist. Millie Taylor (2013) illustrates this with the example of Stephen Sondheim showing how his song “Into the Woods” (Sondheim and Lapine 1987) takes the audience on a journey into difficult places. Here musical theater becomes a form of companionship along the journeys of life, and a guide in negotiating them. Discovering this in times of de-integration can provide people with a tool for handling chaotic times in their lives.

In a similar way, singing particular songs has long been a way of establishing and maintaining identity in difficult circumstances. Ruth Westheimer, writing of her experience of being taken away from her Jewish parents at the beginning of life, writes: “I sang that lullaby—which has a melody written by Heinrich Isaak back in 1490—to my children. And maybe I mangled the melody, but I felt—and still feel –the sweetness of it in my bones” (Westheimer 2003, p. 13).

A letter from the trenches in World War I shows how hymn singing was used to maintain an identity in difficult conditions: “Here we try to keep our spirits up through all the firing. We have short services here in the trenches and in all the mud. I turn to sing the verses that I learnt at dear Mynydd Gwyn. I hope that I will be back there soon” (Griffith Roberts, quoted in Boyce-Tillman 2000a).6

Within this essentially orate process lies the possibility of redeeming and surviving the damaging experiences through the two processes of vocal improvising and the singing of significant songs. In one music at the bedside project an Irish family was strengthened by a singer enabling them to sing the well-known Irish song “Cockles and Mussels.” Such experiences enable us to recreate our selfhood. Listening can also aid this inner journey of transformation.

(p. 944) To summarize, singing can play a significant part in the central life processes of de-integration and re-integration. By playing with small fragments of melody and text people can create new songs that give new meaning and integrity to their lives.

Expression and meaning

This process of self-transformation has another aspect. The Western literature on music and creativity stresses the area of self-expression (Boyce-Tillman 2018, pp. 327–8). It is often linked with human emotion. Traditions of word-based psychotherapy have developed ways of accessing deep areas of feeling and painfully traumatic experiences; but they can leave people with difficult memories allied to powerful feelings, such as anger and despair, with no strategies for dealing with them. Not only does music offer the possibility of expressing these but also of remaking them into an esthetically satisfying object. Ray Charles confirms this in his own use of song;

I’d like to think that when I sing a song, I can let you all know about the heartbreak, struggle, lie and kicks in the ass I’ve gotten over the years for being black and everything else, without actually saying a word about it.

(Quoted in Moore 1986/1992, p. 123)

The process of acceptance of one’s expression by a group creates the possibility of growth; a person can gain acceptance of their private trauma through expression through music. Music can express what is inexpressible in words: “Words are good for many things, but they don’t seem sufficient when it comes to death. The feelings are just too deeply intense and words are too inadequate . . . But music can reach those places where words alone can’t go” (Threshold Choir 2014). This characteristic of inaccessibility makes it, by definition, a confidential medium as well as being expressive. It is a “veiled” medium. As Lévi-Strauss writes, “music is the only language with the contradictory attributes of being at once intelligible and untranslatable” (Levi-Strauss 1970, p. 18). The process of expression can lead to the construction of new meaning by awakening a broader awareness, and expanding personal horizons: “[Music] does not offer meaning but triggers the effort to produce the meaning” (Voegelin 2010, p. 165).

Around this area of meaning and expression lies its use in reminiscence therapy. This exploits the mystery surrounding the precise meaning of music, where this is situated and how it is communicated. It has increasingly become clear that there is an element of cultural and personal interpretation in the process of decoding the meaning of music. Within a piece of music there is not only the meaning encoded by the creator in the sounds themselves—intrinsic meaning. For example, a piece that is slow and soft will have an expressive meaning associated with being calm. However, there is also meaning that has been locked on to a piece by particular circumstances in our lives—extrinsic meaning (Green 1988, but using the author’s terms). An example of the latter is the phenomenon of “they’re playing our tune”—a melody that has been associated with a particularly emotional moment.

It is this phenomenon of explicit meaning, which enables music to be used to unlock painful and pleasant areas of memory. No other person can know what memories are locked onto a piece by someone else. Sometimes the person themselves is not aware. This area of meaning is one used widely in music therapy especially in reminiscence with older patients. (p. 945) Costanza Preti writes how skillfully the artists in the Elevate programs in Salisbury hospital were able to handle sensitively the implications of extrinsic musical meaning:

The artists were not intimidated by the patients’ emotional reactions; they welcomed them instead as an expression of emotional release that was perceived as beneficial and somehow therapeutic. They were observed to take immediate notice of these reactions addressing the patients asking if they wanted them to stop playing a certain song or reading a certain poem.

(Preti and Boyce-Tillman 2014)

Overall, the patients were very appreciative about the opportunity to release their emotions: “Her final choice reduced me to tears but I can only describe them as good tears” (Preti and Boyce-Tillman 2014).

Music was seen in Salisbury Hospital to work with the elderly as an extremely important way of unlocking painful memories—making the private more public so that it can be healed. Patients would request a song that they were keen to hear, such as “The White Cliffs of Dover,” “It’s a Long Way to Tipperary,” “Edelweiss,” “Oh What a Beautiful Morning!” The varied repertoire of the artists allowed patients to engage actively with the songs, singing along, recognizing the tunes.

Most therapeutic studies of singing highlight a significant effect on mood. This was clear in Salisbury in patients with dementia who were suffering from depression, anxiety, and various mental health issues, or experiencing boredom and frustration from their long stay in the hospital. It helped them and their families to focus on something constructive, different from the illness:

The rewards are the smiles on the faces . . . a woman who always asks for “Que Sera Sera”, every time she does, and she’s beautiful, she’s very, very effusive in her praise, you know, she always says “Oh, you’ve cheered me up so much”, “Oh, you’ve made my day.”

(Preti and Boyce-Tillman 2014)

This often opened a new perspective on the patient for the hospital staff who remarked on these unexpected effects—their awareness of the patient was broadened.

The element of expression was also true in the area of singing and mental health, as in the East Kent Singing for Health Network Project. In this project 137 participants were involved, of which 32 participants provided sufficiently complete data at three assessments. EQ-5D and CORE questionnaires were used. Qualitative accounts were gathered and a DVD produced based on a performance event involving all singing groups in the network. Substantial reduction was found in CORE-OM scores over a period of eight months. Changes were found in functioning, problems, and well-being. This account shows how the process of expression also manages extreme emotions:

I have bipolar disorder. When I am depressed, singing in the group and coming together with other people lifts my mood and gives me something positive and productive to focus on. When I am manic, singing is something I can channel my extra energy into and express my enthusiasm for life through. The choir provides structure and purpose in an otherwise sometimes empty life.

(Woman aged 30)

It is this sort of research that has led to an increasing number of Recovery Choirs for people with mental health problems which help them bridge the gap between hospital and life (p. 946) beyond it, as well as giving them a strategy for handling their problems. The range and scope of these will be examined later in this chapter.

The summary of this section is contained in this quotation from Songwriting for Music Therapists:

Songs reflect on the past, present and future. They give us an immediate context. They are a container for thoughts, feelings—a way to explore emotions. They express who we are and how we feel, they bring us closer to others, they keep us closer together, they keep us company when we are alone. They articulate our beliefs and values. As the years pass songs bear witness to our lives. They are our musical diaries, our life stories.

(Bruscia quoted in Hartley et al. 2008, n.p.)

Empowerment—nurturing with singing

Singing in the classical esthetic has followed Western culture’s love of challenge with programs of examinations, competitive events, and auditions. The revaluing of music as empowerment has meant a rediscovery of the nurturing power of singing. In this changing value system there has been a revisiting of ancient traditions:

While bedside singers may be unique in American culture, it’s not unprecedented. In some Hindu and Buddhist practices, hymns are sung near those who are dying, while mantras are chanted into the ear at the moment of death. In the Middle Ages, French Benedictine monks became famous for establishing infirmaries across Europe for the terminally ill, where they used Gregorian chants to soothe the dying.

(Ellen Synakowski in Threshold Choir 2014)

The decline of organized religion and regular attendance once a week at a place of worship—in which singing would have played a prominent part—meant that there was a loss of an inclusive singing tradition that forged community. The burgeoning community choir movement regularly has empowerment and nurture as core values. As church attendance declined, other choirs grew up in the mid to late twentieth century to nurture people. This was apparent in titles like: the Can’t Sing Choir (Joan Taylor at Morley College); Singing for the Terrified (Polly Bolton)

Most importantly into this field came Frankie Armstrong and the Natural Voice Network (1988), as mentioned above. Estelle Jorgensen (1996) highlights the role of the itinerant singing masters in empowering the poor and the women in eighteenth-century society. These delivered the only formal education open to groups of people from otherwise disenfranchised groups, especially women and girls who were excluded from much music-making in the churches and communities. She claims that the nineteenth-century political movements, which encouraged the inclusion of music in the school curriculum of the emerging state-supported schools, were inspired by the work of these singing schools.

However, in the name of music education in a normalizing curriculum we have sometimes cheated people out of their birthright to sing; the use of a culture of musical challenges has engendered a process of demusicalization for many people. The map of singing as presented in the average school is one of a restricted range of pitches and tone colors, and a concern to make children musically literate. What this denies is the premise that we all have our own note, the note that is easiest for us to sing at any time (p. 947) (Boyce-Tillman 1996, p. 215). The limited horizons of the curriculum have excluded people from their singing birthright. Their own note needs validating before they can move forward in acquiring a wider range of pitches.

When people have found their singing power they can use it to survive their darkest moments. It becomes a valuable coping strategy. From the El Mozote massacre in El Salvador in 1981 comes the remarkable story of a young girl, an evangelical Christian, who was raped several times in one afternoon. Through it all she sang:

She had kept on singing, too, even after they had done what had to be done, and shot her in the chest. She had lain there on La Cruz [the hill on which the soldiers carried out their killings]—with the blood flowing from her chest and had kept on singing—a bit weaker than before, but still singing. And the soldiers, stupefied, had watched, and pointed. Then they had grown tired of the game and shot her again, and she sang still, and their wonder turned to fear, until they had unsheathed their machetes, and hacked her through the neck, and at last the singing stopped.

(Danner 1994, pp. 78–79)

When I was leading a workshop on the power of music in Australia, I met a nun who felt overwhelmed by her work in a community that concerned itself with violations of human rights. After the course I was leading, in which she had sung some of her songs, she said: “I know what I had forgotten; I had forgotten to sing. If I remember to sing I can survive the stories that our community is receiving and even transform them in some way.” Similarly, a woman in a difficult marriage used the song “One Day at a Time Sweet Jesus” as her prime strategy for survival.

There are many accounts of the relation of singing and healing. Many of these involve hymns of some kind—possibly because of their extrinsic meaning or possibly because they bring a spiritual dimension to the situation:

After the address came the hymn, “All hail the power of Jesus’ name.” During the singing of it I felt the power of God falling upon me. My sister felt it too, and said “Floie, you’re going to walk.” The Lord gave me faith then.

(RERC Accounts of Religious Experience 1970)

Other accounts include singing as a strategy for retaining/regaining power:

A woman . . . had turned on the gas in her home heaters in order to commit suicide . . . She had forgotten to turn off the radio in the kitchen. As the music continued she heard someone singing the familiar hymn,

  • What a Friend we have in Jesus,
  • All our sins and griefs to bear!

The impact of that hymn changed that woman’s mind and saved her life.

(Carnegie 1944, pp. 154–156)

Singing can be a transmission of love and strength. In Gugulethu, South Africa, I was present at a service where people could come forward for healing. They told the pastor their problem. He relayed this to the congregation. The congregation then sang to support the healing. What was interesting here was that the songs were not soft and gentle but strong louder pieces accompanied by drumming patterns made on hymnbooks. The greater the need, the greater the strength of the singing of the thousand people present. The song appeared to transmit a sense of (p. 948) loving holding through its power. I have seen this phenomenon working beautifully in funeral and memorial services for certain ethnic groups in London.

An exercise that I do in workshops is a humming bath. In this a group surrounds two people in the middle with a group hum executed with loving intention. Participants hum whatever note is easy for them taking a breath when necessary. This gives the people in the middle a sense of being held, warmed, supported, and loved.

Singing can also play a significant part of holding people with memory loss which I attempted to express in a poem:

  • Cry from the Depths
  • 1. Hold me! My eyes are dim, my memory faltering
  • My sense of past and future now are fused
  • I cannot recognise much any longer
  • Except the music that the choir intones.
  • 2. Help me! My limbs are frail and arms that once worked strongly
  • Hang limp and useless, will not respond to me;
  • I cannot understand the puzzling world around me
  • Except the music that the choir intones.
  • 3. Hear me! My earthly usefulness is fading
  • And nurture that I once gave freely, now I need;
  • I can make sense of little any longer
  • Except the music that the choir intones.
  • 4. Heal me! You whom I loved and who once loved me
  • How can I feel that caring love right now?
  • Where can I still lay hold of warm acceptance?
  • Ah! In the music that the choir intones.
  • So now I flow within the river of that song.

(Boyce-Tillman 2014)

Music in the area of memory loss both holds and empowers. In one Singing for Wellbeing choir with which I am familiar, for example, an ex-soldier led the same song each week. Just for a moment he was able to exercise the power he had used for all his working life. In the same group one woman had suffered the onset of her dementia for several years, so she was the most advanced in our group. After two sessions, she walked steadily into the room, and showed no signs of anxiety, and started humming along, perfectly in pitch. She also developed over the term her own “tune,” which occurred at certain songs. She locked eyes and said “Thank you” with a smile.7

The earliest bonding between mother and child through improvised singing has been carefully researched by Colwyn Trevarthen (2002) and has a nurturing, empathetic, bonding function. But the demusicalized parent often needs freeing from their preconceived view of themselves as a singer—to unchain their own melody. Work by Sheila Woodward in her doctoral thesis showed that this process starts in the uterus by placing microphones in a mother’s womb:

(p. 949)

You still hear the sound of the music, but it’s a little like listening to music say, underwater. And, with the human voice, we still hear that it’s a woman or a man, we can hear the particular tone quality of that voice, and we can hear the notes that are being sung.

(Woodward 2015, n.p.)

She investigated whether this singing to the child in the uterus will affect their development from about four to five months onwards. She encouraged mothers to establish a relationship with their unborn child through song. This was also carried out in the UK at St Mary’s Hospital on the Isle of Wight.

The lullaby is an area where traditionally children have been held musically. In child-rearing there have been indications that children use the songs sung to them by their parents as comforters, rather like teddy bears and comfort blankets. My own young son comforted himself in the night with his version of “Twinkle, Twinkle, Little Star.” The publicity for the Threshold Choir links the processes of birth and dying with singing, which is often led by women:

A mother’s heartbeat is the first sound that each of us hears. It feels to me that women’s bodies are the guardians of life entering this world and it feels right that we will be guardians of the gate out. Experienced soloists are often not the best fit because “projection of voice is not the goal; softness and comfort are,” says Munger. She, Synakowski and other choir leaders encourage those who like to sing but lack professional experience to join. It’s easier to teach them to mix their voices into the groups, sing softly and focus on the dying instead of themselves.

(Threshold Choir 2014)

Although self-efficacy was a perceived benefit of community choir participation, Sarah Morgan prefers not to use the word “empowerment”:

I prefer not to use the term “empowering,” as to me that implies that people lack a power which I can mysteriously bestow on them. I do strongly believe that everyone has the ability to experience and enjoy singing in some way, and I see my role as helping to remind people of that, and trying to remove barriers, where they exist, whether they relate to musical technicality, terminology, accessibility or skills.

(Morgan and Boyce-Tillman 2016, pp. 59–60)

Much of this nurturing is about process-based musicking; in this area of the valuing of process, singing groups are sometimes divided about whether to present performances at all, with some members preferring simply to come and sing once a week—valuing the process over the product. However, some of the literature sets out the potential value of performance, in this case with people with mental health problems:

Such performances demonstrate the power of singing to bring people together and support recovery from mental ill-health; they promote social inclusion, social capital and normalization for people with mental health issues, and serve to challenge misconceptions, stigma and prejudice associated with mental illness.

(Morrison and Clift 2012b, p. 16)

The need for a sense of nurturing runs through all the literature on the characteristics of leadership in community singing groups. Sarah Morgan writes about the need to be aware of people’s state of mind:

(p. 950)

At a practical level, one of the most useful skills I acquired was an ability to look around a group and quickly notice people who looked uneasy or uncomfortable, and make it acceptable for people to voice their unease, as well as finding ways of making mistakes an accepted and even a positive part of the process of learning.

(Morgan and Boyce-Tillman 2016, p. 21)

Rehearsals are often seen as uplifting and friendly (Birmingham Wellbeing Choir 2014). In the Elevate program in Salisbury hospital, the nurturing and empowerment was not only for the patients but also for the staff. Members of the hospital staff were actively observed taking part in the artists’ sessions, just by singing a song with the musicians or improvising a little dance in the middle of the bay:

It was also noticed that the staff would sing or hum the tune of a song in a variety of situations, for example while they were washing a patient behind the curtains, when they were taking the blood pressure of a patient or giving them their medications. Furthermore, it became increasingly evident that some of the staff was using music to distract the patients from the procedure they were carrying out.

(Preti and Boyce-Tillman 2014)

The possibility for empowerment for caregivers is also commented on in project evaluations. One caregiver associated with the Winchester Singing for Well-being choir described how taking her husband with dementia to the choir enabled her to find her own singing voice. Indeed, in the Centre for the Arts as Wellbeing at Winchester University we have a motto—Discovery in Recovery. In one program that we planned, older patients will have taster sessions of singing, movement, painting, and drama while in hospital which they can continue after they have been discharged. So their time in hospital will be a time when they can discover new abilities such as their ability to sing.

The role of musical skill in all of this is regularly a subject for discussion and the literature on music therapy does not see itself as giving skills but simply as using existing skills. However, in the wider world this distinction is often blurred. The Can’t Sing Choir in Morley College, London from the late twentieth century saw people wanting to use the choir as a stepping stone to the literate tradition, as these comments from members illustrate:

I have found learning very hard, but very rewarding. It is difficult for a non-reader to pick up a tune . . . I hope to learn to read music and to sing from a score. My ambition would be to join a choir which sings “oratorical” music and it is the older music which we sing that I enjoy most.

I like singing, but cannot sight-read very well, so I joined the Can’t Sing Choir to improve my standard of singing and sight-reading. Also to get some practice in four-part singing for enjoyment. Without the responsibility of preparing for concerts.8

Giving musical skills through education of some kind can improve people’s independence. I arranged music lessons for four children diagnosed with chronic anxiety as part of a treatment program in conjunction with Winchester Child Guidance Unit (Walker and Boyce-Tillman 2002). All of them were re-empowered to return to normal life through the development of musical skills that included improvisation.

To summarize, singing can contribute to personal growth and can allow people both individually and corporately to claim their power. Often this is by validating more process-based, (p. 951) orate traditions. The development of community choirs can be seen as enabling people to overcome past negative musical experiences and regain their musical heritage.

Transforming relationships—building community

Words are designed to classify and identify differences that divide, but singing can unite and has united many cultures (Storr 1993). When a group of people makes music together their unity is restored. The chief loss resulting from the decline of Western Judaeo-Christian theology in our culture may not be the theology but the whole community coming together once a week to make music. The Western classical tradition in the Middle Ages had a notion of community that included the cosmos and, in particular, God, up to the Renaissance. During this period notions of healing through the creation of community were widely found in the literature:

Musical harmony softens hard hearts. It brings in them the moisture of reconciliation, and it invokes the Holy Spirit. When different voices sing in unity, they symbolize the simple tenderness of mutual love. When different voices blend in song, they symbolize the blending of thoughts and feelings which is the highest pleasure human beings can know. Let the sweet sound of music enter your breast, and let it speak to your heart. It will drive out all darkness, and spread spiritual light to every part of you.

(Hildegard of Bingen in Boyce-Tillman 2000b, p. 138)

In post-Enlightenment Europe, the heroic journey model gained prominence (Boyce-Tillman 2007) with the individual composer set over and perhaps against the community. The individual performer often suffered an isolated hot-housing process (Kemp 1996, p. 248) and community music-making was devalued by the literate High Art traditions as we saw above. There is a vision today of a society that establishes peace by giving value to all:

We support the development of a culture of transformative personal, organizational, and social change that fosters and celebrates the highest human qualities and practices, including empathy, altruism, peaceful conflict resolution, and restorative justice.

(Schulman 2012)

From many sources comes the idea that singing can play a significant part as a community-building exercise to defeat the loneliness, isolation, fragmentation, and meaninglessness of our society:

What then does aesthetic experience mean for Dewey? Together with aspects of artistic doings and contextualism of this doing, the aesthetic aspect of experience means a qualitatively different, fulfilling and inherently meaningful mode of engagement in contrast to the mechanical, the fragmentary, the non-integrated and all other non-meaningful forms of engagement.

(Westerlund 2002, p. 191)

We see these elements present in this account from the East Kent Singing for Mental Health Project:

It’s a chance to do something in a group without being competitive. Meeting different people and joining with them in a co-operative venture. It has helped me deal with bouts of depression. I’ve rediscovered the pleasure of singing. I’d become inhibited about singing for several years. I’ve felt more relaxed having found a way to get out of a downward spiral.

(Woman aged 63)

(p. 952) The tolerance of diversity is an important element in the way a community defines itself; the admitting of diversity has enabled new societies and new ways of conceiving society to emerge. The process of readjusting this balance can be seen in a post-apartheid South Africa where musicians have played a part in this process. For example, West Nkosi released a 1992 CD entitled The Rhythm of Healing that brings together a variety of different musical traditions from all over the country. Many other musicians have engaged in peace-making projects to contain diverse elements respectfully within musical structures, well illustrated in Music and Conflict Transformation: Harmonies and Dissonances in Geopolitics (Urbain 2008).

The increase in community singing projects has opened up new horizons for reconciliations across cultures and between groups of people out of contact with one another in a single geographical area, including interfaith dialogue (Illman 2010):

[It may] involve learning new skills and expanding the meaning of concepts, often “unlearning” what was formerly believed to be true . . . Through performance, communities are finding ways of seeking truth and also recognizing its multiple faces.

(Cohen 2008, p. 31)

My own event Space for Peace (Boyce-Tillman 2011, 2012) shows this. It is a radically innovative event designed to bring faiths together through the arts—a vigil for peace. It started in Winchester Cathedral but has been tried in other venues, including a Hindu temple, as a means of interfaith dialogue. The age range of participants is 7 to 85 years with people from many traditions. The way the event is structured creates a resonant meditative space able to contain and merge diversity in a way that accepts it without obliterating it. The groups are situated around the cathedral in various chapels. Each chooses in advance what they would sing—some of their favorite pieces.

This is the middle section of the vigil, which is created by the participants on the basis of choice. Each group chooses when to sing; the audience/congregation moves around the building, lighting candles, praying, being quiet, as they choose, but also participating in creating the musical sound.

The vigil is designed therefore to reflect a new model of peace-making; this is based on the principle that we all do what we want to do but then also have the responsibility of working out how far it fits with what other people want to do. Everyone present has a part in the creation of an experience of beauty and togetherness; they experience intuitive ways of relating to and cooperating with others, as these comments illustrate:

What surprises me also was that an Imam climbed the pulpit and chanted the call for peace in Islamic religion. I would not have thought that such a thing could be possible in a cathedral. The same Imam and a Rabbi chanted together in the same place. If only because of this, I think the performance was truly remarkable.

It was for me poignantly, beautiful and moving, cross-generational and as multi-cultural as is possible in immediate vicinity.

There are many deeply moving personal stories from the informal process-based structure of this event. One person says that in the midst of a violent landscape it enables him to keep alive a vision of peace. In one of the events a woman in a wheelchair who said that the reason for her paralysis was hatred of Islam dating from events in her childhood, parked her chair beneath the pulpit where the imam was singing and cried away all her hatred listening to the imam’s chanting. Other people ask any of the faiths to sing on behalf of someone who (p. 953) needs support, like singing Kaddish for a dead friend. There are also times when everyone sings together, including opening chants which fit together as a Quodlibet and the singing of peace in a variety of languages on a single note. This project opens up a new possibility of improvisation as a route to community building based on giving difference dignity (Boyce-Tillman 2012; Jordaan 2015).

To summarize, singing is a community-building exercise. We need to examine new ways of exploring an increasingly diverse community and enabling both similarity and difference to flourish musically.

Community building—the birth of new choirs

The revaluing of the orate meant a reworking of the concept of choir. We have already seen how in the late twentieth century people were experiencing the opening of the self and relationships with a wider community within the community choir movement; the wider culture too was discovering that everyone could sing. The community generated new singing groups—for the homeless, for the mentally ill, people with memory loss, stroke victims. The next section outlines just a few of them.

The Seaview Singers in Kent were set up for people with dementia and included sufferers and carers. It included not only singing songs but lyric writing and improvisational activities. It did, however, develop relationships, via Christchurch Canterbury University, with other groups including university students and an intergenerational project with the local school (Vella-Burrows 2012, pp. 11–13).

Recovery choirs enable people to be rehabilitated after hospitalization for mental health issues. An example is the Wellbeing Community Choir which was formed in 2009 by Birmingham and Solihull Mental Health NHS Trust for people with mental ill health, carers, friends of the trust, community members, and staff. Originally it performed at community and trust events, but it became an example of the partnerships developing between the two esthetic traditions when it joined with the Handsworth Choir, forming a partnership between the Health Trust and the City of Birmingham Symphony Orchestra and the CBSO Selly Oak Choir, for a pre-concert performance on Friday July 12, 2013 at Symphony Hall, Birmingham. The website declares “This was a fantastic opportunity for all choir members to sing at Symphony Hall, one of the world’s greatest concert halls!” (Wellbeing Community Choir 2014). This sort of project, which involves singing in what the community regards as a significant venue, is always regarded as profoundly empowering. I have experienced the same phenomenon in events taking place in Winchester Cathedral.

Another Recovery choir is called the Raucous Caucus Recovery Chorus, based at Sharp, Liverpool. It is made up of people in active recovery from drug and alcohol addiction. It uses a wide range of musics, including chants, mantras, folk, and pop songs (Raucous Recovery Choir 2014a) and is run by Action on Addiction which sponsors many creative arts projects. Its home is a non-residential recovery center which offers a 48-day recovery program—and includes families as well as recovering addicts. It has performed in other treatment centers. The head of the charity sees it as an unusual treatment but cannot deny its success:

Most people would say people need to be doing group therapy, they need to be doing counselling. But you’ll notice a lot of the guys saying that they didn’t really feel that they (p. 954) belonged anywhere. Taking part in a choir they begin to understand all about communities just through singing.

(Raucous Recovery Choir 2014b)

Again, it is the sense of belonging that is highlighted. One member describes how it enables him to keep connected to other people in recovery who are struggling like him. The space is described as magical and one in which confidence can be built.

The East Kent Singing for Health project includes similar reflections:

For some years, due to numerous life events/close losses, I’ve undergone depression—feeling sometimes life not worth living—despite trying to count my blessings compared to so many in the world. Obviously any activity cannot change the fact that now I’m alone. Yet the singing has made a definite improvement in how I feel, if only while singing and intermittently. It’s a very uplifting thing and I like all the people in the group. Look forward to it.

(Woman aged 66)

Threshold choirs support the process of dying through bringing ease and comfort to clients, family, and caregivers. Their calm focused presence revealed in their songs soothed and reassured (Threshold Choir 2014). This movement is largely in North America, although there are people singing with the dying in hospices in the UK. Again it is about connection with a community; in the past death happened in the context of a community, but dying now often takes place in the separate environment of a hospital or hospice.

The Amies Project works with trafficked women. It was established in 2011 to provide a creative outlet for young women trafficked into the UK for prostitution or domestic labor. In the UK victims of such trafficking receive just 45 days of “compulsory reflection and recovery.” This project has given them much longer support. Here, singing is combined with dancing, sharing stories, and laughter. At the time of the writing of this chapter 60 young women have been helped by the project to move forward in their lives into education, training, and employment. Comments from participants showed its transformative effect and its ability to help people trust again (Amies Choir 2014).

To summarize, the rise of orate singing traditions has resulted in new groups of people finding a sense of belonging through group singing. These groups have sometimes been able to combine with the literate tradition to produce performances that form new communities of empowerment.

Getting it together: inclusion versus exclusivity

Singing groups and inclusive community

Since we have, as a community, recovered the notion that everyone can sing, we have seen how choirs have been established for particular groups within a culture as listed above. Winchester Singing for Wellbeing Choir was originally conceived as being for people with memory loss; but subsequently it was moved to the Winchester Live-at-home scheme and then included a variety of people who had not been diagnosed with memory loss. It still included the original group but the character of the singing changed when a greater variety of people was included.

(p. 955) So can we have people singing together with a variety of needs in order to reintegrate a fragmented society? “Music could be a genuine way to create situations, to construct social relations in situations, to communicate in a holistic way that combines body and ethics, individual and community” (Westerlund 2002, p. 144).

The challenges are considerable, for present in these groups are a variety of bodies and culturally constructed sounds. There needs to be a concern for the expressive elements in music including extrinsic meaning and the use of musical constructions that are orate in origin, as well as musical scores that are notated, and musical structures that embrace both. There needs to be an inclusive value system underpinning an inclusive musical project, valuing diversity and different cultural forms of singing as well as nurturing leadership styles. The research literature is beginning to set out what practicalities are helpful in these contexts. They include:

  • recorded CDs and websites with mp3 files of individual parts

  • a system of mentoring in the choir—a buddy system

  • seating with blocks of singers rather than men behind women

  • a diverse repertoire

  • the use of a variety of criteria for success so that accuracy and uplift are balanced.

In an article entitled “Adapting choral singing experiences for older adults: The implications of sensory, perceptual and cognitive changes,” Yinger Swedberg (2014) provides helpful advice for the inclusion of a variety of needs, such as attention to lighting (many sources and no glare), the use of a 12-point sized typeface in a simple font, large conducting gestures, and fewer rows to help people with visual impairment. People challenged haptically (at risk of falling) need clear floors, the permission to use assistive devices, and the use of a slower tempo for pieces with fast articulation. People with hearing problems need to use their hearing aids, make sure they can see the leader who needs to use a lower-pitched voice, decrease talking, repeat points, give clear instructions and non-verbal cues such as gestures, while keeping their mouth visible for lip reading. People with cognitive impairment (with memory problems) need to be allowed to use copies and have written reminders for rehearsals, etc. They need to use cues from words, not musical notation, and be able to relate music to their experiences by tapping into extrinsic meaning. They need to be allowed to generate some familiar repertoire from the participants, and terminology needs explaining carefully. People with visual attention and spatial cognition problems need a slow instruction pace with only one thing at a time being dealt with and directions repeated. It helps if texts are projected with highlighting important things in color. All choirs need to allow participants to use chairs while singing.

To summarize, the inclusion of people with a variety of needs in a singing group requires a rethinking of the way choral groups have functioned, and some considerable adaption in leadership styles, yet all can benefit from being in a group with people who are different from them, for it creates new communities.

A vision for community—musical inclusion

It is in this general esthetic landscape that the radically inclusive musical event is located. There is a risk that these specific groupings still serve the cause of marginalizing groups (p. 956) of people whom others might deem unacceptable. In my own composing (Boyce-Tillman 2016, pp. 313–33) I have gradually edged towards this inclusiveness. The Healing of the Earth (1997) included professional instrumentalists as well as children who also had a chance to improvise their own pieces. The Call of the Ancestors for Winchester Cathedral from 1998 included three orate groups (Thai gongs, Kenyan drums, and a rock group) alongside a large choir singing from notation. Gradually, I developed in my composing spaces for improvised episodes and a greater variety of performers. The Great Turning, a work on ecological themes in 2014, saw the number and range of community choirs increased. From Conflict to Chorus: An Intermezzo for Peace for March 14, 2015 is a remembering of World War I. Guns were converted into musical instruments for the orchestra. One was in the shape of a battered soldier and was both an artwork and a sounding source played by the children in the school choirs. A flute was made out of a rifle barrel. The concept of the piece is radical inclusivity, which is in my thinking a model for peace. It included the Southern Sinfonia (a professional orchestra), the Singing for Well-being choir (including people with diagnosed memory loss), as well as a school for pupils with profound and multiple learning difficulties, five Hampshire schools, community choirs, notated choral parts for Winchester university choirs and soloists, a young singer songwriter who is visually impaired and has learning difficulties, and a dance performance by a group of young adults with learning difficulties. My vision is of a choral/orchestral event that can include whoever wishes to be involved and their carers. This provides a model of a truly inclusive society where the organizer (previously composer) is a frame-builder in which everyone can participate fully in accordance with ability. The inclusion of this great diversity of people with a variety of abilities has involved substantially more individual work and careful scoring of the accompaniment. Composing becomes not the imprinting of one person’s ideas on a group of people, but the building of a scaffold (Holzman 2008) in which everyone can realize their full potential.

To summarize, I have set out another way of including people with diverse needs, experiences, and traditions in a single performance in which the notion of “composer” needs rethinking into one of enabler. I have set out a musical way of rethinking community by mutual empowerment.

The liminal space

The transformative properties of musicking involve the creation of a liminal space (sometimes called a spiritual space). The notion of the transformative properties of the sacred or liminal space has been explored in various contexts (Boyce-Tillman 2001a, 2007, 2009, 2016, pp. 265–83) including healthcare (Wright and Sayre-Adams 2000/2009). Isabel Clarke’s (Clarke 2005, p. 93) notion of the transliminal way of knowing is drawn from cognitive psychology (Thalbourne et al. 1997). In her thinking, this way of knowing is to do with our “porous” relation to other beings and tolerating paradox. It is in contrast to “propositional knowing,” which gives us the analytically sophisticated individualized way of knowing that “our culture has perhaps mistaken for the whole.” To access the other way of knowing we cross an internal “limen” or threshold to a space which is potentially transformative. The important aspect here is that difference co-exists easily here. It becomes a way for discovery (p. 957) of this alterity within the self (Jackson 1998, p. 119) and accepting it; another example of this is the practice of mindfulness.9 This can extend to encountering others who are different (Derrida 1972; Levinas 1969), as we saw in the communities in the choral groups above. The following characteristics of the spiritual/liminal domain emerge from various sources:

  • a limen that is crossed from ordinary knowing especially in the space/time dimension

  • a sense of encounter

  • a paradoxical knowing so that diversity can exist within it easily

  • a sense of empowerment, bliss, realization

  • a sense of the beyond, infinity

  • a feeling of an opening-up in the experiencer as boundaries start to dissolve

  • a sense of transformation, change

  • an evanescent and fleeting quality that cannot be controlled, which may result in a sense of givenness

  • a feeling of unity with other beings, people, the cosmos.

We have already heard the word “uplift” being used in descriptions of the singing experience. Within the Elevate project staff described this feeling:

Sometimes, members of the hospital staff would come into the bay pretending to dance, or joining in the sing along, creating amusement among the patients. These occasions appeared to break the hospital routine and create a free space where, even for few minutes, everyone was interacting in a different way.

(Preti and Boyce-Tillman 2014)

The Elevate music sessions in the wards of Salisbury Hospital appeared to create a relaxing atmosphere, consequently facilitating the work of the hospital staff. “It relaxes us . . . Our stressful day becomes calm” (Nurse interview in Preti and Boyce-Tillman 2014). Staff invariably responded that they would have liked artistic work to be more frequent because of the relaxing effect on the staff and the patients. The Chief Executive of Salisbury NHS Foundation Trust identified the transformative impact of Elevate on the hospital environment as one of the main features of the program: “It has a very positive impact on the environment both for the individual patient and the patients around them and the staff on the ward and the environment, and it also leaves behind a kind of lasting footprint” (Preti and Boyce-Tillman 2014).

Other authors have described how singing “fills us with awe, with joy, with wellbeing, that which adds meaning to our lives” (Agwin 1998, p. 6) and so helps to deal with burnout in healthcare contexts. Wright and Sayre-Adams describe music as a soul food along with art, nature, and scripture (Wright and Sayre-Adams 2009, p. 29). They summarize the history of music in healing contexts:

From the relaxation effect of soft background music, to patient participation in music making, there are many opportunities for carers to find a path for music in holding the sacred in right relationship. Music, the “food of love” has inspired people to the heights of (p. 958) human achievement, and has been used in all cultures as a meditative and contemplative tool to alter states of consciousness, from the repetitive drumming of the shaman to the ragas of India and the complex and intricate qawaal songs of the Sufis . . . A whole new (some might argue, renewed) science and art is emerging of “music thanatology.” (Schroeder-Sheker 1994), bringing prescriptive music to the dying and seriously ill, with profound beneficial and spiritual effects being reported.

(Wright and Sayre-Adams 2009, p. 94)

Within this thinking we have the concept of being able to hold a sacred (potentially transformative) space:

When you and the choir sang to my mom, I felt your singing was able to hold a space open that we all fear. That “space” could be death or just the struggle of sickness, and when it’s held open like that, we are less alone in it . . . When you sang, your voices had a kind of wisdom of being in dark places or feared places.

(Threshold Choir 2014)

Earlier in the chapter we saw how hymns have been featured in some healing contexts. It is possible that it is through singing that the spiritual can be awakened in healing contexts (Beattie 2007; de Botton 2012) with transformative effect.

To summarize, singing has the potential to take us to a different way of knowing and perceiving the world in which all is connected and transformed by this process. This is beginning to be understood in health contexts and needs further exploration.


This chapter has set out how the re-valuing of orate singing traditions has freed up many therapeutic possibilities and unchained the innate singing power of numerous people. I have explored contexts in which people have found singing to be physically strengthening, psychologically empowering, socially enriching, expressive, and mood improving. We have seen how these effects operate at a cultural level as well and how cultural singing events might interact with personal healing. I have opened up the possibility that singing might restore a spiritual dimension to healing contexts. The chapter has drawn on a wide variety of sources for these findings, which has enabled us to explore therapeutic singing through a number of lenses. There is sufficient evidence for the inclusion of singing formally in healthcare programs and the possibility of establishing sustainable programs of well-being through singing that will be extremely cost-effective and sustainable. This is particularly true of the interface between the personal and psychosocial; it acknowledges that often therapeutic work needs to operate to bring the individual and communal together to provide healing at the deepest level for our society, and in so doing it can effect profound social change.


Agwin, R. (1998). Creating sacred space. Positive Health Dec./Jan.: 6–7.Find this resource:

Amies Choir, available at: Accessed June 15, 2014.

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(1) I have used the word orate throughout rather than aural or oral because I have drawn heavily on Walter Ong’s thinking in this area. It seems to be a word to describe a complete tradition which does not use a written notation system of some kind for its musicking in contrast with a literate tradition which is transmitted and learned through the medium of a written notation. This seems clearer than the words oral/aural which can simply describe a way of teaching rather than a complete tradition.

(2) Described earlier as the dominant value system.

(3) It was as early as 1939 that music was recommended as a prescription to be given by a doctor (Podolsky 1939).

(6) Letter from Griffith Roberts given by John Roberts.

(7) I am grateful to Sandra Thibault and Jackie Shipster for these accounts.

(8) Unpublished interviews from the Can’t Sing Choir, thanks to Joan Taylor.

(9) At the University of Winchester we are examining the potential relationship between this practice and musicking.