A Voice Lab Gives Voice to the Psychoexemplary of Support

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

On Tuesday, we began our series on my so-called psychoexemplaries with a column on peacemaking. It was the first in a tentative list that I had developed. However, over the Memorial Day weekend, I came to realize that another important example was missing. It was the importance of what at first glance seems like a common and causal process that often occurs in psychiatry and society, that being supporting of—or trying to support—others.

The insight and inspiration came to me from attending the celebration and fundraiser for the continuation of the Milwaukee Opera Theatre’s free Voice Lab, which since 2009 had reached number 99, with a reported 1653 singers and at least 15 original productions. The goal, as conveyed by the invitation to the event by the Artistic Director, Jill Anna Ponasik, is described as:

“. . . invite artists to share something they’re working on, facilitate supportive conversations around that work, and see what happens.”

As a clinical psychiatrist, I saw my share of musicians with extensive anticipatory anxiety and other performance psychological concerns. Propanalol and supportive psychotherapy seemed to often help some.

Auditions were particularly stressful in the pressure and lack of feedback. That process reminded me somewhat of sending in submissions to a conference, then receiving an acceptance or rejection, but no explanation for the decision to learn from.

Personally, my wife and a granddaughter have been involved in musical theatre and have gone through such auditions.

What the celebration did was to actually be the 100th Voice Lab, as presented in a series of solo performances, with voluntary commentary by the participants about themselves, the lab, and the song they were to sing. As each participant presented, these words emerged: support, joy, nervous, creative, safe, nourishing, warm, welcoming. Forgetting words of the song was no big deal, just part of the process and principles.

One participant who had never been to a Voice Lab volunteered to participate as if it was one. The audience provided feedback and a second, improved performance emerged. At times, my wife and others were touched with tears.

The Artistic Director later told me about the 4 principles of the Voice Lab, which were derived from a feedback process developed by the dancer and choreographer Liz Lerman¹:

• Affirmations. Providing immediate feedback geared to expanding the singer’s strengths.
• The Artist as Questioner. Here the artist can ask for feedback.
• The Audience as Questioner. The artist has the choice to answer or not.
• The Artist Continues the Work. Here they are gently nudged forward.

It did not take me long to realize that the Voice Lab was a paradigmatic process for mental health. I experienced the same principles that supportive psychotherapy tried to convey in individual or group sessions. Some of those principles are²:

• Active listening
• Empathy
• Encouragement
• Problem-solving
• Gentle pushes forward

The Voice Lab is by no means meant to be therapy, but is more of a self-help process, but if the principles of supportive therapy fit both the Voice Lab and psychiatry as a psychoexemplary, why shouldn’t such sophisticated supporting be relevant, appreciated, and provided in so many other situations, especially in our time of condescension and conflict? A model for mental health, indeed.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. Lerman L, Borstel J. Critique is Creative: The Critical Response Process in Theory and Action. Wesleyan University Press; 2022.

2. Battaglia J. Doing Supportive Psychotherapy. American Psychiatric Association Publishing; 2019.