Music and Illness [2/2]

On October 19 and 20, IRCAM will be hosting a symposium and concert on the theme of "Music and Illness". Imagined and organized by musicologists Laurent Feneyrou and Céline Frigau Manning along with medical historian Vincent Barras, the event will do exactly what its title suggests: shed light on two disciplines whose intricacies are more numerous and complex than first meets the eye.

Laurent Feneyrou presents the major issues at stake, as well as their musical translations, which can be heard in a musical program presented by l'Instant Donné on October 19.
[Read the first part of this interview]

You've left out the cathartic (or therapeutic) aspect of music, particularly by the musician themselves: why?

You're absolutely right, and our approach is deliberate. We've ruled out a positive vision of music, or its reduction to the rank of pharmakon, which has already been studied throughout history, and mainly before the period we've chosen - from the death of Bach or Handel to the present day. It would be useful to reread Plato's Republic or Aristotle's Politics, where music, like sleep and drunkenness, and provided the right instrument is chosen, provides relaxation, relief and pleasure, serves purification and education, and is related to virtue insofar as it induces a certain quality of character. Moreover, since Hippocrates, numerous medical treatises have established what should be listened to during pregnancy, incontinent or agitated infancy, nutrition and digestion (Ryan Weber's paper will extend this discourse to nervous disorders), bathing, bloodletting, or sexual intercourse, as a means of finding sleep, or even in hospital. They use music as a means of alleviating illness, curing it or supporting therapy: against plague, scabies, suet, syphilis, gout, sciatica, spasmodic illnesses, headaches, cardiac disorders, stupor mentis, litargia, apoplexy, catalepsy and constipation, epilepsy and convulsions... The list of illnesses is by no means exhaustive. Or against animal bites, rabies, or tarantulism. Athanasius Kircher comes back to this in his Musurgia Universalis, counting on the fact that music can also have the effect, through sympathetic resonance, of expelling a poison from the body. Of course, the list of illnesses changes over the centuries and from author to author, depending on their medical and philosophical principles, just as the often succinct mentions of music change. I would argue that well-being is a declension of this, which undeniably has a therapeutic project, but also socio-political and economic premises, since the healthy body is also a production tool. In contrast, we refocus on music, or the musical, and ask how the musician of the modern era becomes an object of study, a patient, or a patient of choice. In Alain Corbin's words, the musician's body must be interrogated in "the tension established between the object of science, of work, the productive body, the experimental body, and the fantasized body". Our starting point is the conviction that this question must be taken seriously, and not remain a historical curiosity, or a secondary chapter, fuelled solely by doctors who are keen to "humanize" the medical sciences by advocating the contribution of the arts, whose main quality would be to develop sensitivity, empathy or universal understanding; in short, at the boundaries between the history of music, the body, and medicine, there is a vast field of research for musicologists, historians of medicine and philosophers of science, in equal measure.

Image: Athanasius Kircher, Musurgia universalis sive ars magna consoni et dissoni, Rome, Ex typographia Haeredum Francesci Corbellitti, 1650, vol. 1, vis-à-vis de la page 22.

A final point: in some historical medical texts, we find the idea that music prolongs life. Yet, by choosing illness, we are insisting on the missing link in what Michel Foucault called in Naissance de la clinique a "technical and conceptual trinity": life, illness and death, in which the triangle culminates, which medical experience integrates into its science and institutions, but which the world of modern civilization, with zeal to excess, relegates to the margins of public life.

As you yourself mentioned earlier, when referring to the various proceedings of the colloquium, when it comes to music and illness, one of the first thoughts that comes to mind is mental health - think of auditory hallucinations, for example, and more broadly of the close links between madness and creativity. In this respect, the contributions to the symposium, as well as some of the works on the program, underline the historical evolution of the intangible boundary that separates the normal from the abnormal: initially a boundary between enlightenment, mystical ecstasy and creativity, it gradually shifts towards a more medical vision, that of a boundary between mental pathology and creativity - a vision that qualifies the condition differently, but without changing its effects.

Yes, the most famous case is of course Schumann's—which we won't be discussing at the colloquium—of his nagging tinnitus and strange, scratchy auditory perceptions, which he shared with Mendelssohn. These auditory hallucinations would persist, painfully, over the last few years: a fixed note, a constant A, throughout the night, then the whole day, complex musical phrases, occasionally orchestrated, a symphonic work or the dictation of a wonderfully melodious theme.

We will approach mental illness from several perspectives: Jean-François Lattarico on the representation of the psychiatric asylum in Buonavoglia and Paër's Agnese; Annelies Andries and Marie Louise Herzfeld-Schild on melancholy in the early 19th century, Jon Fessenden on musical autism, Pierre Brouillet and Mathias Winter on the "ear of idiots", Jean-Christophe Coffin on Lombroso and the pathologization of Italian musical genius, independently of the post-concert screening of Une page folle, a film by Teinosuke Kinugasa with music by Mayu Hirano, which also deals with the representation of the asylum.

It's a question that runs through Salvatore Sciarrino's Infinito nero, based on texts by Maria Maddalena de' Pazzi, and which will be performed by L'Instant Donné at the concert on October 19. Following an undiagnosed illness that brought her to the brink of death, this young professed nun experienced forty days of ecstasy, from which Sciarrino draws his inspiration in the extreme model of orality, in excess and in default. It is recounted that eight novices surrounded the saint: four repeated her words, spoken too quickly, chanted, cascading out as if from a machine gun, before she sank, exhausted, into profound silence and unspeakable delight; four others transcribed what was repeated to them. It was still a question of religious truth, of a spiritual approach to delirium, before Charcot and Janet exercised their medical science and modern psychiatry saw in these convulsive agitations or the rigidity of certain limbs the symptoms of an illness. Sciarrino stands at this intersection, between, on the one hand, the religion and verb of the late Renaissance, and, on the other, a certain psychology of the mystic, in the gaze and iconography of the Salpêtrière, the movements of the ecstatic on the ground and the tensions of his body like a bow supported by feet and shoulders.

Image: Désiré-Magloire Bourneville et Paul Regnard, Iconographie photographique de la Salpêtrière, vol. 2, Attitudes passionnelles : Extase (planche XXIII), Paris, Progrès médical / Adrien Delahaye, 1878.

I will discuss this work and two other "religious follies" featuring psychotic, neurotic or perverse women portrayed by men, a male gaze inviting us to a theory of gender, in a lyrical form in which this gender is readily expressed with emphasis: Penderecki's Les Diables de Loudun and Brice Pauset's Exercices du silence, which composes the historicization of pathology: after the cries and "possession", come the negation, self-abandonment and ecstasy of Louise du Néant, a Grand Siècle mystic who loved the flesh and now scrutinizes its decomposition, circling around the ulcers, open varicose veins and rotten skin on which she affixes her lips; the abundant psychological literature of the late 19th and first half of the 20th centuries on this type of case (William James's L'Expérience religieuse, essai de psychologie descriptive, Pierre Janet's De l'angoisse à l'extase, Georges Dumas's Le Surnaturel et les dieux d'après les maladies mentales, essai de théogénie pathologique... whose clinical descriptions Pauset draws on for his vocal and instrumental gestures); the contemporary experience of a "schize" of musical space and, consequently, of sensory disorientation, which itself denotes other inmates.

The simple case of deafness should challenge us: are you interested in what medical or neuroscience researchers are saying about the links between music and deafness?

No, because no one has addressed the subject, but the question is fundamental - even for some contemporary artists. However, if we had tackled it, it would have been from a historical, rather than neuroscientific, perspective, examining successive viewpoints. For example, to cite the most expected example, that of Beethoven, his deafness has been attributed to several causes for almost two centuries: typhus, in the sense of the time, meningitis, meningovascular syphilis, congenital syphilis, vascular insufficiency or damage, otosclerosis, cochlear otosclerosis, osteitis deformans, with bone tissue remodeling, iatrogenic mercury or lead intoxication, neurosensory autoimmune disease, Cogan syndrome... - without even mentioning the consequences of the Vienna bombardments, in 1809, on his hearing. Syphilis, not attested by the autopsy, is retained on the basis of biographical data, including his 1819 order of Louis-Vivant Lagneau's Exposé des symptômes de la maladie vénérienne, barely translated into German, and a letter of June 19, 1817 to Countess Anna Marie Erdödy, in which Beethoven refers to a mercury-based treatment used for syphilis, rheumatism and skin disorders.

We would also have studied the autopsy report, its medical presuppositions about art and the artist, its methods, the history of the doctors who performed it, what the text reveals about their way of apprehending the musician's body... "The cartilage of the auricle is large and irregularly shaped: the navicular fossa, in particular, is enlarged. The cartilage of the auricle is large and irregularly shaped: the navicular fossa, in particular, is enlarged; the concha is very large and half as deep as usual; the branches of the antherix are very divergent and the folds are very deep. The external auditory canal is filled with shiny skin flakes right down to the tympanic membrane, which is masked. The eustachian tube is considerably thickened. The protympanum is somewhat narrow. The mastoid process is large, but the bony sutures are unremarkable. The cells are lined with a blood-tinged mucous membrane. The entire petrous portion of the temporal bone is criss-crossed by a visible vascular network, and also displays a large quantity of blood-like substance, particularly in the region of the cochlea, whose spiral membrane appears slightly reddened. The facial nerves are very thick. The acoustic nerves, on the other hand, are wrinkled and devoid of myelin. The afferent auditory arteries are dilated beyond the size of a crow's feather pipe (four to five times the normal caliber) and have a cartilaginous consistency. The left acoustic nerve is by far the thinnest, with three whitish, very tenuous roots; the right nerve has a much larger, white root." Long thought lost, this document, written in Latin, dated March 27, 1827, and signed Johann Wagner (assistant at the Vienna Museum of Pathology who, together with Carl von Rokitansky, soon to be a leading exponent of modern pathological anatomy, performed the autopsy), was only found in 1970, at the Institute of Pathological Anatomy of the University of Vienna - it was not until 2006 that Schumann's autopsy report and the medical record of his years at the Endenich Clinic were published. The importance of these texts for the knowledge of musicians and the history of music is indisputable.

Image: Johann Wagner, Manuscrit du rapport d’autopsie de Ludwig van Beethoven, 1827, conservé au Pathologisch-Anatomischen Bundesmuseum de Vienne.

Is creativity—and its product, the finished work—seen in some of the works on the program as a symptom of illness (Donatoni's Etwas ruhiger im Ausdruck comes to mind, for example)?

This is the most delicate point. How much is pathology and how much is musical invention? In Donatoni's case, the question is medically twofold: diabetes to the point of coma, on the one hand, resulting from deleterious eating habits, to which we alluded and which Emile Wennekes will study in Alfred, Alfred, along with other representations of this illness (Diagnosis: Diabetes by Michael Park and La straordinaria vita di Sugar Blood by Alberto García Demestres); a bipolar structure, on the other hand, which is not a matter of banal psychology, but an existential structure, marked by the absence of volition: "Will was something essential from which I was totally excluded. " Donatoni had no will. From then on, it was necessary not to hide, conceal or repress it, but to acknowledge its absence, which casts doubt on one's own existence and transforms its modalities: the ego does not think, but is thought; it does not act, but is acted, as Donatoni liked to say. The question of the Self is thus at stake. Negation, irony, sarcasm, doubt, the pathos of dependence, awareness of the illusions of art, the mortification of the self in the work, as much as of the work itself, the atonement of subjectivity are all manifestations of this, and none of them literary. Etwas ruhiger im Ausdruck calls for a succession of "now" points that are incapable of sustaining or anticipating themselves, without continuity or anchorage. This is the essence of manic temporal distension. Psychiatrist Ludwig Binswanger used the term Momentanisierung, momentanéisation or mise-en-moments.

In other words, we grasp the threat of a naked present, with neither before nor after, in a presto almost devoid of the values of memory and expectation. Nothing flows, nothing happens, nothing lasts. At the same time, space becomes more restricted: everything appears to be at hand, without distance, in a proximity where everything and everyone is grasped. In this space, against which he leans and embraces, the maniac, on the surface of his own depths, evades and conceals himself from himself. His torment is the failure of a desire marked by the desire of the Other - due to his absence of volition. He is the anonymous being, in the inauthenticity of One, not towards the other, but towards an experience of otherness where the alter ego becomes neutral, aliud, and where the other is reduced to the alienus, the tool, the object used and consumed, like the first three beats of the eighth bar of the second of the Five Pieces for Piano Op. 23 that Etwas ruhiger im Ausdruck borrows from Schoenberg, a material then subjected to the automatisms of combinatorics. The handling of words or sounds to the point of chosification, which Donatoni's theoretical and musical work magnifies, implies another modality of enunciation. But is it a language game that substitutes volatile association and haste for common usage? Does the whirlwind, the vortex of sounds, translate intoxication, leaping and manic luminosity? Is it the symptomatic expression of an illness or, rather, its representation? Or the representation of its representation?

Jérémie Szpirglas