Between Lines: A Critical Multimodal Discourse Analysis of Black Aesthetics in a Vocal Music Therapy Group for Chronic Pain

Abstract

The purpose of this study was to gain an understanding of Black clients’ experiences within a music therapy context by exploring the discursive construction of aesthetics demonstrated by Black members of a vocal music therapy (VMT) group for chronic pain. For this purpose, the theoretical framework of critical race theories and Africana womanism guided this study, and a critical multimodal discourse analysis was employed as the primary methodological tool. Three primary research questions guided this study: What were the aesthetic experiences of the Black members of the VMT chronic pain group? What was the role of black lifeworlds (musical representations and cultural representations) in Black clients’ aesthetics experiences? What was the function of Black client aesthetics in the VMT group experience? Secondary data of another research study, namely video data obtained in a clinical trial on the effect of vocal music therapy (VMT) on core outcomes in chronic pain management, served as the primary data source for this analysis. The video data documented an eight-week group VMT treatment program, in which six Black individuals with chronic pain, five females and one male, and one white female participated in vocal music therapy techniques such as toning, group singing, vocal improvisation often accompanied with percussion instruments, song reflection, and deep breathing to address core outcomes of chronic pain. These sessions were facilitated by the white music therapist and principal investigator of the clinical trial and assisted by me, her Black research assistant. This analysis evidenced Black clients’ agency-driven aesthetic exploration of Black language and Black musical representations within a music therapy context. In so doing, the VMT group context is revealed as a racially patterned social activity marked by performances of alterity mobilized through Black participants’ aestheticization of personhood. The analysis detailed the social realities co-constructed by the Black participants vis-à-vis non-monolithic experiences of Black language and Black vernacular music as processed through cultural memory and the inherently subordinate nature of therapy. This was demonstrated in four aesthetic formations: (a) (pre)embodied pain aesthetics, evidenced by participants' portrayals of agency within the intersection of socio-historical, socio-structural, and socio-cultural systems of chronic pain and healthcare disparity discourse; (b) Black language aesthetics, revealed in mono- and cross-racial verbal and prosodic communication; (c) healing aesthetics, delineated by participants' spiritual negotiations within a model of medical music therapy; and (d) musicking aesthetics, detailed by the use and situated meaning of Black musical gestures referentially used within music therapy theory and praxis. These findings detailed Black verbal and musical iconicity, client face-saving practices, individual and collective responses to microaggressions and their impact on the therapeutic process exhibited verbally and nonverbally, in-group tensions, the protective function of spiritual coping, paraxial tensions between medical and culturally centered healing practices, and aesthetic relevance of ethnocentricity within the VMT program. The findings of this analysis detailed the sensorial, relational, imaginal, and political nature of aesthetic discourse and served as the first systematic exploration of aesthetic processes of Black participants in the field of music therapy. Furthermore, this research discussed the widely understudied experience of chronic pain by Black participants, as both physical and psychological phenomena. In so doing, it provided a synthesis of Black client narratives that further contribute to the growing knowledge of culturally responsive clinical practice within music therapy and related healthcare disciplines, as well as the collective discourse of Black bodies within cultural aesthetics, semiotic anthropology, and Africana studies. Given the nature of the findings, implications for future research, clinical practice, and music therapy cultural competence development are provided.Ph.D., Creative Arts in Therapy -- Drexel University, 201