I'll probably return to posting distressing pictures and stories about public restrooms soon, but I wanted to share something I've been working on.
Below is a draft of program notes for a two-piano piece about obsessive-compulsive disorder. The original plan was to write a suite about various mental illnesses. However, I've done more research on OCD than any others and I think my ability to write about OCD effectively, to communicate the gravity of it without being overwhelming, and to find the humor in it without being exploitative, is a little stronger than any other condition. I know psych disorders, and they say to write what you know. But if I write a bunch of jarring, uncomfortable pieces, and ESPECIALLY if I incorporate a behavioral element to the whole suite the way I do for the OCD bit, then I'm walking a fine line. You don't want people to walk away with misconceptions, but you don't want to be didactic. If there is too much humor, you run the risk of trivializing conditions that cause real suffering, and coming across as mocking - something that I would never, never want to do. Conversely, if it's too overwrought, then you're milking an easy source of pathos and manipulating the audience. Or you just come across as ham-handed and thick.
I guess what's concerning me is, I've been researching schizophrenia - not that I haven't had a great deal of up-close-and-personal experience with it, but with a year between me and my psych clinic job, I found I could use a refresher. I've been watching lots of interviews, as well as unplanned television appearances by people with the disorder. (I maintain my assertion that The Rent is Too Damn High Party founder Jimmy McMillan's apparent derailment of thought indicates at the very least a mild case of disorganized schizophrenia.) Anyway, I've also been watching a lot of educational videos about schizophrenia, and they all come across hollow. You can tell the fake ones. Even the ones that take the actual words of a person with schizophrenia and put them in an actor's mouth, you can tell. They sanitize it, and in doing so, they take away from the experience. I know that the experience of schizophrenia is a little different for everyone, but I've NEVER dealt with anyone in the midst of a psychotic episode whose language was G-rated like it is in those videos. And when you take that out, and you hire sub-par actors to sleepwalk their way through the lines, then the sheer physical and psychological violence of the experience doesn't get communicated at all. But again, could I communicate it bett? And again, if I am determined not to sanitize it, then I also run the opposing risk of being provocative for its own sake (in that oh-so-predictable, fresh-out-of-art-school way, no less.)
Anyway, I DO have a fairly lengthy piece about obsessive-compulsive disorder, and here, as I said, is a bit of a user's guide, to be included in the program upon performance.
About the Piece
This piece is an attempt at depicting obsessive-compulsive disorder through musical performance.
This piece is an attempt at depicting obsessive-compulsive disorder through musical performance. It is built on a series of increasing motifs, governed by a set of rules. As with obsessive-compulsive disorder, the rules often conflict with or contradict each other, and which rule wins out in the end is often entirely arbitrary.
The piece begins with a three-note motif, representing an intrusive thought - an obsession. The performer wants above all else to shed himself of this idea, but cannot, for fear of some unknown force.
Every fifth measure, the D sounds in the bass clef. This is a pedal tone, of sorts. It sounds every five measures because, as the performer mentions quietly, it HAS to. The consequences of not playing the note are too terrible to be imagined.
The performer rids himself of the idea, of the three-note motif, and another one takes hold - the tetrachord. The performer is acquainting himself with the tetrachord when the three-note motif reasserts itself. A rule emerges - These two musical ideas must be played until they end at the same time, and end at the end of a measure.
As five- and six-note motifs emerge, the rule is established that each motivic idea must have one more note - whatever the rhythmic value - than the idea that came before it. While carrying out the intense need to play these motives until they synchronize, the performer becomes increasingly aware of the expectations of the audience, and ashamed of the performance, culminating in a series of seemingly endless apologies.
The performer attempts settle down, clear his mind, and play something different to drive out the anxieties - a nice, lyrical melody, though occasionally marred by the stubborn compulsion to sound the D every fifth measure. Unfortunately, the original intrusive thought - the three notes - returns forcefully. He hammers at them in anger, but cannot stop playing them. Yet another motif - seven notes this time - appears, and soon he is playing all of them together, again waiting for them to end simultaneously. As this action is being performed, a new compulsion arises, a common one - he must not step on the cracks. The "cracks" in this case are, of course, the bar lines. This results in a stuttery, halting performance. (Similar to the gait of a person who is avoiding the cracks.) The one exemption to this rule is the pedal tone, which continues as normal. As mentioned earlier, the "rules" often conflict, and there is little rhyme or reason to which ones ultimately "win." (For instance, the need to clean a bathroom may conflict with the need to avoid "contamination," resulting in a powerful state of anxiety with the result more or less a toss-up.) In the end, the performer's mounting concern over what he perceives to be the audience's frustration with him compels him to "cheat," and speed up one of the patterns so that they will all line up sooner and he can escape. Unfortunately, he still must contend with the need for a perfect cadence, a suitable final chord, and a satisfactory bow.
The piece is actually performed on two pianos, as too many notes sound simultaneously to be played on one. The second pianist is hidden from view, so as not to distract from the aspect of the OCD sufferer completing his or her rituals. The sheet music includes performance notes for key elements - the cleansing of the keyboard, for instance - but it also serves as an antagonist to the performer, voicing the same sort of intrusive thoughts that take hold of the mind of a person with OCD. "You are terrible," the music says, several times. During the more difficult passages, the music outright taunts the performer - "You are going to mess this up, and everyone will know you are a fraud." This is to set the tone for the performance, and to try to help the performer understand the experience of the disease.
About the Disease
Obsessive-compulsive disorder is an anxiety disorder. Remembering this is key to understanding the condition. The obsessions are myriad, but are often religious, violent, or sexual in nature - they include fears that either something terrible is going to happen to the sufferer, or that the sufferer is going to do something terrible. These fears are almost always completely irrational, but their continued presence makes it difficult for the OCD patient to focus on anything else - enter the compulsions. The compulsions are actions that are repeated over and over in order to reduce the anxiety caused by the obsessive thoughts. It's important to understand that the obsessions and compulsions are seldom logically linked - you know the old saying, "Don't step on a crack, or you'll fall and break your mother's back?" That's textbook OCD - you have an irrational fear and a bizarre behavior, neither of which are logically connected in any way. Now if you can imagine that instead of being a childrens' game that it's an overpowering, sense of all-consuming terror that never quite leaves you, you're pretty close to knowing what OCD is like. In the mind of the OCD sufferer, the action must be performed, or the imagined consequence will become a certainty.
There is a biological basis for OCD - it's correlated with decreased levels of serotonin in the brain and abnormalities in the orbitofrontal cortex and basal ganglia of the brain - parts of the brain involved with planning out behavior. The disease is often found in conjunction with other anxiety disorders, and is also strongly associated with above-average intelligence.
OCD is different from many psych disorders in that patients are usually aware that something is wrong - people suffering from bipolar disorder, schizophrenia, borderline personality disorder, and other psychiatric issues typically don't demonstrate that level of self-awareness about their illness. OCD is also different from gambling addiction, overeating and other addictive behaviors in that the sufferer receives no pleasure from performing these actions, and usually wishes quite desperately to stop.
While it can be debilitating, OCD is also fairly treatable. Because the disease is linked to lower levels of serotonin - one of the same neurotransmitters involved in depression - antidepressants that increase serotonin are often used to treat OCD. Behavior therapy has also shown promise in treating OCD sufferers. While it is a difficult burden with which to be saddled, the prognosis for OCD is much more hopeful than many other psychiatric conditions, and help is available through licensed counselors or even general-practice physicians.
