I am thrilled that what I have been hearing anecdotally from my members over the last 6 years has been demonstrated in new research published in the British Journal of Psychiatrists this week. A study of 134 mothers experiencing symptoms of post-natal-depression were split into three groups: one doing group singing; one doing creative play and one following their usual treatment. The results are astounding. For those experiencing mild to moderate symptoms there was an improvement in their symptoms, but for those experiencing moderate to severe symptoms of PND there was an even faster improvement in their symptoms. Put simply, singing in a choir with your baby works over a matter of weeks to reduce symptoms of post-natal depression.
I have written before about how founding Pram Chorus came out of my own experience of depression and loneliness after the birth of my daughter 7 years ago. I had the idea of setting up a choir for parents, where they could bring their babies/toddlers too. Pram Chorus is a place where the focus is YOU, the parent, rather than the baby (like so many other activities); somewhere to go and do something, which actually works with your baby there, so there is no guilt about leaving them either. What continually inspires me are the frequent reports from members that Pram Chorus is their "saviour", or "the one activity that gets me through the week".
So now we know that group singing works, but do we have any idea how or why?
I have direct experience of this and have thought about it, talked to and tried things out with my choir members, so here are some of my thoughts.
There is something very different to singing in a group from singing on your own in the shower for example. Obviously, in the shower you are alone to let rip, but in a group there is another very important factor: you are also listening and being heard. I think this is a profound aspect of choir-singing and a big clue to its benefits. Our deepest feelings and emotions can be hard to articulate, especially when they are negative, and then there is the problem of having someone to listen, even if we can articulate them. Singing is a means of expression, which somehow seems to express deep emotions in a cathartic way, without you even having to consciously articulate them. I also incorporate active listening exercises into my sessions, so that the singers are really listening and responding to each other; enhancing their interaction, making them more connected to each other. This connection goes further than being emotional and psychological, to being a physical connection, with choir singers' breath being consciously synchronised, whilst unconsciously their heartbeats become synchronised.
This aspect of connection is important to PND. Women who live in close-knit communities are less likely to experience postnatal depression. So when singing together, you are engaging in a unifying activity, which has largely been lost in our society, where on becoming a parent your usual work and social networks are no longer there for you on a day-to-day basis. The loneliness can be excruciating, with it being no surprise that rates of postnatal depression are suggested to be 1 in 8. Personally, I suspect it is a hidden epidemic with a lot of cases going undiagnosed and the grey landscape between being depressed and feeling low, being largely unknown and ignored. I address this by encouraging everyone to both contribute and take responsibility in a musical and social sense (we take it in turns to bring cake), so that the whole group is working together, listening to each other, talking, singing, laughing and eating together.
Which leads us on to confidence and a sense of achievement. I'm not going to pretend to be an expert on postnatal depression or mental health, but it seems to me that if you are struggling with PND, especially having recently gone through the trauma of birth, breast-feeding, sleepless nights etc, you are not going to be feeling at your most confident. I have observed that working together with others to "achieve" a song, where each voice counts and is valued, gives a sense of achievement and over time builds confidence in other areas: personally, socially, and professionally. This improvement in self-esteem has a knock-on positive effect on mental health.
My final point about PND is that I think there is a real crisis of identity on becoming a parent, especially as a mother, after the physical and emotional trauma of birth. I for one, was completely unprepared, so when the reality hit of being alone with a baby that cried a lot for long stretches of time, without anyone to tell me what to do and an unstructured 24-hour existence, I was really at a loss. Everything, from health professionals to family and other activities, seemed so baby-focussed, which I found boring and jarring, compounding the sense of inadequacy and loneliness I felt. In contrast, I very consciously focus on the parents in my choir sessions. I love seeing the babies and getting to know them over time, but my focus is the adults and asking them individually "how are YOU?". I weave exercises into my warm-ups so everyone learns each other’s names and to help members get to know each other. And we don't sing nursery rhymes - we sing a wide variety of songs with members regularly being asked for song suggestions.
What all of this amounts to is building a supportive community, which, through the experience of singing and making music together, creates deep connections between people.
This research is so exciting and hopefully for those suffering from PND, (and potentially many other mental illnesses) could pave a way for cost-effective and drug-free treatments. There are many more questions (I have as many as I have ideas!) but the most pressing for me, is how to improve access to choirs like Pram Chorus for vulnerable women so that they are not too terrified to come. So how about it NHS, GPs, Midwives and Health Visitors. Prescribe a choir? Choir-therapy? Feel free to comment below.
Ruth Routledge - Pram Chorus, Choir Community
Watch a video below about the research....