“I’m an artist, but with other tools!”: Le Théâtre Aphasique and the intersection between artistic and clinical practices with people living with aphasia.
« Je suis un·e artiste, mais avec d'autres outils! » : Le Théâtre Aphasique et le croisement entre pratiques artistiques et cliniques auprès des personnes aphasiques.
Alberto Osa García1,2, Camille d’Anjou1,3, Natasha Létourneau Edwards4,5, Sandro François4, Pénélope Goulet-Simard4, Karine Marcotte
, Richard Gaulin4, Isabelle Côté4, Ingrid Verduyckt1,3
1 École d’orthophonie et d’audiologie, Faculté de Médecine, Université de Montréal (Montréal)
2 Centre de recherche CIUSSS Nord-de-l ’Île-de-Montréal (Hôpital du Sacré Cœur de Montréal, Montréal)
3 Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, CRIR-CRLB du CIUSSS Centre-Sud-de-l ’Île-de-Montréal (Montréal)
4 Le Théâtre Aphasique (Montréal)
5 Department of Psychology, Faculty of Arts and Science, Concordia University
Theatre has come to be one of the main artistic ways to convey the voices of people with disability to the general audience, and this includes people with language and communication disorders. This article aims to describe and discuss the activities of Le Théâtre Aphasique, a non-profit organization located in several cities in Quebec that delivers dramatic art workshops to people with aphasia, an acquired language disorder. Our interest is to understand how this activity has become a successful phenomenon in different disciplines, with different a priori theoretic frameworks, such as disability arts as well as rehabilitation sciences. Specifically, we suggest that the complexity and means of this activity are indeed the cause of its success given that 1) it allows people with different communication abilities to participate, while 2) encouraging the presence of people with disabilities in the theatrical scene and 3) supporting the understanding and use of different communication styles, from both individual and social perspectives. We believe that a framework built upon social, artistic, and care-driven views of disability can account for the complexity of this activity and nourish further research into how different models of disability are integrated in the experience of people with aphasia.
Le théâtre est devenu l’un des principaux moyens artistiques de faire entendre au grand public la voix des personnes handicapées, y compris des personnes ayant des troubles du langage et de la communication. Cet article vise à décrire et à examiner les activités du Théâtre Aphasique, un organisme à but non lucratif situé dans plusieurs villes du Québec qui offre des ateliers d’art dramatique aux personnes atteintes d’aphasie, un trouble acquis du langage. Nous souhaitons comprendre le succès phénoménal de cette activité au sein de disciplines qui ont à priori des cadres théoriques différents, tels que les arts du handicap ainsi que les sciences de la réadaptation. Plus précisément, nous suggérons que la complexité et les moyens de cette activité sont bien la cause de son succès étant donné que 1) elle permet aux personnes ayant des capacités de communication différentes de participer, tout en 2) encourageant la présence de personnes handicapées sur la scène théâtrale et en 3) soutenant la compréhension et l’utilisation de différents styles de communication, tant d’un point de vue individuel que social. Nous pensons qu’un cadre qui repose sur une vision sociale, artistique et axée sur les soins du handicap peut rendre compte de la complexité de cette activité et nourrir de nouvelles recherches abordant la manière dont différents modèles du handicap sont intégrés dans l’expérience des personnes aphasiques.
1. INTENTIONS AND ACKNOWLEDGEMENTS
In this article, we want to show the case of Le Théâtre Aphasique, a non-profit organization operating in several cities in the province of Quebec (Canada) that delivers theatre workshops for people with aphasia and theatre performances by people with aphasia for the broad public. We intend to describe the different activities that Le Théâtre Aphasique delivers and reflect on why it has become such a successful and long-lasting organization (25 years in 2020). The authors of this article reflect the stakeholders in the activities of the TA.
Our interest in this organization and its activities comes from our varied background. AOG is a PhD student in aphasiology and has been a volunteer for three years with Le Théâtre Aphasique. CdA is a master’s student in speech and language pathology involved in patient-partner approaches in the study and development of novel interdisciplinary interventions for persons with communication disorders. NLE is a student of psychology and facilitator in the theatre workshops. Co-authors SF and PGS are members of Le Théâtre Aphasique who live with aphasia. KM is a speech language pathologist and researcher in aphasiology, as well as a professor in speech language pathology. RG and IC and are the artistic directors of le Théâtre Aphasique. IV was a speech language pathologist for over 10 years and now works as a researcher leading interdisciplinary projects studying the contribution of artistic practices in the field of speech language pathology.
Our goal with this article is to open a discussion addressing the multiple ways that interdisciplinary activities, such as those proposed by le Théâtre Aphasique, allow people with aphasia to artistically thrive in an accessible and supported theatre practice. We believe that this discussion is equally important for the aphasic population, speech language therapists, and theatre professionals because it will allow us to embrace different views of how to empower, and at the same time, show our allyship with people with aphasia. This discussion is not easy to establish, due to the nature of the activities offered by Le Théâtre Aphasique, and the diversity of individuals who work there. We furthermore acknowledge that the participants of the TA come with their individual sets of values, worldview, and experiences as people with different communication styles, which might or might not converge with those of the professionals implicated in the activity.
Le Théâtre Aphasique is described as an artistic activity with the goal of social reintegration of people with communication problems, founded in 1992 by Anne-Marie Théroux, a speech language therapist and a professor in dramatic arts. This already introduces us to the main disciplines that are going to involve Le Théâtre Aphasique activities: speech language therapy, theatre practice, and social advocacy for people with aphasia. In this article, each author has contributed with their understanding of Le Théâtre Aphasique and its activities, as informed by their disciplinary knowledge and their own personal experiences. It is not our intention to set a label or to classify the activities offered by le Théâtre Aphasique under any particular model. On the contrary, we advocate for an open and multidisciplinary view of how these activities have originated and evolved, to account for their complexity and better understand why and how they have been rallying a large group of people with aphasia and volunteers from both theatre and speech language pathology for such a long time.
2. A JOURNEY THROUGH LE THÉÂTRE APHASIQUE
Le Théâtre Aphasique was born as an initiative of theatre workshops for people with aphasia in the Villa Medica Rehabilitation Hospital, in Montreal (1992). Anne-Marie Théroux, the founder of Le Théâtre Aphasique, was at the time a speech-language pathologist hired in the rehabilitation center, with a solid background as an actress and theatre instructor. Originally, she designed a weekly one-hour workshop where basic theatrical techniques could be practiced in group sessions. For the first session, only 10 people attended the workshop, but this was not an obstacle for the group to prepare a performance for the Second Congress for people with aphasia, hosted in Quebec in 1993, called Le silence qui parle (“The silence that talks”). From this moment on, Le Théâtre Aphasique started to offer more workshops with an increasing number of participants and officially became a non-profit organization hosted in Villa Medica in 1995, with the support of the Association of Aphasic People of Quebec (AQPA).
These days, the financial support comes from the Program to Support Community Organizations (Ministry of Health and Social Services of Quebec), as well as from the City Hall of Montreal and diverse private foundations, such as the Foundation Grégoire of the Villa Medica Hospital. It currently continues its work in its original place in Montréal, as well as in other cities in the province of Quebec (Laval, Saint-Hubert, Joliette, Trois-Rivières, and Quebec), under the direction of Isabelle Côté and Richard Gaulin, both being the artistic directors of all projects. Côté, former theatre instructor, was a regular assistant in the Troupe’s performances before taking over the administration of the Théâtre Aphasique in 1996, working at the same time as part of the administration council, workshop facilitator, and artistic director for Le Théâtre Aphasique. Gaulin, a professional actor, stage director, and theatre instructor at the art center Les Muses (Quebec), joined le Théâtre Aphasique as facilitator, creator, and counselor for artistic projects in 2000. The staff at Le Théâtre Aphasique consists of 10 to 15 people, including theatre facilitators, speech language pathologists, and production assistants. All facilitators hold training in theatre direction and theatre teaching, and most of them have also worked in theatre productions outside Le Théâtre Aphasique. Speech-language pathologists help with warmup and language stimulation techniques. Volunteers and intern students from social work, psychology, or speech-language pathology also assist regularly in the workshops. Since 1995, it has been estimated that more than 350 people have participated in the theatre workshops.
The workshops offered by Le Théâtre Aphasique evolved from the need to adapt to two realities: 1) the variety of speech and language skills among people with aphasia; and 2) the increasing number of participants. This also reflects that the activity was well received by the community, since potential participants were referred on the recommendation of their therapists or other community resources. Three types of basic workshops are offered (Côté et al., 2011). Act one is a beginner’s workshop which includes a basic training on gestures, facial expression, and improvisation. The two other workshops are more oriented towards written text. Roll! Cameras! Action! is a workshop focused on dramatic reading and improvisation in front of a video camera recording. The most recent Writing workshop is a scene writing workshop facilitated by a professional screenwriter. A theatre specialist leads all workshops, often supported by a speech therapist assisting with the warm-ups. These are scheduled in a two-hour weekly routine. We are going to describe hereafter each of the activities in deeper detail, along with the testimony of two of the coauthors and participants of Le Théâtre Aphasique, Sandro François and Pénélope Goulet-Simard.
The objective of this workshop is to work at all levels of participants’ capabilities, touching on typical theatrical exercises little by little. For example, at the beginning of a workshop, participants take part in a warmup, including breathing, body out-stretching and posture control exercises. Then, facilitators continue with movement and rhythm exercises, improvisation games changing the nuances of gestures and voice, exercises of evocation, mimicking of emotions and facial expressions, etc. Attention to adapting the instructions is especially given in cases where participants may endure more pain or have more problems when mobilizing limbs, which is common among stroke survivors. Voice projection and articulation are also modified if participants have different types of speech (for instance, exercises can range from different pitch production to paced consonant pronunciation). Two phenomena emerge during the workshops where short scenes are improvised. First and most importantly, the feeling of a safe and accessible space. The absence of a priori expectations, respect for the timing participants need, and a facilitation for the participant access convert the shared safe space gradually into an accessible space, where fear is no longer a factor that surrounds participants’ performance. Secondly, active listening is worked on throughout the exercises, demanding that attention be directed onto the actions of others.
These phenomena favor training the spontaneity of each individual, since every attendee must react in response to the other participants (for example, if they must do something different when it is their turn, or if they must respond to something unexpected in the sequence of the game). The pace and complexity of the exercises are also steadily increased over the course of the workshop. For example, as the workshop unfolds, participants create scenes with situations where communication arises as in daily life (e.g., moving while talking, imitating a public space, etc.). The phenomenon of the “safe space” is settled to ensure a suitable and pleasant atmosphere, and this evolves into an accessible space where participants feel comfortable performing, observing, commenting on, and supporting each other’s performances. This experience is explained as follows by the co-authors P.G. and F.S.:
 P.G.: “(…) sometimes you do gestures instead of an “expected” response; you look for new strategies to remember what others say (…). In the end, we create ways to understand each other, and the safe space allows this to happen.”
S.F.: “There is also a special improvement of active listening: people do not realize if you do it or not in other contexts, and sometimes they just want to say what they want to say. But here, there is an almost (compulsory) exchange.”
This working routine allows participants and theatre facilitators to discover their communicative strengths and to develop strategies of communication with facilitated exchange of ideas and feedback during the exercises. Situations employ typically two or three people at the same time, and all participants are either doing the exercise in groups or watching a group performing. It is necessary to cultivate confidence within the person and the group, so that ultimately participants develop the desire to interact and feel like trying new things. Specifically, when using techniques such as role-playing, a group can experience various situations, including different social roles, in a setting where all types of responses are allowed and exploration of multiple communication channels is encouraged by facilitators (Joly, 2003). Active listening is fundamental in this sense, and it has been highlighted as one of the best tools to achieve a feeling of accomplishment and reward through collective artistic empowerment Unsurprisingly, active listening is also one of the challenges in theatre practice with non-disabled people.
S.F.: “It is sometimes difficult to use the same strategies as before, because now things go different on the outside (than what we were used to), and we do not use the same cues. In the end, we learn to listen better to the other, and even to ourselves, like “what is that I really need to say?” We see that people living around us also realize our changes and start paying more attention and start making communication a little easier.”
P.G.: “We feel more confident when talking, there is less of the fear to the “expected moment”. As in theatre, when it is the moment to speak, one may get nervous for it is expected to make it in a certain way (but chances are you are going to make it another way).”
One example of these workshop exercises is the mimic game. Participants are asked to name different sports. Then, they are asked to link these sports to a representative movement. In this simple game two kinds of effects take place within the same task: first, participants make an important effort to listen, in that they have to try to follow other participants’ movements and their intentions with these movements (engaging attention and memory in the meantime); second, by playing this, they give hints and ideas to the rest of the participants at the same time (this helps, for example, participants with ideomotor apraxia, a disorder sometimes present in people with aphasia hindering individuals from mimicking a specific movement or pattern). When good active listening is achieved, a little improvisation can be introduced into the exercise to wrap it up.
The key strategy used in Act One is to break up a typical improvisation exercise so that participants can find themselves easily involved at each step, while avoiding feeling a lack of guidance. The aim is to get everyone in the workshop to participate, and to eliminate the typical self-imposed bias that divides these groups between those who “are able to do things (more easily)” and “those who cannot do things (easily)”. Facilitators also encourage participants to focus on the goal of doing something with a good theatrical value. This underlines the vision of this workshop as an artistic activity and not only an opportunity for rehabilitation.
S.F.: “(…) something you (focus) is to show that you can do the activities, not necessarily to achieve something beautiful (as if in the final stage), but it is always gratifying to see we can do many things.”
P.G.: “Practically when you forget the word “aphasic”, it gets possible to do something original and beautiful.”
Roll! Cameras! Action!
This workshop is open to participants that are more willing to practice their written communication abilities (both reading and writing), without losing attention of the theatrical practice. It also allows participants to create their own material for future access (all scenes are recorded), which additionally helps to create feedback after the workshop. Typically, participants choose a text (a play or ensemble of scenes) among several options, with the goal of practicing reading in a dramatized fashion. The facilitator guides in both the reading, comprehension, and interpretation of the texts, and the dramatized reading which includes adapting to the different voicing styles the participants may come up with. Participants are also encouraged to give their opinion about others’ (and the facilitator’s) interpretation and style of dramatized reading, trying to find the most preferred performance before recording as common ground. Different formats of recording are also suggested, including sometimes a brief staging, as well as the use of other elements (such as music). After the recording, there is a post-editing session done by facilitators to make a comprehensive product out of the workshop. The whole process (studying and reading the texts, practice, and recording) usually takes several months, since the goal is to create videos of the whole text. Finally, in future sessions, scenes may be re-watched to open a discussion for feedback and improvement. In sum, this workshop reflects a progression in the journey that a person with aphasia can undertake with Le Théâtre Aphasique, since it demands more individual concentration than the activities at the Act One workshop. This workshop is also offered on a two-hour weekly basis.
In the same vein as Roll! Cameras! Action!, the Writing Workshop aims to encourage participants who can use a computer to write scenes along with a professional writer. The workshop, open to all members of Le Théâtre Aphasique, takes place over several meetings across several months. All sessions are intended to teach different dramaturgic writing styles to the participants, with the goal of creating their own pieces focusing on the social and political challenges they may want to raise. By the end of the workshop, the professional writer will help compile all created texts to form a final theatre piece. This piece will be practiced by the participants, first as a reading and ultimately as a theatrical performance. An example of an exercise where participants had to come up with possible plots for a brief play is included as an annex.
La Troupe of Le Théâtre Aphasique
La Troupe consists of the ensemble of actors that have gone through other basic workshops at Le Théâtre Aphasique and want to take the next step in performances with an audience. Currently, the Troupe consists of 20 actors, all of them recruited through the workshops. When a new play is planned, performers that are enrolled in the Troupe are offered, in the first place, some roles according to their experience and situation (for example, newcomers receive less dialogue-driven roles, or with less unaccompanied scenes on stage to help them get used to the dynamic of the group). However, performers are also asked if they have personal preferences regarding the available roles. At the same time, adjustments are made for those performers whose physical condition may require more specific accommodations than other performers of the TA. With regards to the rehearsals, it is necessary that actors commit to the preparation of the roles that they have been assigned along with the theatre director. This preparation usually implies reading and performance skills training. Directors must adapt themselves to each actor’s situation, in order to explore the artistic richness and dynamic nature of their character approach. This requires planning ahead rehearsals and allocated time to work on individual parts to adapt to all kinds of necessities (both temporal and physical) that participants may encounter. La Troupe also benefits from having two performers assigned to each role, so that it can ensure that, in case of an incident, performances and repetitions are still happening. It is also important to know how to demand commitment from the actors, especially from newly incorporated actors. A typical situation is that novel participants realise they must work hard to develop their acting skills in their first plays, and veteran actors of the Troupe help them along this process to find what supports them better in both on-stage performing and text reciting. Teamwork is essential in these cases, as it is always a challenge to create an actor from a person who does not do theatre professionally.
P.G.: “When I do this, I am an artist, maybe with (different) tools than a non-disabled artist maybe, but not less of an artist.”
S.F.: “Making theatre in the end it feels just like speaking (as in everyday life), since we are assuming some of the same challenges.”
One of the techniques the Troupe uses to facilitate work together is to ensure “safety nets” for the actors on stage. For any person with little training in theatre, to learn and perform a text can be hard, especially in the moment of presenting it in front of an audience. If, moreover, the person has aphasia, there is often an inherent fear of making a mistake despite the previous training. To solve this, some resources around staging and the intervention of other actors can be implemented. For example, the set for scenes can be adapted to include lecterns or surfaces to house “safety texts” for actors who have long lines or more complicated participations. When an actor has several lines in a row, a repetition resource can be used, so that other actors repeat some of these lines entirely or partially. Doing this, the intervening actor can have more time to prepare the rest of their part. This is especially useful when there are just one or two characters on stage, a more vulnerable situation that can compromise their performance. In sum, it is through adapting the piece (staging, set, performance) to the actors, and not the other way around, that actors with functional diversity can achieve the best performances. It is often presumed, though, that actors must follow the theatre director’s ideas without discussion, but Le Théâtre Aphasique advocates that this approach should be questioned when thinking about new ways of making theatre.
P.G.: “It is theatre, the goal is to keep the text as faithful as possible to the original one, but we are adapting beside that, at least the performance and the dramatization.”
S.F.: “There is always a challenge that you may not preview, but we learn in the end some tricks that help us. And you realize how that is not so different (from real life).”
Productions at Le Théâtre Aphasique
Another mission that is at the heart of Le Théâtre Aphasique is to raise awareness about aphasia and the arts with disabled people. Members of La Troupe, along with the director, organize informative sessions in schools, the community, and rehabilitation centers to promote awareness of aphasia, as well as presenting how social reinsertion is possible through theatrical arts. La Troupe has often traveled in Quebec, and occasionally abroad (e.g., France and Belgium) to show their work at congresses and scientific meetings. Le Théâtre Aphasique also offers seminars during both their travels and when other theatre or rehabilitation specialists have come specifically to Montreal to learn about their theatrical techniques and performance methods (Côté, Getty, & Gaulin, 2011). As a result of these exchanges, several other groups dedicated exclusively to theatre for people with aphasia have appeared in the last years (see Table 1).
Table 1. Organizations that offer theatre workshops for people with aphasia on a regular basis.
|YEAR OF FOUNDATION||NAME||COUNTRY/CITY||ACTIVITIES|
|1992||Le Théâtre Aphasique||Canada (Montreal)||Improvision and Reading Workshop, Theatre production|
|1996||Atelier Théâtre du Groupe des Aphasiques de l’Île de France (GAIL)||France (Saint-Denis)||Theatre Workshop and occasional theatre production|
|2004||Ser em cena||Brazil (São Paulo)||Music and theatre workshops. Speech therapy service|
|2017||Centre de réadaptation fonctionnelle La Roseraie||France (Montfaucon)||Theatre workshops offered to residents|
|2018||Irish Aphasic Theatre||Ireland (Dublin)||Theatre Courses for people with aphasia|
So far, the company has staged 12 productions, each one with a duration of three to five years. Up to now, 260 representations have been given and they have been seen by more than 30,000 spectators in total. The scripts for the plays of Le Théâtre Aphasique are created in several ways. In the first productions, the theatrical practitioners prepared the scripts themselves, based on the experiences of the actors. Subsequent productions have included improvisation scenes or pieces by Eugene Ionesco. The latest project, “Le dernier mot” (“The last word”), consisted of small pieces written specifically for Le Théâtre Aphasique by contemporary Quebec playwrights. The key idea was to build plays adapted to the skills and capabilities of the participants (e.g.: regarding mobility constraints or vocal capacities). It is expected that a new play, the fruit of the Writing Workshop, will be the next production of Le Théâtre. Although the most common topic of the plays centers around the life experience of a person with aphasia in the first years of the organization, it has since expanded to explore other topics that imply communication in other situations of life. For example, the piece “Cha cha cha”, presented in the Symposium VIBE in 2018, introduces the issue of misunderstandings caused by insufficient communication in daily life. This shows that Le Théâtre Aphasique’s mission is not aimed at simply showcasing the daily problems of people with aphasia, but rather to address the central role of communication in all people’s lives, and the implications when it is broken for any kind of reason.
Adapting to COVID-19
Like any organization with social scope, Le Théâtre Aphasique has adapted its ways to maintain a minimum level of activities with all its participants while respecting health recommendations during the pandemic of SARS-CoV-2 in Quebec. Online workshops of one hour and half are delivered instead of the Act One workshops, with usually 10 to 15 attendees. Workshops out of Montreal have been adapted when possible, and on one occasion two of the workshops were merged into one to maximize participation. One positive aspect is that this has permitted le Théâtre to offer one of Act One workshops on a weekly basis instead of a monthly one. The in-person rehearsals of La Troupe have been adapted to dramatized reading workshops, in one-to-one, duo, and group fashion. This has come as an opportunity to work further aspects of sight reading, considered before as only one part of the rehearsals. Finally, Le Théâtre Aphasique has also initiated workshops in English, thus increasing the number of weekly theatre workshops. This aims at more effectively implementing the distance strategy by offering more choice of workshops and consequently resulting in the inclusion of both French and English-speaking participants. Social activities and the maintenance of interpersonal relationships are especially beneficial in the case of people with aphasia, since their previous routine in social and working environments have been abruptly altered (Davidson, Howe, Worrall, Hickson, & Togher, 2008), and in special situations such as the current one, it is vital to try to keep these activities through all possible means.
3. WHAT CAN THEATRE DO FOR PEOPLE WITH APHASIA, AND WHAT PEOPLE WITH APHASIA CAN DO FOR THEATRE
Aphasia and the factors of communication disability
Aphasia is one of the possible impairments caused by a stroke. It is an acquired language disorder due to damage in brain regions specialized in language processing. It entails communication difficulties, which come to affect central interactions with family, colleagues, and friends. Eventually, this leads to reduced social participation due to certain factors that are external to the person with aphasia. (Musser, Wilkinson, Gilbert, & Bokhour, 2015). First, although it is clear that maintaining prior relationships and routines is a way to overcome the negative outcomes of aphasia, relatives or friends usually do not have the knowledge or training to adapt their communication functionally. The new time course that a person with aphasia may have to adopt to meet their own communication needs becomes their crip time, different from the normative time course that non-disabled people impose on people with aphasia when not aware of this dimension (Ljuslinder, Ellis, & Vikström, 2020). The unpreparedness of society for communication styles of people with aphasia creates barriers to social participation, which impact the individual’s life choices and ultimately on their self-image and identity (Parr, 2007). Thomas M Phillips, a stroke survivor with aphasia, explains how he has the impression that aphasia has become a “contagious disease” around him:
“(…) when ‘normal’ people find we have aphasia they forget how to see (‘Oh, I’m sorry, I didn’t see you there’) or can’t communicate anymore (‘I’m too busy, have to go, I can’t talk right now…’) and often times it feels like ‘normal’ people have more problems with communication than those afflicted (…)”
Other testimonies from people with aphasia relate that there is a tendency for their non-disabled conversation partners to “take the word out of their mouths''. Although this is not ill intended, this kind of paternalistic attitude may negatively affect the self-confidence and motivation of the person with aphasia to interact with people (Parr, 2007). Furthermore, communication partners often take for granted that other faculties than language are affected as well, often leading them to adopt patronizing attitudes for decision making. This creates a situation where people with aphasia need to claim their right to a proper voice to tell their own stories, which is particularly challenging when society is unprepared to listen to and understand their style of communication. Their message has a greater chance of becoming distorted or silenced in non-disabled (and even disabled) governed discussions, where not only neurotypical discrimination but also ageism plays a role in which alternative discourses are allowed to emerge (Jönson & Larsson, 2009).
Theatre as a booster for individual capacities
Theatre conveys different cognitive, social, and artistic goals and challenges, proving to be an interesting tool that touches people with aphasia at several levels. First, as an activity, theatre taps into individual challenges for one’s own capacities. Confidence is needed to face the public’s vision of one’s own self, especially in the vulnerable situation of incarnating a role on stage. As any other disabled person, one with aphasia has to fight as a tribune against the established, and expected, sound and image of the perfect voice and body in any exposition space. Two important aspects are observed here. First, people with aphasia must challenge the expected neutral body of the theatre experience (Sandahl, 2005). This neutrality comes from the idea that the performer is a canvas where the character is incarnated, and therefore the character is imposed on the body. In theatre performance history this has been typically taken as the submission of the body to the role, defining which bodies are best suited to represent which roles. People with aphasia defy this concept since their own language and physical conditions may not correlate with expected representations of roles and speech styles. Several theatre initiatives have proven that troupes composed of people with different communication styles are possible and capable of producing quality artistic outcomes as well as any other kind of troupe. (Eckard & Myers, 2011; Gjærum & Rasmussen, 2010; Saur & Johansen, 2013; Wooster, 2011).
Ultimately, the lack of representation of these individuals on stage also has implications in their general social representation. In a world where certain realities are suppressed, theatre can be used as a means to express both individual and collective experiences for minorities and oppressed populations. Theatre has had an inherent political role since antiquity, because any form of communication between subjects, and especially between a tribune and a community, leads to a political conversation (Morgan, 2013). Through the acts of theatre, political action can be embodied, and not only through the play itself, but by means of the performers. The founder of Le T.A. herself, Anne-Marie Théroux, expressed her view of theatre as a political act in which performance is inevitably biased, since no actor can be subtracted from being a “self-represented subject” (Vais, 1999). Theatre is a tool where people can act in ways that go beyond the normative and ableist manners that dominate their reality. Theatre allows people with aphasia to play roles and to portray situations with their own rules of communication, in their own ways and timings:
P.G.: “I feel more comfortable, and not only with the aphasic community, but this helps to (acknowledge) its existence and I say what I am without thinking much about it.”
S.F.: “I am many things, but in the end, it is up to me to define myself in every (context).”
Theatre, disability identity and representation
The individual experiences we have just mentioned grow into the construction of the group identity, and eventually, this group identity will appear also to the audience. It is evident that theatre practice becomes a tool not only for social cohesion, but also for social representation (Vaïs, 2002). On the one hand, theatre practice, as a social activity, enhances the cohesion of the people who build the project, thus creating inner bonds in the troupe. Ahead from this, social cohesion in a group of people who belong to the same minority community boosts the recognition of the group as an identity. This is one of the many points that conveys theatre into political implications (Vaïs, 1999, 2002). We observe that le Théâtre Aphasique plays an important role in representing and giving a voice to people with aphasia. This could be framed as a claim for the right to occupational and artistic life of all people, recognizing the diversity of capabilities and acknowledging the potential of these capabilities, instead of, as it is custom, identifying their limitations. (Vorhaus, 2015). Moreover, le Théâtre Aphasique’s existence and activities also raises the question of access to artistic education for the neurodivergent population, something already discussed in Quebec with initiatives such as the center Les Muses (offering artistic education to “atypical” artists, involving people with all kind of cognitive styles) (McAskill, 2017).
Finally, representation of a diversity of capabilities in a domain such as theatre can become a political tool, as briefly mentioned above. These performances, open to all audiences, help prompt further discussions on topics such as the definition and valorization of artistic creations, and who should support these initiatives, which reflects the political framework addressing disability. Preconceived expectations of audiences and organizations on these projects create a label of “non-professional”, where “disabled” is stated over “artistic” (often considered “amateur theatre” or “community theatre”) (Johnston, 2012). As Saur and Johansen (2013) highlight in the case of their own organization in Norway, financing from various sources (i.e., both health and care welfare and arts councils) is preferable to make the project more appealing. This is certainly not the case for most of the artistic activities targeted at people with aphasia, where a rehabilitation approach is often required to be financed. More similar initiatives would ensure a larger reach to other sponsors and it would also help in the engagement of more people with aphasia that could be interested in participating, while highlighting its proper artistic value as opposed to a purely social activity (Eckard & Myers, 2011).
Theatre as a multi-model paradigm of supporting people with aphasia
Lastly, we would like to suggest a framework that could support efforts to fully understand the phenomenon of Le Théâtre Aphasique and the keys to its longevity. From the perspective of a participant of any of its activities, Le Théâtre Aphasique springs from their individual efforts and desire to participate in a shared activity with peers, which meets their artistic, cultural, social, and personal needs. Although the activity was originally created by a speech language therapist and an artistic director, the maintenance and the evolution of the activity over the long term has depended on the continued and renewed interest and involvement of people with aphasia. This is how le Théâtre Aphasique has appealed to a large proportion of people with aphasia over the years and continues to do so.
In the framework we suggest, we feel it is important to acknowledge the facilitating factor in the social environment of the person with disability that is the role of health and rehabilitation experts, in this case, speech-language pathologists (Fougeyrollas, Boucher, Edwards, Grenier, & Noreau, 2019). All individuals have a right to receive care when an event such as a stroke occurs, and people with aphasia also seek out these services. Moreover, participants of Le Théâtre Aphasique often informally report improvements in the quality of their daily life communication. This kind of outcome has also been reported in studies comparing theatre workshops to other artistic and social activities (Fogg-Rogers et al., 2016; Zumbansen et al., 2017). Despite communication being the main ability affected in aphasia, Le Théâtre Aphasique shows that people with aphasia are able to express themselves and to be understood, and the communication challenge can be overcome when a multimodal approach such as theatre is used to mediate communication. Although there might be a risk that clinicians reduce activities such as Le Théâtre Aphasic as a means to canalize recovery towards standard communication paradigms (St. Pierre & St. Pierre, 2018), the patient’s recovery of their independence and confidence in their performance is the primary common goal for speech-language pathologists and artistic facilitators involved in le Théâtre Aphasique.
Along with a Health Care model, we believe that Le Théâtre Aphasique’s activities can also be framed in other disability models. For instance, its activity is an example of how the identity of a minority group and can help in claiming their rights in society, cementing Le Théâtre Aphasique as an advocacy tool for People with Aphasia (Berghs, Atkin, Graham, Hatton, & Thomas, 2016; Retief & Letšosa, 2018). However, the nature of the activity is important here, since its existence acknowledges the personal capabilities of every individual, especially related to artistic activities, and how this should be available to all members of the community (Vorhaus, 2015). We suggest that a multi-model approach should be employed to study such a complex activity as Le Théâtre Aphasique and how it answers various needs and realities of people with aphasia, but also of the non-aphasic people involved. Such an approach could support a fuller understanding of how people with aphasia perceive and use the activities taking place at Le Théâtre Aphasique to advance their rights as a clinical disability minority and artistically active population.
Bringing together theatre and aphasia may sound as interesting as it is fearsome, because, at a first glance, they might appear to be antagonists. Communication is central to Theatre, and communication is precisely one of the main challenges faced by people with aphasia. As we have seen in this article, theatre is something more than just “art” and “words”. Since it includes the performers’ experience, as well as the possibility of sharing it with audiences via the performance itself, this type of theatre is both a means and an end. People with aphasia, as well as people with other communication impairments, benefit from this art on an individual level. Paraphrasing Lafer’s quotation in Samuels’s article (2017), thanks to theatre, people with aphasia can bend space and time on stage to their communication styles, and not the other way around. As a consequence, exposing themselves to an audience, in divergent voices and bodies, allows other people to get in contact with a larger diversity of language performances and communication styles. The scope of our article was to present the complexity of Le Théâtre Aphasique with the hope to generate a multidisciplinary discussion where this complexity can be embraced without the urge to classify or categorize. After all, the essence of theatre is that it can involve many more things than what can only be expressed with words.
Disclosure: The authors have obtained written consent from each person appearing in the pictures used in this article and the owner of its rights to be used by le Théâtre Aphasique for didactic purposes.
- https://theatreaphasique.org/en/mission-goals-and-annual-report/ (retrieved on 04/23/2021)
- Quotations are extracted from a two-session interview where the project, descriptions of the theatre workshops, and disability models were explained to the two participants through a self-paced presentation. We asked their opinion about each part of the descriptions and the models, and which aspects or facts they would consider most important to highlight. Phrases in parentheses in the quotations are words obtained by cuing if the participants seemed to struggle to retrieve the words.
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Annex: Sample of the work in the Writing Workshop
Original: idea for theatre play
La thérapie des Deux Pierrots, par Diane Paquin
Claude, un avocat, toujours amoureux de sa douce
André, un directeur d’école qui, lui, doit se séparer incessamment.
Ce duo se ramasse au bar Les Deux Pierrots dans une thérapie de groupe, dans le Vieux-Montréal. Depuis quelques années, Les Deux Pierrots, durant le lundi après-midi, est devenu un centre de thérapie.
Claude et André ont une amie en commun, mais qui est-elle ? Les deux détiennent un secret, mais aucun des deux n’est au courant du secret de l’autre. Peut-être est-ce le même secret ?
En effet, cette amie qu’ils ont en commun, c’est une femme qui a eu dans le passé une relation passionnelle avec Claude. Elle a eu une enfant de lui sans lui dire, mais il l’a appris par la suite. André, le conjoint actuel de cette femme, est devenu le père adoptif de cette enfant. Chacun tente de cacher à l’autre le fait qu’ils savent qu’il s’agit de la fille biologique de Claude, ne souhaitant pas trahir la confiance de la femme qu’ils ont aimée.
Avec des larmes, des rires, des escarmouches, et au travers cette thérapie, vous découvrirez ce qui en résulte.
Therapy at Les Deux Pierrots,
by Diane Paquin
Claude, lawyer, still in love with his darling
André, school principal, who is going to divorce soon
This duo meets at a bar - Les Deux Pierrots - for group therapy in Old Montréal. For several years now, Les Deux Pierrots becomes a therapeutic spot every Monday afternoon.
Claude and André have a friend in common, but who is she really? Both keep a secret, but none of them knows that the other has a secret of his own. Is it possible that they share the same secret?
Indeed, this common friend is a woman that had once a romantic relationship with Claude. As a result, she had a child with him, but he only found out about this later. André, who is this woman’s current partner, has become the stepfather of her child. Each one tries to hide the fact that they know about Claude’s biological daughter, since they don’t want to betray the confidence of the woman both have loved.
Among tears, laughs, quarrels, and through a lot of therapy, you will discover what happens.