Recently (1 June in Australia) I spoke with hornist Katie Bergløf over Zoom about focal dystonia. Check out the conversation here:
There are many more conversations with other musicians who are dealing with various forms of focal dystonia. I highly recommend checking out the Youtube playlist: https://www.youtube.com/user/HeldenCors/playlists
Katie’s website: https://www.focalembouchuredystonia.com/
This piece is slightly different from what I usually post on this blog, but I believe I have a unique perspective on the issues concerned, as I will explain in the main text.
I would like to discuss the current advertising campaign from the University of Sydney, and in particular the chosen keyword:
Dear reader, thank you for visiting the blog, and happy new year! This is an update post, letting you know what I have been up to in the last few months.
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(*My apologies for not writing sooner, it has been a very busy time at Uni with many assessments due recently!)
There are some words which (bad) writers of popular science like to throw around in order to sound impressive. Quantum is perhaps among the most frequently abused terms, for instance. Another would be statistically speaking. (Did you really analyse the sample distributions, and compute the variance and correlation coefficients? Didn’t think so). Another buzzword, and the one pertinent to our discussion here, is neuroplasticity. Fortunately, unlike quantum field theory and statistics, we don’t have to pretend to understand neuroplasticity, since there are many cases where it is clearly visible, and I believe its core concepts are readily grasped by the general public. In addition, popular science titles like The Brain That Changes Itself by the neuroscientist Norman Doidge certainly increase public awareness and understanding of this issue. We can observe directly that the brain is capable of remarkable change and adaptation. One of the most dramatic and convincing examples of this is the phenomenon of “phantom limbs” — the ability to feel pain or itching or other sensations in missing limbs. If you are interested, I will save you from googling for unreliable sources, and link this journal article by Ramachandran & Ramachandran (2000). The important and (at the time) revolutionary idea is that the brain is not a static organ. The brain map can be reorganised — new neural networks can be created, and the physical topography of the brain is susceptible to change. This is reassuring for those with dystonia. It means that there is a possibility of “unlearning” the dystonic movements, and creating new neural pathways to replace the old, misbehaving ones. Many dystonia researchers now recognise re-training as a viable treatment option, and from a musician’s point of view, I believe it is also the most useful and least harmful. Medical treatments can work very well for some individuals — and depending on the severity of the symptoms, may even be essential — but the prospect of taking botox injections several times a year, for example, is not exactly pretty. However, re-training requires considerable time investment and dedication… then again, isn’t this exactly like learning a musical instrument!
<— back to part 3a
Many recent studies on musician’s dystonia now acknowledge the role of psychological and emotional factors contributing to the emergence or persistence of the disorder. In the previous section, I have already alluded to one of these psychological pressures: the need or expectation for perfection in classical music training. Indeed, this point has been emphasised many times across many research papers, including several by Altenmüller and his colleagues. For example, Altenmüller & Jabusch (2009) is a noteworthy paper, as it compares psychological profiles (“personality structures” is one of the terms used in the paper) of patients with FD and those without. Interestingly, a group of patients suffering from chronic pain was also examined, with the aim of “detect[ing] unspecific secondary psychological reactions in diseased musicians.” I object slightly to the use of the term “diseased”, but you get the idea!
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In the previous part, I recounted my experience with focal dystonia. In these subsequent installments, I would like to address more general issues, including the prevalence of dystonia in classical musicians and the psychology of dystonia. Finally, I will conclude by describing some possible steps towards overcoming the disorder. Originally, I had intended this to be a single post, but it appears that there are many details worth discussing, and hence, just like the Hobbit movies, I will expand it into three parts.
<— back to part 1
As far back as November 2012, I was noticing a strange sensation in my left hand. During a recording session, I noticed that I could not control my vibrato, and especially when the middle finger was involved. However, I simply attributed this to occupational stress, since there was no pain at all. The holidays were coming up, and I would get a good break, so I was not worried. Near Christmas time, when I was already well rested, I decided to do some practice, which was when I noticed that I had trouble keeping the middle finger on the fingerboard. Any violinist can tell you that already this is a strange turn of events. Typically, the middle finger is one of the strongest, and as far as vibrato is concerned, often the easiest finger to use. Actually, what perplexed me the most was the complete absence of pain. (I’m glad to say that I’ve never experienced pain in my musical practice. Violin playing, or indeed, playing most orchestral instruments, is not inherently comfortable, but I think it’s clear that it should never involve pain!). This made me suspect that there was more to it than the usual repetitive strain injury.
Jonathan Mui 