Age at interview: 22
Brief Outline: Hannah is 22 years of age and was born with a unilateral cleft lip and palate. Hannah has a degree in creative and expressive arts and lives with her parents. She enjoys singing and making music.
Background: Hannah has a degree in creative and expressive arts. She lives with her parents and is White British.

More about me...

Hannah is 22 years of age and was born with a unilateral cleft lip and palate and has been involved in cleft services till the age of 21. Hannah has a degree in creative and expressive therapies and lives with her parents. Hannah describes her childhood as being ‘sheltered’ as she grew up in a small community and attended local schools. Hannah’s parents were careful not to treat her differently to her siblings and were more comfortable with the way Hannah looked. The attitude displayed by her family and friends made Hannah feel comfortable.

However, Hannah experienced some difficulties from other pupils while attending an all-girls school, and from members of the public which she attributes to a lack of awareness of cleft issues. Fortunately, following her transition to further education Hannah found others to be much more accepting. Her further education college provided an environment that enabled her to build self-confidence. 

Hannah had her lip and palate repaired in her first year of life, but her earliest memory of treatment is of a bone graft operation she underwent at about 9 or 10 years of age. Hannah also has impaired hearing and wears hearing aids. Hannah has subsequently undergone further surgery as a consequence of facial growth. Throughout her teenage years and early adulthood more cosmetic oriented surgery that was facilitated with psychological support. However, there is a conflict between Hannah’s self-perception and the availability of surgical procedures such that she has reached a point where she is accepting of her appearance and does not want to undergo further intervention.

Music is central to Hannah’s creative and social life and she enjoys singing and making music as a means of self-expression. Hannah would like a career in music therapy and hence is looking for employment in the field of health and social care.

Hannah recalls her experiences of speech therapy and how she has benefitted from it.

Hmm, hmm so speech therapy I had I think definitely when I started school, if not before.

Yeah, yeah.

And I used to go to a group


Thing, which I used to hate. And I went with a friend of mine who has got a cleft palate, and I just found it really frustrating that we were all sitting there and going round in a circle, he’s saying this sound, you’re saying this sound and, do you know what I mean, it was really intimidating.


And then... I don’t know whether they picked up on that or whether the system changed, but someone came to my house and I had a one to one.

OK hmm.

And ...yeah, that went on for a number of years, probably ten years I would say. And that was a really good relationship that I felt often it was someone that I felt comfortable with and trusted.

With one therapist?

Yeah, so it was good.

OK thanks. And would you say you benefited from the speech therapy?

Yeah I mean... like I do have to put the effort in to make sure I’m being clear for people and, you know, even now there’s still times when people say, “Well like I didn’t get that,” and, you know, that’s just part of it. You have to be gracious for that to happen. ...But I’m quite happy, I would say, and confident in the way that I speak.

But, yeah, really beneficial I think to have.

The availability of treatment for cleft can be overwhelming particularly for young adults. Hannah found it difficult to adjust following surgery and found the psychological support she received helpful.

I think there were times when... you know, like there were essential ones to have, you know, if it was a palate problem or, you know, a functioning problem then it needed to be done. And you know, I appreciate that more now than I did [laughs] at the time.


But there were times when... you know, there were options for cosmetic things to happen, so the rhinoplasty, the implants and all of that kind of thing. And... that actually... had quite a negative effect on me afterwards. So... I mean there was one, I think I was 19 or 18, and... I’d had rhinoplasty, implants and the scar taken all in one big operation. 

And I’d been warned that I... was going to look a bit different afterwards.

And I just, I couldn’t cope afterwards. I saw my face and I just thought, “This isn’t what I expected,” not that I really knew what to expect; it was just, you know, kind of... it’s an adjustment to your face that you now have to reintroduce yourself to every day.

And that was probably the lowest I’ve ever been; it was horrible.

How old were you then?


OK hmm, hmm.

And I’d actually chosen to have that one.


It was very much I was unhappy and... 

So was it a case of making that adjustment or was it a bit more than?

Yeah I think... I think it was one of the things that just took a long time.
I think I mean when I first came home and saw my face I was like, “I just can’t look at myself.”


And ... it doesn’t help with all the swelling and the, you know, bruising and stuff. But even when it went down... I don’t know, I think every day I had to keep... looking in the mirror and getting used to my face again.

But, yeah, just as time, you know, went by I thought... “I’m the same inside: nothing’s changed there,” so... 

What kind of guidance did you get prior to that treatment, did you get any psychological guidance, support?

Yeah I mean there’s a really good... psychology department at the hospital I went to. And after that they were really supportive in... you know, helping me come to terms with, you know, my knew face and whatever.

And I’ve actually really benefited from... the psychology department. I think if I’d had them earlier I would have... done even better.

Hannah creates music as a form of self-expression and it has helped her to be more confident about herself.

Yeah so I started having singing lessons. And then I wanted to play the piano. And then I kind of dabbled in instruments: I’d pick up a guitar and, you know, you kind of experimented by yourself. Once you learnt what the notes were it was... you’d go off and you’d practise and work it out, you know.


And that was part of the fun of it for me, I think.

So could you explain a little bit more about your relationship with music and your confidence levels?

I think... the thing I love about it is when I am performing or you know, even when I’ve done exams or, you know, whatever, I find that quite often an audience will look at me and then they might see that I have a cleft lip and... and then they’ll make a judgement, and then I’ll start playing or singing and then their judgement will change.


And I like that I have the power to do [laughs] that with the music. And…

That’s interesting.

You know, I feel like the music is the real part of me more than the issue with my face. And... you know, it’s nice that I get the opportunity for... to change their judgement of me through the music.

That’s interesting yeah, yeah.

I think it’s really powerful anyway.

Hmm so that’s kind of, it’s been a coping mechanism in a way?

Yeah, yeah.

Yeah OK. And do you write some of your own material or do you?


Yeah, do you write from personal experiences or?



I mean just recently I did a portfolio at uni which was all my own compositions. And one of them was completely about... like the battle with surgeons and… 


…feeling like I didn’t have a voice.

Hannah experienced a big change in the attitude of others from leaving school to going to a college of further education. This change in attitude helped her gain greater self-confidence.

An all-girls school is... it can be quite difficult.

But... it’s the school I wanted to go to: my friends were going there, both my sisters had been there.

OK hmm.

…So, yeah, there wasn’t really a lot of option.

OK but it’s what you wanted at the time?

Yeah, yeah.

And is there anything particularly difficult about going to an all-girls school?

I think... 

Or particularly positive?

Girls, girls are just very… like they’re very self-conscious and very judgemental as teenagers. And... you know, I definitely picked up on that. I’m not saying it would have been easier if boys were around, because I don’t... I haven’t had that experience.


...But I thin ... having been in a mixed primary and middle school it... you know, the balance is better. But, yeah... all-girls school…

That’s how it was?

…that’s how it was [laughs].

That’s your experience was and that’s what you know, yeah.


OK. So at what point did you leave school?

I left school at 16 after my GCSEs.

OK and what happened next?

I did a music course at college.

OK what was that like?

I loved that. That was kind of... the making of my confidence and…


..you know, I really kind of found myself there. And it was just college is a much more accepting environment, and I really felt that from the people on the course and everything else. So that’s really good... memories for me, really good experience. 

And was that music theory or music technology or a bit of both or?

It’s... so it’s music on the theory and then the practical side, so every couple of weeks we’d perform to each other.

Oh OK.

And you know, we’d practise all the time... but yeah.

And where did you do that, where was that?

That was in [place], and that’s like half an hour away.

Oh yeah I think we came through that on the train, yeah.


OK so it’s still quite local to you?

Yeah, yeah.

And familiar to you, yeah?


And did you make some friends there as well?

Yeah I mean I didn’t know anyone there…


…so it was... you know, I was [laughs] terrified.

Were you? Yeah.

But... I got there and within a few days, you know, it was just so laid back that you couldn’t get on... not get on with people, do you know what I mean? Because... yeah.

Yeah so you met like-minded people?


Hannah would like to have been more aware of how the psychologist could be involved in her care.

Is there anything you would recommend which would help health professionals communicate with their patients?

I think it’s really important to check out what services there are. I mean I didn’t know about the psychologist until later, later on.


And... actually, you know, if I had an issue now I could go to them and they could communicate the issue for me, which would make it a lot easier than me waiting half a year for an appointment and everything else.

Yeah. Is that so they could act as a kind of a mediator, is that what you’re saying?


OK yeah.

So actually I think that’s something really important to check out. And... yeah, I’d say that’s the best route to do things, from my experience anyway [laughs].
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