An attitude of not knowing is, I believe, extremely valuable for the mindful therapist, as it is in Buddhist practice. When you think you know, you stop being open. Not knowing helps us remain open to the patient before us, seeing this person as a unique individual in a unique situation rather than another 'case' of depression, or anxiety, or marital difficulties. Not knowing, while the opposite attitude from what we learned in our education, is our best friend in the therapy room. The wise therapist respects not knowing, is comfortable with it, and even cultivates it. We cannot understand if we think we already know. And to know you don't know, taught Confucius, is the beginning of knowing. (p. 138)I write a lot about uncertainty. It seems an integral part of my work. I've also written about the state of "I don't know" and about getting lost.
Sunday, April 26, 2009
Sunday, April 12, 2009
Thursday, April 9, 2009
Wednesday, April 8, 2009
Tuesday, April 7, 2009
I was reading a book called “Practicing the Sacred Art of Listening: A Guide to Enrich Your Relationships and Kindle Your Spiritual Life” (by Kay Lindahl of the Listening Center) this morning, and I was thinking how odd it is that so many music therapy training programs seem (in my mind anyway) to spend way more time helping students learn to lead the group by coming up with effective activities to change behavior and meet goals than they spend in helping students learn how to listen.
This seems sort of ironic, given that we’re music therapists. Ideally, much of our work consists of listening and responding and then making music in some way. Listening (if I may state the obvious), is probably the most crucial aspect of the work of being a music therapist.
In retrospect, it occurs to me that my teacher did actually try to teach me to listen, but I was too young and self-absorbed (in the sense of worrying about what I didn't know) to be able to- er- listen to him at the time. Sigh.
One of the (many) things that, I think, creates a lot of anxiety for the music therapy practicum students who come to the developmental center where I work is wondering how on earth to go about listening to people who don't use speech to communicate. It's certainly a legitimate concern, and it doesn't have easy answers.
It's a complicated enough subject that Herb Lovett (one of my heroes) wrote an entire book about it. He's not the only one who has addressed this issue, of course, but his was one of the first books I read which advocated paying attention and listening to people who don't have access to the usual means of communicating.
I think a lot about how to listen to my clients. Well, I should amend that to say I think a lot about how to hear my clients. After a lot of years of practice (No. Really. A lot of years!) I would say I've gotten better at listening (and also better at noticing when I'm not listening and think I have been). It's still awfully hard to know for sure whether I've heard my clients properly.
Most of the people I work with let me know I'm on the right track by changing something they're doing. For example, I may be working with someone who is throwing or pushing instruments around the room. What I often do in response (as long as instruments and people aren't getting hurt) is to hypothesize out loud as to what's going on (as in, why the need to use this particular way of communicating and why now?).
What I'm doing is trying to find a way to verbally (and/or musically) state what my client may be trying to "say" to me with his action. "Are you telling me you're not interesting in music therapy today? Perhaps you are frustrated about something. (Some people don't respond as well to questions, so I try to re-phrase it as a statement instead.) Maybe something or someone has frightened you."
All the while I pay attention to my client's responses. Meanwhile, I monitor my own reactions and thoughts (simultaneously). I try to be aware of how I'm reacting to my client's action(s): with anger? With anxiety? With sadness? Frustration? Humor? Uncertainty? My reactions give me information about the interaction so that I can do the work of helping my client "talk" to me.
In my work, the relationship is the focus, so whenever something is going on in the session, I relate it back to what is happening between my client and myself. As such, it makes sense to notice how I'm feeling in relation to what my client is doing, because, more than likely, s/he is trying to help me hear him/her in some way (granted, it's not always in the most helpful way, but I believe the intent is there).
So, back to how do I know when I'm getting it right: well, I don't always know. In fact, I will never (and have never) 100% Known. This is what makes this work so difficult (as I've said before). The not knowing for sure. Ever.
But when someone suddenly stops throwing things around when I ask if he's trying to tell me he's scared (and I never said "stop throwing things around" to him), I can at least start thinking about what might be making him scared and have a place from which to start hearing him.
And, at the very least, I know he knows I've been listening to him.
Sunday, April 5, 2009
D helped me to clarify a part of my understanding about music therapy today. During our session I found myself reflecting his music and his general way of being, noticing that I had to keep starting and stopping. When I played quietly he seemed impatient with it (even though he was barely moving and there was very little to even reflect). When I put more energy into the music, he had a brief burst of energy in response, smiling, playing the tubular shaker, and then setting it down again. Just as suddenly, his facial affect changed again, and we were back to the quiet, almost non-existent music again.
I invited D to listen to the sounds he was making and tell me more about his music. Then I revised the question and I wondered (out loud), “what do you think your music is telling me about you? If you were listening to someone playing the sounds you just used, what kind of information do you think you’d have about the person playing it?”
I liked the idea of D learning to listen to himself via his music. It occurred to me to use this as another way to explain what I do when people ask me (the ever present question): "what is music therapy?"
I started to think about this, and I found myself focused on the fact that we don’t always tend to listen to ourselves. When we do listen, we get anxious, and what we have to say about ourselves is usually not all that kind. Or enthusiastic. Or loving. I think we call that: resistance.
I think this is an integral part of improvisational, dynamic music therapy in the sense that we, as music therapists use the music to teach our clients to listen to themselves. “What do you hear yourself saying in the music?” is what we ask. “Tell me more about how you’re saying it," and "what's it like for you to say this?"
Of course, as I already said a couple of paragraphs ago, being human and all, we have a tendency to resist listening to ourselves. This takes a lot of forms where I work. Beside plain old not paying attention, I also hear it as “oh, I can’t play music; I have no talent” and “no, you’re the therapist, you're the musician- you should play.” (Cue the "working with resistance" music here.)
Once people are actually willing to use the music, there are a lot of directions to take. A music therapist could invite a client to consider things such as: What’s it like to listen to yourself? Do other people listen to you? Do you notice that there are times when it’s easier and times when it is more difficult to listen to yourself? At what times is it easier, and at what times is it more difficult? Describe your sounds at those times. Do you think other people hear that in you as well?
But let me go back to this idea of music therapy giving us the space to externalize our internal dialogue (so to “speak”- tee hee). When we are able to do that, when we pay attention to and are present to ourselves (in terms of listening to what and how we talk about or perceive ourselves) isn’t that, in itself, a sign of growing emotional/mental health?
I mean, to be able to listen to our self (as in, to get beyond some of our resistance and concerns about being judged) is an act of courage by itself. To take it a step further and to act on what we hear (either by changing what we’re doing or thinking or changing how we see and experience our self, etc.) is, ultimately, what we’re going for in any kind of therapy (at least that's my understanding).
When we become aware of our characteristic ways of being and interacting, then we’re in a position to change it (when change is warranted). We also have the opportunity to come to a level of self-acceptance- even self-love- as we gradually become familiar with our own sounds, rhythms, melodies, harmonies, timbres.
So, how did D respond when I asked him what his music was telling me and showing him in his session? I’m not sure yet. He paused a few times and seemed thoughtful. When we ended the session though, I felt as if bringing up the idea of listening to himself seemed like a wise (and long overdue) suggestion.