Wednesday, April 8, 2009

"After you've gone and left me crying..."

B jumped up (jumped, I tell you) to come over to me when I showed up in his group (I was feeling guilty, because I was a little bit late). He barely let me get his jacket (um, it's April, and there were snow flurries happening off and on today). Anyway, he barely let me get his jacket out of the closet and on to him before we stopped to get his meds. Then we were on our way.

He got to the Music Room, and somehow we missed the door to actually go in. Don't ask me why. We just kept turning around the corner and walking and heading in the wrong direction. Then when I got him back in the direction of the door, we missed it on the way back again. 

Okay. What?! Already! 

Somehow, I managed to veer him in the direction of "please get in to the Music Room, or I won't be able to pay attention to what you're apparently trying to tell me!" 

Alright. We are now inside the Music Room. Now I can focus. 

B was very upset. To the point where he was actually crying (I think). It was very sad. I decided the best thing I could do was to simply sit with him and wait it out. Try to give him the space to feel lousy, since that seemed to be how he was feeling today.

[Actually, his distress was a continuation of our previous session where there was a lot of instrument throwing, occasionally aimed at me. I reminded him that I would not be able to hear him very well if I was having things hurled at me, so he "agreed" to stop, but made sure to get in an obscene gesture to make his point. Got it. F--- you, Roia!]

When B is upset, there's a lot of moving. When he's more mellow, there's a lot of sitting. Today there was a lot of moving. He speed walked over to the office area, sat in the other music therapist's chair, whimpered, then dashed back over to the music part of the room.

Every so often, after he sat briefly on the couch (his usual hangout), he hopped up and went to look out the window, rocking from side to side as he did so. I noticed his rocking was kind of gentle and not all that fast, but everything else about him seemed to be in high speed.

I tried to figure out whether I should musically reflect the rocking (maybe it was a way for him to self-soothe?) or the agitation or both. I opted for a bit of both, and I think it ended up sounding like a bit of a mish-mosh. 

Even I was up and down a lot. I had decided the guitar was a better option for improvising than the piano, because I could follow him more easily if he happened to run out the door. Also I could turn and see him while holding a guitar.

B was also humming. It was actually a very beautiful and poignant hum, and I tried to follow along with the guitar and, at points, with my own voice. He'd hum at a particular pitch and then drop down an octave as he came to the end of a phrase.

Eventually, his movements came to a gradual settling down, and he (mostly) managed to assemble himself on the couch to catch his breath. I breathed in and out quietly with him.

"I guess underneath all the silence we were exploring two sessions ago you had a lot to say, B."

We sat together, back in the silence, and the lyrics that sang into my mind were: 

After you've gone, there's no denying..."

I have learned over the years to pay attention to the lyrics that pop into my thoughts when I'm with a client. To me they're like messages sent from their consciousness to mine. 

These were the only lyrics I could remember, and I wondered if he was trying to let me know how hard it is for him to have to wait in between our sessions. 

Now, it may seem as if I came up with this from out of nowhere, but that's actually not the case. He has a very difficult time leaving sessions, and there is usually a lot of dawdling and trips to the bathroom and long pauses before the jacket gets put on when it's time to go. 

Also, as I noted, he had been quite distraught in the previous session as well, and we had explored his frustration with me, because I'm not able to fix his life for him (which, I'm thinking, would take the form of my taking care of him outside of the institution). 

In the past month, we've been talking a lot about feeling abandoned, and I also used the Billie Holiday song "Left Alone" in one session (this version is sung by Abbey Lincoln).

When I commented to him that music therapy can be a mixture of deep gratification (it feels so wonderful to be listened to and acknowledged) and extreme frustration (because it's still therapy- it's not life) he immediately picked up the maraca and tossed it across the room (the maraca is the instrument we've designated to express anger and frustration). Score? I think so.

Heck, I sure wish I could tell you I had some brilliant piece of advice to offer him, but let's face it. The truth is, living in an institution is the pits. He knows it. I know it. I can't fix it for him. And, yes, it is frustrating. Insane-makingly so! On a lot of levels and in painful and never-ending ways. It's frustrating for him, and it's frustrating for me too. 

What to do? What to say?

He'd stopped running around by now, and he only got up every so often to punctuate a point I made (I think that's his way of saying, "you're getting it, Roia," but I'm not 100% sure; I never am). 

I told him I was glad he felt safe expressing his feelings to me, and he was welcome to keep doing so in music therapy. To be honest, I felt very honored and humbled by his trust in me. People don't expose that much emotion and pain in front of just anybody. 

I guess the best description of what I did today was to stick with B. I validated his feelings. I kept caring about him. I invited him to keep using the music as a container. I reminded him of when I'd see him next.

I noticed (in myself) how hard it was to end the session today. I knew we needed to go, but I felt awkward insisting (especially given how much emotion happened in the space), and when I tried to play something quiet about breathing, he started hitting his head. 

"Hurting yourself is not a solution, B. Showing up in music therapy every week [I actually see him twice a week] and using sound and movement to tell me how difficult this is for you is a better alternative."

He didn't look like he was buying it, but I had to get up and get the coats already. It was getting late. 

I put my coat on and held his out to him. He paused as long as he could, and he finally got up, took it from me, and put it on. 

When we got back to the cottage his staff greeting him warmly, and he went to sit down. He watched me as I hung up his coat, left the room to sign him in and then walked back through to wave "goodbye" to him. 

The lyrics were still floating through my mind as I walked back to the Music Room to tidy up and go home: 

"After you've gone, and left me crying
After you've gone, there's no denying..."

Sometimes being a music therapist feels like being one of the meanest people in the world. 

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