Thursday, May 28, 2009

Is change a good thing?

The first good thing about last Wednesday was that J decided to go with me to his session. 

That may not seem like a big deal but for him it is. We've had a year and a half (maybe a bit longer) of his hemming and hawing about being in music therapy. Since he doesn't use words to communicate, "hemming and hawing" looks like his walking with me (for all intents and purposes looking as if he's planning to come to his session) only to get completely stuck and not move- unable to move toward the session area and unable to walk back to his day area. (Insert long pause here.)

Sometimes his "hemming and hawing" looks like pulling me (yes, literally) in various directions and not really going anywhere. Sometimes it involves my suddenly noticing that he didn't let me know he needed to use the toilet. (Insert more pausing.)

We had been using the Music Room for sessions.  I've worked with J for quite a few years now, and it had taken us a long time to get to the point where we could safely leave the cottage, walk to the other building, and get to the Music Room, not run out the door in the middle of the session without letting me know he needed to stop for the day (that also took some practice), and get back to the cottage without anything too dramatic occurring. 

A little over a year ago J got to the point where, when he walked with me to the Music Room, he flatly refused to go in, opting instead to pull me around the building, pull me around outside, and pull me to the canteen (never to the cottage). I finally had to say "enough. We need to go back to working in the cottage!" J is a good two heads taller than I am, and, frankly, I need the use of my hands and arms, Furthermore, if I wasn't feeling safe, neither was he (or maybe it was the other way around). 

So there we've been: in the cottage. 

J is clear that he doesn't want to stop music therapy. Even when he doesn't want to actually go to his session, he holds on to my hand tightly and pulls me to sit with him in his day area.

"See Roia? This is where I live."

It has felt frustrating, confusing, heartbreaking and maddening at various points.

Last Wednesday (which is where I started this blog) I found myself, again, wondering out loud to J about his intense ambivalence (a.k.a. "hemming and hawing") with regard to his use of the music therapy process. (Mind you, J has been ambivalent from the beginning, but we had at least worked to a point where he was decidedly certain of his wish to get himself to his sessions.)

I noted that one of the hardest things about going to therapy (any kind of psychotherapy), and I say this from my own experience as well, is that as we get healthier the people and situations in our lives sometimes look, well, a lot sicker. It's a lot harder to tolerate boundary violations, drama, and generally obnoxious behavior when you've made an effort to be more mindful in your interactions and to get your own dramas under control.

The average person can decide for themselves, "I no longer wish to be in this relationship" or "I need to make some life choices so I don't find myself frustrated by being in jobs that are not challenging to me" or some act that requires a sense of agency.

But a person who lives in an institution, whose life is basically organized for him by other people in so many ways, who doesn't have or see any real prospect for getting out of the institution may not be able to do that. 

Even if he makes a monumental effort to convey what is important to him (and many of my clients do!), most institutions don't have the capacity to listen.

To know this, to live this, is nothing short of tortuously frustrating. 

In effect, I could see that J may (quite legitimately) feel as if I have offered him a taste of something that he could only have when he was in his music therapy session. And he may feel angry, resentful and hurt by that. And, yes, he may feel quite ambivalent about wanting to continue this kind of work.

In effect, I feel as if I have supported him to grow within a system that isn't willing to grow. 

As I acknowledged all this to J, he listened, quietly walking around the room where we worked, the noise of television sets, blaring music, and people's voices forming a constant background to our makeshift therapy space.

J walked over to me with a sort of wailing sound (a sound he often makes) and pulled the guitar carefully over my head (it's attached with a strap), waited for me to put it down, and pulled me gently out the door and back over to his day area. 

He sat down in a chair and just watched me as his staff, mostly ignoring him except to verbally acknowledge his return, began to chatter with me. 

"See, Roia?" his eyes seemed to ask me.

Yes, J, I see.

I'm sorry.

This past Wednesday, he got up and came right with me to his session.

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