Tuesday, December 22, 2009

12/22/09 Quote- a patient defines music therapy

Florence Tyson is one of the foremothers of music therapy. And, happily, I've been at this long enough to remember her presence at  conferences back when I was a baby music therapist (she died in 2001).

Her book, Psychiatric Music Therapy: Origins and Development, (1981) has a quote from a patient at the Creative Arts Rehabilitation Center (which has since closed). I put it up over my desk at work, because I think it captures the essence of music therapy so beautifully. Evidently, Florence Tyson felt the same way, because she included it in her book (pp. 71-72).
In music therapy, the music therapist, by the very nature of musical accompaniment, makes a profound psychological statement to the patient. He says: 'With this musical experience I will journey with you from the beginning of the piece (your struggle) to the end (transformation). I will go with you through anxiety, rhythm difficulties, fantasies, whether you finish or not. I will listen to you speak, even musically.' The good therapist becomes aware of this statement and when warranted becomes a guide, brother, sister, the good friend. There is the basic reality of patient and therapist coming together, one human to another. 
With accompaniment assured, the patient can explore strengths and weaknesses, realize his or her own potentials, and define problems. A patient even may become, in a monumental step toward maturity, responsible for his or her course. This reality also may occur in a highly structured session as long as the structure is always realized by the patient to be directed toward his growth, stability and self-discipline -- as long as the demand aims at the patient's eventual responsibility and individuation.

I think that pretty much captures it, don't you?

Monday, December 21, 2009

The joy and rapture of questions

QuestionsImage by Oberazzi via Flickr
People who read my blog know I'm a big fan of questions. And that I obsess over, well, everything


Because the only way to find out more is to ask more. And if we're not willing to ask ourselves questions, then we run the risk of walking around in life in a state of automatic. 

As music therapists, if we don't learn how to ask ourselves bigger and better questions (it really seems to be about learning how to ask ourselves better questions, I think), then our work stagnates. 

And we stop paying attention.

So I thought it was interesting (okay, yes, and delightful) that, in one day, I happened on two rather interesting items related to questions. I thought you might enjoy them as well, so I'm sending you along to have your own questioning party.

Here's where to go:

1. One is an excerpt from the book, The Interrogative Mood: A Novel? by Padget Powell. The entire thing  seems to be written in the form of a series of questions! And they're great questions! I've ordered it, and I'm awaiting it with great anticipation.

2. As if there weren't enough glorious questions in that bit of readery, I somehow discovered Jeffrey Tang's blog, The Art of Great Things. And, darn if he didn't just make a case in his most recent post for the good people of the world to ask the difficult questions

In keeping with the spirit of questioning, I have to wonder: What's next?

Tuesday, December 15, 2009

12/16/09 Quote- effortlessness, waiting, self-awareness

radiant effortlessnessImage by jhave2 via Flickr
From an article by Wayne Muller, "Effortlessness", in Unity Magazine, May/June 2003, pp. 4-6:
Deep within all things there is a natural rhythm, a music of opening and closing, expansion and contraction. Our heart, our lungs, the seasons, the oceans- all life expands and contracts, opens and closes, softens and hardens and then goes soft again. This potent opening and closing cannot be forced to happen, nor can it be stopped. It is simply the way of all things.
We need only remain clear and awake to listen for how things really are, to feel how the smallest changes of energy and attention move in us, in our relationships, in our work. We can learn to follow the spaces between things. Not to fight and push and cajole, but rather simply to wait until the true way reveals itself easily and clearly in this moment. 
My thoughts as I read this:
This seems to me a wonderful (and poetic) reminder of why it's so necessary for us, as music therapists (as any kind of therapists), to examine and to be aware of our own issues and motivations in our work. If we're not aware then we run the risk of "pushing, struggling and cajoling" our clients into getting better (behaving better, functioning better) instead of simply being with them and trusting that they will move forward at their pace. 

When I notice myself reacting in a session with a sense of urgency and "I must do something right now"  this passage reminds me: sometimes I just have to wait and be with my client(s) until s/he/the group is ready to move forward.

When I'm not willing to do that I know my focus has shifted to myself and to my own fear that I'm somehow not fulfilling this idealized (and delusional) notion that I have to be "the perfect therapist who can fix it all for her clients."

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Saturday, December 12, 2009

"I want to be here."

I noticed the word "here" came into my mind rather loudly as I accompanied W's breathing on the piano. Then..."I want to be here."

He was sitting in his usual partially reclined position on the couch and staring straight ahead. No eye-contact. Ignoring the instruments (although I think he tossed a mallet on the floor at one point). 

Just. Sat. 

I knew he was still not feeling all that well. We both had colds this past week. But he had been very clear that he wanted to come to his session.

"Breathe in; breathe out." I sang quietly, accompanying myself on the piano.

He waited until I was finished, and then he quickly tossed the maraca and the bells in rapid succession. 

Obviously something was bothering W. And as I watched him the song "Wish You Were Here" came to my mind. I found it in my folder, and I was all set to start playing when he stopped me, pushing my music folder to the floor.

Okay then. Kill the music. Better stick to just listening. 

"I'm wondering what's upsetting you so much today." 

W pushed the rest of the instruments off the bench next to his seat, making sure to send them into the distant regions of the Music Room. He watched them as they rolled off in various directions. He turned to me and tried to make sound with his voice. It came out as a quiet, brief hum. He waved his arms in frustration, unable to make me understand.

"I can't imagine how frustrating it must be for you to have so much to say and so few ways to say it. Can you go back to the music and use the instruments?" 

W got up and gave a few of the closer instruments, the ones he'd already sent to the floor, a shove with his foot, pushing them even farther away.

I looked at the clock and realized we only had five minutes left before the session ended. I let him know we would have to end shortly. 

I knew he wasn't finished. 

I recalled our previous session in which he kept picking up the bells when it was time to go (seemingly to let me know he wanted to take the instrument back to his cottage with him- like a transitional object). He didn't seem to feel finished then either. 

I asked him if perhaps his current upset was related to not wanting to let go of the bells and leave last time.

Eye-contact. Bingo!

"It is hard to leave a place where it's quiet and where you've developed a sense of safety. I know how much it means to you to be here."

Because I felt his helplessness, I went on and on. 

I reminded him that his worth does not come from me. That music therapy helps him remember and recognize his worth and value as a person. That we work toward his being able to go out in the world with the awareness that he is a worthy and valuable human being. 

I added that I realized this wasn't an easy task. We all struggle with it. "But, W, you have survived living in an institution for over 25 years. And you still care about people. Relationships still matter to you. That's a miracle!" 

He thought about this for a while. 

I gently noted again, "W, we need to stop for today." I got my coat on, brought his coat and hat over and began helping him get into his outer gear.

He paused midway through the process, flapping his left arm in his coat sleeve, not quite finished putting it on. In a second, he took off the coat, took off the hat, handed them back to me and pushed me gently backward in a clear gesture of "No."

He was staying "here". "I want to be here, Roia!" was what he seemed to clearly be stating with his actions.

I sat with him. 

"What do you think is making it particularly difficult for you to leave today? Is it that it's the holidays? Is this an anniversary date for you that I'm unaware of?" He paused and looked up and to the side to consider this.

"Perhaps you're feeling particularly lonely." Eye-contact.

We sat quietly, breathing together. "Loneliness is hard."

After a while he got up to push my tissue box off the piano. I brought him his coat again, and I let him know I thought he'd be okay. He is, after all, a survivor.

He hesitated, but he finally put on his coat and we walked out. 

Here is the song, "Wish You Were Here", that I would have sung for him in our session- mistakes, clunky piano keys and all. 

Wednesday, December 9, 2009

12/8/09 Quotes: Music therapy, observation, paying attention

The process of observing in a music therapy session: noticing what's going on with the client, with the music, how I'm reacting and responding, and the sorting it all out...this is the process of music therapy. 

And Ken Bruscia captures it beautifully:
Once therapist and client enter the therapy room, a steady stream of rich, complex encounters begins, encounters that invariably stretch and challenge the therapist.  Flowing in the steady stream are messages and cues from the client for the therapist to process, multiple physical and emotional reactions that the therapist has, and an unending current of thoughts and questions to ponder, relevant and irrelevant, lucid and fragmented. 
One of the most difficult things for new music therapists (in my opinion) is learning how and what to pay attention to in music therapy sessions

Someday, when I get myself organized enough to write an article about this topic, I'm starting it with this quote.

Bruscia, K. E. (1998).  “Techniques for Uncovering and Working with Countertransference” (pp. 93-119) in Bruscia, K.E. (ed.) Dynamics of Music Psychotherapy.  Gilsum, NH:  Barcelona Publishers.  

Tuesday, December 8, 2009

Quotes I have known and loved: Coming soon to a blog near you

It's been a long time since my first posting of quotes I have known and loved. And that's a shame, because there are so many quotes from so many wonderful writers whose work has inspired and taught me over the years. 

You know? The more I think about this, the more I think it's time to start a weekly quote in this blog. 

Of course, knowing me (and I do), it will be awfully hard for me to limit it to one quote. But I'll do my best. At least I'll try to stick to just one author...or maybe just to one topic. 

Oh, who am I kidding? It's impossible for me to behave when it comes to quotes. 

So there. I think it's an official decision. One day of the week (since I don't blog all that regularly anyway) is dedicated to quoting some of my favorite authors on some of the subjects I spend a lot of time thinking about.

Comments? Opinions?