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. 


Kimberly Sena Moore, MM, NMT, MT-BC said...

Thanks for the vignette, Roia. The clinical skills you used are difficult to teach in a classroom. Examples like these definitely help!

Roia said...

You're absolutely right, Kimberly. This isn't easy stuff to convey in school. One of the reasons I blog is so I can process a session. Writing out the story helps me think about it and catch some of the stuff I didn't catch when it was happening in the first place.

Here's something I wrote a while ago about doing a process paper:

Thanks for stopping by for a read. And happy new year to you and your family!