Monday, December 27, 2010

And how was your day, dear?

Small screamImage via Wikipedia
On the plus side, nobody got hurt (although there were some brief reminders to the effect of "nobody really likes to get their head tapped unexpectedly, K."). On the not-so-plus side, I'm guessing it'll take kind of a while for my co-worker in recreation to sort through the two big stacks of paper from her desk that, um, well, er, ended up all over the floor when I turned my back for a minute to deal with L. 

I think I can safely say that this particular session felt like it was the exact opposite of the lovely one I described  to you a few weeks ago. 

Here's how this whole party started: 

I arrived in the cottage, fully aware that the women there were almost all sick with colds and stomach viruses (lovely). I had called earlier in the afternoon to ask if I should come over or skip it, and I was told, "well, people are running around with the sniffles and stuff, but..." (which I'm fairly sure was code for "Get your a** over here, lady! We've all been suffering through this, and you'd just better do your time!")

First thing, G (one of the more chatty ladies who live in this cottage) came over to announce to me that I should "stay away" from her because she's "sick as a dog," after which she proceeded to follow me around and ask me questions repeatedly until I finally got the women who are actually in my group assembled and closed the door with a firm "I'll see you later, G. Hope you feel better." [Insert heavy sigh here.]

Honestly, I was quite happy as we got started (although a bit nervous) because M had actually joined us. Her staff person walked her over (at my request), and she had miraculously managed to convince M to walk in to the session area with us! Usually I get her as far as the door to the room where we work, and she starts to hum loudly. Then she won't go in to the room with the other two or three women from the group, and she won't go back to her day area either. 

Inevitably, V gets annoyed because she is waiting for the session to begin, so she scoots (she moves on her knees usually- she has a wheelchair, but she tends to hop out of it when she gets to the room) out of the room where we work and sits on the floor, watching me and looking impatient (I'm sure if she were able to stand more comfortably there'd be foot-tapping involved). 

It took some doing for N to get in to the room, because her OCD was making it plain difficult to get through the door. We waited for her and she got in. The problem, however, was that K was sitting in the chair that N prefers to use. Stop. The. Presses.

So. N pushed and pushed (in spite of my requests that she stop doing so) at K (who, on any other day, prefers to wander around the room and throw everything she touches on the floor or across the room), trying to get her out of "her" chair. Having very little luck (K is pretty hardy), N (no slouch herself) took hold of K's shoulder and her behind and unceremoniously shoved her out of the chair. 

Oh, dear.

Somehow, I managed to get K moved to another chair at last (to the one that V prefers, God help me). Mercifully, V decided to stay in her wheelchair for a short period of time. 

Then I had to figure out what to do to get M settled, because she kept coming over to me with magazines that were in the room and insisting that I hold them. Finally, I got the message, tore out a page and handed it to her. That seemed to be what she wanted and she promptly found herself a chair and proceeded to rip paper peacefully.

For twelve blissful seconds, we were all sitting quietly (it was such a glorious moment) when we heard a loud crash at the door. 

"[Expletive deleted]! What now?!?" (I thought, loudly, and in a rather un-music therapist-like fashion.)

L arrived, right behind her giant walker (the thing that had crashed into the door), and she decided she needed to come in and sort through the plastic groceries in the faux grocery basket (that lives in the room we use) right now!  

And L, I need to tell you, is not exactly Miss Let's-Talk-About-This-Shall-We-America."

Dear Lord!

Of course, since we were all sitting (for those twelve brief, yet happy, seconds), this required rearranging everyone so L could get to the table (which was, of course, behind everyone). 

Well, not entirely unexpectedly, in the process of tending to L, and rearranging the furniture and the various people contained therein so nobody would get run over by L's giant walker, K got up to explore, and that's when we heard the two huge piles of paper from the recreation staff's desk hit the floor. 


I couldn't, for anything, get K to sit anywhere, so I gave up and tried to pick up the giant mess of paper and put it somewhere somewhat unreachable until after the session.

While I was dealing with the paper, V decided she'd had enough, so she headed out the door and sat in the hallway, chin in hand, waiting for me to chase after her. Since I'm not supposed to leave V alone (and I'm not supposed to leave M or K alone either), I put a chair in the doorway so I could keep an eye on the group and on V at the same time. 

V, in spite of my best efforts, turned tail and headed back into the day area (through the bathroom door that's across the hall from our room). And, much as I hate to admit it, by that point I just figured, "Okay, that's one less person to worry about right now. Amen."

K roamed around the room some more, tapping N on the head unexpectedly. And M continued her page tearing adventures, assembling the tiny pieces neatly on her lap. 


I'd love to tell you I was able to make a brilliant interpretation to the women in the group about their actions and how they seemed to be all about going from crisis to crisis, and there's all manner of "no, pay attention to me" and some sadistic teasing, all in conjunction with the  incredibly overwhelming way they interact with me and with other people in their lives. 

But no.

Heck, I'd love to say that there was even half enough emotional space left in the room so we could even start to look at that, but that is so not where the group is yet! 

Evidently, the group's goal for right now is to (through their actions/interactions) convey as loudly and dramatically as possible, "Roia!! This is what it feels like to be here. To be us. To live life!!! Do something!!"

And, for now (I have learned) (rather slowly, I must add) that my job is to just listen and get through it. And show up next time and get through it again. And keep setting limits and keep trying to help them use the music or use the music myself.

At some point, they'll be ready to hear me talk about what I'm seeing/experiencing in that group, but not yet. 

Definitely not yet. 

Tuesday, November 30, 2010

How wonderful that you're here!

A photograph from Harleysville, Pennsylvania o...Image via WikipediaWe music therapists are always trying to define what we do. Or, more specifically, help other people understand what it is we do. We write books and articles about it, we blog about it, we put together podcasts- all in an effort to convey to the masses a sense of what makes us go into this profession that seems to defy description!

But, if someone were to have asked me yesterday "what is music therapy and how does it work?", I would probably have said that it's about inviting people to be present to each other, and we use the music to help make that happen. 

Mondays are long days. For me, I go into work a little later and stay a little later. And, I think we can all agree: it's hard for any of us to transition into a Monday, which is, for most folks, the beginning of the work week. And I would say that it requires even more fortitude to get into the Monday spirit of things after a particularly long Thanksgiving weekend, which, of course, marks the beginning of the (dreaded) holiday season.

While staff frantically decorate the cottages and prepare for Open Houses (where everyone's family is invited to come and visit and there's food and music and merriment and so forth), my clients prepare for the annual anxiety of "will my family be coming to spend time with me this year?" 

So, this is a bit of the sense I got when I showed up to work with the group yesterday (Monday) afternoon- "the group" being ten men and me. 

Oh, where to begin? 

Well, let's see. There was a whole lot of messing with chairs (that would be P), switching of seats (that would be R), tossing instruments, trying to pick up instruments and then getting stuck on the floor and needing help to get up (that would be T), repeatedly rearranging and fixing the curtains so the sun wasn't blinding us (um, well, actually, that would be me), coming in, turning off the lights, and then leaving (that would be K), coming in, crying and starving to death and then leaving (a different K who does use some speech), and on and on, all accompanied by a low moaning (courtesy of J), the periodic fist to the head (of B), and the festive crashing of the tambourine (P again).

Can I get a witness? Anyone? Anyone?

Uuuhmmm. Now what?! (And if any music therapist tells you they know exactly what to do when their clients are all freaking out at the same time...just so you know- They. Are. Lying!)

I managed (do not ask me how) to get my thoughts together enough to be aware of the fact that, while the guys were all there, they weren't really There. Nobody was listening to anyone else in the room, we were all kind of...everywhere, but none of us was present to the experience of being in music therapy. 

I pointed this fact out to the guys (who, God bless them, heard me above the drama-filled din), and I asked them, "Gentlemen. What can we do here? How can we use the music? How can we use our thinking, to get ourselves to be here in this room, in music therapy, together? Why don't we just work on that, so that if we do nothing else today, we'll know that we cared about each other enough, that we mattered enough to each other, to notice that we were all here together."

Enter music. 

I moved over next to B, because I didn't want him to be hitting his head, and offered him my hand (he took it). He had been vocalizing while he was hitting himself, in a kind of a hum. So, since I couldn't play guitar with only one hand, I invited the guys to find some kind of way to hum with B to help him settle down.

I started to hum (in B's general key), and it didn't take long at all before the men found ways to join in with their voices and actions. J moved his arm, every few measures, up and then down to the beat. P, in spite of his tambourine prowess (and he really does rock on the tambourine) used his voice- which has more of an "oh" and "ah" quality. Yet another K quietly chimed in on the cabasa he was holding. R stopped moving around and sat, listening, with his eyes closed, breathing deeply. 

B calmed down and kept singing (but stopped hurting himself), so I was able to make use of both of my hands again. I played a very simple progression on the guitar- kind of an Asus4, Cmaj7, to D/F#, B, E (sometimes major and sometimes minor), and I repeated it as we sang and came together.   

It was lovely. 

There was smiling. The moving around and in and out stuff stopped. There was presence. We were looking at and acknowledging each other. 

We managed to be present in the session and we used the music to make it happen. The definition of music therapy on a Monday afternoon. 

And what makes this way of using music so cool is that this particular piece of improvised music  could only have happened on this day and with this group for it to have had any meaning. Taken out of context, it might sound okay, but it will never have the same impact as it did yesterday afternoon as we all sat quietly, after we finished, even after we sang goodbye, nobody wanting to leave quite yet, watching the sun set together.

Sunday, November 28, 2010

So you want to become a music therapist...

MusicImage by doug88888 via FlickrI, rather regularly, receive emails and blog comments from people who are interested in becoming music therapists.  And I regularly send back big, long emails with information I hope they'll find to be useful. Well, suddenly, one of my slower neurons fired, and I thought, "why on earth haven't you written a blog with this advice in it, so you don't have to keep repeating yourself?!" 

Somewhere a dog barked. 

Aaaand, we're back.

Okay. So you want to become a music therapist. Fabulous! And you want to know what it will take, what kind of advice I can offer, whether you'll ever have an actual salary, what to write for that research paper that's due in 13 hours...and so forth.

(Stand back. I'm about to jump into list-making land.) (Actually, even though my blog posts aren't usually in list form, I have a deep and abiding love of lists.) (But I digress.)

1. It helps to be a fairly good musician.That said, it also helps if you learn to play guitar and piano.
Different schools that offer music therapy as a major have different requirements. I think, ultimately, the more skill you have as a musician, the more you have to offer your clients. If you're busy focusing on yourself trying to play a song or a particular instrument, you're no longer focusing on your client, and that sort of defeats the whole purpose of therapy. You know? You don't have to know how to play guitar and piano before you go to school, because that is part of the music therapy curriculum. Those are, however, two instruments that are used an awful lot in the course of a music therapist's day/week/life, so it's worth getting to a point where you're relatively comfortable with them.

2. And, while you're at it, get comfortable with using your voice.
When I first started out as a music therapist I was really shy, and I found it difficult to sing in front of anyone. Mercifully, I managed to move beyond that. We don't have to be brilliant singers, but it's important to carry a tune and be comfortable improvising and playing around with vocal sounds. I still remember a client I worked with who tore up an entire room and threw my entire music cart on the floor. For a good solid year I had to go and do his sessions with nothing but me and my voice. 

3. Be careful of your "helpful" intentions. 
When you're trying to figure out what you want to do with your life, it's not unusual to think, "you know, I really want to do something that helps people." We all have our reasons for wanting to somehow be useful in this world, and they're all valid and important. When we come to a profession like music therapy, though, I think it's important to be mindful of the various implications of being "helpful" (in terms of power, control, what it means to be "the helped", etc.). Because Norman Kunc and Emma van der Klift said it a lot better already, I  highly recommend reading their article, "Hell-Bent on Helping: Benevolence, Friendship, and the Politics of Help". It will, I hope, give you a whole new perspective on being "helpful".

4. Learn to pay close attention. Notice stuff.  
So much of my job is about paying attention. Whenever I have students come to do their practicum experiences with me, I have them fill out an observation form that I developed. It's an insanely complicated form, because in a music therapy session there is so much going on at any given moment and on so many levels. You have to be aware of your client (s), the music, yourself, the environment, the history...there's a lot of stuff happening. This is what makes music therapy so completely fascinating! You can practice at an activity level and be quite effective, and you can also decide that you want to go deeper and explore the therapy relationship, the dynamics within it, and how it's all expressed within the music, and that's really nifty as well! 

5. Expect that this will be a life-long learning experience. 
Music therapy is a growing and evolving field. Because there's so much to know (and you can't cram it all in at school!), so much to pay attention to, and because you can work at a lot of different levels, there's always something new you can be learning. For that reason, getting professional clinical supervision in music therapy after you've graduated is extremely helpful to your growth as a new clinician. Moreover, there are lots of trainings that music therapists can take to deepen their knowledge/skill in specific areas (GIM, Nordoff-Robbins Music Therapy, Neurologic Music Therapy, NICU Music Therapy, Hospice Music Therapy, Vocal Psychotherapy, and I'm sure there'll be more sooner or later). 

6. Get used to advocating for yourself. 
Music therapy isn't the huge mystery it once was. These days when I say I'm a music therapist, people are way less likely to say "a what?!" than they were back when I first started out. Now I'm usually greeted with something along the lines of "oh, how cool!" As nice as that is, people often think they know what we do, but they really don't. Co-workers who've known us for years may still not have a clear idea of what happens in a session. I'l be straight with you: It can be quite frustrating when you see that someone who hasn't gone through the years of training you have is calling him/herself a music therapist (or being called one by the media). It can be even more challenging when supervisors, colleagues, and various other people/organizations who fund our services (who aren't music therapists) feel compelled to tell us how we should do our job.  Having said that, I would still maintain (and I think my music therapy colleagues would agree) that being a music therapist still far outweighs the difficult stuff. 

7. You'll need to figure out a semi-quick way to explain what it is you do for a living. 
Given that you'll have to spend some time advocating for yourself and showing people what music therapy is, it's important to have your "elevator speech" prepared shortly after you graduate from your program. The ladies of the Music Therapy Roundtable (Kimberly Sena Moore, Michelle Erfurt, and Rachel Rambach) address this very topic here.  

8. It's not likely you'll be rich beyond your wildest dreams, but you can definitely make a living as a music therapist.
A few months ago, our Rabbi at work asked me, as nicely as he could, on behalf of one of his congregants, "can music therapists make a living doing this work?" I assured him that we could. We can find jobs (we've been doing a lot of advocating- trust me), we can get health benefits, and we can make enough money to live peacefully. We'll never get the kind of money that, say, a computer programmer or a financial analyst would make, but most of us aren't starving. And if this is truly what you want to do, then you should do it. 

9. Get used to not knowing what's going on and sometimes being uncomfortable or awkward. Or at least come to terms with it. 
I would have to say that it's rarely dull being a music therapist. Sometimes your clients will do unexpected sorts of things, or you'll find yourself dealing with really uncomfortable feelings. And sometimes you can go for a really long time and not be at all sure you're on the right track with a client/group. Again, this is what makes this work so fascinating and so completely worthwhile! It's difficult when your own issues are triggered, but, heck! Your issues will be triggered no matter what you do. You may as well have an interesting job within which to notice them. 

10. Consider getting your own therapy (or your own music therapy, if you can). 
Being a therapist is hard work. Being a client is also hard work. If you've never gone through  your own therapy, and if you've never struggled in a big way with your own problems and emotional baggage, it will be hard for you to have a real understanding of what it's like to see yourself in a new way (which is not always a pleasant experience at first). Making changes in our lives is something most of us resist mightily. Looking at our resistance- ugh! It's not always fun. It's a long, bumpy road. And we ask our clients every day to allow us to stumble along that bumpy road with them. We owe it to ourselves and to our clients to at least bring along the map we saved from our own journey (even if they decide to take a different route). (Okay, I'm getting a bit nuts with the metaphors here, but you get the idea, yes?)

So there you have it. That's the list I have going in my head when people ask me for advice on becoming a music therapist, and now here it is! In blog-land! And if any of you music therapists out there in the world have other advice to offer, bring it on!

The good news (well, to me anyway) is this: I've been a music therapist for 24 years. Even on the worst of days, I have never regretted my decision to do this work! Much good luck to you as you go forth and consider whether or not the life of a music therapist is one you'd like as your own.

Sunday, November 21, 2010

Back off, lady, I've got this!

This is a picture of a light switch. displayin...Image via WikipediaI tried a different approach with B today.  My usual tendency is to sit there, paying as close attention as I can (without being too obvious) and trying my best to figure out what he is (not) saying by asking him bunches and bunches of questions (and driving both of us crazy in the process). 

Yes, even I realize that asking tons of questions is annoying. 

And, no, he doesn't use speech, but when he truly needs to make sure I hear him, he is quite clever in his communicative style.

Well. He was reclining (as he does) on the couch in the Music Room, and he was very specifically looking off in the distance (read as: "I am not looking at you! NOT looking at YOU!"). Okay. Got it. We are not looking at me. Fine. Onward. 

I, of course, started to leap in with my usual round of questions ("Rough day? Too noisy in the cottage? Feeling off because we changed our session time last week? Blah? Blah blah blah? Blah, blah, and more blah?"). Okay, I'm not really proud of the fact that I did this, but I did. So. There it is. B's response? Stay the course. Keep staring straight ahead. 

Hunh. That was effective. 

I stopped (thank God). And I thought, "Try again, Roia. Settle it down, and try again."

So I said to him, "You don't really seem to be ready to be dealing with stuff right now. Why don't I just play piano over here, and when you're ready, you let me know."

I rummaged through the stack (really- there's a stack) of (countertransference) songs I've used in his sessions, and I pulled out the Beatles' song, "Don't Bother Me". I hemmed and hawed (internally) for a bit and decided to just play it on the piano rather than sing it. It didn't seem right to break the silence with words just yet. 

I played through. Aside from tossing the bells he was holding and then picking up the mallet, there wasn't much (visible) change. Moving right along. 

I rummaged some more, and I found "Out Here On My Own" (from the movie Fame). (Anyone else sensing a theme here?) I really wanted to sing the words, but it still didn't feel like it was time to do that, so I played through it with just the piano. 

I feel as if I need to explain two important things here:

One is that the songs I chose were intentional- not as random as it may seem when you read my writing. I wanted to reflect his need for some emotional space, but I also know that he's been struggling with trying to come to terms with what our relationship is and is not (which is a gentle way of saying that I'm trying to help him understand that "we don't have that kind of a relationship.") He has not been happy about that, and although I think that, on some level, he gets why it is the way it is, he still feels very abandoned by me right now.

The second thing is that B spends a part of almost every single session, pulling me to the door and flicking the light switch off and on (you may draw your own conclusions as to what that particular habit may be helping B to say to me). 

Great. So you're up to date. Back to the music...

This time the mallet was tossed, but B still sat quietly listening with his gaze firmly averted. 

I sat quietly for a while (even I can sit quietly sometimes) and waited. 

B leaned forward and tossed the maraca (which he uses to express anger) and tambourine (to express uncertainty) on the floor and was ready to hurl the cabasa (for conveying disappointment and sadness) as well, but I managed to stop him just in time (did I mention he can make sure he's heard when he has something to say?). 

"Maybe," I suggested, "I'll play the song I just played again, only this time I'll sing through it with the words. B, why don't you sing it with me. You can use your voice, you can pick the bells back up and use them, you can move...just pick a part of the song that feels right, and join in." 

So I went back to the piano and started (again) with "Out Here On My Own" 
(Lyrics: Lesley Gore, Music: Michael Gore; Copyright 1979)

Sometimes I wonder where I've been,
Who I am, do I fit in?
Make believing is hard alone, out here on my own.
We're always proving who we are-
Always reaching for that rising star
To guide me far and shine me home,
Out here on my own.

And when I'm down and feeling blue
I close my eyes so I can be with you
Oh, baby, be strong for me, 
Baby, belong to me. 
Help me through. Help me need you...

The minute I started singing the chorus, B joined in! He got up, started to hum in a low tone and rock back and forth. Then he headed over to the light switches and started to flick the lights up and down in time to the music (I could tell, because he paused so he could stay with the beat)!!

He stuck with me- moving, vocalizing and light switch flicking- until I got to the very last words of the song ("out here on my own."), at which point he came over and stopped me from playing any more by pulling me to the door (not because he wanted to leave, but because he wanted me to stand with him). 

Wow. He was glorious.

Clearly, the strong feelings of loneliness and longing are still very present for him. The beauty of this profound musical moment (as I see it) is that B now feels safe enough to fully participate in the experience of actually making music. And I do need to point out that this has taken quite a lot of years. For much of the first twelve years of our work together, he largely avoided using music- often barely even allowing me to use music!

The fact that B was not only willing to sing with me (and in such a creative way), but to make sure it had meaning when he did it, is what makes this work so amazing!

I guess the question (for me) now becomes: knowing that when you back off and allow your clients to say what they have to say, they will not only do it but do it beautifully (and you don't need to worry them along), what's preventing you, Roia, from backing off so much of the time? And what is it you're afraid of hearing when your clients do "speak" to you through their music?

Tuesday, November 2, 2010

Listen Hear

Evidently, November 1st was something of a celebratory day. A day to listen to what autistic people have to say. 

It's kind of unfortunate that there's a need to designate a special day for it, because most of us, autistic or not, want to be heard every day, but I guess that's the state of the world in which we live. 

Anyway, here are links to some of the blogs I read about this most auspicious occasion:

Friday, October 29, 2010

The big comfy couch incident

New Couch!!!Image by SimplySchmoopie via FlickrWell! Work, this morning, was a bit crazy (to put it mildly). 

Both the 9 AM and 10:30 AM groups were either getting ready to take part in or getting ready to watch the big Halloween parade at our facility (which is actually pretty cool- a local high school marching band comes, there are costumes, people bring their dogs, their babies, etc.). 

There was all kinds of flurry and insanity, what with trying to get the guys/gals outfitted with their various costumes and such. There was annoyance, there was attitude, there was drama...well, you know how it goes.

Now, mind you, the guys in the second group weren't actually going to be in the parade. We were just working on getting chairs outside and guys assembled in heavy sweatshirts and caps (it was cold out there today!) so we could all watch before the parade, er, passed us by (as the saying goes). 

Mercifully, we got ourselves all out there in time, caught the all-too-brief parade, cheered loudly for the guys who had gone to boldly march in their costumes (the cottage had gone as race-cars, and they were all sporting their "cars" with frames draped over their shoulders- it was pretty nifty), and managed to get everyone safely back inside with only one incident report having to be filled out (um, that was me, because one of the guys who used to love watching parades and being in the middle of the action...well. He wasn't in that good of a mood to be moved around. My deepest apologies to R for my misunderstanding.)

To put it mildly, we were all shot!

I went to join E on a big, mushy couch, because he seemed to have been out of sorts all week, and I just wanted to check on him. We've known each other for 22 years. To not check on him would have been totally rude. 

So E and I were just sitting there, hanging out and decompressing from the morning's events, and T came over and decided to join us. 

Now, the reason this is news (and very cool) is that T's usual approach to sitting on couches is to shove whoever is on the couch off. This is usually accomplished by pressing his fingers firmly into the back of the person's head, but bopping people over the head has also been employed at various times. 

But he didn't do that. T came over, sat on the other side of me (I was in the middle), and he took my hand, carefully, and he held it for about five minutes. Then he smiled, got up, and continued walking around the room

Now, that's what I'm talking about!

Wednesday, October 27, 2010

Getting to "no" you

Just Say NoImage by donnamarijne via FlickrWhile I was avoiding writing my proposal for the regional music therapy conference this afternoon, I started thinking about one of the women with whom I work- this would be the woman who spent a lot of time being undressed in our sessions initially. 

I thought you might be interested in a brief update.

C has managed to keep her clothes on (although her shoes and socks go flying at times- but who can blame her for that?) since we decided it would work a lot better if we had a much (much) shorter session time of about 7 to 10 minutes. 

Most importantly, she has been able to peacefully let me know when she is not interested in having a session, and that seems like a step in the right direction to me. 

I've said this before, and I'm saying it again: Any time one of my clients feels safe saying "no thanks, not today" to me, I know I'm on the right track. 

Now I just have to hope/trust that, at some point, she'll feel safe enough to say "yes" more often. 

Tuesday, October 12, 2010

So, here's a question for you, happy readers...

Back in April of this year (yes, the one that's passing us by so quickly) I had a series of posts about a presentation I did at the Mid-Atlantic Regional Conference of the American Music Therapy Association on Taboo Topics in Music Therapy (Part I was the Introduction, Part II was the handout, and, of course, Part III- which was The List).

I was asked by the conference chairperson if I would do a follow-up, because it was an interesting topic (thank you) and because people felt as if we'd barely scratched the surface of the issue (very true).

So, I'm thinking and agonizing (shocking, I'm sure- I mean, who would have ever thought I, of all people, would think and agonize?) over which aspects of the vast array of taboos to talk about.

Here are some options I've got floating around in my mind: 

*We could take the handout (which I could happily reprise), have people fill it out and use  participants' case examples to look at as a group. 

*Or we could take a specific aspect of The List (So Far) and focus on a particular topic. Some examples of that could be:

*"Feelings for and about our clients and our clients' feelings about us" (which could be an entire graduate class, frankly)

*"Fantasies we have about ourselves and our clients" (these could include fantasies that we'll fix our clients' lives, we'll make them happy, rescue fantasies and beyond)

*"What to do when you make a mistake" (my friend Judy and I did this one a few years ago, "The Myth of the Perfect Music Therapist, or How I Learned to Stop Worrying and Love My Mistakes", and I've been trying- trying, I tell you- to post the handout, but for some reason it's just not working properly) 

*And, a variation on the above theme, "Feelings of incompetence as a music therapist" (which could get awkward).

I'm sure there are more options. I'm thinking that the ones I've mentioned are things I could talk about with some intelligence/experience. I would be willing to tackle, or at least create a forum, for other issues on the list (fears of clients committing suicide, fears of getting attacked, clients and boundary violations- particularly in the age of social media and such, therapist/client prejudices, and so on and so forth). 

Here, of course, is where my question to you, kind blog readers, emerges:  

If you had a choice (and some of you may, because some of you live in this region), which aspects of taboo topics would you want to explore in a presentation?

I'm presuming that I would probably only have about an hour and a half to hash out heavy stuff. It is, of course, possible to put in two proposals and I could ask if I could do two presentations, both of which would be follow-ups to last year's talk.

So have at it, folks. I look forward to your thoughts/comments! 

Wednesday, September 22, 2010

Upcoming music and dance/movement therapy workshop in NJ

In case you're wondering if I'm still alive (I am)...I've been preparing to present a five-hour Continuing Music Therapy Education (CMTE) workshop on countertransference with my friend, Mark Bottos, a dance/movement therapist at Kardon Institute for Arts Therapies in Philadelphia, PA. If you're a music or dance/movement therapist, and you're interested in attending, here are the particulars:

Date: Sunday, October 3rd, 2010 9 AM to 5 PM

Location: Kingsway Learning Center; Haddonfield, NJ

Cost: Free for NJAMT Members

Title: "It's Complicated: Exploring the Many Aspects of Countertransference"

Presenters: Mark Bottos, MCAT, DTR and Roia Rafieyan, MA, MT-BC

Therapy can be a complicated process, requiring us to attend to many different elements simultaneously. Learning about the role of countertransference (CT) in the therapy relationship as well as developing an awareness of when we are having a reaction in sessions will not only make us more effect clinicians, but it will also help us find ways to cope with difficult feelings that emerge in the course of our work. Participants are invited to share clinical challenges. Through movement and music experiences and dialogue we will explore ways in which CT manifests in our music, movement and clinical choices. 

6 CMTE credits are available. 

Monday, August 23, 2010

Eating a slice of humble pie

Eat PieImage by shandopics via FlickrI knew if I waited a while, calmed myself down and thought about it in a peaceful state, I'd have a better idea of how to proceed with C. 

You may (or may not) recall that I wrote about the dreadful session I had with her a couple of weeks ago. I was feeling terrifically annoyed with myself (among other sources of annoyance) because I had allowed my anxiety about staff being upset with my "letting" C strip in music therapy (I mean, really?) cloud my therapeutic judgment. 


So, as I was driving back from Michigan (which is quite a long drive when you're headed to New Jersey) to visit my friend (a music therapist turned music librarian, as it happens), I was thinking about the coming week. Naturally, my thoughts turned to Monday morning, C's scheduled time for music therapy. 

I had (yet) another twinge of guilt as I remembered our last session before I went on vacation (just for the record, it's not unusual to have a horrible session right before a vacation- in fact, it's one of the, er, perks of being a therapist). 

And let me just say, it was not one of my shining moments as a music therapist. 

As I was trundling along the Ohio Turnpike (where they have very nice rest areas, I must say), I wondered what I was supposed to do about the stripping. I didn't want to stop working with her, because, in spite of the exposure episodes, there were moments of actual connection in the music. 

I tried to perceive the situation from C's point of view (something I've tried to do before), considering the idea (again) that she may, in fact, feel exposed. 

Then it suddenly hit me! 

A forty-five minute session is way too intense for her! Sure she may appreciate parts of the experience, and she may even find herself engaged meaningfully with the music (maybe even with me), but she's not even close to being ready to deal with that kind of constant attentive interaction for that long of a period of time!

Of course!

I need to start out with very short sessions (five to ten minutes at most) and gradually learn when C is letting me know she's ready for more time. 

Honestly, sometimes I think I've been at this a bit too long that I could manage to forget something as basic as that. As basic as: can this client tolerate a 45-minute session, or should we start small and work our way up? 

So, today I showed up in the cottage feeling a little more confident (with regard to the staff), and I explained my plan. I'm not sure they were as enthusiastic about my plan as I was, but they were agreeable enough (which I appreciated).

The supervisor (for some reason) decided to get C, and we sat outside of the room where her group was meeting.

The first thing I felt I needed to do was to apologize to C for misdirecting my frustration in the previous session and aiming it at her. Then I acknowledged that I had not remembered that when someone is paying very close, unwavering attention to you for a sustained period of time it can be uncomfortable as hell. 

I told C my plan. "We'll start with a ten minute session. I'll practically be singing 'hello' and then 'goodbye' and then we'll stop, and I'll plan to be here next Monday again."

C, tucked under her blanket, tapped her hand against her leg. I sang "hello", she listened quietly, then I heard her giggle and vocalize with me a little bit. Then I asked if she needed anything else from the music before we ended for today. She vocalized a bit more. I sang "goodbye," put away my guitar, and I escorted her back to her group. 

She was smiling.