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.


Natalie said...

Congrats! I'm sure you must feel so wonderful!!

Roia said...

Hey, Natalie! Thanks for stopping by and taking the time to comment. You know? I think, more than anything, there is a sense of relief for me when I am on the right track.

I don't know what your experience is, but when it's pretty darned clear that things are going South in a session (or with a client's therapy in general)...there's this sense within me of something being completely off.

When I step back (rather than leap in and do something), I usually have enough distance (after being in a very reactive mode) to be able to think through what I might need to change in order for the therapy to get back on track.

It's sort of like, hm, the satisfaction of scratching an itch. There's the uncomfortableness and then the relief (and, as with any good itch, the relief of being on the right track with a client can sometimes be short-lived). :-)

Niksmom said...

Makes me think of parenting my child w/multiple disabilities...sometimes less IS more. And it takes a very self-aware person to realize that. Kudos to you. I look forward to reading about yours and C's progress together.

Roia said...

Hello, Niksmom. Thank you for the kind words. I think most people's natural inclination is to jump in and try to fix things before pondering the actual problem.

And I, likewise, look forward to reading about your journey with Nik (your writing is lovely). He sounds like a nifty little guy!

Tamara said...

Roia! Yes, yes! Thanks so much for the reminder to pace our clients. I think you are right . . . after so many years of doing this work, us "seasoned" therapists can . . . overlook the basics! I can so relate!

I also had to empathize with the staff's lack of . . . interest / understanding or whatever. It seems to me that the creative arts therapies are often not understood by more traditional therapists. As such, your work can look a bit too woo-woo for them . . . simply because they don't understand or even respect the work that you do.

Hang in there, girl, and keep blogging! I miss it when you disappear!