Tuesday, September 21, 2010

The myth of the perfect music therapist or How I learned to stop worrying and love my mistakes

Back in 2006 my friend, Judy Belland (brilliant music therapist turned happy music librarian), and I presented at the Mid-Atlantic Regional music therapy conference in 2006 (which was in Pittsburgh that year- seems I keep presenting stuff in Pittsburgh...anyway) on "The Myth of the Perfect Music Therapist or How I Learned How to Stop Worrying and Love My Mistakes".


Recently, my blogging friend, psychotherapist Tamara Suttle (whose blog, Private Practice From the Inside Out is on my hit parade) wrote about making mistakes as a therapist


Reading her blog reminded me that I've been meaning (since January, for crying out loud) to post the handout Judy and I put together. So here it is, mistakes and all (just a little perfectionista humor there). Thanks, Tamara, for the reminder/encouragement! 


Note: The original version has a How To Write a Process Paper, which you can find here
Questions to ponder

  • What is my fantasy of "The Perfect Music Therapy Session"? What does it mean when it doesn't go as I planned/hoped/fantasized?
  • What does it mean when our clients fail (about us, about our clients, about music therapy)?
  • What do I see as "the rules" for how a music therapist should be, what a music therapist should do, how clients should respond, etc.? (i.e., I should never become impatient with my clients or lose my temper, it's my job to make my clients happy)
  • What is a mistake? What do I mean when I say I've made a mistake?
  • What kinds of mistakes concern me most (i.e., verbal, musical, interpersonal, procedural, ethical)?
  • How do I handle it when I make a mistake? Do I acknowledge that I've made a mistake? Do I even recognize when I've made a mistake?
  • How have mistakes I've made affected the therapy relationship?
  • What am I modeling for my client(s) when I make a mistake? (i.e., do I address it directly, do I deny that I made a mistake, do I apologize for the mistake?)
  • What are my fears in terms of making a mistake? What are my fantasies of what could happen if I make a mistake?
  • What might my clients think if I make a mistake? (In other words, what is my fantasy of what my client(s) (will) think(s)?) How do I believe my colleagues would react?

What if making mistakes not only isn’t the end of the world
but actually helps the therapy process?

o    Look at why a particular mistake is being made.  Do I have a pattern of making the same mistake?  (i.e., forgetting someone’s name all the time) What might that mistake be about?
o    Is my mistake related to countertransference (i.e., a client reminds me of my mother) or is it more related to the client (i.e., a lot of people in this client’s life find themselves making this “mistake” with or reacting in a particular way to him/her)?
o    What was going on in the session when this mistake occurred?  How was I feeling about the client(s)?  About how the session was going?  What made me respond in the particular way that I chose?
o    Did I have an expectation—about myself, about my client, or about the therapy—that I wasn’t aware of initially?
o    How can I use an awareness of my mistakes to further develop the therapy relationship?
o    What does it mean to me to be a “good enough” therapist?


Resources for Further Reading
Bruscia, K. (Ed.) (1998). The dynamics of music psychotherapy.  Gilsum, NH:  Barcelona Publishers.
Casement, P.  (2002).  Learning from our mistakes:  Beyond dogma in psychoanalysis and psychotherapy. New York:  The Guilford Press.
Casement, P. (1991).  Learning from the patient.  New York:  The Guilford Press.
Chodron, P. (2002).  Comfortable with uncertainty:  108 Teachings.  Boston:  Shambhala .
Dileo, C. (2000).  Ethical thinking in music therapy.  Cherry Hill, NJ:  Jeffrey Books.
Epstein, M. (1998).  Going to pieces without falling apart:  A Buddhist perspective on wholeness:  Lessons from meditation and psychotherapy.            New York:  Broadway Books.
Figley, C. R. (Ed.)            (1995)            Compassion fatigue:  Coping with secondary traumatic stress disorder in those who treat the traumatized (Brunner/Mazel Psychosocial Stress Series). New York:  Brunner/Mazel.
Forinash, M. (Ed.) (2001).  Music therapy supervision.  Gilsum, NH:  Barcelona Publishers.
Gabbard, G. O. & Lester, E. P. (1995).  Boundaries and boundary violations in psychoanalysis.  New York:  Basic Books.
Hutto, B.  (2001).  Some lessons best learned from psychotherapy supervision.  Retrieved: 2/4/06 from http://www.psychiatrictimes.com/p010753.html.
Kottler, J. A. (2003).  On being a therapist (Third Edition).  San Francisco, CA:  Jossey-Bass.
Kottler, J. A. & Carlson, J.  (2003).  Bad therapy:  Master therapists share their worst failures.  New York:  Brunner-Routledge.
Lovett, H.  (1996).  Learning to listen:  Positive approaches and people with difficult behavior.  London:  Jessica Kingsley.
Mayeroff, M. (1971).  On caring.  New York:  Harper & Row.
Misch, D. A. (2000).  “Great expectations:  Mistaken beliefs of beginning psychodynamic psychotherapists”. American Journal of Psychotherapy, (54)2; 172-203.
Pope, K. S., Sonne, J. L. & Holroyd, J. (1993).  Sexual feelings in psychotherapy:  Explorations for therapists and therapists-in-training.  Washington, D.C.: American Psychological Association.
Saakvitne, K. W. & Pearlman, L. A. (1996).  Transforming the pain:  A workbook on vicarious traumatization. New York:  W. W. Norton.
Schlesinger, H. J.  (2005).  Endings and beginnings:  On terminating psychotherapy and psychoanalysis            Hillsdale, NJ:  The Analytic Press.
Skovholt, T. H. (2001).  The resilient practitioner:  Burnout prevention and self care strategies for counselors, therapists, teachers, and health professionals.            Needham Heights, MA:  Allyn & Bacon.
Van der Klift, E. & Kunc, N.  (1994).  Hell-bent on helping:  Benevolence, friendship, and the politics of help Retrieved 9/23/05 from http://www.normemma.com/arhellbe.htm.
Weinberg, G.  (1996).  The heart of psychotherapy:  A journey into the mind and office of the therapist at work. New York:  St. Martin's Griffin.
Yalom, I. D.  (2002).  The gift of therapy:  An open letter to a new generation of therapists and their patients. New York:  Harper Collins.
Yalom, I. D.  (1989). Love's executioner and other tales of psychotherapy.  New York:  Harper Collins.























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