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?


Rachelle Norman said...

Wow, what a great session! Thank you for explaining your thought process in the musical choices you made as the therapist. So much goes on that may not be readily apparent to the outside observer.

I always look forward to your posts, Roia. Thank you for this one!

Roia said...

Thanks for stopping by to read, Rachelle. It really was a nifty experience, and, you're right- there is so much that is going on in a session that isn't visible. I'm not sure whether it's necessarily to our advantage that we make it look "easy" especially because it really isn't. :-)

Anonymous said...

Roia, this was great to read. I like how you use as little or disguise the identifying information to protect the patient. In terms of treatment, thanks for the reminder that songs can be powerful ways to articulate transference and countertransference with a patient. Great blog post!

Roia said...

@Mike Thanks kindly for taking the time to comment. I think one of the (many) nice aspects of being a music therapist is that we think in music (if that makes any sense). It is so interesting to me to notice the various songs that pop into my head while I'm working with a particular person. Of course, it adds to the ton of information we need to process as therapists, but it is particularly useful when working with people who don't use speech as their primary communication mode.