Tuesday, March 15, 2011

In case you were wondering...

...why it's taken me so long to post new blogs, it's because I've been working away at preparing for two workshops, including another five-hour continuing education presentation, at the Mid-Atlantic Regional conference of the American Music Therapy Association

Actually, it all started when I was asked to talk about taboo topics again (who'd have thought?), so I decided to split it up and do one version for students and one for professional music therapists. 

Here's where I was hoping to head with the student version ("Taboo Topics in Music Therapy: What They Didn't Mention in School"):

Music therapy training often focuses on helping students to develop techniques and skills in order to support clients’ goals and objectives. It is only when we begin to work, first in field experiences, then in internships and eventually professionally, that we realize there are some topics that weren’t really addressed in our training. How on earth do we deal with clients who masturbate openly in the middle of music therapy sessions? What is the appropriate professional way to work with a client who has a crush on us? What if we are sexually attracted to one of our clients? How do we manage and come to terms with being a music therapist when we are coping with our own mental illness?  What is the best course of action when we are dealing with a client who pushes all of our buttons?

These are the kinds of questions student music therapists ask themselves every day, and the answers aren’t always readily available in journals, conferences, in listserv discussions, or even in life.

As therapists we are taught: what we repress we project. Without a safe space within which to bring up such topics, and without support and guidance from mentors, clinical supervisors or peers, music therapists run the risk of acting out their shame and discomfort. This can lead to burnout or, worse, unethical behavior.

The focus of this participatory workshop will be on providing a forum for student music therapists to give voice to their experiences and to have their concerns validated. This year we will dig a little deeper into why these issues aren’t being talked about and try to come up with some constructive ways we can use to figure out how to get the support we need to address the difficult topics.

The five-hour workshop will be a bit more intense (as it ought to be), and it's geared (of course) to professional music therapists. I don't know about you folks, but remember when I asked what your thoughts were about doing a follow-up workshop? Well, as I looked over "The List (So Far)" I realized that out of 33 items, something like thirty of them (seriously! Thirty!) were related to the therapy relationship in some way, shape, or form!


I decided to go for it and do a CMTE (yes, a whole five hours) where we get to look at the therapy relationship (this one is called "Taboo Topics in Music Therapy: The Intimate Connection Between Therapists and Clients"). Here's the plan of action for the workshop:

The relationship between therapists and their clients is an intimate one. When we add music, the level of intimacy increases. As with any relationship, as the level of intimacy increases, the levels of resistance, uncertainty, and investment also increase- on both the therapist’s part as well as that of the client. On the one hand we may put up unconscious barriers, preventing a deeper connection with our clients. On the other, we may become so merged as to be in danger of violating important therapeutic boundaries. As such, the  music therapy relationship can become difficult to negotiate.

In this interactive workshop we will begin by defining countertransference. Using case examples, we will work toward an understanding of: What is it? Where does it come from? How does it affect therapy? How do we begin to identify and use countertransference in our work with clients?

Participants will then be invited to share some of the difficult aspects from their own work with particular clients that challenge them in some way. Through dialogue, journaling and music-making we will process and explore some of the following questions: What are some of the ways we use to avoid looking more deeply at some of the clinical challenges we face as professional music therapists? What are some of the beliefs and ideas we, consciously or unconsciously, hold about ourselves, about music therapy, about our clients? And how do these ideas and beliefs affect our work and our clients? Why are certain topics so difficult to bring up in sessions- even if we know our clients need us to do so? What is it about the topics? What is it about our beliefs, ideas that makes it scary? What kinds of messages are being communicated by us to our clients when we don’t address difficult issues?

Through these workshop experiences, participants will work toward developing the skill of self-reflection, using a variety of techniques to process thoughts and reactions that emerge in relationship to their clients. 

But I'm wondering if maybe this topic is too taboo. So far I've only got three people signed up (and it's happening in a little over two weeks). When I consulted with a psychiatrist friend to ask her if she thought I ought to cancel if our group was so small she (wisely, I think) pointed out that doing so would convey to people that the subject should and would remain a taboo- never to be looked at by music therapists. 

So, I'm kind of thinking I'd like to go for it. A small but mighty little group can do amazing things, I imagine. 

I'd be curious to hear if you folks out in blog-reading land have any thoughts about this. Do you think I ought to cancel the whole schmear? Might this topic actually be a little too close to home for people? 

Saturday, March 5, 2011

The Act(ion) of Thinking

Epoch Action FiguresImage via WikipediaI've been thinking about RD of late (well, particularly today, because we had a session this morning). 

RD is a very sweet young man on the autism spectrum (he does not use speech to communicate), and he is very particular about things. And by this I mean that he seems to believe that all things should have a place (I think I can thank one of his family members for his excellent manners and his tidy nature.)

It so happens, that we work in a terrifically messy room in his cottage (oddly enough, it's the, um, "sensory room") (yes) (well). 


No matter how much I try to clean up all the clutter in the place before I go and pick him up for his session, he still finds things to, er, tidy. 

He also likes checking out all kinds of objects. He has a collection of action figures with giant feet (I don't want to know!), and his staff people find him books and various things that have moving parts to them. He keeps them all in a big box with his picture on the front. Great! 

So. Back to the aforementioned "sensory room"...

Because this is, apparently, a full service sensory room, there are almost always broken battery-operated sorts of things lying around in varying states of function and dysfunction. This means that the batteries are lying around (lovely), and the little parts that keep the batteries quietly tucked inside the gadgets are also roaming about freely.

RD, being the tidying kind of guy he is, and being the kind of person who likes to bond with objects, has been picking up these little plastic parts that were supposed to hold in batteries. He just turns them over and over in his fingers and holds them close to his face so he can examine them.

While he's doing that, he sings. He hums little melodies (I've come to learn that he repeats specific melodies with small variations here and there). I either sing them back to him or play them on the guitar (with my own variations and chords). And while he's scurrying about the room arranging things, we sing and play back and forth with each other. 

The other thing you need to know is that, when he borrows an instrument from me (to check out as described) he often puts it back in the closet that's in the sensory room. As such, I have to go and retrieve the instrument quickly because otherwise it'll be there for all eternity (I have reached the official limit on my brain's memory card, and, let's face it: some things are just going to have to go!). 

Now, not only does he take my stuff and put it in the cottage closet, but he puts stuff he picks up in the cottage on my music cart or in my instrument bag. I am forever pulling things out of my bags (after his session) and putting them back in the room (back in circulation, as it were).


So, as I mentioned above, I was thinking about RD, and I was wondering: why does he keep putting cottage things in my bags? And why does he keep putting my stuff in the sensory room closet? What's that about? Is there something he might want me to know? Or that I should be noticing about this?

And I thought, hm. So I mentioned to him during his session that maybe he needs to have me hold on to a small piece of him when I go (i.e., don't forget me, please). And maybe putting my stuff in the cottage closet is a way for him to keep a piece of me as well. 

When I gave it some more consideration, it occurred to me, again, that here's a guy who likes everything to have its own place- whether it's the "right" place or the "wrong" place. And I remembered that he himself grew up in a few different places, being sent around to various family members, because his mother died when he was an infant. 

And now here he is with us, in an institution.  

And it made me think about objects. And about having a place to be. And I wondered (out loud to him) if maybe it was important to him that he have a specific place to be. And what his thoughts are about being in the "right" place or the "wrong" place. And which one he feels the institution might be.

RD's response was to increase his singing. He and I sang back and forth for ten more minutes than usual today (we usually make it for 20 minutes, but today it was 30!) before he hopped up and began pulling the guitar off of me to indicate that we were finished.

So, I'm thinking this is veeeery cool. 

Definitely warrants some more thinking...