Sunday, June 12, 2011

Holding on to our clients' stuff

I seem to be slowly amassing a little pile of stuff from RD (the young man who makes sure I take a little bit of his space along with me when I leave his cottage). 

FIrst it was the purple battery cover for something along with the red disc-ish thing. 

Then, a couple of weeks ago, I had to ask one of the other music therapists (who also works in that cottage) to take back the two air hockey strikers that he'd put in my instrument box . I figured they'd need them if anyone wanted to play air hockey. (Uh-oh, I think I just realized what that red disc-ish thing is- it's probably the puck! Oops! Guess I'd better get that back to the cottage as well. The strikers aren't going to be of much use if there's nothing to strike. Ulk.)

Then last Saturday he put in two dominoes, and today it was a big yellow wooden bead.

Today he used the cabasa and the kalimba, and he put them back in the instrument box (not under the couch or on top of a very high cupboard) (thank God). 

I'm excited to say his sessions are lasting the full forty-five minutes these days (as opposed to ending abruptly after a few minutes, which was the case for quite a while). I think acknowledging his need to know what to expect and saying out loud that I don't tend to tell people what to do in music therapy (unless some specific limit needs to be set) really helped him. Ironically, I think it let him know, well, what to expect. Now he doesn't seem to feel as anxious when he comes to his sessions. 

I mentioned, again, to RD I thought it was interesting to keep finding little objects from his space tucked away in mine. And I asked if maybe it was because a part of him was concerned as to whether or not I'd remember him when we ended the session. 

True, there wasn't any earth-shatteringly clear response or anything, but I figure if I keep commenting about it and pondering the situation with him, letting him know I'm curious and want to understand him better...he'll find a way to tell me what he needs me to know. 

Tuesday, June 7, 2011

Music and countertransference

If you're a person who has been reading this blog, then you know I make liberal use of songs that emerge as a part of music therapy sessions (a couple of other examples can be found here and here). The way I think of these countertransference songs is as a form of unconscious communication that's going on between therapist and client- the stuff that's not being said.

Obviously, since the vast majority of my clients don't use speech, it would stand to reason that these songs are a particularly helpful (and necessary) aspect of the work. 

So, I've been thinking a lot about one of my clients who has been falling asleep in his sessions lately. He gets tired from his medications, I think, but he also doesn't tend to sleep particularly well (a lot of my clients don't). 

At any rate, it seemed to me as if there was more to it than just being tired (I'll explain in a second). I mean, sometimes he'd look fairly wakeful, want to come for his session, get to the room, go lie on the couch (I know, I know, how Freudian can you get?) and suddenly he was exhausted. 

Hey, man. I know how it goes. I've been there before when there's stuff I'm having a hard time looking at- I start journaling about some difficult issue, and suddenly...I need a nap. I get it.

Anyway, here's something that completely fascinated me about our sessions: for the longest time, whenever I played an improvisation in his sessions, I'd think, "Wow! That was gorgeous! I must write down some of those chords, because they'd be great to play around with when I'm writing a song!" And I'd quickly write down the chords, and then, after the session, I'd play them, and what the hey? They never sounded quite the same after my client left. They were nice, but there was something...missing, and it just...didn't sound right. 

After a while of this unusual musical situation happening over and over and over (hey- these things take time!) I started to wonder, "What is this about? Why the heck is this happening?" And I realized this was some kind of countertransference, so I started to talk about it with my client, trying to enlist his assistance in figuring out what he might be needing me to hear (through the music that was only beautiful during our sessions but never afterward). 

I've spent the last couple of months with the following working hypotheses: 
1) Maybe he feels like he has to put on a nice, happy face because somehow he's gotten the idea that this is what people in his life want from him (can't imagine where he could possibly have gotten that message).

2) Maybe he only feels as if he's "beautiful" when he's in music therapy.

Of course, I could be wrong about all of it, but these are what I started working with and bringing up in sessions. So, I started talking about this with him. And the more I talked about this, the more he'd get to snoozing! 

Think I hit a nerve? I think so.

As you can imagine, he and I have been stumbling along now, and somewhere back in May, we were in a session together, and I suddenly heard the lyrics of this song (Joni Mitchell's "Trouble Child") enter my mind. And, as always, as I mentally sang through the song, I thought, "Hunh! This is worth giving a joint listen." 

Interestingly, it's taken a while for us to actually get through the whole song in a session (did I mention he keeps falling asleep?). And as soon as I share the lyrics with you, you'll see why. 

[I debated whether to use my version of the song or the original, and I opted for mine- but linked Joni's version- because it's about the therapy and the use of songs to have a deeper understanding of our clients. I'd add a lot of disclaimers, but they're not going to be of much  use to any of us, so here it is. I had to cut out all of my blabbering because I talked for too long, so that's why it sounds as if I started in mid-sentence.]

Trouble Child
(Words and Music by Joni Mitchell, Copyright 1973 and 1974 Crazy Crow Music)

Up in the sterilized room where they let you be lazy,
Knowin' your attitude's all wrong, and you gotta change and it's not easy.
Dragon's shinin' with all values known,
Dazzlin' you, keepin' you from your own,
Where is the lion in you to defy him when you're this weak and this spacey?

So what are you gonna do about it, you can't live life, and you can't leave it.
Advice and religion you can't take it, you can't seem to believe it.
The peacock is afraid to parade, you're under the thumb of a maid.
And you really can't give love in this condition, still you know how you need it.

They open and close you, then they talk like they know you, they don't know you.
They're friends and they're foes too, 
Trouble child, breakin' like the waves at Malibu.

So why does it come as such a shock to know you really have no one,
Only a river of changin' faces lookin' for an ocean.
They trickle through your leaky plans, 
Another dream over the dam,
And you're lyin' in some room feelin' like your right to be human is goin' over too.

But some are gonna knock you and some'll try and clock you,
You know, it's really hard to talk sense to you,
Trouble child, breakin' like the waves at Malibu.

Okay. First of all, Joni Mitchell is...brilliant! (By the way, go and listen to her singing this song. I seriously don't do it justice.) Second, oh my God! Look. At. These. Lyrics! The experience of a man living in an institution? With a serious reputation for having been a major bad-ass in his younger days? 

I can't say it enough times- I marvel, again and again, at the amazing ways we human beings find to communicate with each other!