Tuesday, July 12, 2011

Journal Prompt #4- Uncertainty

I don't knowImage by cowbite via FlickrOne of the hardest aspects of being a music therapist, at least for me, has been working to come to terms with the experience of uncertainty as I work with clients. I'm sure this won't come as a surprise to you, because I've written about it a number of times (here, here, and here- to name a few).

I think part of what makes it difficult to sit with the sense of "um, I'm not sure what's going on here" is this mythology we tend to buy into as music therapists (I guess as any kind of therapists, really) that tells us "you must always know what's going on with your clients and have the perfect intervention and/or response to address it."   

Even after doing this for 24 years, there's still a nagging sense of "I should know" in the back of my mind- even though I know (intellectually anyway) that I don't have to know, and even though I'm well aware my clients aren't always ready for me to know (or aren't ready to know for themselves), and even though I realize it's just a matter of sitting with the feeling and trusting the process.  

I understand that some of my uncertainty comes from the fact that I work with people who don't use the usual means of communication or ways of relating to people. Using a process-oriented approach (and not a product-oriented one) also increases the likelihood that I won't always know what's going on in my sessions. 

And, really, I'm okay with all of that. I'm just...very aware (shall we say) of a feeling of "hmm" when I'm faced with a situation and I'm not sure how to proceed. 

So, lovely readers, I invite you to join me in looking at this part of our work as you journal.

-Do you allow for a bit of uncertainty as a part of your music therapy practice? If you do, in what ways? If you don't, why not? 

-How do you approach uncertainty when it comes up in your work as a music therapist? Do you power through it on your own? Do you seek supervision or consultation? What kinds of questions do you ask yourself?

-How do your beliefs about what it means to be a "good music therapist" affect the way you deal with uncertainty? What does it mean about you, about your abilities as a music therapist, about how people might view the field of music therapy to "not know" what to do or how to approach a therapy situation? 

-What if the "perfect" song or intervention isn't coming to you and you're in the middle of a session? 

-What are some of the things you're doing in your music therapy practice that help you avoid the experience of uncertainty? How does that affect the therapy relationship? What might you be communicating to your clients?

I'd love to hear your thoughts about uncertainty (written out, sung, played as a piece of music, acted out as a play, whatever works for you), so please share them freely. 


Dr. Dori said...

The nature of music improvisation as treatment is amorphous and thus, in itself, "undertain". There is always uncertainty in people-to-people professions - law, medicine. Are you saying you don't trust your instincts? The problem really beings with YOU (me, others, etc), and what you're feeling in the moment. This is not "me" and "them" but "us", so your uncertainty will generate outward, which is not something you want.

In such moments, you have to 'heal thyself' in order to heal others, so follow your instincts and don't look for self-blame. Maybe that's the "good clinician" inside of all of us. There will be a next time.

Roia said...

@Dr. Dori Thanks for sharing your thoughts. I certainly didn't mean to imply that I don't trust my instincts in my work- I do. I think my hope was more to share the experiences I've gone through to demonstrate what I mean when I'm talking about uncertainty.

You're quite right- any relationship involves some element of uncertainty. My sense is that a clinician's level of comfort regarding knowing/not knowing informs the therapeutic approach one chooses as well.

And definitely agreed that we need to know how our own comfort/discomfort affects the therapy process.

Thanks for swinging by!

Dr. Dori said...

My pleasure. I think you realized that my work "undertain" was a typo and supposed to be "uncertain". Old age is getting to me, I guess. Or the heat!!

Karla said...

Although I'm not a music therapist yet, I know exactly what you're talking about in this article. I'm a writing tutor at my school's writing center, and we get a lot of ESL students who come in for help. Depending on the student's level of proficiency with English, sometimes he/she can express what he doesn't understand and sometimes he/she can't. It's very difficult in situations of the latter kind.

I actually had a student this semester that seemed to understand what I was saying, but really didn't at all. We had a session once a week for three months and a little bit, and he was improving. He seemed to comprehend what was going on, but then he handed in his tutor evaluation form at the end, gave me a terrible review, and wrote in caplocks in the comment section "TUTOR MUST SPEAK SLOWER. WE COME HERE BECAUSE WE DO NOT KNOW ENGLISH." That was upsetting, but I've been trying to talk slower and check in with my students if they definitely understand what I'm explaining since I got got that evaluation.

Uncertainty must be that much more difficult with non-verbal clients who can't tell you when you're wrong, as opposed to my student, who clearly was able to and chose to do so at the end of the semester when we wouldn't be seeing each other again anyway.

Roia said...

Ouch! Thanks for sharing what had to be a totally uncomfortable situation, Karla! Sometimes you just have to do what you're doing and hope people are going to let you know when you're blowing it. I, too, have learned to check in frequently and make sure people have a way to let me know, "Um, Roia...that's not it."