Tuesday, November 29, 2011

A musical portrait

Together We AreImage by mommy peace via FlickrAt first I thought he was angry with me. He certainly looked quite solemn. True, I'd been away for a couple of weeks, but usually he's at least willing to stand up and go to the Music Room with me. 

So I pulled up a chair and sat next to him. "You don't want to go to your session?" I asked. He hung his head down. "Okay. Can I just sit with you for a little bit?" He looked up briefly and then face down again. 

We sat for a minute. "You can come and tell me in the music if you're upset about something." He was listening, but not moving. "You know, I'm going to just go get your jacket and hold on to it. If you still don't want to come with me that's fine. But if you do, we'll have your jacket. I don't know. Maybe we could just go for a walk. It's pretty nice outside." 

I went to the coat closet, fished out his, and went back to sit next to him. The guys in his group were all watching television, so I chatted about that. After a little while, he half-smiled, got up and reached for his jacket.  "Cool!"

We headed outside into the sunshine and walked slowly. I wasn't sure whether we were just walking or if we'd be going to do his session.  As it turned out, we made it to the Music Room. 

He moved the instruments I'd put out for him onto the bench at the end of the couch and proceeded to lie down so he was facing me where I was sitting at the piano. I could hear, from the way he was breathing, that his sinuses were really giving him a hard time. 

His facial expression was still quite serious, unsmiling. I sang a greeting and asked how he was feeling. He responded with a heavy sigh.

"I realize you may have some feelings about my having been on vacation. I wonder if maybe you're feeling angry with me." And I invited him to look my way if that was the case. He did not.

Oh. Hm.

"Feeling abandoned?" A little bit of eye-contact.

We stayed there, quiet. Where to go with this?

"I'm having a hard time figuring out what might be going on for you today. I'd like to play a musical portrait of what I think I might be seeing or hearing, maybe just sensing, from you right now. If you can, will you help me by letting me know if what I'm playing makes sense. Also if it doesn't sound right, can you find a way to steer me in the right direction? I'll do my best to listen."

I played, using the piano. It was halting, dissonant- really quite dissonant, and it didn't feel very grounded. I guess you could say it sounded like someone floating and unsettled. 

As I played, I realized I hadn't "heard" his initial response accurately. He wasn't angry. The music he inspired didn't sound remotely angry. It sounded, and felt, very sad. And it probably wasn't really about me. 

"I misunderstood. I'm sorry. I think, as I'm listening to the music, I might be hearing your sadness." Slowly he turned to face me. Wow. I felt his sadness too.

What now? Where to go with all this sadness? 

As I thought about how to respond, how to be present, I was reminded of my friend, Greg, who often quotes John McNeill to me: "If anyone is willing to enter my private hell and stay there with me, then there are grounds for hope."

I invited him to hum with me as I played. I started the music where I had left off- at the musical portrait. Gradually, the sounds on the piano became slightly- only slightly- more consonant. Eventually, I was just moving between A flat and B flat, humming quietly. 

I heard sounds from him- not a lot, because it was difficult to vocalize with his nose all stuffy as it was. I moved from humming to a quiet "ee" sound, thinking it might be an easier sound for him to make.

His eyes closed and he smiled briefly. I thought he might fall asleep, as he often does. But he didn't. He listened. And we sat together in the sadness and in the music.

It was time to go. I sang a quiet goodbye, reminding him I planned to be back on Thursday. I got up to get my sweater, and he followed me to get his jacket.

He took my hand and we walked back to his cottage in the sunshine. 

Sunday, November 27, 2011

Behavior? Or unanswered question?

4D-RCS control loop basic internal structure.Image via Wikipedia
For at least the twelfth time in the last few years, I sat in a session today with one of my (many) clients who doesn't use speech, asking him if he might put his thoughts and reactions to the fact that we hadn't seen each other in two weeks (because I was away at the music therapy conference) into the music, and I was struck by the thought, "Geez, what if he has questions that he wants me to answer?"

I don't know whether anyone else ever wonders about this, so I'm throwing it out into the blogosphere, because it bugs me. 

All of us have questions, and when we're little kids we have about a million of them! And we ask our parents (and aunts and uncles, and any adult person, frankly) at least nine hundred thousand of the many gazilions of questions that happen to come into our excited little curious minds.

But...my clients who don't use speech can't do that! And who's to say they don't have a million questions of their own? Yet, how do you ask all your questions when talking isn't your thing?

So, as I've given this some thought, my theory is that the folks I work for are sort of forced to come up with other ways to get their questions answered. And those ways may involve doing some unusual things- maybe we could call them experiments- although more likely we call them "behaviors"- which often seems to imply "doing something that someone finds aversive, offensive or annoying and must attempt to stop".


Well, what if those "behaviors" and unexpected and odd things that this person is doing are really about asking questions that s/he needs to have answered? And what if instead of listening and collaborating to try to help figure out the question/answer, we're focusing on the fact that the "behavior" must go? 

Thursday, November 24, 2011


On this quiet Thanksgiving day, it seems right to reflect on the many aspects of being a music therapist for which I'm grateful. 

Since I've just returned from a trip to Atlanta where I participated in the national music therapy conference, it's one of the things that's very  much on my mind (oops! That was very "Georgia On My Mind" there, wasn't it?). To that end, I'm sending out a big thank you to all the folks at the American Music Therapy Association (AMTA) as well as the conference chair-people and numerous volunteers for the huge amount of work that went into putting together a conference of this size! It was a great conference, and I truly enjoyed being there.

I'm also appreciative of the fact that I had the opportunity to meet many of the large collection of music therapists I've gotten to know through their blogs, tweets and list-serv postings in person. Even though I've been a part of this field for quite a long time, it was a comfort to be a part of an already existing online community, many of whom would be at the conference.  Now I can imagine all of your faces and voices as I read your online thoughts! Yay!

A particularly cool element of all that was having the opportunity to be a participant in a social media as music therapy advocacy tool panel, conceived by Kimberly Sena Moore, and joined by Michelle Erfurt, Michelle Strutzel, Matt Logan, Kat Fulton, Sarah Sendlbeck, Meryl Brown, Rachel Rambach, and Bill Matney. What a joy to be with this articulate and energetic group of professionals!

The renegade jam session (for those of us who can not function after 11 PM) was a lot of fun, and we sang and played our collective hearts out in a quieter corner of the giant hotel. 

As I gradually transition back to my usual hectic schedule (not to be confused with the completely crazy conference schedule! Yow!), I extend gratitude for the fact that I have a job and work with clients who, even after almost 24 years, challenge me to learn and grow and get better at serving them. And nowadays I get to add my supervisees to the list of folks who help me think and invite me to push the limits of my knowledge.

My co-workers at the developmental center also inspire my appreciation. We have struggled together to understand what might be going on when our clients try to convey their distress. At times we've sung and laughed and  at times we've cried together. We don't have an easy job, and, at this point, I don't think we'd really want one.

I'm thankful for the happiness that comes with playing music (either by myself or with other like-minded folks), and when people say, "wow, you're really lucky," I have to say, "Yes! Yes, I am!" 

Happy Thanksgiving to you all. May you also feel lucky and fulfilled in your chosen profession!

Friday, November 11, 2011

Going South!

I know, I  know, where the heck have I been?! 

I'll tell you, it's been busy around here. Mostly, though, I've been preparing to present a five-hour CMTE at the national conference for music therapy in Atlanta next week! I haven't been able to attend a national conference in a few years now (not since 2006 when it was in Kansas City, MO!), so I must shout "hooray" that I'm finally able to go again (meaning, it's within driving distance). 

What will I be talking about (you may well be wondering)? "Developing the Art of Self-Reflection: Exploring the Relationship Between Therapists and Clients" (I mean, how would you recognize me if I didn't have a ridiculously long title?). 

I'm quite excited about it! From what I gather, so far anyway, there will be around ten people there, and that sounds like a very nicely sized group (although I imagine we could work just as well with a few more). I'm planning for a lot of interaction, music-making, and thinking (truly...who wants to sit for five straight hours and listen to me lecture? Well, lucky for you, I can't sit for that long these days). 

Anyway, here's the blurb. If you have any thoughts about the topic, do tell! If you end up coming to the presentation, I'm a fan of feedback!  I'm so looking forward to meeting those of you who are heading down to the conference (especially the lot of you I only know through online adventures). Safe travels!

Developing the Art of Self-Reflection: 
Exploring the Relationship Between Therapists and Clients

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. One 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 and 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.