Taboo Topics in Music Therapy- Part III- The List (so far)

Here's a list of taboo topics I generated. I found I had to keep adding to it as I went along. I also included many of the offerings of the conference participants. Feel free to comment and add your own. I dare say there are quite a few taboos to be found in music therapy as yet. 

Taboos (I have known and loved)

1. Sexual feelings and/or arousal

a. for clients

b. dreams about clients

c. our clients feelings about us

2. Fantasies

a. that we will be the one person who makes a difference in our clients’ lives (or that we are the be-all and end-all in their lives)

b. sexual fantasies

c. fantasies of taking clients home and taking care of them, also known as “rescue fantasies”

d. dreaming about clients

3. Mistakes on the part of the music therapist

4. Fee disasters/money/financial transactions

5. Hatred for/anger toward a patient

a. hating a patient’s music

b. clients who are hurting/frustrating us

6. Getting sick and not being able to do your job for a while

a. can include mental illness as well as physical (i.e., needing to take a break from work)

b. music therapists who have mental illness

c. fear of getting sick when working with clients who have communicable diseases

7. Feelings of incompetence

a. not knowing what to do in a session

b. feeling lost

c. feeling uncertain musically

8. Feeling that we need to be all-knowing, all loving (a.k.a. “Music Therapist Syndrome”- the belief that we must always be nice and cheerful, and that it is our job to make our clients feel better, and that we should never be “mean” and confront them or push them in any way or to talk about “sad” subjects.

9. Feeling bored or tired/sleepy during sessions

10. Clients who gross us out or offend us

11. Therapist’s fears/terrors

12. Therapist’s personal issues around shame/guilt

a. May include therapist’s own abuse history

13. Being fired

14. Issues with staff/co-workers/clients’ families

a. having to report staff/clients’ families for abuse/neglect/etc.

b. fears of retaliation should we report abuse

c. dealings with staff regarding clients (having differences of opinion)

d. staff undermining our efforts as therapists

15. Being uncomfortable with the system within which we work

a. disagreeing with the way client services are provided

b. having to represent a facility we don’t always feel comfortable with

16. Boundary violations

a. treating clients or their families as friends

b. hugging/touching clients as a matter of course

c. violating client confidentiality

17. Guilt over terminating/guilt over not terminating

a. “I should have tried harder.”

b. not working on closure

c. difficult endings

d. ending because we don’t know what else to do

18. Fear of violent clients or those who act out in other ways

a. constant anxiety when having to go and work with a particular client

19. Clients who fall asleep in sessions

a. leading to fear that we are inept or ineffective therapists

b. that we’re doing something wrong or boring

20. Having favorites

a. when we admit it we’re less likely to act on it than if we deny it.

b. also the belief that we have to love all of our clients

21. Fear that a client may commit suicide

a. along with the fear that we will miss the warning signs and it will be our fault

b. and the corresponding fantasy that we will be the one to save this client

22. Being in the role of “helper”

a. discomfort with being in the role of ‘helper’

b. not being aware of the power difference between client/therapist

23. Seeing clients as more disabled than they are

a. sometimes leads to an attitude that “they don’t understand what we’re doing, so it won’t hurt them” (this is the kind of belief that can lead to situations like the one with Corey Brown, the music therapist who molested his clients)

24. Working with someone your own age

a. Or working with someone you’ve known in a different context (including survivor guilt)

25. Running into clients outside of the therapy context

a. Clients who want to connect through various online social networks

b. Clients asking for sex/marriage/personal phone numbers

c. Clients who grope themselves/who try to grope the music therapist

26. Clients who are better musicians than we are

27. The myth of music as a “non-threatening” medium

28. Guilt over privilege

29. Assuming our clients are heterosexual, or identify as a particular gender

30. Hating a particular style of music and/or refusing to learn or play a particular style in music therapy sessions

31. Clients dying or getting seriously ill (sometimes in the middle of a session)

32. Racism, sexism, able-ism, heterosexism (in all of their infinite varieties and forms)

33. Music therapists who do not dress in a professional manner (i.e., whose dress is seductive or overly casual)

Why we don’t talk about these things (some of these reasons are taboos in and of themselves, I would say):

• We don’t always know the answer
• We don’t want to look unprofessional/bad
• Ashamed/embarrassed/fear of being blamed
• Music therapy students who are over-protected/over-directed
• Not always recognizing countertransference
• Helplessness
• Not wanting to deal with repercussions
• Competition between colleagues
• Not having a supervisor/mentor/safe resource
• The need to constantly “prove” that music therapy is a valid therapy
• Wanting to be a good example
• Diminishing the impact of an issue (i.e., making light of a difficult topic)
• Fear of being seen as a fake/incompetent

  

"I need to be still"

Today, at a little after 5 PM, Mn died. 

I met Mn back in 1988 when I started working at the developmental center. She was a teeny little woman who didn't use speech. When she was feeling better (she died of cancer), she used to come and sit on my music book while I was playing music in her group. It always made me chuckle.

Mn was surrounded by Mg, Ib, Dn, the nurse who turned off her vent, and me. 

The nurse and chaplain at the hospital told us to let them know when we were ready, and they would ask us to step outside while they removed the machines which were keeping her alive, and then we would be allowed to come back in and be with her as she died.

Before we called the nurse to disconnect her ventilator and prepare her, Mg, Ib, and Dn gathered around her, each holding her hand, rubbing her leg, and touching her long hair, crying. I sang:

I need to be stiIl and let God love me
I need to be still and let God love me
When this old world starts to push and shove me
I need to be still and let God love me

I need to relax and let God take over
I need to relax and let God take over
He'll take this load off my shoulders
I need to relax and let God take over

(Written by: Archie P. Jordan and Naomi Martin)

~~~~~~~~~~~~~~~~~~~~

We were all set to go back in the room when the nurse told us it was okay (we'd gotten rid of our dirty gowns and put on new ones in anticipation).  There was a lot of crying. Even the nurse was sniffing as she watched. 

I mostly stood at the foot of the bed, and I alternated between watching Mn take her last breaths and watching the machine register "0".  

It wasn't that I didn't want to touch Mn. It just seemed important that the people who had taken care of her should have the physical space they needed to say "goodbye". I knew I'd have room when it was time.

When everyone was finished and had begun to wash their hands, I moved closer to her. I took her left hand in mine, and I put my right hand gently on her forehead for a moment, and I wished her well on her journey.

We filed out, thanked the nurses, and left the Intensive Care Unit. 

I was struck by how little I cried, how honored I was to be present for her death, how humbling and quiet it all felt. 

As I drove home, I found myself feeling teary, but it was a gentle tearfulness. To Mn I offer James Dillet Freeman's beautiful "Prayer for Protection":

The light of God surrounds you

The love of God enfolds you

The power of God protects you

The presence of God watches over you

Wherever you are God is.

Death, Loss, Love

We held K's memorial service this past Wednesday.

His morning shift staff asked me to sing "I'll Fly Away", "Amazing Grace" and "The Wind Beneath My Wings". I made it through without crying, which surprised me, because the staff had put up a big collage of pictures of K.

At his service, I learned that K was abandoned by his family at a hospital when he was four months old. He was in his early 60s when he died. Wow. That's a long time to live in an institution.

Toward the end of the memorial, A, the minister said to us,

You're going to go about your daily business, and then some time, maybe in the coming weeks, maybe a couple of years from now, you're going to think of K. When you do, thank him. And remember him, not as a body and not in the form he took when he was alive. Remember him as his true self. As a spirit connected to you.

Yes, just as I remember R, I'll remember K. A lovely smiling spirit for whom I had the privilege of being music therapist.

"I'll Fly Away"

The last thing I remember about K is how worried I was about his health. He had been coming to music therapy and literally crying, "ow, ow, ow". I'd gone straight to the nurses and told them (again), "there's something very wrong with K. I've known him for 20 years, and this is not a sound I have ever heard him make." They assured me they were looking into it.

It was heart-breaking to listen to him. It was difficult to focus when I knew something was wrong. I felt powerless to help him and angry because I had been expressing concern about his health for at least a year.

When I got back to work last Wednesday after a week-long vacation, I heard he was in the Intensive Care Unit at the local hospital. I made plans to go and visit him on Thursday.  

It was too late.  K died Wednesday night.

Alone.

P, one of his regular support staff, also devastated, asked if I would sing the song "I'll Fly Away" for his memorial service. I didn't know the song, but I found the music and started to learn it.

***************************

D was a bit draggy when I went to pick him up for his session this past Saturday. But he got right up to come with me. 

As soon as we got to the Music Room he moved all the instruments off the couch and parked himself there, in a reclining position, facing me. 

He looked sort of glum as I sang a greeting to him, and we spent some time just breathing quietly together. D stared out the window, as he often does, and as I watched him, my mind started to sing, "I'll Fly Away".

I played it for him- painstakingly, since I had only barely begun to learn the song. It seemed to offer a powerful message for him.  He turned to look my way, and he listened intently as I sang.

Some glad morning when this life is o'er,
I'll fly away;
To a home on God's celestial shore,
I'll fly away.

[Chorus]
I'll fly away, Oh Glory
I'll fly away; 
When I die, Hallelujah, by and by,
I'll fly away.

When the shadows of this life have gone,
I'll fly away;
Like a bird from prison bars has flown,
I'll fly away

[Chorus]
I'll fly away, Oh Glory
I'll fly away; 
When I die, Hallelujah, by and by,
I'll fly away.

Just a few more weary days and then,
I'll fly away;
To a land where joy shall never end,
I'll fly away

[Chorus]
I'll fly away, Oh Glory
I'll fly away; 
When I die, Hallelujah, by and by,
I'll fly away.

(written in 1929 by Albert E. Brumley)

The best way I can think of to describe it is that it seemed as if D's eyes, gazing out the window, were singing this song.

A thought crossed my mind as I shared "I'll Fly Away" with D- a song I will be singing for K's memorial service in a couple of weeks. K taught me, as well as many of my practicum students, about being a music therapist (he was a part of the "Sick and Tired" crew I described in my last post). As a result of his death, I've now had occasion to learn this powerful song, and what's more, to share it with another of the people I support.

So, in a way, K remains present, and he continues to share his gift. 

I hope it's true for you, K, wherever you are...that "like a bird from prison bars [you have] flown" and that you're in a state of being in which "joy shall never end".

A visit to the cemetery

On my way to rehearsal last night, I decided to stop at the library.  Well, as it happened, the library had just closed, so I was too late.  While I was waiting to turn out of the library parking lot, it started to occur to me that R was buried in the cemetery across the street.  On a whim I pulled in to visit him.  I couldn't remember whether there was a gravestone, but I had some idea of where he was buried, because he's toward the back by the trees.  

I got out of my car and went to look at the gravestones.  No luck.  I noticed a little metal grave marker, and when I looked closely I saw his name on it.  Then I realized that someone who knew and loved him had placed a little metal smiling bee next to it to mark the space as belonging to R.  I started to cry, because I was very touched.  Back in February I wrote about how R used to come up to me and yell "BEE" at me and want me to yell "BEE" right back to him in his ear.  When he was younger, bees would sit gently on this man's finger- this man who, for a large portion of his life, yelled and slapped and kicked at people (often because he was likely in a lot of pain).  

Now he has a little smiling bee watching over him.  I think the other thing that made me cry was knowing that it meant someone else, probably from the institution, has been visiting him and is missing him. I don't know about anyone else, but I think it's comforting to know that, even when we mess up some things in this life, even if we yell and lash out at people because we're in pain of some sort (emotional, physical, spiritual) or we're scared- there's usually someone (or several someones) who still love us and will miss us when we die.  

The funeral

It’s not as if funerals are supposed to be great occasions.  But I went to R’s funeral this morning (which, I swear, lasted all of fifteen minutes) and I stood out in the extreme cold with his family and the staff who knew him, and it was...gosh, how to describe it?  Well, it felt completely heartless.  The minister didn’t know him, and he sounded downright triumphant while he talked about R being with God and how we weren’t there to honor R but to honor God. 

Now, I consider myself to be a pretty spiritual person (it’s kind of hard to do this work and not have some kind of spiritual belief, I think), but after about ten seconds of listening to this man, I wanted to loudly yell, “Hey, man!  WHO ARE YOU?  You just sit there quietly, and let us tell you who R was!  You just stop your blather about your fairy tale version of God and how happy we are to send R to him, and you let those of us who spent time with R in his life, who loved him, who cared about him, who walked with him, who got kicked by him and hit by him and still loved him, who are mad as hell that he’s dead...let US do the talking, Mr. Minister!”

When the hearse pulled up, I almost burst into tears.  R was in a gray coffin.  One of my co-workers helped carry him out.  I went to stand nearby, and I noticed his plot overlooked a little stream and a lot of trees.  I know how much he liked being outside, so I was happy to know his body would be lying in a pretty place (even though the highway noise was nearby- but he liked watching the cars on the highway when we sat outside and played music too, so maybe that was okay).  

Even though his family was there we didn’t get to talk to them.  It was good to see so many of his staff people there.  I don’t know how they felt about the service.  I was glad we’ll be doing our own memorial service soon.  To me, our services have a lot more meaning.  We play music, we share our memories, and we gather together at the end, and we chat with each other over snacks.  Some of the guys he lived with will also be there.  Hopefully his family will come to that service too.  Maybe then I can tell his mother that I had such a soft spot in my heart for him. 

I can tell her about the time that he smacked me repeatedly and I cried and told him that he had hurt me.  I wanted him to get that his actions had a consequence.  I told him we’d try again, but that it was going to take some doing for me to trust him or feel safe with him.  The next time I was in his cottage (I had a session with someone else the next day), I walked through his group area, and he got up and followed me to the other area.  He took my wrist and he guided my hand to smack at his face (I resisted, because I didn’t want to hurt him), and he stopped and waited, watching my face expectantly.  My immediate thought was that he was trying to ask for my forgiveness.  He understood he hurt me, felt badly about it, offered me the opportunity to “get him back” and wanted to know “are we okay now, Roia?”

I was so touched.  I smiled and said, “Thanks, R.  Yes, we’re okay, and I’ll be there on Friday for your session.”  Sigh.  Tomorrow is Friday...the day of R’s sessions.  I still have to go over to his cottage, because I get someone else from his group as well.  What a big hole he has left.

When I walked through his group area yesterday afternoon I noticed they’d taken his old leather lounge chair out and put it one of the state issue wood and hard plastic ones instead.  Obviously, the staff couldn’t stand to see it empty either.  

Tonight when I got out of my car at my mailbox I noticed the night was very clear, and the stars and constellations were shining away.  I thought about him by himself in a gray box in a cemetery in New Jersey.  I hoped his soul had moved along so he wouldn’t feel scared lying there by himself. 

"Leaving on a jet plane"

Last week R came up to me when I walked through his group on my way to sign someone else out for his session.  I knew before I walked through that I risked his approaching me and wanting to go out for a walk when I didn’t have time to take him out.  Sure enough, he saw me, got himself up out of his lounge chair and came over, caught my arm and loudly proclaimed “BEE!”  (yes, as in the ones that buzz, fly. sting, and are disappearing from the earth).  He leaned his ear in toward my mouth so I could respond with my own rousing “BEE!”  

I guess it wasn’t rousing enough, because he repeated himself, this time adding a gesture, pointing toward the high ceiling, in order (I presume) to make sure I understood what we were talking about.  

“BEE!” he repeated, looking rather triumphant I’d say, and I smiled, because, even though sometimes I have feared for my life when I’ve worked with this man (he hits hard and kicks very unexpectedly), I am very fond of him.  

Some of the old staff (most of whom have retired in the past five to ten years) told me that, when he was younger, bees used to come and sit on his fingertip.  Apparently, this yelling, kicking, biting, and slapping guy managed to be very gentle with these little buzzing creatures.  By the time I’d met him he’d apparently developed a fear of them.  I’m not sure why.  But “BEE” remained one of his favorite words.  “BAH” (which I’m pretty sure was meant as “BYE”) and “GO BACK”(an exclamation he usually made when he was done with me for the day) also figured prominently in his small verbal repertoire. 

Another of his favorite words was “AIRPLANE!” (R would never be described as a quiet man).  He often loudly pronounced this word, while, again, gesturing toward the sky, pulling my arm to look with him out the window.

As it turned out, last Wednesday, he did want to go for a walk, but I had to get to my other session.  I explained that I’d see him on Friday, and his staff person convinced him to wait until then.

It turned out that it was icy and snowy on Friday, so I didn’t even go in to work.  I checked in with him on Saturday to see if he’d like to walk then.  His staff said he wasn’t feeling well.  

I went over to him and he looked up at me from his curled up position on his lounge chair.  He looked rather glum.  I wished him well, and I told him I’d see him the following Friday.  “Hopefully, the weather will be good, and we can take our walk.”

On Monday I heard R had died that Saturday evening.

Last night I woke up after a somewhat disturbing dream, and I thought a lot about R and how he had spent much of his life with physical discomfort of one sort or another.  I was sad thinking that he probably died in pain.

As I was lying there, not sleeping, the following song floated through my tired head.  It felt like something R might have said to me about his death:

All my bags are packed

I’m ready to go

I’m standing here outside your door

I hate to wake you up to say “goodbye”

But the dawn is breaking

It’s early morn

The taxi’s waiting

He’s blowing his horn

Already I’m so lonesome

I could die

So kiss me and smile for me

Tell me that you’ll wait for me

Hold me like you’ll never let me go

‘Cause I’m leaving on a jet plane

I don’t know when I’ll be back again

Oh, babe, I hate to go.

There’s so many times I’ve let you down

So many times I’ve played around

I tell you now

They don’t mean a thing...

So kiss me and smile for me

Tell me that you’ll wait for me

Hold me like you’ll never let me go

‘Cause I’m leaving on a jet plane

I don’t know when I’ll be back again

Oh, babe, I hate to go.

Now the time has come to leave you

One more time, let me kiss you

Then close your eyes

I’ll be on my way

Dream about the days to come

When I won’t have to leave alone

About the time I won’t have to say

Kiss me and smile for me

Tell me that you’ll wait for me

Hold me like you’ll never let me go

‘Cause I’m leaving on a jet plane

I don’t know when I’ll be back again

Oh, babe, I hate to go.

©1967 John Denver

The song made me cry...which I kind of needed to do.