Last chance lost...

I noticed this song- "Last Chance Lost"-  running through my mind over and over again as we struggled to come to some kind of....okay-ness, an okay space today in our session. My client has some very strong feelings toward me, and although he knows "we don't have that kind of relationship" it's hard for him to hear it. Over and over.  

Yes, and it's hard for me to keep having to say it, because I feel cruel. I mean, I realize I'm not being cruel. I'm being truthful (and a therapist), and I know it would be more cruel to lie to him and pretend I don't see how much he wishes this weren't "just music therapy" and it was a better version of his life. 

And I'd be lying to you if I didn't say the rescue fantasies on my end can be intense. If I weren't so used to this happening it would be freaking me out. But this is something I go through, and it's more so with some people than with others. 

But here he was, this man who doesn't use speech, working so hard to be heard- using his voice even (which is rare)- and there I was...rejecting him again. 

When I step away from the session for a while and think about it, I have an idea of how to proceed and what we need to look at: Where are the feelings for me coming from? What might they be helping him to avoid feeling? What relationship(s) might he be trying to create or re-create in our sessions? And so forth. 

But...right there in the session...I feel like such a jerk. 

It's not that I'm afraid he'll be angry with me- although it would mean the beginning of the long period of anger. 

There always seem to be stages in the music therapy process- at least with the folks I work with individually. Initially there's a long period of "I don't trust you." That's usually followed by "okay, maybe you're not so creepy," which eventually works its way into "must we leave now?" Then we get into the "I like you/I can't let you know how much I like you" period which gradually becomes "I love you and you should never leave me!"  

I think my client and I are in that latter period right now. And I'm in the complicated "be firm but kind and figure out a way to reject without being rejecting/remember you're trying to help him realize how he's relating to people that's not really working for him/come on, Roia, you can do this" part of the work. 

And I know. The big anger is coming. Okay, so maybe I'm a little afraid. It's hard to give up being loved. Not that the anger indicates an absence of love. It's just easier, I'm sure you'll agree, when your client is in the "you totally rock" phase versus the "you rejected me and you are horrible and cruel" phase. 

Anyway. We struggled. He was sad. I was sad on his behalf. 

It was hard for him to return his instrument at the end of the session, and he insisted on carrying it back with him to his cottage- where he finally gave it back to me after a brief, gentle tug to make sure I understood he wasn't happy about relinquishing me or the instrument. 

The only part of the song I remembered as we worked through this session was "last chance lost". When I read the lyrics I was fascinated (for the hundredth time) by how our minds create musical connections with people, with moments and experiences. 

Last Chance Lost

by Joni Mitchell

Last chance lost

In the tyranny of a long good-bye
Last chance lost
We talk of us with deadly earnest eyes
Last chance lost
We talk of love in terms of sacrifice and compromise
Last chance
Last chance lost

Last chance lost
The hero cannot make the change
Last chance lost
The shrew will not be tamed
Last chance lost
They bicker on the rifle range
Blame takes aim
Last chance
Last chance lost


© 1994; Crazy Crow Music 

The big comfy couch incident

Image by SimplySchmoopie via FlickrWell! Work, this morning, was a bit crazy (to put it mildly). 


Both the 9 AM and 10:30 AM groups were either getting ready to take part in or getting ready to watch the big Halloween parade at our facility (which is actually pretty cool- a local high school marching band comes, there are costumes, people bring their dogs, their babies, etc.). 


There was all kinds of flurry and insanity, what with trying to get the guys/gals outfitted with their various costumes and such. There was annoyance, there was attitude, there was drama...well, you know how it goes.


Now, mind you, the guys in the second group weren't actually going to be in the parade. We were just working on getting chairs outside and guys assembled in heavy sweatshirts and caps (it was cold out there today!) so we could all watch before the parade, er, passed us by (as the saying goes). 


Mercifully, we got ourselves all out there in time, caught the all-too-brief parade, cheered loudly for the guys who had gone to boldly march in their costumes (the cottage had gone as race-cars, and they were all sporting their "cars" with frames draped over their shoulders- it was pretty nifty), and managed to get everyone safely back inside with only one incident report having to be filled out (um, that was me, because one of the guys who used to love watching parades and being in the middle of the action...well. He wasn't in that good of a mood to be moved around. My deepest apologies to R for my misunderstanding.)


To put it mildly, we were all shot!


I went to join E on a big, mushy couch, because he seemed to have been out of sorts all week, and I just wanted to check on him. We've known each other for 22 years. To not check on him would have been totally rude. 


So E and I were just sitting there, hanging out and decompressing from the morning's events, and T came over and decided to join us. 


Now, the reason this is news (and very cool) is that T's usual approach to sitting on couches is to shove whoever is on the couch off. This is usually accomplished by pressing his fingers firmly into the back of the person's head, but bopping people over the head has also been employed at various times. 


But he didn't do that. T came over, sat on the other side of me (I was in the middle), and he took my hand, carefully, and he held it for about five minutes. Then he smiled, got up, and continued walking around the room


Now, that's what I'm talking about!

Hovering

Image via Wikipedia

On Wednesday this past week, O, was hovering nearby, poking and pushing at me as I tried to find E's jacket in the never-endingly-impossible-to-ever-find-anything-in-it closet. He actually followed me from room to room as I hunted through wardrobes and fished through various drawers for E's hat.

I told him I was glad he wanted to say "hello", but "right now it's E's time," and I promised I'd check in with him when we returned. If he still wanted me to sit with him then, I'd make some time for him.  

Well, E and I left and came back. And forty-five minutes later O was still reaching out and poking at me.

Guess he must mean business.


These days O's music therapy is on an "as needed" basis. When he wants some time with me he lets me know (as evidenced by the above mentioned interaction). He seems to like to just sit quietly, performing his usual series of rituals, while listening to me play the guitar and sing. 


It's probably helpful for you to know that O has terrible problems with his sensory system, and he often asks (and by "asks" I mean pokes and prods until we get the hint) people he knows and feels safe with to help him when he needs a back massage to alleviate his discomfort. 

On this particular day I figured he probably wanted me to provide some deep pressure to his back. 

He pushed me onward, out into the hallway, and we sat on a couch.


As I sat next to him, pressing my hand hard into his back, I grinned as I thought about our first music therapy session together, some seventeen or eighteen years ago. 


At the time we conducted our sessions in the dorms. Each of the dorms had four beds in it. In honor of the session (and in order to create a space that at least sort of implied "we do music therapy here") I pulled in two chairs and brought along my cart full of instruments, setting some of them out on a dresser.  


I picked up O from his day area (the cottages were all locked back then) and brought him to this makeshift music therapy space.


As soon as he got into the room he yanked all the covers and sheets off of the beds, hurled all the instruments onto the floor, kicked over both chairs and knocked over my music cart. 


AAAAUGH!!


The only thing I managed to save (barely) was my guitar, which I'd snatched up when I saw the rhythm instruments go flying.


Whew! 


I mean...really.


Whew!


I sent him back to his day area (wondering why exactly I'd gone into this damned field anyway), went back, cleaned up the mess, and wondered what the heck I was supposed to do now.


I showed up at the next session with nothing but my voice (I learn fast, eh?).  I knew he liked "backrubs," although at the time I didn't realize it had to do with sensory problems. Just as I did this past Wednesday, after I let him know what I was planning to do, I pressed the palms of my hand to his back. And then, unaccompanied by any instrument, I sang to him. 


I sang about what I was doing, what (safe) ways he could use to let me know if he needed me to stop, and I sang about keeping the room a safe (is anyone else noticing a theme here?) place. 


Happily, although it took some time, O got used to me, and I began to understand what worked for him and what didn't. 


The fact that he now can let me know when he needs my assistance (or not) and that I can sit with him playing the guitar with no instruments being hurled about makes my day. 


And it reminds me that music therapy matters. It may not always look as I expect, but it matters. 

"I want to be here."

I noticed the word "here" came into my mind rather loudly as I accompanied W's breathing on the piano. Then..."I want to be here."


He was sitting in his usual partially reclined position on the couch and staring straight ahead. No eye-contact. Ignoring the instruments (although I think he tossed a mallet on the floor at one point). 


Just. Sat. 


I knew he was still not feeling all that well. We both had colds this past week. But he had been very clear that he wanted to come to his session.


"Breathe in; breathe out." I sang quietly, accompanying myself on the piano.


He waited until I was finished, and then he quickly tossed the maraca and the bells in rapid succession. 


Obviously something was bothering W. And as I watched him the song "Wish You Were Here" came to my mind. I found it in my folder, and I was all set to start playing when he stopped me, pushing my music folder to the floor.


Okay then. Kill the music. Better stick to just listening. 


"I'm wondering what's upsetting you so much today." 


W pushed the rest of the instruments off the bench next to his seat, making sure to send them into the distant regions of the Music Room. He watched them as they rolled off in various directions. He turned to me and tried to make sound with his voice. It came out as a quiet, brief hum. He waved his arms in frustration, unable to make me understand.


"I can't imagine how frustrating it must be for you to have so much to say and so few ways to say it. Can you go back to the music and use the instruments?" 


W got up and gave a few of the closer instruments, the ones he'd already sent to the floor, a shove with his foot, pushing them even farther away.


I looked at the clock and realized we only had five minutes left before the session ended. I let him know we would have to end shortly. 


I knew he wasn't finished. 


I recalled our previous session in which he kept picking up the bells when it was time to go (seemingly to let me know he wanted to take the instrument back to his cottage with him- like a transitional object). He didn't seem to feel finished then either. 


I asked him if perhaps his current upset was related to not wanting to let go of the bells and leave last time.


Eye-contact. Bingo!


"It is hard to leave a place where it's quiet and where you've developed a sense of safety. I know how much it means to you to be here."


Because I felt his helplessness, I went on and on. 


I reminded him that his worth does not come from me. That music therapy helps him remember and recognize his worth and value as a person. That we work toward his being able to go out in the world with the awareness that he is a worthy and valuable human being. 


I added that I realized this wasn't an easy task. We all struggle with it. "But, W, you have survived living in an institution for over 25 years. And you still care about people. Relationships still matter to you. That's a miracle!" 


He thought about this for a while. 


I gently noted again, "W, we need to stop for today." I got my coat on, brought his coat and hat over and began helping him get into his outer gear.


He paused midway through the process, flapping his left arm in his coat sleeve, not quite finished putting it on. In a second, he took off the coat, took off the hat, handed them back to me and pushed me gently backward in a clear gesture of "No."


He was staying "here". "I want to be here, Roia!" was what he seemed to clearly be stating with his actions.


I sat with him. 


"What do you think is making it particularly difficult for you to leave today? Is it that it's the holidays? Is this an anniversary date for you that I'm unaware of?" He paused and looked up and to the side to consider this.


"Perhaps you're feeling particularly lonely." Eye-contact.


We sat quietly, breathing together. "Loneliness is hard."


After a while he got up to push my tissue box off the piano. I brought him his coat again, and I let him know I thought he'd be okay. He is, after all, a survivor.


He hesitated, but he finally put on his coat and we walked out. 


Here is the song, "Wish You Were Here", that I would have sung for him in our session- mistakes, clunky piano keys and all. 

"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".

"After you've gone and left me crying..."

B jumped up (jumped, I tell you) to come over to me when I showed up in his group (I was feeling guilty, because I was a little bit late). He barely let me get his jacket (um, it's April, and there were snow flurries happening off and on today). Anyway, he barely let me get his jacket out of the closet and on to him before we stopped to get his meds. Then we were on our way.

He got to the Music Room, and somehow we missed the door to actually go in. Don't ask me why. We just kept turning around the corner and walking and heading in the wrong direction. Then when I got him back in the direction of the door, we missed it on the way back again. 

Okay. What?! Already! 

Somehow, I managed to veer him in the direction of "please get in to the Music Room, or I won't be able to pay attention to what you're apparently trying to tell me!" 

Alright. We are now inside the Music Room. Now I can focus. 

B was very upset. To the point where he was actually crying (I think). It was very sad. I decided the best thing I could do was to simply sit with him and wait it out. Try to give him the space to feel lousy, since that seemed to be how he was feeling today.

[Actually, his distress was a continuation of our previous session where there was a lot of instrument throwing, occasionally aimed at me. I reminded him that I would not be able to hear him very well if I was having things hurled at me, so he "agreed" to stop, but made sure to get in an obscene gesture to make his point. Got it. F--- you, Roia!]

When B is upset, there's a lot of moving. When he's more mellow, there's a lot of sitting. Today there was a lot of moving. He speed walked over to the office area, sat in the other music therapist's chair, whimpered, then dashed back over to the music part of the room.

Every so often, after he sat briefly on the couch (his usual hangout), he hopped up and went to look out the window, rocking from side to side as he did so. I noticed his rocking was kind of gentle and not all that fast, but everything else about him seemed to be in high speed.

I tried to figure out whether I should musically reflect the rocking (maybe it was a way for him to self-soothe?) or the agitation or both. I opted for a bit of both, and I think it ended up sounding like a bit of a mish-mosh. 

Even I was up and down a lot. I had decided the guitar was a better option for improvising than the piano, because I could follow him more easily if he happened to run out the door. Also I could turn and see him while holding a guitar.

B was also humming. It was actually a very beautiful and poignant hum, and I tried to follow along with the guitar and, at points, with my own voice. He'd hum at a particular pitch and then drop down an octave as he came to the end of a phrase.

Eventually, his movements came to a gradual settling down, and he (mostly) managed to assemble himself on the couch to catch his breath. I breathed in and out quietly with him.

"I guess underneath all the silence we were exploring two sessions ago you had a lot to say, B."

We sat together, back in the silence, and the lyrics that sang into my mind were: 

"After you've gone, and left me crying

After you've gone, there's no denying..."

I have learned over the years to pay attention to the lyrics that pop into my thoughts when I'm with a client. To me they're like messages sent from their consciousness to mine. 

These were the only lyrics I could remember, and I wondered if he was trying to let me know how hard it is for him to have to wait in between our sessions. 

Now, it may seem as if I came up with this from out of nowhere, but that's actually not the case. He has a very difficult time leaving sessions, and there is usually a lot of dawdling and trips to the bathroom and long pauses before the jacket gets put on when it's time to go. 

Also, as I noted, he had been quite distraught in the previous session as well, and we had explored his frustration with me, because I'm not able to fix his life for him (which, I'm thinking, would take the form of my taking care of him outside of the institution). 

In the past month, we've been talking a lot about feeling abandoned, and I also used the Billie Holiday song "Left Alone" in one session (this version is sung by Abbey Lincoln).

When I commented to him that music therapy can be a mixture of deep gratification (it feels so wonderful to be listened to and acknowledged) and extreme frustration (because it's still therapy- it's not life) he immediately picked up the maraca and tossed it across the room (the maraca is the instrument we've designated to express anger and frustration). Score? I think so.

Heck, I sure wish I could tell you I had some brilliant piece of advice to offer him, but let's face it. The truth is, living in an institution is the pits. He knows it. I know it. I can't fix it for him. And, yes, it is frustrating. Insane-makingly so! On a lot of levels and in painful and never-ending ways. It's frustrating for him, and it's frustrating for me too. 

What to do? What to say?

He'd stopped running around by now, and he only got up every so often to punctuate a point I made (I think that's his way of saying, "you're getting it, Roia," but I'm not 100% sure; I never am). 

I told him I was glad he felt safe expressing his feelings to me, and he was welcome to keep doing so in music therapy. To be honest, I felt very honored and humbled by his trust in me. People don't expose that much emotion and pain in front of just anybody. 

I guess the best description of what I did today was to stick with B. I validated his feelings. I kept caring about him. I invited him to keep using the music as a container. I reminded him of when I'd see him next.

I noticed (in myself) how hard it was to end the session today. I knew we needed to go, but I felt awkward insisting (especially given how much emotion happened in the space), and when I tried to play something quiet about breathing, he started hitting his head. 

"Hurting yourself is not a solution, B. Showing up in music therapy every week [I actually see him twice a week] and using sound and movement to tell me how difficult this is for you is a better alternative."

He didn't look like he was buying it, but I had to get up and get the coats already. It was getting late. 

I put my coat on and held his out to him. He paused as long as he could, and he finally got up, took it from me, and put it on. 

When we got back to the cottage his staff greeting him warmly, and he went to sit down. He watched me as I hung up his coat, left the room to sign him in and then walked back through to wave "goodbye" to him. 

The lyrics were still floating through my mind as I walked back to the Music Room to tidy up and go home: 

"After you've gone, and left me crying

After you've gone, there's no denying..."

Sometimes being a music therapist feels like being one of the meanest people in the world. 

"...let nothing you dismay..."

For some reason I was dragging through work today. Actually, to tell the truth, I was tired before I even got to work.

I was so exhausted I could barely tolerate the idea of walking all the way to one of the farthest cottages (in a very cold New Jersey "Spring" wind, mind you) to pick up (and walk back with) a very bouncy 20-year-old young man with whom I recently began doing music therapy. 

I managed to temporarily get over myself though, and I'm glad I did. 

As soon as he saw me (and his vision isn't all that great), he leaped up (leaped, I tell you- I have witnesses) and bounded over to his box of stuff to drop off the little wrestler action figure he was holding. (He has a small collection of muscle-bound action figures, which: 1) I think are so darn cute, and 2) I find interesting, because he himself is tall and quite slender as yet.) 

Within seconds he was by my side, waiting for me to fish out his flimsy Spring jacket from the closet. (Someone needs to remind the people in his cottage that Spring only happens in name in these parts at this time of year- it's still March, for crying out loud!)

We hummed little rhythms on our way to the Music Room, and he was all chipper and cheery. When we got there, he quickly tossed aside his jacket (after neatly putting his hat in the sleeve) and sat at the piano with the flourish of Liberace. He began playing a dramatic series of clustered notes on the piano (using some of the rhythms he'd been humming as we walked). 

He decided my role for today was to play the guitar, and he waited patiently until I had assembled myself and handed me the instrument. After some dramatic piano music (he had to keep reminding me to keep my hands on the guitar, not the piano), and a couple of quick treks to the window and back, he turned his attention to the guitar. 

He pushed my hands away from the neck and strings, and he gave it a solid strum. As the notes quieted he listened thoughtfully, and he began to sing (he uses a half hum and half "uh" sound to sing) the notes of the open strings on the guitar. He kept repeating them in various patterns (it was very cool), and the pattern he settled on sounded so much like "God Rest Ye Merry Gentlemen" that I had to hum it to him.

And there we were, both of us with the tune completely stuck in our heads, humming away. What particularly intrigued me was that he listened to me carefully and kept adding the different sections as we went along. In other words, he kept humming, over and over, the part he'd learned, and as I added the different sections he added them gradually too.  

I think it was difficult for both of us when it was time to leave. 

I gave up on the usual singing of "goodbye" and improvised some "I'll see you next Monday" sorts of lyrics to the tune of "God Rest Ye Merry Gentlemen" instead. He seemed okay with that mercifully. 

After that we scrambled back into our respective outer gear and headed back to the cottage, still humming the song as we walked. It was very sweet to see how excited he was. 

Admittedly, it's a rare treat to spend time with someone who so bubbles over with music, seemingly from his very soul (!).  Many of the folks I work with love music, but here is someone who just seems positively enchanted with sound!

It was definitely worth the long, chilly walk, and even in my tired state, I was glad to share in his enthusiasm for a time.

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.  

Thoughts at the end of a long day...

It's odd how the day goes and how the day ends.  I felt terrible at work.  So many of my clients just frustrated me beyond words today.  E (who acts like he  wants me to do all the work and who sits there, essentially laughing at me), R  (who seems fine all the way to the Music Room, but when he gets there he looks like he’s going to pass out, and then suddenly he’s fine again when we go through the 15 minute process of getting the coats back on and very slowly walking back to the cottage), M (who reenacts the painful loss of his family and home over and over and over again, feeling the need to punch at me in the process, and then he can’t let me go at “goodbye”),  R2 (who didn’t get a nap and was sleeping mostly)... 

Sometimes I'm afraid I'm losing my heart for my work.  Lately I've been feeling so angry with the guys, and I feel so guilt-ridden for being angry.  Honestly, in E’s session I was thinking that I could just walk away from the Center and be done with this. I was so tired of always having to do all the work.  I'm really starting to get that my clients are not going to change, ever, unless something drastically changes in their lives.  They can't change, because if they did it would be hell for them.  To be too aware within a system that's so difficult is torture. Maybe it's not fair to ask any more of them.  But, yet, I want to.  I want them to be bigger than this tiny fishbowl they live in.  Is that totally unfair to ask?  Probably.

Before I left work this evening I stopped by the Exercise Room, looking for a colleague.  I knocked on the door, opened it, and there was B, standing right in front of the door.  He immediately approached me and took my hand and clung to me for a little while.  L, his staff person, got the treadmill started for him, and he guided him over to it, and B hopped on, got his balance in ten seconds, and then turned around and just as gracefully, hopped off (after walking backwards on this moving machine for a second or two, watching me), seeming still to want to come on over and hang out with me.

I guess that’s why I stay.  Because of the B moments.  Somehow, for now, they make up for the E, R, M, and R2 moments.   And because even though we have these horrible moments (sometimes weeks and months), I think it still makes a difference that I’m there.    

Healing touch

I will not lie to you.  I went to work in a very unhappy state today.  It wasn’t anything to do with work, and I made every effort (as I always do) to keep my focus on the people in my sessions.  As you can imagine, by the end of the day, I was fading a bit, and it was sort of hard to stop my sadness.

My last session of the day is with two gentlemen (M and G, both of whom I like very much) who experience life on the autism spectrum.  We had had a tough time in the previous week, because M kicked G on Monday and then he kicked me on Thursday, and G and I were both sporting bruised shins.  G, on the other hand, tends to scream very loudly on occasion (with a tendency to be near one’s ears when he does so).  So, of course, when we started there were reminders to try to use words and musical sounds to express any frustration or distress rather than kicking and screaming as a means to make salient points (thank you very much).  [Hm, I just noticed that together M and G do, in fact, kick and scream.  They do this separately, mind you, but how interesting that they ended up in the same session together.   What a very nifty new thing to know.  Anyway...]

G has a hard time staying with us for the duration of the session (although he usually hovers nearby or returns to check back in to our space in the back hallway of the cottage).  M, on the other hand, likes to draw while we work (I think because it helps him to focus on the session more effectively and less directly).  

Well, something about G’s hovering today triggered the sadness with which I’d started the day, and I had to pause for a moment.   I rested both of my hands on the table and looked across it to M, who suddenly stopped what he was doing, put the pen down, reached out and enveloped both of my hands with his, looking at me quietly.  Then he went back to his drawing.  

It was such a sweet and kind gesture, and I knew that he understood that I was sad, and he wanted to offer me comfort (which he did).  I thanked him for his thoughtfulness, and we continued on peacefully for the rest of the session.

"Don't let me be lonely tonight"

Dave Pitonyak has written a great deal about loneliness being the greater disability for folks with a lot of labels (in other words the people I work with every day).  It’s worth reading when you get some time to really think about what he’s saying.  

I spent much of the day running around, because there’s just so much going on at work that there doesn’t seem to be a moment to sit still and gather my thoughts.  Mercifully, my clients remind me to do so- usually simply by needing me to be still and listen.

The three men I see on Wednesday afternoons almost always leave a very strong impression on me.   All three guys have had music therapy with me for ten to twelve years, and our work is often intense.  

The last gentleman is still sitting with me many hours later.  During our session he was shoving away instruments.  He actually took them off the cart in order to shove them across the room.   I asked what or who he needed to push away, and he looked at me (oh.).  He’s struggling with a lot of feelings about me of late, and we alternate between his being very happy to see me and feeling very sad dealing with the limits of our relationship.   If this sounds familiar, it’s because I talked about the same person on September 12th.   

A (countertransference) song that has come up before in our work together is James Taylor’s “Don’t Let Me Be Lonely Tonight”- which is 1) a gorgeous song, and 2) has that wonderful tangle of emotions in it.   The part of the tangle that came to my mind as I watched my client pushing (and then re-pushing) the drum and mallet across the room was

“Go away then, damn you.

Go on and do as you please.

You ain’t gonna see me getting down on my knees.

I’m undecided, and your heart’s been divided.

You’ve been turning my world upside down.” 

© 1972, 1973, 1978 James Taylor

[You can give a listen- at your own risk- to what it sounded like below.]

I sang that part, and then I sang the whole song (I had to do it without my guitar, because I couldn’t remember most of the chords), and he started to move very quickly around the Music Room, pausing to “bump” into me a few times.  

Much of the session was spent with him appearing to want to leave- moving me toward the door, messing with the knob, and pushing my hand up to the door.  The effect, for the most part, was one of “You, Roia, are forcing me to stay here against my will.”   And I said to him, “You know?  We’ve worked together for the past ten years now, and this thing with trying to leave while we’re in our session has been an ongoing theme for our entire history together.  And here we are, ten years later, and I still don’t seem to have a very good idea as to why.  I feel perplexed and uncertain.  Like I’m always doing something wrong.”  And then I wondered “Do you feel that way sometimes?”  He looked away.  

When it was actually time to go he didn’t leap up immediately.   As we walked back he mostly chose to walk on his own (usually he catches my hand or a few fingers and holds on).   I reached out to keep him moving when I saw a car approaching us, and he pushed my hand away.  “I guess that would be another round of ‘Go away then, damn you’, eh?”  

When we arrived in front of his home, he quickly sat down at the table and chairs which are placed outside his front door.  He looked so utterly dejected, and I got such a sense of sadness that I understood at that moment that he really wasn’t pushing me away at all- just trying to cope with his unhappiness that our time for today was ending (and trying to make it last a little longer).  

I know I often talk about uncertainty in my work.  This particular moment, though, did not feel uncertain at all to me.  Obviously I couldn’t articulate the details of his feelings, but it was pretty darn clear that all that effort to “leave” the session was not really about wanting to leave.  

It took us a while, but he was eventually ready to go back inside.   

If I may...(since it is one of my favorites)

Do me wrong; do me right.

Tell me lies, but hold me tight.

Save your goodbyes for the morning light, 

But don’t let me be lonely tonight.

Say goodbye and say hello.

Sure ‘nough good to see you,

But it’s time to go.

Don’t say yes, but please, 

Don’t say no.

I don’t want to be lonely tonight.

Go away then, damn you.

Go on and do as you please.

You ain’t gonna see me getting down on my knees.

I’m undecided, and your heart’s been divided.

You’ve been turning my world upside down.

Do me wrong; do me right.

Go on and tell me lies, but hold me tight.

Save your goodbyes for the morning light.

But don’t let me be lonely tonight.

I don’t want to be lonely tonight.

© 1972, 1973, 1978 James Taylor

Gabcast! The Mindful Music Therapist #0 - "Don't Let Me Be Lonely Tonight" This is how it sounded.