What do I (think I) know?

Gosh, it's been an absolute age since I posted. Ack! Hopefully you're all wondering what the heck is going on, and asking yourselves, "where in Pete has that girl been!?"


So, here's the scoop: this has been the summer of ailments (and, evidently, I forgot to mark it on my calendar). No, really. It's been a little bit ridiculous. 


Since April, I've caught two colds (I hardly ever get sick), one monster case of allergies that led to never-ending coughing and ended up requiring two asthma inhalers (I don't have asthma), and, just because life wasn't going to be complete without it, I've been limping (very painfully) around for four solid weeks with my backside, hip, thigh, and knee out of whack. 


Honestly! Is this truly necessary? 


I say all this to you, not just to whine and kvetch about it (because, I mean, who would I be without my whining and kvetching?), but because getting around with extreme pain (it's finally starting to settle down somewhat, thank goodness) has forced me into an awareness I've never had before.


I'm ashamed to admit to you how completely ignorant I've been of this fact: There are a lot of people walking around in constant and terrible pain. They're not complaining and carrying on (like I am). They just go about their business and do what they've got to do. In pain. 


It's one thing to get this on an intellectual level (and, of course, I've always understood this on an intellectual level), but that doesn't mean anything. 


Sure, I've seen my dear friend get to a point where she's had to walk around with a cane (and only for very short distances) because she has extremely painful knees. I always known that she's in pain most of the time, but until recently I'd only understood it on a peripheral level. 


Until I experienced what it's like to be absolutely unable to get from point A to point B (forget the fact that moving made me want to scream and/or cry)...I had no clue. 


Do I have a point I'm trying to make here? Well, yes, I think so.


I'm realizing (yet again) how important it is for me to question some of the things (maybe many of the things) I think I "know". Because a lot of the time...I really don't. Often, all I have is some vague idea in my mind about what someone's experience is- whether the person's in pain, has a serious illness, comes from a culture or ideology different from mine, has some sort of a label (whether s/he wants that label or not), is socially ostracized...The list goes on indefinitely, as you can imagine.


I am struck by how limited I am in my understanding of what any of these things actually mean in terms of a person's life and how it affects who the person is and how they relate to other people and to the world.


In short, I am, yet again, astonished by how much I just don't know. And, more to the point, how much I'm not even aware I don't know. And I have to ask myself: as a music therapist, what are the things I think I know? And how willing am I to find out my assumption(s) may be incorrect? 

Finally back on track

Image by oddsock via Flickr

You may well be wondering where the heck I've been for the past month and a half!  Frustratingly enough, my clients were probably wondering the same thing.


As it happened, I had to undergo some unanticipated surgery to correct a rather painful medical situation. 


All I can say about it at this point is: boy, am I glad that's over! And, yes, I'm feeling much MUCH better, thank you for asking (because I know you're nice, and I know you will ask). 


Oddly enough, there are actually several good things to say about all this:


Thing #1: My two kindly music therapy colleagues went to almost all of my clients (at my request) and let them know that I would be having some needed surgery and I would be out for a little while. And they emphasized the fact that I planned to return. 


Thing #2: I have a full-time job. I have good health insurance. I have lots and lots of sick time, because I very rarely get sick (yes, I did just knock on wood). I do not take this fact for granted!


Thing #3: I have two neighbors (both women in their 70s) who were absolutely amazing after my surgery. They checked in on me, they ran errands for me, and they just made sure I was alive and everything was okay. What phenomenal gifts they are! 


Thing #4: I discovered that "recovery from surgery" means "lie on the couch and can't do much of anything". Yes. Well. I did a lot of that.


So. Now that I'm back to work, I can also be back to blogging. Thank goodness! 

People in pain

Image by Migraine Chick via Flickr

Monday.


I don't know what it was about this past Monday, but it seemed a day of pain for some of the women in my sessions.


Lately, having experienced a medical situation myself that causes a lot of physical discomfort, I've developed a far greater appreciation for the deep frustration and futility that goes along with chronic pain.


Both women were crying, each doing her best to cope with her body in the best way she could.


The first woman, C (I saw her first thing in the morning), is still fairly new to me. Some of her staff seemed to think the fact that she sat on the floor on her behind and scootched herself forward was (aside from being odd) because of my being someone new and unfamiliar.


OK. I guess the fact that C screamed and cried through much of the session, after throwing her shoes at me (boy, did I have a flashback to George W. Bush and the shoe throwing incident. But I digress.) but didn't try to leave may have been because I was new as well. But she certainly seemed to be hurting from what I could tell.


I sat with her and nearly cried myself as I musically accompanied her frustrated tears and sounds. She reached her hand out to me once or twice, and I did my best to move over (we were sitting on the floor) to be within her grasp.


C then went back to stripping off her clothes. Of course, she first made a sign that looked like "toilet" with her right hand. We managed to limp out the door and into the hallway (where she sat down and proceeded with the stripping process again). I managed to get her dressed and we hobbled into the bathroom area where she completely stripped down. At which point I got someone a bit more familiar with her to get her dressed again.


She then went to sit at the table and seemed mellow and cheerful. That was when her staff let me know that C was just messing with me because she doesn't know me. "See? She's happy!"


Yeah. 


In the second situation, V, when I arrived was restrained because she had been thrashing her head into various hard objects (the floor, the wall, the door, the wooden sides of the chairs...), and her staff felt freaked out (who wouldn't freak out seeing someone do that to their body?). 


One look at her, and it was clear (to me anyway) her sinuses were bothering her. A lot. Her nose was running furiously, and her eyes were swollen shut. (This is a person I've known for a few years, and she is always stuffed up and particularly unhappy when allergy season is in full swing. I also had had a headache the entire day from the shifting weather patterns, so I didn't come up with this thought out of the clear blue, as it may appear.)


Anyway, she came out of restraints in time for the music therapy group to start (thank goodness). We were attempting to make the trip from the day area to the room where we have our session, and that became a whole drama unto itself.


V couldn't seem to organize herself, so her staff got her wheelchair for her. S wanted to run around (and when she runs around it usually involves many curtains being torn down and a general swath of destruction in her wake). M started to vocalize in an angry-sounding way and looked as if she was about to take a bite out of whoever was standing or sitting too close to her. L appeared in the hallway, naked (evidently naked is popular on Mondays...who knew?). 


Music therapy anyone?


The staff took the person who was naked and the person who was all set to run down the hallway with her to get them reassembled, and I took the rest of the ladies in with me. V was still quite distraught, and yanking at my clothing with a death grip. M was still vocalizing loudly and approaching me (and V, who was now clinging to a handful of my shirt and pulling me down toward her), sounding a bit desperate. N was vocalizing, somewhat less loudly, as she attempted to settle herself in a chair (sometimes it takes her a while; she has a bit of the OCD).


M ended up walking out the door and went with her staff person (who told me she needed to shower the person who'd been naked). 


Okay. O....K....We're breathing.


I went back to V, held on to her hands and joined her distressed vocals with my voice, attempting to find a soothing, but reflective, simple vocal pattern (not an easy task, given the circumstances). She let me move behind her wheelchair so I could give her some deep pressure input to her shoulders and arms. V began to rock and very slowly settled down.


Gradually, the rest of the group came in, and we were able to finish the session with some minor semblance of order. 


But, yeah. Pain. Not fun. 

How do we cope when our clients are in terrible emotional pain?

My supervisee brought up a very important question/comment in supervision tonight. We were talking about dealing with clients/patients who are extremely ill, or whose families are coping with very difficult medical news.

One of the most challenging aspects of being a therapist is that it's so hard to see our patients/clients in terrible emotional pain. We, with our images of ourselves as caring music therapists, and as people who tend to be sensitive to the turmoil in other people, want to fix it. We want to come up with the "right" music, the "right" words, the "right" intervention.

We want to do this, but we can't.

We can't always figure out how to be with, come to terms with, help, support our patients (and their families) when they are in the midst of dealing with devastating news, when they are coping with trauma, when we send them back to hellish living situations, and so on.

What I suggested was the usual:

1) We need to trust that what we have to offer may be helpful in ways we can't know.

2) We need to take care of ourselves musically, emotionally, so we can come to terms with this sort of thing.

3) Sometimes having a some sort of spiritual way of understanding things helps.

As I thought about it further (after my supervisee and I said goodnight), it occurred to me that we tend to think we know what our clients/patients need.

We forget that we only see them in a particular setting, in a particular venue, in one specific context, in a specific and painful moment in their lives. And we forget that we don't have the context of the person's whole life and all the many intricate elements that make up someone's complex relationships and experiences.

Because we don't have that, we can easily fall into the trap of thinking (along with our clients/patients) that this is the only moment they're going to have. This terrible thing, moment, or experience is what is going to define them forever and ever.

And, yes, it may. Some people do define themselves by their most painful moments.

But it also may be true that the pain, sadness, fear and struggle are exactly what that person needs to go through at exactly that moment in his/her life in order to become who they came to be in this earth. In order to evolve and grow in some important way.

I try to remind myself (when I'm in the midst of feeling as if I'm never going to do/be enough for a client) that I don't know what my client needs (within the context of his/her life),

But I can offer what I have to offer: my presence, my caring, empathy, music, compassion, and maybe even love (okay, a therapeutic love). And it's important that, on some level, I recognize that what I have to offer is enough, and it may be exactly what the person needed in that specific moment. No one else but me could have offered it in the same way.

By the same token, there will be other people in our clients' lives who offer them what they have to offer them.

For all we know, it could be that our clients' real need is to learn how to receive. Well, we don't know the answer to that. But we do offer ourselves and what we do know. That our clients matter to us.

And our presence matters to them. Somehow.

And so it goes.

"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.