And how was your day, dear?

Image via Wikipedia
On the plus side, nobody got hurt (although there were some brief reminders to the effect of "nobody really likes to get their head tapped unexpectedly, K."). On the not-so-plus side, I'm guessing it'll take kind of a while for my co-worker in recreation to sort through the two big stacks of paper from her desk that, um, well, er, ended up all over the floor when I turned my back for a minute to deal with L. 


I think I can safely say that this particular session felt like it was the exact opposite of the lovely one I described  to you a few weeks ago. 


Here's how this whole party started: 


I arrived in the cottage, fully aware that the women there were almost all sick with colds and stomach viruses (lovely). I had called earlier in the afternoon to ask if I should come over or skip it, and I was told, "well, people are running around with the sniffles and stuff, but..." (which I'm fairly sure was code for "Get your a** over here, lady! We've all been suffering through this, and you'd just better do your time!")


First thing, G (one of the more chatty ladies who live in this cottage) came over to announce to me that I should "stay away" from her because she's "sick as a dog," after which she proceeded to follow me around and ask me questions repeatedly until I finally got the women who are actually in my group assembled and closed the door with a firm "I'll see you later, G. Hope you feel better." [Insert heavy sigh here.]


Honestly, I was quite happy as we got started (although a bit nervous) because M had actually joined us. Her staff person walked her over (at my request), and she had miraculously managed to convince M to walk in to the session area with us! Usually I get her as far as the door to the room where we work, and she starts to hum loudly. Then she won't go in to the room with the other two or three women from the group, and she won't go back to her day area either. 


Inevitably, V gets annoyed because she is waiting for the session to begin, so she scoots (she moves on her knees usually- she has a wheelchair, but she tends to hop out of it when she gets to the room) out of the room where we work and sits on the floor, watching me and looking impatient (I'm sure if she were able to stand more comfortably there'd be foot-tapping involved). 


It took some doing for N to get in to the room, because her OCD was making it plain difficult to get through the door. We waited for her and she got in. The problem, however, was that K was sitting in the chair that N prefers to use. Stop. The. Presses.


So. N pushed and pushed (in spite of my requests that she stop doing so) at K (who, on any other day, prefers to wander around the room and throw everything she touches on the floor or across the room), trying to get her out of "her" chair. Having very little luck (K is pretty hardy), N (no slouch herself) took hold of K's shoulder and her behind and unceremoniously shoved her out of the chair. 


Oh, dear.


Somehow, I managed to get K moved to another chair at last (to the one that V prefers, God help me). Mercifully, V decided to stay in her wheelchair for a short period of time. 


Then I had to figure out what to do to get M settled, because she kept coming over to me with magazines that were in the room and insisting that I hold them. Finally, I got the message, tore out a page and handed it to her. That seemed to be what she wanted and she promptly found herself a chair and proceeded to rip paper peacefully.


For twelve blissful seconds, we were all sitting quietly (it was such a glorious moment) when we heard a loud crash at the door. 


"[Expletive deleted]! What now?!?" (I thought, loudly, and in a rather un-music therapist-like fashion.)


L arrived, right behind her giant walker (the thing that had crashed into the door), and she decided she needed to come in and sort through the plastic groceries in the faux grocery basket (that lives in the room we use) right now!  


And L, I need to tell you, is not exactly Miss Let's-Talk-About-This-Shall-We-America."


Dear Lord!


Of course, since we were all sitting (for those twelve brief, yet happy, seconds), this required rearranging everyone so L could get to the table (which was, of course, behind everyone). 


Well, not entirely unexpectedly, in the process of tending to L, and rearranging the furniture and the various people contained therein so nobody would get run over by L's giant walker, K got up to explore, and that's when we heard the two huge piles of paper from the recreation staff's desk hit the floor. 


Cheeeeeeck!!!!


I couldn't, for anything, get K to sit anywhere, so I gave up and tried to pick up the giant mess of paper and put it somewhere somewhat unreachable until after the session.


While I was dealing with the paper, V decided she'd had enough, so she headed out the door and sat in the hallway, chin in hand, waiting for me to chase after her. Since I'm not supposed to leave V alone (and I'm not supposed to leave M or K alone either), I put a chair in the doorway so I could keep an eye on the group and on V at the same time. 


V, in spite of my best efforts, turned tail and headed back into the day area (through the bathroom door that's across the hall from our room). And, much as I hate to admit it, by that point I just figured, "Okay, that's one less person to worry about right now. Amen."


K roamed around the room some more, tapping N on the head unexpectedly. And M continued her page tearing adventures, assembling the tiny pieces neatly on her lap. 


Now.


I'd love to tell you I was able to make a brilliant interpretation to the women in the group about their actions and how they seemed to be all about going from crisis to crisis, and there's all manner of "no, pay attention to me" and some sadistic teasing, all in conjunction with the  incredibly overwhelming way they interact with me and with other people in their lives. 


But no.


Heck, I'd love to say that there was even half enough emotional space left in the room so we could even start to look at that, but that is so not where the group is yet! 


Evidently, the group's goal for right now is to (through their actions/interactions) convey as loudly and dramatically as possible, "Roia!! This is what it feels like to be here. To be us. To live life!!! Do something!!"


And, for now (I have learned) (rather slowly, I must add) that my job is to just listen and get through it. And show up next time and get through it again. And keep setting limits and keep trying to help them use the music or use the music myself.


At some point, they'll be ready to hear me talk about what I'm seeing/experiencing in that group, but not yet. 


Definitely not yet. 

Back off, lady, I've got this!

Image via WikipediaI tried a different approach with B today.  My usual tendency is to sit there, paying as close attention as I can (without being too obvious) and trying my best to figure out what he is (not) saying by asking him bunches and bunches of questions (and driving both of us crazy in the process). 


Yes, even I realize that asking tons of questions is annoying. 


And, no, he doesn't use speech, but when he truly needs to make sure I hear him, he is quite clever in his communicative style.


Well. He was reclining (as he does) on the couch in the Music Room, and he was very specifically looking off in the distance (read as: "I am not looking at you! NOT looking at YOU!"). Okay. Got it. We are not looking at me. Fine. Onward. 


I, of course, started to leap in with my usual round of questions ("Rough day? Too noisy in the cottage? Feeling off because we changed our session time last week? Blah? Blah blah blah? Blah, blah, and more blah?"). Okay, I'm not really proud of the fact that I did this, but I did. So. There it is. B's response? Stay the course. Keep staring straight ahead. 


Hunh. That was effective. 


I stopped (thank God). And I thought, "Try again, Roia. Settle it down, and try again."


So I said to him, "You don't really seem to be ready to be dealing with stuff right now. Why don't I just play piano over here, and when you're ready, you let me know."


I rummaged through the stack (really- there's a stack) of (countertransference) songs I've used in his sessions, and I pulled out the Beatles' song, "Don't Bother Me". I hemmed and hawed (internally) for a bit and decided to just play it on the piano rather than sing it. It didn't seem right to break the silence with words just yet. 


I played through. Aside from tossing the bells he was holding and then picking up the mallet, there wasn't much (visible) change. Moving right along. 


I rummaged some more, and I found "Out Here On My Own" (from the movie Fame). (Anyone else sensing a theme here?) I really wanted to sing the words, but it still didn't feel like it was time to do that, so I played through it with just the piano. 


I feel as if I need to explain two important things here:


One is that the songs I chose were intentional- not as random as it may seem when you read my writing. I wanted to reflect his need for some emotional space, but I also know that he's been struggling with trying to come to terms with what our relationship is and is not (which is a gentle way of saying that I'm trying to help him understand that "we don't have that kind of a relationship.") He has not been happy about that, and although I think that, on some level, he gets why it is the way it is, he still feels very abandoned by me right now.


The second thing is that B spends a part of almost every single session, pulling me to the door and flicking the light switch off and on (you may draw your own conclusions as to what that particular habit may be helping B to say to me). 


Great. So you're up to date. Back to the music...


This time the mallet was tossed, but B still sat quietly listening with his gaze firmly averted. 


I sat quietly for a while (even I can sit quietly sometimes) and waited. 


B leaned forward and tossed the maraca (which he uses to express anger) and tambourine (to express uncertainty) on the floor and was ready to hurl the cabasa (for conveying disappointment and sadness) as well, but I managed to stop him just in time (did I mention he can make sure he's heard when he has something to say?). 


"Maybe," I suggested, "I'll play the song I just played again, only this time I'll sing through it with the words. B, why don't you sing it with me. You can use your voice, you can pick the bells back up and use them, you can move...just pick a part of the song that feels right, and join in." 


So I went back to the piano and started (again) with "Out Here On My Own" 
(Lyrics: Lesley Gore, Music: Michael Gore; Copyright 1979)

Sometimes I wonder where I've been,

Who I am, do I fit in?

Make believing is hard alone, out here on my own.

We're always proving who we are-

Always reaching for that rising star

To guide me far and shine me home,

Out here on my own.

(Chorus)

And when I'm down and feeling blue

I close my eyes so I can be with you

Oh, baby, be strong for me, 

Baby, belong to me. 

Help me through. Help me need you...

The minute I started singing the chorus, B joined in! He got up, started to hum in a low tone and rock back and forth. Then he headed over to the light switches and started to flick the lights up and down in time to the music (I could tell, because he paused so he could stay with the beat)!!


He stuck with me- moving, vocalizing and light switch flicking- until I got to the very last words of the song ("out here on my own."), at which point he came over and stopped me from playing any more by pulling me to the door (not because he wanted to leave, but because he wanted me to stand with him). 


Wow. Just...wow. He was glorious.


Clearly, the strong feelings of loneliness and longing are still very present for him. The beauty of this profound musical moment (as I see it) is that B now feels safe enough to fully participate in the experience of actually making music. And I do need to point out that this has taken quite a lot of years. For much of the first twelve years of our work together, he largely avoided using music- often barely even allowing me to use music!


The fact that B was not only willing to sing with me (and in such a creative way), but to make sure it had meaning when he did it, is what makes this work so amazing!


I guess the question (for me) now becomes: knowing that when you back off and allow your clients to say what they have to say, they will not only do it but do it beautifully (and you don't need to worry them along), what's preventing you, Roia, from backing off so much of the time? And what is it you're afraid of hearing when your clients do "speak" to you through their music?

Getting to "no" you

Image by donnamarijne via FlickrWhile I was avoiding writing my proposal for the regional music therapy conference this afternoon, I started thinking about one of the women with whom I work- this would be the woman who spent a lot of time being undressed in our sessions initially. 


I thought you might be interested in a brief update.


C has managed to keep her clothes on (although her shoes and socks go flying at times- but who can blame her for that?) since we decided it would work a lot better if we had a much (much) shorter session time of about 7 to 10 minutes. 


Most importantly, she has been able to peacefully let me know when she is not interested in having a session, and that seems like a step in the right direction to me. 


I've said this before, and I'm saying it again: Any time one of my clients feels safe saying "no thanks, not today" to me, I know I'm on the right track. 


Now I just have to hope/trust that, at some point, she'll feel safe enough to say "yes" more often. 

Eating a slice of humble pie

Image by shandopics via FlickrI knew if I waited a while, calmed myself down and thought about it in a peaceful state, I'd have a better idea of how to proceed with C. 


You may (or may not) recall that I wrote about the dreadful session I had with her a couple of weeks ago. I was feeling terrifically annoyed with myself (among other sources of annoyance) because I had allowed my anxiety about staff being upset with my "letting" C strip in music therapy (I mean, really?) cloud my therapeutic judgment. 


Ugh!


So, as I was driving back from Michigan (which is quite a long drive when you're headed to New Jersey) to visit my friend (a music therapist turned music librarian, as it happens), I was thinking about the coming week. Naturally, my thoughts turned to Monday morning, C's scheduled time for music therapy. 


I had (yet) another twinge of guilt as I remembered our last session before I went on vacation (just for the record, it's not unusual to have a horrible session right before a vacation- in fact, it's one of the, er, perks of being a therapist). 


And let me just say, it was not one of my shining moments as a music therapist. 


As I was trundling along the Ohio Turnpike (where they have very nice rest areas, I must say), I wondered what I was supposed to do about the stripping. I didn't want to stop working with her, because, in spite of the exposure episodes, there were moments of actual connection in the music. 


I tried to perceive the situation from C's point of view (something I've tried to do before), considering the idea (again) that she may, in fact, feel exposed. 


Then it suddenly hit me! 


A forty-five minute session is way too intense for her! Sure she may appreciate parts of the experience, and she may even find herself engaged meaningfully with the music (maybe even with me), but she's not even close to being ready to deal with that kind of constant attentive interaction for that long of a period of time!


Of course!


I need to start out with very short sessions (five to ten minutes at most) and gradually learn when C is letting me know she's ready for more time. 


Honestly, sometimes I think I've been at this a bit too long that I could manage to forget something as basic as that. As basic as: can this client tolerate a 45-minute session, or should we start small and work our way up? 


So, today I showed up in the cottage feeling a little more confident (with regard to the staff), and I explained my plan. I'm not sure they were as enthusiastic about my plan as I was, but they were agreeable enough (which I appreciated).


The supervisor (for some reason) decided to get C, and we sat outside of the room where her group was meeting.


The first thing I felt I needed to do was to apologize to C for misdirecting my frustration in the previous session and aiming it at her. Then I acknowledged that I had not remembered that when someone is paying very close, unwavering attention to you for a sustained period of time it can be uncomfortable as hell. 


I told C my plan. "We'll start with a ten minute session. I'll practically be singing 'hello' and then 'goodbye' and then we'll stop, and I'll plan to be here next Monday again."


C, tucked under her blanket, tapped her hand against her leg. I sang "hello", she listened quietly, then I heard her giggle and vocalize with me a little bit. Then I asked if she needed anything else from the music before we ended for today. She vocalized a bit more. I sang "goodbye," put away my guitar, and I escorted her back to her group. 


She was smiling.

When sessions go to hell (yes, Virginia, in a hand basket!)

Image by jamelah via Flickr

Damn! I was all set to wax lyrical about what a wonderful first session I had had with two new clients, C and J, two Saturdays ago. 


I'd even started the blog already. I had a nice little picture all picked out and everything. There was a little singing bird. It was downright idyllic, if I do say so myself.


Well. 


That little gloat-fest sure didn't last too long. 


When I showed up this past Saturday, it all went to hell. (Please observe said hand basket above and to the right.)


First, the room we'd used the previous week was completely unavailable. Apparently, it had just been painted and they didn't want anyone in there until the paint was dry.  It was a nice, relatively quiet room with space, with a big water-bed looking thing (that looked like a cross between this, this, and this), where last week C, who seems to experience a lot of sensory discomfort, tucked herself in under her blanket and her giant beanbag and sang along with her series of sweet little "bee bah" sounds. 


Okay. "So the room isn't available," I thought. I can work around that. I think.


Then, while I was checking out other room possibilities, I noticed that the other person in our small music therapy group, J (who became "the other person in our small music therapy group" simply because she kept walking in to the room last week, and I finally said, "why don't you just join us on a regular basis?"), was unavailable, because she was having some behavioral issue that required a lot of people to stand around her and look concerned. And not too happy. 


Hunh.


No problem, I'll just work with C in the vestibule where she's sitting (tucked under her blanket with her giant beanbag) (is anyone else noticing a theme here?). I'm flexible. I can do this. 


Two seconds into singing "hello" to her (after her staff kindly unplugged the radio that had been playing), C got up and left. 


And that was that.


After that we moved into a whole following around (me following C), pulling (C pulling me, because I guess my following her wasn't going the way she'd expected), stripping (C's, not mine, thank God), bathroom going (again, not me for a change), insisting I put the radio back on (you guessed it, C wanted the radio), irritated "BEE-BAH" sounding...thing. 


There were two (maybe two) blissful (okay, maybe it wasn't blissful, but we're talking comparatively here) minutes in which C sat and smiled as I played and sang with her. 


Then we were back off and running.


Heavy sigh.


A few years back (in 2006, I believe) my friend, Judy and I did a presentation at the Mid-Atlantic music therapy conference which we called "The Myth of the Perfect Music Therapist, or How I Learned to Stop Worrying and Love My Mistakes". 


I think this would definitely qualify as one of those bummer sessions that are more "part of the process" or "grist for the mill" (as the sayings go) than shining examples of moments in therapeutic gloriosity.


I suppose, if there's anything for me to have learned from this, it's that if we music therapists can't own and acknowledge our lousy sessions/days and accept them as part of life, then our clients won't be able to do that either. 


Not that it's any kind of easy.


Well. There's always next week.

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. 

12/16/09 Quote- effortlessness, waiting, self-awareness

Image by jhave2 via Flickr

From an article by Wayne Muller, "Effortlessness", in Unity Magazine, May/June 2003, pp. 4-6:

Deep within all things there is a natural rhythm, a music of opening and closing, expansion and contraction. Our heart, our lungs, the seasons, the oceans- all life expands and contracts, opens and closes, softens and hardens and then goes soft again. This potent opening and closing cannot be forced to happen, nor can it be stopped. It is simply the way of all things.

We need only remain clear and awake to listen for how things really are, to feel how the smallest changes of energy and attention move in us, in our relationships, in our work. We can learn to follow the spaces between things. Not to fight and push and cajole, but rather simply to wait until the true way reveals itself easily and clearly in this moment. 

My thoughts as I read this:
This seems to me a wonderful (and poetic) reminder of why it's so necessary for us, as music therapists (as any kind of therapists), to examine and to be aware of our own issues and motivations in our work. If we're not aware then we run the risk of "pushing, struggling and cajoling" our clients into getting better (behaving better, functioning better) instead of simply being with them and trusting that they will move forward at their pace. 


When I notice myself reacting in a session with a sense of urgency and "I must do something right now"  this passage reminds me: sometimes I just have to wait and be with my client(s) until s/he/the group is ready to move forward.


When I'm not willing to do that I know my focus has shifted to myself and to my own fear that I'm somehow not fulfilling this idealized (and delusional) notion that I have to be "the perfect therapist who can fix it all for her clients."

Oh, THAT's why you're still standing!

It was gorgeous out today (in spite of my itching and sneezing and generalized whining)! TE was sitting outside with his group when I picked him up for his session. He was more than happy to flit along with me, because- well, because we go way back (we've been working together for almost twenty years now) and there was a really loud radio playing right near him. Noise is not his favorite thing (and, oy, can I relate!).

Anyway, we got to the Music Room, and he took off his baseball cap and put it carefully on my cart (which is where we usually put our outer gear when we arrive), but he didn't go and sit down (which is what he always does). 

I thought he might need a toilet, so we headed off the bathroom down the hall. I sent him on in, and I waited. And waited. There didn't seem to be anything happening, so I asked him to come out if he was finished. The door opened, and he appeared. We headed back to the Music Room. 

And TE was still flitting around the room, not sitting. Hm. 

"Maybe you don't want music therapy today? Perhaps a walk instead?" I was about to start heading for the door when it hit me. 

I bought TE a couple of big dog chew toys, because he likes, no, he needs to chew on things. When he doesn't have anything to chew on, he keeps a hand in his mouth or he chews on his shirt. 

Ergo, dog chew toys. 

Hey, they're big, they come in different textures, and he really seems to like them. And usually my neurons are firing, and I remember to leave them out for him when I set up the room before I go and pick him up from his cottage. It being Monday and such, I had forgotten. 

And evidently TE was kindly trying to remind me, "Um, something's missing here, lady."

I went to my desk, got them out, and brought them on over. As soon as I handed them over, he sat down.

"OK, Roia, now we can begin."

I love when I actually get it once in a while.

What autism "awareness" really requires

The thing is this: if we as music therapists are going to be of any use to the folks we serve who are autistic, then our level of awareness must include (from the beginning) paying attention to what autistic people have to say. 

Yes? 

Of course, yes!

Here, for example, is what Asperger Square 8 (aka Bev) has to say:

Asperger Square 8: Autism Awareness!!!

Well, *there's* the way to cure your insomnia, man!

When I went in to pick up W from his cottage this afternoon, he was trying to nod off while sitting at "the table" (a very popular place for staff to have people sit- partly to make sure their clients look like they're doing something, partly to make sure that the staff look like they're doing their job so their supervisors won't yell at them, and so their supervisor's supervisors won't start writing people up, and so on and so on). 

Behind him, his staff person was grumbling at him to "wake up, W!" To me she said, "This is the first time he started nodding off today. [It was 3:15 PM- that unholy hour when almost every living being on earth wants to take a nap- except maybe three-year-olds.]  W didn't sleep last night, and I've been keeping him awake all day, because otherwise he's up all night!"  

Then she turned her attention back to W, giving him an annoyed look. 

Again, loudly, "Wake up, W!  You're not staying awake all night again!  Get up!  Go with the music therapist!"

Evidently, his intentional bout with insomnia from the previous night was distressing her.

I'm not surprised.  I wasn't kidding about supervisors and grand-supervisors all coming down hard on the direct care when the folks they're "in charge of" look like they're just sitting around, doing nothing or sleeping all day.

I'm sad, however, to say that I reacted with some sarcasm.  I'm always torn between sense- I mean, I highly doubt W purposely stayed awake all night so he could feel like crap the entire next day- and the awareness that most of the people who work in direct support are put into these ridiculous no win positions of "You must keep the clients in active treatment at all times. Every moment is teachable. Blah, blah, blah. This is why CMS funds this institution. Blah, blah, blah. Written up. Blah, blah, blah. Fired."

Somehow, through his apparent haze, W caught sight of me approaching him, and he decided to stand up and walk with me (sort of- he was a bit wobbly) to get his meds before we left.

He was so tired that he actually tapped my arm for a moment while we were waiting for the nurse to get his meds organized, and then he went to find a chair to sit down.  

Now, the thing about W is that he is NOT a morning person.  

As such, both of his music therapy sessions are conducted in the afternoon. It's a pretty obvious thing. Whenever I show up in the morning he's dragging all over the place (if he's even awake). In the afternoon, he's Mr. Pleasant and Let's Go! 

Clearly there were no naps happening this morning!  Ahem!

We got his meds, he paused, and I asked him if he wanted to stay in today, and we could try doing this again on Saturday.  There was some nonverbal hemming and hawing on W's part, and he put on his coat, and we slogged on over to my building.

I guess he decided it would be quieter to sleep in the Music Room.

Thinking about acceptance

I was just reading Asperger Square 8's blog where she posted a video made by the mom of a child who is autistic (you should go watch it- it's thoughtful and has a message worth hearing). The mom referred to herself as a former "warrior mom"- in other words, a mother who did everything she could to "cure" her child's autism.  Her child is now ten, and she has changed her focus from trying to "fix" her kid to loving and accepting him as he is (and inviting the rest of the world to do the same).

I commented that I have stopped trying to fix my clients and decided it would be more helpful to get to know them and to enjoy making music together.  Then I re-read my last blog post.  It wasn't a shining example of me being particularly accepting.  Well, I guess if it was a shining example of anything it was my difficulty knowing when to say "enough is enough."  (I did finally have to discontinue music therapy with that particular client, by the way.  It was, in large part, because I was getting kicked and pinched way too regularly, and it really needed to stop.  But it was also because he really doesn't seem able to make use of music therapy right now.  Maybe someday.)

I did, at any rate, want to give some thought (well, more blah-blah) to whether the folks I work with need "fixing" or acceptance. When I stopped doing music-making "activities" (back in 1994 or so) and started using the music to build relationships with my clients, there was a huge sense of relief. My clients were relieved, because I was finally paying attention to them (and not to my concerns as to which activity we'd be doing next and how on earth I was going to get them to do what I wanted them to do).  I was relieved, because I felt as if I'd finally learned how to be a music therapist (versus doing music therapy to my clients).   I also didn't have to come up with bigger and better activities any more (which was especially nice, since I never could get my clients to do any of them anyway).

More importantly, I got to enjoy the work for the first time (hence, my undying gratitude to my clinical supervisor, Janice Dvorkin), and I got to know my clients and to like them in an entirely different way- as people who were worth knowing and not as blobs to be molded through planning and organizing specific interventions to- okay, I admit it- "fix" them.   

If I'm going to be truthful (and I may as well be), it's only been in the past year or so that I have had the conscious thought:  "My clients don't need me to fix them, and they don't need me to fix their lives for them.  What they "need" is for me to be here, and be an ally, and like them for who they are, and help them like themselves for who they are.  Period."   Recognizing this has provided me with even more relief.

It still bothers me when I can't fix life for the guys (it's an institution, and, I'm sorry, but institutions are inherently the pits), and it's hard when it seems as if some of the people I work with can't seem to move beyond a very difficult way of being.  But, if I'm going to be accepting, then it goes beyond not seeing my clients as needing to be fixed in some way.  It also seems to mean that I have to get to a point of being okay with the fact that people are who and where they are, and if they don't choose to make use of the therapy I offer, then part of that acceptance is moving on and supporting someone who is ready to receive my services.

Is this the end?

I had a strange experience today.  I actually had to say to one of my clients that we’ve gone about as far as we can go.  I didn’t want to have to say that to him, but it’s true.  We’ve worked together for about 19 years, and there really isn’t much else I can offer him other than my presence.  

It’s not as if he doesn’t have issues (I mean, who doesn’t have issues?).  It’s mostly that he seems to be letting me know that we aren’t going to be doing any more music therapy.  I can’t say I blame the man.  How much therapy can a person stand in his lifetime (well, some of us can stand a lot, I guess)?

I’m not sure whether he’s ready to actually stop coming to sessions.   I’m fairly certain he values our relationship a great deal.  I don’t think I’ve ever seen him rush up to other people and take their elbows and pull them to the door.  And I know I’m not the only person who takes him out of the cottage.  

I’m not sure how I feel about this.    

As it happens I just said “goodbye” to another long-term client (admittedly, since it’s an institution, the majority of my work with people is long-term...VERY long-term) who has been gradually moving toward ending in the past three or four years.  I still run into him regularly, because I work with other people in his cottage (which has to be weird for him- I know it’s weird for me).  In the last month or so, as we’ve gone from sessions to checking in to just saying “hi,” he’s needed to avoid me.  It hurts to be rejected, but I understand that he needs to do that.  

We had an amazing last session.  We didn’t exactly plan for it to be The Last Music Therapy Session, but I think we both knew it was.  It was joyful, it was celebratory, and it was moving.  Considering this particular person has not been feeling physically well for a rather long time, it seemed clear to me that he and I were absolutely in sync on this closing.  He was more animated during this ending session than I’ve seen him be in almost a year.   It felt to me as if he had the kind of goodbye he might have liked to have had when his family sent him off to live at our facility (back when he was a youngster- he’s in his 40s now).  

I so value both of these men.  They have allowed me into their lives, they’ve used the music, they’ve grown, and they are loving, sensitive guys who care about other people.  Both men also enjoy laughter and playfulness.  What wonderful gifts they bring with them (and they have shared with me) as they move on from our time together!  And what a collection of feelings- joy, sadness, pride, excitement, and a bit of nervousness- I feel as I begin to let them go.  

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.