"You are showing them that they exist"

Excerpt From the transcript of the On Being show in which Krista Tippett interviewed Michel Martin:

MS. MARTIN: What we are simply saying is, I see you. I mean, I know for example when — you know, when I was working for “Nightline,” and I went to Turkey after there was a terrible earthquake there, and like, you know, thousands of people were killed. And I was feeling really useless. Um, thinking, boy I wish I were a doctor. I wish I were a structural engineer. I wish I could do something more useful. But then people would come up to me and say, thank you for being here. And I would feel, like, wow, why are thanking me? And then I thought — and I called my — you know what we do at a time like this. You know, I called my husband, because [laughs] I really feel like so useless. What am I doing here? And he said, you are showing them that they exist. And I appreciated that, because I’ve held onto that. It’s like sometimes the best thing we can do for people is let them know that we see them.

MS. TIPPETT: Mm-hmm.

MS. MARTIN: And so sometimes, you know, other people’s bad news is, you know, their lifeline, and letting them be understood. In fact, this was the very first story I did when I was at The Post as a little baby reporter at The Washington Post, and I was sent out on the summer — it was one of those terrible stories that you hate to do because some little boy had fallen out the window of the projects.

MS. TIPPETT: Yeah.

MS. MARTIN: And I had to knock on the woman’s door to get a comment from her. And I kid you not, I walked around the block three times before I mustered the courage to knock on her door, because I knew I had to. And I felt like, you know, and I knocked on the door. And she — and I said, I’m so sorry, I heard about your son, I came to see if there was any — a comment that you had. And she said, where have you been? Because she felt that if someone from the media didn’t come, then this was invisible and it had no meaning. And she had things she wanted to say, like why weren’t there any safety screens on the windows, which there were supposed to be. So, I bring that up to say a lot of times, what sometimes what middle class people see as intrusion, other people with no power see as validating their existence.

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

This part of the conversation was so meaningful to me, particularly a day after sitting with my clients in their "I hate this place!" rage, fear, anxiety, uncertainty. Literally, from the first session to the last, I heard some variation on this experience of powerlessness. In the first cottage, one of the women was screaming about how much she "hates this place!" The person I actually went to pick up for her session was having a rough time of things, and I found myself feeling quite lost and powerless to be of much help to her. The person I worked with in the afternoon was clear in his wish that I would take him away, because he indicated a wish to leave the session space for a while and he directed me straight to one of the vans sitting in the parking lot. 

My last session was with a challenging group of men who live in an untenable situation- stuck in a room, all day long, dependent on whoever was coming in to support them, and angry, frustrated, powerless. One of the men, the youngest in the group at only 31, yelled and yelled and yelled, as he often does, but this time, even though he doesn't use words to speak, I distinctly heard, through his yelling, the words "I HATE THIS PLACE!! I HATE THIS PLACE!!" 

Our session had begun with one of the guys being pushed back into the room by his annoyed staff person. I knew he preferred not to be with us, and I had encouraged him to go and be in the other area, so instead of taking off his shoes, his shirt, his pants and grabbing at me, he kindly got up and walked toward the door. His staff person pushed him back in, because, she said, "he keeps going and leaving the day area and eloping, and we are so short-staffed, I can't watch him and all these other guys as well, so he's going to have to stay in here! Everyone gets frustrated that there aren't any staff, and then they call off!" She, too, was in an awful situation.

It was hard to know what to offer the men, musically, that could even come close to supporting them. All I could do was acknowledge it and let them know, "I hear you, and, yes, it is very hard to live here, and right now it's also very hard to work here. And I hear you saying you hate this place, and I'm sorry you're feeling so disrespected." 

And so, as I felt as if absolutely nothing I could do would be of any help to the guys, one of the most poignant moments was when the young man who was screaming came over to me, after four times, handing me my guitar case and seemingly letting me know he wanted me to leave, picked up a brush that was sitting on the table, and he handed it to me. I was holding my guitar, and I thought, "Whaaaa?" Until he pulled my hand to his head, and he kept a hold on me as he slowly had me brush his hair. 

So, Michel Martin, thank you for reminding me that what I do have to offer my clients is "show them that they exist."

Celebrating National Psychotherapy Day

It's National Psychotherapy Day today- the first one ever- and I'll be celebrating by heading, just as I do every other week, to my therapist's office. Why? Because I firmly believe getting my own therapy is an important part of my job as a music  therapist. 

Knowing who I am and what kind of emotional baggage I'm carrying around with me helps me be present and attentive to the clients I serve when I show up to provide music therapy.

When my clients do their best to avoid hearing me invite them to look at a belief they're strongly committed to (sometimes even going so far as to literally stick their fingers in their ears), when they fall asleep mid-session because something we're addressing feels way too overwhelming, when they fight mightily against change...I have a pretty good idea of what it's like. I've felt and done the same (okay, maybe I don't actually stick my fingers in my ears or fall asleep in therapy, but I can be pretty darned noisy if I don't want to know something). 

I'll be honest with you: I am uncomfortable recommending any music therapist I know who hasn't spent at least some time looking at his/her own issues in therapy. I mean, what are we communicating to our clients if we think we're above getting our own therapy? If we, essentially, perpetuate the attitude of stigmatization associated with taking care of one's emotional and mental health? 

One of the (many) reasons I loved the HBO show In Treatment was that the writers made sure the therapist, Paul Weston, went (even though he was kicking and screaming the whole way and was more of a pain in his own sessions than any of his clients ever were in theirs)  for his own therapy! 

Psychotherapy for therapists goes beyond the usual nice, self-care sorts of things we tend to talk about in music therapy circles (you know...the whole getting a massage, taking regular vacations, taking a bubble bath and the like). It's an ongoing commitment to self-discovery, a recognition that, yes, we can and do get in our own (as well as our clients') ways, and figuring out how to (much as we may bravely resist) make changes in our perceptions and ideas about our selves, our lives, and our relationships. 

So, good people, with a grateful nod to Ryan Howes (a blogging buddy who shares his insights over at the Psychology Today blogs as well as being a contributing editor at the Psychotherapy Networker), I invite you to consider how you might join in the acknowledgement and celebration of National Psychotherapy Day. 

After all, mental health and self-awareness are most certainly worthy of celebration!

"He's not cranky- he's mischievous."

Her exact words were "he hasn't been cranky- he's been mischievous!" 


I was thinking about what she'd said the previous day about S as we started our session.  As his support staff, she probably was finding him to be rather frustrating. But, in my mind, there has to be a reason for it. 


What does it mean when someone's being mischievous? What if he's learning to assert himself? What if this means he now has enough of a sense of 'self' to assert? And he's not there yet, but he's trying to figure out what having a 'self' means?


That's kind of cool!

Now, back to S in his music therapy session. He was very quiet. His music was also quiet- contemplative, more interactive (in contrast to his usual energetic crashing and playing with great energy and a few brief pauses). He didn't play when I played. He was clear that this was a conversation, not a jam session where we play together. 


Self and other. Separate beings.


Wow. A major developmental step!

A modern chorus line (Photo credit: Wikipedia

A part at the very end of the first song from A Chorus Line ("I Hope I Get It") came to my mind as we stood together (a part which, frustratingly, they didn't include in the video I'm linking):

Who am I anyway? 

Am I my resume? 

That is a picture of a person I don't know. 

What does he want from me? 

What should I try to be? 

So many faces all around, and here we go. 

I need this job. 

Oh, God, I need this show.

I sang it for him, and I talked a little bit about the context for the song. It's sung by a man auditioning for a part as a dancer in a chorus line- which, to me anyway, seems to be a sort of anonymous group of dancers in a Broadway play- the goal of which is to be as uniform and in unison as possible. The character who sang this section of the song was thinking about his identity. I interpreted the lyrics as saying here's a man who is trying to come to terms with the face, the persona he has to present in order to get a job as a dancer.

I connected it to how I thought perhaps S might feel as a man with a disability who lives in an instituionalized setting. Having to put on a face (a persona), perceived by people, based on his behaviors and what is written about him in the institutional paperwork. 


Perhaps he too is wondering: who am I anyway? Who or what defines me? How do I define myself? And what does it mean in terms of safety, my identity as a man, as a disabled person?

Again, his musical responses (taps on the drum or tambourine) were very thought out and short.

We had about 5 minutes to go. I invited S to help me know if I'd been on the right track (by glancing my way) or if not (by making a sound). After a while, he looked my way, and he went slowly to the door and walked out.

Thinking he was done with me (and that either I was way off and misunderstood him- or he needed a bathroom, or maybe he felt a bit overwhelmed), I packed up my stuff. 


I was just about to follow him out, when he reappeared at the door!

He came back over, and I took out my guitar again. I sang a goodbye, in it telling him how excited I was for him. This is a truly important, although difficult, period in his life- one with the potential to offer him growth and a deeper self-awareness. He stayed until we finished, tapped the tambourine goodbye, and we walked slowly back to the day area.

Once we got there, he hovered near me (he doesn't usually). Then he reached into my instrument bag and borrowed the tambourine again, tapped it a few more times, put it back in the bag, and he headed off slowly in a different direction. 


See you later, S. 

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? 

So you want to become a music therapist...

Image by doug88888 via FlickrI, rather regularly, receive emails and blog comments from people who are interested in becoming music therapists.  And I regularly send back big, long emails with information I hope they'll find to be useful. Well, suddenly, one of my slower neurons fired, and I thought, "why on earth haven't you written a blog with this advice in it, so you don't have to keep repeating yourself?!" 


Somewhere a dog barked. 


Aaaand, we're back.


Okay. So you want to become a music therapist. Fabulous! And you want to know what it will take, what kind of advice I can offer, whether you'll ever have an actual salary, what to write for that research paper that's due in 13 hours...and so forth.


(Stand back. I'm about to jump into list-making land.) (Actually, even though my blog posts aren't usually in list form, I have a deep and abiding love of lists.) (But I digress.)


1. It helps to be a fairly good musician.That said, it also helps if you learn to play guitar and piano.
Different schools that offer music therapy as a major have different requirements. I think, ultimately, the more skill you have as a musician, the more you have to offer your clients. If you're busy focusing on yourself trying to play a song or a particular instrument, you're no longer focusing on your client, and that sort of defeats the whole purpose of therapy. You know? You don't have to know how to play guitar and piano before you go to school, because that is part of the music therapy curriculum. Those are, however, two instruments that are used an awful lot in the course of a music therapist's day/week/life, so it's worth getting to a point where you're relatively comfortable with them.


2. And, while you're at it, get comfortable with using your voice.
When I first started out as a music therapist I was really shy, and I found it difficult to sing in front of anyone. Mercifully, I managed to move beyond that. We don't have to be brilliant singers, but it's important to carry a tune and be comfortable improvising and playing around with vocal sounds. I still remember a client I worked with who tore up an entire room and threw my entire music cart on the floor. For a good solid year I had to go and do his sessions with nothing but me and my voice. 


3. Be careful of your "helpful" intentions. 
When you're trying to figure out what you want to do with your life, it's not unusual to think, "you know, I really want to do something that helps people." We all have our reasons for wanting to somehow be useful in this world, and they're all valid and important. When we come to a profession like music therapy, though, I think it's important to be mindful of the various implications of being "helpful" (in terms of power, control, what it means to be "the helped", etc.). Because Norman Kunc and Emma van der Klift said it a lot better already, I  highly recommend reading their article, "Hell-Bent on Helping: Benevolence, Friendship, and the Politics of Help". It will, I hope, give you a whole new perspective on being "helpful".


4. Learn to pay close attention. Notice stuff.  
So much of my job is about paying attention. Whenever I have students come to do their practicum experiences with me, I have them fill out an observation form that I developed. It's an insanely complicated form, because in a music therapy session there is so much going on at any given moment and on so many levels. You have to be aware of your client (s), the music, yourself, the environment, the history...there's a lot of stuff happening. This is what makes music therapy so completely fascinating! You can practice at an activity level and be quite effective, and you can also decide that you want to go deeper and explore the therapy relationship, the dynamics within it, and how it's all expressed within the music, and that's really nifty as well! 


5. Expect that this will be a life-long learning experience. 
Music therapy is a growing and evolving field. Because there's so much to know (and you can't cram it all in at school!), so much to pay attention to, and because you can work at a lot of different levels, there's always something new you can be learning. For that reason, getting professional clinical supervision in music therapy after you've graduated is extremely helpful to your growth as a new clinician. Moreover, there are lots of trainings that music therapists can take to deepen their knowledge/skill in specific areas (GIM, Nordoff-Robbins Music Therapy, Neurologic Music Therapy, NICU Music Therapy, Hospice Music Therapy, Austin Vocal Psychotherapy, and I'm sure there'll be more sooner or later). 


6. Get used to advocating for yourself. 
Music therapy isn't the huge mystery it once was. These days when I say I'm a music therapist, people are way less likely to say "a what?!" than they were back when I first started out. Now I'm usually greeted with something along the lines of "oh, how cool!" As nice as that is, people often think they know what we do, but they really don't. Co-workers who've known us for years may still not have a clear idea of what happens in a session. I'l be straight with you: It can be quite frustrating when you see that someone who hasn't gone through the years of training you have is calling him/herself a music therapist (or being called one by the media). It can be even more challenging when supervisors, colleagues, and various other people/organizations who fund our services (who aren't music therapists) feel compelled to tell us how we should do our job.  Having said that, I would still maintain (and I think my music therapy colleagues would agree) that being a music therapist still far outweighs the difficult stuff. 


7. You'll need to figure out a semi-quick way to explain what it is you do for a living. 
Given that you'll have to spend some time advocating for yourself and showing people what music therapy is, it's important to have your "elevator speech" prepared shortly after you graduate from your program. I usually tell people I use music to listen to people. That usually makes them curious enough to want to know more. Then, depending on how much time they're willing/able to spend, I can expound until they're sick of me. Ahem.  


8. It's not likely you'll be rich beyond your wildest dreams, but you can definitely make a living as a music therapist.
A few months ago, our Rabbi at work asked me, as nicely as he could, on behalf of one of his congregants, "can music therapists make a living doing this work?" I assured him that we could. We can find jobs (we've been doing a lot of advocating- trust me), we can get health benefits, and we can make enough money to live peacefully. We'll never get the kind of money that, say, a computer programmer or a financial analyst would make, but most of us aren't starving. And if this is truly what you want to do, then you should do it. [2024 Update: Having written this some time ago, I want to acknowledge that these days it may be a bit more of a challenge, given the financial realities of the current day. And a lot of younger music therapists have expressed dismay when they can't find full-time jobs, they can't afford housing, and they are often expected to have a Master's degree. This is decidedly problematic, and I will not deny the situation can be quite frustrating. At the same time, there are also a LOT more music therapist-owned businesses, and people are actually familiar with music therapy (or know a music therapist) (of have had their own music therapist) (or have at least heard of it). So, I believe, still, with some flexibility, you'll probably be able to find a job. It may not be where you hoped/expected to work, but it may end up being the right place. Or, like many people do nowadays, you can get some experience and move to an employment situation that feels more in line with who you are.]


9. Get used to not knowing what's going on and sometimes being uncomfortable or awkward. Or at least come to terms with it. 
I would have to say that it's rarely dull being a music therapist. Sometimes your clients will do unexpected sorts of things, or you'll find yourself dealing with really uncomfortable feelings. And sometimes you can go for a really long time and not be at all sure you're on the right track with a client/group. Again, this is what makes this work so fascinating and so completely worthwhile! It's difficult when your own issues are triggered, but, heck! Your issues will be triggered no matter what you do. You may as well have an interesting job within which to notice them. 


10. Consider getting your own therapy (or your own music therapy, if you can). 
Being a therapist is hard work. Being a client is also hard work. If you've never gone through  your own therapy, and if you've never struggled in a big way with your own problems and emotional baggage, it will be hard for you to have a real understanding of what it's like to see yourself in a new way (which is not always a pleasant experience at first). Making changes in our lives is something most of us resist mightily. Looking at our resistance- ugh! It's not always fun. It's a long, bumpy road. And we ask our clients every day to allow us to stumble along that bumpy road with them. We owe it to ourselves and to our clients to at least bring along the map we saved from our own journey (even if they decide to take a different route). (Okay, I'm getting a bit nuts with the metaphors here, but you get the idea, yes?)


So there you have it. That's the list I have going in my head when people ask me for advice on becoming a music therapist, and now here it is! In blog-land! And if any of you music therapists out there in the world have other advice to offer, bring it on!


The good news (well, to me anyway) is this: I worked as a music therapist for 34 years. Even on the worst of days, I have never regretted my decision to do this work! Much good luck to you as you go forth and consider whether or not the life of a music therapist is one you'd like as your own.

Well *that's* good to know

http://blogs.psychcentral.com/unplugged/2009/04/ten-things-a-good-therapist-should-be-aware-of/


As a music therapist working with people who mostly don't use speech as their main communication mode, I thought this was a particularly helpful blog post (written by Sonia Neale).


I particularly appreciated her last comment: "Even after thirteen years, therapy can be an inherently exhausting process." 

Owning your music therapist

Well, it turned out that none of the guys actually said “no” to music therapy today.  There was some ambivalence though (we’ll always have ambivalence, won’t we?), so I thought I might end up going back to the Music Room and doing paperwork (yahoo.) for much of the afternoon.   Thankfully, that wasn’t the case.

Part of my job is picking up my clients for their sessions.  That means that I walk over to the buildings where they live, sign them out, and we walk over to the Music Room.  This, in itself, is not a big deal (well, it is a big deal when I have to break into a sprint if someone I’m walking with takes off in another direction).  The difficulty is that I work with more than one person in a building, so when I’m picking up one person for his session, someone else I work with is very likely to be watching me.

I think we all have a quiet fantasy that our therapist likes us best out of all of his/her clients.   If you happen to be someone who is treated like nothing special, it’s a particularly intense wish.   Let’s face it, living in an institution is not exactly fun, nor is it inspiring, and if you’re a generally sweet, quiet person who doesn’t assert him/herself too strongly, you’re pretty much ignored.  If you don’t use speech, and you have an unusual way of being, people don’t tend to act like they like being around you. 

So, along comes a music therapist who is paying attention to you and who genuinely seems to like you.  How wonderful and gratifying!  But then you see her picking up someone else for his session, and your whole “I’m the special person in her life” fantasy?  Shot to hell! 

The men and women who live in our center (and I dare say in every institution everywhere) are acutely aware of their perpetual loneliness.   An awful lot of people never get visits from their families, have no idea what it means to have or be a friend, and they rely on staff for pretty much everything (because that’s how it’s been set up)- including emotional support and connection.  That connection thing doesn’t always happen.  Being resourceful and hopeful (and how on earth can you not love and respect a person who after years of institutional garbage still has hope?!), my clients keep an alert eye out for people who are truly present and who care about them (not just for them).  

Which brings me to this idea of “owning” your music therapist.  Sometimes it feels as if my clients wish to “own” me.  All three of the folks I worked with this afternoon are somewhere on the autism spectrum, and two of the gentlemen seem to have strong reactions to my working with other people who live in their buildings.  

Interestingly, to me anyway, a couple of weeks ago I used the song “You Don’t Own Me” in a session with one of these men, because it suddenly came to my mind while I was working with him (ah, the miracle of the countertransferential song!).  The song had meaning on a couple of different levels, I thought.  One was my initial experience of him, sensing that he wanted me to back off and let him figure something out on his own.  Another element was my sense that he quite dislikes my working with other people in his living group (yes, people live in groups in institutions) and that sense of his “owning” me.