Asking for help (the hard way)

Some days I come home from work feeling as if my clients all hate me.

Now don't all jump in with the "oh, come on, they don't hate you! Why do you insist on seeing yourself that way? They appreciate you, why would you say such a thing?!" comments. 

Because that would be missing the point.

The things is: it was hard being a music therapist today. And, yes, I did (and always do) say to myself, "oh, come on, they probably don't hate you. Well, maybe they do, but probably it's not really about you." 

Here's what I'm thinking (hoping) (thinking and sooort of hoping, because, really, it's not a great thing to hope): I'm thinking my clients absorb so. Much. Hate. Every. Single. Day. And here I come in, Ms. Gosh-I'm-so-glad-to-be-here-guys-let's-listen-to-each-other-and-see-what-we-can-hear-in-each-other's-music. And there's crying and yelling and toileting accidents and more yelling and more crying and running around and trying to run out the door and handing me my guitar case and climbing on things and hitting each other and pulling and pushing and more toileting accidents.

And we sing, and we play about it, and we stop to get people cleaned up. Okay, well, usually I'm the one playing about it and singing about it, because my clients don't really use speech, and they are often too busy being overwhelmed. And I put it out there, "I know things have been really difficult for you, and it's a lot to cope with all the time." 

And I feel inadequate. I feel like one of those teeny little bandaids that keep falling off. My words and my music hardly cover any one of my clients' deep wounds. And I try to remind myself, "this is what chronic trauma and chronic grief look like. What can I offer in the music, in my words, in my presence? Will it mean anything?" 

Thanks to juliaf for the image!

Then I start in with the whole internal drama of "What if I'm just making assumptions? What if they just think I'm being a pain in the ass? And wrong? What if they wish I wouldn't come because I just remind them of what sucks in their lives and then I'm standing there singing and talking about it and happy to see them, for God's sake?"

So there I was driving myself home (and crazy) today, feeling kind of crappy. And I reminded myself of how much hatred my clients have internalized. How there's nowhere for it to...go! I mean, it just...sits there and festers in them. And my acknowledging it and hearing it is probably new and unexpected. And uncomfortable. 

Listening to the hatred many autistic people (especially those who live in congregate care) have been asked to hold over and over again is plain intense. And I leave sessions feeling as if my clients hate me.

Actually, though, after the initial "oh, woe is me" phase, I do manage to realize, "um, this is countertransference." And I start to wonder if what's really happening is that my clients are asking me to help them - to help them cope with the hatred they're having a hard time metabolizing. In their own way, I think they're asking me to hold on to the hate, to figure out what to do with it, say it out loud for them, and help them find a way to make sense of it. 

And the only way they can ask for that help is to get me to a point where I feel as if they hate me. And I have to be able to experience that awfulness. That terrible "nothing I do has any effect on you, I feel as if I have no power over my life" feeling.

Because until I've fully gone through the pain and rejection with them, they don't know that I've heard them. And until I go through it I don't know how they're feeling.

Next week, I will go back to them. I will sing about it, and I will say it out loud and give it a voice in the music. And hopefully the relationship will grow just a little deeper. Because I allowed myself to feel as if they hate me.


This is one of the songs that came up in the session. 

"I Wish I Knew How It Would Feel To Be Free"

It started some months ago when I, quite by accident, discovered that one of the men I work with (he's autistic, he doesn't use speech to communicate) can indicate "yes" or "no" by pointing to (well, usually by grasping and releasing) one of two index cards. He doesn't need my help (other than to hold the cards in front of him). 

He doesn't always do it. In fact, sometimes he very pointedly chooses not to do it. Sometimes he crumples up the cards and tosses them aside. Which is why they're laminated.

I think, understandably, his feelings about communicating and being heard are deeply conflicted. Even if he were to begin pointing at more words and letters to communicate, the likelihood he'd be listened to is...well...slim. The people in his life are largely committed to seeing him as severely disabled. Period.  

We've been sitting in that unsettled, anxious, frustrated, what-the-hell-do-we-do-now state for a while. I can see he wants to say more. He picks up the letter boards I keep nearby, but he gets upset and then tosses them on the ground.

Aside from trying to come to terms with the whole idea of actually communicating with me and having me understand him- overwhelming in and of itself for him, I think- there's the fact that it probably won't change his life in any appreciable way. 

When it was time to stop we walked back to the unit and I dropped him off in his group (letting him know when I planned to return for his next session). I went into the office and signed him back in, and then I walked around so I wouldn't upset him by walking back through his group. He doesn't tend to like when we have to end.

But he knew I was there. So he left his group (much to the dismay of his staff) and wanted to follow me. He doesn't usually do this, so I sat with him for a little while in the back hallway. 

I wasn't sure what to say, but the words that ran through my mind were the title of a Billy Taylor song, I Wish I Knew How It Would Feel To Be Free. 

I didn't remember much of the song, and I wasn't sure it was something I could conjure up sitting there in the hallway. All I could think to offer him was the reminder that "nobody can take away who we are inside." 

We sat quietly as the shift changed and after a few minutes he got up and headed back in to his day area. 

Sometimes this work is really hard. Really, really hard. 

A book chapter, a presentation, and an interview

Whew! What a fascinating and busy few months it's been! 

Aside from my usual and intense immersion in work, there have been some nifty things happening. Here's what's been up:

First, I am extremely honored to be a part of a new book, edited by Sue Hadley, who is one of the people I greatly appreciate and admire, because she's willing to talk about the stuff nobody else talks about. This time she's talking about race and culture in terms of how it's experienced by music therapists. Here's the description of the book from Barcelona Publishers:

Experiencing Race as a Music Therapist: Personal Narratives is a compilation of critically engaging narratives that grew out of conversations with 17 music therapists living in different parts of the world, from various “racial” groups, about their experiences of their racialized identities in the therapy setting. The music therapists describe the raced and cultural contexts in which they were born and describe the racial demographics of the places they have lived at various times in their lives. The countries in which the individual music therapists spent their formative years include Australia, Canada, Iran, Japan, Korea, New Zealand, Puerto Rico, South Africa, the United Kingdom and the United States, with many of them also having traveled to other countries. The music therapists discussed their specific experiences of their racialized identities when they were studying music therapy and how they experienced their racialized identities in their professional lives. Many of them also described the differences they were aware of in terms of how they experienced themselves as raced or how they experienced the therapeutic relationship when they were working with people of their own “race” compared with working with people who were from a different “race.” From these narratives, we can see that our life experiences shape how we understand ourselves and others, our assumptions and biases, and the effort with which we form relationships with different groups of people. The music therapists in this book have shared their experiences in the hope that we can learn how to sit in our discomfort, without judgment, lowering our defenses, in order to learn more about ourselves and others, so that we can deepen our understandings and our relationships across racialized lines.

I've been slowly reading through the narratives, and they are engaging and thought-provoking. I encourage you to check out this book. It is a wonderful invitation to deeper reflection and conversation about a topic that does not generally come up in our field.

Second, I spent a lot of time trying to organize a presentation I did for the most recent Mid-Atlantic Regional music therapy conference, "Countertransference Songs: Another Way to Listen" (you know- countertransference- one of my favorite topics!). Here is how I described the session:

Far from simply being a means by which to convey skills and the general expression of feelings, music can be used on another level to better understand our clients- especially those who don’t use speech as their main communication modality. Paying attention to the music that emerges in sessions- for example, the sounds we typically use in response to particular clients, or songs that suddenly pop into our minds as we work intensely with someone - can offer us another avenue by which to understand what is going on within the therapy relationship.

Starting from the premise that the therapy relationship is the healing element, the focus and, more significantly, the work of dynamically oriented music therapy is to look at and explore the relationships that develop between the therapist, client and music.

As active participants in the therapeutic relationship, music therapists experience a range of countertransference responses when working with clients, some of which are explored in supervision and some in personal therapy. In this presentation we will start  from the assumption that countertransference includes all of the feelings, reactions, fantasies, thoughts and ideas the therapist experiences in relation to clients, either in response to how a client/group is perceiving him/her, or based on the therapist’s own personal history. Of course, one of the ways countertransference may be expressed within a music therapy relationship is through the music.

Two case studies will be presented, the first of which will describe how musical countertransference became apparent within the context of the type of music improvised in a client’s sessions. The second will follow a lengthy series of countertransference-generated songs that emerged as a part of the therapy relationship. In both cases, exploring the therapist’s musical responses moved the therapeutic process toward deeper understanding of the clients’ internal worlds.

I actually only ended up presenting one case study (since it had all the elements I described). The biggest challenge was trying distill many years worth of therapy (and tons and tons of examples) into 90 minutes! 

As often happens, in the process of reviewing the (volumes of) notes and the songs and the music that came out of this man's sessions, I gained a lot of insight into some of the ways my countertransference reactions caused me to miss some aspects of what may have been going on with him at various points in the therapy. 

Honestly, there was just so much, and it's such a complex topic, I'm wanting to present this material again within a longer context (meaning, maybe a CMTE proposal is in order). 

Meanwhile, the third exciting thing was being a guest on the music therapy world's answer to The View- yes, I got to chat with the lovely ladies of The Music Therapy Roundtable! I mean, look! They even have their very own mug (and, see, they sent me one too). How cool! Heck, how organized! 

I got to blather on and on with Rachel Rambach (of Listen & Learn Music fame) and Michelle Erfurt (the original Boom Tote designer herself!) - their third partner, Kimberly Sena Moore was in transit so she couldn't join us - about one of my other favorite topics: professional clinical supervision! And you'll be thrilled (I'm sure) to know that I discovered I have a shocking tendency to rely on the word "um" while being interviewed. Oy.

And, if you've taken it to the next level and you're a Music Therapy Pro subscriber, you can listen to yet more of my incessant chatter on their Pro podcast. 

So that's what's been happening in my land. I'd love to hear what's going on in yours! 

Fifty shades of "no"

I've been sitting and stewing over the fact that one of my clients decided not to come to his session yesterday. Obviously, it's not the end of the world, and it's mostly likely he'll be back. But I know he's upset with me and he's struggling with a lot of feelings because of the difficult work we're doing right now.

Occasionally, clients with whom I've developed a fairly stable relationship (and I can tell you, that has usually come after quite a long time of working together- usually years), who I can almost always count on to be there for their sessions, refuse to come to music therapy. 

And  when I say "refuse to come to music therapy" I mean I've walked over to their building, signed them out, collected their outer gear, walked in to the group where they spend their days (along with the rest of the people who live with them and along with their staff people), and asked, "would you like to come to music therapy today?" 

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

I'd like to pause here to say what a vulnerable moment this is- for me anyway- as a music therapist. I mean, I'm standing there, exposed, and, honestly, it's like inviting someone out on a date in front of their entire family. Only it's therapy (which is just as intimate as a date, if not more so at times) and the other people in their group may have feelings about this particular person being invited to go to music therapy (when they themselves are not being invited) and their support staff who usually have their own feelings about the person who's scheduled for music therapy as well as a series of opinions about me and what I represent (sometimes good and sometimes not so much). Additionally, support staff have a series of beliefs and understandings (usually passed down from their supervisors) about their role in clients heading out to programs (such as music therapy). Commonly, those beliefs and understandings involve making sure the person is clean and tidy and goes and does what s/he is supposed to be doing. 

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

Now, most of the time, the folks I've worked with for a long time jump up and come over on their own and then pull me to the door. Others go and sit in their wheelchairs, waiting for me to take them out. Some people who have a harder time initiating actions or simply have a lot of physical involvement making it more difficult for them to stand and greet me, wait for me to approach them and let me know they want music therapy that day by making an effort to get up and go with me.

Over the years I've discovered a large (and important) part of my work is figuring out how my clients (most of whom don't use speech) communicate "no".  Some people (the ones who usually hop up to meet me) simply don't get up when I appear and remain seated. Some (who need more physical assistance) let me know by not allowing me- or just not helping me- to put on their coats. Others avoid going toward the door, and I've had a couple folks  pretend (vigorously) to be asleep. A few of my clients will come part of the way with me and then stop repeatedly or keep going in the "wrong" direction, and still others come to the session, wet themselves and have to return to their buildings to get their clothing changed. 

The gentleman I went to pick up yesterday is someone who usually gets up the minute he sees me and comes quickly over to take me by the wrist and pulls me toward the door. His "no" came after a particularly hard series of sessions in which I've been challenging his way of thinking about me and about the role of music therapy. 

His "no" started when he stayed seated, looking at me with a rather unhappy face, leaning his head on his hand. I wondered (out loud to him) if he had a headache (it was pretty loud) or if he was tired (sometimes he doesn't sleep too well). I waited a short time and then I told him I'd go out for a few minutes, come back and check again with him. "If you still don't want to come, that's fine, and I'll check in with you again next week."

So I went and stood in the hallway for three or four minutes and then tromped back in with my armload of sweatshirt, coat, gloves and a hat for him. He still didn't move. 

Mercifully, his support staff didn't tell him to "get up" (which is what usually happens, and, when they do that, he usually stands up and comes with me, but I'm well aware the entire time that he would not have been there had they not told him to be, which, I think we'd agree, is an awful feeling- for both of us). 

I offered to sit with him for a bit, because sometimes he actually needs some more transition time (or to just think about whether he really wants to skip music therapy that day- and it's very rare that he does), but he still didn't get up. 

Just as I was about to turn and leave, he got up and walked past me to the table (where there was more space for me to sit with him and also plastic blocks he likes to hold). He couldn't find any blocks (they were all zipped into a bag, and I guess he didn't want to mess with it just then), and he went to sit down in another chair. This time there was space next to him, so I sat down and pulled off my hat. 

I invited him to let me know if he wanted me to leave by looking toward me and if he wanted me to sit with him to indicate this by tapping my arm. He glanced my way, fleetingly, twice and made no move to grab my hand (which is what he generally does). 

"Okay then. I'll check in with you next week. I'm glad you let me know you didn't want to come today, and I'm glad you let me know you'd rather I don't sit with you right now."  

I wished the guys a decent weekend and headed out into the hall, kind of hoping he'd change his mind and come after me. He did not. 

I headed back to the Music Room, pondering the whole thing, reminding myself that he was likely wanting me to feel as rejected as he'd probably felt in our session. 

But then the inevitable worry began: Did I say something in the wrong way in his last session? Did I accidentally offend him? Did I hurt him by saying something he wasn't ready to hear yet? Is it irreparable? Will he give up and stop coming to music therapy? 

As I was pondering these questions, yet again, this morning, I realized, not only is this the usual litany I go through when a client chooses to not come to music therapy on a given day, but my confusion- my wondering what happened, did I do something wrong, will this person leave- probably very much mirrors the feelings my clients have had with regard to their families placing them in an institution.

Perhaps (along with "no") I was "hearing" his (and many of my clients') experience of ambiguous loss,  which is a loss that doesn't have clear closure and around which there are questions and a great deal of uncertainty. It's often thought of in terms of families' feelings regarding a child who is disabled or mentally ill or a parent or spouse who has Alzheimer's (for example), but there is little, if anything, written about the experience of the person whose family sees them as "gone" or "lost" to them because of their disability. 

When I arrived back in the Music Room, I found myself singing the following song, and once again, I felt amazed at the way our minds speak to each other through music.

"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. 

Music Therapy Show with Janice Lindstrom

I feel as if I've finally arrived in the land of music therapy. I've had an interview with the lovely and thoughtful Janice Lindstrom, the woman and music therapist behind the Music Therapy Show!


We talked about relationally-based music therapy, using a process (versus product-oriented) approach, countertransference, using music to listen to and reflect on what our clients present to us in sessions, and all kinds of nifty stuff.


If you'd like to give it a listen (and share your thoughts on these subjects) (that are near and dear to my heart), here it is!

Listen to internet radio with Janice Lindstrom on Blog Talk Radio

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 

Music and countertransference

If you're a person who has been reading this blog, then you know I make liberal use of songs that emerge as a part of music therapy sessions (a couple of other examples can be found here and here). The way I think of these countertransference songs is as a form of unconscious communication that's going on between therapist and client- the stuff that's not being said.


Obviously, since the vast majority of my clients don't use speech, it would stand to reason that these songs are a particularly helpful (and necessary) aspect of the work. 


So, I've been thinking a lot about one of my clients who has been falling asleep in his sessions lately. He gets tired from his medications, I think, but he also doesn't tend to sleep particularly well (a lot of my clients don't). 


At any rate, it seemed to me as if there was more to it than just being tired (I'll explain in a second). I mean, sometimes he'd look fairly wakeful, want to come for his session, get to the room, go lie on the couch (I know, I know, how Freudian can you get?) and suddenly he was exhausted. 


Hey, man. I know how it goes. I've been there before when there's stuff I'm having a hard time looking at- I start journaling about some difficult issue, and suddenly...I need a nap. I get it.


Anyway, here's something that completely fascinated me about our sessions: for the longest time, whenever I played an improvisation in his sessions, I'd think, "Wow! That was gorgeous! I must write down some of those chords, because they'd be great to play around with when I'm writing a song!" And I'd quickly write down the chords, and then, after the session, I'd play them, and what the hey? They never sounded quite the same after my client left. They were nice, but there was something...missing, and it just...didn't sound right. 


After a while of this unusual musical situation happening over and over and over (hey- these things take time!) I started to wonder, "What is this about? Why the heck is this happening?" And I realized this was some kind of countertransference, so I started to talk about it with my client, trying to enlist his assistance in figuring out what he might be needing me to hear (through the music that was only beautiful during our sessions but never afterward). 


I've spent the last couple of months with the following working hypotheses: 
1) Maybe he feels like he has to put on a nice, happy face because somehow he's gotten the idea that this is what people in his life want from him (can't imagine where he could possibly have gotten that message).


2) Maybe he only feels as if he's "beautiful" when he's in music therapy.


Of course, I could be wrong about all of it, but these are what I started working with and bringing up in sessions. So, I started talking about this with him. And the more I talked about this, the more he'd get to snoozing! 


Think I hit a nerve? I think so.


As you can imagine, he and I have been stumbling along now, and somewhere back in May, we were in a session together, and I suddenly heard the lyrics of this song (Joni Mitchell's "Trouble Child") enter my mind. And, as always, as I mentally sang through the song, I thought, "Hunh! This is worth giving a joint listen." 


Interestingly, it's taken a while for us to actually get through the whole song in a session (did I mention he keeps falling asleep?). And as soon as I share the lyrics with you, you'll see why. 


[I debated whether to use my version of the song or the original, and I opted for mine- but linked Joni's version- because it's about the therapy and the use of songs to have a deeper understanding of our clients. I'd add a lot of disclaimers, but they're not going to be of much  use to any of us, so here it is. I had to cut out all of my blabbering because I talked for too long, so that's why it sounds as if I started in mid-sentence.]

Trouble Child

(Words and Music by Joni Mitchell, Copyright 1973 and 1974 Crazy Crow Music)

Up in the sterilized room where they let you be lazy,

Knowin' your attitude's all wrong, and you gotta change and it's not easy.

Dragon's shinin' with all values known,

Dazzlin' you, keepin' you from your own,

Where is the lion in you to defy him when you're this weak and this spacey?

So what are you gonna do about it, you can't live life, and you can't leave it.

Advice and religion you can't take it, you can't seem to believe it.

The peacock is afraid to parade, you're under the thumb of a maid.

And you really can't give love in this condition, still you know how you need it.

They open and close you, then they talk like they know you, they don't know you.

They're friends and they're foes too, 

Trouble child, breakin' like the waves at Malibu.

So why does it come as such a shock to know you really have no one,

Only a river of changin' faces lookin' for an ocean.

They trickle through your leaky plans, 

Another dream over the dam,

And you're lyin' in some room feelin' like your right to be human is goin' over too.

But some are gonna knock you and some'll try and clock you,

You know, it's really hard to talk sense to you,

Trouble child, breakin' like the waves at Malibu.

Okay. First of all, Joni Mitchell is...brilliant! (By the way, go and listen to her singing this song. I seriously don't do it justice.) Second, oh my God! Look. At. These. Lyrics! The experience of a man living in an institution? With a serious reputation for having been a major bad-ass in his younger days? 


I can't say it enough times- I marvel, again and again, at the amazing ways we human beings find to communicate with each other!

It's a (musical) process

As I thought further about Video Journal #1 I did some writing about it and this is the song that emerged from that bit of processing. 


I think I said everything else I needed to say on the actual video. 


I do, however, want to reiterate the fact that using music to process my sessions has been incredibly useful in terms of trying to understand what may be going on for the folks I see for music therapy. Since they aren't able to use speech (and even if they were, none of us are always completely aware of why we feel out of sorts, and that's what we have our therapists for), I try to use the countertransference material so that I have better questions to ask.

Here, as promised, are the lyrics (with my further hypotheses thrown in for good measure in between things). (Apparently I didn't say everything I had to say on the video.) (Oy.) Sorry if it gets a bit difficult to read:

Blowin' In the Wind 

(Thank you, Bob Dylan!)

How many roads must a man walk down before you call him a man?
     (So much in just the first line alone! Many of the initial countertransference songs with this particular person were songs sung by girls- not just women, girls. And I have had the sense, off and on, that trying to develop an identity as a man has been an issue for him. Living in an institution, not using speech to communicate, and being seen as a disabled person first doesn't exactly  enhance one's sense of self much either.)
Yes, 'n', how many seas must a white dove sail before she sleeps in the sand?
Yes, 'n' how many times must the cannon balls fly before they're forever banned? 
The answer, my friend, is blowin' in the wind, the answer is blowin' in the wind.
     (This may or may not be stretching it a bit, but I wonder if he feels as if he's "blowin' in the wind" without a real sense of direction/meaning/purpose in his life.) 


How many times must a man look up before he can see the sky? 
     (Maybe this means something and maybe not, but his days are spent in a room that doesn't have any windows at eye level, and the windows that are there are, ironically, very high up and next to the very high ceiling.)
Yes, 'n' how many ears must one man have before he can hear people cry?
     (There's that whole sense of futility there and feeling unacknowledged and frustrated.)
Yes, 'n' how many deaths will it take 'til he knows that too many people have died?
The answer, my friend, is blowin' in the wind, the answer is blowin' in the wind.


How many years can a mountain exist before it is washed to the sea?
Yes, 'n' how many years can some people exist before they're allowed to be free?
     (I'm sure this line speaks- loudly- for itself, but it certainly connects to the feeling of being bound and stuck.)
Yes, 'n' how many times can a man turn his head pretending he just doesn't see?
     (I don't know about any of you, but this line always makes me sad, and it is particularly poignant in this context.)
The answer, my friend, is blowin' in the wind, the answer is blowin' in the wind.
     (Oh, I just realized that one of the struggles I've had in this man's sessions is this sense of "I don't know" and perpetual uncertainty. The answer, indeed, seems elusive!)


The answer is blowin' in the wind. 

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

One last thought: I'm always amazed at how clearly my clients are able to convey to me when I am (finally) on the right track. There is such a sense of discomfort within me until I'm finally able to process (or at least start to make sense of) the feelings that come up as a result of projective identification. Once the processed material is shared with my client, and the response seems to be, "yes, you're understanding me," I experience a literal internal shift, and the discomfort eases almost immediately. 

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?