Back at it!

Okay. Seriously, this break from the blog has gone on way too long. Here's the thing though: 

I retired from my job in 2021. 

Yeah, I know. I never would have thought I'd be capable of it either, but here I am. Alive. Retired! And, astonishingly, kind of digging it. So...what the heck am I doing with myself?

I just finished a draft of an article for a special edition of Voices (with huge thanks to my friend, Dr. Henny Kupferstein, who kindly helped me re-organize and finish the thing already, before it ended up becoming a 387 page book). The title is Getting to 'no' you: When nonspeaking autistic people refuse music therapy. Here's the Abstract, in case you're curious:

Nonspeaking autistic people frequently begin music therapy at the request of others. Typically, family or care systems are tasked with making decisions on their behalf and have decided this service will be of benefit. Consequently, music therapy is a given rather than a choice. For this paper I have used my own evolving understanding to explore the complexities and power dynamics related to nonspeaking people being able to say ‘no’ to music therapy. Elements in this discussion include: (a) the ability, and safety, to say 'no' in the context of a culture of compliance (b) the complicated relationship between music therapists and the systems within which they work, and how this affects the therapy relationship, and (c) the role of music therapy practice standards. I advocate the following:  (1) presume competence; (2) enter the therapy space with curiosity and openness, (3) be willing to ‘get to know’, (4) coping skills or communication attempts are not ‘behavior’ in need of correction, and (5) learn how each nonspeaking person communicates ‘no.’ Actively encouraging and respecting treatment refusal goes a long way toward building a respectful music therapy practice/relationship.

 It was, as most things I seem to do are, a complicated topic. Not so much complicated because nonspeaking people should be listened to (that's a given), but more because I wanted to address (in as respectful and calm a way as possible) how many elements stand in the way of nonspeaking autistic people being heard at all, let alone experiencing self-determination. It, um, required a lot of editing before I could submit it. 

I finally finished reading Music heard so deeply: A music therapy memoir, by my colleague, Betsey King, which I quite enjoyed (especially the stories of her work). In fact, as I've discovered, one of the nicest things about being retired is having time to read! 

I've been exploring collage, because...why not? This one was inspired by one of the folx I worked with for a long time. He is a brilliant, curious man, who, besides being a news junkie, wanted to learn about space. 

As you might imagine, I miss the people who I spent so many years with as a music therapist. I suspect you'll be hearing about what it was like to spend my last year or so working, and retiring,  during a pandemic. 

So....you know...welcome back!  

How to be together

We sat together yesterday, our group of seven, on a Monday afternoon. And the curtains in the room were open to the afternoon sun, closed as the sun blinded us, and then open again to watch the beautiful dark frames of leafless trees against the pink and yellow and blue sky as the sun began to set. And, with the early evening news as a background, we noticed, for ourselves and with each other, our music was made of...

...sound and silence,

terror and safety,

change and consistency,

feeling frozen and being in motion,

comfort and discomfort,

certainty and uncertainty,

sleeping and awake,

light and dark,

presence and absence,

judgment and acceptance,

loud and quiet,

intensity and gentleness,

curiosity and detachment,

containment and freedom...

And then, this morning, I read and listened to this gorgeous conversation between Krista Tippett and Ann Hamilton. When Krista asked her what questions we should be asking, without hesitation, Ann responded:

"...how to be together. I mean, isn’t that — that seems like the biggest question. How to be together." (Ann Hamilton) 

Yes! And yes again!

There are so many who believe music therapy sessions with people who don't use speech as their first language are about "playing for your clients." In fact, it is about

listening, 

noticing, 

playing,

 experiencing,

 being

 and wondering 

together.

"...when you’re making something, you don’t know what it is for a really long time. So, you have to kind of cultivate the space around you, where you can trust the thing that you can’t name. And if you feel a little bit insecure, or somebody questions you, or you need to know what it is, then what happens is you give that thing that you’re trying to listen to away. And so, how do you kind of cultivate a space that allows you to dwell in that not knowing, really? That is actually really smart, and can become really articulate? But, you know, like the thread has to come out, and it comes out at its own pace." (Ann Hamilton)

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. 

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.

My life and times as a disappointing music therapist

The session that wasn't:

Walking to the session. Pausing to pull me toward somebody's car and tapping on the trunk:

"Um, no. We can not go in somebody's car. Please don't tap at it, or you'll set off an alarm and that would probably not be a good thing." 

Slowing down and sitting on a bench:

"Yes, I see that you don't want to go to do your session today, and you'd rather we sit outside on a bench."

Still on the bench:

"Yes, I realize I'm frustrating you, but music therapy is what I can offer. I can not take you for a ride, or for an escape, in someone else's car or in my car. I can, however, be your music therapist, and you can come to your session, and we can talk about it in the music."

In front of the Music Room door, but not going in:

"So, okay. You're not going to go into the Music Room."

Pushing past me and heading for the exit:

"I guess you're telling me we're not going to be doing music therapy today, and you'd rather go back to the cottage. Okay then. I'll try again on Wednesday." 

Heavy sigh. 

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

A musical portrait

Image by mommy peace via FlickrAt first I thought he was angry with me. He certainly looked quite solemn. True, I'd been away for a couple of weeks, but usually he's at least willing to stand up and go to the Music Room with me. 


So I pulled up a chair and sat next to him. "You don't want to go to your session?" I asked. He hung his head down. "Okay. Can I just sit with you for a little bit?" He looked up briefly and then face down again. 


We sat for a minute. "You can come and tell me in the music if you're upset about something." He was listening, but not moving. "You know, I'm going to just go get your jacket and hold on to it. If you still don't want to come with me that's fine. But if you do, we'll have your jacket. I don't know. Maybe we could just go for a walk. It's pretty nice outside." 


I went to the coat closet, fished out his, and went back to sit next to him. The guys in his group were all watching television, so I chatted about that. After a little while, he half-smiled, got up and reached for his jacket.  "Cool!"


We headed outside into the sunshine and walked slowly. I wasn't sure whether we were just walking or if we'd be going to do his session.  As it turned out, we made it to the Music Room. 


He moved the instruments I'd put out for him onto the bench at the end of the couch and proceeded to lie down so he was facing me where I was sitting at the piano. I could hear, from the way he was breathing, that his sinuses were really giving him a hard time. 


His facial expression was still quite serious, unsmiling. I sang a greeting and asked how he was feeling. He responded with a heavy sigh.


"I realize you may have some feelings about my having been on vacation. I wonder if maybe you're feeling angry with me." And I invited him to look my way if that was the case. He did not.


Oh. Hm.


"Feeling abandoned?" A little bit of eye-contact.


We stayed there, quiet. Where to go with this?


"I'm having a hard time figuring out what might be going on for you today. I'd like to play a musical portrait of what I think I might be seeing or hearing, maybe just sensing, from you right now. If you can, will you help me by letting me know if what I'm playing makes sense. Also if it doesn't sound right, can you find a way to steer me in the right direction? I'll do my best to listen."


I played, using the piano. It was halting, dissonant- really quite dissonant, and it didn't feel very grounded. I guess you could say it sounded like someone floating and unsettled. 


As I played, I realized I hadn't "heard" his initial response accurately. He wasn't angry. The music he inspired didn't sound remotely angry. It sounded, and felt, very sad. And it probably wasn't really about me. 


"I misunderstood. I'm sorry. I think, as I'm listening to the music, I might be hearing your sadness." Slowly he turned to face me. Wow. I felt his sadness too.


What now? Where to go with all this sadness? 


As I thought about how to respond, how to be present, I was reminded of my friend, Greg, who often quotes John McNeill to me: "If anyone is willing to enter my private hell and stay there with me, then there are grounds for hope."


I invited him to hum with me as I played. I started the music where I had left off- at the musical portrait. Gradually, the sounds on the piano became slightly- only slightly- more consonant. Eventually, I was just moving between A flat and B flat, humming quietly. 


I heard sounds from him- not a lot, because it was difficult to vocalize with his nose all stuffy as it was. I moved from humming to a quiet "ee" sound, thinking it might be an easier sound for him to make.


His eyes closed and he smiled briefly. I thought he might fall asleep, as he often does. But he didn't. He listened. And we sat together in the sadness and in the music.


It was time to go. I sang a quiet goodbye, reminding him I planned to be back on Thursday. I got up to get my sweater, and he followed me to get his jacket.


He took my hand and we walked back to his cottage in the sunshine. 

The eyes have it

I was very conscious of my clients' eyes this past week. 

I'm not sure why I was struck more than usual this week (as opposed to most other weeks), but I noticed there was a lot of eye-contact (which you would kind of think wouldn't really be the case when working with folks who aren't usually all that comfortable with looking directly at people). Anyway.


Here's a summary of my, um, eye-catching (sorry) moments:

1. D stared at me for quite a while during his session. Really. I'd classify it as staring. Something was going on for him, which became even more apparent when he got up and pulled me to the Music Room door (which he has only done once or twice in the 13 years I've worked with him) and headed us back to the cottage. I found myself feeling uncertain as to what was going on with him. Was he excited? Angry? Attracted? Frustrated with me? When he decided to leave the session unexpectedly, I felt disappointed and a bit confused.


2. R looking at me rather intently and frequently today. This is very unusual for him, because he usually looks at my hands and at what I'm doing on the guitar. I have very little conscious memory of him ever even looking at my face! I was joking with one of the other music therapists at work that I must be doing one heck of a job. After working together for almost 23 years (seriously), R finally approaches me and greets me when I arrive in his home. Maybe this is an extension of that?


3. W has been expressing some intense feelings toward me. I have, of course, been responding with "that's not our relationship." During a recent session, I said to him, "you know, it seems as if I'm really frustrating you a great deal lately."  He responded by looking at me. Very. Pointedly. [Insert slight squirm here.] And then he left his session early also. But this time, aside from feeling a bit confused, I also felt (yes) frustrated. ("Take that, you blasted music therapist!")


4. V greeted me today by scooting over to me, looking me in the eye, and taking both of my hands in hers when I arrived in her group. This, I must say, was a way friendlier "hello"  than she had been using when I showed up over the past three weeks! (Observe, to your right, the fascinating and unusual unhappy face she somehow managed- without even intending it- to create on my arm with her nails...isn't that wild?) (And, no, don't worry. I'm fine.)


It certainly looks as if the eyes have it this week! (Sorry, again, for the dreadful string of puns.) (Really, I can't help it.)

Can I get a witness?

Maddeningly, I managed to catch a cold the minute I returned to work. Well, I suppose it has to happen once in a while. As such, I've spent the last two days mostly napping and reading (and, of course, feeling guilty about missing work) (so much for my "perfect music therapist" fantasy) (ahem).


So, while I'm sneezing away here, I figure it's a good a time as any to post an update.


Update #1: The two taboo topics presentations seemed to go fairly well. There was a lot of dialogue, and a couple of people came up to me afterward and told me they had continued the conversation (some from last year) at their workplaces (which is very cool). 


Update #2: I submitted a proposal to do the CMTE (the one I just did at the Mid-Atlantic Regional conference) at the national conference (that would be for the American Music Therapy Association). I changed the title though (just the title). I proposed it as "Developing the Art of Self-Reflection: Exploring the Relationship Between Therapists and Clients". We shall see what happens. 


Update #3: I'm in the process of organizing myself (a task, I admit) so I can put a goodly portion of the work I did on the CMTE into a book (or a monograph of some sort).  Why am I telling you this (you may well be asking)? Because now that I've put it out into the blogosphere, I'll be forced to get on with it and do it! 


Update #4: I had a very touching experience (when I got back to work) with a small group of women who usually react to my absences by being quite challenging and doing a lot of testing and such. This time around, when I showed up on Monday, they all gathered closely around me while I sang "hello" to them. It was so sweet! And...


Update #5: ...the whole session was made even more phenomenal by the fact that their staff person (when approached by a client from another group who wanted to come and sing with us) very beautifully and kindly explained to her, "It's really nice that you want to come and sing, but this is a music therapy group, and Roia is working specifically with the ladies in this group on goals and stuff. She'll be here on Thursday to do the singing group, and you can go join her then." Sproing!!! Somebody shout "amen!" because that was probably one of the most respectful moments I've had in my career as a music therapist! I am so sending her boss a  happy note of "check out what your cool staff person said!"


I think that's pretty much the story so far. It was a good conference, I must say. It was particularly lovely to put some faces to names I know via Twitter and the music therapy list serv. And there were some really excellent and thought-provoking presentations. Another delight was gathering with music therapy colleagues and students to just play music togehter. Of course, staying up way too late probably contributed to my ending up catching a cold, but it was worth it. 

The Act(ion) of Thinking

Image via WikipediaI've been thinking about RD of late (well, particularly today, because we had a session this morning). 


RD is a very sweet young man on the autism spectrum (he does not use speech to communicate), and he is very particular about things. And by this I mean that he seems to believe that all things should have a place (I think I can thank one of his family members for his excellent manners and his tidy nature.)


It so happens, that we work in a terrifically messy room in his cottage (oddly enough, it's the, um, "sensory room") (yes) (well). 


Anyway. 


No matter how much I try to clean up all the clutter in the place before I go and pick him up for his session, he still finds things to, er, tidy. 


He also likes checking out all kinds of objects. He has a collection of action figures with giant feet (I don't want to know!), and his staff people find him books and various things that have moving parts to them. He keeps them all in a big box with his picture on the front. Great! 


So. Back to the aforementioned "sensory room"...


Because this is, apparently, a full service sensory room, there are almost always broken battery-operated sorts of things lying around in varying states of function and dysfunction. This means that the batteries are lying around (lovely), and the little parts that keep the batteries quietly tucked inside the gadgets are also roaming about freely.


RD, being the tidying kind of guy he is, and being the kind of person who likes to bond with objects, has been picking up these little plastic parts that were supposed to hold in batteries. He just turns them over and over in his fingers and holds them close to his face so he can examine them.


While he's doing that, he sings. He hums little melodies (I've come to learn that he repeats specific melodies with small variations here and there). I either sing them back to him or play them on the guitar (with my own variations and chords). And while he's scurrying about the room arranging things, we sing and play back and forth with each other. 


The other thing you need to know is that, when he borrows an instrument from me (to check out as described) he often puts it back in the closet that's in the sensory room. As such, I have to go and retrieve the instrument quickly because otherwise it'll be there for all eternity (I have reached the official limit on my brain's memory card, and, let's face it: some things are just going to have to go!). 


Now, not only does he take my stuff and put it in the cottage closet, but he puts stuff he picks up in the cottage on my music cart or in my instrument bag. I am forever pulling things out of my bags (after his session) and putting them back in the room (back in circulation, as it were).


Okay.


So, as I mentioned above, I was thinking about RD, and I was wondering: why does he keep putting cottage things in my bags? And why does he keep putting my stuff in the sensory room closet? What's that about? Is there something he might want me to know? Or that I should be noticing about this?


And I thought, hm. So I mentioned to him during his session that maybe he needs to have me hold on to a small piece of him when I go (i.e., don't forget me, please). And maybe putting my stuff in the cottage closet is a way for him to keep a piece of me as well. 


When I gave it some more consideration, it occurred to me, again, that here's a guy who likes everything to have its own place- whether it's the "right" place or the "wrong" place. And I remembered that he himself grew up in a few different places, being sent around to various family members, because his mother died when he was an infant. 


And now here he is with us, in an institution.  


And it made me think about objects. And about having a place to be. And I wondered (out loud to him) if maybe it was important to him that he have a specific place to be. And what his thoughts are about being in the "right" place or the "wrong" place. And which one he feels the institution might be.


RD's response was to increase his singing. He and I sang back and forth for ten more minutes than usual today (we usually make it for 20 minutes, but today it was 30!) before he hopped up and began pulling the guitar off of me to indicate that we were finished.


So, I'm thinking this is veeeery cool. 


Definitely warrants some more thinking...

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?

The big comfy couch incident

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


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


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


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


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


To put it mildly, we were all shot!


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


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


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


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


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