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)

5 Reasons Why You Need To Process in Music Therapy

I was off listening to a terrific podcast on processing over at the Music Therapy Round Table (and I highly recommend you go over and give them a good, solid listen). Well, I wanted to make a comment, but it turned out to be, like, six paragraphs, so, um, I figured I'd better head back to my own blog home and write it all out here and link it back to the hardworking Round Table folks: Kimberly Sena Moore, Rachel Rambach, Michelle Erfurt, and Matt Logan! 

As Michelle mentioned (either in the Round Table podcast or the Music Therapy Pro podcast), this business of processing (especially in clinical supervision) is kind of my "thing" (which makes it all sound a little...suspect) (but, really, it's not). I mean, if we're going to be honest (and I think we must), this whole blog is about me processing my experiences as a music therapist. 

I'm determined (determined, I say!) to convince the  music therapy world that we need to make processing a regular part of our work routine. And, yes, I'm sure I've probably said all this before, but I'm saying it again. And this time I'm going to try to be more succinct (stop snickering, I can do this). Okay. Here goes:

5 Reasons Why You Need to Process in Music Therapy:   

1. Processing helps you move your work to a deeper level.

Put simply: processing helps you move beyond observation to trying to understand what you’re seeing, experiencing, hearing, noticing in a session. Matt Logan wisely pointed out that a part of processing is looking at the relationships between the therapist, the client(s) and the music. It's so easy to get caught up in “what do I do? What should I do next?” and completely forget to look at what’s there in the session in a deeper way.

 2. It helps you gain a better understanding of what you're doing and why. 

Thinking through your sessions and trying to understand what happened in your sessions helps you get a stronger grip on the ever-present question:

 What is music therapy?

The longer you practice, the more your understanding of the work you do evolves and your answers to that question change and grow more meaningful. Processing asks you to consider: what is the role of music in my work? What is therapy? Who are the people I'm supporting? 

The more deeply you understand your work the better able you are to communicate why a client, a facility, an organization, a state, a country, the world needs music therapy.  

3. We all have feelings about our clients, and it's important to consider their impact on the therapy process. 

You have feelings about your clients, I have feelings about my clients. It's a normal part of therapy called countertransference. It doesn't matter who you work with (infants right on up through elders) and it doesn't matter how long you've been working and it doesn't even matter what approach you use. It's all part of the process. 

And the things is: just because you aren't necessarily having strong feelings or reactions you might think of as being "negative" (sad, angry, frustrated) it doesn't mean that your feelings aren't getting in the way of your clients' growth. Of course, I'm not saying that they are - just inviting your awareness that they have the potential to do so. 

I'll use myself as an example:

When I pause and reflect on the folks who are in my caseload, I notice there are some clients who stick with me all the time, because the work with them is difficult (or because they appeal to me in some particular way), there are some folks who I avoid thinking about, some who I forget about entirely, and some whose sessions I truly enjoy. 

Processing helps me step back and look at the larger picture of what’s happening. Otherwise, I can easily get bogged down in the "session notes version" of things (you know...what happened first, then what happened) and never move beyond it. 

Processing means I start to be curious and ask questions: 

Hm, why do some of my clients appeal to me more than others? Why do some not? What is it about some people that makes me completely forget about them until I see them in a session? Why is a particular client frustrating me so much? What's my role in this? Is s/he reminding me of someone else in my life? Is my complete joy in working with a particular group of clients making it hard for them to explore feelings of anger they may be feeling toward me (whether it's about me or not)? Is my discomfort about a specific topic obvious to my clients to the point that they're they avoiding looking at it to "please" or protect me? 

4. Processing helps you realize that music therapy doesn’t usually happen in one single session 

Well, okay, depending on where you provide services, sometimes it does. In general, though, processing helps you start to put things together (from one session to the next, over a period of time of working with someone, etc.). If you’re someone who tends to use an activity/therapeutic music experience approach, it’s important to think about what’s going on from moment to moment in a session that you might not have thought to look at. A process paper can help you do this and encourages you to ask questions, such as:

What happened? What patterns am I noticing in our sessions?  Then you move on to: What was I hoping to do with this particular person/group? How did it go? What do I think about that? 

5. Processing with a clinical supervisor helps you see your blindspots.

You don’t see your blindspots. That’s why they’re called blindspots. You don’t know what you don’t know! And, like anybody else, you don’t think to ask yourself something you wouldn’t have thought or known to ask yourself.

And that's okay! That's why there's such a thing called professional clinical supervision!  Yaaay!

Processing with a clinical supervisor helps you begin to see things you might not have looked at before. It doesn't mean you're a bad therapist. It just means that having an extra set of eyes and ears (who happen to have more experience) will help you think about things you hadn't thought to think about before. (Shout out to Michelle Erfurt for your great point that you didn’t really look at stuff to the extent you did until you had supervision!)

So, lovely music therapists: What new and unexpected thoughts are you thinking about your clients and about your work? 

"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

Music therapy at the boundaries

It happens I'm a part of a group on LinkdIn for psychologists, counselors and coaches. Not that I'm a psychologist, counselor or a coach, mind you... 


But anyway.


We've been enjoying (okay, I've certainly been enjoying) a robust discussion with regard to the question of "how much of our personal selves do we share with our clients?"


To the best of my recollection (which is a bit, er, well, let's just say it's not what it used to be), Rachelle Norman has tackled this question (a couple of times, actually) in her blog, Soundscape Music Therapy. A while ago she wondered how much should she share regarding the birth of her baby (who is awfully darned cute, if you must know), and, in a more recent post, she talked about The Top 10 Rules to Break. A big hooray to you, Rachelle, for addressing this complex and apparently rather heated issue!

So, back to the conversation going on at LinkdIn...


I've been sort of surprised at how many counselors and therapists seem to believe, rather ardently, that the "rule" regarding the "therapist as blank slate" is too stringent. A large majority advocate sharing more of themselves as a way of "being authentic" with their patients. If I'm understanding them correctly, they seem to feel, "that's what our clients are really looking for- for someone to be authentic with them."

Interesting.

Among the questions that came up for me in reading comments along these lines was: are we really being inauthentic with our clients if we don't share on a personal level with them? And does being authentic with someone always mean being transparent? 

When I looked up the word, I learned that being "authentic" is associated with being genuine, or being truthful. Which is not the same as being self-revealing. Hm.

For me, I think the question of what and how much to share of ourselves boils down (as most things in the therapy situation seem to do) to another central question: whose need am I meeting in this situation?

As many music therapists are aware, simply because of the nature of our profession, we actually share quite a bit of ourselves through the music-making we do with our clients during sessions. Just as we learn about our clients through their musical expression, they learn an awful lot about us when we interact with each other musically.

Obviously, we do our best to keep to professional boundaries- for many legitimate reasons. One very large reason is the power inequity. It is (usually) a paid relationship. Therapy isn't meant to be a friendship, and, whether or not we choose a fairly egalitarian approach to our work as music therapists, we can't control (or ignore) our clients' perceptions that we have a certain amount of power, authority and influence in their lives. 

As an example, in my particular line of work (with people who have intellectual and developmental disabilities), I often remind myself of the fact that I have keys to my clients' homes, and they don't.

I wonder if, in the end, it's about coming to terms with the duality (maybe it's a plurality?) we are asked to hold as music therapists (or any kind of psychotherapist, I imagine). Yes, our clients often do come to us in pain and in a tremendous state of need- for, among other things,  friendship and for people to be 'real' with them. Simultaneous to that, we are bound to uphold our code of ethics, to maintain an awareness of our own unmet needs (and our rather human tendency to want to take care of those needs in all of our relationships- including those with our clients), and an awareness of the power dynamic that exists in the therapy space.

It certainly isn't easy to keep track of these various elements. Of course, as my supervisor often reminds me, "that's why they call it work."


What are your thoughts on boundaries and being authentic with clients? Does it depend on the situation? Or on the particular group of people receiving services? Are you likely to have more "flexible" boundaries with certain groups of clients and not as much with others? And what does that fact say in terms of the ideas and beliefs we hold about the particular groups of people we serve? 

Going South!

I know, I  know, where the heck have I been?! 


I'll tell you, it's been busy around here. Mostly, though, I've been preparing to present a five-hour CMTE at the national conference for music therapy in Atlanta next week! I haven't been able to attend a national conference in a few years now (not since 2006 when it was in Kansas City, MO!), so I must shout "hooray" that I'm finally able to go again (meaning, it's within driving distance). 


What will I be talking about (you may well be wondering)? "Developing the Art of Self-Reflection: Exploring the Relationship Between Therapists and Clients" (I mean, how would you recognize me if I didn't have a ridiculously long title?). 


I'm quite excited about it! From what I gather, so far anyway, there will be around ten people there, and that sounds like a very nicely sized group (although I imagine we could work just as well with a few more). I'm planning for a lot of interaction, music-making, and thinking (truly...who wants to sit for five straight hours and listen to me lecture? Well, lucky for you, I can't sit for that long these days). 


Anyway, here's the blurb. If you have any thoughts about the topic, do tell! If you end up coming to the presentation, I'm a fan of feedback!  I'm so looking forward to meeting those of you who are heading down to the conference (especially the lot of you I only know through online adventures). Safe travels!

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

Developing the Art of Self-Reflection: 

Exploring the Relationship Between Therapists and Clients

The relationship between therapists and their clients is an intimate one. When we add music, the level of intimacy increases. As with any relationship, as the level of intimacy increases, the levels of resistance, uncertainty, and investment also increase- on both the therapist's part as well as that of the client. One the one hand, we may put up unconscious barriers, preventing a deeper connection with our clients. On the other, we may become so merged as to be in danger of violating important therapeutic boundaries. As such, the music therapy relationship can become difficult to negotiate.

In this interactive workshop we will begin by defining countertransference. Using case examples, we will work toward an understanding of: What is it? Where does it come from? How does it affect therapy? How do we begin to identify and use countertransference in our work with clients?

Participants will then be invited to share some of the difficult aspects from their own work with particular clients that challenge them in some way. Through dialogue, journaling and music-making we will process and explore some of the following questions: What are some of the ways we use to avoid looking more deeply at some of the clinical challenges we face as professional music therapists? What are some of the beliefs and ideas we, consciously or unconsciously, hold about ourselves, about music therapy, about our clients? And how do these ideas and beliefs affect our work and our clients? Why are certain topics so difficult to bring up in sessions- even if we know our clients need us to do so? What is it about the topics? What is it about our beliefs and ideas that makes it scary? What kinds of messages are being communicated by us to our clients when we don't address difficult issues? 

Through these workshop experiences, participants will work toward developing the skill of self-reflection, using a variety of techniques to process thoughts and reactions that emerge in relationship to their clients. 

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? 

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.)

Video journal #1 (So THAT's what Countertransference Sounds Like)

Seriously. What is with me and all this numbering? 

Anyway...

With all this conversation about trying different forms of journaling (okay, maybe there wasn't any actual conversation, but it's definitely something that's been on my mind), I decided I wanted to try a video journal. So I did an improvisation after a session. Here's what that looked/sounded like: 

After I listened to it, it occurred to me that it sounded sad and sort of poignant. I was struck by how extremely consonant it was as well. I didn't think it would be. I guess the point is that maybe on some level I did know what might have been going on in the session, but it just hadn't become conscious yet. 

How wonderful that you're here!

Image via WikipediaWe music therapists are always trying to define what we do. Or, more specifically, help other people understand what it is we do. We write books and articles about it, we blog about it, we put together podcasts- all in an effort to convey to the masses a sense of what makes us go into this profession that seems to defy description!


But, if someone were to have asked me yesterday "what is music therapy and how does it work?", I would probably have said that it's about inviting people to be present to each other, and we use the music to help make that happen. 


Mondays are long days. For me, I go into work a little later and stay a little later. And, I think we can all agree: it's hard for any of us to transition into a Monday, which is, for most folks, the beginning of the work week. And I would say that it requires even more fortitude to get into the Monday spirit of things after a particularly long Thanksgiving weekend, which, of course, marks the beginning of the (dreaded) holiday season.


While staff frantically decorate the cottages and prepare for Open Houses (where everyone's family is invited to come and visit and there's food and music and merriment and so forth), my clients prepare for the annual anxiety of "will my family be coming to spend time with me this year?" 


So, this is a bit of the sense I got when I showed up to work with the group yesterday (Monday) afternoon- "the group" being ten men and me. 


Oh, where to begin? 


Well, let's see. There was a whole lot of messing with chairs (that would be P), switching of seats (that would be R), tossing instruments, trying to pick up instruments and then getting stuck on the floor and needing help to get up (that would be T), repeatedly rearranging and fixing the curtains so the sun wasn't blinding us (um, well, actually, that would be me), coming in, turning off the lights, and then leaving (that would be K), coming in, crying and starving to death and then leaving (a different K who does use some speech), and on and on, all accompanied by a low moaning (courtesy of J), the periodic fist to the head (of B), and the festive crashing of the tambourine (P again).


Can I get a witness? Anyone? Anyone?


Uuuhmmm. Now what?! (And if any music therapist tells you they know exactly what to do when their clients are all freaking out at the same time...just so you know- They. Are. Lying!)


I managed (do not ask me how) to get my thoughts together enough to be aware of the fact that, while the guys were all there, they weren't really There. Nobody was listening to anyone else in the room, we were all kind of...everywhere, but none of us was present to the experience of being in music therapy. 


I pointed this fact out to the guys (who, God bless them, heard me above the drama-filled din), and I asked them, "Gentlemen. What can we do here? How can we use the music? How can we use our thinking, to get ourselves to be here in this room, in music therapy, together? Why don't we just work on that, so that if we do nothing else today, we'll know that we cared about each other enough, that we mattered enough to each other, to notice that we were all here together."


Enter music. 


I moved over next to B, because I didn't want him to be hitting his head, and offered him my hand (he took it). He had been vocalizing while he was hitting himself, in a kind of a hum. So, since I couldn't play guitar with only one hand, I invited the guys to find some kind of way to hum with B to help him settle down.


I started to hum (in B's general key), and it didn't take long at all before the men found ways to join in with their voices and actions. J moved his arm, every few measures, up and then down to the beat. P, in spite of his tambourine prowess (and he really does rock on the tambourine) used his voice- which has more of an "oh" and "ah" quality. Yet another K quietly chimed in on the cabasa he was holding. R stopped moving around and sat, listening, with his eyes closed, breathing deeply. 


B calmed down and kept singing (but stopped hurting himself), so I was able to make use of both of my hands again. I played a very simple progression on the guitar- kind of an Asus4, Cmaj7, to D/F#, B, E (sometimes major and sometimes minor), and I repeated it as we sang and came together.   


It was lovely. 


There was smiling. The moving around and in and out stuff stopped. There was presence. We were looking at and acknowledging each other. 


We managed to be present in the session and we used the music to make it happen. The definition of music therapy on a Monday afternoon. 


And what makes this way of using music so cool is that this particular piece of improvised music  could only have happened on this day and with this group for it to have had any meaning. Taken out of context, it might sound okay, but it will never have the same impact as it did yesterday afternoon as we all sat quietly, after we finished, even after we sang goodbye, nobody wanting to leave quite yet, watching the sun set together.

Listen Hear

Evidently, November 1st was something of a celebratory day. A day to listen to what autistic people have to say. 


It's kind of unfortunate that there's a need to designate a special day for it, because most of us, autistic or not, want to be heard every day, but I guess that's the state of the world in which we live. 

Anyway, here are links to some of the blogs I read about this most auspicious occasion:

http://adeepercountry.blogspot.com/2010/11/regular-person-listening-day.html


and


http://adeepercountry.blogspot.com/2010/11/autistics-speaking-day-post.html


and also


http://adeepercountry.blogspot.com/2010/10/autism-is-world-and-youre-not-invited.html


along with 


http://flashbackdreamsequence.blogspot.com/2010/11/anatomy-of-autistic.html


and

http://www.journeyswithautism.com/2010/11/01/speaking-my-mind-and-heart/


and one more


http://life-with-aspergers.blogspot.com/2010/11/day-of-silence.html

For my part, I will do my best to keep listening.

Eating a slice of humble pie

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


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


Ugh!


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


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


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


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


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


Then it suddenly hit me! 


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


Of course!


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


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


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


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


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


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


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


She was smiling.

"Expectant waiting"

Image by thumeco via Flickr

I was reading an article this morning in an old issue of Unity Magazine (September/October 2005) describing  a Quaker meeting attended by the author, Mason Hayek.


Here's what he shared of his experience:

The Friends who have gathered have brought in their feelings from life as it is for each of them today...Each person has brought a bundle of feelings and sits clutching it. (p. 44)

Image via WikipediaAs time passes, the silence deepens, so that any sound  will seem like a rock breaking the window of one's mind. And yet, part of what we come for is the ministry, the message that we or others may speak. The ministry of presence is helpful and the strength that comes from meditation, contemplation, creative thought, or worship will reward our coming. But the words that arise from the honest and open searching for truth by others can open new paths for us. The words can catalyze our searching. (pp. 44-45)

From one's own worship and meditation, perhaps aided by the ministry of others, may come thoughts that are too strong to restrain. When the words beat against our brains irresistibly, we must speak.  (p. 45)

A Friends Meeting for Worship is a gathering in quiet, waiting and listening for the "still small voice within." (p. 45)

The essential elements of worship can all be practiced and experienced when one is alone, but Meeting for Worship has special qualities. It is a shared experience in searching for the truth, a religious experience enhanced by interaction with other persons. That interaction allows us to test reality. We can see our lives, wishes, and fears in better perspective when we interact with others under conditions where we respect our neighbors as well as ourselves. We feel joined to one another. (p. 45) 

In her online article, Silent Worship and Quaker Values, Marsha Holliday notes:

...Friends in the unprogrammed Quaker tradition base our worship entirely on expectant waiting. 

"Expectant waiting." I think that's such a lovely way to put it!


Two summers ago I attended a class at Pendle Hill, which is a Quaker retreat Center, where we were invited to participate in a Meeting each morning. 


I went once or twice, and I reflected then, as I did again this morning, on how similar it felt (to me) to the process of music therapy, especially when working with people who don't use speech to communicate. (I've written quite a few blogs- here and here, for example- about silence as an important aspect of music therapy.) 


In particular I was struck by the idea of presence within the silence and being present to the experience of silence.  


Unexpectedly (or maybe not), as I was thinking about this, I happened to read a blog, also this morning, about the experience of silence from the perspective of a person on the autism spectrum. 


Mike, the author of the blog Journal of an Autist reminds us:

Even silence speaks...Start by listening through all your senses, and you will hear us speak, even in our silence.

I'm not sure whether it's a taboo or not to talk about therapy and spirituality (I certainly don't see music therapy, or any kind of therapy, as a space to conduct one's religious agenda), but it's hard to not see the parallels. We create a sacred space within which the therapist, the client, and the music come together for the purpose of growth. There is complexity within these relationships and an effort to make sense of the complexity.  There is a joining together for a common purpose...all of these seem like deeply spiritual experiences to me.


I wonder what your thoughts are about this.