"You are showing them that they exist"

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

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

MS. TIPPETT: Mm-hmm.

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

MS. TIPPETT: Yeah.

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

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

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

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

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

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

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

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

Bringing it all back to "Do"

I live in New Jersey, and everywhere I went during the two weeks after mega storm Sandy (work, the grocery store, the library, the gas station), people asked me, "Did you lose power?" 

And I was struck by the metaphor contained in the question: "Did you lose power?" 

People in this area experienced, quite literally, being- let alone feeling- "powerless" (on a lot of different levels). They struggled through "power failure" and had to wait for their "power to be restored." 

Many of my students at Montclair experienced "loss of power", leaving them sounding  somewhat rattled when we returned to class. A music therapist I know described her disabled clients' distress as they coped with yet another storm requiring their temporary relocation to safer and warmer living quarters (we had Hurricane Irene last year, along with a freak snow storm at the end of October, both of which caused a lot of power outage and flooding). 

In pondering our collective experience, I got to thinking, as I tend to do, about how this connects to our work as music therapists- how we react to the unbalancing effect of going through a frightening experience such as a major hurricane (for example). 

As I played around in my mind with this idea of power loss and restoration, I thought about how we in music therapy are, essentially, working in a musical way to restore power, intra- and inter-personally. 

And, sure, this may be sort of a weird way to say it, but, if I were to say this using musical terms, I guess I'd be saying that in music therapy we're working toward "bring(ing) us back to 'Do'." 

[A special thank you to MJ Landaker for her recent post about the important connection between music theory and music therapy. It certainly helps to understand why music is so "powerful" (if you will).]  

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 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? 

Who's in charge here?

I realize this is going to sound like I'm ranting. And not only that, I'm fairly certain I'm going to sound judgmental. And you know what? Maybe I am. This issue is so profoundly important that I think it deserves a bit of a rant, so I'm going to ask you to bear with me today, because this is serious.


It's not exactly news to anyone that I work with people who have intellectual and developmental disabilities (many of whom also happen to have autism and many of whom do not use speech). When I'm talking about clients (below), I mean it to apply not only to doing music therapy with folks who have a whole bunch of labels, but I'm talking about working as a music therapist in general.


So, why am I carrying on? Let us commence with the rant now, shall we?


I have an important question I want us to consider: Is it our clients' jobs to listen to us? Or is it our job to listen to our clients?


I ask this, because I've been noticing what seems to be a tendency in music therapists to go in to a new session and expect their clients who have severe disabilities to just do what they ask them to do. As in, "here are the planned activities/events, and here's what I think you ought to do. Your job, client of mine, is to perform these tasks/activities. And my job is to get you to do that. Period."


Well. Okay...but...


Let's pause a second and think: whose need are we here to meet?


If we want to teach our clients to be better listeners, are we modeling that by listening to them? If we want to help our clients to be be better at paying attention, how willing are we to pay attention to them? If we want people with significant disabilities to engage with us, what steps are we going to take in order to engage on their terms? 


If we can't understand the language someone is speaking (particularly if their language does not contain words), are we truly serving that person when we expect him/her to do what we ask before we even make the effort to try to learn about who they are?


Again I ask the question that my college music therapy professor asked us all the time: whose need are we here to meet? And is that need best met by our coming to our clients in a music therapy session and expecting that they will do what we'd like them to do? 


Or is that need best met by asking that person to help us learn about who they are (even if they don't use speech to say it) and then creating the musical space within which our client can find a way to communicate and then making a point of hearing it?


We are music therapists. Let us honor that fact and work hard to develop skill in the art of listening. 


Let me end by saying this: when we work with folks who confuse us (and even if we think we know what's going on), the first place to start- always, always, always!- is by paying close attention and listening as hard as we can! 

Getting to "no" you

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


I thought you might be interested in a brief update.


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


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


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


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

Exposed

Image by fabbriciuse via Flickr

I'd love to be able to explain why I haven't been writing any blog posts of late, but I'm not sure I could. It's not as if I haven't had things to say. I mean, I've got various notes in journals and on scraps of paper reminding me of thoughts I've had, issues I want to blog about. I've (mostly) accepted that I will write when I need or have to write. 


Today I'm feeling a need to write.


Yesterday morning I showed up for a session with a client I haven't been able to see for two weeks. There were some scheduling changes and then there were some scheduling conflicts, and that's the way it sometimes goes. 


Fine. 


I knew I had to be prepared for possible reactions to my absence. On the other hand, I wasn't sure how "real" I was to her as yet. C and I have only worked together since January. She seems to recognize me these days, but the relationship still feels fairly tenuous.


I found her at the other end of the cottage, and she smiled (which seemed like a pretty good start). She walked along with me and then pulled me toward the bathroom. I was hoping we wouldn't have a stripping issue, but her staff told me she might need to use the toilet. Okay then. 


Her staff accompanied her to the bathroom area, reminding C that she needed to be supervised (for a few reasons we needn't get into), and I waited in the empty day area where we'd be working. 


While I was waiting, K, one of the supervisors (who happens to be a former music therapist), came over to ask me how things were going with C. She was being nice, because I knew that it was code for "The staff are annoyed with you, because you 'let' C strip when she's in music therapy." To K's credit, she wanted to hear my take on the stripping. 


Apparently, I'm the only person who has this problem with C suddenly taking off her clothes (other than the afternoon shift).  


Great. 


I don't know exactly why C strips in music therapy. Maybe it's because I'm mostly new to her. Maybe it's because I only see her once a week (and even that can vary because of her schedule and mine) not every single day, and she doesn't know me that well. Maybe she's testing me. 


All I can say for sure is: I'm trying.  


So that was how I went in to the session.


C came on out of the bathroom with her staff person, and she was in good spirits, everything was going along, she picked up her giant beanbag to set it on her lap, sat on a comfortable couch, and we were off. 


She was vocal, I was reflecting, she was engaged, I was responding...all good things. She was bothered, for some reason, by a couple of binders sitting on the table, so I took those and put them in the next room, and we resumed our musical interaction.


Until...


C decided she needed to go to the refrigerator (there's a dorm sized fridge in the day area where we were working). Now, understand that: 


1)The last time we had dealt with the refrigerator, there was a lot of iced tea to be cleaned up. A LOT of iced tea. 

2) She has a very sensitive stomach, and I wasn't sure what she was safely allowed to have. 


3) It was 11 AM and not long before lunch when I knew she'd get something to drink anyway. 


4) I wanted her to focus on the session. Yes, that was my issue, but for that moment I decided it was a legitimate wish on my part.


Well. I asked her to wait until later, and that was when it all started to deteriorate. Rapidly. Suddenly, the jacket, pants, underwear, adult diaper, shirt and bra were on the floor. 


Crap!


I managed to get her into the bathroom area (and pick up the assorted clothing items) and then it just went from bad to worse. I was aggravated, C was freaking out, and it was argue, fight, fuss, refuse, be naked (not me), and consider becoming a hermit so I'd never have to deal with people again.


Finally, after about 10 minutes of achieving nothing I decided to ask for help.  


Her staff (the one who had helped her in the bathroom earlier) came in, and C set up a yell, but she got dressed.


Wonderful. 


I hung around in the bathroom for a while, trying to watch what her staff did to get her organized (wondering what I had done wrong, not thought of, why I went in to music therapy anyway). 


When they came out of the bathroom area (which is a big area, I must tell you, with a bunch of stalls, showers, a bathtub, and so forth), and C was dressed and calmer, I reminded C (and her staff) that I would see her in two weeks, and that I hoped we could find a way to have her stay dressed.


Her staff commented that "Oh, she'll be dressed when you get here. It's after that we're not sure about," which is code for "If you were a competent professional, my client would not be naked by the end of your session, would she?" 


"Thanks for your help."


I stewed about this for the entire rest of the day, feeling horrible and inadequate. 


And then I realized this morning that the thing that made me most angry about the situation yesterday was that I ended up acting from a place of anger and shame with regard to my reactions to the staff people and not from the perspective of a clinician. 


As such, I'm not only frustrated by the fact that the whole session went to hell suddenly, but I'm also bothered by the fact that I felt as if I allowed my feelings about staff's opinions about what I do/don't do/how I do it to get in the way of my being C's music therapist. 


Now, I'm sure that as soon as I settle myself down about all of this, I'll be able to use these new pieces of information I have (yes, also known as countertransference) in a more constructive way (you know...like, for one thing, using it to get a better understanding of what my client may be going through that she feels the only way she can communicate with me is by stripping).


Until then, I'm still annoyed and agitated about the whole thing. 

1/12/10 Quote(s)- Music therapy and power

Image via Wikipedia

I think a lot about power in the music therapy relationship, to the point where I've even presented on the topic. 


So I was thrilled to find an article in the British Journal of Music Therapy by Randi Rolvsjord called "Whose Power of Music? A Discussion on Music and Power-Relations in Music Therapy" . 


She offers a thought-provoking perspective I hadn't even thought to consider. 


Well, I've probably considered it, but right now I can't recall when.


I've quoted her article rather liberally below, but the basic question I think she intended for me to ask myself when I finished reading the article was this: 


Are we taking away our clients' power when we attribute their progress to the "power of the music" or to the "power of our interventions"?


Just in case I'm not getting it right, I'll let Randi Rolvsjord say it in her own words:

In a contextual approach, the therapeutic outcome is primarily related to the client's ability to use the therapeutic context to make important changes in his or her life. With the therapist's help, the client uses the space provided in therapy to activate or mobilize resources for change (Bohart 2000: 130). In a contextual model, the specific "ingredients" (techniques and procedures) are not seen as the main source of change in the therapeutic process.  

She goes on to address music therapy more specifically:

A contextual approach impels us to shift our attention away from the therapist and the perceived inherent capacities of music, focusing instead on how clients make use  of music and music therapy in their efforts towards health and quality of life - and perhaps even towards music and musical experiences and activities. This does not require us to stop considering music as a powerful resource that can be used therapeutically: rather, it requires us to acknowledge the need for a client to make use of it, or relate to it. It also suggests that the client's own use of music is probably more important than the therapist's use of music, impelling us to consider how we can better nurture the client's own resources for health-related musicking. 

She notes:

When music therapy "works", it is primarily because clients are able to access music as a health resource. To support this process, it is necessary to hand back the "power of music" to our clients and enable them to use their musicality and musical competence, their musics, and their musicking to promote health and quality of life. 

And she repeats:

With a contextual approach to therapy, the focus of therapeutic effectiveness is shifted away from the expert-therapist implementation of effective interventions, and instead toward the client-therapist collaboration concerned with access to music, with enablement and empowerment. I have argued elsewhere (Rolvsjord 2004) that such a process of empowerment implies focus upon the nurturing and development of strengths in a mutual and collaborative relationship. 

I have to admit I don't know a blessed thing about the "contextual approach to therapy", but it sounds interesting, and I believe I'll have to go do some searching to find out more.


Anyone else out there have any opinions to register about this form of power within the music therapy relationship?

Egos on parade

I had to chuckle today at work.  I was sitting outside with one of my clients.  This particular gentleman tends to be...let’s say...unexpectedly rough at times, so when he lets me know  he needs to leave (usually he’ll leap up and say “go baah”- meaning “go back”) I know to pay attention and do as he asks.  

Well, it happened that today one of the psychology staff was sitting outside nearby making a phone call.  He kept an eye on us as we walked out to our usual bench.  Meanwhile, my client was super-focused on the guitar today, watching me play through the entire first song.  He seems to prefer a strong strumming pattern to start and then we can move into plucking.  

At any rate, when the psychology staff person was ready to go, he looked over and grinned, and he asked, “Is that the best he’s ever been for you?”  I thought it was an odd question, but I said, “well, R usually enjoys music” (not wanting to be having a conversation about the man while he was sitting there as if he wasn’t listening).  Psychology man continued smiling, noting “I thought maybe he’d behave a bit better knowing I’m sitting nearby.” 

Now, first of all, yikes!  I’m not sure what that whole “big brother is watching, so you’d better behave” thing is all about.  Second, I finally realized that this psychology person believed that my client was having a particularly good day in music because he was hovering nearby.  The sort of silly thing was that I had been thinking, “Oh, I’m glad this guy from psychology is here to see how well R responds to music.” 

I suppose it’s a toss-up as to whose ego is the bigger in this case.    At any rate, I realized both of us were being asses, and this was really not about either one of us but about R- who really was having a peaceful day today.  Hooray for him.

Rejection and uncertainty

My clients are really good at letting me know when they feel rejected.  They reject me and refuse to come for sessions.  A gentleman I’ve been working with has recently allowed himself to begin to express his strong feelings toward me.  The feelings seem to be a general melange of “take me home with you” and “take care of me”.  

A few sessions ago he chose to sit on the floor and he kept wanting to hold my hand (through much of the session).  When I let go so I could use the guitar, he actually clung for a moment to my skirt (I had a rather billowing long skirt on that day).  I reacted with such a surprised look , he immediately took his hand away (so much for the notion that people with autism are not good at reading nonverbal cues).  The action (holding on to a fold of my skirt), when I thought about it, was just so sweet and child-like to me that the image has stayed with me. 

I, of course, reminded him a number of times that we have a music therapy relationship, because I had a sense that, while there was a definite “I need a mom” quality there was also the adult feelings going on as well.  I reiterated to him that he could express his feelings (preferably in the music) but that we would not be acting on his feelings.

Well, not surprisingly, I think he felt very rejected.  This seemed to be the impetus for the last few “sessions” we’ve had- or hadn’t, as it happens.  These were sessions where he didn’t actually get to the Music Room, ran off a lot, or left his cottage with me and then indicated that he wanted to go back shortly thereafter.

He looked so utterly depressed today it was hard not to want to jump into rescue mode.  I feel kind of dorky now (and I’m not sure that I was necessarily helpful to him), but I got into this “don’t give up” mode in a major way as we progressed through our session.

Sometimes it really rots being a music therapist.  It’s hard to be cast in the role of the “rejecting mother” or “the friend that wasn’t” and variations on those themes.  It’s hard to convey care to someone who has such a strong need for love without it seeming like a total rejection when I try to maintain therapy boundaries.   

What makes it all the more impossible is this:  what if I’m wrong?  I’m understanding all of this from his actions and interactions with me, but what if he really doesn’t have these feelings at all, and I’m simply assigning these various thoughts and emotions to him, and they’re not really his?

Hmm.  I don’t know.  Truly, I don’t know.

I mean, I don’t think I’m entirely incorrect.  As much as he implied a wish to leave the session (he kept messing with the door handle as if he wanted to go) he ended up wanting to sit on a bench for a little while as we walked back to his cottage after our time ended.    

Yalom talks about the therapist being “love’s executioner”.  There you have it.  That’s what I am, I guess.  Ugh.  What a lousy distinction sometimes.  It so goes against my fantasy of being “the good music therapist who could make it all better.” 

Who's responsible for this?

In my very first session this morning (assuming I can remember back that far) I found myself working with my client’s resistance.  He has been receiving music therapy from me for...gosh...a lot of years now.  And while we have a strong relationship he avoids the music-making aspect of things quite a bit.  

He has some movement issues (mostly around organizing his body to move in a specific way), and he does not use speech to communicate, but he has a strong voice, he can be remarkably clear in letting me know what he wants, and he’s quite capable of choosing an instrument and making some sort of sound with it.  But...he doesn’t.  

So I pointed this out to him (because, apparently, being a music therapist means being in a position to point out the obvious) and I invited him to think about it with me:  What prevents him from finding his own musical sounds (rather than relying on songs I choose for him)?  What if he did play his own music/sounds?  What would it sound like?  Is there something he’s afraid to hear?  Is he afraid his sounds won’t be “good enough”?

As I pondered these things I became aware of the fact that, by not playing his own music, by not choosing his own sounds- his own musical voice, he avoids being heard in this world.  Not just by himself but by anyone else.  And if he’s not heard, then he has no power.  

Powerlessness.  Now there’s an issue he and I have addressed in our sessions.   And, without diminishing the reality of how hard it is to live in an institution, I asked him whether he thinks he may have been giving everyone else in his life (me, his staff, his family) the responsibility for his life- for expressing his feelings, for organizing and getting his behavior under control, for his happiness...heck, for his very existence.  

He made a quick sound to indicate “yes” and I honored the courage it took for him to acknowledge that difficult possibility.  It’s not easy for any of us to make that kind of a realization, and his brow became rather furrowed as we continued.  

No one wants to hear that we play an important role in our own lives, and we’re not helpless victims.  Making everyone else responsible for him makes it easy for my client to be angry with everyone for not meeting his needs, for boring him, for not being there when he wanted them to be, for picking the wrong music, for making incorrect assumptions about what is important to him (the list is endless of course).  

What a gift to recognize that we do have a choice, and we are not, in fact, so powerless in our lives.